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The Fate of Intractable Tuberculosis Cases Under National Tuberculosis Programme (국가결핵관리 체계내의 난치성 결핵환자(만성 배균자)의 운명)

  • Lew, Woo-Jin;Lee, Eun-Gyu;Kwon, Dong-Won;Kim, Sang-Jae;Hong, Yong-Pyo;Kim, Jeong-Bae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.11-18
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    • 1995
  • Background: The natural history of bacillary tuberculosis was studied in India and results showed that at the end of the 5-year period, 49% of the patients were dead, 33% were cured and 18% remained sputum-positive. The aim of this survey is to observe the natural course of the patients with intractable tuberculosis disease who were incurable with all drug regimens of the national tuberculosis programme(NTP). Method: Of the patients who have been found as intractable cases in Kang-Weon Province by the supervisory medical officer during the period from January 1,1987 to December 31,1992, 179 were eligible for this study. Sputum examination was done for those who were survived until October in 1993 at the Kang-Weon provincial laboratory of KNTA. 49 out of 179 patients were transferred to the private sectors and retreated with the combination of prothionamide, cycloserine, ofloxacin, enviomycin, etc. They seemed to have been bacteriologically cured, and so they were excluded from the study. Finally 130 patients were analyzed by modified life table method to calculate the fatality rate and the survival rate during the period of 7 years. Results: 1) 80.8% of intractable cases were male and 19.2%, female. 2) More than 94% of intractable cases showed moderately or far advanced Tb findings on their X-rays at the time of registration at health centres. 3) The cumulative case-fatality rate was 19.74% at the end of 1-year period and has risen to 34.55% by the end of 4-year period(increasing by 4.9% a year on an average). The case-fatality rate has shown no appreciable rise since then until the end of 7-year period. 4) The case-survival rate was 80.26% at the end of 1-year period and has decreased to 65.45% by the end of 4-year period. And then there was no appreciable change in the survival rate until the end of 7-year observation. Conclusion: The case-survival rate of intractable cases was higher than that of untreated pulmonary tuberculosis patients and they may have risk of spreading multidrug resistant organisms. It is time we made an effort to improve case-management qualitatively.

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A Study to Validate the Pretest Probability of Malignancy in Solitary Pulmonary Nodule (사전검사를 통한 고립성 폐결절 환자에서의 악성 확률 타당성에 대한 연구)

  • Jang, Joo Hyun;Park, Sung Hoon;Choi, Jeong Hee;Lee, Chang Youl;Hwang, Yong Il;Shin, Tae Rim;Park, Yong Bum;Lee, Jae Young;Jang, Seung Hun;Kim, Cheol Hong;Park, Sang Myeon;Kim, Dong Gyu;Lee, Myung Goo;Hyun, In Gyu;Jung, Ki Suck
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.2
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    • pp.105-112
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    • 2009
  • Background: Solitary pulmonary nodules (SPN) are encountered incidentally in 0.2% of patients who undergo chest X-ray or chest CT. Although SPN has malignant potential, it cannot be treated surgically by biopsy in all patients. The first stage is to determine if patients with SPN require periodic observation and biopsy or resection. An important early step in the management of patients with SPN is to estimate the clinical pretest probability of a malignancy. In every patient with SPN, it is recommended that clinicians estimate the pretest probability of a malignancy either qualitatively using clinical judgment or quantitatively using a validated model. This study examined whether Bayesian analysis or multiple logistic regression analysis is more predictive of the probability of a malignancy in SPN. Methods: From January 2005 to December 2008, this study enrolled 63 participants with SPN at the Kangnam Sacred Hospital. The accuracy of Bayesian analysis and Bayesian analysis with a FDG-PET scan, and Multiple logistic regression analysis was compared retrospectively. The accurate probability of a malignancy in a patient was compared by taking the chest CT and pathology of SPN patients with <30 mm at CXR incidentally. Results: From those participated in study, 27 people (42.9%) were classified as having a malignancy, and 36 people were benign. The result of the malignant estimation by Bayesian analysis was 0.779 (95% confidence interval [CI], 0.657 to 0.874). Using Multiple logistic regression analysis, the result was 0.684 (95% CI, 0.555 to 0.796). This suggests that Bayesian analysis provides a more accurate examination than multiple logistic regression analysis. Conclusion: Bayesian analysis is better than multiple logistic regression analysis in predicting the probability of a malignancy in solitary pulmonary nodules but the difference was not statistically significant.

