The concept of vascular dementia is not still established. Its pathogenesis is not completely understood, either. It may be different among the subtypes, e.g., ischemic, hemorrhaginc, or Binswanger's disease. In this article epidemiology of vascular dementia was reviewed, based on the important findings regarding to prevalence, ethnic difference in prevalence, incidence, risk factors, and natural history and survival. We have to wait for more elegant concept of and better understanding of vascular dementia.
Cerebrovascular Disorders ; Dementia, Vascular* ; Epidemiology* ; Incidence ; Natural History ; Prevalence ; Risk Factors

The contents of educational goals and objectives of 32 Korean medical schools, that were listed in the Korean Medical Education Directory for 1994-1995, were analysed to help developing new educationa l goals and objectives. Regarding the professions in which the graduates of medical schools can be engaged, all of the 32 school were aiming at the medical doctor. 34.4% at the medical scientist, 28.1% at the medical educator, and 15.6% at the health administrator. Only 37.5% of the medical schools stated that their educational objective is training the primary physician and 50% of the schools did not specify the level of their graduates as a physician. The proportion of schools which stated that the medical student should learn in three domains of educational objectives, i.e. medical knowledge,clinical skills and attitude were 18.8% and 56.3% of the schools descirbed learning just in two domains of medical knowledge and skills which may reflect underating the importance of attitude. The proportions of knowledge and skills which may reflect underating the importance of attitude. The proportions of schools that stated aquiring the ability of holistic management of patients and self-learning/life long study in their educational objectives were 28.1% and 62.5%, respectively. The proportion of schools that emphasized on the medical ethics and morality was 93.8% and on cultivating human nature was 71.9%. These reflect that a high quality of ethics and morality was 93.8% and on cultivating human nature was 71.9%. These reflect that a high quality of ethics and human nature is required to the medical doctor. The universal and ultimate goal of human society and universities, such as democratic educational ideology, Korean educational ideology, prosperity of human society, promotion of human welfare, and improvement of public health, were included in the educational goals in 43.8% of the schools. As the primary goal of medical schools is the producing primary physicians, it is suggested to include the affective domain(attitude), cultivation of the capacity of self-learning and ability of holistic management of patients in the educational objectives of medical shools.
Administrative Personnel ; Education, Medical ; Ethics ; Ethics, Medical ; Human Characteristics ; Humans ; Learning ; Morals ; Public Health ; Schools, Medical* ; Students, Medical

BACKGROUND: Many reports claim that propofol anesthesia in cesarean section is safe for neonates, but these studies concern cases of elective, or combined elective and emergency surgery. Our study was designed to investigate the effects of propofol on neonates in emergency cesarean section. METHODS: One-hundred patients for cesarean section were involved. They were divided into 2 main groups; (P) anesthesia with propofol (N = 50) and (E) enflurane (N = 50). Both P and E were subdivided into 2 groups each; (PE) propofol elective (N = 25); (EE) enflurane elective (N = 25); and 2 emergency subgroups, (PM) propofol emergency (N=25), and (EM) enflurane emergency (N = 25). Apgar score (1 min, 5 min), Neurologic Adaptive Capacity Score (NACS, 15 min, 24 hr), cord blood gas analysis (cBGA) were measured. Maternal venous and umbilical artery and venous blood concentration of propofol were measured at delivery. RESULTS: The values of the Apgar score, NACS, and cBGA of group P were not different from the corresponding values of group E. Also there were no differences between groups PM and EM, and between groups PE and EE. The blood concentration of propofol was 2.36 microgram/ml in the maternal vein, 1.13 microgram/ml in the umbilical vein, and 0.89 microgram/ml in the umbilical artery. CONCLUSIONS: From these results, it may be suggested that propofol is safe for neonates in emergency cesarean section surgery.
Anesthesia ; Apgar Score ; Cesarean Section* ; Emergencies* ; Enflurane ; Female ; Fetal Blood ; Humans ; Infant, Newborn* ; Pregnancy ; Propofol* ; Umbilical Arteries ; Umbilical Veins ; Veins

