PURPOSE: This study was conducted to determine the effects of a fall prevention program on falls, physical function, psychological function, and home environmental safety in frail elders living at home in rural communities. METHODS: The design of this study was a nonequivalent control group pre posttest design. The study was conducted from July to November, 2012 with 30 participants in the experimental group and 30 in the control group. Participants were registered at the public health center of E County. The prevention program on falls consisted of laughter therapy, exercise, foot care and education. The program was provided once a week for 8 weeks and each session lasted 80 minutes. RESULTS: The risk score for falls and depression in the experimental group decreased significantly compared with scores for the control group. Compliance with prevention behavior related to falls, knowledge score on falls, safety scores of home environment, physical balance, muscle strength of lower extremities, and self-efficacy for fall prevention significantly increased in the experimental group compared with the control group. CONCLUSION: These results suggest that the prevention program on falls is effective for the prevention of falls in frail elders living at home.
Accidental Falls/*prevention & control ; Aged ; Aged, 80 and over ; Depression ; Exercise ; Female ; Frail Elderly/*psychology ; Health Education ; Humans ; Male ; Massage ; Muscle Strength ; *Program Evaluation ; Risk Factors ; Rural Population ; Self Care ; Self Efficacy

PURPOSE: The purpose of this study was to identify the relations among appropriateness of work, competency on student suicide and attitude toward suicide in health teachers. METHODS: This study was a cross-sectional descriptive one. The subjects were 193 health teachers. Self-administered questionnaires were used to measure the variables of this study. Descriptive statistics, independent t-test, one way ANOVA, Pearson correlation, and stepwise multiple regression with SAS 9.3 software were used for the data analysis. RESULTS: The attitude score toward suicide ranged from 1.47 to −1.03. The average score of appropriateness of work and competency related to student suicide were 2.34 and 2.81 respectively. Associated factors with competency related to student suicide among health teacher were appropriateness of work related to student suicide, two items of attitude toward suicide(suicide is an acceptable means to end an incurable illness and people who commit suicide are usually mentally ill), education level, education experience on suicide prevention and management, and the adjusted R2 of the regression model was 34.3%. CONCLUSION: Health teachers were not tolerable to student suicide. However, they evaluated themselves as low in the appropriateness and competency to the work on student suicide, especially in screening and counselling of high risk groups. The results of this study suggest that it is necessary to develop education programs about counseling and intervention on student suicide for health teachers.
Counseling ; Education ; Humans ; Mass Screening ; Statistics as Topic ; Suicide*

This study was conducted to evaluate prevalence of intestinal helminthic infections and skin tests and Paragonimus and Clonorchis in tuberculosis(TB) patients in Korea. Stool examinations by formalin-ether technique and intradermal tests were carried out in 2 areas; Masan TB hospital and Kong-Ju TB hospital. The positive rate of intestinal helminths of any kind was 51.7 percent among 329 patients in Masan hospital, but 18.1 percent among 215 patients in Kong-Ju hospital. The infection rates of Trichocephalus trichiurus and Clonorchis sinensis were 20.7 percent and 17.6 percent respectively in Masan hospital patients, but the infection rates of T. trichiurus and C. sinensis were 6.5 percent and 6.0 percent respectively in Kong-Ju hospital patients. In skin tests, positive reactions to Paragonimus and Clonorchis antigens were 22.0 percent and 37.6 percent respectively in Masan hospital patients. On the contrary, Kong-Ju hospital patients showed the positive rates of 15.2 percent for Paragonimus and 27.2 percent for Clonorchis respectively.
parasitology-helminth-trematoda ; Ascaris lumbricoides ; Trichuris trichiura ; hookworm ; Trichostrongylus orientalis ; Clonorchis sinensis ; Paragonimus westermani ; Metagonimus yokogawai ; Taenis sp. ; Hymneolepis nana ; epidemiology ; skin test

