PURPOSE: Frailty is a wasting syndrome common in old age and to confer high risk for morbidity and mortality. There is a growing consensus of the definition of frailty, but until now the diagnostic criteria is not clear yet. In the older male patients, almost of studies about testosterone replacement therapy performed to normal healthy population. And also only few studies were performed to the frail elderly patients. So we would like to investigate the effficacy of testosterone supplementation in the frail elderly. METHODS: Since May to Sep 2001, ambulatory elderly patients who were 65 years and over were recruited in the outpatient clinic of Asan Medical Center. All of them showed the typical characteristics of frailty symptom-weight loss, loss of muscle mass, weakness, fatigability, anorexia, inactivity. The patients who have sleep-apnea or previous history of prostate cancer were excluded. All patients were checked the serum PSA, total testosterone level, routine CBC, lipid, liver function test and evaluated prostate status with US or digital rectal examination, and treated with oral formula testosterone unde- canoate 80 mg daily. All patients were surveyed with ADL, IADL before the testosterone therapy and 3month later. RESULTS: A total of 6 male frail patients(mean age: 80+/-8.5) were enrolled. During 3 month Follow-up period, one was expired, 5 were finished the study. Before the testosterone replacement, mean total testos- terone level was 3.0+/-0.5 ng/ml and mean PSA was 1.3+/-0.7 ng/ml. After 3 months, blood hematocrit, cholesterol, total testosterone were not changed significantly and the body weight also showed insig- nificant increase. But after 3 months, all of them reported the increased well-being sensation, improved fatigability, weakness and improved ADL level. There were no significant adverse effects associated with testosterone replacement. CONCLUSION: In male frail elderly patients, the testosterone replacement therapy can be used safely, and can be improve the frailty associated symptom and ADL ability.
Activities of Daily Living ; Aged ; Ambulatory Care Facilities ; Anorexia ; Body Weight ; Cholesterol ; Chungcheongnam-do ; Consensus ; Digital Rectal Examination ; Follow-Up Studies ; Frail Elderly* ; Hematocrit ; Humans ; Liver Function Tests ; Male ; Mortality ; Prostate ; Prostatic Neoplasms ; Sensation ; Testosterone* ; Wasting Syndrome

PURPOSE: The purpose of this study was to identify body esteem, body figure discrepancy and depression in women college students. METHOD: The data were collected during April and May, 2004 using a questionnaire. The participants were 364 women college students attending universities in Seoul and Gangwon-Do. RESULTS: The BMI for under weight, normal weight and overweight for the college women were 49.2%, 48.3%, 2.5% respectively. But 52.6% of the students perceived themselves as obese and only 11.5% described themselves as being 'thin'. The mean scores for BMI, body esteem, body figure discrepancy and depression were 20.11+/-2.20, 2.36+/-.79, 1.07+/-.58 and 1.20+/-.48 respectively. Significant difference was found in body esteem score (F=26.389, p<.0001) and body figure discrepancy (F=64.167, p<.0001) according to BMI scores. There were negative correlations between body esteem and body figure discrepancy (r=-.582, p=.0001), between body esteem and depression (r=-.120, p=.028), between body esteem and BMI (r=-.422, p=.0001), and a positive correlation between body figure discrepancy and BMI (r=.630, p=.0001). Factors such as body figure discrepancy, BMI and depression explained 36.7% of the variance in students' body esteem. CONCLUSION: This study suggests that an intervention program is necessary for women college students to increase their body-esteem.
Depression* ; Female ; Gangwon-do ; Humans ; Overweight ; Surveys and Questionnaires ; Seoul

