This was a descriptive study clarifying the factors affecting family caregivers' sense of well-being. This study was conducted with 131 caregivers using structured self-reporting questionnaires and directly interviewing adult patients who had been under treatment in two general hospitals. The hospitals were located in M city from Aug. 10, 2000 until Sep. 2, 2000. The collected data were analyzed using SAS PC+ program, and the data were tested using descriptive statistics, t-tests, ANOVA, Pearson's Correlation Coefficient, and Stepwise Multiple Regression. The results of this study are as follows; 1) The variables affecting the caregivers' sense of burden were age (F=3.76, p=.0063), education level (F=4.67, p=.0015), monthly income (F=2.49, p=.0466), amount of assistance provided (F=4.19, p=.0037), and the relationship with patient before disease (F=9.49, p=.0001). 2) The variables affecting caregivers' sense of well-being were age (F=9.54, p=.0001), residing with patient (t=11.38, p=.0010), the period of caregiving (F=10.52, p= .0001), education level (F= 2.79, p=.0290), monthly income (F=3.04, p=.0196), and relationship with patient before disease (F= 10.51, p=.0001). Also, all of the variables which showed statistical significance. 3) In viewing the relationship between activities of daily living (ADL) and the senses of burden and well-being, a negative relation- ship between activities of daily living (ADL) and a sense of burden was found (r=-.640, p=.000). However, the relationship between activities of daily living (ADL) and a sense of well-being had a positive correlation (r= .232, p=.008). Also the relationship between the sense of burden and the sense of well-being was revealed to have a negative correlation (r=-.614, p=.000). 4) A sense of burden was the most important indicator to the well-being of the caregivers who took care of stroke patients (R2 =.36). In addition to this, living with the patient (45%), activities of daily living (51%), relationship with patient before disease (53%), and the family's monthly income accounted for 56% of the sense of well-being of the caregivers.
Activities of Daily Living ; Adult ; Caregivers ; Education ; Hospitals, General ; Humans ; Surveys and Questionnaires ; Ships ; Stroke* ; Survivors*

BACKGROUND: Continuity is very important in primary care, and in most studies continuous care has been reported to have a good effect on the result of care. So we studied the factors influencing the continuity of patient care by physician in charge, especially in case of out-patient department in a university hospital. METHODS: We posed questionnaires to 55 persons who had visited continually to Paik Hospital in Pusan for at least 6 months. We classified them into three groups according to the degree of continuity using 'Modified Continuity Index', and compared the lower group (18 patients) with the higher group(18 patients). RESULTS: The incame of the higher continuity group was significantly less than that of the lower continuity group(P=0.042). But there were no significant differences between the two groups according to sex, age, the type of family, marital status, job and the level of education. The higher continuity group agreed more significantly than the lower continuity group with the question whether it is important to be treated continually from physician in charge(P=0.005). About the reasons for visiting to other doctors instead of the physician in charge, most of them in both group replied that they could not keep appointment. And there were no significant differences in the care pattern of disease between the groups. CONCLUSIONS: To improve the continuity of patient care by physician in charge, it is necessary to instruct the importance of continuous care to the patients and to motivate them through various methods.
Busan ; Continuity of Patient Care* ; Education ; Family Practice* ; Humans ; Marital Status ; Outpatients ; Primary Health Care ; Surveys and Questionnaires

BACKGROUND: We conducted a population-based cross-sectional study of Korean adults to evaluate the association between metabolic syndrome and microalbuminuria as a marker for early-stage chronic kidney disease. METHODS: A total of 8,497 adults (3,625 men and 4,872 women) who participated in the Korea National Health and Nutrition Examination Survey between 2011 and 2012 were included. Metabolic syndrome was defined according to recommendation from a joint interim statement of international organizations published in 2009. Microalbuminuria was defined as a urinary albumin-to-creatinine ratio of 30 to 300 mg/g. The association between metabolic syndrome and microalbuminuria was evaluated using logistic regression analysis with adjustment for covariates while considering sampling weights and the complex survey design. RESULTS: The prevalence of microalbuminuriain subjects with metabolic syndrome was 11% for men and 14.4% for women, whereas the prevalence in subjects without metabolic syndrome was 3.1% for men and 6.7% for women. Metabolic syndrome was significantly associated with an increased risk of microalbuminuriain both women (odds ratio, 2.79; 95% confidence interval, 2.01 to 3.88) and men (odds ratio, 3.00; 95% confidence interval, 2.11 to 4.27). All components of the metabolic syndrome were associated with a significantly increased risk of microalbuminuria with the strongest association for high blood pressure. The risk of microalbuminuria increased in a dose-dependent manner (P-value for trend < 0.001) with the number of metabolic syndrome components observed for both sexes. CONCLUSION: These findings suggest that metabolic syndrome is a risk factor for chronic kidney disease from an early stage.
Adult* ; Albuminuria ; Cross-Sectional Studies ; Dyslipidemias ; Female ; Humans ; Hypertension ; Joints ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Obesity ; Prevalence ; Renal Insufficiency, Chronic ; Risk Factors ; Weights and Measures

