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BACKGROUND/AIMS: This study was conducted to assess the disease burden of pneumonia according to age and presence of underlying diseases in patients admitted with community-acquired pneumonia (CAP). METHODS: We performed a retrospective, observational study and collected data targeting patients with CAP (> or = 50 years) from 11 hospitals. Disease burden was defined as total per-capita medical fee, severity (CURB-65), hospital length of stay (LOS), and mortality. RESULTS: Of the 693 enrolled subjects, elderly subjects (age, > or = 65 years) had a higher mean CURB-65 score (1.56 vs. 0.25; p < 0.01) and higher mortality than nonelderly subjects (4.4% [n = 21] vs. 0.5% [n = 1]; p = 0.00). In addition, the total cost of pneumonia treatment was higher in elderly patients compared to in nonelderly patients (KRW 2,088,190 vs. US $1,701,386; p < 0.01). Those with an underlying disease had a higher CURB-65 score (1.26 vs. 0.68; p < 0.01), were much older (mean age, 71.24 years vs. 64.24 years; p < 0.01), and had a higher mortality rate than those without an underlying disease (3.5% [n = 20] vs. 1.7% [n = 2]; p = 0.56). Total per-capita medical fees were higher (KRW 2,074,520 vs. US $1,440,471; p < 0.01) and hospital LOS was longer (mean, 8.38 days vs. 6.42 days; p < 0.01) in patients with underlying diseases compared to those without. CONCLUSIONS: Due to the relatively high disease burden in Korea, particularly in the elderly and in those with an underlying disease, closer and more careful observation is needed to improve the outcomes of patients with CAP.
Age Distribution ; Age Factors ; Aged ; Aged, 80 and over ; Community-Acquired Infections/diagnosis/economics/*epidemiology/mortality/therapy ; Comorbidity ; Costs and Cost Analysis ; Female ; Health Care Costs ; Hospitalization ; Humans ; Length of Stay ; Male ; Middle Aged ; Pneumonia/diagnosis/economics/*epidemiology/mortality/therapy ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Time Factors

Activation of T cells for an immune response requires the participation of antigen presenting cells that express class II major histocompatibility complex gene products on their surface. As far as we know, there is no study on the agerelated changes of ED2 immunoreactive macrophages and MHC class II immunoreactive dendritic cells in the normal rat brain. The aim of the present study is to investigate the age-related changes of dendritic cells and macrophages in rat brain. The distribution and morphology of the macrophages and dendritic cells in the rat brain were studied from the 1 month-, 12 month- and 24 month-old rats by means of immunohistochemical methods using anti-rat MHC class II and anti-rat ED2 monoclonal antibodies. Antigen presenting cells were observed in choroid plexuses and white matter of the rat brain. The numbers of antigen presenting cells gradually increased with age. At all age stages and regions of the rat brain, the numbers of ED2 immunoreactive macrophages was higher than that of MHC class II immunoreactive dendritic cells. According as age increases, shapes of antigen presenting cells became more complex and aggregated together. In conclusion, the above results suggest that the increases of the number and the changes of the morphology in two kinds of the antigen-presenting cells, MHC class II-immunoreactive dendritic cells and ED2-immunoreactive macrophages, with age may influence on effects of cell-mediated immune responses.
Aging ; Animals ; Antibodies, Monoclonal ; Antigen-Presenting Cells* ; Brain* ; Child, Preschool ; Choroid Plexus ; Dendritic Cells ; Humans ; Macrophages ; Major Histocompatibility Complex ; Rats* ; T-Lymphocytes

