No abstract available.
Biopsy* ; Fatty Liver* ; Hepatitis, Chronic* ; Liver*

There are two ways to assess aging: to evaluate the function and to estimate the biological age. The biological age is estimated objectively by measuring the level of biological aging, taking apart with disease. It is measured with some biomarkers, which reflect the change of organ function and body with aging. It is, however, difficult to use in clinical practice. The evaluation of function is more practical and easier to clinicians. The parameters used include Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), and Mini-Mental Status Examination (MMSE) to evaluate the level of cognitive function. Balance test, standing up from chair, and walking pace can be checked to evaluate the physical function. Each method has its own limitations in evaluating the degree of aging precisely.
Activities of Daily Living ; Aging* ; Biomarkers ; Walking

BACKGROUND: As the elderly population grows and increasing average life expectancy, medical needs and utilization by elderly people are rapid increase in recent years. It is thus essential that elderly people are included in clinical studies. There are also needed the standardization of age grouping and guideline of the elderly for the purpose of relative review between studies. And a study must include what age was used as a cut off value. So we set out to discover age grouping, cut off ages and guideline age of the elderly in two major Korean medical journals. METHODS: We examined all original research papers in all the issues of the Korean Journal of Medicine (KJM), and the Journal of The Korean Surgical Society (JKSS) between January 1995 and December 1997. We excluded animal works and papers concerned with special age (children, soldiers). Of the remaining 931 (386 KJM/545 JKSS) papers, we reviewed how many papers included elderly people in them, age grouping and regularity, age group intervals, cut off age, and of the specific to the elderly papers, what age was used as guideline age of the elderly. RESULTS: Of the reviewed 931 papers, included above 60-year were 701 (75.3%), excluded were 166 (17.8%), and no age limit was set in 64 (6.9%) papers. Of the 701 papers that included above 60 years, no age grouping were 349 (49.8%), and 352 (50.2%) had age grouping. Among them, 341 papers used regular intervals, while 11 papers used irregular intervals. Of the 341 regular age interval papers, five year interval were 4, ten year were 322, fifteen year were 2, and twenty year were 13. The cut off age as a specific value were 118, and cut off as a group of ages were 223. Ten papers were specifically about elderly people. Of these papers, the guidelines of the elderly were 60-year in 6, and 65-year in 4 papers. CONCLUSION: Many Korean medical papers included above 60-year people. But near half of them had no age grouping, and no age limit sets were 6.9%. And there were mixed use of 60 and 65 years for guideline of the elderly. So more elderly people should be included in future clinical studies. The standardization of age grouping and guideline of the elderly are also needed.
Aged* ; Animals ; Humans ; Life Expectancy

No abstract available.
Abortion, Habitual* ; Cytogenetics* ; Family Characteristics* ; Female ; Pregnancy

No abstract available.
Suicide, Attempted*

For elderly patients with many chronic and degenerative diseases (multiple comorbidities) and geriatric syndromes, chronic and complex problems should be comprehensively evaluated. The comprehensive geriatric assessment (CGA) is an evaluation of elderly patients in which clinical, medical, and functional evaluations are performed together.Current Concepts: Components of CGA include physical, psychological, and socioenvironmental content. In the physical aspect, the presence of various diseases, determination of the severity of each disease, multi-drug intake (polypharmacy), and vaccination records are evaluated. Geriatric syndromes should also be included in the evaluation. The functional evaluation comprises visual acuity, hearing, upper and lower extremity function, gait ability, balance, fall, urinary incontinence, weight change, oral health, nutritional status, and pain. In the psychological aspect, depression and cognitive function status are evaluated. The residential environment, degree of familial and social support, economic status, and advanced medical directives are evaluated in the socioenvironmental aspect.Discussion and Conclusion: Elderly patients with functional disabilities should be screened via the CGA for various problems and geriatric syndromes that the elderly are prone to developing. Problems found require further evaluation, treatment, and management. In this way, the health and quality of life of the elderly can be maintained and improved.

BACKGROUND: In this article, authors determine whether rectangularization of survival curve occurred in Korea in the period 1966-1995. Rectangularization is defined as a trend toward a more rectangular shape of the survival curve due to increased survival and concentration of deaths around the mean age of death. Authors distinguish between absolute and relative rectangularization, depending on whether an increase in life expectancy is accompanied by concentration of deaths into a smaller age interval or into a smaller proportion of total life expectancy. METHODS: In this study, the authors intended to demonstrate the survival curve according to the year 1966 and 1970 to 1995. For these purpose, the authors used the annual mortality data published by the National Statistical Office from 1966 to 1995 in Korea. Authors used measures of variability based on Keyfitz' H and the standard deviation, both life table-based. Our results show that absolute and relative rectangularization of the entire survival curve occured except mortality data of 1966 which has little reliability over the complete period. RESULTS: In this study, authors observed relative and absolute rectangularization and the survival curves of 1970 to 1995 shows the convergence between mid-60s and mid-80s. All the Keyfitz' H, NH, SD and CV decreased while the life expectancy increased in the period of 1970 to 1995. This result is similar to the mortality curve suggested by Fries according to his compression of morbidity hypothesis. CONCLUSIONS: According to Keyfitz theory, rectangularization happens to survival curve in Korea. The implications of the recent rectangularization at older ages for achieving compression of morbidity have to be exactly understood. So, the authors suggest that health policy and research must be directed to the preventive health service and health promotion to reduce morbidity, postpone infirmity and to warrant the quality of life for senior people.
Health Policy ; Health Promotion ; Korea* ; Life Expectancy ; Mortality ; Preventive Health Services ; Quality of Life

