• Title/Summary/Keyword: The Korean Elderly

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The Bcl-2/Bcl-xL Inhibitor ABT-263 Attenuates Retinal Degeneration by Selectively Inducing Apoptosis in Senescent Retinal Pigment Epithelial Cells

  • Wonseon Ryu;Chul-Woo Park;Junghoon Kim;Hyungwoo Lee;Hyewon Chung
    • Molecules and Cells
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    • v.46 no.7
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    • pp.420-429
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    • 2023
  • Age-related macular degeneration (AMD) is one of the leading causes of blindness in elderly individuals. However, the currently used intravitreal injections of anti-vascular endothelial growth factor are invasive, and repetitive injections are also accompanied by a risk of intraocular infection. The pathogenic mechanism of AMD is still not completely understood, but a multifactorial mechanism that combines genetic predisposition and environmental factors, including cellular senescence, has been suggested. Cellular senescence refers to the accumulation of cells that stop dividing due to the presence of free radicals and DNA damage. Characteristics of senescent cells include nuclear hypertrophy, increased levels of cell cycle inhibitors such as p16 and p21, and resistance to apoptosis. Senolytic drugs remove senescent cells by targeting the main characteristics of these cells. One of the senolytic drugs, ABT-263, which inhibits the antiapoptotic functions of Bcl-2 and Bcl-xL, may be a new treatment for AMD patients because it targets senescent retinal pigment epithelium (RPE) cells. We proved that it selectively kills doxorubicin (Dox)-induced senescent ARPE-19 cells by activating apoptosis. By removing senescent cells, the expression of inflammatory cytokines was reduced, and the proliferation of the remaining cells was increased. When ABT-263 was orally administered to the mouse model of senescent RPE cells induced by Dox, we confirmed that senescent RPE cells were selectively removed and retinal degeneration was alleviated. Therefore, we suggest that ABT-263, which removes senescent RPE cells through its senolytic effect, has the potential to be the first orally administered senolytic drug for the treatment of AMD.

Evaluation of bite force, quality of life, and patients' satisfaction in elderly edentulous patients using implant overdentures

  • Esra Nur Avukat;Canan Akay;Emre Mumcu
    • The Journal of Advanced Prosthodontics
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    • v.15 no.4
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    • pp.214-226
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    • 2023
  • PURPOSE. This study aimed to compare the bite force (BF) between complete dentures and implant overdentures (IODs) retained by two mandibular implants. Additionally, we evaluated the quality of life (QoL) and patient satisfaction among individuals using IODs. In addition, the effects of demographic parameters such as age and sex, and clinical parameters such as implant length, implant diameter, attachment height, attachment color, and interimplant distance on BF, QoL, and patient satisfaction were evaluated. MATERIALS AND METHODS. A total of 51 edentulous patients rehabilitated with the maxillary complete dentures and mandibular IODs retained by two implants were included in this study. BF was measured using a force meter pre- and post-implant in the same patients. Oral health-related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP-14) and patient satisfaction was assessed with the Visual Analog Scale (VAS) questionnaires. RESULTS. It was found that BF values were statistically higher for IODs than complete dentures (P < .001). In terms of attachment height of the OHIP scores, there was a significant difference in the psychological disability and social disability domains (P < .05). When examining the change in patient satisfaction as a function of sex, it was found that mandibular retention satisfaction differed significantly by sex (P < .05), but there was no significant difference in the other domains. CONCLUSION. Within the limitations of this study, it was observed that the BF increased after the use of IODs. Several factors, including age, interimplant distance, attachment height, and attachment color, were found to impact OHRQoL. Sex and implant diameter were identified as factors affecting patient satisfaction.

Research on Developing a Conversational AI Callbot Solution for Medical Counselling

