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.

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

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*

Large intestinal Lipohyperplasia (LPH) is a poorly recognized lesion characterized by adipose tissue infiltration in the submucosal layer of the colon. Most of all, LPH developed at Ileoceal valve, especially upper lip which was called by ileocecal valve syndrome. For endoscopists and radiologists, it has often remained difficult to make a distinction from malignant neoplasia. We report here the case of a mild obese, 51-year-old man who had polypoid lipohyperplasia of the colon associated with extreme hyperplasia of the appendix. His chief complaint was recurrent intermittent abdominal pain. The colonoscopic finding was a submucosal tumor-like polypoid mass originating from appendix with smooth surface, But ileocecal valve was intact. Abdominal CT finding was 2.5 cm sized round heterogeneous low density mass like lesion with intratumoral fatty density of cecal tip area with enhancement of peripheral portion. In barium enema study, after retrograde filling of contrast, smooth extrinsic indentation of cecal tip with partial filling of appendix was seen. Histological exemination revealed infiltration of mature adipose tissue in the submucosal layer. Because of recurrent abdominal pain, ileocecal resection was performed at operation. We discuss the case and review the literatures on this subject.
Abdominal Pain ; Adipose Tissue ; Appendix* ; Barium ; Colon ; Enema ; Humans ; Hyperplasia ; Ileocecal Valve ; Lip ; Middle Aged ; Tomography, X-Ray Computed

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

PURPOSE: The purpose of this study was to identify the current attitudes and knowledge toward Koryo Hand Therapy(KHT) by the experienced people. METHOD: The Subjects for this study included 3,351 people living in Korea who experienced KHT. The data were collected from April 6 to November 25, 2004 using a structured questionnaire. The data were analyzed through the SAS 8.1 Windows Program using frequency, percentage, t-test, ANOVA and Pearson's correlation coefficient. RESULTS: The results of the study are as follows: 1) Families and relatives were a main source of information about Koryo Hand Therapy. The subjects were very satisfied with therapeutic and preventive effects of the therapy. Sujichim was the most preferable choice in the KHT. Most of the subjects thought that KHT could be applied to modern medicine. 2) Those who experienced KHT had a high level of knowledge and very positive attitudes toward KHT. 3) There were statistically significant differences in the attitude toward KHT according to age, gender, educational level, religion, income, place of residence, marital status and experience which studied KHT. 4) There were significant differences in the knowledge of KHT according to age, educational level, income, marital status and experience which studied KHT. 5) The data showed positive correlation between attitude and knowledge. CONCLUSION: According to the above findings, it can be concluded that KHT needs to be actively informed and more easily approached by general peoples. Nursing protocols of KHT needed to be developed.
Hand* ; History, Modern 1601- ; Humans ; Korea ; Marital Status ; Nursing Assessment ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: Although elevations of plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) concentration have been shown to be prognostically significant in patients with non-ST elevation acute coronary syndrome (ACS), the relation between the plasma level of NT-proBNP and the severity of coronary disease remains unknown. SUBJECTS AND METHODS: The NT-proBNP concentration was analyzed in 50 patients with non-ST elevation ACS. We compared plasma NT-proBNP levels and treatment method (medical treatment vs. percutaneous coronary intervention [PCI]). RESULTS: In patients with non-ST elevation ACS, NT-proBNP levels were significantly higher in the PCI (n=37) group than in the medical treatment (n=13) group (296.6 vs. 76.3 pg/mL;p<.001). In patients with unstable angina (UA), NT-proBNP levels were significantly higher in the PCI (n=22) group than in the medical treatment (n=12) group (147.6 vs. 64.5 pg/mL;p<.001). Elevated NT-proBNP level predicted PCI in patient with non-ST elevation ACS. A NT-proBNP level >125.9 pg/mL had sensitivity, specificity, positive predictive value and negative predictive value of 75.7%, 92.3%, 96.6% and 57.1%, respectively. In patients with UA, a NT-proBNP level >123.8 pg/mL had equivalent results of 68.2%, 91.7%, 93.8% and 61.1%, respectively. The area under the curve was 0.891 in non-ST elevation ACS and 0.907 in UA. Elevated NT-proBNP level was also correlated with the severity of culprit artery stenosis and multi-vessel disease. CONCLUSION: Elevated plasma NT-proBNP concentrations were associated with the severity of coronary artery disease in patients with non-ST elevation ACS. In combination with clinical factors, NT-proBNP level will provide a highly discerning tool for early risk stratification and further clinical decisions.
Acute Coronary Syndrome* ; Angina, Unstable ; Angioplasty ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Disease ; Coronary Stenosis* ; Coronary Vessels* ; Humans ; Natriuretic Peptide, Brain ; Percutaneous Coronary Intervention ; Plasma* ; Sensitivity and Specificity

No abstract available.
Arteries* ; Infarction* ; Spinal Cord Vascular Diseases ; Spinal Cord*