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Clinical Analysis of Coronary Artery Bypass Surgery for Ischemic Heart Disease (허혈성 심질환의 치료에서 관동맥우회술의 임상적 고찰)

  • Jung, Tae-Eun
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.225-233
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    • 1996
  • From August 1992 to July 1996, 63 consecutive patients underwent coronary artery bypass surgery. The mean age of these patient was 57 years(range form 30 to 71years). There were 44 men and 19 women. Preoperative 12 patients had stable angina pectoris and 23 patients were unstable angina pectoris. 8 patients had previous myocardial infarctation history and emergency or urgent myocardial revascularization were performed in 9 cases. In the risk factors of coronary atherosclerosis, 25 patients(40%) were hypercholesterolemia, 38 patients(60%) have smoking history and 19 patients(30%) have hypertension history. In the patterns of disease, 9 patients were single vessel disease, 18 patients were two vessele disease and 33 patients were three vessel disease. We performed total 284 distal anastomosis(mean 3.5 anastomosis per patient) and performed one case of ascending aorta graft interposition, two cases of mitral valve replacement, one case of aortic valve replacement, one case of ventricular septal defect repair and one case of atrial septal defect repair and the mean aortic cross clamp time was 115.3 minutes. The common complications were arrhythmia(7cases), wound infection(5cases), perioperative myocardial infarction(4cases), reoperation for bleeding control(4cases) and stroke(4cases). There were six hospital deaths due to low cardiac output syndrome, ventricular arrhythmia and respiratory failure. In the evaluation of operative risk factors, preoperative intravenous nitroglycerin requirement and prolonged aortic cross clamp tirne(>2hours) were found to be predective factor of morbidity and old age(>65years) was found to be predective factor of mortality.

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A Clinical Study on the Prevalence of Skin Diseases in Adult Patients - focused on an ageing society (성인 피부질환 발생빈도에 대한 임상적 연구 - 고령화 사회를 중심으로)

  • Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.19 no.2
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    • pp.242-248
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    • 2006
  • 배경 : 의과학과 사회-경제학의 발전은 인간 수명 연장에 지대한 공헌을 해 왔다. 그러나 결과적으로 피부 질환으로 고생하는 노인 인구도 증가하였다. 본 연구에서는 동국대학교 한방 안이비인후피부과에 피부질환을 주소증으로 내원한 성인 환자들을 대상으로 임상 양상을 조사해 보고 고령사회에서 어떻게 한방 피부과 의료 수요 변화에 대처하고 발전해 나아갈 수 있을지 그 방법을 모색해 볼 수 있는 근거 자료로 활용하기 위해 수행하였다. 연구방법 : 2002년 1월부터 2004년 12월 까지 3년 동안 동국대학교 한방 안이비인후피부과에 피부 질환을 주소증으로 내원한 319명의 환자를 대상으로 하였다. 그들을 내원시기, 연령, 성별로 나누어 질환별 분포를 조사하였다. 통계분석은 $X^2$ test(Window, SPSS 11.0)를 사용하였고 p <.05를 유의수준으로 하였다. 결과 : 2002년부터 2004년 까지 질환별 분포를 살펴보면 습진 21.9%, 소양증 20.4%. 여드름 16.9%,로 나타났다. 2002년에는 습진 17.0%, 소양증 16.0%, 여드름이 14.9%였다. 2003년에는 소양증 34.2%, 두드러기가 23,3%, 습진이 17.1%였다. 2004년에는 습진 61.4%, 여드름 21.1%, 소양증 15.8%였다. 이들 결과는 통계적으로 유의한 차이를 보였다($X^2\;=\;54.135^{***}$, p = .000, df : 20). 남자에서는 습진이 25.0%로 가장 많았고 소양증 19.5%, 두드러기 12.5%, 지루성 피부염 11.7%로 나타났다. 여자에서는 여드름이 22.0%로 가장 많았고 소양증 20.9%, 습진 19.9%였다. 이들 결과는 통계적으로 유의한 차이를 보였다($X^2\;=\;19.839^*$, p = .031, df : 10). 20대 환자에서는 여드름이 24.1%로 가장 많았고 습진과 소양증이 각각 19.5%였다. 30대 환자군에서는 습진이 30.3%였고 소양증이 19.1%였다. 40대에서는 소양증이 28.8%였고 지루성 피부염이 16.0%였다. 50대에서는 습진이 26.7%였고 60세 이상의 그룹에서는 습진이 50.0%, 바이러스 질환과 소양증이 각각 15.0%였다. 이들 결과는 통계적으로 유의한 차이를 보였다($X^2\;=\;74.995^{**}$, p = .001, df : 40). 결론 : 상대적으로 50세 이상 연령충의 대상 환자 수가 많지 않은 원인은 여리 가지 분석이 가능할 것으로 생각된다. 연령에 따라 피부질환이 다른 양상을 보임을 고려할 때 노인층의 신체적, 경제적, 사회적 특성을 이해하고 이에 따른 효과적이고 사회-경제학적 부담을 최소할 수 있는 한방 치료 영역의 확대 및 개발이 필요할 것으로 사려된다.

