Objective: This study aimed to investigate the role of apolipoprotein E (APOE) ε4 allele to the incidence of dementia and cognitive decline in a cohort of a Korean community. Methods: From a community-based dementia-free cohort, 357 participants were genotyped. Participants underwent 2 cognitive assessments separated by a hiatus between 6 to 7 years and were diagnosed as healthy control (n=297), Alzheimer’s disease (AD) (n=44), and other dementia (n=16) at the second assessment. Incidence risk and onset age of disease according to APOE ε4 presence were analyzed in AD and other dementia. Differences in cognitive decline rate depending on APOE ε4 were also examined across all groups. Results: The relative risks and onset age of dementia were not different by the presence of the APOE ε4 allele. Cognitive decline was more prominent in the presence of APOE ε4 allele (score change=7.4) than non-presence (score change=3.1), and this interaction was significant only in the AD group (F=10.51, p=0.003). Conclusion The APOE ε4 alleles can be a critical factor in predicting cognitive change for AD in the Korean community population but not in predicting AD incidence. This finding suggest that clinicians consider the presence of APOE ε4 allele examining patients with rapid declining dementia.

BACKGROUND: In dental intravenous sedation, continuous intravenous infusion of a low-dose drug requires an infusion pump such as a syringe pump. To develop a new syringe pump for clinical use, the functions of the pump must meet certain international standards. Various safety and efficacy tests must be performed on the syringe pump, as stipulated by these standards, and an approval must be received from the approving agency based on such test results. METHODS: The authors of the present study developed a novel syringe pump and performed efficacy evaluation by testing its infusion speed at 1 and 25 ml/h, and infusion performance testing at 2 and 24 h. Moreover, performance evaluation was conducted by comparing the novel pump to an existing pump with the infusion speed varied from 1 to 5 ml/h. RESULTS: In the efficacy testing on the newly developed syringe pump, infusion with the infusion speed initially set to 1 ml/h resulted in infusion speeds of 1.00 and 0.99 ml/h in the 2- and 24-h assessment, respectively. Changing the infusion speed setting to 25 ml/h resulted in an infusion speed of 25.09 and 23.92 ml/h in the 2- and 24-h assessment, respectively. These results show no significant differences when compared with other commercially available pumps. CONCLUSIONS: The efficacy testing of the newly developed syringe pump showed the accuracy to be within tolerance. Based on these findings, we believe that the newly developed syringe pump is suitable for clinical use.
Data Accuracy ; Infusion Pumps ; Infusions, Intravenous ; Syringes*

OBJECTIVES: This study was conducted in order to develop a computerized test to measure the level of mathematic achievement and related cognitive functions in children and adolescents in South Korea. METHODS: The computerized Comprehensive Learning Test-Mathematic (CLT-M) consists of the whole number computation test, enumeration of dot group test, number line estimation test, numeral comparing test (magnitude/distance), rapid automatized naming test, digit span test, and working memory test. To obtain the necessary data and to investigate the reliability and validity of this test, 399 children and adolescents from kindergarten to middle school were recruited. RESULTS: The internal consistency reliability of the CLT-M was high (Cronbach's alpha=0.76). Four factors explained 66.4% of the cumulative variances. In addition, the data for all of the CLT-M subtests were obtained. CONCLUSION: The computerized CLT-M can be used as a reliable and valid tool to evaluate the level of mathematical achievement and associated cognitive functions in Korean children and adolescents. This test can also be helpful to detect mathematical learning disabilities, including specific learning disorder with impairment in mathematics, in Korea.
Adolescent* ; Child* ; Cognition ; Dyscalculia ; Humans ; Korea ; Learning ; Learning Disorders ; Mathematics* ; Memory, Short-Term ; Reproducibility of Results ; Specific Learning Disorder

