Dementia is the progressive or chronic dysfunction of cortical or subcortical functions that results in complex cognitive decline and Alzheimer's disease is the most common etiology of dementia. Currently, causal genetic mutations such as amyloid precursor protein, presenilin 1, presenilin 2 in familial Alzheimer's disease and many susceptible genes including polymorphysm of apolipoprotein E have been reported. Furthermore, genetic testings are available in person at risk for Alzheimer's disease. However, besides from results of genetic testing, there are many issues such as economics, ethics, psychological and legal. So clinician should be considered these complexities before ordering genetic test for patients with/without Alzheimer's disease.
Alzheimer Disease ; Amyloid ; Apolipoproteins ; Dementia ; Genetic Testing ; Humans ; Presenilin-1 ; Presenilin-2

INTRODUCTIONWe performed this study to find clinical features and laboratory parameters that could facilitate the process of selecting patients who should receive lumbar punctures from among those who present with headache and fever.

METHODSWe selected patients aged ≥ 16 years who presented to and received lumbar puncture in the emergency department of Kangwon National University Hospital, South Korea, between 2011 and 2013. Patients who received lumbar punctures were divided into two groups - those who were diagnosed with viral meningitis and those who were not. We compared the clinical features and laboratory data between the two groups. Key indices were then used to develop a scoring system to diagnose viral meningitis in patients and identify those who should receive lumbar punctures.

RESULTSAmong the patients who were included in the study, 42 had viral meningitis and 96 did not. The variables of C-reactive protein level ≤ 1.291 mg/dL, neck stiffness and vomiting were assigned 3 points, 2 points and 1 point, respectively, in the scoring system. Overall scores ≥ 4 yielded a positive likelihood ratio of 7.79 (sensitivity 0.600, specificity 0.923), while negative likelihood ratio decreased to less than 0.1 (0.072) for overall scores < 3.

CONCLUSIONUsing the proposed scoring system, we were able to determine the likelihood of viral meningitis in patients presenting with fever and headache, and to successfully identify those who should receive lumbar punctures.

PURPOSE: This study was to evaluate the effects of foot reflexology on depression and anxiety in coal workers' pneumoconiosis. METHOD: The research design used was a non-equivalent control group pretest-posttest design. The foot reflexology was performed for 60 minutes twice a week through five weeks in the experimental group, not in the control group. The subjects of this study consisted of both the experimental group of twenty-nine and the control group of thirty coal workers' pneumoconiosis. The data were collected from December 10, 2002 to February 15, 2003. To evaluate the effects of foot reflexology the scores of depression and anxiety were measured before and after the experiment in both groups. Data of this experiment were analyzed by Chi-square test, t-test, unpaired t-test, ANCOVA and Repeated Measures ANOVA with the SAS Program. RESULTS: The score of depression decreased in the experimental group, not in the control group. There was a significant difference of depression between the two groups. The score of anxiety decreased in the experimental group, not in the control group. There was a significant difference of anxiety between the two groups. CONCLUSION: As a summary of the study results, foot reflexology was regarded that it attributed to the emotional promotion of coal workers' pneumoconiosis. Therefore the foot reflexology is considered that might be used as an effective skill of nursing intervention program for coal workers' pneumoconiosis.
Anxiety* ; Coal* ; Depression* ; Foot* ; Massage* ; Nursing ; Pneumoconiosis* ; Research Design

