Herpes zoster is a common disease of the dorsal root ganglia and sensory nerve fibers that is clinically characterized by a painful unilateral vesicular eruption of the skin in a dermatomal distribution. Segmental motor weakness is a rare complication that occurs in 0-5% of patients and is associated with an excellent prognosis for recovery. We herein present a case of herpes zoster complicated by segmental motor paresis of the abdominal musculature resulting in a pseudohernia. This rare complication of herpes zoster, which has an excellent prognosis for recovery, should be recognized by physicians as it can save costly consultations and evaluations.
Ganglia, Spinal ; Herpes Zoster* ; Humans ; Nerve Fibers ; Paresis ; Prognosis ; Referral and Consultation ; Skin

Mycobacterium avium complex (MAC) comprises M. intracellulare and M. avium. MAC usually causes pulmonary diseases in individuals with intact immunity, disseminated disease in patients with acquired immunodeficiency syndrome, and cervical lymphadenitis. It can also cause cutaneous disease, but musculoskeletal infection is rare. Herein, we present a case of vertebral osteomyelitis due to M. intracellulare in an elderly immunocompetent patient who underwent vertebroplasty. The patient was successfully treated with antimycobacterial drugs without surgical intervention. MAC should be considered as a causative pathogen of vertebral osteomyelitis when the patient has a history of vertebroplasty.
Acquired Immunodeficiency Syndrome ; Aged* ; Humans ; Lung Diseases ; Lymphadenitis ; Mycobacterium avium Complex* ; Mycobacterium avium-intracellulare Infection ; Mycobacterium* ; Nontuberculous Mycobacteria ; Osteomyelitis* ; Vertebroplasty*

BACKGROUND: In a rapidly aging population, the importance of the quality of life of the elderly has been emphasized. The need for special care services according to an individual's physical, emotional, and social functions changes with aging. This study was conducted to analyze the needs of home dwellers in terms of health-care services for active aging. METHODS: The study subjects were 869 adults older than 40 years who lived in houses. They responded to a survey that inquired about the importance of each health-care item for active aging at home. The important items for active aging at home were graded by using a 5-point Likert scale. RESULTS: Among the items, "affection" topped the list, with 4.68 points, followed by cognitive function (4.67 points) and "social relations" (4.59 points). The top 3 items had no significant differences between the age groups. However, some items related to activities of daily living (ADL; including bathing, eating, and ambulating.) and instrumental ADL (IADL; including taking medicines and preparing meals) had significant differences between the age groups. Compared with the subjects in the older age groups, the subjects in the forties age group placed less importance on ADL and IADL. CONCLUSION: For the subjects who lived in houses, affection, cognitive function, and social relation are highly important for as active aging, regardless of age. ADL and IADL are regarded as more important in ≥50 years age groups.
Activities of Daily Living ; Adult ; Aged ; Aging* ; Baths ; Delivery of Health Care* ; Eating ; Humans ; Quality of Life

BACKGROUND: Pyometra should be treated with caution in elderly patients because it may indicate a malignancy in the post-menopausal period and can result in life-threatening complications such as septicemia or pan-peritonitis. METHODS: We retrospectively analyzed the clinical features of 30 patients aged ≥65 years who received treatment for pyometra between January 2010 and December 2014. RESULTS: The 30 patients (age: median, 74 years; range, 66-88 years) were evaluated. They presented with vaginal discharge (n=17), vaginal bleeding (n=8), abdominal pain (n=6), or fever (n=3). The most common accompanying systemic disease was hypertension (n=15), followed by diabetes mellitus (n=10). Of the 30 cases, seven were associ- ated with gynecologic malignancy (cervical cancers, n=3; endometrial cancers, n=3; and ovarian cancer, n=1); and 14, with gynecologic benign diseases (uterine myoma, n=5; cervical intraepithelial neoplasia, n=4; tubo-ovarian abscess, n=3; endometrial polyp, n=1; uterine prolapse, n=1). All the patients were treated with cervical dilatation and drainage. Fifteen patients underwent gynecologic surgery with antibiotic therapy, and 15 received empirical antibiotic treatment alone. Two women experienced spontaneous perforation of pyometra. Pyometra is considered a complication of benign and malignant gynecologic disease, until proven otherwise. CONCLUSION: In elderly patients with comorbidities, pyometra might induce severe complications such as pan-peritonitis or sepsis. Early accurate diagnosis is important to determine an appropriate individualized treatment to reduce morbidity and mortality.
Abdominal Pain ; Abscess ; Aged* ; Cervical Intraepithelial Neoplasia ; Comorbidity ; Diabetes Mellitus ; Diagnosis ; Drainage ; Endometrial Neoplasms ; Female ; Fever ; Genital Diseases, Female ; Gynecologic Surgical Procedures ; Humans ; Hypertension ; Labor Stage, First ; Mortality ; Myoma ; Ovarian Neoplasms ; Peritonitis ; Polyps ; Postmenopause ; Pregnancy ; Pyometra* ; Retrospective Studies ; Sepsis ; Uterine Hemorrhage ; Uterine Prolapse ; Vaginal Discharge