Small bowel tumors are very rare and generally malignant. As a result of the anatomical location and nonspecific manifestations of small bowel tumors, they are very difficult to diagnose. Balloon-assisted enteroscopy is a relatively noninvasive method compared to surgical resection, and allows for real-time observation, tissue confirmation with biopsy, and interventional procedures. Here, we report the case of a 69-year-old woman with a small bowel metastatic carcinoma observed with double balloon enteroscopy (DBE). She had a history of multiple cancers including ovarian cancer, bladder cancer, and breast cancer. The antegrade DBE procedure was performed before surgery for biopsy tissue confirmation. The patient underwent small bowel resection, and the final diagnosis was the same as that determined by preoperative biopsy. The final diagnosis was metastatic small bowel cancer originating from a cancer of the breast. This is the first detailed report of the preoperative diagnosis of small intestinal metastatic breast cancer by DBE.
Aged ; Biopsy ; Breast Neoplasms ; Diagnosis ; Double-Balloon Enteroscopy* ; Female ; Humans ; Ovarian Neoplasms ; Urinary Bladder Neoplasms

BACKGROUNDS: To investigate the physical functioning state of the rural aged people and its related factors. METHODS: 458 older people aged 65 years or older living in a rural area were interviewed fromAug. 6 to Aug. 9, 2003. Socioeconomic characteristics, structural and functional social supports, chronic disease, stress, and obesity(using body mass index) were included to explore their influencing physical functioning. Physical functioning was measured by Physical Functioning(PF) scale constructed by 2-factor(mobility and self-care). Cronbach's alpha of social support and PF scales were 0.91, 0.89 respectively. After univariate analysis, multiple regression analysis was conducted to identify major contributing factors to physical functioning. RESULTS: 1) Person of younger age, higher education level, having job, higher economic status were more likely to show a higher degree of physical functioning in both male and female. 2) In those who having spouse, the physical functioning scores were significantly higher. And the aged people with high social support got higher physical functioning score. 3) In male with diabetes, physical functioning score were significantly lower. In female with arthritis, physical functioning score were significantly lower. 4) For the aged people which having higher stress, the physical function wasn't good. 5) In multiple regression analysis, for both male and female, physical functioning of those who have no job, lower social support, higher stress was bad. In male with chronic disease and female with arthritis, the physical functional score was lower. CONCLUSION: The physical functioning of some rural aged people were affected by various factors such as social, psychological, economic and physical factors. So diverse policy and programwill be necessary for improve physical functioning of rural older people.
Arthritis ; Chronic Disease ; Education ; Female ; Humans ; Male ; Spouses ; Weights and Measures

BACKGROUND: Inflammatory factors and beta-cell dysfunction due to high-fat diets aggravate chronic diseases and their complications. However, omega-3 dietary fats have anti-inflammatory effects, and the involvement of autophagy in the etiology of diabetes has been reported. Therefore, we examined the protective effects of autophagy on diabetes using fat-1 transgenic mice with omega-3 self-synthesis capability. METHODS: Streptozotocin (STZ) administration induced beta-cell dysfunction in mice; blood glucose levels and water consumption were subsequently measured. Using hematoxylin and eosin (H&E) and Masson's trichrome staining, we quantitatively assessed STZ-induced changes in the number, mass, and fibrosis of pancreatic islets in fat-1 and control mice. We identified the microtubule-associated protein 1A/1B light chain 3-immunoreactive puncta in beta-cells and quantified p62 levels in the pancreas of fat-1 and control mice. RESULTS: STZ-induced diabetic phenotypes, including hyperglycemia and polydipsia, were attenuated in fat-1 mice. Histological determination using H&E and Masson's trichrome staining revealed the protective effects of the fat-1 expression on cell death and the scarring of pancreatic islets after STZ injection. In the beta-cells of control mice, autophagy was abruptly activated after STZ treatment. Basal autophagy levels were elevated in fat-1 mice beta-cells, and this persisted after STZ treatment. Together with autophagosome detection, these results revealed that n-3 polyunsaturated fatty acid (PUFA) enrichment might partly prevent the STZ-related pancreatic islet damage by upregulating the basal activity of autophagy and improving autophagic flux disturbance. CONCLUSION: Fat-1 transgenic mice with a n-3 PUFA self-synthesis capability exert protective effects against STZ-induced beta-cell death by activating autophagy in beta-cells.
Animals ; Autophagy* ; Blood Glucose ; Cell Death ; Chronic Disease ; Cicatrix ; Diet, High-Fat ; Dietary Fats ; Drinking ; Eosine Yellowish-(YS) ; Fatty Acids, Omega-3 ; Fatty Acids, Unsaturated* ; Fibrosis ; Hematoxylin ; Hyperglycemia ; Islets of Langerhans ; Mice ; Mice, Transgenic* ; Pancreas ; Phenotype ; Polydipsia ; Streptozocin

