• Journal of Korean Academy of Nursing Administration
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• v.6 no.2
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• pp.195-209
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• 2000

The purpose of this study is to estimate the population requiring nursing home services among elderly people in Korea. This study identifies the need of nursing home services determined by health care professionals and estimates the proportion of elderly people requiring nursing home service according to the admission criteria. Surveys were conducted on health care professionals including medical doctors, home care nurses, and nurse practitioners. They were asked to assess nursing home need based on four content areas: Physical function (Activities of Daily Living), chronic disease, Physical symptoms (incontinence), mobility, eating, and sensory function. Based on the professionally determined need criteria the proportion of elderly people requiring nursing home services was estimated using secondary data from the 1994 Survey on the Living Status of the Korean Elderly. The number of study subjects to estimate nursing home need who were 60 and older totaled 2,058. The most important factor contributing to the admission eligibility criteria was the elderly living alone. Other factors related were the elderly being unable or having difficulty carrying out activities, and having insufficient help from other our activities, and having insufficient help from other members of the household. Using only physical function, the proportion of elderly people requiring nursing home was $8{\sim}9%$. When only chronic disease was used, proportions varied widely; for the doctor's group, the proportion was over 30%. Using all areas, the proportions of elderly people requiring nursing home were between 13% and 38%. The estimate using chronic disease and physical function was similar to the on using all areas.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.1
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• pp.69-81
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• 2013

Purpose: The aim of this study is to determine associated factors affecting the utilization of Medical Care for an overactive bladder. Methods: Total 114 women with overactive bladder participated in this study. Patients were categorized in two groups, the patients with treatment experiences for an overactive bladder(n=40) and without treatment experiences for an overactive bladder(n=74). Patients completed Overactive Bladder Severity Score, Beck Depression Inventory, King's Health Questionnaire, and questionnaires on treatment experience. The results were analysed using SPSS for Windows 12.0k. All statistical tests were two-sided with a p-value < 0.05 being significant. Results: Patients with treatment experience had a greater score on KHQ, OABSS, BDI and had longer symptom duration period than those without treatment experience. And only Impact of Life(P=0.004), Role Limitation(P=0.004), Social Limitation(P=0.007), Emotion(P=0.035), Sleep/Energy(P=0.001), Incontinence Severity Measures(P=0.012) among KHQ domains were statistically significant difference between two groups. Conclusions: The most influencing factor associated with utilization of Medical Service in overactive bladder is the impact of the patient's quality of life.

• Journal of Acupuncture Research
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• v.23 no.4
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• pp.101-113
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• 2006

Objectives : This study was designed to evaluate the effect of electroacupuncture at ciliao(BL32) on voiding pattern and uroflowmetry of patients with functional voiding disease. Methods Subjects were voluntarily recruited by newspaper·s and internet. All the subjects were confirmed as International Prostatism Symptom Score(IPSS), uroflowmetry, voiding diary, symptom. The acupuncture therapy was performed 3 times a week for 3 weeks by oriental medical doctor at hospital. Acupuncture points were BL32. The patient's symptoms were assessed before and after 3 weeks treatments by IPSS. Uroflowmetry for 5minutes and voiding diary for 48 hours was measured before and after 3 weeks treatments. Results : The results were as follows; 1. After 3 weeks compared to the pre-treatment, IPSS(QOL) scores were significantly unproved. 2. After 3 weeks compared to the pre-treatment, mean voiding volume, min voiding volume and mean voiding time on voiding daiary was significantly improved. 3. After 3 weeks compared to the pre-treatment, max flow velocity and mean flow velocity on uroflowmetry in spite of increase of voiding volume show a statistically significant difference. 4. Acupunctue had hardly some side effect compared to operation and medicines and was economical. Conclusion : This study suggests that acupuncture treatments can be applicable to improve symptoms in the patients with functional voiding disease. Further study on the acupuncture and other acupoints in the patients with functional voiding disease is recommended.

• YAKHAK HOEJI
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• v.50 no.3
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• pp.177-183
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• 2006

Women's aging made a functional decline at ovary, This functional problem causes estrogen deficiency and many disorders, such as, sexual dysfunction, obesity, osteoporosis, urinary incontinence, skin and all body's aging, etc. We determined the ameliorative effects of some herbal extracts mixture on postmenopausal symptoms in ovariectomized Sprague Dawley rats. Nine-weeks-old female rats were ovariectomized and treated with singled pomegranate extracts (0.40, 1.20 g/kg/day) and mixed pomegranate extracts (1.08, 3.24g/kg/day) for 8 weeks. Oral administration of pomegranate extracts for 8 weeks were increased serum estradiol level and improved the serum osteocalcin, ALP activity and bone specific ALP level. And pomegranate extracts were reduced body weight, adipose tissue. Uterus weight in treated group tended to improve. In addition, the concentrationl of triglyceride and total cholesterol were lower after 8 weeks. HDL-cholesterol levels improved with does-dependency in treated groups. Collagen level on skin and cartilage showed a slight increase at treatment for 8 weeks. $^{\infty}These$ results showed that both of singular extract treatments and extracts mixture treatments were effective on general postmenopausal symptoms at overiectomized rats, and especially, the mixture treatments were more effective than singular treatment. $^{\infty}In$ conclusion, these herbal extracts' mixture showed improvement effect in general factors related with postmenopausal disorders.

