TO evaluate the histopathologic features of gastric mucosa by Helicobacter pylori (HP), we reviewed 70 endoscopically biopsied chronic gastritis and peptic ulcer. The results are as fonows. l. HP was detected in 923% (48/52) of active gastritis, 8l8% (9/l l) of peptic ulcer and l43% (1/7) of chronic gastritis. The prevalence of HP infection was significantly higher in active gastritis and peptic ulcer than chronic gastritis (P<0005). 2. The infiltration of intraepithelial neutrophil of the 58 HP-positive cases was significantly more than of the l2 HP-negative cases (P<0005). 3. The infiltration of neutrophil and chronic inflammatory cells in the lamina propria of the 58 HP positive cases were significantly more than of 12 HP-negative cases (P<0.005, P<0.01) 4. The gastric epithelium of 58 HP positive case showed characteristic degenerative change, such as epithelial pits (93.l%), irregular surface (84.4%), individua1 cell drop-out (46.5%) and microerosion (27.6%). The similiar changes were not seen in l2 HP-negative cases. In summary, HP is significantly correlated with inflammatory reaction of the gastric mucosa. It is also significantly correlated with the epithelial degenerative changes that is considered to the precursor of peptic ulcer.

BACKGROUND: Hypertension is one of the frequent problems for which family physicians are well encountered to manage. Nonpharmacologic measures which include stress relaxation, low salt diet, weight reduction, moderation of alcohol intake, physical activity, tobacco avoidance are used as definitive or adjuvant therapy for hypertension. Family physicians should vigorously encourage their patients to adopt these life style modifications. This study was conducted to know how many nonpharmacologic treat,ment modalities are adopted by hypertensives and to find predicting factors. METHODS: A total of 100 of the hypertensive patients who are followed up via the department of family medicine, Hanyang University Hospital, from September 1995 through November 1995 are included in this study. A trained nurse interviewed patients according to the previously designed structured questionnaire. The overall response rate was 90% and the fill-up rate of the questionnaire was 100%. RESULTS: Sixty three patients were women. The mean age was 57.4 years(range, 20 to 84). Sixty one percent accompanied one or more other diseases, of which diabetes mellitus was the most common disorder. The mean systolic pressure was 143.9 mmHg and the mean diastolic blood pressure was 89.3mmHg. Ninty-three percent of patients received antihypertensives with compliance of 81 to 100%. Twenty four percent of patients adhered to regular exercise, 36 percent weight reduction, 48 percent low salt diet, 79 percent moderate drinking, 81 percent stress relaxation, and 87 percent no smoking. Of those six non-pharmacological treatments, 3.6 behaviors were adhered. Male patients were more attended with the low salt diet. Eleven patients of 2S alcoholics(44.0%) reduced their amount of alcohol intake and 8 of 17 smokers quitted smoking (47.1%) after they were diagnosed as hypertension. The mean BEPSI score was 1.5. Fifty one percent of patients had stress within the last three months, 32 percent had cumulative fatigue. The occupational stress was the most common one. All exercise which patients reported were isotonic. Seventeen percent of the patients took certain herb medicine or folk medicine. CONCLUSIONS: Of those 100 hypertensives who were treated at the department of family medicine, Hanyang University hospital, 24% adhered to regular exercise, 36 per cent weight reduction, 48 percent low salt diet, 79 percent moderate drinking, 81 percent stress relaxation, and 87 percent quit smoking in order. Of those six non-pharmacological treatments, 3.6 behaviors were adhered on the average. Nonpharmacologic treatment should be promoted by family physician as an important strategy for treatment of hypertension.
Antihypertensive Agents ; Blood Pressure ; Compliance ; Diabetes Mellitus ; Diet ; Diet, Reducing ; Drinking ; Fatigue ; Female ; Humans ; Hypertension ; Life Style ; Male ; Medicine, Traditional ; Motor Activity ; Physicians, Family ; Relaxation ; Smoke ; Smoking ; Tobacco ; Weight Loss ; Surveys and Questionnaires

