Effects of a Fall Prevention Program on Physical Functions and Psychological Functions in Rural Elderly Women / 재활간호학회지

PURPOSE: The purpose of this study was to determine the effects of a fall prevention program on gait ability, one leg standing-right, one leg standing-left, fear of falling, fall efficacy, and depression in the elderly. METHODS: A fall prevention program was consisted of fall preventing exercise with laughter therapy. Quasi-experimental design with one group pre- and post-test was used. Twenty-two elderly were participated in this study from a community health center located in a rural area, South Korea. SPSS/WIN 18.0 was used for descriptive analysis and paired t-test. RESULTS: After 12 weeks with a fall prevention program, gait ability (t=3.44, p=.002), one leg standing-right (t=-3.73, p=.001), one leg standing-left (t=-4.17, p<.001) and fear of falling (t=2.12, p=.046) in the elderly were significantly improved. CONCLUSION: A fall prevention program was effective on physical and psychological functions. This study suggested that control groups and a larger sample should be included in order to validate the effects of a fall prevention program for the elderly.

Selective Cytotoxic Mechanism of Homocysteine to Motor Neuronal Cells Expressing the Mutant Cu,Zn-superoxide Dismutase

BACKGROUND: Mutations in Cu, Zn-superoxide dismutase (SOD1) cause about 20% of familial amyotrophic lateral sclerosis (FALS) cases. The mechanism of late-onset disease manifestation despite the innate mutation has no clear explanation. The relationship between homocysteine (HC) and amyotrophic lateral sclerosis (ALS) has not been investigated fully, in spite of the similarity in their pathogenesis. METHODS: We investigated the effect of HC on the motor neuronal cell-line (VSC4.1) transfected with SOD1 of either wild-type or mutant forms (G93A and A4V) using various methods including the MTT assay for the cytotoxic assay, the immunocytochemical staining using anti-SOD1 for the aggregation of SOD1, the western blotting using anti-nitrotyrosine and anti-DNPH for the oxidative protein damage, and the measurement of the intracellular Ca2+ concentration using Fura2-AM. RESULTS: In the MTT assay, the HC induced significant cytotoxicity in the mutants, as compared with wild-type. This HC-induced cytotoxicity was inhibited by the trolox and the bathocuproinedisulfonate (BC). HC increased the carbonylation and nitrosylation of the mutant proteins. HC also increased significant SOD1-aggregation in mutants. This HC-induced SOD1-aggregation in mutants was inhibited by trolox, N-nitro-L-arginine methyl ester, BC, and z-VAD-FMK. HC did not change the intracellular concentration of Ca2+ in the mutants compared with the wild-type. CONCLUSIONS: The authors showed that the vulnerability of the SOD1 mutant motor neuronal cells to HC involves the copper-mediated oxygen radical toxicity, and that HC may be a lifelong precipitating factor in some forms of FALS, suggesting a possible treatment modality with vitamin supplements.

Effect of Acupuncture on Regional Cerebral Blood Flow at Acupoints GV 20 , GV. 26 , LI. 4 , ST. 36 , SP. 6 Evaluated by Tc-99m ECD Brain SPECT / 대한핵의학회잡지

PURPOSE: To evaluate the effect of acupuncture on regional cerebral blood flow (rCBF) at acupoints suggested by oriental medicine to be related to the treatment of cerebrovascular diseases. MATERIALS AND METHODS: Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 54 normal volunteers (34 males, 20 females, age range from 18 to 62 years) using six paradigms: acupuncture at acupoints GV. 20, GV. 26, LI. 4, ST. 36 and SP. 6. In the control study, needle location was chosen on a non-meridian focus 1 cm posterior to the right fibular head. All images were spatially normalized, and the differences between rest and acupuncture stimulation were statistically analyzed using SPM for Windows . RESULTS: Acupuncture applied at acupoint GV. 20 increased rCBF in both the anterior frontal lobes, the right frontotemporal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at GV. 26 increased rCBF in the left prefrontal cortex. Acupuncture at LI. 4 increased rCBF in the left prefrontal and both the inferior frontal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at ST. 36 increased rCBF in the left anterior temporal lobe, the right inferior frontal lobes, and the left cerebellum. Acupuncture at SP. 6 increased rCBF in the left inferior frontal and anterior temporal lobes. In the control stimulation, no significant rCBF increase was observed. CONCLUSION: The results demonstrated a correlation between stimulation at each acupoint with increase in rCBF to the corresponding brain areas.

