• Title/Summary/Keyword: Advancing age

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The Prognostic Factors of Solitary Pulmonary Nodule (고립성 폐결절의 예후에 관여하는 인자)

  • Jeong, Yun-Seop;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.425-435
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    • 1989
  • The solitary pulmonary nodule is considered as a round or ovoid lesion with sharp, circumscribed borders, surrounded by normal appearing lung parenchyme on all sides, and found on a simple chest X-ray without any particular symptoms or signs. There is a wide spectrum of pathologic conditions in the solitary pulmonary nodules prove to be malignant tumors, either primary or metastatic. Most Benign granulomas and other benign conditions can also be seen as solitary nodules. The resection of solitary malignant nodules results in a surprisingly high 5-year survival rate. On the contrary, most benign nodules do not need to be resected and a period of prolonged observation and nonsurgical management is usually indicated. Therefore, the best approach to the controversial management of solitary pulmonary nodules depends on finding factors affecting the probability of malignancy. In this article, clinical records and chest roentgenographies of 60 patients operated on over the past 8 years at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital were reviewed. There were 15 malignant nodules and 45 benign nodules and the prevalence of malignancy was 25%. The most common pathologic entity was tuberculoma [21 cases]. The mean age was 55.5*9.6 years in the malignant group, 45.8>12.5 years in the benign group and there was a significant statistical difference between the two groups [P < 0.05]. The malignant ratio in each age group increased with advancing age. The average smoking amount was 35.6*12.9 cigarettes per day in malignant smokers, 20.9* 12.0 cigarettes per day in benign smokers, and there was a significant statistical difference between the two groups [p< 0.05]. The malignant ratio also increased with the increasing smoking amount. Comparing the appearance of the nodule on chest films, 6 calcifications and 7 cavitations were found only in benign nodules, not in malignant nodules. Therefore, calcification and cavitation can be considered as preferential findings for benignity. Previous cancer history was also a significant factor deciding the prognosis of the nodule [p< 0.05]. The average diameter on chest X-ray was 3.07*0.82 cm in malignant nodules, 3.25*1.04 cm in benign nodules and there was no significant statistical difference between the two groups [p< 0.05]. The author used Bayes theorem to develop a simple method for combining individual clinical or radiological factors of patients with solitary nodules into an overall estimate of the probability that the nodule is malignant. In conclusion, patient age, smoking amount, appearance of nodule on chest film such as calcification and cavitation, and previous cancer history were found to be strongly associated with malignancy, but size of nodule was not associated with malignancy. Since these prognostic factors have been found retrospectively, prospective controlled studies are needed to determine whether these factors have really prognostic significance.

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An Exploration on Prescription of Resistance Training for Geriatric Physical Therapy (노인물리치료를 위한 저항트레이닝 처방에 대한 탐색)

  • Shin Hong-Cheul;Jeong Dong-Hyuk
    • The Journal of Korean Physical Therapy
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    • v.15 no.1
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    • pp.61-81
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    • 2003
  • There can be little dissension that the ultimate goal of all physical therapy interventions with the elderly is to restore or maintain the highest level of function possible for the individual. Whenever physical therapists take on this challenge, they assist elders in maintaining their identities as competent adults. Advancing age is associated with profound changes in body composition, including increased fat mass, decreased fat-free mass(particularly muscle), decreased total body water and decreased bone density. Along with these changes in body compositions, and perhaps as a direct result of them, elderly people have lower energy needs, reduced strength and functional capacity and a greatly increased risk for such diseases as noninsulin-dependent diabetes mellitus and osteoporosis. Resistance training is considered a promising intervention for reversing the loss of muscle function and the deterioration of muscle structure that is associated with advanced age. This reversal is thought to result in improvements in functional abilities and health status in the elderly by increasing muscle mass, strength and power and by increasing bone mineral density. In the past couple of decades, many studies have examined the effects of Resistance training on risk factors for age-related diseases or disabilities. We have explored the positive and negative aspects of older adults' participation in resistance training programs. The benefits to older adults are reported to be increased strength, endurance, muscle capacity, and flexibility; more energy; and improved self-image and confidence. The negative aspects include some pain or stiffness and other nonspecific problems. The positive and negative aspects of resistance training are therefore very similar to those in younger populations. Scientific investigations over the past 10 years have demonstrated that resistance training can be safely and successfully implemented in older populations. Even the frail and very sick elderly can benefit and improve their quality of life. Proper design and progression of a resistance training program for older adults is vital to optimal benefits from resistance exercise. The results of data provided by this research on resistance training for health shows that there is enough existing evidence to conclude that resistance training, particularly when incorporated into a comprehensive fitness program, can offer substantial health benefits which can be obtained by persons of all ages. These benefits, including improvements in functional capacity, translate into an improved quality of life.

