This study was conducted as a pilot project to evaluate the feasibility of building an integrate dementia platform converging preexisting dementia cohorts from several variable levels. The following four cohorts were used to develop this pilot platform: 1) Clinical Research Center for Dementia of South Korea (CREDOS), 2) Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer’s disease (K-BASE), 3) Environmental Pollution-induced Neurological Effects (EPINEF) study, and 4) a prospective registry in Dementia Platform Korea project (DPKR). A total of 29916 patients were included in the platform with 348 integrated variables. Among participants, 13.9%, 31.5%, and 44.2% of patients had normal cognition, mild cognitive impairment, and dementia, respectively. The mean age was 72.4 years. Females accounted for 65.7% of all patients. Those with college or higher education and those without problems in reading or writing accounted for 12.3% and 46.8%, respectively. Marital status, cohabitation, family history of Parkinson’s disease, smoking and drinking status, physical activity, sleep status, and nutrition status had rates of missing information of 50% or more. Although individual cohorts were of the same domain and of high quality, we found there were several barriers to integrating individual cohorts, including variability in study variables and measurements. Although many researchers are trying to combine pre-existing cohorts, the process of integrating past data has not been easy. Therefore, it is necessary to establish a protocol with considerations for data integration at the cohort establishment stage.

This study was conducted as a pilot project to evaluate the feasibility of building an integrate dementia platform converging preexisting dementia cohorts from several variable levels. The following four cohorts were used to develop this pilot platform: 1) Clinical Research Center for Dementia of South Korea (CREDOS), 2) Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer’s disease (K-BASE), 3) Environmental Pollution-induced Neurological Effects (EPINEF) study, and 4) a prospective registry in Dementia Platform Korea project (DPKR). A total of 29916 patients were included in the platform with 348 integrated variables. Among participants, 13.9%, 31.5%, and 44.2% of patients had normal cognition, mild cognitive impairment, and dementia, respectively. The mean age was 72.4 years. Females accounted for 65.7% of all patients. Those with college or higher education and those without problems in reading or writing accounted for 12.3% and 46.8%, respectively. Marital status, cohabitation, family history of Parkinson’s disease, smoking and drinking status, physical activity, sleep status, and nutrition status had rates of missing information of 50% or more. Although individual cohorts were of the same domain and of high quality, we found there were several barriers to integrating individual cohorts, including variability in study variables and measurements. Although many researchers are trying to combine pre-existing cohorts, the process of integrating past data has not been easy. Therefore, it is necessary to establish a protocol with considerations for data integration at the cohort establishment stage.

BACKGROUND AND PURPOSE: In Alzheimer's continuum (a comprehensive of preclinical Alzheimer's disease [AD], mild cognitive impairment [MCI] due to AD, and AD dementia), cognitive dysfunctions are often related to cortical atrophy in specific brain regions. The purpose of this study was to investigate the association between anatomical pattern of cortical atrophy and specific neuropsychological deficits. METHODS: A total of 249 participants with Alzheimer's continuum (125 AD dementia, 103 MCI due to AD, and 21 preclinical AD) who were confirmed to be positive for amyloid deposits were collected from the memory disorder clinic in the department of neurology at Samsung Medical Center in Korea between September 2013 and March 2018. To analyze neuropsychological test-specific neural correlates representing the relationship between cortical atrophy measured by cortical thickness and performance in specific neuropsychological tests, a linear regression analysis was performed. Two neural correlates acquired by 2 different standardized scores in neuropsychological tests were also compared. RESULTS: Cortical atrophy in several specific brain regions was associated with most neuropsychological deficits, including digit span backward, naming, drawing-copying, verbal and visual recall, semantic fluency, phonemic fluency, and response inhibition. There were a few differences between 2 neural correlates obtained by different z-scores. CONCLUSIONS: The poor performance of most neuropsychological tests is closely related to cortical thinning in specific brain areas in Alzheimer's continuum. Therefore, the brain atrophy pattern in patients with Alzheimer's continuum can be predict by an accurate analysis of neuropsychological tests in clinical practice.
Alzheimer Disease ; Atrophy ; Brain ; Cognition ; Dementia ; Humans ; Korea ; Linear Models ; Memory Disorders ; Mild Cognitive Impairment ; Neuroanatomy ; Neurology ; Neuropsychological Tests ; Plaque, Amyloid ; Semantics

