OBJECTIVES: The purpose of this study is to investigate the clinical significance of activity of daily living(ADL) and to identify the influencing factors on ADL in elderly patients admitted to the hospital-based acute geriatric care unit. METHODS: We studied a total of 279 patients aged 65 years and older who admitted to the Acute Elderly Care Unit at Seoul National University Bundang Hospital between May, 2004 and April, 2005. Comprehensive geriatric assessment including medical, psychosocial and functional evaluation was performed by the geriatric team. RESULTS: Most of the patients need ADL(62.7%) and IADL(68.8%) assistance. Dependent ADL patients were older (p<0.01), admitted via emergency room(p<0.01), demented(p<0.01), and associated with depression(p<0.01), malnutrition(p<0.01), and stroke(p<0.05) compared to independent ADL group. The length of stay was also significantly increased in dependent ADL group(p<0.01) and six-month mortality rate was higher in dependent ADL group(p<0.01). In correlation analysis, MMSE-KC score(r=0.708, p<0.01), nutritional state(r=0.581, p<0.01), the length of stay(r=-0.433, p<0.01), depression(r=-0.309, p<0.01), the numbers of chronic disease(r=-0.287, p<0.01), age (r=-0.236, p<0.01) showed significant association with ADL. In multivariate analysis, cognitive impairment(OR=5.80), emergent admission(OR=4.33), over the 75 years old age(OR=3.33), malnutrition(OR=2.86), and depression(OR=2.61) were identified as the independent influencing factors on ADL dependency. CONCLUSION: ADL dependency is common in elderly inpatient and significantly associated with poor prognosis. Identifying and controlling the influencing factor on ADL decline may improve the patients' functional status and clinical outcome.
Activities of Daily Living ; Aged* ; Cognition ; Depression ; Emergencies ; Geriatric Assessment ; Humans ; Inpatients ; Length of Stay ; Mortality ; Multivariate Analysis ; Prognosis ; Seoul

Recently xenotransplantation has been thought as a final solution for the controi of donor organ shortage in allograft. In order to be a ciinicai entity, xenotransplantation has many obstacles such as hyperacute rejection and delayed xenogratt rejection as a potent immunologic reaction, zoonosis and ethical problems. We already reported the eariy immunoiogic events occuring soon after xenograft in animal model, in which natural antibody and complement have a crucial roie in rejection response. As a further step for the prolongation of graft survival, we used anticomplement agent (cobra venom factor, CVF) in the same model. Graft survival in discordant (guinea pig-to-rat) xenogratt was extended from 30.6 minutes to 2 days following singie injection of CVF, which showed similar pattern of rejection with the concordant xenogratt in terms of time of rejection response after grafting. In this setting antibody response in the blood did not show any difference between that of pre CVF and post CVF, even though IgM response was more pronounced than IgG. The complement activity in the blood showed marked suppression following CVF injection. Intragraft complement gene (C3 mRNA) expression in CVF injected discordant showed delayed response in a similar pattern like that of concordant xenograft. Interestingly enough intragraft anticomplement gene expression showed the simiiar pattern of response with the complement. From these results we can conclude that anticomplement agent (CVF) extended the graft survival in discordant xenograft upto the level of concordant xenograft by shifting the complement activation response from that of discordant to concordant xenograft.
Rats ; Animals

A 39-year-old hairdresser developed sodium bromate poisoning after drinking a cup of hair neutralizer in a suicide attempt. This is the first case of visual loss afteringestion of sodium bromate. Only few cases are as a cause of acute renal failure reported in medical literature. She presented 1 day later with anuria, required hemodialysis. Sensorineural hearing loss, often a characteristic finding, was developed.
Acute Kidney Injury* ; Adult ; Anuria ; Deafness* ; Drinking ; Hair ; Hearing Loss, Sensorineural ; Humans ; Poisoning* ; Renal Dialysis ; Sodium* ; Suicide

No abstract available.
Allografts* ; Humans ; Living Donors* ; Risk Factors*

No abstract available.
Allografts* ; Humans ; Living Donors* ; Risk Factors*

The present study estimates intake levels of dietary fiber (DF) in Korean adults aged 20 and over, using a newly established dietary fiber database for 3,149 food items, as well as 24-hour recall method data from the 2001 Korean National Health and Nutrition Survey. Dietary fiber intake and food groups are analyzed by gender, age, and region. The average dietary fiber intake, per capita of Korea was estimated to be 12.24 g/1,000 kcal or 23.58 g/day. Caloriebased dietary fiber intake for 20-49 year-old-Korean males, 20-29 year-old females, and the adults who resided in metropolitan areas was under the Adequate Intake for DF, 12 g/1,000 kcal. Further, the dietary fiber intake after adjusting energy intake in people over 75 year-old was estimated to be 75% of AI. Vegetables, cereals and fruits were three major sources of DF for Korean, making up approximately 75% of DF. Regarding the subjects of this study, major sources of dietary fiber were Kimchi and well-polished rice, which supplied 13.98% and 9.16% of total dietary fiber intake, respectively. The result of this study could contribute to the establishment of DRIs for dietary fiber, after adjusting energy intake for Korean aged 75 years and over. The beneficial health effects of DF and the necessity of nutritional education in this area should be continuously emphasized concerning 20-29 year-old people and metropolitan adults.
Adult ; Aged ; Dietary Fiber ; Edible Grain ; Energy Intake ; Female ; Fruit ; Humans ; Korea ; Male ; Nutrition Surveys ; Vegetables

