BACKGROUND: It is a recent trend that the birth and mortality rates has been decreased and average life span prolonged in proportion to the socioeconomic and scientific advances. The goal of this study is to suggest basic data for comprehensive and continuous management of elderly patients. METHODS: Based upon ICD-10 (International Classification of Disease), the author analysed the outpatient's diseases 19,367 and inpatient's diseases 6,783 beyond the age of 65 who visited outpatient department and were hospitalized to the Kosin University, Kosin Medical Center in Pusan from January to December in 1997 RESULTS: The ratio of elderly patient in outpatient was 4.5% and inpatient was 15.0%. The number of outpatient each disease group were disease of the circulatory system 5,367 (27.7%), neoplasms 4,007 (20.7%), disease of the digestive system 2,635 (13.6%), endocrine, nutritional and metabolic disease 1,798 (9.8%) in order. Frequent diseases in individual system of outpatient were followed; malignant neoplasms of digestive organs 2,642 (13.6%), hypertensive diseases 2,053 (10.6%), diseases of esophagus, stomach and duodenum 1,804 (9.3%), ischemic heart disease 1,101 (5.7%) in order. The number of inpatient each disease group were disease of the neoplasms 2,138 (31.5%), disease of circulatory system 1,191 (17.6%), disease of the digestive system 730 (10.8%), endocrine, nutritional and metabolic disease 489 (7.2%) in order. Frequent diseases in individual system of inpatient were followed; malignant neoplasms of digestive organs 956 (14.1%), malignant neoplasms of respiratory and intrathoracic organs 351 (5.2%), hypertensive diseases 348 (4.2%), diabetes mellitus 325 (4.1%) in older. CONCLUSION: This result indicate that the elderly patients abounded mostly with disease of circulatory, neoplasm, disease of the digestive system and endocrine, nutritional and metabolic disease.
Aged* ; Busan ; Classification ; Diabetes Mellitus ; Digestive System ; Duodenum ; Esophagus ; Humans ; Inpatients ; International Classification of Diseases ; Metabolic Diseases ; Mortality ; Myocardial Ischemia ; Outpatients ; Parturition ; Stomach

This study was carried out to survey the prevalence of Helicobacter pylori infection and the incidence of vacuolating toxin producing H. pylori from the gastric biopsy specimens of patients with 178 gastritis, 57 gastric ulcer, 455 gastric cancer and 44 healthy person in Pusan, Korea. Further aim of this study was to evaluate the effect of ginseng extract, sofalcone, ginsenosides (F1, Rb3, Re, Rgl), sangwha, green, arrowroot, ginger, and jujube tea on the activity and production of vacuolating toxin by H. pylori in vitro. The isolation rates of H. pylori by culture method from gastric biopsy specimens were 34.1% in healthy person, 42.1% in gastritis, 36.8% in gastric ulcer, and 39.3% in gastric cancer. The isolation rates of vacuolating toxin producing H. pylori from gastric biopsy specimens were 80% in healthy person, 82.7% in gastritis, 81% in gastric ulcer, and 83.8% in gastric cancer. The growth of H. pylori was not influenced by the addition of 10 ug/ml or 100 ug/ml of Ginseng extract and 10 ug/ml of sofalcone in the medium, but the production of vaculating toxin of H. pylori was significantly inhibited by the addition of 100 ug/ml of Ginseng extract and sofalcone. The activity of vacuolating toxin in the culture supernatant of H. pylori was significantly diminished (1/2-1/16 compared to control) by the addition of 10 mg/ml of sangwha, green, arrowroot, and ginger tea, and 1 ug/ml of ginsenosides F1, Rb3, Re, and Rgl. These results suggest that the isolation rates of vacuolating toxin producing H. pylori were significantly higher than that of the foreign reports. Ginseng extract and sofalcone have direct inhibitory effect on the activity of vacuolating toxin production by H. pylori without considerable growth inhibition and sangwha, green, arrowroot, and ginger tea have direct inhibitory effect on the activity of vacuolating toxin of H. pylori.
Biopsy ; Busan ; Gastritis ; Ginger ; Ginsenosides ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Korea ; Marantaceae ; Panax* ; Prevalence ; Stomach Neoplasms ; Stomach Ulcer ; Tea ; Ziziphus