No abstract available.
Hematoma*

BACKGROUND: Prolongation of the QTc interval is a risk factor for ventricular tachycardia, ventricular fibrillation, especially torsades de pointes, and sudden death. It is associated with increasing age, female sex, some of antiarrhythmic drugs, tricyclic antidepressants, and conditions such as hypokalemia, hypothermia, subarachnoid hemorrhage, congenital long QT syndrome. Earlier studies reported lengthening of the QTc interval with increasing body mass index (BMI) and intra-abdominal fat. But no such reports exist in Korea. Therefore, we determined the relationship between BMI and the QTc interval. METHODS: The study population consisted of 372 persons who undertook periodic health examination in a university hospital between September and December 1998. BMI and standard 12-lead electrocardiogram were measured in all subjects. Excluding 4 patients who had arrhythmia where QTc interval could not be calculated, the QT interval was measured in the electrocardiogram of 368 subjects. The QT interval was measured in the leads that showed the longest interval for three consecutive beats and then were averaged. Correlation between the calculated QTc interval and BMI was examined. The QTc interval difference according to sex and obesity was also analyzed. RESULTS: Among 368 subjects, there were 197 men (54%) and 171 women (46%). The mean ages were 44.5 years for men and 47.6 for women. The BMI was 23.8 3.13 (mean SD). Obese subjects with BMI above 27 kg/m2 totalled 61 (17%), including 31 men and 30 women. The QTc interval was 399 25 msec (mean SD), and the subjects showed prolonged QTc intervals of 24 (12 men and 12 women). There was a statistically significant correlation between BMI and QTc interval (r=0.135, P=0.0094), and the obese subjects were found to have a longer QTc interval than the nonobese controls. Women also had a longer QTc interval than men. CONCLUSION: There was a significant correlation between BMI and QTc interval, and longer QTc interval was observed in obese patients. The QTc interval should be considered when analyzing electrocardiogram of obese patients.
Anti-Arrhythmia Agents ; Antidepressive Agents, Tricyclic ; Arrhythmias, Cardiac ; Body Mass Index* ; Death, Sudden ; Electrocardiography ; Female ; Humans ; Hypokalemia ; Hypothermia ; Intra-Abdominal Fat ; Korea ; Long QT Syndrome ; Male ; Obesity ; Risk Factors ; Subarachnoid Hemorrhage ; Tachycardia, Ventricular ; Torsades de Pointes ; Ventricular Fibrillation

BACKGROUND: The rapid increase in population of old people has been emphasized as a serious social problem even in medical world. Geriatric disease has special characters that can be mentioned as a non-contagious chronic degenerative disease. 'Regular Doctor System' can be considered as one of the efficient ways to care for it continuously. The purpose of this study was to promote the introduction of family doctor system gradually and care of geriatric disease through examination of old people's thinking about 'Regular Doctor System'. METHODS: The result of this study was based on the questionnaire survey on 292 old people(aged 65 and more, response rate 73%) at 2 welfare centers in Seoul, located at Yeongdeungpo-gu and Guro-gu, and 1 college for old people, for 2 weeks from May, 2003. The contents of surveywere consisted of many questions for understanding of old people's thinking about 'Regular Doctor System'. The response method was self-reported. RESULTS: Comparing with other age group surveys, this old people's survey has special character that it has higher affirmative answer rate for the question of 'Do you have a regular doctor?'. The old people's favorite natures of regular doctor were considerateness( 26.9%) and kindness(26.2%). And the most desirable service from their regular doctor was comprehensive health examination( 45.2%). The factors reflecting on selecting of doctor were separately questioned into two aspects, as factors related to doctor's behavior and the others. Among the factors related to doctor's behavior, the effect of medical treatment(22.7%) was top ranked and 'being aware of my disease'(17.3%), 'easy explanation'(15.5%) were followed. The other factors were medical specialty(24,1%), easy access(19.3%) and short waiting time(10.5%). The reasons for changing of doctor were 'to receive specialist's medical treatment'( 37.2%), 'no improvement of patient's condition'(13.1%) and 'distrust of diagnosis'(9.0%). CONCLUSION: The old people wanted considerate and kind attitude from their doctors. The factors, related to doctor's behavior that the old people wanted, were 'good effect of medical treatment', 'being aware of my disease well' and 'easy explanation'. The other factors they wanted were medical specialty, easy accessibility and short waiting time.
Humans ; Surveys and Questionnaires ; Seoul ; Social Problems ; Thinking