We reviewed 93 cases of fine needle aspiration of skin\subcutaneous and soft tissue lesions with histologic confirmation. On the basis of the most prominent cytologic features, morphologic classification of the aspirates was done. Neoplastic lesions of soft tissue were categorized as ; round cell, spindle cell, polygonal cell, well-differentiated and myxoid tumor. This classification is convenient to recognize and categorize most soft tissue tumors.
Biopsy, Fine-Needle ; Classification ; Skin

BACKGROUND: Necrotizing fasciitis is a life-threatening infectious disease with rapidly progressive involvement of the affected site. Because of the high mortality rate of this disease, early diagnosis, surgical exploration, and administration of appropriate antibiotics are necessary. The present study aimed to further review the changes in the clinical and microbiological characteristics of necrotizing fasciitis using patients' medical records from consecutive databases of 3 hospitals in Korea. MATERIALS AND METHODS: In this study, we retrospectively reviewed the medical records of patients with necrotizing fasciitis who were clinically diagnosed between May 2001 and February 2012 in 3 university hospitals in Korea. In total, the data of 83 patients were analyzed, including those of 20 patients from our previous study in 2006. An organism found in a blood culture or surgical specimen was regarded as a causative organism. RESULTS: Of the 83 patients, 68(81.9%) had community-acquired infections. Ninety microorganism species were indentifed by culture. Streptococcus was the most commonly identified pathogen. Non-fermentative gram-negative bacteria and Candida species have recently emerged, especially in immunocompromised hosts. CONCLUSIONS: Gram-positive organisms are still the most common pathogens of necrotizing fasciitis. However in our study, various gram-negative bacteria with different levels of susceptibility to antibiotics, as well as Candida species, were responsible for the necrotizing fasciitis. Initial empirical antimicrobial agents for necrotizing fasciitis should be considered depending on the individual patient's condition.
Anti-Bacterial Agents ; Anti-Infective Agents ; Candida ; Communicable Diseases ; Community-Acquired Infections ; Early Diagnosis ; Fasciitis, Necrotizing* ; Gram-Negative Bacteria ; Hospitals, University* ; Humans ; Immunocompromised Host ; Korea* ; Medical Records ; Mortality* ; Retrospective Studies ; Risk Factors* ; Streptococcus

Currently accurate test for identification of HCV infection is not yet developed. We examined 1) the relationship between the result of anti-HCV by 3rd generation ELISA (ELISA/3) and of HCV-RNA by PCR from pre-transplant stored serum in 89 living donor renal transplant recipients and 2) the correlation between the result of each or combined tests and the development of post-transplant liver dysfunction (LDF). LDF was defined as the increment of serum transaminase over 100 I.U./ml in two consecutive tests. Patients with clinically or biopsy proven LDF by cyclosporine were excluded. Pre-transplant HCV infection rate assessed by ELISA/3 and PCR was 20.2 and 29.2% respectively. Patients with PCR (+) developed LDF frequently compared with negative partners (50 vs. 27%, p=0.0367). Significant disparity between ELISA/3 and PCR was present. In 71 ELISA/3 (-) patients, 16(22.5%) were positive for PCR. However 8 (44.4%) were negative for PCR in 18 ELISA/3 (+) patients. ELISA/3 (+) or PCR (+) patients developed LDF frequently rather than ELISA/3(-)/PCR(-) ones(50.0 vs. 23.6%, p=0.0106). We could explain these data with 5 possibilities; 1) end-stage renal failure patients had a blunt antibody production, 2) serum sample may be collected during the window period for antibody formation, 3) even ELISA/3 could not detect fine molecular response during the early HCV infection(false negative), 4) significant false positive or serum contamination in PCR test, and finally 5) self-clearing of HCV antigen may be present in the body. In conclusion, HCV detection by PCR method and antibody test by ELISA/3 must be complementary for the accurate evaluation of HCV infection during the recipient evaluation and posttransplantation follow-up period.
Antibody Formation ; Biopsy ; Cyclosporine ; Enzyme-Linked Immunosorbent Assay* ; Follow-Up Studies ; Hepacivirus ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Liver Diseases* ; Liver* ; Living Donors ; Polymerase Chain Reaction* ; Transplantation

A granuloma is a compact, organized collection of chronic inflammatory cells, predominantly consisting of mature mononuclear phagocytes. Clinical manifestations of hepatic granulomas vary widely from asymptomatic elevation of serum alkaline phosphatase activity to liver cirrhosis. The hepatic granuloma is nonspecific and represents a pathologic reaction induced by any of a number of factors. Although the causes of hepatic granuloma vary considerably according to geographic site, sarcoidosis and tuberculosis are the two leading causes. Here we present a 20-year-old female with a long history of recurrent otitis media, upper respiratory infection, and unexplained hepatosplenomegaly. A diagnosis of common variable immunodeficiency was made, based on the decreased levels of serum immunoglobulins. A liver biopsy revealed chronic granulomatous inflammation, but neither caseous necrosis nor acid-fast bacillus was found. Her liver disease progressed despite a nine-month course of antituberculous medication. Hypogammaglobulinemia should be included in the differential diagnosis of granulomatous liver disease.
Agammaglobulinemia ; Alkaline Phosphatase ; Bacillus ; Biopsy ; Common Variable Immunodeficiency* ; Diagnosis ; Diagnosis, Differential ; Female ; Granuloma ; Hepatitis* ; Humans ; Immunoglobulins ; Inflammation ; Liver ; Liver Cirrhosis ; Liver Diseases ; Necrosis ; Otitis Media ; Phagocytes ; Sarcoidosis ; Tuberculosis ; Young Adult