Even though colonoscopy is a common and widely performed procedure, it can cause many complications. If any sign of inflammation is observed, a perforation or postpolypectomy coagulation syndrome should be considered. Diverticulitis, a very rare complication with an incidence of 0.04% to 0.08%, also can occur after the diagnostic and therapeutic procedure. We report a case of acute diverticulitis after colonoscopy, diagnosed with typical computed tomography findings after excluding other complications. The patient was treated in the same manner as for complicated diverticulitis, with bowel rest, hydration, and broad-spectrum antibiotics. Acute diverticulitis as a rare complication can occur following prolonged colonoscopy or colonoscopic polypectomy, especially in those with additional risk factors such as obesity and smoking.
Anti-Bacterial Agents ; Colonoscopy ; Diverticulitis* ; Diverticulum ; Humans ; Incidence ; Inflammation ; Obesity ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Recent studies report that nursing home elderly (NHE) have significantly lower serum levels of 25-hydroxy-vitamin D (25-OHD) than community dwelling elderly (CDE); however, in Korea such studies are lacking. We aimed to compare the vitamin D status between NHE and CDE in Korea. METHODS: This study included 203 patients over 65 years, admitted to the geriatric department of Seoul Medical Center between 01/2015 and 12/2015. Their medical records were reviewed for demographic data, type of residence, medical and drug history, serum 25-OHD, albumin, creatinine, and calcium levels, and geriatric assessment results. After excluding 36 subjects who had taken vitamin D supplements, anticonvulsants, or steroids, 33 NHE and 134 CDE were included for final analysis. RESULTS: Almost 80% of subjects showed a vitamin D deficiency (25-OHD <20 ng/mL); 54% were severely deficient (25-OHD <10 ng/mL). NHE had a significantly lower serum 25-OHD level than CDE (5.47±2.95 ng/mL vs. 14.72±11.35 ng/mL, p<0.001). Serum 25-OHD level was related to serum albumin level, the Geriatric Depression Scale score, and the Korean version of the Mini Mental State Examination score (p=0.004, p=0.041, p=0.032, respectively). After adjustment for confounding factors using multiple logistic regression analysis, diagnosis of severe vitamin D deficiency was more likely in NHE than CDE (odds ratio, 8.72; 95% confidence interval, 1.53-49.81). CONCLUSION: This study suggests a high prevalence of vitamin D deficiency in Korean NHE. To prevent falls and osteoporotic fractures in this population, vitamin D supplementation should be considered.
Accidental Falls ; Aged* ; Anticonvulsants ; Calcium ; Creatinine ; Depression ; Diagnosis ; Geriatric Assessment ; Humans ; Independent Living ; Korea* ; Logistic Models ; Medical Records ; Nursing Homes* ; Nursing* ; Osteoporosis ; Osteoporotic Fractures ; Prevalence ; Seoul ; Serum Albumin ; Steroids ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common diseases of the digestive system, with a worldwide prevalence of approximately 20%. However, studies on constipation-predominant IBS in the elderly are scarce. Since Korea has the highest elderly population, with 38.2% of its population expected to be aged over 65 years by the year 2050, a study on the presence of IBS in this population is warranted. METHODS: In the present study, IBS was defined and classified according to the Rome III criteria. This study was performed by using the case and control method at the outpatient Department of Family Medicine and the health promotion center of a hospital in Gwangju. The questionnaire for the demographic characteristics and dietary habits was administered to 128 patients with IBS and 193 controls. RESULTS: Individuals who had a tendency of overeating for >3 days a week, compared to those who had a tendency of overeating for <2 days a week; those who had spicy food for >3 days a week, compared to those who had it for <2 days a week; and the time of meals showed statistically significant results. Meanwhile, the number and regularity of meals and having breakfast were not relevant factors. CONCLUSION: The weekly frequency of overeating and intake of spicy food as well as short time for meals are related to constipation-predominant IBS in the elderly aged above 65 years.
Aged* ; Breakfast ; Constipation ; Digestive System ; Food Habits* ; Gwangju ; Health Promotion ; Humans ; Hyperphagia ; Irritable Bowel Syndrome* ; Korea ; Meals ; Methods ; Outpatients ; Prevalence

