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.

Objectives: The purpose of this study is to analyze the relationship between dental school students’admission scores and their grade point average (GPA) after admission, as well as the relationship between student admission scores at dental school and continuation into the residency program. Methods: This study analyzed data collected from students who entered dental school between 2013 and 2017. The outcome variables were dental school GPA and continuation into residency program. Explanatory variables included admission type (early decision admission/regular admission), academic achievements (undergraduate GPA, Dental Education Eligibility Test [DEET], Test of English Proficiency [TEPS], screening by document review, and in-depth interview score), age, sex, college alma mater, high school alma mater, college major, as well as students’ academic performance in dental school. Regression analysis was performed to determine which factors relating to dental school admissions score had an influence on academic performance in dental school, whereas logistic regression analysis was conducted to determine the students’ decision to pursue a residency. Results: Students who were foreign college graduates, majored in health sciences, accepted on the basis of early decision admission, female, or had a higher college GPA showed higher dental school GPA with statistical significance. Additionally, the likelihood of students pursuing residency was found to be higher in students who were female, of younger age, college graduates in Jeolla Provinces, or who had a higher dental school GPA. Conclusions To ensure regional equality of dental service quality, it is essential that high quality students pursue residency training. For further improvement of dental school, this study’s results can be used as a reference to make students coming from other regions pursue the residency program and contribute to the regional community.

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

Headache is a frequent complaint in coronavirus disease-19 (COVID-19) patients. Nevertheless, no detailed information on the pathophysiology of headache in COVID-19 infection is currently limited. We encountered a patient developing headache, diplopia, and intracranial hypertension after COVID-19 infection. The patient no more complained of headache and diplopia after the intracranial pressure was normalized. Our case suggests that intracranial hypertension is a mechanism of headache in COVID-19 infection. We report herein a case of transient intracranial hypertension after COCVID-19 infection.

PURPOSE: To estimate annual health care and productivity loss costs attributable to overweight or obesity in working asthmatic patients. MATERIALS AND METHODS: This study was conducted using the 2003–2013 Medical Expenditure Panel Survey (MEPS) in the United States. Patients aged 18 to 64 years with asthma were identified via self-reported diagnosis, a Clinical Classification Code of 128, or a ICD-9-CM code of 493.xx. All-cause health care costs were estimated using a generalized linear model with a log function and a gamma distribution. Productivity loss costs were estimated in relation to hourly wages and missed work days, and a two-part model was used to adjust for patients with zero costs. To estimate the costs attributable to overweight or obesity in asthma patients, costs were estimated by the recycled prediction method. RESULTS: Among 11670 working patients with a diagnosis of asthma, 4428 (35.2%) were obese and 3761 (33.0%) were overweight. The health care costs attributable to obesity and overweight in working asthma patients were estimated to be $878 [95% confidence interval (CI): $861–$895] and $257 (95% CI: $251–$262) per person per year, respectively, from 2003 to 2013. The productivity loss costs attributable to obesity and overweight among working asthma patients were $256 (95% CI: $253–$260) and $26 (95% CI: $26–$27) per person per year, respectively. CONCLUSION: Health care and productivity loss costs attributable to overweight and obesity in asthma patients are substantial. This study's results highlight the importance of effective public health and educational initiatives targeted at reducing overweight and obesity among patients with asthma, which may help lower the economic burden of asthma.
Adult ; Asthma/*economics/epidemiology/therapy ; *Cost of Illness ; *Efficiency ; *Employment ; Female ; *Health Care Costs ; Health Expenditures ; Humans ; Male ; Middle Aged ; Obesity/*economics/epidemiology/therapy ; Overweight/economics/epidemiology/therapy ; United States/epidemiology ; Young Adult

BACKGROUND: We investigated the rates of fecal transmission of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) and carbapenem-resistant Enterobacteriaceae (CRE) among patients admitted to intensive care units (ICUs). METHODS: From June to August 2012, rectal cultures were acquired from all patients at ICU admission. For patients not carrying ESBL-E or CRE at admission, follow-up cultures were performed to detect acquisition. A chromogenic assay was used to screen for ESBL-E and CRE. Bacterial species identification and antibiotic susceptibility tests were performed using the Vitek 2 system (bioMerieux, France). ESBL genotypes were determined by PCR, and clonal relatedness of the isolates was assessed by pulsed-field gel electrophoresis. RESULTS: Out of 347 ICU admissions, 98 patients were found to be carriers of ESBL-E (28.2%, 98/347). Follow-up cultures were acquired from 91 of the patients who tested negative for ESBL-E at admission; the acquisition rate in this group was 12.1% (11/91), although none was a nosocomial transmission. For CRE, the prevalence of fecal carriage was 0.3% (1/347), and the acquisition rate was 2.9% (4/140). None of the CRE isolates were carbapenemase-producers. CONCLUSIONS: The high prevalence of ESBL-E carriage on admission (28.2%), coupled with rare nosocomial transmission and the very low carriage rate of CRE (0.3%), challenge the routine use of active surveillance in non-epidemic settings. Nevertheless, passive surveillance measures, such as rapid and accurate screening of clinical specimens, will be critical for controlling the spread of CRE.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/*metabolism ; Carbapenems/*pharmacology ; Carrier State/epidemiology ; Cross Infection/epidemiology/*transmission ; DNA, Bacterial/analysis ; Drug Resistance, Bacterial/drug effects ; Electrophoresis, Gel, Pulsed-Field ; Enterobacteriaceae/enzymology/genetics/*physiology ; Enterobacteriaceae Infections/epidemiology/*transmission ; Feces/*microbiology ; Genotype ; Humans ; Intensive Care Units ; Polymerase Chain Reaction ; Prevalence ; Republic of Korea/epidemiology ; beta-Lactamases/*metabolism

Microorganisms found in bioaerosols from animal confinement buildings not only foster the risk of spreading diseases among livestock buildings, but also pose health hazards to farm workers and nearby residents. This study identified the various microorganisms present in the air of swine, chicken, and cattle farms with different kinds of ventilation conditions in Korea. Microbial air samples were collected onto Petri dishes with bacterial or fungal growth media using a cascade impactor. Endotoxin levels in total dust were determined by the limulus amebocyte lysate kinetic QCL method. Prevalent Gram-positive bacteria were Staphylococcus (S.) lentus, S. chromogenes, Bacillus (B.) cereus, B. licheniformis, and Enterococcus faecalis, while the dominant fungi and Gram-negative bacteria were Candida albicans and Sphingomonas paucimobilis, respectively. Considering no significant relationship between the indoor dust endotoxin levels and the isolation of Gram-negative bacteria from the indoor air, monitoring the indoor airborne endotoxin level was found to be also critical for risk assessment on health for animals or workers. The present study confirms the importance of microbiological monitoring and control on animal husbandry indoor air to ensure animal and worker welfare.
Agriculture ; Animal Husbandry ; Animals ; Bacillus ; Bacteria* ; Candida albicans ; Cattle ; Chickens* ; Dust ; Enterococcus faecalis ; Farmers ; Fungi* ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Horseshoe Crabs ; Korea ; Livestock ; Methods ; Risk Assessment ; Sphingomonas ; Staphylococcus ; Swine ; Ventilation