The purpose of this paper is to provide nurses with a concise review on neurodegenrative dementias. This review includes pathophysiology, clinical course, and tips on management of dementias from Alzheimer’s disease (AD), Parkinson disease (PD) and lewy body dementia (LBD). Considering increasing numbers of dementia cases among older adults, nurses who are cognizant about dementia care are instrumental in maximizing daily activities and quality of life of patients with cognitive impairment and dementia.

PURPOSE: Despite well-known benefits of walking on cardiovascular health, no structured walking exercise program has been formally tested on elderly Korean immigrants (EKIs). This pilot randomized controlled trial study assessed the effect of a walking program on walking behavior (pedometer steps count), stress (cortisol), depressive symptoms (CESD-10), and cardiovascular disease biomarkers (hs-CRP and fibrinogen) via venipuncture in EKIs. METHODS: Seventy EKIs recruited from a Korean community were randomly assigned to a 12-week walking group or control group in a 3:2 ratio. The working program included a pedometer, buddy, monthly coffee card, weekly call for goal setting, and physical activity consultation. Walking group EKIs maintained the Centers for Disease Control and Prevention recommended exercise guidelines and good mental health status over 12 weeks. RESULTS: There was no significant difference in the outcomes between control and walking groups. CONCLUSION: Social networking with Koreans in the senior center and church from a well-established Korean community might have positive effects on mental health.
Aged* ; Biomarkers* ; Cardiovascular Diseases ; Centers for Disease Control and Prevention (U.S.) ; Coffee ; Depression* ; Emigrants and Immigrants* ; Humans ; Mental Health ; Motor Activity ; Phlebotomy ; Senior Centers ; Walking*

There have been a few reported cases of immune hemolytic anemia induced by ceftriaxone. We encountered a patient with immune hemolytic anemia that seemed to be stimulated by a degradation product of ceftriaxone. The patient's direct antiglobulin test was positive only for C3d, and no ceftriaxone-dependent antibodies were detectable in the patient's serum. To demonstrate the presence of the ceftriaxone-induced antibodies, an ex-vivo antigen in urine was obtained from the patient. In addition, we prepared a 1 mg/mL suspension solution of ceftriaxone, and group AB serum as a complement source. Using several combinations of the above reactants, the indirect antiglobulin test was performed. Only the indirect antiglobulin test using the patient's serum with the ex-vivo urine antigen was found to be positive. Other combinations were not reactive. To our knowledge, this is the first reported case in Korea, in which the causative antibody appeared to be stimulated solely by a degradation product of ceftriaxone.
Anemia, Hemolytic, Autoimmune/*chemically induced/*diagnosis/immunology/urine ; Antigens/urine ; Case Report ; Ceftriaxone/*adverse effects ; Cephalosporins/*adverse effects ; Coombs' Test ; Human ; Male ; Middle Age

There have been a few reported cases of immune hemolytic anemia induced by ceftriaxone. We encountered a patient with immune hemolytic anemia that seemed to be stimulated by a degradation product of ceftriaxone. The patient's direct antiglobulin test was positive only for C3d, and no ceftriaxone-dependent antibodies were detectable in the patient's serum. To demonstrate the presence of the ceftriaxone-induced antibodies, an ex-vivo antigen in urine was obtained from the patient. In addition, we prepared a 1 mg/mL suspension solution of ceftriaxone, and group AB serum as a complement source. Using several combinations of the above reactants, the indirect antiglobulin test was performed. Only the indirect antiglobulin test using the patient's serum with the ex-vivo urine antigen was found to be positive. Other combinations were not reactive. To our knowledge, this is the first reported case in Korea, in which the causative antibody appeared to be stimulated solely by a degradation product of ceftriaxone.
Anemia, Hemolytic, Autoimmune/*chemically induced/*diagnosis/immunology/urine ; Antigens/urine ; Case Report ; Ceftriaxone/*adverse effects ; Cephalosporins/*adverse effects ; Coombs' Test ; Human ; Male ; Middle Age

