Most histories of senile dementia begin with Alois Alzheimer's description in 1906 of the first case of Alzheimer's disease. However, the history of senile dementia is quite rich, dating back to the ancient Greek and Roman philosophers and physicians, so the history of dementia is probably as old as mankind itself. Although senile dementia has been recognized as a condition of aged individuals since at least the time of Pythagoras in the 7th century B.C., because it was dismissed as an inevitable feature of aging, it remained largely an uninvestigated disorder until the 19th century. An introduction of a scientific approach to clinical observation and the systematized classification of mental disorders in the mid-19th century that senile dementia began to be differentiated from other dementias, and was established as its own defined class of mental disorder. The identification of Alzheimer's disease at the onset of the 20th century was a turning point for the understanding of senile dementia, and the concepts and histological findings presented by the early researchers of Alzheimer's disease remain relevant still today. Here the author traces the history of the evolution of our current conceptualization of Alzheimer's disease from the Greek-Roman concept of age-associated dementia.
Aged ; Aging ; Alzheimer Disease ; Dementia ; Humans ; Mental Disorders

Here the author reviews the clinical and pathologic characteristics of dementia with Lewy bodies (DLB). DLB took many years to crystallize into a recognizable clinico-pathologic entity. Based on sensitive immunostaining technique, DLB is now considered the second most commonest cause of neurodegenerative dementia in the elderly. It is part of the range of clinical presentations that share a neuritic pathology based on abnormal aggregation of the synaptic protein alpha-synuclein. Lewy body pathology is found from the brainstem to the cortex and, in many cases, associated with concurrent Alzheimer' disease pathology. A recent international consortium on DLB has resulted in revised criteria for the clinical and pathological diagnosis of DLB incorporating new information about the clinical features and improved methods for their assessment. Neuropathologic diagnosis now assigns a weight to both alpha-synuclein and Alzheimer tangle pathology. Accurate identification of patients is important because they have specific symptoms, impairments, and functional disabilities that differ from those of other dementing illness including Alzheimer's disease.
Aged ; alpha-Synuclein ; Alzheimer Disease ; Brain Stem ; Dementia* ; Diagnosis ; Humans ; Lewy Bodies* ; Pathology

OBJECTIVE: The purpose of this study was to identify the factors that influence the consent of case management for suicide prevention. METHODS: This study included 232 suicide attempters from September 1, 2015 to August 31, 2016 at the Emergency Medical Center of Soonchunhyang University Bucheon Hospital, Korea. A retrospective chart analysis was performed using a chi-square test or Fisher exact test, as well as univariate and multivariate logistic regression analysis (R ver. 3.3.3). RESULTS: The positive factors affecting case management consent were direct face-to-face counseling with a case manager, patient's age, suicide attempt without alcohol, first suicide attempt, and no psychiatric history. In addition, suicide attempters who underwent follow-up case management were more likely to participate in outpatient mental health care. Through the case manager, continuous emotional support and encouragement were provided to the suicide attempt, which proved to be effective. CONCLUSION: This study emphasizes the importance of case management for suicide attempters visiting the emergency medical center and suggests that the cooperation of national and regional systems should be expanded to increase the case participation rate.
Case Management* ; Counseling ; Emergencies* ; Emergency Service, Hospital* ; Follow-Up Studies* ; Gyeonggi-do ; Humans ; Korea ; Logistic Models ; Mental Health ; Outpatients ; Retrospective Studies ; Suicide* ; Suicide, Attempted

OBJECTIVES: The purpose of this study is to evaluate the relationship between the severity of white matter changes (WMC), risk factors and cognitive domains, including executive function profiles. METHOD: Forty nine subjects over 55 years with subjective memory complaints were assessed with MRI and neuropsychological tests. The WMC were assessed by MRI T2-FLAIR images and divided into 3 groups of mild vs. moderate vs. severe and 2 groups of mild-moderate vs. severe by using Mantyla's criteria and Fazeka's criteria. The risk factors were examined in hypertension, heart disease history and chemistry Lab. Medical conditions which affect to cognitive dysfunction and definite dementia were also excluded. RESULTS: Comparing 3 groups, hypertension was identified as a risk factor of the WMC. Comparing 2 groups, total cholesterol and LDL were identified for as the risk factor of WMC. The severity of WMC was significantly associated with cognitive disturbances and their main effect on cognition was working memory and inhibition. CONCLUSION: The risk factors of the WMC in the elderly were hypertension, hyperlipidemia. The severity of WMC appears to be associated with executive dysfunction in the elderly.
Aged ; Cholesterol ; Cognition ; Dementia ; Executive Function ; Heart Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Memory ; Memory, Short-Term ; Neuropsychological Tests ; Pyridines ; Risk Factors ; Thiazoles