BACKGROUND: Phagocytosis is probably the first step for mycobacteria to be virulent in host because virulent strains are more readily phagocytosed by macrophage than attenuated strains. According 13 the traditional concept, multi-drug resistant strains have been regarded as less virulent. However, this concept has been challenged, since recent studies(reported) showed that the degree of virulence and drug-resistance is not related. The purpose of this study is to evaluate whether the phagocytic activity of M. tuberculosis by peripheral blood mononuclear cells(PBMC) is different according to drug-resistance or host factor. To evaluate this, we estimated the difference of phagocytic activity of drug-resistant and drug-sensitive M. tuberculosis and also estimated the phagocytic activity of PBMC from intractable tuberculosis patients and healthy controls. METHODS: PBMC from ten intractable tuberculosis patients and twelve healthy control and three different strains of heat-killed M. tuberculosis, ie, ADS(all drug sensitive), MDR(multi-drug resistant), and ADR(all drug resistant) were used. After incubation of various strains of M. tuberculosis with PBMC, the phagocytic activity was evaluated by estimating proportion of PBMC which have phagocytosed M. tuberculosis. RESULTS: Drug-resistant strains of M. tuberculosis were phagocylosed easily than drug sensitive strains(Percentage of PBMC phagocytosed M. tuberculosis in healthy control : ADS : 32.3α2.9%, ADR : 49.6α3.4%, p=0.0022, Percentage of PBMC phagocytosed M. tuberculosis in intractable tuberculosis patients : ADS : 34.9α3.6%, ADR : 50.7α4.5%), p=0.0069). However, there was no difference in phagocytic activity of PBMC from healthy control and intractable tuberculosis patients. CONCLUSION: Drug-resistant strains of M. tuberculosis were phagocytosed easily than drug sensitive strains and host factors does not seems to influence the phagocytosis of M. tuberculosis.
Humans ; Macrophages ; Monocytes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Phagocytosis* ; Tuberculosis ; Virulence

No abstract available.
Cervical Intraepithelial Neoplasia* ; Cervix Uteri* ; Diagnosis* ; Female

We analyzed ERCP findings of 15 patients with clonorchiasis, that were confirmed by stool examination and operation from May, 1976 to September, 1980. The results were as follows. 1) Filling defects due to adult worm of clonorchis sinensis were significant direct findings of clonorchiasis. 2) Irregular stenosis, fuzziness, raggedness, peripheral dilation and disturbance of peripheral filling of intrahepatic bile ducts were significant indirect findings of clonorchiasis. 3) ERCP was excellent method to evaluate biliary tree in patients with clonorchiasis, who showed obstructive jaundice.
Adult ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Clonorchiasis* ; Clonorchis sinensis ; Constriction, Pathologic ; Humans ; Jaundice, Obstructive

PURPOSE: To investigate the usefulness of the measurement of disc-to-fovea distance to disc-diameter ratio (DF/DD ratio) in detecting large and small discs. METHODS: A total of 300 randomly selected subjects were included in the present study. All patients underwent stereoscopic disc photography and DF/DD ratio, which is the shortest distance between disc margin and fovea divided by mean disc diameter was determined by planimetry. The diagnostic accuracy of DF/DD ratio was evaluated using areas under the receiver operating characteristics curves (AUCs), sensitivity, and specificity. RESULTS: No significant differences in disc-to-fovea distance were observed among small and large disc groups. The DF/DD ratio was significantly lower in subjects with large discs (1.74 +/- 0.27) compared with subjects with small discs (2.70 +/- 0.15). AUCs of the DF/DD ratio were 0.942 and 0.947 in detecting large and small discs, respectively. In detecting disc size by a fixed DF/DD ratio of 2.0, sensitivity was 100% for both large and small discs, and specificity was 70.1% and 40.9% for the large and small discs, respectively. CONCLUSIONS: The DF/DD ratio may be a simple and useful clinical aid in detecting large and small discs. The 2.0 fixed DF/DD ratio, showed 100% sensitivity in detecting both large and small discs, although medium discs may be misdiagnosed as small discs more often than as large discs.
Area Under Curve ; Humans ; Photography ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: The percutaneous pleural needle biopsy have been regarded as cornerstone in the diagnosis of lymphocyte dominant pleural effusions of which acid fast bacilli smear and cytologic exam was negative. However, the complications of percutaneous pleural needle biopsy is not rare arid its diagnostic efficacy is not always satisfactory. Recently, pleural fluid adenosine deaminase (ADA) and carcinoembryonic antigen (CEA) are widely accepted as markers of tuberculous pleurisy arid malignant pleural effusion respectively. We designed this study to re-evaluate the role of percutaneous pleural needle biopsy in the diagnosis of lymphocyte dominant exudative pleural effusions whose APE smear, cytologic exam was negative. METHODS: Retrospective analysis of 73 cases of percutaneous pleural needle biopsy in case of lymphocyte dominant exudative pleural effusions whose AFB smear and cytoloic exam was negative from Jan 1994 to Feb 1996 was done. RESULT: In 35 cases, specific diagnosis was obtained(all cases were tuberculous pleurisy), arid in 3(1 cases specific diagnosis was not obtained in spite of getting adequate pleural tissues, and in the other 8 cases, percutaneous pleural biopsy failed to get pleural tissues. In 9 cases, complications were combined including pneuomothorax and hemothorax. All 49 cases of pleural effusions whose ADA value was higher than 40IU/L and satisfying other categories were finally diagnosed as tuberculous pleurisy, however, the pleural biopsy confirmed only 28 cases as tuberculous pleurisy. In 6 cases of pleural effusions of which CEA value is higher than l0ng/ml, the pleural biopsy made specific diagnosis n no case. Final diagnosis of above 6 cases consisted of 4 malignant of fusions, I malignancy associated effusion and I tuberculous pleurisy. CONCLUSION: In the diagnosis of 73 cases of lymphocyte dominant pleural effusions of which acid fast bacilli smear and cytologic exam was negative, percutaneous pleural biopsy diagnosed only in 35 cases. In the diagnosis of tuberculous pleurisy, the positive predictive value of higher ADA than 40 IU/L in lymphocyte dominant pleural effusion with negative AFB smear and negative cytologic exam was l00%. And the diagnostic efficacy of pleural biopsy was 57%. In cases of effusions with high CEA than 10ng/ml 83% and 0% respectively. Finally, we concluded that percutaneous pleural needle biopsy in the diagnosis of APE smear negative and cytologic exam negative lymphocyte dominant exudative pleural effusion was not obligatory especially in effusions with high ADA and low CEA value.
Adenosine Deaminase ; Biopsy ; Biopsy, Needle* ; Carcinoembryonic Antigen ; Diagnosis* ; Hemothorax ; Hominidae ; Humans ; Lymphocytes* ; Needles* ; Pleural Effusion* ; Pleural Effusion, Malignant ; Retrospective Studies ; Tuberculosis, Pleural

