Many pathological surveys of brain tissue in patients with intractable epilepsy have been reported. There have been, however, few studies focused on the differences between childhood and adults in pathological alterations of brain. We retrospectively analyzed histopathology of 164 lobectomy specimens for intractable epilepsy in view of the differences between children and adults. Among 164 cases, 28 cases were children (less than 15 years) and 136 cases adults. We compared frequency of histopathologic features, distribution of involved cortex (temporal or extratemporal lobe), previous injury histories, such as brain trauma, encephalitis or febrile seizure, and coexistence of other lesions (dual pathology) between two groups. Pathologic alterations were encountered in 92% of 164 patients. In children focal cortical dysplasia (n=16, 57.1%), neoplasm (n=8, 28.6%), hippocampal sclerosis (n=6, 21.4%), cortical tuber (n=1, 3.6%), leukomalacia (n=1, 3.6%), and Rasmussen's encephalitis (n=1, 3.6%) were observed, whereas focal cortical dysplasia (n=81, 59.6%), hippocampal sclerosis (n=80, 58.8%), neoplasm (n=19, 14%), and cerebral cysticercosis (n=3, 2.2%) were found in adults. Pediatric patients had a higher proportion of severe focal cortical dysplasia (17.9% in children, 0.7% in adults). Neoplasia and extratemporal lobe involvement were more commonly found in children (28.6%, 50%) than in adults (14.0%, 24.3%), whereas hippocampal sclerosis and dual pathology were more common in adults (58.8%, 44.9%) than in children (21.4%, 17.9%). Previous injury history was statistically significant in patients with hippocampal sclerosis, and lent support to the hypothesis that hippocampal sclerosis is related with acquired lesions. Incidence of focal cortical dysplasia was nearly similar in both adult (59.6%) and pediatric groups (57.1%), and supported the hypothesis that focal cortical dysplasia is developmental abnormality occurring during a prenatal period.
Adult* ; Brain ; Brain Injuries ; Child* ; Cysticercosis ; Encephalitis ; Epilepsy ; Epilepsy, Temporal Lobe ; Humans ; Incidence ; Malformations of Cortical Development ; Pathology ; Retrospective Studies ; Sclerosis ; Seizures* ; Seizures, Febrile

BACKGROUND: Chicken pox and herpes zoster are caused by the varicella-zoster virus(VZV). To investigate the epiderniologial relationship between clinical isolates of VZV, it is essential to distinguish different isolate. OBJECTIVE: This study was conducted to classify the VZV strains according to R5 tandem direct reiterations(TDR) copy numbers and Pst I endonuclease cleavage site mutation, and to analyze the distribution pattern of VZV strains isolated in Korea. METHODS: Strains of VZV were isolated from 61 patients with herpes zoster who had not been immunized with a live vaccine of VZV. Copy numbers of R5 TDR which was located in variable region IV were measured by PCR. The presence of a Pst I cleavage site in a middle portion of the long unique region of VZV genome was analyzed by PCR thereafter restriction enzyme digestion(PCR-RFLP). RESULTS: VZV strains isolated in Korea contained one to three copy numbers of R5 TDR. Of 61 isolates, 43(70%) comtained 2 copies of R5 TDR, while 11(18%) isolates contained only one copy and 7(12%) isolat s contained 3 copies. About 16% of the strains examined did not have a PstI cleavage site, although the majority of strains retained this site. VZV strains could be classified into 6 strains on the basis of the copy number of R5 TDR and PstI cleavage site, in which the strain with 2 copies of R5 TDR and PstI cleavage site positive was the most frequent type (36 out of 61 isolates) in Korea. Four batches of live attenuated vaccine(Biken) that is now used in Korea showed 2 copy numbers of R5 TDR and PstI site negative. CONCLUSION: The copy number of R5 TDR and the presence of PstI cleavage site seems to be a reliable marker for dicrimination of VZV strains in Korea. This discrimination can be used to study the molecular epiclemiology of VZV and as a criterion for identification of vaccine-related isolates.
Chickenpox* ; Discrimination (Psychology) ; Genome ; Herpes Zoster* ; Humans ; Korea* ; Polymerase Chain Reaction ; Repetitive Sequences, Nucleic Acid*

