• 보건교육건강증진학회지
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• 제15권2호
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• pp.119-142
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• 1998

The purpose of this article is to provide a method of losing weight and early managing risky factors of geriatric diseases by having male and female obese middle school students' participate in behavioral modification and aerobic exercise, foster their own desirable behavioral habit and confidence in solving obesity and continue their living pattern all their life. In order to do this, 64, subjects over 20% obese degree obtained using the standard weight, belonging within 50% range of weight percentage per height(male:32, female:32) were grouped to 4 categories of aerobic exercise therapy, behavioral modification therapy, both therapies combinedly applied and control ones by 8 male and female students allocated to each group respectively, and they were practiced to each program for 12 weeks, and the findings between group were obtained as follows. 1. The male and female middle school students' cholesterol amount of blood fat reduced most in the combinedly performed group of aerobic exercise and behavioral modification therapy. It indicated a statistically significant difference between groups (F(3,56) =9.50, p=.000) and the measurements according to the application period of program as well (F(3,168)=554.94, p=.000). The cholesterol amount per measurement period reduced most between 8 and 12 weeks. 2. The male and female middle school students' high density fat amount increased most in the combinedly performed group of aerobic exercise therapy and behavioral therapy, its descending order of next highest rate was aerobic exercise therapy, behavioral modification therapy and control group. It indicated a statistically significant difference between the distinction of male and female sexes (F(1.56)=13.82. p=.000) and the measurements according to the application period of program (F(3,168) =55.58, p=.000). The high density fatty Quality per measurement period increased most between 8 and 12 weeks. 3. The male and female middle school students' low density fat amount reduced most in the combinedly performed group of aerobic exercise therapy and behavioral modification therapy. It indicated a statistically significant difference between groups (F(3,56)=17.35, p=.000) and the measurements according to the application period of program (F(3,168)=891.14, p=.000. The low density fat amount reduced most between 8 and 12 weeks. 4. The male and female middle school students' neutral fat amount reduced most in the combinedly performed group of aerobic exercise therapy and behavioral modification therapy. It indicated a statistically significant difference between the distinction of sexes (F(1,56)=9.54, p=.003) and groups (F(3,56) =25.57, p=.000) and the measurements according to the application period of program (F(3,168) =566.03, p=.000). The male students indicated the most reduction between 4 and 8 weeks. while the female students between 8 and 12 weeks.

• 한국산학기술학회논문지
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• 제18권7호
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• pp.490-499
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• 2017

현대사회의 복잡다기한 문제파악과 분석을 위해 최근들어 다양한 변수를 바탕으로 하는 복잡계 분석의 도입이 활발해 지고 있다. 외래부의 공간배치에 따른 환자들의 공간인지와 사용성을 미리 예측하는 것은 질 높은 병원서비스 제공을 위해 매우 중요한 요소라 할 수 있다. 객관적 분석을 위해 노인의 질환별 표준프로그램 절차 및 분석을 위한 지표를 마련하고 히트맵 분석과 정량적 분석을 통해 대기공간의 균일성을 평가하였다. 이에 본 연구에서는 요양병원을 대상으로 복잡계 분석 방법을 이용하여 진료공간 접수공간 상담공간의 배치변화에 따른 4개 대안의 대기공간 균일성을 분석하기 위해 73개의 셀을 설치하여 시뮬레이션을 구축하고 그에 따른 밀도를 도출하였다. 연구를 통하여 다음과 같은 결론을 얻을 수 있었다. 1)대기공간의 전체 공간밀도는 접수공간의 배치가 가장 큰 영향을 미친다. 2)검사공간과 진료공간의 확실한 분리배치가 대기공간의 균일성을 높여주는 방안이다. 3)접수공간의 위치가 입구에서 가까울수록 대기공간의 밀도균일이 커진다. 마지막으로 본 연구는 대기공간 균일성 평가에 이산사건 시뮬레이션의 적용방안에 관한 연구로서, 행위자기반모델이 공간분석 방법론으로서의 활용과 평가에 활용도를 가질 수 있음을 입증하였다.

