The aims of this study were to examine the rate of the changes in cognitive function and the related-factors in progression from the community-dwelling older adults with mild cognitive impairment to dementia during 3 years. Methods: Data were selected from the Seoul Dementia Management Project with 1,375 community-dwelling older adults with mild cognitive impairment at baseline and monitored the changes in cognitive function after 3 years. The main variables were included demographic characteristics, body mass index, cognitive function, attended number of non-pharmacological programs, and activity of daily living (ADL)-related educational programs. Data were analyzed using chi-square test, independent t-test, and logistic regression. Results: Of all the participants, 83.0% remained with mild cognitive impairment, and 17.0% progressed to dementia after 3 years. Old age (odds ratio [OR]=1.06, 95% confidence Interval [CI]=1.04~1.09), no exercise (OR=1.42, 95% CI=1.04~1.93), attendance at non-pharmacological programs less than eight times (OR=4.17, 95% CI=2.05~8.49), and no attendance at ADL-related educational programs (OR=1.05, 95% CI=1.02~1.26) significantly affected dementia progression. Conclusion: Regardless of the types of non-pharmacological programs, regular and continuous non-pharmacological programs must be one of the important services of the dementia care centers in Korea. The result of this study serves the basis for developing further strategies to activate non-pharmacological programs and ADL-related educational programs at the community level for older adults with mild cognitive impairment to prevent in progressing to dementia.

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

This study was performed to assess the effect of one year's of meal service for home-staying urban elderly with low incole on their nutritional status. One hundred and eighty three subjects, who had already completed the first nutritional survey, were assigned to two group : meal served(served) and non-meal served(non-served). A meal containing approximately on half of the RDA for energy, protein, calcium and iron was served as lunch everyday to served group. After on year of meal service, follow-up-nutritional survey was done and changes of parameters were analyzed with paired t-test. Served female showed signficantly increased intake of riboflavin and calcium, while non-served female showed significantly decreased intake of calcium. Serum total protein, serum albumin and serum cholesterol were significantly increased in female regardless of meal service. Served remale was observed with significantly elevated LDL-cholesterol, whereas non-served female showed singnificantly lowered HDL-cholesterol. Significantly decreased serum iron, serum transferrin saturaion and significantly increased TIBC were observed for female regardless of meal service. But the proportion of anemic elderly according to Hb or serum iron was decreased more in served group. Female showed significantly increased serum zinc and copper regardless of meal service, whereas only served male showed significantly increased serum copper.
Aged* ; Calcium ; Cholesterol ; Copper ; Female ; Humans ; Iron ; Lunch ; Male ; Meals* ; Nutrition Surveys ; Nutritional Status ; Riboflavin ; Serum Albumin ; Transferrin ; Zinc

This study was performed to investigate how milk supplementation can benefit the elderly by increasing bone density but possibly harming the iron status concomitantly. Forty one elderly subjects over 65 years of age(male : 9, female : 32) participated. All subjects were apparently healthy, home staying and attending meal service for lunch at the welfare center. They were from low income area of Puchon city. One cup of milk per day was served for 10 months. The mean intake of calcium was significantly increased for females after milk supplementation. Males showed significantly increased means of triceps skinfold thickness, suprailiac skinfold thickness and waist circumference. Females showed significantly increased measurements fo three kinds of skinfold thickness, waist circumference, and hip circumference. There were no significant change in the mean bone density of lumbar spine(L2~L4), femoral neck, ward's triangle and torchanter, but the proportion of osteopenia estimated by the T score of lumbar spine bone density was lowered from 50.0% to 34.6% for females. The mean Hb level was significantly for males. The proportion of anemia estimated by Hb(<12g/dl), Hct(<36%) and serum ferritin(<15mg/ml) were increased from 17.2% to 51.7%, from 20.7% to 44.8% and from 10.3% to 17.2%, respectively for females. It looks like milk supplementation can effect the intakes of several nutrients considered to be commonly deficient in the Korean diet fo elderly people, increase some anthropometric measurements, and decrease the proportion of osteopenia. However it can have adverse effects on iron status of females.
Aged* ; Anemia ; Bone Density* ; Bone Diseases, Metabolic ; Calcium ; Diet ; Female ; Femur Neck ; Gyeonggi-do ; Hip ; Humans ; Iron* ; Lunch ; Male ; Meals ; Milk* ; Skinfold Thickness ; Spine ; Waist Circumference

The purpose of this study was to investigate effects of nutrition education program and pamphlet for the lower grades elementary students focused on individual daily needed food exchange units using Food Exchange System. Program consisted of four lessons (40 min/lesson), "5 major nutrients & function", "6 food group and sources", "daily needed food exchange units for normal body weight", and "smart snack choice and exercise". Pamphlet as activity book was developed for the program. The subjects were 3rd grade elementary students (educated group, 31 vs. non-educated group, 31). Educated group were lessoned as group and/or individual. We examined the differences in nutrition knowledge, dietary attitudes, dietary intakes and satisfaction of the program and pamphlet. In educated group, there were positive improvements on nutrition knowledge score "function and foods of 5 nutrients" and on dietary attitudes "type of breakfast and snacks". In the evaluation of dietary intakes according to KDRI, there were positive improvements on intakes level of riboflavin, vit. C, folate, Ca, P, Fe and Zn in educated group. In satisfaction with the program and pamphlet, contents, font size, visual, figure, difficulty and program curriculum were over 2.90/3.0. It showed that the developed nutrition education program and pamphlet focused on individual daily needed food exchange units using Food Exchange System improved nutrition knowledge, dietary attitudes and nutrients intake level in the lower grades elementary students.
Breakfast ; Curriculum ; Folic Acid ; Humans ; Pamphlets ; Riboflavin ; Snacks

From Nov. 7. 1988 to Nov. 21. 1988, we visited 20 universities' opticians and contact lens stores affiliated with them, and surveyed contact lens wearing process. We found that in all 14 stores, fitting was done by non-ophthalmologists and in 11 stores, wearing was processed without consulting on ophthalmologists.

