Purpose: The purpose of this study is to analyze the brain waves and develop various exercise programs to improve the physical and mental aspects of stroke patients when neurological physical therapy and sitting table tennis exercise are applied to stroke patients. Methods: In this study, an experiment was conducted on 15 patients diagnosed with stroke, and training was performed after changing the ping-pong table to a sitting position to apply ping-pong exercise to stroke patients. After training was conducted for 40 minutes twice a week for 4 weeks, brain waves were measured before and after. EEG was measured using Laxtha’s DSI-24 equipment as a measurement tool, and data values were extracted through the Telescan program. Results: Most of the relative beta waves showed a significant difference before and after the intervention. As for the characteristics of beta waves, this result can be seen as being highly activated during exercise or other activities. Conclusion Ping-pong exercise in a sitting position is a good intervention method for stroke patients, and it can help to use it as basic data in clinical practice by showing brain activity.

Antiphospholipid antibodies may be produced in cases involving autoimmune diseases and can sometimes be caused by infections, such as Mycoplasma pneumoniae infection. However, antiphospholipid antibodies causing thrombosis associated with M. pneumoniae pneumonia in children have rarely been reported. We report a case of an 8-year-old boy with M. pneumoniae pneumonia with antiphospholipid antibodies, complicated by brachial artery thrombosis. He was found to have antiphospholipid antibodies and low protein S levels. The brachial artery thrombus was removed via thrombectomy. The titers of antiphospholipid antibodies turned normal within 5 months. This is a rare case of M. pneumoniae infection with brachial artery thrombosis associated with transient antiphospholipid antibodies.
Antibodies, Antiphospholipid ; Autoimmune Diseases ; Brachial Artery ; Child ; Humans ; Male ; Mycoplasma pneumoniae ; Mycoplasma ; Pneumonia ; Pneumonia, Mycoplasma ; Protein S ; Thrombectomy ; Thrombosis

Pleomorphic dermal sarcoma (PDS) is a rare mesenchymal neoplasm sharing histopathological features with atypical fibroxanthoma (AFX), but has additional features of deep invasion of the superficial subcutis, tumor necrosis and vascular/perineural invasion. It is not well documented in the literature because of its rarity, and its clinical course has been debated due to the lack of homogenous criteria. We describe here the case of a 91-year-old female with a 6-month history of a solitary, asymptomatic, well-defined, 3.4-cm-sized, reddish, hard, protruding mass on the lateral aspect of the right upper eyelid. On the basis of initial punch biopsy results, storiform cellular infiltrate of pleomorphic spindle and polygonal cells with frequent atypical mitoses, the lesion was identified as AFX. Following the initial biopsy, micrographic surgery was performed and a tumor-free margin was confirmed. Considering the conservation of the periocular function and the advanced age of the patient, we planned secondary intention healing rather than primary suturing. After surgery, skeletal muscle infiltration was found and the diagnosis was revised to PDS by a pathologist based on the currently accepted criteria for PDS. There has been no evidence of recurrence or periocular functional defects during a 2-year follow-up without adjuvant therapy. Although the PDS is highly malignant, complete excision under micrographic surgery can prevent recurrence without adjuvant therapy. Also, the secondary intention healing is an effective method for closure of large defects on the face.
Biopsy ; Diagnosis ; Eyelids* ; Female ; Follow-Up Studies ; Histiocytic Sarcoma ; Histiocytoma, Malignant Fibrous ; Humans ; Intention* ; Methods ; Mitosis ; Muscle, Skeletal ; Necrosis ; Recurrence ; Sarcoma*

Pleomorphic dermal sarcoma (PDS) is a rare mesenchymal neoplasm sharing histopathological features with atypical fibroxanthoma (AFX), but has additional features of deep invasion of the superficial subcutis, tumor necrosis and vascular/perineural invasion. It is not well documented in the literature because of its rarity, and its clinical course has been debated due to the lack of homogenous criteria. We describe here the case of a 91-year-old female with a 6-month history of a solitary, asymptomatic, well-defined, 3.4-cm-sized, reddish, hard, protruding mass on the lateral aspect of the right upper eyelid. On the basis of initial punch biopsy results, storiform cellular infiltrate of pleomorphic spindle and polygonal cells with frequent atypical mitoses, the lesion was identified as AFX. Following the initial biopsy, micrographic surgery was performed and a tumor-free margin was confirmed. Considering the conservation of the periocular function and the advanced age of the patient, we planned secondary intention healing rather than primary suturing. After surgery, skeletal muscle infiltration was found and the diagnosis was revised to PDS by a pathologist based on the currently accepted criteria for PDS. There has been no evidence of recurrence or periocular functional defects during a 2-year follow-up without adjuvant therapy. Although the PDS is highly malignant, complete excision under micrographic surgery can prevent recurrence without adjuvant therapy. Also, the secondary intention healing is an effective method for closure of large defects on the face.
Biopsy ; Diagnosis ; Eyelids* ; Female ; Follow-Up Studies ; Histiocytic Sarcoma ; Histiocytoma, Malignant Fibrous ; Humans ; Intention* ; Methods ; Mitosis ; Muscle, Skeletal ; Necrosis ; Recurrence ; Sarcoma*

