OBJECTIVE: The relationship among chronic fatigue, depressive symptoms, and post-traumatic stress symptoms (PTSSs) among Middle East respiratory syndrome (MERS) survivors is poorly understood. METHODS: Of 148 survivors who consented to be registered and underwent assessments at 12 months (T1) and 18 months (T2) after the MERS outbreak, 72 (48.65%) were evaluated for chronic fatigue, depressive symptoms, and PTSSs based on the Impact of Event ScaleRevised (IES-R), the Patient Health Questionnaire-9 (PHQ-9), and the Fatigue Severity Scale (FSS). Data from 52 subjects, who completed both assessments, were analyzed using a regression-based serial multiple mediation model (PROCESS Model 6). RESULTS: Bootstrap analyses indicated no direct effects of T1 FSS on T2 IES-R but significant positive indirect effects of T1 FSS on T2 IESR through T1 PHQ-9 and T2 PHQ-9 (B=2.1601, SE=1.3268, 95% confidence interval=0.4250–6.1307). In other words, both T1 PHQ-9 and T2 PHQ-9 fully mediated the relationship between T1 FSS and T2 IES. CONCLUSION: Chronic fatigue 12 months after MERS had indirect effects on prolonged PTSSs 18 months after MERS via persisting depression in MERS survivors. This finding supports the need to promote interventional programs for emerging infectious disease survivors with chronic fatigue to reduce depression and prevent prolonged PTSSs.
Communicable Diseases, Emerging ; Coronavirus Infections ; Depression ; Fatigue ; Humans ; Middle East ; Negotiating ; Survivors

PURPOSE: The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia in older adults to identify the 'right tool' for nurses to use in nursing homes. METHODS: A systematic review was done. Electronic databases were searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality and applicability. Tools were evaluated for feasible incorporation into routine care by nurses. RESULTS: 29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52% and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometric quality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagia and aspiration of nursing home residents. CONCLUSION: Results show that GUSS and SSA are reliable and sensitive tools for screening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identified tools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.
Databases, Factual ; Deglutition ; Deglutition Disorders/*diagnosis ; Humans ; Nursing Homes ; Sensitivity and Specificity

Aged ; Aged, 80 and over ; Esophagus ; pathology ; virology ; Herpes Simplex ; diagnosis ; genetics ; pathology ; Humans ; In Situ Hybridization ; Male ; Middle Aged ; Simplexvirus ; genetics

Current anatomy education in Korea has been dependent upon foreign textbooks and atlas. Various models and medical devices from overseas were imported and commonly used in Korea, Now, we need to provide our own literatures and graphic data based on Korean population for student education. It is necessary to design, produce and supply medical education, operative tools and treatment supportive devices customized to Korean human body and constitution. Accordingly, this is the time to assemble and deliver medical data to Korean population. In this study, we primarily focused on building musculoskeletal system of Korea population and set our goal as utilizing its graphic data for medical education in Korea. It is first study preparing theoretical foundations of Korean skeletal graphic system based on Korean body shape by comparison with other ethnic groups and foreign graphical models. Simultaneously, we conducted practical construction of the skeletal atlas by employing Korean standard measures. Parameters from the measurement for various types of bones were calculated, and the results were compared with data from foreign atlas and pictures. Individual drawings of bones from skull, upper extremity was made by using parameters we calculated, thus the atlas of Korean skeleton was constructed from artistic anatomical point of view. As a result, there were significant differences between Korean skeletons and the medical drawings from the oversea edition. Because many foreign drawings used data from Caucasians only and there were numerous exaggerated and false dimensions without actual measurement. In conclusion, the result of the study is expected to provide fundamental data for building anatomical atlas about Korean human body structure.
Constitution and Bylaws ; Education ; Education, Medical ; Ethnic Groups ; Foundations ; Human Body ; Humans ; Korea ; Musculoskeletal System ; Skeleton* ; Skull ; Upper Extremity*

