BACKGROUND: Vascular dementia is common cause of dementia, second to the dementia of Alzheimer desease. However in Asia and many developing countries, the incidence of vascular dementia exceeds that of Alzheimer's disease. Though many stroke-related factors related the nature of vascular injury, e.g. infarction and hemorrhage, have not assessed yet. Clarifying the difference of electroencephalograpy and clinical prognosis between infarction and hemorrhage, the aim of this study was to elucidate the role of nature of vascular injury. METHODS: to reduce confounding factors, the study population was restricted to the patients of single hemispheric striatocapsular infarction and hemorrhage saving cortex. On admission, we checked the KMMSE and FIM scores and using quantified EEG, we analyzed occipital peak frequency and the relative background alpha, theta and delta spectra power taken from 16 derivations by averaging twenty-2 -sec epoch in infarction, hemorrhage patients and elderly controls. After 6 months follow up, we compare the MMSE, FIM score between infarction and hemorrhage group. RESULTS: 1) Compared with infarction group, hemorrhage groups had a significantly bilateral lower occipital peak freqauency and background bilateral alpha spectra power. 2) In hemorrhage group, there is lower tendency in K-MMSE after 6 month follow up compared to infarction group. CONCLUSION: This study suggests that hemorrhage show more bilateral electrophysiological dysfunction than infarction group and possible grave prognosis for vascular dementia compared to infarction group.
Aged ; Alzheimer Disease ; Asia ; Dementia ; Dementia, Vascular ; Developing Countries ; Electroencephalography* ; Follow-Up Studies ; Hemorrhage* ; Humans ; Incidence ; Infarction* ; Prognosis* ; Vascular System Injuries

PURPOSE: To study the short term effects of hypercholesterolemia on corpus cavernosal tissue, we performed isometric tension studies and RT-PCR was used to identify mRNA expression of VEGF on isolated strips of corpus cavernosum, on rabbits which underwent partial ligation of the abdominal aorta and received a diet containing 2% cholesterol. MATERIALS AND METHODS: New Zealand White rabbits were divided into a control group(n=6) fed with a regular diet and a hypercholesterolemic group(n=10) which underwent partial ligation of the abdominal aorta and received a diet containing 2% cholesterol. After 3 weeks, the relationship between hypercholesterolemia and cavernosal smooth muscle pathophysiology was studied. To characterize the cavernosal smooth muscle reactivity in hypercholesterolemia, we performed isometric tension studies with phenylephrine(PE), acetylcholine(Ach), sodium nitroprusside(SNP) and electrical field stimulation(ES). RT-PCR was used to identify the mRNA expression of VEGF. RESULTS: PE-induced cavernous smooth muscle contraction in the hypercholesterolemic group was increased compared with the control group(p<0.05), while relaxation by Ach and ES in PE pretreated cavernosal smooth muscle in the hypercholesterolemic group was decreased(p<0.05). Relaxation by SNP in PE pretreated cavernosal smooth muscle was not different between any experimental groups. Expression of VEGF mRNA in cavernosal smooth muscle was significantly increased in the hypercholesterolemic group compared with the control group. CONCLUSIONS: Hypercholesterolemia caused a significant increase in PE-induced contraction of cavernosal tissue. Hypercholesterolemic cavernosal tissue retained the ability of relaxation induced by endothelium-independent, but relaxation induced by endothelium-dependant was impaired. Furthermore, expression of VEGF mRNA in cavernosal tissues was up regulated in the hypercholesterolemic group. This study showed that a short period of hypercholesterolemia could induce pathophysiologic change of cavernosal tissue.
Aorta, Abdominal ; Cholesterol ; Diet ; Erectile Dysfunction ; Hypercholesterolemia* ; Ligation ; Male ; Muscle, Smooth ; Rabbits* ; Relaxation ; RNA, Messenger ; Sodium ; Vascular Endothelial Growth Factor A

