Encephalitis that primarily involves limbic system structures such as the hippocampus and parahippocampal gyrus has been described in early papers, most commonly characterized by a subacute progressive impairment of short-term memory, psychiatric features and seizures. While these findings might be caused by viral infections or systemic autoimmune disorders, many patients with limbic encephalitis have an immune-mediated etiology (paraneoplastic or not) characterized with serum or CSF antineuronal antibodies. This case reports about non-paraneoplastic autoantibody-negative limbic encephalitis in which there are no detection of antigens and no evidence of tumors.
Antibodies ; Encephalitis ; Hippocampus ; Humans ; Limbic Encephalitis* ; Limbic System ; Memory* ; Memory, Short-Term ; Parahippocampal Gyrus ; Seizures

Background: Various methods have been implemented for pediatric gastrostomy tube placement. We aimed to investigate the performance status of pediatric gastrostomy in South Korea and to present indications and appropriate methods for domestic situations. Methods: A survey was conducted among pediatric endoscopists who performed upper gastrointestinal endoscopy in Korea. The questionnaire consisted of 16 questions on gastrostomy performance status. Results: Among the 48 institutions where the survey was applied, 36 (75%) responded.Of the 36 institutions, gastrostomy was performed in 31 (86.1%). The departments in which gastrostomy was performed were pediatrics at 26 institutions (81.3%), surgery at 24 institutions (75.0%), internal medicine at 9 institutions (28.1%), and radiology at 7 institutions (21.9%). There were 18 institutions (66.7%) using the pull method for percutaneous endoscopic gastrostomy (PEG) and nine institutions (33.3%) using the push method. When performing gastrostomies, fundoplication procedures were performed in 19 institutions (61.3%), if deemed necessary. However, 12 institutions (38.7%) answered that gastrostomy was always implemented alone. Complications after gastrostomy included buried bumper syndrome, wound infection, leakage, tube migration, and incorrect opening site in the stomach, but the number of cases with complications was very small. Conclusion In Korea, a pediatric gastrostomy is implemented in various ways depending on the institution. Clinicians are concerned about choosing the most effective methods with fewer complications after the procedure. In our study, we reported only a few complications.Korea has good accessibility for pediatric gastrointestinal endoscopy, and this survey showed that it is a safe procedure that can be considered initially in pediatric gastrostomy. This study is expected to help to create optimal pediatric PEG guidelines in Korea.

Objectives: In this paper, we aimed to investigate the evolving debate over border closure in Korea during the coronavirus disease 2019 (COVID-19) pandemic, to address the main themes associated with border closure, and to discuss the factors that need to be considered when making such decisions. Methods: We collated and reviewed previously conducted review studies on border closures during infectious disease outbreaks to derive relevant themes and factors. Results: According to our systematic review on border closures and travel restrictions, the effects of such containment efforts are limited. We suggest considering the following factors when determining whether to impose border closure measures: (1) disease characteristics, (2) timeliness of implementation, (3) transmission delay and the basic reproduction number, (4) globalization and pandemics, and (5) social and economic costs. Conclusions Our assessment indicates that the effects of border closures are at best temporary and limited. Alternative measures must be contemplated and implemented to suppress the spread of COVID-19 in particular and infectious diseases more broadly.

Shoulder pain is a common complaint in primary care settings. The prevalence of shoulder pain is on the rise, especially in societies with aging populations. Like other joint-related conditions, shoulder pain is predominantly caused by degenerative diseases. These degenerative changes typically affect bones, tendons, and cartilage, with common conditions including degenerative rotator cuff tears, impingement syndrome, and osteoarthritis. Diagnosing these degenerative diseases in older adults requires a thorough understanding of basic anatomy, general physical examination techniques, and specific diagnostic tests. This review aims to outline the fundamental physical examination methods for diagnosing shoulder pain in older adult patients in primary care. The shoulder's complex anatomy and its broad range of motion underscore the need for a systematic approach to evaluation. Routine inspection and palpation can identify signs such as muscle atrophy, bony protrusions, or indications of degenerative changes. Assessing range of motion, and distinguishing between active and passive deficits, is crucial for differentiating conditions like frozen shoulder from rotator cuff tears. Targeted strength tests, such as the empty can, external rotation lag, liftoff, and belly press tests, are instrumental in isolating specific rotator cuff muscles. Additionally, impingement tests, including Neer’s and Hawkins’ signs, are useful for detecting subacromial impingement. A comprehensive understanding of shoulder anatomy and a systematic physical examination are vital for accurately diagnosing shoulder pain in older adults. When properly executed and interpreted in the clinical context, these maneuvers help differentiate between various conditions, ranging from degenerative changes to rotator cuff pathology.

