BACKGROUND: The number of the elderly living in a home for the aged is increasing as the socio-culture changes, but health management for the institutionalized elderly has been discontinuos, centered on the single treatment of the disease. The aim of this study is to collect baseline data which is for development of the health maintenance program for the elderly living in a house for the aged. METHODS: We reviewed the journals related to the health maintenance program for the elderly. We selected the contents about health management program for the elderly. 3 domain of the contens were done. The 3 domain were physical health (interview for health habit, physical exam, clinical test), mental health (Korean version of geriatric depression scale, Korean version of mini mental status examination), assessment of functional status (katz activities of daily living, lawtons instrumental activities of living).. 158 elderly people living in a home for the aged in Seoul have been researched since August 1996. RESULT: Total subjects were 158 (men 73, women 85). The average age was 78.1(+/-7.2). The rate of smoking, alcohol drinking, exercise were 32%, 20.4%, 34.4%, each. The rate of assitive device use was 28.3%. The prevalence of sleep distur-bance, urinary incontinence were 69.7%, 17.3%. The prevalence of gait disturbance was 38.4%. The occurrence rate of falling for last 1 year was 29.6%. The prevalence of fear of falling was 57.2%. The positive rate of VDRL was 12.3%, the prevalence of anemia was 48.7%. The prevalence of degenerative arthritis, hypertension were 44.2%, 31.3%, each. The prevalence of depression, dementia were 71.3%, 56.7%, each. The rate of elderly person dependent on one and more ADL was 8.1%. CONCLUSION: We found the health status of the elderly living in a home for the aged. On the basis of the results of the study, it is needed that continuous application of the program for management of the elderly in a home for the aged, keeping searching proper contents of examination and methods of measurement.
Activities of Daily Living ; Aged* ; Alcohol Drinking ; Anemia ; Dementia ; Depression ; Female ; Gait ; Humans ; Hypertension ; Mental Health ; Osteoarthritis ; Prevalence ; Seoul ; Smoke ; Smoking ; Urinary Incontinence

No abstract available.
Asthma* ; Dyspnea* ; Humans ; Respiratory Function Tests*

BACKGROUND: Surgical intervention is known as the principle management for hemoptysis of significant amount But surgical procedure is applicable 13 only small number of patients because of increased mortality in emergency surgery and various functional and structural problems after lung resection. Bronchial artery embolization(BAE) has been used as an alternative interventional technique for immediate control of patients with increased risk for surgery due 19 recurrent or massive hemoptysis. BAE also has limitations such as recurrent bleeding after procedure and its role for the application to small amount of hemoptysis is still not established. METHOD: To evaluate immediate and long term effectiveness of BAE, we analysed 65 patients with hemoptysis according to therapeutic modalities they received ; BAE versus conservative management. RESULTS: The success rate for immediate control of hemoptysis was significantly higher in BAE group with 43 cases(100%) among 43 cases compared with 17 cases(77%) among 22 cases in conservative group (p<0.001). The disease control duration was 19.5α8.06 months in BAE group and 18.8α6.06 months in conservative group(p>0.05). The therapeutic response in BAE group was 82%(36/43 cases) and 95%(21/22 cases) in conservative group(p>0.05). According to the amount of hemoptysis, the therapeutic response were seen in 91%(29/32 cases) in less than 100ml and 85%(28/33 cases) in 100~400ml (p>0.05). According to the manifestation of hemoptysis, the therapeutic response in groups of recurrent and nonrecurent were 87%(20/23 cases) and 88%(37/42 cases)(p>0.05). CONCLUSION: The difference of therapeutic response between BAE and conservative group in patients with small amounts of hemoptysis was not found except for immediate control of hemoptysis.
Bronchial Arteries* ; Emergencies ; Hemoptysis* ; Hemorrhage ; Humans ; Lung ; Mortality