This study was performed to investigate the relationships among bone mineral densities (BMD), anthropometric data and lifestyle factors in the elderly. Subjects included 138 elderly (male: 38, female: 100) aged over 65 years, who were home-dwelling in a low-income area of Puchon City. The BMDs of the lumbar spines (LS), femoral necks (FN), Ward's triangles (WT) and trochanters (TC) were measured by dual energy X-ray absorptiometry. The females showed significantly lower BMDs in four sites (p < 0.0001). The elderly aged over 75 revealed significantly more decreased femoral BMDs than the elderly aged 65 to 74. Female with BMIs of 20 to 25, showed significantly higher BMDs in LS, FN and trochanter than those with BMIs of less than 20. However, males displayed significantly higher BMDs in only LS, with increasing BMIs. THe BMDs of LS correlated with weights (r = 0.543, p < 0.001), heights (r = 0.477, p < 0.001), upper arm circumferences (r = 0.368, p < 0.01), waist circumferences (r = 0.367, p < 0.001), subscapular skinfold thicknesses (r = 0.363, p < 0.001) and hip circumferences (r = 0.231, p < 0.01). Non-smokers and non-drinkers showed significantly higher BMDs in trochanters only in the case of the males. Female milk-drinkers showed significantly elevated LS BMDs. Eighteen percent of the males were assessed as having osteoporosis, as compared to fifty percent of the females. Ninety-three percent of the females and 81.6% of the males responded that they often or always had "difficulty in standing for a long time".
Absorptiometry, Photon ; Aged* ; Arm ; Bone Density* ; Female ; Femur ; Femur Neck ; Gyeonggi-do ; Hip ; Humans ; Life Style* ; Male ; Osteoporosis ; Skinfold Thickness ; Spine ; Waist Circumference ; Weights and Measures

Iliopsoas abscess (IPA) rarely occurs in newborns and infants. Symptom triad, including fever, inguinal swelling or discoloration, and limited lower limb movement, is observed in most cases. Herein, we report a case of unusual IPA in an 82-day-old boy who presented with fever as the only symptom. To our best knowledge, there have been no reports of infant IPA presenting without localizing signs. This report highlights the importance of a high degree of suspicion for timely diagnosis of infant IPA when an infant presents only with fever.

BACKGROUND: Despite good surgical results from right transverse hypochondrial incisions for Ramstedt's pyloromyotomies, children remain concerned by the presence of an obvious and permanent scar. The aim of this study is to compare the results of two approaches. METHODS: Forty-eight infants underwent a Ramstedt pyloromyotomy for infantile hypertrophic pyloric stenosis. To facilitate the delivery of the pyloric mass, 22 patients were operated on via a standard right transverse hypochondrial incision and 26 patients via a circumumbilical incision with or without lateral wound extension. These two group were compared retrospectively. RESULTS: The groups did not differ significantly with respect to the length of the hospital stay or the perioperative complications. The circumumbilical incision with lateral wound extension allowed easy access to the pyloric mass without conversion of incisions due to inadequate exposure. All circumumbilical incisions healed well, resulting in an apparently unscarred abdomen. The final good cosmetic result of the circumumbilical incision satisfied all parents. CONCLUSIONS: We propose the circumumbilical incision as an alternative to be used in the operative approach to the pylorus in the treatment of infantile hypertrophic pyloric stenosis.
Abdomen ; Child ; Cicatrix ; Humans ; Infant ; Length of Stay ; Parents ; Pyloric Stenosis, Hypertrophic ; Pylorus ; Retrospective Studies ; Wounds and Injuries

This study was conducted to investigate the effect of an energy restriction program on the weight loss and changes of the biochemical nutritional status for 35 obese women. The energy restriction program took place over a 3-week period that was devided into two parts. The first part consisted of 750-800kcal diet and the second part of 800-1000kcal. Subjects were provided a low energy formula and a menu for the recommended diet. Anthropometric and biochemical measurement before and after the energy restriction program were estimated. Mean weight loss was 3.0 kg, accordingly the obestiy rate was lowered from 40.2 to 34.4, BMI from 29.2 to 28.9 and fat weight from 23.3 kg to 21.0 kg(<0.01.<0.05). Waist circumference loss was most prominent(4.4%) compared to triceps(21% loss)and hip circumference(2.2%loss). Mean RBC count, hemoglobin and hematocrit were significantly lowered(<0.01) but they were in the normal range. Systolic blood pressure was significantly decreased from 124.1 mmHg to 113.1 mmHg . Mean SGOT and SGPT were lowered from 29.3u/L to 20.0u/L and from 28.7u/L to 16.6u/L, respectively. It seems that the 3 weeks of energy restriction program used in this study was effective in improving anthropometric measurements without producing deficiency of iron or other susceptible nutrients.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Pressure ; Diet ; Female ; Hematocrit ; Hip ; Humans ; Iron ; Nutritional Status* ; Reference Values ; Waist Circumference ; Weight Loss*