OBJECTIVES: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. METHODS: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. RESULTS: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092–1.183) for diagnosis of diabetes, 1.278 (1.278–1.386) for diagnosis of dyslipidemia, 0.940 (0.904–0.977) for diagnosis of arthritis, 0.785(0.736–0.837) for treatment of arthritis, 1.159 (1.116–1.203) for diagnosis of cataracts, and 1.285(1.200–1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p<0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p<0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. CONCLUSION Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.

BACKGROUND: A 9-year-old male showed severe defects in midface structures, which resulted in maxillary hypoplasia, ocular hypertelorism, relative mandibular prognathism, and syndactyly. He had been diagnosed as having Apert syndrome and received a surgery of frontal calvaria distraction osteotomy to treat the steep forehead at 6 months old, and a surgery of digital separation to treat severe syndactyly of both hands at 6 years old. Nevertheless, he still showed a turribrachycephalic cranial profile with proptosis, a horizontal groove above supraorbital ridge, and a short nose with bulbous tip. METHODS: Fundamental aberrant growth may be associated with the cranial base structure in radiological observation. RESULTS: The Apert syndrome patient had a shorter and thinner nasal septum in panthomogram, PA view, and Waters’ view; shorter zygomatico-maxillary width (83.5 mm) in Waters’ view; shorter length between the sella and nasion (63.7 mm) on cephalogram; and bigger zygomatic axis angle of the cranial base (118.2°) in basal cranial view than a normal 9-year-old male (94.8 mm, 72.5 mm, 98.1°, respectively). On the other hand, the Apert syndrome patient showed interdigitating calcification of coronal suture similar to that of a normal 30-year-old male in a skull PA view. CONCLUSION: Taken together, the Apert syndrome patient, 9 years old, showed retarded growth of the anterior cranial base affecting severe midface hypoplasia, which resulted in a hypoplastic nasal septum axis, retruded zygomatic axes, and retarded growth of the maxilla and palate even after frontal calvaria distraction osteotomy 8 years ago. Therefore, it was suggested that the severe midface hypoplasia and dysostotic facial profile of the present Apert syndrome case are closely relevant to the aberrant growth of the anterior cranial base supporting the whole oro-facial and forebrain development.
Acrocephalosyndactylia ; Adult ; Child ; Exophthalmos ; Forehead ; Hand ; Humans ; Hypertelorism ; Male ; Maxilla ; Nasal Septum ; Nose ; Osteotomy ; Palate ; Prognathism ; Prosencephalon ; Skull ; Skull Base ; Sutures ; Syndactyly

Fimasartan, a new angiotensin II receptor antagonist, reduces myocyte damage and stabilizes atherosclerotic plaque through its anti-inflammatory effect in animal studies. We investigated the protective effects of pretreatment with fimasartan on ischemia-reperfusion injury (IRI) in a mouse model of ischemic renal damage. C57BL/6 mice were pretreated with or without 5 (IR-F5) or 10 (IR-F10) mg/kg/day fimasartan for 3 days. Renal ischemia was induced by clamping bilateral renal vascular pedicles for 30 min. Histology, pro-inflammatory cytokines, and apoptosis assays were evaluated 24 h after IRI. Compared to the untreated group, blood urea nitrogen and serum creatinine levels were significantly lower in the IR-F10 group. IR-F10 kidneys showed less tubular necrosis and interstitial fibrosis than untreated kidneys. The expression of F4/80, a macrophage infiltration marker, and tumor necrosis factor (TNF)-α, decreased in the IR-F10 group. High-dose fimasartan treatment attenuated the upregulation of TNF-α, interleukin (IL)-1β, and IL-6 in ischemic kidneys. Fewer TUNEL positive cells were observed in IR-F10 compared to control mice. Fimasartan caused a significant decrease in caspase-3 activity and the level of Bax, and increased the Bcl-2 level. Fimasartan preserved renal function and tubular architecture from IRI in a mouse ischemic renal injury model. Fimasartan also attenuated upregulation of inflammatory cytokines and decreased apoptosis of renal tubular cells. Our results suggest that fimasartan inhibited the process of tubular injury by preventing apoptosis induced by the inflammatory pathway.
Animals ; Apoptosis* ; Blood Urea Nitrogen ; Caspase 3 ; Constriction ; Creatinine ; Cytokines ; Fibrosis ; In Situ Nick-End Labeling ; Interleukin-6 ; Interleukins ; Ischemia ; Kidney ; Macrophages ; Mice ; Muscle Cells ; Necrosis ; Plaque, Atherosclerotic ; Receptors, Angiotensin ; Reperfusion Injury* ; Tumor Necrosis Factor-alpha ; Up-Regulation

