PURPOSE: This study was done to examine the association between body mass index (BMI) and any type of clinical dementia. METHODS: Participants were 60,321 people over 60 years of age enrolled in the Seoul Dementia Management Project in 2011. K-MMSE was used to classify participants as having a cognitive impairment and the Clinical Dementia Rating or DSM-IV by psychiatrists or neurologists to determine whether participants were in the dementia group or the non-dementia group. Descriptive statistics, chi-square test, and binary logistic regression analysis were performed. RESULTS: In the univariate analysis, age, education level, living with spouse, BMI, alcohol consumption, and exercise were significantly associated with dementia. In multivariable analysis, increasing age was positively associated with dementia, and educational level was negatively associated with dementia. The exercise group had a lower prevalence of dementia than the non-exercise group. The odds ratio of dementia in the over-weight and obese groups compared to the normal group was 0.85 (95% CI 0.60, 0.98) and 0.64 (95%CI 0.46, 0.75), respectively. CONCLUSION: Results indicate that dementia is negatively associated with increasing BMI in people aged 60 years or older, but a prospective cohort study is needed to elucidate the causal effect relationship between BMI and dementia.
Aged ; Aged, 80 and over ; Alcohol Drinking ; Body Mass Index ; Cross-Sectional Studies ; Dementia/*epidemiology ; Exercise ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; Residence Characteristics ; Risk Factors ; Smoking

PURPOSE: This study is to identify the types of role awareness of home health care specialists working at medical institutions, to understand their role awareness correctly by grasping the quality of each type, and to provide useful help in the education of home health care specialists. METHOD: Q-methodology is used to objectify role awareness of medical institution specialists who may recognize situations differently according to their individual experience and comprehension based on the view of behavior. Q-classification was carried out on 30 home health care specialists working at medical institutions using 30 selected questions. Collected data were examined through factor analysis using QUANL PC program. RESULTS: Three different types of role awareness of home health care specialists working at medical institutions were identified. Type I is "educational-function-centered", Type II "patient-centered" and Type III "professional-service-centered". CONCLUSION: Regardless of these types, home health care specialists commonly had a high pride as a specialist and a sense of mission regarding themselves as important persons responsible for patients' health.
Comprehension ; Delivery of Health Care* ; Education ; Hand Strength ; Humans ; Missions and Missionaries ; Specialization*

PURPOSE: To report the results of 134 cases in which add-on stereotactic core biopsy (ASCB) was performed in patients with mammographically detected breast lesions, and to evaluate the usefulness of this procedure. MATERIALS AND METHODS: We analyzed the results of ASCB of 134 breast lesions in 125 patients, performed during a 41-month period. The mammographic findings were suspicious malignant lesion in 38 cases, benign lesion in 18, and indeterminate lesion in 78. Surgical excision was performed in 23 cases, and follow-up mammography in 39. We analyzed the pathologic results according to each mammographic finding and correlated the results of core biopsy with those of surgical excision. We also evaluated the mammographic changes seen during follow-up, and associated complications and procedural difficulties. RESULTS: Samples were adequate for pathologic diagnosis in 95% of cases (127/134). ASCB revealed malignancy in 47% of cases (18/38) in which this was suspected on the basis of mammographic findings, and in 5% of cases (4/78) in which these findings were indeterminate. The pathologic results of core biopsy and of surgical excision agreed in 78% of cases (18/23). In two of five false-negative cases, ASCB revealed the presence of atypical ductal hyperplasia. The mammographic findings in these five cases were suspicious malignancy in three, and indeterminate in two. Specimen radiography showed calcifications in four cases. The size or extent of mammographic lesions did not change during the mean follow-up period of 17.3 months. In 13/125 patients (10%), the complications and procedural difficulties noted included arterial bleeding, dizziness, syncope, patient movement, and instrument failure. CONCLUSION: ASCB is accurate, safe and useful, but surgical excision should be considered when the ASCB result is either atypical ductal hyperplasia or benign but with mammographic diagnosis of suspicious malignant or indeterminate lesions.
Biopsy* ; Breast* ; Diagnosis ; Dizziness ; Follow-Up Studies ; Hemorrhage ; Humans ; Hyperplasia ; Mammography ; Radiography ; Syncope

