OBJECTIVES: This study is to evaluate the prevalence, incidence, and risk factors of cognitive impairment and depression in the elderly in community. METHODS: This study was a one-year follow-up of Yonchon cohort aged 65 years and over, selected initially in a prevalence study of dementia and depression. A sample of 790 elderly persons who completely interviewed in a prevalence study was re-interviewed with one year interval using the Korean version of Psychogeriatric Assessment Scale (K-PAS). RESULTS: A total of 631 elderly persons was completely interviewed in this follow-up study. The prevalence of cognitive impairment and depression were 21.4% (11.9% in males and 28.3% in females) and 8.4% (6.3% in males and 10.0% in females), respectively. The one-year incidence of cognitive impairment and depression were 11.4% (5.7% in males and 16.2% in females) and 5.1% (3.1% in males and 6.6% in females), respectively. The risk factors of the prevalence of cognitive impairment were education, age, sex, history of stroke, and economic status. The risk factors of the prevalence of depression were family history of depression, history of stroke, marital status, and economic status. The risk factors of the incidence of cognitive impairment were female gander, education, age, alcohol use disorder, marital status, and economic status. The risk factors of the incidence of depression were low education, disrupted marital status, and poor economic status. CONCLUSION: Cognitive impairment and depression were frequent in the elderly. Several risk factors for cognitive impairment and depression were identified. These results suggest that comprehensive health and social services were needed for the elderly.
Aged* ; Cohort Studies ; Cross-Sectional Studies ; Dementia* ; Depression ; Depressive Disorder* ; Education ; Female ; Follow-Up Studies* ; Humans ; Incidence* ; Male ; Marital Status ; Prevalence* ; Risk Factors* ; Social Work ; Stroke

Background: Cigarette smoking and physical inactivity are critical risk factors for the prevalence of metabolic syndrome (MetS). This study aimed to investigate the prevalence of MetS and its related factors in adult men based on their physical activity (PA) levels and smoking status. Methods: In this cross-sectional analysis, 5,984 adult men aged 19-64 years were included based on the 7th Korean national health and nutrition examination survey (2016-2018). MetS was diagnosed based on the National Cholesterol Education Program Adult Treatment Panel III criteria, and PA was categorized as light PA (LPA), moderate, and vigorous PA (VPA). We used linear and logistic regression models to analyze the association between PA, MetS, and smoking status. Results: The prevalence of MetS in adult men was 27.8%, with the risk of MetS increasing with smoking and LPA. The risk of MetS significantly reduced by 64.7% in the VPA and quitter groups compared to that in the LPA and smoking groups (odds ratio, 0.353; 95% confidence interval, 0.232-0.539; P=0.001). Conclusions Our study findings suggest that VPA may be an effective means of reducing the risk of MetS in adult men, while smoking and LPA may increase the risk of MetS.

Background: As a risk factor for diabetes, there are many evidences for physical characteristics and lifestyle habits. There are studies showing that resting heart rate is also related, but evidence is still lacking. Therefore, this study attempted to determine the effect of resting heart rate on diabetes. Methods: The subject of this study was analyzed with 6,622 people who had fasting blood glucose test data out of a total of 7,993 people who participated in the 7th National Health and Nutrition Survey. Fasting blood glucose above 126 mg/dL was defined as a diabetic group and a multiple logistic regression analysis was used. General characteristics, lifestyle and blood chemistry test results were adjusted to investigate the association with diabetes according to the resting heart rate level in the subjects. Results: The risk of diabetes according to the resting heart rate level was 1.434 times in the 2nd quartile, 1.714 times in the 3rd and 1.785 times in the 4th, compared to the 1st quartile. In model 4, except for the 2nd, which was not significant the analysis with all related variables adjusted for the risk rate in the 3rd and 4th order showed that the risk rate increased to 2.364 times and 3.477 times, respectively as the resting heart rate increased. Conclusions This study shows that high resting heart rate is associated with increased diabetes, and suggests that high heart rate, along with other known risk factors, may be a useful tool in predicting diabetes risk.

No abstract available.
Aged* ; Humans

OBJECTIVES: To evaluate the incidence rate and associated factors of dementia in the elderly of rural community. METHODS: This study was three and half year follow-up of Yonchon cohort, participated in a prevalence study of dementia and depression in 1996 (N=1,037). A two-phase study was conducted using the Korean version of Psychogeriatric Assessment Scale in phase I and the diagnostic interview according to DSM-IV criteria by two psychiatrists in stage II. RESULTS: Of the 968 elderly residents who had not dementia in 1996 prevalence study, 596 residents completed the incidence study. The annual incidence rate for total dementia, dementia of Alzheimer's type and vascular dementia were 1.88% (1.86% in men, 1.98% in women), 1.58% (1.39% in men, 1.80% in women) and 0.34% (0.45% in men, 0.25% in women), respectively. Increasing age was significantly associated with total dementia and dementia of Alzheimer's type (p<0.01, p<0.05, respectively). There was statistically significant difference of the three and half year mortality rate between the dementia patients who were diagnosed in prevalence study and the non-dementic elderly (chi2=28.89, df=1, p<0.001). Only the 2.8% of newly onset dementia patients sought psychiatric service in the previously year. CONCLUSIONS: The incidence of dementia among the Korean elderly in a rural community was relatively consistent with the epidemiological studies of other countries. Age was the only risk factor for total dementia and dementia of Alzheimer's type. Very few dementia patients were treated by psychiatrist.
Aged* ; Cohort Studies* ; Cross-Sectional Studies ; Dementia* ; Dementia, Vascular ; Depression ; Depressive Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiologic Studies ; Follow-Up Studies* ; Humans ; Incidence* ; Male ; Mortality ; Prevalence* ; Psychiatry ; Risk Factors ; Rural Population

