OBJECTIVES: This study aims to investigate the prevalence of musculoskeletal symptoms and factors related to daily activities in a representative Korean population. METHODS: This study was based on the questions about musculoskeletal symptoms in the Korean General Social Survey 2010. The questionnaire about musculoskeletal symptoms was adopted from Korean Occupational Safety and Health Agency guide, and it includes general characteristics, characteristics of pain, work type, work intensity and a 12-item Short Form Health Survey (SF-12). We utilized the criteria of the National Institute for Occupational Safety and Health to define the prevalence of musculoskeletal symptoms. Demographic, behavioral and socioeconomic factors were analyzed using logistic regression. RESULTS: The prevalence of musculoskeletal symptoms was 38.3%. The prevalence was higher in females, the elderly, those without health insurance, and those with a low income, low education, and occupations with a heavy workload. The prevalence by body part was highest in the back, shoulder, and knee, in that order. The physical component summary and mental component summary of the SF-12 decreased with increasing musculoskeletal symptoms. CONCLUSIONS: Musculoskeletal symptoms are very common in the general population, and related to various socio-demographic factors. These results suggest that active prevention and management of musculoskeletal symptoms is needed at a national level.
*Activities of Daily Living ; Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group ; Demography ; Female ; Health Surveys ; Humans ; Logistic Models ; Male ; Middle Aged ; Musculoskeletal Diseases/*epidemiology ; Occupational Diseases/epidemiology ; Odds Ratio ; Prevalence ; Questionnaires ; Republic of Korea ; Risk Factors ; Socioeconomic Factors ; Workload ; Young Adult

OBJECTIVES: We aimed to investigate the acute effects of heat stress on body temperature and blood pressure of elderly individuals living in poor housing conditions. METHODS: Repeated measurements of the indoor temperature, relative humidity, body temperature, and blood pressure were conducted for 20 elderly individuals living in low-cost dosshouses in Seoul during hot summer days in 2010. Changes in the body temperature, systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to variations in the indoor and outdoor temperature and humidity were analyzed using a repeated-measures ANOVA controlling for age, sex, alcohol, and smoking. RESULTS: Average indoor and outdoor temperatures were 31.47degrees C (standard deviation [SD], 0.97degrees C) and 28.15degrees C (SD, 2.03degrees C), respectively. Body temperature increased by 0.21degrees C (95% confidence interval [CI], 0.16 to 0.26degrees C) and 0.07degrees C (95% CI, 0.04 to 0.10degrees C) with an increase in the indoor and outdoor temperature of 1degrees C. DBP decreased by 2.05 mmHg (95% CI, 0.05 to 4.05 mmHg), showing a statistical significance, as the indoor temperature increased by 1degrees C, while it increased by 0.20 mmHg (95% CI, -0.83 to 1.22 mmHg) as outdoor temperature increased by 1degrees C. SBP decreased by 1.75 mmHg (95% CI, -1.11 to 4.61 mmHg) and 0.35 mmHg (95% CI, -1.04 to 1.73 mmHg), as the indoor and outdoor temperature increased by 1degrees C, respectively. The effects of relative humidity on SBP and DBP were not statistically significant for both indoor and outdoor. CONCLUSIONS: The poor and elderly are directly exposed to heat waves, while their vital signs respond sensitively to increase in temperature. Careful adaptation strategies to climate change considering socioeconomic status are therefore necessary.
Aged ; Blood Pressure ; Body Temperature ; Climate Change ; Hot Temperature ; Housing ; Humans ; Humidity ; Infrared Rays ; Social Class ; Vital Signs

Facial grimacing can be a manifestation of complex partial seizures from the temporal lobe. We observed a case of seizure with facial grimacing and partial loss of consciousness during an electroencephalography recording. The recording revealed interictal spikes on the left-sided inferior temporal electrodes and ictal discharges starting on the same electrodes. The current source appeared to be in the inferior and lateral temporal areas of the left cerebral hemisphere. These results show that it is possible to localize the current sources responsible for interictal spikes.
Cerebrum ; Electrodes ; Electroencephalography ; Humans ; Seizures ; Temporal Lobe ; Unconsciousness

BACKGROUND: Interictal spikes in gelastic epilepsy-hypothalamic hamartoma syndrome are mainly in the fronto-temporal area. Current source analysis of the interictal spikes has not been done enough. We tried the current source analysis in 2 patients with gelastic epilepsy-hypothalamic hamartoma syndrome using both of the discrete and distributed models. METHODS: Twenty 1 sec epochs including the negative peak of the spikes, were selected from one or two electroencephalographic recordings respectively in each patient. These 20 epochs were averaged into a single spike. The current dipole sources of the averaged spike were analyzed and located on a spherical head model. The current source density of the negative peak point of the averaged spike was located on the Talairach human brain map. RESULTS: The current dipole sources were in the right subcallosal gyrus, or the right or left anterior cingulate gyri. The current source density was distributed in the bilateral medial frontal area including the anterior cingulate gyri. CONCLUSIONS: The interictal spikes of patients with gelastic epilepsy-hypothalamic hamartoma syndrome may be generated by the current sources located in the bilateral medial frontal area.
Brain ; Hamartoma ; Head ; Humans

