No abstract available.
Ureaplasma urealyticum* ; Ureaplasma*

OBJECTIVES: The alcohol dependence in elderly people has been prevalent because of increase in geriatric population. However, it is difficult to find out alcohol dependence in the aged, because they have less specific clinical features as compared with adult alcoholics. The aims of this study were to screen alcohol dependence among elderly Koreans and to know the clinical characteristics of Korean delerly alcoholics. METHODS: The questionnaires translated into Korean such as Michigan Alcoholism Screening Test(MAST-K), the Brief MAST and the MAST-Geriatirc Version(MAST-KG) were used to screen alcohol dependence in the elderly alcoholic inpatients aged over 60(N=43), adult alcoholic inpatients within 20-59 Yrs of age(N=60), which were compared with age matched normal healthy aged(N=18) or adult controls(N=45). The demographic data such as sex, age, education, occupation, socioeconomic status, marital status, numbers of children, dwelling and religion as well as alcohol history such as duration of alcohol drinking, onset age, family history, impulsivity, somatic illness and motivation were also obtained to identify characteristic features of Korean aged alcoholics by structured interviews. RESULTS: 1) The aged alcoholics had the charateristic features of more in males, lower age, low education levels, more in blue-collar workers, lower socioeconomic class, more in single few babies, more living alone, having no religion without statistical significance. 2) The onset age of alcohol dependence was significantly higher in the aged alcoholics(45.3+/-13.6Yrs) than in the adult alcoholics(27.7+/-8.7Yrs)(p<0.0001). The duration of problematic alcohol drinking was significantly longer in the aged alcoholics(22.0+/-15.1Yrs) than in adult alcoholics(14.2+/-8.4Yrs)(p<0.01). Otherwise, there were no significant difference between aged and adult alcoholics in the family history, imulsivity, somatic illness and motivation. 3) The mean score of the MAST-K was significantly higher in the aged alcoholics(20.6 +/-5.4) than in the normal aged(6.7+/-4.4)(p<0.0001), which was significantly lower than in the adult alcoholics(26.2+/-8.0)and in normal adult controls(9.5+/-3.2)(p<0.05). The mean score of the Brief MAST was significantly lower in the aged alcoholics(9.3+/-3.5) than in the adult alcoholics(14.5+/-6.6)(p<0.0001). The mean score of the MAST-KG was significantly higher in the aged alcoholics(10.6+/-3.5) than in the normal aged(4.8+/-4.3)(9<0.0001). The former was significantly lower than in adult alcoholics(12.9+/-4.3)(p<0.005), and the mean score was 4.5+/-2.8 in normal adult controls. 4) The items which showed statistically significant differences between aged alcoholics and normal aged controls could be found in 10 items of the MAST-K(item 2, 3, 4, 5, 11, 14, 17, 21, 22 and 23). 2 items of the Brief MAST(items 2 and 9), and 7 items of the MAST-KG(items 6, 13, 18, 19, 22, 23 and 24)(p<0.01). CONCLUSIONS: The scores of the MAST-K, the Brief MAST and the MAST-KG were significantly lower in the aged alcoholics than those in the adult alcoholics(p<0.05). The statistically significant differences between aged alcoholics and normal aged controls could be found in 10 items of the MAST-K, 2 items of the Brief MAST and 7 items of the MAST-KG. Therefore, a briefer rating scales around 10 items are needed to screen alcohol dependence among Korean elderly people.
Adult ; Age of Onset ; Aged ; Alcohol Drinking ; Alcoholics ; Alcoholism* ; Child ; Education ; Humans ; Impulsive Behavior ; Inpatients ; Korea* ; Male ; Marital Status ; Mass Screening* ; Michigan* ; Motivation ; Occupations ; Surveys and Questionnaires ; Social Class ; Weights and Measures

OBJECTIVES: Previous studies in patients with Tourette's disorder suggested presynaptic dopaminergic dysfunction, demonstrating increased dopamine densities. In present study, we investigated dopamine transporter densities using I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl)tropane(I-123-IPT)-SPECT in drug-naive children with Tourette's disorder and postulated that dopamine transporter density reflected dopamine concentrations. METHODS: Eight drug-naive children with Tourette's disorder and six normal children were included in the with the brain SPECT 2 hours after an intravenous administration of I-123-IPT. Obtained SPECT data were reconstructed for the assessment of specific/nonspecific dopamine transporter binding ratio of basal ganglia and were evaluated both quantitatively and qualitatively. We investigated correlation between total tic severity of children with Tourette's disorder assessed with YGTSS and specific/nonspecific binding ratio of basal ganglia. RESULTS: Drug-naive children with Tourette's disorder had a significantly greater increase of speciffic/nonspecific dopamine transporter binding ratio of left basal ganglia than normal children. However, no significant differences in specific/nonspecific dopamine transporter binding ratio of right basal ganglia were found between children with Tourette's disorder and normal children. Also, we found no significant correlation between total tic severity of children with Tourette's disorder and specific/ nonspecific binding ratio of basal ganglia. CONCLUSION: These findings support the hypothesis of dopamine dysregulation in presynaptic dopamine function of the basal ganglia in the pathophysiology of Tourette's disorder.
Administration, Intravenous ; Basal Ganglia* ; Brain ; Child* ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Tics ; Tomography, Emission-Computed, Single-Photon* ; Tourette Syndrome*

