No abstract available.
Dinoprostone* ; Suppositories*

The cause of essential hypertension is yet unknown, but in general is caused by interaction of hereditary factors, diet, obesity, lack of exercise and stress. The aging process influences various physiological mechanism related to regulation of blood pressure. So elderly hypertensives have a tendancy to consider the disease as a result of the physiological aging process. This attitude causes many complications, worsening of the disease and even early death because of inappropriate care. In order to improve self-management of elderly hypertensives in this study the researcher examined the effect of blood pressure regulation by an education program that improves self-care behavior, through increasing self-efficacy. The education program consisted of group education on hypertension and self-care strategies, and encouraging and reinforcing self-efficacy resources such as verbal persuation, performance accomplishment and vicarious experiences. A quasi-experimental pre-and post-test design was used. Thirty-two elderly hypertensives participated in the study. Eighteen in the education group and fourteen in the control group. The education program consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Data were analysed using SPSS for Windows(Version 8.0). The results were as follows. 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of self-care behavior between the experimental group and control group over three different times, and interaction by groups and over time. 3. There was significant difference in self-efficacy of experimental and control group, depending on the measuring period, but there was no difference between these groups on interaction by groups and over time. 4. There was positive correlation between self efficacy and self care behavior depending on the measuring period. There was negative correlation between diastolic blood pressure and self-care behavior on the posttest of the program, and between systolic blood pressure and self-care behavior on the follow-up test of the program. Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.
Aged* ; Aging ; Blood Pressure* ; Diet ; Education* ; Follow-Up Studies ; Humans ; Hypertension ; Nursing ; Obesity ; Self Care* ; Self Efficacy

PURPOSE: This study was to identify the prevalence of orthostatic hypotension and its association with risk factors of orthostatic hypotension aged over 60 in Seoul and Chungju, Korea. METHOD: The data were collected from the 22th of August, 2000 to the 7th May 2001. The participants were 74 community-dwelling aged who could stand up from sitting position without assistance. Subjects were interviewed with structured questionnaire in order to ask experience of previous falls, hours in per day, symptoms related orthostatic hypotension and demographic characteristics. Orthostatic hypotension was assessed at 1 minute after the subjects standing from sitting position and defined as 20mmHg or greater decrease in systolic blood pressure after standing. RESULT: The prevalence of orthostatic hypotension was 17.1%. The mean drop of systolic blood pressure was 27.46mmHg among orthostatic hypotension subjects. The significant variables which explain the occurrence of orthostatic hypotension was the basal systolic blood pressure, the hit ratio of discriminant function with basal systolic blood pressure was 69.7%. CONCLUSION: Finding indicate that this study will contribute to develop nursing strategies to identify risk factors and to prevent orthostatic hypotension for the aged.

PURPOSE: This study was to identify the prevalence of postprandial hypotension and its related risk factors, and investigate the relationship between the related symptoms and the occurrence of postprandial hypotension. METHOD: The data were collected from the 22th of August, 2000 to 7th May, 2001. The participants were 74 aged over 60 in Seoul and Chungju, Korea. Blood pressure was taken in the sitting position at 15mins, 30mins and 60mins after starting meals. RESULT: 1) The prevalence of postprandial hypotension was 12.2% at 15mins, 25.7% at 30 mins, 25.7% at 60mins after starting meals. 2) There was no significant difference in age, but there was significant difference in basal systolic blood pressure between responders and nonresponders to postprandial hypotension over the three different times. 3) There was no significant relation between the occurrence of postprandial hypotension and its related symptoms over the three different times. CONCLUSION: Findings indicate that this study will contribute to develop an assessment protocol and nursing strategies to identify risk factors and to prevent postrprandial hypotension for the aged.
Blood Pressure ; Chungcheongbuk-do ; Hypotension* ; Korea ; Meals ; Nursing ; Prevalence* ; Risk Factors* ; Seoul

PURPOSE: The purpose of this study was to explore the main prerequisite for Korean Advance Directives [KAD] to ensure their better use. METHODS: Data were collected from two focus group interviews and individual email responses. Study participants were 5 doctors and 6 nurses. All interview data were transcribed and analyzed using qualitative content analysis. RESULTS: Three main themes emerged; establishing a philosophy of KAD, protocol to practice KAD, and the KAD document itself. A philosophy is needed to ensure individual needs, consensus to practice AD and identify principle agents. The core of protocol was found to be as follows; 1) process, 2) premise, 3) procedure, 4) contextual preparation, 5) timing, 6) feasibility. Component and feasibility need to be established for the document itself. CONCLUSION: For a positive acceptance of KAD in Korean society, a culture sensitive, reality based, and user friendly AD needs to be developed.
Adult ; *Advance Directives ; Asian Continental Ancestry Group ; Female ; Focus Groups ; Health Personnel/*psychology ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Qualitative Research ; Questionnaires ; Republic of Korea

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring . evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring . evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.
Diabetes Mellitus ; Diagnosis ; Education ; Humans ; Job Description ; Nutrition Assessment ; Nutrition Therapy* ; Nutritionists*

