Background: The rapidly increasing socioeconomic strain caused by dementia represents a significant public health concern. Regional dementia centers (RDCs) have been established nationwide, and they aim to provide timely screening and diagnosis of dementia. This study investigated the clinical characteristics and progression of patients diagnosed with Alzheimer’s dementia (AD), who underwent treatment in RDCs or conventional communitybased hospital systems. Methods: This retrospective single-center cohort study included patients who were diagnosed with AD between January 2019 and March 2022. This study compared two groups of patients: the hospital group, consisting of patients who presented directly to the hospital, and the RDC group, those who were referred to the hospital from the RDCs in Pohang city. The clinical courses of the patients were monitored for a year after AD diagnosis. Results: A total of 1,209 participants were assigned to the hospital (n = 579) or RDC group (n = 630). The RDC group had a mean age of 80.1 years ± 6.6 years, which was significantly higher than that of the hospital group (P < 0.001). The RDC group had a higher proportion of females (38.3% vs. 31.9%; P = 0.022), higher risk for alcohol consumption (12.4% vs. 3.3%; P < 0.001), and greater number of patients who discontinued treatment 1 year after diagnosis (48.3% vs. 39.0%; P = 0.001). In the linear regression model, the RDC group was independently associated with the clinical dementia rating sum of boxes increment (β = 22.360, R 2 = 0.048, and P < 0.001). Conclusion Patients in the RDC group were older, had more advanced stages of conditions, and exhibited a more rapid rate of cognitive decline than patients diagnosed through the conventional hospital system. Our results suggested that RDC contributed to the screening of AD in a local region, and further nationwide study with the RDC database of various areas of Korea is needed.

BACKGROUND: Considering the unhealthy lifestyle observed in divorced men, we planned this study to compare the lifestyle and cardiovascular risk factors between married and divorced man. METHODS: A total of 11,855 male workers took a health check-up in a University Hospital in Ulsan from March to December 2004. One hundred eight workers were recognized to have checked affirmative on "divorced" check item on the marital status and 400 workers were matched for age and randomly selected from the "married" 10,177 workers. Comparison was performed between the two groups with the results of the main laboratory data and self-recorded life style questionnaire. RESULTS: The divorced men were shorter in height than the married men (P = 0.022), and showed significantly higher diastolic blood pressure (P = 0.033) and gamma-glutamyl transferase (P = 0.001). In lifestyle, the divorced men had significantly lower educational level, lower monthly household income, higher smoking rate, and more frequent irregular meals than the married men. Divorcing had 1.88 times the odds of having higher diastolic blood pressure compared to staying married. CONCLUSION: The divorced men had poorer lifestyle and higher diastolic blood pressure than the married men.
Blood Pressure ; Divorce ; Family Characteristics ; Humans ; Life Style ; Male ; Marital Status ; Meals ; Risk Factors ; Smoke ; Smoking ; Transferases

BACKGROUND: Osteoporotic fractures pose a major public problem, not only in Western populations but also of increasing significance in Asian populations. However, most previous studies for the prevalence of osteoporosis in Korea were carried out from the data of hospitalized or out-patient based subjects, hospital staff, healthy volunteers and so forth. The purpose of present study was to evaluate the normative data of bone mineral density (BMD) in Korean young and perimenopausal women and to determine the prevalence and risk factors of low bone mass, including osteoporosis and osteopenia in a community-based population. METHODS: In 1999, a baseline survey was carried out in the Dong-gu of Ulsan city, a urban area but located in seashore of southeastern Korea. The selected community sample of 3,822 inhabitants (all were women aged 49~54 years) were chosen. We studied 1,629 women among them and 127 healthy women aged 20~35 years. BMD of lumbar spine and femur was measured using dual-energy X-ray absorptiometry. For analysis of risk factors, those were excluded who was the current or recent user of estrogen and who had osteoporosis related disease or unknown menopause due to previous hysterectomy. Thus, 1,020 subjects were analysed for the association of low BMD and risk factors. Significant determinants of BMD were investigated using univariate and multiple regression analysis. RESULTS: When our young normal data were used, 9.8% for the lumbar spine and 1.4% for the femoral neck of our study population (n=1,629) were classified as osteoporosis. Among them, the menopausal status of above 1,020 subjects had independent association with low BMD (T-score<-1.0) of both lumbar spine (odds ratio=4.71 in postmenopause, p<0.001) and femoral neck (odds ratio=2.86 in postmenopause, p<0.001). In premenopausal women (n=507), weight and age of menarche were associated independently with low bone mass, including osteoporosis and osteopenia of both lumbar spine and femoral neck. In postmenopausal women (n=513), weight and duration since menopause were associated independently with low bone mass of both lumbar spine and femoral neck. Also, daily amount of calcium intake had significant association (regression coefficient=0.047; p<0.05) independently with BMD of femoral neck. CONCLUSION: The results of this population-based study suggest that it is important to prevent bone loss and screen the BMD in women aged 49~54 years with menopause, low body weight, late menarche, prolonged duration since menopause, low calcium intake.
Absorptiometry, Photon ; Asian Continental Ancestry Group ; Body Weight ; Bone Density ; Bone Diseases, Metabolic ; Calcium ; Surveys and Questionnaires ; Estrogens ; Female ; Femur ; Femur Neck ; Healthy Volunteers ; Humans ; Hysterectomy ; Korea ; Menarche ; Menopause ; Osteoporosis* ; Osteoporotic Fractures ; Outpatients ; Postmenopause ; Prevalence* ; Risk Factors* ; Spine ; Ulsan

