BACKGROUND: To evaluate usefulness of cerebrospinal aspartate aminotransferase(AST) as a biologic marker for differentiation of Alzheimer's disease(AD) and Vascular dementia(VD) METHODS: A consecutive series of patients who met either the criteria of the National Institute of Neurological Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association(NINCDSADRDA) for probable AD or National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences(NINDS-AIREN) criteria for porbable VD were included in the study. Enzymatic determinations in cere brospinal fluid of aspartate aminotransferase in cerebrospinal fluid of aspartate aminotransferase and serologic analysis of apolipoprotein E were performed in 17 patients with AD and in 15 patients with VD. And we compared CSF AST of AD with that of VD. RESULTS: We found no difference of CSF AST concentration between patients with Alzheimer's disease and vascular dementia. Cerebrospinal AST activity also did not correlate with K-MMSE score, serum AST activity, Functional inde-pence measure(FIM) as a ADL(Activity of daily living), and presence of Apolipoprotein E4 allele in AD. Only serum AST of VD shows correlation with CSF AST. CONCLUSION: These findings suggest that cerebrospinal AST concentration is not useful maker for differentiation between AD and VD.
Alleles ; Alzheimer Disease* ; Apolipoprotein E4 ; Apolipoproteins ; Aspartate Aminotransferases* ; Aspartic Acid* ; Biomarkers ; Cerebrospinal Fluid* ; Dementia, Vascular* ; Humans ; National Institute of Neurological Disorders and Stroke

The Pisa syndrome is a rare extrapyramidal side effect caused by neuroleptic treatment. Its characteristics are the twist-ing and bending to one side of the upper thorax, the neck, and the head. To our knowledge, there have been no reports of Pisa syndrome in risperidone therapy. We report four male patients with Pisa syndrome in risperidone therapy. Significant points to be noted here are the absence of any extrapyramidal symptoms prior to risperidone therapy, occur-rence in risperidone therapy with small dosages, and delayed spontaneous recovery on discontinuation of risperidone.
Head ; Humans ; Male ; Neck ; Risperidone* ; Thorax

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

Ewing's sarcoma had never been described as a primary tumor outside bone, although other malignant skeletal tumors, such as osteogenic sarcoma & chondrosarcoma, are known to arise from extraskeletal soft tissues. In 1975, Angervall & F.M. Enzinger reported 39 cases of small, round or oval cell sarcomas occuring in the soft tissues and considered histologically indistinguishable from Ewing's sarcoma of bone. Recently, We experienced one case of extraskeletal neoplasm resembling Ewing's sarcoma of bone which it was located deeply in the calf area of young female patient and the case review has been followed until the death, approxlmately 10.5 months after removal.
Chondrosarcoma ; Female ; Humans ; Osteosarcoma ; Sarcoma ; Sarcoma, Ewing

The Pisa syndrome is a rare extrapyramidal side effect caused by neuroleptic treatment and its characteristics are twisting and bending to one side of the upper thorax, the neck and the head. When its chatacteristics show both sides, we call it 'Metronome Pisa syndrome'. We report the case of a 53-year-old woman who suffered Metronome Pisa syndrome following risperidone therapy. Risperidone therapy in old ages should be cautious even if its dosage is minimal.
Female ; Head ; Humans ; Middle Aged ; Neck ; Risperidone* ; Thorax

Discontinuation syndrome is a cluster of symptoms that appear when a patient terminates long-term medication. We report 2 patients with Alzheimer's disease who developed significant behavioral disturbances after the cessation of cholinesterase inhibitors. Although the clinical profile of discontinuation syndrome in cholinesterase inhibitors are yet poorly defined, it may be of importance to consider this syndrome when patients develop significant behavioral disturbances after these agents are stopped, and if more severe reactions are expected, retrial of these agents may be prudent.
Alzheimer Disease ; Cholinesterase Inhibitors* ; Cholinesterases* ; Humans

BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) are less well-defined aspects of Alzheimer's disease (AD). We designed this study to explore the followings: 1) the clinical profiles of BPSD 2) the clustered-groups domains of the Korean-Neuropsychiatric Inventory (K-NPI) assessment of BPSD 3) the clinical characteristics of the clustered-groups of BPSD in patients with drug-naive probable AD. METHODS: Descriptive and cluster analyses of the 12 K-NPI domains were done in 220 patients with drug-naive probable AD. After clustering these domains, characteristics of these positive symptoms clustered-group of patients were compared with the negative symptoms groups of patients. RESULTS: The mean Korean-Mini Mental Status Examination (K-MMSE), Clinical Dementia Rating (CDR) scale, and K-NPI scores were 15.0, 1.6, and 14.2, respectively. The CDR and K-MMSE scores correlated with total K-NPI scores, and depression was the most common symptom. According to cluster analysis, five major clusters were identified. Using the associated neuropsychological dysfunctions, characteristics of each group were defined. CONCLUSIONS: This study identified the clustered-domains for K-NPI, and suggested the possible anatomical substrates for these groups in drug-naive AD patients. These attempts may clarify the complex and bizarre behavioral and psychological symptoms as more neurologically relevant symptoms.
Alzheimer Disease ; Cluster Analysis ; Dementia ; Deoxycytidine ; Depression ; Humans

BACKGROUND AND PURPOSE: During Vietnam War, many Korean soldiers were dispatched to fight in the war where they were exposed to Agent Orange. Until now, there exist only limited evidence on existence of association between exposure to Agent Orange and Parkinson's disease (PD). To elucidate the effects of Agent Orange exposure on PD, we compared the clinical characteristics and radiolabeled 18F-FP-CIT PET uptake between patients with Agent Orange exposure and patients with Agent Orange no-exposure. METHODS: We retrospectively evaluated 143 patients exposed to Agent Orange and 500 patients with no exposure to Agent Orange from our movement clinics database. The differences between clinical characteristics and pattern of 18F-FP-CIT PET uptake were investigated. RESULTS: Among Unified Parkinson's Disease Rating Scale III motor subscales, tremor at rest, rigidity, finger taps, and rapid alternating movement was significantly higher in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. The facial expression score was significantly lower in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. Compared to patients not exposed to Agent Orange, all basal ganglia areas (contra- and ipsilateral caudate nucleus, anterior putamen, and posterior putamen) showed a lower18F-FP-CIT uptake and higher asymmetry index of anterior and posterior putamen was found in patients exposed to Agent Orange. The caudate/putamen ratio was significantly lower in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. CONCLUSIONS: This study showed a different clinical profile and FP-CIT PET findings between patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. This finding suggests the possibility of different pathophysiology of PD in patients exposed to Agent Orange from idiopathic PD.
Basal Ganglia ; Caudate Nucleus ; Citrus sinensis* ; Facial Expression ; Fingers ; Humans ; Military Personnel ; Parkinson Disease* ; Putamen ; Retrospective Studies ; Tremor ; Vietnam

No abstract available.
Pericardial Effusion* ; Radionuclide Imaging* ; Technetium Tc 99m Medronate*

BACKGROUND AND PURPOSE: Although depression is a common psychiatric symptom in Alzheimer's disease (AD), there has not been a lot of research on neuropsychological characteristics of this symptom. To determine the characteristic neuropsychological deficit in patients with depression compared to patients without depression, this study compared each neuropsychological test between AD patients with depression and without depression. METHODS: Psychotropic-naïve (drug-naïve) early stage [Clinical Dementia Rating Scale (CDR)=0.5 or CDR=1] probable AD patients with depression (n=77) and without depression (n=179) were assessed with the Seoul Neuropsychological Screening Battery, which includes measures of memory, intelligence, and executive functioning. RESULTS: AD patients with depression had lower scores on the digit forward, digit backward, calculation, and Color Word Stroop Test tests compared to AD patients without depression. CONCLUSION: Our study showed that AD patients with depression have disproportionate cognitive deficit, suggesting frontal (especially in the left dorsolateral), left hemisphere and left parietal dysfunction. Considering the neuropsychological differences between AD patients with depression and without depression, depression may have specific anatomic substrates.
Alzheimer Disease ; Cognition Disorders ; Dementia ; Depression* ; Humans ; Intelligence ; Mass Screening ; Memory ; Neuropsychological Tests ; Rabeprazole ; Seoul ; Stroop Test