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A Study on the Status of Health and Medication in the Elderly (노인의 건강상태와 복약실태)

  • Cho Won Sun
    • Journal of Korean Public Health Nursing
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    • v.14 no.2
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    • pp.431-445
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    • 2000
  • In general the prevalence of old people is high and frequently have multiple diseases and symtoms requiring treatment. The nature of illness in the elderly has to be faced, and drugs do have an important part in the treatment of that illness. The purpose of this study were to describe health status and medication, and to provide some basic data for elderly's health education, especially for the right medication. Body mass index, self perceived health status, activities of daily living, disease and experience of past operation were surveyed to recognize the 249 elderly's actual health status. The degree of the elderly's understanding the way of medication, experience of side effects, experience of drug combination and incidence of drug adverse reaction along with drug combination were examined for medication. The aged $women(BMI; 10.7\pm13.3\%)$ overweighed the aged $men(BMI; 4.0\pm10.4\%)$. $69.0\%$ of them recognized their health good. Their activities of daily living were diminished following by the age group(p=0.0068) and relationship with self perceived health status were very significant(p=0.0005). They(192 elderly) suffered from multiple disease such as $osteoarthritis(49.5\%)$, $hypertension(32.0\%)$, gastric $disorder(16.1%)$, $diabetes(14.6\%)$, $osteomalacia(10.9\%)$, cardiovascular $disease(9.9\%)$, senile $cataract(5.7\%)$, skin $rash(5.2\%)$, liver $disease(4.2\%)$, kidney $disease(3.6\%)$, spinal cord $problem(3.6\%)$, respiratory $disease(2.1\%)$ $tuberculosis(1.0\%)\;etc(1.0\%).$ $28.3\%$ of them replied that they had an operation for appendictis senile cataract, peptic ulcer, spinal cord problem, pleurisy, hemorrhoid and the rest. Most of $them(87.4\%)$ knew the way very well how to use drugs, and $21.6\%$ of the replied 171 elderly experienced adverse drug reaction. Drug compliance rate were $high(83.6\%)$. In our study 56.9% of the 167 elderly took several medicine together. And $18.9\%$ of the 95 elderly who did drug combination had an experience of drug interaction. One person kept average 5.5 kinds of drugs at home among 243 elderly. They kept $digestives(79.4\%)$, $ointments(68.7\%)$, $vitamins(59.7\%)$, $analgesics(59.7\%)$, cold $medicines(45.3\%)$ antiarthritic $drugs(33.3\%)$, health $foods(27.7\%)$, antihypertensive $drugs(25.1\%)$, anti peptic ulcer $drugs(24.7\%)$, $laxatives(19.8\%)$, $antacids(16.5\%),\;antibiotics(l6.5\%)$, hypoglycemic $agents(10.3\%)$, cardiac $stimulants(7.0\%)$, $diuretics(4.5\%)$, antiarrhythmic $drugs(4.9\%)$, anti anginal $drugs(4.1\%)$, $hypnotics(3.3\%)$, $etc(38.3\%)$. With this result, we ascertain that polypharmacy in the elderly caused by multiple disease is common, which lead to drug interaction. So our task is to educate elderly how to use drugs in order to maximize their efficiency and to minimize their adverse effects.

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Topical Application of Clonazepam to Burning Mouth Syndrome (구강 작열감 증후군에서 클로나제팜의 국소적 적용)

  • Shim, Young-Joo;Choi, Jong-Hoon;Ahn, Hyung-Joon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.429-433
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    • 2009
  • Burning mouth syndrome (BMS) is defined as burning pain in the tongue or other oral mucous membrane associated with normal sign and laboratory findings at least 4 to 6 months. There are many factors that affect this condition and the pain characters are various among the sufferers, so it is difficult to diagnose exactly and treat properly. The cause of BMS is currently unknown. The etiology is presumed to be that it is related with local, systemic and psychogenic factor. The BMS is related with local factor such as allergic reaction, oral fungal infection(candidiasis), parafunctional oral habits and systemic factors such as diabetes mellitus, hypothyroidism, nutritional deficiencies(vitamin $B_{12}$, folic acid), hyposalivation and psychogenic factor such as depression, anxiety, cancerphobia. So clinicians must be aware of these factors and can give proper treatment options to patients. The management of BMS are pharmacologic management, cognitive behavioral therapy and psychotherapy treatment. Clonazepam, gabapentin, amitriptyline, alpha-lipoic acid and capsaicin are used to manage the BMS. Among these, topical clonazepam is reported that the effect is higher than systemic medication and the complications are rare. This case report is about some cases of the effect of topical clonazepam on BMS.

