Even though the nonketotic hyperglycemia is a metabolic disorder, it complicates hemic- horea-hemiballism rarely. Moreover, generalized chorea-ballism associated with nonketotic hyperglycemia in diabetes mellitus is very rare, so it has not been reported in Korean literature. Although the precise pathophysiologic mechanisms of these disorders are still poorly understood, deficiency of gamma aminobutyric acid (GABA) in nonketotic hyperglycemia or reduced GABAnergic inhibition by striatal lesion may increase inhibitory output to subthalamic nucleus. These result loss of pallidal inhibition and produce contralateral hemichorea-hemiballism. The striatal lesions, such as transient ischemia with reactive astrocytosis or small amount of petechial hemorrhage, are related with changes of magnetic resonance image (MRI) findings presumably. We report a diabetic old woman who developed generalized chorea-ballismus as a very rare complication of nonketotic hyperglycemia. Her brain MRI showed high signal intensity in left lentiform nucleus and right pallidum on T1 weighted images and low signal intensity in bilateral putamen on T2 weighted images with highly enhanced corresponding lesions on T1 weighted enhancement images.
Brain ; Corpus Striatum ; Diabetes Mellitus* ; Female ; gamma-Aminobutyric Acid ; Gliosis ; Hemorrhage ; Humans ; Hyperglycemia* ; Ischemia ; Magnetic Resonance Imaging ; Putamen ; Subthalamic Nucleus

Purpose: This study identified factors related to the quality of care in nursing homes, and elicited consensus opinions from experts on nursing homes. Methods: A Delphi questionnaire was developed based on a review of the literature using the keywords “nursing homes,” “workforce,” and “quality of care.” A total of two Delphi surveys were conducted with 14 experts. The important and urgent factors related to the quality of care for nursing home residents emerged. Results: A consensus was achieved on the important and urgent factors relating to the quality of care.The related factors were grouped into four sections: Organizational Characteristics, Staffing Characteristics, the Long-Term Care Market and Legal and Policy Issues, and Nursing Processes. In total, 23 items were important factors and 26 items were urgent factors relating to the quality of care. In addition, the unanimous advocacy by the experts for increased hours per resident day for registered nurses (RNs, 41 minutes 59 seconds) was much higher than the current hours per resident day of RNs in Korea. Conclusion To provide optimal care for residents in nursing homes in Korea, the mandatory and essential placement of RNs with professional knowledge and skills is paramount.

Intrauterine inflammation is defined as the inflammation of the chorion, amnion, and placenta. Untreated inflammation increases the risk of fetal inflammatory response syndrome, which may result in multiorgan diseases involving the brain, cardiovascular system, lung, eye, and intestine. Therefore, controlling inflammation is critical in pregnant women to reduce the risk of diseases. However, there are no safe and effective anti-inflammatory drugs for administration during pregnancy. Although the primary function of melatonin is to control circadian rhythms, it has protective effects against cellular insults occurring from hypoxia, oxidative stress, and inflammation. While animal studies support the effective and safe role of melatonin in improving pregnancy-related morbidities, it leaves plenty of opportunities for clinical studies investigating its anti-inflammatory, antioxidant, and protective effects against insults induced by intrauterine inflammation. Therefore, it will be worthwhile to investigate antenatal supplementation of melatonin in pregnant women with intrauterine inflammation to reduce the incidence of associated comorbidities.

Carbapenem resistance is a serious clinical and public health threat. Carbapenemase can confer carbapenem resistance, and most carbapenemase genes are plasmid encoded so resistance can easily spread. In this study, we aimed to develop a novel system based on the TaqMan platform for the rapid detection of 6 clinically prevalent carbapenemase genes: Klebsiella pneumoniae carbapenemase, New Delhi metallo-β-lactamase, oxacillinase, imipenem-hydrolyzing, Verona integron-encoded metallo-β-lactamase, and Guiana extended-spectrum β-lactamase.

