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The Relationship between Hemiplegic Upper Extremity Function and Activities of Daily Living According to Age in Stroke Patients.

Hyung Seok SUN ; Jung Kook KIM ; Hyun Sik YUN ; Hyo Jeong SUN ; Jae Young HAN ; In Sung CHOI ; Sam Gyu LEE

Journal of the Korean Geriatrics Society.2011;15(1):29-36. doi:10.4235/jkgs.2011.15.1.29

BACKGROUND: Age is one of the many factors that can influence functional improvement and activities of daily living (ADL) after a stroke. We looked at the effects of functional improvement of hemiplegic upper extremity (HUE) on ADL according to age in stroke patients. METHODS: We recruited 46 stroke patients beginning acute or subacute rehabilitation. They were classified into two groups according to age, the elderly group (> or =65 years, n=18) and the young group (<65 years, n=28). We performed the Pedretti clinical test for sensory evaluation of the upper extremity, the manual function test (MFT) to exam the motor function, and the functional independence measure (FIM) to assess ADL. RESULTS: Sensory changes to HUE correlated significantly with eating, dressing-lower body, and toileting (self-care sub-item) (p<0.05). Motor changes to HUE correlated significantly with dressing-upper body and toileting (self-care sub-item) (p<0.05). Prior to beginning rehabilitation, there were significant differences in sensory and motor functions of HUE between the two groups (p<0.05) but no significant difference in FIM (p>0.05). There were no significant differences in the changes to Pedretti clinical test, MFT, and FIM between the two groups before and after rehabilitation (p>0.05). In the young group, the motor improvement of HUE correlated significantly with FIM (p<0.05). In the elderly group, however, the sensory improvement and motor improvement of HUE were not correlated with FIM (p>0.05). CONCLUSION: In our study, elderly stroke patients showed improvement in function and ADL similar to young stroke patients. This potential should be maximized and elderly stroke patients should receive active rehabilitation.
Activities of Daily Living ; Aged ; Eating ; Humans ; Stroke ; Upper Extremity

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A Multicenter Study on the Tetanus Antibody Titers of Elderly Koreans.

Jong Hwan SHIN ; Chang Je PARK ; Jin Joo KIM ; Jin Seong CHO ; Seung Chul LEE ; Ji Ho RYU ; Ki Yoel KIM ; Hui Jai LEE ; Young Joon KANG ; Won Chul CHA

Journal of the Korean Geriatrics Society.2011;15(1):20-28. doi:10.4235/jkgs.2011.15.1.20

BACKGROUND: Although tetanus infections have diminished dramatically since the advent of tetanus vaccination, this disease has not disappeared. Those 60 years and older are still very much at risk for this infection. Thus, we investigated the tetanus antibody titers in people 60 years and older in Korea. METHODS: Our subjects included those visiting eight emergency departments from March 2009 to February 2010 after an injury with stable vital signs and without acute disease. Samples obtained were tested using the tetanus immunoglobulin enzyme-linked immunosorbent assay method. The resultant tetanus antibody titers were analyzed. RESULTS: The number of subjects enrolled was 462. The mean titer was 0.09+/-0.14 IU/mL. Twenty-two percent of the subjects had a safe titer level (>0.1 IU/mL). Males and urban subjects had higher tetanus antibody titers than did females and suburban subjects. Subjects living in Incheon, Gangwon-do, Chungcheong-do, and Jeju-do had lower titers. CONCLUSION: The results of this study showed that Koreans 60 years and older did not have a protective mean level of tetanus antibody titer and that 78% of the subjects did not have a seroprotective level after tetanus exposure. Therefore, a national effort to administer tetanus vaccination to elderly Koreans is needed.
Acute Disease ; Aged ; Emergencies ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulins ; Korea ; Male ; Tetanus ; Vaccination ; Vital Signs

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Incidence and Estimation of Socioeconomic Costs of Falls in the Rural Elderly Population.

