BACKGROUND/AIMS: Colonic diverticular bleeding cases account for 30-40% of the lower gastrointestinal bleeding, among which, 3-5% appear to be massive bleeding. The purpose of this study was to evaluate the risk factors for colonic diverticular bleeding diagnosed by colonoscopic examination. METHODS: Among the 1,003 patients, who were identified to have colonic diverticulosis including sleeding by diverticulitis and diverticular bleeding coding search, 216 patients had diverculosis, and they were divided into two groups: one with diverticular bleeding, and the other without bleeding. We evaluated the potential risk factors for diverticular bleeding, based on age, gender, location of diverticulum, comorbidities related to atherosclerosis, smoking, alcohol and medications, and compared them between both groups. RESULTS: Among the 216 patients, we observed colonic diverticular bleeding in 35 patients (16.2%). The mean age of the bleeding group was significantly older than that of non-bleeding group. No difference was observed regarding gender ratio. Right colonic diverticula were common in both groups, but there were higher proportion of patients with bleeding in bilateral diverticuosis. Old age, bilateral diverticulosis, presence of atherosclerosis related diseases (hypertension, diabetes mellitus, ischemic heart disease, obesity), use of aspirin, NSAIDs and calcium channel blocker, increased the risk of bleeding. In a multivariate analysis, use of aspirin and bilateral diverticulosis were identified as independent risk factors for colonic diverticular bleeding. CONCLUSIONS: Since the patients who took aspirin and/or had bilateral colonic diverticulosis increased the risk of bleeding from divertuculi. As such, caution and education of patients are required.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Aspirin/therapeutic use ; Calcium Channel Blockers/therapeutic use ; Colonic Diseases/*etiology ; Colonoscopy ; Diabetes Complications ; Diverticulum, Colon/*epidemiology ; Female ; Gastrointestinal Hemorrhage/epidemiology/*etiology ; Humans ; Hypertension/complications/drug therapy ; Logistic Models ; Male ; Middle Aged ; Myocardial Ischemia/complications ; Obesity/complications ; Odds Ratio ; Risk Factors

BACKGROUND/AIMS: The purpose of this study was to evaluate the efficacy and tolerability of dual therapy consisting of esomeprazole and amoxicillin as a rescue therapy for Helicobacter pylori infection. METHODS: From December 2009 to August 2010, 21 patients who experienced two consecutive eradication failures were included. They received esomeprazole (40 mg, b.i.d.) and amoxicillin (1,000 mg, b.i.d.) for 14 days as a third eradication regimen. Compliance and side effects were determined from an interview. H. pylori status was evaluated using the 13C urea breath test at least 6 weeks after treatment. RESULTS: The mean age of the patients was 59 years and included 52% males. Indications for treatment were functional dyspepsia (61.9%), peptic ulcer disease (28.6%), and gastric adenoma (9.5%). H. pylori was eradicated in 14 of 21 (66.7%) patients. Minor side effects were reported in three of the 21 patients (14.3%). These side effects consisted mainly of nausea and epigastric discomfort. CONCLUSIONS: A 2-week course of dual therapy failed to show satisfactory results in third-line H. pylori eradication, but it was very safe and tolerable. Therefore, dual therapy constitutes an encouraging empirical strategy for the elderly and infirm patients with multiple previous eradication failures.
Adenoma ; Aged ; Amoxicillin ; Breath Tests ; Compliance ; Dyspepsia ; Esomeprazole Sodium ; Helicobacter ; Helicobacter pylori ; Humans ; Male ; Nausea ; Peptic Ulcer ; Urea

BACKGROUND/AIMS: The purpose of this study was to evaluate the efficacy and tolerability of dual therapy consisting of esomeprazole and amoxicillin as a rescue therapy for Helicobacter pylori infection. METHODS: From December 2009 to August 2010, 21 patients who experienced two consecutive eradication failures were included. They received esomeprazole (40 mg, b.i.d.) and amoxicillin (1,000 mg, b.i.d.) for 14 days as a third eradication regimen. Compliance and side effects were determined from an interview. H. pylori status was evaluated using the 13C urea breath test at least 6 weeks after treatment. RESULTS: The mean age of the patients was 59 years and included 52% males. Indications for treatment were functional dyspepsia (61.9%), peptic ulcer disease (28.6%), and gastric adenoma (9.5%). H. pylori was eradicated in 14 of 21 (66.7%) patients. Minor side effects were reported in three of the 21 patients (14.3%). These side effects consisted mainly of nausea and epigastric discomfort. CONCLUSIONS: A 2-week course of dual therapy failed to show satisfactory results in third-line H. pylori eradication, but it was very safe and tolerable. Therefore, dual therapy constitutes an encouraging empirical strategy for the elderly and infirm patients with multiple previous eradication failures.
Adenoma ; Aged ; Amoxicillin ; Breath Tests ; Compliance ; Dyspepsia ; Esomeprazole Sodium ; Helicobacter ; Helicobacter pylori ; Humans ; Male ; Nausea ; Peptic Ulcer ; Urea

