• 대한정형외과스포츠의학회지
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• 제9권2호
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• pp.73-78
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• 2010

목적: 50세 미만 및 50세 이상의 환자에서 전방 십자 인대 재건술 시행의 임상적 결과를 후향적으로 비교 분석하고자 하였다. 대상 및 방법: 2004년 7월부터 2008년 4월까지 전방 십자 인대 재건술을 시행 받은 환자 중 50세 이상(평균 55.1세) 18예, 50세 미만(평균 31.2세) 198예를 대상으로 하였으며, 평균 추시 기간은 50세 이상이 24개월, 50세 미만 군이 26개월 이었다. 임상적 평가는 Lysholm 점수 및 IKDC (International Knee Documentation Committee) 평가 기준을 사용하였고 전방 전위 정도는 KT-2000 관절 계측기를 이용하였으며 두 군간의 최종 추시 시의 결과를 비교 분석하였다. 결과: Lysholm 점수는 50세 이상 군에서는 69.5점에서 93.6점으로 호전되었으며, 50세 미만 군에서는 69.0점에서 92.6점으로 호전되었다(p<0.05). IKDC 평가 기준에 의한 최종 평가상 50세 이상 군의 83% (15예)에서 거의 정상(B) 이상의 결과를 보였고, 50세 미만군의 86% (170예)에서 거의 정상(B) 이상의 결과를 보였다(p<0.05). KT-2000 관절 계측기를 이용한 전방 전위 검사 상 건측과의 평균 전위차가 50세 이상 군에서는 술전 7.4 mm에서 최종 추시 시 2.2 mm로 감소하였고, 50세 미만 군에서는 술 전 7.1 mm에서 최종 추시 시 2.0 mm으로 감소하였다(p<0.05). 결론: 50세 이상 군과 50세 미만 군에서의 전방 십자 인대 재건술의 임상적 결과는 두 군 간에 유의한 차이가 없었으며, 50세 이상 환자에서도 만족할 만한 전방 십자 인대 재건술의 결과를 얻을 수 있었다.

• 한방안이비인후피부과학회지
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• 제21권3호
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• pp.140-149
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• 2008

Objective : This study was performed to find out the difference of symptoms between rhinitis and sinusitis in young patients who were diagnosed by PNS plain radiograph( PNS series), Methods: We did statistical analysis about 147 new outpatients under 12 year-old who had visited the department of ophthalmology, otolaryngology, dermatology in Kyung Hee Oriental Medicine Center from March 2, 2006 to February 29, 2008. All of the patients were diagnosed by PNS series and we divided the patients with two groups; rhinitis group and sinusitis group. We checked the OPD records and explore the distribution on sex, experience of past western therapy, age and duration. Then we divided symptoms into nine; 'nasal obstruction', 'purulent rhinorrhea', 'cough & sneezing', 'watery rhinorrhea', postnasal drip', 'sputum', 'head problem', 'snoring & throat discomfort' and 'epistaxis'. We also divided age into 2 groups: $0\sim7$ years old and $8{\sim}12$ years old. We carried out chi-square test as a statistical method. Results : The results were as follows. 1. Sinusitis group were 102(69.5%); 62 have only sinusitis. 40 have both sinusitis and adenoidal hypertrophy. Rhinitis group were 45(30.5%); 13 have adenoidal hypertrophy and 32 were negative. 2. Male were 98(sinusitis 65, rhinitis 33), female were 49(sinusitis 37, rhinitis 12). 3. Patients who had experienced past western therapy were 120(sinusitis 81, rhinitis 39), no experienced patients were 27(sinusitis 21, rhinitis 6). 4. Distribution on age of sinusitis was 1(1 yr), 2(2 yrs), 3(3 yrs), 15(4 yrs), 15(5 yrs), 23(6 yrs), 13(7 yrs), 12(8 yrs), 8(9 yrs), 5(10 yrs), 1(11 yrs), 4(12 yrs). Distribution on age of rhinitis was 1(1 yr), 0(2 yrs), 1(3 yrs), 1(4 yrs), 9(5 yrs), 5(6 yrs), 3(7 yrs), 5(8 yrs), 1(9 yrs), 8(10 yrs), 6(11 yrs), 5(12 yrs), 5. Duration of sinusitis was 20(<2 months), 6($2{\sim}3$ months), 11($3\sim6$ months), 34($6\sim12$ months), 31(>12 months) and of Rhinitis was 11(<2 months), 0($2\sim3$ months), 5($3\sim6$ months), 18($6\sim12$ months), 11(>12 months) 6. Distribution on symptoms, sinusitis patients were 86(nasal obstruction), 52(purulent rhinorrhea), 46(cough & sneezing), 38(watery rhinorrhea), 41(postnasal drip), 23(sputum), 18(head problem), 15(snoring & throat discomfort), 6(epistaxis). The each symptom and sinusitis have no relation by chi-square test. 7. The number of patients who were 0 $\sim$ 7 years old was 92: sinusitis 72(49%), non-sinusitis 20(13.6%). The number of patients who were 8 $\sim$ 12 years old was 58: sinusitis 30(20.4%), non-sinusitis 25(l7%). By chi-square test(confidence level 95%), sinusitis and age under 7 have a significant relation(p=0.003). Conclusions : There is no relation between rhinologic symptoms and sinusitis. Patients under 7 years old with rhinologic symptoms tend to have sinusitis.

