The effects of brisk walking & muscle strengthening exercise on pain, fatigue, physical function & disease activity were examined in 28 patients with rheumatoid arthritis. Research design was a quasi-experimental study of nonequivalent control group pretest-posttest design. 14 for the experimental group and 14 for the control group were selected from the outpatients on rheumatoid arthritis clinic of Dong-A University Hospital. The experimental group underwent 16 weeks of brisk walking and muscle strengthening exercise using Thera-Band. Pain, fatigue. physical function & disease activity was measured before and after 16 weeks of exercise. At baseline test, Fatigue & physical function score between groups were significantly different. So differences within experimental group (baseline versus follow up)were compared with differences within the control group by Mann-Whitney test. There were significant differences between groups in the difference score on pain (U=6.50 p .001) and fatigue (U=26.5 p .0l). For the experimental group. the score on the pain & fatigue was significantly decreased but no changed for the control group. Also there was a significant differences between groups in the difference score of the physical function (u=22.5 p .001). For the experimental group, the score of the physical function has been significantly increased. However, for the control group, it has been no changed. But there were no significant differences between groups in the ESR (erythrocyte sedimentation rate) and the CRP (C-reactive protein) level. In summary, brisk walking & muscle strengthening exercise led to significant improvements in pain, fatigue. and physical function without exacerbating disease activity in patients with rheumatoid arthritis.
Arthritis, Rheumatoid* ; Fatigue* ; Humans ; Outpatients ; Research Design ; Walking*

This study was carried out to identify the important risk factors for reduced bone mass of postmenopausal RA patients and to develop discriminant function which can classify postmenopausal RA patients with either reduced or normal bone mass. Through the literature review, individual characteristics such as age, body weight, height. age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption exercise habit. alcohol intake, cigarette smoking, coffee consumption, disease activity, corticosteroid therapy were identified as influencing factors of reduced bone mass in RA patients Sixty eight postmenopausal women with rheumatoid arthritis aged between 42 and 76 were selected among those who checked bone mineral density in lumbar spine and femur from October. 1998 to April. 1999 at Dong-a university hospital in Pusan. Assessment of disease activity, duration of disease and corticosteroid therapy were made by the same rheumatologist and included Ritchie articular index, erythrocyte sedimentation rate, and C-reactive measuring bone protein on mineral density. Cumulative steroid dosage was calculated from the daily dosage multiplied by the number of days received. The information of other risk factor including health assessment score, individual characteristics and life style factors were collected by questionnaire. Bone mineral density(BMD) was measured using DXA at lumbar spine and femoral Ward's triangle. Discriminant function (regression equation) was developed for estimating the likelihood of the presence or absence of reduced bone mass. The results are as follows: Among the subjects, thirteen(l9.1%) exhibited osteoporosis in lumbar spine and twenty four(35.3%) exhibited osteoporosis in femoral Ward's triangle. For lumbar spine, the variables significant were age, body weight, health assessment score, while for femoral Ward's triangle, age, body weight, duration of disease. But disease activity and corticosteroid therapy were not signigicant to distinguish reduced bone mass from normal bone mass. When the discriminant function was evaluated by comparing the observed outcome with predicted outcome, the discriminant function correctly classified 85.4% of patients with reduce bone mass and 63.0% of patients with normal bone mass in the lumbar spine and 100% of patients with reduced bone mass and 9.1% of patients with normal bone mass in the femoral Ward's triangle. In summary, we found that osteoporosis in postmenopausal women with RA is more evident at the femur than the lumbar spine. Also the important discriminant factors of reduced bone mass postmenopausal women with RA were age, body weight, duration of disease and health disability. In nursing situation, the efforts to improve of functional capacity of postmenopausal women with rheumatoid arthritis should be considered to prevent osteoporosis and fractures. Also we recommend those postmenopausal women with RA who are classified as a group of the reduced bone mass in the discriminant function should examine the bone mineral density to further examine the usefulness of this discriminant function.
Arthritis, Rheumatoid* ; Body Weight ; Bone Density ; Breast Feeding ; Busan ; Coffee ; Erythrocyte Indices ; Female ; Femur ; Gravitation ; Humans ; Life Style ; Menarche ; Menopause ; Milk ; Nursing ; Osteoporosis ; Parity ; Surveys and Questionnaires ; Risk Factors ; Smoking ; Spine

