No abstract available.
Amputation* ; Amputees* ; Humans ; Knee* ; Rehabilitation*

We report a 57-year-old man with bilateral cranial nerve IX and X palsies who presented with severe dysphagia. After a mild head injury, the patient complained of difficult swallowing. Physical examination revealed normal tongue motion and no uvular deviation. Cervical X-ray findings were negative, but a brain computed tomography revealed a skull fracture involving bilateral jugular foramen. Laryngoscopy indicated bilateral vocal cord palsy. In a videofluoroscopic swallowing study, food residue remained in the vallecula and pyriform sinus, and there was reduced motion of the pharynx and larynx. Electromyography confirmed bilateral superior and recurrent laryngeal neuropathy.
Brain ; Brain Injuries* ; Cranial Nerve Diseases ; Craniocerebral Trauma ; Deglutition ; Deglutition Disorders ; Electromyography ; Glossopharyngeal Nerve ; Humans ; Laryngoscopy ; Larynx ; Middle Aged ; Paralysis* ; Pharynx ; Physical Examination ; Pyriform Sinus ; Skull Fracture, Basilar ; Skull Fractures ; Tongue ; Vocal Cord Paralysis

Invasive pulmonary aspergillosis (IPA) has been known to occur in immunocompromised patients, but has been rarely reported in immunocompetent patients. In immunocompetent patients, pulmonary fungal infections are not initially considered. This results in diagnosis and treatment delays, as well as poor prognosis. We report a case and serial CT findings of IPA in an immunocompetent 29-year-old male after congenital heart disease surgery.

BACKGROUND: Previous studies suggest that the impact of social factors on harmful alcohol use between men and women may be different. We aimed to explore the gender-based difference in temporal trend and social risk factors associated with harmful alcohol use. METHODS: The Korea National Health and Nutrition Examination Survey (2007–2014) was used to explore the recent trend of harmful alcohol use in the general population. Among all current alcohol drinkers aged 20–64 years, the frequencies of harmful alcohol use in each age group, year of birth, marriage, income, education, and occupation were analyzed based on gender. RESULTS: A total of 34,478 people (14,544 men and 19,834 women) who reported drinking alcohol in the last month at the time of interview were included in the analysis. The proportion of harmful alcohol use in men decreased (P for trend = 0.002) during the study period, whereas significant change was not observed in women (P for trend = 0.173). The prevalence of harmful alcohol use was highest in men aged 35–49 years and women aged 20–34 years. For both men and women, lower level of education and service occupation were the common risk factors of harmful alcohol use. Additionally, low income was a risk factor of harmful alcohol use in women but not in men. Marriage increased the risk of harmful alcohol use in women but decreased in men. CONCLUSION: Public health interventions in reducing harmful alcohol use should consider the different high-risk groups between men and women.
Drinking ; Education ; Female ; Humans ; Korea ; Male ; Marriage ; Nutrition Surveys ; Occupations ; Parturition ; Prevalence ; Public Health ; Risk Factors

Monomelic amyotrophy (MMA), also known as Hirayama disease, is a sporadic juvenile muscular atrophy in the distal upper extremities. This disorder rarely involves proximal upper extremities and presents minimal sensory symptoms with no upper motor neuron (UMN) signs. It is caused by anterior displacement of the posterior dural sac and compression of the cervical cord during neck flexion. An 18-year-old boy visited our clinic with a 5-year history of left upper extremity pain and slowly progressive weakness affecting the left shoulder. Atrophy was present in the left supraspinatus and infraspinatus. On neurological examination, positive UMN signs were evident in both upper and lower extremities. Electrodiagnostic study showed root lesion involving the fifth to seventh cervical segment of the cord with chronic and ongoing denervation in the fifth and sixth cervical segment innervated muscles. Cervical magnetic resonance imaging (MRI) showed asymmetric cord atrophy apparent in the left side and intramedullary high signal intensity along the fourth to sixth cervical vertebral levels. With neck flexion, cervical MRI revealed anterior displacement of posterior dural sac, which results in the cord compression of those segments. The mechanisms of myelopathy in our patient seem to be same as that of MMA. We report a MMA patient involving proximal limb with UMN signs in biomechanical concerns and discuss clinical importance of cervical MRI with neck flexion. The case highlights that clinical variation might cause misdiagnosis.
Adolescent ; Atrophy ; Biological Assay ; Denervation ; Diagnostic Errors ; Extremities ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Motor Neurons* ; Muscles ; Neck ; Neurologic Examination ; Shoulder ; Spinal Cord Diseases ; Spinal Muscular Atrophies of Childhood ; Upper Extremity

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by abnormal proliferation of synoviocytes, leukocyte infiltration, and angiogenesis. The endoplasmic reticulum (ER) is the site of biosynthesis for all secreted and membrane proteins. The accumulation of unfolded proteins in the ER leads to a condition known as ER stress. Failure of the ER's adaptive capacity results in abnormal activation of the unfolded protein response. Recently, we have demonstrated that ER stress-associated gene signatures are highly expressed in RA synovium and synovial cells. Mice with Grp78 haploinsufficiency exhibit the suppression of experimentally induced arthritis, suggesting that the ER chaperone GRP78 is crucial for RA pathogenesis. Moreover, increasing evidence has suggested that GRP78 participates in antibody generation, T cell proliferation, and pro-inflammatory cytokine production, and is therefore one of the potential therapeutic targets for RA. In this review, we discuss the putative, pathophysiological roles of ER stress and GRP78 in RA pathogenesis.
Animals ; Arthritis, Rheumatoid/genetics/*pathology ; Autoantibodies/immunology ; Cell Proliferation ; Cytokines/biosynthesis/immunology ; Endoplasmic Reticulum/immunology/pathology ; Endoplasmic Reticulum Stress/*immunology ; Haploinsufficiency/genetics ; Heat-Shock Proteins/*genetics/*immunology ; Humans ; Lymphocyte Activation ; Mice ; Neovascularization, Pathologic/genetics ; Protein Folding ; Synovial Membrane/cytology ; T-Lymphocytes/immunology ; Unfolded Protein Response/*immunology

