Fifty-four adenocarcinomas of stomach were investigated to assess the expression of p21 and p53 using an immunohistochemical method. The relationship between p21 and p53 expression and the clinicopathologic parameters were analysed. The staining pattern of p21/p53 were: p21+/p53+, p21-/p53+, p21+/p53-, and p21-/p53- in 30, 12, 8, and 4 cases, respectively. Loss of p21 expression was observed in 16 of 54 tumor tissues (29%). p21 expression, however, had an inverse correlation with vascular invasion and depth of tumor invasion. The p21 and p53 protein expression showed intratumoral heterogeneity. In 63% of the adenocarcinoma, a proportional relationship was found between p21 and p53 immunostaining. The present results suggest that p53 independent induction of p21 expression may be involved in the molecular mechanism of these tumors, and expression of p21 protein may be related to a favorable prognosis in gastric adenocarcinomas.
Adenocarcinoma* ; Immunohistochemistry ; Population Characteristics ; Prognosis ; Stomach

PURPOSE: The purpose of this study was to identify the relationship of quality of life (QoL) with body weight, anxiety, and depression according to perioperative period. METHODS: Data were secondarily analyzed from 30 gastric cancer patients. RESULTS: There were positive relationships of anxiety with depression (r=.42, p=.019) and appetite symptoms of QoL (r=.41, p=.023) at preoperative day one. There were negative relationships of body weight with physical function of QoL (r=-.40, p=.026), and positive relationships of anxiety with depression (r=.37, p=.044) and constipation symptom of QoL (r=.38, p=.034) at postoperative day 7. Also, at postoperative one month, there were positive relationships of body weight with physical function (r=-.45, p=.011) and constipation symptom (r=.37, p=.039). There was a negative relationship of anxiety with emotional function (r=-.39, p= .035), a negative relationship of depression with physical function (r=-.43, p= .018), and a positive relationship of depression with finance (r=.39, p=.034). CONCLUSION: Oncology nurses should consider diverse factors during the early postoperative period to increase QoL. Also, appropriate and timely interventions should be provided to minimize the negative influence on QoL.
Anxiety* ; Appetite ; Body Weight* ; Constipation ; Depression* ; Gastrectomy* ; Humans ; Perioperative Period* ; Postoperative Period ; Quality of Life* ; Stomach Neoplasms

BACKGROUND: An entry of needle into the epidural space has been identified by the development of negative pressure to the advancing needle; hanging drop, loss of resistance, or use of Macintosh balloon. But it is suspicious that epidural space is a true negative pressure space. METHODS: We measured the epidural pressures of pregnant patients in right lateral decubitus (RLD) and sitting position and compared with the values of non-pregnant patients of respective position. 17G Tuohy needle with closed system was used, the pressure of which was zeroed to the puncture level at third lumbar intervertebral space. RESULTS: Epidural pressures were positive in all subjects. Values of measurement were 13+/-4mmHg, 15+/-7mmHg, 16+/-6mmHg and 25+/-7mmHg for pregnant-RLD, pregnant-sitting, non-pregnant-RLD, and non-pregnant-sitting group, respectively. CONCLUSIONS: There was a significant difference between RLD and sitting position in non-pregnant patient only (p<0.05). It is suggested that the hydrostatic pressure of CSF above puncture level and the hydrostatic pressure of valveless epidural venous plexus blood influenced the epidural pressure of non-pregnant group in sitting position. But in pregnant group, abdominal mass may have elicited a draining effect on epidural venous plexus during lumbar flexion in sitting position and partially nullified the hydrostatic pressure of CSF and blood.
Epidural Space ; Humans ; Hydrostatic Pressure ; Needles ; Pregnancy ; Punctures