Effects of Cyclosporin A on the Cell Cycle Regulation of Human Gingival Fibroblasts (Cyclosporin A가 치은섬유아세포의 세포주기조절에 미치는 영향)

  • Pi, Sung-Hee;Kim, Dae-kyum;Kim, Tak;You, Yong-Ouk;You, Hyung-Keun;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
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    • v.31 no.3
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    • pp.611-623
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    • 2001
  • Cyclosporin A is a cyclic polypeptide produced by the metabolism of fungi. It is widely used at present as immunosuppressive treatment following organ transplants. It is also used to deal with autoimmune diseases such as rheumatoid arthritis or type II diabetes. Gingival hyperplasia is one of the most frequent side-effects associated with the prescription of Cyclosporin A. The mechanisms involved in Cyclosporin A induced gingival hyperplasia are not yet clear. In vitro Cyclosporin A promotes proliferation of gingival fibroblasts, that Cyclosporin A act as a mitogen. Its action is based on mitosis of gingival fibroblasts regulated by cell cycle regulatory proteins. It was the purpose of the present study to examine the effects of Cyclosporin A on human gingival fibroblasts by means of biological and biochemical criteria. In this present study, we examined change of cell proliferation, cell activity, cell viability and cell cycle progression after application of Cyclosporin A. We also examined expression of cell cycle regulatory proteins by western blot analysis. Human gingival fibroblasts were cultured for 48 hours with application of Cyclosporin A at concentrations of 0.01, 0.1, 1, and 10 ng/ml. Cyclosporin A(1 ng/ml) significantly increased the cell activity of gingival fibroblast. Proliferation and viability of gingival fibroblasts were also increased in group treated with 1 ng/ml of Cyclosporin A compared to control group. In the cell cycle analysis, S phase was increased and G1 phase was decreased in the group treated with 1 ng/ml of Cyclosporin A. Cyclosporin A increased the expression of cdk4 and inhibited the expression of pRB and p21. These results suggest that 1 ng/ml of Cyclosporin A may increase the cell cycle progression of human gingival fibroblasts, and its mechanisms may increase the expression of cdk4 and decrease the expression of pRB and p21.

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Antiproliferative Effect of Opuntia humifusa Ethanol Extract on Human Carcinoma HT-29 Cells (천년초 선인장 줄기 에탄올 추출물의 HT-29 대장암 세포증식 저해효과)

  • Park, Soo Young;Kim, Young A;Ly, Sun Yung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.12
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    • pp.1827-1834
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    • 2014
  • Colon cancer is the third highest cause of death in Korea. Known dietary causes of colon cancer include a diet rich in fat and red meat as well as inadequate intake of dietary fiber, fruits, and vegetables. Therefore, recent research has focused on the anticancer effects of natural products. Opuntia humifusa is a type of prickly pear that is known to contain biologically active compounds that can be used in the treatment of diabetes mellitus, arteriosclerosis, and hyperglycemia. The aim of this study was to determine whether or not O. humifusa extract affects proliferation, cell death, and DNA fragmentation in human carcinoma HT-29 cells. O. humifusa is rich in carbohydrates, minerals (Mg, K, and Ca), and total phenolics. HT-29 cells were treated with extracts of O. humifusa at concentrations of 0, 0.25, 0.5, 1, and 2 mg/mL for 24 or 48 hours. O. humifusa extracts inhibited HT-29 cell growth in a dose-dependent manner. Hoechst 33342/PI double staining and Comet assay were performed to observe changes in nuclei of cancer cells undergoing cell death. The results of both tests showed that O. humifusa extract induced cell shrinkage, DNA fragmentation, and chromatin condensation dose-dependently in HT-29 cells. The results of this study suggest that O. humifusa extract inhibits the growth of HT-29 via induction of DNA fragmentation and chromatin condensation.

Consumption of Instant Coffee Mix and Risk of Metabolic Syndrome in Subjects that Visited a Health Examination Center in Gwangju (광주 지역 건강검진센터를 내원한 수진자의 인스턴트 커피믹스 섭취와 대사적 위험요인과의 연관성)

  • Kim, Kyoung Yun;Yang, Soo Jin;Yun, Jung-Mi
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.5
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    • pp.630-638
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    • 2017
  • Metabolic syndrome is associated with risk of developing cardiovascular disease and type 2 diabetes, and incidence of metabolic syndrome is showing an increasing trend. Recently, coffee intake is argued to have an effect on the gut-brain axis, and it is widely recognized has being associated with many beneficial effects, including those related to metabolic imbalance. However, it is essential to understand how the dietary aspects of coffee intake and type of coffee intake affect diet and overall health. The association between coffee consumption and health is still controversial, and the average body weight of the Korean population is increasing. Therefore, this study focused on analyzing the effects of instant coffee (particularly instant coffee mix) in Korea, especially with respect to metabolic syndrome. The study was conducted on participating subject's that visited Sun-Han hospital, and instant coffee mix intakes and metabolic risk factors during the study period were examined from July 2015 to June 2016. The results showed that waist circumference (r=0.405, P=0.036) and serum triglyceride level (r=0.435, P=0.023) were positively correlated with instant coffee mix intakes. In addition, instant coffee mix intakes were significantly associated with serum triglyceride level in subjects who consumed more than 1 cup/d of coffee (P<0.05). Therefore, subjects should be careful about fat intake and be educated about the type and frequency of coffee intakes.

