A 55-year-old woman suffered from upper abdominal pain for two months and remained refractile against the anti-ulcer regimen. The palliative gastrectomy specimen revealed multiple shallow ulcerations on the thickened mucosal folds mainly in the antrum and body along the greater curvature where multiple, whitish nodules were found in the submucosa. Microscopically, individual submucosal nodules clearly corresponded to the necrotizing granulomatous vasculitis which were featured with diffuse fibrinoid necrosis of arterial walls accompanying granuloma formation and heavy infiltration of neutrophils, eosinophils, histiocytes and giant cells. Similar vasculitic lesions involved venules and arterioles. There were scattered vasculitic changes in the liver biopsy specimens and omentum. There were no clinical presentations or serological support of systemic involvement including systemic lupus erythematosus, Henoch-Schoenlein purpura, cryoglobulinemia or Churg-Strauss granulomatous vasculitis. We conclude that this is a hitherto undescribed primary necrotizing granulomatous vasculitis predominantly involving the stomach.
Abdominal Pain ; Arterioles ; Biopsy ; Cryoglobulinemia ; Eosinophils ; Female ; Gastrectomy ; Giant Cells ; Granuloma ; Histiocytes ; Humans ; Liver ; Lupus Erythematosus, Systemic ; Middle Aged ; Necrosis ; Neutrophils ; Omentum ; Purpura, Schoenlein-Henoch ; Stomach* ; Ulcer ; Vasculitis* ; Venules

OBJECTIVE: To investigate the patterns of the temperature effect on motor nerve conduction parameters according to various warming methods and to obtain the most valuable method of warming in clinical setting. METHOD: Twenty normal subjects were studied. After limb cooling in cold water, the cooled hands were warmed by hot pack, fan heater, and whirl pool. The median motor responses were recorded at abdnctor pollicis brevis after the stimulation at the wrist during warming at 1 min interval until the temperature increment reached plateau. We measured the temperature changes and conduction parameters were measured at each examination. RESULTS: The time constants for temperature increment and distal motor latency, duration, area of compound muscle action potentials showed shorter tendency by hot pack and whirl pool than by fan heater (p<0.05). For the measurement of distal motor latency, time constant of whirl pool (2.49 1.21 min) was shorter than that of fan heater (7.12 3.12 min) or hot pack (5.96 1.98 min) (p<0.05). CONCLUSION: These findings suggest that the use of whirl pool is the most effective method for warming of the cooled limb.
Action Potentials ; Extremities ; Hand ; Neural Conduction* ; Water ; Wrist

OBJECTIVE: The purpose of this study was to determine the difference of temperature effects on the nerve conduction variables and to obtain correction factors for temperature in demyelinated and normal peripheral nerves. METHOD: The compound muscle action potentials (CMAPs) were recorded with wrist stimulation during cooling and warming in 10 control subjects and 13 subjects with demyelinating neuropathies. The temperature of cooling and warming were 18degrees C and 40degrees C, respectively. The time of cooling and warming were 60 minutes and composed of successive 4 sessions of 15 minutes. The skin temperature of thenar area, latency, amplitude, duration, and area of CMAPs were measured before and after each session of 15 minutes of cooling or warming. RESULTS: The time constants of parameters of CMAPs were of higher tendency in cooling than in warming. The time constants of latency of CMAP were higher in subjects with demyelinating neuropathy than in controls (p<0.05): 33.3+/-4.0 minutes versus 27.2+/-2.2 minutes in cooling; 30.0+/-7.8 minutes versus 19.6+/-3.3 minutes in warming. The temperature correction factor of latency of CMAPs was 0.23+/-0.03 msec/degrees C in control and 0.33+/-0.06 msec/degrees C in subjects with demyelinating neuropathies (p<0.05). CONCLUSION: When studying a subject with demyelinating neuropathies, we should warm the extremity for more sufficient time than in normal subject, or may applicate a differenct temperature correction factors.
Action Potentials ; Extremities ; Neural Conduction ; Peripheral Nerves ; Peripheral Nervous System Diseases* ; Skin Temperature ; Wrist

Objective: The purpose of this study was to investigate the related factors of elderly depression among Korean adults aged 60 years and above. Methods: From the database of Korea National Health and Nutrition Examination Survey conducted in 2018, data of 2,288 adults over age 60 who responded to the questionnaires of health interview were included in this study. We analyzed the data using logistic regression analysis. Results: According to our results, the number of chronic diseases seemed to be associated with depression in elderly people, es-pecially when they have more than 4 chronic diseases. Poorer self-rated health was identified as a significant factor and the odd ratio was the highest among all independent variables in our study. Walking over 10 minutes more than 4 times a week was considered as a protective factor for elderly depression. The association between education level and depression was inconsistent. Variables such as female gender, single status, smoking showed statistically insignificant results. Older age itself was not identified as a risk factor as odd ratios of all groups (over age 65) compared to reference group (age 60-64) were below 1. Conclusion This study confirms several related factors for elderly depression. Having more than 4 chronic diseases, poorer self-rated health were identified as a significant risk factor for depression. Regular walking was considered as a protective factor for elderly depression. The knowledge of these factors might help to manage risks of elderly depression and devise early intervention approaches.

We reviewed the clinical features, prevalence, pathophysiology, and prevention and treatment of delirium in patients with coronavirus disease of 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, has neurotropic properties, and can penetrate the central nervous system and affect brain neurons. These characteristics may explain the fact that COVID-19 patients may be particularly susceptible to delirium. COVID-19 delirium occurred more frequently in intensive care unit and emergency room settings. Patients with neurologic disorders and the elderly were more vulnerable to delirium. Clinical symptoms of COVID-19 delirium may manifest as a hyper/hypoactive type. Prevention and treatment appear to be similar to conventional treatment strategies. And the patient’s feeling of isolation due to social distancing and a highly intensive labor force of medical personnel must be overcome. Melatonin, alpha-2 agonist, antipsychotics, and valproic acid have been recommended for the treatment of delirium symptoms. However, this article did not go through a systematic literature review.

