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*

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*

Background and Objectives: Recurrent epistaxis requiring emergency department (ED) visits results in increased morbidity in the elderly and associated with high health care costs. This study is to analyze the frequency and characteristics of epistaxis patients in the elderly and to find out the risk factors and effective treatment for recurrent epistaxis. Subjects and Method We studied retrospectively the clinical cases of 977 emergency patients and 155 patients, aged over 65, for the treatment of epistaxis during the last 10 years from January 2008 to January 2018. The group A, comprised of 95 patients (68.29%), was treated with an initial treatment. The group B, which comprised of 60 patients (38.71%), visited for re-bleeding following an initial treatment. Results: Patients made 2 to 10 ED visits due to re-bleeding and 32 of the 60 patients (53.5%) visited twice. The electrocauterization was the most common (61.7%) for treatment method during rebleeding, followed by posterior packing (18.3%). The factors that increases the risk of recurrent epistaxis are anticoagulants, posterior epistaxis, anterior packing, inefficient ED packing. There was no correlation between comorbidities and rebleeding. Conclusion Accurate medical history taking of anticoagulants may enable personnel to provide more effective management of these patients. The most important factors in the failure of primary care were not being able to find the precise area of bleeding and ineffective packing during the initial treatment. Therefore, it is important that we must carefully check the areas using the endoscope to decrease the failure of initial treatment of epistaxis.

Duplications of the alimentary tract are relatively rare congenital malformations usually present during infancy or young childhood. They can occur anywhere in the intestinal tract. The most common site is the terminal ileum, and the least common site is the colon. Duplication of the cecum is very rare. The importance of these congenital lesions lies in the fact that they mimic other surgical disease processes and may result in significant morbidity if left untreated. Prompt recognition and treatment using combined radiologic and surgical management are associated with an excellent outcome. We experienced a case of cystic duplication in the cecum, which gave rise to partial intestinal obstruction and bleeding. We performed a resection of the cecum, including a part of the terminal ileum, and anastomosed in end-to-end fashion with a good result.
Cecum ; Colon ; Hemorrhage ; Ileum ; Intestinal Obstruction

BACKGROUND AND OBJECTIVES: Ten to twenty percent of children with Kawasaki disease (KD) do not respond to initial intravenous immunoglobulin (IVIG) treatment. If untreated, approximately 15% to 25% of KD patients have complications. The aim of this study was to find useful predictors of responsiveness to initial IVIG treatment in KD. SUBJECTS AND METHODS: We retrospectively reviewed medical records of 91 children diagnosed with KD at Myong Ji Hospital from March 2012 to April 2014. Before and after (24 hours to 36 hours) IVIG treatment, the following laboratory data were obtained: hemoglobin (Hb) level, white blood cell count, proportion of neutrophil, lymphocyte and eosinophil, platelet count, erythrocyte sedimentation rate (ERS), C-reactive protein (CRP), creatine kinase (CK), creatine kinase MB (CK-MB), and N-terminal pro-brain natriuretic peptide (NT-proBNP). Subjects were then divided into two groups: IVIG-responsive or IVIG-resistant. RESULTS: Of 91 patients, 11 (12%) required retreatment. By univariate analysis, before-IVIG laboratory parameters of white blood cell count, % neutrophil, ERS, CRP, sodium, CK, CK-MB, and NT-proBNP were significantly different between IVIG-responsive and IVIG-resistant patient groups. In the after-IVIG laboratory parameters, Hb level, white blood cell count, % neutrophil, % lymphocyte, CRP, CK, CK-MB, and NT-pro-BNP were significantly different between the two groups. While the mean-differences were not statistically significant, fractional change (FC)-CRP and FC-% neutrophil showed significant difference. By multivariate analysis, FC-CRP was confirmed to be an independent predictor for initial IVIG resistance. CONCLUSION: Fractional change-C-reactive protein might be a useful and important value for predicting initial IVIG resistance in KD patients.
Blood Sedimentation ; C-Reactive Protein ; Child ; Creatine Kinase ; Eosinophils ; Humans ; Immunization, Passive* ; Immunoglobulins ; Immunoglobulins, Intravenous ; Leukocyte Count ; Lymphocytes ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Multivariate Analysis ; Neutrophils ; Platelet Count ; Retreatment ; Retrospective Studies ; Risk Factors ; Sodium

Bone Marrow ; Kidney Transplantation ; Maxilla ; Multiple Myeloma ; Neoplasms, Plasma Cell ; Plasma ; Plasma Cells

Purpose: The aim of this study was to investigate the outcomes of endodontic treatment of mandibular second molar with C-shaped canal in elderly patients and related factors affecting the survival of the tooth. Materials and Methods: From 2010 to 2015, the survival rate following endodontic treatment was evaluated in elderly patients over 60 years who visited the Veterans Health Service Medical Center for endodontic treatment. The presence of C-shaped canals was confirmed using clinical records and radiographic features. Patientʼs age, sex, systemic diseases, tooth location, vitality, signs and symptoms, fractures, caries, apical radiolucency, canal shaping methods, sealer leakage, filling voids, and restoration of prosthesis were included in the analyses as confounding variables. The survival rate of teeth was analyzed using Kaplan–Meire analysis and the relationship between the survival rate and variables was analyzed using Simple and Multiple Cox regression analysis.Result: In total, 107 teeth in elderly patients had C-shaped canal. The survival rate of teeth that received endodontic treatment was 63.70%. None of the factors investigated significantly influenced the survival rate (P>0.05). Conclusion In elderly patients with C-shaped canal, the survival rate after root canal treatment was not significantly different from that of other mandibular molars.

