PURPOSE: This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes. METHODS: A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0. RESULTS: Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups. CONCLUSION: These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population.
Aged* ; Blood Glucose ; Cholesterol ; Diabetes Mellitus ; Fasting ; Health Education ; Humans ; Linear Models ; Mentors* ; Motor Activity ; Self Care ; Statistics as Topic ; Triglycerides ; Vulnerable Populations

To investigate the pattern of drug-resistance of human influenza virus (A/H1N1) isolated in Korea during 2001~2002, the sequence analysis of hemagglutinin (HA) and neuraminidase (NA) genes and cell-based assay against neuraminidase inhibitor (NI) were performed. Analyses on the nucleotide sequences of NA genes showed that Korean isolates had 98.2 to 98.5% homology with that of the vaccine strain in 2001~2002 season, A/New Caledonia/20/99-like strain. However, there were no significant amino acid substitutions related to the drug-resistance such as E119V, R152K, I222R/Q, H274Y, and R292K. In the sequences of HA gene, no differences were observed on the major antigenic sites as well as the motifs related to the drug resistance. 50% inhibitory concentration (IC50) value against oseltamivir, one of NA inhibitors widely used in the treatment for the influenza, was determined by WST-1 assay. The SI values of Korean isolates against oseltamivir were 7.2 to 383.3, showing that these isolates displayed relatively low SI value against the drug. This result provides the useful information for the surveillance of drug-resistant influenza virus and the control of influenza in Korea.
Amino Acid Substitution ; Base Sequence ; Drug Resistance ; Hemagglutinins* ; Influenza, Human* ; Korea* ; Neuraminidase* ; Orthomyxoviridae* ; Oseltamivir* ; Seasons ; Sequence Analysis

BACKGROUND: Brief intervention with problem drinkers have been shown to be effective, but physicians often do not ask about alcohol use because of time constraints and lack of knowledge. If a sin gle question can be used to screening for problem drinker effectively, primary care physicians could detect problem drinker earlier and reduce future complication and morbidity. The purpose of this study was to evaluate the usefulness of single question. METHODS: One family medicine's resident interviewed 163 patients who visited Dongdaemun Hospital's Health care management center of Ewha Woman's university from January 27th 1999 to February 26th 1999, and the patients answered the written forms of questionnares. This written forms contained the followings: (1) age, sex, education, income level, occupation, smoking, drunken driving, (2) "On any single occasion during the past 3 months have you had more than a bottle of Soju or three bottles of beer or five glasses of whisky?" (3) CAGE, NAST test. Quantity of alcohol was determined by the calendar based review in the past 4 weeks. At risk drinker defined as drinking more than 56 g on one occasion, or more than 196 g of pure alcohol during a week for men ; more than 42 g on one occasion, or more than 98 g of pure alcohol during a week for women. Also alcohol use disorder was defined by the DSM IV criteria and problem drinker was defined as either at risk drinker or a alcohol use disorder. RESULTS: The single question had a positive predictive value of 82.2%, and negative predictive value of 95.5% with a sensitivity of 93.8% and a specificity of 86.9% for problem drinkers. CONCLUSION: A single question about alcohol use would be a effective tool for detecting problem drinker.
Beer ; Delivery of Health Care ; Drinking ; Education ; Eyeglasses ; Female ; Glass ; Humans ; Male ; Mass Screening ; Occupations ; Physicians, Primary Care ; Sensitivity and Specificity ; Smoke ; Smoking

BACKGROUND: Previous data have been reported that subtype B is prevalent in South Korea, but neither the extent nor the proportion of subtypes could be evaluated. This study was designed to analyze the distribution of HIV-1 subtypes, temporal instructions and transmission dynamics between epidemiological groups. METHODS: 1,280 Koreans had been diagnosed as HIV seropositive during the period 1985 to 2000. Among them, 134 individuals were selected for this molecular epidemiological study. 134 DNAs were isolated from uncultured or cultured peripheral blood mononuclear cells. V3-V5 (0.7 kb) fragment of HIV-1 env gene was amplified by nested polymerase chain reaction and was sequenced. RESULTS: HIV-1 isolates from thirty-seven homosexuals were all subtype B (100%). On the other hand, 66 isolates from 94 heterosexuals were subtype B (70%) and 28 were non B subtypes (30%:13 A, 4 C, 2 D, 8 E, 1 G). Only subtype B strains were isolated from 73 males who were infected with HIV inside Korea while 16 B and 20 non B subtype strains were isolated from 36 males who were HIV infected outside of Korea. However, B and non B strains were isolated half and half from females who were infected inside Korea except one. CONCLUSION: The HIV-1 subtype B strains are prevalent in Korea from the early HIV infection until present in both homo and heterosexuals. Non B strains have been transmitted from men who were infected outside Korea to their spouses and casual partners. So, we need further study to monitor subtype B and non B HIV transmission in epidemiological groups of Korea.
DNA ; Female ; Genes, env ; Hand ; Heterosexuality ; HIV ; HIV Infections ; HIV-1* ; Hominidae ; Homosexuality ; Humans ; Korea* ; Male ; Molecular Epidemiology ; Polymerase Chain Reaction ; Spouses

