Vascular dementia is one of the few remediable causes of dementia among the eldery. Prevention of the disease can be best achieved by primary or secondary prevention of controllable risk factors for strokes. Therefore, early and accurate diagnosis of vascular cognitive impairment prior to the dementia stage is essential to the prevention and treatment of vascular dementia. Pharmacological and non-pharmacological methods for prevention of vascular dementia are listed in this article. Recent epidemiologic data, suggesting a direct correlation between vascular risk factors and Alzheimer type dementia, emphasized the importance of controlling vascular risk factors in the prevention of dementia. Treatment strategies for patients diagnosed as vascular dementia are also discussed. Several clinical trials for symptomatic improvement of vascular dementia are ongoing and their success can be a hope to patients with vascular dementia.
Alzheimer Disease ; Cognition Disorders ; Dementia ; Dementia, Vascular* ; Diagnosis ; Hope ; Humans ; Risk Factors ; Secondary Prevention ; Stroke

No abstract available.
Cell Line* ; Chromosome Aberrations* ; Cytogenetics* ; Humans* ; Neuroblastoma*

Some of the techniques for bone grafting for delayed union or nonunion of the long bone are used currently. In 1991, at arthroscopy workshop in Phoenix, Arizona, Lanny L. Johnson, M.D. reported a case of endoscopic bone grafting for the delayed union on the humerus. He suggested the possibilities of endoscopic bone grafting such as minimal incision, magnified visualization, accurate debridement, accurate graft placement, vascular preservation, outpatient surgery and reduced cost. The author performed endoscopic bone grafting and extra-articular adhesionlysis on the delayed union of femur with extra-articular ankylosis. The patient was a 28 year old housewife with blood type Rh(-). The duration after initial operation was more than 9 months. The result of the graft was satisfactory. In the future endoscopic bone grafting could be performed for nonunion, delayed union and congenital bone defect.
Ambulatory Surgical Procedures ; Ankylosis ; Arizona ; Arthroscopy ; Bone Transplantation ; Debridement ; Education ; Femur ; Humans ; Humerus ; Transplants

Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring abdominal surgery in early infancy, and is caused by hypertrophied pyloric muscle. The development of successful surgical treatment in the early 1900s by Fredet and Ramstedt made it possible for infants worldwide to survive. Modern pediatric anesthetic techniques have virtually eliminated mortality from surgical management. Atropine sulfate is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated two cases of IHPS with incomplete pyloromyotomy in 3-month-old and 5-month-old male infants by administering atropine sulfate intravenously. They were free from vomiting after 5 days of intravenous atropine sulfate treatment. In these rare cases of persistent vomiting or refractory emesis following incomplete pyloromyotomy, there may be a role for atropine sulfate.
Atropine* ; Constriction, Pathologic* ; Humans ; Infant ; Male ; Mortality ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic ; Vomiting*

We examined the anatomical position of the mental foramina in mandibles foramen normal adult Koreans. 1. The percentages obtained from the study of the relationships between the mental foramen and the lower teeth showed that the most common location was type lv in which the mental foramen lay at the apex of the second promolar. The foramen between thr apices of ice two premolars (type lll) and the foramen between the second premolar and the first molar (type v) occured often and less often rspectively and find no foramen mesial to the first premolar or at the apex of the first premolar and posterior of the first molar (type l, ll, vl). 2. The study of relationship of the mental foramen to the bo of the mandible revealed that mental foramen was situated closer to the lowed border of the mandibular body. The distance ratio between the mental foramen and the alveolar crest to that between the mental foramen and the lower border was approximately 1.2 : 1. The height of the mandibular body was 31.09±2.80mm on the left side and 30.97±2.48mm on the right. 3. The distance from the mandibular symphysis to the anterior border of the mental foramen measured 29.52±2.01mm on the left, 30.82±2.04mm on the right side, and from the mandibular symphysis to the posterior border of the mandibular ramus was 104.20±4.74mm on the left, 105.44±4.49mm on the right side. It indicates that the mental foramen lies approximately at one-fourth of the distance from the mandibular symphysis to 2017-04-19 the posterior border of the ramus. 4. The distance from the superior border of the mental foramen to the bottom of the lower second premolar socket was found to be positive. It was 5.46±3.09mm on the left, 5.73±3.03mm on the right side. This indicates that the bottom of the lower second premolar socket is slightly higher than the superior border of the mental foramen.
Adult* ; Bicuspid ; Humans ; Ice ; Mandible* ; Molar ; Tooth

