BACKGROUND: Dementia has emerged as a leading public health problem with elderly persons and its early detection is important for treatment in curable cases. Although dementia screening tests are available, they are still complex and time consuming in practice and therefore difficult to use. Our goal was to validate the time and change(T&C) test, a simple, standardized method for detecting dementia in the elderly populations. METHODS: Participants were 59 patients aged 65 years or older at an urban hospital from November 1 to December 31, 2001. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability making 1,000 Won from a group of coins consisting one 500 Won, seven 100 Won, seven 50 Won. T&C ratings were validated against a reference standard based on physician`s diagnosis. Test-retest reliability and inter-observer reliability were assessed. RESULTS: The T&C test had a sensitivity of 73.0%, specificity of 90.9%, positive predictive value of 93.1%, and negative predictive value of 66.7%. Test-retest and inter-observer agreement rates were 95% and 95%, respectively. The T&C test was not influenced by education. The time and change tests took a mean of 7.5 seconds and 19.6 seconds to complete respectively, and was acceptable to participants. When timed cut points were added, the T&C test had a sensitivity of 86.5%, specificity of 40.9% and test-retest and inter-observer agreement rates were 77.3% and 81.8%, respectively. CONCLUSION: The T&C test is a simple, accurate reliable, performance-based tool for detection of dementia in the elderly.
Aged* ; Dementia* ; Diagnosis ; Education ; Hand ; Hospitals, Urban ; Humans ; Mass Screening* ; Numismatics ; Public Health ; Sensitivity and Specificity

To identify the smoking status and its related factors in middle and high school boys in Kwangju a study was performed from 15th to 30th of June 1992. Population were selected by two-stage random sampling method and total 3,959 students replied to the self-administered questionnaire survey(1,574 in middle school, 1,664 in academic high school, 712 in business high school). The results were as follows; 1. The proportion of current smokers was 1.5% in middle schools and 20.1% in high schools. And the smoking rates increased with school grade years(p<0.01). 2. For the motivation of smoking, curiosity was the most frequent factor and the next was temptation by friends. 3. The most common situation on the first experience of smoking was that middle school boys smoked a cigarette which was found in a house, through curiosity, with friends, at home. High school boys smoked a cigarette taken from friends, through curiosity, with friend, on the road or at home. 4. The proportion of smokers who smoke a cigarette regularly was 34.8% among smokers in middle school and 70.2% among smokers in high school. The most proportion of duration of smoking was less than 1 month among middle school boys (20.8%) and more than 2 years among high school boys(43.9%). The first smoking experience was in elementary school among middle school boys and the third grade of middle school in high school students. Most current smokers(73.9% in middle school boys, 65.3% in high school boys) wanted to quit smoking. 5. Smokers had significant association with intimate friend's smoking, mother's and brother's smoking, inharmonious friendships, dissatisfied with home and school life, lower school grades, generous attitude to other smokers, lack of knowledge to passive smoking and no contact to mass media(TV)(p<0.01).
Commerce ; Exploratory Behavior ; Friends ; Gwangju* ; Humans ; Male* ; Motivation ; Surveys and Questionnaires ; Smoke* ; Smoking* ; Tobacco Products ; Tobacco Smoke Pollution

No abstract available.

No abstract available.

BACKGROUND: More attention is given to oxidative hypothesis which causes atherosclerosis to be recognized as inflammatory response. The relationship between serum ferritin which catalyzes lipid peroxidation and high sensitivity C-reactive protein which reflects vascular inflammation was investigated among adults in a health promotion center. METHODS: The study group consisted of 297 men and women (men 86, women 211) who visited the health promotion center of a hospital in Seoul to have a health checkup from October 1, 2004 to April 1, 2005. These subjects answered the questionnares and were measured in the following; blood tests, brachial-ankle pulse wave velocity and several anthropometric measurements. Statistical analysis was performed on 111 subjects after exclusion of those subjects who were taking antihypertensive agents or antidiabetic agents, and who had acute inflammatory diseases, acute liver diseases, anemia, and who had a WBC > or =11,000x10(3)/mm3 or a serum ferritin > or =200 ug/L or a ABI (Ankle Brachial Index) <0.9. RESULTS: The average serum ferritin concentration of men against women was 132.57+/-43.12 ng/ml to 78.23+/-38.10 ng/ml which means that men have about 1.7 times as high concentration than women (P<0.001). Serum ferritin was significantly correlated with high sensitivity C-reactive protein (r=0.332). Even in multiple stepwise regression analysis, there was a independent relationship between serum ferritin and high sensitivity C-reactive protein (beta=0.138, P=0.010). When we analyzed with distinction of sex, this relationship in women was constant (beta=0.131, P=0.031), but serum ferritin in men just showed the trend of correlation with BMI (beta=9.510, P=0.059). CONCLUSION: There is a significant relationship between the increase of serum ferritin and high sensitivity C-reactive protein in healthy women; furthermore, studies in men need to be confirmed.
Acute Disease ; Adult ; Anemia ; Antihypertensive Agents ; Atherosclerosis ; C-Reactive Protein ; Female ; Ferritins ; Health Promotion ; Hematologic Tests ; Humans ; Hypoglycemic Agents ; Inflammation ; Lipid Peroxidation ; Liver Diseases ; Male ; Oxidative Stress ; Pulse Wave Analysis

