No abstract available.
Brain Neoplasms* ; Brain*

BACKGROUND: Osteoporosis is the most common metabolic bone disorder. Osteoporosis has emerged as a leading public health problem with elderly persons and its detection is important for prevention and treatment of fracture. this population-based study was conducted to evaluate the prevalence and risk factors of osteoporosis in the elderly women. METHODS: One hundred thirty eight women aged 60 years or older in rural area were investigated with questionnaires and measurements of height, weight. Bone mineral density(BMD) measurements of lumbar spine and femoral neck were made with dual energy X-ray absorptiometry(DEXA). The World Health Organization criteria for diagnosis of osteoporosis using the manufacturer's young adult population mean and our study young population mean have been applied. Our study's young adult population mean was derived using normal premenopausal 37 women aged 30~45 years. RESULTS: The prevalence of osteoporosis was 45.7% for lumbar spine, 13.0% for femoral neck by the manufacture's young adult mean and 63.0% and 34.8% by our study young adult population mean, respectively. Weight and smoking were associated with lumbar spine BMD. Age was associated with femoral neck BMD. CONCLUSION: Our data suggest that the prevalence of osteoporosis is dependant on reference population mean and measurement site.
Aged* ; Diagnosis ; Female ; Femur Neck ; Humans ; Osteoporosis* ; Prevalence* ; Public Health ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Spine ; World Health Organization ; Young Adult

Background: The association between low-density lipoprotein (LDL-C) levels and cardiovascular disease (CVD) risk in different age groups within the diabetes mellitus (DM) population remains unclear. The cohort study was conducted to investigate this relationship. Methods: We assessed the 2009 to 2012 Korean National Health Screening and National Health Insurance Service records, with follow-up to the primary outcome (myocardial infarction [MI] or stroke) or December 2018. After excluding the participants with a history of MI or stroke, 2,227,394 participants with DM were included and categorized according to baseline LDL-C levels and age. Cox proportional hazards modeling was conducted. The CVD risk of age <40 years and LDL-C <70 mg/dL was set as the reference. In each age group, LDL-C <70 mg/dL was used as a reference for the subgroup analysis. Results: The cut-off LDL-C value for increased MI risk in each age group varied (<40 years old, LDL-C ≥160 mg/dL: hazard ratios [HR], 2.03; 95% confidence interval [CI], 1.644 to 2.506) (40–49-year-old, LDL-C <115 mg/dL: HR, 1.245; 95% CI, 1.04 to 1.489) (50–59-year-old, LDL-C <115 mg/dL: HR, 1.21; 95% CI, 1.014 to 1.445) (60-69-year-old, LDL-C <145 mg/dL: HR, 1.229; 95% CI, 1.022 to 1.479) (≥70 years old group, LDL-C <100 mg/dL: HR, 1.238; 95% CI, 1.018 to 1.504). The cut-off LDL-C values for increased stroke risk varied in each age subgroup (<40 years old, LDL-C ≥160 mg/dL: HR, 1.395; 95% CI, 1.094 to 1.779) (40–49-year-old, LDL-C <145 mg/dL: HR, 1.13; 95% CI, 1.019 to 1.253) (50–59-year-old, LDL-C <160 mg/dL: HR, 1.079; 95% CI, 1.008 to 1.154) (60–69-year-old, LDL-C <130 mg/dL: HR, 1.07; 95% CI, 1.022 to 1.119) (≥70 years old, LDL-C <115 mg/dL: HR, 1.064; 95% CI, 1.019 to 1.112). Conclusion The effect of LDL-C on the risk of CVD differs depending on the age of the population with DM.

