BACKGROUND : Borame hospital nuns geriatric wards with 120 beds (40 beds for patients in Dept. of Internal Medicine, 40 for patients in Dept. of Orthopedics 40 for patients in Dept. of Neurology) from December 1996. We studied clinical characteristics of admissions to acute geriatric wards in Borame hospital in order to assess current status of geriatric wards in Korea. METHODS : 334 patients admitted from December 1996 to May 1997 were studied. By reviewing clinical records of these patients, we studied clinical characteristics of patients in geriatric wards retrospectively. RESULTS : 1) Age distribution: 8.6% of patients were over 85 years old. 16.4% of patients were between age of 80-84. 20.0% between 75-79, 31.3% between 70-74, 26.3% between 65-69, respectively. 2) Disease: 43% of patients have single disease, 67% of patients have multiple disease(23% of patients with 2 disease, 25% with 3 disease, 6% with 4 disease, 3% with over 5 disease respectively). 3) Mortality rate :Total mortality rates were 4.3% with 6.1% of patients in Internal medicine, 3.2% of patients in Neurology. These rates were much higher compared with mortality rates of 2.4% in general wards but similar to those (6.7%) in general wards in Internal medicine. 4) Causes of admission: Malignancies were most common causes of admissions in males, and then cerebrovascular diseases, infectious diseases, musculoskeletal diseases, in order. Musculoskeletal diseases were most common causes, and then diabetes mellitus, infectious diseases, cerebrovascular diseases. CONCLUSION : The elderly patients tend to have multiple diseases, longer hospital stays and higher mortality rates compared with younger patients in general wards. but differences of hospital stays and mortality rates are less than be expected.
Age Distribution ; Aged ; Aged, 80 and over ; Communicable Diseases ; Diabetes Mellitus ; Humans ; Internal Medicine ; Korea ; Length of Stay ; Male ; Mortality ; Musculoskeletal Diseases ; Neurology ; Orthopedics ; Patients' Rooms ; Retrospective Studies

BACKGROUND : There are various factors affecting the nutritional status of the elderly. Depression has been known as an important factor of malnutrition in them. We had already reported the poor nutritional status of elderly diabetics [J Kor Diabetes Association 22(1):71, 1998]. We investigated to document the prevalence of malnutrition and its relationship to depression in elderly diabetic patients. METHODS : We studied 52 patients aged 65 and over (65-00 y, mean 76.7 y; 22 men, 30 women) with diabetes mellitus admitted during from 1996 through 1997. Malnutrition was diagnosed on presence of 1 or more criteria; 10% weight loss in last 3 months, serum albumin <3.3 g/dL, serum transferrin <200 mg/dL, and blood total lymphocyte<1,800/mm3. There was no significant differences between depressed Group and non-depressed Group in duration of diabetes, body mass index, fasting plasma glucose, HbA1c, and number of complication including hypoglycemic episodes. Depression was assessed on Hamilton Depression Scale score of 16 or more. Data were analyzed by Chi square test. RESULTS : 28/52 (53.9%) were malnourished, 12/52 (23.1%) having depression. Of the 12 patients with depression, only 5 had malnutrition. No significant relation between depression and malnutrition was found (Chi squre=2.689, p=0.992). CONCLUSION : Depression might have no significant relationship to malnutrition in the elderly diabetic in-patients.
Aged* ; Blood Glucose ; Body Mass Index ; Depression* ; Diabetes Mellitus ; Fasting ; Humans ; Male ; Malnutrition* ; Nutritional Status ; Prevalence ; Serum Albumin ; Transferrin ; Weight Loss

BACKGROUND : Heart rate variability informed us to diagnose impairment of autonomic nervous system in patient with diabetes, hypertension, ischemic heart disease, chronic renal disease, arrhythmia. Change of autonomic nervous system is related to circadian rhythm, stress, physical activity, age and so on. Especially, impairment of vagal nervous system with age help us to expect sudden cardiac death, myocardial infarction, arrhythmia. So we survey heart rate variability by using 24 hours Holter monitoring to expect impairment of autonomic nervous system in elderly hypertensive patients. METHODS : In order to assess 24 hours heart rate variability, we used Del Mar Avionics 563 Holter monitoring on 15 older hypertensive patient (>or=65 years), 15 older hypertensive patient(<64 years), 15 younger healthy subjects (<64 years), and 15 older healthy subjects (>or=65 years). The following frequency domain variables were considered: low frequency(LF), high frequency(HF) power spectral parameter, and LF/HF ratio. Results : 1) There was significant decrease in LF power spectral parameter in older groups compared with younger groups 394.0+/-237.8 vs 127.7+/-96.3, p<0.05, 171.8+/-173.5 vs 40.8+/-33.8, p<0.05). 2) In hypertensive patients, there was significant decrease in HF power spectral parameter compared with healthy subjects(989.2+/-553.8 vs 526.0+/-364.7, p<0.05, 804.2+/-404.5 vs 368.8+/-241.2, p<0.05). 3) Although there was no significant difference, L/H ratio decreased in older groups compared with younger gourps. 4) In circadian rhythm, control subjects had low HF power spectral parameter at morning. LF/HF ratio was high at morning in younger groups. CONCLUSION : L/H ratio was depressed in older groups. HF was blunted in hypertensive groups. Thus, impairment of autonomic nervous system was accelerated by age and hypertension.
Aged ; Arrhythmias, Cardiac ; Autonomic Nervous System ; Circadian Rhythm ; Death, Sudden, Cardiac ; Electrocardiography, Ambulatory ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Motor Activity ; Myocardial Infarction ; Myocardial Ischemia ; Nervous System ; Renal Insufficiency, Chronic

