BACKGROUND: Observation on the hemodialysis treatment; whether there are any different effects on mortality rate, side effects, or effectiveness of the treatment depending on patients' age. METHODS: Chronic renal failure patients who started hemodialysis treatment between 2002 and 2003 were separated in two groups, 33 patients of 60 and older and 76 patients under 60. We investigated mortality rate difference, A-V shunt re-operation, and total protein and albumin level. Also, comparing and analyzing the urea reduction ratio, we examined whether effectiveness is different depending on the patients' age. RESULTS: The 3 year survivor rate of patients who initially started hemodialysis treatment over 60 was 66.7%, and that of the patients under 60 resulted as 73.1%. The average total protein lefel for over 60 was 6.48g/dL and for under 60 was 6.80g/dL, and albumin for over 60 was 3.15g/dL and under 60 was 3.46g/dL. We identified that the patients who repeated shunt operation in over 60 group was 4(12%) and in under 60 group was 4(5.2%). Effectiveness of the treatment, Urea Reduction Ratio(URR), for both groups was 71%. CONCLUSION: The 3 year survivor rate of patients who initially started hemodialysis treatment over 60 was lower than the control group, but considering the remaining life expectancy, it seems to be no significant difference between the groups; and the treatment effectiveness was same in both groups.
Humans ; Kidney Failure, Chronic ; Life Expectancy ; Prognosis ; Renal Dialysis ; Survivors ; Treatment Outcome ; Urea

BACKGROUND: Sexual Problems of the elderly carry weight with the quality of life. Sexual desire and behavior among the aged in the community are well known, but not at nursing homes. METHODS: The study subjects were 131 residents at two nursing homes in Po-hang and Gyeong-ju city from May 1st 2007 to May 22nd 2007. We interviewed the residents using 10-items which were made by investigators. 31 subjects were excluded due to impossible interview. We analyzed 100 subjects. RESULTS: Subjects were 45% men and 55% women, aged 63 to 92 and the mean age was 77 years old. Men and Women felt sexual desires in 64.4% and 18.2%, performed sexual activity in 35.6% and 5.5%. Obscene jokes and patting were common among sexual behaviors. CONCLUSION: Men's sexual desire was much higher than women, but sexual behaviors were rare in all subjects except obscene jokes.
Aged ; Female ; Humans ; Male ; Nursing Homes ; Quality of Life ; Research Personnel ; Sexual Behavior

BACKGROUND: We compared elderly and adult patients and tried to find a way to make an early diagnosis and proper management for elderly patients with altered mental status in the emergency department(ED). METHODS: During one year, two groups -123 elderly patients over 65 years and 127 adult patients from 20 to 64 years who visited ED in National Police Hospital(NPH)-were selected. Sex, age, arrival time after symptom onset, means of transportation, underlying diseases, causative disease, time of notification to other departments, and pattern of discharge of two groups were analyzed. RESULTS: The average age of the elderly and the adults were 76.43+/-9.51 and 42.12+/-15.0(yrs), respectively. As for the means of transportation, 84% of the elderly used a 911 ambulance service, and 11% used other emergency services. The average times from symptom onset to arrival for two groups were 124 minutes and 69 minutes, respectively. 86.99% of the elderly and 68.38% of the adults had underlying diseases. As for final diagnosis, cerebrovascular disease for the elderly and cardiovascular disease for the adults were the main causes. When patients left the hospital, rate of transfer to other hospital was higher in the elderly(60.2%), and rate of discharge was higher in the adults(15.8%). CONCLUSION: The elderly patients had more intracranial causes and needed longer time for diagnosis than the adult patients. In the case of the patients with intracranial cause who needed an emergency care, they were usually diagnosed at the secondary medical facility and then transferred to the other hospitals for proper treatment causing bad effect on the prognosis of the treatment due to time delay.
Adult ; Aged ; Ambulances ; Cardiovascular Diseases ; Early Diagnosis ; Emergencies ; Emergency Medical Services ; Humans ; Police ; Prognosis ; Transportation

