PURPOSE: This study was to examine the effects of foot reflexology on pain and depression of middle-aged women with Osteoarthritis. METHOD: The subjects were 41 osteoarthritis patients resided in the Jinju city from March to May, 2005. The foot reflexology was applied to the experimental group 3 times a week for 4 weeks, 30 minutes eachs. For the data analysis, chi-square-test was conducted to verify the homogeneity of general characteristics, and t-test was done to verify the homogeneity of pain and depression. To examine the relative efficacy of the intervention, t-test, paired t-test and repeated measures ANOVA were conducted. RESULTS: After foot reflexology, the subjects in experimental group showed significant improvement in pain (F=155.77, p=.000) and depression (F=20.00, p=.000). CONCLUSION: The results suggest that the foot reflexology is effective in relieving of pain and depression. Therefore, it is necessary to develop foot reflexology as an independent nursing intervention.
Depression* ; Female ; Foot* ; Gyeongsangnam-do ; Humans ; Massage* ; Nursing ; Osteoarthritis* ; Statistics as Topic

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poor-quality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.
Benchmarking ; Hospitals ; Humans ; *National Health Programs ; Quality Improvement/*economics ; Quality of Health Care/economics ; Reimbursement, Incentive/*organization & administration ; Republic of Korea

The Committee of Education of the Korean Diabetes Association discussed the need to develop the Diabetes Education Recognition Program. In 2011, the current certification program was reviewed and a survey was conducted to improve the Diabetes Education Recognition Program. This improved program will be a standard for qualified diabetes education for diabetes educators and institutes, and will ultimately become a national standard for diabetes education.
Academies and Institutes ; Certification ; Diabetes Mellitus ; Patient Education as Topic

BACKGROUND: Ventricular function is one of the important prognostic factors in patients with coronary artery disease. Among noninvasive approaches for the evaluation of ventricular performance, radionuclide ventriculo-graphy has shown to be of particular values in the patients with myocardial infarction. We have evaluated ven-tricular function with ECG-gated blood pool scan (GBPS) in patients with myocardial infarction of different locations and compared right and left ventricular functions. METHOD: Left and right ventricular function was assessed with multigated blood pool scan in 49 patients at 2-3 weeks after acute myocardial infarction (anterior infarction=23, inferior infarction=19, and lateral infarction=7). Left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), maximal emptying rate, maximal filling rate, phase angle and full width at half maximum (FWHM) of phase angles were measured during rest. RESULTS: 1) LVEF was signifi-cantly lower in the patients with anterior myocardial infarction (32.2%) than that of inferior (46.5%, p<0.001) or lateral infarction (45.5%, p<0.05), but not different between inferior and lateral infarction. 2) RVEF was significantly lower in the patients with inferior myocardial infarction (24.6%) than that of anterior (30.5%, p<0.05) or lateral infarction (36.1%, p<0.001), and RVEF of anterior infarction was significantly lower than that of lateral infarction (p<0.05). 3) Phase angle and FWHM of left ventricle and right ventricle phase histogram were not significantly different among the patients groups with different infarct sites. CONCLUSIONS: Ventricular function was differently affected by different infarct sites. Inferior infarction resulted in a greater reduction in right ventricular ejection fraction. In contrast, LVEF was greatly depressed in anterior infarction than in inferior infarction.
Coronary Artery Disease ; Heart Ventricles ; Humans ; Infarction ; Inferior Wall Myocardial Infarction ; Myocardial Infarction ; Stroke Volume ; Ventricular Function ; Ventricular Function, Left ; Ventricular Function, Right*

OBJECTIVES: This study was conducted to develop the screening questionnaire (Adolescent Mental Health and Problem Behavior Questionnaire, AMPQ) for detecting mental health problems and various problem behaviors in adolescents. METHODS: First, six main domains of questionnaire were defined and preliminary sub-items were collected through literature study, consultation data from field mental health experts, and preliminary survey study. Next, with these 52 preliminary items, we conducted nationwide survey on 1,267 middle and high school students of five districts of Korea. RESULTS: Through reliability test and factor analysis 34 items were finally filtered out. The Cronbach's alpha of these 34 items was .88. And correlation with K-YSR and K-CBCL were .34 (p<.01) and .68 (p<.01). CONCLUSION: AMPQ, which is comprised of relatively short list of items and at the same time covers overall mental health and problem behaviors in adolescents can be used by non-professionals as a screening questionnaire in school settings or mental health centers.
Adolescent ; Humans ; Mass Screening ; Mental Health ; Surveys and Questionnaires