Background: Telemetry is a wireless implanted device that measures biological signals in conscious animals and usually requires surgery for its removal when the study is finished. After removing the device, the animals are either used for other studies or euthanatized.Case presentation: Herein, we report the case of a living cynomolgus monkey (Macaca fascicularis) that was used for the entire experimental period, instead of euthanasia, after surgical removal of an implanted telemetry system.Radiography was used to determine the status of the implanted telemetry, following which, a repair surgery was performed for removing the system; clinical signs were used to preserve the life of the cynomolgus monkey. Postoperative clinical signs, food consumption, hematology, and serum biochemistry were examined during the 12-month observational period. No abnormal readings or conditions were observed in the subject after implant removal. Conclusions This study may be a useful case report for living cynomolgus monkeys in telemetry implantations used throughout the study period. We suggest minimizing the suffering and improving the welfare of these animals.

No abstract available.
Burkitt Lymphoma* ; Skin*

BACKGROUND: Perfusion scintigraphy with dipyridamole have been reported to be useful for diagnosis of coronary artery disease and the assessment of the presence and extent of myocardium at ischemic risk, especially in patients who can not undergo dynamic exercise testing. Dipyridamole, pharmacologic coronary vasodilator, also induces fall in blood pressure and rise in heart rate. The purpose of this study was to answer the question if dipyridamole induced peripheral hemodynamic responses were related to chest pain, ST changes on EKG, scintigraphic defect or extent of coronary stenosis. METHODS: Dipyridamole 99mTc-MIBI myocardial scintigraphy and coronary angiography on 43 subjects who were suspected to have coronary artery disease. The peripheral hemodynamic response was graded as absent(group 0) if there was a < or =10mm fall in systolic blood pressure (SBP) and/or < or =10 beats/min rise in geart rate(HR) ; moderate(group 1) if there was >10 but < or =20mm fall in SBP and/or >10 but < or =20 beats/min rise in HR ; and marked (group 2) if there was >20mm fall in SBP and/or >20 beats/min rise in HR. RESULTS: The overall diagnostic sensitivity and specificity for coronary artery disease of dipyridamole perfusion scintigraphy were 68%, 83% while per vessel sensitivity and specificity for coronary artery disease were 66%, 97%. The numbers of induced chest pain and ischemic ST changes among hemodynamic subgroups, were 40%, 40% in group 0, 33%, 27% in group 1 and 50%, 40% in group 2 without significant difference in each hemodynamic subgroups. Either the numbers of diseased coronary arteries or the numbers of patients demonstrationg reversible scintigraphic defects were not statically different among each subgroups. CONCLUSION: Although the peripheral hemodynamic response dose not always correlate with its central coronary effect but dipyridamlole 99mTc-MIBI myocardial perfusion scintigraphy is an useful test for diagnosis of coronary artery disease.
Blood Pressure ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis ; Dipyridamole* ; Electrocardiography ; Exercise Test ; Heart Rate ; Hemodynamics* ; Humans ; Myocardial Perfusion Imaging ; Myocardium ; Perfusion Imaging ; Sensitivity and Specificity

BACKGROUND: Ultrafiltration, used in pediatric cardiac operations to remove excessive body water, can be separated into conventional and modified techniques according to the connection with the bypass circuit and the time of starting ultrafiltration. Ultrafiltration provides more precise hemodynamic and fluid management immediately after CPB (cardiopulmonary bypass), especially in the pediatric patient. The mechanism by which blood pressure improves remains uncertain. The purpose of this study was to compare the efficacy of ultrafiltration for hemodynamics and reduce the blood consumption amounts in paediatric open heart operations. METHODS: Fourty children undergoing surgical correction of VSD (ventricular septal defect) or ASD (atrial septal defect) were randomly assigned to a ultrafiltration or control group. Conventional ultrafiltration was performed with a polysurphone hemofilter during rewarming of CPB. Modified ultrafiltration carried out in the first 10 to 15 minutes immediately after bypass. In all patients, moderate hypothermic CPB, in the range of 20~25 degrees C body temperature, was performed with nonpulsating flow. RESULTS: Demographic data as well as data from CPB did not differ among the groups. In the ultrafiltration group, significant reductions of the amount of blood transfusion significant increases in systolic pressure and hematocrit were noted in the ultrafiltration group. We have been impressed with what appears to be a marked improvement in hemodynamic status in the modified ultrafiltration process during the first few minutes. CONCLUSIONS: Ultrafiltration has been employed successfully in our hospital, and this study demonstrates that ultrafiltration may help to control water balance, concentration of blood, increase systemic arterial pressure and reduces intraoperative blood transfusion.
Arterial Pressure ; Blood Pressure ; Blood Transfusion ; Body Temperature ; Body Water ; Child ; Heart ; Hematocrit ; Hemodynamics* ; Humans ; Rewarming ; Thoracic Surgery* ; Ultrafiltration*