With a rapidly aging society, geriatric mental health is emerging as important public health concern. Despite the short history of psychiatric epidemiology in Korea, recently, epidemiologic data regarding geriatric psychiatric problems has started to accumulate. In the current study, we reviewed epidemiological findings regarding geriatric mental health in Korea. It was found that up to 10% of the elderly suffer from dementia, and 10% to 20% from depressive disorder. Further, prevalence estimates of Alzheimer's disease ranged from 4.2% to 9.0%, and vascular dementia from 1.0% to 4.8%. Annual incidence rates for Alzheimer's were 2.7% to 3.4% whereas that for vascular dementia was found to be as low as 0.3%. The prevalence of major depressive disorder was 4.2% to 9.1%, while that of clinically significant depressive symptom was between 9.1% and 33.0%. Finally, those with alcohol use disorders were found to comprise up to 13.6% of elderly population and additionally, 22% to 58% of the elderly were found to have sleep difficulties. Thus major mental disorders are already prevalent among the Korean elderly and are likely to increase rapidly.
Aged ; Aged, 80 and over ; Alzheimer Disease/epidemiology ; Dementia/epidemiology ; Dementia, Vascular/epidemiology ; Depressive Disorder/epidemiology ; Humans ; Mental Disorders/*epidemiology ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors

With a rapidly aging society, geriatric mental health is emerging as important public health concern. Despite the short history of psychiatric epidemiology in Korea, recently, epidemiologic data regarding geriatric psychiatric problems has started to accumulate. In the current study, we reviewed epidemiological findings regarding geriatric mental health in Korea. It was found that up to 10% of the elderly suffer from dementia, and 10% to 20% from depressive disorder. Further, prevalence estimates of Alzheimer's disease ranged from 4.2% to 9.0%, and vascular dementia from 1.0% to 4.8%. Annual incidence rates for Alzheimer's were 2.7% to 3.4% whereas that for vascular dementia was found to be as low as 0.3%. The prevalence of major depressive disorder was 4.2% to 9.1%, while that of clinically significant depressive symptom was between 9.1% and 33.0%. Finally, those with alcohol use disorders were found to comprise up to 13.6% of elderly population and additionally, 22% to 58% of the elderly were found to have sleep difficulties. Thus major mental disorders are already prevalent among the Korean elderly and are likely to increase rapidly.
Aged ; Aged, 80 and over ; Alzheimer Disease/epidemiology ; Dementia/epidemiology ; Dementia, Vascular/epidemiology ; Depressive Disorder/epidemiology ; Humans ; Mental Disorders/*epidemiology ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors

PURPOSE: The purpose of this study was to determine the proton MR spectroscopic features of liver cirrhosis and the different proton MR spectroscopic features between liver cirrhosis and the normal human liver by comparing the two different conditions. MATERIALS AND METHODS: The investigation involved 30 cases of in-vivo proton MR spectra obtained from 15 patients with liver cirrhosis demonstrated on the basis of radiologic and clinical findings, and from 15 normal volunteers without a past or current history of liver disease. MR spectroscopy involved the use of a 1.5T GE Signa Horizon system (GE Medical Systems, Milwaukee, U.S.A.) with body coil. STEAM (STimulated Echo-Aquisition Mode) with 3000/30 msec of TR/TE was used for signal acquisition; patients were in the prone position and respiration was not interrupted. Cases were assigned to either the cirrhosis or normal group, and using the proton MR spectra of cases of in each group, peak changes occurring in lipids (at 1.3ppm), glutamate and glutamine (at 2.4 -2 .5ppm), phosphomonoesters (at 3.0 -3 .1ppm), and glycogen and glucose (at 3.4 -3 .9ppm) were evaluated. Mean and standard deviation of the ratio of glutamate + glutamine/lipids, phospho-monoesters/lipids, glycogen + glucose/lipids were calculated from the area of their peaks. The ratio of various metabolites to lipid content was compared between the normal and cirrhosis group. RESULTS: The main characteristic change in proton MR spectra in cases of liver cirrhosis compared with normal liver was decreased relative intensity of lipid peak. Mean and standard deviation of ratio of glutamate + g-lutamine/ lipids, phosphomonoesters/lipids, glycogen + glucose/lipids calculated from the area of their peaks of normal and cirrhotic liver were 0.0204 +/-0.0067 and 0.0693 +/-0.0371 (p<0.05), 0.0146 +/-0.0090 and 0.0881 +/-0.0276 (p<0.05), 0.0403 +/-0.0267 and 0.2325 +/-0.1071 (p<0.05), respectively. The other character-istic feature of proton MR spectra of liver cirrhosis was the peak detected at 3.9 - 4.1 ppm with unknown nature. Mean and standard deviation of area ratio of the unknown peak to lipid peak in proton MR spectra of liver cirrhosis was 0.1504 +/-0 . 0 3 5 5 . CONCLUSION: Proton MR spectra of liver cirrhosis revealed decreased intensity of lipid with statistical signifi-cance compared with that of normal liver, and peak at 3.9 -4.1 ppm with unknown nature. In conclusion, liver cirrhosis can be diagnosed non-invasively by the analysis of observed proton MR spectroscopic features.
Fibrosis ; Glucose ; Glutamic Acid ; Glutamine ; Glycogen ; Healthy Volunteers ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Magnetic Resonance Spectroscopy ; Prone Position ; Protons* ; Respiration ; Steam

