BACKGROUND AND OJBECTIVES: Nystagmus produced by static placement of the head in different orientations is termed positional nystagmus and in most instances the cause is a peripheral vestibular disorder, as in benign paroxysmal positioning vertigo (BPPV). However, the physiologic basis of the isolated positional downbeat nystagmus has not been fully understood. The goal was to find a possible pathomechanism of dizzy patients who showed isolated positional downbeat nystagmus (pDBN). MATERIALS AND METHOD: Twelve consecutive patients with isolated positional DBN and 50 normal volunteers underwent evaluation of spontaneous, head-shaking and positional nystagmus, smooth pursuit, saccades, and VOR. The patients with focal neurologic signs, abnormal hearing, caloric paresis or acute lesion on brain imaging were excluded. RESULTS: Positional downbeat nystagmus was developed during lying down, straight head-hanging and/or Dix-Hallpike position. Perverted head-shaking nystagmus was observed in seven patients (58.3%). Gait disturbance revealed in six patients. Other cerebellar manifestations including saccadic dysmetria and gaze-evoked nystagmus were not observed. The gains of VOR were increased than normal controls. However, the gains of visual enhancement and visual cancellation of the VOR were not different from controls and OKN/OKAN were normal. The mean VOR time constants did not differ between patients and normal controls. However, tilt suppression of the post-rotatory nystagmus was impaired in the patients (p<0.01). All patients showed normal findings in head thrust test, caloric response, BAEPs, and brain imaging. CONCLUSION: Isolated positional downbeat nystagmus (pDBN) in patients complained intermittent dizziness showed frequently accompanied perverted head-shaking nystagmus (HSN) and increased gain of VOR and impaired tilt suppression. This finding tells us that isolated positional downbeat nystagmus (pDBN) reflects pathologic central nystagmus results from cerebellar (uvulonodular) dysfunction.
Cerebellar Ataxia ; Deception ; Dizziness ; Gait ; Head ; Head Impulse Test ; Healthy Volunteers ; Hearing ; Humans ; Neuroimaging ; Neurologic Manifestations ; Nystagmus, Physiologic* ; Paresis ; Pursuit, Smooth ; Reflex, Vestibulo-Ocular ; Saccades ; Vertigo

Retrospective studies of duodenal polyps have shown a prevalence of 0.3-4.6% in patients referred to upper gastrointestinal endoscopy, and histologic classification have been inconsistent. A prospective consecutive study was carried out in 3,871 patients referred to diagnostic endoscopy, Sixteen patients had polyps in the first part of duodenum, for a prevalence 0.41%(0.28-0.53%, 95% confidence interval). Fourteen polyps were either inflammatory(thirteen polyps) or ectopic gastric mucosa(one polyp). Two hyperplasitc polyps were founded. All polyps were benign and sessile, and most of polyps(75%) were solitary.
Classification ; Duodenum ; Endoscopy* ; Endoscopy, Gastrointestinal ; Humans ; Polyps* ; Prevalence* ; Prospective Studies

The author have performed and epidemiological study on the accidental deaths at industry from 1970 to 1975, in order to seek for the preventive measures of industrial accident with the understanding of its cause and characteristics of the accident deaths. The obtained results were as follows : 1. Total number of deaths for 6 years were 361 (350 males, 11 females) and the mean death rate was 33.8 per 100,000 industrial workers during 6 years. by the highest as 52.9 was in 1974 and the lowest as 13.7 in 1970. By the industry group., the death rate of Electricity, Gas and Water was 149.3, Construction 83.9 and the lowest was Manufacturing as 18.3. 2. Standardized mortality rate of the cases by the age group showed that 20-29 years old group was 43.0, 40-49 years old group 38.1, 30-39 years old group 32.0, and the lowest as 17.9 was under 19 years old group. 3. The cumulative percentage of the cases by years of service showed that under 6 months was 60.4%, under 1 year 72.9%, under 2 years 83.1%. 4. By the month of occurrence, the highest was 15.8% which occurred in August and the lowest was 5.8% in February. The highest as 19.1% was on Friday and the lowest as 11.9% on Monday by the day of a week. 5. By the causes of accident, car accidents was 28.3%, fall accidents 19.1%, accidents by a crash 9.1% in that order. By the location of injury, head was 44.6%, multiple injuries 33.0%, chest 10.5%, and back was the lowest as 1.9% was on Friday and the lowest as 11.9%. The distribution of the cases by nature of injury showed that cerebral contusion and hemorrhage was 39.4%, fracture and dislocation 33.2%, asphyxia 8.0% in that order. 6. The cumulative percentage of the cases by the duration from injury to death showed that the injuried day was 74.2%, within 3 days after injury 88.5%, within 7 days 96.1%. Therefore most of the cases were occurred within 7 days after injury. 7. By the daily mean wages, most of the cases as 91.7% were under 2,000won, and more 4,000won was 1.6% merely.
Accidents, Occupational ; Asphyxia ; Busan* ; Contusions ; Craniocerebral Trauma ; Dislocations ; Electricity ; Epidemiologic Studies* ; Hemorrhage ; Humans ; Male ; Mortality* ; Multiple Trauma ; Salaries and Fringe Benefits ; Thorax ; Young Adult