• 한국임상약학회지
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• 제28권3호
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• pp.174-180
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• 2018

Objective: Clostridium difficile Infection (CDI) is one of the common nosocomial infections. As elderly population increases, the proper treatment has been emphasized. We investigated the risk factors associated with CDI unimprovement in elderly patients. Furthermore, we performed drug use evaluation of old CDI patients and oldest-old CDI patients. Methods: It was a retrospective study using electronic medical record at Kangbuk Samsung Medical Center (KBSMC) from January 2016 to December 2017. Seventy three patients aged 65 years or older, diagnosed with CDI by Clostridium difficile Toxin B Gene [Xpert] were screened and they were assessed for risk factors regarding unimprovement status. We also evaluated drug use evaluation in old patients ($65{\leq}age$<80) and oldest-old patients ($80{\leq}age$) by assessing the use of initial therapy, severity, dose, route, treatment course, days of use, total days of use and treatment outcome of initial therapy. Results: Out of 73 patients aged over 65 years, four patients were excluded because they did not receive any treatment. There were 31 improved patients and 38 unimproved patients after initial therapy. We were able to find out patients with surgical comorbidity or endocrine comorbidity (especially, diabetes mellitus) had 2.885 more risk of becoming unimproved than those patients without surgical comorbidity or endocrine comorbidity. Drug use evaluation for CDI was generally fair, but vancomycin as initial therapy is more recommended than metronidazole. Conclusion: Although age, antibiotics exposure, use of antacids are all important risk factors for CDI, our result did not show statistical significance for these risk factors. However, the study is meaningful because the number of elderly population keeps increasing and recently updated guideline suggests the use of vancomycin as drug of choice for CDI.

• 대한족부족관절학회지
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• 제13권2호
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• pp.133-137
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• 2009

