PURPOSE: To examine the effects of the GEAP on pain, fatigue, self-esteem, perceived health status and self-efficacy in patients with chronic arthritis. METHODS: One group pre- & post-test design was used. Outcome domains included pain, number of painful joints, fatigue, self-esteem, perceived health status and self-efficacy. Thirty-four patients were recruited over four times from a rheumatic clinic affiliated to a university medical center in Seoul, Korea. The GEAP is an exercise program modified by the investigators from PACE program which developed by Arthritis Foundation. The program duration is about 60 minutes, three times a week for 6 weeks. Participants were predominantly women (68%); on average 57.3 years old; and diagnossed with RA (58.8), osteoarthritis (29.4) or other (11.8). RESULTS: After completing the GEAP, subjects showed significant improvement in pain (p=0.02), number of painful joints (p=0.04), fatigue (p=0.0001), and perceived health status (p=0.006). There were no improvements in self-esteem and self-efficacy score for adults with chronic rheumatic diseases. CONCLUSION: This study showed that the GEAP is an effective exercise intervention for improving outcomes for patients with chronic arthritis. More sample and research are needed to 1) accurately evaluate on self-esteem and self-efficacy; 2) understand and improve adherence. And also a longer follow up period is recommended to evaluate long-term effects of the PACE program.
Academic Medical Centers ; Adult ; Arthritis* ; Fatigue* ; Female ; Follow-Up Studies ; Humans ; Joints ; Korea ; Osteoarthritis ; Research Personnel ; Rheumatic Diseases ; Seoul

The aim of this study was to investigate what is the most accurate and quick temperature measurement among rectal, auxiliary and tympanic routes. The body temperatures of 86 preterm infants in incubators, a controlled environment, were measured at three different sites. The measurements were taken to examine the accuracy of the temperatures, proper nursing time for measuring the temperatures and the validity of fever detection. The results were as follows : 1. The mean temperature was significantly lower in the auxiliary site(36.71degrees C) and higher in the tympanic site(37.27degrees C) than in the rectal site(37.03degrees C). 2. The mean nursing time for measuring body temperature was significantly longer in the auxiliary site(171.65 seconds) and shorter in the tympanic site(17.70 seconds) than in the rectal site(83.33 seconds). 3. The nursing time for measuring body temperature included the time needed for preparation, measuring, as well as the post-measuring time. It was found that the time required to prepare for measuring the temperature of the rectal site was significantly longer than for other sites. In addition, the time needed to measure the temperature of the auxiliary site was significantly longer than in the other sites. Finally, the nursing time needed for measuring the auxiliary temperature(171.65 seconds) was the longest among the three sites whereas the nursing time for the tympanic site was the shortest(17.70 seconds). 4. Rectal temperature was significantly correlated to the tympanic(r=0.67) and auxiliary temperatures(r=0.69). Tympanic temperature was also significantly correlated to the auxiliary temperature(r=0.74). 5. The sensitivity, specificity, positive and negative predictive values of tympanic temperatures for detecting fever were 1.00, 0.80, 0.24, and 1.00, respectively. Those for the auxiliary temperatures were 0.00, 0.99, 0.00, and 0.94, respectively. Thus the level of fever detection was lower in the auxiliary temperatures than in tympanic temperatures. The above findings indicate that the tympanic method of temperature measurement offers a useful alternative to conventional methods.
Body Temperature ; Environment, Controlled ; Fever* ; Humans ; Incubators ; Infant, Newborn ; Infant, Premature ; Nursing* ; Sensitivity and Specificity

PURPOSE: A quasi-experimental study was conducted to identify the effects on Self-efficacy, Fatigue, Coping Skills and Self-care Activities by Korean patients following a Systemic Lupus Erythematosus Self-Management (SLESM) Course. METHODS: A two group pre-test and post-test design was used. The participants in the study were forty-one people with Systemic Lupus Erythematosis of which 21 subjects were assigned to the experimental group and 20 to the control group. The experimental group received six weekly 2-hour group sessions, while the control group did not receive any intervention. Outcome measures included self-efficacy, fatigue, coping skills and self-care activities. Baseline demographic and clinical variables did not differ between the two groups. RESULTS: Patients who participated in the self-management course showed significant decrease in fatigue (p=.038), improvement in self-efficacy (p=.001) and coping skills (p=.048), increase in self-care activities (p=.003), and in the number of types of self-care activities(p=.048). CONCLUSION: Self-efficacy, coping skills and self-care activities improved and fatigue was reduced following the SLESM course. This study showed that a SLESM course is a good nursing intervention that can be offered in community settings.
Adaptation, Psychological* ; Fatigue* ; Health Promotion ; Humans ; Korea ; Lupus Erythematosus, Systemic* ; Nursing ; Outcome Assessment (Health Care) ; Self Care*

