BACKGROUND: Dementia has emerged as a leading public health problem with elderly persons and its early detection is important for treatment in curable cases. Although dementia screening tests are available, they are still complex and time consuming in practice and therefore difficult to use. Our goal was to validate the time and change(T&C) test, a simple, standardized method for detecting dementia in the elderly populations. METHODS: Participants were 59 patients aged 65 years or older at an urban hospital from November 1 to December 31, 2001. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability making 1,000 Won from a group of coins consisting one 500 Won, seven 100 Won, seven 50 Won. T&C ratings were validated against a reference standard based on physician`s diagnosis. Test-retest reliability and inter-observer reliability were assessed. RESULTS: The T&C test had a sensitivity of 73.0%, specificity of 90.9%, positive predictive value of 93.1%, and negative predictive value of 66.7%. Test-retest and inter-observer agreement rates were 95% and 95%, respectively. The T&C test was not influenced by education. The time and change tests took a mean of 7.5 seconds and 19.6 seconds to complete respectively, and was acceptable to participants. When timed cut points were added, the T&C test had a sensitivity of 86.5%, specificity of 40.9% and test-retest and inter-observer agreement rates were 77.3% and 81.8%, respectively. CONCLUSION: The T&C test is a simple, accurate reliable, performance-based tool for detection of dementia in the elderly.
Aged* ; Dementia* ; Diagnosis ; Education ; Hand ; Hospitals, Urban ; Humans ; Mass Screening* ; Numismatics ; Public Health ; Sensitivity and Specificity

We report a case of trichorrhexis nodosa in a 27-year-old male. Scanning electron microscopic findings reveals those of typical trichorrhexis nodosa nodal swelling of affected hair showed longitudinal fissures and fractures in the cortex. A paintbrush effect was noted at the site of fracture. Simple avoidance of trauma gave some regrowth of hairs.
Adult ; Hair ; Humans ; Male

PURPOSE: This study was founded to identify perception and ways of coping with stress according to classification of Sasangin(4 constitutions). METHOD: The subjects were 258 regular students who majored in oriental medicine in Jechon and Seoul. Data was collected by 3 types of questionnaires for 3 months; Perceived stess, ways of coping, Questionnaires of Sasang Constitution Classification (QSCC II). Data analysis was conducted by SPSS version 10. RESULT: 1) Difference of perceived stress in Sasangin: Perceived stress by the Sasangin indicated that Soeumin perceived more stress than Soyangin and Taeumin(P=0.013). 2) Different method in coping with stress of Sasangin: It was found that Soeumin didn't make use of emotional coping way according to the analysis(P=0.040). 3) Relationship between ways of coping for stress and perceived stress in Sasangin: It was shown that as Soeumin perceived stress so higher than Soyangin and Taeumin, they tended to use the solving problem-method therefore it was shown to have a negative correlation(P=0.044). CONCLUSION: In conclusion, it was found that there were differences of Sasangin in perceived stress and ways to cope with it. The dose relationship between the perception and coping method of stress was found.
Classification ; Constitution and Bylaws ; Humans ; Medicine, East Asian Traditional ; Seoul ; Statistics as Topic ; Surveys and Questionnaires

PURPOSE: Increase in suicide rate for senior citizens which has become widespread in our society today. It is not a normal social phenomenon and is beyond the danger level. The contents of this study include Korean senior citizens' suicide related risk factors and warning signs, and the development of a simple Geriatric Suicide Risk Scale. METHODS: This study is Methodological Research to verify reliability and validity of the Geriatric Suicide Risk Scale according to the tool development process suggested by Devellis (2012). RESULTS: For predictive validity assessment, high suicide screening accuracy was showed with an Area under the ROC curve (AUC) of .93. For the optimal cutoff point of 11, sensitivity was 93.9%, and specificity, 75.7% which are excellence levels. Cross validity for assessment of generalization possibility showed the Area under the ROC curve (AUC) as .82 and in case of a cutoff point of 11, sensitivity was 73.7%, and specificity, 65.9%. CONCLUSION: When it comes to practical nursing, it is significant that the Korean Geriatric Suicide Risk Scale has high reliability and validity through adequate tool development and the tool assessment step to select degree of suicide risk of senior citizens. Also, it can be easily applied and does not take a long time to administer. Further, it can be used by health care personnel or the general public.
Aged ; Aged, 80 and over ; Area Under Curve ; Delivery of Health Care ; Female ; *Geriatric Assessment ; Humans ; Interviews as Topic ; Male ; ROC Curve ; Republic of Korea ; Risk Factors ; Suicide/*prevention & control ; Surveys and Questionnaires