OBJECTIVE: To understand the clinical manifestations and disease course of adult onset Still' s disease (AOSD). METHODS: 15 patients of AOSD diagnosed at Severance hospital, Yonsei University College of Medicine were retrospectively analysed in the period of September 1988 to September 1995. RESULTS: There were 3 men and 12 women (male to female ratio of 1:4). Age of disease onset ranged from 17-55 years, and over 86% of the patients were younger than age 40 at disease onset. The prevalence of clinical features were as follows fever (100%), arthritis (93%), skin rash (93%), sore throat (60%), abnormal liver function (73%), lymphadenopathy (47%), splenomegaly (47%), hepatomegaly (20%), serositis (13%). Fever was the most common initial symptom. Common labaratory features were leukocytosis with neutrophilia (87%), anemia' Hgb <10 g/dL (67%), increased serum ferritin (83%), ESR (87%) and CRP (93%). Serum ferritin was markedly raised at disease onset and correlated with disease activity. In 2 patients, the disease was controlled with NSAID alone, but most of the patients required steroid to control the disease activity. In 6 patients, MTX was added for steroid sparing effect and for steroid resistant arthritis. Most of AOSD patients had intermittent and chronic disease course. Root joint arthritis and polyarthritis were factors associated with chronicity. CONCLUSION: The clinical features of AOSD in our study generally resemble previous reports. Serum ferritin was a useful marker of disease activity. Most patients of AOSD had intermittent and chronic disease course. Root joint athritis and polyarticular pattern at disease onset were factors associated with chronicity.
Adult* ; Arthritis ; Chronic Disease ; Exanthema ; Female ; Ferritins ; Fever ; Hepatomegaly ; Humans ; Joints ; Leukocytosis ; Liver ; Lymphatic Diseases ; Male ; Pharyngitis ; Prevalence ; Retrospective Studies ; Serositis ; Splenomegaly ; Still's Disease, Adult-Onset*

BACKGROUND: Epidermolysis bullosa is a group of inherited disorcier characterized by blistering of the skin as a result of minor trauma. OBJECTIVE: There exist very little epidemiologic data for most of the major and minor subsets of inherited epidermolysis bullosa in Korea. We look forward to obtaining basic data for the pathogenesis and treatment of epidermolysis bullosa. METHOD: We performed 1st and 2nd trial of survey with the help of 28 dermatologic Departments snd 28 pediatric departments of medical colleges and 14 dermatologic dipartments of general hospitals. RESULTS: 68 cases were collected and classified by disease type, sex distribution, age distribution, and regional distribution. In disease type, 42 cases of EB simplex(62%), 8 cases of junctional type(12%), 10 cases of dominant dystrophic type(15%), 8 cases of recessive dytrcphic type(12%) were reported. In most cases males predominnted, but in dominant dystrophic type both sexes were equivalent. EB simplex, junctional type, RDEB were mostly developed in the 1st decade of life, dominant dystrophic type in the 2nd decade of life. In regional distribution, the number of pi tients was outstanding in large cities such as Seoul, Pusan, Taegu, Kwanju. CONCLUSION: Due to many limitations and shortage of techniques, this epidemiologic study may be notgood enough for the total estimated number of epidermolysis bullos. patients, prevalence rate, and therapeutic modalities. Furthe evaluation should be necessary next time.
Age Distribution ; Blister ; Busan ; Daegu ; Epidemiologic Studies* ; Epidermolysis Bullosa* ; Gwangju ; Hospitals, General ; Humans ; Korea* ; Male ; Prevalence ; Seoul ; Sex Distribution ; Skin

