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

Purpose: This study was performed to identify the factors influencing the fear of dementia in middle-aged and older adults. Methods: Data on the characteristics, dementia knowledge, dementia attitude, dementia health beliefs, and fear of dementia of 156 participants were collected from January 20 to March 22, 2018, using a structured questionnaire. The data were analyzed with the SPSS/WIN 21.0 program for descriptive statistics, using an independent t-test, one-way analysis of variance, Pearson’s correlation coefficient, and stepwise multiple regression. Results: Significant factors associated with fear of dementia among middle-aged and older adults were subjective life satisfaction (F=3.72, p=.006) and regular exercise (t=6.05, p=.015). Fear of dementia has positive correlations with dementia attitude, perceived susceptibility, perceived severity, and perceived barrier. The determining factors affecting fear of dementia in middle-aged and older adults were perceived severity (β=.46, p<.001), followed by a perceived barrier (β=.20, p=.004) and perceived susceptibility (β=.17, p=.023), and the explanation power was about 47.8%. Conclusion The results suggest that perceived severity, perceived barrier, and perceived susceptibility be considered in developing the nursing interventions to increase perceived severity, perceived susceptibility, and to decrease perceived barrier to dementia by evaluating dementia health beliefs to manage the fear of dementia among middle-aged and older adults.

To apply rehabilitation program for stroke patients' functional improvement, various factors such as timing for initiation of rehabilitation, intensity of therapy, and individual compliances should be considered. Both animal and neuroimaging studies suggested that greater intensity of therapy is associated with increased cortical reorganization and subsequent functional recovery, and repetition also may play a major role in inducing and maintaining brain plasticity. However, the proper intensity of rehabilitation therapy has not been well established yet. In this review, we examined the previous studies assessing the effect of intensity and repetition of therapy on functional recovery. From the randomized controlled trials and meta-analysis, increased intensities of treatment and repetitions are shown to be effective in improving activities of daily living and gait function, but limited evidences in functional outcomes of upper extremities. It is difficult to provide standardized optimal intensities and repetitions in clinical practice because of the variability in components of rehabilitation therapies, patients' motivation and participation, the degree of therapists' involvement, and reimbursement and healthcare system. Clinical practice guidelines of US, Europe and Korea recommended that intensive rehabilitation and repetitive task training should be provided to post stroke patients in rehabilitation unit. Further studies are needed to investigate the effective delivery system of rehabilitation program in terms of repetition and intensity.
Activities of Daily Living ; Animals ; Brain ; Delivery of Health Care ; Europe ; Gait ; Humans ; Korea ; Motivation ; Neuroimaging ; Plastics ; Stroke ; Upper Extremity

PURPOSE: The purpose of this study was to identify the effects of job stress, emotional labor, and positive psychological capital on the job satisfaction of physician assistants (PAs). METHODS: The sample consisted of 166 PAs working in general hospitals in B city, Y city, and C city. Data were analyzed through the SPSS/WIN 18.0 program using t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and multiple regression. RESULTS: The factors of job stress (β=−.488, p<.001), positive psychological capital (β=.188, p=.004), and total clinical career (β=−.147, p=.014) had the greatest influence on the level of job satisfaction experienced by the PAs. The total explanatory power was 49.9%. CONCLUSION It was found that job stress, positive psychological capital, and total clinical career were influencing factors in the job satisfaction of PAs. Therefore, to improve their job satisfaction, it is necessary to develop strategies to manage the job stress experienced by PAs, and to strengthen and develop positive psychological capital.

Functional aphonia is a disease in which normal vocal ability is suddenly lost. When voice therapy is started at an early stage, the prognosis is good. However, if the functional aphonia persists for a long time, there is a possibility that the voice disorder may become fixed, though reports of these characteristics are rare. The authors experienced a patient with functional aphonia that occurred in adolescence and lasted for 7 months and reported the result of treatment.

Purpose: Silicone tube intubation is the most common method for treatment of nasolacrimal drainage disorder or repair of lacerated canaliculus. However, some cases are prolapsed earlier than expected, subsequently affecting the success rate of silicone tube intubation. The author introduced a successful reposition of the prolapsed silicone tube. Methods: This study is a retrospective case series of 11 patients who were treated with reposition of prolapsed silicone tube using hole and lacrimal probe method. In all cases, the tubes were prolapsed within 2 months after the first surgery due to careless rubbing of the medial canthus by the patient. In all 11 cases, the development of a biofilm on tube was not observed at the time when the tube was prolapsed. All patients underwent immediate reposition of prolapsed tube without local anesthesia in the outpatient operating room on the day they visited. Results: In all 11 cases, the prolapsed silicone tube was repositioned without any complications using this hole and lacrimal probe method. At 6-month follow-up examination, all patients presented with a well-positioned silicone tube up to the day of extubation without replacing it with a new silicone tube. Conclusions This hole and lacrimal probe method is effective for the repositioning of prolapsed silicone tube after bicanalicular intubation of lacrimal system. This procedure includes easy performance in a short time and without local anesthesia in the outpatient operating room.

