No abstract available.
Arteriovenous Malformations*

OBJECTIVE: To investigate the relationship between medical expenses and the burden of families caring for the elderly in the last 6 months of life, and to evaluate the factors relating to the burden of family caregivers. METHODS: The families of 301 persons older than 65 years, who died between 1 July and 31 December 2001, and were registered in Resident-based- Health Insurance Programs in Seoul, were interviewed. The medical expenses and length of stay among the elderly were collected from Korean Health Insurance Corporations. RESULTS: 31 percents of the elderly had no medical expenses in the last 6 months of life. On average, the objective burden (4.92) was higher than the subjective burden (3.35). Families caring for male elderly had a higher burden. With increasing age at death, the objective burden was significantly increased. The burden on a family seemed to be influenced more by the family income than the property of the elderly. With increasing total health care costs, the objective burden on the family caregivers was significantly increased, but with increasing medical expenses, the subjective burden was significantly decreased. CONCLUSION: An association between healthcare utilization and burden on families was observed. The reason for the decreasing subjective burden when medical expenses were decreased was unclear. Further research will be needed.
Aged* ; Caregivers ; Delivery of Health Care* ; Health Care Costs ; Humans ; Insurance, Health ; Length of Stay ; Male ; Seoul

OBJECTIVES: The aim of this study was to evaluate the association between Agent Orange exposure and self-reported diseases in Korean Vietnam veterans. METHODS: A postal survey of 114 562 Vietnam veterans was conducted. The perceived exposure to Agent Orange was assessed by a 6-item questionnaire. Two proximity-based Agent Orange exposure indices were constructed using division/brigade-level and battalion/company-level unit information. Adjusted odds ratios (ORs) for age and other confounders were calculated using a logistic regression model. RESULTS: The prevalence of all self-reported diseases showed monotonically increasing trends as the levels of perceived self-reported exposure increased. The ORs for colon cancer (OR, 1.13), leukemia (OR, 1.56), hypertension (OR, 1.03), peripheral vasculopathy (OR, 1.07), enterocolitis (OR, 1.07), peripheral neuropathy (OR, 1.07), multiple nerve palsy (OR, 1.14), multiple sclerosis (OR, 1.24), skin diseases (OR, 1.05), psychotic diseases (OR, 1.07) and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the division/brigade-level proximity-based exposure analysis, compared to the low exposure group. The ORs for cerebral infarction (OR, 1.08), chronic bronchitis (OR, 1.05), multiple nerve palsy (OR, 1.07), multiple sclerosis (OR, 1.16), skin diseases (OR, 1.05), and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the battalion/company-level analysis. CONCLUSIONS: Korean Vietnam veterans with high exposure to Agent Orange experienced a higher prevalence of several self-reported chronic diseases compared to those with low exposure by proximity-based exposure assessment. The strong positive associations between perceived self-reported exposure and all self-reported diseases should be evaluated with discretion because the likelihood of reporting diseases was directly related to the perceived intensity of Agent Orange exposure.
2,4,5-Trichlorophenoxyacetic Acid/*poisoning ; 2,4-Dichlorophenoxyacetic Acid/*poisoning ; Cardiovascular Diseases/epidemiology/etiology ; Defoliants, Chemical/*poisoning ; Endocrine System Diseases/epidemiology/etiology ; Gastrointestinal Diseases/epidemiology/etiology ; Humans ; Logistic Models ; Male ; Middle Aged ; Neoplasms/epidemiology/etiology ; Neuromuscular Diseases/epidemiology/etiology ; Odds Ratio ; Prevalence ; Republic of Korea/epidemiology ; Respiratory Tract Diseases/epidemiology/etiology ; *Self Report ; Tetrachlorodibenzodioxin/*poisoning ; *Veterans ; Vietnam Conflict

