No abstract available.

BACKGROUND: Decreased activities of daily living (ADL) in elderly people are related to decreased quality of life and death and are a clinically important issue. However, few studies have investigated the various characteristics and risk factors for a decline in ADL among elderly in-patients in geriatric hospitals in Korea. METHODS: In total, 163 elderly in-patients with dementia in three geriatric hospitals located in Incheon, Gwangju and Yongin, Korea were surveyed prospectively for associated factors of a decline in ADL after 6 months. RESULTS: On average, the subjects were 79.4+/-7.6 years old, and 67.5% were female. Approximately 63% had Alzheimer type dementia, 36.8% only attended primary school, 73.0% were widowed, and 38.7% had been admitted to hospitals for less than 1 year. The Korean version of the Mini Mental State Examination (K-MMSE) score was 14.1+/-6.5, and the clinical dementia rating was 1.9+/-0.9. In total, 8.6% were bed-ridden and 59.5% and 64.6% had never experienced fecal and urinary incontinence, respectively. Total ADL scores declined after 6 months follow-up, and significantly associated factors were low K-MMSE score, fecal incontinence, and co-existence of fecal and urinary incontinence. CONCLUSION: Low K-MMSE scores, fecal incontinence, and the co-existence of fecal and urinary incontinence were associated with ADL declines in elderly in-patients with dementia in long-term care hospitals located in three cities in Korea.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Dementia ; Fecal Incontinence ; Female ; Follow-Up Studies ; Humans ; Korea ; Long-Term Care ; Prospective Studies ; Quality of Life ; Risk Factors ; Urinary Incontinence ; Widowhood

OBJECTIVES: To investigate whether smoking and the smoking status are predictors of the incident impaired fasting glucose (IFG) or type 2 diabetes in Korean men. METHODS: A cohort of 1,717 Korean men without IFG or diabetes, who underwent annual periodic health examinations for 4 years (2002-2006), were retrospectively investigated. IFG and diabetes were defined as a serum fasting glucose concentration of 100-125 mg/dL and more than 126 mg/dL, respectively. Cox's proportional hazards model was used to evaluate the association between smoking and development of IFG or type 2 diabetes. RESULTS: A total of 558 cases (32.5%) of incident IFG and 50 cases (2.9%) of diabetes occurred. After controlling for the potential predictors of diabetes, the relative risk for IFG, compared with the never smokers, was 1.02 (95% CI=0.88 to 1.19) for the ever-smokers, 0.96 (95% CI=0.79-1.16) for those who smoked 1-9 cigarettes/d, 1.15 (95% CI=1.01 to 1.30) for those who smoked 10-19 cigarettes/d, and 1.31 (95% CI=1.10 to 1.57) for those who smoked 20 or more cigarettes/d (the P value for the current smokers was only p<0.002). The respective multivariate adjusted relative risks for type 2 diabetes, compared with the neversmokers, were 1.07 (95% CI=0.64 to 1.92), 1.47 (95% CI=0.71 to 3.04), 1.84 (95% CI=0.92-3.04), and 1.87 (95% CI=1.13-3.67), respectively (the P value for the current smokers was only p=0.004). CONCLUSIONS: The smoking status and the number of cigarettes smoked daily are associated with an increased risk for developing IFG or type 2 diabetes in Korean men.
Adult ; Blood Glucose/*analysis ; Body Mass Index ; Diabetes Mellitus, Type 2/*metabolism ; Health Behavior ; Health Status ; Humans ; Korea/epidemiology ; Male ; Retrospective Studies ; Risk Factors ; Smoking/*adverse effects

BACKGROUND: 'Masked Hypertension' is a phenomenon of blood pressure that is normotensive by clinic measurement but proves to be hypertensive by 24 hour-AMBP and is associated with many cardiovascular complications and its clinical importance has become the center of public interest. However, in Korea no study concerning masked hypertension has ever been published so far. We investigated the frequency and the related factors of masked hypertension among Koreans. METHODS: Overall, 53 volunteers from Incheon and Seoul, Korea, who were 40 years old and abov were enrolled from August 2003 to August 2004. We checked their blood pressure and pulse rate every hour using an ambulatory blood pressure monitoring device [SpaceLabs 90207] for 24 hours. Masked hypertension was defined as office mean BP less than 140/90 mmHg and daytime mean BP over 135/85 mmHg. RESULTS: Among the total, 15 subjects met the criteria of masked hypertension (28.3%) Current smoking (P=0.021), higher clinic mean SBP (P=0.011) and DBP (P=0.027), and prehypertension (P=0.04) were identified as related factors. And when adjusted for sex by logistic regression, only current smoking was statistically significant (P=0.039) and prehypertension showed borderline significance (P=0.092) (CI=95%). Additionally, mean pulse pressures and mean standard deviation of individual mean SBP were higher in the masked hypertension group. CONCLUSION: The frequency of masked hypertension was 28.3% the and related factors were current smoking and higher office BP, especially prehypertension that was introduced in JNC-7. The fact that the pulse pressure and the variability of individual SBP were higher in the masked hypertension group remains thought-provoking.
Adult ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Heart Rate ; Humans ; Incheon ; Korea ; Logistic Models ; Masked Hypertension* ; Masks* ; Prehypertension ; Seoul ; Smoke ; Smoking ; Volunteers*