BACKGROUND: In Korea, there were many socioeconomic changes under the IMF management system. Therefore we assumed that the stress levels increased. This study was done to investigate the changes in people's stress, health behaviors, symptoms, and coping responses which might be affected by socioeconamic changes during the IMF crisis with in 1 year. METHODS: In September, 1998, we sent questionnaires to a total of 560 persons who were over 18 years old and lived in Changwon city. We chose 359 subject who completed the survey. Assuming that the stress of ones own marriage was 50 points, we asked them what degree of stress was the previaus year and after August of 1997. Also, we asked them to estimate how much degree of stress had changed based on the 17 factors of life events according to Likert 5 points scale. Specifically, we investigated on how health behaviors were chared, how people responded to stress by using 19 coping options of Billing and Moos, and how the 20 symptoms were changed. RESULTS: 71.7% of subjects replied that income was within 1 year. The amount of stress was increased by 13.2 points compared to the stress previous year. The levels stress in men increased significantly more than in women(P=0.003), but there were no significant differences in terms of marital status, education, and age. With respect to the change of health behaviors, there was a tendency that the amount of exercise decreased significantly in subjects who had more stress(P=0.020). But there was no significant difference in the amount of smoking and drinking, in the frequency of drinking,sleeping time, and the regularity of eating. The health behavior score, the number of positive health behaviors, was significantly changed to negative in those whose stress increased(P=0.015). There was a tendency that the frequency of 15 symptoms among 20 symptoms significantly increased in those whose stress increased. Also, those whose stress increased significantly used more avoidant coping respanses(P=0.007). CONCLUSIONS: In this study, we found that those whose stress levels increased within 1 year compared to the year before up to September of 1987, had their health behaviors significantly deteriorated, and had more symptoms with avoidant coping responses. In conclusion, we suggest that those whose stress levels increased should be guided to promote good health behaviors, to use active coping responses rather than avoidant coping responses, and should be given more social support.
Adolescent ; Drinking ; Eating ; Education ; Gyeongsangnam-do ; Health Behavior* ; Humans ; Korea ; Male ; Marital Status ; Marriage ; Smoke ; Smoking ; Surveys and Questionnaires

Tuberculosis is common disease in developing countries manifested by multi-organ involvement. Although the incidence of tuberculosis has been reducing recently due to the advancement of anti-tuberculosis chemotherapy, improvement of public health, and early diagnosis, the rate is still higher in developing countries. The diagnasis of colonic tubcrculosis is difficult due to its frequency, vague manifestation, and difficulty in confirming the disease process. Fortunately, the advent of flexible colonoscopy has provided an opportunity to confirm the diagnosis of colonic tuberculosis, however biopsy can frequently leveal false negative results. A-27-year-old man was admitted with a 2 week history of rectal bleeding. He complained of anorexia, abdominal pain, and weight loss. Routine laboratory tests and chest X-ray findings were within normal limits, with the exception of left pleural thickening. A colonoscopy showed irregular and small, multiple, and shallow polypoid mucosal lesions in the ascending colon and multiple ulcers in the transverse colon. Multiple colonic biopsies suggested tuberculosis. After three months of prirnary anti-tuberculosis medica tion, the patient showed slightly improved coiono- scopic findings. Follow-up colono- scopic findings revealed more aggrevation and chest X-ray findings showed multiple patch consolidation in the left lung field. Primary anti-tuberculosis medication was stopped and substituted for secondary anti-tuberculosis medication. When clinical and colonoscopic methods are found to be compatible with intestinal tuberculosis in countries with a high prevalence of colonic tuberculosis, a therapeutic trial with an antituberculosis agent is usually considered. In a failed therapeutic trial, considerations must be made not only to other inflammatory bowel diseases such as crohn's disease, but also to multi-drug resistance tuberculosis.
Abdominal Pain ; Anorexia ; Biopsy ; Colon* ; Colon, Ascending ; Colon, Transverse ; Colonoscopy ; Crohn Disease ; Developing Countries ; Diagnosis ; Drug Resistance, Multiple ; Drug Therapy ; Early Diagnosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Lung ; Prevalence ; Public Health ; Thorax ; Tuberculosis* ; Ulcer ; Weight Loss

