The Relationship among Testosterone, IGF- 1 and Fat Mass

BACGROUND: The age-related increase in fat mass seems related to decrease in hormone level. Few studies have been done in Korea concerning the association between testosterone, GH (growth hormone) and fat mass. This study was undertaken to evaluate the relationship among testosterone, IGF-1 and fat mass. METHODS: The study was performed from February to October 2001 in the Health Screening Center of Pundang CHA Hospital with 243 men as subjects. Fat intake was measured through interview with diet therapist and other data were obtained by self-questionnaire. Fat mass was measured using Inbody 3.0 and the level of total testosterone, SHBG and IGF-1 in serum were measured. RESULTS: Smoking was negatively correlated with fat mass and WHR (waist to hip ratio) (P <0.05) and fat intake was positively correlated with fat mass (P <0.05). Fat mass was negatively correlated with total testosterone, calculated free testosterone, and SHBG (gamma = 0.26; P <0.01, gamma = 0.15; P <0.05, gamma = 0.31; P <0.01). WHR was positively correlated with age (gamma =0.26; P <0.01) and negatively correlated with total testosterone, calculated free testosterone, and IGF-1 (gamma = 0.24; P <0.01, gamma = 0.20; P <0.01, gamma = 0.16; P <0.05). After adjustment for age, body mass index, smoking, and fat intake, the calculated free testosterone and IGF-1 were independently negatively correlated with fat mass (beta = 0.072; P <0.01, beta = 0.0035; P <0.05) and WHR (beta = 6.9E-04; P <0.05, beta = 4.0E-05; P <0.05) but, total testosterone and SHBG were not independently correlated with fat mass and WHR. CONCLUSION: The results indicate that the calculated free testosterone and IGF-1 can be independent determinants of fat mass and WHR in middle-aged men.

The Relationship between Testosterone and Bone Mineral Density in Middle Aged Men

BACKGROUND: With the population aging, osteoporosis is becoming a major health issue. Although not as common as women, osteoporosis and its clinical end point of fracture are significant health care concern in men. Despite the considerable public health burden, our understanding of their pathogenesis is incomplete, and several factors known to affect bone metabolism in men are still controversial. So this study was made to investigate relationship between testosterone and bone mineral density in men. METHODS: This was a cross-sectional study of 432 men undertaken health screening program in Pundang CHA General Hospital from January 2000 to December 2000. We surveyed information concerning exercise and consumption of alcohol and smoking by means of self questionnaire records. Serum total testosterone, SHBG, and osteocalcin were measured at a fasting state. Second morning urine was tested for deoxypyridinoline. BMD was assessed using pQCT. RESULTS: FTI (free testosterone index) was positively correlated with BMD (r=0.265, P<0.01). Age, osteocalcin, SHBG, and urine deoxypridinoline were negatively correlated with BMD (r= 0.397, P<0.01, r= 0.121, P<0.05, r= 0.214, P<0.01, and r= 0.126, P<0.01). BMI and total testosterone had no significant correlation with BMD, and there were no apparent association among the level of alcohol and tobacco use, regular exercise and BMD. FTI was not independently correlated with BMD after age, BMI and urine deoxypyridinoline were adjusted, but showed a trend to significantly predict BMD (beta =0.10, P=0.052). CONCLUSION: These data suggest that FTI may play a role in determination of BMD in men, allowing the potential for clinical intervention. But further investigation of the role of testosterone in bone metabolism in men is necessary.

Risk factors of delirium in elderly inpatients

BACKGROUND: This study was done to investigate the clinical risk factors of delirium in general hospital's elderly inpatients. METHODS: A case-control study design was used. Forty cases and age -sex matched 120 contols were identified using hospital discharge data from June 1995 to May 2001. The controls were selected during the same period. The clinical records of each subject were reviewed using discharged disease code to select cases. Subsequent7, the data were recorded from clinical records. RESULTS: The subjects admitted with delirium tended to have increased age (P=0.007), hypoxia(P=0.018), low hemoglobin(P =0.011),sleep disturbance (P=0.001), more ADL total dependence ( P=0.018), diagnoses with infections (P=0.006), diabetes (P=0.046), and hypertension (P=0.041). Above risk factors seemed to be clinically associated with delirium. CONSLUSION: These findings indicate that rapid infection control, maintenance of good sleep hygiene, well-controlled diabetes and hypertension, and correction of hypoxia may help to prevent delirium in general hospital's elderly inpatients.