BACKGROUND: Upper respiratory infections account for many of the visits in primary care. As most URIs are caused by viruses, antibiotic therapy is not desirable. However, for URI treatment antibiotic therapy is commonly used, which causes many public health problems such as drug resistant bacteria and high medical cost. This paper examines patient knowledge of the normal presentation of a URI, beliefs in the effectiveness of antibiotics and health care utilization. METHODS: A survey of 200 outpatients or their families was conducted in one university hospital from March to April, 1998. Two URI conditions were given for the survey:(1) a condition of 5 days' duration with a cough, sore throat, and clear nasal discharge (question 1), (2) a condition of the same symptom as (1) except a discolored nasal discharge (question 2). For various questions in each of these conditions they were to answer in 5 point Likert type scale. Statistical softwares of SAS 8.0 and GAUSS 3.21 were used for analyzing the survey data. RESULTS: For question 1, 61 % of the sample reported that they would seek care from a physician while for question 2, 75 % of the sample reported that they would do so (p<.01). The health service suppliers, in the order of visiting frequencies, were pharmacy (58 %), hospital (38 %), no visit (2.5 %), public health center (0.5 %), and Chinese medicine clinic (0.5 %) for question 1 and pharmacy (54 %), hospital (42 %), no visit (2 %), Chinese medicine clinic (0.5 %) and public health center (0.0 %) for question 2. For question 1, 54 % of the sample and for question 2, 63 % reported that they believe antibiotics were effective (p=.068). For question 1, 79.5 % and for question 2, 89.5 % of the subjects reported that they had complied to prescriptions of doctors or pharmacists (p<0.05). Out of those subjects, only 19.5 % for question 1 and 21.2 % for question 2 reported that they checked the presence of antibiotics in the prescriptions. A multivariate analysis shows that older people, normally used antibiotics and current smokers had higher tendency of seeking care and stronger beliefs in the effectiveness of antibiotics. CONCLUSION: There is a lack in patient understanding of normal presentation of a URI and the effectiveness of antibiotics as a treatment. A confusion about the meaning ofa discolored nasal discharge is particularly evident. The patients visited pharmacies more often than hospitals, and majority of them (80 %) did not know the details of their prescriptions.
Anti-Bacterial Agents* ; Asian Continental Ancestry Group ; Bacteria ; Cough ; Delivery of Health Care ; Health Services ; Humans ; Multivariate Analysis ; Outpatients ; Pharmacies ; Pharmacists ; Pharmacy ; Pharyngitis ; Prescriptions ; Primary Health Care ; Public Health ; Respiratory Tract Infections*

Intracellular accumulation of bile acids in the hepatocytes during cholestasis is thought to be pathogenic in cholestatic liver diseases. The objective of this study was to determine the role of lipid peroxidation and glutathione on the bile acid-induced hepatic cell death mechanism in primary cultured rat hepatocytes. To induce hepatic cell death, we incubated primary cultured rat hepatocytes with glycochenodeoxycholic acid (GCDC; 0~400 micrometer) for 3 hours. In electron microscopic examination and agarose gel electrophoresis, low concentration of GCDC treatment mainly induced apoptotic feature. Whereas 400 micrometer GCDC treated cells demonstrated both apoptosis and necrosis. Lipid peroxidation was increased dose-dependently in GCDC treated hepatocyte. And this was also accompanied by decreased glutathione. Therefore, oxygen free radical damage may play a partial role in GCDC-induced hepatic cell death.
Animals ; Apoptosis ; Bile ; Bile Acids and Salts ; Cell Death* ; Cholestasis ; Electrophoresis, Agar Gel ; Glutathione* ; Glycochenodeoxycholic Acid ; Hepatocytes* ; Lipid Peroxidation* ; Liver Diseases ; Necrosis ; Oxygen ; Rats*

Intracellular accumulation of bile acids in the hepatocytes during cholestasis is thought to be pathogenic in cholestatic liver injury. Due to the detergent-like effect of the hydrophobic bile acids, hepatocellular injury has been attributed to direct membrane damage. However histological findings of cholestatic liver diseases suggest apoptosis can be a mechanism of cell death during cholestatic liver diseases instead of necrosis. To determine the pattern of hepatocellular toxicity induced by bile acid, we incubated primary cultured rat hepatocytes with a hydrophobic bile acid, Glycochenodeoxycholate (GCDC), up to 5 hours. After 5 hours incubation with 400 muM GCDC, lactate dehydrogenase released significantly. Cell viability, quantitated in propidium iodide stained cells concomitant with fluoresceindiacetate was decreased time-and dose-dependently. Most nuclei with condensed chromatin and shrunk cytoplasm were heavily labelled time- and dose-dependently by a positive TUNEL reaction. These findings suggest that both apoptosis and necrosis are involved in hepatocytes injury caused by GCDC.
Animals ; Apoptosis* ; Bile ; Bile Acids and Salts ; Cell Death* ; Cell Survival ; Cholestasis ; Chromatin ; Cytoplasm ; Glycochenodeoxycholic Acid* ; Hepatocytes* ; In Situ Nick-End Labeling ; L-Lactate Dehydrogenase ; Liver ; Liver Diseases ; Membranes ; Necrosis* ; Propidium ; Rats*

