Objectives : The object of this study was to evaluate repeatability of portable spirometry and to determine an appropriate equation for predicted value. Materials and Methods : The subjects were 76 men and 45 women recruited from among Kyunghee University oriental medical students. Portable spirometry was performed via the procedure recommended in ATS guidelines. Repeatability of spirometry was checked against ATS repeatability standards and NHLEP QC grade. Percentage of predicted value of non-smokers was calculated through a Caucasian population-based regression equation(by Morris et al.) and Korean population based regression equation(by Kim et al.). These were compared. Result : 91.7% of subjects matched repeatability standards of ATS and 95% of subjects got interpretable NHLEP QC grades of A, B, and C. Mean percentage of predicted value by Morris et al. were as follows: Mean of FVC% was 90.86, FEV1% was 96.66, FEV1/FVC% was 107.48. Mean percentage of predicted value by Kim et al. were as follows. Mean FVC% was 92.38, FEV1% was 89.77, FEV1/FVC% was 96.95. Conclusions : Results of this study show that more than 90% of subjects meet repeatability criteria. This supports a role for the portable spirometer as a primary oriental medical office tool. Further, results are a verify that they Korean population-based predicted value equation is a more appropriate standard than the Caucasian population-based one, but a still more accurate standard is needed for the Korean adult population.
The purpose of this study is to find out the educational needs for the coronary heart disease patients of a general hospital in a municipal general hospital. The study subjects were 90 outpatients who had been diagnosed as myocardial infection or angina at the hospital from January 3, 1998 to January 31, 1998. The questionaire was consisted of risk factors and educational needs for coronary heart disease patients. The qusetions on the education needs of the coronary heart disease were consist of 34 questions in 6 fields. In analyzing the data, the number and the percentage were calculated in patients general characteristics, the average and the standard-deviation were calculated to understand the educational needs, t-test and ANOVA were used to find out inter group difference on educational needs. In ANOVA, the advanced analysis was done by Scheffe-test. The results of this study were as follows: 1. 52(57.8%) of the patients (90%) live in Kangnung-city and 95% of the patients live in the middle-east part of Korea. At the age distribution 39 to 80, 41.1% of the patients were in their sixties and average age was 62.4 years old. 40% of the patients left school in mid-course or graduated from middle school or high school 2. As a result of the study on the risk factors of the coronary heart disease, the patients who have hypertension and diabetes were 41.1% and 20% respectively. In smoking and drinking, smokers were 30% and drinkers were 40% and average of smoking and drinking duration over 30 years old. 47.8% were over 140mgHg systolic - BP and 45.8% were over 90mmHg diastolic - BP 3. The patients' educational needs average 94.88 (maximum 134), and item average 2.79(maximum 4.0), the highest needs field was the characteristic of disease 33.22(maximum 44). Item average 3.02 (maximum 4.0) and the lowest education needs field was the physical activity and exercise 10.21(maximum 16). Item average 2.55(maximum 4.0) 4. General characteristics which were different from the general characteristic educational needs were statistically different by group of educational level, occupation, age and sex. 5. The risk factors which were different from the coronary heart disease patients' risk factors educational needs were statistically different by groups of the heart disease patients in family and the patients who take regular exercise. with a result the nurses need to improve the educational programs while considering the high educational needs field and the characteristics which showed significant concerns statistically.
This study was performed to investigate LBP(low-back pain) prevalence rate and its related factors inphysical therapists. A self-administered questionnaire survey was conducted to 522 physical therapists in Daegu and Gyeongsangbuk. The LBP prevalence rate for recent 6 months was $61.7\%$. According to age, the prevalence rate was highest in the group aged 24 or less for both male and female physical therapistis. For male physical therapists , it was higher in smokers and drivers, but for female ones, it was not in a significant relationship with smoking and driving. According to work experience, the prevalence rates of those who had been working for less than one year were the highest, and those who had been working at hospitals and clinics were $69.1\%$, significantly high. According to therapy techinque, the prevalence rate related ti PNF was $71.6\%$, the highest and to occupational therapy was $34.3\%$, the lowest. According to working environment for six months, in both male and female physical therapists. LBP prevalence rate was in a statistically significant relationship with work hours during the day, night and weekend duties, repetitive works, motions that bend or twist the waist, the number of patients per day, the number of time to help patients per day, the number of time to carry medical equipment per day and the length of time to work standing. The rate was also higher when physical therapists fekt nire stress from their work. According to the result of multiple logistic regression analysis, male was in a significant relationship with work experience and motions that bend or twist the waist and female was in a significant relationship with work hours during the night and weekend duties, the number of time to help patients per day, motions that bena or twist the waist, actions taken to protect the waist. As for the developmental pattem of LBP in the group of physical therapists with LBP for six moths, $15.7\%$ of them had LBP for first time, $42.3\%$ had recurred LBP, and $42.0\%$ had chronic LBP. As for the causes of LBP, $51.7\%$ said that it was because they worked in the same posture for a long time, and as for how to treat LBP, 48.8% said that they treated themselvs or got help from their co-wokers. The results presented above suggest that physical therapists are exposed to high risk of LBP caused form occupational activities. Therefire, it is necessary to improve working environment to reduce the occurrence of LBP and to develop education programs for preventing the occurrence and recurrence of LBP.
