Objectives: This study examined the level of depression and anxiety and the related factors, especially the knowledge and attitudes towards dementia, of people caring for a family member with dementia. Methods: Data on the demographics, care burdens, and clinical characteristics of dementia patients and their family caregivers were collected. The Center for Epidemiologic Studies Depression Scale (CES-D) and Korean Screening Tool for Anxiety disorders (K-ANX), Dementia Knowledge Scale (DKS), and Dementia Attitudes Scale (DAS) were performed. This study investigated whether depression and anxiety of caregivers differed according to the caregivers, patients, and the burden of caregivers. Multiple regression analysis was performed to investigate the potential factors that may influence the psychological symptoms in family caregivers. Results: There were 135 respondents. The scores of CES-D and K-ANX were 19.18±12.05 (probable depression) and 11.48±8.88 (mild anxiety), respectively. There was a significant difference in the degree of depression according to the level of education (F=4.14, p<0.05), the severity of dementia (F=3.63, p<0.05), and cohabitation with patients with dementia (t=2.07, p<0.05). On the other hand, the difference in the degree of anxiety was not significant depending on the stratified potential factors. The degree of depression in caregivers was positively associated with severe dementia (β=0.252, p<0.01) and negatively associated with the DAS score (β= -0.392, p<0.001). Anxiety was only inversely affected by the DAS score (β=-0.369, p<0.001). Conclusion This study shows that family caregivers of people with dementia experience high levels of depression and anxiety, which are influenced by the patient’s severity of dementia and the caregiver’s attitude toward dementia.

The inferior alveolar nerve block is the most common method of local anesthesia for intraoral surgery at the posterior mandibular region. However, unexpected complications may occur when administering the local anesthesia. One of these uncommon complications is the fracture of the needle. If the injection needle is broken during the surgery, it should be removed immediately. However, this is one of the most difficult procedures. In this report, we present two cases of needle fracture during the procedure, and its successful removal under general/local anesthesia administration.
Anesthesia ; Anesthesia, Local ; Mandibular Nerve* ; Methods ; Needles* ; Nerve Block

PURPOSE: This study was to examine the effects of treadmill gait training at different controlled inclinations on the standing balance of hemiplegic patients caused by cerebrovascular injury. METHODS: The study's subjects were 44 patients with chronic stroke, randomly divided into three experimental groups: 0° treadmill gait training (n=14), 5° treadmill gait training (n=15), and 10° treadmill gait training (n=15). In addition to conventional physical therapy, the subjects underwent gait training on a treadmill with one of three different inclinations for 30 min per session five times per week for six weeks. The Biodex balance system SD, Berg balance scale, and timed up and go tests were used to measure the postural balance of the patients. RESULTS: This study showed that gait training on a treadmill at controlled inclinations of 0°, 5°, and 10° positively influenced the stroke patients' standing balance. The 5° and 10° inclination gait training groups showed significantly more improvement than the 0° inclination group. CONCLUSION: Gait training on a treadmill with inclinations of 0°, 5°, or 10° can be said to positively affect the postural balance of hemiplegic patients due to stroke. In particular, 5° and 10° inclination gait training offered more significant improvement than the 0° inclination gait training group. When added to regular treatment routines, gait training at controlled inclinations is an effective intervention for improving hemiplegia due to postural balance.
Gait* ; Hemiplegia ; Humans ; Postural Balance* ; Stroke*

Lactobacillus salivarius JWS 58 (JWS 58) and Lactobacillus plantarum JWS 1354 (JWS 1354) are isolated from duck intestine and have ability to produce bacteriocin. The objective of this study was to evaluate the immunomodulatory effects of JWS 58 and JWS 1354. The nitric oxide (NO) and cytokines (IL-1beta and TNF-alpha) were measured in C57BL/6 mouse peritoneal macrophages to determine immune enhancing effects of JWS 58 and JWS 1354. A Listeria (L.) monocytogenes challenge mice model was used to evaluate immune enhancement ability of JWS 58 and JWS 1354 in vivo. The results showed that JWS 58 and JWS 1354 increased the production of NO or cytokines by peritoneal macrophages and that oral administration of viable probiotic strains in mice elicited the immuno-modulatory effect upon L. monocytogenes challenge. JWS 1354 showed stronger immune enhancing effects than JWS 58. Collectively, this study demonstrated that Lactobacillus strain JWS 58 and JWS 1354 possess immune enhancing effect. Furthermore, two stains are expected to use feed supplement to prevent diseases by pathogenic bacteria through releasing bacteriocin and enhancing host immune responses in animal.
Administration, Oral ; Animals ; Bacteria ; Coloring Agents ; Cytokines ; Ducks ; Intestines ; Lactobacillus ; Lactobacillus plantarum ; Listeria ; Macrophages, Peritoneal ; Mice ; Nitric Oxide ; Probiotics ; Sprains and Strains

