Effects of a Health Promotion Empowerment Program Using a Resident Volunteer as a Lay Health Leader on Frail Elders' Health and Empowerment

PURPOSE: This study has been conducted to develop and examine a health promotion empowerment program using a lay health leader for frail elderly. METHODS: The research was organized in a nonequivalent control group pre-post test design. Data collection was performed from August 18 to October 8, 2015. The subjects included 76 frail elders aged over 65 registered in home visiting services (Experimental group=39, Control group=37). A health promotion empowerment program using a resident volunteer as a lay health leader was run for 8 weeks. Health factors (health promotion behavior, perceived health status and frailty) and empowerment factors (empowerment, social participation) were assessed. The data were analyzed by using the SPSS/WIN 18.0 program. RESULTS: After the program, health promotion behavior, perceived health status and social participation increased in the experimental group more significantly than in the control group, but frailty decreased in the experimental group greater than in the control group. CONCLUSION: The health promotion empowerment program using a resident volunteer as a lay health leader was effective. Therefore, the health promotion empowerment program needs to be expanded to other frail elders. Also, a health leader should be recommended as a public health resource and systematically managed.

Validation of the Korean coefficient for the modification of diet in renal disease study equation

BACKGROUND/AIMS: Race and ethnicity are important determinants when estimatingglomerular filtration rate (GFR). The Korean coefficients for the isotope dilution mass spectrometry (IDMS) Modification of Diet in Renal Disease (MDRD) Study equations were developed in 2010. However, the coefficients have not been validated. The aim of this study was to validate the performance of the Korean coefficients for the IDMS MDRD Study equations. METHODS: Equation development and validation were performed in separate groups (development group, n = 147 from 2008 to 2009; validation group, n = 125 from 2010 to 2012). We compared the performance of the original IDMS MDRD equations and modified equations with Korean coefficients. Performance was assessed by comparing correlation coefficients, bias, and accuracy between estimated GFR and measured GFR, with systemic inulin clearance using a single injection method. RESULTS: The Korean coefficients for the IDMS MDRD equations developed previously showed good performance in the validation group. The new Korean coefficients for the four- and six-variable IDMS MDRD equations using both the development and validation cohorts were 1.02046 and 0.97300, respectively. No significant difference was detected for the new Korean coefficients, in terms of estimating GFR, between the original and modified IDMS MDRD Study equations. CONCLUSIONS: The modified equations with Korean coefficients for the IDMS MDRD Study equations were not superior to the original equations for estimating GFR. Therefore, we recommend using the original IDMS MDRD Study equation without ethnic adjustment in the Korean population.

Predictors and Frailty Level in the Frail Elderly Receiving Home Visiting Health Care Services / 農村醫學 地域保健

OBJECTIVE: The purpose of this study was to identify the predictors and frailty level in the frail elderly receiving home visiting health care services. METHODS: The subjects were 177 frail elders aged over 65 registered in the home visiting health care services of three public health centers in Daegu. The data collection was performed from June 9 to June 24, 2015. This study used descriptive statistics, t-test, ANOVA, scheffe test and stepwise multiple regression by SPSS Win 18.0 program. RESULTS: The mean of the frailty score was 10.05 (±4.52). Age and life satisfaction were the significant factors related to the frailty score in frail elderly. Health promotion behavior, empowerment, social participation and perceived health status had a negative correlation with the frailty score. Thirty seven point four percent of the variance in the frailty score can be explained by perceived health status (β=-0.398, p<0.001), health promotion behavior (β=-0.251, p<0.001) and age (β=0.232, p<0.001)(Cum R2=0.374, F=25.744, p<0.001). Perceived health status was the most important factor related to the frailty score in our study. CONCLUSIONS: An integrative care program which includes these significant variables of subjects is essential to prevent the deterioration of frailty in frail elderly.