  • Won Ro LEE;Jeong Hyon CHOI;Min Soo KANG
    • Korean Journal of Artificial Intelligence
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    • v.11 no.4
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    • pp.9-13
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    • 2023
  • In this study, we explored the potential of integrating interactive AI callbot technology into the medical consultation domain as part of a broader service development initiative. Aimed at enhancing patient satisfaction, the AI callbot was designed to efficiently address queries from hospitals' primary users, especially the elderly and those using phone services. By incorporating an AI-driven callbot into the hospital's customer service center, routine tasks such as appointment modifications and cancellations were efficiently managed by the AI Callbot Agent. On the other hand, tasks requiring more detailed attention or specialization were addressed by Human Agents, ensuring a balanced and collaborative approach. The deep learning model for voice recognition for this study was based on the Transformer model and fine-tuned to fit the medical field using a pre-trained model. Existing recording files were converted into learning data to perform SSL(self-supervised learning) Model was implemented. The ANN (Artificial neural network) neural network model was used to analyze voice signals and interpret them as text, and after actual application, the intent was enriched through reinforcement learning to continuously improve accuracy. In the case of TTS(Text To Speech), the Transformer model was applied to Text Analysis, Acoustic model, and Vocoder, and Google's Natural Language API was applied to recognize intent. As the research progresses, there are challenges to solve, such as interconnection issues between various EMR providers, problems with doctor's time slots, problems with two or more hospital appointments, and problems with patient use. However, there are specialized problems that are easy to make reservations. Implementation of the callbot service in hospitals appears to be applicable immediately.

A retrospective clinical investigation for the effectiveness of closed reduction on nasal bone fracture

  • Kang, Byung-Hun;Kang, Hyo-Sun;Han, Jeong Joon;Jung, Seunggon;Park, Hong-Ju;Oh, Hee-Kyun;Kook, Min-Suk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.53.1-53.6
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    • 2019
  • Background: The nasal bone is the most protruding bony structure of the facial bones. Nasal bone fracture is the most common facial bone fracture. The high rate of incidence of nasal bone fracture emphasizes the need for systematical investigation of epidemiology, surgical techniques, and complications after surgery. The objective of this study is to investigate the current trends in the treatment of nasal bone fractures and the effectiveness of closed reduction depending on the severity of the nasal bone fracture. Patients and methods: A total of 179 patients with a nasal bone fracture from 2009 to 2017 were enrolled. Their clinical examination, patient's records, and radiographic images of nasal bone fractures were evaluated. Results: Patients ranged from children to elderly. There were 156 (87.2%) males and 23 (12.8%) females. Traffic accident (36.9%) was the most common cause of nasal fracture. Orbit fracture (44 patients, 24.6%) was the most common fracture associated with a nasal bone fracture. Complications after surgery included postoperative deformity in 20 (11.2%) patients, nasal obstruction in 11 (6.1%) patients, and olfactory disturbances in 2 (1.1%) patients and patients with more severe nasal bone fractures had higher rates of these complications. Conclusion: Closed reduction could be performed successfully within 2 weeks after injury.

A Comparative Study of Nursing Home-Acquired Pneumonia with Community-Acquired Pneumonia

  • Cho, Young-Jae;Jung, Bong-Ki;Ahn, Joon-Seok
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.3
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    • pp.224-234
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    • 2011
  • Background: Little data is available regarding hospitalized patients with nursing home-acquired pneumonia (NHAP). This is unfortunate because there is an increasing number of elderly persons who are living in nursing homes in Korea. The aim of this study was to compare clinical characteristics and treatment responses of NHAP with community-acquired pneumonia (CAP). Methods: Patients with pneumonia who were admitted from eight nursing homes or from their own homes were enrolled between May 2007 and April 2009. Their clinical characteristics and treatment responses were reviewed retrospectively, and differences between the two groups were analyzed. Results: Of 110 Patients with pneumonia, 66 (60%) were from nursing homes and their median age was 84. In the NHAP group, functional performance status was significantly poorer, classical symptoms of pneumonia were less severe, and multi-lobe involvement (on chest radiographs) was more frequent than in the CAP group. Patients with NHAP more frequently showed lymphocytopenia, anemia, hypoalbuminemia, hypoxemia, and elevated blood urea nitrogen on admission. The mean CURB-65 score was 2.2 in the NHAP group, higher than 1.7 in the CAP group (p=0.004), and multi-drug resistant pathogens were also highly identified in NHAP group (39% vs. 10%, p=0.036). The mean duration of antibiotic therapy was greater for the NHAP (12.6 days) than for the CAP group (6.6 days) (p<0.001). The mortality rate was 23% in NHAP group, which was significantly higher than 5% in the CAP group (p=0.014). Conclusion: NHAP should be more intensively investigated because of the higher frequency of multi-drug resistant pathogens and mortality than the CAP.

