• Title/Summary/Keyword: the Elderly

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Risk factors of Pneumonectomy in Non-Small Cell Lung Cancer (비소세포폐암에시 전폐절제술의 위험 인자)

  • Hwang Eun-Gu;Baek Heejong;Lee Hae-Won;Park Jong-Ho;Zo Jae-Ill
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.616-621
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    • 2005
  • Background: In the resection of lung cancer, pneumonectomy occupied $20 {\~}35\%$ of all resections, and significantly high operative mortality is reported in right pneumonectomy ($10{\~}25\%$). The aim of this study is to identify the characteristics of morbidity, operative mortality and factors affecting operative mortality after pneumonectomy. Material and Method: This study recruited the database which performed pneumonectomy for lung cancer in Korea Cancer Center Hospital from Aug 1987 to Apr 2002. Result: Total of 386 pneumonectomies were peformed in that period. Sidedness were left in 238, right in 148; and the procedures were standard resection in 207, and extended resection in 179. Morbidity occurred in 115 cases ($29.8\%$, 115/386). Mortality occurred in 12 cases ($3.1\%$, 12 in 386). This mortality rate was similar to that of lobectomy ($2.1\%$, 13 in 613) during the same period. Morbidity consisted of 42 hoarseness, 17 (9) pneumonia and ARDS, 8 empyema, 5 (1) broncho-pleural fistula, 5 reoperation for bleeding, 5 (1) arrhythmia, 1 (1) pulmonary edema, and 25 others (The number in the parenthesis is the number of mortality case for that morbidity). Several factors affecting the operative mortality were evaluated. At first, extended procedure ($3.3\%$, 6 in 179) affected the operative mortality similar to the standard procedure ($2.9\%$, 6 in 207)(p=0.812). Second, the rate of operative mortality in an elderly group over 60 years ($5.5\%$, 10 in 182) was significantly higher than the younger group under 60 years ($1\%$, 2 in 204)(p=0.016). Third, sidedness of resection affects to operative mortality. Right pneumonectomy ($6.8\%$, 10 in 148) showed higher operative mortality than that of left pneumonectomy ($0.8\%$, 2 in 238)(p=0.002). The group over 60 years showed higher incidence of respiratory morbidity ($11.0\%$, 20 in 182) than that of the group under 60 years ($3.4\%$, 7 in 204)(p=0.005). Right pneumonectomy also showed significantly higher incidence ($11.5\%$, 17 in 148) than that of left pneumonectomy ($4.2\%$, 10 in 238)(p=0.008). Conclusion: Age and sidedness of pneumonectomy were the risk factors of operative mortality and respiratory complications, Therefore, careful selection of patients and more attention perioperatively were demanded in right pneumonectomy. However, because the operative mortality is acceptable, pneumonectomy could be done safely if the pneumonectomy is necessary for curative resection of lung cancer.

The Present State of Food Serviee by the Covered Wagon Bars (포장마차 영업실태조사(營業實態調査))

  • Yoon, Eun-Young;Choi, Kyung-Suk;Park, Young-Sook;Mo, Su-Mi
    • Journal of the Korean Society of Food Culture
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    • v.3 no.2
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    • pp.187-195
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    • 1988
  • In accordance with the rapidly growing number of street food service without a registration, a study was undertaken to determine the present state of food service by the covered wagon bar, through an investigation in Jamwondong, around the south gate market and Kangnam subway station, in Seoul, between July 25th and August 25th of 1987. The survey was comprised of three parts: 1) foodservice operation in covered wagon, 2) personal and food handling hygiene, 3) food behaviors of customers. A total of 54 covered wagon bars, consisting of 51.8% mobile bars and 48.2% non-mobile bars, operating in the above three locations, were investigated. Survey results show non-mobile covered wagon bars to be more popular among persons in their thrities and fourties than among teens or the elderly; also among males than females; among company employees and college students than others. Seventy five percent of the mobile covered wagon bars served snack type foods and others served wine and foods for wine, in contrast to hundred percent of the non-mobile covered wagon bars served wine and foods for wine. The survey found many problems of hygiene, in method of food purchasing, menu planning, food preparation, dish washing treatment of leftovers and water supply, as well as personal hygiene. However, customers prefer the casual and popular atmosphere at the counter of the covered wagon bar. Finally, the study emphasizes a need for better operation of covered wagon bar, improvement of food stuff handling and the way of food services and personal hygiene. A change of the registration system from the illegal operation are urgently needed for better quality food services of covered wagon bars.

