Objective: Cerebral white matter changes (WMCs) and silent brain infarcts (SBIs) are common radiological findings in neurologically asymptomatic elderly people. Their presence is associated with an increased risk of stroke or dementia. Homocysteine (Hcy) can cause atherosclerosis and may thus act as a useful marker of stroke prior to symptom onset. This study aimed to evaluate the utility of Hcy as a surrogate marker for early intervention for stroke in community-dwelling healthy elderly persons with cerebrovascular lesions such as WMCs and SBIs. Methods: We assessed the relationship between the Hcy level and presence of WMCs/SBIs on brain computed tomography (CT) in 554 elderly individuals aged ≥65 years with no history of stroke or dementia. Results: The mean age of the participants was 74.43±7.32 years. Of the 554 patients, 106 (19.1%) had WMCs and/or SBI findings on brain CT. The mean Hcy level was higher in participants with WMCs/SBIs (P=0.001). The WMCs/SBIs group had a significantly greater number of participants with high Hcy levels than the non-WMCs/SBIs group (P<0.001). High Hcy levels (≥12.3 μmol/L) was significantly associated with WMCs and SBIs even after adjusting for age, Korean Mini Mental Status Examination score, education level, and vascular risk factors such as hypertension, diabetes, hyperlipidemia and smoking status. Conclusion: The result of our study suggests that regular monitoring of homocysteine level as a modifiable risk factor may be helpful for predicting the association of cerebrovascular lesions such as WMCs and SBIs for the prevention of future ischemic stroke and cognitive impairment.

No abstract available.
Adenocarcinoma*

The dual muscle flap (Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients (3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.
Axis, Cervical Vertebra ; Extremities* ; Free Tissue Flaps ; Humans ; Myocutaneous Flap

PURPOSE: This study was conducted to identify comprehensive predictors of fatigue in cancer patients. METHODS: One hundred ten cancer patients visiting in-patient or out-patient clinics of a university hospital located in Incheon participated in this study. RESULTS: The hematologic indicators (WBC and Hemoglobin) were significant for explaining fatigue. The psychological factors of fatigue were statistically significant. Both anxiety and depression, included as psychological factors, were significant in explaining fatigue in cancer patients. The influence of physical factors on fatigue was also statistically significant. Among the variables included as physical factors, pain, nausea/vomiting/anorexia, and sleep disturbance were significant whereas, dyspnea was not significant. The influence of the daily activity factor on fatigue was statistically significant. Among the variables included as daily activity factors, regular exercise or not and the usual activity level were significant in explaining fatigue of cancer patients, while the level of rest was not statistically significant. CONCLUSIONS: From the study results fatigue of cancer patients appeared to be influenced by multidimensional factors, such as physiological, physical, psychological, and activity related factors.
Activities of Daily Living ; Adaptation, Physiological ; Adult ; Aged ; Fatigue/etiology/*nursing ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Models, Nursing ; Multivariate Analysis ; Neoplasms/complications/*nursing ; Sick Role ; Sickness Impact Profile

Tardive dyskinesia(TD) is a serious side effect of long-term treatment with neuroleptic medications. To investigate if glutamatergic hyperfunction is associated with TD, effect of MK-801 on the prevention and treatment of TD was studied using a rat model, i.e., vacuous chewing movements(VCM). When comparing VCM scores of Group I(haldol decanoate+MK-801) with that of Group II(hadol decanoate+phosphate buffer saline), late measured VCM scores of former were significantly lower than that of latter, meaning that MK-801 is effective in the prevention of VCM. Furthermore, when MK-801 is also effective in the treatment of VCM. From the above results, it is suggested that glutamatergic hyperfunction might be involved in the development of TD and MK801 could be effective in the prevention and treatment of it.
Dizocilpine Maleate* ; Mastication ; Models, Animal ; Movement Disorders*

A prospective study had been performed in infants with hydronephrosis due to ureteropelvic junction stenosis to determine adequate management plan. Forty infants (47 renal units) were selected for the study during the period from January 1995 to July 1997 in the Department of Pediatrics, Asan Medical Center. They were diagnosed prenatally or early postnatally (<3 months of age) on the basis of renal ultrasonography and techotium-99m-mercap- toacetyltriglycerine (MAG3) scan. The antero-poste- rior pelvic diameter (APPD) was measured from serial renal ultrasonography and relative renal function and clearance half time (T1/2) were calculated from serial MAG3 scan. Those who had accompanying other urogenital anomalies or vesicoureteral reflux were excluded in this study. Follow-up tests (ultrasonography and MAG3 scan) and surgical corrections, if necessary, were performed according to the predetermined algorithrn. The male to female ratio was 3: 1. Hydronephrosis was involved the left side in 24 renal units, the right side in 9 renal units, and the bilateral sides in 14 renal units. All the hydronephrotic renal units were divided into 2 groups; Group A (19 renal units) those had taken surgical correction, and group B (28 renal units) those revealed spontaneous improvement without surgical correction. The mean follow-up duration was 7.2+/-6.3 months in group A and 14.1+/-12.6 months in group B. The mean APPD in the first postnatal renal ultrasonography was 19.4+6.8 mm in group A and 10.0+/-3.0mm in group B and this was statistically significant (P<0.01). The rela- tive renal function of group A in the first MAG3 scan was under 35% in 7 renal units and over 35M in 12 renal units. In group B, the relative renal function was over 35% in the all 28 renal units. Tl/2 in the first MAG3 scan was longer than 20 minutes in the all 19 renal units in group A. In group B, Tl/2 was shorter than 10 minutes in 15 renal units, between 10 minutes and 20 minutes in 6 renal units, and longer than 20 rninutes in 7 renal units. The mean APPD of the 7 renal units in group B of which Tl/2 was longer than 20 minutes was 12.62.6mm and that of group A was 19.4+/-6.8mrn and this was statistically significant (P<0.01). In conclusion, the renal ultrasonography and MAG3 scan can be used effectively to determine the degree of the stenosis of the ureteropelvic junction in hydronephosis during infancy. When the babies are diagnosed with hydronephrosis due to ureteropelvic junction stenosis in the early infantile period, serial renal ultrasonography and MAG3 scan play an important role in the decision of the management.
Chungcheongnam-do ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis* ; Infant ; Male ; Pediatrics ; Ultrasonography* ; Vesico-Ureteral Reflux

