PURPOSE: The purpose of this study is to examine effects of a multifactorial program for preventing the frailty of older adults and effects of a follow-up program applying a capacity building strategy. METHODS: A quasi-experimental pretest-posttest design was used for the nonequivalent control group. The follow-up group (n=75) and non-follow-up group (n=68) received the same multifactorial program comprising muscle strength exercise, cognitive training, and psychosocial programs for 12 weeks. After completion of multifactorial program, the follow-up group took follow-up programs applying the capacity building strategy for following 12 weeks. The data of physical function, cognitive function, and psychological function, and self-rated health were collected from both groups three times: before intervention, after intervention, and 12 weeks after intervention. The data were analyzed using χ2 test and t-test. RESULTS: In comparison with the non-follow-up group, the scores of Timed Up & Go Test, and physical activities energy expenditure were significantly improved in the follow-up group. CONCLUSION: These results indicate that a multifactorial program with follow-up adapting the strategies of capacity building for the older adults group is feasible to prevent the physical frailty in community.
Adult ; Capacity Building ; Cognition ; Energy Metabolism ; Follow-Up Studies ; Humans ; Motor Activity ; Muscle Strength

Accelerated idioventricular rhythm is defined as a ventricular rhythm of 60-100 beats per minute or a ventricular tachycardia that does nor exceed 120 beats per minutes. Although, it rarely converts to a fatal arrhythmia like ventricular fibrillation, it needs to be differentiated from AIVR, which is from another origin. AIVR may occur due to ischemic heart disease (ST elevated myocardial infarction), cardiomyopathy, rheumatic fever and digitalis intoxication. We report here on a case of AIVR that was related to desflurane administration.
Accelerated Idioventricular Rhythm ; Anesthesia ; Arrhythmias, Cardiac ; Cardiomyopathies ; Digitalis ; Isoflurane ; Methyl Ethers ; Myocardial Ischemia ; Rheumatic Fever ; Tachycardia, Ventricular ; Ventricular Fibrillation

OBJECTIVE: Memory Impairment has been proposed as the first sign in preclinical and early Alzheimer's disease (AD). This study aims to assess the utility of a new memory test based on Free and Cued Selective Reminding Test using pattern cue that seems useful for detecting memory impairments associated with AD. METHODS: Twenty-six patients with mild cognitive impairment, 24 AD patients at a mild stage, 35 normal controls and 8 Lewybody dementia (LBD) patients at a mild stage took part in the study. A newly devised Pattern Cued Recall Test (PCRT) was compared with established memory test, the word list recall from the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). To assess the ability of the PCRT subtests and CERAD-K to screen dementia, receiver operating characteristic curves were plotted. RESULTS: The distinctive feature of the PCRT was that encoding specificity was increased by adding an immediate cued recall stage at the encoding phase. PCRT was confirmed as having sufficient validity to diagnose dementias. Compared to CERAD-K, the PCRT had similar accuracy of discriminating AD. But the analysis showed better diagnostic validity of PCRT than CERAD-K in LBD. Therefore, this test appears to be, especially, well suited for the diagnosis of mild LBD. CONCLUSION: This study showed that a memory test based on controlled encoding and retrieval condition and especially using pattern cue could be effective methodology for mild AD and LBD from normal control. PCRT could be an alternative to diagnose LBD by testing visual impairments, which is a hallmark symptom of LBD. Therefore, a further clinical study should be promising.
Alzheimer Disease ; Cues* ; Dementia ; Diagnosis ; Humans ; Memory ; Mild Cognitive Impairment ; ROC Curve ; Sensitivity and Specificity ; Vision Disorders

Cisatracurium was initially characterized to have no evident histamine-releasing potential with excellent cardiovascular stability. However, severe anaphylactic reactions to cisatracurium that resulted in bronchospasms and cardiovascular collapse have been reported worldwide. Two cases of severe anaphylactic reactions after the administration of cisatracurium are presented. The anesthetics used in both cases were lidocaine, midazolam, propofol (microemulsion propofol in the second case), remifentanil and cisatracurium. After the administration of these drugs, bronchospasm and hypotension manifested, leading to the diagnosis of anaphylaxis and appropriate treatment. Skin intradermal testing confirmed that both cases were due to immune-mediated anaphylaxis to cisatracurium, despite the fact that neither of the patients had been exposed to the allergen previously. The anaphylaxis may be due to cross-reactivity between neuromuscular blocking agents and substances with quaternary ammonium ions. Anesthesiologists should be aware that cisatracurium has the potential to trigger severe anaphylactic reactions via an immune-mediated mechanism.
Anaphylaxis ; Anesthesia, General ; Anesthetics ; Atracurium ; Bronchial Spasm ; Humans ; Hypotension ; Intradermal Tests ; Ions ; Lidocaine ; Midazolam ; Neuromuscular Blocking Agents ; Piperidines ; Propofol ; Quaternary Ammonium Compounds ; Skin