BACKGROUND: The aim of this study was to evaluate the effect of aging on the hemodynamic response to endotracheal intubation during the induction of anesthesia. METHODS: Fifty patients with American Society of Anesthesiologists physical status classification 1 or 2 were enrolled and allocated according to age to either group N (35-44 years, not elderly, n=25) or group E (65-74 years, elderly, n=25). The patients were administered 3 minimum alveolar concentrations of sevoflurane for 5 minutes for the induction of anesthesia. Systolic arterial pressure (SAP) and heart rate (HR) were recorded before (baseline), immediately after (T0), and at 1-minute intervals during the first 4 minutes after endotracheal intubation (T1-T4). RESULTS: SAP increased by 15.4% and 10.8%(p<0.05) from the baseline at T0 and T1, respectively, in group N, and by 21.6%, 17.8%, and 11.8%(p<0.05) from the baseline at T0, T1 and T2 respectively, in group E. The SAP increases at T0, T1 and T2 were significantly greater in group E than in group N (p<0.05). The HR increases at T0 and T1 were significantly greater for group N than for group E (p<0.05). CONCLUSION: We recommend that anesthesiologists vigilantly monitor and attenuate adverse hemodynamic responses for at least 5 minutes after endotracheal intubation especially in elderly patients, particularly because significant systolic hypertension can occur in this age group.
Aged ; Aging* ; Anesthesia* ; Arterial Pressure ; Classification ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Intubation ; Intubation, Intratracheal*

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia particularly in the elderly and a potent risk factor for ischemic stroke. Screening for AF in asymptomatic individuals might prevent strokes by earlier detection and anticoagulation therapy. We investigated the prevalence of AF in the Korean elderly and its clinical characteristics. METHODS: This study included 1,483 participants (839 males, 644 females) ≥60 years (72.9±5.4 years) who had undergone electrocardiogram (ECG) screening at the senior health promotion center, Gwangju, from March 2014 to June 2014. Their assessments included 12 lead electrocardiograms, questionnaires and physical examinations. RESULTS: AF was detected in 46 individuals (3.1%), and newly detected in 20 of these 46 (43.4%). The prevalence of AF increased sharply with age-1.0% in 60-69 years group, 3.3% in 70-79 years group, and 7.2% in ≥80 years group. Multivariate logistic regression analysis showed that age (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.05-1.17; p<0.001), male gender (OR 5.28, 95% CI 2.04-13.66; p=0.001), obesity (body mass index>25kg/m2) (OR, 2.17; 95% CI, 1.14-4.11; p=0.017), and heart failure (OR, 8.74; 95% CI, 1.45-52.46, p=0.018) were associated with increased risk for AF. CONCLUSION: The prevalence of AF in the Korean elderly was 3.1% and increased steeply with age from 1.0% to 7.2%. Screening with ECG may be considered as nearly half (43.4%) of AF cases were newly detected.
Aged* ; Arrhythmias, Cardiac ; Atrial Fibrillation* ; Electrocardiography ; Epidemiology ; Gwangju ; Health Promotion ; Heart Failure ; Humans ; Korea* ; Logistic Models ; Male ; Mass Screening ; Obesity ; Physical Examination ; Prevalence* ; Risk Factors ; Stroke

Falls and fall-related injuries are common amongst the elderly population and have deleterious effects on the quality of life or independence in daily living in the elderly. Falling is also associated with substantial morbidity, mortality, nursing home admission, and an increase in medical costs. Given that Korea has shown an extreme demographic shift with its population aging at the fastest pace among developed countries, assessment of fall risks and implementing intervention strategies to the high-risk population are getting more important. The guidelines for the prevention of falls were developed first by The Korean Association of Internal Medicine and The Korean Geriatric Society. These guidelines were developed by an adaptation process and the use of an evidence-based method; 4 guidelines were retrieved by systematic review and by the AGREE (appraisal of guidelines for research and evaluation) II process and 7 statements were made based on the grading of evidence, and these recommendations followed the GRADE (grades of recommendation, assessment, development, and evaluation) framework. Given that falls result from a various combination of many factors, the guidelines contain multidimensional assessment measures and multimodal strategies to prevent falls. These guidelines were developed not only for use by primary physicians but also for patients and the general population. Therefore, these guidelines provide detailed recommendations and concrete measures for the assessment of the risk of a fall and to prevent falls amongst the elderly population.
Accidental Falls ; Aged ; Aging ; Developed Countries ; Humans ; Internal Medicine ; Korea* ; Mortality ; Nursing Homes ; Quality of Life