A Study of the Construction of Nursing Theory in Korean Culture - View of Medicine- (한국문화에 따른 간호정립을 위한 기초조사연구 III -의료관을 중심으로-)

  • Park, Jeong-Sook;Ok, Yun-Jung
    • Research in Community and Public Health Nursing
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    • v.9 no.1
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    • pp.143-162
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    • 1998
  • This is a study for the construction of nursing care based upon the Korean attitude toward medicine. Factors which were investigated include the source of nursing care, the reason for choosing care, the type of heath care chosen, the accessability of caregivers, and the desired location of death. The population examined in this study consisted of 517 adults distributed in six large cities and 191 adults from five rural communities. Data was analyzed using frequency, percent, Cronbach alpha, $X^2$ - test, t - test, F - test and scheffe post hoc contrast with an SAS program. The results of this study are summarized as follows: 1. Among sources of nursing care used, first rank rated-pharmacy(54.4), private hospital(18.2), general hospital(8.4), folk remedies in house (5.0), chinese hospital(2.8), prayer(2.8) and others(8.4), and the reasons for choosing nursing care rated 'the easiest method' (63.6), 'the best method'(15.7), 'reliable'(10.8) and 'lower cost burden'(4.6) in order of preference. 2. The type of nursing care chosen rated western medicine(6.80), chinese medicine(6.15), folk remedies(5.46), faith remedies(3.51) and divination remedies (1.41). There were significant differences in the effect recognition degree to various kinds of medicine. 3. The difference of the type of nursing care chosen according to general characteristics showed that urban residents were higher than rural community residents(t=2.15, p=0.0320) in western medicine, and urban residents, women, and singles were higher than rural community residents(t=2.04, p=0.0414), men (t= -2.89, p=0.0039), and married(t=2.50, p= 0.0126) on folk remedies. With repect to age and education those 21-30, under 20 and 31-40, graduated from college and graduate school were higher than above 51, above 61 (F = 7.76, p = 0.0001), graduated from elementary school(F=4.39, p=0.0006) on folk remedies. In other categories, rural community residents, women, younger people. Christians were higher than urban residents ( t = -2.73, p=0.0305), men(t= -4.15, p=0.0001), older people (F=2.48, p=0.0307), Catholic, Buddhist, or atheist (F= 70.18, p=0.0001) on faith remedies. Those graduated from high school and Buddhist were higher than unschooled, graduated from middle school(F=3.18, p= 0.0075), atheist, Catholic or Christian(F=18.32, p=0.0001) on divination redemies. There were significant differences concerning age and education level. 4. The accessibility of caregivers rated 'caregivers should be nearby if the patients need them' (50.0), 'caregivers must be there all day (24 hours)' (39.6), 'caregivers must be there at night only'(5.0), 'caregivers must be there during the day only'(2.6), 'caregivers always should visit during visiting hours' 0.4), 'caregivers don't need to be there at all' (1.2). The frist rank of suitable caregivers were rated as spouse(66.6), mother(24.2), daughter (3.6), daughter-in-law(1.9), and the reasons of thinking thus were rated as 'the most comfortable' (81.5), 'people should correctly with regards to family they'(7.1), 'the easiest' (5.4), 'take good care of the patient' (5.1) and 'lower cost burden' (0.4). 5. The desired location of death rated as the following: his/her house (91. 6) to the hospital(8. 4). A person going to encounter death in the hospital wanted his house(78.5) over the hospital(21.5), and a person dieing in the hospital prefered his house(52.9) over the hospital(47.1) as a funeral ceremony place. The following suggestions are made based on the above results. 1. A sampling method that enhances the re presentativeness should be used in regional and/or national related research and replicated to confirm the result of this study. 2. This study should be used to understand the Korean view of medical centers and to meet the expectations of patients in Korean nursing. 3. Research on the Korean traditional view of humans and expectations of the sick, health and illness, and health behavior, the perception of dying, the decision to heal, and the view of general medicine should continue to be conducted continuosly so that Korean nursing theory can be advanced on these concepts.

