• Title/Summary/Keyword: Geriatric medicine

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Study on the Single Dose Toxicity of ShinEumHur Pharmacopuncture Injected into the Muscles of Rats

  • Jeong, Hohyun;Cha, Eunhye;Lee, Jongcheol;Lee, Seongjin;Park, Manyong;Kim, Dongwoung;Song, Bongkeun;Lee, Jongdeok;Kim, Sungchul
    • Journal of Pharmacopuncture
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    • v.19 no.4
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    • pp.350-358
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    • 2016
  • Objectives: This study was carried out to analyze the single dose toxicity of ShinEumHur (SEH) pharmacopuncture injected into the muscles of Sprague-Dawley rats. Methods: The SEH pharmacopuncture was made in a clean room at the Korean Pharmacopuncture Institute (K-GMP). After the mixing process with sterile distilled water had been completed, the pH was controlled to between 7.0 and 7.5. All experiments were conducted at Biotoxtech, an institution authorized to perform non-clinical studies under the Good Laboratory Practice (GLP) regulations. Sprague-Dawley rats were chosen for the pilot study. Doses of SEH pharmacopuncture, 0.25, 0.5 and 1.0 mL, were administered to the experimental groups, and a dose of normal saline solution, 1.0 mL, was administered to the control group. We examined the survival rate, weights, clinical signs, mean hematology parameters, mean clinical chemistry, necropsy and histopathological findings. This study was conducted under the approval of the Institutional Animal Ethics Committee. Results: No deaths or abnormalities occurred in any of the four groups. No significant changes in weight, hematological parameters or clinical chemistry between the control group and the experimental groups were observed. To check for abnormalities in organs and tissues, we used microscopy to examine representative histological sections of each specified organ; the results showed no significant differences in any of the organs or tissues. Conclusion: The above findings suggest that treatment with SEH pharmacopuncture is relatively safe. Further studies on this subject are needed to yield more concrete evidence.

Folate-Related Nutrients, Genetic Polymorphisms, and Colorectal Cancer Risk: the Fukuoka Colorectal Cancer Study

  • Morita, Makiko;Yin, Guang;Yoshimitsu, Shin-Ichiro;Ohnaka, Keizo;Toyomura, Kengo;Kono, Suminori;Ueki, Takashi;Tanaka, Masao;Kakeji, Yoshihiro;Maehara, Yoshihiko;Okamura, Takeshi;Ikejiri, Koji;Futami, Kitaroh;Maekawa, Takafumi;Yasunami, Yohichi;Takenaka, Kenji;Ichimiya, Hitoshi;Terasaka, Reiji
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6249-6256
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    • 2013
  • One-carbon metabolism plays an important role in colorectal carcinogenesis. Meta-analyses have suggested protective associations of folate and vitamin $B_6$ intakes with colorectal cancer primarily based on studies in Caucasians, and genetic polymorphisms pertaining to the folate metabolism have been a matter of interest. Less investigated are the roles of methionine synthase (MTR) and thymidylate synthetase (TS) polymorphisms in colorectal carcinogenesis. In a study of 816 cases and 815 community controls in Japan, we investigated associations of dietary intakes of folate, methionine, vitamin $B_2$, vitamin $B_6$, and vitamin $B_{12}$ with colorectal cancer risk. The associations with MTR 2756A>G, MTRR 66A>G, and TSER repeat polymorphism were examined in 685 cases and 778 controls. Methionine and vitamin $B_{12}$ intakes were inversely associated with colorectal cancer risk, but the associations were totally confounded by dietary calcium and n-3 fatty acids. The other nutrients showed no association with the risk even without adjustment for calcium and n-3 fatty acids. The TSER 2R allele was dose-dependently associated with an increased risk. The MTR and MTRR polymorphisms were unrelated to colorectal cancer risk. There was no measurable gene-gene or gene-nutrient interaction, but increased risk associated with the TSER 2R allele seemed to be confined to individuals with high folate status. This study does not support protective associations for folate and vitamin $B_6$. The TSER 2R allele may confer an increased risk of colorectal cancer. The role of the TSER polymorphism in colorectal carcinogenesis may differ by ethnicity.