CD44 is a heterogenous group of cell surface glycoprotein that serves as an adhesion molecule in cell-cell and cell-matrix interactions involving lymphocyte homing, cell migration, and cancer metastasis. CD44 exists at least 20 variants due to alternative splicing of 10 exons(v1-v10) which encode the membrane proximal portion of extracellular domain. It has been reported that malignant transformation is associated with alteration in CD44 alternative splicing that results in a down-regulation of CD44H relative to several other CD44 variant transcripts and overexpression of specific CD44 alternative splice variants on tumor cells has resulted in enhanced metastatic potential. In this study we investigate the expression of CD44 in 21 sets of gastric carcinoma tissue, adjacent noncancerous gastric mucosa and metastatic lymph node by RT-PCR(reverse transcription-polymerase chain reaction) and immunohistochemical staining to elucidate the alteration of CD44 expression during transformation of normal gastric mucosa to carcinoma and lymph node metastasis. In immunohistochemical staining using anti-CD44 antibody BMS113BT which recognize epitopes in the extracellular domain of CD44 molecules, CD44 expression was not demonstrated in normal gastric mucosa. However, 9(64.3%) out of 14 gastric cancer specimens and 9(75.0%) out of 12 metastatic lymph nodes revealed strong reactivity to CD44. In RT-PCR, epithelial variant, CD44E was amplified in 14(66.7%) of 21 gastric cancer specimens and 13(61.9%) of 21 metastatic lymph nodes, whereas 4(19.0%) of 21 normal gastric mucosal tissues. According to Lauren's classification, CD44E was amplified in all of 6 diffuse type gastric carcinomas compared to 8(61.5%) of 13 intestinal type carcinomas(p=0.227). Amplification of CD44E was not correlated with tumor stage or vascular invasion. Eight(38.1%) out of 21 cases demonstrated amplification of CD44E both in primary tumor and metastatic lymph node. Five(23.8%) cases showed amplification of CD44E only in metastatic lymph node. We suggest that the expression of CD44E is strongly related with gastric carcinogenensis, especially in diffuse type carcinomas. PCR amplification of CD44E in premalignant lesions may be useful to predict risk of malignant transformation in molecular level. However, role of CD44E in lymph node metastasis of gastric carcinoma is remained to be solved.
Alternative Splicing ; Carcinogenesis* ; Cell Movement ; Classification ; Down-Regulation ; Epitopes ; Gastric Mucosa ; Lymph Nodes* ; Lymphocytes ; Membrane Glycoproteins ; Membranes ; Mucous Membrane ; Neoplasm Metastasis* ; Polymerase Chain Reaction ; Stomach Neoplasms

PURPOSE: Alarm interventions are effective and safe treatments for nocturnal enuresis when compared with the other treatments. However, the rate of doctors prescribing enuresis alarms is quite low in Korea. This study evaluated the application conditions and treatment results of an enuresis alarm in children with enuresis in Korea. MATERIALS AND METHODS: 147 out of 316 patients who purchased an enuresis alarm through a alarm sales agency in Korea were evaluated retrospectively. The questionnaire had two main categories: items of enuresis(number of episodes during the night, enuresis frequency during a week, etc.) and the items of the enuresis alarm(previous treatment history, a motivation of using enuresis alarm treatment, the period of using the enuresis alarm, initial success, continued success, dropout of using enuresis alarm, nocturia after treatment, etc.). RESULTS: A total 147 children participated in this study. The initial success rate was 30.6% whereas the continued success rate was 34.0%. In addition, the dropout rate was 27.2%. 46.2% of patients purchased the enuresis alarm with a doctor's prescription and 53.8% purchased the alarm without a prescription. Among the factors, the success and dropout rate were affected by only whether the patient visited the hospital. Thirty five patients who took combination therapy with medicine had a significantly lower initial success rate. CONCLUSIONS: In Korea, without a doctor's prescription, 53.7% patients attempt to treat enuresis alarm directly. The initial and continued success rate with the enuresis alarm was approximately 30% and the dropout rate was approximately 30%.
Child ; Commerce ; Enuresis ; Humans ; Korea ; Motivation ; Nocturia ; Nocturnal Enuresis ; Patient Dropouts ; Prescriptions ; Retrospective Studies

Eosinophilia accompanied by eosinophilic invasion and organ dysfunction may develope idiopathic hypereosinophilic syndrome. Any organ can be involved including bone marrow, lung, skin, heart, gastrointestinal tract and nervous system. Cough, dyspnea, pleural effusion or chest pain are common pulmonary manifestation, and they may be attributed to parenchymal infiltration, pulmonary embolism or heart failure. We report a 43-year-old woman with idiopathic hypereosinophilic syndrome involving bone marrow, skin, and lung. The patient developed acute dyspnea and chest pain. High resolution CT demonstrated multiple wedge-shaped segmental involvement with pleural effusion thought to be a pulmonary infarction or heart failure. Echocardiography could not find any abnormality. Lung biopsy showed interstitial eosinophilic infiltration with increased eosinophils in BAL fluid. She was treated with high dose corticosteroid and hydroxyurea. Within few days, most of her symptoms disappeared and chest radiography nearly cleared up.
Adult ; Biopsy ; Bone Marrow ; Chest Pain ; Cough ; Dyspnea ; Echocardiography ; Eosinophilia ; Eosinophils ; Female ; Gastrointestinal Tract ; Heart ; Heart Failure ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome* ; Lung ; Nervous System ; Pleural Effusion ; Pulmonary Embolism ; Pulmonary Infarction ; Radiography ; Skin ; Thorax

