BACKGROUND: The purpose of this study was to identify predictive factors for preventive behaviors of falls in elderly inpatients. METHODS: Data on 200 elderly inpatients at one university hospital were collected. Descriptive analysis, independent t-test, analysis of variance, and stepwise multiple regression analysis were done to analyze the data. RESULTS: The high risk group, scoring higher than 5.0 in the degree of self-awareness of fall risk, scored low in knowledge about falls while subjects with activity limitations and not using hearing aids scored significantly high in the same area. Subjects with no training regarding falls and the high risk group scored low in fall efficacy while subjects with activity limitations and using hearing aids scored significantly high in the same area. The degree of self-awareness of fall risk, knowledge about falls, and fall efficacy were significant factors affecting fall prevention activities. CONCLUSIONS: These findings suggest that self-awareness of the risk of falls, knowledge about falls, and fall efficacy are significant factors in preventing falls. These factors should be considered when developing nursing assessment tools and intervention programs for elderly inpatients.
Accidental Falls ; Aged ; Hearing Aids ; Humans ; Inpatients ; Nursing Assessment

Eleven patients underwent posterior sagittal anorectoplasty(PSARP) as a secondary procedure. Two of them had rectovaginal fistula and another two had rectocutaneous fistula. Six of the rest complained of frequent fecal soiling and the last one had severe anorectal stricture after perineal anoplasty. Five patients had lived with colostomy until the second operations were carried out. The ages at the time of the secondary PSARP were between 7 months and 29 years. Distal colostogram and MRI were taken to evaluate distal colon, position of the rectum and voluntary muscle. All patients had normal sacrum except one who had anorectal stricture. Seven patients, six with fecal incontinence and the other one with rectovaginal fistula had mislocated anorectums. Three patients, two with rectocutaneous fistula, the other one with anorectal stricture, had abdominal approach to obtain enough length of colon for pull-through procedure. With the posterior midsagittal approach, we could manage all the problems, rectovaginal fistulas, rectocutaneous fistulas, strictures and malpositioned rectums, without difficulty. No patients had serious complications except wound infection in one. All patients were satisfied with the results after redo-PSARPs even though normal continence has been achieved in only one patient. Seven patients who had continuous soiling or rectocutaneous fistula, needed no more diapers even though four of them showed fecal staining under stressful condition and the other three showed intermittent fecal leaking less than once a day. The rest three of the patients maintained their continence with support of drugs and/or enemas because of constipation. The PSARP is a popular procedure as a primary operation; however, our results suggested that this procedure also gave us a good opportunity for management of serious complication developed after primary anoplasties.
Colon ; Colostomy ; Constipation ; Constriction, Pathologic ; Enema ; Fecal Incontinence ; Fistula ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Rectovaginal Fistula ; Rectum ; Sacrum ; Soil ; Wound Infection

PURPOSE: To ascertain the factors associated with the proportion of death certificate only (DCO) cases contained in the Kwangju Cancer Registry (KCR) that are not as yet in the good range. MATERIALS AND METHODS: The distribution of DCO cases was analyzed by sex, age, cancer site, histological verification (HV) as well as the physician's death certificate status. RESULTS: All cases (n=4,243) in Kwangju diagnosed as having cancer between 1997 and 1998 were registered with the KCR. Death certificates (n=2,390) reporting cancer as the causes of death were collected from the National Statistics Office and reviewed with hospital data linkage and a total of 590 cases were registered as DCO. DCOs accounted for 12.2% (male 12.8%, female 11.5%) of all registrations in Kwangju, 1997~1998. The proportion of DCO cases was high in subjects under 15 (male13.5%,female 9.4%) as well as those 75 and over (male 20.3%, female 27.2%). For cancer sites, the proportion of DCO cases was high (over 10%) for liver, bronchus-lung, esophagus and pancreas and low (under 3%) for skin, bladder, uteri cervix and breast. The proportion of DCO cases was inversely associated with HV%. When the death certificate was issued by physician, the possibility of DCO decreased. CONCLUSION: The proportion of DCO is positively associated with increasing age and negatively associated with HV% and the issuance of a physician's death certificate. These findings suggest that further socio-cultural efforts are required to reduce the DCO proportion.
Breast ; Cause of Death ; Cervix Uteri ; Information Storage and Retrieval ; Death Certificates* ; Esophagus ; Female ; Gwangju* ; Humans ; Korea ; Liver ; Pancreas ; Skin ; Urinary Bladder ; Uterus

No abstract available.
Disabled Persons* ; Female ; Humans ; Menarche*

No abstract available.

