Objective: Sarcopenic dysphagia is common in elderly subjects with sarcopenia and dysphagia and is not only the result of aspiration pneumonia but also an important cause of its recurrence. The prevention, assessment, and intervention of sarcopenic dysphagia are thus important aspects in management. Methods: This systematic review aimed to analyze the method and effect of interventions for sarcopenic dysphagia, and to provide clinical evidence for the same. Electronic databases, such as Pubmed, CINAHL, and MEDLINE from 2010 to 2020 were used to research theses. “Sarcopenia” AND (“Sarcopenic dysphagia” OR “Dysphagia” OR “Swallowing disorder”) AND (“Intervention” OR “Therapy” OR “Treatment” OR “Program” OR “Strategy”) were used as the main search terminology. The final seven short-listed theses were used for the analysis. Results: The qualitative level analysis included case reports (six articles), and one group non-randomized study (one article). The most common methods of intervention were nutrition, and physical and swallowing rehabilitation. Furthermore, the intervention was provided with a multidisciplinary approach through the cooperation of experts in various fields. Conclusion We suggest that, in the future, intervention methods could be established by conducting intervention studies with a greater number of subjects. Such studies should be actively carried out and used as clinical evidence for formulating methods for evaluation and intervention in patients with sarcopenic dysphagia.

PURPOSE: Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality. METHODS: Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge. RESULTS: Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (chi2=1.15, p=.283). CONCLUSION: Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.
Body Temperature ; Body Weight ; Caregivers/education/psychology ; Counseling ; Female ; Heart Defects, Congenital/mortality/prevention & control/*surgery ; Heart Rate ; Hospitalization ; Hotlines ; Humans ; Infant ; Infant, Newborn ; Male ; Monitoring, Physiologic/*methods ; Oxygen Consumption ; Palliative Care ; *Program Evaluation ; Prospective Studies ; Time Factors

PURPOSE: To evaluate the safety and usefulness of the fluoroscopy-guided percutaneous gastrostomy (FPG) using a large profile gastrostomy tube accompanied with the pull technique, and without the use of an endoscopy or a gastropexy. MATERIALS AND METHODS: From March 2005 to February 2007, 25 patients underwent an FPG using a large profile gastrostomy tube accompanied by the pull technique, in which a 24F pull-type tube was inserted into a patient's mouth and was pulled to the upper abdominal puncture site using a snare, under fluoroscopy. The 18 patients with difficulty swallowing due to muscular atrophic lateral sclerosis or transitional myodystrophy included 5 cases of quadriplegia, 1 case of Parkinson's disease, and 1 metastatic mediastinal tumor. The technical success rate, occurrence of complications, and clinical outcomes were examined. RESULTS: The technical success rate was found to be 100%. In addition, the retention periods for the indwelling tube ranged from 1 to 24 months (mean: 6.5 months), with all tubes retained at a normal position with normal function. No procedure-related mortality occurred. One patient (4%) did however develop a complication in the form of ascites and ascitic fluid leakage around the tube, which was of hepatic origin and was ultimately resolved after the drainage of ascites. CONCLUSION: As a result of this study the FPG, accompanied with the pull technique using a 24F tube, should be considered as a safe and effective method for examining patients. It was found to have a high success rate and a low complication rate.
Ascites ; Ascitic Fluid ; Deglutition ; Drainage ; Endoscopy ; Fluoroscopy ; Gastropexy ; Gastrostomy ; Humans ; Intubation ; Motor Neuron Disease ; Mouth ; Muscular Dystrophies ; Parkinson Disease ; Punctures ; Quadriplegia ; Retention (Psychology) ; SNARE Proteins ; Stomach

Transvenous implantation of an implantable cardioverter defibrillator in patients with a prosthetic valve in the tricuspid position is difficult because a defibrillator lead cannot be implanted into the right ventricle through the prosthetic valve. Hence, there are three options: epicardial implantation, subcutaneous implantable cardioverter defibrillator implantation, and cardiac vein implantation. Here, we report the transvenous implantation of an implantable dual-chamber cardioverter defibrillator in a patient who had undergone tricuspid valve replacement with a prosthetic valve. The patient was a 70-year-old female with a prosthetic valve in the tricuspid position who had experienced two events of sudden cardiac arrest. We successfully performed the procedure by implanting the defibrillator lead into the middle cardiac vein.
Aged ; Death, Sudden, Cardiac ; Defibrillators* ; Defibrillators, Implantable ; Female ; Heart Ventricles ; Humans ; Tricuspid Valve* ; Veins

To gain insight into the differential mechanism of gene promoter hypermethylation in acute and chronic leukemia, we identified the methylation status on one part of 5'CpG rich region of 8 genes, DAB2IP, DLC-1, H-cadherin, ID4, Integrin alpha4, RUNX3, SFRP1, and SHP1 in bone marrows from acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) patients. Also, we compared the methylation status of genes in AML and CML using methylation-specific PCR (MSP). The frequencies of DNA methylation of ID4, SFRP1, and SHP1 were higher in AML patients compared to those in CML patients. In contrast, no statistical difference between AML and CML was detected for other genes such as DLC-1, DAB2IP, H-cadherin, Integrin alpha4, and RUNX3. Taken together, these results suggest that these methylation-controlled genes may have different roles in AML and CML, and thus, may act as a biological marker of AML.
Adolescent ; Adult ; Aged ; CpG Islands ; *DNA Methylation ; Female ; Humans ; Inhibitor of Differentiation Proteins/*genetics/metabolism ; Intercellular Signaling Peptides and Proteins/*genetics/metabolism ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics/metabolism ; Leukemia, Myeloid, Acute/*genetics/metabolism ; Male ; Membrane Proteins/*genetics/metabolism ; Middle Aged ; Promoter Regions, Genetic ; Protein Tyrosine Phosphatase, Non-Receptor Type 6/*genetics/metabolism