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Trends in Genetic Parameters with Age and Site for Early Implications of Genetic Improvement in Korean White Pine (잣나무의 유전적(遺傳的) 형질(形質) 개량(改良)의 조기검정(早期檢定)을 위한 수령(樹齡) 및 입지별(立地別) 생장(生長)과 유전모수(遺傳母數)의 특성(特性)에 관(關)한 연구(硏究))

  • Kim, Dae Eun;Chon, Sang Keun
    • Journal of Korean Society of Forest Science
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    • v.79 no.1
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    • pp.56-70
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    • 1990
  • Eighteen Korean white pine (P. koraiensis S. et Z.) families were tested in 3 different regions from age 5 to 9. Family and site were significant sources of variation for seedling survival and field growth, whereas the effects of family x site interaction ware relatively small as compared with the former sources of variation. Variance components estimated from the separate and combined sites indicated that the most variabilities were associated with individual trees within plot. Family ${\times}$ site interaction components as a percentage of family variance decreased sharply with age. Heritability estimates varied with testing site and tree age. Combined analyses, however, showed a moderate change in heritability with increasing tree ages, and demonstrated high and stable trends of estimates, particularly in family heritabilities of tree height ($h_F{^2}=0.789-0.798$). The gains estimated from combined analysis have expected maximum or near-maximum efficiencies at age 6 or 7. Given equal intensity of selection, mass selection showed the most efficient gains within and across the sites. However, for the differences between mass and combined selections are small, selection made on the combination of family and within-family would be more effective in improving genetic gains. Indirect selection method indicated that 5-and 6-years height were all good predictors of 9-year-old height with little loss of relative efficiency (less than 10%) as compared with direct family selection at age 9. Phenotypic and genetic correlations computed on the basis of family mean values of height and diameter have shown predominantly high, positive, and statistically significant (1% level) relationships between all tested pairs of traits, which indicates that family growth maintained statistically consistent trends with age. The best families are those that maintained a stable superiority overall sites and ages in growth performance, therefore, it can be suggested that early identification of superior families at age 9 is feasible at age 5 or 6 in Pinus koraiensis S. et Z.

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Oxide perovskite crystals type ABCO4:application and growth

