The present study examined cortical cerebral microinfarcts (CMIs) on a 3T magnetic resonance imaging and investigated the impact of CMIs on the comprehensive functional outcomes during the post-stroke rehabilitation period. Patients with acute phase of firstever ischemic stroke were retrospectively recruited (n = 62) and divided into 2 groups with and without CMIs. Clinical parameters including age, sex, stroke lesion laterality, location, the National Institutes of Health Stroke Scale score, as well as history of hypertension, dyslipidemia, diabetes mellitus, and smoking were obtained. Functional outcomes were assessed twice at baseline and one month later with the Korean version of the MiniMental State Examination, the Berg balance scale (BBS), and the functional independence measure. Partial correlation and multiple linear regression analyses were used to examine the relationship between the presence of CMIs and the change in functional outcomes. At least one CMI was reported in 27 patients, who were older (p = 0.043). The presence of CMIs was significantly associated with functional impairment in all 3 functional outcomes, after controlling for confounding factors (p < 0.05). CMIs might contribute to poor functional outcomes during the post-stroke rehabilitation period. These results suggest that CMIs should be considered when establishing rehabilitation treatment strategies or making a prognosis.

No Abstract Available.
Chondrocytes* ; Phenotype*

PURPOSE: Atopic findings may be associated with severity of pneumonia in 2009 pandemic influenza A (H1N1) infection, which could suggest a possible association between atopic findings and the severity of viral infections. Thus, we studied association between atopic findings and severity of disease in children with H1N1 influenza infection. METHODS: A retrospective study was performed in 74 children admitted in a single tertiary institute and confirmed as H1N1 patients by reverse transcriptase (RT) - polymerase chain reaction (PCR). They were divided into 2 groups according to the severity of pneumonia. We evaluated whether the atopic finding is risk factor between the two groups. RESULTS: Children with severe pneumonia had higher percentages of serum eosinophilia (88% vs 40%, P<0.001), asthma (65% vs 35%, P=0.011), allergic rhinitis (71% vs 40%, P=0.009), and IgE level (P=0.007). We found positive correlations between aeroallergen sensitizations and severity of pneumonia (82% vs 53%, P=0.007). CONCLUSION: Among patients with H1N1 pneumonia, asthma and atopic findings are risk factors for severity of pneumonia.
Asthma ; Child ; Eosinophilia ; Humans ; Immunoglobulin E ; Influenza, Human ; Pandemics ; Pneumonia ; Polymerase Chain Reaction ; Retrospective Studies ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; RNA-Directed DNA Polymerase

PURPOSE: The purpose of this study was to explore the clear concept of organizational commitment for effective nursing personnel management. METHOD: This study was conducted using Walker & Avant's conceptual analysis framework(2005). RESULTS: Organizational commitment was identified with six attributes: acknowledgment, acceptance, trust, sacrifice, attachment, regulation. Antecedents of organizational commitment were personal characteristics, perceived organizational support, empowerment, fair compensation, job satisfaction, job autonomy, organizational culture, and leadership. Consequences of organizational commitment were turnover intention, job performance and organizational citizenship behavior. CONCLUSION: Organization commitment is a core concept for understanding the management of nursing personnel. Appropriate instruments to operationalize the concept of organizational commitment including six attributes need to be developed.
Compensation and Redress ; Humans ; Intention ; Job Satisfaction ; Leadership ; Nursing* ; Organizational Culture ; Personnel Management ; Power (Psychology)

Objective: To compare the changes in blood urea nitrogen/creatinine (BUN/Cr) ratio, a dehydration status indicator, among patients with mild dysphagia depending on the addition of fluid thickeners. Methods: A total of 81 patients who underwent serial dietary trials of the videofluoroscopic swallowing study (VFSS) and displayed penetration signs with a penetration-aspiration scale of 4 or less during the liquid trials were enrolled and classified into two groups according to the dietary instructions from the VFSS results. Group A comprised patients who were permitted to freely consume water with a regular diet. Group B comprised patients allowed to take a regular diet but with the addition of a fluid thickener while ingesting water. To analyze whether the patients of each group were dehydrated, we calculated the serum BUN/Cr ratio using blood tests, which were performed within 1 week of the VFSS test date and 1 month later. Results: There were 4 cases of suspected pneumonia within 1 month after the VFSS test, with no significant differences between the two groups. The BUN/Cr ratio of the 1-month follow-up blood test when compared to the initial blood test showed a significant decrease in Group A (P=0.022) compared with Group B (P=0.033). Conclusion Patients with mild dysphagia who consumed water freely showed a decrease in the BUN/Cr ratio compared to those who added fluid thickeners to their drinking water.