One hundred eighty infants with oxygen therapy who were under 2,500gm birth weight or under 37 weeks of gestational age, were examined between January 1990 and November 1992. We performed clnical analysis and results were as follows. 1) Fifty six infants (31.1%) were diagnosed as retinopathy of prematurity. 2) The first examination was performed at 2.5 weeks of life on average, and the retinopathy of prematurity was diagnosed at 3.8 weeks on average. 3) The incidence of retinopathy of prematurity was highly associated with low birth weight (< or =1,890 gm), low gestational age ( < or =33.1 weeks), and high oxygen concentration with long duration (FiO2> or =0.4 over 1 week)(P<0.005). 4) Other associated risk factors were idiopathic respiratory distress syndrome, anemia, neonatal hypoxia and sepsis.
Anemia, Neonatal ; Anoxia ; Birth Weight ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Oxygen ; Retinopathy of Prematurity* ; Risk Factors ; Sepsis

The medical curriculum is designed to provide a core of scientific knowledge and technical skills that ultimately enables a student to care for primary patients. In addition to specific knowledge, the school offers an environment in which students have the opportunity to acquire the habits of study, the sound attitud, and the sense of responsibility for patients that characterize the true physician. To achive these purposes, the clerkship of medical student is very important. We investigated current problems in clinical clerkship of Chonnam University Medical School, and the problems were as follow: (1) relatively short period of clinical training especially in main subjects, (2) lack of presonnels in charge of clinical training, (3) lack of objective test, (4) lack of clinical training in primary care hospital, (5) lack of opportunity of self learning. The methods to improve clinical training were to promote interests in clinical education of staffs, to prolong the duration of clinical clerkship, to select and educate the personnel in charge of clinical education, to do the objective tests, to do the elective tests, to do the elective course, to use of integrated course and problem oriented education, and to let the student care the patients under supervision.
Clinical Clerkship ; Curriculum ; Education ; Education, Medical ; Humans ; Jeollanam-do ; Learning ; Linear Energy Transfer ; Organization and Administration ; Primary Health Care ; Schools, Medical ; Students, Medical*

