• 간호행정학회지
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• 제16권4호
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• pp.475-487
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• 2010

연구목적: 노인을 위한 건강정보 웹사이트들이 사용성과 접근성을 높이기 위해 지켜야 할 디자인 요소를 어떻게 반영하고 있는지 평가·비교함으로써 개선 방향을 제언하고자 하였다. 연구방법: 국내 및 미국에서 개발된 노인 대상의 건강정보 웹사이트를 각각 9개씩 선정하였다. 근거 기반의 웹디자인 지침서인 Make Your Website Senior Friendly: Checklist와 Research-based Web Design & Usability Guideline을 통합 수정하여 얻은 4개 영역의 평가 항목 48개를 적용해 두 명의 평가자가 선정된 총 18개 웹사이트를 평가하였다. 연구결과: '가독성' 영역 중 서체 선택, 줄 간격, 배경색과 글자색 선택 등은 양호하였으나 국내 웹사이트들 중에는 글자 크기가 조절되지 않는 경우가 빈번하였다. '정보의 표현과 구성' 영역에서 다수의 웹사이트들은 정보 배치 등이 우수하고 소비자 용어를 사용하는 노력을 보였다. 그러나 일부 국내 웹사이트들은 프린트 기능을 제공하지 않거나, 노인들의 저하된 인지 능력을 배려하려는 노력이 부족하였다. '미디어 사용' 영역에서 국내 웹사이트들은 글자 외에 다른 매체를 사용하는 빈도가 미국 웹사이트들에 비해 낮았고, 시청각 매체를 사용할 때는 동일한 내용을 문자로도 볼 수 있도록 하라는 권고안을 준수하지 않았다. '내비게이션과 검색의 용이성'에서는 메뉴나 링크의 명칭이 명확하며, 이용 중에도 쉽게 홈페이지로 돌아갈 수 있도록 구성되었다. 그러나 다수의 국내 사이트들이 사이트맵을 제공하지 않거나, 검색어의 철자오류 등에 대한 배려가 부족하였다. 결론: 국내 웹사이트들은 미국 웹사이트들에 비해 노인들의 사용성과 접근성을 높이는 것으로 밝혀진 연구 근거들을 제대로 반영하지 못하고 있었다. 노인 대상의 인터넷과 웹을 활용한 교육이 지속적으로 증가할 것이므로, 그 효과성을 높이기 위해 간호사들은 정보의 질 뿐만 아니라 디자인 측면의 중요성을 인식하고 실천할 수 있어야겠다.

• Journal of Periodontal and Implant Science
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• 제50권6호
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• pp.368-378
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• 2020

Purpose: Vitamin D deficiency may cause bone loss and increased inflammation, which are well-known symptoms of periodontal disease. This study investigated whether serum 25-hydroxyvitamin D (25(OH)D) levels are associated with periodontal disease status and tooth loss. Methods: Cross-sectional data from 5,405 individuals aged ≥50 years (2,253 males and 3,152 females) were obtained from the 2008-2010 Dong-gu study, a prospective cohort study of risk factors for chronic diseases. Periodontal examinations were conducted to evaluate the number of remaining teeth, the periodontal probing depth (PPD), the clinical attachment level (CAL), and bleeding on probing. The percentages of sites with PPD ≥4 mm and CAL ≥4 mm were recorded for each participant. The severity of periodontitis was classified using the Centers for Disease Control and Prevention and the American Academy of Periodontology case definitions. Serum 25(OH)D levels were classified as reflecting severe deficiency, deficiency, insufficiency, or sufficiency. Multivariate linear regression analysis was performed to assess the associations of serum 25(OH)D levels with periodontal parameters and the number of remaining teeth after adjusting for confounders including age, smoking status, alcohol consumption status, month of blood collection, and physical activity. Multivariate logistic regression was used to evaluate the association between serum vitamin D levels and severe periodontitis. An overall statistical analysis and a stratified analysis by sex were performed. Results: Overall, the rates of severe deficiency, deficiency, insufficiency, and sufficiency were 6.5%, 67.9%, 22.4%, and 3.2%, respectively. After adjustment for confounders, vitamin D levels were directly associated with the number of remaining teeth, an association that was significant in males, but not in females. Sufficient serum 25(OH)D was associated with a low frequency of severe periodontitis. Conclusions: This population-based cross-sectional study indicates that low serum 25(OH) D is significantly associated with tooth loss and severe periodontitis in Koreans aged 50 years and older.

