PURPOSE: This study was to develop a valid and reliable self-care performance scale for stomach cancer patients with gastrectomies. METHODS: The initial items for the self-care performance scale were derived by a literature review and in-depth interviews with stomach cancer patients with gastrectomies and a conceptual framework based on Orem's theory was used. The identified items were evaluated for content validity by experts. The main survey with refined items was performed with a sample of 232 patients. The data were analyzed using item analysis, Pearson correlation coefficients, Cronbach's alpha and factor analysis. RESULTS: A 22 item instrument with 7 factors was developed and the total variance explained was 66.9%. The factors were 'manage dietary restriction', 'avoid hazards', 'rest and elimination', 'manage social support and stress', 'regulation diet', 'meal portion control' and 'seek information and follow-up care'. The internal consistency, Cronbach's alpha was .86 and reliability of the subscale ranged from .65 to .82. CONCLUSION: This study suggested that the self-care performance scale is a reliable and valid instrument to measure self-care performance for patients with stomach cancer after gastrectomy.
Follow-Up Studies ; Gastrectomy* ; Humans ; Self Care* ; Stomach Neoplasms* ; Stomach* ; Weights and Measures

PURPOSE: The purpose of this study is to analyze the smoking behaviors and to identify the impacts of depression, temperament, and characteristic on smoking experience in the female adolescents. METHODS: This study surveyed 691 highschool girls in the Gangwon area using self-administered questionnaires. Data were analyzed by SPSS 12.0. using Pearson correlation coefficient and multiple regression. RESULTS: The smoking rate of the highschool girls was lower than that of the national average. Depression was observed to be seriously in the highschool girls. There were a positive correlations among smoking experience, the school records and novelty seeking and a negative correlation between smoking and cooperativeness. The significant predictors of smoking experience were the type of school, the satisfaction with school, the school records, novelty seeking, reward dependence and cooperativeness. CONCLUSION: These results suggest that femalel adolescents who have the factors identified in this study are considered to have the potential for smoking. These results provide the basis for developing smoking prevention and cessation programs.
Adolescent* ; Depression* ; Female ; Gangwon-do ; Humans ; Reward ; Smoke* ; Smoking* ; Temperament* ; Surveys and Questionnaires

OBJECTIVE: The aim of study was to analyze obstetric and neonatal causes of Korean neonatal deaths. METHODS: The study subjects are a cohort of infants who were born during 1996 and who died before their first birthday. The data were collected through three stages of the study: the collection of existing data, a national infant mortality survey at medical facilities, and data integrating and adjusting process. The sources of existing data were health insurance data and the resident registration data. The National infant mortality survey was conducted by both 'Ministry of Health and Welfare' and 'Korea Institute for Health and Social Affairs'. 3930 medical and health facilities where obstetrics services are available were surveyed during November 1998. The survey results were computerized to match data sets, and any overlap among different data sets were filtered. Causes of deaths were grouped according to the KCD (Korean Standard Classification of Diseases). Causes of neonatal death were further analyzed using composite causes combining obstetric and neonatal conditions. RESULTS: Causes of 2,433 neonatal death were known out of 2,856 deaths. "Certain conditions originating in the perinatal period" comprised 77.1% of neonatal death, being the most common cause. The next common cause was 'congenital malformations, deformations and chromosomal abnormalities', constituting 15.7% of neonatal death. Among the 'certain conditions originating in the perinatal period', 'respiratory distress of newborn' constituted 17.1% of neonatal deaths and 'disorders related to short gestation and low birth weight', constituted 15.6% of neonatal deaths. Neonatal sepsis constituted 14.8% of neonatal death. Among congenital malformations 'congenital malformation of the heart' was most common, constituting 6.2% of neonatal death. 'Certain conditions originating in the perinatal period' was more important cause of preterm neonatal death. Of the related maternal condition, idiopathic preterm birth, multifetal pregnancy, premature rupture of the membranes and hypertensive diseases during pregnancy were common conditions. Congenital malformation was the most important cause of term neonatal death. CONCLUSION: Prematurity-related condition was more important cause of preterm neonatal death while congenital malformation was the most important cause of term neonatal death.
Cause of Death ; Classification ; Cohort Studies ; Dataset ; Gestational Age ; Health Facilities ; Humans ; Infant ; Infant Mortality ; Insurance, Health ; Membranes ; Obstetrics ; Parturition ; Pregnancy ; Premature Birth ; Rupture ; Sepsis