PURPOSE: To investigate the relation of the gastric epithelial cell proliferation, apoptosis and genotypes of H. pylori in children. METHODS: Histologic grading by updated Sydney system, PCNA immunostaining, TUNEL method and the genotypes (cagA, picB and iceA) by PCR were performed in H. pylori positive (N=20) and negative (N=20) gastric biopsy specimens. RESULTS: PCNA index was significantly different between H. pylori positive children (77.4+/-13.12) and H. pylori negative children (52.3+/-12.20) (p=0.000). There were positive correlations between PCNA index and H. pylori density (r=0.624, p=0.000), polymorphonuclear neutrophil activity (r=0.460, p=0.005) and chronic inflammation (r=0.433, p=0.009). Apoptosis index of H. pylori positive children (0.70+/-0.411) was significantly higher than of H. pylori negative children (0.14+/-0.201) (p=0.000). Positive correlations between apoptosis index and H. pylori density (r=0.691, p=0.000), polymorphonuclear neutrophil activity (r=0.585, p=0.000) and chronic inflammation (r=0.535, p=0.001) were noted. As PCNA index increased, apoptosis index significantly increased (r=0.527, p=0.001). The positive rates of genotypes were cagA 90%, picB 75%, iceA1 60% and iceA2 15%, respectively. There were no significant correlations between the status of the genotypes and PCNA index, apoptosis index, the endoscopic findings and the histologic findings. CONCLUSION: PCNA index and apoptosis index in H. pylori positive children were higher than in H. pylori negative children but were not related to H. pylori genotypes. This study suggested that correlatively increased gastric epithelial cell proliferation and apoptosis are important to pathogenesis of H. pylori infection in children.
Apoptosis* ; Biopsy ; Child* ; Epithelial Cells* ; Genotype* ; Helicobacter pylori* ; Helicobacter* ; Humans ; In Situ Nick-End Labeling ; Inflammation ; Neutrophils ; Polymerase Chain Reaction ; Proliferating Cell Nuclear Antigen

OBJECTIVE: The aim of this study was to develop a decision support system that helps school nurses manage health problems they encounter while caring for the elementary and secondary school students, and evaluate usability of it. METHODS: Knowledge was aquired by literatures review and interviews with senior school nurses and was validated by another group of school nurses. The Omaha System was used as a standardized nursing terminology to describe nursing diagnoses and interventions. The system was developed under the Windows environment. C++ was used as a program language and MS Structured Query Language as a database. To investigate usability of the system, 30 school nurses in elementary and secondary schools were recruited and asked to apply it to nursing problems they encountered in actual students care setting. RESULTS: The decision support system with seven major signs and symptoms was developed. It automatically makes a nursing diagnosis based on the input data, and also provides nursing interventions with evidence. It was proven that the system was very useful for school nurses to manage students` health problems. CONCLUSION: The system will contribute to development of expert knowledge concerning student's health problems and improve the quality of school nursing and professionalism.
Expert Systems ; Humans ; Nursing ; Nursing Care* ; Nursing Diagnosis ; Nursing Process ; School Nursing

PURPOSE: The purpose of this study was to survey the current status of mental health education and need for mental health education enhancing protective factors in the elementary schools. METHODS: We surveyed 10 school health teachers and 328 fifth- and sixth-grade students using 19- and 20-item questionnaires, respectively. RESULTS: All of the teachers and 65.2% of the students replied that they were either teaching or being taught mental health in school. Topics covered suicide, depression, school violence, and Internet addiction. All of the teachers and 84.1% of the students expressed the need for mental health education enhancing protective factors in school. Both groups replied that two sessions are enough. The teachers preferred role play and discussion as teaching methods, and audiovisual materials and computer as instructional media. The students preferred lecture and role play as teaching methods, and audiovisual materials and smartphone as instructional media. Both groups ranked self-esteem, parent-child relationship, peer relationship, and emotional regulation as the most important topics to be covered in the education. CONCLUSION: There is a high demand for mental health education enhancing protective factors. Therefore, it is recommended to develop educational programs enhancing protective factors by enabling formal and informal learning using smartphone.
Depression ; Education* ; Health Education ; Humans ; Internet ; Learning ; Mental Health* ; Needs Assessment ; Parent-Child Relations ; School Health Services ; School Nursing ; Suicide ; Teaching ; Violence ; Smartphone