The relationship between grip strength and radial BMD in middle aged men

BACKGROUND: Although it has become obvious that male osteoporosis represent a public health issue, few studies has been done in Korea concerning the association between grip strength and bone mineral density(BMD) in men. This study was undertaken to enforce the necessity of muscle strengthening exercise program to improve BMD in middle-aged men by evaluate the association between grip strength and BMD. METHODS: The study was performed from January to December 1998 in the health screening center of CHA hospital with 174 men who measured both BMD and grip strength . BMD was measured at the proximal and distal radius of the dominant hand using Osteoplan p-DXA and grip strength was measured from the dominant hand using dynamometer. Daily calcium intake was measured through the interview with the diet therapist. Other datas were obtained from the questionnaire. RESULTS: We found a significant positive correlation between grip strength and BMD of distal and proximal radius(r=0.208; P<0.01, r=0.255;P<0.01)and a significant negative correlation between age and BMD of distal and proximal radius(r= -0.313; P<0.01, r= -0.190; P<0.05). There was no correlation between calcium intake and BMD. BMI was correlated significantly only with BMD of distal radius(r=0.194; P<0.05). There was no significant difference in BMD either by smoking or exercise. The multiple regression analysis showed that grip strength was independently correlated with BMD of the proximal radius significantly(beta =1.731, P<0.05), but not with BMD of the distal radius after adjusting the confounding variables. CONCLUSION: In conclusion, there is a significant correlation between grip strength and BMD in middle aged men. Therefore it can be safely concluded that it is helpful to carry out muscle strengthening program to improve muscle strength and increase BMD for preventing male osteoporosis.

Relationship between total testosterone and serum lipid in middle aged men

BACKGROUND: The prevalance of coronary heart disease is significantly higher in men than in premenopausal women of the same age. Impact that endogenous androgens have on serum lipid has many arguments and few researches were made in Korea. So this study was made to investigate correlation between total testosterone and serum lipid known as effect on cardiovascular disease. METHODS: This was a cross sectional study on 560 middle aged men undertaken health screening program in Pundang General Hospital, Korea from June 1999 to June 2000. We surveyed informations concerning exercise, consumption of alcohol and smoking by means of self questionnaire records and total testosterone and serum lipid were measured at fasting state. RESULTS: Body mass index was positively correlated with total cholesterol and triglycerides(r=2.023;P<0.01, r=0.229;P<0.01) but negatively correlated with HDL cholesterol(r= 0.284;P<0.001). Total testosterone concentrations were negatively correlated with total cholesterol and triglyceride(r= 0.096; P<0.05, r= 0.145; P<0.01) but positively correlated with HDL cholesterol(r=0.155; P<0.001). Total testosterone concentrations were independently correlated with HDL cholesterol after age and body mass index were adjusted(beta=0.734; P<0.05). And after statistical adjustment for age, body mass index, exercise, smoking and alcohol, total testosterone concentrations were significantly correlated with triglyceride(beta= 10.467; P<0.05). CONCLUSION: The result indicate that total testosterone can be a independent determinant of HDL cholesterol and we expect that appropriate maintenance of total tetosterone concentrations will have a protective effect for cardiovascular disease.

