OBJECTIVES: This study was performed to investigate the level of quality of life (QOL) and to identify its related factors among the elderly using a hall for the aged. METHODS: The study subjects were 350 elderly people living in Nam Gu, Gwangju City. They were interviewed by questionnaire to collect information on social-demographic characteristics, health behaviors, health-related characteristics and QOL. We used statistical analysis methods such as T-test, ANOVA and multiple regression analysis to find which factors affected QOL. RESULTS: The characteristics relating to physical functions were as follows: presence of spouse, education, alcohol drinking, teeth condition, arthritis, frequency of visiting the hall for the aged, and depression. Age, arthritis and depression were significantly related to role limitation due to physical problems. General health was related to gender, age, and depression, and vitality was related to education, frequency of visiting the hall, and depression. Role limitation due to emotional problems was related to age and depression, and mental health was related to age, hypertension, arthritis and depression. CONCLUSIONS: This study showed QOL of the elderly was significantly influenced by socio-demographic factors, and physical or emotional conditions. To improve QOL of the elderly, we need to develop programs to promote health and to manage chronic diseases of the elderly.
Age Factors ; Aged ; *Community Health Centers ; Day Care/*psychology ; Female ; *Health Behavior ; *Health Services for the Aged ; *Health Status ; Humans ; Male ; Quality of Life/*psychology ; Sex Factors ; Socioeconomic Factors

This paper describes a student-centered case study program concerning the tumor pathology course for first year students in medical school under the traditional curricular structure. A traditional, discipline-oriented, lecture-laboratory approach was partly modified by introducing a tutuorial session using a modified case matrix format during the laboratory hours without altering the general scheme of the existing system. Small group tutorial sessions were set with the development of learning objectives emphasizing clinicopathologic reasoning and early exposure to future practical presentation which was followed by the large class session; each tutorial was supplied with a short clinical history, gross kodachrome slides, and microslides. The session for problem identification was replaced by proving a series of instructor-designed questions for both pathology and interdisciplinary correlation during which pedagogical implication was stressed the most. Student's active participation, development of self learning skill and vigorous teaching-learning process among students, and motivation/relevance for forthcoming pathology study were among the benefits conferred by this modification. We conclude that this approach is an interim step to meet the advantages of problem-based learning even in a traditional curricular structure.

BACKGROUND: Two dimensional echocardiographic monitoring of left ventricular resional wall motion abnormalities(RWMA) with incremental injection of ergonovine up to 350microg(ErgEcho) is useful for a noninvasive diagnosis of coronary vasospasm(CVS). The prevalence that CVS may evoke unstable angina(UA). However, this theory has not been the subject of any systematic analysis to date. This prospective study was carried out on patients who had been tentatively diagnosed as having UA when they were carried out on patients who has been tentatively diagnosed as having UA when they were admitted to the coronary care unit due to chest pain. The aim was to determine the significance of CVS in the clinical spectrum of UA and the value of Erg Echo when applied to this situation. METHODS: With antianginal medications a diagnostic coronary angiography was done to rule out significant fixed athrosclerotic disease(FD), with more than 70% narrowing of luminal diameter. In patients with normal coronary angiograms of insignificant FD. Erg Echo was performed to diagnose CVS after the discontinuation of all antianginal medications. All patients with postinfarction or secondary angina were excluded in this study. RESULTS: Of 191 patients(135 males, 57+/-9 yrs) enrolled from Mar 1992 to June 1993,71%(135/191) showed significant FD in the angiography. CVS was documented in 18%(34/191) using Erg Echo with mean injected ergonovine dosage of 125+/-89microg. In patients with CVS only 24%(8/34) had mild fixed lesion in the angiography with mean luminal narrowing of 60%(+/-12%). RWMA in the territory of left anterior descending artery was the most common(70%, 24/34). Other causes of chest were esophageal spasm in 3 patient(1%, 3/191) and hypertrophic cardiomyopathy in 2 patients, and 17 patients were diagnosed as having chest pain of unkwnon etiology. One of them redeveloped chest pain 2 months later. when repeated Erg Echo revealed RWMA. Others were symptom free during the follow-up(8+/-4 months) and there were no cardiac events. CONCLUSION: Our data suggest that in patients presenting UA in Korea, CVA is the main cause of myocardial ischemia in considerable number of patient, and Erg Echo after the angiography is useful and safe for noninvasive diagnosis of CVS in this situation.
Angina, Unstable* ; Angiography ; Arteries ; Cardiomyopathy, Hypertrophic ; Chest Pain ; Coronary Angiography ; Coronary Care Units ; Coronary Vasospasm ; Diagnosis ; Echocardiography* ; Ergonovine* ; Esophageal Spasm, Diffuse ; Humans ; Korea ; Male ; Myocardial Ischemia ; Phenobarbital ; Prevalence ; Prospective Studies ; Thorax

