PURPOSE: We evaluated the distribution of hypoperfusion in patients with traumatic brain injury (TBI) and the relationship of thalamic hypoperfusion to severity of cognitive and behavioral sequelae. MATERIALS AND METHODS: Tc-99m ECD SPECT and MRI were performed in 103 patients (M/F=81/22, mean age 34.7+/-15.4 yrs) from 0.5 to 55 months (mean 10.3 months) after TBI. The patients were divided into three groups showing no abnormalities (G1), focal (G2) and diffuse injury (G3) on MRI. Psychometric tests assessed 11 cognitive or behavioral items. In all patients, we evaluated the distribution of hypoperfused areas in SPECT, and in 57/103 patients, neuropsychological (NP) abnormalities in patients with thalamic hypoperfusion were compared with those of patients without thalamic hypoperfusion. RESULTS: The perfusion deficits were most frequently located in the frontal lobe (G1, 42.3%: G2 34.5%: G3 33.3%), temporal lobe (24~26%) thalami (21~22.4%), parietal and occipital lobe (< or =10%). Numbers of NP abnormalities in the cases of cortical hypoperfusion with or without concomitant thalamic hypoperfusion were following: the former 4.7+/-1.5 and the latter 3.2+/-1.4 in G1, 5.0+/-1.1 and 4.8+/-1.2 in G2, 6.8+/-1.8 and 6.3+/-1.1 in G3, respectively. This difference according to thalamic hypoperfusion was significant in G1 (p=0.002), but was not significant in G2 or G3. CONCLUSION: SPECT in patients with TBI had demonstrated hypoperfusion mostly involving the frontal, temporal and thalami. In normal group on MRI, frontal hypoperfusion was more prominent than that of any other group, Furthermore in this group, SPECT could predict severity of NP outcome by concomitant thalamic hypoperfusion with cerebral cortical abnormalities.
Brain Injuries* ; Brain* ; Equidae* ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe ; Perfusion ; Psychometrics ; Rabeprazole ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon*

The present study was performed to investigate the role catecholamine in the genesis of reperfusion injury of ischemic heart. The possible involvement of catecholamine in the xanthine oxidase-linked production of oxygen free radicals was studied. langendorff preparations of rat hearts were made ischemic for 60 min followed by reperfusion. Upon reperfusion norepinephrine(NE) was significantly released into the coronary effluent regardless of oxygenation of the perfusion solution. Both the increased releases of creatine phosphokinase(CPK) and malondialdehyde(MDA) and the production of superoxide anion in the ischemic-reperfused hearts were significantly reduced by the treatment with either reserpine, a catecholamine depletor, or propranolol, a beta-adrenergic receptor blocker. In the reserpinized hearts, infusion of exogenous NE reversed the releases of CPK and MDA and the superoxide anion production to the original higher levels. The releases of CPK and MDA as well as the production of superoxide anion induced by NE in the reserpinized hearts were significantly depressed either by allopurinol, a specific competitive inhibior of xanthine oxidase(XOD), or by the calcium removal from the perfusion solution. Compared with the XOD activity of control ischemic hearts, that of the hearts treated with reserpine or propranolol showed lower activity in the oxygen radical producing 0-form and higher activity in D/0-form. In the reserpinized ischemic hearts, infusion of exogenous NE increased 0-form, but decreased D/0-form of XOD. The changes in XOD activities induced by exogenous NE was prevented by phenylmethylsulfonyl fluoride(a serine protease inhibitor) and pimoxide(a calmodulin inhibitor) as well as by calcium removal from the perfusion solution. It is suggested from the results that in the inchemic-reperfused heart of rat catecholamine participates in D/0 to 0-form conversion of XOD by promoting the calcium-calmodulin-dependent proteolysis and plays a contributing role in the production of oxygen free radical.
Allopurinol ; Animals ; Calcium ; Calmodulin ; Creatine ; Free Radicals ; Heart* ; Oxygen ; Perfusion ; Propranolol ; Proteolysis ; Rats* ; Reperfusion Injury* ; Reperfusion* ; Reserpine ; Serine Proteases ; Superoxides ; Xanthine Oxidase* ; Xanthine*

