A 79-year-old man visited neurology clinic due to gait ataxia and vertigo for 10 months. Neurologic examination revealed saccadic pursuit, mild dysmetria, impaired tandem gait, and areflexia that recovers after exercise. The amplitude of compound muscle action potentials recorded on the abductor digiti minimi increased up to 6,639.4% during repetitive nerve stimulation at 50 Hz stimulation. This case demonstrates that clinicians should consider Lambert-Eaton myasthenic syndrome as a differential diagnosis when a patient complains of gait ataxia and vertigo.

A 79-year-old man visited neurology clinic due to gait ataxia and vertigo for 10 months. Neurologic examination revealed saccadic pursuit, mild dysmetria, impaired tandem gait, and areflexia that recovers after exercise. The amplitude of compound muscle action potentials recorded on the abductor digiti minimi increased up to 6,639.4% during repetitive nerve stimulation at 50 Hz stimulation. This case demonstrates that clinicians should consider Lambert-Eaton myasthenic syndrome as a differential diagnosis when a patient complains of gait ataxia and vertigo.

Objective: In this study, we investigate the effect of depressive symptoms in elderly on general and cancer health screening participation using the large epidemiological study data in South Korea. Methods: This study was conducted on 1,977 people who responded to a health examination questionnaire among 2,360 adults aged 60 or older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) in 2020.Depressive symptoms were measured by the Patient Health Questionnaire-9 and classified as minimal (0-4), mild (5-9), and moderate and severe (10-27). To investigate the relationship between depressive symptoms and health screening participation, a multiple logistic regression model controlling covariates was used. Results: Compared to the group with minimal depressive symptoms, the mild group did not show a significant difference (odd ratio [OR]=0.71, 95% confidence interval [95% CI]=0.45-1.13), but the moderate to severe group showed a significant negative relationship with general health screening participation (OR=0.59, 95% CI=0.35-0.99). There was a significant negative relation-ship between depressive symptoms and cancer health screening participation (mild group OR=0.77, 95% CI=0.48-1.23; moderate to severe group OR=0.50, 95% CI=0.28-0.87). Conclusion This study showed that people with depressive symptoms are less likely to get a general and cancer health screening. In order to promote health screening participation, policies that consider health behavior promotion programs and psychiatric interventions targeting moderate to severe depressive symptom groups are necessary.

Background: The post-traumatic stress disorder (PTSD) Checklist (PCL)-5, originally a 20-item self-questionnaire, has provided abbreviated versions of the checklist. This study aimed to test the diagnostic utility and validity of four brief versions of PCL-5 in a sample of adults seeking treatment at a psychiatric outpatient unit in a South Korean university-affiliated hospital. Methods: The sample comprised 97 adults diagnosed with PTSD and 130 diagnosed with other psychiatric disorders seeking treatment. Each abbreviated scale was examined with the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and positive predictive power. Additionally, internal consistency, correlation with full scale, convergent validity, and concurrent validity were investigated. Results: All four versions demonstrated excellent discriminative power, with AUC values of >0.9. Suggested cut-off scores were 6, 8, 11, and 16 for the short four-item version (S4), PCL4, PCL6, and PCL8, respectively. Internal consistency was adequate or good except for S4. Additionally, brief scales demonstrated good convergent validity with depression and anxiety scales and excellent concurrent validity with other PTSD scales. Conclusion This study confirms the excellent diagnostic utility and adequate validity of four abbreviated versions of the Korean translation of PCL-5 in the clinical trial.

