PURPOSE: The purpose of this study was to survey the prevalence rate of cognitive impairments and to identify the factors influencing cognitive impairment in the elderly in rural communities of Jeju Province. METHODS: 590 elderly in 6 rural communities of Jeju Province were interviewed, using a questionnaire consisting of sociodemographic characteristics, health behavior, quality of life, and MMSE-K RESULTS: Prevalence of cognitive impairment was 33.1% (39.1% of females, 16.76% of males). Prevalence of dementia was 12.4% (16.3% of females, 2.87% of males). Factors related to cognitive impairment were age, sex, education, standard of living, employment status, and subjective health state. CONCLUSIONS: In community health care for the elderly, factors relating to cognitive impairment have to be considered. When planning community health care, priority should be given to the elderly; who need care but live alone; who lack social support; who have a low standard of living; who experience discomfort in the activities of daily living; who believe they are not in a good state of health; or whose life satisfaction is low.

No abstract available.
Bowen's Disease*

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

Data pools and their integration are fueling the big data revolution in health care with the recent advances in information technology. Korea has shown tremendous promise in the utilization of big data for its advanced technology, computerized health data, and unique identifiers. However, the Personal Information Protection Act (PIPA) severely limits access to personal identifiers, which has discouraged the use of health data even for the public good. In contrast, western countries have focused on research without the use of identifiers, which has augmented the use of the available data while maintaining and respecting privacy; they have allowed some exemptions of informed consent and utilized limited data sets, which have the identifiers removed. The amount of research output has increased rapidly and an in-depth understanding of cancer has been made possible based on the linkage of Surveillance, Epidemiology, and End Results (SEER) and Medicare in the US. More than 700 projects covering a wide range of medical areas have been conducted, which has led to changes in clinical practice based on the Western Australian Data Linkage System. Although rare, evidence-driven decisions based on data linkage have been found in some cases in Korea; the adoption of prostate cancer screening as a national screening program was suspended as its cost-effectiveness has not been verified on the basis of data linkage by the National Evidence-Based Healthcare Collaboration Agency. For the active use of health data, there is an urgent need to amend PIPA, prepare regulations for data analysis, and foster collaboration among data-related institutions. Great projects based on data linkage will guarantee the world's leading research output and will be major sources for moving forward to success.
Computer Security ; Cooperative Behavior ; Dataset ; Delivery of Health Care* ; Epidemiology ; Evidence-Based Practice ; Humans ; Information Storage and Retrieval ; Informed Consent ; Korea ; Mass Screening ; Medicare ; Privacy ; Prostatic Neoplasms ; Social Control, Formal ; Statistics as Topic

Following results were obtained from the light microscopic and stereomicroscopic observations of the breasts of rats treated with 9, 10-Dimethyl-1,2-Benzanthracene(DMBA). 1) Adenocarcinomas developed in 17 rats (24%) among 70 DMBA-treated rats. 2) Terminal and buds (TEB) were observed longer in DMBA-treated rats than in control group, but they finally disppeared 4 monthes after treatment. 3) Many hyperplastic alveolar nodules (HAN) developed in DMBA-treated rats. 4) There were no transitional lesions between TEB and adenocarcinoma or HAN and adenocarcinoma. 5) The number of lobules was decreased in DMBA-treated rats. On the other hand, terminal ducts were increased in number. These findings suggest that DMBA stimulate the regression of lobules and induce to form terminal ducts from which adenocarcinomas and HAN develop independently.
Rats ; Animals ; Adenocarcinoma ; Breast Neoplasms