The pathophysiology of transient global amnesia is uncertain. Several studies have suggested that the anatomical substrates of transient global amnesia are the limbic areas, including the hippocampus, caudate nucleus, cingulate area, and thalamus. We examined a patient who presented with transient global amnesia with left insular infarction. We believe that the insular lobe may be an important area of episodic memory formation, and infarction of this brain area may be the mechanism underlying the amnesia experienced in this case.
Amnesia ; Amnesia, Transient Global ; Brain ; Caudate Nucleus ; Cerebral Infarction ; Hippocampus ; Humans ; Infarction ; Memory, Episodic ; Thalamus

Cerebral lesions can cause dermatomal sensory deficit. The most commonly reported site is the medulla oblongata due to its well-separated sensory systems. Dermatomal sensory deficit that has developed after pontine infarctions have been reported in several cases, the majority of which involved the medial lemniscus. However, restricted spinothalamic sensory loss has rarely been reported in pontine infarctions. We report herein a patient who presented with dermatomal spinothalamic sensory deficits below the tenth thoracic level after pontine infarction.
Humans ; Infarction ; Medulla Oblongata ; Spinothalamic Tracts

BACKGROUND AND PURPOSE: In order to improve inter-rater reliability and minimize diagnosis of undetermined etiology for stroke subtype classification, using a stroke registry, we developed and implemented a magnetic resonance imaging (MRI)-based algorithm for acute ischemic stroke subtype classification (MAGIC). METHODS: We enrolled patients who experienced an acute ischemic stroke, were hospitalized in the 14 participating centers within 7 days of onset, and had relevant lesions on MR-diffusion weighted imaging (DWI). MAGIC was designed to reflect recent advances in stroke imaging and thrombolytic therapy. The inter-rater reliability was compared with and without MAGIC to classify the Trial of Org 10172 in Acute Stroke Treatment (TOAST) of each stroke patient. MAGIC was then applied to all stroke patients hospitalized since July 2011, and information about stroke subtypes, other clinical characteristics, and stroke recurrence was collected via a web-based registry database. RESULTS: The overall intra-class correlation coefficient (ICC) value was 0.43 (95% CI, 0.31-0.57) for MAGIC and 0.28 (95% CI, 0.18-0.42) for TOAST. Large artery atherosclerosis (LAA) was the most common cause of acute ischemic stroke (38.3%), followed by cardioembolism (CE, 22.8%), undetermined cause (UD, 22.2%), and small-vessel occlusion (SVO, 14.6%). One-year stroke recurrence rates were the highest for two or more UDs (11.80%), followed by LAA (7.30%), CE (5.60%), and SVO (2.50%). CONCLUSIONS: Despite several limitations, this study shows that the MAGIC system is feasible and may be helpful to classify stroke subtype in the clinic.
Arteries ; Atherosclerosis ; Classification* ; Diagnosis ; Humans ; Magic ; Magnetic Resonance Imaging ; Recurrence ; Stroke* ; Thrombolytic Therapy

No abstract available.
Intracranial Hemorrhages* ; Stroke*

BACKGROUND AND PURPOSE: About 30%-40% of stroke patients are taking antiplatelet at the time of their strokes, which might increase the risk of symptomatic intracranial hemorrhage (SICH) with intravenous tissue plasminogen activator (IV-TPA) therapy. We aimed to assess the effect of prestroke antiplatelet on the SICH risk and functional outcome in Koreans treated with IV-TPA. METHODS: From a prospective stroke registry, we identified patients treated with IV-TPA between October 2009 and November 2014. Prestroke antiplatelet use was defined as taking antiplatelet within 7 days before the stroke onset. The primary outcome was SICH. Secondary outcomes were discharge modified Rankin Scale (mRS) score and in-hospital mortality. RESULTS: Of 1,715 patients treated with IV-TPA, 441 (25.7%) were on prestroke antiplatelet. Prestroke antiplatelet users versus non-users were more likely to be older, to have multiple vascular risk factors. Prestroke antiplatelet use was associated with an increased risk of SICH (5.9% vs. 3.0%; adjusted odds ratio [OR] 1.79 [1.05-3.04]). However, at discharge, the two groups did not differ in mRS distribution (adjusted OR 0.90 [0.72-1.14]), mRS 0-1 outcome (34.2% vs. 33.7%; adjusted OR 1.27 [0.94-1.72), mRS 0-2 outcome (52.4% vs. 52.9%; adjusted OR 1.21 [0.90-1.63]), and in-hospital mortality (6.1% vs. 4.2%; adjusted OR 1.19 [0.71-2.01]). CONCLUSIONS: Despite an increased risk of SICH, prestroke antiplatelet users compared to non-users had comparable functional outcomes and in-hospital mortality with IV-TPA therapy. Our results support the use of IV-TPA in eligible patients taking antiplatelet therapy before their stroke onset.
Hospital Mortality ; Humans ; Intracranial Hemorrhages* ; Odds Ratio ; Platelet Aggregation Inhibitors ; Prospective Studies ; Risk Factors ; Stroke ; Thrombolytic Therapy ; Tissue Plasminogen Activator