Dysphagia is a common problem in children with a tracheostomy tube. Such children are at risk of malnutrition, developmental problems, increased medical complications, and pose an increased burden on their caregivers. Therefore, proper evaluation and dysphagia rehabilitation are necessary for children with a tracheostomy tube.Also, as many such children experience serious complications, it is necessary to consider decannulation as early as possible, soon after the indication for tracheostomy placement is resolved. Decannulation should be performed safely as per the appropriate protocol.

Cardiovascular syphilis is one of the most important complications of tertiary syphilis, although its incidence is decreasing in recent years. Aortitis is the primary manifestation of cardiovascular syphilis, resulting most commonly in aortic aneurysm, aortic regurgitation and coronary artery ostial obstruction. The authors experienced 46-year-ole male with a history of chancre 20 years ago, and several bouts of right chest pain since last year. Serologic tests revealed reactive in VDRL (1:64) and in TPHA test. Chest x-ray, chest CT, echocardiogram and aortogram showed aneurysm of ascending aorta with no evidence of aortic regrugitation of coronary obstruction. Histologic findings of involved aorta revealed "tree bark" appearance in gross, and microscopically adventitial thickening with endarteritis of the vasa vasorum and destruction of elastic tissue of media, showing moth-eaten appearance. The patient was underwent excision of the aneurysm and dacron aortic prosthetic graft was replaced with success.
Aneurysm* ; Aorta* ; Aortic Aneurysm ; Aortic Valve Insufficiency ; Aortitis ; Chancre ; Chest Pain ; Coronary Vessels ; Elastic Tissue ; Endarteritis ; Humans ; Incidence ; Male ; Polyethylene Terephthalates ; Serologic Tests ; Syphilis ; Syphilis, Cardiovascular ; Thorax ; Tomography, X-Ray Computed ; Transplants ; Vasa Vasorum

The aim of this study was to analyze long-term survivals in patients with stage IB to IIA cervical cancer treated by neoadjuvant chemotherapy setting. Between February 1989 and January 1998, 94 women with previously untreated stage IB to IIA carcinoma of the uterine cervix who received cisplatin based neoadjuvant chemotherapy were enrolled in this study. All of patients with chemoresponse (complete response, n=15; partial response, n=47) and 16 patients with chemoresistance received radical surgery (RS group). The other 16 patients with chemoresistance received radiotherapy for definite treatment (RT group). In the RS group, the 10 yr survival estimation in patients with bulky tumors (diameter > or =4 cm, n=26) was similar to that with non-bulky tumors (83.3% vs. 89.3%, p=NS). In selected patients with chemoresistance, those treated by radiotherapy (n=16) showed significantly poorer survivals than those treated by radical surgery (n=16) [10 yr survival rates of RT (25%) vs. RS (76.4%), p=0.0111]. Our results support that a possible therapeutic benefit of neoadjuvant chemotherapy plus radical surgery is only in patients with bulky stage IB to IIA cervical cancer. In cases of chemoresistance, radical surgery might be a better definite treatment option.
Uterine Cervical Neoplasms/drug therapy/*radiotherapy/*surgery ; Treatment Outcome ; Survival Analysis ; Retrospective Studies ; Prognosis ; Neoplasm Staging ; Multivariate Analysis ; Middle Aged ; Humans ; Follow-Up Studies ; Fluorouracil/administration & dosage ; Female ; Drug Resistance, Neoplasm ; Combined Modality Therapy ; Cisplatin/administration & dosage ; Chemotherapy, Adjuvant ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Adult

Classic Kaposi's sarcoma is a human herpesvirus-8 associated with a multicentric lymphoangioproliferative tumor primarily arising in the lower extremities, but rarely in the head and neck. We herein report a 63-year-old man with primary classic Kaposi's sarcoma on the face. He presented with asymptomatic, erythematous papules on the nasal ala which had been noticed 2 months earlier. Histopathologic examination and nested polymerase chain reaction analysis in the tissue disclosed typical features of Kaposi's sarcoma.
Head ; Humans ; Lower Extremity ; Middle Aged ; Neck ; Polymerase Chain Reaction ; Sarcoma, Kaposi*

No abstract available.
Methotrexate*