PURPOSE: This descriptive study was conducted to identify the level of knowledge of stroke symptoms and risk factors among older adults. METHODS: A total of 200 older adults over 65 years of age were conveniently recruited from out patient departments of two hospitals and a health care center from October to November 2008. The level of knowledge was assessed using both open-ended questions and a structured questionnaire based on semi-structured interviews. Data were analyzed by t-tests and ANOVA using the SPSS program. RESULTS: 52.5% of the sample had hypertension and 30% had diabetes. The mean knowledge scores for symptoms and risk factors were 8.4 +/- 3.1(out of 15) and 9.5 +/- 3.9 (out of 16), respectively. The older adults who had lower education, lower family income, and who lived in rural areas were more likely to have less knowledge of stroke symptom and risk factors(p < .05). There was no significant knowledge difference between the older adults who had at least one risk factor and those who had no risk factor for stroke. CONCLUSIONS: Educational intervention should be focused on informing older adults who are at risk for stroke about the early symptoms and management of risk factors, especially those who have low education and low social status.
Adult ; Delivery of Health Care ; Humans ; Hypertension ; Risk Factors ; Stroke ; Surveys and Questionnaires

OBJECTIVE: To evaluate the effects of piroxicam patch(Trast) in rheumatoid arthritis patients with knee joint pain and swelling and to determine the concentration of plasma and synovial fluid following patch application. METHODS: Twenty-two patients with rheumatoid arthritis participated in a double-blind, placebo-controlled study. The patients were instructed to apply piroxicam or placebo patch at one knee and re-apply it every other day for 2 weeks. They had washout period for 2 weeks and then applied the other patch for 2 weeks at the same joint. The patients recorded knee joint pain using visual analog scale. Knee joint swelling and tenderness were assessed before and after application of piroxicam and placebo patch. Complete blood count, AST, ALT, BUN, creatinine, joint fluid analysis were also done. Piroxicam concentration in plasma and synovial fluid were measured by high performance liquid chromatography(HPLC) after 2 weeks of piroxicam patch application. RESULTS: Knee joint pain improved significantly after the application of piroxicam patch for 2 weeks(visual analog scale, 56. 2+5. 9m vs 48. 2+5. 7mm, p=0. 03 by Wilcoxon signed rank test). There was no significant change in white cell count of synovial fluid, peripheral blood cell count, chemistry, C-reactive protein and erythrocyte sedimentation rate. In terms of adverse effects, mild gastrointesti nal disturbance(8/21 cases, 38%) and local side effects such as pruritus and ery thema(3/21 cases, 14%) were developed, which were insignificant compared with control groups(30%, 15% respectively). Piroxicam concentrations in plasma and synovial fluid after the application of piroxicam patch were 0. 129+0. 04ug/ ml (mean+SE) and 0. 644+0. 202ug/ml respectively. CONCLUSIONS: Piroxicam patch is a safe and effective therapeutic modality for knee joint pain in patients with rheumatoid arthritis. Mild adverse effects such as gastrointestinal disturbance and local side effects were noted. Piroxicam concentration was higher in synovial fluid than in plasma following the application of piroxicam patch.
Arthritis, Rheumatoid* ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Cell Count ; Chemistry ; Creatinine ; Humans ; Joints ; Knee ; Knee Joint ; Piroxicam ; Plasma ; Pruritus ; Synovial Fluid ; Visual Analog Scale

Myositis ossificans progressiva is rare hereditable disorder characterized progressive heterotopic bone formation in connective tissue and muscles in association with congenital skeletal anomalies. We report the plain radiologic and MR findings of myositis ossificans progressiva in two children. One case showed discrete ossification in the right buttock, neck, and both chest walls on plain radiographs, while the other showed diffuse swelling of the left posterior neck, back, and buttock muscles, which was demonstrated on MR images. Both cases showed associated anomalies in the hands and feet.
Buttocks ; Child ; Connective Tissue ; Foot ; Hand ; Humans ; Muscles ; Myositis Ossificans* ; Myositis* ; Neck ; Osteogenesis ; Thorax

