BACKGROUND: Recently elderly people have increased in Korea and increased demands of medical service. This study was carried out to identify diseases and health service utilization patterns of geriatric inpatients to provide better understanding and basis planning to meet the needs of expanding geriatric population. METHOD: We use data of `Patient Survey in Korea` in 1999 and analyzed characteristics of disease structure and utilization patterns of health care service of 54,013 cases of discharged patients aged 65 years or more. RESULT: The proportion of the elderly in total discharged patients is 14.7%. Male to female ratio is 1:1.3 and most common age group was between 65 and 69 years old. 84.2% of elderly patients were admitted at secondary or tertiary health care facilities. The most common disease in geriatric inpatients is malig- nancy in male and vascular disease in female. The average duration of hospitalization is 14.2 days. They stay longer than the nation wide average hospital length and stay longest when they are admitted by mental and behavioral disorders. CONCLUSION: Geriatric patients are admitted mostly with chronic degenerative diseases such as neoplasm and vascular disease. Elders prefer to be admitted to tertiary hospitals and oriental hospitals. They stay more in hospital.
Aged ; Delivery of Health Care ; Female ; Health Services* ; Hospitalization ; Humans ; Inpatients* ; Korea ; Male ; Tertiary Care Centers ; Vascular Diseases

Power lawn mower is a useful equipment for landscape, but it can introduce a new eye trauma. These ocular injuries are recently increasing in Korea. To inform the possibility of visual loss, we reviewed medical records of 11 patients with intraocular foreign bodies by power lawn mowers. All of patients were men and lawn mower operators themselves. Nature of foreign bodies was metallic in 10 eyes(91%), Inlet was through the cornea in 10 eyes(91%), and intraocular location was at the vireo retina in 8 eyes(73%). At final follow-up, best corrected visual acuities were worse than counting fingers in 4 eyes(36%). Safety cover or halmet is needed for prevention of eye trauma caused by power lawn mower, however, more important, operators themselves should follow the ordinary safety rules.
Bays ; Cornea ; Fingers ; Follow-Up Studies ; Foreign Bodies* ; Humans ; Korea ; Male ; Medical Records ; Retina ; Visual Acuity

Congenital adrenal hyperplasia is inherited disorder of adrenal steroidogenesis. 21-hydroxylase deficiency is the most commone enzymatic defect and is divided into classic and late-onset or nonclassic forms. Both classic non-classic 21-hydrozylase deficiencies are inherited in a recessive manner as allelic variants. But it is rare that happened in twin infants. Chief complaints of affected twins in our case were ambiguous genitalia, hyperpigmentation and dehydrations. They were revealed into hyponatremia, hyperkalemia and increased amount of serum progesterone, 17-hydroxyprogesterone and urinary 17-ketosteroid excretion and were administered with DOCA, 9alpha-fluorohydrocortisone, hydrocortisone to control the electrolyte imbalance. And now, both of them are going to normal ratio of weight gain and body growth.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital* ; Desoxycorticosterone Acetate ; Disorders of Sex Development ; Humans ; Hydrocortisone ; Hyperkalemia ; Hyperpigmentation ; Hyponatremia ; Infant ; Progesterone ; Steroid 21-Hydroxylase* ; Twins* ; Weight Gain

BACKGROUND: The optimal management of periampullary Ca. stage III remains controversial. METHODS: A total of 103 patients treated in a 5-ear period at Kwangju Christian Hospital, 54 patients with a curative operation and 49 patients with internal drainage, were retrospectively studied. RESULTS: There was no significant difference in the 30-ay mortality rate between patients with a curative operation and those with internal drainage, 4% versus 6% respectively. There was a difference between a curative operation and the internal drainage procedure in the early morbidity rate (16.7% versus 8%) and the late morbidity rate (9.3% versus 32.7%). The mean survival was more favorable for those with a curative operation than for those with the internal drainage procedure for periampullary Ca. stage III (pancreatic Ca.: 11.6 months versus 4.7 months, CBD Ca.: 12.6 month versus 5.4 months, and Ampulla of Vater Ca.: 16.5 months versus 5.6 months). The 6-onth and the 12-onth survival rates of the curative-operation group were 80% and 55% for pancreatic Ca., 100% and 80% for CBD Ca., and 90% and 80% for Ampulla of Vater Ca.. The 3-onth and the 6-onth survival rates of the internal drainage group were 70% and 30% for pancreatic Ca., 85% and 40% for CBD Ca., and 75% and 45% for Ampulla of Vater Ca. CONCLUSION: The mean survival duration was more favorable for those with a curative operation than for those with an internal drainage procedure for periampullary Ca. stage III. Therefore, if there is no evidence of distant metastasis, a radial resection is the treatment of choice for a patient with a carcinoma of the periampullary Ca.
Ampulla of Vater ; Drainage* ; Gwangju ; Humans ; Mortality ; Neoplasm Metastasis ; Pancreaticoduodenectomy ; Retrospective Studies ; Survival Rate

