It is supposed in Korea that institutional care for the elderly would increase while their home care would decrease. Assessment of the functional status is of much importance for effective caregiving for the institutionalized people. The functional status was evaluated in 89 elderly residents of an institution in Taegu, using the Korean version of the mini-mental state examination, the Blessed Dementia Rating Scale, the Barthel Activities of Daily Living, and the Motoricity Index. Vision and hearing were also examined. Based on scores of the Korean version of mini-mental state examination, 45% were found to have definite cognitive impairment and further 25% to have questionable cognitive impairment. About 35% of the subjects possibly had mild or more severe dementia on the Blessed Dementia Rating Scale. Fifty-seven percent had impairment in activities of daily living, and 66% had impairment in motor power. Sixteen percent and 20% had poor vision and hearing difficulty, respectively, to the degree of impairment in daily activities. These findings indicate that more than half of elderly people in institutional care may need either partial or total help from others.
Activities of Daily Living ; Aged* ; Daegu ; Dementia ; Hearing ; Home Care Services ; Humans ; Korea

No Abstract Available.
Chondrocytes* ; Phenotype*

Guillain-Barre syndrome (GBS) is an autoimmune disease with an acute evolution of inflammatory demyelinating polyradiculoneuropathy. Although the precise immune mechanisms and involved antigens are uncertain, both humoral and cellular immune mechanisms are thought to be involved. Interactions between the various compartments of the immune system are governed by cytokines. Laboratory investigations have shown that immune activation can be quantified by measurement of cytokines and soluble immune activation products in serum. Interleukin-2(IL-2) is probably the best characterized among the many cytokines and soluble interleukin-2 receptor (sIL-2R) and neopterin are major immune activation products. In order to observe activities of cellular immunity of GBS, we measured serum concentrations of IL-2, sIL-2R and neopterin in 28 patients with GBS and in 22 healthy controls. Serial serum samples were drawn 2 to 25 days after motor onset of the disease, 2 to 3 days after treatment with plasmapheresis and 43-300days of follow-up. The occurences of IL-2 positive serum samples were 41.7%, 23.8% and 18.2% in each time in GBS but none in healthy controls. Initial serum sIL-2R and neopterin level were elevated in 21% and 17% of patients with GBS compared with healthy controls. After plasmapheresis, both serum sIL-2R and neopterin level were significantly elevated in GBS compared with initial serum samples and healthy controls. Thus, T-cell and macrophage activation may play a role in the pathogenesis of GBS. However, further study is needed to evaluate the effect of plasmapheresis and clinical severity on the serum concentration of IL-2, sIL-2R and neopterin in GBS.
Autoimmune Diseases ; Cytokines ; Follow-Up Studies ; Guillain-Barre Syndrome* ; Humans ; Immune System ; Immunity, Cellular ; Interleukin-2* ; Macrophage Activation ; Neopterin* ; Plasmapheresis ; Polyradiculoneuropathy ; Receptors, Interleukin-2* ; T-Lymphocytes

BACKGROUND: The relationship between the anterior site of acute myocardial infarction(MI) and occurrence of stroke has become a recent subject of much debate in the relevant literature. The object of this study was to examine the incidence of ischemic stroke during the hospitalization after an acute MI and to identify predictors of MI-related stroke. METHOD: We performed retrospective analysis of 452 patients with acute MI admitted to department of Neurology or Cardiology from January 1990 to August 1997. Patients with a stroke during hospitalization after acute MI were recruited for this study. RESULT: Thirteen cases were recorded. Seventy-seven percent (10/13) of the strokes occurred within 4 days after onset of MI. Multivariate analysis identified the following as independent predictors of stroke : History of hypertension(OR. 2.6: CI, 1.1 to 5.9), previous stroke(OR, 22.3: CI, 5.9 to 84.9) and congestive heart failure (CHF)(OR, 15.4: CI, 2.2-108.6). Transthoracic echocardiography(TTE) was performed in 349/452(77%) during hospitalization. The incidence of left ventricular thrombosis(LVT) in patients with anterior MI who received thrombolytic and anticoagulant therapy was not significantly different from that in patients with anterior MI who didn't(2.6% vs 6.1%, p=0.265). Stroke developed in only one of these patients with LVT. Thrombolytic and anticoagulant therapy were more frequently used in patients without stroke compared with stroke.(p<0.05). CONCLUSION: The incidence of stroke after acute MI is 2.9% and more frequent within the 4 days after MI. History of hypertension, previous stroke and congestive heart failure (CHF) were the factors independently favoring the occurrence of stroke, but there is no relation between the occurrence of stroke and anterior site of MI. Although intravenous thrombolytics followed by full anticoagulation treatment appeared to provide protection against ischemic stroke, it has no effect in the incidence of left ventricular thrombi in this study.
Cardiology ; Heart Failure ; Hospitalization ; Humans ; Hypertension ; Incidence ; Multivariate Analysis ; Myocardial Infarction* ; Neurology ; Retrospective Studies ; Stroke*