Tuberous sclerosis is a heredofamilial disease associated with the diagnostic triad of epilepsy, mental retardation, and skin lesions, adenoma sebaceum. Retinal hamartomas are the most common ocular abnormalities in patients with tuberous sclerosis and are classified as three types: 1) large whitish calcified nodular masses, 2) flat transluscent noncalcified smooth tumors, and 3) intermediate type. We introduce a case on 22 year-old male of tuberous sclerosis who was manifested by epilepsy, adenoma sebaceum without mental retardation. And he was characterized by multiple flat transluscent noncalcified type of retinal astrocytic hamartoma accompanied by Shagreen patch, sclerotic calcification in skull and angiomyolipoma on both kidneys.
Angiomyolipoma ; Epilepsy ; Hamartoma ; Humans ; Intellectual Disability ; Kidney ; Male ; Retinaldehyde ; Skin ; Skull ; Tuberous Sclerosis* ; Young Adult

Changes in contrast sensitivity have been demonstrated in patients with normal Snellen acuity. In an attempt to elucidate more sensitively the visual dysfunction before developement of either overt retinopathy or a reduction in Snellen acuity in patients with retinal disorders, contrast sensitivity test was performed in diabetic patients with normal Snellen acuity and control subjects matched for age and sex. The results were as follows. 1) Throughout all spatial frequencies(1.5 - 3.0 - 6.0 - 12.0 - 18.0 cpd), contrast sensitivity was significantly lower(P-value<0.01) in the diabetic eyes with retinopathy(30.7 - 49.3 - 52.5 - 16.1 - 7.8) than in the normal controls(42.5 - 84.3 - 103.0 - 60.5 - 25.1) or the diabetic eyes without retinopathy(43.1 - 92.2 - 95.8 - 43.4 - 16.4 ). 2) In high spatial frequencies(12.0 - 18.0 cpd) contrast sensitivity in the diabetic eyes without retinopathy group(43.4 - 16.4) was significantly decreased(P-value<0.01) in comparison with the normal controls(60.5 - 25.1). So, contrast sensitivity test is more sensitive test for central visual function than Snellen acuity.
Contrast Sensitivity* ; Diabetic Retinopathy* ; Humans ; Retinaldehyde

Purpose: To report a satisfactory clinical outcome of hemorrhagic retinal macrocyst with retinal detachment after pars plana vitrectomy and silicone oil injection. Case summary: A 33-year-old man visited our clinic with a 1-week history of visual disturbance in his left eye. His ocular and medical history were unremarkable, and best-corrected visual acuity (BCVA) in the left eye was 20/40. Fundoscopic examination of the left eye showed a hemorrhagic retinal macrocyst that was well-demarcated, semi-transparent, dome-shaped, and larger than 8 disc diameters at the superonasal location, with macular-off retinal detachment. B-scan ultrasonography also confirmed the presence of an intra-retinal cystic lesion with internal mobile echogenic signals representing blood. The patient underwent 23-gauge pars plana vitrectomy, barrier laser photocoagulation around the retinal tear and boundary of the cyst, and silicone oil injection, without any other additional procedures for the hemorrhagic retinal macrocyst. After the surgery, the patient stayed in the face down position for two weeks. Three months postoperatively, a completely collapsed hemorrhagic retinal macrocyst with successful retinal reattachment was observed. Six months later, the BCVA in the left eye had improved to 20/30. One year later, even after silicon oil removal, the collapsed hemorrhagic retinal macrocyst and reattached retina remained stable. Conclusions A hemorrhagic retinal macrocyst with retinal detachment was successfully treated with pars plana vitrectomy and silicone oil tamponade.

Objectives: This study examined the current status of depression and related factors among children using community child center. Methods: A cross-sectional study selected children in grades 4-6 who used the Gwangju and Jeollanamdo community child center (n=224) using a convenience sampling method. General characteristics, family characteristics, children's emotional characteristics, children's school life environment and depression status were assessed using a self-reported questionnaire. Results: The average score of depression among children using community child center was 15.31±7.70 out of a total of 27. Fifty-eight (25.9%) children had depression above 22 points. Variables related to children's depression were shown as grade, subjective economic level awareness, after-school activities excluding local children's centers, presence of family members after school, and family structure. Conclusions The depression prevalence of children using community child center was higher. Policy support such as children's psychological support programs would be needed to reduce children's depression, and community child centers are expected to be effective in reducing children's depression if continuous child psychological support services are developed for children's mental health.

