The purpose of the study was to determine factors influencing compliance with anti-tuberculosis therapy. The study subjects were 104 tuberculosis patients who have received the initial treatment in 3 health centers of Kyongju-city, Dalseong-Gun in Teagu and Kumi-city. Data were collected between september and october 1995. The patients were classified into the improved group and the non-improved group according to outcomes of 3 month treatment with short-term therapeutic regimen. To find factors influencing compliance with anti-tuberculosis therapy, multiple logistic regression was made. There was no significant differences between the improved group and the non-improved group in sex, age, education level, occupation, family pattern, and habitual change regarding smoking and drinking. The level of knowledge about anti-tuberculosis therapy in the improved group was significantly higher than the non-improved group(p<0.01). Multiple logistic regression analysis revealed that family support for not forgetting medication(p<0.05) was a predictor of improvement and knowledge about anti-tuberculosis therapy (p=0.054), regularity of medication(p=0.062), and consultation to family, doctor and nurse(p=0.075)were marginal predictors of improvement. Treatment must be given to every patient confirmed as having tuberculosis and must be given free of charge to the patients. The requirements for adequate chemotherapy are prescribed in the correct dosage and taken regularly by the patient for a sufficient period to prevent relapse of the disease after cure. It is suggested that education to the patients should be reinforced and connectedness between patients and tuberculosis control workers and family should be solidated.
Compliance* ; Drinking ; Drug Therapy ; Education ; Humans ; Logistic Models ; Occupations ; Recurrence ; Smoke ; Smoking ; Tuberculosis

Localized cystic degeneration of peripheral arteries represents and unusual cause of arterial insufficiency. It frequently occurs in patient without generalized arteriosclerosis. It has been reported in patients from age 11 to 62 years. Cystic adventitial disease is most common in the popliteal artery. At least 115 cases have been reported worldwide, but none in Korea. We report a case of cystic adventitial disease involving the left popliteal artery. This 64-year-old man presented with an 18-month history of cramping pain of sudden onset in the left calf and claudication. Angiographic findings showed a 6 cm length of luminal obliteration of the popliteal artery. Segmentally resected popliteal artery showed two longitudinally directed cystic masses measuring 3.5x1.5 cm and 2.5x1.5 cm in the adventitia. Microscopic examination revealed cystic space in the arterial adventitia compressing arterial lumen. There were a number of foamy histiocytes collected along the cystic lumen.
Male ; Humans

No abstract available.
Atherosclerosis* ; Hyperuricemia* ; Risk Factors*

BACKGROUND: Administration of hepatitis B vaccine has played a major part in the management of public health in this country. There were many researches to assess the immunogenecity, safety, long term effectiveness, dose, and route of administration of hepatitis B vaccine. But there was lack of validation of the recommendation that hepatit.is B vaccine should be administered in adults with negative HBsAg and AntiHBs, in an endemic area with high prevalence of HBsAg. Authors tried to establish a proper candidate for hepatitis B vaccination evaluating viral markers of hepatitis B in adults vaccinated. METHODS: 172 hepatitis B vaccinated subjects(35.0%) were drawn from 491 adults who have visited at health care center, Asan Kangnung Hospital from April 1st to May 31th, 1997. They were asked designed questions about the beginning year, frequency of vaccination, and the presence of family members with HBsAg in a direct line. RESULTS: Of the subjects(172), 2.3% were HBsAg(+), 63.4% AntiHBs(+), 68.6% AntiHBc(+). Among the HBsAg(-) adults(149) who had been vaccinated more than three times, 70.4%(105) were AntiHBs(+), of whom 66.6%(70) were AntiHBc(+) and 29.6%(44) were AntiHBs(-), of whom 56.8%(25) were AntiHBc(+). In the subjects(20) with family history of HBsAg, 80% were AntiHBc(+), which is higher than 61.2% in the group(129) without family history. Among the HBsAg(-) and AntiHBc(-) adults(54) who had been vaccinated more than three times, AntiHBs(+) group was not significantly differnt from AntiHBs(-) group in comparison of age and years after initial vaccination. CONCLUSIONS: The two thirds(68.9%) of vaccinated subjects showed AntiHBc(+), which means reflection of previous exposure to Hepatitis B virus. Accordingly, vaccination is not thought to be required for these. Consequently, all individuals are thought to have to be pretested for the presence of AntiHBc as well as HBsAg and AntiHBs in Korea.
Adult* ; Biomarkers ; Chungcheongnam-do ; Delivery of Health Care ; Hepatitis B Surface Antigens* ; Hepatitis B Vaccines ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Prevalence ; Public Health ; Vaccination