BACKGROUND: The waist/hip ratio in an useful index of abodominal obesity, but it includes two variables which may result in a false interpretation. The purpose of this study is to evaluate the usefulness of waist/height ratio as a predictor for the risk factors of coronary artery disease(CAD). METHODS: 1,395 persons(818 men & 577 women) were selected as subjects who visited the Health Examination Center at Ewha Mokdong Hospital from October 1998 to March 1997. Waist circumference was measured at the level of umblicus with standing position. Hip circumference was measured at the level of the largest circumference of the hip. We set the criteria if the risk factors as hypertension(systolic BP > OR = 140mmHg and/or diastolic BP > OR = 90mmHg), glucose intolence (fastng blood glucose > OR = 115mg/dl) hypertriglyceridemia(>160mg/dl), hypercholesterolemia(> OR = 200mg/dl), and low HDL-cholesterol level(<35mg/dl). The morbidity index of CAD was calculated by the sim if the risk factor scores(one point per item if present). RESULTS: There was significant correlation between waist/height ratio, waist/hip ratio and body mass index(BMI)(p=0.0001). BMI had more strong correlation with waist/height ratio(r=0.81) than waist/hip ratio(r=0.48). According to the simple regression analysis, BMI, waist/hip ratio and waist/height ratio had significant correlation with all of the risk factors and the morbidity index, According to the multiple regression analysis, waist/height ratio had significant correlation with age, weight, height, systolic BP, triglyceride, cholesterol and HDL-cholesterol. The risk factor morbidity index of the groups with waist/height ratio over 0.45 was significantly more higher than the group of the lowest risk factor morbidity index(waist/height ratio under 0.4) in men(p=0.01). for women, 0.46 was the level which the risk factor morbidity index increased significantly (p<0.01). CONCLUSIONS: Waist/height ratio can be a useful index of abdominal obesity. And it may be used as a more easier and better predictor of multiple CAD risk factors than waist/hip ratio. We can predict that waist/height ratio over 0.45 in men and over 0.46 in women may have more higher coronary artery disease risk.
Blood Glucose ; Cholesterol ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Glucose ; Hip ; Humans ; Male ; Obesity ; Obesity, Abdominal ; Risk Factors* ; Triglycerides ; Waist Circumference

No abstract available.
Pregnancy*

BACKGROUND: Research is essential for the development of family medicine as a professional field in primary care. Since information is available through the articles in the Journals of Family Medicine which contains subjects such as disease mechanism, pathophysiology, drug or new treatment method, and it is necessary to evaluate the contribution of recent researches in this field. This paper is intended to evaluate the current status of the quality of papers published in the Journal of the Korea Academy of Family Medicine (below JKAFM) and provide statistical data & direction of studies in the future. METHODS: 1218 articles in 185 editions of JKAFM were analyzed among 188 editions published from Nov. 1980 to Dec. 1996. The papers were classified into Case Report, Original Article, Review Article by the type of papers, and then categorized Into descriptive studies, analytic studies, and clinical trials by its methodology. In each category, the papers were stratified by the topic. Also, the analysis was conducted according to the authors, research subjects, sampling methods and the statistical methods, and observed the changes each year through 1980s to 1990s. RESULTS: The portion of original articles has increased from 18.6% in 1980s to 73.9% in 1990s. In terms of research methodology, the portions of analytical studies and clinical trials occupy 28.8% and 2.1% in 1990's respectively, compared with those of 1.8% and 0.6% in 1980's. When the papers were stratified by study topics, topics on family medicine showed the highest of 34.9% of the total. According to the detailed stratification, the principle of family medicine recorded 24.2%. In terms of sampling method, 89% and above was from the clinical data when current data were used, and 69.1% was by questionnaires when the data were newly collected. The most of the study subjects were outpatients of family medicine departments. The portion of papers in which the statistical analysis was not included was 29.9% in 1980s which decreased to 15.7% in 1990s. In terms of the statistical analysis methodology, the Chi-square test was the most frequently used(26.2%), followed by Descriptive(19.6%),1-test(18.2% ) and ANOVA(8.7%) were the next. CONCLUSIONS: The academic performance of family medicine can be most effectively measured by the analysis of the journals on family medicine. According to the analysis, the papers based on clinical activity is increasing in recent years with substantial contribution, which means that the field of family medicine has found its own position in medical science and is developing actively. In terms of study methodology, the portion of analytical study is getting larger, and the various method are being tried. The application of statistical methods is being developed in its quality and quantity. It should be noted that research on family medicine should provide the basis for new knowledge and promote public health by the integrated and intensive efforts.
Humans ; Korea ; Outpatients ; Primary Health Care ; Public Health ; Research Design ; Research Subjects ; Surveys and Questionnaires