OBJECTIVES: We investigated the prevalence and composite score of the neuropsychiatric symptoms in patients with mild cognitive impairment(MCI), and dementia of Alzheimer's type(AD). The aim of this study is to analyze the correlation between the result of Korean Neuropsychiatric Inventory(K-NPI) and cognitive function. METHODS: A total of 163 patients diagnosed with MCI or AD was divided into three groups(55 MCI patients, 56 dementia patients with mild stage, and 52 dementia patients with moderate, severe stage). We examined neuropsychiatric symptoms by K-NPI and compared the prevalence and composite score of each subdomain in K-NPI among three groups. RESULTS: The most common symptoms in the MCI group were depression/dysphoria, sleep/night-time behavior, anxiety, and irritability/lability. In mild AD group, the most frequent disturbance was agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, and sleep/night-time behavior. In moderate to severe AD group, the most frequent disturbance was apathy/indifference, depression/dysphoria, agitation/aggression, and delusion. The frequencies of delusion, hallucination, agitation/aggression, apathy/indifference, aberrant motor behavior, appetite/eating change were statistically significant. The total NPI score showed a negative correlation with MMSE-KC and a positive correlation with GDS. CONCLUSIONS: Neuropsychiatric symptoms are common features of MCI and AD. These symptoms observed in MCI are similar to those of mild AD. Psychosis is most common in moderate to severe AD, leading to a faster rate of cognitive decline. Therefore, proper management according to the neuropsychiatric symptoms of MCI and three stages of dementia is needed.
Anxiety ; Delusions ; Dementia ; Hallucinations ; Humans ; Mild Cognitive Impairment ; Prevalence ; Psychotic Disorders

OBJECTIVES: Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. METHODS: A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). RESULTS: The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. CONCLUSIONS: These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.
Alzheimer Disease ; Dementia* ; Depression* ; Fasting ; Homocysteine* ; Humans ; Mild Cognitive Impairment* ; Neurobehavioral Manifestations ; Risk Factors

The purpose of this study were to constructed multi-level cervical spine finite element (FE) model and to investigate changes in load distribution and range of motion (ROM) at index level and adjacent levels at immediately after anterior cervical discectomy and fusion (ACDF) and after full bony union using constrained and semi-constrained cervical plate systems(dynamic plate, variable screw). A FE model of intact cervical spine (C3-6) was created from computer tomography (CT) images of the healthy adult (male, 26 years, no pathologies). The post-op FE models (C5-6 with ACDF, cage with bone graft) were constructed by modifying a intact cervical FE model. Four different configurations of the model were considered: Type 1-Rigid plate+Fixed screw, Type II-Rigid plate + Variable screw, Type III-Dynamic plate + Fixed screw, Type IV-Dynamic plate + Variable screw. The bone-cage and bone screw interface behavior were accomplished via 'tie' contact condition and friction coefficient of 0.2 to assume fusion and non-fusion, respectively. The inferior endplate of C6 vertebral body was constrained in all directions. Loading condition used hybrid protocol with follower load of 73.6N at superior endplate of C3 vertebral body. In non-fusion cases, load at the bone graft increased from Type I to IV (2.3
Adult ; Biomechanical Phenomena ; Bone Screws ; Diskectomy ; Freedom ; Friction ; Humans ; Range of Motion, Articular ; Spine ; Transplants

Thyroid hormones play an important physiological role in maintaining adult bone structure and strength. Consequently, thyroid dysfunction is related to skeletal outcomes. Overt hyperthyroidism is an established cause of high bone turnover with accelerated bone loss, leading to osteoporosis and increased fracture risk. Hyperthyroidism induced by thyroid-stimulating hormone-suppressive therapy in patients with differentiated thyroid cancer is a cause of secondary osteoporosis. In contrast, there is a lack of evidence on the negative impact of hypothyroidism on bone health. Considering the clinical updates on the importance of bone health in thyroid dysfunction, the Task Force from the Clinical Practice Guidelines Development Committee of the Korean Thyroid Association recently developed a position statement on the evaluation and management of bone health of patients with thyroid diseases, particularly focused on endogenous hyperthyroidism and thyroid-stimulating hormone-suppressive therapy-associated hyperthyroidism in patients with differentiated thyroid cancer. Herein, we review the Korean Thyroid Association’s position statement on the evaluation and management of bone health associated with thyroid diseases.

Purpose: This descriptive survey study aimed to examine the effects of grit, social support, job crafting, and evidence-based practice competency on job satisfaction among nurses. Methods: The participants of this study were 211 clinical nurses with experience of more than six months. Data were collected using through an online survey from February 1 to February 17, 2023. The questionnaires was consisted of general characteristics, grit, social support, job crafting, evidence-based practice competency, and job satisfaction. Data were analyzed using descriptive statistics(frequency, percentage, mean, and standard deviation), t-test, ANOVA, Pearson correlation coefficient, and multiple regression analysis with the SPSS/WIN 28.0 program. Results: The average scores of the main variables were 3.08±0.44 out of four for grits, 3.67±0.52 out of five for social support, 4.20±0.64 out of five for job crafting, 4.84±0.71 out of seven for evidence-based practice competency, and 3.72±0.55 out of five for job satisfaction. In the regression model, the factors affecting the nurses’ job satisfaction were grit (β=0.66, p<.001) and social support (β=0.11, p=.046), which explained 78.7% of the variance in job satisfaction. Job crafting and evidence-based practice competency were correlated with job satisfaction; however, there was no statistically significant effects of these variables on job satisfaction. Conclusion Based on the findings of this study, grit and social support showed the most significant effects on the job satisfaction of nurses. Therefore, active support is needed to develop a strategy to improve nurses’ grit and to create a supportive work environment, which would be helpful to increase their job satisfaction.