OBJECTIVE: Exploration of the questionable Alzheimer disease is important for accurate estimation of prevalence and incidence, understanding the natural history, and evaluation of treatment strategies for the Alzheimer disease. Subjects and METHODS: We compared neuropsychological test performances among 14 nondemented controls, 14 elderly persons with questionable dementia of the Alzheimer type and 14 elderly persons with mild dementia of the Alzheimer type. The test performances analyzed were the digit span of the Korean Adult Wechsler Intelligence Scale, registration, short term memory and long term memory of the Cognitive Impairment Diagnosing Instrument, and paired association learning and logical memory of the Wechsler Memory Scale. RESULTS: There was significant difference between questionable dementia of the Alzheimer type and controls in the long-term memory, short-term memory, immediate and delayed recalls of the logical memory, and easy association. But the subjects with questionable and mild dementia of the Alzheimer type scored similarly on all tests except the long-term memory. CONCLUSION: These findings suggest that questionable Alzheimer disease may be the very early Alzheimer disease.
Adult ; Aged ; Aging ; Alzheimer Disease ; Association Learning ; Cognition ; Dementia* ; Humans ; Incidence ; Intelligence ; Logic ; Memory* ; Memory, Long-Term ; Memory, Short-Term ; Natural History ; Neuropsychological Tests ; Prevalence

Cognitive function and its related issues were studied for 10 years in 766 elderly people aged 65 or more as of December, 1990 in Jookjang Myun, Pohang, Kyungpook Province. The major findings on prevalence of dementia, nature of questionable dementia, early cognitive symptoms of Alzheimer's disease, the meaning of a screening test for cognitive impairment, reliability of dementia diagnosis, variables affecting cognitive functions, relation of cognitive dysfunction to survival, and natural course of cognitive functions were summarized in this review.
Aged* ; Alzheimer Disease ; Cognition ; Dementia* ; Diagnosis ; Epidemiology* ; Gyeongsangbuk-do* ; Humans ; Mass Screening ; Neurobehavioral Manifestations ; Prevalence

A survey with self-administered questionnaire method to examine the association of Pap Smear health screening tests and health promotion activities for 500 women who visited OPD of Obstetrics and Gynecology. The compliance of pap smear of the rich, married, house wife and self employed women was higher than others. Women who received Pap smears were significantly more likely to receive breast examiniations, mammograms, gastrofibroscopy and regular blood pressure check-up. The Pap smear was associated with health promotion activities such as own private physician, no cooling beverage intake, milk intake and heptitis B vaccination. In conclusion, health care providers may use the Pap smear as a marker of whether a woman has received screening for several other medical problems. Thus, the Pap smear can be considered a "sentinel" test for health screening in women.
Beverages ; Blood Pressure ; Breast ; Compliance ; Female ; Gynecology ; Health Personnel ; Health Promotion* ; Humans ; Mass Screening* ; Milk ; Obstetrics ; Surveys and Questionnaire ; Spouses ; Vaccination

OBJECTIVE: Elucidation of questionable dementia of the Alzheimer type(QDAT) is important far accurate estimation of prevalence and incidence of dementia of the Alzheimer type, understanding of its natural history and evaluation of treatment strategies for dementia of the Alzheimer type. Subject and METHODS: Performances neuropsychological tests were compared between non-demented controls and 14 elderly people in a community diagnosed as having questionable senile dementia of the Alzheimer type. They lived in a rural community and their sex, age and education were controlled. RESULTS: The two groups were not significantly different comprehension and digit span of the Wechsler Memory Scale. Performances on arithmetic, similarity and block design were significantly lower in QDAT subjects. Scores on associate learning of the Wechsler Memory Stale and immediate and delayed recalls of logical memory were lower in QDAT subjects with statistical significance. performance on the semantic verbal fluency tended to the lower for the QDAT subjects. CONCLUSION: These findings suggest that QDAT may be early dementia of the Alzheimer type.
Aged* ; Aging ; Alzheimer Disease ; Cognition ; Comprehension ; Dementia* ; Education ; Humans ; Incidence ; Learning ; Logic ; Memory ; Natural History ; Neuropsychological Tests ; Prevalence ; Rural Population ; Semantics