OBJECTIVES: The aims of this study were to know the prevalence of cognitive disorders in patients with thyroid cancer, and identify related variables to them. METHODS: Subjects were consisted of fourty-two patients with thyroid cancer, who were admitted for radioiodine ablative therapy at 6-12 months after total thyroidectomy. The data were obtained from interviews about history and assessments of depression and cognitive function(Korean Version of the Montreal Cognitive Assessment, MoCA-K). RESULTS: 1) Among subjects, those with below 22 of total score of the MoCA-K were twenty-one(50.0%). 2) Upon age, education, Pre-radioiodine therapy thyroid stimulating hormone(TSH), there were statistically significant difference between subgroup with above 23 of the total MoCA-K score and those below 22. 3) The total scores of the MoCA-K in subjects had significant correlation with age, education, comorbidity, Pre-radioiodine therapy TSH, total score of the HDRS-17. CONCLUSIONS: Cognitive disorders were more prevalent among patients with thyroid cancer before radioiodine therapy. Therefore, further study should be needed to clarify the mechanism for the cognitive disorders in thyroid cancer. Furthermore, physicians should pay attention to the cognitive function and prepare preventative measures for cognitive disorder during management of thyroid cancer.
Carcinoma, Papillary* ; Comorbidity ; Depression ; Education ; Humans ; Prevalence ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin

The authors reported a case of clozapine-induced agranulocytosis that combined with serious complications in a 37-years-old male patient with chronic schizophrenia. Clozapine-induced agranulocytosis developed on Day 51 of clozapine treatment. The patient was transferred to hematologic department and then treated by massive antibiotics in aseptic room. After the injection of G-CSF, WBC count increased to the normal range. But the day after the normalization of WBC count, patient's general condition was worsened with fever and mild rigidity, and also CK, LDH, BUN/Cr, and LFT was increased. The patient's elevated laboratory findings with those of physical signs and symptoms suggested the neuroleptic malignant syndrome and acute renal failure. Eventually steroid was administered to the patient, and then patient's general condition and laboratory findings were normalized. We suggest that the identification of risk factors and careful regular blood monitoring is the best method for the prevention of clozapine-induced agranulocytosis. After the onset of clozapine-induced agranulocytosis, clozapine should be discontinued immediately and proper antibiotic therapy with administration of G-CSF should be done, as soon as possible. And we emphasize the importance of the education and the establishment of therapeutic relationship with patients and their family also.
Acute Kidney Injury ; Agranulocytosis* ; Anti-Bacterial Agents ; Clozapine ; Education ; Fever ; Granulocyte Colony-Stimulating Factor ; Humans ; Male ; Neuroleptic Malignant Syndrome ; Reference Values ; Risk Factors ; Schizophrenia

Chronic alcohol use may have direct or indirect neurotoxic effects on the brain that can lead to cognitive impairment. However, the precise relationship between alcohol and dementia remains unclear. There are several epidemiological studies suggest that the protective effect of light-moderate alcohol drinking in dementia. But obviously the heavy alcohol drinking can lead to brain damage and increase the risk of various types of dementia. The clinicopathological issues and criteria regarding so-called 'alcoholic dementia' remain under debate. Alcohol-induced persisting amnestic disorder, alcohol-induced persisting dementia, and Wernicke-Korsakoff syndrome (thiamine deficiency) may constitute distinct disease entities, but they may also share some common features. Based on this theory, Oslin and colleagues proposed the broader diagnostic scheme and criteria for Alcohol Related Dementia (ARD), which may include cases of Wernicke-Korsakoff syndrome and also other cases of dementia that appear to be alcohol-related. In pathogenesis of the alcoholic dementia, the chronic exposure to ethanol results in the adaptive up-regulation of NMDA receptor sensitivity, which can result in an increased vulnerability to glutamate induced excitotoxicity. Despite the clinical importance of ARD, few medical treatments for ARD have been proposed and studied. Most of all, the gold standard of the treatment in alcoholic dementia is the maintaining abstinence. Some therapeutic trials with cholinesterase inhibitors (donepezil and rivastigmine) and memantine (NMDA receptor antagonist) have been conducted for the patients with Wernicke-Korsakoff syndrome and alcohol-related dementia, and these studies reported favorable outcomes. Especially memantine can be a more effective agent in the treatment of alcoholic dementia because of anti-craving effect reported in several studies.
Alcohol Amnestic Disorder ; Alcohol Drinking ; Alcoholics ; Brain ; Cholinesterase Inhibitors ; Cognition ; Dementia ; Ethanol ; Glutamic Acid ; Humans ; Korsakoff Syndrome ; Memantine ; N-Methylaspartate ; Up-Regulation