PURPOSE: For medical students to have a meaningful learning experience, the curriculum must integrate what students are learning in class with the skills and knowledge required in the clinicalsetting. To satisfy these needs, an integrated curriculum (IC) has been operating at Chonnam National University Medical School since 1999. The purpose of this study was to evaluate the changes in IC students during two implementation periods, the first in 2001 and the second in 2004. This study focused on the student viewpointin order to create an authentic IC program. METHODS: Questionnaires were used to evaluate the differences in the student perception of IC. The content of the questionnaire dealt with the appropriateness of time management, coherence of the content, teachinglearning method, and IC evaluation. RESULTS: There were positive responses from the second implementation period than from the first, for almost all sub-items. However, the results showed that IC has to be reinforced by instructors teaching a coherentcontent, by using a variety of teaching-learning methods, by having the students participate actively, and by offering holistic and integrated assessments. CONCLUSION: The following three steps are recommended for the improvement of IC: facilitate an IC committee, develop teaching-learning methods, and guide student participation.
Curriculum* ; Humans ; Jeollanam-do ; Learning ; Schools, Medical ; Students, Medical ; Time Management ; Surveys and Questionnaires

OBJECTIVES: Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Time and Change (T and C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. METHODS: The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11: 10, and the change test the ability to make 1, 000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T and C ratings were validated against a reference standard based on the physician? diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T and C Test, the mean K-MMSE scores were compared with the results of the T and C Test in the elderly from a rural community. RESULTS: The T and C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T and C Test were significantly related in the elderly from a rural community (p< 0.01). The T and C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete. CONCLUSION: The T and C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T and C Test will be used for the widespread cognitive screening of aging populations.
Aged* ; Aging ; Dementia* ; Diagnosis ; Educational Status ; Hand ; Hope ; Hospitals, Urban ; Humans ; Mass Screening* ; Methods ; Numismatics ; Primary Health Care ; Public Health ; Reproducibility of Results ; Rural Population ; Sensitivity and Specificity

Merkel cell carcinoma (MCC) is a rare aggressive neuroendocrine carcinoma of the skin that shows locoregional or distant metastasis. Metastasis of MCC to body cavity effusion is extremely rare; only three cases have been reported so far. Metastatic MCC in effusion cytology shows small blue round cells with fine stippled chromatin like other small blue round cell tumors such as small cell lung carcinoma or lymphoma. The diagnosis of metastatic MCC can grant patients good chances at recently advanced therapeutic options. Here, we present a case of metastatic MCC to pleural effusion with characteristic single file-like pattern.
Carcinoma, Merkel Cell ; Carcinoma, Neuroendocrine ; Chromatin ; Diagnosis ; Financing, Organized ; Humans ; Lymphoma ; Neoplasm Metastasis ; Pleural Effusion ; Skin ; Small Cell Lung Carcinoma

Meningeal carcinomatosis is an important neurological complication of systemic cancer, and is increasingly being recognized as a cause of reurologic disability in life. Also there is evidenee that the incidence of this form of metastasis is increasing. We reported a case of 52-year-old female patient, who was diagnosed as early gastric cancer by biopsy under gastrofiberscopy. Other Lab. findings were all normal range except high alkaline phosphatase level. And then performed Billroth II operation. On 7th post-operative day, she was encountered severe headache and insomnia. Abnormal neurologic signs and subjective symptoms were developed and progressed, Repeated lumbar punture was done and CSF was examed. There findings were abnormal, but no specific finding of certain disease. She died of severe neurologic deficit and sudden respiratory arrest. Autopsy was done, and confirmed leptomeningeal carcinomatosis.
Alkaline Phosphatase ; Autopsy ; Biopsy ; Female ; Gastroenterostomy ; Headache ; Humans ; Incidence ; Meningeal Carcinomatosis* ; Middle Aged ; Neoplasm Metastasis ; Neurologic Manifestations ; Reference Values ; Sleep Initiation and Maintenance Disorders ; Stomach Neoplasms ; Stomach*