Extrapleural Pneumonectomy for Diffuse Malignant Mesothelioma: Report of four cases / 대한흉부외과학회지

Diffuse malignant mesothelioma is a rare malignant tumor having poor prognosis. There is still no widely acceptable staging system of the disease and pathologic diagnosis is difficult. Although surgical treatment for diffuse malignant mesothelioma has been controversial, extrapleural peumonectomy in selected patients could prolong the survival when it was combined with adjuvant chemotherapy and radiation therapy. We experienced 4 cases of diffuse malignant mesothelioma for 7 years since 1992, they were treated with extrapleural pneumonectomy without early postoperative mortality. Three patients underwent adjuvant therapy after surgery; chemotherapy in two, and chemo-radiation therapy in one, but one patient could not receive adjuvant therapy because of postoperative complication of hypoxic brain damage due to cardiac torsion and empyema. In this article, we describe surgical experience of extrapleural pneumonectomy and discuss about the controversial points of the disease.

The relationship between the Alzheimer's Disease Assessment Scale and other measures of dementia

BACKGROUND: The cognitive subscale of the Alzheimer's Disease Assessment Scale(ADAS-Cog) has been extensively valiated in assessing cognitive function in patients with Alzheimer's Disease(AD) and used as an efficacy measure in clinical trials of AD. There is a need for additional data on the relationship between cognitive performance and other measures of dementia to fully assess the value of the ADAS-Cog as a measure of treatment efficacy. METHODS: We used data from 53 AD participants in 8 multicenter clinical drug trials to examine the distribution of baseline ADAS-Cog scores in relation to Mini-Mental State Examination(MMSE), Global Deterioration Scale(GDES), Katz Index of Activity of Daily Living(ADL), Lawton Instrumental Activity of Daily Living(IADL), Geriatric Depression Scale(GDS) and Mini-Nutritional Assessment(MNA). RESULTS: The ADAS-Cog score was statistically significantly correlated with MMSE (R=-0.755, P<0.001), GDES(R=0.403, P<0.003), ADL(R=-0.532, P<0.001), IADL(R=-0.626, P<0.001) and MNA(R=-0.427, P=0.004) scores. But GDS scores were not associated with ADAS-Cog scores.(R= -0.123, P=0.396) CONCLUSIONS: This study characterizes the relationship between ADAS-Cog scores and other commonly used measures of dementia in AD patients. As expected, baseline scores on ADAS-Cog and MMSE demonstrated significantly high correlation. The relatively weaker correlation between ADAS-Cog and GDES scores may be related to the fact that GDES does not evaluate cognitive function only. There are also significant correlations between ADAS-Cog and ADL, IADL, and MNA which indicate the severity and progression of dementia in AD patients. Further studies with larger samples including cognitive function of broader spectrum need to confirm the findings in this study.

The relationship between grip strength and radius bone mineral density in postmenopausal women

BACKGROUND: Several studies have reported that muscle strength and bone mineral density have a significant positive correlation and most previous literature on muscle strength and bone mineral density examined their association. To evaluate the association between grip strength and radius bone mineral density, more precise PQCT was used rather than SPA or DEXA. METHODS: The study was performed from June to August 1999 in Pundang community with 154 postmenopausal women who undertaken osteoporosis screening program who participated in this study. Bone mineral density was measured at the radius using PQCT (peripheral quantitive computed tomograpy). Grip and pinch strength were measured in both the dominant and nondominant hands using a dyanometer. Other data were obtained from the questionnaire. RESULTS: Grip and pinch strength of the dominant hands were significantly higher than the nondominant hands. There was no significant difference in bone mineral density by exercise and fracture history. Age-adjusted partial correlation analysis indicated a significant positive correlation of radius BMD with dominant hands grip strength. Significant positive correlations also were found between radius BMD and pinch strength. CONCLUSION: Subjects with stronger grip strength had a low BMD. There was a significant positive correlationship between bone mineral density and dominant hand grip strength. especially with the more positive association of cortical BMD with forearm circumference. The data suggest that grip strength is a weak predictor of radius bone mineral density and provide a feasible way of predicting it.