Shoulder pain is a common complaint in primary care settings. The prevalence of shoulder pain is on the rise, especially in societies with aging populations. Like other joint-related conditions, shoulder pain is predominantly caused by degenerative diseases. These degenerative changes typically affect bones, tendons, and cartilage, with common conditions including degenerative rotator cuff tears, impingement syndrome, and osteoarthritis. Diagnosing these degenerative diseases in older adults requires a thorough understanding of basic anatomy, general physical examination techniques, and specific diagnostic tests. This review aims to outline the fundamental physical examination methods for diagnosing shoulder pain in older adult patients in primary care. The shoulder's complex anatomy and its broad range of motion underscore the need for a systematic approach to evaluation. Routine inspection and palpation can identify signs such as muscle atrophy, bony protrusions, or indications of degenerative changes. Assessing range of motion, and distinguishing between active and passive deficits, is crucial for differentiating conditions like frozen shoulder from rotator cuff tears. Targeted strength tests, such as the empty can, external rotation lag, liftoff, and belly press tests, are instrumental in isolating specific rotator cuff muscles. Additionally, impingement tests, including Neer’s and Hawkins’ signs, are useful for detecting subacromial impingement. A comprehensive understanding of shoulder anatomy and a systematic physical examination are vital for accurately diagnosing shoulder pain in older adults. When properly executed and interpreted in the clinical context, these maneuvers help differentiate between various conditions, ranging from degenerative changes to rotator cuff pathology.

Shoulder pain is a common complaint in primary care settings. The prevalence of shoulder pain is on the rise, especially in societies with aging populations. Like other joint-related conditions, shoulder pain is predominantly caused by degenerative diseases. These degenerative changes typically affect bones, tendons, and cartilage, with common conditions including degenerative rotator cuff tears, impingement syndrome, and osteoarthritis. Diagnosing these degenerative diseases in older adults requires a thorough understanding of basic anatomy, general physical examination techniques, and specific diagnostic tests. This review aims to outline the fundamental physical examination methods for diagnosing shoulder pain in older adult patients in primary care. The shoulder's complex anatomy and its broad range of motion underscore the need for a systematic approach to evaluation. Routine inspection and palpation can identify signs such as muscle atrophy, bony protrusions, or indications of degenerative changes. Assessing range of motion, and distinguishing between active and passive deficits, is crucial for differentiating conditions like frozen shoulder from rotator cuff tears. Targeted strength tests, such as the empty can, external rotation lag, liftoff, and belly press tests, are instrumental in isolating specific rotator cuff muscles. Additionally, impingement tests, including Neer’s and Hawkins’ signs, are useful for detecting subacromial impingement. A comprehensive understanding of shoulder anatomy and a systematic physical examination are vital for accurately diagnosing shoulder pain in older adults. When properly executed and interpreted in the clinical context, these maneuvers help differentiate between various conditions, ranging from degenerative changes to rotator cuff pathology.

Shoulder pain is a common complaint in primary care settings. The prevalence of shoulder pain is on the rise, especially in societies with aging populations. Like other joint-related conditions, shoulder pain is predominantly caused by degenerative diseases. These degenerative changes typically affect bones, tendons, and cartilage, with common conditions including degenerative rotator cuff tears, impingement syndrome, and osteoarthritis. Diagnosing these degenerative diseases in older adults requires a thorough understanding of basic anatomy, general physical examination techniques, and specific diagnostic tests. This review aims to outline the fundamental physical examination methods for diagnosing shoulder pain in older adult patients in primary care. The shoulder's complex anatomy and its broad range of motion underscore the need for a systematic approach to evaluation. Routine inspection and palpation can identify signs such as muscle atrophy, bony protrusions, or indications of degenerative changes. Assessing range of motion, and distinguishing between active and passive deficits, is crucial for differentiating conditions like frozen shoulder from rotator cuff tears. Targeted strength tests, such as the empty can, external rotation lag, liftoff, and belly press tests, are instrumental in isolating specific rotator cuff muscles. Additionally, impingement tests, including Neer’s and Hawkins’ signs, are useful for detecting subacromial impingement. A comprehensive understanding of shoulder anatomy and a systematic physical examination are vital for accurately diagnosing shoulder pain in older adults. When properly executed and interpreted in the clinical context, these maneuvers help differentiate between various conditions, ranging from degenerative changes to rotator cuff pathology.