Purpose: The purpose of this study was to evaluate the clinical results of the old Achilles tendon rupture treated with modified flexor hallucis longus (FHL) tendon transfer. Materials and Methods: Seventeen patients with old Achilles tendon rupture treated with modified FHL tendon transfer between March 2004 and February 2008 were enrolled in this study. Technically FHL was pass through the distal portion of the ruptured tendon instead of the drilled hole made on the calcaneus. The mean age of the patients was 37 years (range, 22~67 years), mean follow-up period was 28 months (range, 12~30 months). Patients' subjective satisfaction, calf circumferential diameter, range of motion of ankle and AOFAS ankle-hind foot score and Arner-Lidholm score was evaluated. Results: The average gap between the ruptured tendon was 52 mm (range, 47~56 mm). The AOFAS score improved from 47 pre-operatively to 91 points at the last follow-up. Sixteen patients were satisfied with the result free from discomfort, a patient had mild discomfort who had DM. fourteen patients had decreased range of motion less than 5 degrees while 2 patients had more than 7 degrees decrease compared to the intact side but had no discomfort in daily activities. Nine patients had less than 1 cm calf circumferential diameter difference and 7 patients had 1 to 3 cm diameter difference compared to the intact side. One who had more than 3 cm diameter difference had deteriorated muscle strength. Conclusion: Modified FHL tendon transfer can be a useful technique for the treatment of old Achilles tendon rupture when the gap is with large gap placed too proximal.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.74-80
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• 2006

Purpose: For prevention and suitable administration, the effect of age on the severity of injuries in traffic accidents should be considered when evaluating a patient, but there have not been enough epidemiological studies that evaluate the age factor in traffic accidents. For that reason, we investigated old-aged patients who were involved in traffic accidents (65 years old or more) and who were admitted to the emergency department of a college hospital in an urban city of Korea. Methods: We collected data from traffic-accident patients who came to the emergency room of a university hospital in Seoul from Jan.1, 2004 to Dec.31, 2005. We compared their abilities to ambulate and the RTSs (Revised trauma scores) by using a LSD (least significant difference), linear regression. Results: A total of 1460 patients were included. The mean RTS of all traffic-accident patients was $7.77{\pm}0.280$. The scores for drivers and passengers, motor-cycle drivers and passengers, bicycle drivers and passengers, and pedestrians were $7.79{\pm}0.21$, $7.78{\pm}0.22$, $7.54{\pm}0.25$, $7.77{\pm}0.20$, and $7.80{\pm}0.21$ respectively (p=0.000). There was no statistically significant difference between the RTS of patients over 65 years and that of other patients. In a regression analysis, the number of patients over 45 ages who were able to ambulate was lower than that of younger people, independently of other influencing factors (B=-0.330, R-square = 0.243, p=0.000). Conclusion: We expected that RTS of old age group more than 65 years old will significantly lower than that of others, but there was no statistically significant difference.

• Journal of Gastric Cancer
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• 제2권4호
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• pp.200-204
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• 2002

Purpose: The aim of this study was to compare the clinicopathological characteristics and postoperative prognosis of two age groups with gastric cancer in order to establish the proper treatment strategy in these groups of patients. Materials and Methods: Among patients with gastric cancer who underwent a gastrectomy between 1990 and 1996 at the Department of Surgery, Kyungpook National University, the clinicopathological characteristics, including the postoperative survival, of patients younger than 40-years old were compared with those of patients over 69-years old. Results: During that period 1,125 gastric cancer patients underwent a gastrectomy. Among them, 111 patients ($9.9\%$) were less than 40-years old, and 96 patients ($8.5\%$) were over 69-years old. In the young group, 79 patients ($71.2\%$) had a poorly differentiated adenocarcinoma, and 59 patients from the elderly group ($61.5\%$) had a well- or moderately differentiated adenocarcinoma (P<0.05). Curative surgery was performed for 88 ($79.3\%$) patients in the young group and 78 ($81.3\%$) patients in the elderly group. This difference was not statistically significant. There was no statistically significant difference in the 5-year survival rates between the young and the elderly ($66.3\%\;vs.\;47.2\%$) groups, but the 5-year survival rate of the young group was significantly higher than that of the elderly group after a curative resection ($83.2\%\;vs.\;53.3\%$; P<0.05). Also the 5-year survival rate of the elderly group was significantly higher than that of the young group after a non-curative resection ($20.4\%\;vs.\;4.6\%$; P<0.05). Conclusions: For young patients, more efforts are needed to detect gastric cancer in its early stages so that a curative surgery can be performed. However, for the elderly, surgical treatment is recommended at any stage because of the relatively high survival rate, even after non-curative surgery.

