Korean Version of the Stroke Rehabilitation Motivation Scale: Reliability and Validity Evaluation

Objective@#To translate the Stroke Rehabilitation Motivation Scale (SRMS), developed to evaluate the motivation level of stroke patients during rehabilitation, into the Korean language and to verify the reliability and validity of the Korean version of SRMS (K-SRMS). @*Methods@#The K-SRMS was developed following a structured process that included translation, verification, compromise assessment, reverse translation, feedback, and final correction. K-SRMS reliability was evaluated by performing internal consistency and test–retest analyses. The reliability test was conducted in 50 stroke patients. Its validity was assessed by comparing the K-SRMS with the scale and performing exploratory factor analysis. The validity test was conducted in 102 stroke patients. @*Results@#The test–retest analysis showed good reliability, and the internal consistency of the K-SRMS was similar to that of the original version for all, except 4, items. Thus, these 4 items were excluded, and then the validity test was conducted. Pearson correlation analysis demonstrated that the K-SRMS score was significantly correlated with the BAS total score (Pearson r=0.207, p<0.05). In the exploratory factor analysis, K-SRMS items were categorized into 7 groups (factors), and factors 1 and 4 showed mutual concordance with K-SRMS subscales, including intrinsic motivation factors and amotivation, respectively. @*Conclusion@#The newly developed K-SRMS showed good reliability and validity. It could also be used as a tool to objectify the degree of motivation for rehabilitation among stroke patients in clinical care and research.

Influence of Self-esteem and Spouse Support on Prenatal Depression in Pregnant Women

Purpose@#This study aimed to identify the effect of self-esteem and spouse support on prenatal depression. @*Methods@#The subjects were 131 pregnant women who visited two women clinics located in Changwon City. Data were collected from September 25 to November 20, 2019, and the self-report questionnaire included spouse support, self-esteem, and prenatal depression. The collected data were analyzed by IBM SPSS Statistics ver. 23.0 using descriptive statistics, independent t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple regression analysis. @*Results@#Prenatal depression had a significant negative correlation with self-esteem (r=-0.39, p=0.001) and spouse support (r=-0.36, p<0.001). The factors affecting prenatal depression were religion (β=-0.16, p=0.035), monthly family income (β=-0.15, p=0.040), self-esteem (β=-0.25, p=0.002), and spouse support (β=-0.19, p=0.017); these variables explained 28.4% of the variance in prenatal depression. @*Conclusion@#To prevent depression in pregnant women, professional counseling and support systems such as spouses, religious and social environments should be applied to pregnant women, especially those with low self-esteem. Additionally, more financial support should be provided for low-income pregnant women. Further, there is a need to screen and manage the risk of depression in pregnancy.

Somatosensory Findings of Pusher Syndrome in Stroke Patients

OBJECTIVE: To investigate the somatosensory findings of pusher syndrome in stroke patients. METHODS: Twelve pusher patients and twelve non-pusher patients were enrolled in this study. Inclusion criteria were unilateral stroke, sufficient cognitive abilities to understand and follow instructions, and no visual problem. Patients were evaluated for pusher syndrome using a standardized scale for contraversive pushing. Somatosensory finding was assessed by the Cumulative Somatosensory Impairment Index (CSII) and somatosensory evoked potentials (SEPs) at 1 and 14 weeks after the stroke onset. Data of SEPs with median and tibial nerve stimulation were classified into the normal, abnormal, and no response group. RESULTS: In the baseline characteristics (sex, lesion character, and side) of both groups, significant differences were not found. The score of CSII decreased in both groups at 14 weeks (p<0.05), but there were no significant differences in the CSII scores between the two groups at 1 and 14 weeks. There were no significant differences in SEPs between the two groups at 1 and 14 weeks after the stroke onset. CONCLUSION: It appears that somatosensory input plays a relatively minor role in pusher syndrome. Further study will be required to reveal the mechanism of pusher syndrome.

The Effect of Prolonged Inpatient Rehabilitation Therapy in Subacute Stroke Patients

OBJECTIVE: To evaluate the effect of prolonged inpatient rehabilitation therapy in subacute stroke patients. METHOD: We enrolled 52 subacute stroke patients who had received 3 months of inpatient rehabilitation therapy. Thirty stroke patients received additional inpatient rehabilitation therapy for 3 months and 22 control patients received only home-based care. The evaluation was measured at 3 and at 6 months after stroke occurrence. Functional improvement was measured using the modified motor assessment scale (MMAS), the timed up and go test (TUG), the 10-meter walking time (10 mWT), the Berg balance scale (BBS) and the Korean-modified Barthel index (K-MBI). The health-related quality of life was evaluated using the medical outcome study, 36-item short form survey (SF-36). RESULTS: In the experimental group, significant improvements were observed for all parameters at 6 months (p<0.05). However, significant improvements were observed only in MMAS, BBS, and K-MBI at 6 months in the Control group (p<0.05). In comparing the 2 groups, significant difference were observed in all parameters (p<0.05) except 10 meter walking time (p=0.73). The improvement in SF-36 was meaningfully higher in experimental group compared to control group. CONCLUSION: This study demonstrates that subacute stroke patients can achieve functional improvements and an enhanced quality of life through prolonged inpatient rehabilitation therapy.

Role of endometrial immune cells in implantation / 대한생식의학회지

Implantation of an embryo occurs during the mid-secretory phase of the menstrual cycle, known as the "implantation window." During this implantation period, there are significant morphologic and functional changes in the endometrium, which is followed by decidualization. Many immune cells, such as dendritic and natural killer (NK) cells, increase in number in this period and early pregnancy. Recent works have revealed that antigen-presenting cells (APCs) and NK cells are involved in vascular remodeling of spiral arteries in the decidua and lack of APCs leads to failure of pregnancy. Paternal and fetal antigens may play a role in the induction of immune tolerance during pregnancy. A balance between effectors (i.e., innate immunity and helper T [Th] 1 and Th17 immunity) and regulators (Th2 cells, regulatory T cells, etc.) is essential for establishment and maintenance of pregnancy. The highly complicated endocrine-immune network works in decidualization of the endometrium and at the fetomaternal interface. We will discuss the role of immune cells in the implantation period and during early pregnancy.

Tic convulsif caused by cerebellopontine angle schwannoma

A case is presented of painful tic convulsif caused by schwannoma in the cerebellopontine angle (CPA), with right trigeminal neuralgia and ipsilateral hemifacial spasm. Magnetic resonance images showed a 4 cm round mass displacing the 4th ventricle and distorting the brain stem in the right CPA. The schwannoma, which compressed the fifth and seventh cranial nerves directly, was subtotally removed by a suboccipital craniectomy. Postoperatively, the patient had a complete relief from the hemifacial spasm and marked improvement from trigeminal neuralgia. The painful tic convulsif in this case was probably produced by the tumor compressing and displacing the anterior cerebellar artery directly.

A Case of Paget's Disease of the Vulva / 대한산부인과학회잡지

Sir James Paget described the first case of Paget's disease of the breast in 1874, and Du-breuilh, in 1901, reported the first case of extramammary Paget's disease of the vulva. Paget's disease of vulva is a rare intraepithelial neoplasm of uncertain histogenesis. Recently we expe-rienced a case of Paget's disease of the vulva that we present a brief review of literature.