BACKGROUND: In vitro generated cells from cord blood (CB) CD34+ cells increase cell dose and may reduce the severity and the duration of pancytopenia after transplantation. But safe engraftment for adolescents and adults is still not predictable and standardized. We attempted to establish a clinically application of in vitro generated cells by investigating the use of cytokines for the culture of CB CD34+ cells. METHODS: CD34+ cells, purified from four separate human CB units by magnetic bead selection, were cultured in IMDM with several cytokines. Differentiation of the in vitro generated cells has been confirmed by flowcytometry with specific erythroid, myeloid and megakaryocytic lineage surface markers. And apoptosis of these cells also was analysed with annexin V staining and morphologic analysis under the electron microscopic examination was done, simultaneously. RESULTS: Purified CB CD34+ cells were expanded with differentiation from CD38- to CD38+ expression with time. CB CD34+ cells could be terminally differentiated into erythroid (GPA+) and myeloid (CD33+/CD15+) lineage cells without apoptosis (annexin-V - ) in the presence of EPO and G-CSF, respectively. Megakaryocytic differentiation was partially arrested in early stage due to apoptosis in the presence of TPO. Morphological examination using electron microscope revealed all stages of erythroid and myeloid lineage cells without apoptosis, and apoptotic megakaryocytic lineage cells of early stage. But we could observe the small number of fully maturated platelets. CONCLUSION: CB CD34+ cells were terminally differentiated to erythroid, myeloid, and megakaryocytic lineage cells with or without apoptosis by several cytokines.
Adolescent ; Adult ; Annexin A5 ; Apoptosis* ; Cytokines* ; Fetal Blood* ; Granulocyte Colony-Stimulating Factor ; Humans ; Pancytopenia

PURPOSE: To evaluate whether mild chemical irritation of the bladder in neonatal rats is associated with persistent vanilloid receptor transient receptor potential vanilloid subfamily 1 (TRPV1) activity in adult rats. METHODS: Female Sprague-Dawley rats were used. Ten-day-old rat pups underwent bladder sensitization via intravesical infusion of 0.2% acetic acid in saline with or without prior bladder desensitization with capsaicin. After 8 weeks, 3 groups of rats (control [group 1], bladder sensitization [group 2], and bladder desensitization [group 3]) underwent cystometry. Inflammation of bladder tissue and the expression of TRPV1 in bladder tissue and dorsal root ganglia (DRG) were also evaluated. RESULTS: The bladder sensitization group showed more frequent voiding contractions. TRPV1 expression in adult bladder tissue was elevated in group 2. TRPV1 mRNA levels in the bladder and DRG were significantly higher in group 2 than in group 1. Moreover, group 2 had significantly more DRG neurons (identified by uptake of the retrograde label Fast Blue) that exhibited TRPV1 immunoreactivity. CONCLUSIONS: We found a significant association between neonatal bladder sensitization and persistent TRPV1 activity in adult rats. This is the first study to focus on the underlying pathogenesis of bladder overactivity from childhood to adulthood. Our findings could lead to the development of new strategies for the treatment and prevention of adult urinary symptoms arising from childhood urinary tract dysfunction.
Acetic Acid ; Adult* ; Animals ; Capsaicin ; Cystitis, Interstitial ; Diagnosis-Related Groups ; Female ; Ganglia, Spinal ; Humans ; Inflammation ; Neurons ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; TRPV Cation Channels ; Urinary Bladder* ; Urinary Tract ; Urinary Tract Infections