Purpose: Silicone tube intubation is the most common method for treatment of nasolacrimal drainage disorder or repair of lacerated canaliculus. However, some cases are prolapsed earlier than expected, subsequently affecting the success rate of silicone tube intubation. The author introduced a successful reposition of the prolapsed silicone tube. Methods: This study is a retrospective case series of 11 patients who were treated with reposition of prolapsed silicone tube using hole and lacrimal probe method. In all cases, the tubes were prolapsed within 2 months after the first surgery due to careless rubbing of the medial canthus by the patient. In all 11 cases, the development of a biofilm on tube was not observed at the time when the tube was prolapsed. All patients underwent immediate reposition of prolapsed tube without local anesthesia in the outpatient operating room on the day they visited. Results: In all 11 cases, the prolapsed silicone tube was repositioned without any complications using this hole and lacrimal probe method. At 6-month follow-up examination, all patients presented with a well-positioned silicone tube up to the day of extubation without replacing it with a new silicone tube. Conclusions This hole and lacrimal probe method is effective for the repositioning of prolapsed silicone tube after bicanalicular intubation of lacrimal system. This procedure includes easy performance in a short time and without local anesthesia in the outpatient operating room.

PURPOSE: This study was undertaken to determine the incidence of chromosome 22q11 deletion in patients with infundibular ventricular septal defect(VSD). METHODS: Sixty-two children with infundibular VSD were included in this study from January 1999 to December 2000. Chromosome 22q11 deletion was confirmed by FISH, using LSI DiGeorge/VCFS region dual color probe(Vysis, USA). RESULTS: Thirty-two patients had conotruncal cardiac defects:tetralogy of Fallot (TOF) in 15; TOF with absent pulmonary valve in 1; VSD with pulmonary atresia in 7; truncus arteriosus in 3; double outlet right ventricle in 2; interrupted aortic arch in 2; transposition of the great arteries in 2. Thirty patients had isolated infundibular VSD without conotruncal cardiac defect:perimembranous infundibular VSD in 15; subarterial infundibular VSD in 9; muscular infundibular VSD in 6. Chromosome 22q11 deletion was observed in 8 patients(male 5, female 3):TOF 2; VSD with pulmonary atresia 4; truncus arteriosus 1; perimembranous infundibular VSD 1. All of the patients with chromosome 21q11 deletion showed typical facial appearance. Low incidence was found of chromosome 22q11 deletion in patients with infundibular VSD without conotruncal cardiac defect than in those with conotruncal cardiac defect(3.3% vs 21.9%). CONCLUSION: These data indicate that a small proportion of isolated infundibular VSD is pathogenetically related to deletion of chromosome region 22q11.
Aorta, Thoracic ; Arteries ; Child ; Double Outlet Right Ventricle ; Female ; Heart Septal Defects, Ventricular* ; Humans ; Incidence ; Pulmonary Atresia ; Pulmonary Valve ; Truncus Arteriosus

The prevalence of chronic diseases including osteoporosis and sarcopenia increases as the population ages. Osteoporosis and sarcopenia are commonly associated with genetics, mechanical factors, and hormonal factors and primarily associated with aging. Many older populations, particularly those with frailty, are likely to have concurrent osteoporosis and sarcopenia, further increasing their risk of disease-related complications. Because bones and muscles are closely interconnected by anatomy, metabolic profile, and chemical components, a diagnosis should be considered for both sarcopenia and osteoporosis, which may be treated with optimal therapeutic interventions eliciting pleiotropic effects on both bones and muscles. Exercise training has been recommended as a promising therapeutic strategy to encounter the loss of bone and muscle mass due to osteosarcopenia. To stimulate the osteogenic effects for bone mass accretion, bone tissues must be exposed to mechanical load exceeding those experienced during daily living activities. Of the several exercise training programs, resistance exercise (RE) is known to be highly beneficial for the preservation of bone and muscle mass. This review summarizes the mechanisms of RE for the preservation of bone and muscle mass and supports the clinical evidences for the use of RE as a therapeutic option in osteosarcopenia.
Activities of Daily Living ; Aging ; Bone and Bones ; Bone Density ; Chronic Disease ; Diagnosis ; Education ; Genetics ; Metabolome ; Muscle Strength ; Muscles ; Osteoporosis ; Prevalence ; Sarcopenia