OBJECTIVES: In an effort to improve hearing aid users’ satisfaction, recent studies on trainable hearing aids have attempted to implement one or two environmental factors into training. However, it would be more beneficial to train the device based on the owner’s personal preferences in a more expanded environmental acoustic conditions. Our study aimed at developing a trainable hearing aid algorithm that can reflect the user’s individual preferences in a more extensive environmental acoustic conditions (ambient sound level, listening situation, and degree of noise suppression) and evaluated the perceptual benefit of the proposed algorithm. METHODS: Ten normal hearing subjects participated in this study. Each subjects trained the algorithm to their personal preference and the trained data was used to record test sounds in three different settings to be utilized to evaluate the perceptual benefit of the proposed algorithm by performing the Comparison Mean Opinion Score test. RESULTS: Statistical analysis revealed that of the 10 subjects, four showed significant differences in amplification constant settings between the noise-only and speech-in-noise situation (P<0.05) and one subject also showed significant difference between the speech-only and speech-in-noise situation (P<0.05). Additionally, every subject preferred different β settings for beamforming in all different input sound levels. CONCLUSION: The positive findings from this study suggested that the proposed algorithm has potential to improve hearing aid users’ personal satisfaction under various ambient situations.
Acoustics ; Classification ; Hearing Aids* ; Hearing* ; Humans ; Noise ; Patient Preference ; Personal Satisfaction ; Signal Processing, Computer-Assisted

OBJECTIVES: The clinical effects of the simultaneous application of nonlinear frequency compression and dichotic hearing on people with hearing impairments have not been evaluated previously. In this study, the clinical effects of the simultaneous application of these two techniques on the recognition of consonant-vowel-consonant (CVC) words with fricatives were evaluated using normal-hearing subjects and a hearing loss simulator operated in the severe hearing loss setting. METHODS: A total of 21 normal-hearing volunteers whose native language was English were recruited for this study, and two different hearing loss simulators, which were configured for severe hearing loss in the high-frequency range, were utilized. The subjects heard 82 English CVC words, and the word recognition score and response time were measured. RESULTS: The experimental results demonstrated that the simultaneous application of these two techniques showed almost even performance compared to the sole application of nonlinear frequency compression in a severe hearing loss setting. CONCLUSION: Though it is generally accepted that dichotic hearing can decrease the spectral masking thresholds of an hearing-impaired person, simultaneous application of the nonlinear frequency compression and dichotic hearing techniques did not significantly improve the recognition of words with fricatives compared to the sole application of nonlinear frequency compression in a severe hearing loss setting.
Dichotic Listening Tests ; Hearing Loss ; Hearing* ; Humans ; Masks ; Reaction Time ; Signal Processing, Computer-Assisted ; Volunteers

No abstract available.
Gynecology/*organization & administration/*standards ; Humans ; Patient Escort Service/*organization & administration/*standards ; Physical Examination/*methods/*standards ; Physicians/*ethics ; Sex Factors

