PURPOSE: To report clinical features and optical coherence tomographic findings of presumed atypical ocular tuberculosis associated with tuberculosis lymphadenitis and encephalomeningitis. CASE SUMMARY: A 28-year-old female with lymphadenitis in the axillary area presented with a fever and headache of a one week duration. CSF study and MRI findings implied tuberculosis encephalomeningitis, and presumed tuberculosis uveitis manifested with visual disturbance after five days. Ocular symptoms were aggravated and showed anterior iridocyclitis, vitritis, macular edema, and multifocal retinitis with miliary granuloma that was distinct from choroiditis or typical tuberculosis granuloma. After the patient received anti-tuberculosis medication and systemic corticosteroids, significant improvements in visual acuity, ocular findings and OCT results were observed. CONCLUSIONS: Ocular tuberculosis can present with various clinical findings, and caution should be taken so as not to misdiagnose based on these characteristics. In the present case, anti-tuberculosis medication and systemic steroids resulted in the resolution of inflammation. In such cases, monitoring the posterior pole lesion via OCT may be helpful in determining improvement.
Adrenal Cortex Hormones ; Adult ; Choroid ; Choroiditis ; Female ; Fever ; Granuloma ; Headache ; Humans ; Inflammation ; Iridocyclitis ; Lymphadenitis ; Macular Edema ; Meningitis ; Meningoencephalitis ; Retinitis ; Steroids ; Tuberculosis ; Tuberculosis, Miliary ; Tuberculosis, Ocular ; Uveitis ; Visual Acuity

Pure ovarian choriocarcinoma of germ cell origin is exceedingly rare neoplasm, and even the presence of choriocarcinomatous elements admixed with other neoplastic germ cell elements is rare. In the most cases, the tumor is admixed with other neoplastic germ cell elemeats, and their presence is diagnostic of noagsatational choriocarcinoma, except for the remote of the tumor being a geatational choriocarcinoma metasttic to an ovarian germ cell tumor. We have experienced a case of nongestational ovarian choriocarcinoma in 10 year dld woman. So we report this case with a brief review of its literatures.
Choriocarcinoma* ; Female ; Germ Cells ; Humans ; Neoplasms, Germ Cell and Embryonal ; Pregnancy

PURPOSE: The purpose of this study was to investigate the effects of case-based learning (CBL) on learning motivation and learning satisfaction of nursing students in a human physiology course. METHODS: The development and application of CBL scenarios was conducted from February to June, 2013. Nursing students (n=142) who registered for a human physiology course were assigned into either a control or CLB group. The control group received traditional lectures for 14 weeks. The CBL group received the same 14-week lectures and an additional 5 CBL sessions. The learning motivation and satisfaction were measured by questionnaires at the beginning and the end of the semester. Seven students in the CBL group were randomly selected for a focus-group interview. Quantitative data were analyzed by chi2-test and t-test, and qualitative data were analyzed by content analysis. RESULTS: The learning motivation and learning satisfaction were not significantly different between the two groups. However, 59% of the CBL group answered with a positive impression on the CBL approach as it helped them to feel a sense of achievement, excitement, to form their identity as nursing students, and so on. CONCLUSION: These findings suggest that the CBL could be a challenging but useful learning method in a physiology course for nursing students. Further studies with guidance, such as instructors' questions and feedback design are needed to utilize CBL more effectively.
Humans ; Humans* ; Learning* ; Lectures ; Motivation* ; Nursing* ; Physiology* ; Students, Nursing*

Congenital complete atrioventricular (AV) block is a rare neonatal disease. It is a passively acquired immune-mediated injury of the conduction system, triggered by transplacental passage of maternal anti-SSA/Ro and anti-SSB/La antibodies. Management of premature infants with symptomatic complete AV block is challenging. If medical treatment with a β-adrenergic agonist and inotropic drugs is not effective, early cardiac pacing should be considered. Here we report a case of congenital complete AV block in a low birth weight, preterm neonate, who was successfully treated with temporary transcutaneous pacing immediately after birth. Temporary transcutaneous pacing may be an option for the emergent management of a low birth weight preterm neonate with congenital complete AV block prior to permanent pacemaker implantation.
Antibodies ; Atrioventricular Block* ; Humans ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Newborn* ; Infant, Premature ; Parturition