Objectives: The purpose of this study was to propose an indirect exposure assessment method using a questionnaire survey at a time when direct exposure assessment would be impossible after a chemical accident. Methods: About two weeks after an accident, a questionnaire survey was performed with 1,264 persons from the local community. Variables related to exposure were extracted from the survey contents, weighted and then graded for comparison with subjective symptoms in order to evaluate the extent of exposure. Survey items suitable for reflecting the previous exposure level during the accident were extracted, weighted and divided into quartile ranges. Subjective symptoms showed an increasing tendency with higher exposure level when compared with final exposure level (p<0.01). Results: For the relationship between the final exposure grade and subjective symptoms, as the exposure grade was increasing the rates complaining of symptom also showed an increasing tendency. However, when adjusted for demographic characteristics, there was a tendency for the eye irritation symptom to appear higher in women, and respiratory organ irritation appeared higher in smokers. Conclusions: When the problem of recall bias is considered, this study may not have completely unraveled exposure and the characteristics of the participants can affect subjective symptoms. Nevertheless, the exposure rating method of using a questionnaire showed a significant relationship with symptom level. It can be deemed that assessment of past exposure may be successfully evaluated by questionnaire in cases such as chemical accidents.
Objectives : Risperidone is a new antipsychotic drug developed to overcome the therapeutic limitation of conventional antipsychotics. It responses to negative as well as positive symptoms by blocking both dopaminergic and serotonergic receptors, causing no significant side effects such as agranulocytosis and seizure. It is, however, not known whether it induces any serious cardiovascular side effects as evoked by other conventional antipsychotic drugs. The aims of this study were to evaluate the effect of risperidone on cardiovascular function, and to discuss the factors affecting the cardiovascular function. Methods : For 42 patients(22 males and 20 females) diagnosed as schizophrenia, schizophreniform disorder or schizoaffective disorder according to the DSM-IV classification, the cardiovascular fuctions such as heart rate, systolic and diastolic blood pressure, PR interval, QRS interval and QT interval were successively checked before and after 2 weeks and 4 weeks risperidone administration. Furthermore, variables such as body weight, Brief Psychiatric Rating Scale(BPRS), Clinical Global Impression(CGI), Extrapyramidal Symptom Rating Scale(ESRS), Anticholinergic Rating Scale(ARS), serum cholesterol level, serum triglyceride level, serum high-density-lipoprotein level, serum WBC, serum Hb, serum platelet level, prothrombin time and partial thromboplastin time were also analyzed before and after 2 weeks and 4 weeks risperidone administration. Results : 1) Risperidone treatment resulted in a significantly decreased heart rate and increased QT interval after 4 weeks administration(p<0.005 respectively). 2) The scores of BPRS and CGI were significantly decreased after 2 weeks and 4 weeks risperidone administration as compared with baseline(p<0.001 respectively). The scores of ESRS and ASRS were significantly increased after 2 weeks and 4 weeks risperidone administration as compared with baseline(p<0.001 respectively). 3) There were positive correlations between heart rate after 4 weeks and total dose(P<0.05). Blood pressure was significantly(p<0.05) correlated with sex(higher in male) and significantly(p<0.05) positive correlated with body weight. QT interval was significantly(p<0.05) correlated with sex(longer in female) and smoking history(shorter in smokers). Conclusions : Risperidone could induce significant change in heart rate and Q-T interval. Therefore, the cardiovascular safety for risperidone should be reconsidered according to the duration and dosage increase.
Objectives: The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. Methods: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non- Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. Results: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. Conclusions: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.
To improve wellness and quality of life by recognizing the health efforts of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests; electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase$(\gamma-GTP)$, fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was $46.5{\pm}11.2$ years and the mean of body mass index was $24.0{\pm}3.7kg/m^2$. The mean vol of stress was $18.5{\pm}6.0$ expressed as the score out of 40. By general characteristics and lift style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skip-ping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lowe. socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system (p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom$(\gamma=0.476)$ and cardio-vascular symptom$(\gamma=0.361)$ in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom$(\gamma=0.371)$. The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life it would be of value that periodic stress evaluation program and stress management including apropriate control of smoking and drinking, regular exercise and meal.