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A Study on Medical Waste Generation Analysis during Outbreak of Massive Infectious Diseases (대규모 감염병 발병에 따른 의료폐기물 발생량 예측에 관한 연구)

  • Sang-Min Kim;Jin-Kyu Park;In-Beom Ko;Byung-Sun Lee;Sang-Ryong Shin;Nam-Hoon Lee
    • Journal of the Korea Organic Resources Recycling Association
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    • v.31 no.4
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    • pp.29-39
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    • 2023
  • In this study, an analysis of medical waste generation characteristics was conducted, differentiating between ordinary situation and the outbreaks of massive infectious diseases. During ordinary situation, prediction models for medical waste quantities by type, general medical waste(G-MW), hazardous medical waste(H-MW), infectious medical waste(I-MW), were established through regression analysis, with all significance values (p) being <0.0001, indicating statistical significance. The determination coefficient(R2) values for prediction models of each category were analyzed as follows : I-MW(R2=0.9943) > G-MW(R2=0.9817) > H-MW(R2=0.9310). Additionally, factors such as GDP(G-MW), the number of medical institutions (H-MW), and the elderly population ratio(I-MW), utilized as influencing factors and consistent with previous literature, showed high correlations. The total MW generation, evaluated by combining each model, had an MAE of 2,615 and RMSE of 3,353. This indicated accuracy levels similar to the medical waste models of H-MW(2,491, 2,890) and I-MW(2,291, 3,267). Due to limitations in accurately estimating the quantity of medical waste during the rapid and outbreaks of massive infectious diseases, the generation unit of I-MW was derived to analyze its characteristics. During the early unstable stage of infectious disease outbreaks, the generation unit was 8.74 kg/capita·day, 2.69 kg/capita·day during the stable stage, and an average of 0.08 kg/capita·day during the reduction stage. Correlation analysis between generation unit of I-MW and lethality rates showed +0.99 in the unstable stage, +0.52 in the stable stage, and +0.96 in the reduction period, demonstrating a very high positive correlation of +0.95 or higher throughout the entire outbreaks of massive infectious diseases. The results derived from this study are expected to play a useful role in establishing an effective medical waste management system in the field of health care.

The Distribution of Oral Candida Species in Patient with Prosthetic Appliance (보철물 장착 환자의 구강 칸디다균 분포)

  • Son, Seung Hwa;Baek, Su Min;Park, Young Min
    • Journal of dental hygiene science
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    • v.14 no.4
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    • pp.477-487
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    • 2014
  • Of the many pathogenic Candida species, Candida albicans is the main fungal pathogen of humans. The oral environmental factors considered in the Candida albicans colony forming unit test contain both host and microbial factors associated with candidiasis. In particular, Candida biofilms can develop on surfaces of prosthesis. The purpose of this study was to investigate the distribution of oral Candida species between the type of prosthesis and the situation of oral environment in patient with prosthetic appliance. The patients were 30 elderly subjects with different types of prosthesis, 7 who wore denture, 12 who wore implant and 15 who wore removable orthodontic appliance. We used Candida albicans colony forming unit test using saliva to exam the distribution of Candida albicans related with 5 oral environmental factors, gender, smoking or nonsmoking, alcohol/nonalcohol consumption, the type of prosthetic appliance and its treatment duration as well as tooth brushing frequency per day. In conclusion, for the patient's gender, site in the oral cavity and the type of prosthetic appliance and its treatment duration was associated with an increase in the distribution of Candida albicans in saliva. The distribution of Candida albicans within the oral cavity performs to be modulated to varying extents by oral environmental factors and, further investigations are required to elucidate these complex interactions.

