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

No abstract available.

No abstract available.
Epilepsy*

No abstract available.
Hypoxia-Ischemia, Brain ; Language Development* ; Mass Screening*

Recent changes in the cause of death among the Korean population seem to be systematic and significant. Data on cause of death from the medically certified death certificates provide at least four types of evidence: a sudden increase in recent years in the numbers of death due to cerebrovascular disease or circulatory diseases including rheumatic fever and chronic heart disease and althersclerosis; increasing steadily in the numbers of death due to malignant neoplasm of various sites, and death due to accident; decreasing steadily in the numbers of death due to communicable diseases or parasite diseases; and a large number of deaths with unspecified symptoms and ill-defined conditions. The lack of complete registration of the occurred or the incomplete description on the cause of death reported suggests that statistical information of cause if death form the medically certified death records is meaning in interpreting changing patterns.
Cause of Death* ; Certification* ; Communicable Diseases ; Death Certificates ; Heart Diseases ; Parasites ; Rheumatic Fever

No abstract available.
Anemia*

No abstract available.
Diagnostic Errors*

The GATS is the first and only set of multilateral rules and commitment covering Government measures which affect trade in services. It has two parts-the framework agreement containing the rules, and the national schedules of commitments through which each Member specifies the degree of access and is prepared for foreign service suppliers. The GATS covers all services with two exceptions, i.e., services provided in the exercise of governmental authority and , in the air transport sector, air traffic rights and all services directly related to the exercise of traffic rights. Notwithstanding this very broad scope, the agreement and the negotiations taking place under it are one of the least controversial areas of the current work in the WTO. This is because of its remarkable flexibility, which allows Governments, to a very great extent, to determine the level of obligations they will assume. There are four main elements of flexibility: Member Governments choose those service sectors or subsectors on which they will make commitments guaranteeing the right of foreign suppliers to provide the service. Each Member must have a schedule of commitments, but there is no minimum requirement as to its coverage and some cover only a small part of one sector; For those services that are committed, Governments may set limitations specifying the level of market access and the degree of national treatment they are prepared to guarantee; Governments were able to limit commitments to one or more of the four re cognized "modes of supply" through which services are traded. They may also withdraw and renegotiate commitments ; In order to provide more favorable treatment to certain trading partners, Governments may take exemption, in principle limited to a 10 years’ duration, from the MFN principle, which is otherwise applicable to all services, whether scheduled or not. The agreement contains a number of general obligations applicable to all services, the most important of which is the MFN rule. But apart from these, each Member defines its own obligations through the commitments undertaken in its schedule. Because it is a basic principle of the agreement that developing countries are expected to liberalize fewer sectors and types of transactions, in line with their development situation, the commitments of developing countries are in general less extensive than those of more industrialized countries. It was this flexibility in the scheduling of commitments which put an end to the north-south controversy over services which marked the early years of th e Uruguay Round. So far, South Korea has been asked by 14 economies, including the U.S., EU, and China, to open its services market wider. According to the initial requests submitted to the World Trade Organization (WTO), these countries urged Seoul to grant greater access to the domestic medical treatment, legal services, education, finance, and distribution markets. The ministry of Foreign Affairs and Trade (MOFAT) plans to hold a related ministerial meeting today and roll out countermeasures by next March for follow-up negotiations with the nations concerned. In the initial requests, Korean newspapers reported that the U.S has demanded Seoul guarantee full access to the medical service markets and provide the same business conditions for American companies as local ones. This was, however, denied by the Korean government, while it accepted that fact that the China also called for the removal of barriers in the herbal medicine market as well as in the education. The WTO member economies have submitted initial requests for follow-up negotiations by sector to the new round of WTO talks in November last year. Thereafter, South Korea is required to come up with a response by next March to resolve the issues by the end of 2004. An agreement with the 14 countries should take effect from January 2005.
Appointments and Schedules ; China ; Commerce ; Delivery of Health Care* ; Developed Countries ; Developing Countries ; Education ; Financing, Organized ; Follow-Up Studies ; Herbal Medicine ; Korea ; Legal Services ; Negotiating ; Periodicals ; Pliability ; Seoul ; Uruguay

No abstract available.

No abstract available.
Pediatrics*