• 한국주거학회논문집
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• 제26권5호
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• pp.19-26
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• 2015

This study examined whether the Fair Housing Amendments Act of 1988 (FHAA) in the US provides more home accessibility features and reduces the home accessibility problems of senior residents with physical disability. The 2011 American Housing Survey data with a sample of 2,326 senior residents age 55 and over with physical disability and living in multifamily housing built between 1970 and 2011 were analyzed. We compared senior residents living in multifamily before (1970-1990) and after (1991-2011) the FHAA. The results show that senior residents living in multifamily housing before the FHAA were at a greater disadvantage because they were more likely to live in older buildings located in urban areas, yet paid lower rent and received government subsidies. This study confirmed that the FHAA enabled residents of multifamily housing to have more home accessibility features. However, there was no significant difference in perceived home accessibility problems between the two groups, indicating that senior residents in multifamily housing have experienced home accessibility problems both before and after the FHAA. This study has important implications for housing policy makers to consider home accessibility features for multifamily housing buildings before the FHAA, and to revisit if the FHAA sufficiently compensates physical disability of senior resident living in multifamily housing after the FHAA.

• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.323-328
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• 2013

Objective : The purpose of this study was to examine the efficacy and perioperative complications associated with lumbar spinal fusion surgery, focusing on geriatric patients in the Republic of Korea. Methods : We retrospectively investigated 485 patients with degenerative spinal diseases who had lumbar spinal fusion surgeries between March 2006 and December 2010 at our institution. Age, sex, comorbidity, American Society of Anesthesiologists (ASA) class, fusion segments, perioperative complications, and outcomes were analyzed in this study. Risk factors for complications and their association with age were analyzed. Results : In this study, 81 patients presented complications (16.7%). The rate of perioperative complications was significantly higher in patients 70 years or older than in other age groups (univariate analysis, p=0.015; multivariate analysis, p=0.024). The perioperative complications were not significantly associated with the other factors tested (sex, comorbidity, ASA class, and fusion segments). Post-operative outcomes of lumbar spinal fusion surgeries for the patients were determined on the basis of MacNab's criteria (average follow up period : 19.7 months), and 412 patients (85.0%) were classified as having "excellent" or "good" results. Conclusion : Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery, whereas other factors were not significant. However, patients' satisfaction or return to daily activities when compared with younger patients did not show much difference. We recommend good clinical judgment as well as careful selection of geriatric patients for lumbar spinal fusion surgery.

• 대한족부족관절학회지
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• 제16권4호
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• pp.223-228
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• 2012

Purpose: To treat hallux valgus in old age patients with chevron metatarsal osteotomy and to see the subsequent clinical and radiological outcomes. Materials and Methods: 23 cases of 18 hallux valgus patients of age 60 years or older who received proximal or distal corrective osteotomy from April 2007 to August 2009 and were followed up for at least 1 year were included in the study. The mean age at operation was 65 years (range, 60~81 years), and the mean follow-up period was 2 years and 6 months (range, 1 year~3 years 6 months). Clinical outcome was assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) score, complications, satisfaction rate, as well as measurements and comparison of pre- and postoperative hallux valgus angles, the 1st~2nd intermetatarsal angle, and the position of hallucal medial sesamoid bone. Results: The AOFAS score was improved from preoperative average of 35.1 (range, 13-47) to average 85.1 at last follow-up (range, 75-100). Patients were satisfied about the operation in 21 cases (91.3%). Preoperative hallux valgus angle was $31.7^{\circ}$ on average (range, $19.1^{\circ}-48.9^{\circ}$), and $4.9^{\circ}$ on average at last follow-up (range, $0.3^{\circ}-21.2^{\circ}$). The 1st~2nd intermetatarsal angle was $14.4^{\circ}$on average (range, $8.7^{\circ}-25.7^{\circ}$) and $3.1^{\circ}$ on average at last follow-up (range, $0.6^{\circ}-7.5^{\circ}$). The hallucal medial sesamoid bone position was improved from preoperative average 3.5 (range, 3-4) to postoperative average 1.0 (range, 0-2). Conclusion: Proximal and distal metatarsal osteotomy treatment yielded good clinical and radiological outcomes in old age hallux valgus patients.

• Journal of Trauma and Injury
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• 제25권2호
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• pp.44-48
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• 2012

Purpose: The management of splenic injuries has shifted from a splenectomy to splenic preservation owing to immunity. The purpose of this study was to assess the kinds of management and outcomes through a review of our experience with splenic injuries. Methods: We retrospectively reviewed 47 patients with traumatic splenic injuries using by electronic medical records from Jan. 2007 and Dec. 2011. Splenic injuries were classified according to the American Association for the Surgery of Trauma (AAST) grading system. Results: There were 11 falls, 11 traffic accidents, 10 motorcylcle accidents, 10 pedestrian accidents and 5 abdominal blunt traumas. Low-grade injured patients (${\leq}$ Grade III) were 29 of 43(61.7%), and High-grade injured patients (${\geq}$ Grade IV) were 18 of 43(38.3%). In 34 patients, non-surgical treatment was performed, and 14 patients underwent a splenectomy. There were relatively more high-grade in older patients, and the high-grade-injury group showed need for a transfusion (p=0.002), more need for a splenectomy (p<0.001), a longer mean hospital stay (p=0.036), a longer ICU stay (p=0.045) and more combined organ injury (p=0.036). Conclusion: Conservative treatment should be considered in low-grade-injury patients (${\leq}$ Grade III). A Splenectomy was performed on 56% of the patients with Grade IV injuries, so a splenectomy should be considered carefully in such patients. In patients with a grade V injury, we think surgical treatment may be needed.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.94-100
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• 2017

