Alzheimer's disease(AD) is one of the most common causes of mental deterioration in elderly individuals, accounting for around 45~60% of the overall cases of dementia over 65 years of age. Although there is presently no "cure" for AD, a large number of potential therapeutic interventions have emerged to correct cholinergic dysfunctions. Currently, cholinergic therapy, particularly cholinesterase inhibition, represents the most realistic approach to the symptomatic treatment of AD. Modest efficacy for mild to moderate AD has been shown in well-designed clinical trials for tacrine, donepezil, rivastigmine, and galantimine. Among other treatment options, estrogen replacement therapy in postmenopausal women is under active investigation, but recent studies showed somewhat disappointing results. Epidemiological and clinical data suggest that nonsteroidal anti-inflammatory drugs are beneficial in the treatment and prevention of AD. But prednisone and COX-2 inhibitor, celecoxib showed no clinical benefit in recent studies. Alpha-tocopherol and gingko biloba showed some beneficial effect in delaying the progression of AD and enhancing cognitive functions. Immunization with beta amyloid peptide was considered to be the only method to prevent and halt disease progression in patients with AD. Recently, phase II clinical trial using synthetic beta amyloid peptide (AN-1792) was discontinued because some patients showed neuro-inflammation which may be caused by autoimmune responses.
Aged ; alpha-Tocopherol ; Alzheimer Disease* ; Amyloid ; Autoimmunity ; Celecoxib ; Cholinesterases ; Cognition ; Dementia ; Disease Progression ; Estrogen Replacement Therapy ; Female ; Ginkgo biloba ; Humans ; Immunization ; Methods ; Prednisone ; Rivastigmine ; Tacrine

An epidemiological study is to observe and analyse 100 cases of lung cancer in Korean, which had been diagnosed actually at the general hospitals in Korea from 1970 through 1974, to discover the tendency of the lung cancer by sex, age, occupation, duration of clinical symptoms before diagnosis, site of cancer in lung, size of cancer, occurrence, treatment, prognosis, smoking and pathological findings as follows. 1. Males were affected 5.7 times more than females, the peak incidence of lung cancer were 50 years old age group. 2. The occupations of the cases were commerce, agriculture, industry, laborers and teachers, etc. in thht order. 3. The average duration symptoms from onset to diagnosis were 5.5 months. 4. The cancers were affected more right side than left side of the lungs, Particularly the most of them were affected in the upper lobes of the lungs. 5. The average diameter of the tumors was 5.5crX6.5cm, However the largest of them was 10cm X 13cm. 6. The most cases of the lung cancers were occurred primarily. 7. Out of the 100 cases, 58 cases had no treatment, 23 cases had palliative-symptomatic treatment, of cases by special chemo-therapy, 7 cases by surgery, and 5 cases by cobalt 60 or X-gay. 8. In the view point of prognosis, the most cases of the lung cancers died within one year atfer diagnosis. 9. The smoking was one of the causative factor of lung cancer, but there was no significant diferentiation by means of the amount of smoking. 10. The most cases of the lung cancers diangosed histo-pathologically, were epidermoid(squamous) type.
Agriculture ; Cobalt ; Commerce ; Diagnosis ; Epidemiologic Studies* ; Female ; Hospitals, General ; Humans ; Incidence ; Korea ; Lung Neoplasms* ; Lung* ; Male ; Middle Aged ; Occupations ; Prognosis ; Smoke ; Smoking

Pityriasis rotunda is an uncommon chronic dermatosis characterized by multiple, round or oval, hyperpigmented or hypopigmented patches that have a fine scale on the trunk and extremities. Most of the cases reported predominantly occurred in Oriental and black patients in association with internal disease. However, in Caucasians it has been documented in healthy persons usually as a familial tendency. We report a case of pityriasis rotunda which showed familial occurrence and had no underlying disease.
Extremities ; Humans ; Pityriasis* ; Skin Diseases

No abstract available.
Portacaval Shunt, Surgical*

OBJECTIVE: The purpose of this study was to investigate clinical charactoristics of adenocarcinoma of the uterine cervix. STUDY METHODS: This study is a retrospective analysis of 103 patients with adenocarcinoma of cervix treated at the Kosin Medical center forom 1984 to 1993. RESULTS: The distribution by stage of disease included FIGO stage I, 51(49.6%); stage II, 32(31%); Stage III, 17(16.5%);Stage IV, 3(2.9%). The 2-year survival results for patients with stage I was 93.5%; stage II was 72.4%;stage III was 46.2% and stage IV was none survived. And 4 year survival results,'83.3/o, 591% and 33.3/o in stage I, II and III, reqxetively. The 4-year survivel rate varied significantly according to tumor size and lymph nade metastasis status-below 2cm 84.2%, 2cm~4cm 75%, above 4cm 0%: (stage I);negative node 91.3%, positive node 40% (stage I). The results of resurrent rate according to clinical stage was 11.8%, 25.8%, 84.6% and 100 % in stage I, ll, III and lV, respectively. CONCLUSION: Treatment strategies should be based on the stage of disease, tumor size, lymph node metastasis status and recurrent.
Adenocarcinoma* ; Cervix Uteri* ; Female ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies

