BACKGROUNDS: As the elderly population in-creases the health problem, especially dementia, becomes the clinically important problem. So in the part of primary care medicine it becomes so important that family physician make a focus on the detection, evaluation, and management of demented patient. Until nowadays there is few cohort study about the dementia and few nursing home in Korea. So author performed the MMSE-K in the elderly who are over 65 to get the cognitive function for early diagnosis, management and rehabilitation of psychosocial problem. METHODS: One hundred three persons who included in community society in Seoul and nursing home of Kyunggido were tested. The survey was done twice on september 1997 and September 1998. Author used the MMSE-K to the elderly by same doctors. The analysis was done by SAS 6.12 and t-test, one-way ANOVA and two-way ANOVA with linear trend test. RESULTS: The mean of first MMSE-K score in the community is 26.1 and in the nursing home is 24.4. And the mean of second MMSE-K score in the community is 25.5 and in the nursing home is 22.0. The MMSE-K score is elevated with male and longer duration of education and is decreased with the advanced age in two groups. According to the classification by MMSE-K score the number of people who have normal cognitive function is 45(43.7%), mild impaired cognitive function is 45(43.7%), moderately impaired cognitive function is 13(12.6%) and none has severely impaired cognitive function in both groups. The follow up MMSE-K score shows that the difference of two MMSE-K scores increases as the age increases. CONCLUSION: Until todays there is few study that designed in the form of cohort study about the elderly cognitive function in Korea. So family physicians must perform the prospective cohort study with the consistent concern and effort to get the research data about the dementia for earthy detection, management and rehabilitation for elderly.
Aged* ; Classification ; Cohort Studies ; Dementia ; Early Diagnosis ; Education ; Follow-Up Studies* ; Gyeonggi-do ; Humans ; Korea ; Male ; Nursing Homes ; Physicians, Family ; Primary Health Care ; Rehabilitation ; Seoul

OBJECTIVE: The objective of this study was to determine the relationship between the fetal doppler flow velocimetry and birth weight in low risk pregnancy population. METHODS: From December 1995 to May 1996, We prospectively performed doppler study in 254 uncomplicated, term pregnant women, who visited Pohang Hospital, Dongguk University. Using pulsed color doppler, we measured umbilical artery RI, middle cerebral artery RI and middle cerebral-umbilical artery RI ratio within one week before delivery. RESULTS: The result was that low birth weight group (below 2500gm) had very significant lationship with umbilical artery RI(P<0.01), middle cerebral artery RI(P<0.05) and middle cerebral-umbilical artery RI ratio(P<0.05), but there was no significant relationship in these blood flow indices between normal birth weight group (2501gm- 3999gm) and macrosomia group (above 4000gm). CONCLUSIONS: We concluded that application of doppler ultrasonopaphy in the assessment of fetal weight is somewhat helpful for identification of low birth weight, not for macrosomia.
Arteries ; Birth Weight ; Female ; Fetal Weight* ; Gyeongsangbuk-do ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Middle Cerebral Artery ; Pregnancy ; Pregnant Women ; Prospective Studies ; Rheology ; Ultrasonography* ; Umbilical Arteries

No abstract available.
Asthma, Occupational*

OBJECTIVE; This study was conducted to evaluate the effect of pregnancy on the activities of oxygen hee radical generating and scavenging system in the female rats. MATERIAL & METHOD; Rats weighing 200-220 gm were grouped to non-pregnant, 2nd trimester and 3rd trimester of pregnancy. The experiment was carried out following overnight fasting. Animals were anesthetized by administration of pentothal sodium, and blood was drawn via abdominal aorta. After exsanguination, the liver, kidney, heart, lung, with or without placenta tissues were excised immediately. The excised tissue was frozen in liquid nitrogen rapidly, and stored in liquid nitrogen for analysis. RESULTS; The gain in body weight was higher in pregnant rats than in normal rats. Lipid peroxidation was not significantly different among all groups in the liver, kidney, heart, lung, and placenta tissue. Xanthine oxidase activity of the kidney in the 3rd trimester of pregnancy was lower than that of non-pregnant rats. Superoxide dismutase activity of the liver was significantly decreased in the 2nd and 3rd trimester of pegnancy compared with that of non-pregnant rats, and that of lung was also decreased than that of non-pregnant rats. Catalase activity of the kidney was decreased in the 2nd and 3rd trimester of pregnancy compared with that of non-pregnant rats. Glutathione content of the liver was markedly decreased in the 2nd and 3rd trimester of pregnancy compared with that of non-pregnant rats. CONCLUSION; In conclusion, these results suggest that oxygen free radical will not increase in the liver, kidney, heart, lung, and placenta during normal pregnancy, but in the cases of overproduction of oxygen free radical, the liver, kidney, and lung will have me chance of tissue damage because of decreased activity of some anti-oxidant enzymes and/or decreased amount of anti-oxidant materials.
Animals ; Aorta, Abdominal ; Body Weight ; Catalase ; Exsanguination ; Fasting ; Female ; Glutathione ; Heart ; Humans ; Kidney ; Lipid Peroxidation ; Liver ; Lung ; Nitrogen ; Oxygen* ; Placenta ; Pregnancy ; Rats ; Sodium ; Superoxide Dismutase ; Thiopental ; Xanthine Oxidase

