BACKGROUND: Depression is prevalent and a serious disorder in the elderly that interferes with social and physical function. It is associated with significant morbidity and a high mortality rate from suicide. Depression is highly treatable disease, but it remain largely unrecognized and untreated among the elderly. This study evaluate the factors related to depression of elderly, to be used as basic reference for management program in the community. METHODS: The cross-sectional study evaluates the depression of community-living elderly, aged 60 and older, in a Korean rural community. The subject were selected from a two stage cluster sampling. Questionnaire contained demographics, Geriatric Depression Scale (GDS), Mini-Nutritional Assessment (MNA), Mini-Mental Status Exam-Korean (MMSE-K), IADL, Social support network. T-test and multiple stepwise regression were constructed to explore the factors related to depression. RESULTS: Mean age was 71.22+/-7.1 with 101 male subjects and 200 female subjects. The mean GDS score was 6.9+/-3.7 and 56.5% of subjects were suggested depression (above 5 point on GDS). The mean score from the GDS showed significant differences in terms of following factors: gender, age, education, marital status, income, expenditures, type of residency, cognitive function, presence of disease, number of medications, stress, subjective self perception of health, IADL, nutrition, emotional support, social activity support, instrumental support (p<0.05). In the multiple stepwise regression analysis on depression, nutrition, IADL, education, presence of disease were selected as highly correlated variables (p<0.05), and religion, cognitive function, subjective self perception of health, stress were also selected (p>0.05). These variables explained 34.2% of depression. CONCLUSION: Nutritional status, cognitive function, physical state, functional state, social support network demographic characteristics were related to depression in the elderly.
Aged* ; Cross-Sectional Studies ; Demography ; Depression* ; Education ; Female ; Health Expenditures ; Humans ; Internship and Residency ; Male ; Marital Status ; Mortality ; Nutritional Status ; Surveys and Questionnaires ; Rural Population* ; Self Concept ; Suicide

OBJECTIVES: Patients with dementia are accompanied with poor autonomy and multiple disability. Therefore moer cost and medical service are required than non-dementia patients. In order to insure comprehensive, systematic care for dementia patients, knowledge of the associated disease of different types of dementia is warranted. This study evaluate the characteristics of associated disease in inpatients with dementia, to be used as basic reference for effective treatment. METHODS: The study popultion consist of 92 patients with dementia admitted between January 1, 1996 and September 30, 1997 to geriatric department, Yosei University Kwangju Severance Psychiatric Hospital. Diagnoses were based on DSM-IV and NINCDS. Severity of dementia was evaluated by GDS (Global Deterioration Scale). Associated diseases was recorded in separated checklist. chi-test, Fisher's exact test, ANOVA, T-test, Wilcoxon rank sum test, Kruskal-Wallis test were used to determine statistical differences among the dementia subgroup. RESULTS: The mean age was 71.8+/-9.2 with 31 male (33.7%) subjects and 61 female subject (66.3%). The types of dementia among the 92 demented patients were as follows:50 (54%) with Alzheimer's disease, 30 (33%) with vascular dementia, 12 (13%) with unclassified dementia. Mean GDS score was 5.4+/-1.1. The mean duration of admission was 66.9+/-88.9 days. Types of discharge were normal discharge 33 (35.9%), discharge against doctors' advice 28 (30.4%), transfer 23 (25.0%). The average number of diagnoses was 4.9+/-2.4. (4.5+/-2.4 in Alzheimer's disease, 6.1+/-2.4 in vascular dementia, 5.3+/-2.1 in unclassified dementia in respectively (p<0.05). The most common associated disease were gastrointestinal disorders (24.8%), cardiovascular disorders (11.8%), urinary tract infection (6.8%), musculoskeletal disorder (6.6%), diabetes mellitus (4.5%). Associated diseases that their frequency showed significant differences in different types of dementia were hypertension, diabetes mellitus, urinary incontinence, oral cavity disease, anemia (p<0.01). CONCLUSIONS: Associated disease are different in different type of dementia. Patients with vascular dementia had more associated disease and received more drugs for associated disease than Alzheimer's disease. Our data emphasize comprehensive and systematic treatment plan according to type of dementia.
Alzheimer Disease ; Anemia ; Checklist ; Dementia* ; Dementia, Vascular ; Diabetes Mellitus ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Gwangju ; Hospitals, Psychiatric ; Humans ; Hypertension ; Inpatients* ; Male ; Mouth ; Urinary Incontinence ; Urinary Tract Infections