A 63-year-old male who had subtotal gastrectomy for early gastric cancer three months ago underwent Tc-99m bone scintigraphy for the evaluation of skeletal metastases. He had no symptoms such as fever, tenderness, or wound discharge. On physical examination, the surgical scar along the midline of the upper abdomen had keloid formation and there was no radiographic evidence of calcification. Bone scintigraphy (Fig. 1A & 1B) demonstrated an unusual linear increased uptake along the midline of the upper abdomen that corresponded to the skin incision for subtotal gastrectomy. Usually, an incisional scar will not be visualized in Tc-99m methylene diphosphate (MDP) scintigraphy beyond two weeks after surgery.1) Upon reviewing the literature, there were only a few reports where localization of Tc-99m MDP in surgical scars were found two months after surgery.2) It was also reported that a few cases with Tc-99m MDP uptake in the keloid scar developed after surgery. Although there are several potential mechanisms that may explain the uptake of Tc-99m MDP in scar tissue, the primary mechanism in older scars is suggested to be a result of pathological calcification.2) Siddiqui et al3) suggested it could be due to microscopic calcification in small resolving hematomas. However, the primary mechanism in keloid scar is not well-known. We should obtain oblique or lateral views to differentiate the uptake in healing surgical scars from the artifactual uptake.
Abdomen ; Cicatrix ; Fever ; Gastrectomy* ; Hematoma ; Humans ; Keloid* ; Male ; Middle Aged ; Neoplasm Metastasis ; Physical Examination ; Radionuclide Imaging ; Skin ; Stomach Neoplasms ; Technetium Tc 99m Medronate* ; Wounds and Injuries

A 60-year-old male with carcinoma of the prostate and cerebral infarction underwent a Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bone scintigraphy (Fig. 1) showed multiple areas of increased uptake of Tc-99m MDP in the skull, spine, and ribs representing skeletal metastases. Two different patterns of uptake occurred in the skull region (Fig. 1A-C); one represents bony metastasis and the other represents cerebral infarction. The shape, size, location, intensity, and border of the increased uptake differed between the two lesions. An oval-shaped pattern with smaller size, greater intensity and more sharply defined border in the frontal region was consistent with bony metastasis. A rectangular-shaped pattern with larger size, lesser intensity and relatively indistinct border in the temporo-parieto-occipital region was consistent with cerebral infarction. Increased uptake of bone-seeking radiotracers in cerebral infarction has been reported previously.1-4) A suggested mechanism by which bone-seeking radiotracers accumulate in the necrotizing cerebral tissue is an alteration of the blood-brain barrier induced during cerebral infarction, which results in entry of the radiotracers into the extracellular space of the brain.4) Brain CT (Fig. 2) performed 7 days before and one month after the bone scintigraphy revealed lesions on the right temporo-parieto-occipital region consistent with acute hemorrhagic and chronic cerebral infarction, respectively.
Blood-Brain Barrier ; Brain ; Cerebral Infarction* ; Extracellular Space ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis* ; Prostate ; Radionuclide Imaging* ; Ribs ; Skull ; Spine ; Technetium Tc 99m Medronate*

The purpose of this study was to develop a standardized job description for dietitians working in the public health nutrition area. Work-oriented job analysis methodology was employed for the study purpose. Subjects of 38 dietitians currently working at health centers in 2002 were recruited. Based on the focus group interview with 7 public health nutritionists and 7 professors, information about task elements was collected. Questionnaires measuring work performance and self-perception of importance of the selected task elements were administered. Reliability and validity of this instrument were tested by Chronbach's alpha and factor analysis. SAS PC package program was used for the statistical analysis. The final developed job description for public health nutritionists included 5 duties, 20 tasks and 93 task elements. The results of this study can be summarized as follows; 1) 5 duty areas are A. plan and evaluation of public health nutrition services, B. developing nutrition education materials, C. implementing nutrition services, D. networking community, and E. self development. 2) Each duty area from A to E was composed with 6, 2, 6, 4, 2 tasks, respectively. 3) Each duty area from A to E was composed with 24, 8, 38, 14, 9, and 2 task elements, respectively.
Focus Groups ; Job Description ; Phenothiazines ; Public Health ; Reproducibility of Results ; Self Concept