Shoulder pain is a common complaint in primary care settings. The prevalence of shoulder pain is on the rise, especially in societies with aging populations. Like other joint-related conditions, shoulder pain is predominantly caused by degenerative diseases. These degenerative changes typically affect bones, tendons, and cartilage, with common conditions including degenerative rotator cuff tears, impingement syndrome, and osteoarthritis. Diagnosing these degenerative diseases in older adults requires a thorough understanding of basic anatomy, general physical examination techniques, and specific diagnostic tests. This review aims to outline the fundamental physical examination methods for diagnosing shoulder pain in older adult patients in primary care. The shoulder's complex anatomy and its broad range of motion underscore the need for a systematic approach to evaluation. Routine inspection and palpation can identify signs such as muscle atrophy, bony protrusions, or indications of degenerative changes. Assessing range of motion, and distinguishing between active and passive deficits, is crucial for differentiating conditions like frozen shoulder from rotator cuff tears. Targeted strength tests, such as the empty can, external rotation lag, liftoff, and belly press tests, are instrumental in isolating specific rotator cuff muscles. Additionally, impingement tests, including Neer’s and Hawkins’ signs, are useful for detecting subacromial impingement. A comprehensive understanding of shoulder anatomy and a systematic physical examination are vital for accurately diagnosing shoulder pain in older adults. When properly executed and interpreted in the clinical context, these maneuvers help differentiate between various conditions, ranging from degenerative changes to rotator cuff pathology.

OBJECTIVE: To improve lower extremity function and balance in elderly persons, we developed a novel, three-dimensional interactive augmented reality system (3D ARS). In this feasibility study, we assessed clinical and kinematic improvements, user participation, and the side effects of our system. METHODS: Eighteen participants (age, 56-76 years) capable of walking independently and standing on one leg were recruited. The participants received 3D ARS training during 10 sessions (30-minute duration each) for 4 weeks. Berg Balance Scale (BBS) and the Timed Up and Go (TUG) scores were obtained before and after the exercises. Outcome performance variables, including response time and success rate, and kinematic variables, such as hip and knee joint angle, were evaluated after each session. RESULTS: Participants exhibited significant clinical improvements in lower extremity balance and mobility following the intervention, as shown by improved BBS and TUG scores (p<0.001). Consistent kinematic improvements in the maximum joint angles of the hip and knee were observed across sessions. Outcome performance variables, such as success rate and response time, improved gradually across sessions, for each exercise. The level of participant interest also increased across sessions (p<0.001). All participants completed the program without experiencing any adverse effects. CONCLUSION: Substantial clinical and kinematic improvements were observed after applying a novel 3D ARS training program, suggesting that this system can enhance lower extremity function and facilitate assessments of lower extremity kinematic capacity.
Aged* ; Education ; Exercise ; Feasibility Studies* ; Hip ; Humans ; Joints ; Knee ; Knee Joint ; Leg ; Lower Extremity ; Reaction Time ; Rehabilitation* ; Walking

OBJECTIVE: Despite successful efforts to shorten the door-to-balloon time in patients with ST-segment elevation myocardial infarction (STEMI), pre-hospital delayremains a problem. We evaluated the factors related to pre-hospital delay using the Jeonbuk regional cardiovascular center database. METHODS: From 2010 to 2013, a total of 384 STEMI patients were enrolled. We analyzed the onset time, door time, and balloon time, and the patients were grouped according to pre-hospital delay (120 minutes). Clinical and socio-demographic variables were compared. RESULTS: 53.2% of patients had prolonged onset-to-door time (median 130, interquartile range [IQR] 66~242 minutes), and 68.5% of patients did not achieve <120 minute of total ischemic time (median 175, IQR 110~304 minutes). Pre-hospital delay was more frequent in patients with old age, female, no local residence, low education level, transfer via other hospital and no use of emergency squad (119). Only 20% of patients used 119, and 119 team responded in a prompt manner (call to scene time 6 min), but 41.6% of patients was transported to non-PCI-capable hospitals. Multivariate analysis revealed that transfer via other hospital [Odds ratio (OR) 2.5, 95% confidence interval (CI) 1.6-4.1, p<0.001), use of 119 (OR 0.4, 95% CI 0.2-0.6, p<0.001), age >60 years (OR 1.8, 95% CI 1.1-3.0, p=0.031) and hypertension (OR 1.9, 95% CI 1.2-2.9, p=0.047) were independent predictors of pre-hospital delay. CONCLUSIONS: The present study demonstrated a significant pre-hospital delay in the treatment of STEMI patients in the Province of Jeonbuk. Public campaigns and education are needed to raise the public awareness of STEMI and the use of 119.
Education ; Emergencies ; Emergency Medical Services ; Female ; Humans ; Hypertension ; Jeollabuk-do* ; Multivariate Analysis ; Myocardial Infarction* ; Time-to-Treatment