PURPOSE: The purposes of this study was to identify the health status, health-related life habits, activities of daily living and biophysical index of the elderly in Korea and Japan respectively, and to compare the Korean elderly with those of the Japanese elderly. METHOD: Two hundred ninety five elderly from Korea and 325 elderly from Japan, aged over 65 years were conveniently recruited from welfare centers in both countries. Health status, health-related life habits, and activities of daily living were assessed by self-report questionnaires. BMI, lean body mass, body fat, body fat rate, muscle area of limbs and grip strength were measured for biophysical indices. Descriptive statistics, non paired t-test and Chi-square test were used to describe and to compare the levels of these variables. RESULTS: The mean scores on frequencies of Korean and Japanese elders' chronic diseases were 2.9 and 0.8. The mean scores on activities of daily living were 9.8 and 12.4 respectively. The Korean elderly had higher mean scores of BMI, and body fat rate than The Japanese elderly, and showed lower mean scores of muscle areas of the lower extremities and grip strength. Hypertension was the most prevalent disease in the both groups. CONCLUSION: Significant differences in several variables of health status, health-related life habits, activities of daily living and biophysical index were noted between the Korean and Japanese elderly.
Activities of Daily Living* ; Adipose Tissue ; Aged* ; Asian Continental Ancestry Group* ; Chronic Disease ; Extremities ; Hand Strength ; Humans ; Hypertension ; Japan ; Korea ; Lower Extremity ; Surveys and Questionnaires

OBJECTIVE: To examine the effects of age, gender and bolus consistency in normal populations using the temporal measurement of Pharyngeal Transit Duration (PTD), which reflects the duration of bolus flow from the ramus of the mandible to the upper esophageal sphincter. METHOD: 40 normal and healthy subjects had Videofluoroscopic Swallowing Examinations (VFSEs) of 5 ml thin and nectar thick liquids, and puree consistencies. A slow motion and frame by frame analysis was performed. Three-way analysis of variance (ANOVA) was performed to examine the main effect and interactions, and paired t-tests for the three consistency comparisons. RESULTS: Older subjects had a significantly longer PTD than younger subjects (p<0.01). In addition, men had significantly shorter PTDs than women (p<0.01). Puree showed a significantly longer PTD than the other two consistencies, regardless of age and gender (p<0.05). CONCLUSION: PTD is an indicative of motor weakness in pharyngeal swallowing secondary to aging. In addition, the results supported the assumption that there is a functional difference in pharyngeal swallowing between men and women. It is expected that the results of this study will be used for further investigation of patients with dysphagia.
Aging ; Deglutition ; Deglutition Disorders ; Female ; Humans ; Male ; Mandible ; Plant Nectar

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.
Acute Kidney Injury ; Adult ; Atrophy ; Biopsy ; Creatinine ; Dermatitis ; Diuretics ; Eosinophilia ; Exanthema ; Female ; Fibrosis ; Furosemide* ; Humans ; Methicillin ; Nephritis, Interstitial* ; Skin ; Vasculitis

To evaluate the change of working length with various instrumentation techniques in curved canals, working length and canal curvature were determined before and after canal instrumentation in buccal or mesial canals of extracted human molars. Stainless steel K-files (MANI(R), Matsutani Seisakusho Co. Takanezawa, Japan), nickel-titanium K-files (Naviflex NT(TM), Brassler, Savannah, USA), ProFile(R), and ProTaper(TM) (Dentsply-Maillefer, Ballaigues, Switzerland) were used to prepare the canals with crown-down technique. In two hand instrumentation groups, coronal flaring was made with Gates Glidden burs. Apical canals were instrumented until apical diameter had attained a size of 30. Positional relation between the tooth apex and the #10 K-file tip was examined by using AutoCAD 2000 (Autodesk Corp., San Rafael. CA, USA) under a stereomicroscope before and after coronal flaring, and after apical instrumentation. Degree of canal curvature was also measured with Schneider's method in radiographs. Data of working length and canal curvature changes were statistically analyzed with one-way ANOVA and Tukey's studentized range test. Working length and canal curvature were decreased significantly in each step in all instrumentation groups. Coronal flaring using Gates Glidden burs in hand instrument groups and whole canal instrumentation using stainless steel hand K-files caused significantly more working length change than in ProFile instrumentation group (p < 0.05). The result of this study demonstrates that all of the above kinds of instrumentation in curved canals cause reduction of working length and canal curvature at each instrumentation steps, and hand instrumentation causes more working length change than ProFile.
Dental Instruments ; Hand ; Humans ; Molar ; Stainless Steel ; Tooth Apex

