A Provincial Population-Based Survey on Attitudes towards Wills of Individuals with Dementia and Related Issues / 신경정신의학

OBJECTIVES: This study investigated the attitudes of a provincial population towards wills of individuals with dementia and related concerns to prevent civil disputes related to dementia in an aging society. METHODS: The target population was registered residents in a province aged 19 years or older. The population forming the sampling frame was 1478821 (as of May 31, 2013). With a confidence interval of 2% and significance level of 5%, 2540 participants were sampled. This survey used a structured questionnaire composed of two main parts : seven items of general information (sex, age, residence, marital status, education, occupation, and income) and Testamentary Capacity-Related Questionnaire-12 items (TCRQ-12) comprising four items of basic knowledge and eight items of specific situational questions, using a five point Likert scale. RESULTS: The respondents were favorable toward the guarantee of will-making capacity of individuals with dementia. Self-relatedness, disadvantageousness and undue influence are significantly associated with objection to the will of individuals with dementia. In the pre-evaluation of testamentary capacity of individuals with dementia, the respondents responded strongly and with more favorable attitudes for evaluation by medical specialists than by lawyers. Last, in acceptance of the denial of self-related will due to dementia, negative response was dominant over positive response. CONCLUSION: Although it would be desirable that the will or testamentary capacity of individuals with dementia should be guaranteed for maximum, institutional and professional approaches are necessary to prevent civil disputes related to dementia.

Successful Treatment of Candida albicans Endocarditis with Liposomal Amphotericin B (AmBisome(R)) in a Very Low Birth Weight Infant

Candida albicans endocarditis is an uncommon manifestation of systemic candidiasis in newborn infants who require intensive care and develops mostly in patients with congenital heart disease; open heart surgery is the majority of predisposing factor. Improvement of techniques managing premature infants leads to increased survival rates, which give much more chances to develop fungal infections and its complications. We report a case of very low birth weight infant who had candidemia and Candida endocarditis, who was successfully treated with AmBisome(R) because of no response to conventional amphotericin B therapy.

The Changes of Intestinal Normal Flora in Neonates for Seven Days Postnatally / 대한소아소화기영양학회지

PURPOSE: Microbial colonization of the intestine begins just after birth and development of the normal flora is a gradual process. The first bacteria colonizing the intestine in newborns are Staphylococcus, Enterobacteriaceae and Streptococcus. For several days after birth, the number of Bifidobacterium spp. increase. The aim of this study was to investigate the changes of microflora for seven days postnatally in neonatal stool. METHODS: Fifteen neonates (breast : formula : mixed feeding 1 : 8 : 6, vaginal delivery : cesarean section 3 : 12) who were born at the Kangdong Sacred Heart Hospital, Hallym University were enrolled. First meconium and stools of postnatal 1-, 3-, and 7-day were innoculated. Blood agar plates for total aerobes, trypton bile X-glucuronide agar for E. coli, phenylethyl alcohol agar for gram positive anaerobes, MRS agar for Lactobacillus spp., bifidobacterium selective agar for Bifidobacterium spp. and cefoxitin-cycloserine-fructose agar for Clostridium difficile were used in the general incubator (CO2 free incubator), CO2 incubator or the anaerobic chamber for 48 or 72 hours at 37oC and then colony forming units were counted. RESULTS: No microflora was identified in the first meconium. Total aerobes, E. coli, and gram positive anaerobes were significantly increased with advancing postnatal days. In only one baby, Lactobacillus acidophilus was detected 2x105 CFU/g in the seven-day stool. Bifidobacterium spp. was detected in two babies. Clostridium difficile was not detected during the seven days. There were no significant differences in the bowel flora depending on the delivery pattern and feeding method. CONCLUSION: This study shows many changes in the intestinal normal flora in neonatal stool during seven days postnatally. If these findings are confirmed with larger studies, the data may be preliminary findings to support use of probiotics in neonates.

Chromosome 7q Deletion Syndrome 46, XX, del(7)(q34) with Hydronephrosis

Chromosome 7q deletion, relatively rare syndrome, was first described by de Grouchy in 1969. The most frequent clinical manifestations of a "7q deletion syndrome" include; low birth weight, postnatal growth retardation, mental retardation, developmental delay, microcephaly, congenital heart disease, hypotonia, bulbous nasal tip and abnormal ears. We report a case of 7q deletion syndrome with microcephaly, upslanting palpabral fissure, micrognathia, bulbous nasal tip, developmental delay and hydronephrosis.