OBJECTIVES: Seoul-Activities of Daily Living(S-ADL) was developed to assess elderly person's basic activities of daily living. This study aims to develop standardized ADL assessment scale and confirm the reliability and validity of the S-ADL. METHODS: It was participated in 336 controls and 145 patients diagnosed Alzheimer's disease. RESULTS: In controls, it was statistically significant to age, but not sex, education, region and presence of spouse. Also, reliability and validity were statistically significant. Principal axis factoring analysis revealed three factors that accounted for 66.67% of the total variance(1.self-care/hygiene, 2.ambulation, 3.toileting). According to each CDR stage, there were significant difference, except for CDR 0.5 and CDR 1 suggesting early dementia. Particularly, it was remarkable for functional impairment in CDR 2 and CDR 3 suggesting moderate to severe dementia. The order of the loss of function was (1) self-care/hygiene, (2) toileting, and (3) ambulation. CONCLUSIONS: Our study showed that the S-ADL could be a very reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-ADL would be useful in assessing daily function of moderate to severe AD.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Axis, Cervical Vertebra ; Dementia ; Education ; Humans ; Reproducibility of Results* ; Spouses ; Walking

In this article, the statement of ethical statement about animal experiment was omitted.

Objectives : We developed the instrument to assess the quality of life(QOL) for demented patients, 'Geriatric Quality of Life-Dementia(GQOL-D)'. The purpose of this study was to standardize the GQOL-D and to introduce administration results in Korean demented patients. METHODS: The normal subjects were 340 elderly people, aged over 55 years old, who were physically and cognitively normal. And the patient group was consisted of 69 demented patients. RESULTS: Both in normal group and in patient group, the internal consistency, Cronbach's = 0.87, 0.90, respectively, and item-total correlation was acceptable. And the test-retest reliability revealed the stability across time by r=0.86, 0.77, respectively. Criterion validity was found to be a high correlation between each itemand overall QOL' item, and adequate correlations between the GQOL-D and scales assessing cognition, psychological wellbeing, behavior and activities of daily living convinced convergent validity. In the result of factor analysis, 2 factors with a variance percentage of 37.7% were extracted. The mean score and standard deviation of items of the GQOL-D for two groups and differences in items such as memory, recreation/leisure, self esteem, general health, and mobility between groups were presented. CONCLUSION: It was confirmed that there is no difficulty for old people to carry out the GQOL-D. As it was suggested that there is enough room for intervening in dementia patients' emotional and behavioral difficulties, the GQOL-D will be useful in research and clinical practice for the patients with dementia.
Activities of Daily Living ; Aged ; Cognition ; Dementia ; Humans ; Memory ; Middle Aged ; Quality of Life* ; Self Concept ; Weights and Measures

OBJECTIVES: Seoul-Instrumental Activities of Daily Living (S-IADL) was developed to assess elderly person's instrumental everyday activities. This study aims to develop standardized IADL assessment scale and to confirm the reliability and validity of the S-IADL. METHODS: The 336 controls were included in standardization study. Reliability and validity of S-IADL were tested by 72 Alzheimer's disease patients and 72 controls matched to age, sex, and education. We also conducted Receiver Operating Characteristics curve for sensitivity and specificity of S-IADL. RESULTS: Because of positively skewed distribution of S-IADL, standardization data were presented using 1SD and 2SD value. Internal consistency, test-retest reliability, and interrater reliability were statistically significant. Principal axis factoring analysis revealed two factors that accounted for 59.95% of the total variance, and second factor was items sensitive to sex (3.preparing food/cooking, 4.household chores). S-IADL was correlated significantly with other standardized cognitive measures, demonstrating good convergent validity. With a cut-off point of 8, the S-IADL had a sensitivity of 83.3% and specificity of 93.1% in the diagnosis of dementia. Also, with a 2SD standardized data, sensitivity was 81.9% and specificity was 93.1%. CONCLUSION: Our study showed that the S-IADL could be a reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-IADL had higher sensitivity and specificity than other IADL instruments, suggesting that it is useful to early detection of dementia.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Axis, Cervical Vertebra ; Dementia ; Diagnosis ; Education ; Humans ; Reproducibility of Results* ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Retention of gestational weight can be a significant contributor to obesity related complications. Few studies have assessed the impact of behavioral factors in Korea. This study was performed to identify the impact of factors on weight change at 1 year postpartum. METHODS: A questionnaire was sent twice by mail to 635 women who delivered singleton infant without complications in Seoul Asan Hospital from January 2002 to March 2002 and 97 available responses were received. Parity, pre-pregnancy weight, fullterm weight and postpartum behaviors were collected from routine medical records and questionnaire. RESULTS: Mean age was 30.5 years and mean pre-pregnancy BMI was 20.9 kg/m2. Mean total weight gain during pregnancy was 13.6+/-4.3 kg/m2 weight change at 1 year postpartum was 1.9+/-3.8 kg. Nearly 17.5% of women experienced a major weight gain of 4.5 kg at 1 year postpartum. Women who had higher pre-pregnancy BMI (> or =23 kg/m2) were at high risk for major weight gained at 1 year postpartum (OR: 4.14). Women who gained 13.6 kg or more during pregnancy and with lower income were at high risk for major weight gain at 1year postpartum (OR: 5.28, 4.13 respectively). CONCLUSION: Pre-pregnancy BMI, gestational weight gain and household monthly income are significantly associated with weight change at 1year postpartum. These findings support the need of the guidelines for preventing major weight retention associated with pregnancy.
Chungcheongnam-do ; Family Characteristics ; Female ; Humans ; Infant ; Korea ; Medical Records ; Obesity ; Parity ; Postal Service ; Postpartum Period* ; Pregnancy ; Seoul ; Weight Gain*

