PURPOSE: This paper studies the influence of the case-management program on the change of blood sugar, lifestyle, and knowledge level of diabetes mellitus (DM) for medium-sizedenterprise employees suffering from DM. METHOD: Subjects, divided into experimental and control groups, are 59 workers with FBS higher than 126mg/dl or under DM medication treatment in the medium-sized enterprises, being managed by two distinct university hospital group occupational health management service teams. The case management program for DM patients consists of 6 different processes in which each subject is treated. RESULT: FBS decreased in the experimental group after the program, while that of the control group increased significantly. In the experimental group, the amount of smoking, the frequency of drinking and the amount of drinking per week decreased. Also, the knowledge level for DM and the change of nutrition management showed significant increase. In the control group, the amount of smoking increased and the frequency of drinking, the amount of drinking and nutrition level did not change significantly. And the knowledge level for DM decreased. CONCLUSION: We expect that taking this case management program for DM management may significantly improve diabetic patients' overall health.
Blood Glucose ; Case Management ; Diabetes Mellitus ; Drinking ; Humans ; Life Style ; Occupational Health ; Smoke ; Smoking ; Stress, Psychological

This study was performed to evaluate the effect of placebo(emotional stimulus) on physical fitness and psychological wellbeing. The subjects for the study were divided into tow groups. One experimental group received placebo and the other control group did not receive. Each group was composed of 15 women. The subjects continued aerobic exercise for an hour each time, three times a week, for eight weeks. The enhancement of physical fitness has been evaluated by body weight, BP, pulse rate, skinfolds thickness, circumference of waist and hip, body fat, % body fat, lean body mass, % lean body mass they were measured three times every 4 weeks. Also to evaluate the enhancement of psychological wellbeing, the self-esteem and self-perception were measured. The results can be summarized as follows : 1. The % body fat of experimental group decreased significantly than that of control group(p<0.1). 2. The % lean body mass of experimental group decreased significantly than that of control group(P<0.1). 3. There was no significant difference of other physical fitness factors between experimental group and control group. 4. There was no significant difference of self-esteem between experimental group and control group. 5. There was no significant difference of self-perception between experimental group and control group. From these results, it may be concluded that placebo(emotional stimulus) which received during aerobic exercise period is partially effective in the enhancement of the physical fitness.
Adipose Tissue ; Body Weight ; Exercise* ; Female ; Heart Rate ; Hip ; Humans ; Physical Fitness* ; Placebo Effect ; Self Concept

This study examined those problems noticed under the Asymptotically Generalized Least Squares estimator in evaluating a structural model of physical health. The problems were highly correlated parameter estimates and high standard errors of some parameter estimates. Separate analyses of the endogenous part of the model and of the metric of a latent factor revealed a highly skewed a kurtotic measurement indicator as the focal point of the manifested problems. Since the sample sizes are far below that needed to produce adequate AGLS estimates in the given modeling conditions, the adequacy of the Maximum Likelihood estimator is further examined with the robust statistics and the bootstrap method. These methods demonstrated that the ML methods were unbiased and statistical decisions based upon the ML standard errors remained almost the same, Suggestions are made for future studies adopting structural equation modeling technique in terms of selecting a reference indicator and adopting those statistics corrected for normality.
Least-Squares Analysis* ; Models, Structural ; Sample Size

PURPOSE: This study investigated attitudes toward general elders and elders with dementia among nursing students before beginning the clinical practicum. In addition, students' characteristics differentiating the attitudes were examined. METHODS: Attitudes were measured with questionnaires developed for Asian culture at the beginning week of the first semester of the junior year in two baccalaureate programs. Responses from 120 out of 121 students were analyzed using Pearson correlation coefficient, paired t-test, ANOVA, and Scheffe test. RESULTS: Students held negative attitudes toward both types of elders except for generosity dimension toward general elders showing a neutral attitude. Elders with dementia were evaluated more negatively than general elders in all the dimensions of vitality, generosity and flexibility. Vitality and generosity toward general elders were different according to intimacy and the degree of communication with elders. Generosity toward general elders was also different according to students' religious beliefs. Students with interest in elders/issues showed more negative attitudes of vitality and flexibility toward elders with dementia. CONCLUSIONS: Students in general had negative attitudes toward elders and more negative attitudes toward elders with dementia. We need to put more efforts into the entire nursing curriculum in order to improve attitudes toward elders with particular concern over attitudes toward elders with dementia.
Asian Continental Ancestry Group ; Curriculum ; Dementia* ; Humans ; Nursing ; Pliability ; Religion ; Students, Nursing* ; Surveys and Questionnaires

BACKGROUND: The term 'ischemic preconditioning', which implies the first, brief, sublethal ischemia before the next ischemia, is widely accepted to have protective effect in the myocardium, and recently with a specified circumstances, in the brain also. However, the existence of this 'ischemic tolerance' phenomenon is not yet clarified in the repeated transient focal cerebral ischemia model. This study was performed to test whether the ischemic preconditiong has protective effect also in this TIA-mimicking condition. METHODS: Using intraluminar suture technique, initial transient focal ischemia was maintained for 30 minutes in the rat brain. After this ischemic preconditioning, second ischemia of 120 minutes duration was performed using the same method at 1, 3, 5, and 7 days after the 1st ischemia (n=20). The resulting brain infarct volume was assessed and compared to that of previously sham-operated paired controls(n=20). RESULTS: Using the infarct volume as parameters, there was no significant difference between the ischemia and control group in all pairs. But when the percent of infarct volume compared to the hemispheric volume was used instead, neocortical infarct percent was significantly smaller at day 3 after preconditiong (p<0.05). But such difference was not found at 1, 5, and 7th day in the neocotex. Neither the percent of total infarct nor the subcortical infarct showed any statistical difference. CONCLUSION: It could be concluded that transient focal cerebral ischemic preconditioning have neuroprotective effect. The optimal interval between ischemia for this 'ischemic tolerance' to happen is 3 days, and this phenomenon seems to be the function of cerebral cortex, but not the subcortex.
Animals* ; Brain ; Brain Ischemia ; Cerebral Cortex ; Ischemia* ; Ischemic Preconditioning* ; Models, Animal* ; Myocardium ; Neuroprotective Agents* ; Rats ; Suture Techniques