Even though colonoscopy is a common and widely performed procedure, it can cause many complications. If any sign of inflammation is observed, a perforation or postpolypectomy coagulation syndrome should be considered. Diverticulitis, a very rare complication with an incidence of 0.04% to 0.08%, also can occur after the diagnostic and therapeutic procedure. We report a case of acute diverticulitis after colonoscopy, diagnosed with typical computed tomography findings after excluding other complications. The patient was treated in the same manner as for complicated diverticulitis, with bowel rest, hydration, and broad-spectrum antibiotics. Acute diverticulitis as a rare complication can occur following prolonged colonoscopy or colonoscopic polypectomy, especially in those with additional risk factors such as obesity and smoking.
Anti-Bacterial Agents ; Colonoscopy ; Diverticulitis* ; Diverticulum ; Humans ; Incidence ; Inflammation ; Obesity ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Recent studies report that nursing home elderly (NHE) have significantly lower serum levels of 25-hydroxy-vitamin D (25-OHD) than community dwelling elderly (CDE); however, in Korea such studies are lacking. We aimed to compare the vitamin D status between NHE and CDE in Korea. METHODS: This study included 203 patients over 65 years, admitted to the geriatric department of Seoul Medical Center between 01/2015 and 12/2015. Their medical records were reviewed for demographic data, type of residence, medical and drug history, serum 25-OHD, albumin, creatinine, and calcium levels, and geriatric assessment results. After excluding 36 subjects who had taken vitamin D supplements, anticonvulsants, or steroids, 33 NHE and 134 CDE were included for final analysis. RESULTS: Almost 80% of subjects showed a vitamin D deficiency (25-OHD <20 ng/mL); 54% were severely deficient (25-OHD <10 ng/mL). NHE had a significantly lower serum 25-OHD level than CDE (5.47±2.95 ng/mL vs. 14.72±11.35 ng/mL, p<0.001). Serum 25-OHD level was related to serum albumin level, the Geriatric Depression Scale score, and the Korean version of the Mini Mental State Examination score (p=0.004, p=0.041, p=0.032, respectively). After adjustment for confounding factors using multiple logistic regression analysis, diagnosis of severe vitamin D deficiency was more likely in NHE than CDE (odds ratio, 8.72; 95% confidence interval, 1.53-49.81). CONCLUSION: This study suggests a high prevalence of vitamin D deficiency in Korean NHE. To prevent falls and osteoporotic fractures in this population, vitamin D supplementation should be considered.
Accidental Falls ; Aged* ; Anticonvulsants ; Calcium ; Creatinine ; Depression ; Diagnosis ; Geriatric Assessment ; Humans ; Independent Living ; Korea* ; Logistic Models ; Medical Records ; Nursing Homes* ; Nursing* ; Osteoporosis ; Osteoporotic Fractures ; Prevalence ; Seoul ; Serum Albumin ; Steroids ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common diseases of the digestive system, with a worldwide prevalence of approximately 20%. However, studies on constipation-predominant IBS in the elderly are scarce. Since Korea has the highest elderly population, with 38.2% of its population expected to be aged over 65 years by the year 2050, a study on the presence of IBS in this population is warranted. METHODS: In the present study, IBS was defined and classified according to the Rome III criteria. This study was performed by using the case and control method at the outpatient Department of Family Medicine and the health promotion center of a hospital in Gwangju. The questionnaire for the demographic characteristics and dietary habits was administered to 128 patients with IBS and 193 controls. RESULTS: Individuals who had a tendency of overeating for >3 days a week, compared to those who had a tendency of overeating for <2 days a week; those who had spicy food for >3 days a week, compared to those who had it for <2 days a week; and the time of meals showed statistically significant results. Meanwhile, the number and regularity of meals and having breakfast were not relevant factors. CONCLUSION: The weekly frequency of overeating and intake of spicy food as well as short time for meals are related to constipation-predominant IBS in the elderly aged above 65 years.
Aged* ; Breakfast ; Constipation ; Digestive System ; Food Habits* ; Gwangju ; Health Promotion ; Humans ; Hyperphagia ; Irritable Bowel Syndrome* ; Korea ; Meals ; Methods ; Outpatients ; Prevalence