PURPOSE: Lung injury imposed by hyperoxia is the most important cause of bronchopulmonary dysplasia (BPD) in premature lungs, and hyperoxia has the chief biological effect of inducing cell death. The objective of this study was to investigate the response of cell death in fetal alveolar type II cells (FATIICs) exposed to different concentrations of hyperoxia for 36 h. METHODS: FATIICs were isolated on embryonic day 19 and exposed to 65%- or 85%-oxygen for 36 h. Cells in room air were used as controls. FACScan was performed in hyperoxic and control samples at 0/6/12/24/36 h, and the patterns of cell death were compared at each time point using flow-cytometry. RESULTS: Cell necrosis as measured by selective propidium iodide staining increased significantly from 12 h of 65%-hyperoxia and 6 h of 85%-hyperoxia, respectively. Cell necrosis increased 1.6-fold, 3.0-fold and 4.6-fold after 12 h, 24 h, and 36 h, respectively during 65%-hyperoxia and increased by 2.4-fold, 3.1-fold, 6.3-fold, and 8.8-fold after 6 h, 12 h, 24 h, and 36 h, respectively during 85%-hyperoxia compared to controls. Apoptotic cells as measured by selective Annexin-V staining peaked at 1.3% at 24 h of 65%-hyperoxia and peaked at 1.2% at 6 h of 85%-hyperoxia, respectively and then decreased rapidly. CONCLUSION: This study shows that exposure to sublethal and lethal hyperoxia increases necrosis of FATIICs remarkably from the early stage of hyperoxia. These findings support the idea that short-term exposure to oxygen from birth may contribute to the evolution of "new" BPD in preterm lungs.
Bronchopulmonary Dysplasia ; Cell Death ; Humans ; Hyperoxia ; Infant, Newborn ; Lung ; Lung Injury ; Necrosis ; Oxygen ; Parturition ; Propidium

A High concentration of oxygen (>40%) is used as a life-saving therapy in preterm newborns since birth. By generating excess reactive oxygen species, however, hyperoxia can cause lung injury leading to bronchopulmonary dysplasia (BPD). Although hyperoxia-induced lung injury contributes to the evolution of BPD, the mechanisms by which hyperoxia contributes to the genesis of lung injury in preterm lungs are not yet fully defined, and there are no specific measures for the protection of preterm lungs against injury secondary to hyperoxia. Alveolar type II cells are key components of the alveolar structure, and they are responsible for the restoration of normal alveolar epithelium after acute lung injury. However, hyperoxia is primarily delivered to the alveolar epithelium and alveolar type II cells can be the main target for the injury secondary to hyperoxia. To date, my researches have been focused on injury of fetal alveolar type II cells exposed to hyperoxia and the role of anti-inflammatory cytokine, IL-10 minimizing fetal type II cell injury induced by hyperoxia. Based on my previous studies, this article summarizes the cellular and molecular mechanisms of fetal type II cell injury induced in the early stage of hyperoxia and the protective potency of IL-10 in fetal alveolar type II cells and neonatal lungs injured by hyperoxia.
Acute Lung Injury ; Bronchopulmonary Dysplasia ; Epithelium ; Humans ; Hyperoxia ; Infant, Newborn ; Interleukin-10 ; Lung ; Lung Injury ; Oxygen ; Parturition ; Reactive Oxygen Species

Neonatologists are deeply concerned with the concept of ventilator-induced lung injury (VILI) and they are greatly careful in the neonatal intensive care unit to apply positive-pressure ventilation (PPV) strategies that are gentle to the lungs. To achieve adequate gas exchange after delivery, lung fluid should be cleared and replaced with air, and functional residual capacity (FRC) should be established. However preterm newborns have difficulties establishing FRC and maintaining upper airway patency at birth. Hence majority of preterm newborns need some assistance to initiate breathing after birth and some require extensive resuscitation. PPV is therefore commonly used in the delivery room, however most clinicians including neonatologists or obstetricians appear less aware that the gentle approach as in NICU should be applied to prevent lung injury during the first few minutes of life. PPV may cause lung injury through various mechanisms such as high Vt (tidal volume) and overdistension (volutrauma), repeated alveolar collapse and re-expansion (atelect-trauma), and infection and inflammation (biotrauma), through which leads to epithelial cell injury, leakage of proteinaceous fluid into the lungs, inhibiting surfactant function and interfering lung mechanics, and consequently generating lung injury. In this review, I describe briefly what causes preterm lung injury during PPV based on animal and human researches, and I suggest some strategies to help minimize lung injury during resuscitation of preterm newborns in the delivery room.
Animals ; Delivery Rooms ; Epithelial Cells ; Functional Residual Capacity ; Humans ; Infant, Newborn ; Inflammation ; Intensive Care, Neonatal ; Lung ; Lung Injury ; Mechanics ; Parturition ; Positive-Pressure Respiration ; Respiration ; Resuscitation ; Ventilator-Induced Lung Injury