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is administered for a few days after lung transplantation (LTx) in recipients who are expected to have early graft dysfunction. Despite its life-saving potential, immediate postoperative ECMO has life-threatening complications such as postoperative bleeding. We investigated the risk factors related to the use of immediate postoperative ECMO. METHODS: We retrospectively reviewed the records of 60 LTx patients who were at our institution from October 2012 to May 2015. Perioperative variables associated with postoperative ECMO were compared between the two groups. RESULTS: There were 26 patients who received postoperative ECMO (ECMO group) and 34 patients who did not (control group). Multivariate regression analysis revealed preoperative ECMO (odds ratio [OR] 12.55, 95% confidence intervals [CI] 1.34 - 117.24, p = 0.027) and lower peripheral pulse oxymetry saturation (SpO2) at the end of surgery (OR 0.71, 95% CI 0.54 - 0.95, p = 0.019) were independent risk factors for postoperative ECMO in LTx patients. The incidences of complications, such as re-operation, tracheostomy, renal failure and postoperative atrial fibrillation, were higher in the ECMO group. There was no difference in the duration of postoperative intensive care unit stay or postoperative 30-day mortality between the two groups. CONCLUSIONS: The preoperative ECMO and lower SpO2 at the end of surgery were associated with postoperative ECMO. Further, postoperative adverse events were higher in the ECMO group compared with the control group. This study suggests that determination of postoperative ECMO requires careful consideration because of the risks of postoperative ECMO in LTx patients.
Atrial Fibrillation ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Humans ; Incidence ; Intensive Care Units ; Lung Transplantation ; Lung* ; Mortality ; Renal Insufficiency ; Retrospective Studies ; Risk Factors* ; Tracheostomy ; Transplants ; Weaning

PURPOSE: The mechanism of hypoxic damage is mainly intracellular influx of calcium ions through the glutamate ionotropic receptor(NMDA, AMPA/kainate). This study was performed to determine alterations in distribution and expression of AMPA receptor subunits after 1-hour of moderate hypoxia in the newborn piglet brain, in a state of mild to moderate perinatal hypoxic-ischemic encephalopathy. METHODS: Ten newborn piglets were mechanically ventilated with a mixture of 21% oxygen and 79% nitrous oxide at PaO2 over 80mmHg for 30min. Thereafter, control group(n=5) was ventilated with 21% oxygen for 1-hour, and hypoxic group(n=5) was ventilated with 6% oxygen at PaO2 below 25mmHg for 1-hour. Concentrations of protein, adenosine triphosphate(ATP) and phosphocreatine were determined. The proteins were immunostained with anti-rat glutamate receptor 1(GluR1), anti-rat GluR2/3 and anti-rat GluR4 antibody. RESULTS: Hypoxia(PaO2 20+/-1mmHg) and acidosis(pH 7.06+/-0.09) developed significantly in the hypoxic group compared to the control group(PaO2 104+/-4mmHg, pH 7.44+/-0.03, respectively, P<0.01). Concentrations of ATP(2.84+/-1.28micromol/kg brain, P<0.05) and phosphocreatine(0.78+/-1.07micromol/kg brain, P<0.001) were significantly reduced compared to the control group(5.04+/-0.25micromol/kg brain, 4.03+/-0.31micromol/kg brain, respectively). The protein contents of GluR1 and GluR2/3 subunits were ordered; hippocampus > cerebral cortex, thalamus, basal ganglia, hypothalamus > white matter, cerebellum, and the protein contents of GluR4 subunits were observed in the cerebellum only. The distribution of GluR1, GluR2/3, and GluR4 subunits between the hypoxic group and control group were similar. CONCLUSION: GluR1 and GluR2/3 subunits were highly distributed in the hippocampus and cere bral cortex, and GluR4 subunits in the cerebellum. These regions may be the most vulnerable to excitotoxic injury. In addition, AMPA receptor subunits did not change after 1-hour of moderate hypoxia.
Adenosine ; Anoxia ; Basal Ganglia ; Brain* ; Calcium ; Cerebellum ; Cerebral Cortex ; Glutamic Acid ; Hippocampus ; Humans ; Hydrogen-Ion Concentration ; Hypothalamus ; Hypoxia-Ischemia, Brain ; Infant, Newborn* ; Ions ; Nitrous Oxide ; Oxygen ; Phosphocreatine ; Receptors, AMPA ; Receptors, Glutamate ; Thalamus

No abstract available.
Dermatitis, Atopic ; Pyroglyphidae

Creutzfeldt-Jakob disease(CJD) is characterized clinically by rapidly progressive dementia with pyramidal, extrapyramidal, and cerebellar symptoms and signs, and histologically by spongiform change, neuronal loss and reactive gliosis. We have experienced 2 cases of CJD. Case 1 was a 36-year-old male who had suffered from myoclonus and cerebellar symptoms including sluggish speech, gait and balance disturbance. Case 2 was a 70-year-old female who had showed cognitive dysfunction, ataxic gait and disturbance of extraocular movement. Both patients, underwent brain biopsy. Case 1 revealed marked cortical atrophy, 2mm in thickness, with neuronal loss and astrocytic proliferation extending into white matter. The spongiform change, made up of many small, usually rounded or oval, vacuoles was noted mainly in the neuropil. Case 2 revealed remarkable spongiform change throughout the cortex and cytoplasmic vacuoles compressing the nuclei of neuronal cells were numerous. Neuronal loss and gliosis were also found without considerable change in the white matter. On double immunostaining against GFAP and PrP(Prion Protein), there was a weak positive reaction for PrP in the perinuclear cytoplasm in case 1, and a strongly positive reaction in case 2. The electron microscopic examination showed numerous membrane-bound vacuoles in neuropil and perikarya of neurons. The majority of the vacuoles were multiseptated by thin membranous structures. They demonstrated curled, or disrupted membrane, that had foldings and protrusions into the vacuolar clear spaces. There were neither identifiable virus-like particles nor amyloid deposition.
Female ; Male ; Humans

