No abstract available.
Classification* ; Humans ; Leukemia* ; Survival Rate*

Purpose: Health literacy is a significant determinant of health and health behaviors such as cancer screening. Despite its significance, there are limited instruments available to assess health literacy targeting Koreans. The purpose of this study was to test the psychometric properties of Korean translation of a validated health literacy instrument in cancer screening—Korean version of assessment of health literacy in breast and cervical cancer screening (K-AHL-C). Methods: A total of 555 women aged 20~65 participated in the online survey study. Of 52 items addressing five domains included in the original version, we focused on 36 items addressing three key domains closely associated with cancer screening: familiarity, health navigation, and comprehension. Results: During content validation, two items from the health navigation domain were removed, yielding 34 items. Using Rasch analysis and confirmatory factor analysis, we found the evidence of construct validity of K-AHL-C. The Korean version was also significantly correlated with measures of Functional Health Literacy scale, cancer prevention behaviors, and subjective health status, suggesting convergent validities respectively. Finally, K-AHL-C had acceptable reliability coefficients (α) ranging from 0.71 to 0.92 for each domain and the total scale. Conclusion These psychometric properties support the K-AHL-C is a valid and reliable instrument for measuring Koreans’ health literacy in cancer screening. Also it is expected to use the instrument to detect breast and cervical cancer early and improve the screening rate, and ultimately to contribute to the promotion of women's health and women's health nursing practice.

Aplastic anemia is pancytopenia with bone marrow hypocellularity. The major risks to the pregnant women with aplastic anemia are hemorrhage and infection. Mortality during or after pregnancy is very high, especially thrombocytopenia complicated by platelet refractoriness, due to bleeding and sepsis. There is no therapeutic guideline for aplastic anemia with platelet refractoriness about cesarean section. A multidisciplinary approach to patients with aplastic anemia refractory to platelet transfusion is essential. Close consultation among the hematologist, anesthesiologist and obstetrician, and a management plan are important. We report the successful management of such a patient during cesarean section under general anesthesia.
Anemia, Aplastic* ; Anesthesia, General* ; Blood Platelets* ; Bone Marrow ; Cesarean Section* ; Female ; Hemorrhage ; Humans ; Mortality ; Pancytopenia ; Platelet Transfusion* ; Pregnancy ; Pregnant Women ; Sepsis ; Thrombocytopenia

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.

PURPOSE: VEGF is thought to be an important angiogenic factor playing significant a role in the aggressiveness of malignant tumor by stimulating neovascularization. We morphologically investicated the tumor angiogenesis in terms of the presence of VEGF expression in advanced gastric carcinoma. MATERIALS AND METHODS: We performed immunohistochemical stains for VEGF, CD 34, and MIB-1 (Ki-67) on the 51 paraffin-embedded tissue sections. The degree of angiogenesis was determined by counting microvessel densities and their Ki-67 labelling indices of endothelial cells within the tumors. We evaluated the correlation between the expression of VEGF, angiogenesis and clinicopathologic factors such as histologic differentiation, depth of invasion, and lymph node metastasis. RESULTS: Immunoreactivity for VEGF revealed positivity in 34 out of 51 cases (66.7%). Microvessel densities and Ki-67 labelling indices of endothelial cells reflecting angiogenesis were higher in VEGF-positive tumors than VEGF-negative tumors. There were no conelations between VEGF expression, histologic differentiation and the depth of invasion. We failed to evaluate the conelation of VEGF expression and lymph node metastasis. CONCLUSION: This study suggests that VEGF expressian is closely related to tumor asso- ciated angiogenesis in advanced gastric carcinoma. Considering that tumor growth depends on angiogenesis, therapies reducing VEGF may be a means of inhibiting angiogenesis and tumor aggressiveness.
Angiogenesis Inducing Agents ; Coloring Agents ; Endothelial Cells ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

