No abstract available.

No abstract available.
Hypertension*

OBJECTIVES: We investigated the prevalence and composite score of the neuropsychiatric symptoms in patients with mild cognitive impairment(MCI), and dementia of Alzheimer's type(AD). The aim of this study is to analyze the correlation between the result of Korean Neuropsychiatric Inventory(K-NPI) and cognitive function. METHODS: A total of 163 patients diagnosed with MCI or AD was divided into three groups(55 MCI patients, 56 dementia patients with mild stage, and 52 dementia patients with moderate, severe stage). We examined neuropsychiatric symptoms by K-NPI and compared the prevalence and composite score of each subdomain in K-NPI among three groups. RESULTS: The most common symptoms in the MCI group were depression/dysphoria, sleep/night-time behavior, anxiety, and irritability/lability. In mild AD group, the most frequent disturbance was agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, and sleep/night-time behavior. In moderate to severe AD group, the most frequent disturbance was apathy/indifference, depression/dysphoria, agitation/aggression, and delusion. The frequencies of delusion, hallucination, agitation/aggression, apathy/indifference, aberrant motor behavior, appetite/eating change were statistically significant. The total NPI score showed a negative correlation with MMSE-KC and a positive correlation with GDS. CONCLUSIONS: Neuropsychiatric symptoms are common features of MCI and AD. These symptoms observed in MCI are similar to those of mild AD. Psychosis is most common in moderate to severe AD, leading to a faster rate of cognitive decline. Therefore, proper management according to the neuropsychiatric symptoms of MCI and three stages of dementia is needed.
Anxiety ; Delusions ; Dementia ; Hallucinations ; Humans ; Mild Cognitive Impairment ; Prevalence ; Psychotic Disorders

OBJECTIVES: Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. METHODS: A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). RESULTS: The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. CONCLUSIONS: These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.
Alzheimer Disease ; Dementia* ; Depression* ; Fasting ; Homocysteine* ; Humans ; Mild Cognitive Impairment* ; Neurobehavioral Manifestations ; Risk Factors

OBJECTIVES: Alzheimer's disease(AD) and mild cognitive impairment(MCI) affect several nervous structures involved with the autonomic nervous system. Association between neuropsychiatric deficits and heart rate variability has been observed. But cardiac autonomic function in AD has been scarcely studied and the results reported are conflicting. We investigated autonomic function in normal control, MCI, AD using heart rate variabil-ity(HRV) technique. METHODS: Time and frequency-domain variability of 5-min R-R interval series was comparatively evaluated in 26 normal control subjects, 22 MCI subjects and 34 AD subjects. Analysis of variance(ANOVA) was used to compare the differences across groups. Correlations between MMSE-KC and HRV components were performed using Pearson's correlation coefficient. RESULTS: No significant difference was observed among the groups in time, frequency-domain analysis of HRV (p>0.05). HRV were not found to be significantly correlated with the degree of cognitive impairment. CONCLUSIONS: There were no differences in HRV with MCI, AD subjects when compared with normal controls. Further investigation is required to use HRV technique as noninvasive parameters of MCI and AD.
Alzheimer Disease ; Autonomic Nervous System ; Heart ; Heart Rate ; Mild Cognitive Impairment

The anxiety disorders make up one of the most common groups of psychiatric disorders. Anxiety is an alerting signal ; it warns of impending danger and enables a person to take measures to deal with a threat. Three major schools of psychological theory-psychoanalytic, behavioral, and existential-have contributed theories about the causes of anxiety. Many drugs are effective in managing distressing signs and symptoms associated with anxiety disorders. As the symptoms are controlled by medication, patients are reassured and develop confidence that they will not be incapacitated by the disorder. Benzodiazepines are useful in panic disorder, phobias, and agitation. In general, benzodiazepines act as hypnotics at high doses and as anxiolytics or sedatives at low doses. The benzodiazepines have become the sedative-hypnotic drugs of first choice because they have a higher therapeutic index and significantly less abuse potential than do many of other sedative-hypnotics. The most common adverse effect of benzodiazepines is drowsiness. Some patients also experience dizziness and ataxia. The most serious adverse effects of benzodiazepines occur when other sedative substances are taken concurrently. When benzodiazepines are used for long periods, they usually cause significant tolerance, dependence, or withdrawal effects. Overdoses with benzodiazepines alone have a predictably favorable outcome. The benzodiazepines should be started at a low dosage, and the patient should be informed about the drug’s sedative properties and abuse potential. Serotonin-specific reuptake inhibitors (SSRIs) have a much more favorable profile of adverse effects and have significantly broadened the horizon for pharmacological treatment of anxiety disorder. Three fourths of patients experience no adverse effects at low starting doses, and doses may be increased relatively rapidly in these patients. In the remaining one fourth of patients, most of the SSRIs’ adverse effects appear within the first 1 to 2 weeks, and they generally subside or resolve spontaneously if the drugs are continued at the same dose.
Anti-Anxiety Agents ; Anxiety ; Anxiety Disorders ; Ataxia ; Benzodiazepines ; Dihydroergotamine ; Dizziness ; Humans ; Hypnotics and Sedatives ; Panic Disorder ; Phobic Disorders ; Sleep Stages

