BACKGROUND: The Seoul Verbal Learning Test (SVLT) is a relatively brief test of verbal learning and memory, which is used to examine dementia patients when a more comprehensive memory assessment is not feasible or when serial testing is desired. The aim of this study was to investigate the pattern of the SVLT performance and its usefulness in making a differential diagnosis between Alzheimer's disease (AD) and subcortical vascular dementia (SVD). METHODS: The SVLT was administered to 15 younger controls, 12 elderly controls, 84 probable AD and 53 SVD patients who met the DSM-IV criteria for dementia. In order to determine the difference of the SVLT parameters between AD and SVD according to the disease severity, the subjects were first grouped into mild dementia (CDR 1 or less) and advanced dementia (CDR2), then the parameters were compared. RESULTS: Pattern analysis of the SVLT performance in subjects with AD and SVD revealed that the mild AD subjects recalled fewer words in trial 2, had a lower discrimination index, a lower combination memory score and more recognition of semantically-unrelated distracter items. In advanced cases, with the exception of combination memory score, there were no differences between the groups in terms of the overall learning or the discrimination index. CONCLUSIONS: Although SVLT has limited differential diagnostic value in advanced cases, in mild cases, pattern analysis of the SVLT performance is a useful tool for discriminating mild AD from SVD. Therefore, a further clinical study should be promising.
Aged ; Alzheimer Disease* ; Dementia ; Dementia, Vascular* ; Diagnosis, Differential* ; Diagnostic and Statistical Manual of Mental Disorders ; Discrimination (Psychology) ; Humans ; Learning ; Memory ; Seoul* ; Verbal Learning*

BACKGROUND: In recent years, lung cancer has been one of most common cause of death in Korea. Despite many physician's high degree of pessimism about the gains made in treatments progressive improvement in the survival of lung cancer by treatment has occurred, particulary in the early stages of the disease. However, a lot of patients refuse treatment or give up in the fight against the disease. This study was done to evaluate factors ifluencing the compliance to therapy and to lead in the establishment of special programs to enhance compliance in patients with lung cancer. METHODS: The medical records of 903 patients, whose ECOG(Eastern Cooperative Oncology Group) performance status was 3 or less and whose medical record was relatively satisfactory, among 1141 patients diagnosed with lung cancer between January 1989 and December 1996 were reviewed retrospectively. Compliance was classified into three groups based on the degree of compliance with physicians practice guideline : (a) complaints ; (b) patients who initially complied but gave up of themselves midway during the course of treatment ; (c) noncompliants who refused the treatment. RESULTS: The overall compliance rats was 63.9%, which was progressively increased from 57.3-61.3% in 1989 and 1990 to 64.2-67.5% in 1995 and 1996. Age, education level and occupation of patients bore statistically significant relationship with the compliance but sell marital status and smoking history did not. The compliance was significantly higher in patients without symptoms than with, and was also significantly higher in patients with good performance status. The compliance was significantly high in patients with NSCLC(non-small cell lung cancer) compared to SCLC(small cell lung cancer), but after exclusion of stage l and ll, among NSCLC, which had higher compliance to surgery there was no significant difference of compliance by histology. The compliance was significantly lower in advanced stage. CONCLUSION: To enhance the compliance, special care including education programs about therapy including complicantion and prognosis are necessary, especially for educationally and economically disadvantaged patients.
Animals ; Cause of Death ; Compliance* ; Education ; Humans ; Korea ; Lung Neoplasms* ; Lung* ; Marital Status ; Medical Records ; Occupations ; Prognosis ; Rats ; Retrospective Studies ; Smoke ; Smoking ; Vulnerable Populations

PURPOSE: The portal blood influx appears to be essential for liver regeneration after a liver resection and transplant. It was reported that only grafts with a gastro-pancreatic-splenic portal inflow into the graft portal vein could increase in size. The aim of this study was to investigate the impact of the gastro-pancreatic-splenic portal flow on the regeneration of a graft liver in a microsurgical model of heterotopic partial liver transplantation model. METHODS: Sprague-Dawley rats weighing 200 to 300 grams were used in this study. The rats were fasted for 12 hours prior to surgery. Thirty percent of the liver was heterotopically transplanted, to connect the donor's portal vein and suprahepatic vena cava with the recipient's superior mesenteric vein and the suprarenal vena cava, respectively. The donor and original liver were weighed preoperatively and 1, 2, 3, 7 days postoperatively. In addition, the histology of the donor and recipient's liver were examined using optical microscopy, and H & E staining. The proliferative capacity of the donor and recipient hepatocytes was evaluated using immunohistochemistry. RESULTS: The liver weights of the donor and recipient were measured at serial time points after surgery. Progressive enlargement was observed in the original liver. However, in assessing the liver weight, the weight of the donor liver was significantly lower at 2 days, 3 days, and 7 days after surgery than that of the original liver. During the observation periods, prominent histopathological differences were observed between the donor and recipient liver. There was a markedly higher number of PCNA (+) cells in the original liver than in the donor liver. CONCLUSION: The gastro-pancreatic-splenic portal inflow into the graft appears to play an important role in regenerating a partial liver graft. However, several variables such as the ischemic time, bile duct ligation, a small-for-size graft, and hepatic artery reconstruction in this model should be considered.
Animals ; Bile Ducts ; Hepatectomy ; Hepatic Artery ; Hepatocytes ; Humans ; Immunohistochemistry ; Ligation ; Liver Regeneration* ; Liver Transplantation* ; Liver* ; Mesenteric Veins ; Microscopy ; Portal Vein ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Tissue Donors ; Transplants ; Weights and Measures