Undifferentiated carcinoma with osteoclast-like giant cells is a rare neoplasm of the exocrine pancreas. Some similar cases have been reported, but the histogenesis of these tumors varies and is controversial. We report here on a case of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. A 77-year old woman presented with abdominal pain and anorexia. Abdominal computed tomography and magnetic resonance imaging showed an approximately 10 x 5 cm highly attenuated mass arising from the tail of the pancreas and invading the spleen and adjacent bowel loop. The initial impression was a malignant endocrine tumor or solid-pseudopapillary tumor of the pancreas. The patient underwent a distal pancreatectomy with splenectomy and left hemicolectomy. The histopathology and immunohistochemistry helped make the diagnosis that of an undifferentiated carcinoma with osteoclast-like giant cells of the pancreas.
Abdominal Pain ; Anorexia ; Carcinoma ; Female ; Giant Cells ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Pancreas ; Pancreas, Exocrine ; Pancreatectomy ; Spleen ; Splenectomy

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world and is the only major disease that is continuing to increase in both prevalence and mortality. The second Korean National Health and Nutrition Survey revealed that the prevalence of COPD in Korean subjects aged > or =45 years was 17.2% in 2001. Further surveys on the prevalence of COPD were not available until 2007. Here, we report the prevalence of spirometrically detected COPD in Korea, using data from the fourth Korean National Health and Nutrition Survey (KNHANES IV) which was conducted in 2007~2009. METHODS: Based on the Korean Statistical Office census that used nationwide stratified random sampling, 10,523 subjects aged > or =40 years underwent spirometry. Place of residence, levels of education, income, and smoking status, as well as other results from a COPD survey questionnaire were also assessed. RESULTS: The prevalence of COPD (defined as forced expiratory volume in 1 sec/forced vital capacity <0.7 in subjects aged > or =40 years) was 12.9% (men, 18.7%; women, 7.5%). In total, 96.5% of patients with COPD had mild-to-moderate disease; only 2.5% had been diagnosed by physicians, and only 1.7% had been treated. The independent risk factors for COPD were smoking, advanced age, and male gender. CONCLUSION: The prevalence of COPD was 12.9% in the KNHANES IV data. Most patients with COPD were undiagnosed and untreated. Based on these results, a strategy for early COPD intervention is warranted in high risk subjects.
Aged ; Censuses ; Female ; Forced Expiratory Volume ; Humans ; Hypogonadism ; Korea ; Male ; Mitochondrial Diseases ; Nutrition Surveys ; Ophthalmoplegia ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Spirometry ; Vital Capacity

BACKGROUND/AIMS: Although only a few sporadic cases of Q fever have been reported in Korea, a total of 13 cases have been seen in our area. We performed this study to evaluate the clinical characteristics of these cases of acute Q fever. METHODS: Demographic features, clinical manifestations, laboratory and radiologic findings, and therapeutic outcomes of all cases were evaluated. Q fever was diagnosed using an indirect micro-immunofluorescence assay (MIFA) and polymerase chain reaction (PCR). RESULTS: A total of 13 patients with acute Q fever seen from January 2006 to August 2008 at three teaching hospitals in the Daegu Metropolitan City area were enrolled. The mean age was 49 years old (range, 24~76), and the male to female ratio was 11:2. Six (46.2%) cases had a history of animal contact. Fever (100%) was the most common manifestation, followed by myalgia (84.6%), headache (61.5%), anorexia (61.5%), and chills (61.5%). All cases were diagnosed with high titers of anti-phase II antibody (IgM> or = 1:50, IgG> or =1:200) and positive nested PCR for the 27-kDa OMP com-1 gene of Coxiella burnettii in the blood. In three cases, liver biopsies revealed the presence of compact fibrin-ring granulomas. No characteristics of pneumonia were diagnosed on chest X-rays. The predominant presentation was acute febrile illness with hepatitis, including three cases (27.3%) of severe cholestatic hepatitis. The most frequently used antimicrobial agent was doxycycline (84.6%), followed by azithromycin (7.7%). CONCLUSIONS: Acute Q fever may be added to the list of differential diagnosis of patients with acute febrile illness and hepatitis in the Daegu Metropolitan City area.
Animals ; Anorexia ; Azithromycin ; Biopsy ; Chills ; Coxiella ; Diagnosis, Differential ; Doxycycline ; Female ; Fever ; Granuloma ; Headache ; Hepatitis ; Hospitals, Teaching ; Humans ; Korea ; Liver ; Male ; Pneumonia ; Polymerase Chain Reaction ; Q Fever ; Thorax