BACKGROUND: The incidence of Crohn's disease in the upper digestive tract, and especially in the stomach, is recently increasing. Focal inflammatory reaction without Helicobacter pylori (H. pylori) infection is thought to be the characteristic pathologic findings suggesting Crohn's disease in the stomach. Yet gastric involvement of Crohn's disease has not been studied in Korea. We studied the endoscopic and pathologic findings of patients with Crohn's disease in the stomach by taking biopsies. METHODS: Thirty patients with Crohn's disease who underwent gastroduodenoscopy followed by biopsies were included in the study. The pathology of the gastric biopsy specimens and the presence of H. pylori were evaluated. RESULTS: Among 30 cases, 22 cases (73.3%) were H. pylori negative and 8 cases (26.7%) were H. pylori positive. For the H. pylori negative cases, all but one cases showed pit abscess and focal lymphocytic collections in the antrum. Granulomas were found in 6 cases (20%) and they were exclusively located in the antrum. CONCLUSIONS: In the stomach, pit abscess and focal lymphocytic collections that are not associated with H. pylori infection are the characteristic pathologic findings found in Crohn's disease.
Abscess ; Biopsy ; Crohn Disease* ; Gastrointestinal Tract ; Granuloma ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Pathology ; Stomach*

OBJECTIVE: Disturbances in the biogenic amine pathways have been hypothesized to be the biochemical basis of schizophrenia. Catechol-O-methyl transferase (COMT) gene is an important candidate gene due to its function to metabolically inactivating these amines. We investigated the association between 472 G/A (158val/met) and -287 A/G polymorphisms of COMT gene with response to clozapine treatment in refractory schizophrenia. METHODS: One hundred twenty patients of refractory schizophrenia, who were treated with clozapine longer than six months, were participated in this study. We evaluated treatment response on the basis of the difference of re-hospitalization frequency and hospitalization duration before and after the first clozapine administration day. Genotyping of the 472 G/A and -287 A/G polymorphisms was performed by SNapShot method. RESULTS: In 472 G/A polymor-phism, there were no significant differences of the re-hospitalization frequency and the hospitalization duration between the A (-) group and A (+) group, and also no differences among GG, GA, and AA groups. In -287 A/G polymorphism, there were no significant differences between G (-) group and G (+) group. However, we observed significant differences in the re-hospitalization frequency (F=4.38, p=0.015) and in the hospitalization duration (F=3.90, p=0.024) among three genotype groups. CONCLUSION: We found that the treatment response to clozapine was not associated with COMT 472 G/A polymorphism but was positively associated with -287 A/G polymorphism in refractory schizophrenia. However, This association is not strong enough to conclude the association between -287 A/G polymorphism in COMT gene and clozapine response. Further studies with a large sample are required to verify this positive finding more clearly.
Amines ; Biogenic Amines ; Clozapine* ; Genotype ; Hospitalization ; Humans ; Schizophrenia* ; Transferases*

The primary mediastinal liposarcoma is very rare and only a few cases have been reported. We report a 25 year-old man who have had coughing and mild fever for a month. The simple chest X-ray and computed tomography of the chest revealed a huge mass in the right thoracic cavity that originated in the anterior mediastinum. Cytologic examination of the needle aspiration biopsy confirmed the diagnosis of a primary mediastinal liposarcoma. Through an exploratory right thoracotomy and a median sternotomy, the huge mass, lobulated and about 2,500 gm in weight, was extirpated. Mass was attached to a portion of the pericardium and diaphragm, but there was no invasion or metastasis to pleura and lung. The patient was discharged on the 12th postoperative day. He is continuously receiving radiotherapy.
Adult ; Biopsy, Needle ; Cough ; Diagnosis ; Diaphragm ; Fever ; Humans ; Liposarcoma* ; Lung ; Mediastinum* ; Needles ; Neoplasm Metastasis ; Pericardium ; Pleura ; Radiotherapy ; Sternotomy ; Thoracic Cavity ; Thoracotomy ; Thorax

Hypothalamic hamartomas (HHs) are nonneoplastic mass lesions located in the hypothalamus that can cause central precocious puberty (CPP) and/or gelastic seizures. Seckel syndrome 5 (OMIM210600, SCKL5) is a rare autosomal recessive genetic spectrum disorder characterized by intrauterine growth retardation, proportionate osteodysplastic primordial dwarfism, a wide range of intellectual disability, "bird-headed" facial features, and microcephaly with various structural brain abnormalities. Two siblings presented with short stature and small head circumference and were diagnosed with SCKL 5. The younger sister had HH with CPP and experienced a slipped capital femoral epiphysis during treatment. The 2 siblings had the same genetic variant but showed different phenotypes, which has not been reported previously; this study also as presents the first cases of SCKL5 diagnosed by genetic confirmation in Korea.