PURPOSE: This exploratory study aims to identify various factors influencing the rehabilitation nursing competencies (RNC) of nurses in various types of health institutes. METHODS: The researcher developed a questionnaire consisting of 45 items based on the ARN rehabilitation nursing competency model. Subjects were 434 nurses working at general hospitals, long-term care facilities, or community health centers. RESULTS: Nurses' RNC were significantly higher among those who have higher levels of education, receive continuing education in rehabilitation nursing, and practice more frequently in rehabilitation nursing. Age and duration of nursing career were significant only for interprofessional care domain. General hospital nurses scored highest in every domain while nurses working at long-term care facilities scored lowest in every domain. Multiple regression analysis showed that practicing daily or more than twice per week in rehabilitation nursing, achieving master's degree or higher, and working at long-term care facilities were statistically significant factors with RNC. These factors explained 31.1% of the total variability in RNC in this sample. CONCLUSION: Currently, there is no official certification program for rehabilitation nurse practitioners in South Korea. The results of this study would be useful in developing RNC training programs for Korean nurses, and provide strong evidence for necessity of certified rehabilitation nurse specialists.
Academies and Institutes ; Certification ; Community Health Centers ; Education ; Education, Continuing ; Hospitals, General ; Humans ; Korea ; Long-Term Care ; Nurse Practitioners ; Nursing ; Rehabilitation Nursing* ; Rehabilitation* ; Specialization

We reported on a 60-year-old man presenting lymphedema of both lower extremities and scrotum for 3 years with unknown cause. We took a computed tomography scan of the lower extremities as a follow-up. There were diffuse subcutaneous edema in both lower extremities and multiple enlarged lymph nodes along the para-aortic and bilateral inguinal areas. For further evaluation, biopsy of an enlarged inguinal lymph node was taken, yielding a diagnosis of primary amyloidosis. A treatment of chemotherapy for amyloidosis was recommended for him. To our knowledge, this is the first report of lymphedema presenting with primary amyloidosis in Asia. This case suggests that primary amyloidosis could be one of the differential diagnoses in patients with lymphedema in the lower extremities.
Amyloidosis* ; Asia ; Biopsy ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Edema ; Follow-Up Studies ; Humans ; Lower Extremity ; Lymph Nodes ; Lymphedema* ; Middle Aged ; Scrotum

PURPOSE: This study aimed to investigate and compare the micro-structural profiles of trabecular bone from different facets at the ankle joint. MATERIALS AND METHODS: In a fresh cadaver ankle, four cored 10 mm of diameter cylindrical specimens of trabecular bone were harvested from the distal tibia, the talar dome, the medial malleolus, and the lateral malleolus. Using a micro-computed tomography, two-dimensional and three-dimensional micro-structural indices of the trabecular bone were analyzed. RESULTS: Each specimen from the tibia, talus, medial malleolus, and the lateral malleolus showed unique micro-structural pattern. Tibia versus talus, the talus was seen a higher bone volume fraction and a wider supporting zone subchondrally whereas the tibia was seen a relatively lower bone volume fraction and a much narrower supporting zone subchondrally. Lateral malleolus versus medial malleolus, the lateral malleolus was seen the thicker but sparse trabeculae pattern whereas the medial malleolus was seen the thinner but more compact trabecular pattern. CONCLUSION: Each four locations from the different facet at the ankle joint have distinct own micro-structural patterns of the trabecular bone, suggesting different mechanical properties.
Ankle Joint* ; Ankle* ; Cadaver ; Talus ; Tibia

Dynamic left ventricular (LV) outflow tract obstruction is a characteristic feature of hypertrophic cardiomyopathy; however, it can also occur in association with hyperdynamic LV contraction and/or changes in the cardiac loading condition, even in a structurally normal or near-normal heart. Here, we report a case of anemia-induced systolic anterior motion of the mitral valve and the resultant intraventricular obstruction in a patient who underwent coronary artery bypass grafting and suffered from anemia associated with recurrent gastrointestinal bleeding.
Anemia ; Cardiomyopathy, Hypertrophic ; Coronary Artery Bypass ; Dyspnea* ; Echocardiography ; Heart* ; Hemorrhage ; Humans ; Mitral Valve* ; Thoracic Surgery*

