PURPOSE: This study investigated various factors relatied to wandering behavior of Korean elders with dementia (KED). METHODS: A sample of 160 ambulatory residents with dementia from 14 long term care facilities was used to examine demographic, individual, cognitive, physical health, and environmental characteristics by comparing wanderers (N=108) to nonwanders (N=52). Subjects were evaluated by Korean versions of the Mini-mental State Exam (K-MMSE), the Physical and Instrumental Activities of Daily Living (K-PIADL), and the Revised Algase Wandering Scale Nursing Home version (KRAWS-NH) along its six dimensions. Demographic and environmental data were also obtained. Independent sample ttests, Chi-square test, Fisher's Exact tests, and ANCOVAs were used to examine differences between wanderers and nonwanders. RESULTS: Wanderers were significantly (p<.05) older and had more limitations in K-PADL and K-IADL. The degree of overall wandering and certain features of wandering were significantly different (p<.05) by total number of residents in the facility, type of bedroom (i.e., "Ondol"), and color of bedroom and living-room walls (i.e., sky blue). CONCLUSIONS: Findings of this study may be useful in understanding wandering behavior of KEDs and thus developing more culturally specific management strategies.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Dementia/*psychology ; Demography ; Female ; Homes for the Aged ; Humans ; Korea ; Male ; Middle Aged ; Nursing Homes ; *Wandering Behavior

PURPOSE: Coronary arterial lesions after Kawasaki disease may cause coronary endothelial dysfunction without initial coronary dilatation, stenosis, and aneurysm. TTE (transthoracic echocardiography) is a non-invasive and widely used method in clinical practice. Adenosine is short acting drug and induces coronary vasodilatation. This study was designed to measure accurate coronary dysfunction by adenosine infusion. Coronary flow reserve(CFR) is defined as "the ratio of peak hyperemic to basal coronary flow velocity(CFV) in the proximal coronary vessel". CFR measurements has provided useful clinical and physiologic information in pediatric patients with congenital or acquired heart disease. METHODS: We examined 29 patients who had a history of Kawasaki disease. 19 patients discontinued low dose aspirin(5 mg/kg/d) after recovered from coronary dilatation and 10 patients have taken low dose aspirin because they had coronary dilatation. Adenosine was infused at 160 microgram/kg/min for 4 min. Diameter, velocity and integral of coronary artery were measured. RESULTS: Diameter and velocity were increased after adenosine infusion in both coronary arteries. A reduced CFR of both coronary arteries was noted in unrecovered group. CONCLUSION: CFR measured by TTE can predict the presence of significant coronary dysfunction in convalescent phase of Kawasaki disease.
Adenosine* ; Aneurysm ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Dilatation ; Echocardiography* ; Heart Diseases ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Vasodilation

A procedure descried by Fontan and Baudet in 1971 successfully bypassed the right ventricle in Tricuspid Atresia patients, after then many modification of the Fontan operation had been described and applied to many cyanotic complex heart patients. Forty patients with a variety of cardiac malformation underwent the Fontan operation at Seoul National University hospital (September 1978 to June 1986). The age at operation ranged 2 months to 18 years. Each number of cases according to basic cardiac anomaly was as follows; 17 in Tricuspid Atresia, 17 in Univertricular Heart, 2 in Double outlet of Right Ventricle, 2 in Transposition of the Great Arteries and 2 in Criss-cross heart. Total mortality rate after the Fontan operation was 50%. There was only one late death (>30 days). Mortality rate under 4 years of age (67%) was higher than that between 4 and 18 years of age (40%). we observed a significantly higher mortality for patients who, in the immediate postoperative period, had central venous pressure greater than 25cm H2O. 45% among survivals did not require further medication. Although mortality rate after the Fontan operation is much higher than that in the foreign literature, operative mortality will decline with the increased expirence of surgeon and the effective patients selection.
Arteries ; Central Venous Pressure ; Crisscross Heart ; Fontan Procedure* ; Heart ; Heart Ventricles ; Humans ; Mortality ; Postoperative Period ; Seoul ; Tricuspid Atresia

PURPOSE: Kawasaki disease is an acute systemic vasculitis syndrome of children. Although its etiology is largely unknown, epidemiological findings suggest that genetic factors play a role in the pathogenesis of Kawasaki disease. We investigated differentially expressed genes in Kawasaki patients. METHODS: we extracted bloods of Kawasaki patients in acute, subacute, convalescent phase and normal control group. Gene expressions were investigated by annealing control primer (ACP)-based GeneFishing PCR. Products were visualized after electrophoresis in 2% agarose gel and automatically sequenced. RESULTS: 165 differentially expressed genes were identified by using 120 ACPs. Expression of immunoglobulin kappa and lambda (DEG 20,45,54) significantly was down-regulated in acute and subacute phase of Kawasaki disease but up-regulated in convalescent phase. Apollon gene (DEG 64) was down-regulated in kawasaki patients. TNIK and other DEGs were also found. CONCLUSION: This findings suggest that different genetic change occur in the coarse of Kawasaki disease. Further study of differentially expressed gene using annealing control primer system may provide etiology and pathogenesis of Kawasaki disease.
Child ; Electrophoresis ; Gene Expression ; Humans ; Immunoglobulins ; Mucocutaneous Lymph Node Syndrome* ; Polymerase Chain Reaction ; Sepharose ; Systemic Vasculitis