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Aortic Unfolding Measurement Using Non-Contrast Cardiac CT: Normal Range of Low-Risk Subjects (관상동맥 석회화 CT에서 측정한 대동맥 전개: 저위험 환자군에서의 정상 범위)

  • Ji Won Lee;Byoung Wook Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.360-371
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    • 2022
  • Purpose This study aimed to assess the factors influencing aortic unfolding (AU) defined by aortic width on coronary artery calcium (CAC) scan and determine the normal limits for AU. Materials and Methods In this retrospective study, we measured AU in 924 asymptomatic subjects who underwent CAC scanning during routine health screening from June 2015 to June 2018. Multivariate regression analysis was used to evaluate the factors influencing AU. After the exclusion of subjects with risk factors associated with AU, 283 subjects were included in the analysis of normal values of AU. Mean AU, standard deviation, and upper normal limit were calculated. Results Sex, age, CAC score, body mass index, body surface area, hypertension, left ventricular hypertrophy, plasma creatinine, and smoking were significantly associated with AU. The mean AU was 102.2 ± 12.8 mm for men and 93.1 ± 10.7 mm for women. AU increased with advancing age (9.6 mm per decade). Conclusion AU determined from a single measurement on CAC scans was associated with cardiovascular risk factors. The normal limits of AU were defined by age, sex, and body surface area in low-risk subjects in this study.

A Study on the Brand Characteristics According to Trends in the Children's Apparel Market

