OBJECTIVES: The purpose of this study was to examine the determinants of care burden of caregivers in patients with dementia. METHODS: 128 dementia patients and patients' caregivers participated in this study. Care burden using the BI ; cognition using the K-MMSE ; dementia severity using the CDR ; activities of daily living using the S-ADL and the S-IADL ; behaviour problems using NPI were measured. RESULTS: The results showed that care burden was related significantly with the K-MMSE, the CDR, the S-ADL, the SIADL and the NPI total score. Of the behavior problems, agitation/aggression, anxiety, disinhibition, irritability, and aberrant behavior correlated positively with care burden of caregivers. Regression analysis indicated that agitation/aggression, anxiety, the CDR contributed to care burden. CONCLUSION: Agitation/aggression, anxiety and dementia severity contributed to care burden of caregivers. The identified determinants of care burden and the stress of caregivers suggest areas of therapeutic intervention to reduce caregiver's burden so that the institutionalization can be delayed.
Activities of Daily Living ; Anxiety ; Caregivers* ; Cognition ; Dementia* ; Humans ; Institutionalization

PURPOSE: This study was to determine the mediator or moderator role of social support in the relationship between stress and depression among family caregivers of older adults with dementia. METHOD: Sixty nine family caregivers were randomly selected from health care centers in P city and a face-to-face interview was conducted using questionnaires from January to May of 2002. Data were analyzed with descriptive statistics, Pearson correlation, and hierarchical multiple regression using SPSS program. RESULT: Family caregivers of older adults with higher dependency in ADLs and higher problematic behaviors, provided care to the older adults for a longer period of time, and perceived less social support reported higher depression. Social support showed mediating effects between stress and depression, while did not show moderating effects. Elderly dependency on ADLs and caregiving duration decreased perceived social support and decreased social support increased depression. CONCLUSION: To increase family and social support to the caregivers of more functionally impaired elderly, family education to increase emotional support and physical assistance to the caregivers and broader and flexible application of social support such as increasing accessibility to the elderly daycare service with lower price may prove beneficial.

OBJECTIVES: Clinical utility of the Short Form of the Samsung Dementia Questionnaire (S-SDQ) as a screening instrument for Mild Cognitive Impairment (MCI). METHODS: Three groups (n=27, Subjective Memory Impairment (SMI); n=41 MCI; n=79, Early Alzheimer's Disease(AD)) recruited from memory clinic were administered a battery of neuropsychological tests including S-SDQ and Korean version-Mini Mental State Examination (K-MMSE). RESULTS: S-SDQ, unlike the K-MMSE, had no association with the age and education of the subjects. Scores of S-SDQ was found to correlate (r=-.496) with scores of K-MMSE. Result of Receiver Operating Characteristic (ROC) analysis revealed that S-SDQ discriminated between the SMI and the MCI groups. CONCLUSION: S-SDQ may be a solution to the problem of contamination by education and age which affect traditional cognitive screening instruments like K-MMSE, and it may be a useful tool for screening MCI.
Dementia* ; Education ; Mass Screening ; Memory ; Mild Cognitive Impairment* ; Neuropsychological Tests ; Surveys and Questionnaires* ; ROC Curve

Histone deacetylase (HDAC) inhibitors are considered novel agents for cancer chemotherapy. We previously investigated MHY219, a new HDAC inhibitor, and its potent anticancer activity in human prostate cancer cells. In the present study, we evaluated MHY219 molecular mechanisms involved in the regulation of prostate cancer cell migration. Similar to suberanilohydroxamic acid (SAHA), MHY219 inhibited HDAC1 enzyme activity in a dose-dependent manner. MHY219 cytotoxicity was higher in LNCaP (IC50=0.67 muM) than in DU145 cells (IC50=1.10 muM) and PC3 cells (IC50=5.60 muM) after 48 h of treatment. MHY219 significantly inhibited the HDAC1 protein levels in LNCaP and DU145 cells at high concentrations. However, inhibitory effects of MHY219 on HDAC proteins levels varied based on the cell type. MHY219 significantly inhibited LNCaP and DU145 cells migration by down-regulation of matrix metalloprotease-1 (MMP-1) and MMP-2 and induction of tissue inhibitor of metalloproteinases-1 (TIMP-1). These results suggest that MHY219 may potentially be used as an anticancer agent to block cancer cell migration through the repression of MMP-1 and MMP-2, which is related to the reduction of HDAC1.
Cell Movement ; Down-Regulation ; Drug Therapy ; Histone Deacetylase Inhibitors* ; Histone Deacetylases* ; Histones* ; Humans* ; Matrix Metalloproteinases ; Prostate* ; Prostatic Neoplasms* ; Repression, Psychology