Sarcoidosis is a multisystem granulomatous disorder commonly affecting young adults. Diagnosis is confirmed by evidence of non-caseating granuloma in more than one organ. A case is presented where the diagnosis was made on a bone marrow biopsy, the first case in Korea. A 54-year-housewife was admitted because of multiple variable sized, skin papules and macules, who showed pancytopenia and evidence of liver cirrhosis on ultrasound. We performed skin biopsy and bone marrow biopsy, which showed non-caseating granulomas. The chest CT, opthalmologic examination was performed and showed the involvement of sarcoidosis of mediastinal lymph nodes and uvea. Multiple joints of both hands and feet also seemed to be involved in view of simple X-ray. By this case, we emphasize the significance of bone marrow biopsy in the sarcoidosis with pancytopenia.
Biopsy ; Bone Marrow* ; Diagnosis ; Foot ; Granuloma ; Hand ; Humans ; Joints* ; Korea ; Liver Cirrhosis ; Liver* ; Lymph Nodes ; Pancytopenia ; Sarcoidosis* ; Skin* ; Tomography, X-Ray Computed ; Ultrasonography ; Uvea* ; Young Adult

Necrotizing sarcoid granulomatosis was first described by Liebow, who included it in the category of pulmonary angiitis and granulomatosis. Wegener's granulomatosis and limited Wegener's granulomatosis are also included in this category. Necrotizing sarcoid granulomatosis is characterized by histologically sarcoid-like granulomata, prominent and granulomatous vasculitis, and varying degrees of necrosis, radiographically pulmonary nodules but no enlarged hilar lymph nodes, clinically benign course. Whether this entity is a variant of necrotizig vasculitis with sarcoid reaction or sarcoidosis with prominent vascultic features and necrosis is not yet, clear, but many authors suggest the relationship with sarcoidosis from the observation of the similarity of histologic features and clinical course between the two entities. Patients are asymptomatic in about one fourth. Even symptomatic patients have vague symptoms such as cough, chest pain. Extrapulmonary involvement is rare. The prognosis is good even without therapy or with steroid alone, if necessary. We report a case that was diagnosed by open lung biopsy as necrotizing sarcoid granulomatosis, and it is assumed to be the first report of this entity in Korea.
Biopsy ; Chest Pain ; Cough ; Humans ; Korea ; Lung ; Lymph Nodes ; Necrosis ; Prognosis ; Sarcoidosis ; Vasculitis ; Wegener Granulomatosis

BACKGROUND: The importance of pro-inflammatory cytokines, especially tumor necrosis factor α(TNF-α) and interleukin-1β(IL-1β), have been extensively documented in the generation of inflammatory lung disease. Lung epithelial cells are also actively involved in initiating and maintaining inflammation by producing pro-inflammatory mediators. Understanding the mechanism of pro-inflammatory cytokine expression in lung epithelial cells is crucial to the development of new therapeutic modalities for inflammatory lung disease. Transcription of most pro-inflammatory cytokines is dependent on the actiation of NF-κB. However, the relationship between pro-inflammatory cytokine expression and NF-κB/IκB pathway in lung epithelial cells is not clear. METHODS: BEAS-2B, A549, NCI-H719 cells were stimulated with IL-1β or TNF-α at various times, and then IL-8 and TNF-αmRNA expressions were assayed by Northern blot analysis. IL-1β or TNF-α-induced NF-κB activation was assessed by the nuclear translocation of p65 NF-κB subunit. The degradation of IκBα and IκBβ by IL-1βor TNF-α stimulation was assayed by Western blot analysis. The phosphorylation of IκBαwas evaluated by Western blot analysis after pre-treating cells with proteasome inhibitor followed by IL-1β or TNF-α stimulation. The basal level of IKKα expression was evaluated by Western blot analysis. RESULTS: IκBαand IκBβ was repidly degraded after 5 minutes of incubation with IL-1β or TNF-α in BEAS-2B, A549, and NCI-H157 cells. The activation of NF-κB and the induction of IL-8 and TNF-α mRNA expressions were observed by IL-1β or TNF-α stimulation in these cells. In contrast, neither the changes in NF-κB/IκB pathway nor IL-8 and TNF-α mRNA expression was induces by IL-1β or TNF-α stimulation in NCI-H719 cell. IL-1β and TNF-α-induced IκB phoshorylation was observed in BEAS-2B, A549, and NCI-H157 cells, but not in NCI-H719 cells. The basal level of IKKα expression was not different between cells. CONCLUSION: NF-κB/IκB pathway plays an important role in the ixpression of pro-inflammatory cytokine in most lung epithelial cells. The absence of the effect on NF-κB/IκB pathway in NCI-H719 cells seems to be due to the defect in the intracellular signal transduction pathway upstream to IKK.
Blotting, Northern ; Blotting, Western ; Cytokines ; Epithelial Cells* ; Inflammation ; Interleukin-8 ; Lung Diseases ; Lung* ; Phosphorylation ; Proteasome Inhibitors ; RNA, Messenger ; Signal Transduction ; Tumor Necrosis Factor-alpha