Conservative or surgical methods have been used for the treatment of fracture of mandibular subcondyle, but consensus has not been reached in regard to the proper management of this injury. Several problems related to the surgical procedure have led many surgeons to avoid surgical management of condylar fractures in favor of closed reduction and intermaxillary fixations. However, luxation of the condyle may lead to various long-term complications such as open bite on the contralateral side, dysfunction, deviation in opening and closing movements, as well as bone apposition leading to ankylosis. As a consequence, open reduction is preferable when the condyle is displaced. Various methods-for example, direct wiring technique, simple bone plating, dynamic compression plating-have been advocated for the treatment of fracture of mandibular subcondyle. Of such methods, a functionally-stable osteosynthesis can be achieved by compression osteosynthesis methods. Lag screw osteosynthesis is essentially a form of compression osteosynthesis in which the bone fragments are bound to one another as a result of traction from the screw. An advantage of compression osteosynthesis is that the end of a fractured bone can be maintained in an opposed position under pressure, and then primary bone healing occurs by direct osteoblastic activity within the fracture. As well, it obviates or reduces the need for maxillomandibular fixation, as well as the morbidity associated with conventional treatment methods such as facial nerve injury and bone resorption due to wide dissection. We have treated 9 cases of displaced subcondylar fractures of the mandible with the lag screw fixation system which is marketed by the Martin corporation. Mobilization and guidance of the jaw was begun from 7 or 10 days postoperatively. The radiologic and clinical evaluations showed good repositioning of the fragments and good occlusion postoperatively The disadvantage is that surgical procedures are relatively compound, and an additional procedure - removal of lag screw - is necessary after complete bone union. Lag screw osteosynthesis can be added as a another valid armament for plastic surgeons in the management of mandibular subcondyle fractures.
Ankylosis ; Bone Resorption ; Consensus ; Facial Nerve Injuries ; Jaw ; Jaw Fixation Techniques ; Mandible ; Open Bite ; Osteoblasts ; Traction

To determine whether personal history of lactation in premenopausal women influence bone mineral density, a cross-sectional study was conducted. One hundred eighty-four premenopausal women were selected from women who had been checked for bone mineral density by dual energy x-ray absortiometry in lumbar spine, femoral neck, Ward's triangle, and trochanteric site at general hospitals in Seoul and Pusan. They completed a questionnaire including life style factors and reproductive history. In the data analysis, Pearson correlation coefficients were used to test any association between individual variables and bone mineral density and a statistical comparisons between long term lactation(>24 months) and short term lactation(<24 months) were made by one way analysis of covariance. The results were summarized as follows: 1) There was no significant difference in the bone mineral density of the lumbar vertebrae in premenopausal women between the long term lactation group(>24months) and the short term lactation group(<24months). 2) There was no significant difference in the bone mineral density of the femur neck, Ward's triangle, and trochanteric site in premenopausal women between the long term lactation group (>24months) and the short term lactation group (<24months). Considering these results, we suggest prospective studies that measure bone mineral density before and after, in addition to those during lactation. We also suggest the further study with premenopausal women less than 35 who have achieved peak adult bone mass.
Adult ; Bone Density* ; Breast Feeding* ; Breast* ; Busan ; Cross-Sectional Studies ; Female ; Femur ; Femur Neck ; Hospitals, General ; Humans ; Lactation ; Life Style ; Lumbar Vertebrae ; Surveys and Questionnaires ; Reproductive History ; Seoul ; Spine ; Statistics as Topic

PURPOSE: The purpose of this study was to examine the effects of a six week self-help empowerment strategy program on the empowerment status, pain intensity, physical function, joint flexibility and depression status in rheumatoid arthritis patients. METHOD: The subjects of the study consisted of a convenience sample thirteen rheumatoid arthritis patients. Data was collected from July to November, 2001. All patient received a self-help empowerment strategy program, once a week for six weeks. RESULT: After receiving the self-help empowerment strategy program, the empowerment status increased significantly, the pain intensity and the depression score decreased significantly and the level of physical function significantly improved but the flexibilities of shoulders, knees and ankles were not significantly changed. CONCLUSION: Further studies need to be done to determine the feasibility of implementing empowerment strategy and its possibility as an effective intervention program for decreasing pain intensity and depression score and improving the physical function.
Ankle ; Arthritis, Rheumatoid* ; Depression ; Humans ; Knee ; Power (Psychology)* ; Range of Motion, Articular ; Self-Help Groups ; Shoulder

