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: A quasi-experimental study was performed to investigate the effects of a home visiting discharge education program on the maternal self-esteem, attachment, postpartum depression and family function in 35 mothers of neonatal intensive care unit (NICU) infants. METHODS: Twenty-three mothers in the intervention group received the home visiting discharge education while 12 mothers in the control group received the routine, hospital discharge education. Baseline data was collected in both groups one day after delivery. The intervention group received the home visiting discharge education while the control group did the routine hospital-based discharge education. The questionnaire including the data on maternal self-esteem, attachment, postpartum depression and family function were collected within 1week after the discharge by mail. RESULTS: The scores of maternal self-esteem, and attachment were significantly increased, and the postpartum depression and the family function score were decreased after the home visiting discharge education in intervention group. There were no changes in these variables before and after the routine hospital-based discharge education in control group. CONCLUSION: These results support the beneficial effects of home visiting discharge education on the maternal role adaptation and family function of the mothers of NICU infants.
Adaptation, Psychological ; Adult ; Aftercare/organization & administration ; Attitude to Health ; Depression, Postpartum/diagnosis/etiology/*prevention & control ; *Family Health ; Female ; Home Care Services/*organization & administration ; Humans ; Infant, Newborn ; *Intensive Care Units, Neonatal ; Korea ; Male ; *Mother-Child Relations ; *Mothers/education/psychology ; Nursing Evaluation Research ; Patient Discharge ; Postnatal Care/organization & administration ; Program Evaluation ; Public Health Nursing/*organization & administration ; Questionnaires ; *Self Concept

PURPOSE: This methodological study was done to develop a Nursing Competency Measurement Scale based on the clinical ladders of nurses working in wards. METHODS: Thirty clinical experts and 501 ward nurses evaluated the content validity of the scale. A survey using the Nursing Competency Measurement Scale was conducted with 114 nurses to evaluate reliability and applicability of the instrument. Data were analyzed using SPSS/WIN 21.0. RESULTS: A review of the literature identified 13 components of nursing competencies and 30 core nursing competencies based on each of the 4 grade clinical ladders. Cronbach's alpha coefficient for the total was .92. Cronbach's alpha reliabilities of each clinical ladder grade were .83 for Grade I, .84 for Grade II, .81 for Grade III, and .84 for Grade IV. The Content Validity Index (CVI) of the scale with 120 individual items was 0.976~1.000 for Grade I scale, 0.986~1.000 for Grade II scale, 0.984~1.000 for Grade III scale, and 0.992~1.000 for Grade IV scale. The expert group nurses' average degree of nursing competence measured using the scale was 3.38~3.75 out of 4.0. CONCLUSION: Through this process, 120 final questions were confirmed to represent items of the Nursing Competency Measurement Scale based on clinical grade.
Career Mobility* ; Mental Competency* ; Methods ; Nursing* ; Patients' Rooms*

No abstract available.
Rubinstein-Taybi Syndrome*

PURPOSE: To evaluate CT findings of normal anatomic alteration after neck dissection. MATERIALS AND METHODS: The postoperative CT findings were retrospectively reviewed in 40 patients with neck dissection, comparing to preoperative CT. There were 28 patients with radical neck dissection and 12 patients with modified radical neck dissection or selective neck dissection. In addition to the neck dissection, 10 patients had undergone pectoralis major myocutaneous flap reconstruction, 20 patients taken laryngectomy, and 25 patients treated with radiotherapy. RESULTS: The typical CT findings of radical neck dissection were non-visualization of internal jugular vein and sternocleidomastoid muscle(28/28), ipsilateral neck flattening(26/28), and trapezius muscular atrophy(12/28). The other non-specific findings were tissue plane eftacement, subcutaneous reticular pattern, platysma muscle thickening, and adjacent soft tissue contrast enhancement which was the only evidence of previous operation in the cases of modified radical neck dissection or selective neck dissection. Reconstruction with myocutaneous flap was shown as ipsilateral bulk of fat and muscle(10/10). In cases with radiation therapy there was much increased density of submandibular gland(12/25). 15 patients showed recurrence on follow up CT scan, including regional metastasis in 10, stomal recurrence in two, and residual mass at primary site in three patients. CONCLUSION: CT is useful in evaluation of patients with neck dissection and in whom postoperative change impese diagnostic problem.
Follow-Up Studies ; Humans ; Jugular Veins ; Laryngectomy ; Myocutaneous Flap ; Neck Dissection* ; Neck* ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Superficial Back Muscles ; Tomography, X-Ray Computed