BACKGROUND: Melatonin has been shown to attenuate the reflex sympathetic increases that arise in response to orthostatic challenges. We tested the hypothesis that the attenuated sympathetic increase induced by melatonin premedication may weaken the arterial blood pressure (ABP) preserving the capability during acute hypotension, thereby altering dynamic cerebral autoregulation and causing a further decrease in cerebral blood flow (CBF). METHODS: Acute hypotension was induced in 12 healthy subjects by releasing bilateral thigh cuffs before and after an oral dose of melatonin (0.2 mg/kg). Heart rate (HR), arterial blood pressure (ABP), Modelflow estimate of cardiac output (CO), total peripheral resistance (TPR) and cerebral blood flow velocity (CBFV) by transcranial Doppler were measured. RESULTS: Steady state HR, the mean arterial pressure and CBFV were not altered 60 minutes after melatonin ingestion. Reduced systolic arterial pressure (DeltaSAP), changes in HR (DeltaHR), CO (DeltaCO), and TPR (DeltaTPR), DeltaHR/DeltaSAP and percentage restoration of SAP were not affected after a temporal decrease in ABP induced by thigh cuff release. In the cerebral circulation, melatonin did not affect changes in CBFV, cerebrovascular resistance index, the rate of regulation and percentage restoration of CBFV following a sudden decrease in ABP. CONCLUSIONS: Contrary to our hypothesis, melatonin did not affect the rapid vasodilatory and recovery responses of cardiovascular and dynamic cerebral autoregulation. These results suggest that melatonin premedication may not impair ABP and CBF preserving capability induced by sudden postural changes or hemorrhage.
Arterial Pressure ; Blood Flow Velocity ; Blood Pressure ; Cardiac Output ; Cerebrovascular Circulation ; Eating ; Heart Rate ; Hemorrhage ; Homeostasis ; Humans ; Hypotension ; Male ; Melatonin ; Premedication ; Reflex ; Thigh ; Vascular Resistance

BACKGROUND: Many patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) experience depression. Depression influences patient quality of life (QOL), dialysis compliance, and medical comorbidity. We developed and applied a group cognitive behavioral therapy (CBT) program including mindfulness meditation for ESRD patients undergoing HD, and measured changes in QOL, mood, anxiety, perceived stress, and biochemical markers. METHODS: We conducted group CBT over a 12-week period with seven ESRD patients undergoing HD and suffering from depression. QOL, mood, anxiety, and perceived stress were measured at baseline and at weeks 8 and 12 using the World Health Organization Quality of Life scale, abbreviated version (WHOQOL-BREF), the Beck Depression Inventory II (BDI-II), the Hamilton Rating Scale for Depression (HAM-D), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS). Biochemical markers were measured at baseline and after 12 weeks. The Temperament and Character Inventory was performed to assess patient characteristics before starting group CBT. RESULTS: The seven patients showed significant improvement in QOL, mood, anxiety, and perceived stress after 12 weeks of group CBT. WHOQOL-BREF and the self-rating scales, BDI-II and BAI, showed continuous improvement across the 12-week period. HAM-D scores showed significant improvement by week 8; PSS showed significant improvement after week 8. Serum creatinine levels also improved significantly following the 12 week period. CONCLUSION: In this pilot study, a CBT program which included mindfulness meditation enhanced overall mental health and biochemical marker levels in ESRD patients undergoing HD.
Anxiety ; Biomarkers ; Cognitive Therapy* ; Comorbidity ; Compliance ; Creatinine ; Depression ; Dialysis ; Humans ; Kidney Failure, Chronic* ; Meditation ; Mental Health ; Mindfulness* ; Pilot Projects ; Quality of Life ; Renal Dialysis* ; Temperament ; Weights and Measures ; World Health Organization

