• The Korean Journal of Physiology and Pharmacology
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• v.25 no.5
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• pp.425-437
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• 2021

Although the contributions of sitagliptin to endothelial dysfunction in diabetes mellitus were previously reported, the mechanisms still undefined. Autophagy plays an important role in the development of diabetes mellitus, but its role in diabetic macrovascular complications is unclear. This study aims to observe the effect of sitagliptin on macrovascular endothelium in diabetes and explore the role of autophagy in this process. Diabetic rats were induced through administration of high-fat diet and intraperitoneal injection of streptozotocin. Then diabetic rats were treated with or without sitagliptin for 12 weeks. Endothelial damage and autophagy were measured. Human umbilical vein endothelial cells were cultured either in normal glucose or in high glucose medium and intervened with different concentrations of sitagliptin. Rapamycin was used to induce autophagy. Cell viability, apoptosis and autophagy were detected. The expressions of proteins in c-Jun N-terminal kinase (JNK)-Bcl-2-Beclin-1 pathway were measured. Sitagliptin attenuated injuries of endothelium in vivo and in vitro. The expression of microtubuleassociated protein 1 light chain 3 II (LC3II) and beclin-1 were increased in aortas of diabetic rats and cells cultured with high-glucose, while sitagliptin inhibited the over-expression of LC3II and beclin-1. In vitro pre-treatment with sitagliptin decreased rapamycin-induced autophagy. However, after pretreatment with rapamycin, the protective effect of sitagliptin on endothelial cells was abolished. Further studies revealed sitagliptin increased the expression of Bcl-2, while inhibited the expression of JNK in vivo. Sitagliptin attenuates injuries of vascular endothelial cells caused by high glucose through inhibiting over-activated autophagy. JNK-Bcl-2-Beclin-1 pathway may be involved in this process.

• Journal of Korean geriatric psychiatry
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• v.21 no.1
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• pp.35-40
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• 2017

Objective : This study aimed to investigate the effect of community-based Goal-Achieving program in geriatric depressive symptoms preliminarily. Methods : We obtained data from elderly Korean subjects with major depressive disorder (n=51) aged 60 years or older at baseline, taking case management from community mental health center. Subjects were randomly assigned to intervention group (n=24) and control group (n=27). We investigated depressive symptoms through Short Form Geriatric Depression Scale-Korean version (SGDS-K) at baseline and every month for 3 months to all subjects. We tested interaction between group and time in SGDS-K score to evaluate the effect of program. And post hoc test examined between group differences of SGDS-K at each time points. Results : In quadratic linear mixed effects model analysis, interaction between group and time was statistically significant (Total SGDS-K score : coefficient=0.29, p<0.001 ; SGDS-K dysphoria subscale : 0.18, p<0.001 ; SGDS-K hopelessness subscale : 0.05, p=0.089 ; SGDS-K cognitive impairment subscale : 0.06, p=0.003). And significant between group difference was shown in post hoc test at time points of third month (SGDS-K score of control group : SGDS-K score of intervention group=$10.74{\pm}3.482$ : $7.25{\pm}4.475$, p=0.0184). Conclusion : These results may suggest that 'Community-based the Goal-Achieving program' has efficacy in reducing geriatric depressive symptoms.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.1-8
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• 2017

Cancer is the disease of aging and Korea is one of the fastest aging country in the world. Older patients have decreased organ function and stress tolerance, therefore are at high risk of functional decline and developing complication from cancer and cancer treatment. Before beginning cancer treatment, it is important to assess patients' life expectancy, whether the patient is likely to die of cancer or of other comorbidity, and also the risks with cancer treatment. In order to estimate patient's physiologic age, it is recommended to perform geriatric assessment and implement appropriate geriatric intervention together with meticulous supportive care, when planning cancer treatment for older patients. In a resource limited country such as Korea, two step approach of applying screening tool followed by geriatric assessment can be more efficient. Geriatric assessment is used to predict toxicity from cancer treatment such as surgery, radiotherapy, and chemotherapy, predict survival, and also to aid treatment decision. Number of randomized trials are ongoing to compare usual care versus oncogeriatric care, and with these results we expect to improve outcome of older patients with cancer.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.5
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• pp.414-421
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• 2004

This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone & joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy & eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis & periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision & drainage, only drugs, pulp capping, restoration in order.

• 한국노년학
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• v.28 no.4
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• pp.1129-1145
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• 2008

In order to develop practical implications for depression among the elderly, this study examines socioeconomic and health-behavioral risk factors of geriatric depression diagnosis. Sample consists of 964 elders aged 65 and over, living in an urban community. Using the Short-form Geriatric Depression Scale(SGDS), study subjects were screened for geriatric depression to those who presented 10 points and over in SGDS. Descriptive statistics shows that about 22.2% elders are estimated to suffer from geriatric depression. Predictors of geriatric depression diagnosis were examined through logistic regression. Results show that elders who live with family, who have medical insurance, who have higher education, who don't smoke, and who do more physical activities were less likely to suffer from geriatric depression. These findings indicate that socioeconomic position such as health insurance, education and health behaviors such as smoking, physical activities are closely related to geriatric depression, suggesting that interventions on socioeconomic position and health behaviors may be effective to reduce depression among the elderly.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.101-107
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• 2014