BACKGROUND: Two dimensional echocardiographic monitoring of left ventricular resional wall motion abnormalities(RWMA) with incremental injection of ergonovine up to 350microg(ErgEcho) is useful for a noninvasive diagnosis of coronary vasospasm(CVS). The prevalence that CVS may evoke unstable angina(UA). However, this theory has not been the subject of any systematic analysis to date. This prospective study was carried out on patients who had been tentatively diagnosed as having UA when they were carried out on patients who has been tentatively diagnosed as having UA when they were admitted to the coronary care unit due to chest pain. The aim was to determine the significance of CVS in the clinical spectrum of UA and the value of Erg Echo when applied to this situation. METHODS: With antianginal medications a diagnostic coronary angiography was done to rule out significant fixed athrosclerotic disease(FD), with more than 70% narrowing of luminal diameter. In patients with normal coronary angiograms of insignificant FD. Erg Echo was performed to diagnose CVS after the discontinuation of all antianginal medications. All patients with postinfarction or secondary angina were excluded in this study. RESULTS: Of 191 patients(135 males, 57+/-9 yrs) enrolled from Mar 1992 to June 1993,71%(135/191) showed significant FD in the angiography. CVS was documented in 18%(34/191) using Erg Echo with mean injected ergonovine dosage of 125+/-89microg. In patients with CVS only 24%(8/34) had mild fixed lesion in the angiography with mean luminal narrowing of 60%(+/-12%). RWMA in the territory of left anterior descending artery was the most common(70%, 24/34). Other causes of chest were esophageal spasm in 3 patient(1%, 3/191) and hypertrophic cardiomyopathy in 2 patients, and 17 patients were diagnosed as having chest pain of unkwnon etiology. One of them redeveloped chest pain 2 months later. when repeated Erg Echo revealed RWMA. Others were symptom free during the follow-up(8+/-4 months) and there were no cardiac events. CONCLUSION: Our data suggest that in patients presenting UA in Korea, CVA is the main cause of myocardial ischemia in considerable number of patient, and Erg Echo after the angiography is useful and safe for noninvasive diagnosis of CVS in this situation.
Angina, Unstable* ; Angiography ; Arteries ; Cardiomyopathy, Hypertrophic ; Chest Pain ; Coronary Angiography ; Coronary Care Units ; Coronary Vasospasm ; Diagnosis ; Echocardiography* ; Ergonovine* ; Esophageal Spasm, Diffuse ; Humans ; Korea ; Male ; Myocardial Ischemia ; Phenobarbital ; Prevalence ; Prospective Studies ; Thorax

Degos disease, also referred to as malignant atrophic papulosis, was first described in 1941 by Köhlmeier and was independently described by Degos in 1942. Degos disease is characterized by diffuse, papular skin eruptions with porcelain-white centers and slightly raised erythematous telangiectatic rims associated with bowel infarction. Although the etiology of Degos disease is unknown, autoimmune diseases, coagulation disorders, and vasculitis have all been considered as underlying pathogenic mechanisms. Approximately 15% of Degos disease have a benign course limited to the skin and no history of gastrointestinal or central nervous system (CNS) involvement. A 29-year-old female with history of systemic lupus erythematosus (SLE) presented with a 2-year history of asymptomatic lesions on the dorsum of all fingers and both knees. The patient had only skin lesions and no gastrointestinal or CNS vasculitis symptoms. Her skin lesions were umbilicated, atrophic porcelain-white lesions with a rim of erythema. On the basis of clinical, histologic, and laboratory findings, a diagnosis of Degos-like lesions associated with SLE was made. The patient had been treated for SLE for 7 years. Her treatment regimen was maintained over a 2 month follow-up period, and the skin lesions improved slightly with no development of new lesions.
Adult ; Autoimmune Diseases ; Central Nervous System ; Diagnosis ; Erythema ; Female ; Fingers ; Follow-Up Studies ; Humans ; Infarction ; Knee ; Lupus Erythematosus, Systemic* ; Malignant Atrophic Papulosis ; Skin ; Vasculitis ; Vasculitis, Central Nervous System

