Although many drugs are currently available in the treatment of vascular dementia, there are no licensed drugs for it with proven efficacy. The major treatment efforts are therefore focused on the management of the underlying causes and control of risk factors. Antiplatelet agents or anticoagulants such as a low dose of aspirin or warfarin should be used in all patients where there is no contraindication. Hypertension should be properly controlled not to make the patient hypotensive. Blood cholesterol and triglyceride, especially LDL cholesterol, should be assessed and, if raised, treated using diet or drugs. And if the patient is diabetic, it should be controlled also. If the patient is a smoker, they should be encouraged to stop smoking. Supportive measures such as gait retraining, prophylaxis against limb contractures, and speech therapy are indicated in selected patients. Pathophysiological processes common to both vascular dementia and dementia of Alzheimer's type may include microglial activation, increased production of cytokines, free radicals and glutamate. Propentofylline, a neuroprotective glial cell modulator, has been shown to be effective in the management of the patients with Alzheimer's disease or vascular dementia. Other therapies such as estrogen, non-steroid anti-inflammatory drugs and anti-oxidants such as vitamin E/selegiline (MAO-B inhibitor), Gingko biloba are sometimes used and show promise in delaying the progression of dementia. But several further clinical trials are needed to determine whether these new therapies can be successfully used in patients with vascular dementia or dementia of Alzheimer's type.
Alzheimer Disease ; Anticoagulants ; Aspirin ; Cholesterol ; Cholesterol, LDL ; Contracture ; Cytokines ; Dementia ; Dementia, Vascular* ; Diet ; Drug Therapy* ; Estrogens ; Extremities ; Free Radicals ; Gait ; Ginkgo biloba ; Glutamic Acid ; Humans ; Hypertension ; Neuroglia ; Platelet Aggregation Inhibitors ; Risk Factors ; Smoke ; Smoking ; Speech Therapy ; Triglycerides ; Vitamins ; Warfarin

OBJECTIVE: The golden standard of serodiagnosis of HFRS is IFA(indirect immunofluorescence antibody test). However, positive IFA for IgG antibody does not always correlate with current infection because IFA may be positive due to past exposure to Hantaan virus such as subclincal infection or due to vaccination in endemic area. So supplementary diagnostic method is needed to diagnosis of HFRS with more accuracy. METHODS: In this study, the usefulness of IgG avidity assay with 8 mole/l urea in diagnosis of HFRS was investigated. Serum samples from 45 patients with acute phase HFRS and 79 residents of endemic area, who had HFRS antibody were tested for IgG avidity. RESULTS: The distribution of IgG avidity index of HFRS antibody was different acute phase of HFRS patients from endemic area residents(p<0.001). Patients with acute phase HFRS exhibited lower avidity of Hantaan virus-specific IgG (mode of 64 of avidity index), in contrast endemic area resident had a higher avidity (mode of 4 of avidity index). CONCLUSION: The IgG avidity assay should assist in the diagnosis of acute phase HFRS and may be used to identify recent infection and past exposure to Hantaan virus.
Diagnosis* ; Fluorescent Antibody Technique ; Hantaan virus* ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Immunoglobulin G* ; Serologic Tests ; Urea ; Vaccination

OBJECTIVES: This pre-clinical study was performed to assess the effects of ethaverine in the two kinds of behavioral models of depression in rats. METHODS: We observed the changes of the immobility time in the forced swimming test and the quantity of sucrose consumed in the chronic mild stress model, using ethaverine(20mg/kg) alone, imipramine(20mg/kg) alone, or ethaverine and imipramine concomitantly. RESULTS: In the forced swimming test, both single treatment and chronic treatment(for 7 days) with imipramine or ethaverine significantly reduced the immobility time, and concomitant chronic treatment with ethaverine potentiated the effect of imipramine. In the chronic mild stress model, both imipramine and ethaverine reversed the decreased sucrose consumption induced by 3-week stress and concomitantly treated ethaverine potentiated the effect of imipramine in the early phase of treatment. CONCLUSIONS: The data suggest that ethaverine can be used alone or concomitantly with other anti-depressants in the clinical situation.
Animals* ; Calcium Channels* ; Calcium* ; Depression* ; Imipramine ; Models, Animal* ; Physical Exertion ; Rats ; Sucrose

PURPOSE: To compare surgical outcomes and complications after percutaneous nephrolithotomy (PCNL) under regional or general anesthesia. MATERIALS AND METHODS: One hundred and one patients who underwent PCNL as a first-line treatment for kidney calculi between June 2004 and June 2013 were enrolled in this retrospective study. Patients were classified into two groups by anesthetic method: 77 were allocated to the regional anesthesia group and 24 to the general anesthesia group. Patient general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. RESULTS: The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes, or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anesthesia group than in the general anesthesia group (8.9+/-3.2 days vs. 11.5+/-6.9 days, respectively, p=0.025). Also, the postoperative fever rate was significantly higher in the general anesthesia group (53.2% vs. 83.3%, respectively, p=0.007). CONCLUSIONS: Regional anesthesia is as effective as general anesthesia during percutaneous nephrolithotomy and is associated with shorter hospital stays and lower rates of postoperative fever.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General* ; Fever ; Humans ; Kidney Calculi ; Length of Stay ; Methods ; Nephrostomy, Percutaneous* ; Retrospective Studies

