The changes of electroencephalogram(EEG) in patients with dementia are most commonly studied by analyzing power or magnitude in certain traditionally defined frequency bands. However because of the absence of on identified metric which quantifies the complex amount of information, there are many limitations in using such a linear method. According to chaos theory, irregular signals of EEG cal also result from low dimensional deterministic chaos. Chaotic nonlinear dynamics in the EEG can be studied by calculating the correlation dimension. The authors have analyzed EEG epochs from three patients with dementia of Alzheimer type and three matched control subject. The result showed that patients with dementia of Alzheimer type had significantly lower correlation dimension than non-demented controls on 12 channels. Topographic analysis showed that the correlation dimensions were significantly lower in patients with Alzheimer's disease on frontal, temporal, central, and occipital head regions. These results show that brains of patients with dementia with dementia of Alzheimer type have a decreased complexity of electrophysiological behavior. We conclude that the nonlinear analysis such as calculating correlation dimension can be a promising tool for detecting changes in the complexity of brain dynamics.
Alzheimer Disease ; Brain ; Dementia* ; Electroencephalography* ; Head ; Humans ; Nonlinear Dynamics*

Purpose: This study investigates the characteristics of different item types to assess learning outcomes and explore the educational implications that can be obtained from the results of learning outcome assessments. Methods: Forty-five second-year premedical students participated in this study. Multiple choice question (MCQ) and short essay question (SEQ) scores and pass rates for 10 learning outcomes were analyzed. Descriptive statistics and correlation analysis were used to analyze the data. Results: The correlation analysis indicated that there was a significant correlation between SEQs and pass rate but there was no significant correlation between MCQs and pass rate. Some students with identical scores on the MCQs had different scores on the SEQs or on the learning outcomes. Conclusion This study showed that students’ achievement of learning outcomes can be assessed using various types of questions in outcome-based education.

OBJECTIVE: To evaluate the effect of a gonadotropin-releasing hormone (GnRH) antagonist protocol using corifollitropin alfa in women undergoing assisted reproduction. METHODS: Six hundred and eighty-six in vitro fertilization-embryo transfer (IVF)/intracytoplasmic sperm injection (ICSI) cycles were analyzed. In 113 cycles, folliculogenesis was induced with corifollitropin alfa and recombinant follicle stimulating hormone (rFSH), and premature luteinizing hormone (LH) surges were prevented with a GnRH antagonist. In the control group (573 cycles), premature LH surges were prevented with GnRH agonist injection from the midluteal phase of the preceding cycle, and ovarian stimulation was started with rFSH. The treatment duration, quality of oocytes and embryos, number of embryo transfer (ET) cancelled cycles, risk of ovarian hyperstimulation syndrome (OHSS), and the chemical pregnancy rate were evaluated in the two ovarian stimulation protocols. RESULTS: There were no significant differences in age and infertility factors between treatment groups. The treatment duration was shorter in the corifollitropin alfa group than in the control group. Although not statistically significant, the mean numbers of matured (86.8% vs. 85.1%) and fertilized oocytes (84.2% vs. 83.1%), good embryos (62.4% vs. 60.3%), and chemical pregnancy rates (47.2% vs. 46.8%) were slightly higher in the corifollitropin alfa group than in the control group. In contrast, rates of ET cancelled cycles and the OHSS risk were slightly lower in the corifollitropin alfa group (6.2% and 2.7%) than in the control group (8.2% and 3.5%), although these differences were also not statistically significant. CONCLUSION: Although no significant differences were observed, the use of corifollitropin alfa seems to offer some advantages to patients because of its short treatment duration, safety, lower ET cancellation rate and reduced risk of OHSS.
Embryo Transfer ; Embryonic Structures ; Female ; Follicle Stimulating Hormone* ; Gonadotropin-Releasing Hormone* ; Humans ; Infertility ; Luteinizing Hormone ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction ; Pregnancy Rate ; Reproduction* ; Spermatozoa