PURPOSE: To report two cases of sutureless corneal surgery performed with human fibrin sealant: lamellar keratoplasty and revision of traumatic LASIK flap dislocation. METHODS: In one case, lamellar keratoplasty was performed because of corneal opacity in the anterior stroma, which occurred after herpes simplex keratitis. Free flaps were made in donor and recipient corneas using an Automated Corneal Shaper(TM) (ACS(TM)). After human fibrin sealant was applied to the surface of the recipient's stromal bed, the donor's corneal flap was attached to the bed. The other patient evaluated had partial dislocation of the LASIK flap following trauma. The corneal epithelium covered the lifted and wrinkled corneal flap. The epithelium was removed after applying 20% alcohol. Then, the flap was repositioned and fixed using human fibrin sealant. RESULTS: At postoperative 3 months, clarity and integrity were maintained without serious complications. Visual acuity was improved in both cases. However, an additional procedure was needed in the case of LASIK flap revision because of epithelial ingrowth. CONCLUSIONS: Human fibrin sealant is an effective tool for corneal surgery and is advantageous because it does not require sutures. However, further studies that involve a large number of patients and a longer follow-up period are required to validate its universal use.
Cornea ; Corneal Opacity ; Corneal Transplantation* ; Dislocations* ; Epithelium ; Epithelium, Corneal ; Fibrin Tissue Adhesive* ; Fibrin* ; Follow-Up Studies ; Free Tissue Flaps ; Humans* ; Keratitis, Herpetic ; Keratomileusis, Laser In Situ* ; Sutures ; Tissue Donors ; Visual Acuity

Background: Recently, a piezoelectric ultrasonic scaler based on a feedback control mechanism was introduced for pain relief. This study aimed to investigate the effects of a new ultrasonic scaler in reducing pain and discomfort in adults. Methods: A newly introduced ultrasonic scaler (Master 700Ⓡ ) was used as the test device and a conventional ultrasonic scaler device (PIEZONⓇ ) was used as the control device. Forty-one healthy adults visited the dental clinic for dental scaling but did not undergo scaling or periodontal treatment within 6 months. Intraoral examinations were performed before scaling and 3 months later; before scaling, both devices were randomly assigned on the left or right side of each dentition (split-mouth model) and scaling was performed by a registered dental hygienist. The levels of pain and discomfort during scaling were evaluated subjectively and objectively using the visual analog scale (VAS) and physiological monitoring of the heart rate (HR), respectively.Time was measured for each device. Results: All clinical indicators, except bleeding on probing, significantly improved with both devices. The treatment times were 7 minutes, 13 minutes (control) and 6 minutes, 59 minutes (test). VAS scores for pain were 4.89±2.12 (control) and 4.58±2.77 (test) points out of 10; for noise, these were 4.68±2.33 (control) and 4.55±2.55 (test), and for vibration, the values were 4.26±2.0 (control) and 4.18±2.48 (test). HR averages were 72.34±3.39 (control) and 75.97±9.78 (test) beats/min. No statistically significant differences were observed between the devices. Conclusion The pain, discomfort levels, and scaling time of the new piezoelectric ultrasonic scaler did not differ from those of the conventional device. Further research and development are necessary for more prominent pain-relief effects of scaling devices.

BACKGROUND/AIMS: Obstructive jaundice is developed from the cholangiocarcinoma, biiliary tract stone, biliary benign stricture and pancreatic head cancer and is rapidly progress to cholangitis or sepsis. So early decompression, accurate diagnosis and treatment are very important. Percutaneous transhepatic choledocoscopy (PTCS) and endoscopic retrograde choledocoscopy (ERCS) have been used for evaluation of the obstructive jaundice. We performed, through the PTCS, electrohydraulic lithotripsy (EHL) for biliary tract stone rernoval, biopsy for diagnosis of biliary stric and self expandible metalic coil stent (EndocoilTM stent, Instent Co.) insertion on biliary stricture to evaluate the usefullness of PTCS in patients with obstructive jaundice. METHODS: Between Auguest 1994 and September 1995, PTCS was performed in 37 patients with obstructive jaundice. First, percutaneous transhepatic biliary drainage (PTBD) with 7Fr. drainage tube was done. Three days later, we exchainged the 7Fr. drainage tube with 16Fr.. Seven days later, through the PTCS, we performed EHL, biopsy and EndocoilTM stent insertion.
Biliary Tract ; Biopsy ; Cholangiocarcinoma ; Cholangitis ; Constriction, Pathologic ; Decompression ; Diagnosis ; Drainage ; Head and Neck Neoplasms ; Humans ; Jaundice, Obstructive ; Lithotripsy ; Sepsis ; Stents