Phospholipase D (PLD), one of the intracellular signal transduction enzymes, may play an important role in developing brain. However, the developmental regulation of PLD protein has not been determined. In the present study, we investigated the temporal and spatial expression of PLD isozyme, PLD1 in the developing rat forebrain using an affinity-purified peptide antibody against PLD1. Our data showed that immunoreactivity for PLD1 was first seen in the germinal zone of the lateral ventricle, differentiating neurons and their processes at embryonic day 18 (E18). At E20, clusters of immunoreactive cells were observed in the medial germinal zone of the lateral ventricle, restricted zones of the frontal and parietal cortex, the nuclei of the medial septum and the diagonal band. During the first postnatal week, there was an increase in the number and staining intensity of the immunoreactive neurons in the cerebral cortex, which peaked at postnatal day 7 (P7). During the second postnatal week, there was an abrupt decrease in the number of immunoreactive cortical pyramidal neurons. By P14, only a few of the pyramidal neurons in cerebral cortex layer V were immunoreactive. These results revealed that expression of PLD1 protein at various stages of development of the septum and cerebral cortex is differentially regulated. This suggests that PLD1 may regulate the developmental processes of some neuronal populations.
Animals ; Brain ; Cerebral Cortex ; Immunohistochemistry ; Lateral Ventricles ; Neurons ; Phospholipase D ; Phospholipases* ; Prosencephalon* ; Rabeprazole ; Rats* ; Signal Transduction

OBJECTIVE: Sequelae of behavioral impairments associated with human traumatic brain injury (TBI) include neurobehavioral problems. We compared exploratory, cognitive, and depressive-like behaviors in pediatric and adult male mice exposed to controlled cortical impact (CCI).METHODS: Pediatric (21 to 25 days old) and adult (8 to 12 weeks old) male C57Bl/6 mice underwent CCI at a 2-mm depth of deflection. Hematoxylin and eosin staining was performed 3 to 7 days after recovery from CCI, and injury volume was analyzed using ImageJ. Neurobehavioral characterization after CCI was performed using the Barnes maze test (BMT), passive avoidance test, open-field test, light/dark test, tail suspension test, and rotarod test. Acutely and subacutely (3 and 7 days after CCI, respectively), CCI mice showed graded injury compared to sham mice for all analyzed deflection depths.RESULTS: Time-dependent differences in injury volume were noted between 3 and 7 days following 2-mm TBI in adult mice. In the BMT, 2-mm TBI adults showed spatial memory deficits compared to sham adults (P < 0.05). However, no difference in spatial learning and memory was found between sham and 2-mm CCI groups among pediatric mice. The open-field test, light/dark test, and tail suspension test did not reveal differences in anxiety-like behaviors in both age groups.CONCLUSION: Our findings revealed a graded injury response in both age groups. The BMT was an efficient cognitive test for assessing spatial/non-spatial learning following CCI in adult mice; however, spatial learning impairments in pediatric mice could not be assessed.
Adult ; Animals ; Brain Injuries ; Eosine Yellowish-(YS) ; Hematoxylin ; Hindlimb Suspension ; Humans ; Learning ; Male ; Memory ; Mice ; Rotarod Performance Test ; Spatial Learning ; Spatial Memory

Background: Myokymia consists of involuntary, fine, continuous contraction that spread across the affected striated muscle. Eyelid myokymia, unlike other dystonic facial contracture such as blepharospasm and hemifacial spasm, is assumed to be a benign, self-limited disorder. Eyelid myokymia is associated with stress, fatigue, excercise, and exccessive caffeine use. The pathophysiology is not well understood, but some drugs or brain structural lesions are the cause of the eyelid myokymia. Especially in Korea hypomagnesemia is generally known the main cause of eyelid myokymia, however there are no evidences so far. This study investigated the relation between eyelid myokymia and serum magnesium level. Methods: We performed a cross sectional study on 72 patients with myokymia and 197 controls. We investigated fatigue, sleep quality, alcohol, smoking, caffeine use, and exercise datas by interview. We analyzed laboratory datas including magnesium, calcium, phosphate, thyroid hormone in serum. Results: Demographic characteristics between the patients with myokymia and controls showed no significant differences in age, gender, smoking, and alcohol history. Fatigue and poor sleep quality were significantly higher in the myokymia group than control group. However, any laboratory results including magnesium showed no significant differences between two groups. Conclusions These data suggested that the eyelid myokymia is not related to the serum magnesium level as well as calcium and phosphate. Only fatigue and sleep quality were shown the relationship with eyelid myokymia.

