OBJECTIVES: This study is to evaluate the prevalence, incidence, and risk factors of cognitive impairment and depression in the elderly in community. METHODS: This study was a one-year follow-up of Yonchon cohort aged 65 years and over, selected initially in a prevalence study of dementia and depression. A sample of 790 elderly persons who completely interviewed in a prevalence study was re-interviewed with one year interval using the Korean version of Psychogeriatric Assessment Scale (K-PAS). RESULTS: A total of 631 elderly persons was completely interviewed in this follow-up study. The prevalence of cognitive impairment and depression were 21.4% (11.9% in males and 28.3% in females) and 8.4% (6.3% in males and 10.0% in females), respectively. The one-year incidence of cognitive impairment and depression were 11.4% (5.7% in males and 16.2% in females) and 5.1% (3.1% in males and 6.6% in females), respectively. The risk factors of the prevalence of cognitive impairment were education, age, sex, history of stroke, and economic status. The risk factors of the prevalence of depression were family history of depression, history of stroke, marital status, and economic status. The risk factors of the incidence of cognitive impairment were female gander, education, age, alcohol use disorder, marital status, and economic status. The risk factors of the incidence of depression were low education, disrupted marital status, and poor economic status. CONCLUSION: Cognitive impairment and depression were frequent in the elderly. Several risk factors for cognitive impairment and depression were identified. These results suggest that comprehensive health and social services were needed for the elderly.
Aged* ; Cohort Studies ; Cross-Sectional Studies ; Dementia* ; Depression ; Depressive Disorder* ; Education ; Female ; Follow-Up Studies* ; Humans ; Incidence* ; Male ; Marital Status ; Prevalence* ; Risk Factors* ; Social Work ; Stroke

In 257 open fracture patients, treated from 1972 to 1979 at Kyung Hee University Hospital and analysed retrospectively, the infection rate was 35.8%. The factors thought to be associated with post-operative infection in open fracture were statistically analysed and discussed. The conclusions of this study were follows: 1. Open fractures require adequate debridement and irrigation. 2. Antibiotics should be administered as early as possible, especially before operation. 3. Early determination of local blood clrculation and its improvement are importent. 4. Contaminated open wound should be treated open, but if wound considered clean by adequate debridement may be closed primarlly. 5. If primary bone fixation is required, external flxation is recommended. Internal fixation should be avoided In grade I & II, but in grade III internal fixatlon is not contraindication for Improvement of blood circulation and open wound management.
Anti-Bacterial Agents ; Blood Circulation ; Debridement ; Fractures, Open ; Humans ; Retrospective Studies ; Wound Infection ; Wounds and Injuries

No abstract available.
Gait*

Bartha strain of pseudorabies virus[PRV-Ba] was utilized as a tracer to identify the neuronal axis of rat tongue muscles ; intrinsic muscles and extrinsic muscles, styloglossus, genioglossus, and hyoglossus muscle. After injection of 10 microliter of PRV-Ba into tongue muscles and 48-96 hours survivals, rats were perfused with 4% paraformaldehyde lysine periodate and brains were removed. PRV-Ba were localized in neural circuits by immunohistochemistry employing rabbit anti PRV-Ba as a primary antibody and ABC method. Injection of PRV-Ba into the tongue muscles resulted in uptake and retrograde transport of PRV-Ba in the rat brain. The result showed a circuit specific connection of many nerve cell groups along the time sequence : PRV-Ba immunoreactive cells appeared in hypoglossal nucleus and motor trigeminal nucleus ipsilaterally as seen with conventional tracers. Raphe nucleus, prepositus hypoglossal nucleus, spinal trigeminal nucleus, Al, A5 and facial nucleus of rhombencephalon showed immunoreactivity bilaterally. There were positive neurons in parabrachial nucleus, locus ceruleus, mesencephalic trigeminal nucleus, periaqueductal gray and A7 of mesencephalon and paraventricular nucleus, suprachiasmatic nucleus, organum vasculosum of lamina terminalis of diencephalon. Also positive reactions were showed in amygdala, insular cortex, frontal cortex and subfornical organ in telencephalon. Early immunoreactivity was appeared in hypoglossal nucleus and motor trigeminal nucleus, and there were positive neurons in the nuclei of the medulla oblongate, midbrain, pons, hypothalamus, cerebellum and medial preoptic area at middle stage. Subsequently the viral antigens were found in forebrain cell groups, paraventricular nuclei, suprachiasmatic nucleus, lateral hypothalamic area and primary motor cortex in frontal lobe bilaterally at 80-90hrs postinjection. These data demonstrate that the PRV-Ba can across synapses in the central nervous system with projection specific pattern, and this virus defines many elements of the neural network governing tongue. Therefore PRV-Ba are proved as a excellent neurotracer in the tract-tracing researches.
Amygdala ; Animals ; Antigens, Viral ; Axis, Cervical Vertebra ; Brain ; Central Nervous System ; Cerebellum ; Diencephalon ; Frontal Lobe ; Hypothalamic Area, Lateral ; Hypothalamus ; Immunohistochemistry ; Locus Coeruleus ; Lysine ; Mesencephalon ; Motor Cortex ; Muscles ; Neural Pathways* ; Neurons ; Paraventricular Hypothalamic Nucleus ; Periaqueductal Gray ; Pons ; Preoptic Area ; Prosencephalon ; Pseudorabies ; Raphe Nuclei ; Rats* ; Rhombencephalon ; Subfornical Organ ; Suprachiasmatic Nucleus ; Synapses ; Telencephalon ; Tongue* ; Trigeminal Nuclei ; Trigeminal Nucleus, Spinal

