No abstract available.

Miller Fisher syndrome is a syndrome of acute external ophthalmoplegia, ataxia and areflexia without significant motor or sensory deficit in the limbs and usually results in complete recovery without specific treatment. It's accurate anatomic lesion sites and pathogeneiss is still unknown. Recently we experienced a 57 year old man who had the sudden onset of ophthalmoplegia, ataxia, areflexia and albuminocytologic dissociation in CSF and completely recovered 2 1/2 months later.
Ataxia* ; Extremities ; Humans ; Middle Aged ; Miller Fisher Syndrome* ; Ophthalmoplegia

Miller Fisher syndrome is a syndrome of acute external ophthalmoplegia, ataxia and areflexia without significant motor or sensory deficit in the limbs and usually results in complete recovery without specific treatment. It's accurate anatomic lesion sites and pathogeneiss is still unknown. Recently we experienced a 57 year old man who had the sudden onset of ophthalmoplegia, ataxia, areflexia and albuminocytologic dissociation in CSF and completely recovered 2 1/2 months later.
Ataxia* ; Extremities ; Humans ; Middle Aged ; Miller Fisher Syndrome* ; Ophthalmoplegia

No abstract available.
Humans

PURPOSE: The purpose of this study was to examine the effect of professional autonomy, organizational commitment, and perceived patient safety culture on patient safety management activities of nurses in medium and small-sized hospitals.METHODS: A cross-sectional design was employed. Self-reported questionnaires were completed by 121 nurses with at least 3 months of working experience in medium and small-sized hospitals located in B city. Data were analyzed using descriptive statistics, a t-test, a one-way ANOVA, Pearson correlation coefficients, and a multiple regression analysis.RESULTS: Professional autonomy (r=.22, p=.016), organizational commitment (r=.34, p < .001), and perceived patient safety culture (r=.55, p < .001) had a statistically significant positive correlation with patient safety management activities. The factors that might affect patient safety management activities were professional autonomy (β=.23, p=.003) and perceived patient safety culture (β=.55, p < .001). The explanatory power of these factors for patient safety management activities was 33.5% (F= 21.19, p < .001).CONCLUSIONS: The development of repetitive and continuous education programs is needed to improve a nurse's professional autonomy and perceived patient safety culture.
Education ; Humans ; Organizational Culture ; Patient Safety ; Professional Autonomy ; Safety Management

Various cancer types have been associated with cancer-related cerebral infarction. In this study, we describe the first case of cancer-related cerebral infarction in which the underlying disease was primary bone marrow lymphoma (PBML). A 79-year-old man presented with abruptly developed bilateral lower extremity weakness and confusion. Diffusion-weighted imaging on admission showed multiple cortical and subcortical embolic infarction lesions in multiple vascular territories. Diagnostic evaluations to determine the embolic source revealed no abnormalities. Laboratory testing demonstrated elevated D-dimer (2.59 μg/mL) but no other prothrombotic abnormalities. In suspicion of cancer-related stroke, we performed chest CT, abdomen CT, and FDG-PET to detect the hidden malignancy. Findings revealed no evidence of cancer; however, they did reveal signs of anemia (hemoglobin 9.0 g/dL). Bone marrow aspiration biopsy showed large atypical B cell involvement suggestive of high-grade B cell lymphoma. The patient was diagnosed with primary bone marrow diffuse large B-cell lymphoma initially presenting with ischemic stroke. Our case suggests that primary bone marrow cancer may be a candidate for the differential diagnosis of hidden malignancy in patients with suspected cancer-related stroke. Bone marrow biopsy may be essential for establishing an appropriate differential diagnosis in patients with abnormal hematologic findings.

OBJECTIVES: This study was conducted to investigate providers' perspectives on current challenges in implementing a program for prevention and management of childhood obesity and adoption of mobile phone as a potential solution of leveraging multimodal delivery and support in a school setting. METHODS: The qualitative data were collected through face-to-face in-depth interviews with 23 elementary-school teachers, 6 pediatricians, and 6 dieticians from community health centers and analyzed using a qualitative research methodology. RESULTS: Current challenges and potential solutions of obesity-prevention and -management program for obesity program for elementary school children were deduced as two themes each. Lack of tailored intervention due to limited recipient motivation, lack of individualized behavioral intervention, and different environmental conditions can be solvable by mobile technology-based personalized intervention which brings about interactive recipient participation, customized behavioral intervention, and ubiquitous accessibility. Lack of sustainable management due to stigmatization, limited interactions between program providers and inconsistent administrative support can be handled by multimodal support based on school setting using mobile platform providing education of health promoting behaviors toward larger scale and interactive networking between program participants, and minimizing administrative burden. CONCLUSIONS: Adoption of mobile-based health management program may overcome current limitations of child obesity program such as lack of tailored intervention and sustainable management via personalized intervention and multimodal supports although some concerns such as increased screen time need to be carefully considered in a further study.
Cell Phones* ; Child* ; Community Health Centers ; Education ; Humans ; Motivation ; Nutritionists ; Obesity* ; Pediatric Obesity ; Qualitative Research ; Stereotyping