Mayer-Rokitansky-Kster-Hauser Syndrome is characterized by the absence of the vagina and uterus, the presence of apparently normal tubes and ovaries, feminine appeara-nce, normal female secondary sexual characteristics, a normal 46,XX karyotype, and a fem-inine psychosexual orientation. Various methods of surgical treatment have been introduced, but the ideal method is still not found. The two cases reviewed in this paper were all treated with McIndoe operation using full thickness skin graft. Both women were satisfied with vaginal depth and excellent result was achieved. We report two vaginoplasties in patients of Mayer-Rokitansky-Kster-Hauser Syndr- ome including a brief review of literature.
Female ; Humans ; Karyotype ; Ovary ; Skin ; Transplants ; Uterus ; Vagina

PURPOSE: Rush immunotherapy (RIT) with house dust mite may be effective to treat house dust mite allergic disease, but the mechanisms are not clear. Considerable attention has been devoted to the IgG subclass in relation to clinical outcome. Usually, conventional immunotherapy with D.f and D.p is followed early on by a rise in allergen-specific IgG1 with a gradual decline over time and slow rise in allergen-specific IgG4. Some investigators have implicated that IgG4 is a more important blocking antibody than IgG1 in RIT. But there is no consistent data on the early changes of allergen-specific IgG1 or IgG4. To inves- tigate the alteration of humoral immunity in the mechanism of early phase of RIT, the D.f -specific IgE, IgG1, and IgG4 levels of the RIT group were compared with that of the con- trol group with asthma. METHOD: The RIT group included 17 D.f and D.p-sensitized asthmatic children, who had received RIT with D.f and D.p, and the control group included 15 D.f and D.p-sensitized asthmatic children who had not received RIT. They received RIT to mite for just over 8 weeks until maintenance was achieved. The symptom scores of asthma, skin reactivity to D.f (allergen/histamine ratio), RIT changes of D.f-specific IgE, IgG1, and IgG4 levels were compared before and 8 weeks after for the two groups. D.f-specific IgE, IgG1, and IgG4 levels were measured by ELISA. RESULTS: The symptom scores and the skin reactivity to D.f decreased significantly 8 weeks after RIT. D.f-specific IgG1 levels increased significantly 8 weeks after RIT in the RIT group but not in the control group. But D.f-specific IgE and D.f- specific IgG4 levels did not change 8 weeks after RIT in either of the two groups. CONCLUSION: D.f-specific IgG1 production was increased in the early phase of RIT. These findings suggest that the early clinical changes after RIT may be linked to the early increase of IgG1 blocking antibody.
Asthma ; Child* ; Dermatophagoides farinae* ; Dermatophagoides pteronyssinus* ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunity, Humoral* ; Immunoglobulin E ; Immunoglobulin G ; Immunotherapy* ; Mites ; Pyroglyphidae* ; Research Personnel ; Skin

EDTA-dependent pseudothrombocytopenia (PTCP) is the phenomenon of a spurious low platelet count due to EDTA-induced aggregation of platelets. Since the failure to recognize EDTA-dependent PTCP may result in incorrect diagnosis and inappropriate treatment, the recognition of this phenomenon is very important. We report an insidious case of EDTA-dependent PTCP confirmed by supplementation of kanamycin to anticoagulant in a 53-year-old women. Although sodium citrate and heparin usually prevented the aggregation of platelets in EDTA-dependent PTCP patients, these anticoagulants failed in preventing PTCP in our case. EDTA-dependent PTCP was confirmed by the findings that the clumping of platelets on microscopic evaluation was found in EDTA-anticoagulated blood samples, whereas thrombocytopenia and platelet aggregation were not revealed in the sample supplemented with kanamycin.
Antibiotics, Aminoglycoside/*pharmacology ; Anticoagulants/*adverse effects/pharmacology ; Case Report ; Edetic Acid/*adverse effects ; Female ; Human ; Kanamycin/*pharmacology ; Middle Age ; Platelet Aggregation/*drug effects ; Platelet Aggregation Inhibitors/*therapeutic use ; Platelet Count ; Thrombocytopenia/*blood/chemically induced