OBJECTIVE: The purpose of this study was to know the correlation between resting calcaneal stance position (RCSP) and height-length (H/L) ratio of foot. METHOD: Both feet of 173 persons who visited the Department of Rehabilitation Medicine, Chungnam National University Hospital were included in the study. Their mean age was 23.6 years old. H/L ratio, RCSP and navicular angle of 346 feet were measured. All people were divided into 3 groups, such as, normal foot (-2degrees2degrees) according to the angle of RCSP. And the relationship between RCSP and H/L ratio were evaluated. Independent T-test, ANOVA and Pearson correlation of SPSS was used for statistical data processing. RESULTS: The mean H/L ratio of rear foot valgus was 0.2206, noraml foot 0.2440 and rearfoot varus 0.2625. H/L ratio and navicular angle showed significant increase in each RCSP groups in order of rear foot angle. CONCLUSION: H/L ratio and RCSP showed strong positive correlation and the value of H/L ratio in normal group was 0.2440+/-0.0114 (Mean+/-S.D.). H/L ratio is easily acceptable parameter in human mechanics or orthotic field of rehabilitation.
Chungcheongnam-do ; Foot* ; Humans ; Mechanics ; Rehabilitation

To identify the central innervating the mammary nerve, viral retrograde transneuronal labelling methods were employed. Pseudorabies virus 6 microliter was injected into the mammary nerve of adult female Sprague-Dawley rats. After 4 days of survival, the animals were perfused with 4% paraformaldehyde-lysine periodate and their brains were processed for immunohistochemistry and double immunofluorescent staining of Pseudorabies virus or oxytocin using polyclonal antibodies. Several nuclei in brain were retrogradely labelled with Pesudorabies virus.Only a few magnocellular neurons of the paraventricular nucleus throughout whole brain showed double immunoreactivity to Pseudorabies virus and oxytocin. Approximately 11 percent of the oxytocinergic cells of the paraventricular nucleus,especially in three subnuclei[dorsomedial cap, lateral magnocelluar part and ventral part] showed double positive reaction to both Pseudorabies virus and oxytocin. These data demonstrate that some CNS cells projecting to the mammary nerve contained oxytocin and it may acts as a neurotransmitter in this pathway and a hormone targeting milk production and secretion.
Adult ; Animals ; Antibodies ; Brain ; Female ; Herpesvirus 1, Suid ; Humans ; Immunohistochemistry ; Milk ; Neurons ; Neurotransmitter Agents ; Oxytocin ; Paraventricular Hypothalamic Nucleus ; Pseudorabies ; Rats* ; Rats, Sprague-Dawley

No abstract available.
Humans ; Survival Rate*

During the past five years we have treated twenty-seven cases of upper cervical injury among total three hundred and seventeen spine injuries. A follow-up study has done on twenty-one upper cervical injuries and the result is reported. The incidence of upper cervical injury was 8.5% of the total spine injury and 17.5% of the cervical injury. Almost all of the injuries(95.2%) were caused by traffic accidents and falls. The types of injury were odontoid fracture(38.1%), hangman's fracture(28.6%), atlanto-axial instability(19.1%), tear drop fracture of the axis(9.5%), and Jefferson's fracture(4.8%). Chief complaints on admission were motor weakness(57.1%), neck pain with limitted range of motion(42.9%), and sensory disturbance was noted in six cases of the motor weakness group(28.6%). Out of twenty-one cases, operative fixation was performed in eight cases with good result in five(62.5%) and thirteen patients were treated conservatively with eleven cases(84.6%) of good result. In chronic nonunited or malnunited cases, it seems to be safer to fuse the level both by anterior and posterior routes than by either route alone because it is not always stable and needs long period of immobilization.
Accidents, Traffic ; Follow-Up Studies ; Humans ; Immobilization ; Incidence ; Neck Pain ; Spine

