PURPOSE: The purpose of this study was to describe how the rural elderly cope with experiences in multiple chronic diseases. METHOD: Data were collected through participant observation and in-depth interview using ethnography. The participants were 9 women and 2 men who aged over 65, were living in rural community, and had experienced two or more chronic diseases. RESULTS: According to the results of this study, those who had experienced multiple chronic diseases went through the stages of 'recognizing of revealed symptoms', 'discovering of disease', 'overcoming', 'neglecting', 'discovering another disease', 'being frustrated' and 'living with suffering'. CONCLUSION: The results of this study are expected to be utilized as basic materials to develop a nursing intervention program for effective management of chronic diseases.
Aged* ; Anthropology, Cultural ; Chronic Disease* ; Female ; Humans ; Male ; Nursing ; Rural Population

This study was performed to investigate the nutritional status of neurosurgical tube-fed patients. The objective of this study was to improve the nutrition management of tube-fed patients. The current practices of tube feeding and enteral nutrition formula as for 95 patients in the hospital were examined by reviewing patients charts, and interviewing patients, nurses and their family members. The results are summarized as follows ; 57.9% of patients that received the formula showed a decrease in mental status. Among the subjects, 55.7% had nervous system diseases due to old age. Most of the tube-fed patients were hospitalized in the emergency room and while hospitalized, the status of their respiratory organ was abnormal. The method of tube-feeding was by Bolus injection and the type of the tube was a 16Fr size silicone tube. The amount of the injection per day while tube-feeding was on average 1424 kcal for men and 1322 kcal for women and the calories per day ranged from 1000-1500 kcal(50.5%). The injection volume averaged 332.7ml and 45% of patients received more than 300ml per injection. The tube feeding intake rate was 127.9ml/min with 50% of subjects in the range of 50-100ml/min and 10% at 20ml/min. The longer the hospitalization, the older age, coma status, and the higher tube feeding rate, the more decreased were the biochemical parameters.
Coma ; Emergency Service, Hospital ; Enteral Nutrition ; Female ; Hospitalization ; Humans ; Male ; Nervous System Diseases ; Nutritional Status* ; Silicones

No abstract available.
Peanut Hypersensitivity

PURPOSE: The relationship between serum cholesterol levels and mortality is complex. Serum cholesterol levels correlate positively with coronary artery disease, but some studies have suggested a negative relationship in cancer patients. Because the serum cholesterol levels are one of the most frequently assayed laboratory values, trends in the levels of cholesterol were investigated, in patients with gastric cancer and assumed a possible role in cancer screening. MATERIALS AND METHODS: The serum cholesterol levels were retrospectively analyzed in a group of 220 patients, diagnosed with gastric cancer, and in 177 healthy subjects. Anthropometric (body mass index: BMI) and biochemical indices of their nutritional status were also determined in the study subjects. Statistical analyses were performed by analyses of variance and covariance, and a discriminant analysis. RESULTS: The levels of serum cholesterol, albumin, Hb and the BMI were significantly lower in the gastric cancer-patients group than in the healthy-subjects group. The serum cholesterol and Hb levels were shown to be independent of each other, when adjusted for the effects of the BMI. In the patients with gastric cancer the levels of cholesterol and Hb showed decreasing tendencies as did the tumor extension, as defined by the TNM system. CONCLUSION: The serum cholesterol and Hb levels were significantly lower in patients with gastric cancer than in the healthy subjects, which seemed to be linked to the progression of gastric cancer. Therefore, further study is required for the serum cholesterol and Hb levels to be used as markers in cancer screening and its progression, in patients with gastric cancer.
Cholesterol* ; Coronary Artery Disease ; Early Detection of Cancer ; Humans ; Mortality ; Nutritional Status ; Retrospective Studies ; Stomach Neoplasms*