Catamenial Hemoptysis: Report of one case / 대한흉부외과학회지

Pulmonary endomertiosis is a rare disorder with the typical symptom of hemoptysis during menstruation (catamenial hemoptysis). We report a case of a 19-year-old woman, gravida 0, with 3-month history of catamenial hemoptysis which was confirmed with chest computed tomography. She was treated by means of thoracoscopic wedge resection for the right lesion and fuperior segmental resection through the left thoracotomy, successively. Preoperative fluoroscopy-guided hooking for thoracosopic target lwsion was helpful in circumstances with one lung anesthesia. Four months of follow-up after an uneventful discharge revealed out no recurrence of catamenial hemoptysis in symptoms and images.

Clonical Experience on Non-Scrotal Testosterone Transdermal Patch in the Middle Aged Male / 대한내분비학회지

BACKGROUND: To evaluate metabolic effects of testosterone on whole bodily systems, non-scrotal testosterone transdermal patch was given to middle aged men. METHODS: Sixteen impotent patients with serum testosterone levels between 300 and 500 ng/dL, were recruited for 6 month of treatment with non-scrotal testosterone transdermal delivery system, and six patients dropped during the study. All patients have a non-organic impotence (mean age:48 +/- 7). After 1 month placebo patch running period, patients were given 1 or 2 patches. The parameters were evaluated at each stage; before treatment, after placebo patch, and after testosterone patch for 3 months and 6 months. The evaluation parameters included body weight, blood pressure, heart rate, body mass index (BMI), body fat, haemoglobin, haematocrit, RBC, lipid profiles, Prostatic Specific Antigen (PSA), Transrectal Ultrasonography (TRUS), International Prostatic Symptom Score (IPSS), bone markers such as osteocalcin and Deoxypyridinoline (dPyr), Bone Mineral Density (BMD), psychological evaluation with Questionnaire and hormones such as cortisol, Dehydroepiandrosterone sulfate (DHEA-S), Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), prolactin, testosterone and Sex Hormone Binding Globulin (SHBG). Sexual functions were evaluated by means of sexual Questionnaire which has grade systems (high grade means good response) on each domain. RESULTS: Hormonal, hematopoietic, lipid and prostatic parametem were not changed with statistical insignificance. There were no significant changes in BMD. But mean osteocalcin values increased about 31.5% (p<0.05). Bone resorption marker, D-Pyr values were also decreased significantly about 18.6% after 4 montbs treatment, but such changes were not shown after 6 months. Tendencies of improvement in all domains of Sexual Questionnaire were noticed, even though they were not statistically significant except in frequency of coitus and satisfaction with ejaculation (p<0.05), CONCLUSION: Decreased bone resorption was noticed while persistent increased bone formation occurred after 4 months treatment of testosterone. Testosterone supplementation has a beneficial effects on mood and sexual function in the impotent patients with lower borderline testosterone level. And it can be concluded that 6 months testosterone treatment dose not produce any adverse reactions on bodily system.

Prevalence and risk factors of Helicobacter pylori infection in general population