Prevalence of Metabolic Syndrome and Related Risk Factors of Elderly Residents in Andong Rural Area 2. Based on the Biochemical Measurements and Nutrient Intakes (안동 농촌지역 중년 및 노인 주민의 대사증후군 유병율과 관련 위험요인 분석 2. 생화학 측정결과와 영양소 섭취를 중심으로)

  • Lee, Hye-Sang;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.10
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    • pp.1459-1466
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    • 2010
  • This study was performed to identify the association between the metabolic syndrome and the biochemical measurements and nutrient intakes. A total of 1,431 people (533 males, 898 females) aged over 45 years living in Andong rural area participated in this study in 2003. Plasma aspartate aminotransferase (AST), alanine aminotransferase (ALT), $\gamma$-glutamyl transferase ($\gamma$-GT) and thiobarbituric acid reactive substances (TBARS) levels in metabolic syndrome were significantly higher than those in normal group. In multiple logistic regression, those biochemical measurements were found to be positively associated with the metabolic syndrome as the adjusted odds ratios (OR) 1.839 (p<0.001) by AST, 2.302 (p<0.01) by ALT, 2.143 (p<0.001) by $\gamma$-GT, and 1.874 (p<0.001) by TBARS. We also found that the increased level of those measurements tended to be strongly associated with high triglyceride among the metabolic syndrome components. However, the nutrient intakes between the metabolic syndrome and the normal group were not significantly different. Also, we could not find any nutrient intakes significantly associated with the metabolic syndrome, except high carbohydrate intake (>70% of kcal) compared to normal intake (55~70% of kcal) showed OR 0.781 (p<0.05). In analyzing the association of nutrient intakes with metabolic syndrome components, we found that the calorie intake was negatively associated with abdominal obesity (OR 0.696, p<0.05) and high fat intake (>25% of kcal) was positively associated with low HDL-cholesterol (OR 1.864, p<0.05). This study revealed that the biochemical measurements, such as plasma AST, ALT, $\gamma$-GT, and TBARS, are associated with metabolic syndrome, but considering the nutrient intakes, we suggest that further studies are needed to identify the associations.

Association between Medial Temporal Atrophy, White Matter Hyperintensities, Neurocognitive Functions and Activities of Daily Living in Patients with Alzheimer's Disease and Mild Cognitive Impairment (알츠하이머병 및 경도인지장애 환자에서 내측두엽 위축, 대뇌백질병변, 신경인지기능과 일상생활 수행능력과의 연관성)

  • An, Min hyuk;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.67-76
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    • 2021
  • Objectives : The aim of this study was to compare activities of daily living (ADLs) according to degenerative changes in brain [i.e., medial temporal lobe atrophy (MTA), white matter hyperintensities] and to examine the association between neurocognitive functions and ADLs in Korean patients with dementia due to Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods : Participants were 111 elderly subjects diagnosed with AD or MCI in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. ADLs was evaluated with the Korean version of Blessed Dementia Scale-Activity of daily living (BDS-ADL). Neurocognitive function was evaluated with the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). Independent t-test was performed to compare ADLs with the degree of MTA. Pearson correlation and hierarchical multiple regression analyses were performed to analyze the relationship between ADLs and neurocognitive functions. Results : The group with high severity of the MTA showed significantly higher BDS-ADL scores (p<0.05). The BDS-ADL score showed the strongest correlation with the word list recognition test among sub-items of the CERAD-K test (r=-0.568). Findings from the hierarchical multiple regression analysis revealed that the scores of MMSE-K and word list recognition test were factors that predict ADLs (F=44.611, p<0.001). Conclusions : ADLs of AD and MCI patients had significant association with MTA. Our study, which identifies factors correlated with ADLs can provide useful information in clinical settings. Further evaluation is needed to confirm the association between certain brain structures and ADLs.