BACKGROUND: The goals of this study are to evaluate the propensity to depression in Korean internet users associated with internet using environment and attempt to aid proper management of internet users in the field of family practice. METHODS: A group of 1,674 subjects who replied to internet research were selected from March 26 to 28, 1999. Making use of CES-D-K for Korean internet users, we investigated the propensity to depression. At the same time, general characteristics, internet using environmental characteristics were investigated and their relationship was assssed. RESULTS: The CES-D-K score was 16.19. The CES-D-K score was significantly higher in females, in younger age and low education level group(P<0.001). There was no significance between CES-D-K score and region. In internet using environmental characteristics, the CES-D-K score was significantly higher in low velocity users, long internet using time per day group (P<0.001). There was no significance between CES-D-K score and internet using year. CONCLUSION: There was a significant correlation between internet using velocity, internet using time per day and the propensity to depression. Therefore, family physician should think about the correlation of the propensity to depression and internet using environment, if internet users have symptoms of depression.
Depression* ; Education ; Family Practice ; Female ; Humans ; Internet* ; Physicians, Family

BACKGROUND: Anomalous origin of a coronary artery is rare, but it can lead to angina pectoris, acute myocardial infarction, or even sudden death in the absence of atherosclerosis. Even when an anomalous vessel is identified angiographically, it may be difficult to delineate its true course on the basis of angiography alone. We attempted to determine whether transesophageal echocardiography (TEE) is of value in making the diagnosis and outlining the course of anomalous left circumflex (LCx) or right coronary arteries (RCA). METHOD: Eight adult patients with anomalous origin of LCx or RCA documented by selective coronary angiography were studied by transthoracic echocardiography (TTE) and multiplane TEE. RESULTS: Anomalous coronary ostia were visualized in all eight patients by TEE, but in only one with anomalous RCA out of eight patients by TTE. The proximal segments of anomalous coronary vessels were delineated in all eight patients by TEE and in only three with anomalous LCx out of eight patients by TTE. CONCLUSION: TEE is a valuable adjunctive diagnostic tool for the identification of anomalous coronary origin and course and is superior to TTE in adult patients.
Adult ; Angina Pectoris ; Angiography ; Atherosclerosis ; Coronary Angiography ; Coronary Vessels* ; Death, Sudden ; Diagnosis ; Echocardiography ; Echocardiography, Transesophageal* ; Humans ; Myocardial Infarction

The therapeutic strategy of the left main disease is quite different frorn usual coronary artery disease. Therefore, the diagnostic evaluation should be done carefully. Eventhough coronary angiography has been considered as a gold standard for the diagnosis of left main disease, its diagnosis is not possible in all cases. In questionable situation, direct visualization of the left main coronary artery and Doppler measurements of coronary blood flow by transesophageal echocardiography may give some diagnostic aids. We report a case of suspected isolated ostial left main stenosis, which was helped diagnotically by perfoming transesophageal Doppler echocardiography.
Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Echocardiography, Doppler* ; Echocardiography, Transesophageal

BACKGROUND: Thrombus-containing lesions (TCL) are associated with lower initial success rates and higher restenosis rates after balloon dilation. Furthermore, it has been considered as an absolute contraindication of coronary stenting. With advances in antithrombotic regimens and implantation techniques, coronary stenting has been widened to lesions with adverse morphologic features or to patients with acute coronary syndrome. Here we report the early clinical and angiographic results of coronary stenting in TCL. METHODS: We studied 24 consecutive patients (58+/-8 years, 18 males) undergoing coronary stenting in TCL. Fifteen patients (63%) were treated for acute myocardial infarction (AMI) and 9 (37%) for unstable angina. Stenting was performed as the primary therapy in 23 patients (96%) and secondary after angioplasty failure in I patient (4%). RESULTS: 1) Twenty-five stents were deployed successfully in all 24 patients with TCL. Distal flow with TIMI grade 3 was obtained immediately in 21 patients (88%). Ventricular fibrillation occurred in 3 patients (13%) during the procedure-related death or emergency bypass surgery did not occur. Marked CK elevation (over 5000U/L) was observed in 5 patients (21%) with AMI who underwent primary stenting. Two of these 5 patients (8%) had distal flow with TIMI grade 2 consistent with distal embolization, and one (4%) had distal flow with TIMI grade 0, suggesting acute stent occlusion. All 24 patients (100%) were event-free and showed clinical improvement at the last follow-up visit (71+/-15 days). 2) Quantitative angiography demonstrated excellent angiographic results after stenting (minimal luminal diameter 0.3+/-0.3 vs. 3.4+/-0.3mm, diameter stenosis 90.1+/-10.7 vs. -13.3+/-8.1%, p<0.005 respectively). Acute gain was 3.1+/-0.3mm (p<0.005). CONCLUSIONS: With low incidents of complications, coronary stenting could be used successfully for select patients with TCL as a primary therapeutic option under aggressive antithrombotic therapy. Although early clinical results were excellent, the long-term benefits remain to be established.
Acute Coronary Syndrome ; Angina, Unstable ; Angiography ; Angioplasty ; Constriction, Pathologic ; Emergencies ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Phenobarbital ; Stents* ; Ventricular Fibrillation

