Report of Newborn deaths at Post-delivery care facilities in 2001 and 2002 / 대한법의학회지

The increase in number of nuclear families and double-income families contributed to the birth of many post-delivery care facilities, and this trend also bolstered such facilities that are not registered as a medical institution to provide post-delivery care to group of infants and new mothers. The fear of anthrax that hit America after the September 11 Attack has attributed to aggravation of the fear of virus in Korea, and the cause of infant deaths at post-delivery care facilities drew unprecedented public attention. In this context, it would be worth to note the cause of infant deaths in six cases that took place in October and November of 2001, March of 2002 at post-delivery care facilities. The age of the victims were 11 days(twin boys), 17 days(girl), 21 days(girl), 15 days(girl), 14 days(girl) and 14 days(boy). The circumstances under which those infants died were varied, but with a exception of one infant, all were presumed to have suffered from diarrhea at the facilities, and were brought to hospitals after suffering from respiratory difficulties only after care providers suspected more serious medical problems than initial thought. The first two autopsies indicated positive for rotavirus test. Autopsies of all cases except one reveal no specific findings that are noteworthy. One case shows global ischemic myocardial necrosis and pneumonia. In five cases where the amount of feeding was tracked down, the less than normal amount of feeding and the slower than normal body-weight increase were noted that lasted for several days before deaths. It is our opinion that even healthy infants in a group care facility require a higher standard of sanitation to prevent various infection and that the use of measurement that easily indicates the correlation between the amount of feeding and the body-weight increase will be helpful to prevent deaths from virus infection at group care type of post-delivery facilities.

Prevalence and Risk Factors of Dementia and Depression in the Elderly / 신경정신의학

An epidemiological survey was conducted to estimate the prevalence of and identify the risk factors of dementia and depression in the elderly between December 1997 and August 1998 in Yonchon County, Korea. A total of 1,037 elderly aged 65 years and over underwent a two phase diagnositc procedure. Multiple stage, random cluster sampling method was used to select the subjects. Response rate was 85.4%. For the 1st stage screening survey, the Korean Psychogeriatric Assessment Scale was used as a primary screening tool, which had already been standardized in Korea, and functioning and social support were assessed by ADL, IADL and APGAR. At the 2nd stage, diagnoses were confirmed according to the DSM-III-R. And several other scales were used as supporting information for differential diagnoses and for evaluating severity. 1) Age-sex adjusted prevalence(%)[95% C.I.] of dementia was 6.83[6.12-7.54](male 6.34[5.29-7.40]female 7.09[6.14-8.04]). Prevalence of the dementia of the Alzheimer's type was 4.17[3.61-4.74](male 2.42[1.76-3.08], female 5.31[4.48-6.14]) and that of the vascular dementia was 2.38 [1.95-2.81](male 3.46[2.67-4.25], female 1.63[1.16-2.10]). 2) Age-sex adjusted prevalence(%)[95% C.I.] of depressive disorder was 10.99 [10.11-11.87] (male 7.59[6.44-8.73], female 13.46[12.20-14.73]). Among depressive disorders, prevalence(%) [95% C.I.] of major depressive disorder was 7.50[6.76-8.26](male 4.42[3.54-5.31], female 9.78 [8.68-10.88]), that of dysthymic disorder was 2.02[1.62-2.42](male 1.37[0.86-1.87], female 2.46 [1.88-3.03]) and that of depressive disorder NOS was 1.49[1.15-1.83](male 1.85[1.47-2.23], female 1.28[0.96-1.60]). 3) Five statistically significant risk factors of the dementia of the Alzheimer's type were identified: age over 85(O.R.=10.27), illiteracy(O.R.=4.01), alcohol abuse(O.R.=2.98), smoking[030(O.R.=4.60)] and family history of dementia(O.R.=4.85). 4) Three statistically significant risk factors of the vascular dementia were identified: illiteracy (O.R.=3.78), history of CVA(O.R.=26.76) and smoking over 40 pack year (O.R.=11.15). 5) Three statistically significant risk factors of the depressive disorder were identified: age between 75 and 79(O.R.=2.87), past history of CVA(O.R.=3.33) and family history of depressive disorder (O.R.=7.16).