BACKGROUND: The purpose of this study was to find an independent relationship between waist circumference/waist-to-hip ratio which estimates abdominal fat and fasting insulin/atherogenic index which is a predictor of coronary heart disease in obese women. METHODS: The subjects were 80 obese (BMI > or = 25 kg/m2) women. Whole body fat was estimated by body fat mass, % body fat using bioelectrical impedence, and by BMI. Abdominal fat was measured by waist circumference (WC) and waist-to-hip ratio. Fasting insulin was examined and atherogenic index was defined asthe ratio of serum total cholesterol to HDL-cholesterol. Independent association between abdominal fat and insulin/AI was analyzed using partial correlation, multiple regression and Hotelling t-test. RESULTS: Among subjects, 85.7% of obese women had WC greater or equal to 80 cm. The mean BMI was 30.3 kg/m2. The partial correlations between whole body fat and insulin/AI were not significantly different from the partial correlations between abdominal fat and insulin/AI. When age and height were adjusted, partial correlations between abdominal fat and insulin were 0.38 and 0.39. The partial correlations were reduced to 0.15-0.29 after further adjusting for whole body fat. Age and height-adjusted partial correlations between abdominal fat and AI were 0.34 and 0.36. The partial correlations were reduced to 0.11-0.17 when whole body fat was additionally adjusted. Whole body fat explained 9.9-13.7% for variability of insulin; abdominal fat explained 14.2% and 15.9%. Whole body fat explained 12.5-12.8% for variability of AI and abdominal fat explained 11.9%. CONCLUSION: Most of the obese women showed abdominal obesity. Abdominal fat did not seem to be independently associated with fasting insulin and atherogenic index.
Abdominal Fat* ; Adipose Tissue ; Cholesterol ; Coronary Disease ; Fasting ; Female* ; Humans ; Insulin* ; Obesity ; Obesity, Abdominal ; Waist Circumference ; Waist-Hip Ratio

It has been known that antidepressants have calcium antagonist-like action in neuronal tissues. However, their mechanisms are still obscure. For the study of neurochemical machanism of antidepressants, the authors examined the effects of antidepressants(1-100 microM ) on the intracellular Ca2+ concentration ([Ca2+]i) and the membrane potential in PCl2 cells using fluorescent dyes, fura-2/AM and bisoxonol, respectively. The results were as follows : 1) Sertraline, a selective serotonin reuptake inhibitor (SSRI), inhibited the increment of [Ca2+]i induced by high 60 mM KCI and 100 microM ATP with an IC50 value of 2.5 microM and 5.4 microM, respectively. 2) SSRIs(sertraline, paroxetine and fluoxetine) and tricyclic antidepressants(imipramine and amitriptyline) had strong effects on the inhibition of both voltage-dependent Ca2+ channel and receptor-dependent Ca2+ channel, whereas atypical antidepressant(trazodone) and MAO inhibitor(moclobemide) had lisle effects. 3) Sertraline itself depolarized the membrane potential in a sustained manner depending on its own concentration and it also increased the basal level of [Ca2+]i. 4) The increment of [Ca2+]i might be induced partly by the release from the intracellular calcium store, but mostly induced by the calcium transport through membrane. 5) Among those antidepressants tested, sertraline was the most potent one. Other SSRIs(paroxetine and fluoxetine) and tricyclic antidepressants(imipramine and amitriptyline) were moderately potent. Atypical antidepressant(trazodone) had little effects, and MAO inhibitor (moclobemide) had no effect on the depolarization. 6) External application of ATP induced temporary depolarization. This effect was blocked by prior treatment with sertraline with an IC50 value of 30 microM. 7) The increment of [Ca2+]i through voltage-dependent Ca2+ channel was almost inhibited by a selective calcium channel blocker(nimodipine). However, the ATP-induced increment of [Ca2+]i was partially inhibited by nimodipine. These inhibitory effects were potentiated by the addition of sertraline. In the light of these results, it is likely that SSRIs and tricyclic antidepressants could show the blocking effects on both voltage-dependent and receptor-dependent calcium channel by depolarizing neuronal cell membrane potential in a sustained manner and by increasing intracellular free calcium level.
Adenosine Triphosphate ; Antidepressive Agents* ; Antidepressive Agents, Tricyclic ; Calcium Channels ; Calcium* ; Cell Membrane ; Fluorescent Dyes ; Inhibitory Concentration 50 ; Membrane Potentials ; Membranes ; Monoamine Oxidase ; Neurons ; Nimodipine ; Paroxetine ; Serotonin ; Sertraline*