Purpose: To report a case of orbital infarction syndrome in a patient with hemophagocytic lymphohistiocytosis (HLH).Case summary: A 70-year-old woman with diabetes mellitus and hypertension was referred to the Department of Ophthalmology for sudden-onset left upper eyelid ptosis after being diagnosed with HLH. After 3 days, the best corrected visual acuity in the right eye was 0.8, while there was no light perception in the left eye. In the left eye, the ocular motility examination showed limitations in all fields of gaze. On fundus examination, optic disc pallor, retinal hemorrhage, and narrowed retinal arteries were observed in the left eye. Fluorescein angiography showed no blood flow in the retinal arteries and veins in the left eye. On neck computed tomography angiography, the left distal internal carotid artery was narrowed. Orbit computed tomography showed exophthalmos and extraocular muscle hypertrophy in the left eye. Orbit magnetic resonance imaging confirmed optic nerve edema, enhancement of the optic nerve sheath, and high signal intensity of the intraocular fat in the left eye. Slit-lamp examination revealed ischemia of the anterior segment and ischemic necrosis of the eyelid in the left eye. The patient was diagnosed with orbital infarction syndrome. Conclusions Several factors may lead to ischemia of the orbital tissues in patients with HLH, including coagulopathy, an increased incidence of blood clots, and inflammation in the orbit. It is necessary to consider the possibility of orbital infarction syndrome when HLH patients present with visual loss, ocular movement limitations, and anterior segment ischemia.

The expression of Bis (also called Bag-3), a Bcl-2-binding protein, was investigated in the rat kainic acid (KA) model of temporal lobe epilepsy. Western blot analysis showed a significant increase in the expression levels of Bis protein in the hippocampus following the systemic administration of KA. Bis immunoreactivity increased preferentially in the CA1 and CA3 regions, as well as in the hilar region of the dentate gyrus. Experiments with double immunofluorescence revealed that, in KA-administered rats, the cells expressing Bis were GFAP-expressing reactive astrocytes. The increase in Bis immunoreactivity was accompanied by increased Bcl-2 in reactive astrocytes in the striatum radiatum, whereas Bcl-2 immunoreactivity in pyramidal neurons was not affected. These results of the co-expression of Bis and Bcl-2 in reactive astrocytes in this seizure model suggest that Bis might modulate the glial reaction under excitotoxic brain injury, probably by interacting with Bcl-2.
Animals ; Apoptosis ; Astrocytes/*metabolism ; Blotting, Western ; Carrier Proteins/*biosynthesis ; Disease Models, Animal ; Epilepsy, Temporal Lobe/chemically induced/*metabolism ; Fluorescent Antibody Technique ; Hippocampus/*metabolism/pathology ; Kainic Acid ; Male ; Neurons/physiology ; Protein Binding ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Rats ; Rats, Sprague-Dawley

Nitric oxide (NO) system has been implicated in a wide range of physiological functions in the nervous system. However, the roleof NO in regulating the neural activity in the gustatory zone of nucleus tractus solitarius (NTS) has not been established. The present study was aimed to investigate the role of NO in the gustatory NTS neurons. Sprague-Dawley rats, weighing about 50 g, were used. Whole cell patch recording and immunohistochemistry were done to determine the electrophysiological characteristics of the rostral gustatory nucleus of the tractus solitarius and distribution of NO synthases (NOS). Neuronal NOS (nNOS) immunoreactivity was strongly detected along the solitary tract extending from rostral to caudal medulla. Resting membrane potentials of NTS neurons were -49.2+/-2 mV and action potential amplitudes were 68.5+/-2 mV with a mean duration measured at half amplitude of 1.7+/-0.3 ms. Input resistance, determined from the response to a 150 ms, -100 pA hyperpolarizing current pulse, was 385+/-15 MOmega. Superfusion of SNAP or SNP, NO donors, produced either hyperpolarization (68%), depolarization (5%), or no effect (27%). The hyperpolarization was mostly accompanied by a decrease in input resistance. The hyperpolarization caused by SNAP or SNP increased the time to initiate the first action potential, and decreased the number of action potentials elicited by current injection. SNP or SNAP also markedly decreased the number of firing neural discharges of the spontaneous NTS neural activity under zero current. Superfusion of L-NAME, a NOS inhibitor, slightly depolarized the membrane potential and increased the firing rate of NTS neurons induced by current injection. ODQ, a soluble guanylate cyclase inhibitor, ameliorated the SNAP-induced changes in membrane potential, input resistance and firing rates. 8-Br-cGMP, a non-degradable cell-permeable cGMP, hyperpolarized the membrane potential and decreased the number of action potentials. It is suggested that NO in the gustatory NTS has an inhibitory role on the neural activity of NTS through activating soluble guanylate cyclase.
Action Potentials ; Animals ; Fires ; Guanylate Cyclase ; Humans ; Immunohistochemistry ; Membrane Potentials ; Nervous System ; Neurons* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Rats* ; Rats, Sprague-Dawley ; Solitary Nucleus* ; Tissue Donors