BACKGROUND: Whether the changes of risk factors (hypertension, diabetes mellitus, smoking, alcohol) can precipitate stroke remains unknown, and antecedent infection and psychologic stress are described insufficiently as predisposing risk factors for cerebral infarction. Therefore, we attempted to examine the roles of recent infection, psychologic stress, and the changes of risk factors as potential precipitants in each stroke subtypes. We also tested the temporal relationship between preceding exposure to coldness and stroke onset. METHODS: In this case-control study, 113 consecutive patients with acute cerebrovascular disease (38 small vessel disease, 43 large vessel disease, 11 cardiogenic infarction, 4 infarction of undetermined cause, and 17 intracerebral hemorrhage) and 23 control subjects were evaluated. Changes of the risk factors (and their management) were interviewed. A sign/symptom based questionnaire was used to characterize the prevalence of recent prior infection and exposure to coldness. Psychologic stress was measured with the use of Social Readjustment Rating Scale. RESULTS: The negative change of alcohol drinking was significantly higher in the stroke group. However, there was no significant difference between stroke and control groups in the changes of the other risk factors. The prevalence of previous (within 1 month) infection was significantly higher in the stroke group compared with control subjects (p=0.03). However, there were no significant differences among the stroke subtypes in the prevalence of infection(p=0.08). Upper respiratory tract infections constituted the most common type of infection. The exposure to coldness was significantly higher in the stroke group compared with control subjects (p=0.002). The level of stress within the prior 1 month/1 year was significantly higher in the stroke group than control group (p=0.01). CONCLUSION: Our data suggest that preceding infection, exposure to coldness, psychologic stress, and the negative change of alcohol drinking may be com.
Alcohol Drinking ; Case-Control Studies ; Cerebral Infarction ; Diabetes Mellitus ; Humans ; Infarction ; Prevalence ; Surveys and Questionnaires ; Respiratory Tract Infections ; Risk Factors* ; Smoke ; Smoking ; Stress, Psychological* ; Stroke*

BACKGROUND: Patients with Parkinson's disease (PD) experience various types of sleep disturbances, and exhibit multiple risk factors for sleep disturbances. However, few studies have considered the demographic and psychosocial factors related to sleep disturbances in Korean PD patients. This study investigated the characteristics of sleep disturbance and related factors, including demographic and psychosocial factors, in Korean PD patients. METHODS: A population of 181 PD patients was studied; all agreed to be interviewed using structured questionnaires. RESULTS: The Parkinson's Disease Sleep Scale (PDSS) score was not correlated with sex, age, educational level, marital status, household income, or the presence of religion, a job, or a hobby. With regard to psychosocial factors, the PDSS score was positively correlated with the Self-Esteem Score and the Social Support Score. The PDSS score was negatively correlated with the Parkinson Fatigue Scale score, the pain score, the Beck Depression Index, and the Spielberger Anxiety Score. On stepwise multiple regression analysis, the most significant factors contributing to low PDSS scores were severe anxiety, a shorter duration of levodopa therapy, severe fatigue, and a higher daily levodopa dosage, in that order. CONCLUSIONS: Sleep disturbance in PD patients was significantly associated with anxiety, fatigue, and daily levodopa dosage, suggesting that these factors should be carefully managed in PD patients.
Anxiety ; Depression ; Family Characteristics ; Fatigue ; Hobbies ; Humans ; Levodopa ; Marital Status ; Parkinson Disease* ; Psychology ; Surveys and Questionnaires ; Risk Factors

OBJECTIVES: The purpose of the study was to examine the relationships between temperament and character dimensions and family environments, and to investigate the influences of those factors on the antisocial personality traits in delinquent adolescents. METHODS: The subjects consisted of 160 male adolescents detained at the public prosecutor's office on the suspicion of crimes. To assess personality dimensions and family environmental factors, the Temperament and Character Inventory(TCI) and the Family Environment Scale(FES) were completed. Antisocial personality traits were assessed by the number of antisocial personality disorder symptoms of the Personality Disorder Questionnaire-Revised. RESULTS: Most of the TCI dimensions except Reward Dependence(RD) were highly correlated with the subscales of FES. Among temperament dimensions, Novelty Seeking(NS) and Persistence(P) were significantly affected by Organization, and Harm Avoidance(HA) was influenced by Expressiveness of FES. Self-Directednss(SD) was best predicted by Organization and Achievement-Orientation. While the Independence had significant effect on Cooperativeness, Expressiveness and Achievement-Orientation best predicted the level of Self-Transcendence(ST). On factor analysis, NS, HA, SD and ST were allocated to the same factors with subscales of FES. The level of antisocial personality trait was best predicted by NS, P and SD scores of TCI, and conflict subscale scores of FES. CONCLUSION: The findings of this study suggest that not only the character dimensions but also the temperament dimensions have close relationships with family environmental factors, and that the antisocial personality traits of delinquent adolescents may developed by the interaction between temperament/character dimensions and family environments.
Adolescent* ; Antisocial Personality Disorder* ; Crime ; Humans ; Personality Disorders ; Reward ; Temperament*