No abstract available.
Aged* ; Humans ; Hyperhomocysteinemia*

BACKGROUND : The recent studies shows that Helicobacter pylori (H. pylori) related chronic gastritis leads to dysplasia, intestinal metaplasia and gastric cancer. The aim of this study was to determine the association between precancerous lesion of stomach (dysplasia, intestinal metaplasia) and H.pylori infection in the elderly. METHODS : 469 patients were enrolled this study, Patients with intestinal metaplasia or dysplasia (case, n=148) were compared with controls (without intestinal metaplasia and dysplasia, n=321) about H. pylori positive rates H. pylori positivity was confirmed by histologic determination of endoscopic biopsy specimens. Results : 1) Among study populations H. pylori positive rates were 51.8% (55.8% in male, 40.7% in female). It was significantly higher in male (p=0.001). 2) There were no significant differences in sex distribution between cases and controls, but in old age, the cases were more frequent than in young age (p<0.001). 3) Age distribution of H. pylori positive rates were not significant between cases and controls. 47.5% in intestinal metaplasia, 43.4% in dysplasia, 21.3% in dysplasia+intestinal metaplasia were H. pylori positive. H. pylori positive rates were more higher in controls than cases, followed by in decreasing order by the intestinal metaplasia group, the dysplasia group, and those having both (p=0.003). 4) Age and sex adjusted H. pylori positive rates were more higher in controls (42.7%) than in cases (25.0%)(p<0.009). CONCLUSION : The prevalence of intestinal metaplasia and dysplasia was age dependent. But we couldn't explain the carcinogenic effect of H. pylori, because H. pylori positive rates were lower in cases than in controls
Age Distribution ; Aged ; Aging* ; Biopsy ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Male ; Metaplasia* ; Prevalence* ; Sex Distribution ; Stomach ; Stomach Neoplasms

No abstract available.
Aged* ; Gait* ; Humans ; Muscle Strength*

No abstract available.

Rheumatoid arthritis is a chronic inflammatory disease and afflicts approximately 1% of general population. Once considered as a benign non-fatal disease, rheumatoid arthritis is a debilitating condition with a serious physical, emotional, and economic consequences. Life expectancy is reduced among patients with rheumatoid arthritis, and survival rates are comparable to those for three-vessel coronary disease Hodgkin's disease, and diabetes mellitus. For the past 20 years the treatment of rheumatoid arthritis has been developed on pyramid approach, which has had limited success. This led to a move towards using disease modifying antirheumatic drugs early in the disease. Future of rheumatoid arthritis tensive induction therapy, and treatment for resistant disease. This review will be focused on current principles and general guidelines of drugs for the treatment of rheumatoid arthritis.
Antirheumatic Agents ; Arthritis, Rheumatoid* ; Coronary Disease ; Diabetes Mellitus ; Hodgkin Disease ; Humans ; Life Expectancy ; Survival Rate

No abstract available.
Adult* ; Diabetes Mellitus* ; Humans

Transvenous embolization has become the treatment of choice for cavernous sinus dural arteriovenous fistula(cDAVF). However, there are potential complications associated with this procedure such as cranial nerve palsies and venous perforations. A 66-year-old woman presented with a 2-week left periorbital swelling and conjunctival injection. Brain MRI showed engorgement of the left superior ophthalmic vein. Cerebral angiography revealed a dural arteriovenous shunt of the cavernous sinus with retrograde venous drainage into the superior ophthalmic vein. Her proptosis and conjunctival injection resolved completely after transvenous embolization of cDAVF. However, an abducens nerve palsy developed the day after the procedure, which, fortunately, resolved spontaneously. She was symptom-free at the follow- up evaluation 2 months later. The abducens nerve palsy related to the transvenous embolization of cDAVF was presu- med due to either dense packing of the sinus, venous thrombosis, or direct nerve injury. We report a case of transient abducens nerve palsy associated with transvenous embolization of cDAVF, suggesting the benign course of this com- plication.
Abducens Nerve ; Abducens Nerve Diseases ; Aged ; Brain ; Cavernous Sinus ; Caves ; Central Nervous System Vascular Malformations ; Cerebral Angiography ; Cranial Nerve Diseases ; Drainage ; Exophthalmos ; Female ; Humans ; Veins ; Venous Thrombosis