No abstract available.
Cushing Syndrome*

During the last decade, many clinical investigators at various cancer centers have reported the efficacy of various chemotherapeutic agents in the treatment of osteosarcoma. The regimens using high-dose methotrexate (HDMTX) with citrovorum factor rescue are now considered to be one of the most effective treatments of choice. From December 1989 to May 1991, sixteen patients with Enneking's stage (Enneking et al., 1980) IIB osteosarcoma of the extremities were treated with a high-dose methotrexate regimen. After two cycles of preoperative chemotherapy, an operation was performed; either limb salvage or amputation. The resected lesions were examined pathologically and classified according to Huvos' criteria. On pathological examination, 8 (50%) cases showed Grade IV; 1 (6.25%) Grade III; 4 (25%) Grade II; and 3 (18.75%) Grade I. The types of surgery performed were tumor prosthesis replacement (11); wide resection with or without reconstruction (2); resection and arthrodesis (1); and amputation (2).
Adolescent ; Adult ; Bone Neoplasms/*drug therapy/pathology/surgery ; Child ; Combined Modality Therapy ; Female ; Humans ; Male ; Methotrexate/administration & dosage/*therapeutic use ; Osteosarcoma/*drug therapy/pathology/surgery

Indolent T-lymphoblastic proliferation has been rarely reported in the upper aerodigestive tract. The lymphoid cells associated with this condition have the morphological and phenotypical features of immature thymocytes. However, their pathogenesis and biology are unknown. We present an unusual type of tumor infiltrating lymphocytes in a case with hepatocellular carcinoma, presumed to be a T-lymphoblastic proliferation. A 58-yr-old female patient presented with indigestion and a palpable epigastric mass. The abdominal computed tomography revealed a mass in the S6 region of the liver. A hepatic segmentectomy was performed. Microscopic examination showed dense isolated nests of monomorphic lymphoid cells within the tumor. Immunohistochemically, the lymphoid cells were positive for CD3, terminal deoxymucleotide transferase (TdT) and CD1a. In addition, they showed dual expression of CD4 and CD8. The polymerase chain reaction used to examine the T-cell antigen receptor gamma gene rearrangement showed polyclonal T-cell proliferation. This is the second case of hepatocellular carcinoma combined with indolent T-lymphoblastic proliferation identified by an unusual tumor infiltrating lymphocytes.
Antigens, CD3/metabolism ; Antigens, CD4/metabolism ; Antigens, CD8/metabolism ; Carcinoma, Hepatocellular/*diagnosis/pathology/secondary ; DNA Nucleotidylexotransferase/metabolism ; Female ; Humans ; Liver Neoplasms/*diagnosis/immunology/pathology ; Lymphocytes, Tumor-Infiltrating/*pathology ; Mastectomy, Segmental ; Middle Aged ; Precursor Cells, T-Lymphoid/*pathology ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/complications/metabolism/*pathology ; Tomography, X-Ray Computed

We experienced a case of adult T cell leukemia/lymphoma (ATLL) in a 48-year-old Korean female, who has never been abroad since birth and no history of blood transfusion. The patient had hypercalcemia and multiple lymphadenopathy. Histopathologic study of left cervical lymph node (LN) and bone marrow (BM) revealed that infiltrates of malignant lymphoid cells were composed of small, medium and large cells with pleomorphic nuclei. Smears of peripheral blood (PB) showed lymphopenia (16%) with the appearance of a few atypical lymphoid cells (less than 2%), but not the typical clover leaf cells seen in ATLL. Immunophenotypic study of LN and BM revealed T cell phenotype. PB showed increased CD4+ T cell (T(H), CD3/CD4+, 57%) and decreased CD8+ T cell counts (T(S), CD3/CD8+, 6.7%). The sera of the patient and her family were reactive for HTLV-I antibody. The specific sequences of pol, env, and tax of HTLV-I DNA were detected in the lymphoma cells and peripheral blood mononuclear cells (PBMC) using polymerase chain reaction. Ultrastructural examination of PBMC confirmed numerous type c virus particles in extracellular space. This case was an acute type of ATLL without overt leukemic features in PB. Despite chemotherapy and intensive conservative treatment, she died 3 months after admission.
Biopsy ; Bone Marrow/pathology ; Case Report ; DNA, Viral/analysis ; Fatal Outcome ; Female ; Flow Cytometry ; Gene Products, env/genetics ; Gene Products, pol/genetics ; Gene Products, tax/genetics ; HTLV-BLV Infections/pathology ; HTLV-I ; Human ; Hypercalcemia/virology ; Hypercalcemia/pathology ; Immunophenotyping ; Korea ; Leukemia, T-Cell/virology ; Leukemia, T-Cell/pathology* ; Leukemia, T-Cell/immunology ; Lymph Nodes/pathology ; Lymphopenia/virology ; Lymphopenia/pathology* ; Lymphopenia/immunology ; Microscopy, Electron ; Middle Age ; Support, Non-U.S. Gov't ; T-Lymphocytes/virology ; T-Lymphocytes/ultrastructure ; T-Lymphocytes/pathology