  • Han, Gyung-Hee
    • Journal of Fashion Business
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    • v.9 no.6
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    • pp.160-174
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    • 2005
  • Despite the decrease in the number of children due to low birth rate, the domestic children's apparel market has been achieving steady growth as family income is rising thanks to more opportunities for working women, parents spend more on their children, and they prefer brand products that make their children look special. In addition, the market is suffering from hard competition as large enterprises have joined the race. The present study purposed to survey the children's apparel market in Korea, which is in a transitional period, and to contribute to the development of the market with Korean brands. For this purpose, we analyzed the characteristics of children's apparel brands in the 21st century based on the current state of the domestic children's apparel market and, based on the findings, forecasted the future trend of children's apparel brands, suggested improvements for expected problems, proposed standards for coping with changes such as diversification, high quality and differentiation in the children's apparel market, and provided consumers with information on how to purchase products. According to the result of analyzing the characteristics of children's apparel brands in the 21st century, brands are categorized largely into four types - life cultural brands, functional product brands, character brands and brands advancing to China. Life cultural brands equipped with all necessities for children are expanding, and with the deepening social problems of environmental pollution and the reduction of the child population, functional products made of environment-friendly materials are spreading widely, targeting infants and children. Furthermore, for extending age targets and diversifying products, children's apparel is using characters. The use of characters is expected to have a considerable effect on the growth of brands because children are more subjective as consumers than before and they are more easily persuaded with characters. Domestic children's apparel brands advancing to China have a high expectation of success in overcoming the limitation of the local market that has reached its peak and growing into global brands. Korean apparel makers are struggling to overcome the depressed domestic market, to recover consumers' consumption, to cope with market opening, to pursue high value of sensibility and to expand the seniors' market, etc. In this situation, future trends of children's apparel brands will be the expansion of family brands, brand totalization, quality price, niche market (pre-teen market), etc. In response to these trends, we made the following suggestions for improvement. 1. Children's apparel brands are evolving into family brands as well as into total brands through voluming. Today, however, apparel makers are advancing to the children's apparel market with the concept of adults' apparel and, as a result, children's apparel is merely adults' apparel of reduced size, having problems in design, color and materials. Thus, apparel makers must develop design considering the wide range of size and the characteristics of children's apparel, strengthen sourcing abilities to create revenues, and make thorough survey of customers to find common denominators between adults' apparel and children's apparel considering that characteristic that the target class is different from the buyer class. Furthermore, they must make active investments in human resources, develop outstanding products through advanced planning and design, and support marketing techniques and management systems to stores. 2. As the declining birth rate will continue to have a negative effect on the market, it may be difficult to expand the market size but there is still a margin for growth through high-sensibility and high-quality products. The competitiveness of brands is determined by their market shares. Accordingly, concepts should be specialized according to lifestyle, customers' diverse needs should be satisfied, and cross-coordination should be achieved within a brand. 3. Considering Korean parents who do not spare investment in their children despite shrinking consumption, functional products must be high value-added goods that can enhance efficiency. However, in the current situation of the infants' apparel industry where a textile manufacturer supply its products to multiple brands, it is difficult to develop unique products only based on materials. Thus, it is considered urgent to appeal to consumers not by relying on materials only but by finding methods of applying their own characters to children's dress.

A RADIOGRAPHIC STUDY OF HYPERCEMENTOSIS (과백악질증에 관한 X선학적 연구)

  • Kim Si Hyun;Hwang Eui Hwan;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.2
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    • pp.249-259
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    • 1991
  • The purpose of this study was to evaluate the incidence and radiographic features of 677 cases of hypercementosis by means of the analysis of full mouth periapical radiograms in 4,236 persons visited the Department of Oral Radiology, School of Dentistry, Kyung Hee University during January 1984 to December 1989. The obtained results were as follows: 1. The incidence of hypercementosis was revealed to be 8.2% in total examined persons, and there was a higher incidence in females (9.4%) than in males (7.1%). 2. The hypercementosis was most frequently occurred in the 6th decades (29.2%), and the incidence was increased by advancing age until 6th decades. 3. There was a higher incidence in the maxilla (59.5%) than in the mandible (40.5%), and maxillary second premolar (18.5%) was the most frequently involved tooth. The maxillary first premolar (11.7%) was next in order to frequency followed by maxillary canine (10.0%) and mandibular first and second premolars (9.6%). 4. In the etiologic factors, 35.0% were inflammation, 31.2% were elongation, 6.2% were trauma from occlusion, 0.1 % were uneruption, and 27.5% were unknown. 5. In the degree of cementum apposition, 35.3% were Type Ⅰ, 29.5% were Type Ⅱ, and 35.2% were Type Ⅲ. 6. In the status of cementum apposition, 3.2% were mesial side, 8.9% were distal side, and 87.9% were mesial & distal side. 7. In the identification of radiographic density between normal cementum and excessive cementum, 12.7% could be identified, and 87.3% could be unidentified.