Sang Gon LEE ; Sin KAM

Journal of the Korean Geriatrics Society.2011;15(1):8-19. doi:10.4235/jkgs.2011.15.1.8

BACKGROUND: This study was done to delineate the incidence and socioeconomic cost of fall-related injuries in the rural elderly population. METHODS: From February 1, 2010 to March 31, 2010, a questionnaire-based interview survey was conducted on 2,295 persons 65 years or older living in rural communities (1 Myoen and 1 Eup of Gyoengsangnam-do). The socioeconomic cost due to falls in the elderly in 2009 was estimated using direct and indirect costs. The direct costs included medical costs covered by health insurance and those not covered by insurance. The indirect costs included nursing care, diapers, transportation, health function foods, medical assistance device, and productivity loss. RESULTS: Of the 2,295 subjects, 735 (32.0%) had suffered from fall-related injuries during the previous year. The direct costs of these injuries calculated to be 596,466,000 Won (56.6%). The indirect costs was 458,081,000 Won (43.4%). Of the indirect cost, loss of productivity was 274,993,000 Won, health function foods was 65,531,100 Won, nursing care was 48,755,000 Won, and transportation was 43,122,000 Won. The total socioeconomic costs (direct costs+indirect costs) of the study subjects was 1,054,547,000 Won. The socioeconomic costs per person was 459,500 Won for the total number of study subjects and 1,435,000 Won for the 735 subjects. CONCLUSION: When the above calculated socioeconomic cost for the 2,295 subjects is applied to the 1,067,262 Korean rural elderly population in 2009, the socioeconomic costs owing to fall-related injuries can be estimated to as much as 343,614,988,000 Won. In the future, the socioeconomic costs due to injuries such as falls is expected to increase as the elderly population increases. Therefore, injury prevention programs and studies for reducing the socioeconomic costs in the elderly community are needed.
Aged ; Efficiency ; Humans ; Incidence ; Insurance ; Insurance, Health ; Medical Assistance ; Nursing Care ; Rural Population ; Transportation

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Recent Progression in Sarcopenia and Sarcopenic Obesity.

Hak Chul JANG

Journal of the Korean Geriatrics Society.2011;15(1):1-7. doi:10.4235/jkgs.2011.15.1.1

One of the important changes of body composition with ageing is the increase of fat mass and visceral fat and the decrease of muscle mass and strength. Sarcopenia, the age-related decrease in skeletal muscle mass, is associated with functional disability, falls, and mortality. Recent studies found that older people with low skeletal muscle mass and obesity (sarcopenic obesity) have a higher risk for cardiovascular and metabolic diseases. However, a consensus of the definition of sarcopenia is lacking in clinical practice. The reported prevalence of sarcopenia and sarcopenia in Koreans is a wide range. This may be due to differences in study population and diagnostic criteria for sarcopenia. The European Working Group on Sarcopenia in Older People proposed a clinical definition and diagnostic criteria for sarcopenia. These diagnostic criteria include the presence of both low muscle mass and low muscle function (strength or performance). Further studies for the clinical application of newly developed criteria for sarcopenia are needed.
Body Composition ; Consensus ; Intra-Abdominal Fat ; Metabolic Diseases ; Muscle, Skeletal ; Muscles ; Obesity ; Prevalence ; Sarcopenia

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Cerebral Infarction after Honey Bee Venom Acupuncture.

So Young HUH ; Bong Goo YOO ; Min Jeong KIM ; Jong Kuk KIM ; Kwang Soo KIM

Journal of the Korean Geriatrics Society.2008;12(1):50-52.

Bee venom acupuncture have been associated with wide variety of reactions from mild local reaction to fatal systemic reaction. Vascular complications of bee and wasp stings are rare. A 71-year-old man developed pontine and thalamic infarction after honey bee venom acupuncture. Dysarthria and left hemiparesis were noted 3 days later. The brain MRI showed cerebral infarcts in the left pons and thalamus. The presumed mechanisms include vasoconstriction and platelet aggregation secondary to an injection of distinct allergens contained in bee venom acupuncture.
Acupuncture ; Aged ; Allergens ; Bee Venoms ; Bees ; Bites and Stings ; Brain ; Cerebral Infarction ; Dysarthria ; Honey ; Humans ; Infarction ; Paresis ; Platelet Aggregation ; Pons ; Thalamus ; Vasoconstriction ; Venoms ; Wasps

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Pure Limb Ataxia as Isolated Manifestation in Lateral Medullary Infarction.