No abstract available.
Bone Density* ; Female ; Lactation* ; Postpartum Period*

The long term administration of anti-convulsants on children with convulsive disorders may cause osteomalacia, depending on the dosage, duration, type and combination of anti-convulsants administred. Fifteen children, comprising 10 male and 5 female, dignosed with convulsive disorders and administered with phenobarbital for a long term period of more than 9 months but less than 84 months and 15 healthy children of a similar age-group were selected for the investigation the density of she spinal backbone of each individual was measured by means of the "QDR-2000 X-ray bone densitometer's (made by Hologic company) which uses the double energy X-ray absorption technique. The levels of serum calcium, phosphrus and alkaline phosphatase for each child were also measured for comparative analysis. The results were as follows: 1) The mean bone density for the healthy group of chlidren was 0.69+/-0.09g/cm(2) and that for the group of children administered with phenobarbital was 0.59+/-0.07cm(2) indicating a significant decrease in density for the latter group (p<0.05). 2) As for the relationship between the duration of phenonbarbital and the decrease in bone mineral density, 5 of 6 patients(83%) administered with phenobarbital for more than 4 years showed a decrease in bone mineral density and 5 of 9 patients (56%) administered with phenobarbital for less than 4 years showed a decrease in bone mineral density. 3) the mean vitamin D level for the healthy group of chlidren was 26.8+/-2.5pg/ml indicating a significant decrease in vitamin D3 level for this group(p<0.05). 4) The mean serum alkaline phospatase evel for the health group of children was 240+/-50u/L and 462+/-110u/L for those administered with phenobarbital. This indicate a significant increase in ALP for phenobarbital group(p<0.05). 5) The posphorus and calcium levels were within the normal range for all the groups of children.
Absorption ; Alkaline Phosphatase ; Bone Density* ; Calcium ; Child* ; Cholecalciferol ; Female ; Humans ; Male ; Osteomalacia ; Phenobarbital* ; Reference Values ; Vitamin D

PURPOSE: The ulcerative colitis is a major chronic intestinal disease of unknown etiology affecting principally the rectum and left colon, and its incidence is markedly increasing in Korea. The main differential diagnosis of ulcerative colitis is an acute self-limited colitis. This study was performed to evaluate difference of cell kinetics between chronic ulcerative colitis and acute self-limited colitis. METHODS: The normal colon (n=25), acute self-limited colitis (n=25) and chronic ulcerative colitis (n=25) were investigated by using Ki-67 immunohistochemical staining for proliferation and TUNEL method for apoptosis. The Ki-67 labeling indices and TUNEL labeling indices were determined. RESULTS: The means of Ki-67 labeling indices in normal colon, acute self-limited colitis and chronic ulcerative colitis were 5.14 5.25%, 6.81 5.73%, 13.10 10.15%, respectively. And the means of TUNEL labeling indices in normal colon, acute self-limited colitis and chronic ulcerative colitis were 1.59 0.10%, 2.54 1.60%, 2.51 1.40%, respectively. CONCLUSIONS: The apoptosis is one of method of cell loss in both acute self-limited colitis and chronic ulcerative colitis. High proliferative activity of chronic ulcerative colitis may predispose to mutational events in colonic mucosa, therefore may be one of the increased cancer risk factors in chronic ulcerative colitis.
Apoptosis ; Cell Proliferation* ; Colitis* ; Colitis, Ulcerative ; Colon ; Diagnosis, Differential ; In Situ Nick-End Labeling ; Incidence ; Intestinal Diseases ; Kinetics ; Korea ; Mucous Membrane ; Rectum ; Risk Factors ; Ulcer*

Lung function reportedly declines with age and that this decline is accelerated during disease progression. However, a recent study showed that the decline might peak in the mild and moderate stage. The prognosis of chronic obstructive pulmonary disease (COPD) can be improved if the disease is diagnosed in its early stages, prior to the peak of decline in lung function. This article reviews recent studies on early COPD and the possibility of applying the U.S. Preventive Services Task Force recommendation 2008 and 2015 for early detection of COPD in Korea.
Advisory Committees ; Disease Progression ; Early Diagnosis ; Health Planning Guidelines ; Korea ; Lung ; Prognosis ; Pulmonary Disease, Chronic Obstructive*

Brain infarction restricted to the unilateral hypothalamus is known to be very rare because of the abundant blood supply from the circle of Willis. We report a case of right hypothalamic infarction. A 63-year-old woman developed hyperphagia, hypersomnolence and hemihyperhidrosis limited to the left half of the face. Brain MRI revealed a high signal intensity at the right anteromedial hypothalamus.
Brain ; Brain Infarction ; Circle of Willis ; Disorders of Excessive Somnolence* ; Female ; Humans ; Hyperphagia ; Hypothalamus ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.
Adrenal Cortex Hormones ; Adult ; Aged ; Asian Continental Ancestry Group ; Asthma* ; Asthma, Exercise-Induced ; Cough ; Education ; Epidemiology ; Humans ; Korea ; Lung Diseases, Obstructive ; Spirometry ; Tuberculosis