• Journal of muscle and joint health
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• v.18 no.2
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• pp.169-181
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• 2011

Purpose: This paper presents the development process and the final contents of the sellf- management education program integrated with exercise training (Healthy Aging Happy Aging, HAHA program) for community residing older adults with chronic diseases. Methods: The program evaluation methodology was applied which is an interactive program development process based on needs assessment, formative evaluation, process evaluation and outcome evaluation. The program was developed and revised while the program was implementing to 22 hypertension (HT) and 32 diabetic (DM) participants. Results: The final program has two sub-programs for HT and DM participants utilizing self-efficacy resources. They share four common components; 1) health screening of exercise risks, 2) weekly 1-hour group self-management education classes, 3) biweekly 1-hour group exercise training and 4) a mid-term individual counseling. Both sub-programs were 12-weeks long but have different education and exercise contents. Participants-rated mean satisfaction scores were 3.47/4 and 3.61/4 for HT and DM program respectively. Attendance rate were 83.1% ~ 92.3% for the classes. Conclusion: The HAHA program developed by multidisciplinary team which reflected participants needs was accepted well by participants evidenced by high attendance rate and perceived satisfaction level.

• Journal of muscle and joint health
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• v.14 no.1
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• pp.13-25
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• 2007

Purpose: The purpose of the study was to identify the effects of Tai Chi self-help program on glucose control, cardiovascular risks, and quality of life in patients with type II diabetes. Method: The study subjects were 95 adults with type II diabetes recruited from five primary health centers and one outpatient clinic. The Tai chi self-help program was provided twice a week for 6 months. Outcome measures included blood glucose(HbA1c), cardiovascular risk checklist, and quality of life(SF36). Result: At the completion of 6-month program, HbA1c for Tai Chi group dropped from 6.79 to 6.59 without significant group differences. However, cardiovascular risk scores for Tai Chi group has been significantly reduced compared to the control group. In 6 months, quality of life (SF36) was significantly better for Tai Chi group especially in the areas of physical and social functioning. Conclusion: Tai Chi self-help program applied for type 2 diabetes patients has been partially effective to control cardiovascular risk factors, and some dimensions of quality of life. Tai Chi self-help program can be safely and easily applicable to primary care centers for diabetic patients and other people with chronic disease for their symptom management, and health promotion.

• Journal of muscle and joint health
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• v.25 no.2
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• pp.92-103
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• 2018

Purpose: This study aimed to identify factors affecting the quality of life of the elderly people with chronic musculoskeletal pain. Methods: The data were collected from 307 older adults aged 65 years or older with chronic musculoskeletal pain, who visited senior welfare centers in two cities. We used self-rated questionnaires including NRS for pain, WHOQOL-BREF for quality of life, Pain Response Inventory for coping responses to pain, and MSPSS for social support. Stepwise multiple regression analysis were performed using SPSS/WIN 23.0 to identify factors affecting the study subjects' quality of life. Results: The regression model explained 43% of quality of life, which was statistically significant (F=34.11, p<.001). Educational level of high school (${\beta}=.13$, p=.006), pain (${\beta}=-.13$, p=.013), restriction of function (${\beta}=-.13$, p=.028), accommodative pain coping (${\beta}=.24$, p<.001), family support (${\beta}=.18$, p<.001), colleague's support (${\beta}=.25$, p<.001), and perceived health status (${\beta}=.25$, p<.001) were identified as influential factors on subjects' quality of life. Conclusion: Developing integrative interventions is necessary to improve accommodative pain coping skills and to engage family and colleague in support for positive perception of older adults' health status and management of symptoms.