PURPOSE: The purpose of this study was to identify the relationship of job stress, state of sleep, and depression and to identify factors influencing depression of emergency medical technicians. METHODS: The research was a cross-sectional, descriptive study. Data collection were done using self-report questionnaires with 162 emergency medical technicians working in hospitals who agreed to participate in the study. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple regression with the SPSS/WIN 18.0 Program. RESULTS: Depression had significant negative correlations with state of sleep, (r=-482, p<.001) and positive correlations with job stress (r=.196,p=.013). State of sleep had significant negative correlations with job stress (r=-.168, p=.033). The variance for life satisfaction was 23.7% (F=25.964, p<.001). Variable of state of sleep significantly predicted depression of emergency medical technicians. CONCLUSION: Considering these results, for emergency medical technicians' job stress, state of sleep, and depression, further studies are needed. Furthermore, there is a need to develop and implement new strategies to improve depression among emergency medical technicians.
Data Collection ; Depression ; Emergencies ; Emergency Medical Technicians ; Humans ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to determine the effects of a 6-week Tai Chi exercise program on reducing blood pressure for hypertensive patients. METHOD: A non-equivalent pretest-posttest experimental design was used. Participants were recruited from the Community Health Center in Busan, Korea. Twenty-eight hypertensive patients participated in this study. Among them, fourteen were in the experimental group and the rest are in the control group. Members in the experimental group participated in a 6- week program of Tai Chi exercise. In order to evaluate the effects of the Tai Chi program, blood pressure, total cholesterol, and cortisol level were measured before and after week 6. RESULT: After the 6-week Tai Chi program, there were significant differences in systolic pressure (t=-3.13, p= .004) and diastolic blood pressure (t=-4.75, p= .000) in the experimental group when compared to the control group. However there were no significant differences in the total cholesterol (t=1.07, p=.294) and cortisol level (F=1.35, p= .256). CONCLUSION: These results suggest that a 6-week Tai Chi program can be utilized as an effective nursing program to reduce blood pressure for hypertensive patients.
*Blood Pressure ; Cholesterol/*blood ; Female ; Humans ; Hydrocortisone/*blood ; Hypertension/blood/physiopathology/*therapy ; Male ; Middle Aged ; *Tai Ji

PURPOSE: The purpose of this study was to determine the effects of a 6-week Tai Chi exercise program on reducing blood pressure for hypertensive patients. METHOD: A non-equivalent pretest-posttest experimental design was used. Participants were recruited from the Community Health Center in Busan, Korea. Twenty-eight hypertensive patients participated in this study. Among them, fourteen were in the experimental group and the rest are in the control group. Members in the experimental group participated in a 6- week program of Tai Chi exercise. In order to evaluate the effects of the Tai Chi program, blood pressure, total cholesterol, and cortisol level were measured before and after week 6. RESULT: After the 6-week Tai Chi program, there were significant differences in systolic pressure (t=-3.13, p= .004) and diastolic blood pressure (t=-4.75, p= .000) in the experimental group when compared to the control group. However there were no significant differences in the total cholesterol (t=1.07, p=.294) and cortisol level (F=1.35, p= .256). CONCLUSION: These results suggest that a 6-week Tai Chi program can be utilized as an effective nursing program to reduce blood pressure for hypertensive patients.
*Blood Pressure ; Cholesterol/*blood ; Female ; Humans ; Hydrocortisone/*blood ; Hypertension/blood/physiopathology/*therapy ; Male ; Middle Aged ; *Tai Ji

No abstract available.
Osteoma, Osteoid* ; Tetracycline*

PURPOSE: Periventricular leukomalacia(PVL) is associated with various neurologic sequelae such as cerebral palsy and cortical blindness. The aim of this study was to analyse the correlation between the degree of PVL on MRI and clinical features or its severity. METHODS:Thirty-eight children with PVL on MRI among children brought to Pusan National University Hospital between January 1996 and August 1999 with development delay, cerebral palsy or epilepsy were included into the study group. We reviewed medical records of the patients including the gestational age, birth weight and neurologic sequelae. The grade for PVL was divided into 1 to 3, and it was based on abnormally increased signal intensity in periventricular white matter or a reduced amount of periventricular white matter or both, and compensatory focal ventricular enlargement. We analysed the relationship of the grade of PVL and various clinical findings. RESULTS: The age ranged from 11 months to 13 years old with a mean of 42 months. History of cesarean delivery and ventilator care were significantly frequent for the severe grade of PVL. Birth weight was significantly lower according to grade of PVL. Gestational age was lower according to the grade of PVL, but was not significant statistically. Incidence of cerebral palsy was significantly higher on the severe grade of PVL. Incidence of epilepsy and mental retardation were 34.2Yo and 23.9M, not associated with the grade of PVL. CONCLUSION: Incidence of cerebral palsy was associated with the severe grade of PVL, so we think MRI can be helpful in predicting neurodevelopmental outcome. (J Korean Pediatr Soc 2000;43 798-805)
Adolescent ; Birth Weight ; Blindness, Cortical ; Brain* ; Busan ; Cerebral Palsy ; Child ; Epilepsy ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Intellectual Disability ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging* ; Medical Records ; Ventilators, Mechanical