PURPOSE: This study was conducted to examine the effects of a multicultural course on nursing students' multicultural acceptability and competency. METHODS: The research design for this study was a non-equivalent control group, non-synchronized pre- and post-test. The experimental group (n=28) took 13 weeks of the multicultural course, while the control group (n=28) received only regular classes over the same period. Pre- and post-tests were done to identify the effects of the program. The data were collected using self-administered questionnaires and analyzed using the PASW 18.0 program. RESULTS: All indices of multicultural acceptability and competency in the experimental group were significantly higher than that of control group after the program, except for two: universality (a measure of multicultural acceptability) and multicultural awareness (a measure of multicultural competency). CONCLUSION: These results suggest that the multicultural course was effective in elevating the level of multicultural acceptability and competency among nursing students.
Cultural Competency ; Humans ; Nursing* ; Research Design ; Students, Nursing*

Neutrophils are important effector cells against protozoan extracellular parasite Entamoeba histolytica, which causes amoebic colitis and liver abscess in human beings. Apoptotic cell death of neutrophils is an important event in the resolution of inflammation and parasite's survival in vivo. This study was undertaken to investigate the ultrastructural aspects of apoptotic cells during neutrophil death triggered by Entamoeba histolytica. Isolated human neutrophils from the peripheral blood were incubated with or without live trophozoites of E. histolytica and examined by transmission electron microscopy (TEM). Neutrophils incubated with E. histolytica were observed to show apoptotic characteristics, such as compaction of the nuclear chromatin and swelling of the nuclear envelop. In contrast, neutrophils incubated in the absence of the amoeba had many protrusions of irregular cell surfaces and heterogenous nuclear chromatin. Therefore, it is suggested that Entamoeba-induced neutrophil apoptosis contribute to prevent unwanted tissue inflammation and damage in the amoeba-invaded lesions in vivo.
Animals ; Apoptosis/*physiology ; Entamoeba histolytica/*physiology ; Host-Parasite Relations/physiology ; Humans ; In Vitro ; Neutrophils/physiology/*ultrastructure ; Research Support, Non-U.S. Gov't

PURPOSE: Macro language was programmed to analyze and process on Macintosh personal computers GE MR imagesdigitally transferred from the MR main computer, with special interest in the interpretation of information such as patients data and imaging parameters under each image header. By this method, raw data(files) of certain patients may be digitally stored on a hard disk or CD ROM, and the quantitative analysis, interpretation anddisplay is possible. MATERIALS AND METHODS: Patients and images were randomly selected. 4.X MR images were transferred through FTP using the ethernet network. 5.X and SPECT images were transferred using floppy diskets. Toprocess transferred images, an freely distributed software for Macintosh namely NIH Image, with its macrolanguage, was used to import images and translate header information. To identify necessary information, aseparate window named "Info-txt", was made for each image series. MacLC, Centris650, and PowerMac 6100/CD,7100/CD, 8100/CD models with 256 color and RAM over 8 Mbyte were used. RESULTS: Different versions of MR images and SPECT images were displayed simultaneously and a separate window named "Info-txt" was used to show all necessary information(name of the patient, unit number, date, TR, TE, FOV etc.). Additional information(diagnosis,pathologic report etc.) was stored in another text box in "Info-txt". The size of the file for each image planewas about 149 Kbytes and the images were stored in a step-like file folders. CONCLUSION: 4.X and 5.X GE Signa 1.5T images were successfully processed with Macintosh computer and NIH Image. This result may be applied to manyfields and there is hope of a broader area of application with the linkage of NIH Image and a database program.
Hope ; Humans ; Microcomputers* ; Tomography, Emission-Computed, Single-Photon* ; Information Storage and Retrieval

As the prevalence of hypertension in the elderly population is increasing, information regarding the characteristics, optimal blood pressure targets, and special considerations for elderly hypertensive patients is needed to improve clinical outcomes. Various factors should be considered when managing hypertension in elderly patients, and there are many controversial issues and conflicting results related to the optimal treatment of hypertension in the elderly. In this review, we provide an overview of the epidemiology and characteristics of elderly hypertensive patients and discuss the optimal treatment of hypertension in elderly people.

BACKGROUND: Kinesio taping is a treatment for pain and dysfunction of musculoskeletal system, using tapes which have a similar elasticity to skin. This study was done to find out about the efficacy of kinesio taping on patients with a low back pain. METHODS: This study was performed in patients with a non-specific low back pain who had visited the Inchon International Airport Construction Authority Clinic from January 2000 to April 2000. We performed taping to a randomized case group and a placebo to control group during the first 3 days. After the first 3 days, we assessed the changes of improvement in low back pain with visual-analogue pain scale (VAS) . From the second visit on, we also started carrying out kinesio taping in the control group. RESULTS: The total number of patients participating in this study was 43, but 4 patients did not complete the study stopped. After the first 3 days, control group showed just 0.93 of the VAS score improvement, while randomized case group showed 2.55(p=0.003). The VAS score of case and control group were 3.18 and 3.03 respectively, which showed improvement at the end point of treatment compared with the first score. CONCLUSIONS: Kinesio taping was more efficacious than placebo in patients with a nonspecific low back pain.
Airports ; Elasticity ; Humans ; Incheon ; Low Back Pain* ; Musculoskeletal System ; Skin