Hantaan and related viruses have been implicated as causative agents for a diverse group of human diseases known collectively as "hemorrhagic fevers with renal syndrome" (HFRS). Outbred SD rats obtained within 24 hours after birth were inoculated by intracerebral (the first group) or intramuscular routes (the second group) with 10(9.5)/ml DL50 of Hantaan seed virus suspension in 0.02 ml and 0.1 ml, respectively. Brain, lung, liver, kidney and spleen were used for virus antigen detection by immunofluorecence and histopathologic examination. In the first group, immunofluorescent intensity of virus antigen was increased in all organs (especially brain) and persisted until time of death(day 9). The histopathologic changes were relatively mild in brain and spleen and unremarkable in liver, lung and kidney. In the second group, immunofluorescent intensity of virus antigen was markedly increased in brain until time of death(day 17), but decreased in other organs. The histopathologic findings, such as meningoencephalitis, interstitial pneumonitis with focal hemorrhage, and lymphoid hyperplasia of splenic white pulp were much prominent compared to the first group. However, those of liver and kidney were unremarkable. The chronology of virologic and pathologic findings in Hantaan-infected suckling rats suggests a possible immune-mediated mechanism in disease pathogenesis.
Humans ; Rats ; Animals

Granulocytic sarcoma is an uncommon extramedullary localized tumor composed of granulocytic precursor cells. The majority of cases have been reported in association with acute myeloid leukemia(AML) especially in children, but infrequently may occur in patients with myeloproliferative disorders or myelodysplastic syndromes. Most common sites of involvement were bone, soft tissue, lymph nodes and skin, but gastrointestinal tract, testis, central nervous system are also involved rarely. We present an unusual case of granulocytic sarcoma of the intracranium and the retro-orbital soft tissue occurring in a patient with concurrent myelodysplastic syndrome, diagnosed by brain magnetic resonance images and ultrasound guided needle biopsy.
Biopsy, Needle ; Brain ; Central Nervous System ; Child ; Gastrointestinal Tract ; Granulocyte Precursor Cells ; Humans ; Lymph Nodes ; Myelodysplastic Syndromes* ; Myeloproliferative Disorders ; Sarcoma, Myeloid* ; Skin ; Testis ; Ultrasonography

OBJECTIVE: The purpose of this paper is to study the possible differences in clinical and polysomnographic findings, depending on the presence or absence of subjective complaints of abnormal sleep behavior, in patients with RWA on polysomnography. METHOD: We reviewed patient records and polysomnographic data of patients referred to the Sleep Laboratory at Seoul National University Hospital from June 1996 through October 2002. We defined the manifest RBD group (n=32) as patients having both complaints of abnormal sleep behavior and RWA on polysomnography. The latent RBD group (n=20) consisted of patients who exhibited RWA on polysomnography but did not complain of abnormal sleep behavior. The clinical characteristics and polysomnographic findings between the two groups were compared and analyzed. RESULTS: Fifty-two subjects had RWA, as detected by polysomnography (42 males and 10 females, mean age of 55.1+/-19.1 years). Subjects in the manifest RBD group were significantly older than those in the latent RBD group (61.59+/-13.5 vs. 44.70+/-2.76 years, independent t-test, p<0.01). More subjects in the manifest RBD group exhibited abnormal REM behavior on polysomnography than did subjects in the latent RBD group (81.3 vs. 50.0%, Fisher's exact test, p<0.05). No significant differences between the groups were found in the prevalence of brain disorders and primary sleep disorders, gender proportion, and sleep architecture. CONCLUSION: No difference in sleep architecture was found between the manifest and the latent RBD groups. Only age and the presence of abnormal sleep behavior on polysomnography differentiated the two groups. We suggest that RWA on polysomnography without complaints of abnormal sleep behavior may be early manifestation of manifest RBD. Attention to RWA on polysomnography is necessary to help prevent full-blown RBD from developing.
Brain Diseases ; Female ; Humans ; Male ; Mental Disorders* ; Polysomnography ; Prevalence ; REM Sleep Behavior Disorder ; Seoul ; Sleep Wake Disorders ; Sleep, REM*