Manifestation of Cognitive Function in Geriatric Patient with Subjective Memory Complaint (주관적 기억력 저하를 호소하는 노인 환자의 인지기능 양상)

  • Park, Han-Kyul;Kim, Jin-Sung;Lee, Jong-Bum;Seo, Wan-Seok;Koo, Bon-Hoon;Bai, Dai-Seg
    • Journal of Yeungnam Medical Science
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    • v.27 no.1
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    • pp.27-36
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    • 2010
  • Purpose : The purpose of this study was to find out cognitive function of the patients with subjective memory complaint. Material and Methods : From March 1st 2005 to May 31st 2009, 155 normal individuals without any medical illness who visited Yeungnam University Hospital to undergo medical checkup with neurocognitive test was enrolled, and checked by using Cognitive Assessment & Reference Diagnostic System. Results : 107 of the patients had normal cognitive function, 21 patients (about 15%) were diagnosed with dementia, and 10 patients (about 7%) were diagnosed with considerable psychiatric illness, such as depression, anxiety disorder, adjustment disorder. In amnesia, agnosia, aphasia, attention, calculation, dysexecution, Dementia group and Psychiatric illness group has worse score than Normal individuals group. But, in apraxia, Dementia group has worse score than Psychiatric illness group and Normal individual group. Conclusion : Because the patients with subjective memory complaint can be diagnosed as any psychiatric illness as well as dementia, sensitive screening test and early psychiatric approach is needed.

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Risk Factors Associated with Loneliness in the Elderly Living Alone (독거노인의 외로움에 영향을 미치는 위험요인)

  • Lee, Seung Woo;Paik, Ki Chung;Lee, Kyung Kyu;Lee, Seok Bum;Kim, Kyung Min;Kim, Dohyun;Lee, Jung Jae
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.173-180
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    • 2019
  • Objectives : Loneliness is associated with negative mental and physical health. However, little is known about the risk factors of loneliness in the Korean elderly living alone. The aim of this study was to examine sociodemographic and social network related risks for loneliness among the elderly living alone. Methods : This is a cross-sectional study that enrolled 1,091 subjects who are the community-residing elderly living alone. Sociodemographic status, medical condition, cognition, mood disorder and levels of loneliness were collected using a self-administered questionnaire and a specific semi-structured interview conducted by a trained nurse. Descriptive statistics were used to analyze data regarding sociodemographic variable and loneliness. Univariate and Multivariate regression analyses were applied to examine factors associated with loneliness. Results : The mean score of loneliness was 3.8 (SD=1.7). No family contact (standardized β=0.115, p<0.001), no religious attendance (standardized β=0.057, p=0.028), no gathering with friends (standardized β=0.088, p=0.001) and high score of Short for of Geriatric Depression Scale (standardized β=0.502, p<0.001) were significantly associated with high loneliness in the elderly living alone. Conclusions : Family function, social network and depressive mood could be significant risk factors for high loneliness in the elderly living alone. Public health promotion efforts to reduce loneliness should focus on improving family function, social network and decreasing depression.

The Development of Physical Functioning Scale for Community-Dwelling Older Persons (지역사회 노인의 신체기능 평가도구 개발)

