OBJECTIVES: Seoul-Activities of Daily Living(S-ADL) was developed to assess elderly person's basic activities of daily living. This study aims to develop standardized ADL assessment scale and confirm the reliability and validity of the S-ADL. METHODS: It was participated in 336 controls and 145 patients diagnosed Alzheimer's disease. RESULTS: In controls, it was statistically significant to age, but not sex, education, region and presence of spouse. Also, reliability and validity were statistically significant. Principal axis factoring analysis revealed three factors that accounted for 66.67% of the total variance(1.self-care/hygiene, 2.ambulation, 3.toileting). According to each CDR stage, there were significant difference, except for CDR 0.5 and CDR 1 suggesting early dementia. Particularly, it was remarkable for functional impairment in CDR 2 and CDR 3 suggesting moderate to severe dementia. The order of the loss of function was (1) self-care/hygiene, (2) toileting, and (3) ambulation. CONCLUSIONS: Our study showed that the S-ADL could be a very reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-ADL would be useful in assessing daily function of moderate to severe AD.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Axis, Cervical Vertebra ; Dementia ; Education ; Humans ; Reproducibility of Results* ; Spouses ; Walking

The intramedullary nailing for humeral shaft fractures has become popular fixation method. It affords less invasive procedure, good stability and early rehabilitation. However many complications were reported such as nonunion, pain and motion limitation of shoulder. We managed 33 patients using interlocking intramedullary nail for the humeral shaft fractures, and nonunion occurred in 9 patients. We reviewed these 9 cases and analyzed the relationship between the nonunions and the fracture sites as well as fracture types. The results were as follows; 1. Nonunion occurred in 9 patients of 25 patients treated closed reduction, but did not occur in 8 patients treated open reduction. 2. The union was obtained in all 6 patients with proximal one third fracture. But nonunion occurred in 6 patients of 19 patients with middle one third fracture and in 3 patients of 8 patients with distal one third fracture. 3. Nonunion after interlocking nails for humeral shaft fractures did not occur in all 6 spiral fracture patients. Nonunion occurred in 5 patients of 8 comminuted fracture patients, in 3 patients of 6 transverse fracture patients and in 1 patient of 3 oblique fracture patients with below the middle one third of humerus. Our study showed that the high rate of nonunion occurred in the comminuted, transverse and oblique fracture below the middle one third of humerus. On the basis of these findings, we recommend that closer attention should be paid when choose the fixation method in these types of the humeral shaft fractures.
Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Humans ; Humerus ; Rehabilitation ; Shoulder

PURPOSE: To investigate the peripapillary choroidal thickness (PCT) of polypoidal choroidal vasculopathy (PCV) and exudative age-related macular degeneration (AMD) and to evaluate their responses to anti-vascular endothelial growth factor (VEGF). METHODS: Thirty eyes with PCV and 25 eyes with exudative AMD who were treatment naïve were included in this study. PCT and subfoveal choroidal thickness were evaluated both before and after intravitreal anti-VEGF. RESULTS: The initial mean PCT of PCV (153.78 ± 56.23 µm) was thicker than that of exudative AMD (88.77 ± 23.11 µm, p < 0.001). Temporal, superior, nasal, and inferior PCTs of PCV were all thicker than those observedin exudative AMD (all p < 0.05). After anti-VEGF, the mean PCT of PCV was significantly reduced (134.17 ± 41.66 µm, p < 0.001), but the same was not true not in exudative AMD (86.87 ± 22.54 µm, p = 0.392). PCTshowed a similar tendency in all quadrants. CONCLUSIONS: PCV exhibits a thick choroid in the peripapillary region. PCT decreases after anti-VEGF in PCV but not in exudative AMD. In exudative AMD, subfoveal choroidal thickness decreased, but that in the peripapillary region did not.
Choroid* ; Endothelial Growth Factors* ; Macular Degeneration

Atrial natriuretic peptide (ANP), a 28 amino acid basic polypeptide, is known to induce histamine release from human and rat mast cells in vitro and cause a wheel formation in rat skin. However, cellular events associated with histamine release are not clearly understood. In this study, we have examined the calcium flux and cGMP formation associated with histamine release in the ANP-treated mast cells. ANP, in vitro, induced mast cell degranulation and histamine release in a dose-dependent manner. ANP also induced an enhanced calcium uptake into cells and increased the cellular level of cGMP in mast cells. A high level of calcium in the media caused an inhibition of ANP-dependent histamine release but enhanced the level of intracellular cGMP of mast cells. ANP inducing a dose-dependent increase in vascular permeability of rat skin was confirmed by the extravasation of the circulating Evans blue. The results indicate ANP induced the histamine release and an increase in vascular permeability through mast cell degranulation in cGMP-independent and calcium uptake-dependent manner.
Animal ; Atrial Natriuretic Factor/*pharmacology ; Biological Transport ; Calcium/*metabolism ; Capillary Permeability ; Cell Degranulation ; Cyclic GMP/*metabolism ; Dose-Response Relationship, Drug ; *Histamine Release ; Mast Cells/*drug effects ; Peritoneal Cavity/cytology ; Rats