BACKGROUND: The purpose of this study is to obtain the accurate information on the obesity indices, such as body mass index(BMI), relative weight and waist-hip ratio(WHR) and to investigate their relationship in order to assess the childhood and adolescent obesity more appropriately. METHODS: In May, 1995, a total of 6943(male; 3469, female; 3474) students from primary, middle and high schools in Seoul were selected and each students height, weight, waist and hip circumference data were collected. RESULTS: The BMI increased with age in both sexes. From age 12 to 16, values of BMI 50th percentiles for females exceeded those for males. And the BMI 95th percentiles at the age of 13 to 14 years were higher for females than for males. The prevalence of obesity by relative weight was higher in males than in females(male ; 17.9%, female ; 13.1%). The WHR was higher in males than females in all age group and decreased with age in both sexes, showing more sharp reduction in females. Strong correlations were observed between the BMI and the relative weight, and the BMI and the relative weight correlated closely with WHR. The WHR was significanly higher in obese group' than in non-obese group. In the female obese group aged 6 to 11 years, no significant correlation was found between the relative weight and the WHR. CONCLUSIONS: There were significant relationships between the indices of obesity and body fat distribution. This study suggests that WHR as well as BMI and relative weight might be useful in assessing the childhood and adolescent obesity.
Adolescent* ; Body Fat Distribution ; Body Mass Index* ; Child* ; Female ; Hip ; Humans ; Male ; Obesity ; Pediatric Obesity ; Prevalence ; Seoul* ; Waist-Hip Ratio*

BACKGROUND: The studies about that hypertension commonly associated with dyslipidemia and that dyslipidemic hypertension increased mortality compared with hypertension only and dyslipidemia only, suggests an important clinical entity. Therefore, this study aimed to identify prevalence and describe potential insulin resistance of dyslipidemic hypertension, and compare about them with two other groups(dyslipidemia only, hypertension only). METHODS: The data in this study was analyzed from 1,296 persons who had visited Health examination center in Ewha Womans University Mok-dong Hospital from Jan. to April, 1996. Prevalence of dylipidemia, hypertension and dislipidemic hypertension were measured. Average age, and frequency of male, obesity and NIDDM in three groups were measured. Odds ratios of sex, obesity, smoking, and DM according to two age group consisting of persons before and after 50 years were calculated for three groups. RESULTS: Frequency of dyslipidemia only was 27% and of hypertension only was 8%.; conjoint frequency(dyslipidemic hypertension) was 7%, which is 1.5 times greater than expected value(4.7%) if the two diseases were independent. In characteristics for age, sex, obesity and NIDDM, All three groups(dyslipidemic hypertension, dyslipidemia only, hypertension only) w-normal subjects. Dyslipidemic hypertension was more likely to be obese and had a greater frequency of NIDDM than two other group(dyslipidemia only, hypertension only). Odds ratio was contrasted with three groups for sex, smoking, obesity, NIDDM stratified by age to more indentify association with insulin resistance. Sex was associated with male in two groups(dyslipidemia only, dyslipidemic hypertension) of younger group and dyslipudemia only group of older group, but associated with female in hypertension only and dyslipidemic hypertension of older group. Smoking was associated with dyslipidemia only group of younger group. Obesity was associated with increased odds of dyslipidemia only(2.03) and hypertension only(2.02), dyslipidemic hypertension (4.38) in younger group, and dyslipidemic hypertension(2.24) in older group, but associated with decreased odds with dyslipidemia only(0.56). NIDDM was associated with increased odds of dyslipidemia only(2.39) and dyslipidemic hypertension(3.32) in youger group. CONCLUSIONS: Dyslipidemic hypertension is common and more often than would be dictated by chance alone, which is consistent with a distinct syndrome. Dyslipidemia and hypertension were associated with potential insulin resistant states of obesity and DM in this study. So, treatment of dislipidemic hypertension should focus on weight control and exercise, which increase insulin sensitivity.
Diabetes Mellitus, Type 2 ; Dyslipidemias ; Female ; Humans ; Hypertension* ; Insulin ; Insulin Resistance ; Male ; Mortality ; Obesity ; Odds Ratio ; Prevalence* ; Smoke ; Smoking