• The Journal of Internal Korean Medicine
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• v.26 no.4
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• pp.918-925
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• 2005

The basic mechanism of normal pressure hydrocephalus(NPH) is found in an impediment to CSF absorption. In about half of the cases, the etiology remains obscure. NPH is more frequently found in elderly people. The main symptoms are gait disturbances, urinary incontinence and various degree of cognitive changes. The current treatment is ventriculo-peritoneal shunting, ideally using an adjustable valve. In about half of surgical operations, results are poor. Hyeongbangjihwang-tang(荊防地黃湯) is used to treat Soyangin(少陽人) weakness(虛弱) and edema(浮腫). It is and important Gang-Yin(降陰) medicine. A Soyangin patient diagnosed with NPH, who had undergone surgery for ventriculo-peritoneal shunting, was treated with Hyeongbangjihwang-tang. Significant improvement of clinical symptoms was seen, so it is here reported.

• Childhood Kidney Diseases
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• v.16 no.1
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• pp.68-71
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• 2012

Neurofibromatosis is a rare systemic disease, and genitourinary tract involvement is especially uncommon. Bladder is the most frequently involved organ in the genitourinary tract. Bladder neurofibromatosis may present as a diffuse infiltrative process or an isolated neurofibroma. The symptoms vary, ranging from urinary incontinence to retention. Treatment is usually conservative. The patient should be worked up to rule out other manifestation of tumor enlargement and followed to evaluate the development of new lesion. We report a case of the development of invasion of bladder in a patient with neurofibromatosis.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.565-570
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• 2010

Purpose: Due to the closed and humid condition of the perineal area, wound problems occurring at this site are sometimes complicated, especially following postoperative radiation therapy. Moreover, the anal sphincter is a very important functional structure but reconstruction of the anal sphincter after severe trauma poses a challenging problem to plastic surgeons. In this article, we demonstrate the usefulness of the pedicled gracilis flap in the reconstruction of the perineal area. Methods: From September 2008 to November 2009, 6 patients, 4 males and 2 females, underwent surgery of the perineal area. The age of the patients ranged from 21 to 62 years (mean age was 48). The mean follow up period was 14 months. In 4 cases, the patient presented with wound problems after postoperative radiation therapy for anal cancer. In 2 cases, the patient presented with traumatic sphincter damage. Only the gracilis muscle was used in the 4 cases and a musculocutaneous flap was used in the 2 cases involving skin defects, respectively. Results: Among the 6 patients, 1 patient underwent hematoma evacuation of the donor site, and 1 patient presented with prolapse of the vaginal mucosa which recovered spontaneously. There were no report of other complications and there were no wound recurrences. Minimal incontinence was observed in all patients who underwent sphincter reconstruction, but all were satisfied with the overall results. Conclusion: The gracilis flap is useful in the reconstruction of the perineal area, such as in cases of radiotherapy induced wound problems and sphincter damage following severe trauma, due to its easy accessibility, rich vascularity, and minimal donor site morbidity.

• Journal of Korean Neurosurgical Society
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• v.49 no.4
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• pp.241-244
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• 2011

Sparganosis is a rare parasitic infection affecting various organs, including the central nervous system, especially the lumbar epidural space. This report describes the identification of disease and different strategies of treatments with preoperative information. A 42-year-old man presented with a 2-year history of urinary incontinence and impotence. He had a history of ingesting raw frogs 40 years ago. Magnetic resonance (MR) imaging showed an intramedullary nodular mass at conus medullaris and severe inflammation in the cauda equina. A 51-year-old woman was admitted with acute pain in the left inguinal area. We observed a lesion which seemed to be a tumor of the lumbar epidural space on MR imaging. She also had a history of ingesting inadequately cooked snakes 10 years ago. In the first patient, mass removal was attempted through laminectomy and parasite infection was identified during intra-operative frozen biopsy. Total removal could not be performed because of severe arachnoiditis and adhesion. We therefore decided to terminate the operation and final histology confirmed dead sparganum infection. We also concluded further surgical trial for total removal of the dead worm and inflammatory grannulation totally. However, after seeing another physician at different hospital, he was operated again which resulted in worsening of pain and neurological deficit. In the second patient, we totally removed dorsal epidural mass. Final histology and enzyme-linked immunosorbent assay (ELISA) confirmed living sparganum infection and her pain disappeared. Although the treatment of choice is surgical resection of living sparganum with inflammation, the attempt to remove dead worm and adhesive granulation tissue may cause unwanted complications to the patients. Therefore, the result of preoperative ELISA, as well as the information from image and history, must be considered as important factors to decide whether a surgery is necessary or not.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.2
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• pp.137-145
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• 2020

Purpose: The Oral-anal Transit Test (OTT) is a simple method of obtaining information about colonic transit. We aim to assess the correlation of OTT with the neuromuscular integrity of the colon determined by colonic manometry (CM). Methods: All patients who had OTT followed by CM were evaluated. Less than 6 of 24 markers remaining on OTT was considered normal. CM was performed per previously published guidelines. A normal CM was defined as at least one High Amplitude Propagating Contraction progressing from the most proximal sensor through the sigmoid colon. Results: A total of 34 patients underwent both OTT and CM (44% male, age 4-18 years, mean 11.5 years, 97% functional constipation +/- soiling, Hirschsprung's Disease). Of normal and abnormal OTT patients, 85.7% (6/7) and 18.5% (5/27) respectively had normal CM. When all markers progressed to at least the sigmoid colon, this was 100% predictive against colonic inertia. Greater than 50% of patients with manometric isolated sigmoid dysfunction had markers proximal to the recto-sigmoid. Conclusion: OTT and CM are both valuable studies that assess different aspects of colonic function. OTT can be used as a screening test to rule out colonic inertia. However, the most proximal extent of remaining markers does not predict the anatomical extent of the manometric abnormality, particularly in isolated sigmoid dysfunction.

• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.370-374
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• 2014

To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.