Blink reflex (BR) was known as a useful test fordetection of brainstem lesions and cranial neuropathy. We performed BR test in 52 non-insulin dependent diabetics, and the results were compared with 26 controls. In diabetics, 23 patients (44.2%) had abnormal results with delayed R1 in 20 (38.5%), delayed ipsilateral R2 in 6 (11.5%) and delayed contralateral R2 in 4 (7.7%). BR abnormalities were related to age and presence of peripheral neuropathy, but not related to duration of diabetes and fasting blood sugar level. It is suggested that BR test could be an additional electrodiagnostic tool for the diabetic neuropathy, especially to evaluate a subclinical brainstem or cranial nerve involvement.
Blinking* ; Blood Glucose ; Brain Stem ; Cranial Nerve Diseases ; Cranial Nerves ; Diabetic Neuropathies ; Fasting ; Humans ; Peripheral Nervous System Diseases

The congenital renal cystic disease encompasses a complex group of pathologic and clinical entities. We retrospectively reviewed 42 cases of congenital renal cystic lesions classified into four Potter types in a series of 2,063 consecutive autopsies from 1981 to 1996. According to our study based on morphologic, clinical, genetic features and associated anomalies, type I and III are relatively compatible with Potter's original definition. However, it was reasonable that type II and IV are classified to the same group because of: 1) very similar histologic findings representing dysplastic kidney, 2) many associated anomalies, 3) no evidence of inheritance, and 4) presence of a combined type. Syndrome associated cysts, such as Meckel-Gruber syndrome, were also separately classified. If the dysplastic evidence was insufficient for diagnosis to the dysplastic kidney in type II and IV, then these cases would be better classified into a cystic disease associated with congenital hydronephrosis. We propose a classification of the congenital cystic disease of the kidney to be: 1) dysplastic kidney, 2) cystic disease associated with congenital hydronephrosis, 3) polycystic kidney, and 4) syndromic cystic disease.
Autopsy ; Classification* ; Diagnosis ; Hydronephrosis ; Kidney* ; Polycystic Kidney Diseases ; Retrospective Studies ; Wills

This study was performed to observe the effectiveness of thymectomy in the management of myasthenia gravis. Twenty-seven myasthenic patients were undergone thymectomy at Keimyung University Dongsan Hospital between January 1981 and December 1990. The most prevalent age group was the 3rd decade and the myasthenic syrnptom developed below thirty in most. Seven patients had remission and 10 patients fared better after thymectomy. There was no significant effect with age and duration of the disease in the result of thymectomy. Those with less severe group had better response than more severe group and non-thymoma group had higher remission rate without statistical significance than thymoma group. There were better response and more complications in the group with maximal thymectomy than simple thymectomy. This study demonstrated that the effect of thymectomy was better in less severe, nontymoma and maximal thymectomy group in myasthenia gravis.
Humans ; Myasthenia Gravis* ; Thymectomy* ; Thymoma