No abstract available.
Bone Marrow* ; Necrosis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

PURPOSE: This study was performed to investigate the quantities of three neo-maternal exposures; visiting frequency, auditory contact and physical contact, and to examine the relationship between the quantities of each exposure and maternal attachment, maternal self-esteem and postpartum depression in 40 mothers of NICU babies during the first week in the NICU. METHOD: Each neo-maternal exposure was counted at every mother's visit to the newborn and maternal attachment, maternal self-esteem and postpartum depression were measured using the maternal attachment inventory, the maternal self-report inventory and Edinburgh Postpartum Depression Scale (EPDS) on the first and seventh day in the NICU. RESULT: The Mean of each neo-maternal exposure was 8.77(2.81) for the visiting frequency, 5.82(3.66) for the auditory contact and 5.60(2.89) for the physical contact during 7 days in the NICU. No significant changes were found in the scores of maternal attachment, maternal self-esteem and postpartum depression between the first and the seventh day in the NICU. The quantities of neo-maternal exposures were positively related to the scores of maternal attachment and maternal self-esteem but not related to postpartum depression. CONCLUSION: The results of the study suggest the lack of early neo-maternal exposure in cases of NICU hospitalization negate its beneficial effects on maternal psychological well-being in increasing maternal attachment and self-esteem. More efforts are neededfor the neo-maternal interaction and the reevaluation of NICU visitation hours in order to promote maternal-infant interaction.
*Self Concept ; *Object Attachment ; Mothers/psychology ; *Mother-Child Relations ; Maternal Behavior ; *Intensive Care Units, Neonatal ; Infant, Newborn ; Humans ; Female ; Depression, Postpartum/*psychology ; Adult

OBJECTIVE: We studied the expression of epidermal growh factor(EGF) and transforming growth factor(TGF)-a and epidermal growth factor receptor(EGFR) in human trophoblast and decidua at the first and third trimester. METHODS: To confirm the expression of EGF, TGF-a and EGFR immunohisochemically in human trophoblast and decidua, we used monoclonal antibodies to EGF, TGF-a and EGFR. RESULTS: Immunohistochemical stainings using anti-EGF, anti-TGF- a and anti-EGFR antibodies showed a specific stainings in human trophoblast and decidua at the first and third trimester. The staining intensity of EGF in the trophoblast was light to moderate at the first trimester and moderate at the third trimester, and that in the decidua was light to moderate at the first trimester and light at the third trimester. The patterns of expression of TGF- a in the trophoblast and decidua were similar to that seen with EGF in the trophoblast and that of EGFR in trophoblast and decidua were similar to that seen with EGF in decidua. CONCLUSION: These findings suggest that EGF, TGF-a and EGFR may play an important role in human trophoblast and decidua during gestation.
Antibodies ; Antibodies, Monoclonal ; Decidua* ; Epidermal Growth Factor* ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Receptor, Epidermal Growth Factor* ; Trophoblasts*

PURPOSE: Recently there have been some reports that percutaneous absces drainage(PAD) was ineffective in treating multiloculated liver abscess. We therefae, reviewed our results of catheter drainage in jultiloculated liver absces. MATERIALS AND METHODS: PADs in 10 cases of multiloculated liver abscesses were performed with 8.5F Pig tail, 12 & 14F Sump cahteters, under ultrasonic & fluoroscopic guidance. RESULTS: All the 10 cases were successfully drained without major complications. Mean drainage duration was 16.3 day and the result was not significantly different from those obtained by draining unilocular pyogenic liver abscess. The success was the result of using large caliber catheter and repetition in insertion of guidewire deeply into abscess cavity to make communications between the Iocules which was proven by abscessogram. CONCLUSION: PAD was safe and effective method for multiloculated abscess as unilocular liver abscess, and it is recommended that the multiloculated liver abscess be draincd.
Abscess* ; Catheters ; Drainage* ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Ultrasonics

No abstract available.
Acute Disease ; Antiviral Agents/therapeutic use ; Colon/pathology ; Colonoscopy ; DNA, Viral/blood ; Enzyme Inhibitors/therapeutic use ; Ganciclovir/therapeutic use ; Hepatitis B/diagnosis ; Humans ; Immunosuppressive Agents/adverse effects/therapeutic use ; *Liver Transplantation ; Male ; Middle Aged ; Mycophenolic Acid/therapeutic use ; Tacrolimus/adverse effects/therapeutic use ; Thrombotic Microangiopathies/chemically induced/*etiology/pathology