Oral calcium supplementation has been recommended for prevention of osteoporosis in postmenopausal women. However experimental studies have suggested that oral calcium supplementation may increase the biliary calcium concentration and the incidence of gallstone formation in some animals. We designed an experiment to establish the effect of oral calcium supplementation in Guinea pigs. Nineteen Guinea pigs were divided into 2 groups. Group I (n=10) was fed with normal water, and group II (n=9) was fed with calcium-containing water(oscal 1000 mg/250 ml normal water). After 6 weeks, all animal were sacrifised, and the presence of gallstones was examined by inspection. Gallbladder bile and blood also were sampled. Gallstones were not found in group I, but in group II, gallstones were observed in five animals (56%). The level of calcium, bile acid, phospholipid, cholesterol, and bilirubin in the gallbladder bile was the same for both group I and group II. The levels of calcium and cholesterol in the serum was also the same for these two groups, but the level of bilirubin was remarkably lower group II than in group I. Oral calcium supplementation increased gallstone formation in guinea pigs, but there was no difference in the level of calcium in the bile composition. This present study could not confirm that oral calcium supplementation increased biliary calcium and then the incidence of gallstone formation in Guinea pigs. We think that the increase of biliary calcium after oral calcium supplementation is not the sole fator in gallstone formation and that other factors may be involved.
Animals ; Bile ; Bilirubin ; Calcium* ; Cholesterol ; Female ; Gallbladder ; Gallstones* ; Guinea Pigs* ; Guinea* ; Humans ; Incidence ; Osteoporosis ; Water

Oral calcium supplementation has been recommended for prevention of osteoporosis in postmenopausal women. However experimental studies have suggested that oral calcium supplementation may increase the biliary calcium concentration and the incidence of gallstone formation in some animals. We designed an experiment to establish the effect of oral calcium supplementation in Guinea pigs. Nineteen Guinea pigs were divided into 2 groups. Group I (n=10) was fed with normal water, and group II (n=9) was fed with calcium-containing water(oscal 1000 mg/250 ml normal water). After 6 weeks, all animal were sacrifised, and the presence of gallstones was examined by inspection. Gallbladder bile and blood also were sampled. Gallstones were not found in group I, but in group II, gallstones were observed in five animals (56%). The level of calcium, bile acid, phospholipid, cholesterol, and bilirubin in the gallbladder bile was the same for both group I and group II. The levels of calcium and cholesterol in the serum was also the same for these two groups, but the level of bilirubin was remarkably lower group II than in group I. Oral calcium supplementation increased gallstone formation in guinea pigs, but there was no difference in the level of calcium in the bile composition. This present study could not confirm that oral calcium supplementation increased biliary calcium and then the incidence of gallstone formation in Guinea pigs. We think that the increase of biliary calcium after oral calcium supplementation is not the sole fator in gallstone formation and that other factors may be involved.
Animals ; Bile ; Bilirubin ; Calcium* ; Cholesterol ; Female ; Gallbladder ; Gallstones* ; Guinea Pigs* ; Guinea* ; Humans ; Incidence ; Osteoporosis ; Water

OBJECTIVES: To analyze medical service utilization and trends among the elderly in the last year of life. METHOD: The subjects of this study were people that had died at the age sixty-five and above between January 1st and June 30th 2000 The names of the deceased and their dates of death were collected from the data of the funeral-expenses-receivers of the National Health Insurance Corporation (NHIC). This data was merged with that of the individual medical expenses of the NHIC. RESULTS: In the first half of 2000, 84.2% of the funeral-expenses-receivers (53, 063) utilized medical services during the year prior to their death; 51.0% (27, 042) were female and 49.0% (26, 021) male. In the last twelve months of life, the medical fees, the number of days receiving medical services and the number of days receiving medicine were 3, 107, 935 Won, 47.88 and 153.21, respectively, for each person. As the age of the groups increased, the level of medical service utilization decreased; the change was more obvious in female group. The level of medical service utilization during the twelve months prior to death drastically increased around the time of death. CONCLUSIONS: This study, from an analysis of the level of medical service utilization prior to death, shows a concentrated volume of medical services during a certain time period prior to death.
Aged* ; Fees, Medical ; Female ; Humans ; Male ; Methods ; National Health Programs