BACKGROUND: It is necessary for most effective treatment of neoplasms to detect it in early stage. For the purpose we use many screening tests currently, however, the tumor marker have many limitations as a screening test for neoplasm. Nevertheless most of Health screening centers are using CEA as a screening test for neoplasm. So, we began this study for the assessment of validity of CEA as a screening test for neoplasm. METHODS: The subjects were 4265 persons who visited Health screening center of Kyung hee Medical Center from July 1995 to June 1996. The number of elevated CEA among the subjects was 156. We evaluated the frequencies of factors known as etiologies of increased CEA. We followed up whether neoplasms were developed in normal CEA group. Through the random sampling of normal CEA group, 391 subjects were obtained for statistical analysis by SPSS/PC+. Immunoradiometric assay kit, of Eiken company was used for gauging CEA level and normal level was less than 2.4ng/ml according to manual of manufacturer. RESULTS: There was no significant difference of CEA according to sex, age. The factors that significantly affect CEA were neoplasms, chronic lung disease, liver cirrhosis. In t,his study, smoking, hypertension, diabetes mellitus, fibrocystic disease, chronic renal failure, alcohol drinking, hepatitis, peptic ulcer disease known as etiologies of elevated CEA in other studies did not show statistical significance. 9 cases of neoplasms were developed in both elevated CEA and normal CEA group during follow up. In former, 4 cases of 9 neoplasms were early stage. In latter, all cases were stage IV and inoperable. Specificity and sensitivity of CEA were each 96.5%, 50.0%. Positive & negative predictive value of CEA were each 5.8%, 99.8%. CONCLUSIONS: CEA was increased in various benign conditions and even if any neoplasm exists, CEA was not elevated in most of all in early stage. It showed high false positive rate and low sensitivity. Thus, this study showed that it was not valid to use CEA as a screening test for early detection of neoplasms.
Alcohol Drinking ; Diabetes Mellitus ; Follow-Up Studies ; Hepatitis ; Humans ; Hypertension ; Immunoradiometric Assay ; Liver Cirrhosis ; Lung Diseases ; Mass Screening* ; Peptic Ulcer ; Renal Insufficiency, Chronic ; Sensitivity and Specificity ; Smoke ; Smoking

BACKGROUND: Although it is known that patients wth peripheral vascular disease are at high risk for coronary arterial disease, however, it has not been determined that patients with coronary artery disease(CAD) correlates with peripheral vascular disease(PVD). This study was designed to determine the prevalence and clinical characteristics of peripheral vascular disease(PVD) in patients with coronary artery disease(CAD). METHODS: A total of one hundred seventy-eight patients with CAD confirmed by coronary angiogram(145 male, age 58.5+/-10.1) were included in this study from February 1992 to May 1994. Coronary and peripheral angiograms were performed in all patients and the patients were divided into two groups; patients with PVD dand patients without PVD. Clinical characteristics were compared between two groups. RESULTS: Peripheral vascular disease was present in 49 patients(27.5%) among 178 CAD patients. The mean age of patients with PVD was significantly older than that of patients without PVD. The hypertension was statistically significant difference between two groups(P<0.05). There were no major differences in the number of risk factors or number of stenotic coronary arteries in patients with and without PVD. CONCLUSION: The prevalence of PVD in patients with CAD was high and it is reasonable to state that most common risk factors for coronary and peripheral atherosclerosis were age, hypertension and obesity.
Atherosclerosis ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Hypertension ; Male ; Obesity ; Peripheral Vascular Diseases* ; Prevalence ; Risk Factors

Congenital dyserythropoietic anemia Type II (herditary erythroblatic multinuclearity with positive acidified serum test; HEMPAS) is characterized by binuclearity, multinuclearity, pluripolar mitoses, karyorrhexis of normoblasts, and the presence of abnormal antigens on the red cells. We experienced a case of HEMPAS in a 2 month old girl patient who had an intermittent fever, abdominal distention with palpable liver & spleen, and generalized jaundice. The blood analysis revealed anemia, and thrombocytopenia. Peripheral blood smear showed an averge of 6 mature normoblast per 100 leukocyte count. The red cells showed moderate anisocytosis, poikilocytosis, irregularly crenated, contracted cells and occasional spherocytes. The leukocytes showed relative lymphocytosis, and there were occasional villous lymphocytes. The marrow smear showed abnormality in erythroid series. About ten percent of the erythroblasts showed 2~7 nuclei or lobulated nuclei. The mitotic forms of the erythroid precursors were also increased in frequency. The M:E ratio was 1:3.2. Blood culture on this patient showed a pure growth of Coxiella burnetti. Medical treatment with Doxycycline and Rifampin was performed. After treatment, she became afebrile showing improved general condition with decreased size of liver & spleen. In spite of clinical improvement, she died suddenly 3 weeks after initial treatment.
Anemia ; Anemia, Dyserythropoietic, Congenital* ; Bone Marrow ; Coxiella ; Doxycycline ; Erythroblasts ; Female ; Fever ; Hempa ; Humans ; Infant ; Jaundice ; Leukocyte Count ; Leukocytes ; Liver ; Lymphocytes ; Lymphocytosis ; Mitosis ; Rifampin ; Spherocytes ; Spleen ; Thrombocytopenia