This study was conducted to examine the reliability, validity and clinical utility of the Severe Impairment Battery (SIB) for a Korean population. 69 dementia patients with Clinical Dementia Rating (CDR) stages 2 or 3 were participated in this study. The SIB, Korean version-Mini Mental State Examination (K-MMSE), CDR, and Seoul-Activities of Daily Living (S-ADL) were administered. The validity of the SIB was confirmed by evaluating the correlation coefficients between the SIB and K-MMSE, CDR, S-ADL, which were found to be significant. Cronbach's alpha for the total SIB score and each subscale score showed high significance, and the item-total correlation for each subscale was also acceptable. The test-retest correlation for the total SIB score and subscale scores were significant, except for the praxis and orienting to name. The total SIB score and subscale scores were examined according to CDR. The results suggest that the SIB can differentiate the poor performances of severely impaired dementia patients. On the basis of the receiver operating characteristic (ROC), it can be concluded that the SIB is able to accurately discriminate between CDR 2 and 3 patients. The results of this study suggest that the SIB is a reliable and valid instrument for evaluating severe dementia patients in Korean population.
Severity of Illness Index ; Reproducibility of Results ; ROC Curve ; *Neuropsychological Tests ; Male ; Korea ; Humans ; Female ; Dementia/*diagnosis ; Cognition Disorders/diagnosis ; Cognition ; Aged ; Activities of Daily Living

Based on the assumption that apparent diffusion coefficients (ADCs) define high-risk clinical target volume (aCTVHR) in high-grade glioma in a cellularity-dependent manner, the dosimetric effects of aCTVHR-targeted dose optimization were evaluated in two intensity-modulated radiation therapy (IMRT) plans. Diffusion-weighted magnetic resonance (MR) images and ADC maps were analyzed qualitatively and quantitatively to determine aCTVHR in a high-grade glioma with high cellularity. After confirming tumor malignancy using the average and minimum ADCs and ADC ratios, the aCTVHR with double- or triple-restricted water diffusion was defined on computed tomography images through image registration. Doses to the aCTVHR and CTV defined on T1-weighted MR images were optimized using a simultaneous integrated boost technique. The dosimetric benefits for CTVs and organs at risk (OARs) were compared using dose volume histograms and various biophysical indices in an ADC map-based IMRT (IMRTADC) plan and a conventional IMRT (IMRTconv) plan. The IMRTADC plan improved dose conformity up to 15 times, compared to the IMRTconv plan. It reduced the equivalent uniform doses in the visual system and brain stem by more than 10% and 16%, respectively. The ADC-based target differentiation and dose optimization may facilitate conformal dose distribution to the aCTVHR and OAR sparing in an IMRT plan.
Contrast Media ; Gadolinium ; Glioma/*radiotherapy ; Humans ; Magnetic Resonance Imaging/*methods ; *Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/*methods ; Radiotherapy, Intensity-Modulated/*methods ; Tumor Burden

OBJECTIVES: Clinical studies have shown cognitive dysfunctions and soft neurological signs in schizophrenic patients and these findings have been suggested as evidence of organic bases in the pathophysiology of schizophrenia. This study was intended to investigate the characteristics of cognitive deficits and soft neurological signs in schizophrenia and, to determine whether any abnormality in these functions can be regarded as a trait marker of the illness which is independent of antipsychotic treatment and clinical improvement. We also investigated the correlation between cognitive deficits and soft neurological signs reflecting cognitive dysmetria, respectively. METHODS: Twenty schizophrenic patients were assessed for the soft neurological signs and cognitive functions before and after neuroleptic treatment. The patients had been medicated for at least 3 weeks with one of the atypical neuroleptics. Cognitive functions were evaluated by Trail making A, B, Stroop test and Word fluency test. Soft neurological signs were assessed by Cambridge Neurological Inventory(Part 2). Positive and Negative Syndrome Scale(PANSS) and Clinical Global Impression(CGI) were used to assess the clinical severity and Extrapyramidal Symtoms Rating Scale was used to estimate the extrapyramidal symptoms. Cognitive functions and soft neurological signs of twenty normal controls were assessed with the same scale. RESULTS: Before treatment, schizophrenic patients showed significant impairments on cognitive function tests(Trail Making A, B, Stroop Test) and soft neurological sign tests(8 items:Grasp reflex, Go/no-go, Finger thumb opposition, Rhythm tapping, Finger agnosia, Fist-edge-palm, Left-right orientation, Extinction). Although significant clinical improvements were observed after the treatment, there were no significant changes in cognitive functions and soft neurological signs(except for Go/no-go test and Finger agnosia). Among the soft neurological signs of the patients, abnormality in Rhythm tapping was significantly correlated with cognitive deficits. CONCLUSION: Schizophrenic patients showed characteristic cognitive deficits and soft neurological signs which were independent of medication and clinical symptoms. And these two characteristics were partly correlated with each other.
Agnosia ; Antipsychotic Agents ; Cerebellar Ataxia ; Fingers ; Humans ; Reflex ; Schizophrenia ; Stroop Test ; Thumb