The authors report an anomalous fenestration at the M1 portion of the middle cerebral artery found incidentally in a patient affected with a ruptured aneurysm at the ipsilateral internal carotid artery(ICA) and unruptured small aneurysms at the contralateral P1 and ICA. The anomaly was confirmed both angiographically and intraoperatively. A review of the literature indicated several reports of this same anomaly, many of which were associated with aneurysms involving either the proximal end of the fenestration or other cerebral arteries. In the interpretation of cerebral angiograms and during intracranial operations, clinical attention should be paid to this rare anomaly.
Aneurysm* ; Aneurysm, Ruptured ; Cerebral Arteries ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery

BACKGROUND: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. METHODS: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. RESULTS: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. CONCLUSIONS: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.
California ; Follow-Up Studies ; Humans ; Humerus ; Shoulder ; Shoulder Fractures*

No abstract available.

BACKGROUND: The regurgitative valvular heart diseases are important underlying diseases that result in congestive heart failure, and the prevalence increase with the increasing age. Early detection and management of the regurgitative valvular heart disease could decrease the morbidity and mortality rate of the elderly. METHODS: We reviewed medical records of 425 patients who visited KonKuk University Medical Center ChungJu Hospital for the echocardiography between April 1994 to September 2000. 281 out of 425 patients were diagnosed with regurgitative valvular heart disease, and they were analyzed according to their age, sex, underlying disease, and accompaniment of congestive heart failure. Also the relationships between the regurgitative valvular heart disease and fractional shortening(FS), and also with ejection fraction(EP) were analyzed. RESULTS: There were 281 patients diagnosed with regurgitative valvular heart disease. Greatest number of patients was diagnosed with MR, followed by AR, TR and PR, accordingly. The prevalence of regurgitative valvular heart disease increased as the age increased. The prevalence of regurgitative valvular heart disease in male patients were 74% and for female patients, 62%. For patients with hypertension, it was 59%, and for DM patients it was 60%. For patients with past history of ischemic heart disease, or congestive heart failure, the prevalences of regurgitative valvular heart disease were high. FS for the patients with regurgitative valvular heart disease was 28.91% compared 32.69% for the patients without regurgitative valvular heart disease. EF for the patients with regurgitative valvular heart disease was 54% compared to the 60% for without regurgitative valvular heart disease. The FS for patients with symptomatic regurgitative valvular heart disease was 23.86% compared to 27.7% for asymptomatic group. The EF for symptomatic regurgitative valvular heart disease was 46.2% compared to 52.3% for asymptomatic group. CONCLUSION: When 2D-echocardiography was performed on elderly patients who were older than 65 years of age, most of them featured degenerative structural changes in valves and deterioration of valvular functions resulting in regurgitative valvular heart disease. When patients had any symptoms or underlying diseases, the decrease in cardiac function and high prevalence of regurgitative valvular heart disease were apparent. Therefore in elderly patients, even if they are asymptomatic or without any underlying diseases, aggressive diagnostic approaches and early intervention may delay the progress of valvular heart disease.
Academic Medical Centers ; Aged* ; Chungcheongbuk-do ; Early Intervention (Education) ; Echocardiography ; Female ; Heart Failure ; Heart Valve Diseases* ; Humans ; Hypertension ; Male ; Medical Records ; Mortality ; Myocardial Ischemia ; Prevalence

No abstract available.
Coronary Sinus*

Herpes zoster involving noncontiguous dual dermatomes is very rare in both immunocompetent and immunocompromised persons. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 22-year-old woman, who had been treated for acute leukemia, congestive heart failure and chronic disseminated candidiasis, was referred to our department for painful papulovesicular eruptions on the right side of the anterior chest and upper back for 2 days, and the left buttock for 1 day. Tzanck smear revealed multinucleated giant cells with intranuclear inclusion bodies. We report a rare case of zoster duplex bilateralis.
Buttocks ; Candidiasis ; Female ; Giant Cells ; Heart Failure ; Herpes Zoster* ; Humans ; Intranuclear Inclusion Bodies ; Leukemia ; Thorax ; Young Adult