• 대한영양사협회학술지
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• 제17권2호
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• pp.176-189
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• 2011

The purpose of this study was to investigate the status of clinical nutrition services at various medical centers in Seoul, Korea. A questionnaire was distributed to the departments of nutrition at 44 hospitals in Seoul on July 2009. Nutritional screening carried out at a rate of 59.1% at the medical centers, and a significant difference was found according to the type of center, from 100% in tertiary hospitals to 18.8% in normal hospitals. On annual average, the numbers of inpatients, inpatients for malnutritional screening, inpatients with malnutrition, and inpatients for malnutrition management were 15,169.5, 10,870.9, 2,224.8, and 1,546.2, respectively. On average the group nutrition education was done 36.1 times/year for diabetes, 8.2 times/year for cancer, and 1.9 times/year for renal disease, and the numbers of participants 423.1, 95.1, and 31.5, respectively. On average the individual nutrition education of inpatients with diabetes was done 135.4 times/year for ordered-type, and 119.3 times/year for unordered-type, 106.2 times/year for paid-type, and 148.5 times/year for unpaid-type. The mean fee for education and counseling was the highest for peritoneal dialysis (73,090.9 won) but the lowest for heart disease (23,609.1 won). On average the individual nutrition education of outpatients with diabetes was done 234.6 times/year for ordered-type, and 2.5 times/year for unordered-type, 204.4 times/year for paid-type, and 32.7 times/year for unpaid-type. The mean fee for education and counseling was also the highest for peritoneal dialysis (63,500.0 won) but the lowest for heart disease (21,336.4 won). To implement more effective clinical nutrition service, a national medical insurance imbursement policy should be urgently instituted such that diseases left as unpaid are covered by health insurance, including all nutrition-related disease.

• 한국환경보건학회지
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• 제7권2호
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• pp.119-126
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• 1981

This study aims to research on the actual state of the ways that the aged people live in Seoul use intentionally or unintentionally to maintain in their health. The aged people selected randomly for the study are 541 men and 902 women who are all more than 65 years old. This survey carried out from April to May in 1980. The results of this study are summed up as follows: 1. The main means of making a living engage was agriculture with the per cent of 57. 3 and next was commerce (11.9%). 2. As for their staple foods, the majority of them eat mixed food of rice and barley, and the rest eat rice or minor-grain mixed rice. As subsidiary foods, vegetables are the most common side dishes (68.9%) and see-weeds (6.7%) are taken by the minority of them. 3. Most of them (74.6%) frequently or occasionally take special health foods to maintaing their health. The most common health food turned out to be tonic liquor to men, while honey to women. 4. The majority of them(23.2% of men and 45.5% women) refrain from drinking and smoking. 5. 39.5 per cent of men and 25.5 per cent of wome) take light exercise such as going up hill and walking. 6. The majority of them undergo routine health check with the per cent of 10.8 or occasioanal health check with the 42.9. As medical treatment, many of them(45.9%) take Chinese remedies, western remedies(39.1%) and folk remedies (15.0%). 7. Many of them (66.0%) feel subjective symptoms about some geriatric diseases such as neuralgia, hypertension and cough. 8. Many of them (63.2%) free from mental trouble, while 17.7 per cent of them appeal to no job to do, 10.0 per cent of alienation and 9.1 per cent of domestic troubles. 9. Their subjective judgements of their secrets of health and longevity attach more importance to leading a regular life. 10. Most of them want to be served appropriate medical care, rest place, health consultations, etc. All these results reveal that health and longevity of the aged people are maintained by necessary cares and efforts, not by accident nor by apathy. It is thus highly desired tha tmany studies, enlightments and nationwide support about this problem be carried out in future.

• 가정간호학회지
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• 제2권
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• pp.5-18
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• 1995

While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

• 말소리와 음성과학
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• 제2권4호
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• pp.245-252
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• 2010

Korea does not have a certain criteria on the respiratory ability and phonation of the normal aged, and also has no clear standard to examine the boundaries of geriatric diseases. This study analyzed the characteristics in respiration and phonation of the aged in normal healthy elderly from diverse angles with different variables. Thirty-three participants in total, seven males and eight females in the age group 55-64 participated in the study. Seven males and eleven females in the age group 65-74 were selected for the respiration and phonation experiments, and 10 different variables such as FVC, $FEV_1$, $FEV_1$/FVC, MPT, MFR, Psub, f0, jitter, shimmer and NHR were comparatively analyzed for each group of different age and gender. To see the difference in respiration and phonation by age and gender, the study conducted a two-way ANOVA. First, from the result of the analysis on respiratory ability, FVC of male appeared to be significantly greater than female. In both age groups of 55-64 and 65-74, male displayed greater FVC than female did. Second, as for $FEV_1$, $FEV_1$/FVC, the age group of 55-64 showed greater values than the values measured in the age group of 65-74. Third, MFR showed a significant difference by gender. In both age groups, male showed significantly higher MFR than female. Fourth, for different gender, a significant difference in MFR was observed. In both age groups of 55-64 and 65-74, male exhibited higher MFR than female. This study has a clinical implication in that it analyzed the criteria on respiration and phonation in normal healthy elderly according to gender and age. The normal aged showed a difference in their respiratory and phonatory functions by age and gender, it was closely related to the decline of pulmonary function due to the physical aging and the weak respiration coming from weakness of respiratory muscles. Also, the physical differences in height, weight, and the muscles in laryngeal and respiratory system between males and females had an influence on the performance. These results from this study might be a helpful guideline for the clinical criterion in the future.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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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.

