Practicality of thermography in evaluation of osteoarthritis of knee joint

BACKGROUND: About 80 percent of the Korean population over 55 years old show radiographic signs of osteoarthritis. Hence, osteoarthritis has become one of the most important public health problem among the old age. Despite the importance of this disease, proper methods for evaluation and diagnosis of osteoarthritis have not been developed. Authors have investigated the sensitivity and specificity of thermography in diagnosing osteoarthritis. METHODS: Twenty patients who had visited the department of family medicine, Korea University Hospital, with non-traumatic knee pain during the period from April 1 to May 30, 1999, were included in the study. Patients had gone through series of careful history taking, physical examination and laboratory evaluations for clinical evaluation of osteoarthritis of the knee joints. Furthermore, the radiographic and thermographic examination of both knee joints were assessed. RESULTS: Among the twenty patients who have been examined, 15 patients were to have shown radiographic abnormality; on the other hand, 14 patients showed thermographic abnormality. Seventeen patients showed clinical manifestations of osteoarthritis. Twelve patients, among those who had clinical osteoarthritis, were shown to have osteoarthritis in both image studies, i.e. radiographic and thermographic abnormalities. All patients who had not shown clinical osteoarthritis, were normal on both image studies. The sensitivity and specificity of thermography in diagnosing osteoarthritis were 80% and 80%, respectively (P<0.05). CONCLUSIONS: Hot spots or asymmetric distribution in the knee joint area of osteoarthritis patients were in thermographic examination. Thermography has shown efficacy in the evaluation of osteoarthritis.

A study on the bacteriuria in the elderly who reside in a nursing home

BACKGROUND: Urinary tract infection(UTI) is one of the most common diseases dealt with by primary physicians. UTI is common in the elderly and has a great influence on the quality of the elderly's life. Thus, we conducted a study in one nursing home to find out the prevalence of bacteriuria and epidemiologic characteristics of the elderly. METHODS: The study was performed twice on April 12 and on May 4, 1999 among 108 subjects residing in a nursing home of Hanam City. The authors inquired the subjects pertaining to the history of UTI symptoms, collected urine samples by midstream clean-catch technique and catheterization and performed routine and microscopic urine analysis and urine culture. RESULTS: The overall prevalence of bacteriuria in subjects was 23.1%(25/108) ; 20% (3/15) in males and 23.7%(22/93) in females. The prevalence of the bedrriden subjects was 40.9%(9/22). Among the urine samples of 25 cases which were positive in the urine culture, E. Coli was found in 15 cases(60%). The sensitivity, specificity, positive and negative predictive value of pyuria for bacteriuria were 44.0%(11/25), 87.9%(73/83), 52.3%(11/21) and 83.9%(73/87), respectively, while those of nitrite test for bacteriuria were 64.0%(16/25), 97.5%(81/83), 88.8%(16/18) and 90.0%(81/90), respectively. The prevalence of bacteriuria increased by 16.23% as age increased by ten years using the Cochran-Armitage's linear trend test. CONCLUSIONS: The prevalence of bacteriuria in the elderly residing in a nursing home was higher than that of the elderly residing in a community. In the elderly over 60 years old, the prevalence of bacteriuria increased as the age increased. Immobility is considered as a risk factor of bacteriuria. Bacteriuria may be treated by antibiotics focused on E. Coli. Thus, we can expect improvement in the quality of life as well as extension of life span.

One year follow up Study of the MMSE-K in the Elderly

BACKGROUNDS: As the elderly population in-creases the health problem, especially dementia, becomes the clinically important problem. So in the part of primary care medicine it becomes so important that family physician make a focus on the detection, evaluation, and management of demented patient. Until nowadays there is few cohort study about the dementia and few nursing home in Korea. So author performed the MMSE-K in the elderly who are over 65 to get the cognitive function for early diagnosis, management and rehabilitation of psychosocial problem. METHODS: One hundred three persons who included in community society in Seoul and nursing home of Kyunggido were tested. The survey was done twice on september 1997 and September 1998. Author used the MMSE-K to the elderly by same doctors. The analysis was done by SAS 6.12 and t-test, one-way ANOVA and two-way ANOVA with linear trend test. RESULTS: The mean of first MMSE-K score in the community is 26.1 and in the nursing home is 24.4. And the mean of second MMSE-K score in the community is 25.5 and in the nursing home is 22.0. The MMSE-K score is elevated with male and longer duration of education and is decreased with the advanced age in two groups. According to the classification by MMSE-K score the number of people who have normal cognitive function is 45(43.7%), mild impaired cognitive function is 45(43.7%), moderately impaired cognitive function is 13(12.6%) and none has severely impaired cognitive function in both groups. The follow up MMSE-K score shows that the difference of two MMSE-K scores increases as the age increases. CONCLUSION: Until todays there is few study that designed in the form of cohort study about the elderly cognitive function in Korea. So family physicians must perform the prospective cohort study with the consistent concern and effort to get the research data about the dementia for earthy detection, management and rehabilitation for elderly.