PURPOSE: Unilateral ureteral obstruction results in tubulointerstitial fibrosis of the affected kidney which is driven by increased levels of angiotensin II. In this study, we examed the fibrotic changes in un inephrectomized rats with incomplete urteral obstruction and explored the effect of an angiotensin converting enzyme(ACE)inhibitor, enalapril on the tubulointerstitial fibrosis of obstructive uropathy. MATERIALS AND METHODS: 130 Rats were sacrificed at 1, 2, 4 weeks after nephrectomy or obstruction. Collagen type I, II, and III were localized by immunohistochemical staining. And the distribution of each collagen type was analyzed using differences of their staining densities. RESULTS: There is no difference in total collagen amount and immunohistochemical staining between control and uninephrectomized group. After 2weeks in incomplete ureteral obstruction in uninephretomized rat, the total amount of collagen in affected kidney was significantly increased compared to control (p<0.05), and immunohistochemical staining for all type of collagen was gradually increased by increased duration of incomplete ureteral obstruction. Enalapril did not affect the total collagen amount and immunohistochemical staining in the kidney of uninephrectomized rat. Enalapril significantly decreased the collagen amount in affected kidneys of collagen was not significantly changed compaired to control group. CONCLUSIONS: the incomplete ureteral obstruction in uninephrectomized rat induces progressive increase of amount of collagen according to the duration of obstruction, especially 2 weeks, and enalapril administration after incomplete unilateral obstruction of tubulointerstitial fibrosis of obstructive uropathy.
Angiotensin II ; Angiotensins ; Animals ; Collagen Type I ; Collagen* ; Enalapril* ; Fibrosis ; Kidney ; Nephrectomy ; Rats* ; United Nations ; Ureter* ; Ureteral Obstruction*

PURPOSE: To evaluate the dose under lung block as a function of depth and the effectiveness of a block as a function of block width. MATERIALS AND METHODS: Field size of mantle field was 22.8 x 32.4 cm2 . Dose distribution of the mantle field was measured with two dimensional water phantom system. To analyze the effectiveness of the lung block, central axis plane, 5cm off-axis plane, and 10cm off-axis plane were studied. RESULTS: The dose under the lung block was recorded with maximum at the depth between , 5cm and 10cm . In the central axis plane, dosimetric block width was 10-15% les than physical block width. In the 5cm off-axis plane. Dosimetric block width was 4-9% less than physical block width. In the 10cm off-axis plane, dosimetric block width was 2% less than physical block width. CONCLUSION: Depth dependence of the dose under the lung block was founded. Also, block width dependence of the lung block was founded. To induce the accurate relation between the physical block width and the "effective" block width, it needs more detailed understanding of the variables involved.
Axis, Cervical Vertebra ; Lung* ; Water