PURPOSE: To report the clinical manifestations and prognoses in 5 cases of mixed Candida and bacterial keratitis and present a literature review on mixed fungal and bacterial keratitis. CASE SUMMARY: Five eyes of 5 patients (1 male, 4 female) diagnosed as mixed Candida and bacterial keratitis by corneal smear and culture were included in the present study. Patient mean age was 62.80 years. All patients had preexisting ocular or systemic conditions as predisposing factors for mixed Candida and bacterial keratitis. The most common Candida species isolated was Candida albicans (3 eyes, 60%), while Staphylococcus (3 eyes, 60%) was the most common mixed bacterial species. The average size of ulceration was 7.02 mm2. In 2 eyes (40%), the lesions were located at the corneal center. The depth of the infiltration was significant in all cases, and hypopyon was present in 2 eyes (40%). On the initial visit, the visual acuity was counting fingers or worse in all cases. Four eyes (80%) unresponsive to the topical and systemic treatment underwent surgical intervention but only 1 eye (20%), which had responded to the topical and systemic treatment, showed acuity improvement of more than 1 line on the final visit. CONCLUSIONS: In managing chronically compromised cornea, the possibility of mixed infections with Candida and bacterial organisms should be considered as keratitis shows poor prognosis.
Bacteria ; Candida ; Candida albicans ; Coinfection ; Cornea ; Eye ; Fingers ; Humans ; Keratitis ; Male ; Prognosis ; Staphylococcus ; Ulcer ; Visual Acuity

Human untreated costal cartilage was compared with lyophilized human costal cartilage which was treated with defatting solution for 48 hours and freeze drying for 72 hours (-70degree C, 10??bar) on the tendency of distortion. All cartilages, which were taken from six cadavers, were carved 5x5x30mm in size on principle of the balanced cross section. Their distortions were evaluated by two methods at intervals of one week, one month, three months, six months after experiment. At first, the degree of distortion was grossly graded with four steps: grade O; no distortion / grade I; minimal distortion / grade II; moderate distortion / grade III; severe distortion. Second method is measurement and quantification of distortion in the horizontal and vertical plane of cartilage.Untreated cartilage is shown to be an unsatisfactory material, with only three(12%) of the 25 cartilages being cosmetically acceptable(grade 0 and 1) after 6 months. In lyophilized cartilage, 18(94%) of the 19 cartilages were cosmetically acceptable(grade 0 and 1) at 6 months. This figure is highly significant(p<0.01). In another method, distortion in the horizontal(h) and vertical (v) planes of cartilage were measured, and mean values of ???? were calculated. In untreated group, the mean values of ???? were 0.82 at 1 week, 0.91 at 1 month, 1.13 at 3 months, and 1.31 at 6 months. In lyophilized group, the mean values were 0.27 at 1 week, 0.29 at 1 month, 0.40 at 3 months and 0.47 at 6 months. All values were statistically significant(p<0.01).
Cadaver ; Cartilage* ; Freeze Drying ; Humans

BACKGROUND: There are many rating scales for assessment of geriatrics. But each of these scales were not sufficient to evaluate comprehensive geriatric assessment, physical and psychologic efforts for care. METHODS: We developed new scales to comprehensive geriatric assessment for care of geriatric patients. The Geriatrics Physical Support Scale(GPSS) evaluates physical effort consists of 10 areas and the Geriatrics Global Support Scale(GGSS) evaluates general condition of patients consist of 6 areas. Eighty probable and possible AD patients received the Clinical Dementia Rating Rating Scale(CDR), Korearn version of Mini-Mental State Examination(K-MMSE), Barthel Activity of Daily Living Index(B-ADL) GPSS, GGSS. We tested internal consistency, correlation among dementia rating scales. RESULTS: The GPSS correlated to CDR -0.63(p<0.01), B-ADL -0.90(p<0.01) and the GGSS correlated to CDR -0.60(p<0.01), B-ADL -0.75(p<0.01). The internal consistency were 0.69(GGSS), 0.92(GPSS). CONCLUSION: The Geriatrics Global Support Scale evaluate general condition of patients and the Geriatrics Physical Support Scale evaluate physical efforts needed for care of geriatric patients. These scales an also brief and easy rating scales to grade degree of caregiver`s burden.
Dementia ; Geriatric Assessment ; Geriatrics* ; Humans ; Physical Exertion ; Reproducibility of Results* ; Weights and Measures

No abstract available.
Hearing*