Ataxia is one of the most serious neurological symptoms in elderly The clarification of the related anatomical structures are necessary for the understanding of pathophysiologic mechanisms of ataxia. We have recently experienced a case of thalamic infarct in the territory of thalamogeniculate artery. The localization of lesion was based on CT and MR imaging. At first time, right hemiparesis and ataxia were prominent. Hemiparesis was transient but ataxia had been persistent for several months. It has been suspected that thalamus could be the part of neural circuits in balancing. Our case support this suggestion clinically. Based on clinical observations, a plausible extrapolation can be made to thalamic ataxia. It maybe related with dysfunction of dentatorubrothalamic and corticopontine pathway. Thus our case led us to conclude that thalamus could be engaged in balance control of human body.
Aged* ; Arteries ; Ataxia* ; Human Body ; Humans ; Magnetic Resonance Imaging ; Paresis ; Thalamus

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

PURPOSE: This study was done to identify the level of knowledge, attitude and performance ability in CardioPulmonary Resuscitation (CPR) and provided data for the development of an education program to improve CPR performance ability of nursery teachers. METHODS: The participants were 220 nursery teachers working in daycare centers in A city located in G province. Data were collected during July, 2013. RESULTS: The mean scores were 45.88 of 100 for knowledge, 3.69 of 5 for attitude, 2.65 of 5 for performance ability. There were significant differences in knowledge and performance ability according to education experience. There were positive correlations between knowledge and performance ability, and between attitude and performance ability. Factors affecting CPR performance ability were knowledge (beta=.133), attitude (beta=.327), and education in CPR (beta=.343). These factors explained 29.4% of the variance in CPR performance ability. CONCLUSION: Results indicate that nursery teachers' knowledge, attitude and CPR performance ability were not sufficient enough to perform accurate CPR in an emergency. Therefore, to improve performance ability of nursery teachers to carry out CPR in a cardiac arrest emergency of a child, educational strategies that focus on increasing knowledge and attitude need to be developed.
Cardiopulmonary Resuscitation* ; Child ; Education ; Emergencies ; Heart Arrest ; Humans ; Nurseries*

We described 2 patients with Marchiafava-Bignami disease, a neurological disorder associated with chronic alcohol consumption. Patient 1 expressed general weakness and confusion, while patient 2 expressed dysphagia and seizures. Lesions involving the corpus callosum were identified with T2 weighted MR imaging in which there was a hyperintensity in the splenium of patient 1 and in the entire corpus callosum of patient 2. While the conditions of both patients were improved by with nutritional support, they were left with cognitive impairment.
Alcohol Drinking ; Corpus Callosum ; Deglutition Disorders ; Demyelinating Diseases ; Humans ; Magnetic Resonance Imaging ; Marchiafava-Bignami Disease* ; Nervous System Diseases ; Nutritional Support ; Seizures

We report a case of exogastric schwannoma of the stomach in 41-years-old male patient with papable mass in left upper abdomen. Upper GI series revealed extrinsic compression on the greater curvature of the stomach. CT scan showed a low density mass attached to greater curvature of the stomach with inhomogeneous contrast nhancement in the mass lesion. The mass was removed by surgery, and confirmed pathologically as schwannoma arising from the stomach.
Abdomen ; Humans ; Male ; Neurilemmoma* ; Stomach* ; Tomography, X-Ray Computed

PURPOSE: This study was performed to develop an infection prevention education program for child care teachers and to verify its effects. METHODS: The study was conducted using a nonequivalent control group with a pretest-posttest design. Four private daycare centers (2 centers per city) that were alike in terms of the number of children by age, number of child care teachers, and child care environment were chosen. Participants were assigned to the experimental group (n=20) or control group (n=20). As a part of the program, visiting education (90 min) was provided in the 1st week, and smartphone application education (10 min) was provided thrice a week, in the 2nd and 3rd weeks. RESULTS: Child care teachers' self-efficacy for infection prevention revealed a significant interaction effect between the group and time of measurement (F=21.62, p < .001). In terms of infection prevention behavior, a significant difference was observed between the experimental and control groups (z=−5.36, p < .001). CONCLUSION: The program implemented in this study was effective in improving the infection prevention self-efficacy and infection prevention behavior of child care teachers. Thus, this program may be effective in enhancing their infection control.
Child ; Child Care* ; Child* ; Education* ; Humans ; Infection Control ; Smartphone*

PURPOSE: In this study self-efficacy, emotional labor, pediatric nurse-parent partnership and job stress of pediatric nurses were examined. Factors affecting job stress of pediatric nurses were also investigated. METHODS: The study was done between June and September 2014, with a convenience sample of 145 nurses from 3 advanced general hospitals, 5 general hospitals and 2 children's hospitals. Research data were collected via questionnaires and analysed using SPSS version 18.0. RESULTS: Average levels of self-efficacy, emotional labor and job stress were similar to other general nurses and the average level of pediatric nurse-parent partnership was also similar to other pediatric nurses. Job stress of pediatric nurses showed a positive correlation with emotional labor and negative correlations with self-efficacy and pediatric nurse-parent partnership. The most significant factor affecting job stress in pediatric nurses was emotional labor (beta=0.372, p<.001). The combination of emotional labor, pediatric nurse-parent partnership and self-efficacy accounted for 25.4% of job stress in pediatric nurses. CONCLUSION: These results suggest that nursing management strategies to decrease emotional labor and improve pediatric nurse-parent partnerships and self-efficacy are critical to decrease job stress for pediatric nurses. Continued development of nursing management interventions to decrease job stress in pediatric nurses is suggested.
Child ; Hospitals, General ; Humans ; Nursing ; Parents ; Professional-Family Relations