BACKGROUND/AIMS: The tolerance of the liver to ischemia during intermittent hepatic pedicle clamping was compared with that during continuous hepatic pedicle clamping, and intermittent hepatic pedicle clamping was thought to more tolerable to ischemia/reperfusion injury. The mechanisms underlying this were unknown. We examined the relationship between ischemia/reperfusion injury and the production of oxygen-derived free radicals using spin resonance spectrometry. METHODS: Adult male Sprague-Dawley rats were subjected to either continuous or intermittent hepatic pedicle clamping. Alpha-(4-pyridyl 1-oxide)-N-tert-butylnitrone was administered to rats as a spin trap agent. Continuous clamping (15, 30, or 60 minutes) or intermittent clamping(four cycles of 15-minutes ischemia and 5 or 15 minutes of reperfusion) of hepatic pedicle was carried out. After reperfusion, blood samples were obtained and measuring liver enzyme to evaluate hepatic injury. Hepatic tissue blood flow was measured using a color Doppler blood flowmeter. RESULTS: When there was a longer period of hepatic pedicle occlusion, increased oxygen-derived free radical generation was detected after reperfusion. There was no significant increase in oxygen-derived free radical production or liver enzymes leakage when the duration of ischemia was 15 minutes. Oxygen-derived free radical generation and liver enzyme leakage were significantly less in intermittent pedicle clamping than in continuous clamping for 60 minutes. CONCLUSION: According this results, there is a oxygen-derived free radicals and liver damage in less in intermittent pedicle clamping than continuous clamping although many oxygen-derived free radicals are produced.
Adult ; Animals ; Constriction* ; Flowmeters ; Free Radicals ; Humans ; Ischemia ; Liver* ; Male ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Spectrum Analysis

BACKGROUND: In Korea, the number of liver transplantation (LT) center is still changing. Many more centers are performing liver transplantations than that during the past decades. But several centers have stopped liver transplantation, while some centers have newly started performing liver transplantation. We present our initial experience in a newly built center as an example for any center that is considering performing LT. METHODS: A total of 33 consecutive adult LTs that were performed from June 2006 to October 2009 were analyzed by comparing the first 11 living donor liver transplants (LDLTs) performed with the help of an outside experienced team (group 2) with the second 11 LDLTs (group 3) and the 11 deceased donor liver transplantations (DDLTs) cases (group 1) that were independently performed in our center. RESULTS: There was no operative mortality for the donors and there were two operative mortalities for the recipients. During a mean follow-up of 27.1 months (range: 2 days~61 months), there were two cases of late mortality for the recipients. There were no re-operations and no major complications for the donors. The warm ischemic time was significantly longer in group 1 than that in groups 2 and 3. Otherwise, there was no significant difference in the operative outcomes among the three groups. CONCLUSIONS: Thorough preparation and the valuable assistance of an experienced liver transplantation team at the beginning can facilitate a more rapid learning curve and bring about good outcomes even in a small, newly established institution.
Adult ; Follow-Up Studies ; Humans ; Korea ; Learning Curve ; Liver ; Liver Transplantation ; Living Donors ; Tissue Donors ; Transplants ; Treatment Outcome ; Warm Ischemia

BACKGROUND: Urinary tract infection(UTI) is one of the most common diseases dealt with by primary physicians. UTI is common in the elderly and has a great influence on the quality of the elderly's life. Thus, we conducted a study in one nursing home to find out the prevalence of bacteriuria and epidemiologic characteristics of the elderly. METHODS: The study was performed twice on April 12 and on May 4, 1999 among 108 subjects residing in a nursing home of Hanam City. The authors inquired the subjects pertaining to the history of UTI symptoms, collected urine samples by midstream clean-catch technique and catheterization and performed routine and microscopic urine analysis and urine culture. RESULTS: The overall prevalence of bacteriuria in subjects was 23.1%(25/108) ; 20% (3/15) in males and 23.7%(22/93) in females. The prevalence of the bedrriden subjects was 40.9%(9/22). Among the urine samples of 25 cases which were positive in the urine culture, E. Coli was found in 15 cases(60%). The sensitivity, specificity, positive and negative predictive value of pyuria for bacteriuria were 44.0%(11/25), 87.9%(73/83), 52.3%(11/21) and 83.9%(73/87), respectively, while those of nitrite test for bacteriuria were 64.0%(16/25), 97.5%(81/83), 88.8%(16/18) and 90.0%(81/90), respectively. The prevalence of bacteriuria increased by 16.23% as age increased by ten years using the Cochran-Armitage's linear trend test. CONCLUSIONS: The prevalence of bacteriuria in the elderly residing in a nursing home was higher than that of the elderly residing in a community. In the elderly over 60 years old, the prevalence of bacteriuria increased as the age increased. Immobility is considered as a risk factor of bacteriuria. Bacteriuria may be treated by antibiotics focused on E. Coli. Thus, we can expect improvement in the quality of life as well as extension of life span.
Aged* ; Anti-Bacterial Agents ; Bacteriuria* ; Catheterization ; Catheters ; Female ; Gyeonggi-do ; Humans ; Male ; Middle Aged ; Nursing Homes* ; Nursing* ; Prevalence ; Pyuria ; Quality of Life ; Risk Factors ; Sensitivity and Specificity ; Urinary Tract