BACKGROUND: In elderly, chronic diseases are common, and depression is frequently associated with the chronic physical conditions and their progress. This study was conducted to propose the basic data to assist the comprehensive care of chronically ill elderly through draw-up the trimmed model to explain the factors affecting depression. METHODS: The subjects were 402 elderly patients (114 men, 288 women) who had been taking medication more than one year at the community health centers in the city of Busan. During March 2000, the questionnaire survey was performed on their demographic characteristics, the state of chronic disease and depression, psychosocial resources(mastery, self esteem, social support), nutritional state, economic strain, stress and functional state(ADL and IADL). The state of depression was assessed with the Short Form of Geriatric Depression Scale(SGDS) The reliability test and path analysis were done by SPSS(ver7.5) and LISREL(ver 8.3) RESULTS: The reliability of the scales were fair in all items(Cronbach's alpha>0.5) In the state of present chronic diseases, hypertension(30.4%), musculoskeletal disorders(28.6%), and diabetes mellitus(12.8%) were common. The prevalence of depression(>6 scale in SGDS) was relatively high as 61.2%. In the result of path analysis, depression was aggravated with undermined self-esteem and mastery, chronic disease, economic strain, poor functional and nutritional state (p<0.01). Chronic disease affected depression directly(65.6%) as well as indirectly through psychosocial resources, untritional state, functional state and stress. CONCLUSION: The results show that chronic disease were closely associated with depression, though this study was questionnaire based and limited to the elderly who visited the health centers. concludingly, when take care elderly with chronic disease, physicians'considerations about the depression as well as physically ill conditions were important for the comprehensive care.
Aged* ; Busan ; Chronic Disease* ; Community Health Centers ; Depression* ; Humans ; Male ; Prevalence ; Surveys and Questionnaires ; Self Concept ; Weights and Measures

Squamous cell carcinoma of the nail bed is a low grade, slowly progressive, malignant neoplasm. A 66-year-old man had nail lesion on his right thumbnail for two years. After partial nail avulsion, an incisional biopsy was done. The histologic diagnosis was a squamous cell carcinoma. A radiological examination of digit was normal and no lymphadenopathy was palpable. The lesion was totally excised and surgical defect of nail bed was reconstructed by dermal graft. There was no recurrence of tumor till one year after surgery and out-look of nail recovered almost normal. When the underlying malignancy is suspected, it is necessary to examine the nail bed after partial nail avulsion. And application of dermal graft may be useful procedure for regeneration of nail plate when there is a large nail bed defect after excision.
Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Diagnosis ; Humans ; Lymphatic Diseases ; Recurrence ; Regeneration ; Transplants*

Squamous cell carcinoma of the nail bed is a low grade, slowly progressive, malignant neoplasm. A 66-year-old man had nail lesion on his right thumbnail for two years. After partial nail avulsion, an incisional biopsy was done. The histologic diagnosis was a squamous cell carcinoma. A radiological examination of digit was normal and no lymphadenopathy was palpable. The lesion was totally excised and surgical defect of nail bed was reconstructed by dermal graft. There was no recurrence of tumor till one year after surgery and out-look of nail recovered almost normal. When the underlying malignancy is suspected, it is necessary to examine the nail bed after partial nail avulsion. And application of dermal graft may be useful procedure for regeneration of nail plate when there is a large nail bed defect after excision.
Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Diagnosis ; Humans ; Lymphatic Diseases ; Recurrence ; Regeneration ; Transplants*

BACKGROUND: Colorectal cancer in Korea has become more prevalent over the few last decades, and calcium is considered a preventive factor for colorectal cancer development. We examined the associations between total and dietary calcium intake and the prevalence of colorectal adenoma in Korean adults. METHODS: This cross-sectional study included 112 colorectal adenoma cases and 252 adenoma-free non-cases, aged 45 to 71 years, who underwent colonoscopies at the Daegu Catholic University Medical Center from August 2011 to September 2012. Participants were asked about their diet using a validated food frequency questionnaire and about supplement use through interviews. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate the association between total and dietary calcium intake and the prevalence of colorectal adenomas using multivariable logistic regression models. RESULTS: Increasing total calcium intake from foods and supplements was significantly associated with a decreased prevalence of colorectal adenoma in women; comparing the highest quartile with the lowest quartile, the OR (95% CI) was 0.35 (0.15-0.85; P for trend = 0.03). Likewise, high dietary calcium intake from foods was associated with a lower prevalence of colorectal adenoma in women; compared with the lowest quartile, the ORs (95% CIs) were 0.32 (0.13-0.82) for the 3rd quartile and 0.44 (0.19-1.03; P for trend = 0.13) for the 4th quartile. However, the association was not clear for either total or dietary calcium intake among men. CONCLUSIONS: A higher intake of calcium was associated with a reduction of colorectal adenoma prevalence in Korean women.
Academic Medical Centers ; Adenoma* ; Adult* ; Calcium ; Calcium, Dietary* ; Colonoscopy ; Colorectal Neoplasms ; Cross-Sectional Studies ; Daegu ; Diet ; Female ; Humans ; Korea ; Logistic Models ; Male ; Odds Ratio ; Prevalence