Incidence of post-transplant glomerulonephritis and its impact on graft outcome

BACKGROUND: Herein, the significance of post-transplant glomerulonephritis (PTGN) has been revisited to investigate whether PTGN induces allograft failure. The aim of this study was to identify the incidence of PTGN and its association with allograft failure, as well as to analyze the risk factors for PTGN. METHODS: Among the 996 Korean patients who underwent kidney transplantation in a multicenter cohort from 1995 to 2010, 764 patients were enrolled in this study. RESULTS: The incidence rate of PTGN was 9.7% and 17.0% at 5 and 10 years of follow-up, respectively. PTGN was diagnosed in 17.8% of the recipients with results of biopsy tests or clinical diagnosis identifying glomerular diseases as the underlying cause, compared with 0.0%, 4.4%, 4.9%, 5.5%, and 5.7% of the recipients with renal vascular diseases, renal interstitial diseases/pyelonephritis/uropathy, diabetic renal disease, hereditary renal diseases, and diseases with unknown etiologies, respectively. Allograft survival was significantly decreased in patients with PTGN. PTGN was associated with a fourfold increase in graft failure with a hazard ratio of 7.11 for both acute rejection and PTGN. Results of the risk factor analysis for PTGN revealed that the underlying glomerular renal diseases and treatment methods using drugs such as tacrolimus and basiliximab significantly increased PTGN development, after adjusting for other risk factors. CONCLUSION: We conclude that PTGN is strongly associated with poor kidney allograft survival. Therefore, optimal management of recurrent or de novo GN should be the critical focus of post-transplant care.

Factors Influencing Perceived Health Status and Life Satisfaction in Rural Residents / 農村醫學 地域保健

OBJECTIVES: This study was performed to compare rural residents' perceived health status and life satisfaction according to their general and health related characteristics and to identify factors related to perceived health status and life satisfaction in this population. METHODS: Subjects were 1,091 adults aged 20 years or older living in Geochang Gun, South Korea. A survey was conducted from June 28 to August 25, 2009. We used the health self rating scale by Lawton et al. (1982) and the overall life satisfaction scale by Wrosch et al. (2000). The collected data were analyzed using SPSS WIN 18.0. RESULT: Sex, age, education, spouse, medical diagnosis, currently taking medication, main health maintenance behavior, alcohol consumption, frequency of alcohol consumption, exercise, family harmony, and friend relationships were significantly related to perceived health status. Age, education, spouse, main health maintenance behavior, smoking, exercise, family harmony, and friend relationships were significantly related to life satisfaction. Further, 29.3% of the variance in perceived health status could be explained by medical diagnosis, exercise, family harmony, education, currently taking medication, and friend relationships, while 11.1% of the variance in life satisfaction could be explained by family harmony, perceived health status, main health maintenance behavior, and friend relationships. CONCLUSION: Health management programs must be designed so as to incorporate the general and health related characteristics of rural residents if they aim to improve the perceived health status and life satisfaction in that population.

The Effects of Psychosocial Intervention on Depression, Hope and Quality of Life of Home-Based Cancer Patients / 성인간호학회지

PURPOSE: The purpose of this study was to identify the effects of psychosocial intervention on depression, hope and quality of life of home-based cancer patients. METHODS: The study design was a nonequivalent control group pretest-posttest design. Data were collected from September 21 to November 13, 2009. The subjects consisted of 81 cancer patients randomly selected who were registered at four public health center in Daegu, Korea. The 39 subjects in the experimental group received a psychosocial intervention and the 42 subjects in the control group received the usual nursing care. The weekly psychosocial Intervention protocol was comprised of health education, stress management, coping skill training and support (60 min) for eight weeks. Data were analyzed by using the SPSS/WIN 12.0 program. RESULTS: Depression (F=23.303, p<.001) scores in the experimental group were significantly less than that of the control group. Further, hope (F=58.842, p<.001) and quality of life (F=31.515, p<.001) scores were significantly higher than those reported by the control group. CONCLUSION: The findings indicate that the psychosocial intervention was an effective intervention in decreasing depression and increasing hope and quality of life of home-based cancer patients.

An Analysis of Cancer Symptoms, Perceived Health Status, and Given Nursing Services for Community Dwelling Cancer Patients who are Registered in a Public Health Center / 종양간호학회지

PURPOSE: The purpose of this study was to analyze cancer symptoms, perceived health status, and nursing services for community dwelling cancer patients who are registered in a public health center. METHODS: The subject of the study were 561 community dwelling, and home-based cancer patients who were registered in 8 different public health centers in Daegu, Korea. The data collection was performed from September 28 to October 10, 2009. Analysis of data was done by using descriptive statistics, t-test and ANOVA with SPSS program. RESULTS: The mean score of cancer symptom index was 1.63. The level of fatigue was the highest in cancer symptom index. The mean score of perceived health status was 6.92. The exercise guidance was identified as the most frequently practiced nursing service. The scores of cancer symptom index were significantly different by economic status, marital status, living condition, the status of cancer, and metastasis. The scores of perceived health status was significantly different by education, economic status, type of social insurance, time of cancer diagnosis, status of cancer, and metastasis. CONCLUSION: The above findings indicate that it is necessary to develop a special nursing intervention differentiated according to the time points of cancer diagnosis, status of cancer. In addition, nurses should apply it in their practice to ameliorate fatigue for community dwelling cancer patients who are registered in public health center.

