Primary central nervous system lymphoma (PCNSL) is a rare tumor that accounts for less than 2% of all cerebral neoplasms. A 72-year-old man had been suffering from recurrent cranial nerve palsies for several years. His condition improved with steroid treatment, but then eventually worsened; he developed encephalopathic symptoms, quadriparesis, axonal neuropathy, and skin lesions. He was eventually diagnosed with PCNSL following an examination of skin and sural nerve biopsy samples. Biopsy of skin lesions or nerves should be considered for the accurate and early diagnosis of PCNSL.
Aged ; Axons ; Biopsy ; Central Nervous System ; Cranial Nerve Diseases ; Early Diagnosis ; Humans ; Lymphoma ; Organic Chemicals ; Peripheral Nervous System ; Quadriplegia ; Skin ; Stress, Psychological ; Sural Nerve

OBJECTIVES: The aim of this study was to investigate shame-related adjectives in the Korean language and to explore the factor structure of these adjectives. METHODS: Shame-related words were extracted from an adjectives checklist, the Korean Dictionary, the Korean Synonym Dictionary, and various shame scales developed by Western investigators. A questionnaire (the Korean Shame Scale: KSS) was constructed from 62 selected adjectives, and administered to 210 college students and 204 adults. The subjects also completed the Beck Depression Inventory, the Brief-Fear of Negative Evaluation Scale, the Social Avoidance and Distress Scale, the Revised Cheek & Buss Shyness Scale, and the Marlowe-Crowne Social Desirability Scale. RESULTS: A principal component analysis of the KSS data revealed a four factor structure: mortification, modesty, shyness, and embarrassment. All except the modesty factor showed significant correlations with depression, fear of negative evaluation, social avoidance and distress, and shyness. The college student group reported experiencing a shame-related distressful emotion more frequently than the adult group. CONCLUSION: Shame was found to be a complex psychological construct composed of quite different emotions. These emotions not only included painful feelings and uncomfortable self-consciousness, but were also related to personality traits and interpersonal attitudes.
Adult ; Checklist ; Cheek ; Depression ; Factor Analysis, Statistical ; Humans ; Principal Component Analysis ; Surveys and Questionnaires ; Research Personnel ; Shame ; Shyness ; Social Desirability ; Weights and Measures

OBJECTIVES: The aim of this study was to investigate shame-related adjectives in the Korean language and to explore the factor structure of these adjectives. METHODS: Shame-related words were extracted from an adjectives checklist, the Korean Dictionary, the Korean Synonym Dictionary, and various shame scales developed by Western investigators. A questionnaire (the Korean Shame Scale: KSS) was constructed from 62 selected adjectives, and administered to 210 college students and 204 adults. The subjects also completed the Beck Depression Inventory, the Brief-Fear of Negative Evaluation Scale, the Social Avoidance and Distress Scale, the Revised Cheek & Buss Shyness Scale, and the Marlowe-Crowne Social Desirability Scale. RESULTS: A principal component analysis of the KSS data revealed a four factor structure: mortification, modesty, shyness, and embarrassment. All except the modesty factor showed significant correlations with depression, fear of negative evaluation, social avoidance and distress, and shyness. The college student group reported experiencing a shame-related distressful emotion more frequently than the adult group. CONCLUSION: Shame was found to be a complex psychological construct composed of quite different emotions. These emotions not only included painful feelings and uncomfortable self-consciousness, but were also related to personality traits and interpersonal attitudes.
Adult ; Checklist ; Cheek ; Depression ; Factor Analysis, Statistical ; Humans ; Principal Component Analysis ; Surveys and Questionnaires ; Research Personnel ; Shame ; Shyness ; Social Desirability ; Weights and Measures