Purpose: To report a satisfactory clinical outcome of hemorrhagic retinal macrocyst with retinal detachment after pars plana vitrectomy and silicone oil injection. Case summary: A 33-year-old man visited our clinic with a 1-week history of visual disturbance in his left eye. His ocular and medical history were unremarkable, and best-corrected visual acuity (BCVA) in the left eye was 20/40. Fundoscopic examination of the left eye showed a hemorrhagic retinal macrocyst that was well-demarcated, semi-transparent, dome-shaped, and larger than 8 disc diameters at the superonasal location, with macular-off retinal detachment. B-scan ultrasonography also confirmed the presence of an intra-retinal cystic lesion with internal mobile echogenic signals representing blood. The patient underwent 23-gauge pars plana vitrectomy, barrier laser photocoagulation around the retinal tear and boundary of the cyst, and silicone oil injection, without any other additional procedures for the hemorrhagic retinal macrocyst. After the surgery, the patient stayed in the face down position for two weeks. Three months postoperatively, a completely collapsed hemorrhagic retinal macrocyst with successful retinal reattachment was observed. Six months later, the BCVA in the left eye had improved to 20/30. One year later, even after silicon oil removal, the collapsed hemorrhagic retinal macrocyst and reattached retina remained stable. Conclusions A hemorrhagic retinal macrocyst with retinal detachment was successfully treated with pars plana vitrectomy and silicone oil tamponade.

Primary aldosteronism (PA) is the most common cause of secondary hypertension and increases the morbidity and mortality associated with cardiovascular diseases. When PA coexists with autonomous cortisol secretion (ACS), the cardiovascular risk increases significantly, especially in cases of bilateral adrenal adenomas with asymmetric hormone secretion, which poses diagnostic and therapeutic challenges. A 50-year-old female presented with hypertension and hypokalemia. PA was diagnosed based on elevated aldosterone levels, suppressed plasma renin activity, and the results of various dynamic endocrine tests. Imaging revealed bilateral adrenal adenomas, and adrenal venous sampling (AVS) confirmed aldosterone hypersecretion from the left adrenal gland and cortisol hypersecretion from both adrenal glands. The patient subsequently underwent left adrenalectomy, which resolved the aldosterone hypersecretion and normalized blood pressure and potassium levels. However, the cortisol hypersecretion persisted. This case highlights the importance of AVS in identifying the sources of hormone secretion and enabling targeted surgical treatment while avoiding bilateral adrenalectomy, which can lead to lifelong adrenal insufficiency. Comprehensive endocrine evaluation, including ACS assessment, in patients with PA is essential to help reduce the cardiovascular risks associated with PA and ACS and thus improve treatment outcomes.

Primary aldosteronism (PA) is the most common cause of secondary hypertension and increases the morbidity and mortality associated with cardiovascular diseases. When PA coexists with autonomous cortisol secretion (ACS), the cardiovascular risk increases significantly, especially in cases of bilateral adrenal adenomas with asymmetric hormone secretion, which poses diagnostic and therapeutic challenges. A 50-year-old female presented with hypertension and hypokalemia. PA was diagnosed based on elevated aldosterone levels, suppressed plasma renin activity, and the results of various dynamic endocrine tests. Imaging revealed bilateral adrenal adenomas, and adrenal venous sampling (AVS) confirmed aldosterone hypersecretion from the left adrenal gland and cortisol hypersecretion from both adrenal glands. The patient subsequently underwent left adrenalectomy, which resolved the aldosterone hypersecretion and normalized blood pressure and potassium levels. However, the cortisol hypersecretion persisted. This case highlights the importance of AVS in identifying the sources of hormone secretion and enabling targeted surgical treatment while avoiding bilateral adrenalectomy, which can lead to lifelong adrenal insufficiency. Comprehensive endocrine evaluation, including ACS assessment, in patients with PA is essential to help reduce the cardiovascular risks associated with PA and ACS and thus improve treatment outcomes.