Background/Aims:The fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale is a screening tool for frailty status using a simple 5-item questionnaire. The aim of this study was to evaluate the clinical feasibility and validity of the Korean version of the FRAIL (K-FRAIL) scale.Methods:Questionnaire items were translated and administered to 103 patients aged ≥ 65 years who underwent a comprehensive geriatric assessment at the Seoul National University Bundang Hospital. In this cross-sectional study, the K-FRAIL scale was compared with the domains and the multidimensional frailty index of the comprehensive geriatric assessment. We also assessed the time required to complete the scale.Results:The participants’ mean age was 76.8 years (standard deviation [SD], 6.1), and 55 (53.4%) were males. The mean overall frailty index was 0.19 (SD, 0.17). For K-FRAIL-robust, prefrail, and frail patients, the mean frailty indices were 0.09, 0.18, and 0.34, respectively (p for trend < 0.001). A higher degree of impairment in the K-FRAIL scale was associated with worse nutritional status, poor physical performance, functional dependence, and polypharmacy. The number of items with impairment in the K-FRAIL scale was positively associated with the frailty index (B = 3.73, p < 0.001). The K-FRAIL scale could differentiate vulnerability from robustness with a sensitivity of 0.90 and a specificity of 0.33. Of all patients, 75 (72.8%) completed the K-FRAIL scale within < 3 minutes.Conclusions:The K-FRAIL scale is correlated with the frailty index and is a simple tool to screen for frailty in a clinical setting.

www.e-agmr.org significantly increase the risk of adverse drug events (ADEs) in older populations. 3) Although statistical data about ADEs in older Koreans are limited, the United Kingdom and the United States studies showed that ADEs are a common cause of morbidity and mortality in older patients. In two UK hospitals, ADEs accounted for 6.5% of hospital admissions and patients admitted with ADEs were significantly older than patients without ADEs. 4) A US study also reported that ADEs are responsible for about 100,000 hospitalizations per year in adults ≥65 years of age and nearly half of these hospitalizations were among adults ≥80 years. 5) In addition, the prediction and detec

Multimorbidity is one of the common clinical characteristics in older patients and its occurrence rises with age. With the increase of older population, physicians should know the clinical significance of multimorbidity in managing older patients. Multimorbidity focuses on the findings of multiple diseases in a single patient and interactions between diseases and a patient. It has been reported that the prevalence of multimorbidity is over 50% in elderly people and co-occurrence of certain chronic diseases is often observed in patients with multimorbidity. Multimorbidity is significantly associated with higher mortality, increased disability, impaired quality of life, and increased medical costs. Unfortunately, current guidelines do not address enough for older patients with multimorbidity. Simple and fragmented approach for multiple medical conditions in older patients may lead to many clinical problems including polypharmacy, iatrogenic events, and increased medical cost. Accordingly, comprehensive geriatric assessment and multidimensional approach for this population should be encouraged.

estenosis after percutaneous coronary intervention is the most problematic issue for interventional cardiology 1 and the main mechanisms are excessive neointimal formation, extracellular matrix synthesis, and negative vessel remodeling in response to balloon injury. 2 Stent implantation has led to a 30-50% decrease in the rate of restenosis, with good clinical results. 3,4 Coronary stenting reduces restenosis primarily by preventing the constrictive remodeling and elastic recoil of the artery, but it fails to inhibit neointimal proliferation. 5 Thus, a new technique that could prevent neointimal hyperplasia would be of great clinical benefit. Intracoronary radiation therapy (IRT) has been introduced to decrease the exaggerated response to injury and it is believed that IRT is not only effective in treating in-stent restenosis (ISR), but also prevents its recurrence. [6][7][8][9][10][11] IRT using the rhenium-188 ( 188 Re)-filled balloon system is attractive because it has the advantages of self-centering and ease to use. Several clinical trials have shown that IRT using the 188 Re-filled balloon system is safe and effective in treating coronary artery disease, but its long-term safety and efficacy remains uncertain. [12][13][14] The objective of the present study was to evaluate the long-term clinical outcome of IRT using the 188 Re-filled balloon system in treating de novo or restenotic lesions. Methods Study PatientsThe Seoul National University Hospital Post-Angioplasty Rhenium (SPARE) trial was designed as a prospective, randomized, case-controlled trial. The purpose of this trial was to evaluate the safety and efficacy of source irradiation following angioplasty in patients with de novo or restenotic lesions of native coronary arteries. For the inclusion criteria to be met, the diameter of the vessel had to be between 2.5 and 4.0 mm, and the lesion length had to be shorter than 20 mm. Patients were excluded if there was a history of recent myocardial infarction (<4 weeks), an ostial lesion, a bifurcation lesion that require intervention for both branches, an angiographic thrombus, pregnancy, contraindication to antiplatelet therapy, or concomitant serious disease with an expected survival of less than 2 years. Patients underwent clinical and angiographic followup at 9 months and clinical follow-up at 3 years. The study protocol was approved by the Institutional Review Board of the Seoul National University Hospital before the initiation of the study. Informed consent was obtained from all participants. Background Intracoronary radiation therapy (IRT) prevents recurrent in-stent restenosis, but its long-term safety and efficacy remain uncertain. In the present study, the long-term clinical outcome of IRT using the rhenium-188 ( 188 Re)-filled balloon system was evaluated. Methods and ResultsAfter successful catheter-based treatment of either a de novo or restenotic lesion, 187 patients were randomly assigned to either the radiation (N=104) or the control (N=83) group. The 188 Re-filled balloon system was de...

A numerical simulator entitled TOUGH-UDEC is introduced for the analysis of coupled thermalhydraulic-mechanical processes in fractured porous media. Two existing well-established codes, TOUGH2 and UDEC, are coupled to model multiphase fluid flows, heat transfers, and discontinuous deformations in fractured porous media by means of discrete fracture representation. TOUGH2 is widely used for the modeling of heat transfers and multiphase multicomponent fluid flows, and UDEC is a well-known distinct element code for rock mechanics. The two codes are solved sequentially, with coupling parameters passed to each equation at specific intervals. After solving thermal-hydraulic equations within the TOUGH2 code, pressure and temperature information is imported into the UDEC model. After solving the mechanical equation within the UDEC code the calculated fracture apertures are converted to the equivalent permeability and porosity values for a TOUGH2 flow analysis. The solution is calculated by iteratively following an explicit sequence for numerical efficiency. Verifications are presented to demonstrate the capabilities of the coupled TOUGH-UDEC simulator. Three application examples of (1) shear dilation due to increased pore pressure, (2) thermal stress and (3) CO 2 injection, show that the new simulator can be an effective tool for geoengineering applications involving shear activation of fractures and faults.