OBJECTIVES: This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. METHODS: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. RESULTS: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. CONCLUSIONS: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.
Adult ; Aged ; Aged, 80 and over ; Antihypertensive Agents/therapeutic use ; Blood Pressure ; Diet ; Exercise ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; Hypertension/drug therapy/physiopathology/*therapy ; Male ; Middle Aged ; Qualitative Research ; Socioeconomic Factors

This study was performed to investigate satisfaction of 119 rescue users and to know how much different in perception around emergency circumstance between 119 rescuers and users. We reviewed emergency care records of users who were transported by 119 rescue of six agencies in Chungnam province from July 13, 1998 to August 8, 1998, and in order to find real utilization pictures and users' satisfaction, we analysed 113 mail questionnaires with perfect address and answers at January, 1999. The difference about perception around emergency circumstances between users and rescuers were as follows, degree of coincidence about mental state was 28.6% in alert, 61.9% in stupor, 28.6% in coma. Also, the degree of coincidence about patient 's severity was 50.0% in emergent, 64.1% in urgent, 19.4% in nonurgent. Difference between rescuers and users about duration from 119 call receipt to scene arrival The reason of satisfaction about 119 rescue service was 94.7% in kindness, 79.6% in equipment and facilities. Factors about dissatisfaction were delayed time(25.0%), insufficient equipment(19.2%), etc.
Chungcheongnam-do ; Coma ; Emergencies* ; Emergency Medical Services ; Humans ; Postal Service ; Surveys and Questionnaires ; Stupor

PURPOSE: During the 2017–2018 season, influenza vaccination among elementary, middle, and high school students was not supported by the government. As vaccines that are not included in the national immunization schedule are not registered in the computerized national immunization registry, vaccination rates in these groups during this season remain unknown. Thus, the aim of this study was to estimate the vaccination rate among elementary, middle, and high school students during the 2017–2018 influenza season. METHODS: A total of 1,910 student's parents (690 elementary school students; 611 middle school students; 609 high school students) participated in this survey. The survey involved a computer-assisted telephone interview (CATI). The following information related to participants' 2017–2018 seasonal influenza vaccination status were collected: date, type, provider, and data source. Other data collected included student's sex, grade, area of residence, and birth order, and parent's age, educational level, and job status. RESULTS: The influenza vaccination rate for the 2017–2018 season was 70.1%, 48.9%, and 35.9% for elementary, middle, and high school students, respectively. Factors that were significantly related to the influenza vaccination rate in the 2017–2018 season were student's sex, grade, area of residence and birth order, and parent's age, educational level, and job status. CONCLUSION In the future, it will be necessary to conduct regular assessments of the rate of seasonal influenza vaccination to inform national policy development regarding seasonal influenza infectious diseases control or as an evaluation tool for vaccine programs.

Objectives: This study aimed to identify the vaccination rate for pneumococcus among aged 65 or older, and at the same time to determine the reasons for vaccination or non-vaccination. Methods: The population of this study was aged 65 or older, with a total of 1,150 subjects to be analyzed and a computer assisted telephone interviewing was used. The survey included pneumococcal vaccination status, reasons of vaccination, sources of information on vaccination, reasons for not vaccination, and other related factors. Results: The vaccination rate for pneumococcus among aged 65 or older was 56.2 percent, lower than 69.0 percent in the U.S. (2017), and 69.2 percent in the U.K. (2019). Among the factors related to the pneumococcal vaccination, the groups with the high vaccination rate were women, low age groups, residents of urban areas, people without a job, people with high education, medical insurance subscribers, married people, and people who have family members. In addition, the groups with high vaccination rates were those with high awareness, those who received recommendations from doctors, those who had vaccination records, those who believed in vaccination effects, and those who saw public service advertisements. Conclusions In the future, it is necessary to develop alternatives to accurately manage vaccination records for adults who are not eligible for state support, and regular adult vaccination rates should be calculated so that they can be used as evidence for the country's infection control policy.