PURPOSE: The purpose of this study was to identify the factors influencing file-up family stress in the family with a family member having a chronic mental illness. METHOD: Data was collected by questionnaires from 365 families with a member having a chronic mental illness, in an outpatient clinic of a General Hospital and Government Psychiatric Hospital in Seoul. The data was analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. RESULT: The score of file-up stress showed a significantly negative correlation with the score of level of hardiness (r=-.31, p=.00), family support (r=-.13, p=.00), family cohesion (r=-.25, p=.00), and sense of coherence (r=-.26, p=.00). The most powerful predictor of file-up stress was family hardiness and the variance was 11.1%. A combination of hardiness, family support, and sense of coherence account for 14.8 % of the variance in file-up stress of the family with a member having a chronic mental illness. CONCLUSION: This study suggests that family support, hardiness, cohesion, and sense of coherence are significant influencing factors on file-up stress inthe family with a member having a chronic mental illness.
Adolescent ; Adult ; Caregivers/*psychology ; Chronic Disease ; *Family ; Female ; Humans ; Male ; *Mental Disorders ; Middle Aged ; Stress, Psychological/*etiology

PURPOSE: This study was to identify the relationship between stress, social support and depression in the elderly. METHOD: The subjects were 283 elderly adults over 60 in Seoul. Data was collected by questionnaire surveys using convenience sampling. The instruments used in this study are the ELSI developed by Aldwin(1990), the Interpersonal Support Evaluation List developed by Cohen & Hoberman (1983), and the Geriatric Depression Scale by Yesavage & Brink(1982). Data was analyzed by the SAS program, using descriptive statistics, Pearson Correlation Coefficient, t-test, ANOVA and progressed Multiple Regression. RESULT: The relationship between stress and depression had a positive correlation (r= 0.33), but the relationship between stress and social support had no significant correlations. The relationship between social support and depression had a negative correlation (r= -0.38). The most powerful predictor of depression was the economic status and then a combination of stress, and social support account for 39% of the variance in depression in the elderly. CONCLUSION: These results suggested that stress and social support deficits can be potential risk factors in old age depression. Therefore, these findings give useful information for constructing an intervention program focused on depression in the elderly.
Aged ; Depression/*etiology ; Female ; Humans ; Korea ; Male ; Middle Aged ; *Social Support ; Stress, Psychological/*complications

PURPOSE: This study was to identify the relationships of trait anger, mode of anger expression, and perceived stress to mental health status in middle aged women. METHOD: The subjects were 157 middle aged women from 40s to 60s who lived in Seoul. Data was collected by questionnaire surveys using the convenience sampling. The instruments used for this study were Spielberger's trait anger scale and anger expression scale, Cohen, Kamarck, and Mermelstein's perceived stress and Derogatis's SCL-90-R. The collected data was analyzed using descriptive statistics, Pearson correlation coefficient, and Stepwise multiple regression with SAS/PC. RESULT: The trait anger of middle aged women indicated a significantly positive correlation to perceived stress(r=.180, p=.023) and mental health status(r.=021, p=.014). Anger-in(r=.237, p<.05), and perceived stress(p=.461, p<.01) showed significantly positive correlation to mental health status. The most significant predictor influencing health status of middle aged women was perceived stress, and anger-in and the variance explained was 27%. CONCLUSION: These results suggested that middle aged women with high degree of trait anger is likely to be high in stress perception. Perceived stress and anger-in are major factors influencing mental health status.

PURPOSE: The purpose of this study was to investigate the relationships among variables of transtheoretical model for exercise in the elderly. METHOD: A hypothetical model explaining the stage of change was constructed based on a transtheoretical model. Empirical data for testing the hypothetical model was collected from 246 old adults over 65 years old in a community settings in Seoul, Korea in June and July, 2000. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling(LISREL) 8.0 program was used to find the best fit model which explain causal relationship of variables. RESULT: The fitness of modified model to the data was X2= 96.75(df=49, p=.00005), GFI= .98, NFI=.99, AGFI=.95, NNFI=.99. The the predictable variables of stage of change explained 64% of stage of change for exercise. CONCLUSION: Results are consistent with the studies of application of the transtheoretical model, which has been used to understand how people change health behaviors. The findings of this study give useful informations to construct exercise intervention program for the elderly about relationships among variables influencing to the stage of change of exercise.
Adult ; Aged* ; Health Behavior ; Humans ; Korea ; Seoul