A human malignant lymphoid cell line(JeKo-1) was established from a Korean patient with retroperitoneal tumor presenting peripheral blood and bone marrow involvement by malignant lymphoid cells. This cell line was established from peripheral blood, and the cell line had the identical immunophenotypic features as malignant cells from the peripheral blood. The established cell line had features of a mature B-cell phenotype with no evidence for commitment to other lineages. The JeKo-1 grows in suspension with a doubling time of 33 hours. By light and electron microscopic examination, the established cells had a follicular center showing, a small, cleaved, lymphoid appearance, and had a large amount of cytoplasm containing few vacuoles and an irregular cytoplasmic membrane. Immunophenotypic analyses with monoclonal antibodies using flow cytometry showed a monoclonal IgM kappa and CD5- B-cell phenotype. The cells were non-reactive for T-cells and myeloid/monocyte antigens, and no evidence of Epstein-Barr virus nuclear antigen by polymerase chain reaction. DNA analysis showed a hypodiploid stemline with a DNA index of 0.83. The established cells were strongly reactive for bcl-2 and c-myc onco-protein, but lacked expression of multidrug resistance gene protein, p-glycoprotein by Western blot analysis. Karyotypic analysis of JeKo-1 showed 40-41 chromosomes. This cell line should be a valuable tool to study the dissemination of malignant lymphoma into the peripheral blood and bone marrow.
Humans

A hand-arm vibration syndrome, local vibration illness, occurs in some workers who use hand held vibration tools. It consists of white fingers, diffusely distributed finger neuropathy, pain in the hand and arm, and a small excess risk of osteoarthritis. This study is aimed to identify effective methods to confirm local vibration illness among various health exams, which are mentioned in worker's special health exam regulation. In addition, this study is aimed to quantitatively assess the daily vibration exposure level as a major determinant of vibration illness. The subjects, 46 vibration workers, were selected according to the results of the first special health exam about vibration hazards at shipbuilding industry in 1997. They all had experiences of work related blanching of fingers. Fifteen controls, who had no vibration exposure at all, were also recruited to compare their test results with the results of vibration workers. We adopted 1 subjective and 6 objective tests to evaluate the effectiveness and feasibility for confirming local vibration illness. These tests were history taking of subjective symptoms according to the Stockholm classification, checking blood pressure of finger, checking grasp power, checking finger skin temperature, nail-bed pressing test, vibration perceptional threshold test, and skin prick test for pain perception. Among these, checking skin temperature, nail-bed pressing test, and vibration perception test included cold water provocations. We also estimated some vibration exposure levels of hand held vibration tools by using previously published data from one automobile company. In conclusion, history taking of subjective symptoms according to the Stockholm classification, nail-bed pressing test, and vibration perceptional threshold test were discovered to be effective to diagnose local vibration illness. Furthermore, vibration perceptional threshold on right fingers showed a dose-response relationship to daily vibration exposure levels. The parameter beta was 0.0005(+/-0.0002), and statistically significant by REM (random effects model).
Arm ; Automobiles ; Blood Pressure ; Classification ; Fingers ; Hand ; Hand Strength ; Hand-Arm Vibration Syndrome ; Osteoarthritis ; Pain Perception ; Skin ; Skin Temperature ; Vibration* ; Water

PURPOSE: This study was done to assess the bone mineral density (BMD), biochemical bone turnover markers (BTMs), and factors associated with bone health in young Korean women. METHODS: Participants were 1,298 women, ages 18-29, recruited in Korea. Measurements were BMD by calcaneus quantitative ultrasound, BTMs for Calcium, Phosphorus, Osteocalcin, and C-telopeptide cross-links (CTX), body composition by physical measurements, nutrients by food frequency questionnaire and psychosocial factors associated with bone health by self-report. RESULTS: The mean BMD (Z-score) was -0.94. 8.7% women had lower BMD (Z-score< or =-2) and 14.3% women had higher BMD (Z-score< or = 0) than women of same age. BTMs were not significantly different between high-BMD (Z-score> or =0) and low-BMD (Z-score<0) women. However, Osteocalcin and CTX were higher in women preferring caffeine intake, sedentary lifestyle and alcoholic drinks. Body composition and Calcium intake were significantly higher in high-BMD. Low-BMD women reported significantly higher susceptibility and barriers to exercise in health beliefs, lower bone health self-efficacy and promoting behaviors. CONCLUSION: Results of this study indicate that bone health of young Korean women is not good. Development of diverse strategies to intervene in factors such as exercise, nutrients, self-efficacy, health beliefs and behaviors, shown to be important, are needed to improve bone health.
Adolescent ; Alcohol Drinking ; Asian Continental Ancestry Group ; Biological Markers/*metabolism ; Body Composition ; Bone Density ; Bone and Bones/*metabolism/radiography/ultrasonography ; Calcium/metabolism ; Collagen Type I/metabolism ; Female ; Health Promotion ; Humans ; Knowledge ; Life Style ; Osteocalcin/metabolism ; Peptides/metabolism ; Phosphorus/metabolism ; Republic of Korea ; Self Efficacy ; Women/*psychology ; Young Adult