BACKGROUND: Following the improvement of the economic status and increasing medical availability, the interest for the public health and nutrition in elderly is increasing in Korea. It is well known that aging is associated with the deterioration of nutritional status, but in Korea, there were no clear data about that yet. PURPOSE: This study was performed to identify the normal distribution of the nutritional indices such as biochemical and anthropometric variables, showing the association between nutritional risk factor and aging. METHODS: Among 151,000 subjects over 40 year olds in Jung-Up County, Korea, 1051 were selected for a random cluster sample. After the blood tests and anthropometric measurements were performed during Dec 1996 to Feb 1997. RESULTS: Of the 1051 subjects(M:F=410:641), 340 were over 65 years(elderly) at the enroll time, while 711 were between 40 to 65 years(middle aged). Triceps skin fold thickness(TSF), body mass index(BMI), hematocrit(Hct) serum protein and albumin showed a weak negative correlation with age, whereas not in the case of the waisthip ratio(WHR), leucocytes, serum cholesterol and creatinine. Compared with middle aged with elderiy, TSF, BMI, albumin showed a significant differences(p<0.05). CONCLUSION: We showed the normal distribution of the variable nutritional indices and their changes associated with aging in the ambulatory elderly Korean living in the rural community. It needs further follow-up study including association with mortality.
Adult ; Aged* ; Aging ; Cholesterol ; Creatinine ; Hematologic Tests ; Humans ; Jeollabuk-do ; Korea ; Middle Aged ; Mortality ; Nutrition Assessment ; Nutritional Status ; Public Health ; Risk Factors ; Rural Population ; Skin

BACKGROUND: In recent years, estrogen has also been shown to modulate the development and function of the brain, bur not exclusively in areas involved with sexual behavior. Among the most novel and fascinating effects of estrogen are those on cognitive function and memory process and their alterations during aging and neurodegenarative disease like Alzheimer. Estrogen receptors distributed not only in the hypothalamus but many different areas, like cerebral cortex, hippocampus, basal forebrain, midbrain, spinal cord, and the diverse action of estrogen is supported by this fact. Numerous studies suggest thai estrogen may be beneficial in preserving cognitive function, but it is not clear yet. PURPOSE: In this study, we perform the immunohistochemical staining in the hippocampus of normal aged rat, and show the distribution of estrogen receptor compared with the neonatal rat. METHODS: we have used antibodies against a estrogen receptor(ER)-alpha to determine their distribution in neonatal and aged SD rat hippocampus. RESULTS: In neonatal rat hippocampus, ER-alpha immunoreactivity was observed in the nucleus of Purkinje cells, whereas in aged rat hippocampus, ER-a immunoreactivity was found mainly in the cytoplasm of Purkinje cells. CONCLUSION: We showed the age related intracellular differential distribution of ER-alpha immunoreactivity in the rat hippocampus. But, further investigations are required to establish whether functional relations like cognitive ability exist with this different intracellular expression of ER-alpha immunoreactivity.
Aging ; Animals ; Antibodies ; Asian Continental Ancestry Group ; Brain ; Cerebral Cortex ; Cytoplasm ; Estrogens* ; Hippocampus* ; Humans ; Hypothalamus ; Memory ; Mesencephalon ; Prosencephalon ; Purkinje Cells ; Rats* ; Receptors, Estrogen ; Sexual Behavior ; Spinal Cord

Purpose: This study aimed to identify the modifiable factors affecting breastfeeding planning and duration among healthy mothers and their use of breastfeeding information resources. Methods: A cross-sectional survey was conducted in a community setting. Four hundreds participants were recruited at five pediatric clinics and three community health centers located in Paju-si and Goyang-si, Gyeonggi-do, between January and May 2019. Based on the breastfeeding decision-making model, driven by Martens and Young’s work, the survey items consisted of demographics, childbirth and breastfeeding characteristics, and breastfeeding information resources. In the analysis, 389 responses were used in the t-test, ANOVA, and logistic regression. Information resource networks were compared before and after childbirth including a subgroup analysis depending on the breastfeeding duration. Results: The modifiable factors affecting breastfeeding planning and duration were antenatal and postpartum breastfeeding education and the provision of information in the hospital.The frequency of Internet use and websites visited were notable and potentially modifiable factors, which were also observed in the networks showing different relationship patterns according to participant subgroups and times. The childbirth event increased the centralization of the network in the planned group, while the network of the non-planned group was more diffused after childbirth. The network of the short-term breastfeeding group was characterized by a more centralized pattern and the resources of high betweenness centrality than the long-term group. Conclusion Breastfeeding education is a consistent factor that affects breastfeeding behavior. A well-designed internet-based approach would be an effective nursing intervention to meet the needs of women seeking breastfeeding information and changing their behaviors.

