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Comprehensive Geriatric Assessment for Community Living Elderly in a Rural Area (일부 농촌지역 거주 노인들에 대한 포괄적 노인평가)

  • Rhee, Jung-Ae;Shin, Hee-Young;Chung, Eun-Kyung;Shin, Jun-Ho
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.21-31
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    • 2002
  • The aim of this study was to analyse and conduct the comprehensive geriatric assessment for the elderly in rural area. The subjects were 388 older people aged 65 years or older living in the community. Data for comprehensive assessment such as physical, mental, functional, social and environmental conditions were collected from January to February, 2001 through a person-to-person interview. Of the total 388 olders, 169(43.6%) were men and 219(56.4%) were women. Mean ages of men and women were $73.5{\pm}6.4$ and $74.0{\pm}6.2$ years respectively. Three common diseases of the elderly were arthralgia(51.6%), chronic back pain(33.2%) and hypertension(18.6%), and higher in women than in men. Impairment rate of vision, hearing and bowel or bladder control was 59.0%, 20.1%, and 28.4% respectively. But that of lover extremities 3.4%. In terms of cognitive function, short term memory loss was found in 33.7% of males and 44.7% of females. The percentage of fully independent in the six ADL items was 72.2% in men and 58.9% in women. In the social supportive system, 49.5% of the elderly were living with spouse, and 22.9% living alone, 26.3% having care giver. These results will provide basic data for the development of community-based health program, which gives appropriate health service for the elderly living in the community.

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Usefulness of Blood Pool Half Body in Three Phase Bone Scan in Patients with R/O Reflex Symphathetic Dystrophy Syndrome (반사성교감신경 이영양증후군 환자의 삼상 골 스캔 시 Half Body 혈액 풀 영상의 적용)

  • Lee, Moo-Seok;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Hwa-Jin;Song, Hyeon-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.105-110
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    • 2010
  • Purpose: Three phase bone scan was considered sensitive in Patients with Reflex Symphathetic Dystrophy Syndrome (RSDS). Generally, three phase bone scan in the RSDS patients shows increased uptake of one side extremity joint. But three phase bone scan has been performed with flow, blood pool and delayed scan. We performed blood pool half body scan in order to investigate its usefulness. Materials and Methods: From October 2007 to September 2009, three phase bone scan (flow, blood pool, half body blood pool, delayed) was performed after injection of 750 MBq of $^{99m}Tc$-DPD in diagnosed patients with RSDS (M:F=8:7, R:L=9:6). For quantitative analysis, we obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in the three phase images and compared with the count ratios of shoulders in half body blood pool and delayed images. Results: In flow images, right/left ratios were $1.09{\pm}0.53$. In blood pool images, right/left ratios were $1.13{\pm}0.47$ (hand), $1.08{\pm}0.26$ (shoulder). In delayed images, right/left ratios were $1.24{\pm}0.75$ (hand), $1.11{\pm}0.31$ (shoulder). As a result, Log of right/left counts of the others and that of shoulder blood pool image were correlated well with statistical significance (Spearman's R, p<0.005 SPSS for windows ver.12.0). Conclusion: Half body blood pool scan may be helpful in the diagnosis of patients with RSDS. Moreover, Half body blood pool scan reduced false negative and false positive rates. In order to improve agreement on interpretation of RSDS, Blood pool half body scan should be established as common criteria.

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Hemophagocytic Syndrome Presenting as Severe Acute Hepatitis (중증 급성 간염으로 발현한 혈구탐식증후군에 관한 연구)

  • Ryu, Jeong Min;Chang, Soo Hee;Kim, Joon Sung;Lee, Joo Hoon;Lee, Mi Jeong;Park, Kie Young;Kim, Kyung Mo;Seo, Jong Jin;Moon, Hyung Nam;Ghim, Thad;Chi, Hyun Sook
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.213-221
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    • 2005
  • Purpose: Hemophagocytic syndrome (HPS) is characterized by persistent high fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, and/or hypofibrinogenemia. Hepatic manifestations including overt hepatic failure and fulminant hepatitis are common in HPS. Liver transplantation (LT) should be considered in a case of fulminant hepatitis by other than HPS, but LT is contraindicated and complete cure is possible by chemotherapy in HPS. Therefore, we conducted this study to define the characteristics of HPS presenting as severe acute hepatitis. Methods: Among the total of 23 patients diagnosed as HPS by bone marrow examination between 1994 and 2005 in Asan Medical Center, 11 cases presented as severe acute hepatitis were enrolled in this study. We analyzed the clinical features, laboratory findings and outcome retrospectively. Results: Seven (64%) of the 11 children with HPS and hepatitis were referred to pediatric gastroenterologist at first. The mean age of onset was 50 months. There was no case with family history of primary HPS. Epstein-Barr virus was positive in 4, and herpes Simplex virus was positive simultaneously in 1 case. As the presenting symptoms and signs, fever was present in 10, hepatosplenomagaly was noted in all and jaundice in 10. Anemia was observed in 10, thrombocytopenia in 10, leukopenia in 8, hypertriglyceridemia in 9, hypofibrinogenemia in 8 and hyperferritinemia in 7 cases, respectively. Nine children received chemotherapy including etopside. The overall mortality rate was 72% (8/11). Conclusion: HPS, which needs chemotherapy, should be considered as a cause of severe acute hepatitis especially when accompanied with prolonged high fever and cytopenias.