BACKGROUND: It was reported that Helicobacter pylori causes duodenal ulcer and chronic active gastritis, but is still controversial on the relationship with gastric cancer. H. pylori is still clinically significant despite improvements in microbiologic, pathologic and therapeutic aspects. The purpose of this study is to evaluate the prevalance of H. pylori infection according to age and sex, the risk factors of H. pylori infection and the relationship with upper gastrointestinal symptoms. METHODS: The subjects were 409 people who underwent esophagogastroscopy and CLO test from Feb. to Jun. in 1997 at Health Promotion Center, Pundang CHA General Hospital. Six types of upper gastrointestinal symptoms and demographic characterastics were surveged by questionnaire. The relationship with H. pylori infection according to age, sex, education, smoking,alcohol, coffee, stress and exercise was evaluated. And, the frequencies of H. pylori according to the presence of symptoms and the six different symptoms(indigestion, frequent belching, dyspepsia, nausea/vomiting, distension, anorexia) were anallyzed by Chi-square test. RESULTS: CLO test was positive for 264(64.5%) in total, 156(65.3%) in females. not different significantly in each group. The frequency of CLO test positive was 53.5%(under 30 years old), 64%(thirties), 67.9%(fifties), 48%(over 60years old). H. pylori infection increased slightly as age increased, but deacreased in over sixties. The frequency of H. pylori infection according to sex, education, smoking, alchol, coffee, stress, and exercise was not different significantly. 174(60.2%) of 284 symptomatic subjects(who had more than one symptom) was positive by CLO test and 93(74.4%) of 125 asymptomatic subjects was positive. The frequency of H. pylori infection according to six symptoms was not different significantly. The sensitivity, specificity, false negative rate, false positive rate, positive predictive value and negative predictive value of CLO test to pathologic report were 77.4%, 81.3%, 22.6%, 18.7%, 93.2%, 52% respectively. CONCLUSIONS: The prevalence of H. pylori infection was 64.5% and showed no difference by sex. H. pylori infection infection increased slightly as age increased. Education, smoking, alcohol, coffee, stress, exercise were not considered as risk factors. The relationship of upper gastrointestinal symptoms and H. pylori infection infection was not significant biostatiscally.

Mediastinal Cavernous Hemangioma / 대한흉부외과학회지

Mediastinal hemangioma is a rare tumor and only few cases have been reported in the literatures. We have experienced one case of cavernous hemangioma occuring at the superior vena cana. The patient was a thrity-five year old female with no specific symtoms except palpable cystic mass in the right cervical area. A routine chest radiography showed an upper mediastinal mass. Computed Tomography showed about 4x5 cm sized cystic mass communicating to the superior vena cava 2 cm above of the veno-atrial junction. After the evaluation, surgical excision was performed and the pathologic diagnosis was confirmed to cavernous hemangioma. Postoperative course was uneventful and the patient has been followed up without any problems.

Correlation of liver dysfunction in Oriental medicine and liver disease in Western medicine

BACKGROUND: Among the outpatient clinic visitors who were diagnosed as "your liver is fragile or weak" by Oriental doctors, many patients asked Western medical doctors of the opinion about their status of liver. No study exists on the correlation of Oriental and Western medicine concerning liver disease. The authors have investigated to evaluate the correlation of liver disease which was diagnosed in Oriental and Western medicine. METHODS: From January to March 1997, 122 subjects had undergone health screening program in Oriental Western Integrated Health Promotion Center of Pundang CHA General Hospital. Liver dysfunction in Oriental medicine was diagnosed by on Oriental medical doctor in the Center. Cases were reviewed and compared with laboratory and abdominal ultrasonographic findings on chart record. RESULTS: Of the total 122 subjects, 15 were diagnosed as having normal liver and 107 as having liver dysfunction in Oriental medicine. Comparing these two groups, there was no statistical significant difference. No statistical significance was found between liver dysfunction in Oriental medicine and HBsAg, HBsAb, HBeAb, alcohol drinking. 43 subjects had findings of fatty liver on abdominal ultrasonography in which. 26(21.3%) were mild, 14(11.5%) moderate, and 3(2.5%) severe. There was no statistical significance between liver dysfunction in Oriental medicine and fatty liver. Among the abnormal findings on abdominal ultrasonography, 43(35.2%) were fatty liver, 3(2.5%) polyp of gallbladder, and 2(1.6%) were gallstone. There was no statistical significance between liver dysfunction in Oriental medicine and abdominal abnormalities on ultrasonography. 58 patients were diagnosed as having liver disease by laboratory test and sonographic finding among which 43(35.2%) were fatty liver, 7(5.7%) hepatitis, 3(2.5%) alcoholic liver dysfunction, 3(2.5%) polyp of gallbladder, and 2(1.6 %) were gallstone. There was no statistical significance between liver dysfunction in Oriental medicine and liver disease in Western medicine. CONCLUSIONS: The result suggests that the meaning of liver dysfunction in Oriental medicine is different in Western medicine.