The intrathecal chemotherapy with methotrexate and cytarabine arabinoside is used for the treatment and prophylaxis of the primary central nervous system lymphoma. The therapy may induce neurotoxicity including the cauda equina syndrome. We report a case of a 58-year-old man with the diffuse large B-cell lymphoma, who developed the cauda equina syndrome after the administration of intrathecal methotrexate and cytarabine arabinoside, as diagnosed by the electrodiagnostic, urodynamic, and radiologic approaches.
Cauda Equina ; Central Nervous System ; Cytarabine ; Humans ; Injections, Spinal ; Lymphoma ; Lymphoma, B-Cell ; Methotrexate ; Polyradiculopathy ; Urodynamics

Pseudomembranous colitis (PMC) is a frequent cause of morbidity and mortality among hospitalized patients. Although diarrhea is the most common manifestation, PMC may be associated with intraperitoneal fluid accumulation in the severe cases. And a few cases showing both ascites and pleural effusion have been reported in patients with PMC. We report a case of PMC who showed elevated serum and ascites levels of carcinoembryonic antigen (CEA) with a normal CEA level in pleural effusion and who successfully recovered after oral administration of metronidazole. After treatment, the serum CEA level returned to the reference range.
Administration, Oral ; Ascites ; Carcinoembryonic Antigen* ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Humans ; Metronidazole ; Mortality ; Pleural Effusion ; Reference Values

Phenylpropanolamine (PPA) is the major ingredient of over-the-counter drugs, including diet pills and nasal decon-gestants. We present a case of ICH induced by PPA in diet pills in a 36-year-old woman. She didn't have any medical concerns when she began taking diet pills, containing PPA, since 10 days before admission. A brain CT showed large ICHs on the right basal ganglia and lateral ventricle. Physicians should be alerted to the potential fatal side effects of PPA, in commonly used OTC drugs. (J Korean Neurol Assoc 19(3):298~301, 2001)
Adult ; Basal Ganglia ; Brain ; Cerebral Hemorrhage* ; Diet ; Female ; Humans ; Lateral Ventricles ; Nonprescription Drugs ; Phenylpropanolamine*

PURPOSE: To evaluate the immediate effects of 3% diquafosol ophthalmic solution on tear MUC5AC concentration and corneal wetting property in rabbit eyes. METHODS: Six New Zealand white rabbits were used in the present study. Fifteen minutes after instilling 50 microL of 3% diquafosol into the right eye of each rabbit and 50 microL of saline into the left eye, corneal wetting property, tear MUC5AC concentrations and the area of periodic acid-Schiff (PAS)-stained conjunctival goblet cells were evaluated under general anesthesia using conjunctival impression cytology. Corneal wetting property was evaluated by measuring the duration from when the image of the microscopic light beam was clear on the corneal surface immediately after blinking to when the image began to blur. RESULTS: The mean time of corneal wetting property was 86.40 (+/- 17.90) seconds in the diquafosol group and 49.00 (+/- 6.35) seconds in the control group. There was a significant difference between the two groups (p = 0.043). The mean concentration of tear MUC5AC was significantly higher in the diquafosol group (18.21 +/- 1.52 ng/mL) than the control group (12.75 +/- 1.82 ng/mL; p = 0.028). Conjunctival impression cytology showed the area of PAS-stained conjunctival goblet cells was significantly lower in the diquafosol group (23.17 +/- 0.05%) than the control group (32.49 +/- 0.08%; p = 0.028). CONCLUSIONS: Immediately after instilling 3% diquafosol, corneal wetting property improved significantly. Also tear MUC5AC concentration, which was released from conjunctival goblet cells increased compared to saline.
Anesthesia, General ; Blinking ; Goblet Cells ; Rabbits* ; Tears

PURPOSE: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been proposed for controlling peritoneal seeding metastasis in some kinds of cancers, including those of colorectal origin, but their safety and oncological benefits are subjects of debate. We present our early experience with those procedures. METHODS: Data were retrospectively collected from all patients with peritoneal carcinomatosis (PC) and pseudomyxoma peritonei (PMP) treated using CRS and HIPEC at Yonsei Cancer Center between July 2014 and July 2015. Short-term outcomes and risk factors for postoperative complications were analyzed. RESULTS: Twenty-three patients with PC (n = 18) and PMP (n = 5) underwent CRS and HIPEC. Median follow-up and age were 2 months and 54 years, respectively. The median peritoneal carcinomatosis index score was 15, and CC0-1 was achieved in 78.3% of all patients. The median operation time and bleeding loss were 590 minutes and 570 mL, respectively. Grade-IIIa/grade-IIIb complications occurred in 4.3% (n = 1)/26.1% (n = 6) of the patients within 30 days postoperatively, and no 30-day mortalities were reported. Factors related to postoperative complications with CRS and HIPEC were number of organ resection (P = 0.013), longer operation time (P < 0.001), and amount of blood loss (P = 0.003). All patients treated with cetuximab for recurred colorectal cancer had grade-III postoperative complication. CONCLUSION: Our initial experience with CRS and HIPEC presented about 30% grade-III postoperative complications. Therefore, expert surgeons need to perform those procedures with great caution in selected patients who might benefit from it.
Carcinoma ; Cetuximab ; Colorectal Neoplasms ; Cytoreduction Surgical Procedures ; Drug Therapy* ; Follow-Up Studies ; Hemorrhage ; Humans ; Mortality ; Neoplasm Metastasis ; Postoperative Complications ; Pseudomyxoma Peritonei ; Retrospective Studies ; Risk Factors ; Surgeons