The objective of this study was to investigate clinical and radiographic features and gender differences in Korean patients with adult-onset ankylosing spondylitis. Multicenter cross-sectional studies were conducted in the rheumatology clinics of 13 Korean tertiary referral hospitals. All patients had a confirmed diagnosis of ankylosing spondylitis according to the modified New York criteria. Clinical, laboratory, and radiographic features were evaluated and disease activities were assessed using the Bath ankylosing spondylitis disease activity index. Five hundred and five patients were recruited. The male to female ratio was 6.1:1. Average age at symptom onset was 25.4+/-8.9 yr and average disease duration was 9.6+/-6.8 yr. Males manifested symptoms at a significantly earlier age. HLA-B27 was more frequently positive in males. Hips were more commonly affected in males, and knees in females. When spinal mobility was measured using tragus-to-wall distance and the modified Schober's test, females had significantly better results. Radiographic spinal changes, including bamboo spine and syndesmophytes, were more common in males after adjustment of confounding factors. In conclusion, we observed significant gender differences in radiographic spinal involvement as well as other clinical manifestations among Korea patients with adult-onset ankylosing spondylitis. These findings may influence the timing of the diagnosis and the choice of treatment.
Adult ; Age of Onset ; *Asian Continental Ancestry Group ; Female ; HLA-B27 Antigen/diagnostic use ; Humans ; Joints/pathology ; Male ; Severity of Illness Index ; Spondylitis, Ankylosing/diagnosis/*pathology/*physiopathology/*radiography

OBJECTIVES: The Korean College of Neuropsychopharmacology and the Korean Academy of Schizophrenia developed the Korean medication algorithm project for schizophrenia (KMAP) to aid clinical decisions. The purpose of this study was to investigate problems and revision of Korean Medication Algorithm for Schizophrenia after feasibility test. METHODS: A total of 108 schizophrenia patients were enrolled at 19 centers and treated according to the algorithm. Prescribing investigators were able to change the recommended treatment strategies of the algorithm if necessary. All subjects were assessed over a 4-month period. Appropriateness of choice, dosage, duration and switch of antipsychotics and definition of treatment response were examined. RESULTS: Compliance of 1(st) choice antipsychotics in KMAP was favorable. Atypical antipsychotics which is a 1(st) stage drug selected first was above 84%, especially in case of no previous medical history was nearly all. In case that shift of stage was needed, there is a trend that combination treatment stage (6(th) stage) and clozapine treatment stage (5(th) stage) were preferred to rather than 3(rd) stage and 4(th) stage (typical antipsychotics and atypical antipsychotics treatment stage). The rates of switching antipsychotics at the time points other than CDP (critical decision points) was low and the reason was almost the side effects. So the compliance of CDPs in KMAP was good in case of insufficiency of treatment response. Also the reasons why many investigators continued using current antipsychotics without switching despite insufficiency of treatment response were definition of treatment response, discrepancy between brief symptom rating scale for negative symptom and decision of clinicians. In addition, compliance of co-existence symptoms and side effect of medication in KMAP was favorable. CONCLUSION: It is some difference from clinical practice such as stage of antipsychotics, definition of treatment response and usefulness of brief symptom rating scale for negative symptom. But the majority apart from points of preceding paragraph is feasible in clinical practice. These results are essential to revise the next version of KMAP.
Antipsychotic Agents ; Clozapine ; Compliance ; Cytidine Diphosphate ; Humans ; Research Personnel ; Schizophrenia

OBJECTIVE: To evaluate the differences of mid-trimester triple marker levels in patients with mild versus severe and early versus late onset preeclampsia. METHODS: From January 2000 to December 2004, a retrospective study of 65 women with preeclampsia for whom mid-trimester triple test data were available was made. None of these patients had diabetes, other medical disorders, multiple pregnancy, abnormal karyotype and malformations. Preeclampsia patients were grouped to "early onset" [<32 weeks of gestation (wks), n=17] and "late onset" (n=48), and also "mild" (who had delivered with no symptoms and lab findings of severe preeclampsia at term spontaneous labor or elective cesarean delivery, n=31) and "severe" (n=34). The levels of mid-trimester maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin (hCG) and unconjugate estriol (MSuE3) in patients with early and late onset, mild and severe were compared. RESULTS: The each groups of comparison did not differ significantly with regard to age, weight, parity. The mean MSuE3 [0.92+/-0.09 (MoM+/-SE)] in patients with early onset was significantly lower than in patients with late onset preeclampsia (1.24 MoM, SE 0.07). In the comparison according to severity, the mean MSuE3 was significantly lower (0.98 MoM, SE 0.06 vs 1.28 MoM, SE 0.10, p=0.016) and the mean hCG was significantly higher (1.46 MoM, SE 0.12 vs 1.12 MoM, SE 0.07, p=0.015) in patients with severe preeclampsia than in those had mild preeclampsia symptoms at term delivery. CONCLUSION: Lower levels of mid-trimester MSuE3 and higher levels of hCG were associated with the severe preeclampsia rather than mild. Especially, lower levels of mid-trimester MSuE3 was also associated with early onset preeclampsia.
Abnormal Karyotype ; alpha-Fetoproteins ; Chorionic Gonadotropin ; Estriol ; Female ; Humans ; Parity ; Pre-Eclampsia* ; Pregnancy ; Pregnancy, Multiple ; Retrospective Studies