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Assessment of Elderly's Isokinetic Muscle Function, Flexibility and Balance in a Region of Seoul (서울 일부 지역 노인들의 등속성 근기능, 유연성, 균형성 측정 및 평가)

  • Kim, Suk-Won;Sohn, Jee-Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.37-44
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    • 2016
  • The aim of the present study was to compare the strength, balance, and flexibility across two age groups (older adults vs. young adults). The isokinetic muscle function, ankle ROM, trunk forward flexibility, stability, and antropometric data for the elderly and 46 university students were collected. The results indicated that male older adults possessed relatively low flexibility (2.97cm) among the groups and showed better stability in the right foot than in the left foot and $35^{\circ}$ of plantar flexion ROM, which was not in the normal range. Their peak strength at the knee joint was below 50% of their counterpart. They revealed a hamstring deficit of 18.55%, ankle eversion deficit of 23.08%, and ankle inversion deficit of 19.19%. The results indicated that female older adults possessed comparable flexibility compared to female young adults. The reciprocal muscle strength ratio of both knees was under 50%, and the deficit was 14.32% (extension) and 19.73% (flexion). The ankle plantar flexion peak torque was approximately 62% (left) and 73% (right) of WS's. The ankle dorsi flexion deficit was 25.05% and the plantar flexion was 26.86%. The eversion deficit was 19.97% and the inversion was 21.09%. These results will be significant in establishing an elderly fitness enhancement program and policy.

The Effect of Basic Pension on Depression in the Elderly: Comparison of Male and Female Living Alone and Couple Households (기초연금 시행이 노인의 우울에 미친 영향: 남녀 독거 가구 및 부부가구 비교)

  • Kim, Jung-Hyun;Chun, Miae
    • 한국노년학
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    • v.41 no.1
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    • pp.169-185
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    • 2021
  • This study investigated whether the increased Basic Pension amount in 2014 affect the level of depression of recipients and whether the effect differs according to three groups by household type(living-alone male, living-alone female, and couple households). Data from two waves of the Korean Longitudinal Study of Ageing(KLoSA) in 2012 (before the introduction of the Basic Pension) and 2016 (after the introduction of the Basic Pension), the elderly aged 65 years or older as of 2012 and the recipients of the basic pension in 2016 (N=2,277) were analyzed. Using the statistical package SPSS 25, mean comparison and multiple regression analyses were implemented. The results confirmed that the level of depression in female elderly living alone and married couples significantly decreased after the introduction of the Basic Pension, while there was no significant change in the level of depression in male elderly living alone. As results of regression analysis in the whole sample, the increased Basic Pension amount had an effect on the depression level of recipients in 2016, the higher the Basic Pension increase, the lower the depression level. Also, the regression analyses among the three groups by household type found that the significant effect of raising the basic pension on depression was reported only in elderly women living alone. Based on the main results of this study, implications were presented.

Status of health and nutritional intake of the elderly in long-term care facilities: focus on Gwangju Metropolitan City (노인의료복지시설 입소 노인의 건강 상태 및 영양소 섭취 현황: 광주광역시를 중심으로)

  • Han, Gyusang;Yang, Eunju
    • Journal of Nutrition and Health
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    • v.53 no.1
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    • pp.27-38
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    • 2020
  • Purpose: This study assessed the food intake and nutritional status of the elderly in long-term care facilities in order to provide adequate food services and improve the nutritional status. Methods: The survey was carried out from August 2019 to October 2019 for the elderly in long-term care facilities located in Gwangju Metropolitan City. The survey was conducted to collect data from 199 elderly persons (34 males and 165 females) aged over 65 years old. The food intake was assessed using a 1-day 24-hour recall method. Results: More than 90% of the subjects were over 75 years old. Forty five percent of the subjects were active, 44.2% of the subjects perceived themselves as not being healthy. Dementia and Parkinson's disease were the most common diseases, followed by hypertension, musculo-skeletal disease, diabetes, and stroke. Only 25.6% of the subjects had most of their teeth intact, and 44.7% of the subjects had difficulty in chewing and swallowing. The total food intake was 1,127 g in males and 1,078 g in females. The most frequently consumed foods were kimchi, cooked rice with multi-grains, soybean soup, cooked rice with white rice, yogurt, pumpkin porridge, soy milk, and duck soup. The average energy intake of the subjects was 1,564.9 kcal in males and 1,535.5 kcal in females. The overall nutritional status of the elderly in the long-term care facilities was poor. In particular, the intake of vitamin D and calcium, vitamin C, riboflavin, and potassium were very low. The intake of vitamin D was 5 ㎍, and 86.4% of the elderly were below the estimated average requirement, while the intake of sodium was high. Conclusion: The results of this study can be used to understand the health and nutritional status and to improve the food services and nutrition management for the elderly in longterm care facilities.