PURPOSE: The purpose of this study was to identify effects of EMLA (Eutectic Mixture of Local Anesthetics) cream application on pain perception and pain response during insertion of implanted venous access port needle in children with cancer. METHODS: From December 2010 to August 2011, at U university hospital, 20 patients scheduled for implanted venous access port needle insertion were recruited, and randomly assigned to receive either EMLA or a placebo cream 1 hour before the implanted venous access port needle insertion. While conducting needle insertion, changes in pulse and oxygen saturation on the pulse oxymeter monitor were measured and pain behavior reaction was also measured during needle insertion in the treatment room. After conducting needle insertion, self-reported pain reaction, and mothers' perception of the children's pain reaction were measured. Collected data were statistically processed using SPSS version 17.0 for Windows, and analyzed using descriptive statistics, t-test. RESULTS: Children's self-reported degree of pain, degree of pain as perceived by mothers and pain behavior reaction decreased significantly in the EMLA application group compared with the placebo group. CONCLUSION: Findings indicate that application of EMLA cream is effective in relieving pain in these children during implanted venous access port needle insertion.
Anesthesia ; Child* ; Humans ; Mothers ; Needles* ; Oxygen ; Pain Perception*

PURPOSE: The purpose of this study was to identify effects of Massage therapy on feeding intolerance and physical growth in premature infants. METHODS: This study was conducted in the NICU of U university hospital, from June to December 2014. A quasi experimental design was used. A total of 60 premature infants were randomly assigned into two groups of 30 infants each. Infants of control group were given conventional treatment, while infants of experimental group given conventional treatment plus massage therapy. Massage therapy was performed for 15 minutes, 60 min before feeding, 3 times per day for 21 times over 7 days. The number of feedings withheld for feeding intolerance, number of gastric residuals, number of fecal excretions and physical growth variables (weight, height) were measured. RESULTS: After the intervention, number of fecal excretions and weight gain in the experimental group were significantly higher than that of the control group. Also, number of gastric residuals in the experimental group was lower than that of the control group. CONCLUSION: Massage therapy laid the basis for nursing intervention to promote feeding tolerance and physical growth in premature infants.
Enteral Nutrition ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Massage* ; Nursing ; Research Design ; Weight Gain

Anaplastic large T-cell lymphoma (ALCL) encompasses different clinical entities that can be aggressive or localized. Scalp anaplastic lymphoma kinase (ALK)-negative ALCL is considered a localized lymphoma, and usually extends to the regional lymph nodes; intracranial invasion is rare. A 74-year-old woman was diagnosed with scalp ALK-negative ALCL, but did not exhibit invasion of the lymph nodes. Computed tomography and magnetic resonance imaging revealed intracranial masses with bony erosions. We treated the patient using CHOP chemotherapy and achieved short-term regression of the scalp and intracranial lesions. However, the patients ultimately died of pneumonia during the pancytopenic period. Therefore, caution must be exercised when treating scalp ALK-negative ALCL with intracranial invasion.
Aged ; Central Nervous System* ; Drug Therapy ; Female ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell* ; Magnetic Resonance Imaging ; Meningioma ; Neurofibromatoses ; Phosphotransferases ; Pneumonia ; Scalp ; T-Lymphocytes*

PURPOSE: This study was conducted to develop a comprehensive cognitive rehabilitation program that can be easily applied to brain injured patients by family members or nurses in community or hospital settings. METHODS: A Systemic literature review design was used. Thirty-three related studies were reviewed. RESULT: Based on the results of the literature review, the training tasks for attention were designated to enhancing 4 hierarchical areas, i.e., focused, selective, alternating, and divided attention. On the other hand, the memory rehabilitation tasks mainly consisted of mnemonic skills, such as the association method which helps patients memorize given information by linking together common attributes, the visual imagery method, and self-instruction method. The problem solving rehabilitation program included a task of games or plays which stimulated the patients' curiosity and interest. The training tasks for problem solving were to encourage the process of deriving reasonable solutions for a problematic situation resembling real problems that the patients were faced with in their everyday life. CONCLUSION: It is expected that the cognitive rehabilitation program developed from this study could help patients having difficulty in their every day life, due to a reduced cognitive ability resulting from brain injury, to effectively adapt to every day life.
Problem Solving ; Memory ; Humans ; *Cognitive Therapy ; Cognition Disorders/etiology/*rehabilitation ; Brain Injuries/complications/nursing/*rehabilitation