A total of 1,708 small mammals (1,617 rodents and 91 soricomorphs), including Apodemus agrarius (n = 1,400), Microtus fortis (167), Crocidura lasiura (91), Mus musculus (32), Myodes (= Eothenomys) regulus (9), Micromys minutus (6), and Tscherskia (= Cricetulus) triton (3), were live-trapped at US/Republic of Korea (ROK) military training sites near the demilitarized zone (DMZ) of Paju, Pocheon, and Yeoncheon, Gyeonggi Province from December 2004 to December 2009. Small mammals were examined for their intestinal nematodes by necropsy. A total of 1,617 rodents (100%) and 91 (100%) soricomorphs were infected with at least 1 nematode species, including Nippostrongylus brasiliensis, Heligmosomoides polygyrus, Syphacia obvelata, Heterakis spumosa, Protospirura muris, Capillaria spp., Trichuris muris, Rictularia affinis, and an unidentified species. N. brasiliensis was the most common species infecting small mammals (1,060; 62.1%) followed by H. polygyrus (617; 36.1%), S. obvelata (370; 21.7%), H. spumosa (314; 18.4%), P. muris (123; 7.2%), and Capillaria spp. (59; 3.5%). Low infection rates (0.1-0.8%) were observed for T. muris, R. affinis, and an unidentified species. The number of recovered worms was highest for N. brasiliensis (21,623 worms; mean 20.4 worms/infected specimen) followed by S. obvelata (9,235; 25.0 worms), H. polygyrus (4,122; 6.7 worms), and H. spumosa (1,160; 3.7 worms). A. agrarius demonstrated the highest prevalence for N. brasiliensis (70.9%), followed by M. minutus (50.0%), T. triton (33.3%), M. fortis (28.1%), M. musculus (15.6%), C. lasiura (13.2%), and M. regulus (0%). This is the first report of nematode infections in small mammals captured near the DMZ in ROK.
Animals ; Animals, Wild ; Female ; Helminthiasis/epidemiology/parasitology ; Helminths/*classification/*isolation & purification ; Insectivora/*parasitology ; Intestinal Diseases, Parasitic/epidemiology/parasitology/*veterinary ; Intestines/parasitology ; Male ; Prevalence ; Republic of Korea/epidemiology ; Rodentia/*parasitology

A total of 1,708 small mammals (1,617 rodents and 91 soricomorphs), including Apodemus agrarius (n = 1,400), Microtus fortis (167), Crocidura lasiura (91), Mus musculus (32), Myodes (= Eothenomys) regulus (9), Micromys minutus (6), and Tscherskia (= Cricetulus) triton (3), were live-trapped at US/Republic of Korea (ROK) military training sites near the demilitarized zone (DMZ) of Paju, Pocheon, and Yeoncheon, Gyeonggi Province from December 2004 to December 2009. Small mammals were examined for their intestinal nematodes by necropsy. A total of 1,617 rodents (100%) and 91 (100%) soricomorphs were infected with at least 1 nematode species, including Nippostrongylus brasiliensis, Heligmosomoides polygyrus, Syphacia obvelata, Heterakis spumosa, Protospirura muris, Capillaria spp., Trichuris muris, Rictularia affinis, and an unidentified species. N. brasiliensis was the most common species infecting small mammals (1,060; 62.1%) followed by H. polygyrus (617; 36.1%), S. obvelata (370; 21.7%), H. spumosa (314; 18.4%), P. muris (123; 7.2%), and Capillaria spp. (59; 3.5%). Low infection rates (0.1-0.8%) were observed for T. muris, R. affinis, and an unidentified species. The number of recovered worms was highest for N. brasiliensis (21,623 worms; mean 20.4 worms/infected specimen) followed by S. obvelata (9,235; 25.0 worms), H. polygyrus (4,122; 6.7 worms), and H. spumosa (1,160; 3.7 worms). A. agrarius demonstrated the highest prevalence for N. brasiliensis (70.9%), followed by M. minutus (50.0%), T. triton (33.3%), M. fortis (28.1%), M. musculus (15.6%), C. lasiura (13.2%), and M. regulus (0%). This is the first report of nematode infections in small mammals captured near the DMZ in ROK.
Animals ; Animals, Wild ; Female ; Helminthiasis/epidemiology/parasitology ; Helminths/*classification/*isolation & purification ; Insectivora/*parasitology ; Intestinal Diseases, Parasitic/epidemiology/parasitology/*veterinary ; Intestines/parasitology ; Male ; Prevalence ; Republic of Korea/epidemiology ; Rodentia/*parasitology