OBJECTIVES: The purpose of this study was to evaluate the changes in defense mechanisms in medical students as they progress towards becoming a doctor. METHODS: Ninety premedical students were enrolled from Soonchunhyang University. All subjects were evaluated at baseline, during their 6th year of medical school, during their 4th year as a practicing doctor by the Ewha defense Mechanisms Test which contained 20 defense mechanisms and 4 factors (unstable, narcissistic, self-negative, and avoidant). In the end, 60 subjects were included in the analysis. RESULTS: During the period from premedical student to medical doctor, the use of passive-aggressive, acting-out, displacement, somatization, dissociation, projection, denial, regression, and distortion decreased significantly. Also, there was a significant difference in the use of defense mechanisms from the time as a premedical student to a medical student. However, there was no significant difference in the period from medical student to medical doctor. CONCLUSION: We concluded that the use of unstable and avoidant defense scales decreased in the course of becoming a doctor from a premedical student, compared to mature or stable defense scales.
Defense Mechanisms ; Denial (Psychology) ; Displacement (Psychology) ; Dissociative Disorders ; Follow-Up Studies ; Humans ; Schools, Medical ; Students, Medical ; Students, Premedical ; Weights and Measures

OBJECTIVES: To explore the relationship of white matter changes (WMC) on magnetic resornance imaging (MRI) with plasma homocysteine and folate levels in Alzheimer's disease (AD) patients. METHODS: Forty-one patients with probable AD were evaluated on WMC on brain MRI, plasma homocysteine and folate levels, and cerebrovascular risk factors. Subjects were divided into two groups according to WMC scores (lower group with < 5 and higher group with > or = 5). WMC were assessed by a scale of the European Task Force on Age-Related WMC. RESULTS: Plasma homocysteine levels were correlated with right frontal WMC and have a tendency of correlation with left frontal WMC. When subjects were divided into two groups: higher plasma homocysteine group (> or = 14 micronmol/L) and lower plasma homocysteine group (< 14 micronmol/L), the former was significantly higher than the latter in both frontal WMC. In a logistic regression analysis, higher plasma homocysteine were not a significant risk factor for higher WMC. Increasing age was a only significant risk factor for higher WMC and correlated with both frontal WMC. There was no relationship folate with any WMC. CONCLUSION: It is possible that plasma homocysteine levels have a region-specific correlation with frontal WMC in AD. However, it is important that effect of age on the relationship should be considered.
Advisory Committees ; Alzheimer Disease ; Brain ; Folic Acid ; Homocysteine ; Humans ; Logistic Models ; Magnetics ; Magnets ; Plasma ; Risk Factors

OBJECTIVES: This study investigated the factors associated with suicidal ideation in the elderly. METHODS: A total of 136 subjects over 60 years old who visited the public offices in Bucheon-si, Gyeonggi Province in South Korea participated in the study. Subjects completed a series of questionnaires including the following : demographic information ; physical illness ; psychological illness ; suicidal ideation. In addition, Center for Epidemiologic Studies-Depression Scale and Attitudes Towards Suicide-20 were used to assess the severity of depression and the attitude towards suicide, respectively. RESULTS: Multivariate logistic regression analyses were performed to determine the factors that affect suicidal ideation in the elderly. As a result, living alone, depression, having any physical illness, and permissive attitude towards suicide were risk factors for suicidal ideation in the elderly. CONCLUSION: ConclusionZZIn addition to previously identified risks factors (living alone, physical illness, and depression), the study found that permissive attitude towards suicide also serves as a risk factor for suicide in elderly people. Therefore, permissive attitude towards suicide should be addressed and evaluated in order to prevent suicide in the elderly.
Aged* ; Depression ; Gyeonggi-do ; Humans ; Korea ; Logistic Models ; Risk Factors* ; Suicidal Ideation* ; Suicide