A YIDD Mutation in a Case of Recurrent Hepatitis B after Liver Transplantation Induced by an S-escape Mutant

A 47-year-old woman underwent orthotopic liver transplantation (OLT) for hepatitis B virus (HBV)-related end-stage liver cirrhosis. The patient received hepatitis B immunoglobulin prophylaxis after OLT. Despite the protective level of the serum anti-hepatitis-B surface antibody, HBV recurred at 22 months post-OLT and induced subacute hepatic failure. The pre-OLT HBV genome contained a complex mutation pattern in overlapping frame regions of the surface (S) and polymerase (P) genes, which is the same mutation pattern as seen in post-OLT HBV DNA. G145R and K141R mutations in the "a" determinant were detected only in the post-OLT sample. Clevudine (30 mg once daily) was administered for recurrent hepatitis B. Hepatitis B was reactivated with a flare-up, and a M204I mutation (YIDD mutant type) appeared with a higher viral load at 9 months after clevudine treatment. We report here a case of a YIDD mutation that developed in recurrent hepatitis B after OLT induced by an S-escape mutant.

A Case of Pulmonary Sparganosis in a Patient with a History of Recurrent Sparganum Infections / 결핵및호흡기질환

Sparganosis is a zoonosis caused by the migrating larvae of cestode genus Spirometra. We report a rare form of sparganosis that invades the lung. A 44-year-old man presented with newly appeared pulmonary nodules that were found accidentally on regular medical checkup, and on sequential chest CT, which we checked at an interval of every 2 months, revealed that the pulmonary lesion had migrated. The patient had a medical history of having undergone surgical excisions for sparganosis in muscles and in subcutaneous tissues of the lower abdomen, perianus, thigh, right axilla, and scapula area, several times over 7 years. A right middle lobectomy was performed and the lesion was diagnosed as sparganosis based on the characteristic histological findings.

A Case of Intraductal Papillary Mucinous Neoplasm Arising from Santorini's Duct in a Patient with Complete Type of Pancreas Divisum / 대한소화기학회지

There have been an increasing number of reports of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas since its first report by Ohhasi et al. in 1982. Most IPMNs arise from Wirsung's duct or its branches, whereas IPMNs arising from Santorini's duct are rare. Pancreas divisum is a common congenital anatomical anomaly characterized by the lack of fusion of the ventral and dorsal parts of the pancreas during the eighth week of fetal development. Although clinical significance of pancreas divisum has been the subject of debate for many years, there seems to be little doubt that in certain patients there is a causal relation between pancreas divisum and pancreatitis. Also, it is occasionally accompanied by a pancreatic tumor. Herein, we report a case of IPMN arising from Santorini's duct in patient with complete type of pancreas divisum.

A Case of Hepatocellular Carcinoma with Pulmonary Metastases Treated Successfully with a Combination of Repeated Hepatic Arterial Infusion Epirubicin and Cisplatin Chemotherapy and Systemic Low-Dose Infusion of 5-Fluorouracil

We report a case of hepatocellular carcinoma (HCC) with pulmonary metastases treated with repeated hepatic arterial infusion chemotherapy (HAIC) comprising epirubicin and cisplatin, and systemic infusion of 5-fluorouracil (a modified EC/F protocol), which led to complete remission. A 49-year-old man with compensated liver cirrhosis experienced intrahepatic recurrence of HCC with extensive lung metastases. The modified EC/F therapeutic protocol, which was applied at the tenth cycle every 4-5 weeks, resulted in disappearance of the pulmonary metastases and normalization of serum alpha-fetoprotein levels. A single small HCC lesion was found in the left lobe of the liver 13 months after the final chemotherapy session. HAIC with the same regimen was conducted again, followed by percutaneous intratumoral chemoinjection therapy with 5-fluorouracil and interferon-gamma. Thereafter, there was no evidence of recurrence in either the liver or the lung, as evidenced by image analysis and expression of tumor markers. The disease-free intervals for the liver and lung were 41 and 54 months, respectively.