BACKGROUND: This study was carried out to examine the trends of government-supported health promotion research projects conducted in Korea over the past 12 years. METHODS: Research type, area of interest, organization, and expense of 726 research projects conducted from 1998 to 2009 were examined and the health promotion content analyzed. RESULTS: In Korea, 361 health policy researches (HPR) and 365 general health researches (GHR) were supported by the government during the defined time period. A total of 60.5 health promotion research were conducted annually with a total amount of 27.1 billion won provided (2.26 billion won per year). With the average research project lasting 8.5 months, HPR (7.7 months) projects were completed sooner than GHR (9.2 months). Those who majored in preventive medicine completed 177 research (24.4%), the most number of research projects, followed by public health (22.5%), and family medicine (15.6%). There were 641 health promotion research projects done mostly on policies, legal systems, and grasping current conditions, and only 85 (11.7%) clinical test research on the development or effects of health promotion programs. CONCLUSIONS: HPR have been increasing annually. However, our study could not be certain of how close the studies were to the government's health promotion policies. Furthermore, the main health promotion area, 'healthy living', was not researched as often as should be. Additionally, to improve applicability of the research projects, interdisciplinary cooperation should be promoted.
Hand Strength ; Health Policy ; Health Promotion ; Humans ; Korea ; Preventive Medicine ; Public Health

PURPOSE: The purpose of this study was to identify the factors affected with nurses' prevention activity against hospital fall. METHODS: The data were collected from 325 nurses at C University Hospital in G City by using the structured questionnaires from February 21, 2011 to March 12, 2011. The data were analyzed by stepwise multiple regression. RESULTS: The main factor associated with prevention activity against hospital fall was the attitude towards hospital fall (beta=.26, p<.001), the next one was the educational level (beta=.16, p=.002), and the last one was the frequency of fall prevention education (beta=.14, p=.009). The all factors could explain 11.1% of the variance in the nurses' prevention activities against hospital fall. CONCLUSION: Hospital managers need to make hospital culture to enhance the nurse's positive attitude about hospital fall prevention. In addition, educators need to develop educational programs including hospital fall prevention through academic curriculum and continuing education.
Accident Prevention ; Accidental Falls ; Curriculum ; Education, Continuing ; Surveys and Questionnaires ; Risk Factors

OBJECTIVES: This study was conducted to examine the effects of mobile health (mHealth), using mobile phones as an intervention for weight loss in obese adults. METHODS: An electronic search was carried out using multiple databases. A meta-analysis of selected studies was performed. The effects of mHealth were analyzed using changes in body weight and body mass index (BMI). RESULTS: We identified 20 randomized controlled trials (RCTs) involving 2,318 participants who fit our inclusion criteria. The meta-analysis showed that body weight was reduced with a weighted mean difference (WMD) of −2.35 kg (95% confidence interval [CI], −2.84 to −1.87). An examination of the impact of duration of intervention showed that weight loss was greater after 6 months of mHealth (WMD = −2.66 kg) than between three and four months (WMD = −2.25 kg); it was maintained for up to 9 months (WMD = −2.62 kg). At 12 months, weight loss was reduced to a WMD of −1.23 kg. BMI decreased with a WMD of −0.77 kg/m2 (95% CI, −1.01 to −0.52). BMI changes were not statistically significant at 3 months (WMD = −1.10 kg/m2), but they were statistically significant at 6 months (WMD = −0.67 kg/m2). CONCLUSIONS: The use of mHealth for obese adults showed a modest short-term effect on body weight and BMI. Although the weight loss associated with mHealth did not meet the recommendation of the Scottish Intercollegiate Guideline Network, which considers a reduction of approximately 5 to 10 kg of the initial body weight as a successful intervention. Well-designed RCTs are needed to reveal the effects of mHealth interventions.
Adult* ; Body Mass Index ; Body Weight ; Cell Phones ; Humans ; Mobile Applications ; Obesity ; Telemedicine* ; Weight Loss