  • Lee, Kyung-Jong;Han, Geun-Shik;Yoon, Soo-Jin;Lee, Yeon-Kyung;Kim, Chan-Ho;Kim, Jeong-Lim;Lee, Yun-Hwan
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.4
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    • pp.359-374
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    • 2002
  • Objectives : To develop a physical functioning instrument for older adults living in the community. Methods : A representative sample of 979 people aged 65 years or over were interviewed in-person. Of these, 199 people also completed a detailed in-hospital examination. The scale items were selected based on the frequency of endorsement, along with the item-total and inter-item correlations. The associations of the scale with their physical performance and clinical examination were analyzed to evaluate the criterion-related validity. Construct validity was assessed using factor analysis, and internal consistency through Cronbach's alpha and item-total correlations. Test-retest reliability was measured by agreement between the household survey and the repeat survey at the in-hospital examination. Results : Initially, 23 items on the level of difficulty, ranging from no difficulty to an inability to complete a task, with the specific mobility and self-care tasks were included. Those with a high frequency of endorsement and a low inter-item or item-total correlations were excluded, resulting in a 10-item Physical Functioning (PT) scale. Equal weights were given to each item and a summated score was calculated. Significant associations were found between the PF scores and the physical performance, surrey and clinical data. The scale revealed a 2-factor (mobility and self-care) structure. Cronbach's alpha was 0.92 and the item-total correlations were in the 0.63 to 0.78 range. Pearson's correlations for the test-retest ranged between 0.56 and 0.61. Conclusions : The newly developed Physical Functioning (PF) scale showed good psychometric properties in older people. Further work, however, is needed to improve its sensitivity to discriminate higher levels of functioning, in addition to assessing its predictive value in detecting changes in health.

Psoraleae Semen Ethanol Extract Inhibits RANKL-Induced Osteoclast Differentiation and Osteoclast Specific Genes Expression (보골지 추출물이 파골세포 분화 및 골흡수 관련 유전자 발현에 미치는 영향)

  • Ryu, Gwang-hyun;Kim, Eom Ji;Kim, Minsun;Kim, Jae-Hyun;Lee, Yujin;Jin, Dae-hwan;Sohn, Youngjoo;Jung, Hyuk-Sang
    • Korean Journal of Acupuncture
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    • v.38 no.3
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    • pp.140-150
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    • 2021
  • Objectives : The increase of osteoclasts could cause osteoporosis and bone-related diseases. Also, the inhibition of osteoclast differentiation is important in treating bone-related diseases. Traditionally, Psoraleae Semen has been used for geriatric diseases, aging and musculoskeletal diseases. The purpose of this study is to investigate the effect of Psoraleae Semen ethanol extract (PS) on osteoclast differentiation and its function. Methods : To confirm the effect of PS on osteoclastogenesis and bone resorption activity, various levels of concentrations of PS (5, 10, 20 and 40 ㎍/ml) were tested on RAW 264.7 cells cultured with RANKL. We measured tartarate-resistant acid phosphatase (TRAP)-positive cells, TRAP activity, pit formation and F-actin ring formation. The expressions of nuclear factor of activated T-cells (NFATc1) and c-Fos were confirmed through western blot and reverse transcription- polymerase chain reaction (RT-PCR). Also, the expression of bone resorption and fusion-related genes in osteoclast was confirmed by RT-PCR. Results : PS decreased the number of TRAP-positive cells and the TRAP activity. In addition, PS significantly inhibited the formation of pit and F-actin ring. Furthermore, PS decreased the expression of osteoclast related genes. Conclusions : PS inhibits osteoclast differentiation and bone resorption ability through inhibition of the expression of osteoclast-related genes. This indicates that PS may be a potential therapeutic agent to osteoporosis by suppressing osteoclastogenesis.

The Prognosis of Spontaneous Intracerebral Hemorrhage in over the Seventies with Poor Initial Conditions (초기상태가 불량한 자발성 뇌출혈 환자의 예후 - 70세 이상의 고령환자를 대상으로 -)