OBJECTIVES: The aim of this study was to evaluate the degree of remineralization over time after application of fluoride varnish with and without tricalcium phosphate (TCP). METHODS: This in vitro study used extracted bovine lateral incisors without dental caries. Artificial lesions were created in the enamel specimens. The amount of mineral loss (ΔF(before)) was measured using quantitative light-induced fluorescence (QLF). Test fluoride varnishes (10 mg) were applied to the enamel surface of the specimen and dried for 4 min. No fluoride varnish was applied to the specimens in the control group. Each group was randomly assigned 12 specimens, and remineralization was allowed to occur to different time points (0.5, 1, 3, 6, 12, and 24 h) in each group. Specimens were washed with distilled water and dried with compressed air for 3 s. ΔF(after) was determined using QLF. RESULTS: When fluoride varnish containing TCP was applied for up to 6 h, the amount of mineral loss significantly increased, and when non-TCP fluoride varnish was applied for up to 12 hours, the amount of mineral loss significantly increased (P<0.05). However, the amount of mineral loss was higher in the control group. The difference between ΔF(before) and ΔF(after) (ΔΔF) increased over time. There was a significant difference between the TCP group and the control group after 6 h. The non-TCP group showed a significant difference after 24 h compared to the control group. After 12 h, significant differences were observed in the TCP group compared to both the non-TCP and control groups. CONCLUSIONS: This study showed that the degree of remineralization increased gradually over time after fluoride varnish application compared to the control group. In particular, fluoride varnish containing TCP showed better remineralization capability than varnish without TCP.
Compressed Air ; Dental Caries ; Dental Enamel ; Fluorescence ; Fluorides* ; Fluorides, Topical ; In Vitro Techniques ; Incisor ; Miners ; Paint* ; Water

The origin of motor neuronal cell bodies innervating heart in the cat was investigated using CTB (Cholera toxin B subunit) as neuronal tracer. The neural tracer was injected into subepicardial layer and myocardium of the right atrium, left atrium, right ventricle and left ventricle, respectively. Labeled parasympathetic motor neuronal cell bodies were found in DMV (dorsal motor nucleus of vagus nerve) and anterolateral part of NA (nucleus ambiguus) of brainstem. Heavier labeled neuronal cell bodies were found in the NA when the neural tracers were injected into left ventricle and DMV when injected into left atrium and left ventricle. These results may provide a neuroanatomical data on origin of motor neuronal cell bodies innervating the heart of the cat.
Animals ; Brain Stem ; Cats* ; Cholera Toxin ; Heart Atria ; Heart Ventricles ; Heart* ; Motor Neurons* ; Myocardium ; Neurons*

The origin of sympathetic and sensory nerves innervating heart in the cat was investigated using HRP (Horseradish peroxidase) and WGA-HRP (Wheat germ agglutinin-horseradish peroxidase) as neuronal tracers. The neural tracers were injected into subepicardial layer and myocardium of the right atrium, left atrium, right ventricle and left ventricle, respectively. Labeled sympathetic neuronal cell bodies were found in superior cervical ganglia, middle cervical ganglia, stellate ganglia and 4th and 5th thoracic ganglia, mainly in middle cervical ganglia and stellate ganglia. Heavier labeled neuronal cell bodies were found in the middle cervical ganglia and stellate ganglia when the neural tracers were injected into left atrium, right ventricle and left ventricle. Labeled sensory neuronal cell bodies were found in nodose ganglia and T1-T6 spinal ganglia, mainly in T1-T5 spinal ganglia. Heavier labeled neuronal cell bodies were found in the nodose ganglia when the neural tracers were injected into left atrium and right ventricle. These results may provide a neuroanatomical data on origin of sensory nerves innervating the heart of the cat.
Animals ; Cats* ; Ganglia ; Ganglia, Sensory ; Ganglia, Spinal ; Ganglia, Sympathetic ; Heart Atria ; Heart Ventricles ; Heart* ; Horseradish Peroxidase ; Myocardium ; Neurons* ; Nodose Ganglion ; Sensory Receptor Cells ; Stellate Ganglion ; Superior Cervical Ganglion ; Wheat Germ Agglutinin-Horseradish Peroxidase Conjugate*