The effect of restrictions on oral health-related activities of adults in Korea on quality of life: Using the 8th Korean National Health and Nutrition Examination Survey (우리나라 성인의 구강건강 관련 활동 제한이 삶의 질에 미치는 영향: 국민건강영양조사 제8기 1차년도(2019)자료 활용)

  • Mi-Jeong Kim;Cha-Young Lim
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.173-182
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    • 2023
  • Background: This study aims to investigate the effect of restrictions on oral health-related activities of young adults, middle-aged, and elderly in Korea on the quality of life and contribute to the development of intervention strategies to improve the quality of life by improving the importance of oral health care and healthy lifestyle habits of adults. Methods: The 8th National Health and Nutrition Survey was used, targeting adults categorized into three age groups: young adults aged 19 to 29, middle-aged adults aged 30 to 49, and prime-aged adults aged 50 to 64. Demographic characteristics and EQ-5D, HINT-8 and oral-related toothache experience, chewing problems, speaking problems, and complaint of discomfort to chew analyzed. T-test and one-way ANOVA were performed to find out the difference in quality of life according to the restrictions on oral activities of adults, and linear regression analysis was performed to investigate the factors affecting the quality of life of adults. Results: The differences between EQ-5D and HINT-8 according to the restrictions on oral health-related activities of young, middle-aged, and prime-aged were statistically significant in all oral activity restriction variables(p ≦0.05). Factors affecting EQ-5D of all adults were statistically significant in all variables such as region, gender, household monthly income, education level, basic living status, economic activity, subjective oral health status, toothache experience, chewing problem, speaking problem, and complaint of discomfort to chew(p ≦0.05). Factors affecting HINT-8 of all adults were statistically significant in variables such as gender, household monthly income, education level, basic living status, economic activity, toothache experience, chewing, speaking, and complaint of discomfort to chew(p ≦0.05). Conclusions: Various measures are needed to improve the quality of life in old age by allowing adults to face physically, mentally, and socially prepared old age. Based on the results of this study, an adult oral health program should be developed to improve the oral health and quality of life of adults.

Meta-Analysis about Effect of Aromatherapy on Stress (향기요법이 스트레스에 미치는 효과에 대한 메타 분석)

  • Kim, Gyung-Duck;Suh, Soon-Rim
    • Journal of Hospice and Palliative Care
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    • v.11 no.4
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    • pp.188-195
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    • 2008
  • Purpose: The purpose of this study was to analyze the effects of aromatherapy on stress using meta-analysis. Methods: Meta-analysis was done with 21 published studies, and data were analyzed with the SAS 9.1 program. Results: Fifty eight effect size was estimated with data from 21 published studies. Overall mean effect size (ES), and mean effect size of dependence variables according to the type of intervention and subject and according to the total amount of time spent in aromatherapy were estimated. Overall mean effect size of the effects of aromatherapy was .593, and the subjective stress (.983) was most effective in the physiological faculty, followed by mean effect size of cortisol (.648) and pulse (.40). On the other hand, mean effect size of systolic blood pressure (.490) was moderate, and that of diastolic blood pressure (.401) was not large. Mean effect size of elderly (.706) cancer patients was considerable(.337). There were significant differences depending on the subjects. With regards to the types of aromatherapy, the effect size of aroma massage combined with inhalation therapy was .590, and there were no significant differences between the intervention methods. With regards to the time of intervention, $20{\sim}30$ minutes spent in aromatherapy was .730, and there were no significant differences between the times of intervention. The relationship between the effect size and intervention frequency was r=.349 and showed significant difference. Conclusion: This result suggests that aromatherapy is an effective intervention to reduce stress for subjects. Nursing intervention protocol by using aromatherapy should be developed and applied in clinical and community settings. Further studies on the effects of aromatherapy on stress should be done by using meta-analysis.

