Duret hemorrhage is characterized by an upper brainstem hemorrhage due to increased intracranial pressure by mass effect such as subdural hematoma or a brain tumor. The anteroposterior elongation and downward displacement of the upper brainstem by transtentorial herniation results in the compression and tearing of the paramedian perforating vessels that feed the upper brainstem tegmentum. The consequent hemorrhage that involves the upper brainstem renders recovery to be almost impossible. Following a tricuspid valve replacement surgery, a 56-year-old woman developed a left fronto-temporo-parietal nontraumatic subdural hematoma resulting in transtentorial herniation of the left mesial temporal lobe. A successful surgical evacuation of the hematoma was done with clinical improvement. Two days later, she was referred to neurology with an aggravated right side weakness, dysarthria, and a newly developed extraocular movement disturbance. A brain CT and MRI showed a pontine hemorrhage. We report a case of pontine hemorrhage, a Duret hemorrhage, after the surgical evacuation of nontraumatic subdural hematoma.
Brain ; Brain Neoplasms ; Brain Stem ; Dysarthria ; Female ; Hematoma ; Hematoma, Subdural* ; Hemorrhage* ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Middle Aged ; Neurology ; Temporal Lobe ; Tricuspid Valve

PURPOSE: This study was done to explore the relationship between aggression and internet over-use, depression-anxiety, self-esteem, all of which are known to be behavior and psychological characteristics linked to "at-risk" children for aggression. METHODS: Korean-Child Behavior Check List (K-CBCL), Korean-Internet Addiction Self-Test Scale, and Self-Esteem Scale by Rosenberg (1965) were used as measurement tools with a sample of 743, 5th-6th grade students from 3 elementary schools in Jecheon city. Chi-square, t-test, ANOVA, Pearson's correlation and stepwise multiple regression with SPSS/Win 13.0 version were used to analyze the collected data. RESULTS: Aggression for the elementary school students was positively correlated with internet over-use and depression-anxiety, whereas self-esteem was negatively correlated with aggression. Stepwise multiple regression analysis showed that 68.4% of the variance for aggression was significantly accounted for by internet over-use, depression-anxiety, and self-esteem. The most significant factor influencing aggression was depression-anxiety. CONCLUSION: These results suggest that earlier screening and intervention programs for depression-anxiety and internet over-use for elementary student will be helpful in preventing aggression.
*Aggression ; Anxiety ; Behavior, Addictive ; Child ; Child Behavior/psychology ; Depression ; Female ; Humans ; Internet ; Male ; Self Concept ; Students/*psychology

Based on the limitation of biomedical model of tinnitus, more attention has been paid to personalities or psychological aspects. Depressive disorder, anxiety disorder, and sleep disturbance were comorbid illnesses of tinnitus and research showed that neurobiological mechanisms such as dysfunction of limbic system or HPA axis were common in tinnitus and affective disorders and that comorbid psychiatric disorders enhanced the negative outcome of tinnitus. Recently, more attention is being paid to the relation of tinnitus with personality and the role of stress. Although the causal relation of personality and tinnitus is unclear, stress in itself showed that it can be a trigger in the development of tinnitus, and stress of tinnitus can cause adverse effects. Since the effect of fear-related cognition such as catastrophic thought about tinnitus was revealed more recently, its therapeutic implication should be explored. This review will describe the product of previous research and discuss future direction about psychological factors related to tinnitus.
Anxiety Disorders ; Cognition ; Depressive Disorder ; Limbic System ; Mood Disorders ; Psychology* ; Tinnitus*