BACKGROUND/AIMS: The standard guideline for the management Helicobacter pylori infection in Korean children is not present until now. In present study, we conducted the questionnaire survey to investigate the real situation of H. pylori eradication in children. MATERIALS AND METHODS: Questionnaire concerning the indications of H. pylori eradication, the first choice of treatment modality, the decision method of eradication result, experience of eradication failure, the second choice of treatment modality was sent to doctors who are members of the Korean Society for Pediatric Gastorenterology, Hepatology, and Nutrition. RESULTS: A total of 28 doctors (90.3%) answered the questionnaires among 31 doctors. The most common indication for eradication of H. pylori was peptic ulcer (n=24) followed by chronic abdominal pain (n=17) and positive family history of gastric cancer (n=12). The most common choice of first-line eradication therapy was omeprazole, amoxicillin, clarithromycin triple therapy (n=21) and followed by bismuth subsalicylate, amoxicillin, metronidazole, clarithromycin quadruple therapy (n=7). The results of treatment were judged by C13-urea breath test after 2 months later in 19 doctors (67.8%). Twenty four (85.7%) out of 28 doctors had experienced treatment failure. The most common second-line therapy was the sequential therapy (58.3%, 14 doctors among 24). CONCLUSIONS: This was the first study for the survey of the treatment of H. pylori infection to Korean pediatricians. The results of this study showed that most pediatric gastroenterologists used to treat H. pylori infection according to the textbook and the common use of bismuth-based quadruple therapy for the first-line treatment was notable.
Abdominal Pain ; Amoxicillin ; Bismuth ; Breath Tests ; Child* ; Clarithromycin ; Gastroenterology ; Helicobacter pylori* ; Helicobacter* ; Humans ; Methods ; Metronidazole ; Omeprazole ; Peptic Ulcer ; Pilot Projects* ; Stomach Neoplasms ; Treatment Failure

PURPOSE: To assess the tolerance, complete response rate, bladder preservation rate and survival rate in patients with muscle-invading bladder cancer treated with selective bladder preservation protocol. METHOD AND MATERIALS: From October 1990 to June 1998, twenty six patients with muscle-invading bladder cancer (clinical stage T2-4, N0-3, M0) were enrolled for the treatment protocol of bladder preservation. They were treated with maximal TURBT (transurethral resection of bladder tumor) and 2 cycles of MCV chemotherapy (methotrexate, crisplatin, and vinblastine) followed by 39.6~45 Gy pelvic irradiation with concomitant cisplatin. After complete urologic evaluation (biopsy or cytology), the patients who achieved complete response were planed for bladder preservation treatment and treated with consolidation cisplatin and radiotherapy (19.8 Gy). The patients who had incomplete response were planed to immediate radical cystectomy. If they refused radical cystectomy, they were treated either with TURBT followed by MCV or cisplatin chemotherapy and radiotherapy. The median follow-up duration is 49.5 months. RESULT: The patients with stage T2-3a and T3b-4a underwent complete removal of tumor or gross tumor removal by TURBT, respectively. Twenty one out of 26 patients (81%) successfully completed the protocol of the planned chemo-radiotherapy. Seven patients had documented complete response. Six of them were treated with additional consolidation cisplatin and radiotherapy. One patient was treated with 2 cycles of MCV chemotherapy due to refusal of chemo-radiotherapy. Five of 7 complete responders had functioning tumor-free bladder. Fourteen patients of incomplete responders were further treated with one of the followings : radical cystectomy (1 patient), or TURBT and 2 cycles of MCV chemotherapy (3 patients), or cisplatin and radiotherapy (10 patients). Thirteen patients of them were not treated with planned radical cystectomy due to patients' refusal (9 patients) or underlying medical problems (4 patients). Among twenty one patients, 12 patients (58%) were alive with their preserved bladder, 8 patients died with the disease, 1 patient died of intercurrent disease. The 5 years actuarial survival rates according to CR and PR after MCV chemotherapy and cisplatin chemoradiotherapy were 80% and 14%, respectively (p=0.001). CONCLUSION: In selected patients with muscle-invading bladder cancer, the bladder preservation could be achieved by MCV chemotherapy and cisplatin chemo-radiotherapy. All patients tolerated well this bladder preservation protoco. The availability of complete TURBT and the responsibility of neoadjuvant chemotherapy and chemoradiotherapy were important predictors for bladder preservation and survival. The patients who had not achieved complete response after neoadjuvant chemotherapy and chemoradiotherapy should be immediate radical cystectomy. A randomized prospective trial might be essential to determine more accurate indications between cystectomy or bladder preservation.
Chemoradiotherapy ; Cisplatin ; Clinical Protocols ; Combined Modality Therapy* ; Cystectomy ; Disulfiram ; Drug Therapy ; Follow-Up Studies ; Humans ; Radiotherapy ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