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PTV Margins for Prostate Treatments with an Endorectal Balloon (전립선 암의 방사선치료 시 직장 내 풍선삽입에 따른 계획표적부피마진)

  • Kim, Hee-Jung;Chung, Jin-Beom;Ha, Sung-Whan;Kim, Jae-Sun;Ye, Sung-Joon
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.166-176
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    • 2010
  • Purpose: To determine the appropriate prostate planning target volume (PTV) margins for 3-dimensitional (3D) conformal radiotherapy (CRT) and intensity-modulated radiation therapy (IMRT) patients treated with an endorectal balloon (ERB) under our institutional treatment condition. Materials and Methods: Patients were treated in the supine position. An ERB was inserted into the rectum with 70 cc air prior to planning a CT scan and then each treatment fraction. Electronic portal images (EPIs) and digital reconstructed radiographs (DRR) of planning CT images were used to evaluate inter-fractional patient's setup and ERB errors. To register both image sets, we developed an in-house program written in visual $C^{++}$. A new method to determine prostate PTV margins with an ERB was developed by using the common method. Results: The mean value of patient setup errors was within 1 mm in all directions. The ERB inter-fractional errors in the superior-inferior (SI) and anterior-posterior (AP) directions were larger than in the left-right (LR) direction. The calculated 1D symmetric PTV margins were 3.0 mm, 8.2 mm, and 8.5 mm for 3D CRT and 4.1 mm, 7.9 mm, and 10.3 mm for IMRT in LR, SI, and AP, respectively according to the new method including ERB random errors. Conclusion: The ERB random error contributes to the deformation of the prostate, which affects the original treatment planning. Thus, a new PTV margin method includes dose blurring effects of ERB. The correction of ERB systematic error is a prerequisite since the new method only accounts for ERB random error.

The Influence of Gender on the Long-term Outcome of Coronary Artery Bypass Surgery (성별에 따른 관상동맥 우회술의 장기 결과)

  • Choi Jong-Bum;Lee Mi-Kyung;Cha Byoung-Ki;Lee Sam-Youn
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.449-455
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    • 2006
  • Background: Female sex was known to be a risk factor for mortality after coronary bypass grafting (CABG), and women showed higher in-hospital mortality than men. Material and Method: Between 1992 and 1996, 147 consecutive patients (98 men and 49 women) undergoing CABG were included in the study. Most patients had undergone CABG with left internal thoracic artery and saphenous vein under cardiopulmonary bypass. We examined the influence of gender on survival after CABG and looked for risk factors for survival. Result: There was no in-hospital mortality in women, but 3 death (3.0%) in men. During the mean follow-up period of $138.5{\pm}23.0$ months, mortality was lower in women than in men (20.4% vs 44.9%, p=0.004), and the most common cause of death in women was chronic renal failure (40%). Survival in women at 1, 5, 10, and f4 years was 100%, $98.0{\pm}2.0%,\;81.2{\pm}5.6%,\;and\;78.4{\pm}6.1%$, respectively, which was better than in men (p=0.004). Although preoperative left ventricular ejection fraction was higher in women than in men, this did not affect early and long-term survival difference between two sexes (p=0.15). Risk factor for long-term survival in women was diabetes (p=0.033) and in men number of diseased coronary artery (p=0.006). Conclusion: Long-term survival after CABG was better in women than men. Risk factor for long-term survival in women was morbid disease rather than cardiac disease.