Ectopic pancreas is a congenital anomaly and the most common type of ectopic tissue in the gastrointestinal tract. Most patients with an ectopic pancreas are asymptomatic and rarely have complications. Ectopic pancreatitis after an endoscopic biopsy has not been reported. We report a patient who developed acute ectopic pancreatitis in the stomach after an endoscopic biopsy. A 71-year-old male patient presented with a subepithelial tumor (SET) in the stomach and had no symptoms. Endoscopic ultrasonography demonstrated a 30-mm hypoechoic mural mass, lobulated margins, and anechoic duct-like lesions. To obtain proper tissue specimen, endoscopic biopsy was performed through the opening on the surface of the mass. The pathologic results confirmed an ectopic pancreas. One day after the endoscopic biopsy, he developed persistent epigastric pain. His serum amylase and lipase elevated. Computed tomography of the abdomen showed swelling of the SET and diffuse edema of the gastric wall. His condition was diagnosed as acute ectopic pancreatitis occurring after endoscopic biopsy.
Abdomen ; Aged ; Amylases ; Biopsy* ; Choristoma ; Edema ; Endosonography ; Gastrointestinal Tract ; Humans ; Lipase ; Male ; Pancreas* ; Pancreatitis* ; Stomach

Bortezomib is an inhibitor of 26S proteasome, which is an effective treatment for multiple myeloma. The common adverse effects of bortezomib are asthenic conditions, gastrointestinal disturbances, and peripheral neuropathy. Here we describe a patient with dyspnea and general weakness because of complete atrioventricular block while receiving bortezomib. We immediately stopped bortezomib, and after inserting a permanent VDD pacemaker, the patients' symptoms disappeared.
Atrioventricular Block/*chemically induced ; Boronic Acids/*adverse effects/*therapeutic use ; Female ; Humans ; Middle Aged ; Multiple Myeloma/*drug therapy ; Pyrazines/*adverse effects/*therapeutic use

Bortezomib is an inhibitor of 26S proteasome, which is an effective treatment for multiple myeloma. The common adverse effects of bortezomib are asthenic conditions, gastrointestinal disturbances, and peripheral neuropathy. Here we describe a patient with dyspnea and general weakness because of complete atrioventricular block while receiving bortezomib. We immediately stopped bortezomib, and after inserting a permanent VDD pacemaker, the patients' symptoms disappeared.
Atrioventricular Block/*chemically induced ; Boronic Acids/*adverse effects/*therapeutic use ; Female ; Humans ; Middle Aged ; Multiple Myeloma/*drug therapy ; Pyrazines/*adverse effects/*therapeutic use

The aim of this study was to evaluate the association of plasma fibroblast growth factor (FGF)-21 with angiographically significant coronary artery disease (CAD) in patients with type 2 diabetes mellitus. Serum FGF-21 was measured in 120 patients undergoing coronary angiography. Patients were divided into 4 groups based on the presence/absence of type 2 diabetes mellitus and of significant CAD. The atherosclerotic burden was obtained by two angiographic scores: Gensini score (GS) and Extent score (ES). FGF-21 levels were higher in type 2 diabetes mellitus than in non-diabetic patients (P = 0.014). FGF-21 levels were significantly correlated with GS (r = 0.358, P < 0.001) and ES (r = 0.324, P < 0.001) in univariate analysis with all patients. After adjusting for several confounding factors, both GS and ES were associated with FGF-21 in all patients (r = 0.271, P = 0.014; r = 0.217, P = 0.041, respectively). However, FGF-21 lost significant correlation with both GS and ES with type 2 diabetes mellitus in the final model. The patients with type 2 diabetes mellitus and CAD feature had elevated FGF-21 levels. Despite of a limited role in diabetic patients, FGF-21 levels are independently associated with angiographic severity and extent of CAD.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Artery Disease/complications/*diagnosis/pathology ; Diabetes Mellitus, Type 2/complications/*diagnosis ; Female ; Fibroblast Growth Factors/*blood ; Humans ; Male ; Middle Aged ; Regression Analysis ; Severity of Illness Index ; Young Adult