PURPOSE: The purpose of this descriptive study was to identify the nursing needs of patients with chronic illness. METHOD: The subjects of this study were 636 patients with chronic illness, 323 general nurses, and 106 public health nurses. The instruments used for this study were questionnaires including perceived functions of nursing from the center for chronic illness, preference to placement, intention to use, needs to receive services from the center for chronic illness, strategies management for nursing, and nursing needs of chronically ill patients. RESULTS: The mean of perceived functions for nursing from the center were 3.1(0.5) in public health nurses, 2.9 (0.59) in general nurses, and 2.4(1.33) in chronically ill patients. Regards of needs to receive on services of the nursing centers were, the regularly physical examination, for health educational services which was perceived highest request amongst chronically ill patients. We found the means of each specific need as 2.2(0.6), for physical health, 2.1(0.7), for psychosocial health, and 1.8(0.6) for spiritual health. CONCLUSION: From the results of this study, it is suggested that establishing a nursing center for chronically ill patients consider physical, psychosocial, for spiritual health needs of chronically ill patients. It is also a consideration that direct care for symptom management and health education in the nursing center be implemented.
Chronic Disease* ; Health Education ; Humans ; Intention ; Nurses, Public Health ; Nursing* ; Physical Examination ; Surveys and Questionnaires

PURPOSE: This study was designed to construct a structural model for health promoting behavior of patients with chronic disease. The hypothetical model was developed based on the literature review and Pender's health promotion model. METHOD: Data was collected by questionnaires from 1748 patients with chronic disease in General Hospital from December 1999 to July 2000 in Seoul. The disease of subject were cardiac disease included hypertension peptic ulcer, pulmonary disease included COPD and asthma, DM, and chronic kidney disease. Data analysis was done with SAS 6.12 for descriptive statistics and PC-LISREL 8.13 Program for Covariance structural analysis. RESULTS: 1. The fit of the hypothetical model to the data was moderate, it was modified by excluding 4 path and including free parameters to it. The modified model with path showed a good fitness to the empirical data (x2=591.83, p<.0001, GFI=0.97, AGFI= 0.94, NNFI=0.95, RMSR=0.01, RMSEA=0.05). 2. The perceived benefits, perceived barriers, self-efficacy, self-esteem, and the plan for action were found to have significant direct effect on health promoting behavior of chronic disease. 3. The health concept, health perception, emotional state, social support were found to have indirect effects on health promoting behavior of chronic disease. CONCLUSION: The derived model in this study is considered appropriate in explaining and predicting health promoting behavior of patients with chronic disease. Therefore, it can effectively be used as a reference model for further studies and suggested implication in nursing practice.
Asthma ; Chronic Disease* ; Health Promotion ; Heart Diseases ; Hospitals, General ; Humans ; Hypertension ; Lung Diseases ; Models, Structural* ; Nursing ; Peptic Ulcer ; Pulmonary Disease, Chronic Obstructive ; Surveys and Questionnaires ; Renal Insufficiency, Chronic ; Seoul ; Statistics as Topic

The purpose of this study was to investigate the factors influencing social adaptation of chronic mental illness. The subjects of this study were 190 patients, over the age of 20 with chronic mental illness diagnosed by a physician, and living in Seoul, Korea during May, 2000 to December 2000. The instruments for this study were the social adaptation scale by Wallace (1979), the self-esteem scale by Rogenberg (1965), social support scale by ParkJiWon (1985), coping behavior scale by Shirley Zeitlin (1978), self efficacy scale by Sherer et. al (1982), and Rand mental health inventory(1979). The data were analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. The results of this study are as follows: 1. The level of social adaptation showed moderate (M=3.43). 2. The social adaptation showed significant positive correlation with self-esteem (r=0.39, p=0.00), self-efficacy (r=0.31, p=0.00), social support (r=0.47, p=0.00), self-productive coping (r=0.14, p=0.05), self-flexible coping (r=0.22, p=0.00), environment-active coping (r=0.21, p=0.00), and environment-flexible coping (r=0.14, p=0.04). The social adaptation showed significant negative correlation with anxiety (r=-0.16, p=0.02), and emotional problems (r=-0.18, p=-0.00). 3. The stepwise multiple regression analysis revealed that the most powerful predictor of social adaptation was social support (21%). A combination of social support, depression, behavioral controllability, self-efficacy, and environmental coping behavior accounted for 39% of the variance in social adaptation in chronic mental illness. From the results of this study, it is suggested to develop and apply a social adaptation training program for chronic mental illness.
Adaptation, Psychological ; Anxiety ; Depression ; Education ; Humans ; Korea ; Mental Health ; Self Efficacy ; Seoul