Neoadjuvant imatinib therapy used to treat locally advanced or metastatic gastrointestinal stromal tumors (GI ST) remains under active investigation. We studied three cases of locally advanced gastric GISTs treated with imatinib on a neoadjuvant basis, followed by a complete surgical resection. Three patients were diagnosed with locally advanced unresectable GIST of the stomach and were started on imatinib 400 mg/day. After the imatinib treatment, partial responses were achieved in all patients and the tumors were considered resectable. Surgical resection was done after 7, 11, and 8 months of imatinib therapy, respectively. In one case, a metastatic liver lesion was detected during the imatinib treatment using computed tomography scans, so the imatinib therapy was maintained for 11 months postoperatively. In the other two patients without distant metastasis, imatinib treatment was not restarted after surgery. Mutational analysis revealed a mutation in exon 11 of the c-kit gene in two patients, and wild-type c-kit and PDGFRA in one patient. During pathology review of all three cases, we noted several features common to imatinib treatment. There was no evidence of tumor recurrence in all three patients at respective follow-up visits of 22, 15, and 7 months. These results suggest that the neoadjuvant imatinib therapy is a potentially curative approach for selected patients with locally advanced GIST.
Exons ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Humans ; Liver ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Pathology ; Recurrence ; Stomach* ; Imatinib Mesylate

BACKGROUN: Talc sclerotherapy is widely used for symptomatic malignant pleural effusion. The object of this study was to evaluate the outcome of talc slurry sclerotherapy, and to compare the efficacy of the small-bore catheter with that of chest tube in sclerotherapy of malignant pleural effusion. METHODS: From January 2000 to May 2002, 37 patients with malignant pleural effusion were enrolled and randomized to the chest tube (28F, n=17) or the small-bore catheter (14F, n=20) groups. The majority of patients had lung cancer (n=33, 89%) and two had breast cancer. The median age was 55 years. After verification of reexpansion of lung on chest radiogram. five grams of purified asbestos-free talc in 50 mL of normal saline were used for talc slurry sclerosis. The success of the procedure was defined as daily drainage below 50 mL within 1 week after talc slurry instillation. Side effects of the sclerotherapy and complications were compared by the drainage method and the recurrence rates in 3, 6 and 9 months were evaluated. RESULTS: Initial success rates of sclerotherapy by small-bore catheter was 80% and that of chest tube was 70.5% (p=0.07). The most common early complication after talc slurry instillation was pain followed by fever. But procedure related mortality or respiratory failure was not developed. The mean duration of drainage by small-bore catheter was 8.2days and that of chest tube was 8.8days (p=0.60). But the catheter-related complications of pain, subcutaneous infection and, emphysema were significantly less in the small-bore catheter group than the chest tube groups (15% vs 88%, 5% vs 23.5%, 0% vs 17.5% respectively) There was no statistically significant difference between the two groups in the recurrence rate at 3 months (37.5% for the small-bore catheter vs. 33.3% for the chest tube, p=0.45), 6 months (56.3% vs. 58.3%, p=0.75), and 9 months (87.5% vs. 83.3%, p=0.65). CONCLUSION: Talc slurry sclerotherapy via chest tube or small-bore catheter was a safe and effective method for the treatment of symptomatic malignant pleural effusion. But small-bore catheters are preferred to the chest tube in the sense of catheter-related complications.
Breast Neoplasms ; Catheters* ; Chest Tubes* ; Drainage ; Emphysema ; Fever ; Humans ; Lung ; Lung Neoplasms ; Mortality ; Pleural Effusion, Malignant* ; Recurrence ; Respiratory Insufficiency ; Sclerosis ; Sclerotherapy* ; Talc* ; Thorax*