BACKGROUND: Exercise tests (ET), hyperventilation tests (HVT) and cold pressor tests (CPT) have been used to induce coronary artery spasm. However their diagnostic significance and the circadian variation of exercise test response in patients with vasospastic angina are still uncertain. METHODS: To elucidate the circadian variation of ET response and to evaluate the diagnostic significance of non-pharmacological provocation tests, 21 consecutive patients with pure vasospastic angina were studied. Six ETs were performed in the early morning, late morning, and late afternoon in consecutive days, 2 HVTs and 2 CPTs in the early morning. The circadian distribution and types of angina (at rest, on physical activity, or both) from before admission to after discharge (mean follow-up periods 19+/-9 months) were evaluated by clinical history, clinical records and Holter recordings. Circadian distribution of anginal attacks recorded through the all observation periods were classified into 3 patterns (morning and night : MN, morning and afternoon or evening : M+F/E, morning, night and afternoon and/or evening : MN+F/E). RESULTS: One hundred and eleven ETs (39 early morning, 38 late morning, 34 late afternoon tests), 35 HVTs and 33 CPTs were performed. ETs showed 14 positive responses (36%) in the early morning, 14 (37%) in the late morning and 12 (35%) in the late afternoon without any circadian variation. Among the 11 patients who underwent all 6 exercise tests, 3 patients (27%) showed at least one positive response in the early morning, 4 (36%) in the late morning and 4 (36%) in the late afternoon. Subgroups of the subjects according to the types and activity of angina and the numbers of spastic artery also failed to show any circadian variation in ET response, but M+F/E group of circadian pattern of angina showed a peak of positive response in the early morning (p<0.05). HVTs showed significantly higher positive response (23/35, 66%, p<0.05) than ETs (14/39, 36%) and CPTs showed significantly lower positive response (2/33, 6%, p<0.01) than ETs in the early morning. Double tests with more than 1 positive response couldn't increase the positive response in ETs (9/19, 47%), and CPTs (2/14, 14%) but increased significantly in HVTs(15/16, 94%, p<0.05), particularly in the group with low activity (7/8, 86%, p<0.01). ETs showed ST segment elevation in 29 (72%) and depression in 11 (28%) of the 40 positive tests, HVTs in 21 (91%) and 2 (9%) of the 23 positive tests and CPTs in 2 (100%) and 0 (0%) of the 2 positive tests. The ST segment elevation was significantly higher in HVTs than in ET (p<0.05). CONCLUSION: These findings suggest that the exercise test in the early morning do not increase positive response and is not a sensitive diagnostic test associated with occasional depression of ST segment, but hyperventilation test, especially if repeated, is a very sensitive test with predominant elevation of ST segment in patients with vasospastic angina.
Arteries ; Circadian Rhythm ; Coronary Vasospasm ; Coronary Vessels ; Depression ; Diagnostic Tests, Routine ; Exercise Test* ; Follow-Up Studies ; Humans ; Hyperventilation ; Motor Activity ; Muscle Spasticity ; Spasm

PURPOSE: To explain hypothesis that there are two types of human retinal capillary pathways. One is simple type and the other is complex type. The former plays a role in blood flow regulation and the latter does capillary function itself. METHODS: We measured the length, tortousity, and flow velocity of human retinal capillaries using Fluorescein Leukocyte Angiography (FLA) with a Scanning Laser Ophthalmoscope (SLO) on two healthy adult male volunteers. We studied distribution and pathways of human retinal capillaries on the posterior pole. RESULTS: The lengths of capillaries were distributed with two peak incidence. One was 70 microgram and the other 240 microgram. There was no relationship between capillary length and tortousity. The correlation between capillary length and leukocyte velocity showed that the shorter capillary group has a wide range of velocity but the longer group has a narrow range of velocity. CONCLUSIONS: Two types of retinal capillary pathways exist on human retina. Compared with two types of capillaries on the cat retina described by Ben-nun et al, we found that the shorter capillary type plays a role in blood flow regulation and the longer type in capillary function itself.
Adult ; Angiography* ; Animals ; Capillaries* ; Cats ; Fluorescein* ; Humans* ; Incidence ; Leukocytes* ; Male ; Ophthalmoscopes ; Retina ; Retinaldehyde* ; Volunteers

PURPOSE: The aim of this study was to understand factors that influence post-traumatic stress (PTS) in Korean forensic science investigators. METHODS: A total of 111 forensic science investigators were recruited in Korea. PTS was measured using the tool modified by Choi (2001) from the original developed by Foa, Riggs, Dancu, and Rothbaum (1993) based on DSM-IV. Factors influencing PTS included demographic and job-related characteristics, emotional intelligence, and death anxiety. RESULTS: PTS scores were positively correlated with personality type, fatigue from work, and death anxiety. PTS scores were negatively correlated with length of career as a forensic science investigator and emotional intelligence. The factors that had the greatest influence on PTS were death anxiety, years spent as a forensic science investigator, personality type, emotional intelligence, fatigue, and homicide experience. The explanatory power of these six factors was 44.0%. CONCLUSION: Therefore, it is necessary to regularly evaluate the mental health of those who are vulnerable to PTS. Based on these results, various interventions could be implemented for promoting overall health of the forensic science investigators.
Anxiety ; Attitude to Death ; Diagnostic and Statistical Manual of Mental Disorders ; Emotional Intelligence ; Fatigue ; Forensic Sciences* ; Homicide ; Humans ; Korea ; Mental Health ; Research Personnel* ; Stress Disorders, Post-Traumatic