A Case Report of Lymphoepithelioma-like Carcinoma on the Temple (측두부에 발생한 피부림프상피양 암종 증례보고)

  • Oh, Gwang Jin;Lee, Nae Ho;Yang, Kyung Moo
    • Archives of Craniofacial Surgery
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    • v.9 no.1
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    • pp.31-34
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    • 2008
  • Introduction: Lymphoepithelioma-like carcinoma of the skin (LELCS) is a rare cutaneous tumor of low grade malignancy and microscopically resembles lymphoepitheliomatous malignancies in the nasopharynx, palatine tonsils, salivary glands and uterine cervix. LELCS presents as scarlet-colored firm nodules or plaques on the face, scalp, or shoulder of middle-aged to elderly individuals. Material and Methods: A 72 year-old female had complained a papule like lesion with intermittent pruritis on the left temple for 2 years. But the lesion was changed to scarlet-colored firm nodule with ulceration. The mass was diagnosed as LELCS on the biopsy. And to confirm that the mass is not metastatic lymphoepithelioma-like carcinoma from other sites or direct tumor extension from the nasopharynx, selective radiographic and laboratory tests were done carefully. Results: Wide excision was performed with general endotracheal anesthesia. The tumor is composed of island of large epithelial cells surrounded by as dense infiltrate of lymphocytes. Immunohistochemical staining with cytokeratin and epithelial membrane antigen(EMA), the tumor cells were positive reaction for stain. And Epstein-Barr virus genome was not detected by in situ hybridization. So, the tumor was confirmed as LELCS. Conclusion: LELCS was described by Swanson at 1988, but has not been reported in the field of plastic surgery of Korea. We report a case of primary LELCS that occurred in the left temple with clinical characteristics, histologic features and references.

An Approach to Develop a Speech Recognition Speaker Using Chatbot for Senior Users (시니어 사용자를 위한 챗봇활용 음성인식 스피커 개발 방법)

  • Noh, Gunho;Lee, Kyoung Yong;Moon, Mikyeong
    • Journal of IKEEE
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    • v.22 no.2
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    • pp.330-338
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    • 2018
  • As population aging progresses, there is a growing demand for IT technology that can relieve the psychological anxiety of the elderly living alone, recognize the dangerous situation, and check the family members' affection. In this paper, we describe the development of a speech recognition speaker that enable senior users to give simple interactive commands by voice and monitor the status of the user. The speaker analyzes the user's voice, grasps the conversation contents through the chatbot, connects the desired service to the user, and provides the result again by voice. By using this speaker, senior users can feel relaxed by natural conversation, and can monitor the status of danger more easily.

The Association between Health Examination and Personal Medical Cost through Panel Survey (건강검진이 개인 의료비지출에 미치는 영향)

  • Lee, Hwan Hyung;Park, Jae Yong
    • Health Policy and Management
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    • v.24 no.1
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    • pp.35-46
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    • 2014
  • Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.

Development of Emotion Contents Recommender System for Improvement of Sentimental Status (감정 및 정서상태 전이를 위한 감성 컨텐츠 추천 시스템 개발)

  • Park, Myon-Woong;Ha, Sung-Do;Jeong, Do-Un;Lyoo, In-Kyoon;Ahn, Seong-Min
    • Science of Emotion and Sensibility
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    • v.10 no.1
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    • pp.1-11
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    • 2007
  • An Infotainment Service intended to enhance the human emotion is introduced in this paper. The service is to be installed on the robot helping elderly persons to live comfortable and enjoyable life. The research started with defining the undesirable status of emotion in everyday life, and the psychological skills to cope with the status were sought about. Then, a methodology for providing emotion contents reflecting the coping skill has been suggested. Based on the Cognitive Behavior Therapy, the coping skill is used to edit animation clips. A movie recommendation system to utilize the edited animation clips has been being developed. A series of process for developing the system is described, where the emotion elements are taken into consideration in addition to the user preference as the criterion for recommendation.

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Communication Aid System For Dementia Patients (치매환자를 위한 대화 보조 시스템)

  • Sung-Ill Kim;Byoung-Chul Kim
    • Journal of Biomedical Engineering Research
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    • v.23 no.6
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    • pp.459-465
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    • 2002
  • The goat of the present research is to improve the quality of life of both the elderly patients with dementia and their caregivers. For this Purpose, we developed a communication aid system that is consisted of three modules such as speech recognition engine, graphical agent. and database classified by a nursing schedule. The system was evaluated in an actual environment of nursing facility by introducing the system to an older mail patient with dementia. The comparison study was then carried out with and without system, respectively. The occupational therapists then evaluated subject"s reaction to the system by photographing his behaviors. The evaluation results revealed that the proposed system was more responsive in catering to needs of subject than professional caregivers. Moreover we could see that the frequency of causing the utterances of subject increased by introducing the system.