BACKGROUND: Nutrition is closely related to morbidity and mortality, and active intervention is known to be effective in their prevention. This study evaluates the factors related to nutritional status of elderly, to be used as a basic reference for effective prevention program. METHODS: The cross-sectional study evaluates the nutritional status of community-living elderly, aged 60 and older, in a Korean rural community. The subject were selected from a two stage cluster sampling. Questionnaire contained demographics, the Mini-Nutritional Assessment(MNA), Mini-Mental Status Exam-Korean(MMSE-K), Geriatric Depression Scale(GDS), IADL, Social support network, and dietary patters. T-test and hierarchical regression models were constructed to explore the factors related to nutritional status. RESULTS: Mean age was 72+/-7.1 with 101 male subjects and 200 female subject. The MNA score revealed 41.5% of subjects who were at risk of malnutrition. The mean MNA score showed significant differences in terms of following factors: gender, age, education, marital status, income, expenditures, MMSE-K, GDS, social support, instrumental support, regularity of meal, changes in taste, satisfaction in food, unbalanced dietary habit, number of family members sharing the meal, IADL, presence of disease, number of medications(p<0.05). Multiple regression analysis revealed that demographic characteristics explained 7.5% of nutritional status, social support network 6.7%, mental disease 25.3%, dietary pattern 23.8% , and physical disease 22.2% correspondingly. Whole model explained 45.1% of nutritional status. The significant variables were the number of medications, presence of stress, unbalanced dietary habit, regularity of meal, instrumental support, depression, cognition, and satisfaction in food(p<0.05). CONCLUSION: Mental and physical state, dietary pattern, social support network, demographic characteristics were related to nutritional status.
Aged* ; Cognition ; Cross-Sectional Studies ; Demography ; Depression ; Education ; Female ; Food Habits ; Health Expenditures ; Humans ; Male ; Malnutrition ; Marital Status ; Meals ; Mortality ; Nutritional Status* ; Surveys and Questionnaires ; Rural Population

PURPOSE: Rheumatoid arthritis is a chronic multisystemic disease involving joints. It has been difficult to explain why the inflammatory responses of the rheumatoid arthritis (RA) are mostly limited to the joints. To explain this localizing phenomenon, we hypothetized that the cartilage, which exists in the joints, maintaines the activated status of synovial membrane and provides local specific environment for the maintenance of inflammatory response of arthritis. MATERIALS AND METHODS: Synovial fibroblast were proliferated with and without the addition of cartilage tissues, chondrocytes, type II collagens to the growth media respectively. MTS assay (CellTiter 96(R) AQ One Solution Cell Proliferation Assay) was done at 1st, 3rd, 4th, 5th, 6th, 7th, 9th and 11th days to evaluate the proliferation of the cells. The data were assessed with one-way ANOVA and unpaired t-test. Results : In a group where 0.1 g/ml of cartilage tissues were added to the growth media, the synovial fibroblasts from the normal people and rhematoid arthritic patients showed higher amount of proliferation from the 3rd day compared to the control group. When 0.02 g/ml of cartilage tissues were added, the synovial fibroblasts from the normal people showed higher amount of proliferation from the 4th day and those from RA patients from the 3rd day compared to the control group (p< 0.05). There was no significant statistical difference according to the concentration of the cartilage tissues.In a group where chondrocyte extract was added to the growth media, the synovial fibroblasts from the normal people showed higher amount of proliferation from the 4th day and those from RA patients from the 3rd day compared to the control group (p< 0.05). In a group where type II collagens were added to the growth media, the synovial fibroblasts from normal people and RA patients showed no significant statistical differences compared to the control group. CONCLUSION: The cartilage tissue is important in maintenance of synovial fibroblast proliferation. Of the cartilage tissue, chondrocyte, not extracellular type II collagen, played a major role. But further study is needed about what component of the chondrocyte extract maintaines the proliferation of synovial fibroblast.
Arthritis ; Arthritis, Rheumatoid ; Cartilage* ; Cell Proliferation ; Chondrocytes ; Collagen ; Collagen Type II ; Fibroblasts ; Humans ; Joints ; Synovial Membrane

