The changes of electroencephalogram(EEG) in patients with dementia of Alzheimer's type are most commonly studied by analyzing power or magnitude in traditionally defined frequency bands. However because of the absence of an identified metric which quantifies the complex amount of information, there are many limitations in using such a linear method. According to the chaos theory, irregular signals of EEG can be also resulted from low dimensional deterministic chaos. Chaotic nonlinear dynamics in the EEG can be studied by calculating the largest Lyapunov exponent(L1). The authors have analyzed EEG epochs from three patients with dementia of Alzheimer's type and three matched control subjects. The largest L1 is calculated from EEG epochs consisting of 16.384 data points per channel in 15 channels. The results showed that patients with dementia of Alzheimer's type had significantly lower L1 than non-demented controls on 8 channels. Topographic analysis showed that the L1 were significantly lower in patients with Alzheimer's disease on all the frontal, temporal, central, and occipital head regions. These results show that brains of patients with dementia of Alzheimer's type have a decreased chaotic quality of electrophysiological behavior. We conclude that the nonlinear analysis such as calculating the L1 can be a promising tool for detecting relative changes in the complexity of brain dynamics.
Alzheimer Disease ; Brain ; Dementia* ; Electroencephalography* ; Head ; Humans ; Nonlinear Dynamics*

To investigate the imbalance of the cytokine production profile of T cells from atopic asthmatics, we measured concentrations of IL-4, IL-5 and IFN-y by ELISA method in the culture supernatants of peripheral blood mononuclear cells(PBMCs) and Derrnato-phagoides pteronyssinus(Der p) J-stimulated PBMCs from Der p-sensitized atopic asthmatics, Der p-sensitized healthy atopits, non-atopic asthmatics and healthy non-atopics. The suppressive effect of IFN-y on cytokine production of Der p J-stimulated PBMCs was also examined. The PBMCs from atopics showed higher IL-4 and IL-5 production in response to PHA +TPA and higher IFN-gamma production in response to Der p Jq compared with non-atopits. The Der p J-stimulated PBMCs from atopics showed a tendency of increased IL-5 production in response to Der p J and higher IL-4 and IL-5 production in response to PHA+TPA compared with non-atopics. IL-5 production of Der p J-stimulated PBMCs from atopics was suppressed by IFN It is suggested that an imbalance in IL-4, IL-5 and IFN-y production is a feature of the atopic state. The TH2 characteristics of allergen-stimulated PBMCs could be regulated by IFN-y.
Enzyme-Linked Immunosorbent Assay ; Interleukin-4 ; Interleukin-5 ; T-Lymphocytes

Topiramate is an antiepileptic drug effective for multiple types of seizure and is also used to prevent migraine attack. Several side effects have been reported, such as metabolic acidosis, nephrolithiasis, anorexia, weight reduction, drowsiness, glaucoma, hyperthermia, and cognitive dysfunction, whereas skin manifestationis were rarely reported. We report a case of a 12-year-old girl on medication of topiramate for 8 months due to focal epilepsy. She had fever, sore throat, burning sense in the vaginal area, and then flaccid bullae and erythematous patches proceeded to the whole bodyskin and mucosa including the conjunctiva, oral cavity, and genital areas. She was diagnosed with toxic epidermal necrolysis (TEN) and improved after the discontinuation of topiramate and with administration of high-dose intravenous steroid and immunoglobulin. We, herein, report a girl who developed severe side effects on the skin, TEN, due to topiramate.

Multiple primary or secondary malignancies after anticancer therapy were recently reported to be increasing in frequency. The authors describe a case of metachronous metastatic pulmonary basaloid carcinoma to the central nervous system that was discovered after chemotherapy and radiation therapy for cervical uterine carcinoma. Two different types of cancer developed within some interval. There's the possibility that a secondary pulmonary neoplasm developed after the chemotherapy and radiotherapy conducted as cervical cancer treatment.
Central Nervous System ; Drug Therapy* ; Lung Neoplasms ; Neoplasm Metastasis* ; Neoplasms, Second Primary ; Radiotherapy ; Uterine Cervical Neoplasms

Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a rare, self-limited lymphadenopathy, typically in young women, that usually remits spontaneously and does not recur. KD is clinically characterized by cervical lymphadenopathy and a high fever. Extranodal involvement (skin, arthritis, meningitis) rarely occurs. When KD is involved in a skin lesion, it presents with various shapes, but rarely manifests with symmetrically distributed, erythematous, firm nodules only on the face. In this report, we describe a patient with KD and unique skin manifestations.
Arthritis ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymphatic Diseases ; Skin ; Skin Manifestations

No abstract available.
Nephrotic Syndrome* ; Prenatal Diagnosis*

Dental caries and periodontal disease are considered to be chronic, but can be prevented through an incremental oral health program covering all ages. The National Oral Health Program for adults provides oral health exam and scaling, and is covered by national health insurance for those over 20 years of age in Korea. The aim of this study was to collect basic data for developing an oral health program for adults by identifying factors related to awareness and need. The data were obtained by convenience sampling of 303 subjects. The use of dental plaque disclosing agents affected tooth brushing frequency, toothbrushing time and use of oral auxiliary devices. Education on toothbrushing methods affected toothbrushing time and use of oral auxiliary devices. Of those surveyed, 93.1% replied that an incremental oral health program for adults was needed, and 68.0% intended to participate. In a regression model, the factors that had an effect on the perceived need for an oral health program were education level, use of oral hygiene auxiliary devices, and toothbrushing time, and the factors affecting intent to participate were education for prevention of periodontal disease and the use of oral hygiene auxiliary devices. The subjects stated that the following oral health programs were needed: an oral bacteria exam (74.3%), toothbrushing education (71.6%), a bad breath exam (69.3%), education on use of oral hygiene auxiliary devices (46.9%), a dental plaque exam (42.9%) and a saliva exam (37.6%). Oral health education appears to be an important factor for participation in an incremental oral health program.
Adult* ; Bacteria ; Dental Caries ; Dental Plaque ; Education ; Humans ; Korea ; National Health Programs ; Oral Health* ; Oral Hygiene ; Periodontal Diseases ; Program Development ; Saliva ; Tooth ; Toothbrushing

Far Eastern countries including Korea show the high prevalence of hepatitis B virus carriers, so that the incidence of liver cirrhosis is higher than in western countries. But pregnancies with liver cirrhosis are rarely encountered in clinical settings, since liver cirrhosis usually develops after childbearing ages and often causes the disturbance of estrogen metabolism, resulting in severe menstrual irregularity and infertility. Therefore, little is known about the interactions between liver cirrhosis and pregnancy. Liver cirrhosis and portal hypertension are not contraindications to pregnancy but necessitate intensive monitoring throughout pregnancy because the complications of liver cirrhosis, which pose additional risks during pregnancy, are numerous and unpredictable. We report 3 cases of pregnancies in patients with liver cirrhosis with brief review of the literature.
Estrogens ; Hepatitis B virus ; Humans ; Hypertension, Portal ; Incidence ; Infertility ; Korea ; Liver Cirrhosis* ; Liver* ; Metabolism ; Pregnancy* ; Prevalence