Maxillary full-arch fixed dental prosthesis of the elderly patient with worn dentition (마모된 치열을 지닌 고령 환자의 상악 전악 고정성 수복 증례)

  • Lee, Jae hyun;Choi, Yeon jo;Ryu, Jae jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.2
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    • pp.154-162
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    • 2017
  • Tooth wear, one of the physiological changes in the elderly patient's mouth, generally does not require treatment, but requires prosthodontic restoration when occlusal disharmony, poor masticatory function, pulp exposure occurs. One of the primary considerations in prosthodontic restoration for tooth wear is vertical dimension. It is necessary to make an accurate diagnosis and analysis, correct judgement of the interdental relationship for predictive treatment plan. A step-by-step approach considering dental care for aged is also required. In this case, a 93-year-old male patient presented with worn dentition and mobility of existing fixed dental prosthesis. After diagnosis and evaluation, maxillary rehabilitation without any change in the occlusal vertical dimension was performed and this shows satisfactory results both functionally and morphologically.

Nutritional Status and Related Factors of Residents Aged Over 50 in Longevity Areas - II, Effect of Dietary Factors on Bone Ultrasound Measurements in Aged Men - (고령인구 비율이 높은 지역 장년, 노년층의 건강.영양상태 및 이에 영향을 미치는 인자에 관한 연구 - II. 남자의 골밀도와 이에 영향을 미치는 식이요인분석 -)

  • Choe Jeong-Sook;Kwon Sung-Ok;Paik Hee-Young
    • Journal of Nutrition and Health
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    • v.39 no.2
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    • pp.171-183
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    • 2006
  • This study was conducted to examine dietary factors affecting bone status in the rural aged men. Quantitative ultrasound measurements (QUS) of bone, that may reflect certain architectural aspects of bone, have been shown to be associated with bone mineral density and fracture. Information of diet and anthropometry was collected in 164 aged men. Dietary intake data were obtained by 24-hour recall method. Measurements of the speed of sound (SOS, m/s), at distal radius, mid-tibia, phalanx, were performed using Omnisense 7000S analyzer (Sunlight Ltd., Tel Aviv, Israel). T-scores for bone SOS measurements at distal radius, mid-tibia and phalanx were 0.60, 0.03 and -0.42 respectively. The prevalence of osteopenia by use of the WHO criteria was 17.7% at the mid-tibia and 25.3% of the subjects at the distal radius. Age were negative association with bone SOS at three sites. Osteopenia group of radius were significantly lower in total foods and vegetable intakes than normal group. After adjusted for age, vegetable intakes were significantly and positively related to bone SOS at the radius. The bone SOS of the tibia were significantly and positively related to vegetable protein, iron, folate and vegetable intakes, but negatively related to fat intakes. Multiple regression analysis showed that bone SOS of tibia was positively associated with folate intakes. Vegetable intakes were positively associated with the bone SOS at three sites. These results indicate that the consumption of vegetables, sources of folate, may have a effect on bone status of men.

The Effect of Psychological Factors on Caregiver Burden and Depression of Spousal Caregivers (배우자 부양자의 심리적 요인이 부양부담과 우울에 미치는 영향)

  • Choo Yon Hong;Min Hee Kim;Bang Hee Jung
    • Korean Journal of Culture and Social Issue
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    • v.18 no.3
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    • pp.367-387
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    • 2012
  • The purpose of the current study was to examine the effect of psychological factors on caregiver burden and depression among Korean spousal caregivers. 142 spousal caregivers (89 wives, 52 husbands) in Seoul and Incheon City were surveyed to determine the influence of objective factors of the care recipient, demographic of the caregiver, personality dimensions of extroversion and neuroticism of caregiver, social support, and pre-caregiving marital satisfaction on caregiver burden and depression of spousal caregivers. Hierarchical regression was used to determine the influence of the various factors on caregiver burden and depression. Finding suggest that care recipient's activities of daily living(ADL) and caregiver neuroticism predicted caregiver burden, whereas pre-caregiving martial satisfaction and caregiver neuroticism predicted depression. In particular, psychological factors were better predictors of caregiver burden and depression compared with objective factors. Based on the results, the implications, interventions, limitations and future directions for research were discussed about the psychological factors on spousal caregiving.

