Objective To investigate the effect of 2-methoxyestradiol(2ME2)on the expressions of hypoxia-inducible factor 1α and apoptosis-related genes(RTP801 and caspase-3)in the hippocampus of rats following global cerebral ischemia.Methods A total of 168 adult male SD rats were randomized into 2 groups,global cerebral isehemia group(GI group,n=84)and global cerebral ischemia+2ME2 treatment group(GI+2ME2 group,n=84).In GI and GI+2ME2 groups,4 vessel occlusion(4-vo)global ischemia was induced,and the rats were sacrificed at 6,12,24,48,96h,and 5 and 7 days after the reperfusion.Nissl staining was used for quantitative analysis of the hippocampal neurons,and immunohistochemistry and RT-PCR were performed to detect the expressions of HIF-1α protein,caspase-3 protein and RTP801 mRNA.Results At 48,96h and 5 and 7 days after the reperfusion,the numbers of hippocampal neurons in GI+2ME2 group were 37.09±3.52,26.93±3.10,22.22±3.091,and 6.98±3.07,respectively,significantly higher than those in GI group(P＜0.05).2ME2 significantly suppressed the expression levels of HIF-1α and reduced the numbers of the cells positive for HIF-1α protein to 1 1.47±1.9,20.27±2.07,3.12±0.89,1.07±0.83 at these time points(P＜0.05).The expressions of caspase-3 protein were decreased significantly in GI+2ME2 group,with the numbers of positive cells of 12.39±1.67,20.65±2.01,15.61±1.26,and 6.57±1.12 at the time points.The absorbance of RTP801 mRNA expression at the time points from 12 h to 5 days in GI+2ME2 group was 0.750±0.078,1.008±0.090,0.717±0.072,0.43 1±0.047,and 0.23 1±0.028,respectively,significantly lower than that in GI group(P＜0.05).Conclusion 2ME2 offers brain protection in rats with global cerebral ischemia and suppresses the elevation in the expressions of hypoxia-inducible factor 1α,RTP801 and caspase-3.

Activities of daily living (ADL) refer to the ability to care for self and perform daily activities within an individual's place or in outdoor environments. ADL comprise two main categories: Basic or physical ADL and Instrumental ADL. The latter allows for the earlier detection of functional decline than the former. The cognitive changes in neurodegenerative dementias contribute to the impaired ability of the patients to take care of themselves. Activities of daily living is a major criterion for diagnosing dementia. Furthermore, it has recently been emphasized that some impairment of activities of daily living, particularly of complex instrumental functions, is already present even in mild cognitive impairment prodromal stage of dementia, although mild cognitive impairment is distinguished from dementia by the absence of significant deficit in activities of daily living. The impaired activities of daily living increase the rate of institutionalization of the patients with dementia to nursing home and inevitably bring about the changes in the qualities of life not only of the patients but their caregivers. One of the best ways to evaluate the degree of impairment in activities of daily living and the care burden is through standardized functional assessment tools according to the severity of dementia. These tools provide objective data, thereby allowing the clinicians to judge decline and improvement in the functional status and to plan individualized care. In this review, we will review the clinical significance of evaluating ADL, the assessment tools according to the severity of dementia, and therapeutic approaches to enhance the functional levels. We will also review the impact of the impaired ADL on the quality of life among the patients and their care providers.
Activities of Daily Living ; Caregivers ; Dementia ; Humans ; Hypogonadism ; Institutionalization ; Mild Cognitive Impairment ; Mitochondrial Diseases ; Nursing Homes ; Ophthalmoplegia ; Prodromal Symptoms ; Quality of Life

OBJECTIVES: The Behavioral Activation of Depression Scale (BADS) has been reported to be a valid tool for assessing the different behavioral aspects of depression, such as activation, rumination or avoidance, and functional impairment. The aim of this study was to assess the reliability and validity of the Korean version of BADS (K-BADS). METHODS: A sample of 196 outpatients completed the K-BADS and the data were analyzed for internal consistency and factor structures. An additional 51 outpatients re-filled the K-BADS after two weeks for the test-retest reliability. To test for the validity, the Hospital Anxiety and Depression Scale (HADS), Working Alliance Inventory (WAI), Drug Attitude Inventory-10 (DAI-10), and Mindfulness Attention Awareness Scale (MAAS) were administered. RESULTS: Internal consistency of K-BADS was good (Cronbach's alpha=0.843) and principal component factor analysis revealed the four-factor structure. The K-BADS showed a reasonable test-retest reliability (r=0.863, p<0.001). The total score of K-BADS correlated significantly with the total scores of the HADS depression (r=−0.694) and HADS anxiety (r=−0.681). No correlations were found between the K-BADS and the K-WAI (r=0.170) and between the K-BADS and the K-DAI-10 (r=0.311). CONCLUSION: The K-BADS is a reliable and valid instrument for measuring the behavioral activation for depression in Korean patients with depressive symptoms.
Anxiety ; Depression* ; Humans ; Mindfulness ; Outpatients ; Reproducibility of Results*