Objectives: This study aimed to identify the vaccination coverage for hepatitis B among aged 19 or older, and at the same time to determine the reasons for vaccination or non-vaccination. Methods: The survey was conducted through a Mixed-Mode Random Digit Dialing Survey (RDD) method. The survey included hepatitis B vaccination status, reasons of vaccination and non-vaccination, sources of information on vaccination, and other related factors. Results: The vaccination coverage for hepatitis B among adults 19 years of age and older were 38.0%, 32.5%, and 26.9% for the first, second, and third doses. A related factors with high rate of hepatitis B vaccination was women, younger than 65 years of age, rural residents, having a job, highly educated, health insurance subscribers, living with spouse, family members living together. In addition, the vaccination rate was higher in those who was aware of the states recommended adult vaccination, were explained by a doctor about the need for adult vaccination, kept their vaccination records, and recognized that it helped prevent infectious diseases, and had seen promotional materials. Conclusions In the future, it is necessary to check the antibody retention rate along with the hepatitis B vaccination coverage of adults on a regular basis. In addition, in order to accurately and quickly identify the hepatitis B vaccination coverage, it is necessary to prepare a plan to improve the computerized registration rate to manage adult vaccination records.

Objectives: This study aims to reveal the relationship between social relations and physical activity in the young-old and old-old elderly. Methods: Data from 2020 National survey of Older Koreans were used, and a total of 10,097 subjects over the age of 65 were included in analysis. The dependent variable was physical activity, and the independent variables were social relations barrier and motivational factors. x2 -test and binary logistic regression were performed for data analysis. Results: The physical activity rate in the elderly were 40.8% in the young-old and 29.2% in the old-old. The socio-demographic characteristics affecting physical activity were the young-old elderly were sex, residential area, employment status and household income, and the old-old elderly were sex, age, residential area, education level and household income. The social relations barrier factors affecting physical activity were the young-old elderly were number of close friends, family care, exercise information search and video viewing, and the old-old elderly were household type, number of close friends, participation in exercise education, exercise information search and video viewing. The social relations motivational factors affecting physical activity were the young-old elderly were call with children/relative/friend, participation in sports activity, access time from home to parks, and the old-old elderly were call with children/relative/friend, participation in sports activity, satisfaction with green spaces. Conclusions It was found that social relations barrier and motivational factors of the elderly are important factors to consider when developing physical activity promotion strategy, and there are also difference between the age of the elderly.

BACKGROUND: Laparoscopic gynecologic surgery is a standard procedure today for its small skin incision and short hospital admission stay. However pneumoperitoneum (PP) and Trendelenberg position induce adverse effects in hemodynamics and pulmonary gas exchange. The purpose of this study is to evaluate the effects of propofol compared with enflurane for pulmonary gas exchange in the Trendelenberg position and pneumoperitoneum. METHODS: Twenty women were randomly allocated to either the enflurane (n = 10) or propofol (n = 10) with fentanyl-N2O/O2 anesthesia. PaCO2, PaO2, PETCO2 were checked at pre-PP, 10 min after PP, 30 min after PP, and 10 min after CO2 deflation. In addition the Vd/Vt ratio was calculated according to the Bohr equation. Vital sign and peak airway pressure were checked at each stage. RESULTS: PaCO2 and PETCO2 increased and PaO2 decreased significantly during PP in both groups. Vd/Vt increased significantly in the enflurane group at 30 min after PP. Peak airway pressure increased significantly in both groups. Blood preassure and heart rate were not changed significantly. All of the parameters were not significantly different between groups. CONCLSIONS: Propofol compared with enflurane did not show any advantage in gas exchange during gynecologic laparoscopic surgery under Trendelenberg position and PP.
Anesthesia* ; Enflurane* ; Female ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics ; Humans ; Laparoscopy* ; Pneumoperitoneum ; Propofol* ; Pulmonary Gas Exchange ; Skin ; Vital Signs