OBJECTIVE: To evaluate the radiological and clinical findings of congenital cystic neuroblastomas as compared with those of the cystic presentation of neonatal adrenal hemorrhage. MATERIALS AND METHODS: We analyzed the US (n = 52), CT (n = 24), and MR (n = 4) images as well as the medical records of 28 patients harboring congenital cystic neuroblastomas (n = 16) and neonatal adrenal hemorrhagic pseudocysts (n = 14). The history of prenatal detection, location, size, presence of outer wall enhancement, internal septations, solid portion, calcification, turbidity, vascular flow on a Doppler examination, and evolution patterns were compared in two groups of cystic lesions, by Fischer's exact test. RESULTS: All (100%) neuroblastomas and three (21%) of the 14 hemorrhagic pseudocysts were detected prenatally. Both groups of cystic lesions occurred more frequently on the right side; 11 of 16 (69%) for neuroblastomas and 11 of 14 (79%) for hemorrhagic pseudocysts. The size, presence of solid portion, septum, enhancement, and turbidity did not differ significantly (p > 0.05) between the two groups of cystic lesions. However, tiny calcifications (n = 3) and vascular flow on color Doppler US (n = 3) were noted in only neuroblastomas. The cystic neuroblastomas became complex solid and cystic masses, and did not disappear for up to 90 days in the three following cases, whereas 11 of the 14 (79%) hemorrhagic pseudocysts disappeared completely and the three remaining (27%) evolved to calcifications only. CONCLUSION: Although the imaging findings of two groups of cystic lesions were similar, prenatal detection, the presence of calcification on initial images, vascularity on color Doppler US, and evolution to a more complex mass may all favor neuroblastomas.
Adrenal Gland Diseases/*diagnosis ; Adrenal Gland Neoplasms/*congenital/*diagnosis ; Catha ; Cysts/*diagnosis ; Diagnosis, Differential ; Female ; Hemorrhage/*diagnosis ; Humans ; Infant ; Infant, Newborn ; Male ; Neuroblastoma/*congenital/*diagnosis ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: Smoking and high-risk occupation have been known to be the risk factors of lung cancer. The carcinogen-metabolizing enzymes in human body such as glutathione S-transferase M1, T1 and N-acetyltransferase 1 have also been regarded as risk factors in many cancers, because the activities of those enzymes play a role in metabolizing the carcinogen. A case-control study was conducted to evaluate the genetic polymorphism of GSTM1, T1 and NAT1 in lung carcinogenesis in Korean men. METHODS: The histologically proven lung cancer cases were recruited from Seoul National University Hospital. The patients of more than 40-year-old with the nonmalignant urinary tract diseases were recruited as controls from the same hospitals. The informations of demographical characteristics and smoking were obtained by interview or chart review and the genetic polymorphisms of GSTM1, T1 and NAT1 were determined by PCR-based assay. The statistical analyses were performed by linear logistic regression. RESULTS: The number of case-control was 118 and 150, respectively. The smoking history was significantly higher in the lung cancer patients than the controls. The prevalence of GSTM1 null-type was statistically higher(OR=2.25 ; 95% C I=1.12-4.51) in squamous cell carcinoma than other genotypes, but other histologic types were not. The prevalence of GSTT1 null-type were not statistically higher than other genotypes in all histologic types. The fast acetylator of NAT1 was more prevalent than normal(OR-2.13 ; 95% C I=1.04-4.40) in all lung cancer patients. CONCLUSION: The null-type of GSTM1 and fast acetylator of NAT1 are associated with development of lung cancer in Korean men.
Adult ; Carcinogenesis ; Carcinoma, Squamous Cell ; Case-Control Studies ; Genotype ; Glutathione Transferase* ; Glutathione* ; Human Body ; Humans ; Logistic Models ; Lung Neoplasms* ; Lung* ; Male ; Occupations ; Polymorphism, Genetic* ; Prevalence ; Risk Factors ; Seoul ; Smoke ; Smoking ; Urologic Diseases

We report the first case of summer-type hypersensitivity pneumonitis(SHP) in Korea diagnosed by positive serum antibodies to Trichosporon cutaneum. Hypersensitivity pneumonitis(HP) has been commonly classified as an occupational respiratory diseases. However, evidence that sensitizing organisms can also contaminate and cause pulmonary diseases in home environment has been increasing. One such disease is SHP. In Japan, 75% of cases with HP are SHP. Even though there has been no known SHP case in Korea yet, there has been high possibility of SHPs in Korea because our country has areas which have hot and humid summer climate similar to Japan. This first case of SHP in Korea suggests that there may be another cases in Korea and nation-wide survey may be required. We report here the first confirmed case of SHP in Korea.
Antibodies ; Climate ; Hypersensitivity ; Japan ; Korea* ; Lung Diseases ; Trichosporon ; Trichosporonosis*