• Journal of Korean Neurosurgical Society
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• 제64권6호
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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.

• Annals of Geriatric Medicine and Research
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• 제22권4호
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• pp.176-183
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• 2018

Background: Although the frequency and intensity of headaches decrease in older adults, headaches in this population are still an important neurological disorder. The purpose of this study was to investigate the associations of headache characteristics in older adults with the development of cardiovascular disease and cognitive dysfunction. Methods: We prospectively enrolled 125 older (${\geq}65$ years old) patients with headache who were making their first visit to outpatient clinics and who had no prior history of cognitive dysfunction from 11 hospitals in Korea between August 2014 and February 2015. We investigated the occurrence of newly developed/or recurrent headache, cardiovascular disease, cognitive dysfunction, and poor functional outcomes. Results: The mean age of all included patients was 72.6 years, 68.8% were women, and 43 (34.4%) had newly developed/or recurrent headache during follow-up. During a median follow-up of 31 months (interquartile range, 28-34 months), 21 participants (16.8%) experienced cardiovascular disease, and 26 (20.8%) developed cognitive dysfunction. Upon multivariate analysis and after adjusting for sex, age, and other factors, presence of newly developed/or recurrent headache was found to be associated with cardiovascular disease (hazard ratio [HR], 4.03; 95% confidence interval [CI], 1.28-12.61; p=0.017) and frequency of headache for the recent 3 months was related with cognitive dysfunction (HR, 1.05; 95% CI, 1.00-1.09; p=0.017) and poor functional outcomes (HR, 1.06; 95% CI, 1.01-1.11; p=0.011). Conclusion: Our study demonstrated that there is an increased risk of cardiovascular disease, cognitive dysfunction, and poor functional outcomes in older patients with frequent, newly developed, or recurrent headache.

• 생명과학회지
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• 제32권6호
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• pp.482-490
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• 2022

근육 양과 근력의 감소에 의한 근감소증은 다양한 병적 상태의 악화, 삶의 질 저하, 사망률의 증가를 동반하며, 기대수명이 증가함에 따라 앞으로도 유병률은 계속 증가할 것이다. 노화 과정에서 만성 산화 스트레스와 염증 반응의 증가는 골격근 소실의 주요 원인으로 작용하며, 에너지 대사에 필수적인 미토콘드리아의 기능 장애와 관련된 자가포식 및 세포사멸 신호의 교란은 근육 단백질의 손실을 가속화한다. 오래전부터 각종 질병의 예방 및 치료에 널리 사용되어온 동충하초의 주요 생리활성물질인 cordycepin의 약리학적 효과는 항산화 및 항염증 작용과 직접적인 관련이 있는 것으로 알려져 있다. 본 총설에서는 근감소증의 예방과 치료에의 적용을 위한 cordycepin의 세포사멸, 자가포식, 단백질의 이화작용 및 근육 재생에 중요한 위성세포의 활성에 대한 연관성을 제시하였다. 비록 현재까지 근감소증에 대한 cordycepin의 연구는 미진한 수준이지만, 그동안의 연구 결과에서 cordycepin은 노화로 인한 미토콘드리아 기능 약화를 억제하고 근육 단백질의 분해를 차단하는 데 기여할 수 있음을 알 수 있다. 또한 근세포 손상에 대한 cordycepin의 보호 효과는 항산화 및 항염증 활성과 밀접한 관련이 있음을 제안한다. 따라서 근세포의 노화방지에 관여하는 cordycepin의 분자생물학적 기전을 중심으로 보다 지속적인 기초 연구가 필요할 것으로 사료된다.