OBJECTIVE: This aim of this study was to evaluate the quality and agreement of electronic medical records with paper-based medical records. METHODS: Data was collected from the paper-based medical records generated during 2004 and electronic medical records during 2007, in patients hospitalized for arterial fibrillation. The categories evaluated included the chief complaint, history of present illness, past illness, medication history, admission history, family history, allergies, smoking history, and drinking history in admission record. RESULTS: The electronic medical records scored higher for: the existence of a medical record, level of information in the medical record and agreement of information. However, there were some categories of disagreement between the information from doctors and nurses, and there were several categories with no record by doctors or nurses. CONCLUSION: The results of this study confirmed that the quality of the electronic medical record is better than that of paper-based medical with regard to: the existence of the record, level and agreement of information. However, there are discrepancies in the information contained within both types of records.
Drinking ; Electronic Health Records ; Electronics ; Electrons ; Hospital Information Systems ; Humans ; Hypersensitivity ; Medical Records ; Smoke ; Smoking

BACKGROUND: Recent studies suggest that coffee consumption has an influence on kidney function. This study investigated the relationship between habitual coffee consumption and renal impairment in Korean women, in consideration of diabetic status. METHODS: This study involved 2,673 women aged 35 to 84 years who had participated in the Fourth Korea National Health and Nutrition Examination Surveys, conducted in 2008. Habitual coffee consumption was classified into three categories: less than 1 cup per day, 1 cup per day, and 2 or more cups per day. Renal function impairment was defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m2 by the Modification of Diet in Renal Disease equation. RESULTS: The prevalence of diabetes and renal function impairment was higher in women who drank < 1 cup of coffee per day. Compared with drinking < 1 cup of coffee per day, the odds ratio (OR) for renal function impairment was significantly lower (OR, 0.59; 95% confidence interval [CI], 0.37 to 0.95; P = 0.03) in those who habitually drank > or = 2 cups per day after adjusting for multiple confounding factors. When data were stratified according to the presence of diabetes, coffee consumption > or = 2 cups of coffee per day showed an inverse association with renal function impairment in only diabetic women (OR, 0.14; 95% CI, 0.02 to 0.88; P = 0.04), compared with consumption < 1 cup of coffee per day. CONCLUSION: In a representative sample of Korean women, coffee consumption was significantly associated with a decreased risk of renal impairment especially in middle and elderly-aged diabetic women.
Aged ; Coffee ; Diabetes Mellitus ; Diet ; Drinking ; Female ; Glomerular Filtration Rate ; Humans ; Kidney ; Korea ; Nutrition Surveys ; Odds Ratio ; Prevalence

This study aimed to explore the correlation between usual vitamin K intake and response to anticoagulant therapy among patients under warfarin therapy. We conducted a retrospective survey of patients (n = 50) on continuous warfarin therapy. Clinical information and laboratory parameters were sourced from medical records. Anticoagulant effect was evaluated by using the percent time in therapeutic range (TTR) and the coefficient of variation (CV) of International normalized ratio (INR). Dietary vitamin K intake was assessed using a semi-quantitative food frequency questionnaire that has been developed for the purpose of assessing dietary intake of vitamin K. A total of 50 patients aged between 21 and 87 years were included in the study. The mean vitamin K intake was 262.8 +/- 165.2 microg/day. Study subjects were divided into tertiles according to their usual vitamin K intake. The proportion of men was significantly higher in second and third tertile than first tertile (p = 0.028). The mean percent TTR was 38.4 +/- 28.4% and CV of INR was 31.8 +/- 11.8%. Long-term warfarin therapy group (> or = 3 years) had a higher percentage of TTR as compared to the control group (< 3 years) (p = 0.046). No statistically significant correlation was found between usual vitamin K intake and percent TTR (p > 0.05). In conclusion, no significant association was observed between usual vitamin K intake and anticoagulant effects. Further studies are required to consider inter-individual variability of vitamin K intake. Development of assessment tools to measure inter-individual variability of vitamin K intake might be helpful.
Humans ; International Normalized Ratio ; Male ; Medical Records ; Retrospective Studies ; Vitamin K* ; Vitamins* ; Warfarin*