PURPOSE: Neuroendocrine carcinomas of the stomach account for only about 0.3% of all gastric tumors. The prognosis of this disease is very poor compared with the common type of gastric adenocarcinoma. The purpose of this retrospective study was to review the clinicopathologic features of 18 cases of this unusual gastric tumor and to establish a treatment strategy for this tumor. MATENRIALS AND METHODS: Excluding 2 cases of non-curative resection and 1 case of operative mortality, 18 cases of typical neuroendocrine carcinoma who had curative resection from January 1991 to December 2000 at Asan Medical Center were analyzed; 6841 gastric cancer patient were treated surgically during the same period. RESULTS: The mean age at the time of diagnosis was 58.6 years (range: 35~75 yr). Sixteen patients were male, and two were female. Eleven tumors (61.1%) developed in the lower part of the stomach, three (16.7%) in the middle part, and three (16.7%) in the upper part. One tumor involved the entire stomach. Eight cases (44.4%) were Borrmann type 2, and six case (33.3%) were Borrmann type 3. The mean tumor size was 6.94 cm (range: 0.6~15 cm). Nine cases (50%) showed recurrence of the disease, and eight of them died within 20 months. Of the nine recurred cases, 7 cases (77.8%) showed liver metastasis. The mean disease-free interval was 6.8 months (range: 2.5~11 months) after surgical resection, and the mean survival was 17.9 months (range: 8~40 months) for recurrence cases. One patient with liver metastasis was treated with a liver-wedge resection just after diagnosis and was still alive for 37.5 months postoperatively. There were 9 deaths after the median follow-up period of 40 months (range: 8~72 months). CONCLUSION: Gastric neuroendocrine carcinomas frequently recur at the liver, even in early stage cancer, and have a poor prognosis. We experienced a case of successful control of hepatic metastasis by surgical resection and a case of a small cell carcinoma which was successfully controlled with systemic chemotherapy.
Adenocarcinoma ; Carcinoma, Neuroendocrine* ; Carcinoma, Small Cell ; Chungcheongnam-do ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Liver ; Male ; Mortality ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms ; Stomach*

BACKGROUND: Small cell lung cancer represents approximately 20% of all carcinomas of the lung, and is recognized as having a poor long term outcome compared to non-small cell lung cancers. Therefore, this study investigated the prognostic factors in small cell lung cancer patients in order to improve the survival rate by using the proper therapeutic methods. MATERIAL AND METHOD: The clinical data from 394 patients, who diagnosed with small cell lung cancer and treated from 1993 to 2001 at the Kosin University Gospel Hospital, were analyzed. RESULT: There were 314 male patients (79.7%), and 80 female patients (20.3%). The number of those with limited disease was 177 (44.9%), and the number of those with extensive disease was 217 (55.1%). Overall, 366 out of 394 enrolled patients had died. The median survival time was 215 days (95% CI : 192-237days). The disease stage, Karnofsky performance state, 5% body weight loss for the recent 3 months, chemotherapy regimens, and the additive chest radiotherapy were identified as being statistically significant factors for the survival time. The median survival times of the supportive care group, one anticancer therapy, and two or more treatment groups were 71 days, 211 days, and 419 days, respectively (p<0.001). The data emphasizes the importance of anticancer treatment for improving the survival time for patients. The group of concurrent chemoradiotherapy regimens (30 patients) showed a significantly longer survival time than the group given sequential chemoradiotherapy (55 patients) (528 days versus 373 days, p=0.0237). The favorable prognostic factors of the laboratory study were groups of leukocytes =8,000/mm3, ALP=200 U/L, LDH=450 IU/L, NSE=15 ng/mL, s-GOT=40 IU/L. In extensive disease, there was no difference according to the number of metastatic sites. However, the median survival time of the patients with an ipsilateral pleural effusion was longer than the patients with other metastatic sites. According to the survey periods, three groups were divided into 1993-1995, 1996-1998, and 1999-2001. The median survival time was significantly prolonged after 1999 in comparison to previous groups (177 days, 194 days, 289 days, p=0.001, 0.002, respectively). CONCLUSION: Disease stage and 5% body weight loss for the recent 3 months at the diagnostic state were significant prognostic factors. In addition, the performance status, serum ALP, LDH, NSE, CEA levels also appear to be prognostic factors. The survival time of those patients with small cell lung cancer has been prolonged in recent years. It was suggested that the use of the EP (etoposide and cisplatin) chemotherapy method and concurrent chemoradiotherapy for patients with a limited stage contributed to the improved survival time.
Body Weight ; Chemoradiotherapy ; Drug Therapy ; Female ; Humans ; Leukocytes ; Lung ; Lung Neoplasms ; Male ; Pleural Effusion ; Radiotherapy ; Small Cell Lung Carcinoma* ; Survival Rate ; Thorax