OBJECTIVE: We assessed the characteristics of Capgras syndrome in patients diagnosed as probable Alzheimer disease, and compared the clinical and imaging findings with other previous reports. METHODS: We obtained medical records of patients with Capgras syndrome diagnosed as probable Alzheimer disease in three hospitals from March 2009 to March 2010. The basic characteristics, neuropsychologic tests, brain imaging data were investigated. RESULTS: The mean age of the patients was 74.7 years old and all of the patients experienced this syndrome in relation to a spouse. Brain magnetic resonance imaging showed mild-to-moderate global atrophy, variable hippocampal atrophy in this study. The Mini-Mental State Examination mean scores were 18.78 and clinical dementia rating scores were from 1 to 2. All of the patients took medicine of acetycholine esterase inhibitors and two patients recovered with antipsychotic medication. Five patients had showed continuous Capgras syndrome, at the last follow-up day, for a year. CONCLUSION: Capgras syndrome patients in this study who were diagnosed as probable Alzheimer disease showed similar results to the individuals from other reports. More study is needed to estimate the numbers and characteristics of patients with this syndrome.
Alzheimer Disease ; Atrophy ; Brain ; Capgras Syndrome ; Dementia ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Neuroimaging ; Neuropsychological Tests ; Spouses

Malignant melanoma may spread through the lymphatic channels or via the bloodstream. The lung, liver, bone and brain are common sites of hematogenous metastases. Malignant melanoma that has recurred to the stomach or peritoneum is not common. An 83-year old male patient was admitted to the Department of Oncology due to abdominal distension; 13 years ago, the patient had previously received a complete surgical resection for malignant melanoma of the right heel. According to a computed tomography (CT) scan of the abdomen, peritoneal carcinomatosis was suggested. Under a gastrofiberoscopic examination, two small sized polyps with central umbilication were found on the midbody of the stomach. The gastric polyps were histopathologically confirmed as metastatic melanoma. We report a rare case of metastatic malignant melanoma that has recurred to the stomach and peritoneum 13years after its initial diagnosis.
Abdomen ; Aged, 80 and over ; Brain ; Carcinoma ; Diagnosis ; Heel ; Humans ; Liver ; Lung ; Male ; Melanoma* ; Neoplasm Metastasis ; Peritoneum* ; Polyps ; Stomach*

Botulinum neurotoxin type A (BoNT/A) is a metalloprotease that cleaves SNAP-25 (synaptosome-associated protein of 25 kDa), a specific cellular protein essential for neurotransmitter release. As well as mouse bioassay to detect BoNT/A, various assay methods based on its endopeptidase activity have been developed. In this study, we tried to develop a BoNT/A assay system using recombinant SNAP-25 with glutathione S-transferase (GST) tags at both termini as substrate. The recombinant GST-SNAP-25-GST with 70 kDa was expressed and purified in E. coli and synthesized N-terminal 50 kDa and C-terminal 25 kDa fragment after cleavage at the Gln(197)-Arg(198) bond by BoNT/A. To detect both fragments, we obtained rabbit antisera against peptides corresponding to the cleaved ends of each fragment. In the western blotting, the N-terminal fragment was detected by the antibody specifically recognizing the newly exposed C-terminus (corresponding to amino acid residue 191-197). This assay system was able to detect until 3.125 ng of BoNT/A, which corresponded to about 90 fold LD50 in mice. These results suggest that the in vitro endopeptidase assay developed in this study would replace others to detect BoNT/A.
Animals ; Biological Assay ; Blotting, Western ; Glutathione Transferase ; Immune Sera ; Lethal Dose 50 ; Mice ; Neurotransmitter Agents ; Peptides

Botulinum neurotoxin type A (BoNT/A) is a metalloprotease that cleaves SNAP-25 (synaptosome-associated protein of 25 kDa), a specific cellular protein essential for neurotransmitter release. As well as mouse bioassay to detect BoNT/A, various assay methods based on its endopeptidase activity have been developed. In this study, we tried to develop a BoNT/A assay system using recombinant SNAP-25 with glutathione S-transferase (GST) tags at both termini as substrate. The recombinant GST-SNAP-25-GST with 70 kDa was expressed and purified in E. coli and synthesized N-terminal 50 kDa and C-terminal 25 kDa fragment after cleavage at the Gln(197)-Arg(198) bond by BoNT/A. To detect both fragments, we obtained rabbit antisera against peptides corresponding to the cleaved ends of each fragment. In the western blotting, the N-terminal fragment was detected by the antibody specifically recognizing the newly exposed C-terminus (corresponding to amino acid residue 191-197). This assay system was able to detect until 3.125 ng of BoNT/A, which corresponded to about 90 fold LD50 in mice. These results suggest that the in vitro endopeptidase assay developed in this study would replace others to detect BoNT/A.
Animals ; Biological Assay ; Blotting, Western ; Glutathione Transferase ; Immune Sera ; Lethal Dose 50 ; Mice ; Neurotransmitter Agents ; Peptides