Effects of Acanthopanax senticosus Water Extract on Glucose-Regulating Mechanisms in HepG2 Cells (가시오갈피 물 추출물이 간세포에서 포도당 이용 대사에 미치는 영향)

  • Kim, Dae-Jung;Kang, Yun Hwan;Kim, Kyoung Kon;Kim, Tae Woo;Park, Jae Bong;Choe, Myeon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.5
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    • pp.552-561
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    • 2017
  • This study aimed to investigate glucose uptake mechanisms and metabolic mechanisms for absorbed glucose in HepG2 cells treated with Acanthopanax senticosus water extract (ASW). A colorimetric assay kit was used to measure polyphenol content, glucokinase (GK) activity, glucose uptake, glucose consumption in cell culture medium, and glycogen content. RT-PCR and western blotting were performed to examine changes in the expression levels of glucose transporter 2 (GLUT2), hepatocyte nuclear factor $1{\alpha}$ ($HNF-1{\alpha}$), phosphatidylinositol 3-kinase (PI3k), protein kinase B (Akt), phospho-AMP-activated protein kinase (AMPK), phosphoenolpyruvate carboxykinase, GK, and glycogen synthase kinase $3{\beta}$ ($GSK3{\beta}$). Increased glucose uptake upon ASW treatment was confirmed to result from increased expression of $HNF-1{\alpha}$, which is one of the transcription factors acting on the GLUT2 promoter. From the measurements of GK activity, we observed that ASW had an effect on glucose phosphorylation, and we also confirmed that increased AMPK phosphorylation promoted glycolysis and suppressed gluconeogenesis. We confirmed that the increase in glycogen upon ASW treatment was induced by activation of Akt by PI3k, followed by phosphorylation of $GSK3{\beta}$. This study demonstrates that ASW activates glucose metabolic mechanisms in liver cells and is therefore a potential candidate to alleviate diabetes.

Pediatric Pancreatic Tumors-Clinical Experience (소아 췌장종양의 임상양상 및 치료결과 분석)

  • Park, Hyung-Woo;Kim, Dae-Yeon;Cho, Min-Jeong;Kim, Tae-Hun;Kim, Seong-Cheol;Kim, In-Ku
    • Advances in pediatric surgery
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    • v.16 no.1
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    • pp.11-17
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    • 2010
  • Pancreatic tumors in children are relatively rare, and their prognosis differs from that in adults. The purpose of this study is to examine the clinical characteristics, treatment, and prognosis for children with pancreatic tumors. We retrospectively reviewed the medical records of children under 15 years of age with pancreatic tumors who were treated surgically at Asan Medical Center between January 1992 and November 2009. There were 16 patients, fourteen of whom were pathologically diagnosed with solid pseudopapillary tumor. The other two patients were diagnosed with pancreatoblastoma and acinar cell carcinoma, respectively. Six patients of the 16 patients (38 %) were male, and there was a male-to-female ratio of 1:1.6. The initial presentations were upper abdominal pain in eight patients (50 %), palpable abdominal mass in three, and vomiting in one. Four patients were diagnosed incidentally. Six patients' tumors were located in the pancreatic head, six in the pancreatic body, and four in the pancreatic tail, respectively. The surgical procedures performed included distal pancreatectomy (n=7, 44 %), median segmentectomy (n=3), enucleation (n=3), pancreaticoduodenectomy (n=2), and pylorus-preserving pancreaticoduodenectomy (n=1). Three patients underwent laparoscopic surgery. The median tumor size was 6.5 cm (1.8~20 cm). Early surgical complications included pancreatic fistula (n=4), bile leakage (n=1), and delayed gastric emptying (n=1). A late complication in one patient was diabetes. The median follow-up period was five years and four months, and all patients survived without recurrence. While pancreatic tumors in adults have a poor prognosis, pancreatic tumors of childhood are usually curative with complete resection and thus have a favorable prognosis.