  • Kim, Joo Han;Lee, Ja Kyu;Lim, Dong Jun;Kwon, Tack Hyun;Park, Jung Yul;Chung, Hung Seob;Lee, Hoon-Kap;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.207-210
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    • 2001
  • Objective : The prognosis of spontaneous intracerebral hemorrhage often depends on initial neurologic condition, size and location of hemorrhage and associated intraventricular hemorrhage. However, age of patient, coagulation state and other associated vascular diseases may also play a role when present. In recent years, the geriatric population has been increasing. The age distribution of the patients with intracerebral hemorrhages also has been increased, accordingly. However, such patients, especially when associated with poor initial conditions often tend to be managed rather conservatively. The authors analyzed retrospectively on forty-five patients with spontaneous intracerebral hemorrhage over the seventies with poor initial condition to find out whether there exists a difference of outcome between surgery and non-surgery group. Material and Method : A total of 45 patients over seventies with spontaneous intracerebral hemorrhage with Glasgow Coma Scale(GCS) 4-8 treated over last six years were included. The validity of surgical management for these patients as well as clinical variables which might have been operated on the outcome of these patients were evaluated. The Glasgow Outcome Scale(GOS) after three months was used for comparison of outcome. Results : In surgical group(19 cases), mean age was 74.5 years old, mean hematoma volume 67.2ml and mean GCS score 5.7 points. In nonsurgical group(26 cases), mean age was 79.3 years old, mean hematoma volume 32.1ml, and mean GCS score 6.8 points. Mortality rate in surgical group was 47.4%(9 patients), including 2 cases of post-operative rebleeding, while that in nonsurgical group was 46.2%. However, when patients with initial GCS 4-6 points and over 30ml in hematoma volume were regrouped, mortality rate in surgical group was 46.2%, whereas mortality rate in nonsurgical group was 66.7%. Conclusion : It is concluded that the mortality rate is much low in surgery group with initial GCS less than 6 points and hematoma volume over 30cc. There was no significant difference of outcome in patients with basal ganglia and thalamic hemorrhage. However, surgical treatment lowered the mortality and morbidity rate in patients with subcortical and cerebellar hemorrhage.

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Central Sarcopenia, Frailty and Comorbidity as Predictor of Surgical Outcome in Elderly Patients with Degenerative Spine Disease

  • Kim, Dong Uk;Park, Hyung Ki;Lee, Gyeoung Hae;Chang, Jae Chil;Park, Hye Ran;Park, Sukh Que;Cho, Sung Jin
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.995-1003
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    • 2021
  • Objective : People are living longer and the elderly population continues to increase. The incidence of degenerative spinal diseases (DSDs) in the elderly population is quite high. Therefore, we are facing more cases of DSD and offering more surgical solutions in geriatric patients. Understanding the significance and association of frailty and central sarcopenia as risk factors for spinal surgery in elderly patients will be helpful in improving surgical outcomes. We conducted a retrospective cohort analysis of prospectively collected data to assess the impact of preoperative central sarcopenia, frailty, and comorbidity on surgical outcome in elderly patients with DSD. Methods : We conducted a retrospective analysis of patients who underwent elective spinal surgery performed from January 1, 2019 to September 30, 2020 at our hospital. We included patients aged 65 and over who underwent surgery on the thoracic or lumbar spine and were diagnosed as DSD. Central sarcopenia was measured by the 50th percentile of psoas : L4 vertebral index (PLVI) using the cross-sectional area of the psoas muscle. We used the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight (K-FRAIL) scale to measure frailty. Comorbidity was confirmed and scored using the Charlson Comorbidity Index (CCI). As a tool for measuring surgical outcome, we used the Clavien-Dindo (CD) classification for postoperative complications and the length of stay (LOS). Results : This study included 85 patients (35 males and 50 females). The mean age was 74.05±6.47 years. Using the K-FRAIL scale, four patients were scored as robust, 44 patients were pre-frail and 37 patients were frail. The mean PLVI was 0.61±0.19. According to the CD classification, 50 patients were classified as grade 1, 19 as grade 2, and four as grade 4. The mean LOS was 12.35±8.17 days. Multivariate stepwise regression analysis showed that postoperative complication was significantly associated with surgical invasiveness and K-FRAIL scale. LOS was significantly associated with surgical invasiveness and CCI. K-FRAIL scale showed a significant correlation with CCI and PLVI. Conclusion : The present study demonstrates that frailty, comorbidity, and surgical invasiveness are important risk factors for postoperative complications and LOS in elderly patients with DSD. Preoperative recognition of these factors may be useful for perioperative optimization, risk stratification, and patient counseling.