This experiment was performed to investigate morphological and immunohistochemical changes of the connective tissue, the nerve and the smooth muscle cell in the pregnant and postpartum rat myometrium. The materials were the non-pregnant control, the 2-, the 4-, the 10-day gestation and the 1-, the 2-, the 6-day birth of rat myometrium. The light microscopic findings were examed after van Gieson and malachite green stainings. The reaction of nitric oxide synthase activity, apoptosis, type IV collagen, and estrogen receptor were examined immunochemically. The results were as follows: A. Light microscopic findings: 1. In the van Gieson staining for collagen fibers and smooth muscles, it showed the increase of pinky collagen fibers and yellow smooth muscle cells from the 2-day gestation. At the 1-day birth, the yellow hypertrophic smooth muscle cells were in the form of the papilla. The collagen fibers of the 2-day birth were more abundant than that of the 1-day birth. 2. In the malachite green staining for nerve fibers, it showed the blue spots. The size of spots of the 4-day gestation enlarged and at the 10-day gestation the number of fine spots was increased. At the 1-day birth, it showed the decreased number and increased size of spots. B. Immunohistochemical findings : 1. The NOS activity showed the increased positive reaction at the 2-day gestation. At the 10-day gestation, the outer zone of myometrium showed prominent positive. At the 1-day birth, the endothelium of the vessels were weakly positive. 2. The apoptotic reaction was localized at the connective tissue cells between the outer and inner zones of myometrium. The positive reaction cells were a few at the 1-day birth, several at the 2-day birth, and many at the 6-day birth. 3. The type IV collagen reaction appeared at the perivascualr area and the comnnective tissues of the inner zone. The positive reaction showed weak at the control, moderate at the 2-day gestation, and strong at the 4-day gestation. At the 1- and 2-day birth, the connective tissue of inner zone was moderately positive. 4. The estrogen receptor reaction cells appeared at the papillary outer zone of the 10-day gestation. The reaction cells were several at the 1-day birth and a few at the 2-day birth. C. Electron microscopic findings : 1. At the 10-day gestation, one group of smooth muscle cells had well-developed sarcoplasmic reticulum and the other group with abundant mitochondria appeared. At the 2-day birth, one group smooth muscle cells had degenerating processes and the other group with the serrated processes showed. At the 6-day birth, smooth muscle cells were degenerated. 2. Mitochondria were abundant in the smooth muscle cell with many processes of the 10-day gestation. The onset of mitochondrial degeneration began at the 2-day birth. The mean section of mitochondria was increased by the 2-day birth and markedly decreased at the 6-day birth. 3. At the 1-day and 2-day birth, the electron-dense region of cell membrane was increased and submembranous caveolae were decreased. The mean section of caveolae was the mostly decreased at the 10-day gestation, nearly restored at the 1-day birth and enlarged at the 6-day birth.
Animals ; Apoptosis ; Caveolae ; Cell Membrane ; Collagen ; Collagen Type IV ; Connective Tissue ; Connective Tissue Cells ; Endothelium ; Estrogens ; Female ; Mice ; Mitochondria ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Myometrium* ; Nerve Fibers ; Nitric Oxide Synthase ; Parturition ; Postpartum Period* ; Pregnancy ; Rats* ; Sarcoplasmic Reticulum

White matter hyperintensity (WMH) is commonly observed on the brain MRI of elderly subjects. It has been considered as an important biomarker for the micro-vascular damages of white matter of the brain. Aging, hypertension, diabetes mellitus, and hyperhomocysteinemia have been associated with WMH development. WMH is an important risk factor for the vascular dementia (VD), however it also considered as one of risk factors for conversion of mild cognitive impairment to dementia and progression of Alzheimer's disease (AD). WMH has impact on gait, bladder control, and fine motor coordination. It also has negative effects on memory retrieval, mental flexibility, mental processing speed, and executive function by disconnecting nerve fibers that convey signals for normal cognition. Control of vascular risk factors can delay progression of WMH and this may be beneficial for VD as well as AD with ischemic changes, especially in the early state of diseases. In this paper, we will review clinical significance of WMH and three important diseases, subcortical vascular dementia, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, and cerebral amyloid angiopathy that associated with cerebral micro-vascular damages.
Aged ; Aging ; Alzheimer Disease ; Brain ; CADASIL ; Cerebral Amyloid Angiopathy ; Cognition ; Dementia ; Dementia, Vascular ; Diabetes Mellitus ; Executive Function ; Gait ; Humans ; Hyperhomocysteinemia ; Hypertension ; Memory ; Mild Cognitive Impairment ; Nerve Fibers ; Pliability ; Risk Factors ; Urinary Bladder