Encephalitis associated with antibodies to the N-methyl-D-aspartate (NMDA) receptor has variable clinical manifestations and treatment responses. Anti-NMDAR encephalitis is often associated with ovarian teratoma, but some cases without tumor have been reported. Here, we describe a patient who has shown psychiatric symptoms, memory impairment and been diagnosed as schizophrenia for one year and had anti-NMDA receptor antibody. The patient showed atypical clinical course compared to previous cases with anti-NMDA receptor encephalitis.
Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; Antibodies ; Encephalitis ; Humans ; Memory ; N-Methylaspartate ; Schizophrenia ; Teratoma

OBJECTIVE: The purposes of this study were to evaluate the relationship between the dental and basal arch forms; to analyze their differences in the tapered, ovoid, and square arch forms in normal occlusion by using three-dimensional (3D) virtual models; and to test the hypothesis that the overjet and maxillomandibular basal arch width difference have a significantly positive correlation. METHODS: Seventy-seven normal occlusion plaster casts were examined by 3D scanning. Facial axis (FA) and WALA points were digitized using the Rapidform 2006 software. The dimensions of the dental and basal arches and the overjet were measured. The samples were classified into 3 groups according to arch forms: tapered (n = 20), ovoid (n = 20), and square (n = 37). Analysis of variance (ANOVA) was used to compare the dental and basal arch dimensions. The Pearson correlation coefficients between the intercanine as well as the intermolar widths at the FA and WALA points were calculated. RESULTS: With regard to the basal arch dimensions, the tapered arch form showed a larger mandibular intermolar depth than the ovoid. Strong correlations were noted between the basal and dental intermolar widths in both the upper and lower arches (r = 0.83 and 0.85, respectively). Moderate correlation was found between the upper and lower intercanine widths (r = 0.65 and 0.48, respectively). CONCLUSIONS: The 3 dental arch form groups differed only in some dimensions of the skeletal arch. Moderate correlations were found between the basal and dental intercanine widths. These findings suggest that the basal arch may not be a principle factor in determining the dental arch form.
Axis, Cervical Vertebra ; Casts, Surgical ; Dental Arch

BACKGROUND: Increases in unemployment and suicide in the young Korean population have recently become major social concerns in the country. The purpose of this study was to examine mental health status in young job seekers and identify sociodemographic factors related to job-seeking stress, depression, and suicidal ideation. We also explored the mediating effect of depression on the relationship between job-seeking stress and suicidal ideation and examined whether social support moderated this effect. METHODS: In total, 124 university graduates completed the Job-Seeking Stress Scale, Beck Depression Inventory-II, Beck Scale for Suicide Ideation, and Multidimensional Scale of Perceived Social Support. Descriptive statistics were calculated for participants' general characteristics, and t-tests or analyses of variance, correlation analysis, simple mediation analysis, and mediated moderation analysis were performed. RESULTS: Of the 124 participants, 39.5% and 15.3% exhibited clinical levels of depression and suicidal ideation, respectively. Sociodemographic factors (i.e., sex, academic major, educational expenses loan, and willingness to accept irregular employment) were associated with job-seeking stress, depression, and suicidal ideation. Women and graduates who were willing to accept irregular employment exhibited high levels of job-seeking stress, depression, and suicidal ideation. Job-seeking stress affected suicidal ideation via depression, and perceived social support moderated the effect of job-seeking stress on depression and the effect of depression on suicidal ideation. CONCLUSION: The results suggest that depression management and interventions are urgently required for young job seekers, and social support should be provided to assist them both emotionally and economically.
Depression ; Employment ; Female ; Humans ; Korea* ; Mental Health* ; Negotiating ; Suicidal Ideation ; Suicide ; Unemployment

OBJECTIVE: To investigate the activities of upper trapezius and deltoid muscles in shoulder abduction in full can and empty can position in rotator cuff tear patients. METHOD: Twelve subjects with right rotator cuff tear patients participated in this study. Each subject performed scapular plane abduction with humeral external rotation (full can position) and with humeral internal rotation (empty can position). Electromyography (EMG) was recorded with surface electrodes at the both upper trapezius, anterior, lateral, and posterior deltoid muscles during shoulder abduction. The EMG activity of each muscle was normalized according to the highest EMG activity during a maximum manual muscle test for the corresponding muscle. RESULTS: Muscle activities of the lesion side's upper trapezius and lateral deltoid were significantly greater than those of the normal side in full can position. In empty can position, the activities of upper trapezius, anterior, and lateral deltoid increased in lesion side. In comparison between full can and empty can exercises, over 30degrees abduction arcs, empty can exercise showed increased muscle activities of upper trapezius and all deltoid muscle in lesion side. In contrast, anterior and lateral deltoid only showed increased in the muscle activities under empty can exercise in sound side. CONCLUSION: Rotator cuff tear is involved in changed the activities of upper trapezius and deltoid muscles. And these results suggested that in rotator cuff tear patients, the changed pattern of muscle contraction should be considered in shoulder exercise.
Anesthetics, Local ; Deltoid Muscle ; Electrodes ; Electromyography ; Exercise ; Humans ; Lidocaine ; Muscle Contraction ; Muscles ; Rotator Cuff ; Shoulder ; Tears