BACKGROUND: Elevated plasma homocysteine level (tHcy) is one of the risk factors for coronary artery disease (CAD). It has been demonstrated that doses of folate as low as 0.25 mg/d significantly decreased tHcy in healthy, young women. Homozygosity for C-677T polymorphism in the Methylenetetrahydrofolate reductase (MTHFR) gene seems to be correlated with an elevated tHcy in the situation of low blood folate concentrations. In this study, we evaluated the response of the low dose folate treatment on the tHcy and whether genetic variation of MTHFR gene might influence the response of the folate treatment in korean CAD patients. METHODS: CAD patients (n=3), confirmed by coronary angiography, and controls were analyzed for CAD risk factors including tHcy and MTHFR gene C-677T polymorphism. Patients were treated with daily 0.25mg folate for 4weeks and the level of folate and tHcy was reevaluated. RESULTS: Low dose folate treatment for 4weeks significantly increased folate level (38%, p<0.05), but did not influence tHcy. Patients whose tHcy was decreased with folate replacement (n=1) were characterized by low basal folate level (7.0+/-2.6 vs 9.1+/-2.7 nmol/L, p<0.05) and high basal tHcy (12.6+/-4.4 vs 8.6+/-2.4 micromol/L, p<0.05) compared to the patients whose tHcy was unaffected or increased with folate. tHcy was decreased 11.2% and 12.6% each in patients with high basal tHcy (>10 micromol/L) and low folate level (<7 nmol/L), but increased 7.3% and 4.5% in patients with low tHcy and high folate level (p<0.05, each). MTHFR C-677T polymorphism was not a significant contributing factor for tHcy and for the response to folate treatment. CONCLUSION: Low dose folate treatment can decrease tHcy in CAD patients with low basal folate level and high basal tHcy. C-677T MTHFR gene mutation does not influence the effects of low dose folate treatment on tHcy in Korean CAD patients.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Folic Acid* ; Genetic Variation ; Homocysteine* ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma ; Risk Factors

Disclosure of a diagnosis of cancer to patients is a major problem among physicians in Korea. Many questions arise when considering issues involved in telling the diagnosis of cancer beyond the question of whether to tell. But there has been no consensus guideline on how, and in what context, to tell the diagnosis of cancer to the patients. The review of the literature reveals that the attitudes of physicians on the truth telling have been changing from favoring non-disclosure to disclosure over time. The disclosure rate was 81.8% in a Korean survey performed in 1990, while it was 65% in a survey in 1979. The younger the patient's age was, the higher the disclosure rate was. This tendency was same in Korean nurses and patients. The majority of Korean patients wanted their doctors to break the bad news, not only because the patients wanted to obtain detailed information about their conditions but also because they believed their doctors. They also wanted their family to hear the truth first, immediately after the diagnosis had been confirmed. The most important issue in the process of disclosing a diagnosis of cancer to patients is truth. Otherwise, doctors will lose the chance to give help to the patients when they are in real need of doctor's help at the very end of their lives.
Consensus ; Diagnosis* ; Disclosure ; Humans ; Korea ; Terminally Ill*

No abstract available.
Humans ; Lung Diseases*

No abstract available.
Humans ; Lung Diseases*

We studied arterial oxygen desaturation, using a pulse oximeter, in 132 patients undergoing diagnostic upper gastrointestinal endoscopy to obtain predictive factors of the change. The baseline arterial oxygen saturation (SaO2) level was 98.8+/- 1.2%. During the procedure, oxygen desaturation (SaO2>95%) was found in 90.2% of the patients, Mild oxygen desaturation (95>SaO2>90%) was found in 9.8% of the patients, and there was no severe oxygen desaturation(SaO2<90%). Age(P=0.52), gender(P =0.48), smoking(P =0.71), body mass index(P =0.32), and endoscopy time(P = 0.68) was not related to the degree of oxygen desaturation. These results suggest that oxygen desaturation, which may rarely induce serious cardiopulmonary events, is not frequently observed during non-sedated diagnostic upper endoscopy.
Endoscopy ; Endoscopy, Gastrointestinal* ; Humans ; Oxygen*

No abstract available.
Classification* ; Lung Diseases*

PURPOSE: The purpose of this study was to describe hospital nurses' knowledge and beliefs about hand hygiene and to identify the relationships between knowledge and beliefs. METHODS: Data were collected from 232 nurses working in four university hospitals and were analyzed using SPSS/WIN 20.0 program. RESULTS: The mean score of knowledge of hand hygiene was 8.1. The mean scores of behavioral, normative, and control belief about hand hygiene were 2.3, 2.5, and -0.7, respectively. Knowledge was correlated with educational level (p=.013) and experience of hand hygiene campaign (p=.018). The behavioral belief was correlated with age (p<.001) and career (p=.002). The normative belief was correlated with work department (p=.007). The control belief was correlated with educational level (p=.043) and experience of being monitored on hand hygiene (p=.010). The subjects who believed that head nurses, charge nurses, and colleagues practiced better hand hygiene had higher behavioral and normative belief scores than those who did not. There were no significant relationships between knowledge and beliefs. CONCLUSION: There is a need to improve knowledge of hand hygiene in hospital nurses. This study provides information for developing strategies to strengthen beliefs about hand hygiene.
Hand ; Hand Hygiene ; Hospitals, University ; Infection Control ; Nursing, Supervisory