The Validity of a Combined High Saphenous Division and Sclerotherapy for Varicose Vein (하지정맥류의 치료에 있어서 복재정맥 분리 결찰 및 혈관 경화요법 병용의 유용성)

  • Choi Se-Yong;Yang In-Suk;Won Tae-Hee
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.544-548
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    • 2006
  • Background: The purpose of this study is to evaluate the validity of a combined high saphenous vein division and sclerotherapy without sacrificing saphenous vein for varicose vein. Material and Method: Between August 2004 and October 2005, 70 limbs in 50 patients were treated by a combined high saphenous vein division and sclero-therapy. The operative indication is valvular incompetence of femoral-saphenous or popliteal-saphenous junction. Patients received local anesthesia and were treated by a combined high saphenous vein division, ligation of incompetent perforating vein and $1{\sim}3%$ sclerosant. Patients received 1 day hospitalization and applied in com-pression stocking for 6 weeks. Patients followed after 1 week, 1 and 3 months. Result: Mean age of patients was $50{\pm}11$. The female was more common. 8 patients was no symptom, another 42 patients complained of pain, heaviness and fatigue of limbs. The symptoms of varicose vein disappeared 1 month after the procedure in all symptomatic patients. 8 patients needed a adjuvant sclerotherapy for residual varicose vein on 1 week after the procedure. There were only minor complications such as hematoma (1), wound infection (1), thrombophlebitis (20), skin blister (10), hyper-pigmentation (1), and skin ulcer (1). Conclusion: We concluded that a combined high saphenous vein division and sclerotherapy without sacrificing saphenous vein for varicose vein is simple, less invasive, economical, and effective treatment for primary varicose vein, and it has a special advantage that saphenous vein can be used as a bypass conduit later. The method was selective in old aged patients.

Lymphangioleiomyomatosis in Korea (한국의 폐 림프관평활근종증)

  • Mo, Eun-Kyung;Jung, Man-Pyo;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Im, Jung-Gi;Seo, Jeong-Wook;Lee, Seung-Sook;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.519-531
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    • 1993
  • Background: Lymphangioleiomyomatosis(LAM) is a very rare disease occurring in women of reproductive age and leading to progressive respiratory failure despite therapy. But the natural history of this disease is uncertain and although anti-estrogenic agents have been used for more than twenty years, it's efficacy is still in debate. This study was performed to enhance understanding of this fatal disease in Korea by examining clinical, radiological, and pathologic findings of all the previously reported cases of LAM on Korea along with four new cases of LAM whom we report in this paper. Method: Out of twlve cases of LAM previously unpublished and published in domestic papers, two cases whose diagnoses were considered doubtful after review of clinical, radiological, and pathologic findings at "Asian Congress on Lymphangioleiomyomatosis" at Kyoto, Japan in feburary of 1993 were excluded from this study. Six cases which were reported previously and four new cases of LAM whom we report in this paper were analysed for the clinical, radiological, and pathologic characteristics. Results: All ten patients were women with mean age of $33{\pm}7$. The most common symptom was exertional dyspnea and most patients had history of pneumothoraces. Pulmonary function tests showed decreased diffusing capacity. on high resolution computed tomography(HRCT), all the cases had characteristic cysts. Most of the patients did not respond to hormonal therapy. Conclusion: In women of reproductive age, presenting with dyspnea who has a history of pneumothorax, LAM should always be considered as one of the diagnostic possibilities. If suspected, HRCT should be done to look for characteristic cysts and if needed, open lung biopsy should be done to confirm the diagnosis.

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Comparisons of 12-Hour and 24-Hour Sustained-Release Theophyllines in the Management of Asthma (천식치료에서 서방형 Theophylline의 1일 1회 제형과 1일 2회 제형의 비교)

  • Lee, Yang-Deok;Park, Seoung-Ju;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.293-299
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    • 2001
  • Background : Sustained-release theophylline, which is generally prescribed as a twice-daily equal-dose regimen, is one of the more common asthma treatments. The development of a sustained-release drug delivery technology that enables improved control of the theophylline blood levels represents a significant advancement in both the efficacy and safety of dosing. Method : A crossover study was conducted with 25 adult chronic asthmatic patients requiring daily bronchodilator therapy. The study group included thirteen males and twelve females with ages ranging from 19 to 71 years. The overall approach was to place the patients first on the twice-daily preparation($Etheophyl^{(R)}$) for 28 days at 8 AM and 8 PM, and measure the pulmonary function and theophylline level on the 28th day. The patients were subsequently switched to the once-daily preparation($Uniphyl^{(R)}$) in the same daily dose at 8 PM on the 29th day and the same parameters were measured on the 56th day. Results : The mean serum levels of theophylline were $8.18{\pm}1.66\;{\mu}g/ml$ in the $Etheophyl^{(R)}$-treated period and $8.00{\pm}1.75\;{\mu}g/ml$ in the $Uniphyl^{(R)}$-treated period. ln addition, the $FEV_1$ showed $71.40{\pm}7.48$ percent in the $Etheophyl^{(R)}$-treated and $69.18{\pm}9.00$ percent in the $Uniphyl^{(R)}$-treated period. Thus there were no significant differences between the once-daily and twice-daily preparation. Conclusion : The results indicated little clinical differences between the two medications. The two drugs are equally effective in controlling asthma over the four weeks of treatment.