In the current investigation, the status of the septo-hippocampal cholinergic pathway and hippocampal mitogen-activated protein kinase (MAPK) signaling was examined in male Wistar rats with chronic cerebral hypoperfusion, which showed cognitive deficits based on assessment on a version of the Morris water maze. Chronic cerebral hypoperfusion was induced by bilateral common artery occlusion and maintained for 12 weeks until behavioral testing. Chronic cerebral hypoperfusion was shown to induce memory impairments and microglial activation in regions of white matter, including the fimbria of hippocampus. Choline acetyltransferase expression of the basal forebrain and expression of hippocampal MAPKs was decreased in rats with BCCAo compared to control rats. The results of this study suggest that cognitive decline induced by chronic cerebral hypoperfusion could be related to dysfunction of the basal forebrain cholinergic system and reduction of hippocampal MAPK activities.
Adult ; Animals ; Arteries ; Choline O-Acetyltransferase ; Dementia, Vascular ; Hippocampus ; Humans ; Male ; Maze Learning ; Memory ; Prosencephalon ; Protein Kinases ; Rats ; Rats, Wistar

OBJECTIVE: To investigate the risk factors for poststroke delirium and evaluate its influence on functional recovery after ischemic stroke. METHOD: Risk factors for delirium were investigated retrospectively in three hundred twenty nine acute ischemic stroke patients over 60 years of age. Among the 329 patients, sixty seven developed delirium. Data were analyzed between delirium group (n=22) and control group (n=22) according to age, sex, lesion location and clinical features. Korean modified Barthel index (K-MBI), Korean National Institutes of Health stroke scale (K-NIHSS) and Korean mini-mental state examination (KMMSE) were measured at second and sixth weeks after onset and compared for both groups. RESULTS: Parameters showing statistically significant difference between two groups were age over 80, hyponatremia, sleep deprivation, cognitive impairment and cardiogenic embolism. There was no significant difference in K-MBI, K-NIHSS and K-MMSE scores at second week between the two groups. The delirium group showed significantly less improvement in K-MBI and K-NIHSS scores compared to control group (9.5+/-10.2 vs 18.5+/-11.6, p=0.011; -0.7+/-1.2 vs -1.8+/-1.3, p=0.014). There was no significant improvement in K-MMSE score. CONCLUSION: The possible risk factors for delirium in acute ischemic stroke are age over 80, hyponatremia, sleep deprivation, cognitive impairment and cardiogenic embolism. Stroke patients with comorbid delirium showed poorer functional outcome. Delirium seems to have detrimental effect in functional recovery after stroke.
Delirium ; Embolism ; Humans ; Hyponatremia ; National Institutes of Health (U.S.) ; Prognosis ; Retrospective Studies ; Risk Factors ; Sleep Deprivation ; Stroke

This study was designed to assess the effect of inflatable obstetric belts on uterine fundal pressure in the management of the second stage of labor. One hundred twenty-three nulliparas with a singleton cephalic pregnancy at term were randomized. Standard care was performed in the control group, and uterine fundal pressure by the Labor Assister(TM) (Baidy M-420/Curexo, Inc., Seoul, Korea) was utilized in addition to standard care in the active group. The Labor Assister(TM) is an inflatable obstetric belts that synchronized to apply uniform fundal pressure during a uterine contraction. The 62 women in the active group spent less time in the second stage of labor when compared to the 61 women in the control group (41.55+/-30.39 min vs. 62.11+/-35.99 min). There was no significant difference in perinatal outcomes between the two groups. In conclusion, the uterine fundal pressure exerted by the Labor Assistertrade mark reduces the duration of the second stage of labor without attendant complications.
Adult ; Delivery, Obstetric/*methods ; Female ; Humans ; *Labor Stage, Second ; Pregnancy ; Pressure ; Prospective Studies ; Time Factors ; Uterine Contraction

PURPOSE:The purpose of this study is to evaluate the ultrasonographic finding and clinical course of fetal ovarian cysts. METHODS:A retrospective study of 11 cases of fetal ovarian cysts, evaluated by prenatal and postnatal ultrasonographic studies was conducted. We analyzed the demographic factors, the ultrasonographic findings, the change of ultrasonographic parameters, the mode of delivery, the management of ovarian cysts and pathologic finding. RESULTS:In all cases, fetal ovarian cysts were unilateral simple cysts at the time of diagnosis. The mean sizes of the ovarian cysts were 29.7 mm on prenatal and 19.8 mm on postnatal studies. In four of the 11 cases, the ultrasonographic patterns of cysts changed from simple to complicated cysts on serial monitorng, and one of them required postnatal surgery. Ten of 11 cases were spontaneously resolved during perinatal follow-up ultrasound. CONCLUSION:We recommend continuous ultrasonographic assessment of antenatally diagnosed ovarian cysts, which is helpful to predict the outcome of cysts and decide on the management.
Demography ; Diagnosis ; Female ; Follow-Up Studies ; Ovarian Cysts* ; Prenatal Diagnosis* ; Retrospective Studies ; Ultrasonography