BACKGROUND: Adjuvant chemotherapy is the most accepted treatment for localized osteosarcoma. We studied the effectiveness of preoperative cisplatin and adriamycin combination chemotherapy in non-metastatic osteosarcoma. METHODS: Twenty four cases of patient with osteosarcoma were divided into two groups except four patients treated only conservatively. Group A (14 patients) received chemotherapy before operation and Group B (6 patients) received chemotherapy after operation. The chemotherapy regimen consisted of cisplatin (120 mg/m2 on day 1) and adriamycin (adriamycin 25 mg/m2 on days 2 to 4). RESULTS: The average age of the 20 patients was 27.5 years and the median follow-up duration was 39.3 months. 12 patients of group A were treated with limb-salvage operation and 2 patients with amputation because of tumor growing. According to Kaplan-Meier's plot, one year, three year overall survival rate were 100%, 85% in Group A and 100%, 75% in Group B. Histologic responses were assessed in patients received preoperative chemotherapy. Tumor necrosis over 90% is noted in 9 patients, under 90% necrosis is noted 5 patients. Their mean survival was 82 months and 25 months, respectively (p>0.05). CONCLSUION: Adjuvant chemotherapy with cisplatin and adriamycin was feasible in non-metastatic osteosarcoma and clinically significant adverse effect was neutropenia.
Amputation ; Chemotherapy, Adjuvant ; Cisplatin* ; Doxorubicin* ; Drug Therapy* ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Limb Salvage ; Necrosis ; Neutropenia ; Osteosarcoma* ; Survival Rate

0.05). 7. There were significant differences between group A, B and group C in their bony density until post-op 24 months but a little differences at post-op 36 months(P<0.01)]]>
Bone Density ; Follow-Up Studies ; Gingival Recession ; Humans ; Jaw Cysts ; Jaw ; Reoperation ; Tissue Donors ; Transplants

PURPOSE: Human papillomavirus (HPV) infection has a significant role in cervical carcinogenesis, and HPV oncoprotein E7 plays an important part in the formation and maintenance of cervical cancer. Interleukin-12 (IL-12) has been reported to induce a cellular immune response, and to suppress the tumor growth and the E7 production. Here we describe the use of adenoviral delivery of the HPV 16 E7 subunit (AdE7) along with adenoviral delivery of IL-12 (AdIL-12) in mice with HPV-associated tumors. MATERIALS AND METHODS: Mice were injected with TC-1 cells to establish TC-1 tumor, and then they were immunized with AdIL-12 and/or AdE7 intratumorally. The anti tumor effects induced by AdIL-12 and/or E7 were evaluated by measuring the size of the tumor. E7-specific antibody and INF-gamma production in sera, and the T-helper cell proliferative responses were then measured. Cytotoxic T-lymphocyte (CTL) and T cell subset depletion studies were also performed. RESULTS: Combined AdIL-12 and AdE7 infection at the tumor sites significantly enhanced the antitumor effects more than that of AdIL-12 or AdE7 single infection. This combined infection resulted in regression of the 9 mm sized tumors in 80% of animals as compare to the PBS group. E7-specific antibody and INF-gamma production in the sera, and the T-helper cell proliferative responses were significantly higher with coinfection of AdIL-12 and AdE7 than with AdIL-12 or AdE7 alone. CTL response induced by AdIL-12 and AdE7 in the coinjected group suggested that tumor suppression was mediated by mostly CD8+ and only a little by the CD4+ T cells. CONCLUSION: IL-12 and E7 application using adenovirus vector showed antitumor immunity effects against TC-1 tumor, and this system could be use in clinical applications for HPV-associated cancer.
Adenoviridae ; Animals ; Carcinogenesis ; Coinfection ; Human papillomavirus 16 ; Humans* ; Immunity, Cellular ; Immunization* ; Interleukin-12* ; Mice ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic ; Uterine Cervical Neoplasms