In Uk SONG ; Jae Young AN ; Joong Seok KIM ; Seon Young RYU ; Sang Bong LEE ; Seung Jae LEE ; Yeong In KIM ; Kwang Soo LEE

Journal of the Korean Geriatrics Society.2008;12(1):47-49.

Pure limb ataxia without other common symptoms of Wallenberg syndrome has rarely been reported as manifestation of lateral medullary infarction. We describe a patient with lateral medullary infarction who presented with almost isolated right limb(mainly lower limb) ataxia without usual symptoms such as hemibody sensory changes, dysphagia, hoarseness, hiccup, and Horner sign. The brain magnetic resonance image showed small ischemic lesion involving the dorsolateral portion of the medulla oblongata.
Ataxia ; Brain ; Deglutition Disorders ; Extremities ; Hiccup ; Hoarseness ; Humans ; Infarction ; Lateral Medullary Syndrome ; Magnetic Resonance Spectroscopy

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A Case of Cameron Ulcer Associated with Massive Gastrointestinal Bleeding Treated by Angiographic Embolization.

Dong Gyu KIM ; Sung Hee JUNG ; Young Geun KIM ; Soung Hoon CHO ; Si Bum KIM ; Sung Hoon LEE ; Hyang Ie LEE ; Yun Jung LEE ; Hyeon Woong YANG ; Anna KIM ; Sang Woo CHA

Journal of the Korean Geriatrics Society.2008;12(1):42-46.

Gastric erosions or ulcers located at or near the level of the neck of a large diaphragmatic hernias are referred to as Cameron ulcers. Cameron ulcers are almost always incidental findings. In some patient, Cameron ulcers cause the dyspepsia, gastroesophageal reflux disease and iron deficiency anemia due to chronic gastrointestinal bleeding or even acute bleeding. We report the case of an acute upper gastrointestinal bleeding due to a Cameron ulcer in a patient with a history of aspirin and NSIADs use, which was successfully treated with angiographic coil embolization.
Anemia, Iron-Deficiency ; Angiography ; Aspirin ; Dyspepsia ; Gastroesophageal Reflux ; Hemorrhage ; Hernia, Diaphragmatic ; Hernia, Hiatal ; Humans ; Incidental Findings ; Neck ; Ulcer

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Clinical Behavior of Geriatricians Regarding Periodic Screening for Gastro-intestinal Cancers in Older Adults.

Hwan Sik HWANG ; Chang Won WON ; Dong Ho LEE

Journal of the Korean Geriatrics Society.2008;12(1):35-41.

BACKGROUND: A questionnaire for geriatricians regarding their clinical practice of periodic gastro-intestinal cancer screening was developed. METHODS: The survey was administered to geriatricians participating in the 2007 Korean Geriatrics Society meeting at Busan, Korea. RESULTS: 162 completed the questionnaire. Average age of respondents was 46 years. Background specialty included family medicine(24%), internal medicine(22%), obstetrics and gynecology(9%), and general surgery(8%). 90% of geriatricians recommend screening for colorectal cancer in their practice. They recommend a colonoscopy if fecal occult blood test is positive(53%) or colonoscopy(31%). On average, they recommend screening for colorectal cancer every 2.5 years. Screening for colorectal cancer is recommended to those 75-79 years(33 %), 70-74 years(24%), and 65-69 years(24%). 94% of respondents recommend screening for stomach cancer in their practice. They recommend gastrofiberoscopy(95%) or upper GI series(5%). On average, screening is recommended every 1.5 years. Screening is recommended to those aged 75-79 years(34%), 70-74 years(19%), and 65-69 years(22%). CONCLUSION: Most geriatricians prefer endoscopic examinations for screening for GI cancer. They recommend, on average, screening for colorectal cancer and stomach cancer every 2.5 and 1.5 years, respectively. Most geriatricians recommend GI cancer screening to those aged 75-79 years.
Adult ; Aged ; Colonoscopy ; Colorectal Neoplasms ; Surveys and Questionnaires ; Early Detection of Cancer ; Geriatrics ; Humans ; Mass Screening ; Obstetrics ; Occult Blood ; Stomach Neoplasms

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Ultrasonographic Measurements of Abdominal Aortic Diameter in Elderly Patients.