PURPOSE: This study aimed to investigate the effects of a secondary stroke prevention education program on the health risk indicators and self-care compliance of stroke patients. METHODS: A non-equivalent control group pretest-posttest design was used to select the participants. Subjects were 54 stroke patients (27 in the experimental group and 27 in the control group) hospitalized in a K university hospital in D city, Korea. Health risk indicators and self-care compliance were measured both for a baseline, as well as after intervention. The data was analyzed using a chi-square test, paired t-test and ANCOVA. RESULTS: There were significant differences in systolic blood pressure, diastolic blood pressure, fasting blood sugar, weight and self-care compliance. CONCLUSION: The results of the study indicate that an educational secondary stroke prevention program is effective for health risk indicators and self-care compliance of patients. Therefore it can be used as an effective nursing intervention in clinical practice.
Blood Glucose ; Blood Pressure ; Compliance* ; Education ; Fasting ; Humans ; Korea ; Nursing ; Secondary Prevention ; Self Care* ; Stroke*

Purpose: This study aimed to examine the pediatric sedation knowledge and performance of nurses in tertiary hospitals. Methods: Altogether 120 nurses working in the Pediatric Departments of 4 tertiary hospitals in Busan and Kyungnam participated in this descriptive survey. The questionnaire was developed based on domestic and international guidelines and consisted of 40 questions including 18 questions on knowledge and 22 on the performance level of sedation nursing. Results: The mean score regarding the knowledge of pediatric sedation care was 3.14 points and the mean performance level score was 3.44 points. Questions that received low scores in terms of pediatric sedation care knowledge included items regarding the latest policies, level of sedation, and fasting before sedation. Questions that received low scores in the performance level included items regarding psychological preparation before sedation, sedation education considering developmental level and disease, and items related to blood pressure measurement. Pediatric sedation knowledge scores were higher in the groups with higher age, longer clinical experience, higher educational experience, and awareness of sedation guidelines. Performance scores were significantly higher in the groups having educational experience in pediatric sedation and in those exhibiting awareness of sedation guidelines. Conclusion Sedation education was significantly associated with both knowledge and performance of sedation nursing, conducting educational programs on pediatric sedation nursing.

PURPOSE: This study was conducted to examine an exercise program using a lay health leader for elderly participants. The test covered physical fitness (grip strength, static balance and complex movement abilities), depression, cognitive function and quality of life. METHODS: A quasi-experimental study using a non-equivalent control group pre-post design was employed. The participants were 62 elders from an institution for the aged, of whom 30 were included in the experimental group and 32 in the control group. The exercise program using a resident volunteer as a lay health leader was run three times a week for 12 weeks. The collected data were analyzed by chi2 test, t-test, paired t-test, and ANCOVA with SPSS/WIN 19.0. RESULTS: After the program, left grip strength (F=1.77, p<.001), right grip strength (F=9.97, p<.001), static balance (F=2.79, p<.001), ability to move complex (F=1.76, p<.001), depression (F=7.66, p<.001), the cognitive function (F=8.39, p<.001) and quality of life (F=1.08, p<.001) in the experimental group were significantly better than those in the control group. CONCLUSION: Study findings indicated that using a resident volunteer as a lay health leader was effective. It can be recommended as a public health resource and for consistent and comfortable education for the elderly in communities.
Cognition ; Depression* ; Hand Strength ; Physical Fitness* ; Public Health ; Quality of Life*

PURPOSE: The purpose of this study was to identify the obesity stress, weight bias and health care on Body Mass Index (BMI) in soldiers of non-combat area and to provide data for improving the quality of their life. METHODS: This research involved 165 soldiers working in non-combat area. Data collection was conducted from November 1 to 20, 2015. Statistical analysis of the collected data were t-test and ANOVA, Scheffé method post hoc analysis, Pearson's correlation coefficients, and multiple liner regression using IBM SPSS 22.0. RESULTS: The mean score of obesity stress was moderate (19.05±5.28). The mean score of weight bias was 69.03 and health care was 2.41 points. There are a positive correlation between obesity stress and BMI (r=.19, p<.05). Weight bias (r=-.19, p<.01) and health care (r=-.26, p<.01) among the subjects had negative correlations with BMI. In a multiple liner regression, obesity stress (β=.18, p<.05), health care (β=-.18, p<.05) were associated with BMI. CONCLUSION: Based on the findings that obesity stress and health care influence BMI, there is a need to control stress and to properly set proper guidelines on health care for soldiers.
Bias (Epidemiology)* ; Body Mass Index ; Body Weight ; Data Collection ; Delivery of Health Care ; Humans ; Methods ; Military Personnel* ; Obesity*