Longitudinal Cerebral Perfusion Changes in Parkinson's Disease with Subjective Cognitive Impairment

BACKGROUND AND PURPOSE: Although subjective cognitive impairment (SCI) is often accompanied by Parkinson's disease (PD) and may predict the development of mild cognitive impairment or dementia, longitudinal brain perfusion changes in PD patients with SCI remain to be elucidated. The current prospective study examined cerebral perfusion changes in PD patients with SCI using technetium-99m hexamethylpropylene amine oxime single photon emission computed tomography (SPECT). METHODS: Among 53 PD patients at baseline, 30 patients were classified into the PD with SCI group and 23 patients were assigned to the PD without SCI group. The mean follow-up interval was 2.3±0.9 years. The Mini-Mental State Examination, Clinical Dementia Rating, and Global Deterioration Scale were used to assess impairments in cognitive function. Brain SPECT images were acquired at baseline and follow-up. RESULTS: Significant differences between the two groups were not found for demographic variables, PD severity, or cognitive function at either baseline or follow-up. At baseline, the PD with SCI group showed decreased perfusion in the left angular gyrus compared to the PD without SCI group. Longitudinal analysis revealed widespread perfusion reductions primarily in the bilateral temporo-parieto-occipital areas and cerebellum in the PD with SCI group. Relative to the PD without SCI group, an excessive decrease of perfusion was found in the left middle frontal gyrus of the PD with SCI patients. CONCLUSIONS: Our findings suggest that perfusion deficits in the middle frontal area may play an important role in the pathophysiology of SCI in PD.

The Impacts of Cognitive Function, Disease Severity, and Disability on Ability to Perform Activities of Daily Living after Stroke / 재활간호학회지

PURPOSE: This study aimed to examine influence of cognitive function, disease severity and disability on ability to perform activity of daily living (ADL) after ischemic stroke. METHODS: A total of 88 patients with ischemic stroke were recruited from January 1, 2008 to December 31, 2012 and assessed with the standardized cognitive test battery and self-reports about disease severity, disability, and ADL. To analyze the data, ANOVA, Pearson correlation coefficients and multiple regression were conducted using SPSS/WIN program. RESULTS: Significant correlations were found between ADL and visuospatial function, visual memory, executive function, and disability (r=.29~.38). Executive function and disability explained 17.3% of total variability in ADL performance after ischemic stroke. CONCLUSION: Executive function may be a promising target for cognitive rehabilitation after ischemic stroke. Thus, effective therapeutic interventions such as cognitive training for stroke patients should be considered to improve their ability to perform ADL.

Epidemiology and Resistance Patterns of Bacterial Pathogens in Urinary Tract Infections in the Northern Gyeonggi-do Area during 2007-2011

BACKGROUND: Bacteria that cause urinary tract infections (UTIs) are found with different frequencies in different regions; moreover, antibiotic susceptibility can also vary by region. We retrospectively studied and compared the species and antimicrobial susceptibility of bacterial pathogens isolated from patients with UTIs in the northern Gyeonggi-do area. METHODS: We analyzed urine specimens collected from patients who visited the Myongji Hospital between 2007 and 2011. The urine specimens were cultured, and bacteria were identified by biochemical examination with an API kit (bioMerieux Inc., USA). Antimicrobial susceptibility was determined by the disc diffusion method and the Vitek II system (bioMerieux Inc., USA). RESULTS: A total of 11,818 (31.4%) urine specimens were culture positive. The most common species identified were Escherichia coli (37.1%), Klebsiella pneumoniae (7.4%), Enterococcus faecium (6.1%), and Candida spp. (5.5%). The proportion of isolates producing extended-spectrum beta-lactamases significantly increased during the study period. CONCLUSIONS: E. coli, K. pneumoniae, and E. faecium were the 3 most common organisms identified. Of note, however, was the increasing frequency of Pseudomonas spp. and Proteus spp. isolated during the more recent years. Further studies are required from other centers in the northern Gyeonggi-do area.

A Transfusion Experience for a Patient with Cis-A2B3 Phenotype / 대한수혈학회지

We report the case of a 64-year-old man presenting to the hospital for treatment of his anemia. Exact ABO blood typing is an essential step to prevent transfusion reactions. The selection of the wrong blood component for transfusion can be a clinical problem and in this case the patient had a cis-AB blood type that could have caused an ABO discrepancy. In this case neither autologous or directed blood transfusion was possible and O+ red blood cell was transfused without a transfusion reaction.