OBJECTIVES: To evaluate the incidence rate and associated factors of dementia in the elderly of rural community. METHODS: This study was three and half year follow-up of Yonchon cohort, participated in a prevalence study of dementia and depression in 1996 (N=1,037). A two-phase study was conducted using the Korean version of Psychogeriatric Assessment Scale in phase I and the diagnostic interview according to DSM-IV criteria by two psychiatrists in stage II. RESULTS: Of the 968 elderly residents who had not dementia in 1996 prevalence study, 596 residents completed the incidence study. The annual incidence rate for total dementia, dementia of Alzheimer's type and vascular dementia were 1.88% (1.86% in men, 1.98% in women), 1.58% (1.39% in men, 1.80% in women) and 0.34% (0.45% in men, 0.25% in women), respectively. Increasing age was significantly associated with total dementia and dementia of Alzheimer's type (p<0.01, p<0.05, respectively). There was statistically significant difference of the three and half year mortality rate between the dementia patients who were diagnosed in prevalence study and the non-dementic elderly (chi2=28.89, df=1, p<0.001). Only the 2.8% of newly onset dementia patients sought psychiatric service in the previously year. CONCLUSIONS: The incidence of dementia among the Korean elderly in a rural community was relatively consistent with the epidemiological studies of other countries. Age was the only risk factor for total dementia and dementia of Alzheimer's type. Very few dementia patients were treated by psychiatrist.
Aged* ; Cohort Studies* ; Cross-Sectional Studies ; Dementia* ; Dementia, Vascular ; Depression ; Depressive Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiologic Studies ; Follow-Up Studies* ; Humans ; Incidence* ; Male ; Mortality ; Prevalence* ; Psychiatry ; Risk Factors ; Rural Population

BACKGROUND: According to the results of Diabetes Control and Complication Trial, the best strategy to prevent and/or delay diabetic complications is to maintain the normal blood glucose levels. This led to emphasize the necessity of intensive management of diabetes. The purpose of the study was to determine blood glucose/insulin index and carbohydrate (CHO)-to-insulin ratios after normalization of blood glucose levels, and to select the factors to influence the blood glucose/insulin index and CHO-to-insulin ratios in Korean type 2 diabetic patients with continuous subcutaneous insulin infusion (CSII) treatment using insulin pump and CHO counting as a meal management. METHODS: Fifty-five type 2 diabetic patients who started CSII therapy checked their blood glucose levels before and after three meals, and recorded the amounts of insulin injected in fasting and each meal and the amounts of carbohydrates consumed in each meal. Actual blood glucose/insulin index and CHO-to-insulin ratio were determined using the records, and also they were calculated using Functional Insulin Treatment Training Methods (FITTM) proposed by Howorka. Calculated values were compared to actual values. The meaningful factors to influence the actual values were selected by backward stepwise regression analysis. RESULTS: The average age of the subjects was 49.9+/-12.5 years, and the duration of diabetes was 8.7+/-4.5 years. Their body mass index was 22.5+/-3.6 kg/m2. Daily insulin requirements to normalize the blood glucose levels reached to maximum levels at l0 day CSII treatment, and they were reduced and stabilized after 20 days of the treatment. The quotient K, representing insulin sensitivity, was also decreased after CSII treatment. The basal insulin index was 0.21 IU/kg at 10 days and 0.16 IU/kg at 20 days in our study, and these values were lower than the value from FITTM, 0.35 IU/kg The blood/glucose index was -2.5 mmol/L at 10 day CSII treatment, and it was decreased to -4.4 mmol/L at 20 day treatment to the stable levels. CHO-to-insulin ratio provided by FITTM was 2.59 IU/CHO exchange unit and the ratio was 3.12 IU/CHO exchange unit at 10 days, which was decreased to 1.84 IU/CHO exchange unit at 20 days in our study. CHO-to-insulin ratios at breakfast from carbohydrate counting were higher than those of lunch and dinner, and the ratios were 1.5 to 2.5 IU/CHO exchange unit. According to the stepwise regression analysis, the blood glucose/insulin index was affected by gender, age, body mass index (BMI), fasting blood glucose levels and fasting c-peptide levels, and CHO-to-insulin ratios were influenced by gender, age, BMI, post-prandial blood glucose levels and post-prandial c-peptide levels. CONCLUSIONS: CSII treatment can make blood glucose levels maintain in normal ranges in Korean type 2 diabetic patients, and can improve insulin sensitivity. Basal insulin requirements were lower and prandial insulin requirements were higher than those calculated from FITTM. This difference between Korean and the Western can be related to difference of insulin secretion from pancreas and nutrient intake.
Blood Glucose ; Body Mass Index ; Breakfast ; C-Peptide ; Carbohydrates ; Diabetes Complications ; Fasting ; Humans ; Insulin Resistance ; Insulin* ; Lunch ; Meals ; Pancreas ; Reference Values