Health Promotion Behavior, Health Problems, Perceived Health Status and Farmers' Syndrome of Rural Residents / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was to identify the health promotion behavior, health problem, perceived health status and farmers' syndrome of rural residents. METHODS: The subjects of this study were 637 adults of 19 primary health care post extracted from 1.875 primary health care post in Korea by quota sampling method. The collected data were analyzed by descriptive statistics, Pearson's correlation. RESULTS: The average score of health promotion behavior was 2.23. In the sub-scales, the highest degree of performance was 'nutrition', followed by 'spiritual growth' and the lowest degree of performance was 'physical activity'. The most prevalent health problem was ailments in 'musculoskeletal system', followed by 'fatigue', 'eyes and ears', 'cardiovascular system'. The mean score of perceived health status was 8.54. The prevalence of farmers' syndrome was 98.4%. Health promotion behavior showed a significant positive correlation health status and perceived health status showed a significant negative farmers' syndrome. CONCLUSIONS: With the above findings, rural residents' physical activity is less than urban residents', and the rural resident's score of perceived health status, musculoskeletal system and fatigue are lower than urban residents'. The farmers' syndrome of the rural people is high. A tailored health promotion program for rural community is needed to develop in the consideration of these findings.

A Case of Escherichia Coli Empyema Preceded by Acute Pyelonephritis / 감염과화학요법

We experienced a case of acute pyelonephritis which progressed to Escherichia coli bacteremia and later complicated by empyema in a 65-year-old female. She was successfully treated with intravenous antibiotic therapy and percutaneous drainage of empyema.

A Case of Escherichia Coli Empyema Preceded by Acute Pyelonephritis / 감염과화학요법

We experienced a case of acute pyelonephritis which progressed to Escherichia coli bacteremia and later complicated by empyema in a 65-year-old female. She was successfully treated with intravenous antibiotic therapy and percutaneous drainage of empyema.

The Effects of a Tailored Health Promotion Program on Self Efficacy, Health Problems and Quality of Life of Rural Residents

PURPOSE: The purpose of this study is to identity the effects of a tailored health promotion program on rural residents' self efficacy, health problems and quality of life. METHOD: Data were collected from May 13th, 2006 to July 29th, 2006. The subjects were selected at Gajo-myeon, Geochang-gun, Gyeonsangbuk-do, Korea. Forty three residents were included in the experimental group and 39 in the control group. The 12-week health promotion program was given to the experimental group. Data were analyzed by descriptive statistics, chi2-test, t-test and ANCOVA test with the SPSS/Win 12.0 program. RESULT: The experimental group showed higher scores of self efficacy and quality of life than the control group, and a lower score of health problem than the control group. CONCLUSION: From the above results, it can be concluded that the tailored health promotion program for rural residents is an effective intervention for improving their self efficacy and quality of life and reducing their health problems. Therefore, it is necessary to spread the tailored health promotion program for residents in other rural areas in Korea.

Severe hypernatremic dehydration in a breast-fed neonate / 소아과

Although it is a rare condition, breast-feeding may result in hypernatremic dehydration. However, incidences might be increasing with more mothers breast-feeding. Although the early detection and management of hypernatremic dehydration from breast-feeding is important, its prevention is even more important on account of its serious complications. In order to prevent hypernatremic dehydration secondary to breast-feeding, it is essential to educate mothers in successful breast-feeding methods. An early follow-up after discharge is recommended. We report a case of hypernatremic dehydration secondary to breast-feeding in a full-term newborn that was corrected without any complications.

The Effect of Health Promotion Program on Self Efficacy, Health Problems, Farmers Syndrome and Quality of Life of the Rural Elderly / 성인간호학회지

PURPOSE: The purpose of this study was to identity the effects of a health promotion program for rural elderly people on self efficacy, health problems, farmers syndrome and quality of life. METHOD: The study was a nonequivalent control group pre-post experimental design. The data collection was performed from April 12th, 2003 to August 2nd, 2003. The subjects were selected at Mari Myun Geochang Gun in Korea. Forty-four elders were included in the experimental group and 45 elders were included in the control group. The 16-week health promotion program was given to the experimental group. Data were analyzed by descriptive statistics, chi-square-test, t-test, paired t-test with SPSS/Win 10.0 program. RESULT: The experimental group showed a lower scores of health problems and farmers syndrome than the control group, and higher scores of quality of life than the control group. There were no significant differences in self efficacy. CONCLUSION: From the above results, it can be concluded that the health promotion program for rural elderly is an effective intervention for improving the rural elderly's quality of life and reducing health problems and farmer's syndrome. Therefore, development of strategy that can spread the health promotion program for rural elderly to the elderly of other rural areas are needed.