Purpose: Cysteinyl leukotrienes (CysLTs) have been recognized as key mediators associated with type 2 inflammation in the airways of asthmatic patients. CysLTs are associated with airway constriction, eosinophil recruitment/activation, and airway remodeling. The study aimed to understand the role of CysLTs in adult asthmatics in a real-world clinical setting. Methods: One hundred five adult asthmatics who had maintained antiasthmatic medications were enrolled. Asthmatic subjects were classified into 2 groups according to urinary leukotriene E4 (uLTE4) levels, and their clinical parameters and inflammatory mediators, including forced expiratory volume in 1 second (FEV1) %, fractional exhaled nitric oxide (FeNO), blood eosinophil count, serum periostin (sPON), and urinary eosinophil derived neurotoxin (uEDN) were compared between the high-uLTE4 and low-uLTE4 groups. Results: The prevalence of chronic rhinosinusitis (CRS), severe asthma, and aspirin-exacerbated respiratory disease (AERD) were significantly higher in the high-uLTE4 group than in the low-uLTE4 group. The high-uLTE4 group had lower FEV1% and maximal midexpiratory flow %, but higher FeNO levels than the low-uLTE4 group. In addition, blood eosinophil count, sPON, and uEDN levels were significantly higher in the high-uLTE4 group than in the low-uLTE4 group. The presence of AERD and levels of FeNO, sPON, and uEDN were significantly associated with higher uLTE4 levels in asthmatics. Conclusion CysLTs are associated with type 2 inflammation in the airways of asthmatic patients, contributing to the development of AERD, CRS, and asthma severity. The stratification of clinical phenotypes according to the uLTE4 level could support optimizing anti-inflammatory therapy for better control of asthma.

PURPOSE: The aims of this study were to determine the factors affecting the outcome of patent ductus arteriosus ligation in very low birth weight infants (VLBWI) and demonstrate the safety of PDA ligation in VLBWI performed in the neonatal intensive care unit (NICU). MATERIALS AND METHODS: From October 1994 to July 2006, medical records of 94 VLBWI weighing < 1,500g who underwent PDA ligation in the NICU of Samsung Medical Center were reviewed retrospectively. Factors affecting the final outcome of PDA ligation were evaluated by dividing the infants into 3 groups according to mortality and major morbidities as follows: mortality group (Mo), major morbidity group (Mb), and no major morbidity group (NM). RESULTS: In the Mo group, birth weight was significantly lower and the preoperative mean FiO(2) and mean dopamine dose were significantly higher than those in the other 2 groups. There was no significant difference in gestational age, incidence of RDS, number of courses of indomethacin, surgery-related factors, including weight and age at surgery, perioperative vital signs, and complications after surgery between the 3 groups. During surgery in the NICU, there were no significant hemodynamic instability or serious acute complications. CONCLUSION: The factors affecting the outcome of surgery in VLBWI are not the factors related to surgery but the preoperative conditions related to the underlying prematurity. PDA ligation of VLBWI performed in the NICU is safe without serious complications.
Ductus Arteriosus, Patent/*surgery ; Humans ; Infant, Newborn ; *Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal/*statistics & numerical data ; Ligation/*methods ; Treatment Outcome