No abstract available.
Foreign Bodies* ; Granuloma, Foreign-Body* ; Lipectomy*

covered with liguid nitrozen and pulverized with a pestle. To the powered tissue 5ml of 3.3M formic acid/0.5% Tween 20 was added and centrifuged at 40,000*g for 10 min. An aliquot of supernate was put into C18 sepak minicolumn to eliminates IGF-BPs. Measurement of IGF-I in rat tissues was done by RIA with anti-hIGF-I antibody and hIGF-I(PSIII) standard which was prepared by Drs. L. E. Underwood and J. J. Van Wyk UNC at Chapel Hill, NC, USA and distributed through the National Hormone and Pituitary Distribution Program. Distribution of IGF-I in rat tissue was seen by SDS-PAGE and ligand blotting method. A cDNA library in lambda gt11 of rat liver was used to isolate the cDNA of IGF-I. Phage containing inserts encoding rat IGF-I were identified by hybridization with biotin labeled synthesized oligomer which was the sequence from 1 to 8 aminoacids of known rat IGF-I. The EcoRI inserts were subcloned into PBluescript SK. The nucleotide sequence of both strands was determined by the dideoxy chain termination method. RESULTS: 1)IGF-BPs in tissue extract which could compete with antibody for IGF-I in measureing the IGF-I were eluted at 50Kdalton molecular weight marker using Protein-pak 300SW column. Using C18-sepak minicolumn, IGF-BPs were completely eliminated from tissue extract as much as possible, using Protein-pak 300SW column. 2)The amount of IGF-I in tissues was as folows: liver 575+/-41.6ng/g, lung 552.0+/-40.8ng/g. kidney 503+/-30.8ng/g, heart 449.0+/-30.4ng/g, testis 225+/-18.8ng/g, spleen 146+/-26.4ng/g, muscle 92+/-7.6ng/g and brain 49.0+/-5.8ng/g. The amount of IGF-I in blood was 1403+/-60.8ng/ml. 3)Banding patterns of IGF-BPs in rat tissues extract were obtained using ligand blotting. IGF-BP3 bands at 50 Kdalton molecular weight marker were strongly shown in testis, heart, and lung extracts but not in brain and muscle. IGF-BP1 and 2 band at 30Kdalton molecular weight marker was strongly shown in liver, kidney, spleen, testis, heart and lung. IGF-BP4 band at 21 Kdalton molecular weight marker was weakly shown only in spleen and muscle. 4) The nucleotide sequence of cloned cDNA of rat IGF-I is as follows. 5 10 15 5'----- CC CTT TGC GGG GCT GAG CTG GTG GAC GCT CTT CAG TTC GTG TGT 20 25 30 -GGA CCA AGG GGC TTT TAC TTC AAC AAG CCC ACA GGC TAT GGC- 35 40 45 -TCC AGC ATT CGG AGG GCA CCA CAG ACG GGC ATT GTG GAT GAG------3 CONCLUSION: This study suggests that tissue extraction method for IGF-I from tissues and elimination of IGF-BPs using C18 sepak minicolumn is suitable for measuring in large numbers of samples. Expression of IGF-I and IGF-BPs in multiple tissues suggests some phsiologic function at each tissue level. Subcloning of cDNA of exon 3 and 4 of IGF-I was useful for studying regulation of IGF-IA and IB mRNA in rat tissue.
Animals ; Bacteriophages ; Base Sequence ; Biotin ; Brain ; Carrier Proteins* ; Clone Cells ; DNA, Complementary ; Electrophoresis, Polyacrylamide Gel ; Exons ; Gene Library ; Heart ; Insulin-Like Growth Factor I* ; Kidney ; Liver ; Lung ; Molecular Weight ; Polysorbates ; Rats* ; RNA, Messenger ; Spleen ; Testis

BACKGROUND: Clonidine, which is known to have analgesic and sedative properties, has recently been shown to be an effective preanesthetic medication in humans. The drug may cause side effects, including bradycardia and hypotension. This study was conducted to evaluate the ability of intravenous atropine to increase the heart rate (HR) in awake adults receiving clonidine preanesthetic medication. METHODS: We studied HR responses to intravenous atropine in 45 patients assigned randomly to either a control group, who received no medication (group 1, n=15), or clonidine groups, who received oral clonidine of 2~2.5 mcg/kg (group 2, n=15), or 4.5~5 mcg/kg (group 3, n=15) 90 min before scheduled induction of anesthesia. When HR and blood pressure had been confirmed to be stable in operating room, all patients received incremental doses of atropine, 2.5, 2.5 and 5 mcg/kg at 2-min intervals. The HR and mean arterial pressure were recorded at 1-min intervals. RESULTS: Before atropine injection, the HR decreased significantly (P<0.05) in group 3. The increases in HR in response to a cumulative dose of atropine 10 mcg/kg were 21+/-8, 17+/-7 and 7+/-5 beats/min (mean+/-SD) in group 1, 2 and 3, respectively (P<0.05). The positive chronotropic response to intravenous atropine was attenuated significantly only in group 3 (P<0.01). CONCLUSIONS: It was concluded that oral clonidine of 4.5~5 mcg/kg decreased HR significantly, and blunted the increase in HR after intravenous atropine in awake adults although oral clonidine of 2~2.5 mcg/kg did not.
Adult* ; Anesthesia ; Arterial Pressure ; Atropine* ; Blood Pressure ; Bradycardia ; Clonidine* ; Heart Rate* ; Heart* ; Humans ; Hypotension ; Operating Rooms ; Preanesthetic Medication