We conducted an epidemiologic study to understand temporal and spatial patterns of hemorrhagic fever with renal syndrome (HFRS) in the Republic of Korea (ROK). We estimated the incidence among civilians in endemic areas through the active surveillance system during the major epidemic periods, from September to December, between 1996 and 1998. We also estimated the prevalence among Korean military personnel from 1995 to 1998. In addition, we assessed seroprevalence, subclinical infection rate, and vaccination rates in both civilians and military personnel. The incidence in civilians ranged from 2.1 to 6.6 per 100, 000 person-months. The annual prevalence in the military personnel was 40-64 per 100, 000 military populations, and remained generally constant throughout the study period with seasonal variation. This is the prospective epidemiologic data set on HFRS in the ROK since the inactivated Hantaan virus vaccine was licensed for use in the late 1990s. These results will be invaluable in establishing a national immunization program against HFRS.
Vaccination/statistics & numerical data ; Seroepidemiologic Studies ; Seasons ; Population Surveillance ; Military Personnel ; Korea ; Incidence ; Humans ; Hemorrhagic Fever with Renal Syndrome/*epidemiology/prevention & control ; Disease Outbreaks/*statistics & numerical data

BACKGROUND: The age group of Rubella virus (RV) infection in most industrialized nations located in temperate climates, has in large part shifted from children to young adults since introducing of the RV vaccine in late 1960's. Interestingly, there were rubella outbreaks from 1995 through 1996 in Korea, and middle and high school students were mostly affected during that time. Although continued cycling of the rubella epidemics, there were no reports about the isolation or genetic information of rubella viruses circulated in Korea. METHOD: To isolate RV circulated in Korea, and determine the phylogenetic relationship between RV strains in Korea and RV isolates from other geographic regions including vaccine strains, we inoculated nasopharyngeal secretion samples from clinically diagnosed rubella patients to Vero E6 cells, and sequenced corresponding region of the 5' E1 encoding genomic regions of RV isolates. RESULT: Seven RV strains isolated from Korea showed 93.6 to 97.8% and 98.3 to 100% sequence homologies in nucleotide and amino acid levels, respectively, compared to RA27/3 vaccine strain. Phylogenetic tree based on 359bp of RV indicated that at least two different groups of RV circulated in Korea during 1995-1996 epidemics. CONCLUSION: Our data suggested that mutant RV strains were possibly not the cause of recent rubella epidemics in Korea.
Child ; Climate ; Developed Countries ; Disease Outbreaks ; Humans ; Korea* ; Phylogeny ; Rubella virus* ; Rubella* ; Sequence Homology ; Young Adult

BACKGROUND: There is increasing interest in the use of a very low calorie diet (VLCD) as a treatment regimen for weight loss in obese subjects. This study was designed to investigate the effects and safety of a traditional Korean very-low-calory diet. METHODS: Twelve hospitalized obese patients at Dong Eui hospital in Busan city from May 1998 to December 1998 were selected. Height, body weight, blood lipids, blood insulin level, body fat, lean body mass, subcutaneous fat and visceral fat were measured. A traditional Korean VLCD was supplied for 14 days. RESULTS: Patient's body weight was significantly decreased from 83.8 kg to 78.6 kg, body fat from 32.2 kg to 28.6 kg, lean body mass from 32.2 kg to 28.6 kg, and BMI from 31.4 to 29.5, respectively (p<0.05). Total fat was significantly decreased from 807 cc to 659 cc, subcutaneous fat from 567 cc to 473 cc, visceral fat from 273 cc to 185 cc, respectively. However there were no significant changes in minerals. After VLCD intervention, total cholesterol was significantly decreased from 199 mg/dL to 166 mg/dL, HDL-cholesterol from 42 mg/dL, to 35 mg/dL, triglyceride from 158 mg/dL, to 75 mg/dL (p<0.05). The insulin area under the curve was also significantly decreased from 205 micro International-Unit/mL x 2hr to 168 micro International-Unit/mL x 2hr (p<0.05). CONCLUSION: Above findings suggested that a traditional Korean VLCD is effective and safe for short term use in terms of reducing body fat and improving insulin resistance in obese patients.
Adipose Tissue ; Body Height ; Body Weight ; Busan ; Caloric Restriction ; Cholesterol ; Diet* ; Humans ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Minerals ; Subcutaneous Fat ; Triglycerides ; Weight Loss