In order to evaluate the mutagenic effects of extractable indoor air pollutants (organic matters), we measured the mutagenic activities by sensitive microsuspension Ames test using new tester strains (YG 1024 and YG 1029). And additionally to evaluate the mutagenic effects on vital cell, we examined the frequencies of micronucleus appearing in lymphocytes from dye handling workers and controls. This study was conducted from Jan. toMay, 1995. The extractable indoor air pollutants were collected by low volume air sampler in a general office room and 3 of dye handling factories. And the environment of general office room divided into 3 different groups according to the type of room heaters. To determine the frequencies of micronucleus appearing in lymphocytes, we sampled peripheral venous blood from 20 of dye handling workers and 20 of controls, and cultured, and then examined the lymphocytes. The results obtained were as follows: 1. The indirect mutagenic activities of extractable organic matters from suspended particulates colleced in a general office room were higher than the direct one. 2. The strain YG 1024 was the most sensitive, and the increasing order of test strainsthat showed higher number of revertant were YG 1024, YG 1029, TA 100, and TA 98. 3. In the general office room, the room using kerosene heater showed the highest mutagenecity, and the next was buthan gas heater, and non-heating room in order. 4. The mutagenic effects of suspended particulates in::dye handling factories on the strain YG 1024 was 1.2 times higher than YG 1029. 5. The frequencies of micronucleus appearing in lymphocyte of the circulating blood of dye handling workers and the control were 5.65+/-2.97% and 4.65+/-0.97%, respectively. And the difference was statistically significant.
Air Pollutants* ; Kerosene ; Lymphocytes*

OBJECTIVES: Our study investigated the behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD) patients with three groups (mild, moderate, severe) and prevalence of BPSD with the severity of AD. METHOD: In a study group of 338 patients with AD (mild:184, moderate:99, severe:55), information on gender, age, education was collected. The severity of dementia was measured by the Korean version of mini-mental status examination (K-MMSE) and Clinical dementia rating (CDR). The Korean version of Neruopsychiatric Inventory (K-NPI) was administered to all patients. RESULTS: Depression/dysphoria, apathy/indifference, irritability/lability, anxiety were frequent in the mild AD group. Apathy/indifference, Depression/dysphoria, agitation/aggression, delusion were frequent in the moderate AD group. Apathy/indifference, agitation/aggression, aberrant motor behavior, nighttime behavior, anxiety were frequent in the severe AD group. CONCLUSION: These observations suggest that delusion was a more dominant symptom in moderate AD group and the prevalence of depression declined in severe AD group.
Alzheimer Disease ; Anxiety ; Delusions ; Dementia ; Deoxycytidine ; Depression ; Humans ; Prevalence

PURPOSE: To analyze the length and area of limbal dermoid invading the cornea and to evaluate the effects on visual acuity and astigmatism before and after surgery. METHODS: This retrospective study included 20 eyes of 20 patients who underwent surgical removal of limbal dermoid. The preoperative and postoperative visual acuity and astigmatism level were measured. In addition, we evaluated the correlations of astigmatism with the length ratio (length of limbal dermoid invading the cornea/total corneal diameter), width ratio (width of limbal dermoid invading the cornea/total corneal diameter), and area ratio (area of limbal dermoid invading the cornea/total corneal area) using preoperative anterior segment photographs. RESULTS: The mean preoperative astigmatism was 0.85 ± 0.71 D in the sound eye and 3.00 ± 3.14 D in the affected eye (p = 0.004). Length, width, and area ratio of limbal dermoid have positive correlation with astigmatism (p < 0.010 for all variables), with a larger length ratio of limbal dermoid invading the cornea producing greater reduction in postoperative astigmatism (p = 0.010, r = 0.816). The amount of astigmatism was significantly higher in patients with amblyopia in the affected eye (p = 0.030). Visual acuity gain more than 2 lines was achieved in 8 among 10 patients with amblyopia under the age of 7 years through the appropriate refractive correction and occlusion 1 year after surgery. CONCLUSIONS: Astigmatism is a major cause of amblyopia in pediatric patients with limbal dermoid. The degree of astigmatism can be predicted by the size factors of the limbal dermoid. In particular, the relative length of limbal dermoid invading the cornea has a stronger correlation with preoperative astigmatism than other factors and has correlation with postoperative reduction of astigmatism. It should be emphasized that children with limbal dermoid need appropriate refractive correction and occlusion in addition to surgical excision.
Amblyopia ; Astigmatism ; Child ; Cornea ; Dermoid Cyst* ; Humans ; Retrospective Studies ; Visual Acuity