Drug-induced immune hemolytic anemia is a rare disease that occurs in 1 in 1 million individuals of the general population. Rifampin-induced immune hemolytic anemia is caused by drug-dependent antibodies and this can be treated without complication by drug cessation. Herein, we present a case of rifampin-induced immune hemolytic anemia in a patient with primary Sjogren's syndrome (pSS) which occurred during treatment of pulmonary tuberculosis. At admission, the patient's laboratory tests revealed hemolytic anemia and positive direct antiglobulin test result. Since the incidence of autoimmune hemolytic anemia (AIHA) in pSS is reported to be 3 percent, which is higher than that of the general population, differential diagnosis between AIHA and rifampin-induced immune hemolytic anemia was required for planning future anti-tuberculous treatment. We identified rifampin-dependent antibody by drug-induced immune complex test and diagnosed rifampin-induced immune hemolytic anemia. Based on this experience, if rifampin administration is considered in patients with systemic autoimmune disease such as pSS, which has a high incidence of AIHA, we suggest evaluating the presence and the cause of hemolytic anemia at baseline by testing serum lactate dehydrogenase, haptoglobin, and direct and indirect antiglobulin tests before drug administration to promptly identify the cause of hemolysis if hemolytic anemia develops.

Remyelination via the transplantation of oligodendrocyte precursor cells (OPCs) has been considered as a strategy to improve the locomotor deficits caused by traumatic spinal cord injury (SCI). To date, enormous efforts have been made to derive OPCs from human pluripotent stem cells (hPSCs), and significant progress in the transplantation of such cells in SCI animal models has been reported. The current methods generally require a long period of time (>2 months) to obtain transplantable OPCs, which hampers their clinical utility for patients with SCI. Here we demonstrate a rapid and efficient method to differentiate hPSCs into neural progenitors that retain the features of OPCs (referred to as OPC-like cells). We used cell sorting to select A2B5-positive cells from hPSC-derived neural rosettes and cultured the selected cells in the presence of signaling cues, including sonic hedgehog, PDGF and insulin-like growth factor-1. This method robustly generated neural cells positive for platelet-derived growth factor receptor-α (PDGFRα) and NG2 (~90%) after 4 weeks of differentiation. Behavioral tests revealed that the transplantation of the OPC-like cells into the spinal cords of rats with contusive SCI at the thoracic level significantly improved hindlimb locomotor function. Electrophysiological assessment revealed enhanced neural conduction through the injury site. Histological examination showed increased numbers of axon with myelination at the injury site and graft-derived myelin formation with no evidence of tumor formation. Our method provides a cell source from hPSCs that has the potential to recover motor function following SCI.
Animals ; Axons ; Behavior Rating Scale ; Cues ; Hedgehogs ; Hindlimb ; Humans* ; Methods ; Models, Animal ; Myelin Sheath ; Neural Conduction ; Oligodendroglia ; Platelet-Derived Growth Factor ; Pluripotent Stem Cells* ; Rats ; Spinal Cord Injuries* ; Spinal Cord*

PURPOSE: The purpose of this study was to seek the direction of community health nursing practice education focus on the nursing education accreditation criteria. METHODS: We collected data through e-mail survey to all of 202 Korean nursing baccalaureate education institute in April, 2016. The 93 professors teaching community health nursing was responded about their affiliated institute (response rate 46.0%). RESULTS: The Korean nursing graduates in Feb. 2016 was practiced 3.01 credits, 131.6 hours in community health nursing course. Community health nursing practice agency was public health center (98.9%), Public health center post (43.0%), Public health center branch (32.3%) in order. The possibility to achieve the course objectives up to national examination was recognised Public health center (3.4), Public health center post (3.3), Public health center branch and school (3.2) from 5 score likert scale. A lot of nursing education institute have difficulty in clinical placement in community health nursing practice agency that meet eligibility of preceptor and space gaining for only nursing students. CONCLUSION: The nursing education accreditation criteria in 3rd cycle have to be considered real community health nursing practice situation and newly emerging community health nursing fields.
Accreditation* ; Community Health Nursing* ; Education* ; Education, Nursing* ; Electronic Mail ; Humans ; Nursing* ; Public Health ; Public Health Practice ; Students, Nursing

Harlequin syndrome, which is a rare disorder caused by dysfunction of the autonomic system, manifests as asymmetric facial flushing and sweating in response to heat, exercise, or emotional factors. The syndrome may be primary (idiopathic) with a benign course, or can occur secondary to structural abnormalities or iatrogenic factors. The precise mechanism underlying idiopathic harlequin syndrome remains unclear. Here, we describe a case of a 6-year-old boy who reported left hemifacial flushing and sweating after exercise. He had an unremarkable birth history and no significant medical history. Complete ophthalmological and neurological examinations were performed, and no other abnormalities were identified. Magnetic resonance imaging was performed to exclude lesions of the cerebrum and cervicothoracic spinal cord, and no abnormalities were noted. His final diagnosis was classic idiopathic harlequin syndrome. Herein, we report the first pediatric case of idiopathic harlequin syndrome in Korea.
Cerebrum ; Child ; Diagnosis ; Flushing ; Hot Temperature ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Neurologic Examination ; Pediatrics ; Reproductive History ; Spinal Cord ; Sweat ; Sweating