No abstract available.
Spleen ; Embolization, Therapeutic ; Liver Cirrhosis

Objective: To investigate the feasibility of a public health center-based aerobic and resistance training program for primary prevention of cardiovascular disease in people with visual, auditory, or physical/brain impairments. Methods: The study included 25 adults aged >40 years who lived in Cheorwon-gun in South Korea, had a disability registered for visual, auditory, or physical/brain impairments under the Disability Welfare Act, and had either known cardiovascular disease or two or more risk factors for cardiovascular disease. The program comprised four education sessions and 12 weeks of customized aerobic and strengthening exercises performed twice a week at moderate intensity, with each exercise session lasting for 1 hour. The body mass index (BMI), percent body fat, 6-minute walk distance (6MWD), and 30-second sit-to-stand test results were measured at baseline and on program completion. Results: Seventeen subjects (68%) completed the program. There were significant decreases in BMI and percent body fat (both p<0.05), with a significant increase in 30-second sit-to-stand strength (p<0.05) but no changes in the 6MWD. In subjects with visual or auditory impairments, BMI and percent body fat were significantly decreased after the program; however, there was no significant change in the results of the 30-second sit-to-stand strength test or the 6MWD. Conclusion In people with disabilities, a 3-month community-based exercise program can decrease body mass index and percent body fat and increase sit-to-stand strength. The 30-second sit-to-stand test may be a useful measure of the strength and endurance of the lower extremities in people with disabilities.

Uterine myomas (fibroids) are the most common benign tumors in women and occur in 20%–40% of women of reproductive age. Myomas are benign monoclonal tumors that develop from the smooth muscle cells of the myometrium. Most pregnant women with myomas do not have complications during pregnancy, but complications can occur. Among the complications, pain is the most common, and the risks of miscarriage, preterm labor and delivery, abnormal positioning of the fetus, and placental abruption increase slightly. There are also concerns about the potential effects of uterine myomas on infertility and reproductive function. Therefore, there are frequent clinical concerns about the presence of myomas during pregnancy;however, the treatments are unclear. In this study, we summarize the latest trends in uterine myomas and pregnancy and consider the treatments.

Objective: To investigate the feasibility of a public health center-based aerobic and resistance training program for primary prevention of cardiovascular disease in people with visual, auditory, or physical/brain impairments. Methods: The study included 25 adults aged >40 years who lived in Cheorwon-gun in South Korea, had a disability registered for visual, auditory, or physical/brain impairments under the Disability Welfare Act, and had either known cardiovascular disease or two or more risk factors for cardiovascular disease. The program comprised four education sessions and 12 weeks of customized aerobic and strengthening exercises performed twice a week at moderate intensity, with each exercise session lasting for 1 hour. The body mass index (BMI), percent body fat, 6-minute walk distance (6MWD), and 30-second sit-to-stand test results were measured at baseline and on program completion. Results: Seventeen subjects (68%) completed the program. There were significant decreases in BMI and percent body fat (both p<0.05), with a significant increase in 30-second sit-to-stand strength (p<0.05) but no changes in the 6MWD. In subjects with visual or auditory impairments, BMI and percent body fat were significantly decreased after the program; however, there was no significant change in the results of the 30-second sit-to-stand strength test or the 6MWD. Conclusion In people with disabilities, a 3-month community-based exercise program can decrease body mass index and percent body fat and increase sit-to-stand strength. The 30-second sit-to-stand test may be a useful measure of the strength and endurance of the lower extremities in people with disabilities.