• Journal of Microbiology and Biotechnology
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• v.24 no.1
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• pp.119-126
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• 2014

Rheumatoid arthritis (RA) is a chronic and systemic inflammatory disorder that primarily affects the flexible joints and may also affect a number of tissues and organs. The progression of RA involves an inflammatory response of the capsule around the joint, swelling of synovial cells with excess synovial fluid (SF), and the development of fibrous tissue in the synovium. Since the progressive pathology of the disease often leads to the irreversible destruction of articular cartilage and ankylosis of the joint, early diagnosis of RA is essential. Thus, we undertook a comparative proteomic approach to investigate novel biomarkers for early diagnosis using SFs and serums from RA patients. As a result, we identified 32 differentially expressed spots in SFs and 34 spots in serums. The differential expression of the STEAP4 and ZNF 658 proteins were validated using immunoblotting of the SFs and serums, respectively. These data suggest that differentially expressed proteins in SFs and serums could be used as RA-specific biomarkers for the diagnosis and monitoring of RA. Furthermore, these findings advance our understanding of the molecular etiopathogenesis of RA.

• Journal of Gastric Cancer
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• v.17 no.3
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• pp.212-219
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• 2017

Purpose: The aims of this study were to compare the 7th and 8th editions of the American Joint Committee on Cancer (AJCC) staging manuals on tumor, node, and metastasis (TNM) staging systems and to evaluate whether the 8th edition represents a better refinement of the 7th staging system, when applied for the classification of gastric cancers. Materials and Methods: A total of 5,507 gastric cancer patients, who underwent treatment from January 1989 to December 2013 at a single institute, were included. We compared patient survival rates across the disease groups classified according to the 7th and 8th editions of the AJCC TNM staging systems. Results: Stage migration was observed in 6.4% (n=355) of the patients. Of these, 3.5% (n=192) and 2.9% (n=158) of patients showed a higher stage and lower stage, respectively. According to the 8th edition of the AJCC TNM staging criteria, the 5-year overall survival rates of the patients with stage IIIB and IIIC showed a significant difference (40.8% vs. 20.2%, P<0.001) whereas no significant differences in the 5-year overall survival rates were observed according to the 7th edition criteria (37.6% vs. 33.2%, P=0.381). Conclusions: Restaging stage III cancers according to the 8th edition of the AJCC TNM classification criteria improved survival rate discrimination, particularly, in institutes where the stage III patients were not distinctly categorized.

• Journal of muscle and joint health
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• v.4 no.1
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• pp.26-47
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• 1997

The purpose of this study is to explore the treatment pattern of treatment of patients with arthritis. The grounded theory approach methodology was used in this study. The purposive sampling was conducted. 16 subjects who experienced RA, lived in middle sized city in Korea, and all women The results of this study were as follows : 1. The process of treatment was composed of the stage of symptom experience and the stage of sick role experience. The naming of the symptom was conducted in the stage of symptom experience through, the doctor shopping. The sick role experience was patterned by the choice of the treatment mode. 2. The treatment modes were roughly devided by western medicine and oriental or ethnic medicine. Several factors which affected the choice of the treatment mode were patient's economic state, educational level, religion, the acknowledgement of the cause of illness, duration of illness, lay referral system, the relationship of medical staff, and the acculturation of medical professionalism. The key component of the decision of the treatment was the level of the acculturation of medical professionalism. To enhance the acculturation of medical professionalism, we have to provide the information of cause and the prognosis of the disease to the patients and the variety of communication channel between medical staff and patients, and we should understand the medical culture according to the ages, gender, locations in Korea.

• Journal of muscle and joint health
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• v.4 no.2
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• pp.177-196
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• 1997

This study was undertaken to explore the antecedent factors and process of the treatment-seeking behaviors of medical and alternative treatments in patients with arthritis using methodological triangulation. The data were collected from 995 arthritic patients who were registered either in a center of rheumatology for medical treatment or residents of community having no treatment to classify different treatment patterns. Sixteen patients with various types of treatment only, alternative treatment only, and no treatment were selected among the total samples to identify the antecedent factors through in-depth interview. The quantitative data were analyzed by percentile, t-test, chi-square test and discrimant analysis using SAS PC program, while the qualitative data were analyzed by means of grounded theory methodology. Treatment-seeking behaviors of patients change from the early stage to the sick-role stage. At the early stage, initial characteristics of pain and acculturation of medical professionalism affect the choice of treatment patterns. The acculturation of medical professionalism is affected by health care accessibility, level of education, duration of sickness and lay referral system. At the sick-role stage, lay referral system and acculturation of medical professionalism affect the choice of treatment patterns. The acculturation of medical professionalism is affected by characteristics of symtoms, perceived treatment effects, perceived causes of diseases and socio-economic status as well as health care accessibility, level of education and lay referral system. In conclusion, different factors as well as common factors are influencing the treatment-seeking behaviors depending on the disease and treatment stages. More detailed further studies are required to explore the value system or medical acculturation of patients which is one of the most important factors in decision-making about treatment modalities.