PURPOSE: This study was based on social-role theory, and purposes were to investigate (1) how depression and health determinants vary with married and employed women, and (2) what factors contribute to depression according to family cycle. METHODS: A stratified convenience sample of 765 married and employed women was recruited during May to August 2010. Study variables of depression, socio-demographic threatening factors, psycho-stimulating factors, and social-role related factors were measured via a structured questionnaire. RESULTS: Prevalence rate for depression was 18.6%, with highest rate (25.4%) from elementary laborers. Greater levels of depression were related to women's occupation, higher life stress, and poorer health; lower social support and vulnerable personality; higher levels of social-role related stress. From multivariate analysis, women with preadolescents were the most vulnerable to depression affected by occupation, life stress, personality, and parenting stress. These factors (except for occupational class) combined with economic status, social support, and housework unfairness were significant for depression in women with adolescents. CONCLUSION: Depression among married and employed women differs by psycho-stimulating and social role relevant factors in addition to occupational class and family life cycle. Female elementary laborers and women with children need to have the highest prioritization for community mental health programs.
Adult ; Depression/epidemiology/*psychology ; Employment ; Family ; Female ; Humans ; Marriage ; Models, Theoretical ; Parenting ; Questionnaires ; *Social Support ; Socioeconomic Factors ; Stress, Psychological ; Women's Health

Dystonia is a symptom defined by involuntary and irregular contractions of the muscles, which cause movement disorders and postural problems. Deep brain stimulation (DBS) in globus pallidus interna (GPi) is a good option for controlling dystonia. DBS has already been shown to have significant effects on primary dystonia as well as Parkinson's disease. Dystonia is very difficult to manage, as seen in cerebral palsy (CP) mixed with spasticity. As CP patients grow, their musculoskeletal problems may require orthopedic surgery. However, the outcome of orthopedic surgery is not usually suitable due to dystonia. Therefore, we attempted to control dystonia through DBS initially and perform orthopedic surgery to correct musculoskeletal deformities after treatment of dystonia. Herein, we report a case that showed remarkable improvement in terms of the dystonia rating scale and gait pattern after combined therapy of DBS and orthopedic surgery.
Cerebral Palsy ; Congenital Abnormalities ; Contracts ; Deep Brain Stimulation ; Dystonia ; Dystonic Disorders ; Gait ; Globus Pallidus ; Humans ; Movement Disorders ; Muscle Spasticity ; Muscles ; Orthopedics ; Parkinson Disease

PURPOSE: The purpose of this study was to analyze the effects of a walking leader program on changes in walking knowledge and self-efficacy. METHODS: The subjects were 276 participants who participated in the nationwide walking leader program 9 times from May to September in 2008. Data were collected before and after the program by an organized questionnaire. RESULTS: 1) Knowledge related to walking exercise increased significantly to 4.14 point from 2.90 point after the program (t=-20.70, p<.001). 2) Self-efficacy related to walking exercise increased significantly to 4.08 point from 3.40 point after the program (t=13.93, p<.001). 3) Significant factors that affected knowledge and self efficacy before the program were regular exercise and subjective health status. The history of chronic disease and smoking were significantly affecting factors to knowledge and self-efficacy after the program. CONCLUSION: The walking leader program promoted the participants' walking knowledge and self-efficacy. It is necessary to develop more specific programs tailored to socio-demographic characteristics of participants and to make efforts to increase participants with active public information.
Chronic Disease ; Self Efficacy ; Smoke ; Smoking ; Walking* ; Surveys and Questionnaires

OBJECTIVE: To investigate the effect of cycling ergometry and to compare energy expenditure and walking performance after arm cycling with those after leg cycling in patients with brain diseases. METHOD: Twenty-two adults with brain diseases (6 stroke, 4 traumatic brain injury, 4 brain tumor, 4 parkinsonism, 4 cerebral palsy) were recruited as subjects. They were randomly assigned to disease-matched groups; arm cycling and leg cycling (n=11 each). VO2 (L/min), VCO2 (L/min), VE (L/min), O2 rate (ml/kg, min), O2 pulse (ml/kg, bpm), O2 cost (ml/kg, m) and VO2 peak (ml/kg, min) during cycling test or walking test, and walking performance were evaluated after cycling training for 4~6 weeks. RESULTS: Arm cycling exercise did not improve any parameters such as VO2, VCO2, O2 rate and O2 cost during walking test, whereas it increased VCO2, VE and O2 pulse during cycling test. In contrast, leg cycling significantly improved walking velocity and distance, and decreased O2 cost during walking test. It also increased all parameters including VO2 peak during cycling test (p<0.05). CONCLUSION: Leg cycling exercise improved walking performance and energy efficiency of walking as well as cardiorespiratory fitness relative to arm cycling. Therefore, leg cycling promoted lower-extremity task such as walking in patients with brain diseases.
Adult ; Arm ; Brain ; Brain Diseases ; Brain Injuries ; Brain Neoplasms ; Energy Metabolism ; Ergometry ; Humans ; Leg ; Parkinsonian Disorders ; Stroke ; Walking

Aplasia cutis congenita is a rare congenital anomaly characterized by focal absence of skin at birth. It most commonly manifests as a solitary defect on the scalp, but sometimes it may occur as multiple lesions. Frieden classified aplasia cutis congenita into nine types according to the associated anomalies, but a unifying theory has not been identified to explain the etiology of this disease. We report a case of a newborn with isolated aplasia cutis congenita on the scalp at birth, whose mother was treated with methimazole up to the 22 weeks of gestation due to hyperthyroidism.
Ectodermal Dysplasia ; Humans ; Hyperthyroidism ; Infant, Newborn ; Methimazole ; Mothers ; Parturition ; Pregnancy ; Scalp ; Skin

No abstract available.
Health Promotion*