Effect of volunteerism as exercise instructor on physical and cognitive function in community-dwelling elderly women / 体力科学

The purpose of this study was to examine whether volunteering as exercise instructors over a continuous period of time affected the physical and cognitive functions of community-dwelling, elderly women. Longitudinal analysis was conducted on data from 18 volunteer leaders (Leader group) aged 65-79 years (69.6 ± 3.9 years) and 18 age-matched survey participants (Control group). We evaluated physical function using 8 physical performance tests along with their standardized total score, and we evaluated cognitive function using the Five Cognitive Function Test. We used two-way ANOVA to examine the effectiveness of engaging in a yearlong volunteer activity and Cohen's d for effect size. There were significant interactions in timed up and go, hand working with pegboard, standardized score of performance tests and the Five Cognitive Function Test score (<i>P</i> < 0.05). The Leader group improved significantly in sit and reach (d = 0.55), 5-repetition sit-to-stand (d = 0.77), timed up and go (d = 0.77), 5-m habitual walk (d = 0.88), 4-way choice reaction time (d = 0.86), standardized score of performance tests (d = 0.96) and the Five Cognitive Function Test score (d = 0.93). Although the Control group also improved significantly in some tests, the effect size tended to be lower: sit and reach (d = 0.49), hand working with pegboard (d = 0.57), standardized score of performance tests (d = 0.38) and the Five Cognitive Function Test score (d = 0.54). These results suggest that volunteering as an exercise instructor improves volunteers' physical and cognitive functions.

Effects of static acceleration training with a whole-body vibration machine in community-dwelling older adults / 体力科学

The purpose of this study was to examine the effects of 9 weeks of resistance training, with and without static acceleration training (AT), on participants' lower-limb muscle strength, power, and physical function. Healthy participants (19 men and 28 women), aged 65-75 years, were assigned to a static AT group (AT, n = 31) or a non-AT control group (C, n = 16). The AT group and the C group trained three times/week for 9 weeks. The AT group performed unloaded static AT and low-intensity aerobic activity. The C group performed dynamic weight-bearing resistance training without whole-body vibration and the same aerobic activity as the AT group. We collected and analyzed data from 45 participants (AT = 30, C = 15) who completed pre- and post-tests. There was no significant Group × Time interaction on any measurements of lower-limb muscle strength, power, or physical function. Significant time effects were observed in the following tests:isokinetic knee extensor and flexor peak torque, 5-time sit-to-stand, usual gait speed, timed up and go, standing time from a long sitting position, and sit and reach. All of these 7 variables showed positive changes. These results suggest that static AT is a suitable training method having approximately the same efficiency as conventional, weight-bearing, dynamic resistance training for improving lower-limb muscle strength and power, mobility, and flexibility in community-dwelling Japanese older adults.

THE RELATIONSHIP BETWEEN GROUND REACTION FORCE IN A SIT-TO-STAND MOVEMENT AND PHYSICAL FUNCTIONING, HISTORY OF FALLS, FEAR OF FALLING, AND MOBILITY LIMITATIONS IN COMMUNITY-DWELLING OLDER ADULTS / 体力科学

The vertical ground reaction force (GRF) parameters in a sit-to-stand movement are useful for measuring lower-limb muscle strength and power in older adults. The purpose of this study was to examine which GRF parameters would be more strongly associated with a person's physical functioning, history of falls, fear of falling and mobility limitations, all of which are known to be related to lower-limb muscle strength and power. We performed cross-sectional analyses on 363 community-dwelling older adults, which included 160 men and 203 women, aged 65-85 years (73.4 ± 5.3 years). Five parameters were measured: peak reaction force, two rate of force development and two time-related parameters. Their rate of force development was relatively higher correlated with results from timed “up and go” tests, standing times from a long sitting position and 4-way choice reaction times (partial r = -0.37 ∼ -0.52); these tests were accompanied with a dynamic movement of lower-limb; than their peak reaction force and time-related parameters. The rate of force development were poorer in subjects reporting falls, a fear of falling or a mobility limitation compared with those reporting no falls, fear of falling or mobility limitation. These results suggest that measuring the rate of force development in a sit-to-stand movement provide a better assessment of lower-limb muscle strength and power.