OBJECTIVES: To evaluate the patterns of changes in maternal weight and fetal weight discordance in twin pregnancies during consecutive gestational periods. METHODS: A retrospective chart review was done for a total of 148 twin pregnancies taken care of throughout pregnancies between February 2002 and May 2004. They were divided into two groups; group A consisting of 109 cases without postnatal complications and with no more than 25% twin weight discordance at birth, and group B consisting of 39 cases with more than 25% twin weight discordance. Both ultrasound examination and maternal weight measurement were conducted in the three gestational intervals; between prepregnant times to gestational age 18 weeks, between gestational ages 18 to 28 weeks, and from gestational age 28 weeks to delivery. RESULTS: Except for maternal weights, none of the pregnancy factors such as maternal age, parity, gravity, height, prepregnant weight, duration of pregnancy, natural or artificial pregnant status, gender and chorionicity showed any significant difference by means between the two groups. The maternal BMI of the group A vs. the group B at the first, the second, and the third period were 0.53+/-0.10% and 2.01+/-1.28%, 2.97+/-0.11% and 4.84+/-1.23%, and 3.29+/-0.16% and 2.15+/-0.63% respectively. Inter-twin weight discordances between the two groups were 8.29+/-0.67% vs. 11.26+/-1.25 %, 7.79+/-0.05% vs. 11.03+/-1.36%, and 9.07+/-0.55% vs. 32.79+/-1.13%, respectively. CONCLUSIONS: Although several factors that affect twin weight discordance may be considered, we showed that the pattern of maternal weight gain during the gestational period is associated with the estimated values of twin weight discordances in the first gestational period.
Chorion ; Female ; Fetal Weight ; Gestational Age ; Gravitation ; Humans ; Maternal Age ; Parity ; Parturition ; Pregnancy ; Pregnancy, Twin ; Retrospective Studies ; Twins* ; Ultrasonography ; Weight Gain ; Weights and Measures

About 90% of primary gastrointestinal lymphomas originate from the B-cell and less than 10% from the T-cell. In respect of anatomical location, the stomach is the most common site of gastrointestinal lymphomas followed by the ileum, colon, and rectum. However, esophagus and duodenal lymphomas are infrequently involved. Primary T-cell lymphoma of the duodenum is not common and peripheral T-cell lymphoma of the duodenum is very rare. In Korea, there has been no case report of peripheral T-cell lymphoma which simultaneously involved the stomach and duodenum. In this report, we present a case of primary peripheral T-cell lymphoma of the duodenum and stomach. A 63-year-old man was hospitalized complaining of weight loss of 15 kg and dyspepsia for 2 months. Esophagogastroduodenoscopy showed a large annular infiltrative lesion in the descending portion of the duodenum. At the posterior side of the upper body of the stomach, an ill-defined, broad, flat, and infiltrative lesion was also noted. Microscopic examination of the biopsy specimen showed that atypical bizzare lymphocytes infiltrated the mucosa of the duodenum and stomach. The lymphocyte was positive for CD3, CD5 and negative for CD20, CD23, and CD56 by immunohistochemistry. We made a diagnosis of primary peripheral T-cell lymphoma of the stomach and duodenum. We report a case of peripheral T-cell lymphoma of the stomach and duodenum with a review of the literature.
B-Lymphocytes ; Biopsy ; Colon ; Diagnosis ; Duodenum* ; Dyspepsia ; Endoscopy, Digestive System ; Esophagus ; Humans ; Ileum ; Immunohistochemistry ; Korea ; Lymphocytes ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Middle Aged ; Mucous Membrane ; Rectum ; Stomach* ; T-Lymphocytes ; Weight Loss

Colorectal cancer developed during pregnancy is extremely rare condition associated with a poor prognosis. Pregnant women usually present with more advanced stage at diagnosis than their non-pregnant counterparts. There are several possible reasons for this disparity as follows. The first one is delay in making the diagnosis due to similarity between the early symptoms of colon cancer and the gastrointestinal complains of pregnancy, the second is proliferation and decreased apoptosis of tumor cells due to the effects of various cytokines and hormonal environmental stimuli related to the state of pregnancy, and the third is an increased opportunity for tumor spread due to the immunosuppressed state of pregnancy and increased perfusion of all the organs. Thus, it is important not to underestimate the patient's symptoms because the early diagnosis is essential for better prognosis. We report a 27-year-old primigravida with advanced stage adenocarcinoma of the left colon diagnosed after cesarean delivery with a brief review of literature.
Adenocarcinoma ; Adult ; Apoptosis ; Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; Cytokines ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Perfusion ; Pregnancy* ; Pregnant Women ; Prognosis