The purpose of this study was to detect the motor neuron losses in progressive neurologic diseases before the weakness or wasting of muscles became apparent using the motor unit number estimation technique. Method for estimating the number of motor units based on electrical stimulation of motor nerves was introduced first by McComas. The author describe the method which was applied to the median nerve innervated thenar muscles in healthy subjects. This study showed that the results of motor unit number estimation were 196.9+/-56.2 in male, 187.6+/-79.2 in female, and the most influencing factor for the number of motor unit was the size of amplitude or area of compound muscle action potential.
Action Potentials ; Electric Stimulation ; Female ; Humans ; Male ; Median Nerve ; Motor Neurons ; Muscles ; Statistics as Topic

Purpose: To investigate the effect of order of examination on the results of noninvasive keratograph tear film evaluation using Keratograph5M in dry eye patients. Methods: One hundred and four patients with dry eye symptoms were analyzed retrospectively. All patients underwent bilateral noninvasive tear film evaluation using measurements of tear meniscus height (TMH) and noninvasive keratograph break-up time (NIKBUT) obtained using Keratograph5M. Measurements were performed sequentially in the order of right TMH, left TMH, right NIKBUT, and left NIKBUT. Results: There was no statistically significant difference in TMH values between the right and left eyes (0.24 ± 0.08 and 0.23 ± 0.08 mm, respectively). Mean NIKBUT-first (time at first tear film break-up) and mean NIKBUT-average (the mean of all tear film break-up time over the entire cornea) were 6.17 ± 3.28 and 10.00 ± 3.97 seconds, respectively, for right, and 7.43 ± 3.86 and 11.57 ± 4.34 seconds, respectively, for left eyes. In addition, mean NIKBUT-first between right and left eyes, and mean NIKBUT-average between them were statistically significant (p = 0.013 and p = 0.007, respectively). Mean NIKBUT and mean TMH differences were not significantly influenced by right or left eyes, age, or sex (all p > 0.050). Spearman correlation analyses of TMH, NIKBUT-first, and NIKBUT-average results showed moderate positive correlations between right and left eyes (r = 0.470, r = 0.322, and r = 0.576, respectively; p < 0.001). Conclusions TMH evaluation was not affected by test order; however, NIKBUT measurement was affected by test order, because of reflex tearing due to forced eye opening during the examination. Therefore, TMH should be evaluated before NIKBUT, and sufficient time interval and caution should be needed between NIKBUT measurements on both eyes.

No abstract available.
Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Minocycline*

BACKGROUND: Tracheal intubation by direct laryngoscopy induces frequently transient hypertension, tachycardia and arrhythmia. The purpose of this study was to examine the effect of esmolol and clonidine in attenuating the changes of blood pressure and heart rate by tracheal intubation. METHODS: Eighty patients were randomly divided into four groups: Group 1 (control , n=20), Group 2 (esmolol 0.5 mg/kg IV, n=20), Group 3 (clonidine 4 mcg/kg PO, n=20) and Group 4 (clonidine 4 mcg/kg PO and esmolol 0.5 mg/kg IV, n=20). The clonidine premedication were given orally with a sip of water 90 minutes before induction of anesthesia. Anesthesia was induced with thiopental 5 mg/kg, vecuronium 0.1 mg/kg, 50% nitrous oxide in oxygen and 2 vol % enflurane. After 5 minutes, tracheal intubation was performed. Patients in the group 2 and group 4 were given esmolol 0.5 mg/kg 90 seconds prior to tracheal intubation. Blood pressure and heart rate were measured at ward, preinduction, preintubation, immediately after intubation, 1, 3 and 5 minutes after intubation. RESULTS: After tracheal intubation, the increase in systolic blood pressure was supressed significantly in the clonidine-treated patients (Group 3, Group 4) compared with control group (p<0.05). The attenuating effect on increase of mean arterial pressure(MAP) was sustained longer in group 4 than group 3. Heart rate increased after tracheal intubation in all groups, but were markedly increased in the control group (p<0.05). The differences of MAP which measured at preinduction and immediately postintubation were smaller in group 4 than control group (p<0.05). The differences of heart rate which measured at preinduction and immediately postintubation were smaller in group 4 than group 1 or group 3 (p<0.05). CONCLUSIONS: Esmolol 0.5 mg/kg given as bolus, is effective for controlling the increase of heart rate but not in attenuating increase of blood pressure. Oral clonidine is effective for controlling the increase of blood pressure but not in attenuating increase of heart rate. Therefore esmolol combined with oral clonidine results in effective control of both heart rate and blood pressure.
Anesthesia ; Arrhythmias, Cardiac ; Blood Pressure ; Clonidine* ; Enflurane ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Intubation* ; Laryngoscopy ; Nitrous Oxide ; Oxygen ; Premedication* ; Tachycardia ; Thiopental ; Vecuronium Bromide ; Water