Prevalence of Depressive Mood and its Associated Factors in the Elderly

BACKGROUND: It was known that physical illness and depression due to cognitive function defects increase in the elderly, This study was designed to evaluate the prevalence of depressive mood, associated factors and to help understanding recent trends of the depressive elderly. METHODS: We selected 108 subjects over 65-year-old who visited Health Promotion Center, Pundang CHA General Hospital for geriatric health evaluation from Mar. 1996 to Feb. 1997. We analyzed Geriatric Evaluation Record to Know the effect of sociodemographic factors, life styles and geriatric medical factors by Geriatric Depression Scale(GDS). RESULTS: The result showed that depressive mood appeared 20(37.0%) in male, 35(64.8%) in female and 55(50.9%) in total among 108 subjects. Factors associated with depressive mood of the elderly were occupation(p<0.05), regular exercise(p<0.001), nutritional status(p<0.05), functional status and alcohol drinking. CONCLUSIONS: The prevalence of depressive mood of the elderly was 50.9%, and the depressive mood have been affected more for the elderly who was out of work, not doing regular exercises and got high nutritional risk. Further study is required to know other factors influencing on depressive mood of the elderly.

Age Changes and Sex Differences in Serum Dehydroepiandrosterone Sulfate (DHEAS) Concentrations & its related factors throughout Adulthood

BACKGROUND : DHEAS, the major circulating adrenal hormone, has been suggested to have a role in many aging related diseases and perhaps in aging itself. But, there is no epidemiologic data of DHEAS in normal adults in Korea. We studied age changes and sex differences in serum DHEAS & its related factors throughout adulthood. METHODS : We administ structured questionnaires to the study subjects. We measured serum DHEAS levels and several biochemical markers (total cholesterol, triglyceride, HDL-cholesterol, glucose etc) in 1.710 healthy men(857) and women (853), aged 17-76 years. We also measured their height, weight, waist & hip circumference and body fat contents with bioimpedance method. We analyzed various variables relating to serum DHEAS levels by using SPSS. Reference data of serum DHEAS level in normal adults were also suggested. RESULTS : The DHEAS concentration peaked at age group blow age of 30 years in man(260.9 microgram/dL). Then mean values declined steadily in both sexes (r=-0.38, por=2 times/week, 219.1 vs 185.3 microgram/dL, p0.85, 227.1 vs 197.4 microgram/dL) after adjusting age. DHEAS was positively correlated with body mass index (r=0.12, p<0.01). But in women, drinkers (154.3 vs 131.7 microgram/dL, p<0.05) and regular exercise group (146.1 vs 131.6 microgram/dL, p=0.05) had higher mean DHEAS value. There were no significant association between DHEAS and lipid profile (total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol) & fasting glucose level in both sex. CONCLUSION : Our data suggest that DHEAS levels may influenced by several sociodemographic factors (e.g. smoking, alcohol, exercise etc) and body mass index. DHEAS level was inversely correlated by age in both sex and men had 1.5 times higher DHEAS values than women. We could not find any association between DHEAS level and lipid profile & fasting blood sugar.

The frequency of common hidden disease in the elderly

BACKGROUND: With the rapid increase in the number of the aged population, curable or controlled disease were treated as aging process because of the difficulty of early detection and treatment of disease and the specificity of elderly patients. We help manage elderly patients by studying their frequency of common known disease and hidden disease that would enable the curable diseases to be detected early, and noncurable disease to be controlled. METHODS: The subjects included 128 patients over 60 years old who had completed structured questionnaires and we reviewed chart records among 208 patients registered from January 1997 to July at the Health Screening Center of a general hospital in Kyonggi-do. Known diseases were based on charts recorded through structured questionnaires and hidden diseases were based on health screening results and overall geriatric assessment data. RESULTS: The number of patients was 128 in which male was 47 and female was 81. The ratio between male and female was 1: 1.72 and the average age was 66.0 years. In the order of frequency the most common known diseases were hypertension, arthritis, G-I disturbance, diabetes mellitus, chronic obstructive pulmonary disease, heart disease, depression and the hidden diseases they were arthritis, G-1 disease, depressive mood, malnutrition, hypertension, osteoporosis, hearing loss, hypercholesterolemia, hypomagnesemia, incontinence, anemia, decreased cognitive function. CONCLUSION: We assessed the characteristics of multiple pathology in geriatric patients and realized that it was important t manage aggressively those with a hidden disease that can be treatable after early detection through overall geriatric assessement.