Low back pain and sciatica is one of the most frequent and troublesome problem in the orthopedic field. A study of the effectivity and reliability of the anterior interbody fusion with autoiliac bone graft for the spondylogenic and Discogenic back pain was done on 166 patients who had been hospitalized from January 1978 to December 1984. The approach to the lesion was retroperitoneal with anterior approach. The anterior interbody fusion was performed by using one block or two block from autoiliac bone. The status of the spine fusion after operation was decided by the plane roentgenogram or clinical sign, and the tomogram or dynamogram in some case. We analysed 116 patients having anterior fusionto study whether fusion rate has any relation with the number of the grafted bone, preoperative diagnosis and the level of fusion. At 9 months after operation, the clinical result was assesed and was compared between the group of the preoperative diagnosis. The following results were obtained from analysis of the cases studied. 1. The fusion rate for the grafted bone was 92.2%. There was no difference in fusion rates between the group of patients operated using one block and two-block. 2. The fate of the grafted bone could be categorized into 5 different types. 3. In patients with spondylolisthesis or spondylolysis, there was high incidence of non union.Also in terms of the vertebral level, the fusin between the L5-Sl showed high incidence of non union. 4. High fusion rate was obtained by using back brace without cast immobilization. The average duration of brace wearing was 6.6 months. 5. Overall clinical results were as follows:excellent or good 64.6%, fair 31.9%, poor 3.5%,and spondylolisthesis showed better clinical results than other diseases. 6. Post sympathectomy symptoms were noticed in 12 patients after operation and there were no permanent genitourinary problem.
Arthrodesis ; Back Pain ; Braces ; Diagnosis ; Equidae ; Humans ; Immobilization ; Incidence ; Low Back Pain ; Orthopedics ; Receptors, CXCR4 ; Sciatica ; Spine ; Spondylolisthesis ; Spondylolysis ; Sympathectomy ; Transplants

The objective of this study was to establish a good methodology to isolate single smooth muscle cells that are alive and respond properly to pharmacological agents. Canine urinary bladders were employed as the source of single cells, and acetylcholine, atropine and imipramine were used as indicators of pharmacological responsiveness. Imipramine, an antidepressant drug exhibited the anticholinergic and calcium antagonizing properties on rat detrusor muscle. To establish a control value for a further experiment to elucidate the mechanism of action of imipramine on detrusor muscle, we measured the concentration-response of single cells to acetylcholine in the presesnce of imipramine by length of the cells and compared the result with the response in the presence of atropine. Tiny chops of smooth muscle taken from anesthetized canine urinary bladder were incubated in collagenase solution at 36℃ for 17-20 minutes. The collagenase solution included collagenase 1.2 mg/ml, soybean tryspin inhibitory 0.08 mg/ml, bovine serum albumin 2% in 10 ml Krebs-Henseleit buffer solution aerated with a consistent breeze of 95/5% O2/CO2 to maintain the pH at 7.4. After washing with plain K-H solution on 450 mesh, cells were dissociated from the digested tissue for 12-15 minutes. Cell suspension was transfered in 5 ml test tubes and acetylcholine was added for the final concentration to be 10⁻¹⁴~10⁻⁹M. To find the optimal time to fix the cells to determine the contractile responses, 1% acrolein was added 5, 10, 20, 30, 60 and 120 seconds after the administration of ACh. The length of cells fixed by acrolein were measured by microscaler vis CCTV camers on phaes-contrast microscope. The average length of 50 cells from a slide glass was taken as the value of a sample at the very concentration point. Single cells were isolated from canine detrusor. The length of untreated cells varied from 82 µm to 94 µm. The maximal response to actylcholine 10E-9M was accomplished within 5 seconds of exposure, and the shortening was 19±3%. Atropine reduced the contraction of the cells concentration-dependently. Lmipramine which exerts a cholinergic blocking action on some smooth muscles also reduced the contraction concentration-dependently and by a similar pattern as atropine. These findings document that imipramine may exerts a cholinergic blocking activity in the single smooth muscle cells isolated from canine urinary bladder.
Acetylcholine ; Acrolein ; Animals ; Atropine ; Calcium ; Collagenases ; Glass ; Hydrogen-Ion Concentration ; Imipramine* ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Rats ; Serum Albumin, Bovine ; Soybeans ; Urinary Bladder

No abstract available.
Child* ; Humans ; Thyroid Gland* ; Thyroid Nodule*

Over the past 10 years, considerable advances have been made in the surgical treatment of pituitary adenomas, with a high incidence of complete tumor removal reported. Increasing use of surgical magnification for surgery of the sellar region has created a need for more detailed surgical anatomical studies of this area and for special attention to the anatomical variants important to the transfrontal and transsphenoidal surgical approaches. The author discussed the surgical problems conderning hypersecretory pituitary adenomas. Here, there is a triple objective:treatment of the tumor, treatment of the hyperhormonism and the prevention of postoperative recurrences and complications. In this paper, an attempt has been made to correlate a surgical management of pituitary tumor characteristics with 1) microsurgical anatomy of the sella region; 2) surgical approaches and indication; 3) surgical complications; 4) comparison of therapentic options between surgical and medical treatment; 5) pituitary adenoma and pregnancy; 6) management of recurrent hyperfunctional pituitary adenomas; 7) pre-and postoperative radiation therapeutic effects.
Acromegaly ; Incidence ; Pituitary Neoplasms* ; Pregnancy ; Prolactinoma ; Recurrence