Radioactive iodine (RAI) therapy is widely used for the treatment of Graves disease. After RAI therapy, 44% become hypothyroid and up to 28% remain hyperthyroid. The development of thyrotoxicosis after RAI therapy is believed to be mediated by 2 different mechanisms: a transient increased release of thyroid hormone due to radiation thyroiditis and the rare development of Graves disease due to the formation of antibodies to the thyroid-associated antigens released from the damaged follicular cells. A 55-year-old woman was hospitalized with severe headache, weight loss, and palpitation. She received a dose of 7 mCi of RAI (I-131) about 6 weeks earlier. Thyroid function test showed 7.98 ng/dL free T4, >8 ng/mL T3, <0.08 microIU/L thyroid stimulating hormone, and high titer thyroid stimulating immunoglobulin (TSI) (85.8 IU/L). She improved with propylthiouracil, propranolol, and steroid treatment. The TSI, however, was persistently elevated for 11 months.
Antibodies ; Female ; Graves Disease* ; Headache ; Humans ; Immunoglobulins, Thyroid-Stimulating ; Iodine* ; Middle Aged ; Propranolol ; Propylthiouracil ; Thyroid Function Tests ; Thyroid Gland ; Thyroiditis ; Thyrotoxicosis* ; Thyrotropin ; Weight Loss

BACKGROUND: Pregabalin is an antiepileptic drug that is effective for treating postoperative pain, neuropathic pain, anxiety, and hemodynamic instability. The aim of this study was to investigate the effect of a single preoperative dose of pregabalin in patients with opioid-induced hyperalgesia (OIH). METHODS: Ninety ASA I-II patients undergoing laparoendoscopic single-site urologic surgery were randomly assigned to one of the following three groups that received either pregabalin or placebo 1 h before anesthesia and an intraoperative remifentanil infusion. Group plL received placebo and 0.05 microgram/kg/min remifentanil, group plH received placebo and 0.3 microgram/kg/min remifentanil, and group prH received 300 mg pregabalin plus 0.3 microgram/kg/min remifentanil. The primary endpoint was pain intensity upon movement 1, 6, 12, and 24 h after surgery. Secondary endpoints were the area of hyperalgesia and mechanical hyperalgesia threshold 24 h after surgery, time to first postoperative analgesic requirement, and cumulative postoperative volume of morphine administered via a patient-controlled analgesia (PCA) pump over 24 h. RESULTS: The time to first postoperative analgesic requirement in group plH was significantly shorter than that in group plL. The injected PCA volume was significantly greater in group plH than that in the other two groups. Postoperative pain intensity in group plH was significantly greater than that in the other two groups at 6, 12, and 24 h after surgery. The mechanical hyperalgesia threshold and the area of hyperalgesia around the surgical incision 24 h after surgery in group plH differed significantly from those in the other two groups, which were not significantly different. Adverse effects were comparable among groups. CONCLUSIONS: High-dose remifentanil induced hyperalgesia, including increased pain intensity, increased area of hyperalgesia, and decreased mechanical hyperalgesia threshold. These effects were attenuated by oral administration of a single preoperative dose of pregabalin (300 mg) in patients undergoing laparo-endoscopic single-site urologic surgery.
Administration, Oral ; Analgesia, Patient-Controlled ; Anesthesia ; Anxiety ; gamma-Aminobutyric Acid ; Hemodynamics ; Humans ; Hyperalgesia ; Morphine ; Neuralgia ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Piperidines ; Pregabalin

