PURPOSE: The purpose of this study was to explore ways to define the concept of health inequality. METHODS: The concept analysis process by Walker and Avant was used to clarify the meaning of health inequality. RESULTS: Defining attributes of health inequality included differences in health status between individuals or groups, infringement of fundamental rights to health, unfair use of medical services, and social discrimination. The antecedents of health inequality included differences in demographic characteristics (age, gender, education, occupation, residential location), limitations in accessibility to health care, and social exclusion. Consequences of health inequality were increased costs for medical care, decreased health-related quality of life, and lack of ability to cope with health problems resulting in crisis situations, increases in morbidity and mortality, and shortening of life span. The concept was clarified through presentation of model, borderline, related, and contrary cases. CONCLUSION: Results of this study can be used to guide the direction of future studies through concept analysis in which conceptual attributes in the context of health inequality are examined. Also, based on the result of this study, development of standardized tools to measure health inequality is recommended as well as development of educational programs to reduce health inequalities.
Delivery of Health Care ; Education ; Human Rights ; Mortality ; Occupations ; Quality of Life ; Social Discrimination ; Socioeconomic Factors*

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

No abstract available.

Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as therapeutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Drainage ; Endoscopes ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Ligaments ; Needles ; Sphincterotomy, Endoscopic

PURPOSE: The purpose of this study was to investigate the current status of dietary education carried out by dieticians or nutrition teachers at elementary, middle, and high schools in Gyeonggi province. We compared dietary education status not only among school level but also between dieticians and nutrition teachers. METHODS: The survey using self-administered questionnaires was conducted by dieticians or nutrition teachers at 91 schools (43 elementary schools, 33 middle schools, and 15 high schools) in Gyeonggi province in December, 2015. The questionnaire consisted of questions regarding general characteristics of respondents, current status of dietary education, opinion about dietary education methods, and cooperation level of persons concerned. RESULTS: The placement rate of nutrition teachers was 50.5% overall. Only 36 out of 91 schools conducted regular dietary education, and the percentage of schools conducting regular dietary education was significantly different according to school level with the lowest percentage in high schools, equivalent to 20% (p = 0.003). The average annual dietary education time was 12.4 hours, and it was very low in high schools (5.1 hours) and in schools without a nutrition teacher (1.6 hours). The levels of cooperation and support from principals, teachers, parents, and students were significantly lower in high schools than elementary and middle schools (all p < 0.001) and in schools without a nutrition teacher than schools with a nutrition teacher (all p < 0.05). CONCLUSION: The results show that the level of dietary education is not enough and needs to be improved, especially at middle and high schools and at schools without a nutrition teacher. Government support polices need to be implemented to encourage dietary educational activities.
Education* ; Gyeonggi-do* ; Humans ; Nutritionists ; Parents ; Surveys and Questionnaires

No abstract available.
Plasma Exchange* ; Plasma* ; Purpura, Thrombotic Thrombocytopenic*

PURPOSE: This study was done to identify the effects of nurse-physician collaboration on nursing performance and organizational commitment in intensive care unit (ICU) nurses. METHODS: A cross-sectional survey was used and data were collected from 203 ICU nurses working in two advanced general hospitals and two general hospitals. Data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients and Hierarchical multiple regression with SPSSWIN 23.0 program. RESULTS: The sub-domains of nursephysician collaboration were as follows: 3.77±0.51 for sharing of patient information, 3.36±0.65 for decision-making process on the cure or care, and 3.20±0.72 for relationship between nurse and physician. Nurse-physician collaboration was significantly positively correlated with nursing performance and organizational commitment. Regression analysis showed that nurse-physician collaboration explained an additional 24.9%p of nursing performance and an additional 13.4%p of organizational commitment. 'Sharing of patient information' and 'Relationship between nurse and physician' were significant predictors of nursing performance. 'Relationship between nurse and physician' was a significant predictor of organizational commitment. CONCLUSION: These results provide evidence that the collaboration between nurses and physicians should be enhanced in terms of sharing patient information and mutual respect, to improve nursing performance and organizational commitment of ICU nurses.
Cooperative Behavior ; Critical Care ; Cross-Sectional Studies ; Hospitals, General ; Humans ; Intensive Care Units ; Nursing ; Work Performance

BACKGROUND: The captopril reduces radiation induced lung injury and fibrosis. We designed a study to evaluate the antifibrogenic effect of Captopril in radiation induced lung injury. METHODS: Fifty Sprague-Dawley rats were divided into radiation group (I) (n=30) and radiation plus captopril group (II) (n=15). The rats were sacrificed at 12 hours and 11 weeks after radiation. We examined light microscopic, immunohistochemical and electron microscopic features in each groups. RESULTS: In Group I, the lungs showed acute lung injury at 12 h. The lungs showed patchy fibrosis with collagen deposits at 11 weeks. The severity of the alveolar injury and fibrosis was correlated with radiation doses. The Group II showed less severe lung fibrosis than Group I. The mean numbers of mast cells and myofibroblasts of Group II were lower than Group I (p< 0.05). The TNF-alpha and TGF-beta were higher expressed according to radiation doses in Group I, and less prominent in Group II. Ultrastructurally, the alveolar cell injury and fibrosis were less severe in Group II. The TUNEL stains showed higher expressions according to radiation doses in Group I, and expressed in Group II. CONCLUSIONS: The captopril decreases the number of mast cells and myofibroblasts, reduces collagen deposition and apoptosis of alveolar cells in rat lungs after radiation, and so reduces the degree of pulmonary injury and fibrosis.
Acute Lung Injury ; Animals ; Apoptosis ; Captopril ; Collagen ; Coloring Agents ; Fibrosis* ; In Situ Nick-End Labeling ; Lung Injury* ; Lung* ; Mast Cells ; Myofibroblasts ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

PURPOSE: This study is aimed at identifying the effects of telephone counseling as nursing support on distress, anxiety, depression, and adverse events in cancer patients undergoing their first chemotherapy. METHODS: This was a randomized controlled trial (pretest-posttest design). A total of 70 patients who showed 4 or higher distress scores were selected from the screening process. Four patients dropped out; therefore, 66 patients participated in this research. Thirty-two and 34 patients were randomly assigned to the experimental and the control group, respectively. After a preliminary survey, telephone counseling support was given to the experimental group at three time points. The post survey was done before the second cycle of chemotherapy. RESULTS: Regarding distress, both groups showed a statistically significant decrease in the scores: 3.4 for the experimental group and 1.8 for the control group (p=.002). Furthermore, the experimental group demonstrated a statistically significant decrease relative to the control group. Anxiety and depression showed no statistically significant difference between the two groups. CONCLUSION: This study concludes that nursing support through phone counseling is effective in decreasing distress in patients undergoing chemotherapy for the first time.
Anxiety* ; Counseling* ; Depression* ; Drug Therapy* ; Humans ; Mass Screening ; Nursing ; Telephone*