Multiple Primary Malignant Neoplasms: A Case Report of Breast Mucinous Carcinoma and Extramammary Diffuse Large B-Cell Lymphoma in a Male Patient (다발성 원발성 악성종양: 남성 환자에서 유방의 점액성 선암과 유방외 미만성 거대 B세포 림프종이 병발한 증례 보고)

  • Su Young Kim;Ji Young Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.729-736
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    • 2021
  • Multiple primary malignant neoplasms refer to two or more malignancies in an individual that are not related. We report a case of a 78-year-old male with concurrent breast mucinous carcinoma and extramammary lymphoma. The patient initially presented with palpable masses in the left breast and the right groin, which were pathologically confirmed after a surgical biopsy as breast mucinous carcinoma and diffuse large B-cell lymphoma, respectively. He underwent whole-body 18-fluorine deoxyglucose PET/CT before surgery, and an enhancing nodular lesion in the left lingual tonsil was found incidentally. It was later confirmed as a diffuse large B-cell lymphoma, a pathology of the same type as the right inguinal mass. Unspecified lymphadenopathies in breast cancer patients may easily be considered as metastatic lesions. However, this case suggests that lymphomas should be included in the differential diagnoses to avoid misdiagnosis and treatment delay, especially in older adult patients.

Clincal Manifestations of Patients Dying of Severe Community Acquired Pneumonia (중증 원외폐렴으로 사망한 환자의 임상적 분석)

  • Choi, Won-Il;Sohn, Jeong-Ho;Kwun, Oh-Yong;Heo, Jeong-Sook;Whang, Jae-Seok;Han, Seong-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.537-545
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    • 1994
  • Background: In 1987, the British Thoracic Society (BTS) subjected an extensive list of patient variables to statistical analysis in a prospective study of prognosis in 453 adults with community-acquired pneumonia and, subsequently published guidelines for management of severe community acquired pneumonia. It was hoped that those at risk of dying from community acquired pneumonia could be easily identified and treated appropriately, thereby reducing mortality. To date, severe community acquired pneumonia has not been well studied in Korea. Therefore, we studied retrospectively 10 patients dying of severe community acquired pneumonia in Dongsan Hospital to see clinical manifestations of dying of severe community-acquired pneumonia. Methods: Between July 1987 and july 1993, 498 patients were admitted to Keimyung University Dongsan Hospital with community acquired pneumonia, and 77 of them received intensive care. Of the 77 patients, 10 patients died. We reviewed medical records of these patients. Results: 1) The mean age of the patients was 56.2 years(range, 25 to 75 years). There were 7 men and 3 women. Seven patients(70%) were older than 60years of age. 2) The clinical features on admission were as follows: tachypnca, hypoxemia, mental change, cyanosis, leukopenia, leukocytosis, azotemia, hypotension, hypoalbuminemia in order of frequency. Three patients had one abnormal physical finding, 3 patients had 2, 2 patients had 3, and 2 patients had none of these abnormal physical findings. All patients had at least one of the abnormal laboratory findings. 3) A potential bacterial pathogen was isolated in sputum culture from 2 patients. One was E.coli, the other Enterobacter species. Sputum stain were positive in eight cases (G(+)cocci in six, G(+) cocci and G(-)bacilli in two). 4) Features of respiratory failure were the main reasons for ICU transfer, but two patients were transferred only following a cardiac or respiratory arrest in the general ward. 5) The mean of 2.7 different antibiotics were given to the patients. The aminoglycoside and first generation cephalosporin were the most frequently prescribed antibiotics, followed by the third generation cephalosporin and vancomycin. The most frequently prescribed antibiotics combination was a 1st generation cephalosporin plus an aminoglycoside. 6) Seven patients death(70%) occured after admission within the first five days, and a mean duration of hospitaliztion was 11.2 days. Conclusion: As the results show most death occured within the first five days after admission and aged patients; consequently, an aggressive intensive treatment should be provided early to the patients with severe community acquired pneumonia, and we should pay more attention to the aged patients.

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