PURPOSE: The purpose of this study is to correlate the MR findings with clinical stage and clinical outcome, and to describe the evolutional changes of abnormal MR findings of transverse myelitis. MATERIALS AND METHODS: Medical records and spinal MR images of 23 patients with both clinical and radiological diagnosis of transverse myelitis were retrospectively reviewed. MR findings were correlated with clinical stages including interval between MR imaging and full development of clinical symptoms, and compared with the clinical outcome. RESULTS: Diffuse high signal intensity of the spinal cord on T2-weighted image with mild cord bulging (67%) and focal contrast enhancement of the cord (75%) were observed within the first four weeks after full development of clinical symptoms. The findings decreased in extent or vanished later than four weeks on either initial or follow-up MR images. Most patients with either cord atrophy or focal hemorrhagewithin the cord lesion had poor clinical outcome. CONCLUSION: The MR findings of transverse myelitis are nonspecific, which may be seen in a variety of diseases. Serial MRIs, especially follow up examination over at least one month after full development of clinical symptoms are useful in the diagnosis of transverse myelitis and predicting its prognosis.
Atrophy ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Myelitis, Transverse* ; Prognosis ; Retrospective Studies ; Spinal Cord

Radiofrequency ablation (RFA) is a new, minimally invasive modality that serves as an alternative to surgery in patients with thyroid tumors. The Task Force Committee of the Korean Society of Thyroid Radiology developed recommendations for the optimal use of RFA for thyroid tumors in 2012 and revised them in 2017. Herein, we review and summarize the 2017 thyroid RFA guideline and compare it with the 2012 thyroid RFA guideline.
Advisory Committees ; Catheter Ablation ; Humans ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography

Purpose: This study was an quasi-experimental study to compare the effect of applying polyethylene wrap and aircap in maintaining body temperature of preterm infants. Methods: The participants were 51 preterm infants.Aircap was applied to the experimental group (n=23) and polyethylene wrap was applied to the control group (n=28) when the preterm infants admitted to neonatal intensive care unit. The data was collected at W hospital in J-province from June 2016 to May 2017. A total of 9 body temperature measurements were taken at 3 hours interval from 5 min to 24 hours after admission. Repeated measure ANOVA, independent t-test and x 2 test were conducted used with SPSS/WIN 24.0 Results: There were no significant difference in the homogeneity tests for general characteristics and dependent variables prior to the experiments (t=0.57, p=.566). There was a significant difference on body temperature of preterm infants over time (F=3.24, p=.020). There was no significant difference on body temperature between polyethylene wrap and aircap application groups (F=1.29, p=.261). The interaction between the group and the time was insignificant (F=1.51, p=.214). Conclusion The findings demonstrated that both methods of applying polyethylene wrap and aircap on the body in preterm infants had effect in maintaining body temperature.

PURPOSE: Helicopter parenting is emerging in parenting as a way of rearing adolescents and adult children. The aims of this study were to develop a Korean version of the Helicopter Parenting and Autonomy Supportive Behaviors Scale (HPASB). METHODS: The HPASB questionnaire items were translated into Korean and reviewed by experts and Content Validity Index (CVI) in a preliminary study with 10 university students. During September and October, 2014 data were collected from 229 nursing students from five different universities in different locations. For data analysis, SPSS 21.0 statistics which included exploratory factor analysis, t-test, one-way ANOVA were utilized. RESULTS: Content validity was over CVI .8. The 6 factors of K-HPASB were extracted and accounted for 59.30% of variance. The Cronbach's alpha coefficient was .71 indicating high reliability. CONCLUSION: The Korean version of the HPASB was identified as a scale with a high degree of validity and reliability. The results of this study provide a valuable scale which can be useful in the study of parenting as a way of rearing adolescents and adult children in Korea. To enhance the positive aspect of helicopter parenting, we suggest the development of intervention programs on parenting.
Adolescent ; Adult Children ; Aircraft* ; Humans ; Korea ; Parenting* ; Parents* ; Reproducibility of Results* ; Statistics as Topic ; Students, Nursing