Effect of Integrated Cognitive Intervention Therapy in Patients with Mild to Moderate Alzheimer's Disease

Background@#and Purpose: The effect of the integrated program comprising cognitive training, art therapy, and music therapy has not been extensively studied in patients with Alzheimer's disease (AD). The present study investigated the effect of integrated cognitive intervention therapy on cognition, and activity of daily life (ADL), and mood in patients with mild to moderate AD. @*Methods@#In this study, the data of 59 patients who met the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer disease and Related Disorders Association (NINCDS-ADRDS) criteria of probable AD among those who registered at the Centenarian's Good Memory Program in Goyang from September 2014 to August 2019 were collected. We statistically analyzed the scores of Korean version of a Mini-Mental Status Examination (K-MMSE), Korean Dementia Screening Questionnaire-Cognition (KDSQ-C), Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), and Seoul-Instrumental Activities of Daily Living (S-IADL) of the same patients before and after the use of integrated cognitive intervention therapy. @*Results@#K-MMSE slightly increased from 18.7±4.5 to 19.7±5.0 (p<0.001) and KDSQ-C improved from 14.5±7.6 before therapy to 12.6±7.2 after therapy (p=0.001). Mean S-IADL score improved from 17.6±7.6 before therapy to 15.7±9.5 after therapy (p<0.001). Additionally, mean GDS score before the therapy was 5.6±3.5 that improved to 4.2±3.0 after the therapy (p<0.001).Mean BAI score decreased from 8.4±10.3 before therapy to 5.9±8.4 after therapy (p=0.001). @*Conclusions@#In conclusion, this study demonstrated the possibility that the use of an integrated cognitive therapy improved cognition, ADL, and mood (depression and anxiety) in patients with mild to moderate ADs.

The attitudes of Korean physicians toward emergency contraceptive pills: regarding women's access and rescheduling

OBJECTIVE: This study investigated the attitude of Korean physicians toward women's access to emergency contraceptive pills (ECPs) and the reclassification of ECP to a behind-the-counter (BTC) drug. METHODS: This study involved 946 physicians who had prescribed ECP in South Korea. The written questionnaires were completed by obstetricians and gynecologists, family physicians, internal medicine doctors, and pediatricians. RESULTS: Regarding the barriers limiting women's access to ECP, 24.8% of physicians responded that women lacked information about ECP and 22.5% felt that women were likely to be emotionally burdened by visits to clinics or hospitals to obtain ECP prescriptions. Ninety-two percent of physicians responded that ECP should remain a prescription drug while 6.1% stated preferences for a switch to a BTC drug. Physicians who opposed the switch were concerned about the potential abuse of ECP. In order to prevent ECP abuse, the most important factor to be considered was education on contraception. CONCLUSION: A majority of Korean physicians opposed the reclassification of ECP to a BTC drug owing to their belief in increasing the role of educational initiatives about contraception and contraceptive practices before improving the access to ECP. This study is also of the opinion that contraceptive education for youth and adults in Korea should be more realistic and active, with an emphasis on regular contraception use before reclassification. Furthermore, we believe that efforts are needed to ensure accuracy of information on contraception to facilitate women's access to ECP.

The Effect of Group Musical Therapy on Depression and Activities on Daily Living in Patients with Cognitive Decline

BACKGROUND: Beside pharmacological treatment, non-pharmacological interventions are a great deal of interest resides on ways that allow modulation of brain plasticity in the elderly. Music therapy is a potential non-pharmacological treatment for the behavioral and psychological symptoms of dementia, but a few studies reported it to be helpful. The aim of this study was to evaluate the effect of structured musical intervention therapy in patient with cognitive decline. METHODS: The subjects of the study were a total of fifty elderly with cognitive decline (K-MMSE: 21+/-3.99, CDR: 0.80+/-0.38). The musical therapy was applied to the group twice a week, fifty minutes per session for eight weeks. The data were analyzed by using chi-square and paired t-test before and after musical intervention. RESULTS: The study showed a significant reduction in depression and anxiety after musical therapy measured with short form-GDS and BDI (p<0.001). Activities daily living (ADL) markedly improved after the all session of musical interventions (p<0.001). CONCLUSION: Group music therapy is a safe and effective method for treating depression and anxiety, and also improving ADL in patients with cognitive decline.