BACKGROUND: To assess the efficacy of functional electrical stimulation(FES) with multi-joints coordinate movement compared to electric muscular stimulation for mono-joint movement in enhancing the upper extremity motor and functional recovery of hemiplegic survivors. METHODS: Forty patients with hemiplegia were divided into two groups. The FES group received FES to produce hand grip, elbow flexion, elbow extension and hand release in sequence with voluntary movement. Control group received electrical stimulation to produce wrist extension without voluntary movement. All groups received for 20 minutes per session, twice a day, 5 days a week during 4 weeks and under the same occupational and physical therapies during 4 weeks. Outcomes were assessed in a blinded manner with the upper extremity component of the Fugl-Meyer Motor Assessment, the self-care component of the Modified Barthel Index(MBI), Upper extremity muscle strength, Wolf Motor Function Test(WMFT), spasticity, and Range of motion(ROM) of shoulder before and after treatment. RESULTS: There were significant improvements of the power at shoulder & elbow flexion, WMFT, Fugl-Meyer, hand grip, and MBI in both group(p<0.05). ROM of shoulder, the power of wrist extension, and pinch improved only at the FES group(p<0.05). The FES group had better effects at WMFT, Fugl-Meyer, hand grip, pinch, MBI, shoulder ROM, and spasticity after treatment(p<0.05). CONCLUSION: This study showed that FES and multi-joints coordinate movements are better than electric muscular stimulation for mono-joint movement to enhance the upper extremity functional recovery in hemiplegia.
Arm ; Elbow ; Electric Stimulation ; Hand ; Hand Strength ; Hemiplegia ; Humans ; Muscle Spasticity ; Muscle Strength ; Muscles ; Self Care ; Shoulder ; Upper Extremity ; Wolves ; Wrist

Korea is becoming aging society and the number of the aged who need long-term care service is increasing. Korean Elderly Long-Term Care Insurance System will be newly adopted soon and to make the system work successfully, comprehensive evaluation and management by professionals with have knowledge of geriatrics is necessary. In addition, long-term care hospitals should play their role between medical services and nursing care facilities as central organizations and form mutual system. The new insurance system only focuses on nursing care without regards of above facts. Other problems of it will be discussed in this study.
Aged ; Aging ; Geriatrics ; Humans ; Insurance ; Insurance, Long-Term Care ; Long-Term Care ; Nursing Care

Geriatric disorder is a polyhedron of conditions which reflects diverse features from different angles. It is an accumula tion of time which is an important variable of successful aging, a state of functional change, one syndrome, and one category. Geriatric disease needs more research and more argument to define the integrated definition of the geriatric disorder to be developed.
Aging

Migraine without aura was significantly frequent in Beh et's disease patients. While, the relationship of TAC(trigeminal autonomic cephalalgia) and Beh et's disease was not known. And, it is thought that pathogenesis of proxysmal headache with autonomic features in neuroBehcet's disease as our case may be different from those of clust headache and TAC. A 45-year-old male admitted with left sided periobital poxysmal headache accompained by ipsilateral conjunctival injection and lacrimination with autonomic features. T2WMR image showed about 1.5x2.6x2.6 cm sized mass with high signal intensity surrounded by a rim of low signal intensity in pons. Enhanced MR image showed enhancing mass-like lesion inside the T2 high signal intensity. CSF study revealed neutrophilic pleocytosis with normal pressure, protein and glucose concentration. No malignant cell were seen. Antiphospholipid antibody and cryoglobuline was significantly increased. 3 days after hospitalvisit, oral ulcerations appeared in the patient. He was treated with high-dose steroid for a week and his headache and abnormal findings of CSF study became fully recovered. Two weeks later, the mass was nearly reduced in the pons on follow-up MR image. We suggest to include a careful interviewfor 2ndary TAC as the first neurologic symptom in the diagnostic work-up of Behet's disease.
Antibodies, Antiphospholipid ; Brain Stem* ; Brain* ; Follow-Up Studies ; Glucose ; Headache* ; Humans ; Leukocytosis ; Male ; Middle Aged ; Migraine without Aura ; Neurologic Manifestations ; Neutrophils ; Oral Ulcer ; Pons ; Trigeminal Autonomic Cephalalgias