X-linked ichthyosis (XLI) is a recessively inherited ichthyosis. Skin barrier function of XLI patients reported in Western countries presented minimally abnormal or normal. Here, we evaluated the skin barrier properties and a skin barrier-related gene mutation in 16 Korean XLI patients who were diagnosed by fluorescence in situ hybridization and array comparative genomic hybridization analysis. Skin barrier properties were measured, cytokine expression levels in the stratum corneum (SC) were evaluated with the tape stripped specimen from skin surface, and a genetic test was done on blood. XLI patients showed significantly lower SC hydration, but normal basal trans-epidermal water loss and skin surface pH as compared to a healthy control group. Histopathology of ichthyosis epidermis showed no acanthosis, and levels of the pro-inflammatory cytokines in the corneal layer did not differ between control and lesional/non-lesional skin of XLI patients. Among the mutations in filaggrin (FLG), kallikrein 7 (KLK7), and SPINK5 genes, the prevalence of KLK7 gene mutations was significantly higher in XLI patients (50%) than in controls (0%), whereas FLG and SPINK5 prevalence was comparable. Korean XLI patients exhibited unimpaired skin barrier function and frequent association with the KLK7 gene polymorphism, which may differentiate them from Western XLI patients.
Adolescent ; Adult ; Asian Continental Ancestry Group/*genetics ; Child ; Chromosomes, Human, X ; Comparative Genomic Hybridization ; Cytokines/metabolism ; Humans ; Hydrogen-Ion Concentration ; Ichthyosis/diagnosis/*genetics/pathology ; In Situ Hybridization, Fluorescence ; Intermediate Filament Proteins/genetics ; Kallikreins/*genetics ; Male ; Polymorphism, Single Nucleotide ; Proteinase Inhibitory Proteins, Secretory/genetics ; Republic of Korea ; Skin/metabolism/*pathology ; Young Adult

X-linked ichthyosis (XLI) is a recessively inherited ichthyosis. Skin barrier function of XLI patients reported in Western countries presented minimally abnormal or normal. Here, we evaluated the skin barrier properties and a skin barrier-related gene mutation in 16 Korean XLI patients who were diagnosed by fluorescence in situ hybridization and array comparative genomic hybridization analysis. Skin barrier properties were measured, cytokine expression levels in the stratum corneum (SC) were evaluated with the tape stripped specimen from skin surface, and a genetic test was done on blood. XLI patients showed significantly lower SC hydration, but normal basal trans-epidermal water loss and skin surface pH as compared to a healthy control group. Histopathology of ichthyosis epidermis showed no acanthosis, and levels of the pro-inflammatory cytokines in the corneal layer did not differ between control and lesional/non-lesional skin of XLI patients. Among the mutations in filaggrin (FLG), kallikrein 7 (KLK7), and SPINK5 genes, the prevalence of KLK7 gene mutations was significantly higher in XLI patients (50%) than in controls (0%), whereas FLG and SPINK5 prevalence was comparable. Korean XLI patients exhibited unimpaired skin barrier function and frequent association with the KLK7 gene polymorphism, which may differentiate them from Western XLI patients.
Adolescent ; Adult ; Asian Continental Ancestry Group/*genetics ; Child ; Chromosomes, Human, X ; Comparative Genomic Hybridization ; Cytokines/metabolism ; Humans ; Hydrogen-Ion Concentration ; Ichthyosis/diagnosis/*genetics/pathology ; In Situ Hybridization, Fluorescence ; Intermediate Filament Proteins/genetics ; Kallikreins/*genetics ; Male ; Polymorphism, Single Nucleotide ; Proteinase Inhibitory Proteins, Secretory/genetics ; Republic of Korea ; Skin/metabolism/*pathology ; Young Adult

This study analyzed the reasons for continuing education among dietitians. An internet-based survey of 622 dieticians was conducted from August 31, 2012 to September 12, 2012. Based on data from the Participation Reasons Scale (PRS) questionnaire, factor analysis was conducted by principle component analysis for the extraction of major factors. Subsequent reliability analysis was performed by assessing Cronbach's alpha. The ANOVA-test was performed to compare the participation reason scores for each factors according to general characteristics. Statistical analysis was performed using SPSS ver.17.0, and P<0.05 was considered significant. Factor analysis for the participation reasons revealed four types of factors. These factors were "maintenance and development of professional competencies", "interaction and responsibility of professionals", "job stability and personal profits" and "services for customers" respectively. Among the participation reasons, "maintenance and development of professional competencies" was the first reason with a 29.34% variance. In addition, the participation reasons for continuing education differed according to age (P<0.05), the highest level of education (P<0.05), workplace (P<0.01), and work experience in dietetic area (P<0.001). In conclusion, continuing education programs for dietitians should focus on effectively developing and promoting professionalism.
Education ; Education, Continuing* ; Humans ; Surveys and Questionnaires