RELATIONSHIP BETWEEN COGNITIVE FUNCTION AND PHYSICAL PERFORMANCE IN OLDER ADULTS / 体力科学

The purpose of this study was to investigate the relationship between cognitive function and physical performance in Japanese older adults. Ninety four older adults, aged 65 to 87 years (mean age 71.9±5.3 years), were recruited as participants. Cognitive function was evaluated by Five-cognitive Function Test (FCFT). The FCFT, which was developed specially for Japanese older adults, consists of 5 subscale elements: attention, verbal memory, visuospatial cognition, word fluency, and associate learning. Hand dexterity (3 items), muscle strength (2 items), balance (3 items), flexibility (2 items), walking ability (2 items) and reaction ability (2 items) were defined as lifestyle-related physical performances. After adjusting for age, educational level and systolic blood pressure the FCFT score was significantly correlated with observed data of hand dexterity (hand working with a peg board, r=0.485, p<0.001), lower-extremity muscle strength (5-repetition sit-to-stand, r=-0.231, p<0.05), walking ability (5-m habitual walk, r=-0.225, p<0.05; timed up and go r=-0.304, p<0.01), and reaction ability (simple reaction time, r=-0.415, p<0.001; 4-way choice reaction time, r=-0.401, p<0.001). Multiple regression analysis revealed that the FCFT score was explained by the hand working with a peg board (F=42.36, p<0.001) and 4-way choice reaction time (F=29.62, p<0.01). The contribution rate on this model was 42%. These results suggest that cognitive functions were associated with some physical performance. Especially, hand dexterity (hand working with a peg board) and reaction ability (4-way choice reaction time) may be the useful synthetic indicators of cognitive functions in Japanese older adults.

Interpregnancy interval after a previous preterm birth and subsequent preterm birth risk / 대한산부인과학회지

OBJECTIVE: To investigate the recurrent preterm birth (PTB) risk in women with a history of previous PTB, and whether the interpregnancy interval or the indication for previous PTB is associated with the recurrent PTB risk. METHODS: A retrospective analysis was conducted on a group of 325 women whose first delivery ended at preterm and subsequently delivered their second birth. Data regarding delivery dates, gestational age at delivery and indication for PTB in the first and second pregnancies, respectively, were collected from medical records. Interpregnancy interval was defined as the period of time between the first PTB and subsequent conception. The patients were divided into six groups based on the interpregnancy intervals (48 months). RESULTS: The recurrent PTB rate in the study population was 24.3%, which was significantly higher than PTB rate in the control groups (primipara, 15.5%, P<0.001; multipara who delivered at term in their first pregnancy, 11.8%, P<0.001). The recurrent PTB rate was lowest in the 6-12 months interpregnancy interval group, and highest in the 36-48 months group. However, the rate of recurrent PTB was not significantly different among the six different interpregnancy interval groups (chi square test, P=0.394, linear-by-linear association test, P=0.343). In addition, there was no association between the indication for previous PTB and the recurrent PTB rate. CONCLUSION: Although the risk of PTB was increased in women with a history of PTB, the risk was not influenced by the interpregnancy interval or the indication for previous PTB.