PURPOSE: Allergic rhinitis is clinically defined as a disorder of the nose induced by IgE mediated inflammation after allergen exposure of the nasal mucosa. Many reports have stated that Panax ginseng and fermented red ginseng have anti-inflammatory effects, especially against Th2-type inflammation. This study was conducted to evaluate the therapeutic effects of fermented red ginseng in allergic rhinitis. METHODS: In this 4-week, double-blind, placebo-controlled study, 59 patients with persistent perennial allergic rhinitis were randomly divided into two groups: those receiving fermented red ginseng tablets (experimental group) and those receiving placebo (control group). The primary efficacy variable was the total nasal symptom score (TNSS; rhinorrhea, sneezing, itchy nose, and nasal congestion). Secondary efficacy variables were the Rhinitis Quality of Life (RQoL) score and skin reactivity to inhalant allergens, as determined by the skin prick test. RESULTS: There was no significant difference in the TNSS score and TNSS duration score between the experimental and placebo groups in weeks 1, 2, 3, or 4. For nasal congestion, fermented red ginseng was significantly effective (P<0.005), while placebo caused no change. The activity and emotion of RQoL improved markedly secondary to treatment with fermented red ginseng (P<0.05), while placebo caused no change. Additionally, fermented red ginseng reduced skin reactivity to sensitized perennial allergens (P<0.05). Fermented red ginseng was well tolerated. CONCLUSIONS: Fermented red ginseng improved nasal congestion symptoms and RQoL in patients with perennial allergic rhinitis.
Allergens ; Complementary Therapies ; Estrogens, Conjugated (USP) ; Humans ; Immunoglobulin E ; Inflammation ; Nasal Mucosa ; Nose ; Panax ; Quality of Life ; Rhinitis ; Rhinitis, Allergic, Perennial ; Skin ; Sneezing ; Tablets

Purpose: The aim of this study is to evaluate the safety and efficacy of ex vivo activated and expanded natural killer (NK) cell therapy (SNK01) plus pembrolizumab in a randomized phase I/IIa clinical trial. Materials and Methods: Overall, 18 patients with advanced non–small cell lung cancer (NSCLC) and a programmed death ligand 1 tumor proportion score of 1% or greater who had a history of failed frontline platinum-based therapy were randomized (2:1) to receive pembrolizumab every 3 weeks +/– 6 weekly infusions of SNK01 at either 2×109 or 4×109 cells per infusion (pembrolizumab monotherapy vs. SNK01 combination). The primary endpoint was safety, whereas the secondary endpoints were the objective response rate (ORR), progression-free survival (PFS), overall survival, and quality of life. Results: Since no dose-limiting toxicity was observed, the maximum tolerated dose was determined as SNK01 4×109 cells/dose. The safety data did not show any new safety signals when SNK01 was combined with pembrolizumab. The ORR and the 1-year survival rate in the NK combination group were higher than those in patients who underwent pembrolizumab monotherapy (ORR, 41.7% vs. 0%; 1-year survival rate, 66.7% vs. 50.0%). Furthermore, the median PFS was higher in the SNK01 combination group (6.2 months vs. 1.6 months, p=0.001). Conclusion Based on the findings of this study, the NK cell combination therapy may consider as a safe treatment method for stage IV NSCLC patients who had a history of failed platinum-based therapy without an increase in adverse events.

This paper describes a student-centered case study program concerning the tumor pathology course for first year students in medical school under the traditional curricular structure. A traditional, discipline-oriented, lecture-laboratory approach was partly modified by introducing a tutuorial session using a modified case matrix format during the laboratory hours without altering the general scheme of the existing system. Small group tutorial sessions were set with the development of learning objectives emphasizing clinicopathologic reasoning and early exposure to future practical presentation which was followed by the large class session; each tutorial was supplied with a short clinical history, gross kodachrome slides, and microslides. The session for problem identification was replaced by proving a series of instructor-designed questions for both pathology and interdisciplinary correlation during which pedagogical implication was stressed the most. Student's active participation, development of self learning skill and vigorous teaching-learning process among students, and motivation/relevance for forthcoming pathology study were among the benefits conferred by this modification. We conclude that this approach is an interim step to meet the advantages of problem-based learning even in a traditional curricular structure.
Humans ; Learning ; Pathology* ; Problem-Based Learning* ; Schools, Medical

BACKGROUND: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
Cross-Sectional Studies ; Hospitalization ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Logistic Models ; Malnutrition ; Multivariate Analysis ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Risk Factors ; Survival Rate