Effects of BeHaS Program on Health Behavior, Physiologic Index and Self-Esteem of the Elderly Living Alone with Metabolic Syndrome Based on Community Based Participatory Research

Purpose@#This study aimed to determine the effects of a 12-week metabolic syndrome BeHaS (Be Happy and Strong) program in elderly people with metabolic syndrome living alone, based on a community-based participatory research (CBPR). @*Methods@#A nonequivalent control group pre-posttest design was used, and the participants were 43 elderly people living alone (experimental group 24, control group 19). The experimental group received a one-hour program per week and two individual health consultations during 12 weeks. The control group received two sessions about the metabolic syndrome and two individual health consultations. The effects of health behavior, blood pressure, blood sugar levels, abdominal circumference, triglycerides, and self-esteem were evaluated. The data were analyzed using the independent t-test and Mann-Whitney U test. @*Results@#The health behavior with respect to the metabolic syndrome in the experimental group increased significantly (t = - 3.19, p = .002). Both diastolic blood pressure and abdominal circumference decreased in the experimental group (t = 2.00, p = .028 and t = 3.91, p < .001). No significant differences were observed between the groups in systolic blood pressure, fasting blood sugar levels, triglycerides, and self-esteem. @*Conclusion@#The 12-week metabolic syndrome BeHaS program using community resources improves the health of elderly people with metabolic syndrome living alone. Based on these findings, further studies on the effectiveness of the metabolic syndrome BeHaS program and the experiences of those who participated in the CBPR are warranted.

The Effects of Hippocampal Sclerosis Revealed by MRI on the Pharmacoresistance of Temporal Lobe Epilepsy / 대한간질학회지

PURPOSE: Hippocampal sclerosis is known to strongly correlate with medical intractability of temporal lobe epilepsy. However, the informations about this have been biased due to improper selection of the sampling obtained from severe cases of tertiary epilepsy center and surgical epilepsy field. We tried to investigate the influence of hippocampal sclerosis on the pharmacoresistance in temporal lobe epilepsy by group comparison study. METHODS: The fifty patients with complex partial seizures of temporal lobe origin, and temporal spike on EEG and/or hippocampal sclerosis on brain MRI were selected. Follow-up period of them were more than 2 years. The patients who had a seizure or seizures during the last 1-year period and had already been in adequate doses of two or more antiepileptic drugs were considered to be poorly controlled epileptics. RESULTS: Five of 17 patients without hippocampal sclerosis (29. 4%) and 24 of 33 patients with hippocampal sclerosis (72.7%) were poorly controlled by medication and the difference was significant (p=0.003, chi-square). Other factors, including sex, age of onset, febrile convulsion, secondary generalization, familial history of epilepsy, duration of disease, and delay of initial therapy had no significant effects on medical response (p>0.05). The only independent predictor of intractable epilepsy after multiple logistic regression analysis was also hippocampal sclerosis (p=0.005). CONCLUSION: Medical response in temporal lobe epilepsy was significantly associated with hippocampal sclerosis. Hippocampal sclerosis on brain MRI itself may be a crucial factor determining pharmacoresistance of temporal lobe epilepsy.

Effects of Hemodynamic Disturbance on Occurrence of Stroke in Patients with Internal Carotid Artery or Middle Cerebral Artery Occlusion

BACKGROUND: Previous studies suggest that impaired cerebral hemodynamics may play a relevant but unclear role in the occurrence of stroke in patients with carotid artery occlusion.. The purpose of the current study was to investigate the relationship between hemodynamic disturbances and cerebrovascular events in patients with major cerebral artery occlusions. METHODS: We examined hemodynamic disturbances as cerebrovascular reactivity (CVR) to acetazolamide (ACZ), judged with single-photon emission CT (SPECT) and an ACZ challenge in 21 patients with internal carotid artery or middle cerebral artery occlusions who had transient ischemic attacks/minor or asymptomatic infarctions. CVR was calculated by a regional cerebral blood flow (rCBF) ratio on pre-ACZ-SPECT minus the rCBF ratio on post-ACZSPECT. They were followed longer than 2 years and the mean follow-up duration was 36 months. We compared the hemodynamic disturbances and risk factors between the ipsilateral stroke recurrance group and a stable group. RESULTS: Eight patients had additional ischemic events during the follow-up period, and all but 2 events occurred ipsilaterally to the carotid artery occlusions. Two patients died of acute myocardial infarction and brainstem infarction, retrospectively. All patients with recurred stroke or death were noted to have symptomatic carotid artery occlusions. There was no significant difference of risk factors between the two groups. But the ipsilateral stroke recurrance group had worse CVR than the stable group (p<0.05). CONCLUSIONS: These data suggest impaired CVR was significantly associated with the risk of ischemic events in patients with carotid artery occlusions.

A Case of Purple Glove Syndrome

Purple glove syndrome is a complication of the intravenous infusion of phenytoin. It is characterized by progressive distal edema, discoloration and pain. The mechanism of purple glove syndrome is poorly understood, but the chemical properties of intravenous phenytoin and the extravasation of that are possible causes. We present a woman with purple glove syndrome, whose symptoms were subsided gradually with conservative management.

A Case of Guillain-Barre Syndrome Associated with Diabetic Ketoacidosis

A 30-year-old man was admitted due to decreased mentality. He was diagnosed as a diabetic ketoacidosis by hyperglycemia, metabolic acidosis, and positive urinary ketone bodies. Two weeks later, despite the improved state of ketoacidosis, he complained of dysphagia, quadriparesis, and respiratory difficulty. Cerebrospinal fluid analysis showed albumino-cytologic dissociation. Nerve conduction study revealed axonal motor neuropathy. His neurological deficit was rapidly improved by intravenous immunoglobulin. We report a case of Guillain-Barre syndrome just after a ketoacidosis.

A Case of Akinetic Mutism Caused by Volume Change of Cerebral Ventricles

Akinetic mutism is a syndrome caused by various etiologies, and characterized by silent immobility and preserved alertness. The repetitive ventriculoperitoneal shunt for the recurrent hydrocephalus can be a forerunner of that. We present a man with akinetic mutism following two times of ventriculoperitoneal shunt revision. Akinetic mutism of the patient may be caused by the damage on the ascending dopaminergic projections. Symptoms were not alleviated by the normalization of ventricular size but by a large dose of bromocriptine.

A Case of Miyoshi Type Distal Myopathy

No abstract available.