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 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

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

We described a case of a 54-year-old male who presented with dizziness and dyspnea due to cardiac metastasis of leiomyosarcoma. Cardiac metastasis of leiomyosarcoma caused both bradyarrhythmia and tachyarrhythmia in the patient. He was treated with implantation of a permanent pacemaker for management of complete atrio-ventricular block and anti-arrhythmic drug that suppressed ventricular tachycardia successfully.
Bradycardia ; Dizziness ; Dyspnea ; Heart ; Humans ; Leiomyosarcoma* ; Male ; Middle Aged ; Neoplasm Metastasis* ; Tachycardia ; Tachycardia, Ventricular*

Although the incidence of uremic pericarditis was high in the past, it has decreased in recent decades with early and appropriate dialysis. However, cardiac tamponade caused by uremic pericarditis is still a life-threatening emergency and it requires urgent management. Herein we report a case of 38-year-old man with chronic renal disease who represented critical uremic pericarditis followed by cardiac tamponade despite of appropriate hemodialysis. Careful consideration of risk factors and aggressive treatment are very important for effective and safe treatment of uremic pericarditis and cardiac tamponade.
Adult ; Cardiac Tamponade* ; Dialysis ; Emergencies* ; Humans ; Incidence ; Pericardial Effusion ; Pericardiocentesis ; Pericarditis* ; Renal Dialysis* ; Renal Insufficiency, Chronic ; Renal Replacement Therapy ; Risk Factors

Cytomegalovirus (CMV) is a well-established cause of morbidity and mortality in pediatric recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT). CD8⁺ T-cells are important for controlling CMV infection. We conducted a prospective pilot study to investigate the clinical utility of measuring the CMV-specific T-cell immune response using the QuantiFERON-CMV assay (QF-CMV) in pediatric allo-HSCT recipients. Overall, 16 of 25 (64%) patients developed CMV infection. QF-CMV was evaluated in these 16 patients during the early and late phases of the first CMV infection post allo-HSCT. Whereas the initial QF-CMV results during the early phase of CMV infection did not correlate with the course of the corresponding infection, the QF-CMV results post resolution of the first CMV infection correlated with the recurrence of CMV infection until 12 months post allo-HSCT; no recurrent infections occurred in the four QF-CMV-positive patients, while recurrent infections manifested in five of eight QF-CMV-negative (62.5%) and all three QF-CMV-indeterminate patients (P=0.019). In spite of the small number of patients examined, this study supports the potential application of monitoring CMV-specific T-cell immunity using the QF-CMV assay to predict the recurrence of CMV infection in pediatric allo-HSCT recipients.
Cytomegalovirus ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Mortality ; Pilot Projects ; Prospective Studies ; Recurrence ; T-Lymphocytes