Many different myelographic contrast media have been employed for the radiographic visualization of the spinal cord. Unfortunately, none has fulfilled all the requirements of an ideal contrast medium-no toxicity, complete and rapid absorption, good radiographic contrast, and miscibility with the cerebrospinal fluid. Toxic reactions have been reported from the water soluble contrast media, which require the administration of a spinal anesthesia and have thus been employed clinically only in examination of the lumbosacral area. Some authors have advocated the use of new contrast media, Conray(Meglumine iothalamate), Dimer-X, for the lumbar myelography without a spinal anesthesia and obtained good results. The present work is an attempt to provoke and emphasize the toxicologic response and the pathologic changes by variation in amount of Conray and rate of injection. Each dog was prepared with a catheter in lumbar subarachnoid space under the light anest hesia. After recovery from the anesthesia, myelography was performed by lumbar subarachnoid injection of Conray by variations in amount of Conray and rate of injection under the control of a fluoroscope. The experimental conditions were varied as follows. 1. Conray was injected in variable amounts from the lumbosacral subarachnoid space to the high cervical and intracranial subarachnoid space. 2. Conray was injected in variable rate of injection. 3. Decadron was added to Conray in another group. 4. The brain and the spinal cord including the dura and the nerve roots were taken for the pathologic study in variable durations after myelography. The results were summarized as follows. 1. A large amount of Conray injection to the high cervical and intracranial subarachnoid space produced wevere toxic reactions followed by death. 2. Rapid injection of Conray was considered to elicit more toxic reactions. 3. The toxic reactions included changes in behavior and respiration, neck muscle spasms, paresis of forelegs and hindlegs, urination, defecation and epileptiform convulsions. 4. There was no difference in toxic reactions in adding Decardon. 5. Radiographic contrast densities were somewhat less than that of Pantopaque. Conray was freely miscible with the cerebrospinal fluid, thus providing total myeloraphy. 6. No recognizable reaction was noted in gross and histopathological examination.
Absorption ; Anesthesia ; Anesthesia, Spinal ; Animals ; Brain ; Catheters ; Cerebrospinal Fluid ; Contrast Media ; Defecation ; Dogs ; Iophendylate ; Myelography* ; Neck Muscles ; Paresis ; Respiration ; Seizures ; Spasm ; Spinal Cord ; Subarachnoid Space ; Urination

PURPOSE: The purpose of this study is to evaluate the expression of E-cadherin and cathepsin-B in prostatic carcinomas and correlate with the Gleason grades. MATERIALS AND METHODS: The expressions of E-cadherin and cathepsin B were examined by the immunohistochemical technic using the antibodies against the E-cadherin and cathepsin B on the paraffin block sections of 56 prostatic carcinomas with evaluation of Gleason grading. RESULTS: E-cadherin expression in normal epithelium was membranous intercellular expression and those of prostate carcinomas were aberrant expressions such as negative expression or cytoplasmic presentation. The expressivity of the E-cadherin according to the progression of the Gleason grading revealed negative membranous expression and tendency of gradual increase of aberrant expression. The normal prostate and BPH revealed expression of cathepsin B mostly in the basal layers of acini as cytoplasmic reaction and the stromal macrophages and microvessel wall also showed positive expression. The prostatic carcinoma showed cytoplasmic positivity in the cancer cells and the expression rate was increased from Gleason grade 2 to Gleason grade 4. But the Gleason grade 5 tissue revealed decreased or negative expression. The Gleason grade 4, especially in the invasive cells and invasive edges, revealed the most intense and frequent expression of cathepsin B and this findings were consistent with the nonnal function of the cathepsin B as a protease degrading the extracellular matrix proteins. CONCLUSION: E-cadherin expression was aberrant after Gleason grade 6 related with high histologic grades. It is suggested that the E-cadherin expression could tell the potential cancer progression as a tumor suppression factor. The cathepsin B was most strongly expressed in basal cells of the benign prostatic acini and the cancer nests of Gleason grade 4, which tells the possibility that cathepsin B could be a marker of basocellular differentiation and of assessing stromal invasion of prostatic carcinomas.
Antibodies ; Cadherins* ; Cathepsin B* ; Cathepsins* ; Cytoplasm ; Epithelium ; Extracellular Matrix Proteins ; Macrophages ; Microvessels ; Neoplasm Grading ; Paraffin ; Prostate