BACKGROUND: Home health-care services have been implemented to promote health among older adults (medicare beneficiaries and low-income or vulnerable older adults) with health conditions, though there is limited evidence to support their effectiveness. This study aimed to identify improvements in frailty and depression in vulnerable older adults who received home health-care services. METHODS: We used a database comprised of approximately 15,053 older adults residing in the Seoul metropolitan area having received home health-care services from 2008 to 2011. Frailty was measured using the Otasha-Kenshin scale, and geriatric depression was measured using the short-form Geriatric Depression Scale. RESULTS: We observed a significant decline in the prevalence of frailty and depression symptoms in vulnerable older adults between 2009 and 2011 (p<0.001). Logistic regression analysis found that the decreased prevalence observed in vulnerable older adults was statistically significant for both frailty (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.43-0.63; p<0.001) and depression (OR, 0.61; 95% CI, 0.51-0.72; p<0.001). A greater decrease was observed among the younger elderly subjects. CONCLUSION: This study showed that frailty and depression were significantly improved in the vulnerable older adults who received home health-care services. These services need to focus on high-risk groups with frailty and depression. In particular, early intervention is needed for younger elderly people, and more professional and focused management is needed for those aged 85 and above.
Adult ; Aged* ; Delivery of Health Care* ; Depression* ; Early Intervention (Education) ; Frail Elderly ; Home Care Services ; House Calls* ; Humans ; Logistic Models ; Prevalence ; Seoul

BACKGROUND: This study aimed to evaluate the effectiveness of lean body mass analysis using dual-energy X-ray absorptiometry (DEXA) for diagnosing sarcopenia. METHODS: We conducted a systematic review by searching eight Korean databases and international databases, including Ovid-MEDLINE, Embase, and Cochrane Library. Twenty-five studies using DEXA were included in the final assessment. Two reviewers independently assessed the quality of the included studies and extracted data. The quality of the studies was assessed according to the Scottish Intercollegiate Guidelines Network tool. RESULTS: The effectiveness of lean body mass analysis using DEXA was assessed by means of correlations with comparators, relevance to clinical symptoms, and forecasting of prognosis. The correlations with comparators (magnetic resonance imaging, computed tomography, bioelectrical impedance analysis, and anthropometry) took different positions. The risk ratio (RR) or odds ratio (OR) of the decrease in physical functions was 0.57-2.48, and the RR of osteoporosis was 1.15-9.4. The hazard ratio of death was 1.24-3.12, OR of cardiovascular disease was 1.768, and RR of survival was 0.85. CONCLUSION: Lean body mass analysis using DEXA for diagnosing sarcopenia seems promising, but more studies are needed to clarify the diagnostic criteria for sarcopenia and cut-off for DEXA.
Absorptiometry, Photon* ; Cardiovascular Diseases ; Diagnosis* ; Electric Impedance ; Forecasting ; Odds Ratio ; Osteoporosis ; Prognosis ; Sarcopenia*

BACKGROUND: Malnutrition is common in elderly patients with cancer and is associated with many adverse clinical outcomes, including longer length of hospital stay (LOS), muscle loss, and various postsurgical complications. In particular, elderly patients with hepatocellular carcinoma have a high risk for malnutrition, which is associated with mortality and reduced quality of life. Therefore, we evaluated the association between nutritional status and the LOS after hepatectomy for the treatment of hepatocellular carcinoma in elderly patients. METHODS: A retrospective study was conducted on 66 patients aged ≥65 years admitted consecutively from January 2010 to December 2014 for elective surgery to treat hepatocellular carcinoma. The Geriatric Nutritional Risk Index (GNRI) was applied for the assessment of nutritional risk in hospitalized elderly patients before surgery. RESULTS: The association between several factors that have been identified to influence outcomes and the LOS were evaluated by using multiple regression analysis. We found that only the GNRI was associated with the LOS. CONCLUSION: Our study shows that identifying nutritional risk using the GNRI before elective surgery is associated with increased risk of prolonged LOS. Therefore, prospective research based on GNRI can serve as a valuable resource for evaluating nutritional status of elderly patients under various clinical circumstances. Moreover, this particular research allows us to establish new ways of reducing the length of hospital stay for patients who underwent hepatic resection.
Aged* ; Carcinoma, Hepatocellular ; Hepatectomy* ; Humans ; Length of Stay* ; Malnutrition ; Mortality ; Nutrition Assessment ; Nutritional Status ; Prospective Studies ; Quality of Life ; Retrospective Studies