BACKGROUND: The main source of carbohydrate in the Korean diet is rice, which is usually served in a rice bowl. This study investigated the impact of a meal plan using smaller rice bowls on dietary energy intake and macronutrient composition in overweight or obese patients with type 2 diabetes mellitus. METHODS: A total of 67 women with type 2 diabetes were enrolled in our study. We divided these participants into three groups: a normal-weight group (NW; body mass index [BMI] < 23 kg/m2; n = 17), an overweight group (OW; 23 < or = BMI < 25 kg/m2; n = 24) and an obese group (OB; BMI > or = 25 kg/m2; n = 26). Three-day dietary records were analyzed for total energy intake (TEI) and macronutrient composition both before enrollment and two weeks after patients received instruction in a dietary plan based on using a small (200 mL) rice bowl. RESULTS: After the intervention, TEI decreased in the OW and OB groups. Decreased carbohydrate (NW, -4 +/- 5%; OW, -4 +/- 5%; OB, -3 +/- 6%) and increased fat intakes were found in all three groups, which complies with Korean Diabetes Association recommendations. The protein proportion of TEI significantly increased only in the OW group. Body weight decreased both in the OW and OB groups. CONCLUSION: A short-term, small-rice-bowl-based meal plan was effective for body weight control and macronutrient balance in overweight or obese women in Korea with type 2 diabetes.
Body Mass Index ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet ; Diet Records ; Energy Intake ; Female ; Humans ; Korea ; Meals ; Overweight

BACKGROUND: Regional anesthesia is widely used for a cesarean section. However, the awake state during a cesarean section could be a horrible experience for mothers and adverse effects such as nausea, vomiting, abdominal discomfort, pruritus and shivering are common complications of regional anesthesia. Therefore, we administered propofol that has sedative and antiemetic effects using target controlled infusion (TCI) and evaluated optimal predicted propofol concentrations that have maximal satisfaction with minimal side effects. METHODS: One hundred twenty parturients scheduled for an elective cesarean section were randomly allocated into one of four groups (control, Gr 1ng/ml, Gr 1.5ng/ml, and Gr 2ng/ml). A combined spinal epidural procedure was performed. After the baby's delivery, propofol TCI of a predetermined concentration (0, 1, 1.5, or 2ng/ml) was administered to the end of operation. Sedation scores (1 - 6, 1: full awake, 6: unresponsive to firm facial tap), satisfaction scores by VAS system (0 - 100 mm, 0 mm: no satisfaction at all, 100 mm: perfect satisfaction), and side effects (nausea/vomiting, abdominal discomfort, pruritus, shivering, retrograde amnesia, hypotension, desaturation, and excitation) were checked. RESULTS: Mean sedation scores were increased along with a higher propofol concentration. All TCI groups felt more satisfaction compared to the control group. Incidences of nausea/vomiting, pruritus and abdominal discomfort were higher in the control group. Excitation without cooperation and desaturation (SpO2 < 90%) occurred in 4 and 5 parturients in Gr 2ngg/ml. CONCLUSIONS: We concluded that sedation using propofol TCI is useful in reducing intraoperative side effects and increasing parturients' satisfaction during regional anesthesia for a cesarean delivery. The appropriate predicted concentration of propofol for this purpose was 1.0 or 1.5ngg/ml.
Amnesia, Retrograde ; Anesthesia, Conduction* ; Antiemetics ; Cesarean Section* ; Female ; Humans ; Hypotension ; Incidence ; Mothers ; Nausea ; Pregnancy ; Propofol* ; Pruritus ; Shivering ; Vomiting