OBJECTIVES: The Montgomery-Asberg Depression Rating Scale (MADRS) has been reported as a valid tool for the assessment of depression because it is based on the core symptoms of depression. The aim of this study is to assess the reliability, validity and psychometric properties of the Korean version of the MADRS (K-MADRS). METHODS: One hundred seven patients, including in-patients and out-patients, diagnosed as major depressive disorder according to the DSM-IV criteria were enrolled in this study. They were assessed with K-MADRS, Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Clinical Global Impression (CGI) to examine cross-validation. Statistical analysis was done using calculation of Cronbach's alpha, Spearman Correlation Coefficient and Principal Components Analysis. RESULTS: The Cronbach's alpha coefficient of K-MADRS was 0.79. And the correlations of each item with total score were statistically significant (r=0.47-0.75, p<0.001). The inter-rater reliabilities of total score (r=0.89, p<0.001) and individual score (r=0.74-0.95, p=0.001) were high. The factor analysis revealed two factors. However, the first one accounted for 39% of variance, while the second one only for 11.1%. The total score of K-MADRS showed a significant correlation with those of HDRS, BDI and CGI (r=0.82, 0.47, 0.74, respectively, p=0.001). CONCLUSION: The K-MADRS showed good reliability and validity for the assessment of severity of depressive symptoms. And it demonstrated similar psychometric properties to previous studies. The K-MADRS is an useful instrument for assessing depressive symptoms in Korea.
Depression* ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Outpatients ; Psychometrics ; Reproducibility of Results

PURPOSE: To determine the utility of oblique coronal MR (OMR) imaging in the evaluation of bony foraminal narrowing of the cervical spine by comparison of its findings with those of combined axial and sagittal MR (CMR) imaging and correlation with the findings of oblique radiography. MATERIALS AND METHODS: One hundred and eight cervical neural foramina in 18 patients formed the basis of this study. Three radiologists working in a blind fashion independently graded the degree of bony narrowing of the foramina seen on OMR and CMR images and on oblique radiographs (0=none, 1=stenosis below 25% of AP dimension, 2=stenosis exceeding 25% of AP dimension). Inter-observer variance was measured for each modality, and for each of these and for each foramen, consensus was reached as to whether of CMR or OMR showed better correlation with radiographs. RESULTS: Inter-observer variance in OMR was less (kappa=0.88) than in CMR (kappa=0.41). Correlation between the findings of OMR and radiography was also better (kappa=0.63) than between those of CMR and radiography (kappa=0.41). CONCLUSION: OMR can be a useful supplement in evaluating foraminal stenosis, especially when oblique radiographs and CMR images show discrepancies.
Consensus ; Constriction, Pathologic* ; Humans ; Magnetic Resonance Imaging* ; Radiography ; Spine

PURPOSE: Mucopolysaccharidosis (MPS) is a lysosomal storage disease that causes tissue distortion and dysfunction due to the infiltration of mucopolysaccharide in connective tissue. The purpose of this study was to evaluate the characteristic findings of abdominal CT and plain chest radiography in patients with MPS. MATERIALS AND METHODS: Sixty-two children with MPS diagnosed by urine analysis were involved in this study; 24 of these underwent abdominal CT and the findings were reviewed by two radiologists, who reached a consensus. Organomegaly was classified as severe, moderate or mild. On chest PA radiographs of 42 of the children, the transverse diameter of the trachea was measured and compared with that of 42 normal controls. Student's t test was used for statistical analysis. RESUTLS: At abdominal CT, hepatomegaly was observed in 22 patients (92%; 2 severe, 15 moderate and 5 mild); and splenomegaly was present in 18 (75%; 2 severe, 4 moderate and 12 mild). Among eight patients (33%) with pancreatic enlargement, one had a severly enlarged pancreas, while in the remaining seven, enlargement was mild. Also present were inguinal hernia (n=15), umbilical hernia (n=12), undulation with thickening of the diaphragmatic crura (n=10), abnormalities related to the male genitalia (n=5) and vascular anomaly (n=3). In MPS patients, the mid-point diameter of the trachea (range, 5.6-9 mm; mean, 6.9 mm) was significantly less than in normal controls (range, 8-14 mm; mean, 10.8 mm) (p<0.001). CONCLUSION: An awareness of the characteristic abnormalities observed at abdominal CT and chest PA radiography can lead to a better understanding of MPS in children.
Abdomen* ; Child ; Connective Tissue ; Consensus ; Genitalia, Male ; Hepatomegaly ; Hernia, Inguinal ; Hernia, Umbilical ; Humans ; Lysosomal Storage Diseases ; Male ; Mucopolysaccharidoses* ; Musculoskeletal System* ; Pancreas ; Radiography ; Splenomegaly ; Thorax* ; Tomography, X-Ray Computed ; Trachea

Schwannoma, also known as a neurilemmoma, neurinoma, and perineural fibroblastoma, can be either a benign or malignant tumor, arising from the associated nerve sheath. A retroperitoneal malignant schwannoma is a rare tumor. Immunohistochemical staining for S-100, leucine-7 and the myelin basic protein is useful for diagnosis. Here we report a case of retroperitoneal malignant schwannoma with a brief review of the literatures.
Diagnosis ; Myelin Basic Protein ; Neurilemmoma*