Diphtheria-tetanus-acellular pertussis (DTaP) vaccination must currently be administered three times starting at 2 months of age, at intervals of two months, with the first and second boosters administered at 15 to 8 months and 4 to 6 years of age. A high rate of vaccination is maintained, but studies of the efficiency and safety of booster vaccination are lacking. This study evaluated the immunogenicity and safety of the DTaP booster vaccine. Seventy-two infants who had been vaccinated with the first booster and 78 children who had been vaccinated with the second booster were enrolled in this study. Local and systemic adverse reactions after vaccination were recorded. Sera obtained before and 1 month after booster vaccination were analyzed for antibodies to diphtheria and tetanus toxoid, and anti-pertussis toxin. Diphtheria: The GMT was increased. Tetanus: The geometric mean antibody titer (GMT) was increased. Pertussis: The GMT was increased by 13.72 times and 14.37 times after the first and the second additional vaccination, respectively. Although the seroconversion rate was low prior to the first booster, the average amount of anti-pertussis toxin antibodies before the first additional vaccination was 143.37 EU/mL, which rose to 261.88 EU/mL after the vaccination. The seroconversion rate also increased to 100%. Adverse reactions showed spontaneous resolution within a few days after vaccination. After the second additional vaccination, there was a statistically significant increase in the manifestation of myalgia compared to after the first additional vaccination. In conclusion, DTaP booster vaccination was effective in Korean children, demonstrating that modifications to the current regimen would be unnecessary.
Antibodies ; Child ; Diphtheria ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Humans ; Immunization, Secondary ; Infant ; Tetanus Toxoid ; Vaccination ; Whooping Cough

Sclerosing angiomatoid nodular transformation (SANT) is a rare, benign vascular neoplasm. Most patients have no clinical symptoms, and the tumors are usually discovered incidentally on abdominal computed tomography or ultrasonography. Some studies have reported the clinical features and imaging findings of SANT, but the diagnosis is based on histopathologic examination of a tissue specimen obtained at splenectomy. We report herein an incidentally discovered case of SANT and review the related literature.
Diagnosis ; Humans ; Spleen* ; Splenectomy ; Splenic Neoplasms ; Ultrasonography ; Vascular Neoplasms

PURPOSE: This study was undertaken to evaluate the immunogenicity and reactogenicity of Td booster immunization in early preadolescents of Korea. METHODS: Healthy preadolescents, who had been vaccinated with 4 or 5 doses of DTaP vaccines until 6 years old age, were enrolled in this study from August 2006 to April 2007 . Diphtheria and tetanus anti-toxoid antibodies in sera were measured by ELISA just before vaccination and 4 weeks after vaccination to evaluate immunogenicity. Local and systemic adverse reactions observed for 4 weeks after vaccination to access reactogenicity. RESULTS: 183 preadolescents were enrolled and mean age was 11.40+/-0.51 years old. All subjects achieved seroprotective diphtheria and tetanus anti-toxoid antibodies (titers > or =0.1 IU/mL) after Td booster vaccination. Among 183 vaccinees, 73.8% showed local adverse reactions and 37.2% systemic adverse reactions. Pain at injection site (66.1%) was the most common local reaction, and the most commonly shown systemic reaction was myalgia (17.5%). The adverse reactions were spontaneously relieved within three days after vaccination. CONCLUSION: Td vaccine in this study was high immunogenic and showed an acceptable tolerance in Korean preadolescents. Td booster vaccination at 11 -12 years old is the most effective method to increase compliance of the vaccination and to decrease the incidence of diphtheria and tetanus.
Aged ; Antibodies ; Compliance ; Diphtheria ; Diphtheria-Tetanus Vaccine ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunization ; Immunization, Secondary ; Incidence ; Korea ; Tetanus ; Vaccination

PURPOSE: To evaluate the utility of fluid-attenuated inversion recovery(FLAIR) sequence by comparing thesignal intensities in various cerebral lesions with those on T2-weighted MR imaging. MATERIALS & METHODS: In 41patients who showed different signal intensities between T2-weighted images and FLAIR sequences, we reviewed theVirchow-Robin space(VRS), acute or chronic infarctions including lacunar cavities, and postoperativeencephalomalacia. In all patients, the location, shape and size of abnormal signal intensities were evaluated. RESULTS: The hyperintensities of VRS and lacunar infarctions on T2-weighted imaging appeared as hypointensitieson FLAIR imaging. The hyperintense rims or crescents around lacunar cavities were only detected on FLAIR imaging.The extent of acute and chronic infarctions with homogenous hyperintensities seen on T2-weighted images was welldelineated on FLAIR imaging. Postoperative encephalomalacia and adjacent lesions showed low and high signalintensities, respectively, on FLAIR imaging, though they were hyperintense on T2-weighted images. CONCLUSION: ForVRS, infarction and encephalomalacia, FLAIR provides images that are superior to T2-weighted images, and may thusbe useful as an additional MR sequence in various cerebral lesions.
Encephalomalacia ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Stroke, Lacunar