BACKGROUND: Previous studies have indicated adenosine triphosphate (ATP) is as potent coronary vasodillator as adenosine (A). We designed this study to compare the vasomotion of coronary artery (CA) between the infusion of ATP and that of A (1). METHOD AND RESULTS: Ten patients with normal CA (6 male and 4 female) age ranging from 41 to 74 years (57+/-11) were studied at LAD and RCA for measurement of coronary flow reserve (CFR), time to maximum effect (Tmax), time to baseline (TBL) in CA during ATP and A infusion. Tmax was achieved earlier with ATP than A, and these results suggest that maximum vasodilation occurs faster with ATP. Side effect profile was similar in 2 patients with mild chest pain with ATP and A. CONCLUSION: Since it has appeared that vasodilatory effect of ATP was comparable to A which has been used in pharmacological stress test in many diagnostic modalities, ATP can be used safely in many clinical setting where A has been used.
Adenosine Triphosphate* ; Adenosine* ; Chest Pain ; Coronary Vessels ; Exercise Test ; Humans ; Male ; Vasodilation

PURPOSE: The triple therapy with proton pump inhibitor (PPI) has been recognized as the treatment of choice in Helicobacter pylori (H. pylori) infection in adults. However, the effect of triple therapy with omeprazole, amoxicillin and clarithromycin (OAC) on eradication of H. pylori infection in children has not been established yet. This study was performed to evaluate the efficacy of OAC triple therapy and to compare the effect of one-week with two-week therapy on H. pylori eradication. METHODS: From July 1998 to July 2000, 34 children with upper gastrointestinal symptoms, who underwent upper gastrointestinal endoscopy with biopsy at entry and 4 or more weeks after therapy, were enrolled in this study. H. pylori infection was assessed by CLO test and histologic examination (Hematoxylin-Eosin stain or Alcian yellow stain) with biopsy specimens. The regimen consisted of omeprazole (0.7 mg/kg/day), amoxicillin (50 mg/kg/day), and clarithromycin (25 mg/kg/day) for 1 week (n=21) or 2 weeks (n=13). Eradication of H. pylori was determined after the termination of treatment by the CLO test and histologic examination. RESULTS: One-week treatment group consisted of 21 children (11 male, 10 female) with a mean age of 9.5+/-3.0 years. Two-week group consisted of 13 children (4 male, 9 female) with a mean age of 9.9+/-4.0 years. The endoscopic diagnoses included nodular gastritis in 19 cases, superficial gastritis in 7 cases, gastric ulcer in 4 cases, purpuric duodenitis in 2 cases, and normal in 2 cases. H. pylori was eradicated in 28 of total 34 children (82.4%). In 1-week group, H. pylori was eradicated in 17 of 21 children (81%). In 2-week group, H. pylori was eradicated in 11 of 13 children (84.6%). In remaining 6 cases in whom H. pylori had not been eradicated with OAC regimen, H. pylori infection persisted despite of the treatment with additional drugs such as colloidal bismuth subcitrate (Denol(r)) and metronidazole. CONCLUSION: In this study, eradication rate of H. pylori with OAC regimen was 82.4%, and the triple therapy would be highly effective as primary treatment. However, there was no significant difference in the eradication rate between the 1-week and 2-week treatment group (P=0.785).
Adult ; Amoxicillin* ; Biopsy ; Bismuth ; Child* ; Clarithromycin* ; Colloids ; Diagnosis ; Duodenitis ; Endoscopy, Gastrointestinal ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Male ; Metronidazole ; Omeprazole* ; Proton Pumps ; Stomach Ulcer