It is uncommon that Anesthesiologist experience thyroid storm during the elective surgery because of marked reduction of operation for the treatment of hyperthyroidism owing to the development of radio-active iodide, antithyroid drugs and the use of beta-receptor blockers such as propranolol. In the treatment of Graves' disease, the conditions such as persistant symptoms of hyperthyroidism with resistance to the antithyroid drugs, frequent relapses and increasing size of thyroid gland must be considered for the need of surgery. It is essential to maintain the euthyroid state before surgery in these cases, if not, the possibility of thyroid storm is increased from increased release of thyroid hormones owing to manipulation of surgery. In our case, the patient had been medicated for 6 years, however, the euthyroid state had not been achieved before the day of surgery. Under the judgement of difficulty for more control of hyperthyroidism the surgeon requested for operation without delay. Immediately after starting operation, the symptoms suggesting thyroid storm such as the abrupt onset of high fever, the increasing blood pressure and heart rate were occured. The sugery was stopped and then the management for thyroid storm was begun. At arterial blood gas analysis, respiratory acidosis and metabolic acidosis were developed and increased hilar haziness suggesting severe pulmonary edema were present in both lung fields at chest x-ray. The patient was mechanically ventillated until improvement of metabolic and respiratory acidosis and pulmonary edema. Two days after operation, vital signs were stabilized and the patient was transferred to general wards.
Acidosis ; Acidosis, Respiratory ; Antithyroid Agents ; Blood Gas Analysis ; Blood Pressure ; Fever ; Graves Disease ; Heart Rate ; Humans ; Hyperthyroidism ; Lung ; Patients' Rooms ; Propranolol ; Pulmonary Edema ; Recurrence ; Thorax ; Thyroid Crisis* ; Thyroid Gland* ; Thyroid Hormones ; Thyroidectomy* ; Thyrotoxicosis* ; Vital Signs

Background: Many studies have assessed the risk factors for adverse drug reactions (ADRs) in elderly patients. However, most of these studies have focused on risk factors for ADRs, not serious ADRs (s-ADRs). s-ADRs are commonly found in hospitalized patients. s-ADRs warrant imminent but thorough investigations, given their critical impact on patient health. Therefore, this retrospective study aimed to assess the associated risk factors for s-ADRs in elderly hospitalized patients. Methods: In-patients aged >65 years having ADRs during hospitalization at a university hospital in Korea between 2010 and 2012 were included. Medical professionals spontaneously reported ADRs using an electronic submission system at the study hospital. Further, all descriptions of ADRs were characterized and categorized through the screening of electronic medical records. We compared the characteristics of patients having s-ADRs with those of patients not having s-ADRs. Results: There were 353 cases of ADRs, 67 of which were s-ADRs. Patients taking more than eight concomitant drugs showed the highest odds ratio (OR, 11.99; 95% confidence interval [CI], 3.42–42.03). The ratio of aspartate aminotransferase (AST)/alanine aminotransferase (ALT) was also significantly related to s-ADRs (OR, 2.78; 95% CI, 1.33–5.81). The use of antibiotics (OR, 2.39; 95% CI, 1.13–5.02) and antineoplastics (OR, 4.17; 95% CI, 1.09–15.94) were significant risk factors. Conclusion Our findings highlight the importance of polypharmacy. Liver function tests (AST/ALT ratio) must be monitored carefully within high-risk groups for ADRs.

The incidence of opportunistic infection has decreased since the introduction of highly active antiretroviral therapy, so lymphoma is now far and away the most lethal complication of acquired immunodeficiency syndrome. We have experienced four cases of NHL in AIDS patients. The first patient was a 37 year old male who presented with left sided hemiplegia due to CNS lymphoma. The second patient was a 40 year old male who was admitted because of jaundice; he was diagnosed as having lymphoma that exclusively involved the liver. The third patient was a 38-year-old male who presented with palpable mass in the left cervical region, which was diagnosed as lymphoma. Above three cases were confirmed as diffuse large B cell lymphoma. The fourth patient presented with a protruding swollen chest wall mass on the right side of his chest, this was determined pathologically to be the Burkitt's type. The latter case is the first report of NHL involving the chest wall musculature in a Korean AIDS patient.
Tomography, X-Ray Computed ; Male ; Lymphoma, Non-Hodgkin/*complications/diagnosis ; Humans ; Fatal Outcome ; Diagnosis, Differential ; Biopsy ; Aged ; Adult ; Acquired Immunodeficiency Syndrome/*complications/diagnosis

Background: This study aimed to explore the time interval distribution pattern between the Physicians Order for Life-Sustaining Treatment (POLST) form completion and death at a tertiary hospital in South Korea. It also examined the association between various independent parameters and POLST form completion timing. Methods: A total of 150 critically ill patients admitted to Korea University Guro Hospital between June 1, 2018 and December 31, 2018 who completed the POLST form were retrospectively analyzed and included in this study. Data were analyzed with descriptive statistics, and group comparisons were performed using the chi-square test for categorical variables. Fisher’s exact test was also used to compare cancer versus non-cancer groups. Results: More than half the decedents (54.7%) completed their POLST within 15 days of death and 73.4% within 30 days. The non-cancer group had the highest percentage of patients (77.8%) who died within 15 days of POLST form completion while the colorectal (39.1%) and other cancer (37.5%) groups had the lowest (P=0.336). Conclusion Our findings demonstrated a current need for more explicit guidance to assist physicians with initiating more timely, proactive end-of-life discussions.