Purpose: This study aimed to identify the modifiable factors affecting breastfeeding planning and duration among healthy mothers and their use of breastfeeding information resources. Methods: A cross-sectional survey was conducted in a community setting. Four hundreds participants were recruited at five pediatric clinics and three community health centers located in Paju-si and Goyang-si, Gyeonggi-do, between January and May 2019. Based on the breastfeeding decision-making model, driven by Martens and Young’s work, the survey items consisted of demographics, childbirth and breastfeeding characteristics, and breastfeeding information resources. In the analysis, 389 responses were used in the t-test, ANOVA, and logistic regression. Information resource networks were compared before and after childbirth including a subgroup analysis depending on the breastfeeding duration. Results: The modifiable factors affecting breastfeeding planning and duration were antenatal and postpartum breastfeeding education and the provision of information in the hospital.The frequency of Internet use and websites visited were notable and potentially modifiable factors, which were also observed in the networks showing different relationship patterns according to participant subgroups and times. The childbirth event increased the centralization of the network in the planned group, while the network of the non-planned group was more diffused after childbirth. The network of the short-term breastfeeding group was characterized by a more centralized pattern and the resources of high betweenness centrality than the long-term group. Conclusion Breastfeeding education is a consistent factor that affects breastfeeding behavior. A well-designed internet-based approach would be an effective nursing intervention to meet the needs of women seeking breastfeeding information and changing their behaviors.

Objectives: To increase the efficiency of hemodialysis, an appropriate vascular pathway must be created, and its function must be maintained. This study aimed to identify the effects of an arteriovenous fistula (AVF) stenosis prevention program on upper muscular strength, blood flow, physiological indexes, and self-efficacy among patients receiving hemodialysis. Methods: The participants were patients receiving hemodialysis at Keimyung University Dongsan Medical Center in Daegu, Republic of Korea. They were divided into experimental and control groups based on the day of the week they received hemodialysis at the outpatient department and included 25 participants each. The study was conducted for 8 weeks. Results: The AVF stenosis prevention program was effective in improving upper extremity muscle strength (F = 15.23, p < 0.001) and blood flow rate (F = 36.00, p < 0.001). As a result of the program, the phosphorus index level, which is a physiological indicator in hemodialysis patients, decreased (F = 8.64, p < 0.001). Encouragement and support through text messages and practice lists also resulted in an increase in self-efficacy (F = 18.62, p < 0.001). Conclusion The AVF stenosis prevention program in this study resulted in an increase in upper extremity muscle strength through grip strength exercises and was effective in preventing AVF stenosis by increasing the blood flow rate.

No abstract available.
Lip* ; Neurofibroma*

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.
Accreditation ; Administrative Personnel ; Aged ; Counseling ; Diet ; Diet Therapy ; Education ; Enteral Nutrition ; Hospital Departments ; Hospitals, Convalescent* ; Humans ; Malnutrition ; Meals ; Medical Records ; Nutrition Assessment ; Nutritional Status ; Nutritionists

To develop the specialty of geriatric medicine which pursues a comprehensive medical care from the trend of superspecialization of modern medical science, it is hard job to take a triangular position in area of expertise. The speed of entering aged society is so fast in Korea, the spare time to prepare multiple problems that found aged society is not enough. So, geriatric medicine should do important role, from fundamental research of aging and degenerative disease which is caused by aging, research for developing efficient treatment mo- dality for multi-problem elderly patients for preserving good functional status, research for growing evidence in clinical geriatric care, to research about health care system. Geriatric medicine suited in demand of like this society, and as a part of medical science, the effort of specialized research for improving elderly care, and the effort with a professionalization of geriatric field, should be continued.
Aged ; Aging ; Clinical Medicine ; Delivery of Health Care ; Geriatrics ; Humans ; Korea