BACKGROUND: It has long been suggested that neutrophils and their products are implicated as the central mediators of the acute lung injuries. Contrary to the dominant role of neutrophils in ARDS, many cases of ARDS has occurred in the setting of severe neutropenia without pufrnonary neutrophil infiltration. Therefore it is certain that effector cell(s) other than neutrophil play an important role in the pathogenesis of ARDS. This experiment was performed to define the mechanism of ARDS in the setting of neutiopenia, 1) by comparing the severity of endotoxin-induced lung injury, 2) by measurement of hydrogen peroxide production and cytokine concentration in the bronchoalveolar lavage cells and fluids obtained from different rats with and without cyclophosphamide-pretreatment. METHOD: The male Sprague-Dawleys were divided into the normal control (NC)-, endotoxin (ETX)-, and cyclophosphamide (CPA)-group in which neutropenia was induced by injecting cyclophosphamide intraperitoneally. Acute lung injury was evoked by injecting lipopolysaccharide (LPS) into a tail vein. The bronchoalveolar lavage (BAL) was performed at 3 and 6 hour after administration of LPS to measure the change of cell counts and concentrations of protein and cytokines, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). Hydrogen peroxide (HPO) production from BAL cel]s was measured at 6 hour after LPS administration by phenol red microassay with and without zymosan stimulation. RESULTS: The results were as follows. A change of leukocyte counts in the peripheral blood after treatment with CPA More than 95% of total leukocytes and neutrophils were reduced after CPA administration, resulting in severe neutropenia. A change of BAL cells In the ETX-group, the number of total cells (p<0.01) and of macrophage and neutrophll (p<0.05) were increased at 3 and 6 hour after LPS administration compared to those of NC- group. In the CPA-group, the number of total leukocyte and macrophage were not changed after LPS administration, but neutrophil counts were significantly reduced and jt took part in less than 0.1% of total BAL cells (p<0.01 vs NC-group). BAL cells in this group were almost all macrophages (99.7%). A change of protein concentration in the BALF In the ETX-group, protein concentration was increased at 3 hour and was more increased at 6 hour after LPS administration (p<0.05 and <0.01 vs NC-group, respectively). In the CPA-group, it was also significantly elevated at 3 hour after LPS administration (p<0.05 vs NC-group) , but the value was statistically not different from that of ETh-group. The value measured at 6 hour after LPS administration in the CPA-group became lower than that of ETX-group (p<0.05), but showed still a higher value compared to that of NC-group (p<0.05). A change of cytokine concentration in the BALF TNF-alpha and IL-6 were elevated in the ETX- and CPA-group compared to those of NC-group at both time intervals. There was no statistical difference in the values of both cytokines between the ETX- and CPA-groups. Measurement of hydrogen peroxide production from BAL cells There was no intergroup difference of HPO production from resting cells. HPO production after incubation with opsonized zymosan was significantly elevated in all groups. The percent increment of HPO production was highest in the ETX-group (89.0%, p<0.0008 vs NC-group ), and was 42.85 in the CPA-group (p = 0.003 vs NC-group ). Conclusion Acute lung injury in the setting of neutropenia might be caused by functional activation of resident alveola r macrophages.
Acute Lung Injury* ; Animals ; Bronchoalveolar Lavage ; Cell Count ; Cyclophosphamide ; Cytokines ; Humans ; Hydrogen Peroxide ; Interleukin-6 ; Leukocyte Count ; Leukocytes ; Lung Injury ; Macrophages* ; Male ; Neutropenia ; Neutrophil Infiltration ; Neutrophils ; Phenolsulfonphthalein ; Rats* ; Tumor Necrosis Factor-alpha ; Veins ; Zymosan

No abstract available.
Female ; Fetal Heart* ; Hearing* ; Heart Rate, Fetal* ; Pregnancy ; Pregnancy*

We experienced a case of Ebstein's anomaly prenatally by fetal sonography. Ebstein's anomaly is a rare congenital heart defect characterized by abnormally downward displacement of the septal and posterior leaflets of the tricuspid valve. In the absence of tricuspid regurgitation, this condition may be completely asymptomatic. On the other hand, symptomatic newborns often develop life-threatening congestive heart failure. A 30-year-old multiparous woman was referred for the evaluation of fetal cardiac defect at 26th gestational week from a private clinic. Fetal ultrasonography showed markedly enlarged right atrium and downward displacement of tricuspid valve into the right ventricle. After discussion with the patient, the pregnancy was terminated and Ebstein's anomaly was confirmed by autopsy.
Adult ; Autopsy ; Ebstein Anomaly* ; Female ; Hand ; Heart Atria ; Heart Defects, Congenital ; Heart Failure ; Heart Ventricles ; Humans ; Infant, Newborn ; Pregnancy ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Ultrasonography, Prenatal

Placenta accreta is a rare complication of pregnancy with high rates of maternal morbidity and mortality.It is usually discovered when removal of the placenta after delivery is difficult or there is substantial postpartum bleeding.Placenta accreta can be complicated by disseminated intravascular coagulation (DIC) and this increases maternal morbidity and mortality.DIC is characterized by the widespread activation of coagulation, which results in the intravascular formation of fibrin and ultimately thrombotic occlusion of small and midsize vessel.We report a 24-year-old woman with DIC, who developed severe pre- and intraoperative bleeding and massive transfusion during emergent cesarean section.
Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Fibrin ; Hemorrhage ; Humans ; Placenta ; Placenta Accreta ; Postpartum Period ; Pregnancy ; Young Adult

Placenta accreta is a rare complication of pregnancy with high rates of maternal morbidity and mortality.It is usually discovered when removal of the placenta after delivery is difficult or there is substantial postpartum bleeding.Placenta accreta can be complicated by disseminated intravascular coagulation (DIC) and this increases maternal morbidity and mortality.DIC is characterized by the widespread activation of coagulation, which results in the intravascular formation of fibrin and ultimately thrombotic occlusion of small and midsize vessel.We report a 24-year-old woman with DIC, who developed severe pre- and intraoperative bleeding and massive transfusion during emergent cesarean section.
Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Fibrin ; Hemorrhage ; Humans ; Placenta ; Placenta Accreta ; Postpartum Period ; Pregnancy ; Young Adult