PURPOSE: This study was conducted to determine the effects of a fall prevention program on knowledge, efficacy, and prevention behavior of falls among the low-income elderly. METHODS: This study used a nonequivalent control group pre and post test quasi-experimental research design. The study was conducted from August to October, 2008 with 20 subjects in the experimental group and 22 in the control group who were registered at the public health center of S District in D City. RESULTS: Hypothesis 1 "The experimental group that participated in the fall prevention program will show a higher degree of knowledge about falls than the control group" was supported. Hypothesis 2 "The experimental group will have a higher degree of self-efficacy of falls than the control group" was not supported. Hypothesis 3 "The experimental group will report fall prevention behavior more frequently than the control group" was supported. CONCLUSION: It was verified that the fall prevention program in this study was an effective intervention to improve knowledge about falls and fall prevention behaviors among the low-income elderly. The results can be used as part of an intervention to prevent falls for the vulnerable elderly such as the low-income elderly.
Accidental Falls ; Aged* ; Humans ; Public Health ; Research Design ; Self Efficacy

BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.
Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Methods* ; Rotator Cuff ; Scapula ; Shoulder ; Tears

We have experienced a case of 13 ring chromosome in a 40-month-old girl who demonstrated psychomotor retardation with delayed speech, growth retardation, hearing loss(left), microcephaly, trigonocephaly with flat occiput, hypertelorism, epicanthal folds, microophthalmia, broad prominamt nasal bridge, high arched palate, micrognathia, large auricles and other anomalies. Cytogenetic studies of peripheral blood lymphocytes with differential staining of chromosomes revealed 46, XX, r13. Her parents' karyotypes were normal. We reported the case with the review of the associated literatures.
Child, Preschool ; Craniosynostoses ; Cytogenetics ; Female ; Hearing ; Humans ; Hypertelorism ; Karyotype ; Lymphocytes ; Microcephaly ; Palate ; Ring Chromosomes*

The escalating conflict between the government and medical community, particularly the increase in medical school admissions by 2,000, has plunged Korea into a pressing healthcare crisis. This study delves into the heart of this dispute and proposes solutions to tackle critical issues in essential and regional healthcare.Current Concepts: Despite government assertions, the number of active physicians in Korea is increasing rapidly. With a similar physician-to-population ratio (2.65 per 1,000 inhabitants by 2022), Japan is reducing its number of medical school admissions. Korea is facing a severe shortage of essential medical fields crucial for public health, and significant regional healthcare disparities. These issues stem not from a lack of physicians, but from poor working conditions and inadequate payment systems of the National Health Insurance Services of Korea, leading to an inequitable medical ecosystem. It is crucial that policies affecting public health, such as increasing medical school admissions, are meticulously evaluated. This evaluation should consider future population projections, healthcare supply and demand systems, and financial aspects. Furthermore, any changes in medical policy should be grounded in scientific evidence and implemented in close collaboration with medical experts.Discussion and Conclusion: To effectively address imbalances in essential and regional healthcare, it is imperative to normalize the healthcare delivery system and foster an environment that motivates physicians to work voluntarily in these sectors. This change necessitates the implementation of supportive measures and financial strategies developed through extensive consultations with the medical community.