BACKGROUND: Currently the most common treatment modality of refractory ascites in patients with liver cirrhosis was large volume paracentesis, but this procedure usually needed albumin infusion and occasionally developed unwanted complications. By reason of albumin shortage in Korea and occasional unfavorable complications, we studied the usefulness of dialytic ultrafiltration as an another treatment modality of refractory ascites. METHODS: Dialytic ultrafiltration was done in 10 patients (total 48 times) with liver cirrhosis or hepatocellular carcinoma. Two drainage conduit (via 16 gauge angio-catheter) of input and output were made by puncture of patient's right and left lower quadrant abdomen. The initial ultrafiltration rate of dialyser was 250mL/min. Ascitic fluid was removed continuously until the filtration rate down at 50mL/min. After ultrafiltration, ascitic fluid contained concentrated albumin and large molecules was reinfused via input conduit. Pre-treatment and post-treatment level of blood chemistry, plasma renin concentration, aldosterone, and electrolytes in serum; total protein and albumin in ascites were measured. During the ultrafiltration, we closely observed the change of blood pressure, heart rates and mental status. RESULTS: The mean ultrafiltration time was 231+/-28min, ultrafiltrated volume was 5.15+/-1.41 L. During dialytic ultrafiltration, patient's blood pressure and heart rate were stable and there was no change of mental status. After dialytic ultrafiltration, blood urea nitrogen level significantly decreased from 30.5+/-23.7mg/dL to 25.7+/-20.2mg/dL; serum aldosterone level decreased from 807.3+/-301.1pg/ml to 431.1+/-187.2pg/ml in serum (P<0.01). The albumin level in the ascitic fluid significantly increased from 0.67+/-0.28g/dL to 1.90+/-1.16g/dL (P<0.01). Plasma renin concentration level tend to decreased (P=0.06). The patient's serum total protein, albumin, electrolytes, and creatinine were not changed. Complications of dialytic ultrafiltration were peritonitis (one case) and hypotension (one case). But these unwanted complications were readily managed by adequate antibiotics and intravenous fluid therapy. CONCLUSION: The dialytic ultrafiltration can be used effectively without albumin infusion in the treatment of refrartory ascites in patients with advanced liver cirrhosis.
Abdomen ; Aldosterone ; Anti-Bacterial Agents ; Ascites* ; Ascitic Fluid ; Blood Pressure ; Blood Urea Nitrogen ; Carcinoma, Hepatocellular ; Chemistry ; Creatinine ; Drainage ; Electrolytes ; Filtration ; Fluid Therapy ; Heart Rate ; Humans ; Hypotension ; Korea ; Liver Cirrhosis* ; Liver* ; Paracentesis ; Patient Rights ; Peritonitis ; Plasma ; Punctures ; Renin ; Ultrafiltration*

BACKGROUND: Insulin exerts an effect on cell proliferation and inhibition of apoptosis. However, the actions of insulin on cell cycle progression and signal transduction pathway are not well understood and insulin shows diverse effects on cell proliferation depending on cell types. OBJECTIVE: We attempted to understand the underlying mechanism by which insulin exerts this proliferative effect on 3T3 L1 fibroblasts by various markers of cell proliferation. METHOD: We investigated the effect of insulin on cell proliferation by [3H]thymidine incorporation, analyzing the cell cycle stages by flow cytometric measurement of DNA content per cell, cell counting, analysing cell division as well as the signal transduction pathway of insulin by measuring of phosphatidylinositol 3-kinase(PI3-kinase) and p44/42 mitogen-activated protein kinase (p44/42 MAPK/ERK) activity. RESULTS: The results were as follows: 1. Total accumulated [3H]thymidine incorporation increased approximately two-fold with insulin over the 0.5% serum control at 48 h incubation, and the maximal rate of DNA synthesis was observed during 8-12 h incubation and continuously declined until 48 h without a second increase in DNA synthnesis.. 2. The flow cytometric analysis of cell population distribution showed that insulin increased the cell population in S phase. 3. After insulin treatment for 48 h, cell number was increased approximately 45% in comparison with 0.5% serum control. 4. The cell division analysed after staining 3T3 L1 fibroblasts with carboxyfluorescein diacetate succinimidyl ester (CFSE). Cell division occured only once in 24h after insulin treatment.. 5. Insulin stimulated PI3-kinase and p44/42 MAPK/ERK activity about three- and two-folds, respectively. CONCLUSION: Taken together, this data indicates that insulin stimulated the transit from G0/G1 to S phase, progressed cell cycle through G2/M phase, increased the cell number and PI3-kinase, p44/42 MAPK/ERK stimulate cell proliferation. However, under our experimental conditions, insulin has a limited efficacy for late cell cycle events required for completion of miosis and cell cycle progression into the second round and the increase of the cell number by insulin was much less than the increase of the PI3-kinase and p44/42 MAPK/ERK activity. Therefore, the authors think that another pathways other than PI3-kinase or p44/42 MAPK/ERK might be involved in the effect of insulin on cell proliferation.
Apoptosis ; Cell Count ; Cell Cycle* ; Cell Division ; Cell Proliferation* ; Demography ; DNA ; Fibroblasts* ; Insulin* ; Miosis ; Phosphatidylinositol 3-Kinases ; Phosphatidylinositols ; Protein Kinases ; S Phase ; Signal Transduction