• The Korean Journal of Pain
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• v.21 no.2
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• pp.164-167
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• 2008

Frozen shoulder is known to be a self-limited disease, and it is associated with chronic pain and limitation of joint movement. Although its etiology is still unknown, frozen shoulder is associated with several diseases. The diagnosis is made based on the medical history, the clinical and radiological examinations and exclusion of other shoulder pathologies. The skeleton is one of the most common sites of metastasis in patients with lung cancer. It has been reported that the incidence of bone metastases in lung cancer patients is approximately 30-40%, and the median survival time of patients with such metastases is 6-7 months. We experienced a case of a 77-year-old female patient who complained of right shoulder pain and limited joint mobility, and these symptoms were due to metastatic lung cancer in the shoulder.

• Journal of Trauma and Injury
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• v.21 no.2
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• pp.140-143
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• 2008

Degloving injuries result from the tangential force against the skin surface, with resultant separation of the skin and the subcutaneous tissue from the rigid underlying muscle and fascia. These injuries are associated with extensive soft tissue loss and occasionally with exposure of bone, and they require reconstructive modality for resurfacing and successful rehabilitation that considers the vascular anatomy and the timing of the operation. A 19-year-old male patient was transferred to our facility with degloving injury extending from the lower third of the right thigh to the malleolar area. The tibial bone was exposed to a size of $2{\times}3.5cm^2$ on the upper third of the lower leg at the posttraumatic third day. The exposed soft tissue was healthy, and the patient did not have any other associated disease. At the posttraumatic sixth day, one-stage resurfacing was performed with a medial gastrocnemius muscle flap transposition for the denuded bone and a split-thickness skin graft for the entire raw surface. The transposed gastrocnemius muscle attained its anatomical shape quickly, and the operating time was relatively short. No transfusion was needed. This early reconstruction prevented the accumulation of chronic granulation tissue, which leads to contracture of the wound and joint. The early correction of the gastrocnemius muscle flap transposition made early rehabilitation possible, and the patient recovered a nearly full range of motion at the injured knee joint. The leg contour was almost symmetric at one month postoperatively.

• Journal of muscle and joint health
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• v.3 no.1
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• pp.4-22
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• 1996

Purposes of this study were to identify a hospital-based home care model and to improve the physical, emotional and economical effectiveness of arthritic patients through medical and nursing team approach. The design in nonequivalent control group pretest-posttest design with matched samples in terms of age, sex and disease severity. Fifty two patients in each group were assigned in Seoul, Kyunggi, Kangwon and Kwangju. Before and after 6-month period of home care, level of pain, duration of morning stiffness, Richie Index, ADL, self efficacy, depression, cost expenditure were measured. Nine patients were excluded from the control group in the period of study because of denial of participation. Contents of home care provided to the experimental group include mainly distribution of prescribed drugs, 'assessment of patients' condition and side-reactions of drug. All of the information related to the home care patient were reported to the physician. On the bases of these data, the physician prescribe the specific drugs to each patient. Each patient visited the physician every 2 or 3 month for laboratory test. Patients assigned to the control group visited the outpatient clinic once a month as usual. Null hypotheses were selected because physicians concerned about the ineffective change of patients' conditions due to indirect communication with patients through nurses. Level of pain, Richie index, ADL, self-efficacy, depression, duration of morning stiffness and direct medical cost were the home care provided to them. If a family member accompany in a home care group can save 10,676 Won/month in Seoul, 34,000 Won/month in other districts. Other in-direct cost for transportation and meal can also be saved. In conclusion, those patients with low level of ADL, high level of pain and Richie index, living in the remote area definitely need the home care.