Lung cancer is the most common fatal malignant lesion in both sexes. Detection of the solitary pulmonary nodule is important because surgical series up to a third of solitary pulmonary nodules are bronchogenic carcinoma. Bronchioloalveolar cell carcinoma is a rare primary lung cancer and surgery is treatment of choice in brochioloalveolar cell carcinoma. We experienced a case of broschioloalveolar cell carcinoma in solitary pulmonary nodule with cavitary lesion in chest CT scan, which is an uncommon finding in brochioloalveolar cell carcinoma.
Carcinoma, Bronchogenic ; Lung Neoplasms ; Solitary Pulmonary Nodule ; Tomography, X-Ray Computed

Aggressive angiomyxoma (AAM) is a rare, benign tumor. It usually involves the connective tissue of the perineal regions in women of reproductive age. In this report, we present a case of AAM in a 66-year-old female, which presented itself as a retrovesical tumor on pelvic magnetic resonance imaging and caused lower urinary tract symptoms. The tumor was resected en bloc and the patient's voiding symptoms disappeared.
Aged ; Connective Tissue ; Female ; Humans ; Lower Urinary Tract Symptoms ; Magnetic Resonance Imaging ; Myxoma ; Pelvic Neoplasms

BACKGROUND: Since the demonstration of the fact that vascular relaxation by acetylcholine(Ach) results from the release of relaxing factor from the endothelium, the identity and physiology of this endothelium-derived relaxing factor(EDRF) has been the target for many researches. EDRF has been identified as nitric oxide(NO). With the recent evidences that EDRF is an important mediator of vascular tone, there have been increasing interests in defining the role of the EDRF as a potential mediator of hypoxic pulmonary vasoconstriction. But the role of EDRF in modulating the pulmonary circulation is not compeletely clarified. To investigate the endotbelium-dependent pulmonary vasodilation and the role of EDRF during hypoxic pulmonary vasoconstriction, we studied the effects of N(G)-monornethyl-L-arginine(L-NMMA) and L-arginine on the precontracted pulmonary arterial rings of the rat in normoxia and hypoxia. METHODS: The pulmonary arteries of male Sprague Dawley(300~350g) were dissected free of surrounding tissue, and cut into rings. Rings were mounted over fine rigid wires, in organ chambers filled with 20ml of Krebs solution bubbled with 95 percent oxygen and 5 percent carbon dioxide and maintained at 37℃. Changes in isometric tension were recorded with a force transducer(FT. 03 Grass, Quincy, USA). RESULTS: 1) Precontraction of rat pulmonry artery with intact endothelium by phenylephrine(PE, 10(-6)M) was relaxed completely by acetylcholine(Ach, 10(-9) -10(-5)M) and sodium nitroprusside (SN, 10(-9) -10(-5)M), but relaxing response by Ach in rat pulmonary artery with denuded endothelium was significantly decreased. 2) L-NMMA(10-4M) pretreatment inhibited Ach(10(-9) -10(-5)M)-induced relaxation, but L-NMMA(10-4M) had no effect on relaxation induced by SN(10(-9) -10(-5)M). 3) Pretreatment of the L-arginine(10(-4)M) significantly reversed the inhibition of the Ach(10(-9) -10(-5)M)-induced relaxation caused by L-NMMA(10(-4)M). 4) Pulmonary arterial contraction by PE(10(-6)M) was stronger in hypoxia than normoxia but relaxing response by Ach(10(-9) -10(-5)M) was decreased. 5) With pretreatment of L-arginine(10(-4)M), pulmonary arterial relaxation by Ach(10(-9) -10(-5)M) in hypoxia was reversed to the level of relaxation in normoxia. CONCLUSION: It is concluded that rat pulmonary arterial relaxation by Ach is dependent on the intact endothelium and is largely mediated by NO. Acute hypoxic pulmonary vasoconstriction is related to the suppression on NO formation in the vascular endothelium.
Animals ; Anoxia ; Arginine ; Arteries ; Carbon Dioxide ; Endothelium ; Endothelium, Vascular ; Humans ; Male ; Nitric Oxide* ; Nitroprusside ; omega-N-Methylarginine ; Oxygen ; Physiology ; Poaceae ; Pulmonary Artery ; Pulmonary Circulation ; Rats* ; Relaxation* ; Vasoconstriction* ; Vasodilation