Purpose: The American Academy of Pediatrics provides guidelines for managing febrile urinary tract infection (UTI) in infants and children 2-24 months old, but little guidance is offered regarding UTIs in those younger than 8 weeks of age. The definition of UTI is unclear and whether to proceed with micturating cystourethrography (MCUG) or $^{99m}$technetium-dimercaptosuccinic acid (DMSA) scintigraphy scan in this age group is controversial. Methods: We retrospectively analyzed 29 neonates and infants younger than 2 months of age who underwent late DMSA scans 9 months following the first episode of febrile or symptomatic UTI between July 2009 and June 2016. Results: In total, 192 children aged 0-24 months underwent ultrasound and DMSA scans (MCUG in 174/192). Neonates and infants younger than 2 months of age were significantly less likely to develop fever, and had a lower fever peak, shorter duration of fever before admission and after starting antibiotics, longer hospitalization period, lower C-reactive protein, and greater incidence of nonEscherichia coli infection. There was no difference in pyuria response at diagnosis. The prevalence rates of an ultrasound abnormality (28%), vesicoureteral reflux (28%), UTI recurrence (38%), and renal scarring (10%) in infants younger than 8 weeks of age were similar to those in children 2-24 months old. Conclusion: Neonates and infants younger than 2 months of age with UTI warrant special consideration because the fever response used for diagnosis in older children may be absent or blunted. Clinical guideline is needed for the diagnosis and management of UTI in this age group.

• Nutrition Research and Practice
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• 제4권3호
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• pp.243-251
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• 2010

Although noodles occupy an important place in the dietary lives of Americans, up until the present time research and in-depth data on the noodle consumption patterns of the US population have been very limited. Therefore, this study aimed to analyze the food consumption and diet patterns of noodle consumers and non-consumers according to age, gender, income, and ethnicity. The 2001-2002 NHANES databases were used. The NHANES 2001-2002 data showed that noodle consumers reporting noodle consumption in their 24-h recall were 2,035 individuals (23.3% of total subjects). According to the results, the mean noodle consumption was 304.1 g/day/person, with 334.3 g for males and 268.0 g for females. By age, the intake of those in the age range of 9-18 years old ranked highest at 353.0 g, followed by the order of 19-50 year-olds with 333.5 g, 51-70 year-olds with by 280.4 g, older than 71years old with 252.3 g, and 1-8 year-olds with 221.5 g. By gender, males consumed more noodles than females. Also, according to income, the intake amount for the middle-income level (PIR 1~1.85) of consumers was highest at 312.5 g. Noodle intake also showed different patterns by ethnicity in which the "other" ethnic group consumed the most noodles with 366.1 g, followed by, in order, Hispanics with 318.7 g, Whites with 298.6 g, and Blacks with 289.5 g. After comparing food consumption by dividing the subjects into noodle consumers and non-consumers, the former was more likely to consume milk, fish, citrus fruits, tomatoes, and alcoholic beverages while the latter preferred meat, poultry, bread, and non-alcohol beverages.

• Clinics in Shoulder and Elbow
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• 제20권2호
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• pp.90-94
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• 2017

Background: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. Methods: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. Results: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was $127.5^{\circ}$. Conclusions: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.

• Journal of Gastric Cancer
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• 제17권4호
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• pp.363-373
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• 2017

Purpose: The aims of this study were to evaluate the expression of the large tumor suppressor (LATS) genes LATS1 and LATS2 by immunohistochemical staining of gastric cancer, and to evaluate the clinicopathological significance of LATS expression and its correlation with overall survival (OS). Materials and Methods: LATS1 and LATS2 expression in a tissue microarray was detected by immunohistochemistry, using 264 gastric cancer specimens surgically resected between July 2006 and December 2009. Results: Low expression of LATS1 was significantly associated with more advanced American Joint Committee on Cancer (AJCC) stage (P=0.001) and T stage (P=0.032), lymph node (LN) metastasis (P=0.040), perineural invasion (P=0.042), poor histologic grade (P=0.007), and diffuse-type histology by the Lauren classification (P=0.033). Low expression of LATS2 was significantly correlated with older age (${\geq}65$, P=0.027), more advanced AJCC stage (P=0.001) and T stage (P=0.001), LN metastasis (P=0.004), perineural invasion (P=0.004), poor histologic grade (P<0.001), and diffuse-type histology by the Lauren classification (P<0.001). Kaplan-Meier survival analysis revealed significantly poor OS rates in the groups with low LATS1 (P=0.037) and LATS2 (P=0.037) expression. Conclusions: Expression of LATS1 or LATS2 is a significant marker for a good prognosis in patients with gastric cancer.