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

Background and Objectives: Anticoagulation clinics are widely used for anticoagulation management in many countries, but have only recently began to gain acceptance in Taiwan. Our service model is a physician-managed outpatient clinic collaborating with clinical pharmacist and nurse. This study aimed to evaluate the adequacy of anticoagulation and rates of warfarin-related complications before and after referral to our collaborative anticoagulation clinic (CAC). Methods: Stroke patients taking warfarin from the neurology department were identifi ed and referred to the CAC during the 12-month period from February 2009 to January 2010. Quality markers include percentage of international normalized ratio (INR) values in the therapeutic range, frequency of INR monitoring, and frequency of follow-up visits and the mean interval of next INR monitoring after non-therapeutic INRs were compared one year before and after management in the CAC. Using studied patients as self-control, they were included in the analysis if patients had at least 3 months follow-up or 3 INR values both before and after referral. Results: A total of 44 stroke patients were included: mean age of 75.0 ± 9.7 years, with a CHADS2 score of 3.71 ± 0.69. The adequacy of anticoagulation was signifi cantly greater during CAC care compared with the period before referral; the percentage of INR within expanded therapeutic range was 60.9% versus 53.7%, respectively (p=0.049). Reduction in sub-therapeutic INR values from 31.8% to 24.2% (p=0.023) contributed mostly to the improved quality of care. The time interval of next INR monitoring after non-therapeutic INRs ( 4.0 or 1.5) was also signifi cantly shorter. However, there was no signifi cant difference in the rates of thromboembolic and hemorrhagic events which may be attributed to a small sample size. Conclusion: Based on results of our study, a CAC may be the optimal structure for anticoagulation management service in the future.

Granular cell tumors are uncommon benign tumors occurring most commonly on the tongue, skin and subcutaneous tissue. They are most often seen as a solitary nodule in adults. Multiple lesions are very rare, particularly in children. We report a case of multiple granular cell tumors in a 13-year-old boy on his left arm which was presented as firm, flesh-colored, match-head to pea-sized, tender nodules for 6 months. Histologically, the tumors are nonencapsulated nodules, composed of large, polyhedral cells with an abundant eosinophilic granular cytoplasm. By immunohistochemistry, the granular cells are strongly positive for S-100 protein.
Adolescent ; Adult ; Arm ; Child ; Cytoplasm ; Eosinophils ; Granular Cell Tumor* ; Humans ; Immunohistochemistry ; Male ; S100 Proteins ; Skin ; Subcutaneous Tissue ; Tongue

Nevus lipomatosus superficialis presented as soft, yellowish papules or cerebriform plaques occurring usually on the buttock or thigh, less often on the ear or scalp. We herein report a case of nevus lipomatosus superficialis on the leg.
Buttocks ; Ear ; Leg* ; Nevus* ; Scalp ; Thigh

To investigate the drug effect of topical Mitomycin C in various concentrations combined with steroid, we used 30 rabbits whose corneal epitheliums were abraded intentionally. They were divided into 5 groups. Using MMC in various concentrations and steroids, we instilled them into right eyes and saline into left eyes as control. We measured the healing rate at a interval of 12 hours. Three months later, we sacrificed one of them and examined the pathological changes from various ocular tissues. We found many complications such as corneal edema, ulcer, opacity and definite delay of wound healing when the concentration higher than 0.04%MMC was used. There were also decreased fibroblast cells in H-E staining. The steroids seemed not to pose any influence on the effect of MMC. In conclusion, we must take the great care in the use of MMC, and the concentration should be low when used. In addition, we still think there ought to be more studies as to the effect of steroids according to MMC levels.
Cornea* ; Corneal Edema ; Epithelium, Corneal ; Fibroblasts ; Intention ; Mitomycin* ; Ophthalmic Solutions* ; Rabbits ; Steroids ; Ulcer ; Wound Healing

To investigate the drug effect of topical Mitomycin C in various concentrations combined with steroid, we used 30 rabbits whose corneal epitheliums were abraded intentionally. They were divided into 5 groups. Using MMC in various concentrations and steroids, we instilled them into right eyes and saline into left eyes as control. We measured the healing rate at a interval of 12 hours. Three months later, we sacrificed one of them and examined the pathological changes from various ocular tissues. We found many complications such as corneal edema, ulcer, opacity and definite delay of wound healing when the concentration higher than 0.04%MMC was used. There were also decreased fibroblast cells in H-E staining. The steroids seemed not to pose any influence on the effect of MMC. In conclusion, we must take the great care in the use of MMC, and the concentration should be low when used. In addition, we still think there ought to be more studies as to the effect of steroids according to MMC levels.
Cornea* ; Corneal Edema ; Epithelium, Corneal ; Fibroblasts ; Intention ; Mitomycin* ; Ophthalmic Solutions* ; Rabbits ; Steroids ; Ulcer ; Wound Healing