OBJECTIVE: The purpose of this study is to investigate the prevalence rate of OSA in subjects whose main sleep complaint is insomnia and to find differential factors of OSA in these insomniac subjects. METHOD: We reviewed the medical records and polysomnographic findings of patients referred to the Sleep Laboratory at Seoul National University Hospital from January 1996 to December 2002. Four-hundred and seventy subjects complained of insomnia as their main sleep problem (235 males and 235 females, mean age 53.6+/-12.4 years). First, we investigated the prevalence rate of OSA in these insomniac patients. Second, we compared the clinical and demographic characteristics of the OSA-associated group with those of the non-associated group. Third, we examined whether the degree or presence of differential factors within the OSA group correlate with severity of OSA, as determined by the respiratory disturbance index (RDI). RESULTS: Among 470 insomniac subjects, 125 subjects (26.6%) were diagnosed as OSA by nocturnal polysomnography. OSA-associated subjects were significantly older (58.4+/-12.3 years vs. 51.8+/-11.2 years, p<0.01), and had significantly higher body mass index (BMI) (23.4+/-3.3 kg/m2 vs. 22.5+/-3.1 kg/m2, p=0.44) than non-associated subjects. The OSA-associated group had more subjects with male gender (64.0 % vs. 44.9 %, p<0.01), hypertension (20.0 % vs. 9.3 %, p<0.01) or snoring (96.0 % vs. 63.5 %, p<0.01). Within the OSA-associated group, age had a significant positive correlation with RDI (p=0.01). CONCLUSION: We found that a considerable portion of patients complaining of insomnia as their main sleep problem were diagnosed as OSA. Snoring, old age, male gender, obesity, and comorbid hypertension were found to be differential factors of OSA in insomniac patients. We suggest that diagnostic efforts including nocturnal polysomnography are needed for insomniac patients with any of the above risk factors of OSA.
Body Mass Index ; Female ; Humans ; Hypertension ; Male ; Medical Records ; Obesity ; Polysomnography ; Prevalence ; Risk Factors ; Seoul ; Sleep Apnea, Obstructive* ; Sleep Initiation and Maintenance Disorders* ; Snoring

PURPOSE: The frontal lobe is the highest center of importance in the control of micturition. Patients with frontal lobe lesion have detrusor hyperreflexia, detrusor areflexia or uninhibitory urethral relaxation. However, the precise regions controlling the detrusor activity have not been established. Therefore, we analogize the regions of the frontal lobe controlling micturition by means of analyzing the detrusor change of patient with frontal lobe lesion. MATERIALS AND METHODS: The cystometric findings of twenty-two patients, who had frontal lobe lesions bun don't any other causes of a neurogenic bladder, were analyzed. And the frontal lobe lesions were classified by magnetic resonance imaging into seven lesions(the olfactory frontal center, gyrus recti, cingulate gyrus, inferior frontal gyrus, medial frontal gyrus, superior frontal gyrus, and precentral gyrus). RESULTS: In the urodynamic study, 11 patients showed detrusor overactivity(40.0%), 2 normal findings(14.7%) and 8 detrusor areflexia(36.3%). In the detrusor hyperreflexia group, high involvement of the medial frontal gyrus 63.6%, superior frontal gyrus(54.5%) and precentral gyrus(54.5%) were observed. In the detrusor areflexia group, the medial frontal gyrus 62.5%, superior frontal gyrus 37.5%, and precentral gyrus 62.5% were also more involved. CONCLUSION: The patients with detrusor hyperreflexia and detrusor areflexia have high incidences of precentral gyrus and medial frontal gyrus involvement. This implies that the superior surface of the frontal lobe(precentral gyrus and medial frontal gyrus) might be associated with the inhibitory reflex of micturition and detrusor contractibility.
Frontal Lobe* ; Gyrus Cinguli ; Humans ; Incidence ; Magnetic Resonance Imaging ; Reflex ; Reflex, Abnormal ; Relaxation ; Urinary Bladder, Neurogenic ; Urination ; Urodynamics

PURPOSE: The purpose of this study was to suggest agenda priorities for nursing service R&D (Research and Development) related policies development. METHODS: Two steps in developing the agendas and priorities were performed in this descriptive study. First, nursing service R&D agendas were extracted through needs assessment of nursing researchers and practitioners. Then, the priority of agendas was set by Analytic Hierarchy Process by ten experts who were representatives of nursing and other healthcare professionals. RESULTS: Six core areas and forty-six nursing service R&D agendas were developed. The priority of agendas was different according to the evaluation criteria depending on weight value of nursing services. CONCLUSION: In order to select and promote nursing service R&D projects within national healthcare policy, nursing service R&D policy should be proposed with consideration to the importance of the criteria in reflecting characteristics of nursing care. By strengthening R&D capabilities for quality improvement and sensitive awareness of national directions for healthcare R&D policies, nursing service R&D can be appropriately promoted.
Delivery of Health Care ; Needs Assessment ; Nursing ; Nursing Care ; Nursing Research ; Nursing Services* ; Quality Improvement