Purpose: Recently, the population of elderly people has been increasing rapidly all over the world. The social activities of the aging population have increased, which has also increased the number of elderly patients injured in traffic accidents. Thus, we analyzed the characteristics of elderly patients involved in traffic accidents. Methods: This study was conducted retrospectively from July 2008 to March 2009 among trauma patients involved in traffic accidents who visited Wonju Severance Christian Hospital. Patients under 18 years of age and pregnant patients were excluded. We divided the patients in two groups, a geriatrics group and an adult group on the basis of an age of 65. We compared the types of traffic accidents, the locations of the accidents, the behaviors of the patients at the times of the accidents, the use of seat-belts, and alcohol consumption between the two groups. We calculated the Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) for each group. Results: Total number of the included patients was 903, and the number of elderly patients was 181 (mean age: $71.7{\pm}4.9$ years old). There were no significant differences in the initial vital signs, GCS (Glasgow Coma Scale), and RTS between the two groups. There were differences in the types and the locations of the crashes, the behaviors of the patients at the times of the accidents, the use of seat belts, and alcohol consumption between the two groups (p<0.05). The average ISS of the geriatric group was higher than that of the adult group ($9.66{\pm}10.11$ vs. $6.59{\pm}8.99$, p=0.004). The mortality was higher in the geriatric group (n=17,9%) than in the adult group (n=23,2%) (p=0.004). Conclusion: The numbers of mortalities and surgical procedures were greater within the elderly group than the adult group. The average ISS was higher in the geriatric group than in the adult group. The severity of injuries due to traffic accidents was higher in the geriatric group than it was in the adult group.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.684-690
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• 2017

Objective : As increasing the size of the geriatric population, the number of elderly patients, who need the surgery for painful degenerative spinal stenosis has been increasing. The geriatric population may be relatively high complications, because of age and age-associated medical conditions. However, there is a lack of studies addressing the perioperative complications and outcomes in elderly patients with posterior lumbar inter body fusion with screw augmentation (PLIF). Methods : We retrospectively reviewed the medical records and radiographic studies of geriatric patients who had spine surgery of PLIF due to spinal stenosis for 11 years. We divided into 2 groups (A; 70-75 years, B; over then 76 years) according to the age. Surgical level of each groups, hospital day and postoperative day, co-morbidities, complications, clinical outcomes were analyzed. Operative reports, hospital and outpatient clinic charts, and radiographic studies were reviewed. Results : Group A was composed of 80 patients, their mean age was 72.21 and female dominant (n=46), and their mean surgically fused level was 1.52 level. Group B was 36 patients, their mean age was 78.83 and female dominant (n=20), and their mean surgically fused level was 1.36 level. Comparing between two groups, complications, postoperative hospital stay were slightly increase in group B and co-morbidity was statistically high in group B, however clinical outcomes were similar between two groups. Conclusion : Increasing age might be an important risk factor for complications in patients undergoing PLIF, however, we would like to recommend that if the situation of spine of extreme geriatric patients need PLIF, it should be in the surgeon's consideration after careful selection and clinical judgement.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2643-2648
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• 2016

Background: High-sensitivity C-reactive protein (hsCRP) levels are lower in Japanese compared with Western subjects. Since it is uncertain whether hsCRP is a potent predictor of mortality at low CRP concentrations, the present study examined associations with all-cause and cause-specific mortality in a large population of Japanese. Materials and Methods: Subjects were 4,737 men and 6,343 women aged 49-76 years participating in the baseline survey of an ongoing cohort study of lifestyle-related diseases between February 2004 and July 2006. Hazard ratios for all-cause and cause-specific mortality associated with hsCRP levels were estimated using Cox proportional hazards regression. Results: A total of 436 all-cause deaths occurred during a median follow-up of 8 years. The main cause of death was cancer. In men, hsCRP levels were positively associated with the risk of all-cause mortality as well as deaths from cancer and cardiovascular disease (CVD). All-cause mortality hazards for the 2nd (0.34-0.84 mg/L) and the 3rd (${\geq}0.85mg/L$) tertiles of hsCRP were 1.27 (95% confidence interval [CI], 0.93-1.73) and 1.75 (1.30-2.37), respectively (p for trend=0.001). In women, increased risk of all-cause and cause-specific mortality associated with elevated hsCRP levels was observed, but the associations were not statistically significant. Conclusions: HsCRP may be an independent predictor of all-cause, cancer and CVD mortality in apparently healthy Japanese men, but not women. The differential effect of hsCRP in predicting mortality risk by sex warrants further investigation.

• Annals of Laboratory Medicine
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• v.38 no.6
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• pp.503-511
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• 2018

Background: Sampling a healthy reference population to generate reference intervals (RIs) for complete blood count (CBC) parameters is not common for pediatric and geriatric ages. We established age- and sex-specific RIs for CBC parameters across pediatric, adult, and geriatric ages using secondary data, evaluating patterns of changes in CBC parameters. Methods: The reference population comprised 804,623 health examinees (66,611 aged 3-17 years; 564,280 aged 18-59 years; 173,732 aged 60-99 years), and, we excluded 22,766 examinees after outlier testing. The CBC parameters (red blood cell [RBC], white blood cell [WBC], and platelet parameters) from 781,857 examinees were studied. We determined statistically significant partitions of age and sex, and calculated RIs according to the CLSI C28-A3 guidelines. Results: RBC parameters increased with age until adulthood and decreased with age in males, but increased before puberty and then decreased with age in females. WBC and platelet counts were the highest in early childhood and decreased with age. Sex differences in each age group were noted: WBC count was higher in males than in females during adulthood, but platelet count was higher in females than in males from puberty onwards (P <0.001). Neutrophil count was the lowest in early childhood and increased with age. Lymphocyte count decreased with age after peaking in early childhood. Eosinophil count was the highest in childhood and higher in males than in females. Monocyte count was higher in males than in females (P <0.001). Conclusions: We provide comprehensive age- and sex-specific RIs for CBC parameters, which show dynamic changes with both age and sex.