  • Pajaczkowska, A.
    • Proceedings of the Korea Association of Crystal Growth Conference
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    • 1996.06a
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    • pp.258-292
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    • 1996
  • In the last year great interest appears to YBCO thin films preparation on different substrate materials. Preparation of epitaxial film is a very difficult problem. There are many requirements to substrate materials that must be fullfilled. Main problems are lattice mismatch (misfit) and similarity of structure. From paper [1] or follows that difference in interatomic distances and angles of substrate and film is mire important problem than similarity of structure. In this work we present interatomic distances and angle relations between substrate materials belonging to ABCO4 group (where A-Sr or Ca, B-rare earth element, C-Al or Ga) of different orientations and YBCO thin films. There are many materials used as substrates for HTsC thin films. ABCO4 group of compounds is characterized by small dielectric constants (it is necessary for microwave applications of HTsC films), absence of twins and small misfit [2]. There most interesting compounds CaNdAlO4, SrLaAlO4 and SrLaGaO4 were investigated. All these compounds are of pseudo-perovskite structure with space group 14/mmm. This structure is very similar to structure of YBCO. SLG substrate has the lowest misfit (0.3%) and dielectric constant. For preparation of then films of substrates of this group of compound plane of <100> orientation are mainly used. Good quality films of <001> orientations are obtained [3]. In this case not only a-a misfit play role, but c-3b misfit is very important too. Sometimes, for preparation of thin films substrates of <001> and <110> orientations were manufactured [3]. Different misfits for different YBCO faces have been analyzed. It has been found that the mismatching factor for (100) face is very similar to that for (001) face so there is possibility of preparation of thin films on both orientations. SrLaAlO4(SLA) and SrLaGaO4(SLG) crystals of general formula ABCO4 have been grown by the Czochralski method. The quality of SLA and SLG crystals strongly depends on axial gradient of temperature and growth and rotation rates. High quality crystals were obtained at axial gradient of temperature near crystal-melt interface lower than 50℃/cm, growth rate 1-3 mm/h and the rotation rate changing from 10-20pm[4]. Strong anisotropy in morphology of SLA and SLG single crystals grown by the Czochralski method is clearly visible. On the basics of our considerations for ABCO4 type of the tetragonal crystals there can appear {001}, {101}, and {110} faces for ionic type model [5]. Morphology of these crystals depend on ionic-covalent character of bonding and crystal growth parameters. Point defects are observed in crystals and they are reflected in color changes (colorless, yellow, green). Point defects are detected in directions perpendicular to oxide planes and are connected with instability of oxygen position in lattice. To investigate facets formations crystals were doped with Cr3+, Er3+, Pr3+, Ba2+. Chromium greater size ion which is substituted for Al3+ clearly induces faceting. There appear easy {110} faces and SLA crystals crack even then the amount of Cr is below 0.3at.% SLG single crystals are not so sensitive to the content of chromium ions. It was also found that if {110} face appears at the beginning of growth process the crystal changes its color on the plane {110} but it happens only on the shoulder part. The projection of {110} face has a great amount of oxygen positions which can be easy defected. Pure and doped SLA and SLG crystals measured by EPR in the<110> direction show more intensive lines than in other directions which allows to suggest that the amount of oxygen defects on the {110} plane is higher. In order to find the origin of colors and their relation with the crystal stability, a set of SLA and SLG crystals were investigated using optical spectroscopy. The colored samples exhibit an absorption band stretching from the UV absorption edge of the crystal, from about 240 nm to about 550 m. In the case of colorless sample, the absorption spectrum consists of a relatively weak band in the UV region. The spectral position and intensities of absorption bands of SLA are typical for imperfection similar to color centers which may be created in most of oxide crystals by UV and X-radiation. It is pointed out that crystal growth process of polycomponent oxide crystals by Czochralski method depends on the preparation of melt and its stoichiometry, orientation of seed, gradient of temperature at crystal-melt interface, parameters of growth (rotation and pulling rate) and control of red-ox atmosphere during seeding and growth (rotation and pulling rate) and control of red-ox atmosphere during seeding and growth. Growth parameters have an influence on the morphology of crystal-melt interface, type and concentration of defects.

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Radiological Safety Perception Change after Spatial Dose Measurement of Radiology Department Students (방사선학과 학생들의 공간선량 측정 경험이 방사선 안전 인식에 미치는 영향)

  • Moon, Jae Mi;Park, Sang Tae;Yu, Ji Hyun
    • Journal of Radiation Protection and Research
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    • v.40 no.3
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    • pp.174-180
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    • 2015
  • There are currently many research papers on the knowledge, perceptions and actions of radiation-related staff, but hardly any papers on radiation major students in college who are to be staff members of radiation related jobs in the future. It is of course important to understand the perceptions of staff working on the lines and change their knowledge and perceptions, but in the long term it seems more efficient to understand those who are in the stage of being educated to be staff members-their knowledge and perception of radiation so that ultimately they can attain the right kind of understanding. Therefore the aim of this study is to grasp the pre-radiation staff's basic concept of radiation and space dose, their understanding of radiation safety based on this, and whether there is a change in their perception before and after the space dose measurement experiment; in the end this is to see if the space dose measurement experiment is effective in changing perception on radiation safety. This study took as its subject 64 students majoring radiation in college, I.e. pre-radiation staff members, and gauged their basic conceptualization of radiation, understanding of space dose, and understanding of radiation safety; in the X-ray room within the department the students were asked to measure space dose for themselves, so as to see whether there was a change in their understanding of radiation safety before and after the experiment, according to their understanding of the basic concept of radiation and of space dose. As a result of the space dose measurement experiment, students' increased basic knowledge of concept of radiation and understanding of the dangers of space dose were noteworthy, and accordingly their understanding of radiation safety became stricter and more conservative. In spite of this, their work ethic stayed in the lead of their understanding of radiation safety; this implies the need of a more departmentalized safety education program. Therefore instead of safety education that simply uses visual-audial material in a kind of lecture, I suggest here that there be a more experiential safety education program that enables learners to try out space dose measurement experiments for themselves, a work ethic education that aims for a conventional point of view towards radiation safety as well as a stern attitude.