Bronchioloalveolar carcinoma may present with a variety of clinical and radiographic findings. It is originated from the periphery of the lung and can be mistaken for lobar pneumonia or atypical pneumonia. The most frequent symptoms and signs are cough, sputum, shortness of breath, weight loss, hemoptysis, and fever. Brochorrhea is unusual and a late manifestation. We conclude that early diagnosis of disease will increase operability and improve chances of survival and that aggressive diagnostic workup for suspicious pulmonary infiltrate is essential as early operation offers the best chances of cure.We report two cases of brochioloalveolar carcinoma presenting as proper clinical and radiological findings.
Adenocarcinoma, Bronchiolo-Alveolar* ; Cough ; Dyspnea ; Early Diagnosis ; Fever ; Hemoptysis ; Lung ; Pneumonia* ; Sputum ; Weight Loss

BACKGROUND: Cholinergic neurons in the forebrain of mamals are well elucidated, meanwhile, the distribution of these neurons in the brainstem is not conformed according to investigators. To identify cholinergic neurons in the brainstem of CD rat, the authors performed immunohistochemical staining with monoclonal antibody to choline acetyltransferase(ChAT), the enzyme responsible for the biosynthesis of acetylcholine. METHODS: In order to decrease nonspecific reactions of the secondary antibody, an anti-rat IgG without biotin was pretreated before the primary antibody treatment. Blockage of the protein transport was tried to decrease the secretion of ChAT from neurons with colchicine injection into the lateral ventricle of the rat 36, to 48 hours before cardiac perfusion of fixative agent. RESULTS: Choline acetyltransferase immunoreactive neurons were identified in all motor nuclei of cranial nerves with some other nuclei and nerve fibers in rat brainstem. They were all multipolar cells mostly composed of magnocellular neurons, however parvocellular ones were also observed with colchicine pretreatment. CONCLUSION: Distribution of the ChAT-immunoreactive nuclei in the brainstem of the CD rats were found in the area where motor functions are closely involved. This means that acetylcholine is the neurotransmitter of these area composing brainstem motor center.
Acetylcholine ; Animals ; Biotin ; Brain Stem* ; Choline O-Acetyltransferase ; Choline* ; Cholinergic Neurons ; Colchicine ; Cranial Nerves ; Humans ; Immunoglobulin G ; Immunohistochemistry ; Lateral Ventricles ; Nerve Fibers ; Neurons ; Neurotransmitter Agents ; Perfusion ; Prosencephalon ; Protein Transport ; Rats* ; Research Personnel

BACKGROUND: Macrophage migration inhibitory factor(MIF) was discovered in 1960s as a T-cell cytokine which inhibited random migration of macrophages. MIF is a multifunctional protein acting as cytokine, hormone, or enzyme. It plays a pivotal role in innate and adaptive immune responses and early phase of inflammatory response, as well as cell proliferation, differentiation, and tumor progression. Many inflammatory diseases and cancers show increased activity and serum concentration. The purpose of this study was to measure the normal serum MIF concentration of Korean people to be utilized as base data for future MIF research. METHODS: Sera of 20 healthy adults from each groups of 20's to 60's(total 100 persons) who visited the Health Promotion center of Inha university Hospital were collected. The MIF concentration in each serum was measured by enzyme-linked immunosorbent assay(ELISA). RESULTS: The average serum MIF concentration was 1.49 ng/ml(ranging from 0 to 3.33), and there was no significant difference between age groups. CONCLUSION: The normal serum MIF concentration of Korean people is 1.49 ng/ml, and seems to be unchanged with aging.
Adult ; Aging ; Cell Proliferation ; Health Promotion ; Humans ; Macrophages* ; T-Lymphocytes