PURPOSE: Frailty is a wasting syndrome common in old age and to confer high risk for morbidity and mortality. There is a growing consensus of the definition of frailty, but until now the diagnostic criteria is not clear yet. In the older male patients, almost of studies about testosterone replacement therapy performed to normal healthy population. And also only few studies were performed to the frail elderly patients. So we would like to investigate the effficacy of testosterone supplementation in the frail elderly. METHODS: Since May to Sep 2001, ambulatory elderly patients who were 65 years and over were recruited in the outpatient clinic of Asan Medical Center. All of them showed the typical characteristics of frailty symptom-weight loss, loss of muscle mass, weakness, fatigability, anorexia, inactivity. The patients who have sleep-apnea or previous history of prostate cancer were excluded. All patients were checked the serum PSA, total testosterone level, routine CBC, lipid, liver function test and evaluated prostate status with US or digital rectal examination, and treated with oral formula testosterone unde- canoate 80 mg daily. All patients were surveyed with ADL, IADL before the testosterone therapy and 3month later. RESULTS: A total of 6 male frail patients(mean age: 80+/-8.5) were enrolled. During 3 month Follow-up period, one was expired, 5 were finished the study. Before the testosterone replacement, mean total testos- terone level was 3.0+/-0.5 ng/ml and mean PSA was 1.3+/-0.7 ng/ml. After 3 months, blood hematocrit, cholesterol, total testosterone were not changed significantly and the body weight also showed insig- nificant increase. But after 3 months, all of them reported the increased well-being sensation, improved fatigability, weakness and improved ADL level. There were no significant adverse effects associated with testosterone replacement. CONCLUSION: In male frail elderly patients, the testosterone replacement therapy can be used safely, and can be improve the frailty associated symptom and ADL ability.
Activities of Daily Living ; Aged ; Ambulatory Care Facilities ; Anorexia ; Body Weight ; Cholesterol ; Chungcheongnam-do ; Consensus ; Digital Rectal Examination ; Follow-Up Studies ; Frail Elderly* ; Hematocrit ; Humans ; Liver Function Tests ; Male ; Mortality ; Prostate ; Prostatic Neoplasms ; Sensation ; Testosterone* ; Wasting Syndrome

BACKGROUND: The recent surge of tuberculosis in association with AIDS and multi-drug resistant tuberculosis in the world has made even apparent the need for more rapid and accurate technologies of detecting and characterizing mycobacteria in the clinical microbiology laboratory. The BACTEC radiometric method which is known rapid alternative to traditional culture methods has been reported to be useful for the rapid detection and identification of mycobacteria from clinical specimens. I report the experience for the use of the BACTEC 460TB for detection of mycobacteria from clinical specimens. METHODS: All clinical specimens received in the department of clinical pathology from July 1993 through August 1994 were used for this study. Smears were prepared and stained for acid-fast bacilli(AFB) by Ziehl-Neelson method Middlebrook 7H12 medium(BACTEC 12A) containing a 14C-labeled palmitic acid was used as the basal medium. Quantitation of the liberated 14CO2 was used as a measure of cell growth. A BACTEC 460TB instrument was used for the detection and quantitation of 14CO2 liberated in the culture bottle. NAP tests for differentiating the M. tuberculosis complex from mycobacteria other than tuberculosis(MOTT) were performed. RESULTS: A total of 111(9.6%) mycobacterial isolates were recovered from 1.151 clinical specimens. The sensitivity of the BACTEC 460TB for detecting M. tuberculosis in acid-fast smear-positive specimens was 93.8%. The mean time required for the primary isolation of mycobacteria(GI of > or =10) was 9.8 days and the mean detection time of M. tuberculosis complex was 19.3 days. In according to the acid-fast smear results, the mean detection times of M tuberculosis complex in smear-positive and smear-negative specimens were 14.9 days and 20.9 days, respectively. The mean detection time of M. tuberculosis complex in smear-positive specimens was better for respiratory specimens(14.7 days) than for extrapulmonary specimens(21 days). All 111 isolates were susceptible to rho-nitro-alpha-acetylamino-beta-hydroxypropiophenone(NAP) and the contamination rate was 4%. CONCLUSIONS: The BACTEC radiometric method for detecting and characterizing mycobacteria requires expensive instrument and reagents using radioisotope and additional expenditure of time and effort, but The BACTEC 460TB is extremely useful for the rapid detection, isolation and identification of clinically important mycobacteria in clinical laboratory.
Health Expenditures ; Indicators and Reagents ; Mycobacterium tuberculosis* ; Mycobacterium* ; Palmitic Acid ; Pathology, Clinical ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

No abstract available.
Korea*

No abstract available.
Anemia*

No abstract available.

No abstract available.
Epilepsy*

No abstract available.
Hypoxia-Ischemia, Brain ; Language Development* ; Mass Screening*

No abstract available.
Child* ; Humans ; Mass Screening* ; Seoul*

Lung ultrasound (LUS) is an emerging tool for intensivists to diagnose and monitor thoracic diseases of critically ill patients. It is easily applied at the bedside in real time and is free of radiation hazards. In the intensive care units (ICUs) lung ultrasound can be used to diagnose pneumothorax and interstitial syndrome. It can also be used to monitor changes in the lung. However, the major limitations of LUS is that it is highly operator dependent and cannot be applied in patients with thoracic dressings, subcutaenous emphysema or pleural calcifications. This article reviews the basic principles of lung ultrasound and discusses how it can be used in ICUs.
Bandages ; Critical Illness* ; Emphysema ; Humans ; Intensive Care Units ; Lung* ; Pneumothorax ; Thoracic Diseases ; Ultrasonography*

PURPOSE: The purpose of this study was to identify the trends of nurses' stress based on the last 10 years of international research and to suggest directions for future research. METHODS: Fifty three articles between 2002 and 2011 were selected using key words such as 'nurse' and 'stress' from the PubMed and CINAHL. RESULTS: The number of experimental studies increased. The nurses from the various fields were studied. Most studies used a reliable and valid tool for measuring stress of specific nursing staff. The Internet survey was recently used for a data collection method. Significant variables correlated with nurses' stress were categorized into 8 domains: Individual susceptibility, quantitative workload, qualitative workload, physical environment, organizational factors, and interpersonal conflict. CONCLUSION: In Korea, the next phase of research on nurses' stress needs to consider the experimental study design to find more specific causal relationships. Also, it is necessary to develop the nurses' stress tool for reliable and valid measurement.
Data Collection ; Humans ; Internet ; Korea ; Nursing Staff