PURPOSE: This study is aimed at obtaining the information on the physical fitness level of female flight attendants at a local airline. METHODS: The subjects are 2,409 female flight attendants who have had medical examination and physical fitness tests at an airline medical center from January 2 to December 30, 2008. The independent variables include socio-demographic & behavioral characteristics, and medical examination results, whereas the dependent variable is their physical strength score representing their fitness level. RESULTS: Factors that affect the fitness strength score are age, flight hours per year, and fasting blood sugar level. It is found that physical fitness level is higher when the subjects are over 35, on board for over 850 hours per year and their fasting blood sugar level is over 100 mg/dL. CONCLUSION: It is concluded that for the improvement of flight attendants' health, more exercise to develop cardio-respiratory endurance and muscular strength is needed, and further study needs to be done to develop fitness enhancement programs considering flight attendants' job characteristics, working years, and flight hours per year, and programs for those returning to their workplace after a long-term leave, and new employees.
Blood Glucose ; Fasting ; Female ; Humans ; Physical Fitness

BACKGROUND: Skin smoothness in aging skin, in combination of intrinsic aging and photoaging, is of ever-increasing interest which leads to the development of various wrinkle diminuation products including those containing herbal medicines. OBJECTIVES: The purpose of this study was to assess the efficacy of cosmetics containing roots of Ephedra sinica and Betula platyphylla var. japonica on reducing skin furrows. METHOD: Creams containing Ephedra sinica's root and Betula platyphylla var. japonica were applied to forearms of 30 healthy subjects in 2 age groups for 8 weeks and 4 weeks, respectively while silicone skin replicas were taken from medial and lateral sides of the forearm every 4 weeks of the study starting from the week 0. Then the changes of the skin furrows were analyzed with skin visiometer. RESULTS: 1. At week 8, a significant reduction of average roughness and maximum roughness were observed in volunteers younger than age 50 on their Ephedra sinica's root-treated side compared with the placebo-treated side (p<0.05). 2. No statistically significant changes were observed with both Ephedra sinica's root and Betula platyphylla var. japonica in the group of age over 50. 3. Comparison of the changes between treatment groups of both Ephedra sinica's root and Betula platyphylla var. japonica at any assessment time did not show statistically significant differences between the medial and lateral side of forearm, while the treatment group of Ephedra sinica's root showed statistically significant differences between the young and old at week 8 (p<0.05). CONCLUSIONS: The treatment of Ephedra sinica's root seems to be partially effective in improving skin furrows in youth. To our knowledge, this study is the first trial to evaluate the efficacy of both Ephedra sinica's root and Betula platyphylla var. japonica on decreasing wrinkle in the world.
Adolescent ; Aging ; Betula* ; Ephedra sinica* ; Ephedra* ; Forearm ; Humans ; Silicones ; Skin* ; Volunteers

PURPOSE: Cardiovascular adverse events (AEs) after use of dipeptidyl peptidase-4 (DPP4) inhibitors have been reported and suspected since the launch of DPP-4 inhibitors in 2006. However, few studies have investigated the association between cardiovascular AEs and DPP-4 inhibitors. The objective of this study is to detect the signals of cardiovascular AEs after use of DPP-4 inhibitors by analyzing the Korea Institute of Drug Safety & Risk Management-Korea Adverse Event Reporting System Database (KIDS-KD). MATERIALS AND METHODS: Data on the use of oral antidiabetic drugs from 2008 to 2016 were extracted from KIDS-KD, and analyzed descriptively. Data mining was conducted by calculating three indices, which were proportional reporting ratios, reporting odds ratios, and information components, to detect signals from use of all oral antidiabetic drugs including DPP-4 inhibitors. Then, the suspected adverse drug reactions (ADRs) were confirmed by signal detection, and drug label information between the Korea Ministry of Food and Drug Safety and the U.S. Food and Drug Administration were compared. RESULTS: Cardiovascular AEs after taking DPP-4 inhibitors were detected in only three (1.0%) out of a total of 307 AE reports. Two of the three cardiovascular AEs were reported after using sitagliptin and one using gemiglipitin, but these were not statistically significant. CONCLUSION: Analysis of spontaneous ADR reports data on the use of DPP-4 inhibitors could not showed the association between DPP-4 inhibitors and cardiovascular AEs, due to a small number of cardiovascular AEs reports.
Cardiovascular Diseases ; Data Mining ; Drug-Related Side Effects and Adverse Reactions ; Hypoglycemic Agents ; Korea ; Odds Ratio ; Pharmacovigilance ; Sitagliptin Phosphate ; United States Food and Drug Administration

Purpose: The purpose of this study was to identify the influence of digital literacy and patient activation on sick role behavior in vulnerable older adults with diabetes. Methods: This cross-sectional, descriptive study included 142 vulnerable older adults aged over 65 with diabetes who were seen at Busan Medical Center. Data were analyzed using descriptive statistics, the t-test, one-way analysis of variance, and stepwise multiple regression analysis with SPSS for Windows version 23.0. Results: Sick role behavior was significantly correlated with digital literacy (r=.68, p<.001) and patient activation (r=.83, p<.001). Digital literacy had a significant correlation with patient activation (r=.63, p<.001). Multiple regression analysis for sick role behavior revealed that the most powerful predictor was patient activation (β=.55, p<.001). Patient activation, digital literacy, gender (female), religiosity (being religious) and cohabitation (living with family) explained 81.0% of the variance in sick role behavior. Conclusion Various factors were found to be related to the sick role behavior of vulnerable older adults with diabetes. Based on the results of this study, further development and application of a customized educational interventional program for improving the sick role behavior of older adults with diabetes will have a positive influence on disease treatment and health management for this population.