To gain insight into the differential mechanism of gene promoter hypermethylation in acute and chronic leukemia, we identified the methylation status on one part of 5'CpG rich region of 8 genes, DAB2IP, DLC-1, H-cadherin, ID4, Integrin alpha4, RUNX3, SFRP1, and SHP1 in bone marrows from acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) patients. Also, we compared the methylation status of genes in AML and CML using methylation-specific PCR (MSP). The frequencies of DNA methylation of ID4, SFRP1, and SHP1 were higher in AML patients compared to those in CML patients. In contrast, no statistical difference between AML and CML was detected for other genes such as DLC-1, DAB2IP, H-cadherin, Integrin alpha4, and RUNX3. Taken together, these results suggest that these methylation-controlled genes may have different roles in AML and CML, and thus, may act as a biological marker of AML.
Adolescent ; Adult ; Aged ; CpG Islands ; *DNA Methylation ; Female ; Humans ; Inhibitor of Differentiation Proteins/*genetics/metabolism ; Intercellular Signaling Peptides and Proteins/*genetics/metabolism ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics/metabolism ; Leukemia, Myeloid, Acute/*genetics/metabolism ; Male ; Membrane Proteins/*genetics/metabolism ; Middle Aged ; Promoter Regions, Genetic ; Protein Tyrosine Phosphatase, Non-Receptor Type 6/*genetics/metabolism

OBJECTIVE: The aim of our study was to define the prevalence, demographic data, selection of the medical services and disability of the patients with self-reported arthritis which were based on the data of National Health and Nutrition Survey (NHNS) conducted by Korea Institute for Health and Social Affairs (KIHASA) and Ministry of Health and Welfare in 1998. MEHTODS: By a stratified multistage probability sampling method, 200 sample districts which consisted of total 13,523 households were selected all over the country. The investigation started with a basic household survey which was completed in 12,189 households with exclusion of non-kinship family. The Health Interview Survey was subdivided to 5 parts including the basic household survey (n=39,060), the diseases survey (n=26,448), and the disability survey (n=694). RESULTS: An estimated 8.0% of Koreans had some form of self-reported arthritis in 1998 and this proportion was higher than that of other chronic medical conditions such as peptic ulcer disease, hypertension, and diabetes mellitus (DM) -7.0%, 4.5%, and 2.2%, respectively. Arthritis was more prevalent among people with female, increasing age, lower income (less than 500 thousand \ per month), lower educational attainment (less than 9 years), and lower standard of living. Especially, arthritis ranked first in prevalence as the cause of the chronic disease in the population aged over 45 years, with the prevalence rate of 22.6%. People with arthritis were more likely to report functional limitations such as activities of daily living (ADL) and instrumental activities of daily living (IADL) (5.4%), compared with people who had other musculoskeletal diseases, such as low back pain (3.8%), and herniated intervertebral disc (2.8%). The loss of productivity from arthritis was estimated to reach 0.25% of gross domestic product (GDP) amounts to won 1,133 billion per year which was remarkably higher than that of cardiovascular diseases or cancers. CONCLUSION: Arthritis has a major impact on the health profile of our population. High burden of arthritis in our society should be considered as an important factor in planning health care services and setting research priorities.
Activities of Daily Living ; Arthritis* ; Cardiovascular Diseases ; Chronic Disease ; Delivery of Health Care ; Diabetes Mellitus ; Efficiency ; Epidemiology ; Family Characteristics ; Female ; Gross Domestic Product ; Humans ; Hypertension ; Intervertebral Disc ; Korea* ; Low Back Pain ; Musculoskeletal Diseases ; Nutrition Surveys ; Peptic Ulcer ; Prevalence* ; Socioeconomic Factors

BACKGROUND: Compared to adult patients, mitral regurgitation in pediatric patients is uncommon and it shows a wide spectrum of morphologic abnormalities. We retrospectively evaluated the midterm results of mitral valve repair in pediatric patients. MATERIAL AND METHOD: Between December 1993 and August 2006, mitral valve repair was performed in 35 patients who were aged less than 18 years. The mean age was 5.3+/-5.3 years and the mean body weight was 20.0+/-16.3 kg. 18 patients had associated cardiac anomalies. The most common pathologic finding was leaflet prolapse (n=17). The most common method of repair was the double orifice technique (n=15). RESULT: There was no early mortality. Eight patients underwent reoperation (24.2%), and five of them required mitral valve replacement. Among the four ring annuloplasty cases, two have developed mitral stenosis. Four out of the 14 double orifice cases required reoperation. One case of early mortality and one case of late mortality occurred in the reoperation cases. The 5-year survival rate and the freedom from reoperation rate were 93.3+/-4.6% and 76.1+/-8.2%, respectively. The 5-year freedom from mitral valve replacement rate was 83.6+/-6.7%. There was no significant risk factor for reoperation. CONCLUSION: The midterm results of mitral valve repair are very acceptable in pediatric patients compared to the adult cases, although the reoperation rate is slightly higher.
Adult ; Body Weight ; Child ; Freedom ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis ; Mitral Valve* ; Mortality ; Prolapse ; Reoperation ; Retrospective Studies ; Risk Factors ; Survival Rate