Acute gastric anisakiasis with multiple anisakid larvae infection is reported. A 68-year-old woman residing in Busan, Korea, had epigastric pain with severe vomiting about 5 hours after eating raw anchovies. Four nematode larvae penetrating the gastric mucosae in the great curvature of the middle body and fundus were found and removed during gasteroendoscopic examination. Another one thread-like moving larva was found in the great curvature of upper body on the following day. On the basis of their morphology, the worms were identified as the 3rd stage larvae of Anisakis simplex. This case is acute gastric anisakiasis provoking severe clinical problems by the multiple infection and the greatest number of anisakid larvae found in a patient in Korea.
Acute Disease ; Aged ; Animals ; Anisakiasis/*parasitology/surgery ; Anisakis/*growth & development ; Female ; Gastric Mucosa/parasitology/pathology/surgery ; Gastroscopy ; Human ; Stomach Diseases/*parasitology/pathology/surgery

Benign ductal or glandular neoplasms of the esophagus unrelated to Barrett esophagus are extremely rare. Only 9 cases have been reported in the English language literature. We now report a case of esophageal gland duct adenoma incidentally found in a 73-year-old man. A 0.8 cm-sized, polypoid submucosal lesion in the distal esophagus was removed. Histologically, the lesion was well circumscribed and consisted of several ducts or cysts with focal papillary configurations. Interstitial lymphocytic infiltration with germinal centers was also observed. The lining cells of ducts or cysts were composed of two layers: an inner intensely eosinophilic luminal duct cell layer and an outer myoepithelial cell layer that was accentuated by alpha-smooth muscle actin. There was no significant nuclear atypia or mitosis. Mucin production was occasionally observed in a few goblet cells. To the best of our knowledge, this is the first case of benign ductal or glandular neoplasm of the esophagus among Koreans.
Actins ; Adenoma ; Aged ; Barrett Esophagus ; Eosinophils ; Esophagus ; Germinal Center ; Goblet Cells ; Humans ; Mitosis ; Mucins ; Muscles ; Neoplasms, Glandular and Epithelial ; Phenobarbital

PURPOSE: It is necessary to develop a proper payment system for more health care facilities to provide hospice and palliative cares. In deciding the proper level of payment for hospice per diem fee, willingness to pay (WTP) may provide one of the critical information. This study was conducted to determine WTP for hospice care and to analyze those factors affecting WTP. MATERIALS AND METHODS: A contingent valuation method with a double-bounded dichotomous-choice model was used. Interview survey was organized and conducted by a survey company from April 4 to 18, 2008. The mean WTP was calculated through an infinite integration of survival functions. RESULTS: The average willingness to pay was found to be 42,240 Korean won (KRW) (USD 35), with the amount becoming higher as hospice services were deemed more necessary or where average monthly household income was higher. The amount was also higher among male respondents than females. CONCLUSION: To compare this WTP with actual cost (32,500 KRW) (USD 27) for hospice care. To facilitate hospice service, hospice specific payment system should be developed. This study provides information regarding the general public's preference of hospice service and their WTP for hospice care, and it may be useful in the decision-making process.
Fees and Charges ; Female ; Health Care Costs ; Hospice Care/*economics/psychology ; Humans ; Male ; *Public Opinion ; Socioeconomic Factors

Uterine fibroids are the most common benign tumor of the female genital tract. Traditional therapy for symptomatic fibroids has been either myomectomy or hysterectony, depending on whether futhur fertility is desire. A promised new altermative therapy-embolization of the uterine arteries- is now available. A 29 year-old woman was diagnosed of uterine fibroid by ultrasonogram and other techniques. We have experienced one case of uterine fibroid necrosis after transarterial embolization. Now we report a case of uterine artery embolization for treattement of uterine fibriods with a brief review.
Adult ; Female ; Fertility ; Humans ; Leiomyoma* ; Necrosis* ; Ultrasonography ; Uterine Artery Embolization

During childhood, meningioma is an uncommon tumor, and in infants, extracranial meningioma is very rare. We report a case of primary cutaneous menigioma occurring on the scalp of a ten-month-old girl.
Female ; Humans ; Infant* ; Meningioma* ; Scalp*

No abstract available.
Pregnancy*