Relationship Between Status of Physical and Mental Function and Quality of Life Among the Elderly People Admitted from Long-Term Care Insurance / 예방의학회지

OBJECTIVES: This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). METHODS: The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. RESULTS: The mean scores of QOL among all the subjects was 55.4 +/- 15.62 (Grade I: 49.7 +/- 14.17, Grade II: 56.8 +/- 14.62, Grade III: 59.4+/-16.36), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). CONCLUSIONS: The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).

A Case of Malignant Mixed M llerian Tumor arising after Irradiation for Cervical cancer / 대한산부인과학회잡지

Malignant mixed m llerian tumors are uncommon neoplasms of the female genital track that histologically consist of malignant epithelial and stromal components. Malignant mixed m llerian tumors generally occur in elderly woman and are associated with a poor prognosis. We experienced a case of malignant mixed m llerian tumor recieved pelvic irradiation for the uterine cervical cancer 11 years prior to the diagnosis of the tumor and report with a brief review of the literature.

A Case of Kallmann Syndrome and A Case of Successful Pregnancy of Kallmann Syndrome Patient / 대한산부인과학회잡지

Kallmann's syndrome is characterized by hypogonadotrophic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia, which has been related to agenesis of olfactory bulbs. We experienced a case of 17 year-old Kallmann's syndrome woman and a case of successful pregnancy of 29 year-old Kallmann's syndrome woman with hMG and hCG treatment and present two cases with a review of literatures.

A Clinical and Statistical Study on Pregnancy of Elderly Primipara / 대한산부인과학회잡지

OBJECTIVE: Recently, the incidence of elderly primipara is increasing. Thus, impact of old age on pregnancy outcomes became important. Our purpose was to assess the effect of maternal age on pregnancy outcomes. METHODS: 73 cases of the elderly primipara over 35 years at the department of obstetrics and gynecology, Chon-ju presbyterian medical center, from Jan. 1, 1995 to Dec. 31, 1998, were compared with 73 cases randomly chosen young primiparas during same period. RESULTS: Elderly primipara had higher rate of infertility and spontaneous abortion history, antenatal complications, cesarean section, poorer neonatal outcome than young primipara. CONCLUSION: The pregnancy outcome of elderly primipara is considered to be less favorable than those of young primipara. Careful antenatal and intrapartal care should be performed for the elderly primipara. We think that many clinical study of congenital anomaly in elderly primipara will be necessary.

A Clinical study on the incompetent internal Os of the Cervix / 대한산부인과학회잡지

OBJECTIVE: To evaluate the effect of Mcdonald's cerclage and postoperative care on perinatal outcome in patient with incompetent cervix and bulging fetal membranes. METHODS: In the descriptive study, the charts of 78 patients admitted from 1993 to 1997 with a diagnosis of incompetent cervix and cervical dilatation (3cm) were reviewed, Mcdonald's cerclage rate, predisposing factor, fetal salvage by time, factors of falled operation, delivery type were analyzed. RESULTS: The results of the study were as follows; The incidence of II OC was 0.4% of 18702 case, the mean age was 31.9 years old, the average number of gravida was 2.9, the fetal salvage rate was 83.3%, the predisposing factor was previous history of midtrimester termination(56.4%), dilation and curettage(19.2%), unknown(14.1%) etc, the fetal salvage by time was the highest success rate(88.9%) revealed with period from 14th to 16th weeks of gestation, the factors of falled operation were preterm labor(76.9%), PROM(15.4%), infection(7.7%), and delivery type was vaginal delivery in 36 case(55.4%), cesarean section in 29 case(44.6%). CONCLUSION: We concluded that fetal salvage rate was greatly increased when Mcdonald operation was done from 14th to 16th week of gestation if midtrimester abortion and dilatation and curettage were experienced, Even though we have not compared experimental group with control group, upper part of Mcdonald cerclage, no exposure of suture material, benzol conium dressing, bed rest were increased to fetal salvage rate.