The Prevalence of Elevated Serum Liver Enzymes in Obese Children / 대한소아소화기영양학회지

PURPOSE: With a remarkable increase in the prevalence of childhood obesity, the prevalence of nonalcoholic fatty liver disease is assumed to be increasing. The aim of this study is to evaluate the prevalence of nonalcoholic fatty liver disease, hyperlipidemia, and glucose intolerance in normal and obese children. METHODS: A total of 2,206 elementary students (boys: 1340, girls: 866) were grouped according to obesity index; normal group and obesity group (mild, moderate, severe). Aspartate aminotransferase (AST, SGOT) and alanine aminotransferase (ALT, SGPT) were measured with total cholesterol, triglyceride, and fasting blood glucose. RESULTS: Compared with the 4.6% of elevated aminotransferases in normal group, obese groups showed significantly higher prevalence; 12.1% in mild obesity group, 19.4% in moderate group, and 21.6% in severe group (p<0.0001). The prevalence of hypertriglyceremia was 16.9% in normal weight group, which was significantly lower than obesity group (mild obesity group 30.3%, moderate and severe 37.6%, 38.2% each). In boys, the prevalences of elevated aminotransferases in normal weight and obese groups (mild, moderate, severe) were 6.8%, 18.0%, 23.0%, and 26.0%, respectively (p<0.0001). In girls, those were 2.1%, 5.1%, 12.0%, and 12.6%, respectively (p<0.0001). The prevalence of hypertriglyceremia was relative to severity of obesity in boys and girls (p<0.0001). CONCLUSION: The prevalence of elevated serum liver enzymes increased with severity of obesity. For the prevention and treatment of fatty liver and hypertriglycemia, it is important to lower the obesity degree and enforce the education for a weight loss in the student and the parents.

An Unusual Case of Acute Pyelonephritis Caused by Shigella dysenteri in a Child

Shigella infection usually produces gastrointestinal symptoms but rarely causes urinary tract infection. A 7-year-old girl was admitted for fever, chills, right flank pain, and dysuria. She had no vomiting or diarrhea. There was mild tenderness in her right lower abdomen, and right CVA tenderness was also noted. Acute pyelonephritis was diagnosed by abdominal CT. She showed improvement with intravenous administration of antibiotics. The first urine culture grew 1 x 10(5) CFU/mL Shigella dysenteri. Although urinary tract infections due to Shigella species are extremely rare, Shigella species should be considered as a possible cause of pediatric urinary tract infection. We report the first case of urinary tract infection caused by S. dysenteri, which presented as acute pyelonephritis without gastrointestinal symptoms in a child.

The Effects of a Health Promotion Program in Rural Elderly on Health Promotion Lifestyle and Health Status / 간호학회지

PURPOSE: The purpose of this study was to identity the effects of a health promotion program for rural elderly on health promotion lifestyle and health status. METHOD: The study was a nonequivalent control group pre-post experimental design. Data collection was performed from April 12th, 2003 to August 2nd, 2003. The subjects were selected at Mari Myun Geochang Gun in Korea. 44 elders were in the experimental group and 45 elders were in the control group. The 16-week health promotion program was given to the experimental group. Data was analyzed by descriptive statistics, chi2-test, t-test, and ANCOVA test with SPSS/Win 10.0 program. RESULT: The experimental group showed higher scores of a health promotion lifestyle and perceived health status than the control group. In addition, systolic BP, heart rate, body fat and glucose of the experimental group were lower than the control group. Waist flexibility, left hand grip power, back strength and leg strength of the experimental group were higher than the control group. However, there were no significant differences in diastolic BP, total cholesterol and right hand grip power between the two groups. CONCLUSION: This health promotion program for rural elderly can be recommended as an effective nursing intervention in rural communities.