Malformations of umbilicus are a feature of many dysmorphic syndromes and the measurement of periumbilical skin length should be considered as the basic step in the description of the umbilical malformations. So, we measured the periumbilical skin length in the 103 normal neonates and obtained the following results. 1) The means (+SD) of the periumbilical skin length were the 11.7mm (+3.0) in the cranial site and the 8.2mm (+2.5) in the caudal site, and the cranial length was 3.5mm longer than the caudal length. 2) No difference was observed between the male and female groups in the periumbilical skin length. 3) Age was the only statistically significant variable associated with the periumbilical skin length and it was observed that the periumbilical skin length decreased according to the advance of age (hour).
Female ; Humans ; Infant, Newborn ; Male ; Reference Values* ; Skin* ; Umbilicus

PURPOSE: The purpose of this study is to provide essential resources on various evaluation strategies by identifying relationships between professor-evaluation, peer-evaluation, and self-evaluation of the core basic nursing skills in nursing students. METHODS: Forty third-year nursing students who participated in core basic nursing skills were given the same checklist that was used for assessment by the examiners. Then, the scores of the professor and the students were compared and analyzed with SPSS/WIN 18.0. RESULTS: The scores of the student peer (178.54) and student self-evaluation(177.74) was significantly higher than the scores of professor-evaluation (172.05),(F=5.03, p=.008). There was a significant, positive correlation between the professor-evaluation and the student-peer-evaluation in skill-scores(r=.47, p=.002) and attitude-scores(r=.52, p<.001). In addition, the professor-evaluation and the self-evaluation each showed a significant, positive correlation in skill-scores(r=.61, p<.001) and attitude-scores(r=.36, p=.023). CONCLUSION: The study result indicates that in order to expand the evaluation method, the professor evaluation, as well as the student self and the peer evaluation, will contribute to improve the educational achievement of learners.
Checklist ; Diagnostic Self Evaluation ; Education* ; Education, Nursing ; Educational Status ; Humans ; Nursing* ; Students, Nursing*

Two cases of old unreduced radial head dislocation in children were experienced in this hospital. These were the results of neglected Monteggia fracture. Dislocated radial heads were reduced under direct vision and the anular ligaments were reconstructed. Follow up study taken 9 months and 6 years respectively after operation revealed excellent elbow motion including pronation and supination. The radial nerve palsy which had been developed in one of the two patients after injury was recovered spontaneously after reduction of the radial head without opening of the Arcade of Frohse. Then we are reporting these cases with a review of the literature.
Child ; Dislocations ; Elbow ; Follow-Up Studies ; Head ; Humans ; Ligaments ; Monteggia's Fracture ; Paralysis ; Pronation ; Radial Nerve ; Supination

No abstract available.
Fractures, Spontaneous* ; Osteoporosis*

Purpose: The purpose of this study was to investigate the validity and reliability of the Korean Version of the Grit (Grit-K) scale for nursing students in Korea. Methods: The participants in the study were 277 nursing students. Their grit was verified by using self-reports and the results of a questionnaire. Grit was translated into Korean and its content validity was verified by five experts. The validity of the instrument was verified through item analysis, exploratory factor analysis, and confirmatory factor analysis. Reliability verification was analyzed by using internal consistency reliability. Results: Two factors were identified through exploratory factor analysis and six items of the original instrument were found to be valid. In the confirmatory factor analysis, the validity of the instrument was verified as the model. The internal consistency reliability was also acceptable and Grit was found to be an applicable instrument. Conclusion This study shows that the Korean Version of the Grit Questionnaire is a valid and reliable instrument to assess nursing students in Korea.