BACKGROUND: It is clear that deregulation of coil cycle progression is a hallmark of neoplastic transformation and genes involved in the G1/S transition of the coil cycle are especially frequent targets for mutations in human cancers, including lung cancer. P16 gene product, one of the G1 cell-cycle related proteins, that is recently identified plays an important role in the negative regulation of the kinase activity of the cyclin dependent kinase (cdk) enzymes. Therefore p16 gene is known, to be an important tumor suppressor gene and is also called MTS1 (multiple tumor suppressor 1). No more oncogenes have ken reported to be frequently related to multiple different malignancies than the alterations of p16 gene. Especially when it comes to non-small cell lung cancer, there was no expression of p16 in more than 70% of cell lines examined. Ann also it is speculated that p16 gene could exert a key role in the development of non-small cell lung cancer. This study was designed to evaluate whether p16 gene ould be used as a candidate for gene therapy of non-small cell lung cancer. METHODS: After the extraction of total RNA from normal fibroblast cell line and subsequent reverse transcriptase reaction and polymerase chain reaction, the amplified P16 cDNA was sukloned into eukaryotic expression plasmid vector, pRC-CMV. The constructed pRC-CMV-p16 was transfected into the NCI-H441 NSCLC cell line using lipofectin. The changes of U I cell-cycle related proteins were investigated with Western blot analysis and immunoprecipitation after extraction of proteins from cell lysates and tumor suppressive effect was observed by clonogenic assay. RESULTS: (1) p16(-) NCI-H441 cell line transfected with pRC-CMV-p16 showed The formation of p16 : cdk 4 complex and decreased phosphorylated Rb protein, while control cell line did not. (2) Clonogenic assay demonstrated that the number of colony formation was markedly decreased in p16(-) NCI-H441 cell line transfected with pRC-CMV-p16 than the control cell line. CONCLUSION: It is confirmed that the expression of p16 protein in p16 absent NSCLC cell line with the gene transfection leads to p16 cdk4 complex formation, subsequent decrease of phosphorylated pRb protein and ultimately tumor suppressive effects. And also it provides the foundation for the application of P16 gone as a important candidate for the gene therapy of NSCLC.
Blotting, Western ; Carcinoma, Non-Small-Cell Lung* ; Cell Cycle ; Cell Line* ; Cyclins ; DNA, Complementary ; Fibroblasts ; Genes, p16 ; Genes, Tumor Suppressor ; Genetic Therapy ; Humans ; Immunoprecipitation ; Lung Neoplasms ; Oncogenes ; Phosphotransferases ; Plasmids ; Polymerase Chain Reaction ; Retinoblastoma Protein ; RNA ; RNA-Directed DNA Polymerase ; Transfection*

BACKGROUND: Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). METHODS: The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. RESULTS: Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT>37℃ 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. CONCLUSION: Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.
Aged* ; Diagnosis ; Drug-Related Side Effects and Adverse Reactions ; Early Diagnosis ; Fever ; Follow-Up Studies ; Hemoptysis ; Humans ; Lung Diseases, Obstructive ; Lung Neoplasms ; Medical Records ; Mortality ; Pneumonia ; Retrospective Studies ; Seoul ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*