• Archives of Plastic Surgery
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• 제33권3호
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• pp.308-312
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• 2006

Time to time, we face patients who missed the proper time for primary palatal repair. Although we do not have enough available documents, it is important to establish efficacy of palatal repair in patients more than 4 years old. From May 1995 to March 2005, we selected 14 patients who underwent palatal repair in more than 4 years old patients and they are able to tolerate speech articulation tests. Out of 14 patients 5 males an 9 females in sex, aged form 4 to 50 years old. 6 patients with incomplete cleft palate and 8 patients with submucous cleft palate. Double reversing Z-plasty(n=5), pushback palatoplasty(n=4), two flap palatoplasty(n=2), von Langenbeck palatoplasty(n=2), and intravelar veloplasty(n=1) were performed. Preoperative and postoperative speech articulation test, "Simple method of speech evaluation in Korean patients with cleft palate", were conducted. Satisfaction rate was sorted into 5 levels. There is no significant statistical correlation in the speech improvement, satisfaction rate, patients sex, cleft type and operative method. But there is significant statistical correlation between the speech improvement and patienet's age. There were better result in younger patient group than aged patients group.

• 임상간호연구
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• 제27권1호
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• pp.77-84
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• 2021

Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m². Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.

• Journal of Chest Surgery
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• 제18권1호
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• pp.36-45
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• 1985

During the twelve-year period from March 1973 through July 1984, 23 consecutive operations for coarctation of the aorta were performed at Seoul National University Hospital. The patients included 19 male and 4 female in the range of 4 months and 16 years old. Associated cardiac anomalies were present in 19 patients [70%] and they were VSD+PDA [9 patients], VSD[2], PDA[1], VSD+ASD+PDA[1], VSD+MS+AS+PDA[1], D-TGA+VSD+PDA[1], P-ECD[1], MS[1], Al[1], and DORV+PDA[1]. The preoperative main symptoms included congestive heat failure, hypertension, subacute bacterial endocarditis and nonspecific symptoms. Congestive heart failure was the most common symptom in the group younger than 2 years and hypertension in the adult group. Operative techniques for coarctation of the aorta were resection and end to end anastomosis in 10 patients, prosthetic patch aortoplasty in 8, subclavian flap aortoplasty in 4, and LSCA-aortic anastomosis in 1. There were 4 operative deaths among the nine patients less than 2 years old[44.4% mortality]: all of these patients had associated cardiac anomalies. And only one operative death occurred in patients older then 2 years old[7.1% mortality]. No hospital death occurred in patients with isolated coarctation of the aorta. Operation of the coarctation was performed primarily in 6 patients associated with ventricular septal defect and subsequently underwent successful VSD closure except one operative death.

• Journal of Chest Surgery
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• 제19권3호
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• pp.407-411
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• 1986

Between March 1978 and December 1985, 39 patients were admitted to our hospital & surgery was performed to 27 patients. Among 39 patients, male patients were 31 cases, female 8 cases and the age ranged from 42 years old to 69 yrs old with the average of 55 years old. Main symptoms of esophageal cancer were dysphagia [6%], weight loss [20%], retrosternal and epicardial discomfort [18%], hoarseness [13%], and hiccup [5%]. The anatomical locations of esophageal cancer were followed as; 51% in lower esophagus & cardia, 44% in middle, and 5% in upper esophagus. Among 27 cases, 5 cases were managed by feeding gastrostomy and jejunostomy due to inoperability, 19 cases by esophagogastrostomy, and 3 cases by colon bypass with the resection of esophageal cancer. Postoperative complications were noticed in 7 cases, such as anastomotic leakage in 2 cases [7%], respiratory insufficiency in 2 cases [7%], intussusception in 1 case [4%], wound dehiscence in 1 case [4%], and hepatitis in 1 case [4%]. Among 2 respiratory insufficiency, 2 patients die as a result of that complication and operative mortality was 7%.