Background: While individuals exposed to radiation in hospitals are typically registered as radiation workers, with regulated exposure levels, many interns and residents who are not registered as radiation workers are occupationally exposed to radiation. This study aimed to assess the current status and awareness of radiation exposure and related protective practices among interns and residents. Methods: An online survey was conducted nationwide from June 3 to June 16, 2023, engaging 262 interns and 799 residents. Descriptive analyses were conducted to summarize the status of occupational radiation exposure and radiation protection practices. Results: Approximately 6% of interns and 18% of residents reported receiving personal dosimeters, and 6% and 20%, respectively, were registered as radiation workers. In contrast, compliance with personal radiation protection equipment, such as lead aprons and thyroid shields, exceeded 85% during tasks involving radiation exposure. On average, interns spent 7 months (standard deviation [SD], 2.1) and residents 8.1 months (SD, 4.8) in main departments with potential radiation exposure. While overall safety performance showed improvement, the provision of personal dosimeters and radiation worker registration remained low (14.7%, 16.6%). Conclusion Despite improvements in radiation protection education and the provision of personal protective equipment, the registration rate for radiation workers among interns and residents remains low. Ensuring these medical professionals are registered and managed as radiation workers is crucial for prioritizing their safety and well-being.

We report a case of a cardiac lipoma arising from the free wall of right atrium, which was diagnosed as the presumed source of angina by compressing the right coronary artery in a 54-year-old woman. Surgical excision of the tumor was performed well. She continues to do well for six months without angina.
Coronary Vessels ; Female ; Heart Atria ; Humans ; Lipoma ; Middle Aged

BACKGROUND AND OBJECTIVES: Survivors of pediatric hematopoietic stem cell transplantation (HSCT) are at risk for developing hypertension. The objectives of this study are to evaluate the prevalence and risk factors of early onset hypertension during the engraftment period after HSCT. SUBJECTS AND METHODS: This is a retrospective study of 157 consecutive patients (mean age at HSCT: 9.1+/-5.1 years) who underwent HSCT for acute myeloid leukemia (n=47), acute lymphoblastic leukemia (n=43), severe aplastic anemia (n=41), and other reasons (n=26). Blood pressure data were collected at five time points: 0, 7, 14, 21, and 28 days after HSCT. Hypertension was defined as having systolic and/or diastolic blood pressure > or =95th percentile according to age, gender, and height. To analyze the risk factors related to hypertension, data, including patients' demographic and transplant characteristics, were reviewed. RESULTS: Hypertension developed in 59 patients (38%), among whom 12 (7.6%) required long term therapy. Thirty-two (54%) patients had systolic and diastolic, 8 (14%) had only systolic, and 19 (32%) had only diastolic hypertension. Younger age, acute graft-versus-host disease, sinusoidal obstruction syndrome, treatment with antifungal agent, and greater increase in serum creatinine (Cr) levels were associated with hypertension. Multivariate analysis showed that younger age at HSCT and greater increase in serum Cr level were independent risk factors for hypertension. CONCLUSION: Prevalence of hypertension during immediate post-HSCT period is high, especially in younger children. A greater increase in Cr after HSCT was significantly associated with hypertension. Further study is needed to elucidate long-term cardiovascular complications in pediatric HSCT survivors.
Anemia, Aplastic ; Blood Pressure ; Child ; Creatinine ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Hepatic Veno-Occlusive Disease ; Humans ; Hypertension* ; Incidence* ; Leukemia, Myeloid, Acute ; Multivariate Analysis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prevalence ; Retrospective Studies ; Risk Factors* ; Survivors