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Peripheral Neuropathy Associated with Human Immunodeficiency Virus Infection (사람면역결핍바이러스 감염과 연관된 말초신경병증)

  • Lee, Min Hwan;Lim, Young-Min;Pyun, So Young;Kim, Jimin;Kim, Kwang-Kuk
    • Annals of Clinical Neurophysiology
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    • v.14 no.1
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    • pp.29-35
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    • 2012
  • Background: Peripheral neuropathy is the most frequent neurological complication in human immunodeficiency virus (HIV) infection, related with diverse etiologies including inflammation, opportunistic infection and side effects of medications. The purpose of the present study was to evaluate characteristics of HIV associated neuropathy according to the stage of HIV infection. Methods: In reviewing the medical records of HIV patients who underwent electrodiagnostic studies between 1997 and 2011, total 11 patients (all males; median age, 47 years; range, 28-71 years) with comorbid neuropathy were enrolled. Stage of HIV infection was categorized according to the Centers for Disease Control and Prevention (CDC) criteria. Classification of peripheral neuropathy was based on clinical and electrophysiological features. Results: Distal symmetric polyneuropathy was observed in 8 patients (72.7%), inflammatory demyelinating polyneuropathy in 2 patients (18.1%), and polyradiculopathy in 1 patient (9.1%). Median CD4+ T cell count was $123/mm^3$ (range, $8-540/mm^3$) and 7 patients (60%) had the most advanced HIV disease stage (CDC-C3). There was no neuropathy caused by CMV infection. Conclusions: Distal symmetric polyneuropathy was the most common type of neuropathy in HIV infection, but various forms of neuropathy such as inflammatory demyelinating polyneuropathy and polyradiculopathy were also present. HIV associated neuropathy is more frequently associated with advancing immunosuppression, although it can occur in all stages of HIV infection.

Association between Systemic Health Conditions and Self-Reported Oral Health in Korean Elderly (한국노인의 전신건강상태와 주관적 구강건강 관련성)

  • Choi, Eun Sil;Lyu, Jiyoung;Patton, Lauren L.;Kim, Hae-Young
    • Journal of dental hygiene science
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    • v.17 no.1
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    • pp.56-64
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    • 2017
  • Systemic health conditions increase with advancing age, and may be linked to poor self-reported oral health. The purpose of this study was to evaluate the association between systemic health conditions and poor self-reported oral health among Korean elderly. The study used a nationally representative sample of Koreans (2012 Korea National Health and Nutrition Examination Survey) aged 65~98 years (n=1,595). Systemic health conditions in this population were assessed by the presence of one or more of the following conditions: obesity, hypertension, diabetes, and hypercholesterolemia. The relative risk of poor self-reported oral health according to the occurrence of systemic health conditions was estimated by multivariate logistic regression after controlling for several potential confounders (i.e., socio-demographic factors, oral health behaviors, health behaviors, and psychological factors). After adjustment for these confounders, the relative risk of having poor self-reported oral health was greater among the elderly with one or more systemic health conditions than in those without a systemic health condition. The odds ratio of having poor self-reported oral health according to the occurrence of systemic health conditions was 1.51 (95% confidence interval, 1.08~2.12). Among the Korean elderly, perception of poor oral health was associated with the presence of one or more systemic health conditions. Future studies are needed to examine the detailed causal relation between systemic health conditions and poor oral health longitudinally.

Prediction of the Environmental Conditions in Underground Tunnelling Spaces (地下터널 굴착作業場內 作業環境豫測)

  • Park, Hee-Bong
    • Tunnel and Underground Space
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    • v.2 no.1
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    • pp.116-122
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    • 1992
  • A comprehensive, nonsteady state, computer simulation program for the environmental conditions in advancing tunnels (the HEADSIM simulation program) is constructed and successfully validated with heat balance amongst all heat sources, and with mass conservation amongst various airflows including the leakage air from ducts, under timedependent variations of inlet air conditions. which include sudden, diurnal and seasonal changes. Heat conduction in the wall strata and face strata is simulated with most complicated boundary conditions using the finite difference method, and the climatic conditions in roadway sections which contain air ducts, booster fan, spray cooler, compressed air pipes, cold water pipes, return water pipes, machinery and broken rock are simulated taking into account the variations of face operation and the heat storage mechanism in the strata. The limitations of simulation time steps and roadway section lengths are defined according to the stability criteria satisfying the principles of thermodynamics. Variations of heat transfer coefficients, which are newly set, and those of wetness factors are taken into account according to the variations of other parameters and the stepwise advance of the face. Newly-derived formulae are used for computing the air duct leakage and the pressure inside of the duct. A new concept of an 'imaginary duct' is introduced to simulate the climatic conditions in tunnels during holiday periods, which directly affect conditions on subsequent working days under the consideration of natural convection. A subsidiary program (the WALLSIM simulation program) is made to compute the dimensionless tunnel surface temperatures and to compare the results with those from analytical approaches, and to demonstrate the stability, convergence and accuracy of the strata heat conduction simulation, adopting the finite difference method. The WALLSIM also has wide applications, including those for the computation of age coefficients.

