Basic Demand Survey of Community Based Stroke Disabled in an Urban Area

OBJECTIVE: To investigate the status and basic demand of community based stroke-disabled for rehabilitation program development in an urban area. METHOD: The subjects were 46 residencial stroke disabled over 6 months after disease onset. Two teams (composed of one physiatrist and one nurse, respectively) visited patient's home, and evaluated physical and functional status and surveyed for the status and basic demand of community based rehabilitation. RESULTS: Forty two patients (91.3%) received primary medical care after onset of the stroke, and twenty two patients(47.8%) received rehabilitation therapy. The most common reason for not having received rehabilitation therapy was poor economic state. University hospital was the most common place of their rehabilitative management. Mean score of Modified Barthel Index (MBI) was 60.7. Mean score of Craig Handicap Assessment and Reporting Technique (CHART) was 223 and economic self-sufficiency scale presented the lowest score as 6.5+/-4.6. The desire of patients for rehabilitation and welfare service was rehabilitation management and the desire of subjects for the government and society was warrant for livelihood. CONCLUSION: We concluded that rehabilitation program utilizing common resource such as areal university rehabilitation team and facilities of community health center should be developed.

Clinical efficacy of the 7-Minute Screen at primary care setting

BACKGROUND: Because dementia tends to be underdiagnosed, Solomon PR developed a brief neurocognitive screening battery to identify Alzheimer's dementia. The 7-Minute Screen consists of four individual tests(orientation, memory, clock drawing, verbal fluency). It can be rapidly administered and it may be appropriately used in the primary care setting. We attempted to develop a screening tool of dementia based on the 7-Minute Screen at primary care setting in Korea. METHODS: We adapted the 7 Minute Screen to the Korean version of 7 Minute Screen(7 MS-K). 7 MS-K and MMSE-K were administered to 61 elderly people who visited the Sungbuk Public Health Center. Inter-rater reliability and test-retest reliability were evaluated. RESULTS: The 7 MS-K has a sensitivity of 92% and a specificity of 90% for cutoff point of MMSE-K 23/24. Inter-rater reliability and test-retest reliability for the entire battery was very high(both r=1). Mean time of administration was 10 minutes. CONCLUSION: 7 MS-K has a reasonable validity, reliability and can be administered in a brief period, and requires no clinical judgement and minimal training. It may be a useful tool for screening dementias in primary care setting.

Health status and behavior of homeless in Seoul

BACKGROUND: Since recent economic crisis(IMF) in Korea, the number of new homeless is increasing(that is, 'IMF style homeless'). There are only few studies on the health problem of this uniquely formed population. We have attempted to estimate the problem of health behavior and health status of this population. METHODS: Some homeless who agreed to enter the asylum during the winter were taken for medical check-up in Sungbuk Community Health Center from November to December, 1998. The participants filled up a self-reported questionnaire and physical examination, laboratory test, and chest x-ray were performed. RESULTS: Among 'IMF style homeless', the prevalence of hypertension(30.9% in primary screening, 7.3% in secondary screening), diabetes mellitus(9.4% in primary screening, 3.5% in secondary screening), syphilis(7.3%), and hepatitis B antigen carrier(5.3%) was higher than among the general population. But we could not find statistical difference according to the duration of homelessness. We found higher smoking rate and higher alcohol drinking amount per week in homeless than in the general population. The amount of alcohol drinking per week was larger among those who had been homeless for more than 3 months(p< 0.01). CONCLUSION: The prevalence of chronic diseases in homeless was higher than in the general population, but statistical difference according to the duration of homelessness could not be found. The longer the duration of homelessness, the larger the amount of alcohol drinkin was seeng.

The Result of Radiation Therapy of superior Vena Cava Syndrome / 대한치료방사선과학회지

To access the result of radiation therapy for 8 years experiences, 21 patients who were treated with superior vena cava syndrome had been analysed according to dose fractionation and toal dose. The results are as follows; 1. In high fractionate dose group, six of eleven patients (54.5%) exhibited relief of symptoms in 1-2 days, and additional three patients of nine (81.7%) within 3-4 days, while standard fractionated dose treatment is not effective to achieve initial relief of symptoms. 2. Graded response by total dose was correlated with total dose rather than dose fractionation. 3. Overall one year survival rate with superior vana cava syndrome was 9.1% and mean survival was 4.2 months.

CT of Late Complication of Central Nervous System after Radiation Therapy of Brain Tumors / 대한치료방사선과학회지

The normal intracranial structures are relatively resistant to therapeutic radiation, but may react adversely in a variety of ways and the damage to nerve tissue may be slow in making its appearance and once damage has occurred the patient recovers slowly and incompletely. Therefore, it is important to consider the possibility of either recurrent tumor or late adverse effect in any patient who has had radiotherapy. The determination of morphological/pathological correlation is very important to the therapeutic radiologist who uses CT scans to define a treatment volume, as well as to the clinician who wishes to explain the patient's clinical state in terms of regress, rogression, persistence, or recurrence of tumor or radiation-nduced edema or necrosis. The authors are obtained as following results; 1. The field size (whole CNS, large, intermediate, small field) was variable according to the location and extension of tumor and histopathologic diagnosis, and the total tumor dose was 4,000 to 6,000 rads except one of recurred case of 9,100 rads. The duration of follow up CT scan was from 3 months to 5 year 10 months. 2. The histopathologic diagnosis of 9 cases were glioblastoma multiforme (3 cases), pineal tumor (3), oligodendroglioma (1), cystic astrocytoma (1), pituitary adenoma (1) and their adverse effects after radiation therapy were brain atrophy (4 cases), radiation necrosis (2), tumor recurrence with or without calcification (2), radiation-nduced infarction (1). 3. The recurrent sysptoms after radiation therapy of brain tumor were not always the results of regrowth of neoplasm, but may represent late change of irradiated brain. 4. It must be need that we always consider the accurate treatment planning and proper treatment method to reduce undesirable late adverse effects in treatment of brain tumors.