Objective : This research was done to discover whether or not workers' health related quality of life(HRQOL) depends on their own Yangseng(養生) level, which is also known as one's care of one's health, and also if their HRQOL is affected by the level, to what extent. The subjects of the study were blue-collar workers of a workplace. Method : Blue-collar workers of a workplace were asked to fill out their pre-organized questionaires given to them by their company as a process of health examination. The questionaires carried questions regarding their levels of Yangseng and their HRQOL. For the purpose of the research, a total of 961 data were selected from the questionaires filled out by the blue-collar workers and then analyzed. Result : Each workers's level of Yangseng becomes high or low by one or all of general characteristics. With regard to Yangseng level according to health-related lifestyle were found to have a relatively higher level of Yangseng. With reference to HRQOL according to general characteristics, those in the 20s were found to have a physical summary scale(PCS), but no significant difference was found in the other scales. As regards the quality of life(QOL) according to health-related lifestyle, those who exercise regularly were found to have a relatively higher PCS, while no smokers, those who do not drink alcoholic, and those who sleep at least seven hours a day were found to have a relatively higher mental summary scale(MCS). As to the relation between the level of Yangseng and HRQOL, the level of Yangseng was found to have an interrelation with PCS and MCS in terms of its degree. Statistics also show that each area of Yangseng level has a significant impact on the two qualities-PCS and MCS. Conclusion : One who has a higher level of Yangseng was found to be the one who enjoys a higher HRQOL. Specially, the three kinds of habits that are good for good health -non-smoking, no drinking and seeping seven hours a day- were found to be able to improve the QOL. In this respect, those who want to stay healthy are recommended to cultivate a healthier habit of living.
자발성 기흉이 원발성 폐암의 초발 소견으로 나타나는 경우는 드물다. 이러한 경우 폐암은 진행된 경우가 많아 수술적 치료를 시행하더라도 예후가 안 좋은 경우가 많다. 과거 폐결핵을 앓았던 65세 남자 환자가 다수하 자발성 기흉으로 비디오흉강경을 이용한 폐기포 절제술 중 우연히 파열된 공동이 발견되어 동결절편으로 조직 생검한 결과 편평 상피 세포암으로 진단되었다. 폐종양은 상엽에서 폐열을 지나 하엽으로까지 침윤된 상태라 폐전절제술이 시행되었고 병리조직 병기는 stage I(T2N0M0) 이었다. 수술 이후 1년 6개월간 추적관찰상 재발이나 합병증은 없었다. 40대 이상의 흡연력이 있거나 만성기관지염, 폐기종이 있는 폐암 고위험군에서 자발성 기흉이 생긴 경우에 폐암의 가능성을 염두에 두고 객담세포검사, 기관지경 검사 및 흉부 CT촬영을 시행해서 기저 폐질환에 대한 세심한 관찰이 필요하며 지속적인 공기 누출이 있는 경우 흉강경 수술 등 보다 적극적인 접근이 필요하다.
이 연구의 목적은 대학생의 CIMT (목동맥 내막-중막 두께)와 흡연 습관, 음주 습관 및 두 가지 연관성을 조사하는 것이다. 이 연구는 CAGE (음주 관련: 절주, 비판에 대한 반감, 죄책감, 해장) 설문지, FTND (Fagerstrom Test for Nicotine Dependence) 설문지, 대학생들의 CIMT에 대하여 수행되었다. 세 군으로 분류 된 각 음주 수준에 따른 CIMT 결과 간에는 통계적으로 유의 한 차이가 없었다. FTND 흡연 분류에 따른 CIMT의 결과는 흡연 군이 비 흡연 군보다 높았다(P<0.01). 흡연과 음주는 좌우 CIMT 간에는 통계적으로 유의 한 차이가 있었다(P<0.01). 음주의 위험만 있는 군에서 왼쪽 CIMT (19.84 순위)는 낮은 순위를 보였다. 왼쪽(42.38 순위)과 오른쪽(42.81 순위)의 CIMT는 흡연 위험만 있는 집단에서 높은 순서를 보였다(P<0.01). 이 연구 결과 흡연자와 음주자 사이의 평균 CIMT, 특히 흡연 상태가 높은 사람들 사이에 뚜렷한 차이가 있음을 시사한다. 이 연구에는 몇 가지 제한 점이 있다. 첫째, 작은 연구 대상 두번째, 대상자가 어리고, 셋째, 흡연, 음주 및 CIMT에만 중점을 두었다. 결론적으로, 흡연은 젊은 성인에서 무증상 아테롬성 동맥 경화 위험인자에 대한 부작용과 CIMT를 현저하게 악화 시키며 젊은 성인에서 금연의 중요성이 강화되어야 한다.
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