A survey was conducted to study perception and attitudes of health workers towards health centers activities and organization of health services, from August 15 to September 30, 1994. The study population was 310 health workers engaged in seven urban health centers in Taegu City area. A questionnaire method was used to collect data and response rate was 81.3 percent or 252 respondents. The following are summaries of findings: Profiles of study population: Health workers were predomina1itly female(62.3%); had college education(60. 3%); 'and held medical and nursing positions(39.6%), technicians(30.6%) and. public health/administrativc positions(29.8%). Perceptions on health center's resources: Slightly more than a half(51.1%) of respondents expressed that physical facilities of the centers are inadequate; equipments needed are short(39.0%); human resource is inadequate(44.8%); and health budget allocated is insufficient(38.5%) to support the performance of health center's activities. Decentralization and health services: The majority revealed that the decentralization of government system would affect the future activities of health centers(51.9%) which may have to change. However, only one quarter of respondents(25.4%) seemed to view the decentralization positively as they expect that it would help perform health activities more effectively. The majority of the respondents(78.6%) insisted that the function and organization of the urban health centers should be changed. Target workload and job satisfaction: A large proportion (43.3%) of respondents felt that present target setting systems for various health activities are unrealistic in terms of community needs and health center's situation while only 11.1 percent responded it positively; the majority(57.5%) revealed that they need further training in professional fields to perform their job more effectively; more than one third(35.7%) expressed that they enjoy their professional autonomy in their job performance; and a considerable proportion (39.3%) said they are satisfied with their present work. Regarding the personnel management, more worker (47.3%) perceived it negatively than positive(11.5%) as most of workers seemed to think the personnel management practiced at the health centers is not fair or justly done. Health services rendered: Among health services rendered, health workers perceived the following services are most successfully delivered; they are, in order of importance, Th controi, curative services, and maternal and child health care. Such areas as health education, oral health, environmental sanitation, and integrated health services are needed to be strengthening. Regarding the community attitudes towards health workers, 41.3 percent of respondents think they are trusted by the community they serve. New areas of concern identified which must be included in future activities of health centers are, in order of priority, health care of elderly population, home health care, rehabilitation services, and such chronic diseases control programs as diabetes, hypertension, school health and mental health care. In conclusion, the study revealed that health workers seemed to have more negative perceptions and attitudes than positive ones towards organization and management of health services and activities performed by the .urban health centers where they are engaged. More specifically, the majority of health workers studied revealed to have the following areas of health center's organization and management inadequate or insufficient to support effective performance of their health activities: Namely, physical facilities and equipments required are inadequate; human and financial resources are insufficient; pefsonnel management is unsatisfactory; setting of service target system is unrealistic in terms of the community needs. However, respondents displayed a number of positive 'perceptions, particularly' to those areas as further training needs 'and implementation of decentralization of government system which will bring more autonomy of local government as they perceived these change would bring the necessary changes to future activities of the health center. They also displayed positive perceptions in their job autonomy and have job satisfactions.
Aged ; Budgets ; Child ; Child Health ; Chronic Disease ; Daegu ; Surveys and Questionnaires ; Delivery of Health Care ; Health Education ; Health Priorities ; Health Services ; Humans ; Hypertension ; Job Satisfaction ; Local Government ; Mental Health ; Nursing ; Oral Health ; Personnel Management ; Politics ; Professional Autonomy ; Rehabilitation ; Sanitation ; School Health Services ; Urban Health*