BACKGROUND: Though symptomatic improvements after treatment of donepezil is well documented in Alzheimer's disease (AD), the electrophysiological change have not yet been elucidated. Among the parameters of quantitative electroen-cephalography (q-EEG), high frequency activity, especially gamma rhythm, may play a role in normal cognitive function including the integration of sensory processing, association, coupling or selective attention, which are characteristically impaired in AD. METHODS: In order to define the profile of q-EEG changes including gamma rhythm after donepezil treatment, we followed 17 AD patients for 12 weeks. We analyzed the spectra power taken from 16 derivations by averaging twenty-2-sec epoch in normal controls and AD patients. After logarithmic transformation of spectra power, statistical test was done and the effect of donepezil treatment on q-EEG profile was analyzed during follow up period. RESULTS: Before medication of donepezil, AD patients had a significantly lower alpha spectra power as well as a significant higher delta spectra power, compared with normal control. After medication of donepezil in AD patients, compared to base-line q-EEG, gamma spectra power was significantly increased, whereas delta spectra power was significantly reduced. Compared to absolute power, relative power was more sensitive in detecting change of EEG after donepezil treatment. CONCLUSIONS: This study suggests that donepezil significantly change delta and gamma spectra power in q-EEG, and the increase in gamma rhythm may be correlated with the clinical improvements after donepezil treatment. (J Korean Neurol Assoc 19(3):245~250, 2001)
Alzheimer Disease* ; Electroencephalography* ; Follow-Up Studies ; Humans

BACKGROUND: Alzhiemeranjx disease (AD) and vascular dementia (VD) are common types of dementia. As a result of the development of new specific agents for AD, and because vascular dementia is a potentially preventable dementia, differentiating these diseases is of great importance. The role of EEG spectral analysis in the differential diagnosis between Alzheimer type and vascular dementia is still controversial. Since there have been few studies concerning the differential diagnosis of dementia by EEG, the present study has focused on this aspect. Usefulness of EEG in differen-tial diagnosis of dementia will be elucidated by clarifying relationship between type of dementia and spectral profile of EEG. METHODS: We analyzed the power spectra taken from 16 derivations and spectral profile was constructed by averaging twenty 2 sec epochs in three study groups (normal controls, AD and VD). Spectral profile was divided into three groups; (I) type A, showing a dominant 6.5-12 Hz peak (ii) type B, lacking a dominant peak in the 6.5-12 Hz (iii) type C, corresponding to a flat, low voltage, spectrum. To elucidate the relationship between spectral profile and other factors including diagnosis, statistical test was done. RESULTS: (1) In AD, type C profile was statistically more prevalent than in VD and type A profile was reversed. (2) In AD, Mini-Mental State Examination (MMSE) score was statistically lower in type C profile. (3) Spectral profile was not associated with age, age of symptom onset, and symptom duration. CONCLUSIONS: This study suggested that spectral profile is a useful tool for the differential diagnosis of dementia (AD and VD) and correlated with the severity of disease in AD.
Dementia ; Dementia, Vascular* ; Diagnosis ; Diagnosis, Differential* ; Electroencephalography*

No abstract available.
Animals ; Rats* ; Urinary Bladder*

PURPOSE: The identification of factors present at the time of initial evaluation may be important to predict the prognosis in patients with superficial bladder carcinoma. Attempts were made to identify predictive factors of recurrence and progression. MATERIALS AND METHODS: This study included twenty seven patients with superficial bladder tumor(pTa-pTl) who had no recurrence within 5 years. A comparative non-randomized study was performed of a control group of twenty six patients with same superficial bladder tumor who had recurrence within 1 year after transurethral resection of bladder tumor(TURBT) was done. Between the former and the latter patients cumulative and multivariate analyses were performed to estabilish predictive factors of pathological recurrence and progression. The resected tumors were immunohistochemically stained with anti-lamin rabbit serum to evaluate the presence or absence of basement membrane breakage, the vascular and/or lymphatic invasion, and to count number of neovascularizasion. RESULTS: In superficial bladder carcinoma, invasion of basement membrane, grade, invasion of lymphatics and vessels, and neoangiogenesis were significant factors affecting recurrence and progression, and these factors acted independently. CONCLUSIONS: These factors used to predict recurrence and progression of superficial bladder tumor were thought to be the important risk factors. These results suggested that close follow-up and aggressive treatment such as BCG instillation should be considered for the treatment of superficial bladder cancer with unfavourable prognostic factors.
Basement Membrane ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Mycobacterium bovis ; Prognosis ; Recurrence* ; Risk Factors ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Myasthenia gravis is a disorder characterized by fluctuating muscle weakness. This is frequently associated with thymoma or thymic hyperplasia, and thymectomy is an important step of treatment. We present one case of primary wquamous cell carcinoma of the thymus in myasthenia gravis. Review of literature indicate relative good prognosis.
Carcinoma, Squamous Cell* ; Muscle Weakness ; Myasthenia Gravis* ; Prognosis ; Thymectomy ; Thymoma ; Thymus Gland ; Thymus Hyperplasia