BACKGROUND: To find out characteristics and classification of toxic agents by clinical analysis of pediatric poisoning and to determine the clinical availability of grading by using MSPC score. METHOD: Subjects were patients under 15 years exposed to toxic agents, who visited Ajou university hospital emergency center from June, 1994 to October, 1997. The study was performed retrospectively. RESULTS: The subjects were 126 cases and male to female sex ratio was 1.2:1. Mean age was 29+/-30 months old. The most common route of exposure was ingestion, following contact, inhalation and bite. The most common reason was mistake by the patient, following mistake by caregiver, suicide attempt and accident. The MSPC score distribution of symptomatic patient was as follows; 1 point: 26 cases(63.4%), 2 point: 12 cases(29.2%), 3 point: 1 case(2.4%), 4 point: 2 cases(4.8%). The classification of exposed poison was as follows; therapeutic drugs: 29 cases(23.0%), non-therapeutic drugs: 97 cases(73.0%). The most common exposed poison was household products: 23 patients(18.3%) were admitted to hospital. CONCLUSION: There was statistically significant difference in the classification of poison, MSPC score, treatment modality at hospital, first follow up period after discharge between admitted group and non-admitted group. There was statistically significant difference in the reason of exposure, route of exposure, MSPC score, admission period according to patient's age. severity grading according to MSPC score is regarded as an available method to determine the modality of management.
Caregivers ; Classification ; Eating ; Emergencies ; Female ; Follow-Up Studies ; Household Products ; Humans ; Inhalation ; Male ; Poisoning* ; Retrospective Studies ; Sex Ratio ; Suicide

BACKGROUND AND PURPOSE: A variety of sensory disturbances such as tingling, numbness, muscle cramp, pain and burning are recognized in Parkinson's disease. There is a hypothesis that sensory symptoms of Parkinson's disease could be related to "release" of sensory centers from extrapyramidal systems. We investigated the characteristic features of sensory symptoms in Parkinsonian patients and the possibilities that sensory symptoms may be related to dopaminergic pathways. METHODS: We included 130 patients with Parkinson's disease. The patients with medical illness such as diabetes, arthritis or musculoskeletal disease were excluded. We studied 38 Parkinsonian patients with sensory complaints using electrophysiologic studies and neuroimaging. RESULTS: 1) Thirty-eight(29.2%) of 130 Parkinsonian patients(mean age ; 57.9 +/- 10.1 ; 13 men, 25 women) had sensory symptoms. 2) Among thirty-eight Parkinsonian patients with sensory symptoms, 19 patients had pain, 10 tingling sensation, 3 burning sense, and 2 muscle cramp. 3) The arm and leg were most common sites for sensory symptoms 4) Sensory complaints preceded motor symptoms in 17 patients(21.1 +/- 19.1 months) and followed in 13 patients(26.7 +/- 41.9 months). 5) In 25 patients(66%), sensory symptoms were improved with levodopa. 6) There was no significant correlation between sensory symptoms and motor disabilities. CONCLUSIONS: Many Parkinsonian patients had various sensory complaints as well as motor symptoms. In some patients, sensory symptoms preceded motor disabilities. It was also suggested that sensory symptoms in some patients with Parkinson's disease be related to dopaminergic pathways.
Arm ; Arthritis ; Burns ; Humans ; Hypesthesia ; Leg ; Levodopa ; Male ; Muscle Cramp ; Musculoskeletal Diseases ; Neuroimaging ; Parkinson Disease* ; Sensation