BACKGROUND: Epstein-Barr virus (EBV) is a well-known causative agent of various diseases including post-transplant lymphoproliferative disorders. Although the level of EBV viral load in donors is expected to have a direct effect on recipients after hematopoietic stem cell transplantation (HSCT), little has been studied providing a clear evidence for that. We performed EBV DNA quantitation in donors and analyzed the effect of donors' EBV viral load on the recipients after HSCT. METHODS: EBV DNA quantitation of peripheral blood in 94 healthy HSCT donors was performed by real-time PCR. We analyzed the distribution of EBV viral load in HSCT donors and EBV positivity in the recipients transplanted from donors who had detectable EBV. RESULTS: Fifteen HSCT donors (16%) showed positive results in EBV real-time quantitative PCR. EBV viral load was below 500 copies/mL in 5 donors and above 500 (680-11,300) copies/mL in 10 donors. Five of the recipients (33.3%) transplanted from these 15 donors showed positivity in EBV PCR after HSCT. All of the EBV PCR positive recipients were transplanted from donors with viral load of >1,000 copies/mL, and 5 (71%) of 7 donors with viral load of >1,000 copies/mL was associated with posttansplant EBV PCR positivity in the recipients. CONCLUSIONS: Higher levels of EBV viral load in donors appear to be associated with EBV transmission to recipients in HSCT. EBV real-time quantitative PCR may be needed for screening EBV DNA level in HSCT donors.
Adolescent ; Adult ; Aged ; Child ; DNA, Viral/*blood ; Female ; *Hematopoietic Stem Cell Transplantation ; Herpesvirus 4, Human/*genetics ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction/*methods ; Tissue Donors ; Transplantation, Homologous ; Viral Load

Commercial bivalent killed Salmonella vaccine Salenvac-T has been used in several countries in order to prevent salmonellosis with Salmonella enterica serovars Enteritidis (SE) and Typhimurium (ST) in poultry. However, this vaccine has not been used in poultry farms in South Korea. In this study, we evaluated the efficacy of Salenvac-T vaccine to protect against the challenge of virulent SE and ST, and the effect of the vaccine on egg production and mortality in layer hens. The colonization of liver, spleen and cecum with challenged SE and ST was reduced in vaccinated chickens compared with that of unvaccinated control group. The twice vaccination with Salenvac-T induced elevated antibody responses against both SE and ST detected by enzyme-linked immunosorbent assay (ELISA). The higher average hen-day production was observed in the vaccinated layer hens than in the unvaccinated layer hens without significance. The average mortality was lower in the vaccinated layer hens during the experiment period. The antibody responses to both SE and ST were persistently detected in the vaccinated layers. In summary, vaccination with Salenvac-T reduces colonization of internal organs and induces good antibody responses, thereby results in higher performance and lower egg contamination with SE and ST in layer hens.
Antibody Formation ; Cecum ; Chickens ; Colon ; Enzyme-Linked Immunosorbent Assay ; Liver ; Ovum ; Poultry ; Republic of Korea ; Salmonella ; Salmonella enterica ; Salmonella enteritidis ; Salmonella Infections ; Salmonella typhimurium ; Spleen ; Vaccination

OBJECTIVE: To evaluate the clinical features that could serve as predictive factors for improvement in gait speed after robotic treatment. METHODS: A total of 29 patients with motor incomplete spinal cord injury received 4-week robot-assisted gait training (RAGT) on the Lokomat (Hocoma AG, Volketswil, Switzerland) for 30 minutes, once a day, 5 times a week, for a total of 20 sessions. All subjects were evaluated for general characteristics, the 10-Meter Walk Test (10MWT), the Lower Extremity Motor Score (LEMS), the Functional Ambulatory Category (FAC), the Walking Index for Spinal Cord Injury version II (WISCI-II), the Berg Balance Scale (BBS), and the Spinal Cord Independence Measure version III (SCIM-III) every 0, and 4 weeks. After all the interventions, subjects were stratified using the 10MWT score at 4 weeks into improved group and non-improved group for statistical analysis. RESULTS: The improved group had younger age and shorter disease duration than the non-improved group. All subjects with the American Spinal Injury Association Impairment Scale level C (AIS-C) tetraplegia belonged to the non-improved group, while most subjects with AIS-C paraplegia, AIS-D tetraplegia, and AIS-D paraplegia belonged to the improved group. The improved group showed greater baseline lower extremity strength, balance, and daily living function than the non-improved group. CONCLUSION: Assessment of SCIM-III, BBS, and trunk control, in addition to LEMS, have potential for predicting the effects of robotic treatment in patients with motor incomplete spinal cord injury.
Gait* ; Humans ; Locomotion ; Lower Extremity ; Paraplegia ; Quadriplegia ; Rehabilitation ; Robotics ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries ; Walking