Anomalous origin of the left circumflex coronary artery(LCx) from the right sinus of Valsalva is the most common coronary anomaly and, generally, is considered to be benign. Nevertheless, myocardial infarction or sudden death in young patients with this coronary anomaly has infrequently been described. The LCx arises from the right sinus of Valsalva or proximal right coronary artery, courses posterior to the aorta to enter the left atrioventricular groove, and provide branches to the left lateral wall of heart. Transthoracic or transesophageal echocardiography may provide a useful diagnostic clue although coronary angiography is the standard diagnostic method. We report 2 cases of anomalous origin of the LCx from right aortic sinus with typical echocardiographic images.
Aorta ; Coronary Angiography ; Coronary Vessels* ; Death, Sudden ; Echocardiography* ; Echocardiography, Transesophageal ; Heart ; Humans ; Myocardial Infarction ; Sinus of Valsalva

BACKGROUND: The students who had traveled in Jeju island developed symptoms of diarrhea at a girls' high school in Busan, June 2000. The goals of this study are to investigate the pattern of shigellosis and to compare drug resistance to S. sonnei with recent studies by reference reports. METHODS: Through epidemiological investigation and stool test of new patients, 993 students were registered from Jun.12 to 17, 2000 in a girls' high school, Busan. 2nd grade students(N=355) who had traveled in Jeju island described a questionnaire of the source of infection. Clinical and bacteriological studies were carried out on 6 cases of patients with S. sonnei. RESULTS: Among total 993 students, 79 patients were considered to have diarrhea. But 54 patients of 2nd grade students developed symptoms of diarrhea(14.7%) and the analysis of associative symptoms showed that it contained abdominal pain(72.2%), headache(61.6%), tenesmus(57.4%). 43 students of 2nd grade students who had traveled in Jeju ate chinese foods. Of them, 40 students showed diarrhea(93.0%) confirmed shigellosis(6 students), probable shigellosis(34 students). S. sonnei was isolated from 6 patients(14.0%). The attack rate of diarrhea was 20.7 times more in the group eating chinese foods than in the group not eating chinese foods(p<0.001). After the 2nd grade students ate chinese foods in Jeju, diarrhea attack day distribution was first day(23.2%), second day(39.7%), and third day(16.3%). The result of drug resistance test to S. sonnei(ampicillin, amoxicillin/clavulanic acid, tetracycline, sulfamethoxazole trimethoprim, and streptomycin) was 100%. CONCLUSION: The 2nd grade patients with shigellosis ate chinese foods in a restaurant, Jeju. The pattern of antibiotic resistance to S. sonnei was different from that of several previous cases of shigellosis in Busan.
Asian Continental Ancestry Group ; Busan* ; Diarrhea ; Drug Resistance ; Drug Resistance, Microbial ; Dysentery, Bacillary ; Eating ; Epidemiologic Studies* ; Humans ; Restaurants ; Shigella sonnei* ; Shigella* ; Sulfamethoxazole ; Tetracycline ; Trimethoprim ; Surveys and Questionnaires