The upper gastrointestinal bleeding is to be controlled and prevented for recurrent bleeding with several endoscopic methods. The sapphire contact probe in Nd: YAG laser photocoagulation was compared to conventional non-contact probe in hemostatic efficacy. (continue...)
Aluminum Oxide ; Arteries* ; Hemorrhage ; Lasers, Solid-State* ; Light Coagulation* ; Rabbits*

The causes of jaundice in patients with hepatocellular carcinoma are usually attributed to the underlying liver diseases or extensive hepatic destruction by tumor. Obstructive jaundice by the intraluminal tumor fragment of intrahepatic and/or extrahepatic bile duct in hepatocellular carcinoma is exceedingly rare and usually diagnosed by operation or autopsy. Recently, we observed a patient in whom the fragment of tumor from the primary hepatocellular carclnoma obstructed the common hepatic duct, which was confirmed by peroral choledochoscopy. Using peroral choledochoscopy. we could see the mass located at the common hepatic duct and diagnose histologically by cytologic examination of aspirated material of common bile duct. We describe here this rare case with review the literature on primary hepatocellular carcinoma with jaundice caused by biliary obstruction.
Autopsy ; Bile Ducts, Extrahepatic ; Carcinoma, Hepatocellular* ; Common Bile Duct ; Hepatic Duct, Common* ; Humans ; Jaundice ; Jaundice, Obstructive* ; Liver Diseases

OBJECT: It seemed worthwhile to estimate nonlinear measures of the electroencephalogram (EEG) in schizophrenic patients, because nonlinear measures might serve as indicators of the specific brain function in schizophrenia. METHOD: Previous studies which estimated the chaoticity in the brain of schizophrenia with nonlinear methods recorded the EEGs at limited electrodes, so we tried to record EEGs from 16 channels for nonlinear analysis in 19 patients with Schizophrenia and 8 healthy control subjects. We employed a new method to calculate the nonlinear invariant measures. For limited noisy data, this algorithm was strikingly faster and more accurate than previous ones. RESULTS: Our results showed that the schizophrenic patients had lower values of the largest positive Lyapunov exponent at the left inferior frontal and anterior temporal head regions compared with normal controls. CONCLUSIONS: These results suggest that the nonlinear analysis of the EEGs such as the estimation of the largest positive Lyapunov exponent seems to be a useful tool in analyzing EEG data to explore the neurodynamics of the brain of schizophrenic patients.
Brain ; Electrodes ; Electroencephalography* ; Head ; Humans ; Nonlinear Dynamics* ; Schizophrenia*

OBJECTIVES: The aim of this study was to evaluate whether or not depressive symptoms were related to differences in the abilities of daily living activities and cognitive functions among the elderly attending senior community centers. METHODS: A total of 304 respondents over 65 years of age completed a set of interviews, which included clinical evaluation, neuropsychological batteries, Short Geriatric Depression Scale (S-GDS), and Instrumental Activities of Daily Living (IADL). RESULTS: Depression was observed in 34.2% respondents (n=105). The depressed group significantly decreased the sum of IADL than that of the non-depressed group (t=3.8, p=0.0002). With logistic analysis, they indicated significant impairment in six items of IADL associated with cognitions, but not in other items with physical functions. The depressed group scored significantly lower in MMSE-K (F=8.56, p<0.01) and delayed recall assessment (F=10.53, p<0.01) despite they showed no difference in immediate memory, compared with the non-depressed group. Among the sociodemographic variables, gender was not a significant risk factor in the depressed elderly, whereas lower income was the only risk factor after adjusting for other variables. CONCLUSION: The depressed elderly attending senior community centers showed impaired functions in their usual daily activities and cognitions. Furthermore, they revealed impairment in cognitive IADLs, whereas they preserved functions in physical IADLs.
Activities of Daily Living ; Aged ; Surveys and Questionnaires ; Depression ; Humans ; Memory, Short-Term ; Risk Factors