Relationship between Sleep Insufficiency and Excessive Daytime Sleepiness (수면 부족과 과도한 주간졸림증의 관련성)

  • Choi, Yun-Kyeung;Lee, Heon-Jeong;Suh, Kwang-Yoon;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.10 no.2
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    • pp.93-99
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    • 2003
  • Objectives:Sleep loss and excessive daytime sleepiness may have serious consequences, including traffic and industrial accidents, decreased productivity, learning disabilities and interpersonal problems. Yet despite these adverse effects, there are few epidemiological studies on sleep loss and daytime sleepiness in the general population of Korea. This study investigates the number of people who suffer from sleep insufficiency, how much recovery sleep occurs on weekends, and the relationship between the amount of recovery sleep and daytime sleepiness. Methods:A total 164 volunteers, aged 20 and over, were recruited by advertisement. The subjects were workers and college students living in Seoul, Korea. Subjects were excluded if they were aged over 60;if they had medical, neurological, psychiatric or sleep disorders that could cause insomnia or daytime sleepiness;if they were not following a regular sleep schedule;if they traveled abroad during the study;or if they did not leave home to work or were shift workers. They were interviewed and given a sleep log to complete on each of 14 consecutive mornings. They also completed the Epworth Sleepiness Scale (ESS) at noontime on the last day of the second week. All statistical data were analyzed by t-test, $X^2$-test or ANOVA, using SPSS/PC+. Results:The results showed that the subjects woke up at 6:50 (${\pm}1$:16) on weekdays, 7:09 (${\pm}1$:29) on Saturdays, and 8:12 (${\pm}1$:39) on Sundays and holidays. They took more frequent and longer naps on Sundays than on weekdays and Saturdays. The mean sleep duration was 6h 35 min. on week nights, with a mean increase of about 1h on weekends. Only 9.1% of the subjects spent more than 8h in bed on week nights, with 67% spending less than 7h, and 49.4% reported recovery sleep of more than 1h on Sundays. The subjects who reported recovery sleep of more than 2h on Sundays, showed significantly more excessive daytime sleepiness than those who reported less than 30 min (F=2.62, p<.05). Conclusions:These findings suggest that sleep insufficiency and excessive daytime sleepiness are relatively common in Korea, and that the people who get insufficient sleep on weekdays try to compensate for sleep loss with oversleeping and daytime napping on Sundays and holidays. It appeared that daily sleep insufficiency had a cumulative effect and increased daytime sleepiness.

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THE MORPHOLOGICAL OBSERVATION OF HUMAN GINGIVAL FIBROBLASTS ATTACHMENT AND SPREADING ON THE MECHANICAL TREATED TITANIUM PLASMA SPRAYED IMPLANT SURFACE (기계적 표면 처리된 TITANIUM PLASMA SPRAYED IMPLANT에 대한 치은섬유아세포전개양상의 형태학적 관찰)