BACKGROUND: The bioincompatability of the conventional peritoneal dialysis can be partly attributed to the presence of GDPs, which are generated during the heat sterilization. Formation of GDPs can be significantly reduced by the use of multi-chamber bag systems because high concentrated glucose is separated from alkaline lactate. In order to investigate whether multi-chamber bag system can improve the in vivo biocompatibility, we performed a randomized, prospective study comparing the multi-chamber bag system with the conventional PD system, measuring CA125 and PIIINP levels in the effluent dialysates as well as the other clinical and biochemical parameters. METHODS: Forty five patients who were stable on CAPD were enrolled randomly assigned to experiment group (n=27), and control group (n=18). Overnight effluent was collected for measurement of CA125 and PIIINP and the other clinical, biochemical parameters were compared including the number of peritonitis, the ultrafiltration volume. RESULTS: In patients treated with the multiple chamber bag system, there were significantly higher levels of CA125 and PIIINP from 1 month. No clinical and biochemical parameters influenced on their levels. The incidence of peritonitis or ultrafiltration volume did not differ between the two groups. CONCLUSION: Using the low GDP solution resulted in a better preservation of peritoneal mesothelial mass and an improvement of local peritoneal homeostasis, which are supposed to contribute to the biocompatibility of peritoneal dialysis fluid.
Dialysis Solutions ; Glucose ; Guanosine Diphosphate* ; Homeostasis ; Hot Temperature ; Humans ; Incidence ; Lactic Acid ; Peritoneal Dialysis* ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Prospective Studies ; Sterilization ; Ultrafiltration

BACKGROUND: Blood lipid profiles have been suggested to be a risk factor for osteoporosis. However, the association between lipid profiles and bone mineral density (BMD) is still unclear. This study aimed to evaluate an association between blood lipid profiles and BMD through both a cross-sectional and a longitudinal study. METHODS: Study subjects were 958 postmenopausal Korean women who have repeatedly undertaken laboratory tests and BMD measurements at lumbar spine and femur neck with an interval of 7.1 years. The associations between lipid profiles and BMD were examined using Spearman correlation analysis with an adjustment for age, smoking, alcohol drinking, physical activity, body mass index, and follow-up duration. RESULTS: Lumbar spine BMD was not associated with total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HLD-C) regardless of when the measurement was performed. In an analysis using data measured at the beginning of the study, femur neck BMD was not associated with TC and LDL-C. However, femur neck BMD showed weak but significantly positive correlation with HDL-C (correlation coefficient, 0.077; 95% confidence interval, 0.005 to 0.149). When the analysis was repeated with data measured at the end of the follow-up, there was no significant correlation between femur neck BMD and any lipid profile. In addition, change in femur neck BMD during follow-up was not associated with the change in lipid profiles. CONCLUSION: Although further study with a consideration of calcium intake and osteoporosis medication seems necessary, this study found no association between serum lipid profiles and BMD in postmenopausal Korean women.
Alcohol Drinking ; Body Mass Index ; Bone Density ; Calcium ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Female ; Femur ; Femur Neck ; Follow-Up Studies ; Humans ; Lipoproteins ; Motor Activity ; Osteoporosis ; Risk Factors ; Smoke ; Smoking ; Spine

The preoptic area and anterior hypothalamus plays a pivotal role in body temperature regulation, and damage in this region causes hyperthermia. This hyperthermia is particularly troublesome because of the possibility that it may reflect an occult infectious process. We report a case of fever of unknown origin in a patient after removal of neoplasm involving the hypothalamus. A 29-year old man underwent craniotomy and removal of hypothalamic choroid meningioma. Seventy days after the removal of his tumor, his body temperature began to rise. But, there was no evidence of infection, inflammatory disease, metabolic disease, drug fever and recurred tumor. Repeated administration of antipyretic agent did not reduce body temperature. So, we considered that the elevated temperature had a central basis. The patient was treated with chlorpromazine in an attempt to lower his temperature. This drug reduced successfully his body temperature.
Adult ; Body Temperature ; Body Temperature Regulation ; Chlorpromazine ; Choroid ; Craniotomy ; Fever of Unknown Origin* ; Fever* ; Humans ; Hypothalamic Neoplasms* ; Hypothalamus ; Hypothalamus, Anterior ; Meningioma ; Metabolic Diseases ; Preoptic Area