BACKGROUND: In postmenopausal women, progestogen should be added to protect the endometrium from hyperplasia or carcinoma induced by the unopposed estrogen. However, the effects of progestogen on bone mineral densities and serum lipodproteins have not been precisely evaluated in Korean postmenopausal women. METHODS: To evaluate the effects of progestogen on bane mineral densities and serum lipoprotein in estrogen rephcement therapy, we canducted a 2-year trial of long conjugated equine estrogen(conjugated estrogen 0.625mg/day) with or without cyclic progestogen(MPA 5mg/day for 12 days) in 120 postmenopausal women. In all subjects, bone mineral density was measured in lumbar vertebra(L2-L4) and femur neck using dual energy X-ray absorptiometry(DEXA) and serum lipoprotein was measured from the beginning of the treatment, 12 manths, and 24 manths later, respectively. RESULTS: BMD of femur neck in both groups increased but not significantly compared to basal level at 12 months and/or 24 months of treatment. As for BMD of lumbar spine, it increased significantly in both groups. Both groups showed a significant decrease in the levels LDL cholesterol, but there was no statistical significance in serum triglycerids. Conjugated estrogen plus MPA group in constrast to conjugated estrogen only group showed a significant decrease in total cholesterol levels. CONCLUSIONS: These results suggest that the addition of MPA of the daily of 5mg for 12 days cyclically in estrogen replacement treatment appear to be effective in postmenopausal women with protection on bone mineral density and maintenance of long-term favorable effects on serum lipoprotein.
Bone Density* ; Cholesterol ; Cholesterol, LDL ; Endometrium ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Femur Neck ; Humans ; Hyperplasia ; Lipid Metabolism* ; Lipoproteins ; Postmenopause ; Spine

BACKGROUND AND OBJECTIVES: Eectrocardiogram (ECG) may provide valuable informations regarding the infarct-related artery (IRA), which may be of guidance in selecting the therapeutic modality. ST segment elevation in inferior leads usually indicates occlusion of right coronary artery, less often left circumflex coronary artery or rarely occlusion of left anterior descending coronary artery may be the cause. We are to determine whether the initial ECG can differentiate the right coronary artery (RCA) or left circumflex artery (LCx) occlusion in acute inferior myocardial infarction (IMI). MATERIALS AND METHOD: We compared retrospectively the ECG recorded within 12 hours from the onset of chest pain with coronary angiographic findings in 85 patients (34% of all 250 patients) having electrocardiographic criteria for IMI. RESULTS: 1) Angiographic characteristics. Of the 85 patients, IRA was RCA in 65 (76%) (38[58%] proximal, 27[42%] distal to first right ventricular branch), and LCx in 20 (24%) (nine[45%] proximal to first obtuse marginal branch or involving a high first marginal branch, eleven[55%] distal obstruction). RCA dominance was more common in RCA occlusion group (100% vs 80%, p=0.001), and LCx dominance in LCx occlusion group (15% vs 0%, p=0.001). No significant difference was noted between two groups regarding vessels diseased, involvement of left anterior descending coronary artery and contralateral artery (RCA or LCx), location of the lesion. 2) Electrocardio-graphic characteritics. Lateral limb leads (I, aVL) :ST segment depression (> or = 1 mm) was more common in RCA occlusion group (82% vs 45%, p=0.001). Isoelectric ST segment in I was more common in LCx occlusion group (100% vs 15%, p=0.001). Left precordial leads (V(5,6)) :ST segment elevation (> or = 1 mm) was more common in LCx occlusion group (60% vs 15%, p=0.001). Isoelectric ST segment was more common in RCA occlusion group (57% vs 20%, p=0.004). ST segment depression (> or = 1 mm) was not different between two groups. Right precordial leads (V(1-4)) :ST segment changes were not different between two groups. Lead I and left precordial leads (V(5,6)) :Isoelectric ST segment in lead I and ST segment elevation (> or = 1 mm) in V(5) or V(6) was more common in LCx occlusion group (60% vs 5%, p<0.05, sensitivity 60% specificity 95% positive/negative predictive value 80%/89%, test accuracy 87%). Amplitude of R wave in V(1) :Amplitude of R wave in V was greater in LCx occlusion group (3.60+/-1.42 mm vs 2.20+/-1.42 mm, p<0.05). CONCLUSION: The initial electrocardiogram was useful in differentiating LCx occlusion from RCA occlusion in patients with IMI. Absence of ST segment depression in I and aVL, and ST segment elevation in V(5,6), isoelectric ST segment in I, tall R wave in V(1) were significantly more common in LCx occlusion.
Arteries* ; Chest Pain ; Coronary Vessels ; Depression ; Electrocardiography* ; Extremities ; Humans ; Inferior Wall Myocardial Infarction* ; Retrospective Studies ; Sensitivity and Specificity