Purpose: : This study aims to assess the extent of work value, psychological ownership, the nursing work environment, and retention intention, examine the correlation between these variables, and identify the factors that influence retention intention. The goal is to provide foundational data to enhance retention intention.Method : The study involved 159 nurses employed at a tertiary general hospital and a general hospital. Data were gathered through structured questionnaires and analyzed using an independent t-test, one-way ANOVA, Scheffé test, Pearson correlation coefficient, and multiple regression analysis with a simultaneous stepwise method, all conducted using the SPSS 26.0 software. Results: : The intention to remain in the profession was found to have a positive correlation with work value (r = .45, p ＜ .001), psychological ownership (r = .37, p ＜ .001), and the nursing work environment (r = .27, p = .001). Significant factors influencing the intention to stay included total clinical career (β = .17, p = .016), work value (β = .38, p ＜ .001), and psychological ownership (β = .19, p = .020). These variables accounted for 24.1% of the variance in the intention to remain in the profession (F = 17.71, p ＜ .001). Conclusion To enhance the intention of hospital staff to remain in their positions, it is crucial to identify and bolster positive psychological competencies, such as a sense of work value and psychological ownership.

PURPOSE: The aim of this study was to compare the color stability, water sorption and cytotoxicity of thermoplastic acrylic resin for the non-metal clasp dentures to those of thermoplastic polyamide and conventional heat-polymerized denture base resins. MATERIALS AND METHODS: Three types of denture base resin, which are conventional heat-polymerized acrylic resin (Paladent 20), thermoplastic polyamide resin (Bio Tone), thermoplastic acrylic resin (Acrytone) were used as materials for this study. One hundred five specimens were fabricated. For the color stability test, specimens were immersed in the coffee and green tee for 1 and 8 weeks. Color change was measured by spectrometer. Water sorption was tested after 1 and 8 weeks immersion in the water. For the test of cytotoxicity, cell viability assay was measured and cell attachment was analyzed by FE-SEM. RESULTS: All types of denture base resin showed color changes after 1 and 8 weeks immersion. However, there was no significant difference between denture base resins. All specimens showed significant color changes in the coffee than green tee. In water sorption test, thermoplastic acrylic resin showed lower values than conventional heat-polymerized acrylic resin and thermoplastic polyamide resin. Three types of denture base showed low cytotoxicity in cell viability assay. Thermoplastic acrylic resin showed the similar cell attachment but more stable attachment than conventional heat-polymerized acrylic resin. CONCLUSION: Thermoplastic acrylic resin for the non-metal clasp denture showed acceptable color stability, water sorption and cytotoxicity. To verify the long stability in the mouth, additional in vitro studies are needed.
Cell Survival ; Coffee ; Denture Bases ; Dentures* ; Immersion ; Mouth ; Nylons ; Water*

Purpose: Attending physicians in Korea are aware of the existence of the Nutrition Support Team (NST), but even when the NST are consulted, compliance with their recommendations may be low. This study was performed to identify physicians’ compliance with the NST advice and how this affected the outcome of treatment for critically ill patients. Methods: This study was a retrospective observational study. Critically ill patients who were older than 18 years, younger than 90 years, and had been admitted and managed in the intensive care unit were selected for this study. Patients were assigned to either the compliance group or the non-compliance group according to physician compliance with the NST advice. Each group were compared using variables such as calorie supply, protein supply, laboratory findings, hospital stay, 30-day mortality, and survival rate. Results: The compliance group (81% of cases) was supplied with a significantly higher energy (1,146.36 ± 473.45 kcal vs. 832.45 ± 364.28 kcal, p < 0.01) and a significantly higher protein (55.00 ± 22.30 g/day vs. 42.98 ± 24.46 g/day, p = 0.04) compared with the non-compliance group. There was no significant difference in the basic demographics between groups, although the compliance group had a better outcome in the 30-day mortality rate (8% vs. 26%, p = 0.02), and in survival beyond 1 year (Crude model, hazard ratio: 2.42, CI: 1.11-5.29). Conclusion Critically ill patients whose attending physician complied with the NST advice, received an increased energy intake and supply of protein which was positively associated with survival.