The genus Acanthamoeba can cause severe infections such as granulomatous amebic encephalitis and amebic keratitis in humans. However, little genomic information of Acanthamoeba has been reported. Here, we constructed Acanthamoeba expressed sequence tags (EST) database (Acanthamoeba EST DB) derived from our 4 kinds of Acanthamoeba cDNA library. The Acanthamoeba EST DB contains 3,897 EST generated from amebae under various conditions of long term in vitro culture, mouse brain passage, or encystation, and downloaded data of Acanthamoeba from National Center for Biotechnology Information (NCBI) and Taxonomically Broad EST Database (TBestDB). The almost reported cDNA/genomic sequences of Acanthamoeba provide stand alone BLAST system with nucleotide (BLAST NT) and amino acid (BLAST AA) sequence database. In BLAST results, each gene links for the significant information including sequence data, gene orthology annotations, relevant references, and a BlastX result. This is the first attempt for construction of Acanthamoeba database with genes expressed in diverse conditions. These data were integrated into a database (http://www.amoeba.or.kr).
Acanthamoeba/*genetics ; Animals ; *Databases, Genetic ; *Expressed Sequence Tags

PURPOSE: Although 80~90% of patients with lung cancer are smokers, only 11% of smokers develop lung cancer. Genetic susceptibility according to the polymorphism of the epoxide hydrolase (mEPHX) gene and homozygous deletion of GSTM1 (M1 subunit of Glutathione S transferase) was studied in this case control study. MATERIALS AND METHODS: Genomic DNA from 76 subjects with lung cancer (40 squamous cell carcinoma, 13 adenocarcinoma, 10 subtype undetermined non-small cell lung cancer, and 13 small cell lung carcinoma) and 62 age- matched controls were extracted from peripheral white blood cells. PCR and RFLP (restriction fragments length polymorphism) with restriction enzyme (RsaI) and automatic sequencing were used for mEPHX genotyping (T-->C, Tyr113His) in exon 3 and (A-->G, His139Arg) in exon 4. Looking for homozygous deletions of GSTM1, multiplex PCR with primers for the GSTM1 gene and coagulation factor V gene (as positive control) were performed. RESULTS: The age distribution between the cancer and control groups were similar (63.6 7.2 vs. 61.1 7.9 years). The lung cancer group, however, had more smokers (73.3%, 44/60) than the control group (21/54, 38.9%, p<0.001). The rate of homozygous deletion of the GSTM1 gene was significantly higher in the lung cancer group (65.8%, 50/76) than in the control group (46.8%, 29/62, p<0.05), causing the relative risk of GSTM1 deletion for lung cancer as 2.19 (95% CI: 1.10~4.35, p=0.02). Among 118 subjects whose mEPHX gene polymorphisms were studied, 62 (52.5%) subjects showed genotypes with slow enzyme activity while 45 (38.1%) showed normal enzyme activity and 11 (9.3%) showed fast enzyme activity. There was no significant difference in the distribution of mEPHX gene polymorphisms between the two groups. CONCLUSION: The homozygous deletion of the GSTM1 gene was associated with high lung cancer susceptibility, whereas the mEPHX genotype showed no significant connection with risk of lung cancer in a sample Korean population.
Adenocarcinoma ; Age Distribution ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Case-Control Studies ; DNA ; Exons ; Factor V ; Genetic Predisposition to Disease ; Genotype ; Glutathione ; Glutathione Transferase ; Humans ; Leukocytes ; Lung Neoplasms* ; Lung* ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Polymorphism, Restriction Fragment Length

Background: Korea recently established 70 emergency medical service areas. However, there are many concerns that medical resources for stroke could not be evenly distributed through the country. We aimed to compare the treatment quality and outcomes of acute stroke among the emergency medical service areas. Methods: This study analyzed the data of 28,800 patients admitted in 248 hospitals which participated in the 8th acute stroke quality assessment by Health Insurance Review and Assessment Service. Individual hospitals were regrouped into emergency service areas according to the address of the location. Assessment indicators and fatality were compared by the service areas. We defined the appropriate hospital by the performance of intravenous thrombolysis. Results: In seven service areas, there were no hospitals which received more than 10 stroke patients for 6 months. In nine service areas, there were no patients who underwent intravenous thrombolysis (IVT). Among 167 designated emergency medical centers, 50 hospitals (29.9%) responded that IVT was impossible 24 hours a day. There are 97 (39.1%) hospitals that meet the definitions of appropriate hospital. In 23 service areas (32.9%) had no appropriate or feasible hospitals. The fatality of service areas with stroke centers were 6.9% within 30 days and 15.6% within 1 year from stroke onset than those without stroke centers (7.7%, 16.9%, respectively). Conclusions There was a wide regional gap in the medical resource and the quality of treatments for acute stroke among emergency medical service areas in Korea. The poststroke fatality rate of the service areas which have stroke centers or appropriate hospitals were significantly low.