Clinical study of urinary tract infection, natural courses, and prenatal ultrasonographic results according to the grades of hydronephrosis / 소아과

PURPOSE: Although renal ultrasonography (USG) has improved the detection rate of hydronephrosis (HN), its clinical courses and postnatal management remains controversial. Here, we reviewed the clinical features of patients with HN according to the grades. METHODS: We retrospectively studied 207 patients who were regularly followed-up among 367 patients with HN detected by renal USG postnatally between April 1998 and December 2007. These patients were grouped into four groups, grades 1-4, according to renal pelvic diameter (RPD). For analysis, each group was merged into two categories (mild: grade 1, 2; severe: grade 3, 4). RESULTS: During follow-up, 128 episodes of urinary tract infection (UTI) occurred in 91 patients. According to grades from 1 to 4, 35/89 (39.3%), 41/88 (46.5%), 11/22 (50%), and 4/8 (50%), respectively, had UTI, without any significance between the mild and severe groups. However, the severe group presented a higher risk in cumulative episodes of UTI per year (P=0.041). The spontaneous resolution of HN was observed in 103 (58.8%) of the 175 mild group patients and in 3 (10.7%) of the 28 severe group patients (P<0.001). Furthermore, the detection rate of prenatal HN by prenatal USG was much higher in patients with severe RPD (P<0.001). CONCLUSION: We found that the severer the grade of HN, the lower was the rate of spontaneous resolution and higher was the frequency of UTI. Therefore, the establishment of guidelines for managing treatments such as antibiotic prophylaxis for patients with HN is needed to improve renal prognosis.

Spectrin Cleavage Induced by LLP-1 Lentivirus Lytic Peptide Domain in the Intracytoplasmic Tail of Human Immunodeficiency Virus Type 1 GP41 in Rat Organotypic Hippocampal Slice Cultures

We previously demonstrated that the lentivirus lytic peptide 1 (LLP-1) corresponding to the carboxyl terminus of HIV-1 gp41 induced cell death in human neuronal cells. Present study was conducted to further elucidate the pathogenic mechanisms involved in HIV-1 gp41-induced neurodegeneration in AIDS patients with cognitive deficits. The effect of LLP-1 on activation of calpain-1, a calcium-activated cysteine protease, which has been implicated in neuronal degeneration and death, was monitored by the proteolysis of spectrin in rat organotypic hippocampal slice cultures. Protease specific spectrin breakdown products revealed that LLP-1 generated~150/145-kDa fragments characteristic of calpain-1 activation in hippocampus undergoing cell death as evidenced by LDH release. This spectrin cleavage pattern was further confirmed by in vitro calpain-1 proteolysis. Futhermore, calpectin and MDL28170, inhibitors of calpain activity, blocked calpain-1-mediated spectrin cleavage. Spectrin cleavage likely occurred in the absence of overt synaptic loss, as suggested by the preserved levels of synaptophysin. Among pharmacological agents tested, apocynin, NADPH oxidase inhibitor, ameliorated the LLP-1-induced spectrin. Given the role of spectrin essential for synapse stabilization, LLP-1-induced spectrin cleavage as occurs with the activation of calpain-1 may be an important effector in LLP-1mediated cell injury in hippocampus, which is primarily linked to cognitive dysfunction.

A study on the antero-posterior morphology of the upper face in angle's Class III malocclusion patients / 대한치과교정학회지

To find out the antero-posterior morphology of the upper face in Angle's class III malocclusion patients, 90 patients, adults in Hellman's Dental age, were used as samples and following results were obtained after the relative comparision of antero-posterior relationship of upper facial structures between Angle's class I malocclusion patients and Angle's class III malocclusion patients and of antero-posterior size of upper facial structures to horizontal and vertical structures in each patients. 1. After comparison of the distance from PMV line to anterior margin of maxillary sinus and cheek, which determines the antero-posterior position of the upper face, upper face in Angle's class III patients are underdeveloped relative to Angle's class I patients. The distance between orbitale and anterior margin of maxillary sinus were greater in Angle's class I patients, whic implies thart the upper face in Angle's class III are depressed. 2. Antero-posterior dimension of anterior cranial base from PMV line and vertical dimension of upper face are statistically insignificant between two groups. After comparing antero-posterior position of upper face to anterior cranial base, the upper face in Angle's class III patients are depressed antero-posteriorly in relation to anterior cranial base. Following the comparision of antero-posterior position of upper face in relation to vertical dimension of upper face, the upper face in Angle's class III patients seem to be narrow antero-posteriorly