Friction melanosis (FM) is an acquired pigmented disease that is caused by recurrent mechanical stress. There is no previous report explaining the presence of tiny brown-colored particles confined to the corneal layer. We describe a case of a rare form of FM of the finger that showed a relatively transient clinical course. A 17-year-old Korean female presented with a 5-month history of an asymptomatic localized hyperpigmented patch on the tip of the right index finger. The dermoscopic examination revealed homogenous globular pattern, which favored pigmentation over hemorrhage. Histopathologically, hyperkeratosis and acanthosis with lymphohistiocytic infiltration of the superficial dermis were noted on hematoxylin and eosin staining; however, there was neither a definite increase in melanophages in the upper dermis nor melanocytic proliferation in the basal layer. Per high-power field, multiple brown-colored tiny particles were scattered in the corneal layer. The particles were not dyed by Fontana-Masson stain, iron stain, and S-100. We questioned the patient about the presence of irritation and found that she had bought new shoes at the time of the onset. She was habituated to placing her fingers in her shoes while wearing them because they were slightly tight. The lesion disappeared spontaneously a week after the cause of friction was eliminated.Altogether, we encountered a rare form of FM that occurred in a rare location with a transient clinical course. Further cases on pigmentation restricted to finger tips might reveal the origin of the particles.

Diabetic muscle infarction (DMI), also known as diabetic myonecrosis, is a rare complication of diabetes mellitus (DM); hence, it is often underdiagnosed. Thus, timely diagnosis and treatment are essential for a better prognosis. We describe a 24-year-old woman with Prader-Willi syndrome and an 8-year history of uncontrolled type 2 DM, who presented with a sudden onset of fever and subacute painful swelling of her left thigh. She was finally diagnosed with DMI based on magnetic resonance imaging and muscle biopsy after excluding other infectious and inflammatory diseases of proximal muscles. The patient was treated with bed rest, strict glycemic control, and analgesics, and her symptoms gradually resolved. DMI should be considered in the differential diagnosis of patients with poorly controlled DM, who present with subacute pain and swelling of lower extremity muscles, without a history of trauma.

Diabetic muscle infarction (DMI), also known as diabetic myonecrosis, is a rare complication of diabetes mellitus (DM); hence, it is often underdiagnosed. Thus, timely diagnosis and treatment are essential for a better prognosis. We describe a 24-year-old woman with Prader-Willi syndrome and an 8-year history of uncontrolled type 2 DM, who presented with a sudden onset of fever and subacute painful swelling of her left thigh. She was finally diagnosed with DMI based on magnetic resonance imaging and muscle biopsy after excluding other infectious and inflammatory diseases of proximal muscles. The patient was treated with bed rest, strict glycemic control, and analgesics, and her symptoms gradually resolved. DMI should be considered in the differential diagnosis of patients with poorly controlled DM, who present with subacute pain and swelling of lower extremity muscles, without a history of trauma.

A 70-year-old female was referred for brown-to-gray colored papules and nodules on her lower legs. She had been diagnosed with diffuse large B-cell lymphoma (DLBCL) in her stomach, and myelodysplastic syndrome (MDS) by bone marrow biopsy. Three years after complete remission of DLBCL, she experienced DLBCL recurrence in her small bowel and was hospitalized. MDS had been stationary, but during the treatment of DLBCL, her laboratory findings suggested signs of leukemia. Bone marrow biopsy was done, and acute monoblastic leukemia (AMoL) was diagnosed. After 1 cycle of chemotherapy for AMoL, skin lesions developed, and her skin biopsy showed cutaneous T-cell lymphoma (CTCL). Terminal deoxynucleotidyl transferase staining and CD123 staining were negative, and bone marrow re-biopsy conducted after the skin lesion developed still showed monoblastic proliferation. Whether the CTCL represented with an AMoL lineage switch could not be completely proved due to the absence of molecular or clonal marker evaluations, but the possibility of coexistence of three different malignancies was higher. During treatment, a neutropenic fever developed, and the patient died due to sepsis. We herein report a rare case of CTCL accompanied by AmoL and DLBCL.