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Clinical Manifestations of Persistent Smear Positive and Culture Negative Sputum Tests 5 Months after First-Line Anti-Tuberculous Chemotherapy (일차 항결핵제 치료 5개월 후 도말 양성 및 배양 음성을 보이는 폐결핵 환자의 임상 양상)

  • Kim, Do Hyung;Hwang, Su Hee;Cheon, Du Su;Min, Jin Hong;Kang, Hyung Seok;Park, Seung Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.417-422
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    • 2007
  • Background: It is not known with certainty whether patients with persistently positive sputum smear results who have also had negative sputum culture results require prolongation of treatment for tuberculosis in order to avoid an increased risk of eventual relapse. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the appropriate duration of treatment in these patients. Methods: Sixty of 69 patients with sputum smear positive and culture negative tests at 5 months after first line anti-tuberculous chemotherapy from 2002 to 2003 were retrospectively analyzed. Exclusion criteria included incomplete treatment or resistance to rifampicin or two additional antibiotics, as determined by a drug susceptibility test (DST). Results: Smear conversion of the study subjects was observed after $8.3{\pm}2.3$ months treatment, and the patients were culture negative after $2.0{\pm}0.8$ months. The relapse rates of the study subjects were 3.8, 10.0, and 25.8% after 1, 2, and 5 years of anti-tuberculosis chemotherapy, respectively. The relapse rates were not significantly affected by a series of risk factors such as age, sex, presence of diabetes, a sputum culture examination after 2 months treatment, previous treatment history, chest radiograph, and duration of the treatment (P>0.05). Conclusion: Regimen change is not required for patients with persistent smear positive but culture negative tests in the fifth month for first line antituberculous treatment. However, a further study will be needed to clarify the high relapse rate in this specific group of patients.

Oviposition and Feeding Preference in Monochamus Saltuarius (Coleoptera: Cerambycidae) (북방수염하늘소의 산란부위 및 식이 선호성)

  • Park, Yong Chul;Kim, Jong Kuk;Cho, SaeYoull;Shin, Sang Chul;Chung, Yeong Jin;Won, Dae Sung
    • Journal of Korean Society of Forest Science
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    • v.96 no.4
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    • pp.414-418
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    • 2007
  • The average number of oviposion scars in lower (facing the Land) and upper part (facing the Sun) of P. koraiensis logs were $16.3{\pm}13.9$ and $3.3{\pm}3.6$, respectively. Oviposition preference of Monochamus saltuarius adults was lower part of Pinus koraiensis. Estimated average number of larvae and egg from oviposition scars ($64.7{\pm}23.8$) in P. koraiensis logs was $18.8{\pm}10.0$ in the laboratory condition. However, oviposition scars were $63.6{\pm}31.1$ and average number of larvae and egg was $2.0{\pm}2.6$ in field condition. When we fed with inner bark (phloem) and xylem of P. koraiensis, body weight of M. saltuarius larvae was normal. However, when we only fed xylem of P. koraiensis, body weight and size were reduced but they were recovered after feeding inner bark (phloem). Esterase isozymes were assessed from larvae fat body of M. saltuarius and Est1 were specifically activated when we fed with inner bark (phloem) and xylem.

Flexible Bronchoscopic Observation on Endobronchial Tuberculosis (굴곡성기관지경으로 진단된 기관지결핵에 대한 고찰)

  • Choi, Jae-Sung;Lee, Young-Hyun
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.161-166
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    • 1985
  • Endobronchial tuberculosis is frequently associated with lymphadenopathy, bronchial stenosis, atelectasis which needs to be differentiated with other pulmonary disease. Authors are presenting 25 cases of endobronchial tuberculosis which were confirmed by bronchoscopic biopsy and AFB smear and/or culture. The study was done on patients who visited Yeungnam University Hospital from May 1983 to July 1985. The following results were obtained: 1. Of the 25 cases, 8 cases were male and 17 cases were female (male : female= 1 : 2). 32 percent of the cases was older than 60 years of age. 2. Abnormal findings on chest x-ray were seen on 22 cases of 25 cases (88%) and its most predilective site was right upper lobe.(24%). 3. Symptoms were coughing (56%), hemoptysis, hoarseness, chest pain, dyspnea and fever in orders. 4. The positive results were obtained in 73 percent of sputum AFB sme ar (11 cases of 15 cases), 60 percent of AFB culture (3 cases of 5 cases) and 58 percent of bronchoscopic biopsy (14 cases of 24 cases). 5. Complete pulmonary function test was done on 19 cases and showed normal result in 6 cases, restrictive pattern in 8 cases and small airway dysfunction in 5 cases. No case of obstructive airway disease was detected. 6. Associated disease were hypertension (2 cases), tuberculous meningitis (1 case), diabetes mellitus (1 case), and cataract (1 case). 7. The site of bronchoscopic lesion on bronchoscopic examination were as follows; 8. All 25 patients were treated with anti-tuberculosis theyapy and 6 patients were treated with additional steroid therapy because of severe respiratory symptom and showed dramatic improvement of symptom as well as lung function.

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