  • Whang, Yun-Hi;Lee, Jae-Mok;Suh, Jo-Young
    • Journal of Periodontal and Implant Science
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    • v.25 no.3
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    • pp.741-755
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    • 1995
  • Currently titanium is the material of choice for implants because of its biological acceptance. This high degree of biocompatibility is thought to result, in part, from the protective and stable oxide layer that presumably aids in the bonding of the extracellular matrix at the implant-tissue interface. Endosseous dental implants are interfaced with bone, connective tissue, and epithelium when implanted into the jaw bone. The soft tissue interface including connective tissue and epithelium is one of the most critical factors in the determination of implant maintenance and prognosis. For maintenance of failing or failed implants, it is essential to treat the implant fixture surface to remove bacterial endotoxins and make a surface tolerated by surrounding soft and hard tissues. In this study, the effect of mechanical treatment on titanium plasma sprayed implant on adhesiveness and proliferation of human gingival fibroblasts and changed surface characteristics were studied. titanium plasma sprayed discs manufactured by Friedrichsfeld company were treated with loaw speed stone bur, a rubber point and a jetpolisher. Its surface components were analyzed with Energy dispersive X-ray spectroscopy to evaluate whether the surface characteristics were altered or not. To observe the spreading pattern of the human gingival fibroblasts which attached to the all specimens author used the scanning electron microscope. The results were as follows : Pure titanium and plasma sprayed titanium, stone polished titanium showed titanium peak and small amout of aluminum, so there was no alteration on surface characteristics. Under the scanning electron microscopic examination in the initial attachment of human gingival fibroblast, there was a slight enhancement in pure titanium, stone polished titanium than plasma sprayed titanium. After 6 hours, the pure titanium and stone polished titanium showed human gingival fibroblasts were elongated and connected with numerous processes. Human gingival fibroblasts were more intimately attached on the pure titanium discs than on the other discs. The human gingival fibroblasts attached on the plasma sprayed titanium by thin and elongated processes. After 24 hours, the human gingival fibroblasts connected with each other via numerous processes and compeletly covered the pure titanium and stone polshed titanium discs. Human gingival fibroblasts had multiple point contacts with more long and thin lamellopodia and showed a little bare surface on plasma sprayed titanium discs.

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Improved Electrochemical Performance and Minimized Residual Li on LiNi0.6Co0.2Mn0.2O2 Active Material Using KCl (KCl을 사용한 LiNi0.6Co0.2Mn0.2O2계 양극활물질의 잔류리튬 저감 및 전기화학특성 개선)

  • Yoo, Gi-Won;Shin, Mi-Ra;Shin, Tae-Myung;Hong, Tae-Whan;Kim, Hong-kyeong
    • Journal of the Korean Electrochemical Society
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    • v.20 no.1
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    • pp.7-12
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    • 2017
  • Using a precursor of $LiNi_{0.6}Co_{0.2}Mn_{0.2}O_2$ as a starting material, a surface-modified cathode material was obtained by coating with KCl, where the added KCl reduces residual Li compounds such as $Li_2CO_3$ and LiOH, on the surface. The resulting electrochemical properties were investigated. The amounts of $Li_2CO_3$ and LiOH decreased from 8,464 ppm to 1,639 ppm and from 8,088 ppm to 6,287 ppm, respectively, with 1 wt% KCl added $LiNi_{0.6}Co_{0.2}Mn_{0.2}O_2$ that had been calcined at $800^{\circ}C$. X-ray diffraction results revealed that 1 wt% of KCl added $LiNi_{0.6}Co_{0.2}Mn_{0.2}O_2$ did not affect the parent structure but enhanced the development of hexagonal crystallites. Additionally, the charge transfer resistance ($R_{ct}$) decreased dramatically from $225{\Omega}$ to $99{\Omega}$, and the discharge capacity increased to 182.73mAh/g. Using atomic force microscopy, we observed that the surface area decreased by half because of the exothermic heat released by the Li residues. The reduced surface area protects the cathode material from reacting with the electrolyte and hinders the development of a solid electrolyte interphase (SEI) film on the surface of the oxide particles. Finally, we found that the introduction of KCl into $LiNi_{0.6}Co_{0.2}Mn_{0.2}O_2$ is a very effective method of enhancing the electrochemical properties of this active material by reducing the residual Li. To the best of our knowledge, this report is the first to demonstrate this phenomenon.

An Effect of Aquatic Exercise Program with Self-help Group Activites and Strategies for Promoting Self-efficacy on Pain, Physiological Parameters and Quality of Life in Patients having Rheumatoid Arthritis. (자조집단 활동과 자기효능성 증진법을 이용한 수중운동 프로그램이 류마티스 관절염 환자의 통증, 생리적 지수 및 삶의 질에 미치는 영향)

  • Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.1 no.1
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    • pp.1-30
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    • 1994
  • Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS $PC^+$ program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.

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