OBJECTIVE: Our purpose was to describe the clinical progress and the maternal and fetal outcome in 16 pregnancies complicated by the HELLP(hemolysis, elevated liver enzymes, low platelet). Material: We reviewed the maternal and neonatal charts from 16 consecutive pregnancies complicated by the HELLP syndrome among 302 pregnancies complicated by preeclamsia and eclamsia managed at our hospital during the period of 4 years from June 1994 through June 1998. The HELLP syndrome was defined by previously published laboratory criteria. We assessed the time of onset, presenting symptom, laboratory finding, mode of delivery, fetal and maternal complication in each case. We also reviewed the clinical finding in detail in the case resulted in maternal death. RESULTS: In regards to the time of onset, 15 cases (93.7%) occurred at antepartum period and only 1 case (6.2%) occurred at postpartum period. Among the 15 cases occurred at antepartum period, 13 cases (81.25%) developed at 27 to 36 weeks gestation and 2 cases (12.5%) developed at near term. In regards to the presenting symptom, twelve patients (75%) complained of right upper quardrant or epigastric pain. Of 16 patients, 12 patients (75%) experienced headache and 10 patients (62.5%) complained of nausea, or vomiting and 5 patients (31.2%) had visual disturbance. The laboratory finding of all 16 cases were as follow; the mean level of platelet: 68700/mm3 (range: 48000 to 91700), the mean level of serum asparate aminotransferase: 335 IU/L (range: 62 to 135), the mean level of lactic dehydrogenase: 910 IU/L (range: 558 to 5794), and the mean level of total bilirubin: 2.6 mg/dl (range: 0.7 to 10.4). To review the mode of delivery, cesarean sections were done on 10 patients (62.5%) including 7(43.7%) emergency and 3(18.7%) elective operations. However, 6 patients (37.5%) delivered vaginally. Maternal complications were as follow; abruptio placenta in 1 case (6.2%), DIC in 2 cases (12.5%), pulmonary edema in 3 cases (18.7%), pleural effusion in 4 cases (25%), renal failure in 4 cases (25%), and 1 case of death. Fetal and neonatal outcome was assessed; 9 cases of intrauterine growth retardation (56.2%), meconium stained in 3 cases (18.7%), 2 stillbirth (12.5%), and 2 neonatal death (12.5%). CONCLUSION: HELLP syndrome is associated with serious maternal and fetal morbidity and mortality.
Bilirubin ; Blood Platelets ; Cesarean Section ; Dacarbazine ; Emergencies ; Female ; Fetal Growth Retardation ; Headache ; HELLP Syndrome ; Hemolysis* ; Humans ; Liver* ; Maternal Death ; Meconium ; Mortality ; Nausea ; Oxidoreductases ; Placenta ; Pleural Effusion ; Postpartum Period ; Pregnancy* ; Pulmonary Edema ; Renal Insufficiency ; Stillbirth ; Vomiting

BACKGROUND: This study aims to analyze quality of and satisfaction with Korea medical services and identify factors affecting medical service satisfaction, revisit, and recommendation intention among international patients. METHODS: Secondary analysis of survey data conducted by Korea Health Industry Development Institute from June 10th to July 17th in 2013 was done using multiple regression and logistic regression analysis. The 191 international patients from 9 medical institutions in Seoul were enrolled. RESULTS: The results showed that international patients were satisfied with 85.6 points out of 100.0 points. International patients appraised higher in staff service rather than other services. Factors influencing medical service satisfaction were gender, religion, medical specialty, length of stay, and quality of medical services. Quality of medical service explained 29.8% of medical service satisfaction and especially, ‘doctor's care’ and ‘communication and patient respect‘ were significantly related to medical service satisfaction. Medical specialty had a significant influence on revisit intention. There were no statistically significant influencing factors of recommendation intention. Additionally, more satisfied patients were associated with higher revisit and recommendation intention. CONCLUSION: This study implies that quality of medical services is a critical factor for patient satisfaction and that satisfaction with medical services is an important factor for increasing revisit and recommendation intention among international patients. In addition, health care providers should consider cultural differences to enhance satisfaction with medical services for international patients. Therefore, multidimensional strategy is required to strengthen the cultural competency of healthcare providers.
Cultural Competency ; Health Personnel ; Health Services ; Humans ; Intention* ; Korea* ; Length of Stay ; Logistic Models ; Patient Satisfaction ; Seoul