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A Study on the Determinants of Luxuriousness: With Focus on Product Attributes and Luxuriousness (명품성의 결정요인에 관한 연구: 제품속성과 명품성을 중심으로)

  • Lim, JoongSik;Koh, InKon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.10 no.4
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    • pp.95-111
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    • 2015
  • This purpose of this study is to academically define what "luxury products" mean, and to clarify the cognitive structural relationship between product attributes and "luxuriousness" in relation to the determinant of luxuriousness that eventually affects the purchase intention of consumers. This study is also written under the theory that luxuriousness leads to benefits such as functional benefit, experiential benefit, symbolic benefit, and exclusive benefit; which all provide core values to consumers and serve as effect factors that influence the psychological satisfaction of consumers. The commonly discussed measure of the determinant of luxuriousness has often failed to adequately describe the reasons to why the consumers prefer luxury products. This study also aims to suggest a new path in how and what the consumers perceive as luxury products, and to conceptualize what luxuriousness means in the marketing perspectives on the background of a previous theory. The part of product attributes are divided in the following sections: the quality and design of functional cues and brands of symbolic cues, as well as prices. The part of the determinant of luxuriousness is divided in sections of superiority, scarcity, differentiation, and traditionality. Therefore, this study used the theoretical concept used in such common measures as well as 282 examples to empirically analyze the relationship between product attributes and luxuriousness of luxury products, and how such affect the purchase intentions of consumers. The survey used to aid this study targeted luxury product consumers regarding "B" brand of automobiles. Using the analysis through a structural equation model, the study draws a conclusion that in a relationship between product attributes and luxuriousness, quality(which is one of the functional cues) affects the facts of superiority, differentiation in a significant way, and design affects the factors of scarcity in a significant way. And brand(one of the symbolic cues) significantly affects the factors of traditionality within the luxuriousness factors, and price appeared to affect superiority and scarcity. Additionally, the brand of product attributes significantly affects purchase intention, and superiority and scarcity of luxuriousness affects purchase intention in a significant way. The structural concept of luxury and luxuriousness suggested in the study will provide the theoretical basis for building a new case study, and the determinants of luxuriousness in the marketing perspective will be a practical help for checking the consumers' psychological reasons for purchase.

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Measurements of Carotid Intima, Media, and Intima-media Thickness and Their Clinical Importance (경동맥의 내막, 중막, 내중막 두께 분리측정 및 임상적 중요성)

  • Kim Wuon-Shik;Jeong Hwan-Taek;No Ki-Yong;Bae Jang-Ho
    • Progress in Medical Physics
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    • v.16 no.4
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    • pp.207-213
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    • 2005
  • The severity of carotid Intima-media thickness (IMT) is an Independent predictor of atherosclerosis which causes transient cerebral ischemia, stroke, and coronary events such as myocardial Infarction. The IMT consists of Intima thickness (IT) and media thickness (MT). However, the Individual clinical significance of IT and MT has not been well studied. We devised a method of measuring IT, MT, and IMT using B-mode ultrasound Image processing technique for the diagnosis of atherosclerosis. To inspect the clinical significance of IT, MT, and IMT, one hundred forty-four consecutive patients (mean age; 57 years old, 72 males) were underwent common carotid artery scanning using high-resolution ultrasound. Results showed that, the IT (p<0.05), MT (p<0.05) as well as IMT (p<0.01) of patients with atherosclerotic disease were significantly thicker than that of the patients without atherosclerotic disease. Patients with hyperiension showed significantly thicker IT (p<0.01), MT (p<0.001), and IMT (p<0.001). However, only IT was thicker in patients with smoking (p<0.01). The IT (r=0.374, p=0.001), MT (r=0.433, p=0.000), and IMT (r=0.479, p=0.000) showed positive correlation with age. The coefficients of determination ($r^2$) were estimated to be $92.4\%$ for IMT and MT, $49.1\%$ for IMT and IT, and $27.4\%$ for IT and MT. This result suggests that the Intima layer of the carotid artery has a different physiology with the media layer.

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