BACKGROUND: The studies about that hypertension commonly associated with dyslipidemia and that dyslipidemic hypertension increased mortality compared with hypertension only and dyslipidemia only, suggests an important clinical entity. Therefore, this study aimed to identify prevalence and describe potential insulin resistance of dyslipidemic hypertension, and compare about them with two other groups(dyslipidemia only, hypertension only). METHODS: The data in this study was analyzed from 1,296 persons who had visited Health examination center in Ewha Womans University Mok-dong Hospital from Jan. to April, 1996. Prevalence of dylipidemia, hypertension and dislipidemic hypertension were measured. Average age, and frequency of male, obesity and NIDDM in three groups were measured. Odds ratios of sex, obesity, smoking, and DM according to two age group consisting of persons before and after 50 years were calculated for three groups. RESULTS: Frequency of dyslipidemia only was 27% and of hypertension only was 8%.; conjoint frequency(dyslipidemic hypertension) was 7%, which is 1.5 times greater than expected value(4.7%) if the two diseases were independent. In characteristics for age, sex, obesity and NIDDM, All three groups(dyslipidemic hypertension, dyslipidemia only, hypertension only) w-normal subjects. Dyslipidemic hypertension was more likely to be obese and had a greater frequency of NIDDM than two other group(dyslipidemia only, hypertension only). Odds ratio was contrasted with three groups for sex, smoking, obesity, NIDDM stratified by age to more indentify association with insulin resistance. Sex was associated with male in two groups(dyslipidemia only, dyslipidemic hypertension) of younger group and dyslipudemia only group of older group, but associated with female in hypertension only and dyslipidemic hypertension of older group. Smoking was associated with dyslipidemia only group of younger group. Obesity was associated with increased odds of dyslipidemia only(2.03) and hypertension only(2.02), dyslipidemic hypertension (4.38) in younger group, and dyslipidemic hypertension(2.24) in older group, but associated with decreased odds with dyslipidemia only(0.56). NIDDM was associated with increased odds of dyslipidemia only(2.39) and dyslipidemic hypertension(3.32) in youger group. CONCLUSIONS: Dyslipidemic hypertension is common and more often than would be dictated by chance alone, which is consistent with a distinct syndrome. Dyslipidemia and hypertension were associated with potential insulin resistant states of obesity and DM in this study. So, treatment of dislipidemic hypertension should focus on weight control and exercise, which increase insulin sensitivity.
Diabetes Mellitus, Type 2 ; Dyslipidemias ; Female ; Humans ; Hypertension* ; Insulin ; Insulin Resistance ; Male ; Mortality ; Obesity ; Odds Ratio ; Prevalence* ; Smoke ; Smoking

BACKGROUND: The prevalence of dementia is estimated to be as high as 11.3% among coummunity-dwelling persons over 65 years of age in Korea. The fear of dementia for both patients and families is growing because of the chronicity and progressiveness of the disease. Though the recognition, evaluation, and management of patients with dementia are important for the care of older pateint, unfortunately, MMSE takes 5 to 10 minutes to administer and is cumbersome to carry for all elderly patients in busy office. The Clock Drawing Test has been known as valid, easily administered and low cost screening procedure for the congnitive impaiment associated with dementia in general geriatric clinic population. In this study, we assessed the usefulness of this measure as a screening test for dementia, on the basis of the correlation between clock drawing and MMSE-K. METHODS: The subjects for this study consisted of 47 elderly who visited to two elderly clubs in Seoul from April 1996 through June 1996 or the outpatient department of Family medicine of the Ehwa Mok-dong hospital. They received the Mini-Mental Status Exam and the Clock Drawing test. Three observers evaluated them by ratings from 10(best) to 1(worst). Inter-rater reliability of scores from the Clock Drawing Test was assessed and Pearson correlation coefficients were used to examine the relationships between scores from the Clock Drawing Test and MMSE-K. RESULTS: Their mean age was 75.4 years with range of 65 to 91 years. There were 34 women and 13 men. Correlations between individual raters was highly significant(y=0.8939, 0.8552, and 0.8698, respectively ; P<0.01). Compared to scores on MMSE-K, rating from clock drawings by each of 3 raters revealed statistically significant correlations(y=0.7164, 0.7398, and 0.6884, respectively ; P<0.01). CONCLUSIONS: The clock drawings can be rated reliably by even untrained observers and performance on this task relates significantly to performance on MMSE-K of severity. We confirmed the usefulness of clock drawings as a simple, easily administered, low cost, and reliable general screening tool for dementia in a general geriatric clinic population.
Aged ; Dementia* ; Female ; Humans ; Korea ; Male ; Mass Screening* ; Outpatients ; Prevalence ; Seoul