Objective: To overcome the limited effectiveness of standard case management services, the Seoul Intensive Case Management program (S-ICM) for patients with serious mental illnesses was introduced in 2017. This study aimed to evaluate its effectiveness in reducing the length of hospital stay. Methods: Monitoring data from April 2019 to March 2020 were retrieved from the Seoul Mental Health Welfare Center. A total of 759 participants with serious mental illnesses were included. The average length of admission per month was compared between the pre-ICM (previous year) and during-ICM periods. For post-ICM observation subgroup, average length of admission per month was compared between pre-ICM, during-ICM, and post-ICM periods. To determine the relative contributions of risk factors for during-ICM and post-ICM admission, multivariate logistic regression analyses were performed. Results: The average admission stay for pre-ICM period was significantly longer than that for during-ICM period (1.47 vs. 0.26 days). Among the predictors for during-ICM admission, pre-ICM psychiatric admission was the most important risk factor, followed by medical aid beneficiary and suicidal behavior. In the subgroup analysis of the post-ICM observation period, the pre-ICM, during-ICM, and post-ICM average admission stays were 1.45, 0.29, and 0.57 days/month, respectively. There was a significant difference in the average length of stay between the pre-ICM and during-ICM periods and between the pre-ICM and post-ICM periods. Post-ICM admission risks included pre-ICM admission, S-ICM duration <3 months, and chronic unstable symptoms. Conclusion The results suggest that the S-ICM effectively reduces psychiatric hospitalization duration, at least over a short-term period.

PURPOSE: Although the screening with a mammography has been shown to reduce breast cancer mortality, it has limitations relating to its sensitivity and efficacy. Interval cancers are those that become symptomatic, and are detected between screening examinations. The success of a screening program in reducing the rate of mortality due to breast cancer relies on keeping the number of interval cancers at a minimum. This study was performed to review the mammographic features of interval cancers, and to compare their clinicopathological factors with those cancers detected by screening. METHODS: Of the 881 women who had operations for breast cancer performed between 1995 and 1999, we retrospectively analyzed the medical records and mammograms of 57 who received at least a mammogram before the diagnosis of their breast cancer. These patients were divided into an interval cancer group, who had symptoms, and a screen detected cancer group, who had not. The factors compared included the clinical, radiographic, histopathological, and immunohistochemical features. RESULTS: Interval cancers were more likely to have masses, than microcalcifications, in their mammographic features, and were more likely to be invasive and at a higher stage according to their histopathological features. The false negative rate was 48% for the screen detected cancers, and 35% for the interval cancers (P=0.414). HRT users had the higher false negative rate of 51.6% than the 26.9% for the nonuser (P=0.103). CONCLUSION: The interval cancers were found to be different from the screen detected cancers in terms of their radiological and pathological features. The standardization of screen interval, and additional magnification mammography, or ultrasonography may contribute to reduce false negative rates of mammography.
Breast Neoplasms ; Breast* ; Diagnosis ; Female ; Humans ; Mammography ; Mass Screening ; Medical Records ; Morinda ; Mortality ; Retrospective Studies ; Ultrasonography

Objective: To establish and to promote the qualitative development of a housing service model in South Korea. Methods: The questionnaire was collected through the housing needs survey and the focus group interview on the mental health professions. We enrolled 365 subjects from 63 places (community conversion facilities, cohabitation, cohabitation families, hospitals, psychiatric nursing homes) to answer the questionnaires. Results: The survey result confirms the needs of people with a mental illness to be self-reliant, but it shows that the economic vulnerability is a hindrance. In addition, the most necessary factor for self-reliant living is to provide services that support daily living. Therefore, the study points out that a system that guarantees self-reliance must be added in order for the housing services to be distributed throughout local communities for the people with mental illness. Conclusion The study proposes the Seoul-type housing services model to replace the housing services that functions in a fragmented manner with the provision of an integrated services through a unified channel by establishing a housing support center (tentative name). This will ultimately help people with a mental illness to live a healthy life that meets their needs as community members.

