Neural tube defects are reported one of the important congenital malformation in the world, with an incidence of 1.4 to 2 per 1000 pregnancies. Maternal serum AFP at the second trimester is used as screening test. But this is associated with numerous causes, including twins, fetal death, misdated pregnancies, cystic hygromas, teratomas, renal abnormalities, esophageal atresia and aberrations in the placenta. If the AFP level was elevated, targeted ultrasonography should be evaluated for confirming the gestational age and fetal viability, fetal number. Then if the ultrasonographic examination is nondiagnostic, or if an NTD is suspected, amniotic fluid AFP should be measured with acetylcholinesterase. But the false positive rate of the AF-AFP is high, and there is 0.3% of the false positive rate in amniotic acetylcholinesterase. This time the women with normal ultrasonographic examination continue the pregnancy after counseling of family history, past history with follow up of ultrasonography. We report a case with elevated second trimester MS-AFP, AF-AFP and positive amniotic acetylcholinesterase, but in which repeated sonographic findings were normal and result in delivery of a healthy baby without anomalies.
Acetylcholinesterase* ; Amniotic Fluid ; Counseling ; Esophageal Atresia ; Female ; Fetal Death ; Fetal Viability ; Follow-Up Studies ; Gestational Age ; Humans ; Incidence ; Lymphangioma, Cystic ; Mass Screening ; Neural Tube Defects ; Placenta ; Pregnancy Trimester, Second ; Pregnancy* ; Teratoma ; Ultrasonography

No abstract available.
Keratitis*

With the number of long-term care facilities in Korea increasing substantially, their quality and evaluation system has been an issue of concern. Policy makers need to consider critical aspects relating to health outcomes and client satisfaction when evaluating quality in long-term care. This requires a substantial amount of information gathered from a system of inspection, survey, data, and feedback. This study reviews the characteristics of Online Survey Certification and Reporting system (OSCAR) and the survey instrument used by the Centers for Medicare and Medicaid Services (CMS) in the U.S. and introduces the history of the U.S. nursing home (NH) inspection/survey system. OSCAR is administered by state agencies that contract with CMS and collect data through onsite inspections of facilities approximately once per year. The major components of OSCAR data are facility characteristics, resident characteristics, and survey deficiencies including scope and severity. We discuss the strengths and weaknesses of OSCAR, the primary source of information on the performance of all Medicare/Medicaid certified facilities, including a comparison of resident health outcome evaluation measurement between Korea's assessment tool and OSCAR. Introduction of a data collection system that includes a periodic survey process similar to OSCAR may help policy makers gain a better understanding of the NH industry in Korea and address shortcomings of the system.
Administrative Personnel ; Centers for Medicare and Medicaid Services (U.S.) ; Certification ; Contracts ; Data Collection ; Humans ; Korea ; Long-Term Care ; Nursing Homes ; United States

Purpose: This study aimed to investigate the perceptions of precocious puberty and elucidate the distinct characteristics of each type of perception related to precocious puberty among school-aged children who had undergone treatment for the condition. Methods: This study applied the Q methodology to identify and classify the perceptions of precocious puberty among school-aged children who had undergone treatment for the condition. The analysis involved 34 questions from the Q sample and data from 35 individuals in the P sample, using the PC-QUANL Program for analysis. Results: The perceptions of precocious puberty among school-aged children who had undergone precocious puberty treatment were classified into the following four types: "shyness - passive self-management," "resentment - suppression," "anxiety - fear," and "adaptation - acceptance." Conclusion This study investigated the experiences and perceptions of children who have undergone treatment for precocious puberty. Through the identification of four types of perceptions, we can see that there is a need to develop an intervention program for nursing that is tailored to the specific type of precocious puberty.

No abstract available.
Epilepsy ; Humans ; Ophthalmoplegia

No abstract available.
Cervix Uteri* ; Female

Intrathecal chemotherapy with methotrexate and cytarabine arabinoside is used for the treatment and prophylaxis of malignancies, but can induce myelopathy. We report the case of a 50-year-old woman with stomach cancer who developed myelopathy after administration of intrathecal cytarabine arabinoside and methotrexate. The patient's neurologic status improved rapidly after the administration of folinate (15 mg) four times daily and cyanocobalamin (100 mug) once daily. The folate metabolites may be effective in the management of intrathecal-chemotherapy-induced myelopathy.
Cytarabine ; Female ; Folic Acid ; Humans ; Methotrexate ; Middle Aged ; Spinal Cord Diseases ; Stomach Neoplasms ; Vitamin B 12