Ginseng Radix(GR) had been used widely from oriental medicine and the effects of it have been investigated by many researchers. The purpose of present study was to investigate the effects of GR on the cell cycle progression and its molecular mechanism in human fetal osteoblast. The results were as follows. Increased cell proliferation was observed in cells exposed to 100 ng/ml, 10 ng/ml of GR-1 at 12 hours and 24 hours, 1 microgram/ml of GR-1 at 48 hours, and 100 microgram/ml, 10 microgram/ml of GR-2 at 12 hours, all treatment groups of GR-2 at 24 hours(p<0.05). S phase and G1 phase was increased in the group of treated with 100 ng/ml of GR-1, with 10 microgram/ml and 1 microgram/ml of GR-2, with 100 microgram/ml and 10 microgram/ml of GR-3 in the cell cycle analysis. The cell cycle regulation protein levels of Cyclin D1, Cyclin E, CDK 2, CDK 4 and CDK 6 were increased in the group of treated with 1 microgram/ml and 100 ng/ml of GR-1, with 10 microgram/ml and 1 microgram/ml of GR-2, with 100 microgram/ml and 10 microgram/ml of GR-3. On the other hand, p21 was decreased in the treatment group with 1 microgram/ml and 100 ng/ml of GR-1, with 10 microgram/ml and 1 microgram/ml of GR-2, 10 microgram/ml of GR-3, and p53 and p16 was decreased in the treatment group with 100 ng/ml of GR-1, 100 microgram/ml GR-3 and pRb was decreased in the all treatment groups except 1 microgram/ml of GR-1. These results suggested that GR increases the cell proliferation and the cell cycle progression in human fetal osteoblast, which is linked to increased cell cycle regulation protein levels of Cyclin D1, Cyclin E, CDK 2, CDK 4, CDK 6 and decreased cell cycle regulation protein levels of p21, pRb.
Humans

Objectives: The aim of this study was to investigate elementary school teachers' knowledge and perception of attention-deficit/hyperactivity disorder (ADHD). Variables associated with the teacher's tendency to recommend treatment to parents of the ADHD children were also evaluated. Methods: A total of 73 elementary-school teachers completed a self-questionnaire regarding their demographic characteristics, previous experience, and perception of ADHD children. Knowledge of the Attention Deficit Disorders Scale (KADDS) was used to examine the participants' level of knowledge of ADHD. Multivariable logistic regression analysis was performed to identify the variables associated with the participants' tendency to recommend treatment to parents of ADHD students. Results: The average correct rate was 64.4% on the KADDS. 64 (87.7%) participants had a positive perception of medical treatments of ADHD, but only 41 (56.2%) participants reported that they would recommend treatment to parents of ADHD children. Teachers that were older and married were more likely to recommend treatment. The teacher's sense of efficacy was found to have a positive association with the tendency to recommend treatment to parents. Conclusion Educational programs and specific guidelines that can improve the knowledge of ADHD and self-efficacy as a teacher are needed for elementary school teachers. Teachers should understand that they have significant roles in the management of ADHD children.

OBJECTIVES: The aim of this study was to determine whether children with Tourette disorder (TD) have functional impairment and executive dysfunction in comparison to children with attention-deficit hyperactivity disorder (ADHD) and non-affected controls. METHODS: From January 2006 to December 2013, 45 children and adolescents with TD and 50 children and adolescents with ADHD diagnosed at the Soonchunhyang University Bucheon Hospital and 50 non-affected controls were enrolled in this study. Functional impairment of the subjects was assessed using the Child and Adolescents Functioning Impairment Scale (CAFIS), parent and teacher versions. In addition, neuropsychological tests including Stroop color-word Test, Finger windows Test (FWT), and Digit span were administered. Outcomes were compared across the TD, ADHD, and non-affected controls. RESULTS: No difference in CAFIS-parent and CAFIS-teacher results was observed between children with TD and non-affected controls, whereas, children with ADHD showed more impairments relative to non-affected controls in the CAFIS-parent. According to the Stroop color-word Test, FWT, and Digit span, executive function in children with TD did not differ from non-affected controls. Children with ADHD had poorer performance in measures of the Stroop color-word Test compared to children with TD. CONCLUSION: Children and adolescents with TD but not ADHD were not significantly different from non-affected controls on most measures of functional impairment and executive function. These findings suggest that an education program and intervention for children with TD would be important to reducing the stigma of TD.
Adolescent ; Child* ; Education ; Executive Function ; Fingers ; Gyeonggi-do ; Humans ; Neuropsychological Tests ; Parents ; Tourette Syndrome*