PURPOSE: Hormone replacement therapy (HRT) has been associated with an increased risk for breast cancer. Cancers in women who undergo HRT are often less advanced, and a lower mortality has been reported in those who use HRT vice nonusers. We sought to explain this by a comparison of indicators of tumor aggressiveness in patients who received HRT with those in patients who did not. METHODS: A population-based cohort of 370 postmenopausal women with breast cancer were interviewed for the use, type, and duration of HRT. Clinical variables and indicators of tumor aggressiveness (nuclear grade, hormone receptors, c-erb B2 overexpression, tumor size, lymph node) were analyzed. RESULTS: Breast tumors from 268 HRT patients were smaller (P=0.001), had less involved axillary lymph nodes (P=0.0), and had a lower overexpression of c-erb B2 (P=0.047) than the tumors from 102 non-recipients. These differences persisted after adjustments for age at diagnosis and screening with mammography by multiple logistic regression. No significant differences were observed in estrogen (ER) or progesterone receptor content (PR) or, nuclear grade. Neither the type of HRT (estrogen versus combination of estrogen and progesterone), nor the duration of HRT was not associated with the tumor size or with the involvement of lymph nodes. The use of HRT was significantly associated with a longer metastasis free survival in women with breast cancer (P=0.028), but was not associated with longer overall survival. The use of HRT was not significantly associated with longer overall survival or with a longer metastasis free survival after adjustment for T-stage, N-stage, age at diagnosis or screening mammography. CONCLUSION: The results indicate that breast cancer in women who receive HRT is biologically less aggressive than those without previous HRT. This may at least partly explain why breast cancer in HRT users has a more favorable clinical course.
Breast Neoplasms* ; Breast* ; Cohort Studies ; Diagnosis ; Estrogens ; Female ; Hormone Replacement Therapy* ; Humans ; Logistic Models ; Lymph Nodes ; Mammography ; Mass Screening ; Morinda ; Mortality ; Neoplasm Metastasis ; Receptors, Progesterone

PURPOSE: To evaluate the CT appearance of normal variations in the minute central skull base foramina in infants and children. MATERIALS AND METHODS: One hundred and fourteen children under the age of 17 years without skull base abnormality underwent CT scanning. A high spatial frequency algorithm was used, and contiguous axial scanning parallel to the orbitomeatal line was performed from the foramen magnum to the orbital roof, with a 1-mm slice thickness. The presence or absence of eight foramina, pseudoforamina, or ossification centers including anterior presphenoidal foramen, posterior presphenoidal foramen, rostro-orbital pseudoforamen, intralateromedial postsphenoidal pseudoforamen, intrapostsphenoidal pseudoforamen, spheno-occipital pseudo-foramen, canalis basilaris medianus and intrasynchondral ossified bodies was analysed according to age. The presence of foramina or pseudoforamina was indicated if a ring-shaped structure was seen on two or more CT scans at the location anatomically predicted, and intrasynchondral ossified bodies were indicated if linear or dot-like structures with high attenuation accompanied spheno-occipital synchondrosis. RESULTS: CT indicated that within a certain age range, various kinds of foramina, pseudoforamina, and ossification centers were frequent. The anterior presphenoidal foramen was most commonly seen in infants aged 1-12 months (16/17, 94 %); the posterior presphenoidal foramen in children less than 2 years old(27/37, 73 % ) ; the rostro-orbital pseudoforamen in children aged 2 -5 years (9/17, 53%); intrapostsphenoidal pseudoforamen in children 6 -12 years old(20/37, 54%) and spheno-occipital pseudoforamen and intrasynchondral ossified bodies in children aged 13 -16 years. The canalis basilaris medianus was identified in about 20 % of all subjects regardless of age. CONCLUSION: Development of the minute central skull base foramina varied greatly according to age. Knowledge of the CT appearances of such embryologic variants of the central skull base should not only help Provide an understanding of complex skull base anatomy but also identify abnormal skull base development.
Child ; Foramen Magnum ; Humans ; Infant ; Orbit ; Skull Base* ; Skull* ; Tomography, X-Ray Computed