Behavioral and psychological symptoms of dementia are major components of Alzheimer’s disease. In this study, we aimed at investigating the prevalence and severity of behavioral and psychological symptoms of dementia in very mild to mild Alzheimer’s disease. Forty-four patients with Alzheimer’s disease who visited the neurology outpatient clinic of Seoul Medical Center were included. A trained neurologist or a supervised test technician administered the neuropsychological test, the Seoul Neuropsychological Screening Battery including Mini Mental State Examination and Clinical Dementia Rating. The instrument used for assessing behavioral and psychological symptoms of dementia was Neuropsychiatric Inventory-Questionnaire. In order of prevalence, apathy, depression, irritability, anxiety, and agitation were the most common symptoms occurring in very mild-to-mild Alzheimer’s disease group. The prevalence and severity of behavioral and psychological symptoms of dementia were found to be in positive correlation with the Clinical Dementia Rating scores. Behavioral and psychological symptoms of dementia are found even in the very early stage of Alzheimer’s disease, apathy and depression being the most common symptoms. Physicians should be aware of this when managing dementia patients.

Bilateral calcifications of the basal ganglia, the thalami, the dentate nuclei of the cerebellum, and the white matter of the cerebral hemisphere characterize Fahr's disease. The common clinical manifestations of the disease are movement disorders accompanied by cognitive impairment and mood disorder. Herein we report a case of Fahr's disease with atypical clinical manifestations. The patient was a 48 year-old man who presented with behavioral changes. His neurological examination showed no focal neurological deficits except for frontal dysfunctions. Abnormal involuntary movement was absent. Neuroimaging work-ups were compatible with Fahr's disease.
Basal Ganglia ; Cerebellum ; Cerebrum ; Dyskinesias ; Frontal Lobe* ; Humans ; Middle Aged ; Mood Disorders ; Movement Disorders ; Neuroimaging ; Neurologic Examination

PURPOSE: This study was conducted to analyze the change in the obesity index in girls receiving a gonadotropin-releasing hormone agonist (GnRHa), based on treatment duration, and to aid in nutritional counseling by investigating dietary habits and lifestyle. METHODS: Anthropometric examinations were conducted on 62 girls treated with GnRHa from January 2010 through July 2014. Parents were asked to fill out questionnaires on patient dietary habits and lifestyle. RESULTS: The group taking GnRHa for over 1 year had a higher rate of obesity increase than the group taking GnRHa for less than 1 year, but they had common habits related to obesity, which should be corrected. In addition, 69.2% of the normal weight group taking GnRHa for over 1 year gained weight, and needed more intensive programs, which include physical exercise and nutritional education. Although girls with precocious puberty showed a decrease in the intake of high-calorie foods with nutritional intervention regardless of treatment duration, they still had problems that needed improvement, such as shorter meals and lack of exercise. CONCLUSION: Girls with precocious puberty and their parents should emphasize maintenance of proper body weight, especially when treatment for over 1 year is anticipated. Consistent education in nutrition, ways to increase intensity and duration of physical activity, and the need to slow down mealtimes are important in managing obesity; doctors need to perform regular checkups and provide nutritional counseling.
Body Weight ; Counseling ; Education ; Exercise ; Female* ; Food Habits* ; Gonadotropin-Releasing Hormone ; Humans ; Life Style* ; Meals ; Motor Activity ; Obesity ; Parents ; Puberty, Precocious*

Lumbar puncture is a simple bedside procedure that is essential for the diagnosis and treatment of several neurologic diseases. Known complications include headache, backache, infection, and hemorrhage, with the most common being postpuncture headache. We report a case of postpuncture spinal subdural hematoma-which is extremely rare-in a 29-year-old female. Although most cases of postpuncture spinal hematomas are associated with coagulation abnormalities, this case shows that it can occur in the absence of predisposing factors.
Back Pain ; Female ; Headache ; Hematoma ; Hematoma, Subdural, Spinal ; Hemorrhage ; Humans ; Spinal Puncture