Overgrowth syndromes comprise a diverse group of conditions with unique clinical, behavioral and molecular genetic features. While considerable overlap in presentation sometimes exists, advances in identification of the precise etiology of specific overgrowth disorders continue to improve clinicians' ability to make an accurate diagnosis. Among them, this paper introduces two classic genetic overgrowth syndromes: Sotos syndrome and Beckwith-Wiedemann syndrome. Historically, the diagnosis was based entirely on clinical findings. However, it is now understood that Sotos syndrome is caused by a variety of molecular genetic alterations resulting in haploinsufficiency of the NSD1 gene at chromosome 5q35 and that Beckwith-Wiedemann syndrome is caused by heterogeneous abnormalities in the imprinting of a number of growth regulatory genes within chromosome 11p15 in the majority of cases. Interestingly, the 11p15 imprinting region is also associated with Russell-Silver syndrome which is a typical growth retardation syndrome. Opposite epigenetic alterations in 11p15 result in opposite clinical features shown in Beckwith-Wiedemann syndrome and Russell-Silver syndrome. Although the exact functions of the causing genes have not yet been completely understood, these overgrowth syndromes can be good models to clarify the complex basis of human growth and help to develop better-directed therapies in the future.
Beckwith-Wiedemann Syndrome* ; Epigenomics ; Genes, Regulator ; Genomic Imprinting ; Haploinsufficiency ; Humans ; Molecular Biology ; Silver-Russell Syndrome ; Sotos Syndrome*

Craniosynostosis is defined as the premature fusion of one or more of the cranial sutures. It leads not only to secondary distortion of skull shape but to various complications including neurologic, ophthalmic and respiratory dysfunction. Craniosynostosis is very heterogeneous in terms of its causes, presentation, and management. Both environmental factors and genetic factors are associated with development of craniosynostosis. Nonsyndromic craniosynostosis accounts for more than 70% of all cases. Syndromic craniosynostosis with a certain genetic cause is more likely to involve multiple sutures or bilateral coronal sutures. FGFR2, FGFR3, FGFR1, TWIST1 and EFNB1 genes are major causative genes of genetic syndromes associated with craniosynostosis. Although most of syndromic craniosynostosis show autosomal dominant inheritance, approximately half of patients are de novo cases. Apert syndrome, Pfeiffer syndrome, Crouzon syndrome, and Antley-Bixler syndrome are related to mutations in FGFR family (especially in FGFR2), and mutations in FGFRs can be overlapped between different syndromes. Saethre-Chotzen syndrome, Muenke syndrome, and craniofrontonasal syndrome are representative disorders showing isolated coronal suture involvement. Compared to the other types of craniosynostosis, single gene mutations can be more frequently detected, in one-third of coronal synostosis patients. Molecular diagnosis can be helpful to provide adequate genetic counseling and guidance for patients with syndromic craniosynostosis.
Acrocephalosyndactylia ; Antley-Bixler Syndrome Phenotype ; Cranial Sutures ; Craniofacial Dysostosis ; Craniosynostoses* ; Diagnosis ; Genetic Counseling ; Humans ; Skull ; Sutures ; Synostosis ; Wills

No abstract available.
Adolescent ; Capsule Endoscopy ; Endoscopy, Gastrointestinal ; Humans ; Male ; Meckel Diverticulum/*diagnosis/radionuclide imaging/surgery ; Radiography, Abdominal ; Radiopharmaceuticals/diagnostic use ; Sodium Pertechnetate Tc 99m/diagnostic use ; Surgical Instruments ; Tomography, X-Ray Computed

Recent research has demonstrated that genetic alterations or variations contribute considerably to the development of congenital heart disease. Many kinds of genetic tests are commercially available, and more are currently under development. Congenital heart disease is frequently accompanied by genetic syndromes showing both cardiac and extra-cardiac anomalies. Congenital heart disease is the leading cause of birth defects, and is an important cause of morbidity and mortality during infancy and childhood. This review introduces common genetic syndromes showing various types of congenital heart disease, including Down syndrome, Turner syndrome, 22q11 deletion syndrome, Williams syndrome, and Noonan syndrome. Although surgical techniques and perioperative care have improved substantially, patients with genetic syndromes may be at an increased risk of death or major complications associated with surgery. Therefore, risk management based on an accurate genetic diagnosis is necessary in order to effectively plan the surgical and medical management and follow-up for these patients. In addition, multidisciplinary approaches and care for the combined extra-cardiac anomalies may help to reduce mortality and morbidity accompanied with congenital heart disease.
22q11 Deletion Syndrome ; Congenital Abnormalities ; Diagnosis ; Down Syndrome ; Follow-Up Studies ; Heart Defects, Congenital* ; Humans ; Mortality ; Noonan Syndrome ; Perioperative Care ; Risk Management ; Turner Syndrome ; Williams Syndrome

No abstract available.
Female ; Humans ; Osteoporosis* ; Uterine Prolapse*