BACKGROUND: In a health examination program, advice from physician for change of health-related behavior and distribution of health educational pamphlets is routine. This study was done prospectively to analyze factors such as personal general characteristics, results of health examination, health examination satisfaction that relate to change of health promotion attitudes and compliance towards overweight, smoking, heavy drinking, elevated blood pressure, dyslipidemia, chronic diseases such as diabetes, hypertension. METHODS: The subject population was 689 cases from May 1997 to June 1997 in a general hospital health examination center. After health examination, 60.2%(415 cases) showed personal satisfaction by questionnaire. Three to four months later 78.4%(540 cases) responded to the telephone survey on change of health beliefs, health-related attitudes and compliance. RESULTS: In the telephone survey, 239 cases(46.0%) comprised high compliance group that had positive attitudes toward abnormal health examination results, 145 cases(27.9%) were mid compliance group, and 135cases(26.0%) were low compliance group. In males there was higher frequency of high compliance group than females(p<0.05). According to age, the older, the higher frequencies of high compliance group(p<0.05). In educational level group, the higher the educational level, the lower the frequencies of high compliance group(p<0.01). There was no difference in frequency of each compliance group between symptom motive and non-symptom motive group with each satisfaction group(p>0.05). In positive responders to the correspond advice of physician or health educational pamphlets, the frequencies for quit smoking, reduction of drinking amount, regular exercise, Compliance with taking antihypertensives, blood sugar control, diet control for dyslipidemia, taking antihyperlipidemics were higher(p<0.01). CONCLUSIONS: Health examination service includirg advice of physician and education changed health belief and influenced positively to health promotion attitudes. Health examination is not only important for early detection of disease but also to promote positive change of health-related behavior. Further studies are needed to understand the changing process of management of health and disease.
Antihypertensive Agents ; Blood Glucose ; Blood Pressure ; Chronic Disease ; Compliance ; Diet ; Drinking ; Dyslipidemias ; Early Diagnosis ; Education ; Health Education ; Health Promotion ; Hospitals, General ; Humans ; Hypertension ; Hypolipidemic Agents ; Male ; Overweight ; Pamphlets ; Personal Satisfaction ; Prospective Studies ; Smoke ; Smoking ; Telephone ; Surveys and Questionnaires

No abstract available.
Tomography, Emission-Computed, Single-Photon*

PURPOSE: Either gated myocardial perfusion SPECT or attenuation corrected SPECT can be used to improve specificity in the diagnosis of coronary artery disease. We investigated in this study whether gating or attenuation correction improved diagnostic performance of rest/stress perfusion SPECT in patients having intermediate pre-test likelihood of coronary artery disease. MATERIALS AND METHODS: Sixty-eight patients underwent rest attenuation-corrected T1-20l/dipyridamole stress gated attenuation-corrected Tc-99m-MIBI SPECT using an ADAC vertex camera (M:F=29:39, aged 59+/-12 years, coronary artery stenosis> or =70%. one vessel: 13, two vessel: 18, three vessel: 8, normal: 29). Using a five-point scale, three physicians graded the post-test likelihood of coronary artery disease for each arterial territory (1 normal, 2: possibly normal 3:equivocal, 4: possibly abnormal, 5: abnormal). Sensitivity, specificity and area under receiver-operating-characteristic curves were compared for each operator between three METHODS: (A) non-attenuation-corrected SPECT; (B) gated SPECT added to (A); and (C) attenuation-corrected SPECT added to (B). RESULTS: When grade 3 was used as the criteria for coronary artery disease, no differences in sensitivity and specificity were found between the three methods for each operator Areas under receiver- operating-characteristic curves for diagnosis of coronary artery disease revealed no differences between each modality (p>005). CONCLUSION: In patients at intermediate risk of coronary artery disease, gated SPECT and attenuation-corrected SPECT did not improve diagnostic performance.
Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Humans ; Perfusion* ; ROC Curve ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Gastrointestinal Diseases*

This study was done to evaluate the frequency, intensity, and specificity of a positive pathergy reaction (PR) in Behcet's disease (BD) patients, to clarify an association between the PR and the clinical features or disease severity, and to assess whether patients with pustule formation at the venous puncture site (PFVPS) without positive PR could be regarded as a positive reaction. The PR was tested in 64 BD patients, 74 disease controls, and 20 healthy controls. Venous PR was performed in 8 BD patients with PFVPS. Follow-up PR was done in 14 patients with positive reaction during inactive phase. The PR was positive in 35.9% of BD patients, in 1 patient among disease controls, and in none of healthy controls. The pustule formation was observed in one BD patient. There was no statistical significance between positive PR and the clinical variables. The mean clinical activity score of BD patients with positive PR was similar to patients with negative reaction. Venous PR was positive in 7 patients. The follow-up PR was positive in 2 patients during inactive phase. Conclusively the positive PR appeared to be specific for BD, and was not associated with the clinical variables or disease severity, but was usually found during active phase in cases with positive reaction. The PFVPS in patients with negative PR might be considered to be positive.
Adult ; Behcet Syndrome/*pathology ; Female ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Severity of Illness Index ; Skin/*pathology ; Suppuration