OBJECTIVE: Although middle cerebral artery (MCA) aneurysms are less amenable to coil embolization, an increasing number of studies support favorable endovascular treatment for them. The purpose of this study is to compare the outcomes of two different treatments (surgery versus coiling) and evaluate the benefits of surgical clipping for MCA aneurysms. METHODS: Here we retrospectively analyzed the outcomes of 178 ruptured and unruptured MCA aneurysms treated in patients between September 2008 and April 2012. Parameters assessing treatment outcomes include degree of aneurysm occlusion, presence of regrowth, clinical status, and complications. RESULTS: Among 178 MCA aneurysms, 153 were treated surgically. After a mean follow-up of 12 months, the surgery group showed a clinically significant complete occlusion rate (98%) compared with the coiling group (56%) (p<0.001). Follow-up radiologic evaluation showed a higher regrowth rate (four of 16 cases) in the coiling group than in the surgery group (one of 49 cases) (p=0.003). There was no statistically significant difference in favorable clinical outcome rate between the two groups. The procedure-related permanent morbidity and mortality rates were 2% (three of 153 cases) in the surgery group and 0% (0 of 25 cases) in the coiling group. CONCLUSION: Compared to endovascular treatment, surgical neck clipping for both ruptured and unruptured MCA aneurysms results in a significantly higher complete obliteration rate and less regrowth. Therefore, even in this endovascular era, we still recommend surgical clipping as the primary treatment option for MCA aneurysms rather than coil embolization.
Aneurysm* ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery* ; Mortality ; Neck* ; Retrospective Studies ; Surgical Instruments

In Korea, cases of direct insertion of foreign bodies into the rectum are rare in the literature. Most cases of rectal insertion of foreign bodies are associated with sexual acts and psychiatric disorder such as schizophrenia. Objects inserted into the anus are usually blunt and shaped like the male genitalia. The removal method can be varied depending on the size and shape of the foreign object, its anatomical location, and the accompanying complications. In cases wherein attempts to remove the object fail or there are rectal perforation and peritonitis complications, immediate laparotomy may be required in order to prevent serious complications such as sepsis. Here, we report on a case of rectal perforation and peritonitis due to insertion of a foreign body in a middle-aged patient, with a literature review. He inserted a sharp pig backbone in his rectum and he only had depression. The patient underwent a Hartmann's operation as well as psychiatric counseling and treatment. Thus, after removal of foreign bodies, psychiatric counseling and treatment should be carried out in order to prevent similar accidents and to minimize the need for trauma medicine.
Anal Canal ; Counseling ; Depression* ; Foreign Bodies ; Genitalia, Male ; Humans ; Korea ; Laparotomy ; Male ; Peritonitis ; Rectum ; Schizophrenia ; Sepsis

The approach to ethmoidal dural arteriovenous fistulas (eDAVFs) is usually via a pterional or a frontal craniotomy. However, the transfrontal sinus is a more direct route to the fistula. The aim of this report is to describe our experience and associated complications occurring as a result of flow diversion in the transfrontal sinus approach for eDAVFs. In this report, we discuss visual field defects occurring after a transfrontal sinus operation. This approach is most direct for surgical treatment of an eDAVF, enabling preservation of neural structures with minimal to no negative effects on the brain. Although the surgery was uneventful, the patient presented with a left side visual field defect. An ophthalmologic exam detected an arterial filling delay in the choroidal membrane and ischemic optic neuropathy was highly suspected. The patient is currently recovering under close observation with no special treatment. The transfrontal sinus approach provides the most direct and shortest route for eDAVFs, while minimizing intraoperative bleeding. However, complications, such as visual field defects may result from a sudden flow diversion or eyeball compression due to scalp traction.
Brain ; Central Nervous System Vascular Malformations* ; Choroid ; Craniotomy ; Fistula ; Frontal Sinus ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations ; Membranes ; Optic Neuropathy, Ischemic ; Scalp ; Traction ; Visual Fields*

A 36-year-old man visited Yeungnam University Hospital with a sudden onset of palpitation, headache, and was found to be hypertensive. Chest radiography showed a 6 cm sized mass lesion on the posterior mediastinum. A biochemical study showed elevated levels of catecholamines. An I-123 metaiodobenzylguanidine scan revealed a hot uptake lesion on the posterior mediastinum. The patient was prepared for surgery with alpha and beta blocking agents. Two months later, we removed the tumor successfully. A histological study proved that the resected tumor was mediastinal pheochromocytoma. Functional mediastinal pheochromocytomas are rare. Therefore, we reported the case with a literature review.
Catecholamines ; Headache ; Humans ; Hypertension ; Mediastinum ; Pheochromocytoma ; Thorax

Omental pregnancy is an extremely rare form of abdominal pregnancy that may cause life threatening massive hemorrhage in case of rupture. It may occur by primary implantation of the fertilized ovum in the omentum. The diagnosis is very difficult, but prompt surgical intervention is required when it is suspected, because perinatal mortality and maternal mortality in abdominal pregnancy were 85~95% and 0.5~6%. We experienced a case of omental pregnancy in the first times and reported it with brief review of literature.
Diagnosis ; Female ; Hemorrhage ; Maternal Mortality ; Omentum ; Perinatal Mortality ; Pregnancy* ; Pregnancy, Abdominal ; Rupture ; Zygote

Social discrimination against people with epilepsy is a common phenomenon all over the world, in spite of different cultural backgrounds. To know the public attitude toward epilepsy in Chonnam rural area, questionnaire survey was performed. Total 802 people answered to the questionnaire which consisted of 39 parts on several aspects of attitude and knowledge for epilepsy. The results were as follows; 1) In Chonnam rural area, epilepsy was a well known illness. 2) The incantatory, supernatal thinking was markedly prevalent, compared with other societies. 3) The social attitude for the jobs of epileptic people was negative even in the well controlled cases. 4) The prejudice was more serious in the lower educated people, and in the female group 5) The most important factor leading to the inadequate social attitude toward epilepsy was the knowledge, "epilepsy could not be treated." Public education and campaign for epilepsy should be considered to improve the quality of life of epileptic patients in rural areas.
Education ; Epilepsy* ; Female ; Humans ; Jeollanam-do* ; Prejudice ; Quality of Life ; Surveys and Questionnaires ; Social Discrimination ; Thinking