PURPOSE: Primary pulmonary lymphoma(PPL) arising in the lung as the initial site is very rare. Authors experienced two cases of PPL and report the radiologic findings and clinical characteristics with a brief reviewof the literature. METHODS AND MATERIALS: Plain chest radiograph and enhanced axial CT scan of the chest were taken. We analyzed radiologic findings of the two cases and correlated with broncoscopic and pathologic findings. RESULTS: Plain chest radiograph showed a mass like consolidative lesion on RML without peripheral atelectasis. Chest CT scan revealed a mass like consolidation with airbronchogram and the absence of a hilar mass or thoracic adenopathy. Percutaneous needle aspiration and biopsy(PCNA and PCNB) of the RML mass confirmed B-cell lymphoma, in both cases. CONCLUSION: PPL must be included in the differential diagnosis of chronic alveolar consolidation such as bronchioloalveolar cell carcinoma.
Diagnosis, Differential ; Lung ; Lymphoma* ; Lymphoma, B-Cell ; Needles ; Pulmonary Atelectasis ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

In addition to severe deficits in speech production and auditory comprehension, patients with global aphasia general-ly have a dense hemiplegia. However, acute global aphasia without hemiparesis (GAWH) occurs rarely and only a few cases of GAWH have been reported with variable conclusions regarding lesion localization, etiology, and prognosis. We report an unusual case of GAWH in which magnetic resonance imaging (MRI) and single photon emission comput-ed tomography (SPECT) revealed only a single lesion of the left superior temporal area. Our case supports the notion that the functional anatomy of aphasia may be complex and that GAWH may have a more benign prognosis than typi-cal global aphasia with hemiparesis.
Aphasia* ; Comprehension ; Hemiplegia ; Humans ; Magnetic Resonance Imaging ; Paresis* ; Prognosis ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: The role of family caregivers is becoming more important for the recovery of patients with stroke, as the prevalence of stroke is increasing. Consequently, the burden of caregiving can affect both patients' and caregiver's functional health. The purpose of this study was to make a novel caregiving burden scale and evaluate factors that influence the burden of the family caregiver. METHODS: The caregiver burden scale consists of four aspects: psycho-emotional, financial, physical and isolation from social activities. The questionnaire was administrated to the family care-givers of 118 patients with stroke who consented to be interviewed. Among 118 caregivers, we analyzed 106 caregivers who answered the questionnaire completely. We evaluated the construct validity and internal reliability of the burden scale and applied multiple regression analysis for the factors that influence caregiver's burden. RESULTS:1) Construct validity by factor analysis and Internal reliability was high 2) Among 106 caregivers, 40 (37.7%) approached subjective depression on the Beck Depression Inventory (BDI). There was a statistically significant difference(p<0.01) in the strength of burden between the groups with and without depression. 3)Of the variables, including patient's age, caregiver's age, duration of caregiving, education level of caregiver, and socio-economic status of family, only the BDI scores of caregivers and the Barthel Index scores of patients were correlated to the degree of caregiving burden. CONCLUSIONS: This caregiving burden scale can be a useful tool for the evaluation of caregiver's burden with stroke. We believe that thoughtful consideration and realistic support for family caregivers can be very important in the long-term management of patients with stroke. (J Korean Neurol Assoc 19(3):213~218, 2001)
Caregivers ; Depression ; Education ; Humans ; Prevalence ; Surveys and Questionnaires ; Stroke*