OBJECTIVE: The aim of this study was to determine the optimal loading conditions for pure intrusion of the six maxillary anterior teeth with miniscrews according to alveolar bone loss. METHODS: A three-dimensional finite element model was created for a segment of the six anterior teeth, and the positions of the miniscrews and hooks were varied after setting the alveolar bone loss to 0, 2, or 4 mm. Under 100 g of intrusive force, initial displacement of the individual teeth in three directions and the degree of labial tilting were measured. RESULTS: The degree of labial tilting increased with reduced alveolar bone height under the same load. When a miniscrew was inserted between the two central incisors, the amounts of medial-lateral and anterior-posterior displacement of the central incisor were significantly greater than in the other conditions. When the miniscrews were inserted distally to the canines and an intrusion force was applied distal to the lateral incisors, the degree of labial tilting and the amounts of displacement of the six anterior teeth were the lowest, and the maximum von Mises stress was distributed evenly across all the teeth, regardless of the bone loss. CONCLUSIONS: Initial tooth displacement similar to pure intrusion of the six maxillary anterior teeth was induced when miniscrews were inserted distal to the maxillary canines and an intrusion force was applied distal to the lateral incisors. In this condition, the maximum von Mises stresses were relatively evenly distributed across all the teeth, regardless of the bone loss.
Alveolar Bone Loss* ; Finite Element Analysis* ; Incisor ; Tooth*

PURPOSE: This study was aimed to evaluate the effect of the deproteinated bovine bone powder (DBBP) coated with calcium phosphate (Ca-P) on osseous regeneration in the calvarial bone defect of rat. MATERIALS AND METHODS: The DBBP (Control group, n=6) and the Ca-P coated DBBP (Experimental group, n=6) were grafted in the critical sized calvarial bone defect (8 mm) of rat weighing 250 g. The animals were sacrificed at 1, 4 week. The biopsy specimens were decalcified with 5% formaldehyde and embedded in paraffin. The rats were sacrificed at 8 week received tetracycline (1 week), calcein blue (4 week), and alizarin red (7 week), and the biopsy specimens were taken. The specimens were embedded in methylmethacrylate and ground to 10 micrometer thin sections were made. All of the specimens were stained with H & E and Masson's trichrome and examined under light microscope. The specimens at 8 week were examined under fluorescent microscope. RESULTS: In the Control group, the grafted DBBP was surrounded with connective tissue, and osteoblasts were observed partially around the grafted particles at 1 week. At 4 week, some osteoid was observed and, new bone formation was observed at the periphery of grafted materials at 8 week, In the Experimental group, some osteoid was seen at the periphery of the grafted Ca-P coated DBBP at 1 week, and osteoblast and newly formed bone were observed around the grafted materials. At 8 week, newly formed bone was observed at the periphery of the grafted materials. CONCLUSION: These results suggest that Ca-P coated DBBP group was more and faster than DBBP group in new bone formation and Ca-P could contribute to enhance bone formation in the critical sized calvarial bone defect of rat.
Animals ; Biopsy ; Calcium ; Connective Tissue ; Formaldehyde ; Methylmethacrylate ; Osteoblasts ; Osteogenesis ; Paraffin ; Rats* ; Regeneration* ; Tetracycline ; Transplants

The long-term effects of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on postural instability and gait difficulty (PIGD) in patients with Parkinson’s disease (PD) remain unclear. In this study, we aimed to evaluate the longterm effects of STN-DBS surgery on PIGD symptoms in patients with advanced-stage PD. Methods This study included 49 consecutively included patients with PD who underwent bilateral STN-DBS. The Unified Parkinson’s Disease Rating Scale (UPDRS) scores and subscores for PIGD were assessed at baseline and at 1, 3, and 5 years postoperatively. The PIGD subscore was divided into PIGD-motor and PIGD-activities of daily living (ADL) scores according to parts III and II of the UPDRS, respectively. Results The PIGD-motor and PIGD-ADL scores at the “medication-off” state improved at 3 and 5 years, respectively. Overall, the UPDRS III and II scores at “medication-off” improved at 5 years. The UPDRS IV score also significantly improved and the levodopa equivalent daily dosage decreased at all follow-ups. Finally, the PIGD-motor score at baseline was able to predict long-term improvement in the PIGD-motor score at the 5-year follow-up. Conclusion The STN-DBS has both short- and long-term effects on PIGD, as well as overall motor function, in patients with advanced PD. The degree of PIGD at the preoperative evaluation can be used to predict long-term outcomes after STN-DBS surgery.