Enterohemorrhagic Escherichia coli (EHEC) is an important cause of bloody diarrhea in children, but is considered to be rare in infants. Herein, a case of infant hemorrhagic colitis of verotoxin-producing E. coli O157:H7 diagnosed by multiplex PCR is reported. A nine-month-old boy was admitted to our hospital with bloody diarrhea for the previous two days. Multiplex PCR using Seeplex(R) Diarrhea ACE Detection Kit (Seegene, Seoul, Korea) was directly applied to the stool specimens. Amplified bands specific for verotoxin, O157, and H7 indicated the presence of O157:H7 EHEC. The stool specimens were inoculated on sorbitol-MacConkey agar (SMA) and tryptic soy broth containing mitomycin C (TSB-M). Colorless colonies on sorbitol-MacConkey agar were O157-positive. TSB-M enrichment cultures of the stool specimen and the isolates were positive for verotoxin according to an enzyme immunoassay (EIA). The prepared ingredients of baby foods for the patient including ground meat, chopped carrot, chopped cabbage, and white rice porridge showed no EHEC on TSB-M and SMA. The patient's parents and three-year-old sister did not recently have any gastrointestinal symptoms. Cefdinir was administered for one day and was ceased after diagnosis of EHEC colitis. The stool culture and verotoxin assay were negative on the second day of hospitalization. Application of multiplex PCR and verotoxin EIA directly to diarrheal stool warrants the rapid diagnosis and appropriate treatment of EHEC colitis.
Agar ; Brassica ; Caseins ; Cephalosporins ; Child ; Colitis ; Daucus carota ; Diarrhea ; Enterohemorrhagic Escherichia coli ; European Continental Ancestry Group ; Hospitalization ; Humans ; Immunoenzyme Techniques ; Infant ; Meat ; Mitomycin ; Multiplex Polymerase Chain Reaction ; Parents ; Protein Hydrolysates ; Shiga Toxins ; Shiga-Toxigenic Escherichia coli ; Siblings

OBJECTIVES: Osteoclasts (OCs) are bone-resorbing multinucleated cells derived from hematopoietic progenitors of the monocyte-macrophage lineage. OC precursors, such as bone marrow-derived macrophages (BMMs), are formed in the presence of macrophage colony-stimulating factor (M-CSF) and differentiate into OCs in response to M-CSF and receptor activator of nuclear factor kappaB ligand (RANKL). In this study, we investigated the role of mixed lineage kinases (MLKs)-c-Jun amino-terminal kinase (JNK) pathways in OC formation. METHODS: We performed an OC formation assay and reverse transcription polymerase chain reaction (RT-PCR) analysis. RESULTS: We first explored the role of JNK on osteoclst formation using mouse bone marrow (BM) culture system. We found that OC formation was impaired when the JNK inhibitor was added either in early or late stage, suggesting the requirement for JNK activation during OC formation. MLKs are serine/threonine kinases that regulate signaling by the JNK. Since the JNK activity is specifically required for osteoclastogenesis, we examined the messenger ribonucleic acid (mRNA) levels of MLKs in BMs, BMMs and OCs by RT-PCR. Among MLKs, the level of MLK3 mRNA expression is highest in BMs, BMMs and OCs. Moreover, we found that the mRNA expression of MLK2 and MLK3 is increased with the differentiation of BMs to BMMs, and is sustained in OCs. Finally we investigated the role of MLK3 in OC differentiation using gene knock-down techniques. The silencing of MLK3 in BMMs partly attenuated RANKL-induced OC differentiation. CONCLUSIONS: These data suggest that JNK and MLK3 may positively regulate OC formation.
Animals ; Bone Marrow ; Gene Knockdown Techniques ; Macrophage Colony-Stimulating Factor ; Macrophages ; Mice ; Osteoclasts ; Phosphotransferases ; Polymerase Chain Reaction ; RANK Ligand ; Reverse Transcription ; RNA ; RNA, Messenger