BACKGROUND: There are few comparative studies about the optimal method of pneumatic compression to prevent deep vein thrombosis (DVT). The aim of this prospective randomized study was to compare venous hemodynamic changes and their clinical influences between two graded sequential compression groups (an alternate sequential compression device [ASCD] vs. a simultaneous sequential compression device [SSCD]). METHODS: In total, 34 patients (68 limbs) undergoing knee and spine operations were prospectively randomized into two device groups (ASCD vs. SSCD groups). Duplex ultrasonography examinations were performed on the 4th and 7th postoperative days for the detection of DVT and the evaluation of venous hemodynamics. Continuous data for the two groups were analyzed using a two-tailed, unpaired t-test. Relative frequencies of unpaired samples were compared using Fisher exact test. Mixed effects models that might be viewed as ANCOVA models were also considered. RESULTS: DVT developed in 7 patients (20.6%), all of whom were asymptomatic for isolated calf DVTs. Two of these patients were from the ASCD group (11.8%) and the other five were from the SSCD group (29.4%), but there was no significant difference (p = 0.331). Baseline peak velocity, mean velocity, peak volume flow, and total volume flow were enhanced significantly in both device groups (p < 0.001). However, the degrees of flow and velocity enhancement did not differ significantly between the groups. The accumulated expelled volumes for an hour were in favor of the ASCD group. CONCLUSIONS: Both graded sequential compression devices showed similar results both in clinical and physiological efficacies. Further studies are required to investigate the optimal intermittent pneumatic compression method for enhanced hemodynamic efficacy and better thromboprophylaxis.
Aged ; *Arthroplasty, Replacement, Knee/adverse effects ; *Fracture Fixation/adverse effects ; Hemodynamics ; Humans ; *Intermittent Pneumatic Compression Devices ; Knee/surgery ; Prospective Studies ; Risk Factors ; *Spinal Fusion/adverse effects ; Spine/surgery ; Treatment Outcome ; Venous Thrombosis/etiology/physiopathology/*prevention & control/ultrasonography

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) affects systemic blood pressure and cardiac function. The development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac rhythm, suggests that recurrent hypoxia and arousals from sleep may increase a sympathetic nervous system activity. Continuous positive airway pressure(CPAP) therapy has been found to be an effective treatment of OSAS. However, only a few studies have investigated the cardiovascular and sympathetic effects of CPAP therapy. We evaluated influences of nasal CPAP therapy on the cardiovascular system and the sympathetic activity in patients with OSAS. METHODS: Thirteen patients with OSAS underwent CPAP therapy and were monitored using polysomnography, blood pressure, heart rate, presence of arrhythmia and the concentration of plasma catecholamines, before and with CPAP therapy. RESULTS: The apnea-hypopnea index (AHI) was significantly decreased (p<0.01) and the lowest arterial oxygen saturation level was elevated significantly after applying CPAP (p<0.01). Systolic blood pressure tended to decrease after CPAP but without statistical significance. Heart rates during sleep were not significantly different after CPAP. However, the frequency and number of types of arrhythmia decreased and sinus bradytachyarrhythmia disappeared after CPAP. Although there was no significantly decreased after CPAP (p<0.05). CONCLUSION: CPAP therapy decreased the apnea-hypopnea index, hypoxic episodes and plasma norepinephrine concentration. In addition, it decreased the incidence of arrhythmia and tended to decrease the systemic blood pressure. These results indicate that CPAP may play an important role in the prevention of cardiovascular complications in patients with OSAS.
Anoxia ; Arousal ; Arrhythmias, Cardiac ; Blood Pressure* ; Cardiovascular System ; Catecholamines* ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Norepinephrine ; Oxygen ; Plasma ; Polysomnography ; Sleep Apnea, Obstructive* ; Sympathetic Nervous System