PURPOSE: The human genetic disorder ataxia-telangiectasia (AT) is a multisystem disease characterized by extreme radiosensitivity. The recent identification of the gene mutated in AT, ATM, and the demonstration that it encodes a homologous domain of phosphatidylinositol 3-kinase (PI3-K), the catalytic subunit of an enzyme involved in transmitting signals from the cell surface to the nucleus, provide support for a role of this gene in signal transduction. Although ionizing radiation was known to induce c-fos transcription, nothing is known about how ATM or PKCI mediated signal transduction pathway modulates the c-fos gene transcription and gene expression. Here we have studied the effect of PKCI on radiation sensitivity and c-fos transcription in normal and AT cells. MATERIALS AND METHODS: Normal (LM217) and AT (AT5BIVA) cells were transfected with PKCI expression plasmid and the overexpression and integration of PKCI was evaluated by northern blotting and polymerase chain reaction, respectively. 5 Gy of radiation was exposed to LM and AT cells transfected with PKCI expression plasmid and cells were harvested 48 hours after radiation and investigated apoptosis with TUNEL method. The c-fos transcription activity was studied by performing CAT assay of reporter gene after transfection of c-fos CAT plasmid into AT and LM cells. RESULTS: Our results demonstrate for the first time a role of PKCI on the radiation sensitivity and c-fos expression in LM and AT cells. PKCI increased radiation induced apoptosis in LM cells but reduced apoptosis in AT cells. The basal c-fos transcription activity is 70 times lower in AT cells than that in LM cells. The c-fos transcription activity was repressed by overexpression of PKCI in LM cells but not in AT cells. After induction of c-fos by Ras protein, overexpression of PKCI repressed c-fos transcription in LM cells but not in AT cells CONCLUSION: Overexpression of PKCI increased radiation sensitivity and repressed c-fos transcription in LM cells but not in AT cells. The results may be a reason of increased radiation sensitivity of AT cells. PKCI may be involved in an ionizing radiation induced signal transduction pathway responsible for radiation sensitivity and c-fos transcription. The data also provided evidence for novel transcriptional difference between LM and AT cells.
Animals ; Apoptosis ; Ataxia Telangiectasia ; Blotting, Northern ; Catalytic Domain ; Cats ; Gene Expression ; Genes, fos ; Genes, Reporter ; Humans ; In Situ Nick-End Labeling ; Phosphatidylinositol 3-Kinase ; Plasmids ; Polymerase Chain Reaction ; Protein Kinase C* ; Protein Kinases* ; Radiation Tolerance* ; Radiation, Ionizing ; Signal Transduction ; Transfection

Chronic cough-defined as a cough that persists for more than 3 weeks-is one of the most common symptoms during childhood that requires evaluation of causes and appropriate management, because it can be very disturbing to daily activities at home and school. Besides asthma, postnasal drip syndrome, post infectious cough, chronic bronchitis, gastroesophageal reflux disease and congenital anomaly, psychogenic factors are known to be possible causes of chronic cough in children. "Habit cough" and "respiratory tic" are different names given to psychogenic coughs. Psychogenic cough is croupy, loud, and unresponsive to antitussives or bronchodilators. It becomes more noticeable to attention and disappears during sleep. Over 90% of cases of psychogenic cough have been reported in patients under 18 years of age and its diagnosis is often delayed due to the time consumed for exclusion of other underlying organic disorders and the recognition of psychogenic factors as an etiology. We report on the case of an 11-year-old boy who presented with chronic cough of a barking nature and was diagnosed as having psychogenic cough by characteristics and 24-hour monitoring of cough frequency and who was treated by psychological interview.
Antitussive Agents ; Asthma ; Bronchitis, Chronic ; Bronchodilator Agents ; Child ; Cough* ; Diagnosis ; Gastroesophageal Reflux ; Humans ; Interview, Psychological ; Male

The facial flatness was studied by the metric method which involves six measurements of breadth and projection of the midfacial skeleton, the calculation of three indices from the measurements. The indices of the modern Korean adult crania, Korea & Chosun Dynasty crania, the Iron Age Korean crania, and the late Neolithic Korean crania were investigated. The indices were compared to those of other published data on the Korean crania and those of neighboring asian races as well. All indices for facial flatness of Korea & Chosun Dynasty were similar to modern Korean. However, zygomaxillary index was different between modern and late Neolithic crania. The difference of zygomaxillary index was prominent in males than females. The difference of facial flatness between modern and ancient seems to be mainly due to zygomatic breadth. The frontal indices of modern Korean and Korea & Chosun Dynasty crania were relatively low and the simotic indices were relatively high among neighboring asian races. The zygomaxillary index is intermediate. Clustering analysis represented that the flatnesses of the modern Korean crania and Korea & Chosun Dynasty crania were closely related to those of the northern Chinese, modern Japanese, however, somewhat different from that of ancient Korean, Mongol, Siberian etc.
Adult ; Asian Continental Ancestry Group ; Continental Population Groups ; Female ; Humans ; Iron ; Korea ; Male ; Skeleton