OBJECTIVES: To evaluate the degree of adolescent internet addiction, and investigate its relationship to the general characteristics, internet environments, and contents, especially the stress measured by the psychosocial wellbeing index-short form (PWI-SF). METHODS: The data was obtained from self-administered questionnaires from 886 11th grade urban area students. The questionnaires consisted of general characteristics, internet user's environments, frequencies by internet contents, internet addiction test and PWI-SF. RESULTS: The possible rate of internet use at home was 95.1%, and the area of most internet use was the home. The frequencies of internet game and porno site use were higher in males, with web searching and community uses higher in females. The total mean of internet addiction score was 56.8, and was higher for male than for female students. From multiple regression, as analyzed by the internet addiction score as a dependent variable, on-line friends, internet use times, years of internet use, frequencies of internet game & porno site use, and PWI-SF scores were significant in male. Internet use times, the frequencies of internet game, chatting, community use, and PWI-SF score were significant in female. Four PWI-SF subscales (social role & self reliability, depression, general health & vitality, and sleep disturbance & anxiety) and internet addiction were significantly correlated in both male and female students, with depression having the most correlation. CONCLUSION: The results of this study suggest that intervention should be provided to prevent internet addiction, especially for coping with stress in Korean teenage students.
Adolescent ; Depression ; Female ; Friends ; Humans ; Internet* ; Male

Melanocytic nevus is the benign proliferation of melanocytes. The most common location of melanocytic nevus is the skin of the extremities; however, there are few case reports of melanocytic nevus at the rectal mucosa. No prior case of malignant melanoma from melanocytic nevus at the rectal mucosa has been reported; therefore, it is unclear whether resection should be performed or close observation is sufficient. However, the potential malignant transformation of melanocytic nevus should be considered, including melanocytic nevus on the rectum. Melanocytic nevus of the skin can be removed by surgical excision; however, due to rare incidence on the mucosa of the gastrointestinal tract, the optimal treatment for rectal melanocytic nevus remains controversial. Here, we report the first case of melanocytic nevus on the rectal mucosa that was removed by endoscopic submucosal dissection. This case report provides useful information about the optimal management of rectal melanocytic nevus.
Extremities ; Gastrointestinal Tract ; Incidence ; Melanocytes ; Melanoma ; Mucous Membrane* ; Nevus, Pigmented* ; Rectum ; Skin

OBJECTIVES: The research was aimed at analyzing the contents of university intranet for systematically execution of the healthy information provision and healthy consultation services from 2000 January to 2004 December. METHODS: We have analyzed 300(28.3%) the instances of accomplished health consultation cases from the whole 1,059 instances which were the replied in a university intranet. RESULTS: According to the contents of health consultation in ICPC code, a general symptom 91 cases(30.3%) was most, muscle-skeletal system 44 cases(14.7%), and digestive system 43 cases(14.3%) in order of cases of health counselling. The symptoms and complaint with 155 cases(51.7%) were most in the distribution of the health counselling contents by 17 charter of ICPC. The most common reason of counselling by 17 charter of ICPC were as follows; questions about the symptom and diagnosis(118 cases, 39.3%), the preventive and treatment methods(91 cases, 30.0%), and medical fee(20cases, 6.7%) in order. We mainly answer on the content of health counselling were as follows; make an offer of medical information and knowledge(48.3%), recommend visit clinic or hospital(23.7%), guide to treatment(12.7%), and so on. CONCLUSIONS: This research showed that the program of health counselling may not meet completely the high quality and adequate distribution of health counselling by the intranet in a university by content analysis. The finding suggests that health counselling by intranet in a university may be used to supplement of systemic improvement on the intranet Q/A format from current lack of essential health information and security for the quality of the health counselling.
Computer Communication Networks* ; Counseling* ; Digestive System

Background/Aims: This study evaluated the long-term cardiovascular complications among Korean patients with hypertension and compared them with that of controls without hypertension. Methods: The Korean Hypertension Cohort (KHC) enrolled 11,043 patients with hypertension and followed them for more than 10 years. Age- and sex-matched controls without hypertension were enrolled at a 1:10 ratio. We compared the incidence of cardiovascular events and death among patients and controls without hypertension. Results: The mean age was 59 years, and 34.8% and 16.5% of the patients belonged to the high and moderate cardiovascular risk groups, respectively. During the 10-year follow-up, 1,591 cardiovascular events (14.4%) with 588 deaths (5.3%) occurred among patients with hypertension and 7,635 cardiovascular events (6.9%) with 4,826 deaths (4.4%) occurred among controls. Even the low-risk population with hypertension showed a higher cardiovascular event rate than the population without hypertension. Although blood pressure measurements in the clinic showed remarkable inaccuracy compared with those measured in the national health examinations, systolic blood pressure (SBP) ≥ 150 mmHg was significantly associated with a higher risk of cardiovascular events. Conclusions This long-term follow-up study confirmed the cardiovascular event rates among Korean hypertensive patients were substantial, reaching 15% in 10 years. SBP levels ≥ 150 mmHg were highly associated with occurrence of cardiovascular event rates.