PURPOSE: To evaluate the CT findings of tuberculous pericardial effusion. MATERIALS AND METHODS: In 12patients with tuberculous pericardial effusion. CT scans were obtained. The condition was diagnosed by thepresence of chronic granulomatous inflammation with caseous granuloma or acid fast bacilli in a biopsy specimen orpericardial fluid. CT findings were evaluated with regard to the appearance and the location of pericardialthickening, location of pericardial effusion, loculation of the pericardial effusion by adhesion of pericardiumand associated findings such as pulmonary tuberculosis or pleural effusion. RESULTS: In all cases, pericardialeffusion and thickening were seen. This thickening was usually even(10 of 12 cases), and occurred mainly in theanterior portion(7 of 12 cases). Thickened pericardium was enhanced and showed higher attenuation than adjacentchest wall muscle. Effusion was usually found in the anterior portion(10 of 12 cases), though the right and leftside were also involved(5/12 and 6/12 cases, respectively). Loculation of pericardial effusion was noted in tencases. Pleural effusion occurred in eight cases and associated active pulmonary tuberculosis in five. CONCLUSION: The CT findings of tuberculous pericardial effusion are enhanced evenly-thickened pericardium and anteriorloculated pericardial effusion, and are helpful for the diagnosis of tuberculous pericardial effusion.
Biopsy ; Diagnosis ; Granuloma ; Inflammation ; Pericardial Effusion* ; Pericardium ; Pleural Effusion ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: To describe the chest radiographic and CT findings of diffuse pulmonary hemorrhage. MATERIALS AND METHODS: Two radiologists retrospectively analysed the chest radiographic and CT findings of six patients withdiffuse pulmonary hemorrhage. Using open lung biopsy (n=2) and transbronchial lung biopsy or bronchoalveolarlavage (n=4), diagnosis was based on the presence of hemosiderin-laden macrophage or intra-alveolar hemorrhage.Underlying diseases were Wegener's granulomatosis (n=2), antiphospholipid antibody syndrome (n=2),Henoch-Schonlein purpura (n=1), and idopathic pulmonary hemosiderosis (n=1). In all patients, sequential chestradiographs, obtained during a one to six-month period, were available. HRCT scans were obtained in five patients,and conventional CT scans in one. Follow-up HRCT scans were obtained in two. We also analyzed the patterns ofinvolvement, distribution and sequential changes in the pulmonary abnormalities seen on chest radiographs and CTscans. RESULTS: Chest radiographs showed multifocal patchy consolidation (n=6), ground-glass opacity (n=3), andmultiple granular or nodular opacity (n=3). These lesions were intermingled in five patients, while in one therewas consolidation only. Sequential chest radiographs demonstrated the improvement of initial pulmonaryabnormalities and appearance of new lesions elsewhere within 5-6 days, though within 7-25 (average, 13) days,these had almost normalized. HRCT scans showed patchy consolidation (n=5), multiple patchy ground-glass opacity(n=5), or ill-defined air space nodules (n=4). These lesions were intermingled in five patients, and in one,ground-glass opacity only was noted. In two patients there were interlobular septal thickening and intralobularreticular opacity. The distribution of these abnormalities was almost always bilateral, diffuse with no zonalpredominancy , and spared the apex of the lung and subpleural region were less affected. CONCLUSION: Althoughchest radiographic and CT findings of diffuse pulmonary hemorrhage are nonspecific, sequential changes inbilateral multifocal patchy consolidation and ground-glass opacity, accompanied by clinical symptoms such ashemoptysis or anemia, may be helpful in the diagnosis of diffuse pulmonary hemorrhage.
Anemia ; Antiphospholipid Syndrome ; Biopsy ; Diagnosis ; Follow-Up Studies ; Hemorrhage* ; Hemosiderosis ; Humans ; Lung ; Macrophages ; Purpura ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed ; Wegener Granulomatosis