PURPOSE: A growing body of evidence indicates that zoledronic acid (ZA) can improve the clinical outcome in patients with breast cancer and low estrogen levels. In the present study, we aimed to investigate the survival benefit of ZA administration in postmenopausal Korean women with breast cancer who were also receiving aromatase inhibitors. METHODS: Between January 2004 and December 2010, 235 postmenopausal breast cancer patients undergoing aromatase inhibitor therapy were investigated. All patients were postmenopausal, as confirmed by laboratory tests. Of these patients, 77 received adjuvant upfront ZA for at least 1 year in addition to conventional adjuvant treatment. The remaining 158 patients never received ZA and were treated according to the St. Gallen guidelines. RESULTS: The baseline characteristics for ZA treatment were not different between the two groups. The median follow-up time was 62 months, and the patients who received ZA in addition to aromatase inhibitors showed a better recurrence-free survival compared to those who received aromatase inhibitors alone (p=0.035). On multivariate analysis, the patients who received ZA showed a better recurrence-free survival independent of the tumor size, nodal status, progesterone receptor, and histological grade. For this model, Harrell c index was 0.743. The hazard ratio of ZA use for recurrence-free survival was 0.12 (95% confidence interval, 0.01-0.99). CONCLUSION: Our findings suggest that upfront use of ZA as part of adjuvant treatment can offer a survival benefit to postmenopausal breast cancer patients receiving aromatase inhibitor treatment.
Aromatase ; Aromatase Inhibitors* ; Breast Neoplasms* ; Estrogens ; Female ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Postmenopause ; Receptors, Progesterone

PURPOSE: To determine whether high-resolution contrast-enhanced three dimensional imaging with spoiled gradient-recalled sequence (HR-CE 3D-SPGR) plays a meaningful role in the assessment of intracranial vertebral artery (ICVA) and posterior inferior cerebellar artery (PICA) in lateral medullary infarction (LMI). MATERIALS AND METHODS: Twenty-five patients confirmed with LMI were retrospectively enrolled with approval by the IRB of our institute, and 3T MRI with HR-CE 3D-SPGR and contrast-enhanced magnetic resonance angiography (CE-MRA) were performed. Two radiologists who were blinded to clinical information and other brain MR images including diffusion weighted image independently evaluated arterial lesions in ICVA and PICA. The demographic characteristics, the area of LMI and cerebellar involvement were analyzed and compared between patients with arterial lesion in ICVA only and patients with arterial lesions in both ICVA and PICA on HR-CE 3D-SPGR. RESULTS: Twenty-two of twenty-five LMI patients had arterial lesions in ICVA or PICA on HR-CE 3D SPGR. However twelve arterial lesions in PICA were not shown on CE-MRA. Concurrent cerebellar involvement appeared more in LMI patients with arterial lesion in ICVA and PICA than those with arterial lesion in ICVA alone (p = 0.069). CONCLUSION: HR-CE 3D-SPGR can help evaluate arterial lesions in ICVA and PICA for LMI patients.
Arteries* ; Brain ; Diffusion ; Ethics Committees, Research ; Humans ; Infarction* ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Pica ; Retrospective Studies ; Vertebral Artery*

Congenital muscular torticollis (CMT) and craniosynostosis are diseases that cause plagiocephaly and craniofacial asymmetry in children. In our literature review, we did not find any report of concurrent manifestation of CMT and craniosynostosis. A 41-month-old boy visited our hospital with left torticollis, right laterocollis, and craniofacial asymmetry as the main findings. During clinical examination, prominent right sternocleidomastoid muscle and limited range of motion of the neck were noted, and right CMT was confirmed by magnetic resonance imaging of the neck. Three-dimensional computed tomography of the skull, which was conducted due to the unusual appearance of the skull with a large head circumference, mild brachycephaly, as well as left plagiocephaly, revealed premature closure of the sagittal suture. Thus, we report the first case that showed concurrence of CMT and sagittal synostosis. We recommend that concurrently manifested craniosynostosis needs to be examined if the subject with CMT displays unusual craniofacial asymmetry to a greater extent than deformational plagiocephaly.
Child ; Child, Preschool ; Craniosynostoses* ; Head ; Humans ; Magnetic Resonance Imaging ; Male ; Neck ; Plagiocephaly ; Plagiocephaly, Nonsynostotic ; Range of Motion, Articular ; Skull ; Sutures ; Torticollis*