• Journal of Korean Neurosurgical Society
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• 제38권2호
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• pp.107-110
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• 2005

Objective : Lumbar spinal stenosis is increasingly recognized as a common cause of low back pain in elderly patients. Conservative treatment has been initially applied to elderly patients, however, surgical treatment is sometimes indispensable to relieve severe pain. We retrospectively examine the age-related effects on the surgical risk, and results following general anesthesia and operative procedure in geriatric patients for two different age groups of at least 65years old. Methods : Consecutive 51 patients [${\ge}$ 65years], who underwent open surgical procedure for degenerative lumbar spinal stenosis, were selected in the study. Patients were divided into two groups. Group A included all patients who were between 65 and 69years of age at the time of surgery. Group B included all patients who were at least 70years of age at the time of surgery. We reviewed medical history including preoperative American Society of Anesthesiologists[ASA] classification of physical status, anesthetic risk factor, operative time, estimated blood loss, transfusion requirements, hospital stay, operated level, and clinical outcome to look for comparisons between two age groups [$65{\sim}69$ and over 70years]. Results : In preoperative evaluation, mean anesthetic risk factor of patients was numerically similar between the groups. The American Society of Anesthesiologists classification of physical status was similar between two groups. There was no difference in operated level, operative time, estimated blood loss, hospital stay, and anesthetic risk factor between the two groups. The clinical successful outcome showed 82.7% for Group A and 81.8% for group B. The overall postoperative complication rates were similar for both group A and B. Conclusion : We conclude that advanced age per se, did not increase the associated morbidity and mortality in surgical decompression for spinal stenosis.

• 디지털융복합연구
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• 제15권9호
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• pp.435-441
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• 2017

본 연구는 미국에 거주하고 있는 한인 노인을 대상으로 현재 뉴욕 시에서 시행하고 있는 데이케어 프로그램(Adult Day Care Program)의 일환인 치료 레크리에이션의 신체적, 정신적 효과를 평가하고자 시행되었다. 연구 방법은 비동등성 대조군 사후 실험 연구로 2017년 2월부터 4월까지 진행되었다. 본 연구에 참여한 대상자는 실험군 35명, 대조군 35명이었으며 이 중 66명의 자료를 분석하였다. 본 연구에 참여한 대상자의 평균연령은 79.4세 이었으며 미국에 거주한 기간은 평균 24.6년 이었다. 치료 레크리에이션 프로그램은 데이케어센터에서 제공하는 프로그램으로서 본 연구결과, 데이케어센터 치료 레크리에이션에 참여한 노인의 일상생활 수행능력, 우울 및 외로움에 효과가 있는 것으로 나타났다. 따라서 향후 문화적 감수성을 고려한 노인 대상 다양한 치료 레크리에이션 프로그램이 개발, 운영되어져야 할 것이며 이에 대한 효과를 평가하기 위하여 근거기반 연구가 수행되어져야 할 것이다.

• Archives of Plastic Surgery
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• 제33권3호
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• pp.289-293
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• 2006

By means of microsurgical free-tissue transfer providing a large amount of required tissue, the surgeon can resect tumoral tissue more safely, which allows tumor-free margins and enhances the reliability of the ablative surgery that otherwise could not be performed radically. The morbidity of elective free-tissue transfer seems to be quite low, carrying acceptable risks for most patients. But the elderly patients are at risk for cardiac and respiratory problems, deep vein thrombosis, pulmonary emboli and infection merely as a function of age. This study was undertaken to define further risks of the elderly population with regards to free-tissue transfer. We retrospectively reviewed our experience with 110 microsurgical free-tissue transfers for head and neck reconstruction in patients greater than 60 years of age. Microsurgical procedures in all cases were preformed by the plastic and reconstructive department at Yonsei medical center. The investigated parameters were patient demographics, past medical history, American Society of Anesthesiologists(ASA) status, site and cause of defect, the free tissue transferred and postoperative complication including free-flap success or failure. There were 46 patients in the age group from 60 to 64 years, 34 patients from 65 to 70 years, and 30 patients 70 years or older. There happened 3 flap losses, resulting in a flap viability rate of 97%. Patients with a higher ASA designation experienced more medical complication(p=0.05, 0.01, 0.03 in each age group I, II, III) but not surgical complication p=0.17, 0.11, 0.54 in each age group I, II, III). And the relationship between postoperative complication and age groups was not significant. These observations suggest that major determinant for postoperative medical complication be the patient's American Society of Anesthesiologists score, and chronologic age alone should not be an exclusion criterion when selecting patients for free-tissue transfer

• Preventive Nutrition and Food Science
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• 제10권2호
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• pp.179-186
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• 2005