Idiopathic segmental ileal dilatation is a rare congenital condition in which the caliber of the bowel lumen increases locally without distal luminal obstruction or thickening of the muscle coats in involved lumen. Congenital abnormalities such as exomphalos, malrotation of the midgut, and Meckel's diverticulum are found frequently in the patients with segmental dilatation of the small bowel. Intermittent abdominal pain or anemia may be the symptoms of segmental dilatation of the small bowel in infants, children and occasionally adults. The radiologic finding in barium studies of the small bowel is characteristic axial segmental dilatation. The pathologic finding is nonspecific ulcer and mild congestion, but it has normal nervous system and smooth muscle bundle. There are no evidence of ischemic changes, inflammatory changes or neoplastic changes. The condition can be cured with surgical excision of the dilated segment. A case of idiopathic segmental ileal dilatation associated with melena and recurrent abdominal pain diagnosed by enteroclysis in a 47 years old man was presented with brief review of the literature.
Abdominal Pain ; Adult ; Anemia ; Barium ; Child ; Congenital Abnormalities ; Dilatation* ; Estrogens, Conjugated (USP) ; Hemorrhage* ; Hernia, Umbilical ; Humans ; Infant ; Meckel Diverticulum ; Melena ; Middle Aged ; Muscle, Smooth ; Nervous System ; Phenobarbital ; Ulcer

Xanthogranulomatous cholecystitis is a rare form of chronic gallbladder inflammation that is characterized by a severe proliferative fibrosis and has rarely been described in the radiologic literature. Like xanthogranulomatous pyelonephritis, it is an entirely benign but unusual expression of a reactive process and may be confused with a malignant neoplasm. Histologically, foamy histiocytes, multinucleated giant cells, other inflammatory cells, fibrous reaction with spindle cells, cholesterol cleft and noncaseating granuloma were found. Treatment of this benign inflammatory condition requires cholecystectomy to remove the focus of inflammation, control subsequent infection and relieve symptoms A case of xanthogranulomatous cholecystitis mimiking carcinoma of the gallbladder on abdominal USG, abdominal CT, and ERCP examination is presented with brief review of the literature.
Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystitis* ; Cholesterol ; Fibrosis ; Gallbladder ; Giant Cells ; Granuloma ; Histiocytes ; Inflammation ; Pyelonephritis, Xanthogranulomatous ; Tomography, X-Ray Computed

We experience coronary artery aneurysm and coronary artery stenosis in an adult as complications of Kawasaki disease. The patient suffered from ischemic heart disease due to coronary artery aneurysm and stenosis, We carried out PTCA and stenting at stenotic coronary artery successfully. A brief review of related literature was made.
Adult* ; Aneurysm ; Angioplasty, Balloon, Coronary* ; Constriction, Pathologic ; Coronary Aneurysm* ; Coronary Stenosis* ; Coronary Vessels* ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Ischemia ; Stents

No abstract available.
Carcinoma, Squamous Cell* ; Head* ; Humans ; Interleukin-2* ; Neck*

Successful middle ear surgery requires the availability of al safe, effective bonding material. Side effect caused by synthetic materials have led to the use of biologic adhesive, However, they carry the risk of transmission of infectious diseases if they are prepared from pooled human blood. The adhesive strength of ammonium sulfate fibrin adhesive produce an adhesive strength that is half that of the homologous commercial product. It is, however, good enough for use in several otolaryngological operations, tympanoplasty, facial nerve repair, reconstruction of ossicles. Reconstruction of posterior wall of ear canal and obliteration of frontal sinus and mastoid antrum using bone dust.
Adhesives ; Ammonium Compounds* ; Ammonium Sulfate* ; Communicable Diseases ; Dust ; Ear Canal ; Ear, Middle ; Facial Nerve ; Fibrin Tissue Adhesive* ; Fibrin* ; Frontal Sinus ; Humans ; Mastoid ; Tympanoplasty