BACKGROUND: Blood pressures rneasured by a nurse at reception room as a part of routine physical examination are oft,en used as a indicator of medical care. Blood pressure at reception room and consultation room are, however, often different to each other and these differences are caused by various factors including difference of white coat effect by nurse and doctor. Thus, this study was performed in order to know whether blood pressure difference really exit, and its associated factors. METHODS: Two hundred ninety one patients who visited to one university hospital farnily practice were enrolled in this study. Blood pressure and pulse rate at reception room and consultation room, waiting t,ime, time interval between reception and consultation, smoking status, and intake of coffee and food were collected. Nine patients were excluded, because blood pressure either at reception room or at consulation room was not recorded. This study was performed by one nurse and two doctors. They defined the guideline for method of blood pressure measurement before the study, and used the same kind of indirect cuff sphygmomanometer. RESULTS: Two hundred eighty two patients were analyzed. The number of men was one hundred twenty five. Systolic blood pressure at consultation room was higher than that at reception room by 1.6+/-11.9mmHg (P<0.05). Sixty five cases(65%) in systolic blood pressure and 111 cases(40%) in diastolic blood pressure showed blood pressure differences more than 5mmHg. The group with systolic blood pressure difference between reception room and consultation room(SBP) in more than 5mmHg is more likely to be hypertensive than the group with SBP in less than 5mmHg(P<0.01). More female patients(66%) and hypertensive patients(59%) were belong to the group whose systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). Twenty four patients(30%) of the group whose systolic blood pressure at reception room were 5mmHg higher than at consultation room had cigarette smoking within 1 hour, and this ratio was significantly higher than the other groups whose systolic blood pressure difference was less than 5rnmHg or systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). There was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site(Overall kappa, 0.747, P<0.01). CONCLUSIONS: Many patients showed blood pressure differences more than 5mmHg between reception room and consultation room. Systolic blood pressure at consultation room was higher than that at reception room, and there was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site, but the adverse effect by misclassification should not be neglected. The importance as well as the limitation of blood pressure measurement at reception room should be considered in screening and treating hypertensive patient. Every time when blood pressure is taken, physicians should keep in mind to consider patients factors which may influence blood pressure level.
Blood Pressure* ; Coffee ; Female ; Heart Rate ; Humans ; Hypertension ; Male ; Mass Screening ; Outpatients* ; Physical Examination ; Smoke ; Smoking ; Sphygmomanometers

PURPOSE: This study was to develop and evaluate a folk play program as a nursing intervention for the elderly with dementia. METHOD: First, a folk play program was developed through a careful study of literature review and field-work. Second, a nonequivalent control group pre-post test was designed. The subjects of the study were the elderly with dementia staying in nursing homes; 15 were in an experimental group adopting a folk play program developed through this study, 18 in the control group on a gymnastics and walking program which is generally used. The 40 min. intervention was conducted 5 times a week for 4 weeks. RESULT: The folk play program improved the cognition(t=6.12, p<.001) and ADL(t=2.92, p=.014) and diminished the frequency of problematic behaviors significantly(t=-6.39, p<.001). There was a significant difference of cognition, ADL, and problematic behaviors between the control and the experimental group before and after the experiment(t=3.38, p=.002; t=2.05, p=.046; t=-7.74, p<.001). CONCLUSION: Compared with the gymnastics and walking program, the folk play program proved to be much more effective in the elderly with dementia in improving their cognition and ADL, as well as in diminishing their problematic behaviors. Therefore, a folk play program should be appliedas an effective and practical Korean nursing intervention for the elderly with dementia.
*Play Therapy ; Male ; Humans ; Female ; Dementia/*psychology/therapy ; *Cognition ; Aged, 80 and over ; Aged ; *Activities of Daily Living