No abstract available.
Spina Bifida Occulta*

Urea reduction ratio (URR) and Kt/Vurea are objective parameters of dialysis delivery in hemodialysis patients and correlate with nutritional status and patient outcome. URR and Kt/Vurea depend on postdialysis blood urea nitrogen (BUN). In patients with severe postdialysis urea rebound (PDUR), these parameters do not accurately reflect dialysis adequacy. We measured PDUR 30 minutes after dialysis in 26 chronic stable hemodialysis patients. The impact of PDUR on dialysis delivery assessed by URR and Kt/Vurea and the independent factors affecting on PDUR were evaluated. All patients had been dialyzed for 4 hours thrice a week using hemophan membrane. 1) The mean age of patients was 48.6+/-14.8 years and sex ratio was 1:2.3. The mean duration of hemodialysis was 42.7+/-45.0 months. Primary renal diseases were chronic glomerulonephritis 11 (42.3%), diabetic nephropathy 7 (26.9%), and hypertension 4 (15.4%). 2) The mean blood flow was 209.2+/-17.4ml/min. URR, Kt/Vurea, and nPCR using immediate postdialysis BUN were 60+/-7%, 1.13+/-0.21, 1.09+/-0.28g/kg/ day, respectively. The mean recirculation rate was 4.4+/-2.3%. 3)The mean PDUR was 12.2+/-4.6% (range:6-22 %). URR, Kt/Vurea, and nPCR using BUN 30 minutes after dialysis were 55+/-7%, 0.99+/-0.18, and 1.02+/-0.25 g/kg/day, respectively and were significantly lower than those using immediate postdialysis BUN (P<0.05). 4) When the patients were divided according to the degree of PDUR (low PDUR group:<12%, high PDUR group: > or = 12%), high PDUR group was significantly higher than low PDUR group in hematocrit (27.0+/-2.6 vs. 23.5+/-3.6%, P=0.008), URR (64.3+/-5.4 vs. 55.8+/-6.8%, P=0.002), Kt/Vurea (1.26+/-0.17 vs. 1.03+/-0.18, P=0.002), and total recirculation rate (5.6+/-2.7 vs. 3.6+/-1.7%, P=0.05). There were no differences in age, sex, postdialysis body weight, ultrafiltration rate, blood flow, serum albumin, predialysis BUN, creatinine, and nPCR. 5) In multiple regression analysis, the independent factors affecting on PDUR were Kt/Vurea (beta=0.546, P<0.001), recirculation rate (beta=0.422, P<0.001), and hematocrit (beta=0.366, P=0.0017). In conclusion, we think that PDUR should be considered in hemodialysis patients when estimating dialysis delivery, especially if they had high Kt/ Vurea, recirculation rate, and hematocrit.
Blood Urea Nitrogen ; Body Weight ; Creatinine ; Diabetic Nephropathies ; Dialysis* ; Glomerulonephritis ; Hematocrit ; Humans ; Hypertension ; Membranes ; Nutritional Status ; Renal Dialysis* ; Serum Albumin ; Sex Ratio ; Ultrafiltration ; Urea*

Pemphgus vulgaris (PV), Bullus pemphigoid (BP), and Epidermolysis bullous acqusita (EBA) are autoimmune bullous dermatoses, characterized by circulating IgG autoantibodies. These antibodies react with antigens located at the intercellular substance (ICS) of epidermis, basement membrane zone (BMZ), and subepidermal anchoring fibril zone (AFZ), respectively. The subclass distribution of IgG autoantibodies, and the properties and degrees of complement fixing activities of these autoantibodies in each of the above diseases have not been well understood. Indirect immunofluorescence and in vitro complement stainings were performed for the titration of subclasses of IgG antibodies and for the immunofluorescence staining reactivities of complement components C3, C4, C5b-9, H, C4bp, and S. Each serum specimen from five cases of PV, five cases of BP. and three cases of EBA was tested. The findings of multistep technique with monoclonal and polyclonal antibodies are as follows : All four subclasses of IgG antibodies were identified at the antigenic sites in these group, however there were some differences in the antibodies titers. In PV and BP the dominant subclass of highest antibody titer was IgG1 and/or IgG4. In EBA only IgG4 was dominant in all three cases. The results of complement component stainings, in most of the cases of PV, showed positive for C3 and C4 but were negative for the other components or inhibitor proteins at the ICS of epidermis. In BP most of the cases revealed positive staining reactivities at the BMZ for C3, C4, C5b-9, H, and C4bp-9 with no staining reactivities for the inhibitor proteins No significant relevancy was found between the titers of complement fixing IgG subclasses and the numbers of positive complement staining reactivities for complement components. The results suggest that the complement system may contribute more strongly to the formation of bullous lesions in BP and EBA than in PV.
Antibodies ; Autoantibodies ; Basement Membrane ; Blister ; Complement Membrane Attack Complex ; Complement System Proteins ; Epidermis ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Indirect ; Immunoglobulin G ; Pemphigoid, Bullous* ; Pemphigus* ; Skin Diseases, Vesiculobullous