A case of Factor V deficiency, the first case in Korea, is reported in a 9-year-old boy whose plasma concentration of Factor V was 6%. He complained of easy bruisability, prolonged bleeding from the mouth after minor trauma and hemarthrosis and flexion contracture of the right knee. His parents are heterozygous (maternal Factor V concentration 52%, paternal 40%).
Child ; Factor V Deficiency/*congenital ; Humans ; Male

No abstract available.
Cyclosporine* ; Fluorescence Polarization Immunoassay* ; Fluorescence Polarization* ; Fluorescence*

OBJECTIVE: Evaluation of how much the presence of dementia is underdiagnosed or misdiagnosed in the elderly population by themselves. METHOD: The number of self-professed dementia cases was compared to the estimated number of cases with cognitive impairment based on the Korean version of the Mini-Mental State Examination (MMSEK) employed in a nationwide survey "Need assessment of the long-term care in the elderly" in three representative areas of Korea. The would-be dementia cases were analyzed. RESULTS: Only eighteen (0.7%) of 2,638 reported the presence of dementia while 414 (15.7%) were diagnosed as having questionable cognitive impairment and 385 (14.6%) as having definite cognitive impairment on the MMSEK. On the other hand, some of the self-professed "dementia" cases were not impaired on the MMSEK. CONCLUSION: The public should be educated on clinical manifestations of dementia for its early diagnosis and appropriate treatment because they are mostly without understanding about dementia.
Aged* ; Dementia* ; Diagnosis ; Early Diagnosis ; Epidemiology ; Hand ; Humans ; Korea ; Long-Term Care

No abstract available.
Child* ; Humans

PURPOSE: Hyperhomocysteinemia is known as an independent risk factor for cardiovascular diseases such as atherosclesosis and myocardiac infarct. A common mutation in 5, 10-methylenetetrahydrofolate reductase(MTHFR) gene results in a valine for alanine substitution, which makes enzyme thermolabile and reduces enzymal activity. We examined the relation of MTHFR genetic mutation and Kawasaki disease. METHODS: We extracted DNA from the peripheral blood of Kawasaki disease patients who were treated in Ewha University Mokdong Hospital between January 2000 and June 2003, and normal children. We genotyped for the polymorphism by using PCR of known alleic varients and digested them with Hinfl restriction enzyme. Products were visualized after electrophoresis in 2.5% agarose gel. RESULTS:The respective prevalence of the homozygous and heterozygous genotypes(CC genotype, CT genotype, TT genotype) was 33.3%, 38.9%, and 27.8% in the control group and 31.3%, 47.9%, and 20.8% in the Kawasaki disease group(P>0.05). CONCLUSION:The mutation of MTHFR gene shows no relation to development of coronary artery complications in Kawasaki disease.
Alanine ; Cardiovascular Diseases ; Child ; Coronary Vessels ; DNA ; Electrophoresis ; Gene Expression* ; Genotype ; Humans ; Hyperhomocysteinemia ; Methylenetetrahydrofolate Reductase (NADPH2) ; Mucocutaneous Lymph Node Syndrome* ; Polymerase Chain Reaction ; Prevalence ; Risk Factors ; Sepharose ; Valine

PURPOSE: We evaluated the diagnostic implications and therapeutic efficacy of antithrombin III(AT III) in the disseminated intravascular coagulation(DIC) of premature infants. METHODS: Ninety-two premature infants diagnosed with DIC and treated with AT III from March, 2000 to May, 2003 were retrospectively reviewed. Clinical manifestations, complete blood counts, coagulation tests, and AT III levels were compared between the two groups:definite DIC if clinical signs of DIC and AT III <70% with more than two abnormal laboratory parameters were present, and suspected DIC if not more than two abnormal laboratory parameters were present. RESULTS: AT III was given for an average of 3.2 days and no side effects related to the treatment were reported. The AT III levels increased significantly more than four fold with treatment in both groups. The clinical signs and laboratory values improved significantly after treatment. CONCLUSION: AT III level is a sensitive parameter in the diagnosis of DIC in premature infants, and it is useful as a treatment modality since it improves the clinical symptoms and the laboratory parameters without significant side effects.
Antithrombin III* ; Blood Cell Count ; Dacarbazine ; Diagnosis* ; Disseminated Intravascular Coagulation* ; Humans ; Infant, Newborn ; Infant, Premature* ; Retrospective Studies