This study was conducted to find the gender and age differences in dietary behaviors and food consumption pattern of Korean American adults living in western parts of USA. The structured survey forms and self-administered food frequency questionnaire were used to assess dietary behavior and nutrient intakes. It was found that younger subjects kept their meal time more irregularly and skipped breakfast more often than older subjects due to lack of time. There were significant age differences in skipping meals, kind of skipping meals, and the reasons for skipping meals. Young subjects consumed more American type food while older subjects consumed more traditional Korean food. Nutrient intakes of males' except for the elderly were significantly higher in energy, protein, Fe and P than those of females'. Vitamin A and vitamin C intake were significantly higher in females. Energy ratio of carbohydrate: protein: fat was 56.2 : 16.8 : 27.0. Females consumed more plant food as their dietary sources of protein, fat, Ca and Fe, compared to males. Ca intakes of participants' were below $75\%$ of RDA except for the youngest male and $30\~49$ aged male and females. Futhermore, Ca intake was below $70\%$ after age 50 in both genders. Effective nutrition education program targeting Korean Americans in the community should be developed and implemented to increase Ca consumption.

• 한국노년학
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• 제29권2호
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• pp.611-627
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• 2009

본 연구는 한국성인자녀와 미국성인자녀의 노부모와의 관계의 질과 부양행동을 비교하였다. 이를 통하여 한국과 미국 두 나라의 성인자녀와 노부모와의 관계 및 부양에 대한 문화적인 차이를 살펴보고, 나아가 우리나라 노부모 부양의 발전 방안모색에 유용한 자료를 제공하고자 한다. 연구대상자는 만 60세 이상의 노부모가 적어도 1명이상 살아있는 성인자녀로서, 미국 캘리포니아 주의 성인자녀 320명과 한국 경상남도의 성인자녀 554명 이다. 연구결과, 성인자녀의 노부모와의 관계의 질은 미국 성인자녀가 한국 성인자녀보다 더 높게 나타났으며, 성인자녀의 노부모 부양행동은 한국 성인자녀가 미국 성인자녀보다 더 높게 나타났다. 성인자녀의 노부모부양행동에 가장 영향을 미치는 변인은 미국은 노부모부양의식으로 나타났으며, 한국은 노부모와의 관계의 질로 나타나 나라간 차이를 보였다. 본 연구 결과를 통하여 노부모 부양행동에 있어서 미국의 경우 성인자녀의 노부모부양의식의 중요성을 알 수 있었고, 우리나라의 경우 성인자녀와 노부모의 세대 간 관계의 질이 중요함을 알 수 있었으므로 향후 우리나라의 노부모 부양정책 방안과 관련하여 성인자녀- 노부모 관계의 질을 강화할 수 있는 프로그램 모색이 필요하다하겠다.

• 대한족부족관절학회지
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• 제21권3호
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• pp.93-97
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• 2017

Purpose: The aim of this study was to evaluate the radiological and clinical outcomes of scarf osteotomy for hallux valgus (HV) deformity in elderly patient with osteoporosis. Materials and Methods: A total of 58 elderly patients (mean age, 72.6 years) underwent scarf osteotomy for HV deformity between 2008 and 2015. The mean follow-up period was 24.4 months. Of the 58 patients, 42 were diagnosed with osteoporosis and 16 were diagnosed as normal. The radiological and clinical outcomes were assessed preoperatively, postoperatively, and at final follow-up, including HV angle, intermetatarsal (IM) angle, American Orthopaedic Foot and Ankle Society (AOFAS) score, patient satisfaction, visual analogue scale (VAS), and complication. Results: There was no significant difference in HV angle and IM angle between the osteoporosis group and normal bone mineral densitometry group at all time points, preoperative, postoperative, and final follow-up. Moreover, there was no statistically significant difference between the two groups with respect to the AOFAS score and VAS evaluations. In the osteoporosis group, the mean HV angle improved from $36.7^{\circ}$ preoperatively to $11.3^{\circ}$ at the time of final follow-up, and the mean IM angle improved from $13.2^{\circ}$ to $5.7^{\circ}$. The mean AOFAS score improved from 52.6 preoperatively to 89.1 at the time of final follow-up. With respect to satisfaction, 83.4% of patients were very satisfied or satisfied. There were no serious complications, and all cases showed complete union at the osteotomy site. Conclusion: We believed that scarf osteotomy is a safe, effective procedure for the correction of elderly patients with osteoporosis.