OBJECTIVES: To evaluate cognitive reserve in Korea using Korean version of Cognitive Reserve Index questionnaire (K-CRIq) and to investigate the effects of gender and age on cognitive reserve. METHODS: Three hundred and fifty-eight healthy subjects aged 25–85 years old in one community participated in the study. K-CRIq was developed and administered to all subjects to assess the effects of gender and age on cognitive reserve. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were administered to subjects over 65 years old to test concurrent validity. RESULTS: Age and gender as well as their interaction significantly affected Cognitive Reserve Index (CRI) score. Men had higher cognitive reserve than women over 45 years old, but at younger ages there was no gender difference in cognitive reserve. CRI score and sub-scores were strongly associated with the MMSE and MoCA. CONCLUSION: The results indicate that the gender effect on cognitive reserve is disappearing in the young generation in Korea. Scores in neuropsychological tests are predicted well by the CRI score.
Aging ; Cognitive Reserve* ; Female ; Healthy Volunteers ; Humans ; Korea* ; Male ; Methylenebis(chloroaniline) ; Neuropsychological Tests

PURPOSE: To compare the antibiotic release kinetics of the implant coated with antibiotic-impregnated polymers MATERIALS AND METHODS: Authors used polylactic acid (PLA) and polylactic-co-glycolic acid (PLGA) as the biodegradable carriers, gentamicin sulfate as the antibiotic and Steinmann pin as the implant. Ten Steinmann pins were coated with gentamicin of each 10, 20 and 30% mixture of PLA or PLGA for the elution kinetics study. In the elution study, total 60 coated implants were incubated in 10 mL of phosphate buffered saline (PBS) at 37 delta C and sampled at 6 hrs, 1, 3, 6, 9, 12, 15, 20, and 25 days. Assays were performed with fluorescence polarization immunoassay. Statistical analysis was done with SAS release 2.01. RESULTS: Released concentration of GM decreased with time. Minimum inhibitory concentration was maintained until 6th day on PLA 10% subgroup, 9th day in the 20 and 30% subgroups, until 6th day on PLGA 20% subgroup, and 3rd day in the 10 and 30% subgroups. Released concentrations were significantly higher in all PLA subgroups than in PLGA as a parameter of sampled time (all p<0.05). There was no statistical difference between PLA 20 and 30% subgroup after 12th sampled day (p=0.2636). CONCLUSION: PLA-GM group showed higher effective concentration for longer time than PLGA-GM group. 20 and 30% subgroups of PLA-GM showed prolonged maintenance of minimum inhibitory concentration compared with 10% subgroup, but there was no difference between the two groups.
Fluorescence Polarization Immunoassay ; Gentamicins ; Kinetics* ; Microbial Sensitivity Tests ; Polymers*

PURPOSE: Medical and business are one of the most popular majors among students, and both fields require intensive training to reach certain level of expertise. During the development of professionalism, goal can become a crucial role in psychological impetus. The purpose of this study is to compare goal contents, goal characteristics, and effect of goal characteristics on student's major satisfaction between medical and business. METHODS: A total of 193 undergraduate students (97 medical students, 96 business students) answered survey questions including goal contents, goal characteristics (goal autonomy, goal attainability, social value of goal) and satisfaction on their majors. Qualitative analysis of goal contents and quantitative analysis of goal characteristics, and their effects on student major satisfaction were performed. RESULTS: Goal content analysis showed percentage of social concern goal was higher in medical students (25.8%) than business students (6.3%), whereas percentage of wealth goal was higher business students (24.0%) than medical students (3.1%). Among goal characteristics, goal attainability and social value of goal were higher in medical students than business students. In both groups, social value of goal was significantly predict major satisfaction. CONCLUSION: Goal contents and goal characteristics are different between medical and business students. Curriculum and educational interventions that concerning students' goal and developing programs to enhance students' social value of goal is necessary.
Adolescent ; Adult ; *Career Choice ; Commerce ; Curriculum ; *Education, Medical, Undergraduate ; Female ; *Goals ; Humans ; Income ; Male ; *Motivation ; *Personal Satisfaction ; Social Responsibility ; Social Values ; Students ; *Students, Medical ; Surveys and Questionnaires ; Young Adult