BACKGROUND/OBJECTIVES: The relationship between folate and colorectal neoplasia remains controversial. We examined the association between serum folate concentrations and colorectal adenomas in a case-control study of Korean adults and conducted a meta-analysis. SUBJECTS/METHODS: Our case-control study included 113 pairs of case and control who underwent colonoscopy and provided blood samples. We used multivariable conditional logistic regression models to obtain the odds ratios and 95% confidence interval (CIs). For meta-analysis, we identified the relevant studies by searching the PubMed database up to February 2017, included our case-control study and combined the study-specific relative risks (RRs) using a random-effects model. RESULTS: In this case-control study, we included 58 men and 55 women with colorectal adenomas and sex and fasting status matched the controls. We did not find any significant association between the serum folate levels and colorectal adenomas in either men or women. For meta-analysis, a total of eleven studies were included in our analysis and classified into two groups; polyp clearance group (PC) for the studies that included participants who underwent endoscopies and had their polyps removed at baseline; and no polyp clearance group (NPC) for the studies that included participants whose histories of endoscopies were unknown or who underwent their first endoscopies. Four PC (1,311 cases and 1,672 non-cases) and eight NPC studies (3,501 cases and 11,347 non-cases) were included. The combined RRs (95% CIs) comparing the bottom with the top categories of circulating folate levels were 1.07 (0.97-1.18) for the NPC group but 1.45 (1.16-1.74) for the PC group. CONCLUSIONS: Low circulating folate levels were associated with new adenoma formation.
Adenoma* ; Adult ; Case-Control Studies* ; Colonoscopy ; Fasting ; Female ; Folic Acid* ; Humans ; Logistic Models ; Male ; Odds Ratio ; Polyps

The upper trunk of the brachial plexus is the most common area affected by neuralgic amyotrophy (NA), and paresis of the shoulder girdle muscle is the most prevalent manifestation. Posterior interosseous nerve palsy is a rare presentation in patients with NA. It results in dropped finger on the affected side and may be misdiagnosed as entrapment syndrome or compressive neuropathy. We report an unusual case of NA manifested as PIN palsy and suggest that knowledge of clinical NA phenotypes is crucial for early diagnosis of peripheral nerve palsies.
Brachial Plexus ; Brachial Plexus Neuritis* ; Early Diagnosis ; Fingers ; Humans ; Paralysis* ; Paresis ; Peripheral Nerves ; Phenotype ; Shoulder

BACKGROUND: Ceramides are the main lipid component of the stratum corneum and are a structurally heterogeneous and complex group of sphingolipids of which sphingoid bases are the basic structural constituents. Altered levels of sphingoid bases have been reported in skin conditions that involve dryness and barrier disruption, including atopic dermatitis. OBJECTIVE: The purpose of this study was to investigate the altered levels of sphingoid bases in psoriatic epidermis and their relationship with the clinical severity of the psoriasis. METHODS: Samples from the lesional and non-lesional epidermis were obtained from eight psoriasis patients. Levels of sphingosine and sphinganine were analyzed by high-performance liquid chromatography. The expression of ceramide synthase and ceramidase proteins, which are related to sphingosine and sphinganine metabolism, were measured using Western blot analysis. RESULTS: Levels of sphingosine and sphinganine in the lesional epidermis were significantly higher than those in the non-lesional epidermis. Although there was no altered ceramide synthase and ceramidase, there was a highly significant positive correlation between the % change of ceramidase, the degradative enzyme of ceramide into sphingosine, and the Psoriasis Area Severity Index (PASI) score. CONCLUSION: The levels of sphingosine and sphinganine were significantly increased in psoriatic epidermis and the % change of ceramidase was positively correlated with the clinical severity of psoriasis.
Blotting, Western ; Ceramidases ; Ceramides ; Chromatography, Liquid ; Epidermis ; Humans ; Oxidoreductases ; Proteins ; Psoriasis ; Skin ; Sphingolipids ; Sphingosine

BACKGROUND: Ceramides are the main lipid component of the stratum corneum and are a structurally heterogeneous and complex group of sphingolipids of which sphingoid bases are the basic structural constituents. Altered levels of sphingoid bases have been reported in skin conditions that involve dryness and barrier disruption, including atopic dermatitis. OBJECTIVE: The purpose of this study was to investigate the altered levels of sphingoid bases in psoriatic epidermis and their relationship with the clinical severity of the psoriasis. METHODS: Samples from the lesional and non-lesional epidermis were obtained from eight psoriasis patients. Levels of sphingosine and sphinganine were analyzed by high-performance liquid chromatography. The expression of ceramide synthase and ceramidase proteins, which are related to sphingosine and sphinganine metabolism, were measured using Western blot analysis. RESULTS: Levels of sphingosine and sphinganine in the lesional epidermis were significantly higher than those in the non-lesional epidermis. Although there was no altered ceramide synthase and ceramidase, there was a highly significant positive correlation between the % change of ceramidase, the degradative enzyme of ceramide into sphingosine, and the Psoriasis Area Severity Index (PASI) score. CONCLUSION: The levels of sphingosine and sphinganine were significantly increased in psoriatic epidermis and the % change of ceramidase was positively correlated with the clinical severity of psoriasis.
Blotting, Western ; Ceramidases ; Ceramides ; Chromatography, Liquid ; Epidermis ; Humans ; Oxidoreductases ; Proteins ; Psoriasis ; Skin ; Sphingolipids ; Sphingosine

No abstract available.

No abstract available.