No abstract available.
Abdominal Wall ; Herpes Zoster

BACKGROUND: With the ageing population, number of dementia patients is on the rise, as well as the public interest. The population who would visit memory disorder clinic will also grow. The diagnostic significance of brain MRI in dementia lies in idetifying hippocampal atrophy or ischemic lesions. However, patients visiting memory disorder clinic are mostly old-aged with multiple vascular risk factors, raising the risk of cerebrovascular abnormalities. The authors set out to evaluate the need for cerebrevascular imaging in patients who visited memory disorder clinic. METHODS: The study recruited patients who visited the memory clinic in Seoul medical center between July 2011 and June 2012. Among those, patients who had taken the neuropsychiatric test and had both brain MRI and MRA taken were included for analysis. In brain MRI, severities of white matter hyperintensities and presence of cerebral infarction were assessed. In brain MRA, intra- and extra-cranial arterial stenosis and presence of aneurysm were noted. RESULTS: A total of 173 patients was included, and 64 were men. The mean age was 71+/-9.4 years, and the mean education period was 7+/-5.2 years. In brain MRI, white matter hyperintensities were observed in 113 patients (65.3%), and cerebral infarction was present in 57 patients (32.9%). In brain MRA, 88 (50.9%) patients showed more than one stenotic segment in intracranial vessel or proximal ICA and 6 patients (3.5%) were diagnosed with unruptured aneurysm. CONCLUSIONS: The incidence of white matter hyperintensities or stenosis of cerebral vessels on magnetic resonance imaging is very high. Therefore, brain MRI and MRA should be included in diagnostic work up for dementia in patients who are old aged and have multiple vascular risk factors. It would provide clinicians with valuable information in making treatment decisions and prevention of future cerebrovascular accident.
Aged ; Aneurysm ; Atrophy ; Brain ; Cerebral Infarction ; Constriction, Pathologic ; Dementia ; Glycosaminoglycans ; Hospitals, General ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Memory ; Memory Disorders ; Risk Factors ; Stroke

PURPOSE: Many studies have suggested that neuronal cells protect against oxidative stress-induced apoptotic cell death by polyphenolic compounds. We investigated the neuroprotective effects and the mechanism of action of Momordica charantia ethanol extract (MCE) against H₂O₂-induced cell death of human neuroblastoma SK-N-MC cells. METHODS: The antioxidant activity of MCE was measured by the quantity of total phenolic acid compounds (TPC), quantity of total flavonoid compounds (TFC), and 2,2-Diphenyl-1-pycrylhydrazyl (DPPH) radical scavenging activity. Cytotoxicity and cell viability were determined by CCK-8 assay. The formation of reactive oxygen species (ROS) was measured using 2,7-dichlorofluorescein diacetate (DCF-DA) assay. Antioxidant enzyme (SOD-1,2 and GPx-1) expression was determined by real-time PCR. Mitogen-activated protein kinases (MAPK) pathway and apoptosis signal expression was measured by Western blotting. RESULTS: The TPC and TFC quantities of MCE were 28.51 mg gallic acid equivalents/extract g and 3.95 mg catechin equivalents/extract g, respectively. The IC₅₀ value for DPPH radical scavenging activity was 506.95 µg/ml for MCE. Pre-treatment with MCE showed protective effects against H₂O₂-induced cell death and inhibited ROS generation by oxidative stress. SOD-1,2 and GPx-1 mRNA expression was recovered by pre-treatment with MCE compared with the presence of H₂O₂. Pre-treatment with MCE inhibited phosphorylation of p38 and the JNK pathway and down-regulated cleaved caspase-3 and cleaved PARP by H₂O₂. CONCLUSION: The neuroprotective effects of MCE in terms of recovery of antioxidant enzyme gene expression, down-regulation of MAPK pathways, and inhibition apoptosis is associated with reduced oxidative stress in SK-N-MC cells.
Apoptosis ; Blotting, Western ; Caspase 3 ; Catechin ; Cell Death ; Cell Survival ; Down-Regulation ; Ethanol ; Gallic Acid ; Gene Expression ; Humans* ; Hydrogen* ; MAP Kinase Signaling System ; Mitogen-Activated Protein Kinases ; Momordica charantia* ; Momordica* ; Neuroblastoma* ; Neurons ; Neuroprotective Agents* ; Oxidative Stress ; Phenol ; Phosphorylation ; Reactive Oxygen Species ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Sincalide

No abstract available.
Hearing* ; Infarction*

BACKGROUND: The effects of omega-3 polyunsaturated fatty acids (PUFAs) on cerebral vessels have not been clarified until now. Thus we investigated the efficacy of omega-3 PUFAs supplementation on cerebral blood flow velocity and vascular resistance via transcranial doppler (TCD). METHODS: Consecutive twenty patients (13 male and 7 female) with at least 1 cerebrovascular risk factor or a known cerebrovascular disease were enrolled. Patients were treated with omega-3 PUFAs (1 g, two times per day) for 12 weeks. Cerebral blood flow velocity, resistance index, and pulsatile index were checked before and after 12 weeks of treatment using TCD. RESULTS: The change of resistance index in right MCA (from 0.58 +/- 0.07 to 0.55 +/- 0.07, p = 0.042) and left PCA (from 0.56 +/- 0.07 to 0.53 +/- 0.06, p = 0.037) showed significant improvement after 12 weeks of omega-3 PUFAs treatment. The changes in other vessels, however, failed to show any significant changes compared to the baseline. CONCLUSIONS: Omega-3 PUFAs treatment showed feasible efficacies for cerebral vascular resistances in this open label trial. To confirm these results, larger samples of patients and longer period of follow-up is warranted.
Blood Flow Velocity ; Fatty Acids, Unsaturated ; Follow-Up Studies ; Humans ; Male ; Passive Cutaneous Anaphylaxis ; Risk Factors ; Vascular Resistance*