PURPOSE: Bone morphogenic protein (BMP)-7, a member of TGF-beta1 superfamily, is an endogenous antifibrotic protein highly expressed in normal kidney. It is not known, however, whether human peritoneal mesothelial cells (HPMC) express BMP-7 or if BMP-7 protects against peritoneal fibrosis and by what mechanism. We examined the effect of BMP-7 overexpression in TGF-beta1-induced epithelial-mesenchymal transition (EMT) of HPMC and in TGF-beta1 signaling in HPMC to elucidate the mechanisms of antifibrotic effect of BMP-7. METHODS: Growth arrested and synchronized HPMC were stimulated with 2 ng/mL of TGF-beta1 to induce EMT. HPMC were transiently transfected with adenovirus-mediated human BMP-7 (AdBMP-7) or with GFP (AdGFP). EMT was defined as downregulation of E-cadherin and upregulation of alpha-smooth muscle actin (SMA). RESULTS: HPMC constitutively expressed BMP-7 mRNA and protein. BMP-7 mRNA and protein expression were significantly inhibited by 50 mM D-glucose, 2x diluted commercial peritoneal dialysis solution, and 2 ng/ml of TGF-beta1. Transfection of AdBMP-7 resulted in 2.5-fold increase in BMP-7 mRNA expression in HPMC. TGF-beta1 significantly decreased E-cadherin and increased alpha-SMA expression in GFP transfected cells. BMP-7 overexpression effectively reversed TGF-beta1-induced E-cadherin and alpha-SMA expression and significantly suppressed TGF-beta1-induced phosphorylation of Smad2/3, ERK1/2, JNK, and p38 MAPK in HPMC as compared to GFP transfected cells. CONCLUSION: BMP-7 is an endogenous antifibrotic protein and downregulation of BMP-7 in HPMC by high glucose, PD solution, and TGF-beta1 may permit the development of peritoneal fibrosis during long-term PD. Our data demonstrate that BMP-7 overexpression reverses TGF-beta1-induced EMT of HPMC and consequent peritoneal fibrosis possibly through inhibition of Smad2/3 and MAPK phosphorylation.
Actins ; Bone Morphogenetic Protein 7* ; Cadherins ; Down-Regulation ; Epithelial-Mesenchymal Transition ; Glucose ; Humans ; Kidney ; p38 Mitogen-Activated Protein Kinases ; Peritoneal Dialysis ; Peritoneal Fibrosis ; Peritoneum* ; Phosphorylation ; RNA, Messenger ; Transfection ; Transforming Growth Factor beta1 ; Up-Regulation

OBJECTIVES: This study aimed to evaluate the healing rate of non-surgical endodontic treatment between C-shaped and non-C-shaped mandibular second molars. MATERIALS AND METHODS: Clinical records and radiological images of patients who had undergone endodontic treatment on mandibular second molars between 2007 and 2014 were screened. The periapical index scoring system was applied to compare healing outcomes. Information about preoperative and postoperative factors as well as the demographic data of the patients was acquired and evaluated using chi-square and multinomial logistic regression tests. RESULTS: The total healing rate was 68.4%. Healing rates for the mandibular second molar were 70.9% in C-shaped canals (n = 79) and 66.6% in non-C-shaped ones (n = 117). The difference was not statistically significant. CONCLUSIONS: The presence of a C-shaped canal in the mandibular second molar did not have a significantly negative effect on healing after treatment. Instead, proper pulpal diagnosis and final restoration were indicated as having significantly greater influence on the healing outcomes of C-shaped and non-C-shaped canals, respectively.
Dental Pulp Cavity* ; Diagnosis ; Humans ; Logistic Models ; Molar* ; Retrospective Studies*

No abstract available.
Catheters* ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Fetal Therapies* ; Lung*