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The Assessment for Nutrient Intakes of Korean Patients with Heart Failure (우리나라 일부 심부전 환자의 영양소 섭취량 평가 연구)

  • Lee, Hye-Ran;Kang, Bo-Rum;Chung, Hye-Kyung;Do, Hyun-Joo;Shim, Jee-Seon;Bae, Soon-Hwa;Kang, Seok-Min;Shin, Min-Jeong
    • Journal of Nutrition and Health
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    • v.43 no.3
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    • pp.224-232
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    • 2010
  • The prevalence of heart failure (HF) is increasing globally and growing evidence has shown that dietary factors play an important role in preventing and improving prognosis of HF. However, little data on nutrient intake in Korean HF patients which are available to develop dietary guidelines for HF. The aims of this study were to estimate nutrient intake in 78 HF patients and evaluate whether the estimated nutrient intake is appropriate compared to dietary reference intake for Koreans. Data are presented as the ratio of actual intake and estimated average requirement (EAR) for each nutrient. The result showed that the average nutrient intakes including total energy and protein met EAR in total patients. However, the deficiencies in mineral and vitamin intakes were found. Moreover, the proportion of subjects with lower intake than EAR was substantial. The results showed that the proportion of male HF patients with inferior intakes to EAR in calcium, potassium (compared to adequate intake: AI), folate and vitamin $B_{12}$ were 38%, 79%, 38%, and 65%, respectively. Also, the proportion of female HF patients with inferior intakes to EAR in calcium, potassium (compared to AI), folate and vitamin $B_{12}$ were 35%, 88%, 38% and 40%, respectively. In particular, the elderly with HF ($\geq$ 70 yrs, n = 28) showed more serious deficiencies in calcium, potassium (compared to AI), folate and vitamin $B_{12}$. In summary, the intakes of potassium, calcium, folate, and vitamin B12 were not sufficient to meet EAR in HF patients. Furthermore, the proportions of subjects with lower intake than EAR in these nutrients were substantial, raising the possibility that these micronutrients may be involved in the pathogenesis of HF. Practical dietary guideline for HF patients is needed to improve prognosis of HF.

Clinical Study of Simultaneous Acquisition Rest 99mTc-sestaMIBI/Stress 201Tl Dual-Isotope Myocardial Perfusion Imaging with a Solid-State Dedicated Cardiac Gamma Camera (반도체 심근 전용 감마카메라를 이용한 Rest 99mTc-sestaMIBI/Stress201Tl 이중 동위원소 심근 관류 동시 스캔에 관한 임상적 고찰)

  • Bahn, Young-Kag;Kim, Dong-Heui;Choi, Yong-Hoon;Kang, Chun-Koo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.2
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    • pp.88-91
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    • 2018
  • Purpose The purpose of this study is to investigate the simultaneous dual isotope (SDI) myocardial perfusion scan that can be performed in a short time using a semiconductor gamma camera. Materials and Methods Of the 86 patients who underwent Rest/Stress $^{99m}TC$-sestaMIBI 1-day myocardial perfusion scan and Rest $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ simultaneous dual isotope myocardial perfusion scan using a heart-only gamma camera, the test results were the same, 36 patients who did not show any change in the clinical outcome. Quantitative values were statistically analyzed using a QPS program to confirm the correlation between the images of the two examinations. Results Rest/Stress $^{99m}TC$-sestaMIBI simultaneous dual myocardial perfusion scans and $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ double-isotope myocardial perfusion scans were analyzed for Summed score. The $R^2$ value of the Rest summed score (RSS) was 0.91 and the $R^2$ value of the stress summed score (SSS) was 0.71. Conclusion The $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ simultaneous dual isotope scan confirmed its correlation with the previous day's test. The $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ simultaneous dual isotope scan can be completed in approximately 30minutes. It maybe clinically useful for patients who need short examination time such as emergency patients or elderly patients.