Recently, the Well-dying Act was legislated in Korea, and it will come into force in 2018. The rapid aging of this society has made many older patients and their families suffer from pain and disability for a long time towards the end of life. Hospice care, when compared to life-sustaining treatment, can relieve such burdens. Regarding the decision of choosing hospice care at the end of life, advance care planning and advance directives can help people express their preference beforehand. In Korea, hospice care is still not actively used and most patients endure life-sustaining treatment until death. Many patients want hospice care, but there has not been a legal basis for such a decision, leading to social conflict and many legal problems. The Well-dying Act will provide a legal basis for such a decision. This will help establish and promote hospice care in Korea. However, sufficient discussion and preparation are required before enforcing the Act.
Advance Care Planning ; Advance Directives ; Aging ; Hospice Care ; Humans ; Korea*

Herpes zoster is a common disease of the dorsal root ganglia and sensory nerve fibers that is clinically characterized by a painful unilateral vesicular eruption of the skin in a dermatomal distribution. Segmental motor weakness is a rare complication that occurs in 0-5% of patients and is associated with an excellent prognosis for recovery. We herein present a case of herpes zoster complicated by segmental motor paresis of the abdominal musculature resulting in a pseudohernia. This rare complication of herpes zoster, which has an excellent prognosis for recovery, should be recognized by physicians as it can save costly consultations and evaluations.
Ganglia, Spinal ; Herpes Zoster* ; Humans ; Nerve Fibers ; Paresis ; Prognosis ; Referral and Consultation ; Skin

Mycobacterium avium complex (MAC) comprises M. intracellulare and M. avium. MAC usually causes pulmonary diseases in individuals with intact immunity, disseminated disease in patients with acquired immunodeficiency syndrome, and cervical lymphadenitis. It can also cause cutaneous disease, but musculoskeletal infection is rare. Herein, we present a case of vertebral osteomyelitis due to M. intracellulare in an elderly immunocompetent patient who underwent vertebroplasty. The patient was successfully treated with antimycobacterial drugs without surgical intervention. MAC should be considered as a causative pathogen of vertebral osteomyelitis when the patient has a history of vertebroplasty.
Acquired Immunodeficiency Syndrome ; Aged* ; Humans ; Lung Diseases ; Lymphadenitis ; Mycobacterium avium Complex* ; Mycobacterium avium-intracellulare Infection ; Mycobacterium* ; Nontuberculous Mycobacteria ; Osteomyelitis* ; Vertebroplasty*

BACKGROUND: In a rapidly aging population, the importance of the quality of life of the elderly has been emphasized. The need for special care services according to an individual's physical, emotional, and social functions changes with aging. This study was conducted to analyze the needs of home dwellers in terms of health-care services for active aging. METHODS: The study subjects were 869 adults older than 40 years who lived in houses. They responded to a survey that inquired about the importance of each health-care item for active aging at home. The important items for active aging at home were graded by using a 5-point Likert scale. RESULTS: Among the items, "affection" topped the list, with 4.68 points, followed by cognitive function (4.67 points) and "social relations" (4.59 points). The top 3 items had no significant differences between the age groups. However, some items related to activities of daily living (ADL; including bathing, eating, and ambulating.) and instrumental ADL (IADL; including taking medicines and preparing meals) had significant differences between the age groups. Compared with the subjects in the older age groups, the subjects in the forties age group placed less importance on ADL and IADL. CONCLUSION: For the subjects who lived in houses, affection, cognitive function, and social relation are highly important for as active aging, regardless of age. ADL and IADL are regarded as more important in ≥50 years age groups.
Activities of Daily Living ; Adult ; Aged ; Aging* ; Baths ; Delivery of Health Care* ; Eating ; Humans ; Quality of Life