• 대한임상검사과학회지
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• 제49권2호
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• pp.121-127
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• 2017

이 연구에서는 복부비만을 가진 고령여성을 대상으로 대사증후군 동반 유무에 따른 대사증후군 위험요인과 hs-CRP와의 관련성에 대해 알아보고자 하였다. 대사증후군 진단은 AHA/NHLBI (American Heart Association/National Heart, Lung and Blood Institute) 2005년 기준에 따라 5가지 기준 중 3개 이상 해당되는 경우 대사증후군 진단군(MetS, N=77), 2개이하의 위험요인에 해당하는 경우 대조군(Absent, N=97)으로 분류하였다. hs-CRP 농도는 대사증후군 위험요인과 밀접한 관련이 있으며, 특히 복부비만(r=0.190, p=0.014), 공복혈당(r=0.240, p=0.002), HDL-콜레스테롤(r=-0.164, p=0.035)과 연관이 있음을 확인할 수 있었다. 또한 대조군보다 대사증후군 진단군에서 hs-CRP가 높게 나타났으며(p=0.007), 복부비만 상태일지라도 높은 혈당(p=0.006)과 낮은 HDL-콜레스테롤혈증(p=0.010)의 위험요인이 있는군에서 hs-CRP가 높았다. 결론적으로 복부비만이 있더라도 대사증후군 위험요인의 동반 유무에 따라 염증관련 위험도가 달라짐을 알 수 있었다.

• Journal of Korean Neurosurgical Society
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• 제37권6호
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• pp.410-415
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• 2005

Objective: The aim of our study is to evaluate the effectiveness of unilateral hemilaminectomy for bilateral decompression in elderly patients with degenerative spinal stenosis. For this purpose, we studied the co-morbid condition and clinical outcome of patients who underwent decompressive surgery using the unilateral approach technique. Methods: Thirty-four patients over 65years of age who underwent unilateral partial laminectomy for bilateral decompression from January 2000 to October 2003 were analyzed. These patients were studied for preoperative co-morbid condition and physical status according to the American Society of Anesthesiologists(ASA) classification, postoperative morphometrical change, and clinical outcomes, including visual analogue scale(VAS) score. The mean follow-up was 23months (range 6 - 48months). Results: A patient's physical status was recorded as class I, II, or III by ASA classification, which correlated to 41.2%, 44.1%, and 14.7% of patients, respectively. The cross-sectional area of the pre- and postoperative dural sac at the level of the stenosis was $52.5{\pm}19.9mm^2$ and $110.6{\pm}18.2mm^2$, respectively. The outcome was excellent in 8.8%, good in 58.8%, fair in 23.6%, and poor in 8.8% of the patients. The VAS was changed postoperatively to $3.1{\pm}1.2$. There was no operation-related transfusion yet there was no evidence of postoperative instability at the follow-up examination. Conclusion: Unilateral laminectomy for bilateral decompression, in spite of the limited exposure, can result in satisfactory decompression of the lumbar spinal stenosis and tolerable clinical outcome. This approach is thought to be appropriate for elderly patients who have a greater surgical burden.

• 대한임상검사과학회지
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• 제50권3호
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• pp.245-252
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• 2018

한국 노인을 대상으로 대사증후군 예측인자로서 혈중 Non HDL-콜레스테롤과 중성지방/HDL-콜레스테롤 비율의 임상적용 가능성을 평가하고자 하였다. 2015년 1월부터 2017년 12월까지 경기지역 종합병원의 건강검진센터를 내원하여 건강검진을 실시한 65세 이상 노인을 1,543명을 대상으로 하였다. 대사증후군은 American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI)기준에 따라 진단하였다. 복부비만은 World Health Organization (WHO) West Pacific Region에서 제시하는 아시아-태평양인의 기준을 적용하였다. Non HDL-콜레스테롤은 총콜레스테롤과 HDL-콜레스테롤의 차이로 계산하였다. 대사증후군 예측력은 Non HDL-콜레스테롤보다 중성지방/HDL-콜레스테롤 비율이 높게 나타났다. 관련요인을 보정한 후 중성지방/HDL-콜레스테롤 비율은 1사분위수보다 4사분위수의 대사증후군 발병 위험이 높았다. 또한 대사증후군 발병을 예측하는 중성지방/HDL-콜레스테롤 비율의 적정 기준값은 2.8이었다. 중성지방/HDL-콜레스테롤 비율은 대사증후군 위험을 평가하는 간단하고 실용적인 지표가 될 수 있겠다.

• 대한정형외과학회지
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• 제55권2호
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• pp.188-192
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• 2020

본 증례에서는 노인 환자에 발생한 견관절의 급성 외상성 전방 탈구에서 회전근개 파열과 동반되어 생긴 거대 Hill-Sachs 병변에 대한 치료법으로 상완 이두근 구를 통한 간접 정복과 동종 장골 삼중 피질골 이식을 시행하였다. 수술 후 6개월째, 회전근개의 치유 및 골유합을 확인하였다. 또한 American Shoulder and Elbow Surgeons (ASES) shoulder score 95점, 전방 능동 거상 155도, 외전 120도, 외전 90도에서 외회전 70도와 내회전 30도의 운동 범위로 만족스러운 임상결과를 보였다. 노인 환자에 발생한 견관절의 급성 외상성 전방 탈구에서 회전근개의 파열과 동반된 거대 Hill-Sachs 병변 대해 본 수술 방법을 고려해 볼 수 있을 것이다.