BACKGROUND AND OBJECTIVES: Statin prevents atherosclerotic progression and helps to stabilize the plaque. According to a recent study, statin reduces inflammation in blood vessels. However, it has not been demonstrated to have any anti-inflammation reaction in patients who have been diagnosed as having a triple-vessel coronary artery disease (CAD). SUBJECTS AND METHODS: This study included a total of thirty (30) patients who had been diagnosed by coronary angiogram as having a triple-vessel CAD. Patients who already had been taking statin were given doubled dosage. An interview, physical examination and blood test were performed at the beginning of this study and three months later. RESULTS: After doubling the dose of statin, there was no statistically significant decrease in total cholesterol, low density lipoprotein-cholesterol, (increase in) high density lipoprotein-cholesterol and triglyceride in the blood test. C-reactive protein (CRP), an acute phase reactant, significantly decreased from 0.34 mg/dL at the beginning of the study to 0.12 mg/dL at the end of study (p<0.01). The interleukin-6 concentration also significantly decreased from 8.55 pg/dL to 4.81 pg/dL (p<0.001). No major cardiovascular events occurred and the dosage regimen was not modified during the close observation period. There was no difference in the symptoms of angina pectoris, established by World Health Organization Angina Questionnaires, before and after the dose increase. Liver enzymes remained within normal range with no significant increase before and after conducting this study. CONCLUSION: Doubling the dose of statin alone significantly lowers pro-inflammatory cytokine concentration, which is closely related to the potential acute coronary syndrome, and CRP, a marker of vascular inflammation.
Acute Coronary Syndrome ; Angina Pectoris ; Blood Vessels ; C-Reactive Protein ; Cholesterol ; Coronary Artery Disease ; Coronary Vessels ; Hematologic Tests ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Inflammation ; Interleukin-6 ; Liver ; Physical Examination ; Reference Values ; World Health Organization ; Surveys and Questionnaires

BACKGROUND: Liver transplantation (LT) is a complicated procedure with a high incidence of postoperative acute kidney injury (AKI). Previous studies indicate that even transient or mild post-LT AKI can result in critical conditions, including prolonged stays in hospitals and intensive care units and increased morbidity and mortality. The aim of this study was to investigate the association between body mass index (BMI) and occurrence of AKI in LT recipients. METHODS: Medical data from 203 patients who received LT surgery from January 2010 to August 2016 in a single university hospital setting were retrospectively collected and analyzed. Patients were classified as either underweight (BMI <20 kg/m²) or normal weight (20 ≤ BMI < 30 kg/m²). Demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Propensity analyses and logistic regression were performed to evaluate the association between BMI and post-LT AKI. RESULTS: There was no significant difference in occurrence of post-LT AKI between underweight and normal weight patients. The underweight patient group had significantly longer hospital stay compared with the normal weight patient group (P = 0.023). CONCLUSIONS: BMI classification was neither a positive nor negative predictor of postoperative AKI occurrence. However, patients with lower BMI had significantly longer hospital stay compared with their counterparts. Although our study was limited by its retrospective design, our observations suggest that lower BMI might play a role in post-LT AKI.
Acute Kidney Injury* ; Body Mass Index* ; Classification ; Humans ; Incidence ; Intensive Care Units ; Length of Stay ; Liver Transplantation* ; Liver* ; Logistic Models ; Mortality ; Retrospective Studies* ; Thinness

Purpose: This study aimed to identify trends in changes of cognitive function, physical function, depression, and activities of daily living (ADL) among people with dementia who had used day care centers for at least 12 months, through the analysis of data collected from day care center records. Methods: The participants in this descriptive survey were 63 older people with dementia. Data were collected from two dementia day care centers located in Incheon city. General characteristics and disease related characteristics were analyzed in terms of the frequency, percentage, mean, and standard deviation. Correlations between major variables were analyzed using Pearson correlation coefficient. Cognitive function, depression, physical performance, and ADL were analyzed using the mean, standard deviation, Wilcoxon signed-rank test, and Friedman test. Results: The mean age of the participants was 77.33±6.73 years (range, 58 to 91 years) when they began attending the centers. Cognitive function significantly increased at 3 months (18.63±5.06), 6 months (18.73±5.20), and 12 months (18.63±5.43) compared to baseline (17.41±4.77). Depression significantly decreased at 3 months(2.94±2.96), 6 months (3.13±3.14), and 12 months (2.81±3.27) compared to baseline (5.20±3.87). At 3 months, 6 months, and 12 months, the physical function score (respectively 10.19±2.90, 10.33±2.84, 10.11±2.55) increased significantly compared to baseline (9.13±3.01). ADLs decreased at 3 months (8.51±1.92), 6 months (8.67±2.12), and 12 months (8.89±2.19) compared to baseline (8.41±1.88). Conclusion Without receiving customized day care service for dementia, cognitive function and physical function will decline and depressive feelings will increase. Therefore, delaying cognitive decline, reducing depression, and improving physical function through the use of day care services, especially at an early stage are essential to strengthen and maintain aging in place.