Thoracoscopic Sympathectomy in Hyperhidrosis / 대한흉부외과학회지

BACKGROUND: Recently thoracoscopic surgery is widely applied in thoracic surgical field and hyperhidrosis is one of the most frequently operated diseases. MATERIAL AND METHOD: From June 1997 to February 1998, 30 patients with hyperhidrosis underwent bilateral thoracic sympathectomy under thoracoscopy at Inje University Sanggye Paik Hospital. There were 10 males and 20 females whose mean age was 22.42+/-6.84 years ranging from 17 to 51. All patients underwent bilateral thoracic sympathectomy under semi-sitting position and two 5 mm sized trocars were inserted. RESULT: Mean operation time was 52.32+/-11.72 minutes and the mean elevation of palmar temperature after sympathectomy was 2.17+/-0.47degree C. Eighteen patients (60%) complained compensatory hyperhidrosis. All patients except one were able to discharge at the operation day or postoperative one day. There were no recurrence during follow up from 2 to 8 months (mean 5.30+/-2.17 months). CONCLUSION: Thoracoscopic sympathectomy is simple and effective technique in hyperhidrosis and widely applied indication will be necessary. We conclude that further discussion should be made about the resection area and method to get maximal effect and minimal side effect.

Laceration of Left Main Bronchus and Azygos Vein Following Stab Wound: 1 case report / 대한흉부외과학회지

Tracheobronchial injuries are uncommon. Except for the cervical region, most tracheobronchial injuries are due to blunt chest trauma in Korea. The depth of the tracheobronchial trees renders these structures relatively safe from stab wound. We experienced a case of left main bronchial laceration with azygos vein tear following stab wound in the back of right chest firstly in Korea. The patient was a 24 years old male. A routine chest radiography showed a knife in chest at emergency room. We didn't remove the knife at emergency room. This patient was carried to operation room in 30 minutes after arrival of our hospital without computed tomography and bronchoscopy. The operation was performed through standard right posterolateral thoracotomy and then the knife was removed. The left main bronchus and azyos vein were lacerated obliquely. The penetrated azygos vein was ligated and the laceration of the left main bronchus was repaired. Postoperative course was uneventful.

Geriatric Diseases: Characteristics and Preventive Measures

BACKGROUND: For the remembrance of the first 'Older People's Day' on Goober 2nd, The Korean Geriatrics Society (KGS) held geriatric conference for the improvement of the health on the aged. We summarized the discussion. RESULTS: We generally agree that many of the conditions of decrepit old age are not time-determined, but are the results of preventable and tretable illness. Rates of aging and senescence vary markedly in the aged. This has also been observed in different organ systems of the body. The comprehensive geriatric assessment developed in response to the complexity of medical, psychological and social problems occurred in older people It will be more necessary to develop Korean culture specific assessment tools. The proportion of the aged population to the whole is expected to reach 6.8% in the year 2000 and 12.5 % in 2020, forecasting that Korea will indeed enter the era of an aging society in the early 21s1 century. In Korea, geriatric diseases have the characteristic structure having multiple entities. The most common medical problem is arthralgia (with 57.8 % of 65 and older). In Korea, there are three kinds of medical care programs for the aged . medical insurance, medical assistance, and health screening, CONCLUSION: The desire for the improvement of older people's health is increasing now in Korea. Thus KGS suggests 'The Guideline for The Age'.

A study of the relationship between health risk factors and family function

No abstract available.