BACKGROUND: The goal of therapeutic interventions for Parkinson's Disease (PD) is to improve the symptoms and mitigate the effect on the Quality of Life (QOL) in the individual patient. The purpose of this study was to investigate QOL and related factors in PD patients in Korea. METHODS: Between January 1, 2004 and July 15, 2004, eighty-one PD patients were included. The patients were assessed using Parkinson's Disease Quality of Life (PDQL), Modified Beck Depression Inventory (BDI), and K-MMSE. RESULTS: Twenty-five male and 56 female patients were included in the study. The mean age was 60.7 years and the mean disease duration was 7 years. The male patients (p=0.07) and young age at onset (p=0.07) showed borderline correlation with PDQL score. Medical cost for PD showed significant correlation with PDQL score (p<0.001). The patients working in the daytime or spending the daytime with their spouse showed significantly higher PDQL score than those who did not (p=0.01). Among the disease characteristics, the disease duration, levodopa dosage, UPDRS score, ADL, Hoehn and Yahr stage, the presence of motor fluctuation and dyskinesia, showed that depression had a strong correlation with the PDQL score (p<0.001). On the stepwise regression analysis, the most important factor was presence of depression, disease duration and the UPDRS total score in order of strength. CONCLUSIONS: The QOL in PD patients was strongly associated with depression, disease duration, and the severity of PD. We suggest that the assessment and proper management of depression as well as other PD symptoms is necessary to improve QOL of the PD patients.
Activities of Daily Living ; Depression ; Dyskinesias ; Female ; Humans ; Korea ; Levodopa ; Male ; Parkinson Disease* ; Quality of Life* ; Regression Analysis ; Spouses

Chorea is an uncommon clinical manifestation of Sytemic lupus erythematosus (SLE). Its pathogenic mechanism has not been clearly clarified. We report a 54-year-old woman with SLE who presented with generalized chorea as an initial manifestation. Fluorine-18-fluorodeoxyglucose (FDG) PET revealed increased metabolism in the bilateral putamen. Intravenous and oral administration of steroid markedly improved chorea. Hypermetabolism of the bilateral putamen diminished on follow-up FDG-PET after the disappearance of chorea. This study suggests that chorea in SLE is associated with striatal hypermetabolism.
Administration, Oral ; Chorea* ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Lupus Erythematosus, Systemic* ; Metabolism ; Middle Aged ; Putamen

PURPOSE: Radionuclide cisternography may be helpful in understanding pathophysiology of postural headache and low CSF pressure in patients with spontaneous intracranial hypotension. The purpose of this study was to characterize radionuclide cisternographic findings of spontaneous intracranial hypotension. MATERIALS AND METHODS: The study population consists of 15 patients with spontaneous intracranial hypotension. Diagnosis was based on their clinical symptoms and results of lumbar puncture. All patients underwent radionuclide cisternography following injection of 111 to 222 MBq of Tc-99m DTPA into the lumbar subarachnoid space. Sequential images were obtained between 1/2 hour and 24 hour after the injection of Tc-99m DTPA. Radioactivity of the bladder, soft tissue uptake, migration of radionuclide in the subarachnoid space, and extradural leakage of radionuclide were evaluated according to the scan time. RESULTS: Radionuclide cisternogram showed delayed migration of radionuclide into the cerebral convexity (14/15), increased soft tissue uptake (11/15), and early visualization of bladder activity at 30 min (6/10) and 2 hr (13/13). Cisternography also demonstrated leakage site of CSF in 4 cases and 2 of these were depicted at 30 min. Epidural blood patch was done in 11 patients and headache was improved in all cases. CONCLUSION: The characterstic findings of spontaneous intracranial hypotension were delayed migration of radionuclide and early visualization of the soft tissue and bladder activity. These scintigraphic findings suggest that CSF leakage rather than increased CSF absorption or decreased production may be the main pathophysiology of spontaneous intracranial hypotension. Early and multiple imaging including the bladder and soft tissue is required to observe the entire dynamics of radionuclide migration.
Absorption ; Blood Patch, Epidural ; Diagnosis ; Headache ; Humans ; Intracranial Hypotension* ; Pentetic Acid ; Radioactivity ; Spinal Puncture ; Subarachnoid Space ; Urinary Bladder