The depolarizing neuromuscular blocking agent succinylcholine, which was synthesized by Hunt and Taveau in 1906, is still regarded as the drug of choice when speed of onset and good intubating conditions matter most. This agent has several disadvantages, some of which may be unpredictable, serious and immediate, for example, muscle pain, bradycardia, rise in intragastric pressure, increase in intraocular pressure and elevation of serum potassium. These disadvantages may be regarded as the side effects of depolarization and indicate a need for a nondepolarizing neuromuscular blocking agent with rapid onset and good muscle relaxation. Simpson et al. described the neuromuscular blocking properties of the nondepolarizing .neuromuscular blocking agent, Fazadinium (AH 8165) in 1972. This initial work indicated a more rapid onset of action than occurs with succinyleholine and without muscle fasciculation or concomitant rise in plasma potassium concentration. However, Coleman et al., Young, t al., Hartley and Fidler, and Metha et al., concluded that using succinylcholine, a ignificantly greater number of patients had excellent intubating conditions at predetermined times after administration than when using Fazadinium. Several reports have indicated that administration of a small dose of nondepolarizing neuromuscular blocking agents would markedly diminish the fasciculation and muscle pains which so frequently occur, when succinylcholine is given. Many other reports have indicated that administration of a small dose of nondepolarizing neuromuscular blocking agents could attenuate or eliminate the adverse effects of succinylcholine such as increased intra-gastric pressure and intraocular pressure, bradycardia, arrhythmia and hyperkalemia. Several investigators have recommended that when small doses of nondepolarizing neuromuscular blocking aKent are given before succinylcholine administration, larger doses of succinylcholine should be given to achieve satisfactory relaxation. A comparative study using d-tubocurarine, gallamine and pancuronium for precurarization indicates that any of them successfully attenuates fasciculation. They have a little antagonizing effect of vocal cord relaxation after succinylcholine administration, but there was no difficulty during endotracheal intubation.
Arrhythmias, Cardiac ; Bradycardia ; Fasciculation ; Gallamine Triethiodide* ; Humans ; Hyperkalemia ; Intraocular Pressure ; Intubation, Intratracheal ; Muscle Relaxation ; Myalgia ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pancuronium* ; Plasma ; Potassium ; Relaxation ; Research Personnel ; Succinylcholine ; Tubocurarine* ; Vocal Cords

PURPOSE: The purpose of this study is to identify factors that affect coping with fatigue in middle-aged men according to Q-methodology and to provide basic strategies for health promotion. METHOD: 25 subjects in Seoul, Incheon, Chung-buk classified 24 selected Q-statements in to 9 points standard. The collected data were analyzed by using a QUNAL pc program. RESULT: Principal component analysis identified 3 types of coping with fatigue among middle-aged Korean men. 1st Type: Coping with fatigue through various kinds of game, using alcohol, smoking cigarette other than rest and sleep. 2nd Type : Coping with fatigue through rest and sleep, taking medicine or food which helps relieving fatigue. 3rd Type : Coping with fatigue through acitivities such as sports or trip other than sleep. CONCLUSION: We have found how Korean middle-aged men cope against fatigue through this research. To setup and apply different nursing intervention on each type based on this result is needed.
Adaptation, Psychological ; Fatigue* ; Health Promotion ; Humans ; Incheon ; Male ; Middle Aged ; Nursing ; Principal Component Analysis ; Seoul ; Smoke ; Smoking ; Sports ; Tobacco Products

We report a case of pneumomediastinum, subcutaneous emphysema, and mild pneumothorax that occurred after endotracheal intubation with a metallic endotracheal tube for the laser operation. Fortunately, pneumomediastinum and subcutaneous emphysema were self-limited. But potentially life-threatening events such as upper airway obstruction, tension pneumothorax, pneumopericardium, mediastinitis might be possible. These complications may result from mucosal perforation of upper airway. The use of a tube with rigid and relatively narrower internal diameter than polyvinylchloride endotracheal tube, tough endotracheal intubation technique, high peak inspiratory pressure, suction technique and negative pressure are included as complication factors.
Airway Obstruction ; Intubation, Intratracheal ; Mediastinal Emphysema* ; Mediastinitis ; Pneumopericardium ; Pneumothorax ; Subcutaneous Emphysema* ; Suction