Needs of Training Programs for Practice Courses in Advanced Practice Nurse Education (전문간호사를 위한 임상 전문실습교육프로그램 요구)

  • Ryu, Ho-Sihn;Oh, Pok-Ja;Lim, Ji-Young;Kang, Hee-Sun;Yang, Seung-Hee;Kim, Ae-Kyung;Ham, Ok-Kyung;Chu, Sang-Hui;SeoMun, Gyeong-Ae
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.4
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    • pp.553-561
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    • 2007
  • Purpose: This study aimed to assess needs of training programs for APN practice courses and continuing education programs for APNs to provide baseline data to improve APN education and practice. Methods: A total of 98 questionnaires were distributed to professors in 38 nursing institutions and 64 (65.3%) were returned. Data collection was performed in November and December, 2007 through email. Results: Professors in charge of geriatric and home care nurse practitioner programs constituted 43.7% of the study participants. Forty-one percent answered that they were satisfied with the practice programs they currently have operated, while 36.5% responded to have difficulty in appointment of institutions for practice programs and 56.3% had problems in assignment of preceptorship. In case of developing training programs for APN practice courses, 58.7% answered that they are willing to participate, and 90.6% felt needs for development of continuing education programs for APNs. Regarding liability insurance for APN students, only 11.5% provided insurance policy. Conclusion: The study results indicated that standardized training programs are needed to assure quality of APN education, and continuing education programs are required to provide opportunities for APNs to improve competencies.

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Effect on Alzheimer's Disease by Sesim-tang in CT105-overexpressed SK-N-SH Cell Lines (CT105로 유도된 신경모세포종 세포주에서 세심탕의 항치매 효과)

  • 권형수;박치상;박창국
    • The Journal of Korean Medicine
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    • v.25 no.2
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    • pp.138-150
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    • 2004
  • Objectives : Alzheimer's disease (AD) is a geriatric dementia that is widespread in old age. In the near future AD will be the biggest problem in public health service. Although a variety of oriental prescriptions, including Sesim-tang, have been traditionally utilized for the treatment of AD, their pharmacological effects and action mechanisms have not yet been fully elucidated. The present study investigated the effects of Sesim-tang on apoptotic cell death induced by CT105 (carboxy terminal 105 amino acid peptide fragment of APP) overexpression in SK-N-SH neuroblastoma cell lines. Methods: We studied the regenerative and inhibitory effects on Alzheimer's disease in CT105-induced SK-N-SH cell lines by Sesim-tang water extract. We examined for cell morphological pattern, DNA fragmentation, LDH activity assay, zymography assay, and immunohistochemistric analysis. Additionally, we investigated the association between the CT105 and neurite degeneration caused by CT105-induced apoptotic response in neurone cells. Results: Findings from our experiments have shown that Sesim-tang inhibits the synthesis or activities of CT105, which has neurotoxicities and apoptotic activities in the cell line. In addition, pretreatment with Sesim-tang ($>50\mu\textrm{g}/ml$ for 12 hours) partially prevented CT105-induced cytotoxicity in SK-N-SH cell lines. SK-N-SH cell lines overexpressed with CT105 exhibited remarkable apoptotic cell damage. Based on morphological observations by phase-contrast microscope and LDH activity measurements in the culture media, the CT105-induced cell death was significantly inhibited by Sesim-tang water extract. Sesim-tang was found to reduce the expression of APP and caspase-3 induced by CT105 in SK-N-SH cell lines and in rat hippocampus. Conclusions: As the result of this study, in the Sesim-tang group, apoptosis in the nervous system is inhibited, the repair against the degeneration of SK-N-SH cell lines by CT105 expression is promoted. Hence, Sesim-tang may be beneficial for the treatment of AD.

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