Tuberculous meningitis is qutie a common disease and delay in treatment is associated with poor prognosis. But the study on the prognosis of tuberculous meningitis is rare in Korea. We analyzed the clinical and laboratory findings of 159 cases seen between 1986 and 1990 at the Yonsei University College of Medicine, Severance Hospital. The specific aims of this study were to evaluate the clinical presentation, course and outcome and to determine the factors that may have influence on the outcome of tuberculous meningitis. The following results were obtained. 1. The highest incidence of age was noted in third decade as 37 cases (23.3%)and there was a tendency that the annual incidence of tuberculous meningitis declined since 1989. 2. The most presenting symptoms on admission were headache in 114 cases (71.7%), fever and chilling in 112 cases (70.4%), nausea and vomiting in 71 cases (44.7%), altered consciousness in 38 cases(23.9%) in order and clinical stage on admission revealed 83 cases of stage 2 and 14 cases of stage 3. 3. Associated tuberculous lesions other than central nervous system were found in 56 cases (35.2%) including miliary tuberculosis (15.7%), pulmonary tuberculosis (13.8%), spinal tuberculosis (3.1%), renal tuberculosis and so on. 4. Comparing with those who have not developed neurological sequelae on discharge, the mean protein value of cerebrospinal fluid on admission was increased and the mean glucose value and WBC count were decreased in patients who have developed neurological sequelae. 5. Brain computed tomography scan was performed in 122 cases and it revealed no abnormal findings in 54 cases (44.3%), enlarged ventricle in 44 cases (36.1%), basal enhancement in 25 cases (20.5%), lacunes in 18 cases (14.8%) and tuberculous granu-lomas in 8 cases (6.6%). 6. The neurological sequelae were developed in 53 cases (33.3%) including altered consciousness (13.2%), cranial nerve palsies (10.1%), death (5.0%), hemiparesis (4.4%), paraparesis(3.1%)and so on. 7. Prognosis of tuberculous meningitis app.
Brain ; Central Nervous System ; Cerebrospinal Fluid ; Consciousness ; Cranial Nerve Diseases ; Fever ; Glucose ; Headache ; Humans ; Incidence ; Korea ; Nausea ; Paresis ; Prognosis ; Tuberculosis, Meningeal* ; Tuberculosis, Miliary ; Tuberculosis, Pulmonary ; Tuberculosis, Renal ; Tuberculosis, Spinal ; Vomiting

Amyloidosis is classified according to the distribution pattern of amyloid deposition sites and associated diseases. Hepatic amyloidosis is not infrequent, although rarely causes clinical liver disease. We report two cases of amyloidosis diagnosed by liver biopsy. One presented with symptoms related almost to the liver disease, such as jaundice, hepatomegaly and indigestion. Echocardiogram revealed hypertrophic cardiomyopathy, suggesting cardiac involvement of the amyloidosis. The patient died of hepatic failure. The other case was found in a patient with an end stage renal disease. Features of congestive heart failure in this case may reflect cardiac involvement. The pattern of hepatic amyloid deposition in both of these cases was diffuse perisinusoidal. The predominant intralobular deposition suggests that these are amyloidosis of the secondary type.
Amyloidosis/*diagnosis/pathology ; Humans ; Liver Diseases/*diagnosis/pathology ; Male ; Middle Aged

We report the first Korean case of HTLV-I associated myelopathy (HAM), which was confirmed by Western blot assay of serum and cerebrospinal fluid. Interestingly, the proband's wife was a Japanese Korean who had lived in the endemic area of HAM, Kyushu. Japan, Investigations revealed significantly elevated anti HTLV-I antibody titers in the serum, but not in the CSF, suggesting that she was a carrier of HTLV-I. Considering that the patient had not had a previous blood transfusion, the most common route of HTLV-I, it is likely that the patient was infected by his wife through sexual intercourse. Although previous reports suggest that the transmission of HTLV-I is essentially from man to man or man to woman, our case suggests that woman to man transmission also occurs.
Adult ; Blotting, Western ; HTLV-I Antibodies/analysis ; Human ; Korea/epidemiology ; Male ; Paraparesis, Tropical Spastic/*epidemiology/immunology

We report 11 patients who developed dystonia and parkinsonian symptoms and signs. All of them developed the onset of parkinsonian symptoms 1 month to about 50 years(median: 2 yrs) after the onset of dystonia. Six of 11 patients developed dystonia affecting a hand; two affecting a foot; one affecting the neck; one affecting bilateral hands and a foot; one affecting a foot, trunk and neck Their parkinsonian symptoms had progressed very slowly and responded well to the levodopa treatment. Beside, none of them had clinical features suggestive of parkinsonian-plus syndrome. These findings suggest that they may have pathological changes confined to the nigrostriatal dopaminergic system as those with idiopathic Parkinson's disease. However, no change or worsening of dystonia after levodopa treatment suggest that they may have additional lesions out-side of the nigrostriatal dopaminergic system. More pathological studies and functional brain imaging studies are needed to define the exact pathogenesis of clinical syndrome of dystonia-parkinsonism.
Dystonia ; Foot ; Functional Neuroimaging ; Hand ; Humans ; Levodopa ; Neck ; Parkinson Disease

No abstract available.
Child* ; Heart* ; Humans

No abstract available.
Animals ; Congenital Abnormalities* ; Rats*