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Efficacy of Transradial Cerebral Angiography in the Elderly

  • Park, Jung-Hyun;Kim, Dae-Yong;Kim, Jin-Wook;Park, Yong-Seok;Seung, Won-Bae
    • Journal of Korean Neurosurgical Society
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    • v.53 no.4
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    • pp.213-217
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    • 2013
  • Objective : Transradial angiography has become popular among many cardiologists as a diagnostic and therapeutic tool. However, transradial cerebral angiography is not utilized to the same extent. The purpose of this study is to present our experience regarding the usefulness of transradial cerebral angiography, especially in elderly patients. Methods : Between May 2011 and February 2012, a total of 126 cerebral angiographies were performed via a transradial approach in a single center. Of them, only 47 patients were over 60 years old. In our institution, we shifted the initial access from the right femoral artery to the right radial artery in all patients requiring cerebral angiography in 2011. We did not attempt radial access in 40 cases for variable reasons. Results : The procedural success rate was 92.2%. We have four failures of transradial angiography; two because of loop formations of the radial and brachial artery and two due to multiple puncture failures. All supra-aortic vessels were successfully catheterized. However, the selective catheterization rates of the left side distal vessels were lower, as success rates were 89.7% for the right internal carotid artery and 75% for the left internal carotid artery. Procedure-related vascular complications, such as puncture site hematoma, hand ischemia, pseudoaneurysm, arteriovenous fistula and arterial dissection were not observed in our series. However, intraprocedural thrombosis developed in one patient, which was resolved completely by intraarterial thrombolytic agents. Conclusion : With advancing patient's age, we believe that transradial cerebral angiography is a useful tool to decrease patient's discomfort and more effectively manage the vessel tortuosity.

A case of pseudohypoaldosteronism type 1 with a mutation in the mineralocorticoid receptor gene

  • Lee, Se-Eun;Jung, Yun-Hye;Han, Kyoung-Hee;Lee, Hyun-Kyung;Kang, Hee-Gyung;Ha, Il-Soo;Choi, Yong;Cheong, Hae-Il
    • Clinical and Experimental Pediatrics
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    • v.54 no.2
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    • pp.90-93
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    • 2011
  • Pseudohypoaldosteronism type 1 (PHA1) is a rare form of mineralocorticoid resistance characterized in newborns by salt wasting with dehydration, hyperkalemia and failure to thrive. This disease is heterogeneous in etiology and includes autosomal dominant PHA1 owing to mutations of the NR3C2 gene encoding the mineralocorticoid receptor, autosomal recessive PHA1 due to mutations of the epithelial sodium channel (ENaC) gene, and secondary PHA1 associated with urinary tract diseases. Amongst these diseases, autosomal dominant PHA1 shows has manifestations restricted to renal tubules including a mild salt loss during infancy and that shows a gradual improvement with advancing age. Here, we report a neonatal case of PHA1 with a NR3C2 gene mutation (a heterozygous c.2146_2147insG in exon 5), in which the patient showed failure to thrive, hyponatremia, hyperkalemia, and elevated plasma renin and aldosterone levels. This is the first case of pseudohypoaldosteronism type 1 confirmed by genetic analysis in Korea.