The syndrome of postural headache associated with low CSF pressure usually occurs after a dural puncture, myelography, or spinal anesthesia. However, it can also develop spontaneously or after minor trauma. Although the clinical and MRI findings of this syndrome are well described, radionuclide cisterno-graphic findings have not yet been clearly characterized. We report four patients presenting with postural headache associated with very low or unmeasurable CSF pressure. Three patients developed after minor trauma, while one developed spontaneously. Brain MRI revealed symmetric pachymeningeal enhancement in all four patients. Radionuclide cisternography demonstrated delayed migration of tracer to the cerebral convexity at 6 and 24 hours in three patients, and early soft tissue uptake suggestive of CSF leakage in one. We suggest that these radionuclide cisternographic findings are supportive evidences for the presence of intracranial hypotension and may provide useful information for appropriate treatment.
Anesthesia, Spinal ; Brain ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Myelography ; Punctures

BACKGROUND: Lower back pain (LBP) in Parkinson's disease (PD) is common but frequently overlooked, due to the tendencies of focusing on the management of the motor symptoms and signs by most neurologists. Uncontrolled LBP may impact on the activities of daily living of the PD patients. However, study on the LBP in PD has been rarely reported. METHODS: Sixty three PD patients with LBP were included, between October 2004 and April 2005. We investigated the clinical characteristics of LBP and response to the management prospectively. RESULTS: Eleven male and 52 female patients were included and the mean age was 64.4 years. On lumbar MRI and/or X-ray, degenerative spondylosis was detected in 22 patients, bulging discs in 30, and fractures in 9. Fourteen patients reported improvement of LBP after levodopa therapy. Young age at onset and abnormally flexed posture correlated with the responsiveness of LBP to levodopa therapy (p<0.05, respectively). These responders were more frequently experiencing motor fluctuation and dyskinesia than the non-responders (p<0.05, respectively). CONCLUSIONS: LBP in PD has diverse etiologies and clinical features. Some PD patients with LBP show response to levodopa therapy. We suggest that the prudent evaluation and proper management of LBP are important to achieve the better activities of daily living in PD patients.
Activities of Daily Living ; Dyskinesias ; Female ; Humans ; Levodopa ; Low Back Pain* ; Magnetic Resonance Imaging ; Male ; Parkinson Disease* ; Posture ; Prospective Studies ; Spondylosis

PURPOSE: The aim of this study is to investigate the seroepidemiology of hepatitis A and hepatitis B in Korean children. METHOD: 801 children aged 6 to 12 years were enrolled. IgG antibody to hepatitis A virus (anti-HAV), hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), and IgG antibody to HBc (anti-HBc) were measured by radioimmunoassay. RESULTS: Of the 801 children, the seroprevalence of anti-HAV was 0%. Three (0.4%) were seropositive for HBsAg. The seroprevalence of anti-HBs was 61.8%. Two (0.4%) of 495 anti-HBs positive subjects were positive for anti-HBc. Of the 801 children, 658 (82.1%) had received hepatitis B vaccination. CONCLUSIONS: Since natural anti-HAV is not acquired in the childhood, the outbreak of hepatitis A is possible in adolescents and young adults. The decrease in seroprevalence of HBsAg and the increase in seroprevalence of anti-HBs might result from hepatitis B vaccination program in childhood.
Adolescent ; Child* ; Hepatitis A Antibodies ; Hepatitis A virus ; Hepatitis A* ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoglobulin G ; Radioimmunoassay ; Seroepidemiologic Studies ; Vaccination ; Young Adult

BACKGROUND AND PURPOSE: Hypertension and alcohol consumption are well known independent risk factors of spontaneous intracerebral hemorrhage (ICH). However, it is uncertain whether controlling of them reduces the volume of ICH. Furthermore, it remains also unkown whether other factors such as age, sex, education level, smoking, diabetes mellitus, and previous history of stroke are related to the volume of ICH. This study was designed to evaluate the relations of those things with the volume of ICH. METHODS: We prospectively assessed above items in 103 consecutive patients with ICH aged 33 to 87 years (mean age : 64 years, 50 men and 53 women ). We divided the volume of ICH with the use of CT scan into small (<10cc, n=71) and large (>=l0cc, n=32) groups. RESULTS: The patients with previous history of stroke significantly have a smaller volume of ICH compared to those without (p=0.04). However, the other factors (age, sex, education level, antihypertensive medication, alcohol consumption, smoking, and diabetes mellitus) were not significantly correlated with the volume of ICH to multivariate analysis. The patients with previous history of stroke tended to receive more regular antihypertensive medication than these without (p-0.06). CONCLUSION: The patients with previous history of stroke have a smaller volume of ICH possibly due to adequate antihypertensive treatment. However, the other factors which we evaluated were not significantly correlated with the volume of ICH.
Alcohol Drinking ; Cerebral Hemorrhage* ; Diabetes Mellitus ; Education ; Female ; Humans ; Hypertension ; Male ; Multivariate Analysis ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Stroke ; Tomography, X-Ray Computed