PURPOSE: The aim of this research was to explore nurses' knowledge of and attitudes toward pediatric palliative care (PPC) in Korea. METHODS: A descriptive cross-sectional design was used. A total of 196 participants were recruited from the ELNEC-PPC course held in Seoul, Korea. All participants completed a 20-item survey questionnaire which assessed knowledge of and attitudes toward PPC using a 7-point Likert scale. RESULTS: Nurses' knowledge of PPC correlated with their educational level and work experience in the pediatric unit and hospice care unit. The work experience in the pediatric unit, career length in PPC and completion of palliative education course made differences in the attitudes toward PPC. Married nurses scored significantly higher on the parental rights in determining palliative care service for their child, and nurses with master's degree or higher showed a higher level of understanding of and attitudes toward the differences between PPC and adult palliative care. CONCLUSION: The factors influencing nurses' knowledge of and attitudes toward PPC need be considered to develop a pediatric palliative training program.
Adult ; Child ; Education ; Hospice Care ; Human Rights ; Humans ; Korea ; Palliative Care* ; Parents ; Seoul ; Surveys and Questionnaires

BACKGROUND: Retinoic acid (RA) has been reported to induce the up-regulation of inflammatory cytokines such as IL-1, TNF-alpha and IL-8 in dermal fibroblasts and keratinocytes. There is no evidence to support a direct interaction between the RA-mediated transcriptional machinery and IL-8 gene transcription. OBJECTIVE: The aim of this study is to clarify the mechanism of the up-regulation of IL-8 in keratinocytes by RA. METHODS: The IL-1, IL-8, TNF-alpha and MCP-1 mRNA expressions in HaCaT cells stimulated by RA were measured by quantitative RT-PCR. The effects of a NF-kappaB inhibitor and IL-1 receptor antagonist (ra) on the IL-8 mRNA expression were measured by quantitative RT-PCR. Electrophoretic motility shift assay (EMSA) was conducted on the RA-stimulated HaCaT cells that were or were not treated with NF-kappaB inhibitor to measure the NF-kappaB binding activity in each group. The phospho-IkappaB activity in the HaCaT cells after stimulation with RA was also measured by Western blotting. RESULTS: An up-regulation of the IL-8 gene expression by RA was demonstrated in the HaCaT cells. The inhibition assay revealed the involvement of the NF-kappaB binding site of the IL-8 gene in the RA-enhanced promoter activity. EMSA demonstrated that RA enhanced the formation of the DNA-NF-kappaB complex. There was no evidence to support IL-1 as an intermediate stimulus between the RA-mediated transcriptional machinery and IL-8 gene transcription. Western blot analysis revealed increased phospho-IkappaB activity in the HaCaT cells after stimulation with RA. CONCLUSION: Our result suggested that the IL-8 gene expression of HaCaT cells after RA stimulation is caused by the activation of IKK and the dissociation of IkappaB from NF-kappaB and the transcription of NF-kappaB in the nucleus.
Binding Sites ; Blotting, Western ; Cytokines ; Dissociative Disorders ; Fibroblasts ; Gene Expression ; Interleukin-1 ; Interleukin-8 ; Keratinocytes ; NF-kappa B ; RNA, Messenger ; Tretinoin ; Tumor Necrosis Factor-alpha ; Up-Regulation

A retropharyngeal abscess is a rare disease entity in young infants but can develop after nasopharyngeal viral infection. Group B Streptococcus and Staphylococcus aureus are the most common pathogens in young infants, however, Mycobacterium tuberculosis is very rare. We report the case of retropharyngeal abscess and coinfection with S. aureus and M. tuberculosis in a very young infant presenting with respiratory symptoms due to upper airway obstruction. Usually tuberculous retropharyngeal abscesses are caused by the direct invasion of the bacteria from the spine via anterior longitudinal ligament of the spine. However, in this case, no associated spinal disease was observed.
Airway Obstruction ; Bacteria ; Coinfection ; Humans ; Infant ; Longitudinal Ligaments ; Mycobacterium ; Mycobacterium tuberculosis ; Rare Diseases ; Retropharyngeal Abscess ; Spinal Diseases ; Spine ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Tuberculosis