The Compliance of Stroke Patients for Secondary Prevention: In Seoul & Kyunggi province

BACKGROUND: The secondary prevention of stroke which is defined as the control of risk factors and continuous antithrombotic therapy if indicated plays an important role in decreasing stroke recurrence. Unlike most developed countries, the stroke mortality in Korea has yet to be on the decline. It is well known that treatment non-compliance for secondary prevention after a stroke is associated with stroke recurrence and poor functional outcome. There has been no investigation about outpatient treatment compliance of Korean stroke patients who were previously hospitalized. This study aimed to explore the behavior and preference for treatment of stroke patients after discharge and to assess the recurrence rate of stroke for those patients who were not compliant with therapy for secondary prevention and their reasons for not being compliant. METHODS: Study subjects included three hundred thirty-eight stroke patients who were admitted to the Hallym Stroke Center between Jan. 1 and Dec. 31 of 1995. Those who died during hospitalization and those who were discharged to go home on impending death were excluded. The mean age was 63.6 years and the male to female ratio was 1.2 to 1. Telephone inquiries were performed with patients or caregivers regarding the recurrence of stroke, the reasons for non-compliance with secondary preventive management and other kinds of care they received for stroke. RESULTS: Among two hundred six patients (60.9%) not given a follow up on the out-patient basis, 110 patients completed telephone interviews and 102 patients were found to be non-compliant. Nineteen patients (17.7 %) of this non-compliant group reportedly had a recurrent stroke. The age, level of education, and Rankin score were factors which influenced the compliance of patients. Non-compliant patients were currently under the care of: 1) oriental medicine and/or acupuncture (n=56); 2) alternative medicine (n=17); 3) inadvertent over-the-counter drugs (n=16); and 4) no treatment at all (n=26). The reasons for non-compliance included: 1) biased preponderance of oriental medicine (n=44); 2) ignorance about the importance of secondary prevention (n=36); 3) inconvenience of the bureaucratic procedure of hospitals (n=34); 4) economic burden (n=17); 5) dissatisfaction with medical care (n=10); and 6) other reasons (n=6). CONCLUSIONS: Secondary prevention care for Korean stroke patients seems to be inadequately achieved. The proper education of patients and their caregivers about the importance for the secondary prevention of stroke is needed to decrease stroke recurrence in Korea.

Role of AP-1 Transcriptional Regulation of Vimentin Gene during 12-O-Tetradecanoylphorbol-13-Acetate Differentiation of HL-60 Cells / 대한암학회지

PURPOSE: To gain insight on the role of AP-1 in transcriptional regulation of vimentin gene during differentiation of HL-60 cells by 12-0-tetradecanoylphorbol-13-acetate (TPA), the levels of vimentin mRNA and AP-1 have been investigated with Northern blot hybridization and DNA mobility shift assay. MATERIALS AND METHODS: HL-60 cells were grown in RPMI 1640 medium supplemented with 10% heat-inactivated fetal calf serum and antibiotics in a humidified 5% CO2 at 37 degree C. Total RNA was prepared by a modification of the method of Karlinsey et al. Northern blot hybridization was performed by the method of Virca et al. EcoRI fragment of pVIM-GEM was used as probe for vimentin mRNA. DNA mobility shift assay was performed by the method of Lim et al. End labeled DNA probe(Upper strand, 5'-CGCTTGATGAGTCAGCCG- 3') for AP-1 binding activity was mixed with nuclear extracts in a 20 microliter reaction volume containing 300 mM KC1, 60 mM HEPES, pH 7.9, 25 mM MgCl2, 1 mM EDTA, 1 mM DTT, 60% glycerol, and 2 microgram of poly[dI-dC]. RESULTS: TPA increased vimentin mRNA levels, with maxima1 stimulation reached at 24 hr. The level of vimentin mRNA was induced in proportion to the concentration of TPA. TPA-induced vimentin mRNA was almost reduced by actinomycin-D pretreatment. TPA- induced stimulation of vimentin gene was completely reduced by staurosporin pretreatment. In DNA mobility shift assay, AP-I newly appeared at 24 hr during TPA- induced differentiation and was almost not detected after the pretreatment of staurosporin. CONCLUSIONS: These results suggest that the induction of vimentin mRNA during TPA- dependent differentiation in HL-60 cells may be mediated by protein kinases C signal transduction and AP-1 is important to transcriptional regulation.