PURPOSE: To assess the value of the bolus-tagging method for improving the image quality of contrast-enhanced MR abdominal angiography, and to evaluate the relationship between peak arterial enhancement time and patients' age, weight and heart rate. MATERIALS AND METHODS: Contrast-enhanced 3D FISP abdominal MR angiography was performed in 81 patients during a four-month period. The bolus-tagging method was used in a study group comprising 33 patients, and to this end, 1 ml of Gd-DTPA (gadolinium-diethylenetriamine penta-acetic acid) was administered. thirty sequential images (1 image/sec) were then obtained using turbo-FLASH sequencing. After determining peak arterial enhancement time from the time-to-signal intensity curve, optimal scan delay time can be calculated according to the formula used in our patient series. The 48 patients in whom the bolus-tagging method was not used comprised the control group ; in the study group scanning commenced at the optimal scan delay time (and at 10 seconds in the control group) after the administration of 0.2 mM/kg Gd-DTPA using an automatic power injector. Using a three-point scale we evaluated and compared between the two groups the success with which arterial images were obtained. In addition, vascular visibility -an indication of the quality of arteries and veins-was determined using a four-point scale. In the study group, the relationship between peak arterial enhancement time and patients' age, weight heart rate was also assessed. RESULTS: Pure arterial images were successfully obtained in 32 patients (97%) in the study group and in 40 (83%) in the control group. This difference was not statistically significant (p>.05). With regard to vascular visibility, diagnostic arterial images were seen in 30 patients (91%) in the study group and in 33 patients (69%) in the control group; arterial visibility was significantly better in the study group (p=.0197). On the other hand, the diagnostic venous images were seen in 31 patients (94%) in the study group and in 36 (75%) in the control group; there was no significant difference between the two groups (p=.2367). Peak arterial enhancement time increased significantly with age (r=.443, p=.0098); no correlation,however was seen between peak arterial enhancement time and weight (p>.05) or heart rate (p>.05). CONCLUSION: Used with contrast-enhanced 3-D FISP MR abdominal angiography, the bolus-tagging method provides better arterial visibility. Peak arterial enhancement time increased significantly with age.
Angiography* ; Arteries ; Gadolinium ; Gadolinium DTPA ; Hand ; Heart Rate ; Humans

PURPOSE: To assess the value of the bolus-tagging method for improving the image quality of contrast-enhanced MR abdominal angiography, and to evaluate the relationship between peak arterial enhancement time and patients' age, weight and heart rate. MATERIALS AND METHODS: Contrast-enhanced 3D FISP abdominal MR angiography was performed in 81 patients during a four-month period. The bolus-tagging method was used in a study group comprising 33 patients, and to this end, 1 ml of Gd-DTPA (gadolinium-diethylenetriamine penta-acetic acid) was administered. thirty sequential images (1 image/sec) were then obtained using turbo-FLASH sequencing. After determining peak arterial enhancement time from the time-to-signal intensity curve, optimal scan delay time can be calculated according to the formula used in our patient series. The 48 patients in whom the bolus-tagging method was not used comprised the control group ; in the study group scanning commenced at the optimal scan delay time (and at 10 seconds in the control group) after the administration of 0.2 mM/kg Gd-DTPA using an automatic power injector. Using a three-point scale we evaluated and compared between the two groups the success with which arterial images were obtained. In addition, vascular visibility -an indication of the quality of arteries and veins-was determined using a four-point scale. In the study group, the relationship between peak arterial enhancement time and patients' age, weight heart rate was also assessed. RESULTS: Pure arterial images were successfully obtained in 32 patients (97%) in the study group and in 40 (83%) in the control group. This difference was not statistically significant (p>.05). With regard to vascular visibility, diagnostic arterial images were seen in 30 patients (91%) in the study group and in 33 patients (69%) in the control group; arterial visibility was significantly better in the study group (p=.0197). On the other hand, the diagnostic venous images were seen in 31 patients (94%) in the study group and in 36 (75%) in the control group; there was no significant difference between the two groups (p=.2367). Peak arterial enhancement time increased significantly with age (r=.443, p=.0098); no correlation,however was seen between peak arterial enhancement time and weight (p>.05) or heart rate (p>.05). CONCLUSION: Used with contrast-enhanced 3-D FISP MR abdominal angiography, the bolus-tagging method provides better arterial visibility. Peak arterial enhancement time increased significantly with age.
Angiography* ; Arteries ; Gadolinium ; Gadolinium DTPA ; Hand ; Heart Rate ; Humans