Seung Hwan CHEON ; Jung Tae CHOI ; Hee Cheol AHN ; Gu Hyun KANG ; Moo Eob AHN ; Jeong Youl SEO ; You Dong SOHN ; Gyu Chong CHO

Journal of the Korean Geriatrics Society.2008;12(1):30-34.

BACKGROUND: Researchers have reported that the prevalence of abdominal aortic aneurysm(AAA) is 1~4% in the entire population and 4~9% in the population older than 65 years. 40 to 50% of AAA patients die before arrival at a hospital; and mortality from a ruptured AAA is greater than 90%. Moreover, diagnosis is frequently delayed because the majority of patients are asymptomatic. Even if AAA is quickly diagnosed(ruptured or symptomatic) and operated on, survival rate is less than 50%. Recently, trials have been done to detect asymptomatic AAA by ultrasonography in the elderly population with a subsequent increase in the number of surgeries of asymptomatic AAA. Method: We measured the diameter of the abdominal aorta in all patients aged 65 years and older seen in the emergency room at Chuncheon Sacred Heart Hospital, Hallym University. We investigated the correlations between risk factors and prevalence of AAA and the diameter of the abdominal aorta. We also screened for age, gender, and history of smoking, hypertension, coronary heart disease, and CVA. RESULTS: 444 cases were enrolled in this study with 185 being male(41.7%) and 259 female(58.3%). Mean age was 73.91+/-7.02 years. Mean maximum diameter of the abdominal aorta was 2.08+/-0.37cm. Comparing maximum diameters, men averaged 2.17+/-0.37cm and women 2.01+/-0.35 cm (p<0.001); smokers 2.16+/-0.39cm and nonsmokers 2.05+/-0.35cm(p=0.007); hypertension history 2.10+/-0.42 cm and no hypertension history 2.06+/-0.33cm(p=0.246); coronary heart disease history 2.35+/-0.84cm and no coronary heart disease 2.07+/-0.35 cm(p=0.01); and CVA history 2.08+/-0.37 cm and no CVA history 2.08+/-0.37cm(p=0.997). CONCLUSION: There were notable differences in the maximum abdominal aortic diameter with gender and histories of smoking, hypertension, and coronary heart disease. Ultrasound screening of AAA should be strongly recommended in male smokers 65 years and older with a history of coronary heart disease. Overall, ultrasound screening of AAA for elderly patients should be carefully considered.
Aged ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal ; Coronary Disease ; Emergencies ; Female ; Heart ; Humans ; Hypertension ; Male ; Mass Screening ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Survival Rate

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A Safety and Effectiveness of High Pressure Balloon Dilatation for Sirolimus-Eluting Stent Implantation in the Ischemic Heart Disease.

Seung Eun LEE ; Woo Hyung BAE ; Nam Sik KIM ; Sung Han YUN ; Han Cheol LEE ; Jun KIM ; June Hong KIM ; Kook Jin CHUN ; Taek Jong HONG ; Yung Woo SHIN

Journal of the Korean Geriatrics Society.2008;12(1):24-29.

BACKGROUND: We have no information about the safety and effectiveness when we perform overdilating a sirolimuseluting stent(SES) with high pressure. In some specific animal model, the study reported overdilatation of SES with high pressure resulted in increase of restenosis. The aim of this study was to evaluate the safety and effectiveness of overdilatation of SES with high pressure. METHODS: 97 patients underwent PCI using SES between August 2003 and July 2005 were divided into two group(high pressure group, low pressure group), stents were implanted with high pressure(>18 atm) and low pressure(<12 atm). We compared between the two group of safety of stents, major adverse cardiac events(MACE), rate of restenosis, late loss. RESULTS: In high pressure group, there are more type C lesion(51% vs 38%, p<0.01). There were no significant differences between the two groups regarding MACE(12.8% vs 17.2%, p=0.78), in-stent restenosis rate(2.6 % vs 5.2%, p=0.65). There are small increasing of late loss in high pressure group, but no statistically significant difference(0.30 vs 0.15, p=0.05). CONCLUSION: Implantation of SES overdilated with high pressure is able to be performed safely to obtain wider inner lumen of stents.
Dilatation ; Humans ; Models, Animal ; Myocardial Ischemia ; Stents

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