PURPOSE: To evaluate the prognostic factors and outcomes of dexamethasone intravitreal implant (DEX implant) for intravitreal bevacizumab refractory macular edema secondary to branch retinal vein occlusion (BRVO). METHODS: This was a retrospective, interventional case series. Medical records were reviewed, and a total of 38 eyes that were treated with DEX implant for macular edema secondary to BRVO that did not respond to at least two consecutive intravitreal bevacizumab injections (IBIs) were included. Best-corrected visual acuity (BCVA), central subfield macular thickness, and central subfoveal choroidal thickness were evaluated at baseline, 2 months, and 6 months after DEX implantation. RESULTS: Patients had undergone an average of 6.32 ± 4.66 prior IBI treatments. The average BCVA improved from 0.53 ± 0.26 to 0.41 ± 0.25 and 0.44 ± 0.23 logarithm of the minimal angle of resolution (logMAR) at 2 and 6 months, respectively (p < 0.001). The average central subfield macular thickness was 504.00 ± 121.54 µm at baseline and changed to 293.21 ± 74.17 µm and 427.28 ± 119.57 µm at 2 and 6 months, respectively (p < 0.001 and p = 0.002). Average central subfoveal choroidal thickness was 237.46 ± 92.21 µm at baseline and changed to 204.75 ± 74.74 µm and 226.86 ± 90.77 µm at 2 and 6 months, respectively (p < 0.001 and p = 0.455). Twenty-two eyes (58%) gained ≥0.1 logMAR at 2 months, while 16 eyes showed no improvement. Low BCVA at symptom presentation, low baseline BCVA, and shorter duration of macular edema were correlated with increased BCVA after treatment. CONCLUSIONS: The DEX implant improves functional and anatomical outcomes for up to 6 months in about half of the patients treated with IBI refractory macular edema secondary to BRVO, particularly in patients with low initial and baseline BCVA.
Bevacizumab* ; Choroid ; Dexamethasone* ; Humans ; Intravitreal Injections ; Macular Edema* ; Medical Records ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Visual Acuity

The light and electron microscopic studies were carried out to find the morphological changes of epithelial cells covering Peyer's patch after simple observation of gerbil (Mongolian gerbil) ileum. Animals were classified as the control, 6 hour-ligation and 18 hour-ligation groups. Terminal ileum was ligated with white silk around Peyer's patch without the vascular injury. In control group, epithelia of the gerbil ileum was consisted of villous epithelium and follicle-associated epithelium (FAE) covering Peyer's patch. FAE represented typical dome structure, and was composed of the cuboid absorptive cells mainly and M cells. M cells were distributed at the periphery rather than central portion of dome-like FAE that are distinguishable from absorptive cells, owing to their typically short and thick microvilli on its free surface. In the light mictoscopy on 6 hour-ligation group, cells with vacuoles were appeared in FAE, and some lymphocytes in lymphoid follicle were condensed and then densely stained. There are many lymphocytes in FAE, infiltrated through the interrupted basement membrane. In the electron microscopic findings of 6-hour-ligated group, absorptive cells appeared to have many vesicle and vacuoles in various size, some lipid droplets and membranous structure contained inclusion bodies. Microvilli of M cell appeared to be destroyed at the central portion on its free surface. In the light microscopy of 18 hour-ligation group, FAE destructed partially and lymphoid follicle was hypertrophied and atrophied simultaneously. In the electron microscopic findings of 18 hour-ligation group, absorptive cells appeared to have the irregular and densely stained nucleus, and have many lipid droplets other than structures observed in 6 hour-ligation group. M cell appeared to have various-sized vacuoles, and have the bleb-like and irregular membrane-limited structures that protrude into the lumen and have less the cytoplasmic cell organs. These results suggested that the simple ligation of ileum gives rise to the inflammatory response on FAE of 6 hourligated group and then lead to the various response; degeneration, necrosis and atrophy of cells in FAE, and the hypertrophy and atrophy of lymphocytes in lymphoid follicle. M cell might have no special function and have the degenerative change with the adjacent absorptive cells during simple obstruction.
Animals ; Atrophy ; Basement Membrane ; Cytoplasm ; Electrons ; Epithelial Cells ; Epithelium ; Gerbillinae ; Humans ; Hypertrophy ; Ileum ; Inclusion Bodies ; Ligation ; Light ; Lymphocytes ; Microscopy ; Microvilli ; Necrosis ; Silk ; Vacuoles ; Vascular System Injuries

This report describes a case of angiographically documented foveal avascular zone (FAZ) enlargement after a single intravitreal injection of bevacizumab for macular edema secondary to central retinal vein occlusion (CRVO). A 71-year-old female was treated with an intravitreal bevacizumab injection for macular edema following CRVO. Despite successfully decreased edema one month after injection, the postinjection best-corrected visual acuity immediately decreased from 20/40 to 20/1000 (Snellen equivalent). The FAZ area increased from 0.37 mm² to 3.11 mm² (8.4-fold increase). While intravitreal anti-vascular endothelial growth factor is effective and should be considered as a first-line treatment for macular edema secondary to CRVO, it may aggravate macular ischemia.
Aged ; Bevacizumab* ; Edema ; Endothelial Growth Factors ; Female ; Fluorescein Angiography ; Fovea Centralis ; Humans ; Intravitreal Injections ; Ischemia* ; Macular Edema* ; Retinal Vein* ; Visual Acuity