BACKGROUND: Ambulatory surgery has become popular because patients believe it allows them greater control over their business and personal lives and because third party payers find it reduces cost. This study was designed to compare the characteristics of induction and recovery as well as the safety of propofol with those of midazolam used for intravenous anesthesia in outpatient cystoscopy. METHODS: 56 healthy consenting outpatients were randomly assigned to receive either bolus of propofol (2 mg/kg, n=29) or midazolam (0.1 mg/kg, n=27) for anesthesia in outpatients cystoscopic procedure. All patients also received bolus of fentanyl 1ug/kg before induction and N-M blocking agent was not injected for maintenance of spontaneous respiration. Mean arterial pressure, HR and SpO2 were recorded and induction time (time to spontaneous eye closure), recovery time (time to response, time to orientation, time to ambulation) and adverse effects were evaluated. RESULTS: The results were as follows; 1) Both propofol and midazolam produced smooth induction, but caused significant respiratory depression. 2) The time of induction and postoperative recovery (time to ambulation) was faster in propofol than in midazolam. 3) There were less postoperative side effects (nausea, vomiting, dizziness) in propofol than in midazolam. 4) There were more cardiovascular depression in propofol than in midazolam. CONCLUSION: These results suggest 1) that propofol has significant advantage over midazolam in outpatient surgery, where early ambulation and discharge is desirable and 2) that both propofol and midazolam should be administered by expert anesthesiologist only when ventilatory assistant device with oxygen is immediately available.
Ambulatory Surgical Procedures ; Anesthesia* ; Anesthesia, Intravenous ; Arterial Pressure ; Commerce ; Cystoscopy* ; Depression ; Early Ambulation ; Fentanyl ; Humans ; Insurance, Health, Reimbursement ; Midazolam* ; Outpatients* ; Oxygen ; Propofol* ; Respiration ; Respiratory Insufficiency ; Vomiting

The physical activities of daily living are a final outcome of many functions and dependent on many factors. This study was aimed at exploring the relationships of motor function, dementia, education, age, and cognitive function to the physical activities of daily living in 67 elderly people residing in an institution in Taegu, Korea. Their mean ( +/- SD) age was 75.6 +/- 8.1 and 24 (35.8%) were men. Twenty-eight (41.8%) were classified as having definite cognitive impairment, 17 (25.4%) as having questionable impairment, and 22 (32.8%) as having no impairment by the Korean version of the mini-mental state examination. Of the aforementioned 5 variables, the Motoricity Index could account for 42% of the Barthel Activities of Daily Living variance. If the modified Blessed Dementia Rating Scale was included in the multiple regression, the accountable portion of the Activities variance increased by 4% only. Using the 2 variables, regression equation, y = 0.248 x chi 1-0.359 x chi 2-6.250 (y: Barthel Activities of Daily Living score, chi 1: Motoricity Index score, chi 2: modified Blessed Dementia Rating Scale score) could be produced. Conclusively, the physical activities of daily living of elderly people could be related mainly with motor function of the limbs and severity of dementia.
*Activities of Daily Living ; Age Distribution ; Aged ; Aged, 80 and over ; *Aging ; *Cognition ; *Education ; Female ; Human ; Male ; Middle Age ; *Motor Skills ; Regression Analysis ; Sex Distribution ; Support, Non-U.S. Gov't

Mazabraud's syndrome is rare benign disease characterized by the association of intramuscular myxoma and fibrous dysplasia of bone. We present a case of multiple intramuscular myxomas of the right forearm with polyostotic fibrous dysplasia. X-rays suggested fibrous dysplasia of adjacent bones and CT scans showed two intramuscular cystic masses on the right forearm. 99mTc bone scintigraphy also showed a markedly increased uptake in the skull, both scapulas, both clavicles and both humeri. The masses were successfully removed. Fibrous dysplasia of the radius and myxoma were confirmed by pathologic study.
Clavicle ; Fibrous Dysplasia of Bone ; Fibrous Dysplasia, Polyostotic ; Forearm ; Myxoma ; Radionuclide Imaging ; Radius ; Scapula ; Skull ; Tomography, X-Ray Computed