OBJECTIVES: Osteoclasts (OCs) are bone-resorbing multinucleated cells derived from hematopoietic progenitors of the monocyte-macrophage lineage. OC precursors, such as bone marrow-derived macrophages (BMMs), are formed in the presence of macrophage colony-stimulating factor (M-CSF) and differentiate into OCs in response to M-CSF and receptor activator of nuclear factor kappaB ligand (RANKL). In this study, we investigated the role of mixed lineage kinases (MLKs)-c-Jun amino-terminal kinase (JNK) pathways in OC formation. METHODS: We performed an OC formation assay and reverse transcription polymerase chain reaction (RT-PCR) analysis. RESULTS: We first explored the role of JNK on osteoclst formation using mouse bone marrow (BM) culture system. We found that OC formation was impaired when the JNK inhibitor was added either in early or late stage, suggesting the requirement for JNK activation during OC formation. MLKs are serine/threonine kinases that regulate signaling by the JNK. Since the JNK activity is specifically required for osteoclastogenesis, we examined the messenger ribonucleic acid (mRNA) levels of MLKs in BMs, BMMs and OCs by RT-PCR. Among MLKs, the level of MLK3 mRNA expression is highest in BMs, BMMs and OCs. Moreover, we found that the mRNA expression of MLK2 and MLK3 is increased with the differentiation of BMs to BMMs, and is sustained in OCs. Finally we investigated the role of MLK3 in OC differentiation using gene knock-down techniques. The silencing of MLK3 in BMMs partly attenuated RANKL-induced OC differentiation. CONCLUSIONS: These data suggest that JNK and MLK3 may positively regulate OC formation.
Animals ; Bone Marrow ; Gene Knockdown Techniques ; Macrophage Colony-Stimulating Factor ; Macrophages ; Mice ; Osteoclasts ; Phosphotransferases ; Polymerase Chain Reaction ; RANK Ligand ; Reverse Transcription ; RNA ; RNA, Messenger

Tracheal intubation for general anesthesia is usually performed using a rigid laryngoscope and reguires the mandible to be opened with forward and upward traction of the patient's jaw which may at times result in the inadvertant injury to temporomandibular joint(TMJ). The injury may include internal derangement, dislocation and hematoma of TMJ; subsequent intraarticular adhesion formation ; dislocation of the meniscus, and rarely auriculotemporal nerve damage from traumatic TMJ dislocation. We studied in 200 patients the size of mouth opening during intubation, the change of mouth opening by tracheal intubation evaluated after operation, and any TMJ disorder arising after tracheal intubation. The results were as follows; 1) The mean size of mouth opening before operation was 42.7+/-7.0 and 40.6+/-6.2mm in male and female patients, respectively. 2) The mean size of mouth opening during intubation was 24.7+/-2.6 and 23.4+/-2.7mm in male and female patients, respectively. When vecuronium was used to prevent fasciculation, the mean was 24.3+/-3.1 and 25.2+/-2.0mm in male and female patients, respectively. 3) One week following operation The mean size of mouth opening one week postoperation was 48.3+/-8.9 and 42.2+/-6.3mm in male and female patients, respectively. When vecuronium was used to prevent fasciculation, the mean size of mouth opening was 55.5+/-5.3 and 43.2+/-6.2mm in male and female patients, respectively. 4) Five patients complained of discomfort around TMJ after tracheal intubation. It seems that upward 45 mandibule lifting by laryngoscope caused trauma to TMJs.
Anesthesia, General ; Dislocations ; Fasciculation ; Female ; Hematoma ; Humans ; Intubation ; Intubation, Intratracheal* ; Jaw ; Laryngoscopes ; Lifting ; Male ; Mandible ; Mouth ; Temporomandibular Joint Disorders ; Temporomandibular Joint* ; Traction ; Vecuronium Bromide