BACKGROUND: Laparoscopic cholecystectomy is a standard treatment for cholelithiasis and indication is continuously widened to acute and complicated cholecystitis. It has been proved to give advantages such as less postoperative pain, postoperative complications and early recovery. However, postoperative hepatic dysfunction after laparoscopic cholecystectomy has been repeatedly reported and when we evaluate postoperative hepatic dysfunction, laparoscopic surgery has been thought as one of the contributors. So authors planned this study to satisfy the growing need of reevaluation of postoperative hepatic dysfunction because we have had many achivements and improvements in knowledge and operative techniques since a while. METHODS: From January to December in 2000, 182 patients were randomly selected among who had undergone cholecystectomy in one university hospital. The numbers of each group (group OC; open, group LC; laparoscopy) were equal. Demographic data, duration of operation and level of liver enzymes (alanine transferase, alkaline phosphatase, total bilirubin and direct bilirubin) on operation day and one postoperative day were estimated by medical records. RESULTS: Mean operation time was longer in group OC than in group LC. Levels of alanine transferase, total bilirubin and direct bilirubin of postoperative one day were increased significantly in both groups. The degrees of increase of alanine transferase and bilirubin were higher in group OC than group LC in statistically significant manner. CONCLUSIONS: Laparoscopic cholecystectomy has more advantages than open cholecystectomy in many aspects.
Alanine ; Alkaline Phosphatase ; Bilirubin ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholelithiasis ; Humans ; Laparoscopy ; Liver* ; Medical Records ; Pain, Postoperative ; Postoperative Complications ; Transferases

Objective: The purpose of this study was to investigate the efficacy of medication management as a method of early intervention in dementia. Methods: This study used data of survey and Mini-Mental State Examination for Dementia Screening score of 46 dementia patients given medication management. Participants were separated into three groups based on the duration of medication management. Then we compared the change in cognitive ability and the frequency of community service usage. Results: The decline of Mini-Mental State Examination score that each group reported was -0.93±2.69, -1.38±1.71, and -1.00± 3.52 and there was no significant difference. In terms of the community service, after being given the medication management, the usage of community service increased. Conclusion Continuous medication management might relieved the decrease of cognitive ability and encourage dementia patients to participate in community service.

Objective: The distinction between idiopathic normal pressure hydrocephalus (iNPH) and hydrocephalus ex vacuo caused by encephalic volume loss remains to be established. This study aims to investigate radiological parameters as clinically useful tools to discriminate iNPH from hydrocephalus ex vacuo caused by Alzheimer’s disease (AD). Methods: A total of 54 patients with ventriculomegaly (iNPH, 25; hydrocephalus ex vacuo, 29) were recruited in this study. Consequently, nine radiological parameters were compared between iNPH and hydrocephalus ex vacuo using magnetic resonance imaging (MRI). Results: A small callosal angle (CA), the Sylvian fissure dilatation, and absence of narrowing of superior parietal sulci discriminated the iNPH group from the hydrocephalus ex vacuo group (p<0.05). The final binary logistic regression model included narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure after controlling for age and global Clinical Dementia Rating (CDR). The composite score made from these three indicators (narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure) was statistically different between iNPH and hydrocephalus ex vacuo. Conclusion The narrowing of the CA, dilatation of the Sylvain fissure, and narrowing of superior parietal sulci may be used as radiological key indices and noninvasive tools for the differential diagnosis of iNPH from hydrocephalus ex vacuo.

Objective: The distinction between idiopathic normal pressure hydrocephalus (iNPH) and hydrocephalus ex vacuo caused by encephalic volume loss remains to be established. This study aims to investigate radiological parameters as clinically useful tools to discriminate iNPH from hydrocephalus ex vacuo caused by Alzheimer’s disease (AD). Methods: A total of 54 patients with ventriculomegaly (iNPH, 25; hydrocephalus ex vacuo, 29) were recruited in this study. Consequently, nine radiological parameters were compared between iNPH and hydrocephalus ex vacuo using magnetic resonance imaging (MRI). Results: A small callosal angle (CA), the Sylvian fissure dilatation, and absence of narrowing of superior parietal sulci discriminated the iNPH group from the hydrocephalus ex vacuo group (p<0.05). The final binary logistic regression model included narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure after controlling for age and global Clinical Dementia Rating (CDR). The composite score made from these three indicators (narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure) was statistically different between iNPH and hydrocephalus ex vacuo. Conclusion The narrowing of the CA, dilatation of the Sylvain fissure, and narrowing of superior parietal sulci may be used as radiological key indices and noninvasive tools for the differential diagnosis of iNPH from hydrocephalus ex vacuo.