Emergent hysterectomy and angiographic embolization for the management of obstetrical hemorrhage: 8-year experiences / 대한산부인과학회지

OBJECTIVE: To compare the clinical characteristics and outcome of hysterectomy and angiographic embolization in the management of obstetrical hemorrhage unresponsive to conservative management. METHODS: We retrospectively analyzed 88 patients who underwent hysterectomy and 53 patients who underwent angiographic embolization for the management of obstetrical hemorrhage from January 1999 to July 2007. We analyzed the maternal characteristics and outcomes by the review of medical records and telephone interview. Nonparametric test was performed for comparison of both groups. RESULTS: Angiographic embolization for the management of obstetrical hemorrhage is on the increase year by year, consisting of about three quarters of total cases in the last year. The most common indication of hysterectomy was abnormal placentation (68.2%) followed by uterine atony (25.0%). For the embolization, the most common indication was uterine atony (54.7%) followed by abnormal placentation (17%). The median pre-operative hemoglobin was significantly lower in embolization group than hysterectomy group [8.3 (3.8~12.7 g/dL) vs. 10.8 (2.4~13.7 g/dL), P<0.001]. There was no difference in the total transfusion amount of packed RBC between the two groups. The median hospital stay was shorter in embolization group [8 (5~57 days) vs. 6 (3~14 days), P<0.001]. Overall success rate of embolization was 89% and procedure-related acute complications were not occurred. Of the total population, there was one maternal death in the hysterectomy group. We found that most women who underwent the embolization resume normal menstruation. CONCLUSION: Angiographic embolization for the management of obstetrical hemorrhage is more commonly performed in recent years. Angiographic embolization was associated with shorter hospital stay, reasonable success rate, and minimal complication rate.

A case report of quadruple cancer in a single patient including the breast, rectum, ovary, and endometrium / 부인종양

Multiple primary cancer is defined as the multiple occurrence of malignant neoplasms in the same individual. Due to the development of new diagnostic techniques and the rise in long-term survival of cancer, reports of multiple primary cancers have gradually increased. Herein, we describe the case of a 68-year-old female patient with quadruple primary cancer of the breast, rectum, ovary, and endometrium. For its great rarity, we report this case with a review of the literature.

A case report of quadruple cancer in a single patient including the breast, rectum, ovary, and endometrium / 부인종양

Multiple primary cancer is defined as the multiple occurrence of malignant neoplasms in the same individual. Due to the development of new diagnostic techniques and the rise in long-term survival of cancer, reports of multiple primary cancers have gradually increased. Herein, we describe the case of a 68-year-old female patient with quadruple primary cancer of the breast, rectum, ovary, and endometrium. For its great rarity, we report this case with a review of the literature.

MR Imaging in Endometrial Carcinoma as a Diagnostic Tool for the Prediction of Myometrial Invasion and Lymph Node Metastasis / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study was to evaluate the factors that are associated with the accuracy of magnetic resonance (MR) imaging for predicting myometrial invasion and lymph node metastasis in women with endometrial carcinoma. MATERIALS AND METHODS: We retrospectively reviewed the medical records and preoperative MR imaging reports of 128 women who had pathologically proven endometrial carcinoma. We compared the MR imaging and the histopathology findings. RESULTS: The sensitivity, specificity and accuracy for identifing any myometrial invasion (superficial or deep) were 0.81, 0.61 and 0.74, respectively; these values for deep myometrial invasion were 0.60, 0.94 and 0.86, respectively. The sensitivity, specificity and accuracy of MR imaging for detecting lymph node metastasis were 50.0%, 96.6% and 93.0%, respectively. The patients who were older, had more deliveries and a larger tumor size more frequently had incorrect prediction of deep myometrial invasion (p=0.034, p=0.044, p=0.061, respectively). A higher tumor grade, a histology other than the endometrioid type, myometrial invasion on MR findings and a larger tumor size were associated with a more frequent false-negative prediction of lymph node metastasis (p=0.018, p=0.017, p=0.002, p=0.047, respectively). A larger tumor size was also associated with more frequent false-positive results (p=0.009). CONCLUSIONS: There are several factors that make accurate assessment of myometrial invasion or lymph node metastasis difficult with using MRI; therefore, the patients with these factors should have their MR findings cautiously interpreted.