Hemoglobinopathy poses many challenges to the anesthesiologists. The central issue is the accuracy about interpretation of pulse oximetry saturation value during anesthesia. There are limited data with respect to the correlation between pulse oximetry saturation and oxygen saturation by arterial blood gas analysis in different hemoglobinopathies. We report here a case of a patient with hemoglobinopathy undergoing general anesthesia. Before the induction of anesthesia, various fractions of inspired oxygen were administered with concomitant measurement of oxygen saturation by pulse oximetry and arterial blood gas analysis. The saturation value by pulse oximetry, together with arterial blood gas analysis for oxygen tension, was used for evaluation of the patient's oxygenation status and speculation of the patient's oxygen saturation curve during the anesthesia.
Anesthesia ; Anesthesia, General ; Blood Gas Analysis ; Hemoglobinopathies ; Humans ; Oximetry ; Oxygen

A case of acute intraoperative hypoxemia following placement in the lateral decubitus position in a chronic diaphragmatic hernia patient undergoing general anesthesia for hip arthroplasty is presented. The patient had previously received a series of transurethral cystectomies under general anesthesia without any pulmonary complications, even though the patienthad a diaphragmatic hernia. Hypoxemia occurred after the induction of anesthesia and reposition, and surgery was subsequently postponed. The mechanisms proposed for the hypoxemia were a progressive compression atelectasis of the dependant lung caused by placement in the lateral decubitus position and the presence of the diaphragmatic hernia during anesthesia, and further reduction of the FRC of the dependent lung caused by mechanical ventilation. The patient was intubated with a left-sided endobronchial tube. After placing the patient in the lateral decubitus position, intermittent passive hyperinflation to the dependent lung and then positive pressure ventilation of both lungs was maintained to provide adequate oxygenation throughout the surgery. Therefore, differential ventilation using a double lumen tube is effective at improving hypoxemia of a patient in altered pulmonary compliance, such as in the lateral decubitus position with adiaphragmatic hernia.
Anesthesia* ; Anesthesia, General ; Anoxia* ; Arthroplasty ; Compliance ; Cystectomy ; Hernia ; Hernia, Diaphragmatic* ; Hip ; Humans ; Lung ; Oxygen ; Positive-Pressure Respiration ; Pulmonary Atelectasis ; Respiration, Artificial ; Ventilation

This study was conducted to investigate osteopenia and osteoporosis prevalence of radius and tibia using Quantitative Ultrasound (QUS) and to identify affecting factors of osteoporosis. A total of 4,340 women aged 40 - 69 years, living in Ansung (rural) and Ansan (mid-sized) area, and free of illnesses affecting bone metabolism participated in the community-based cohort study. Among them 4,059 subjects measured radius bone density and 4,089 measured tibia. The T-score threshold, defined as < -1.0 and < or = -2.5, was used to identify subjects with osteopenia and osteoporosis by WHO criteria. The crude prevalence of osteoporosis in radius and tibia was 8.4% and 23.3% respectively; after adjustment for age, it changed 6.3% and 18.8%. In simple logistic regression analysis, the prevalence of osteoporosis increased by aging, non-marital status, low education, low income. Otherwise, high intakes of Ca/P, thiamin, riboflavin, vitamin B6, and vitamin E were decreased osteoporosis prevalence. Compared to the normal BMI (body mass index) group (18.5 < or = BMI < 23), the odds ratio (ORs) of the low BMI group (BMI < 18.5), and high BMI groups (BMI 25 - 30, BMI > or = 30) were significantly increased. The OR of osteoporosis decreased across increasing quartiles of intakes of Ca, P and Ca/P. Therefore, maintaining normal BMI and increasing Ca intake and Ca/P ratio may have a beneficial effect on bone health of Korean women.
Aging ; Bone Density ; Bone Diseases, Metabolic ; Cohort Studies* ; Education ; Female ; Genome* ; Gyeonggi-do ; Humans ; Logistic Models ; Metabolism ; Odds Ratio ; Osteoporosis* ; Prevalence* ; Radius* ; Riboflavin ; Tibia* ; Ultrasonography* ; Vitamin B 6 ; Vitamin E ; Vitamins