This is a descriptive study on quality of life(QOL) and related factors of ostomates to provide a basic data for development of nursing interventions. The subjects were 110 ostomates who were members of the Daegu or Daejon branches of the Korean Ostomy Association. Data collection was performed between March 1st and April 6th, 1998. Measurements of QOL, self-care, family support, self-esteem, and hope were used as the study tools. Data were analyzed with the SAS program by using t-test, ANOVA, Pearson correlation and stepwise multiple regression. The results are as follows : 1) The score on the QOL scale ranged from 97 to 226 with a mean of 164.53(+/-28.29). 2) The score of QOL on the general and ostomate-related characteristic showed significant differences according to monthly income, monthly participation in ostomate meetings, combined treatments after operation, types of evacuation management, problems of ostomy, help in caring for the ostomy, length of time since ostomate surgery, and presence or absence of readmission after discharge. 3) There were significant positive correlations between quality in life and other factors ; self-esteem(r=0.7107, P<0.001), hope(r=0.6584, P<0.001) family support(r=0.6191, P<0.001), perception of health condition(r=0.6017, P<0.001), and self-care(r=0.2286, P<0.05). 4) The variables that affected the quality of life of the subjects were self-esteem, level of family support, perception of health condition, monthly participation in ostomate meetings, combined treatments after operation, monthly income, level of hope, and age in that order. The variance of quality of life was R2=77.20 percent by calculating the sum of those variables. In conclusion, it is necessary for nursing intervention to promote self-esteem, family support, and hope in the care of ostomates in order to improve QOL.
Daegu ; Daejeon ; Data Collection ; Hope ; Humans ; Nursing ; Ostomy ; Quality of Life* ; Self Care

OBJECTIVES: This study was conducted to delineate the long-term natural change of cognitive functions in aged community residents, using the Korean version of the mini-mental state examination (MMSEK) METHODS: The first MMSEK was administered to as the screening test for identification of dementia between January and December, 1990 in a total of 702 persons. They were residents of a Myun area, Pohang, Kyungpook Province and 65 or more as of December 31. 1990. The MMSEK was repeated from November, 1995 to June, 1996, using the Cognitive Impairment Diagnosing Instrument and was successful in 440. RESULTS: The 6-year mean(+/-SD) decline of the total MMSEK score was 1.52+/-3.45 and 6.42%. Of the subtests, memory registration showed no significant decline while comprehension/judgement improved significantly. The decline was most prominent in attention/calculation and memory recall, and then language, orientation in time and orientation in place in order. Change of the total score was not related to sex, education and the first total score. Decline of language function was more severe in the educated than in the noneducated-illiterate. Performances of all subtests declined significantly with aging and improvement of the comprehension/judgement was less prominent in the group aged 75 or more. Relations of the change with the first total score were inconsistent among the subtests. The stepwise multiple regression analysis revealed that age, the first total score and education were the variables significantly affecting the decline of MMSEK score. However, they could account for only 16.4% of the variance of decline of the total MMSEK score. CONCLUSIONS:Decline of the cognitive function was small during the 6-year period, and the change pattern was not homogenous among the subtests. Age, the first total MMSEK score and education were idenrified as significant, but not so important, factors accounting for the variance of the cognitive decline.
Aged* ; Aging ; Cognition ; Dementia ; Education ; Follow-Up Studies* ; Gyeongsangbuk-do ; Humans ; Mass Screening ; Memory

OBJECTIVES: To study of the effects of gender, age and education on the MMSEK performances in the elderly. METHOD: The MMSEK was administered to a total of 702 persons aged 65 or more in a rural area. The effects on the total and subtest MMSEK scores of the 3 independent variables were analyzed by Student t-test, Pearson's correlation, oneway analysis of variance, analysis of covariance, and stepwise multiple regression. RESULTS: The total and all subtest scores of MMSEK were found to be affected by age. All subtest, except memory registration and memory recall, scores were affected by education and sex. 39.6% of the variance of total MMSEK score could be accounted for by the 3 variables. CONCLUSIONS: 40% of the variance of the total MMSEK score could be accounted for by age, gender and education while the remaing 60% is assumed to be affected by other variables than age, sex, and education. Memory registration and memory recall seems to be resistant to sex and education effect, but sensitive to aging.
Aged* ; Aging ; Cognition ; Education* ; Humans ; Memory ; Rural Population*