Primary tumors of the great vessels are rare. Most encountered cases are sarcomas which most commonly develop in the aorta, pulmonary artery, and inferior vena cava. We experienced an intimal sarcoma arising in the left common iliac artery in a 68-year-old male, who suffered from claudication in his left lower extremity for a year and was diagnosed as arteriosclerosis obliterans, clinically. Bypass surgery was performed on the obstructive lesion. Grossly, the vascular lumen was filled with dark hemorrhagic materials. Microscopically, the lesion showed proliferation of anaplastic spindle cells with a marked nuclear atypia, arranged haphazardly. There were numerous mitotic figures. Foci of cholesterol clefts were also found in the intima. Immunohistochemically, the tumor cells were positive for vimentin, smooth muscle actin, and cytokeratin in certain areas. Stains for CD34, desmin, myosin heavy chain, caldesmon, and S-100 protein were negative. A pathologic diagnosis was made as intimal sarcoma with myofibroblastic differentiation.
Actins ; Aged ; Aorta ; Arteriosclerosis Obliterans ; Calmodulin-Binding Proteins ; Cholesterol ; Coloring Agents ; Desmin ; Humans ; Iliac Artery ; Keratins ; Lower Extremity ; Male ; Muscle, Smooth ; Myofibroblasts ; Myosin Heavy Chains ; Pulmonary Artery ; S100 Proteins ; Sarcoma ; Vena Cava, Inferior ; Vimentin

PURPOSE: To present a rare case of tear drainage since birth from a lacrimal ductule fistula, which is the first report in the Republic of Korea. CASE SUMMARY: 3-month-old female who presented with discharge of clear fluid from a small skin opening lateral to the right upper eyelid since birth visited the outpatient clinic. The patient was healthy and was receiving no medication. She was born on gestation age 35 weeks and 3 days. No other specific history or other ophthalmic abnormality was found. On examination, a small skin orifice approximately 2 mm diameter and no sign of infection or discoloration was observed. To relieve this symptom, the patient underwent a fistulectomy under general anesthesia. Histopathological examination of the surgical specimen was performed. The patient's symptom subsided postoperatively without recurrence. CONCLUSIONS: This is the first report in the Republic of Korea of tears draining from a lacrimal ductule fistula since birth and the subsequent clinical treatment procedures.
Ambulatory Care Facilities ; Anesthesia, General ; Congenital Abnormalities ; Drainage ; Eyelids ; Female ; Fistula ; Humans ; Infant ; Lacrimal Apparatus ; Parturition ; Pregnancy ; Recurrence ; Republic of Korea ; Skin ; Tears

Coronavirus disease 2019 (COVID-19) is rapidly spreading around the world, causing much morbidity and mortality everywhere. However, effective treatments or vaccines are still not available. Although convalescent plasma (CP) therapy can be useful in the treatment of COVID-19, it has not been widely used in Korea because of the concerns about adverse effects and the difficulty in matching patients to donors. The use of ABO-incompatible plasma is not contraindicated in treatment, but can be hesitated due to the lack of experience of physicians. Here, we describe a 68-year old man with COVID-19 who was treated ABO-incompatible plasma therapy; additionally, we comment on the acute side effects associated with ABO mismatch transfusion. To overcome the obstacles of donor-recipient connections (schedule and distance), we propose the storage of frozen plasma, modification of the current Blood Management Law, and the establishment of a CP bank. We suggest that experience gained in CP therapy will be useful for not only the treatment of COVID-19, but also for coping with new emerging infectious diseases.