Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
Adenocarcinoma* ; Adenomyosis ; Carcinogenesis ; Cell Proliferation ; Crowding ; Endometrial Hyperplasia* ; Female ; Genes, p53 ; Humans ; Hyperplasia ; Prognosis

Purpose: : This study aims to identify job stress, emotional intelligence, and exhaustion of the nurses in comprehensive nursing service units and then verify the moderating and mediating effects of emotional intelligence on the relationship between job stress and exhaustion. Methods: : Participants are 118 nurses working in two general hospitals. The collected data are analyzed using the SPSS WIN 27.0 and AMOS 18.0 programs by assessing frequency and percentage, mean and standard deviation, independent t-test and one-way ANOVA, Scheffé test, Pearson correlation coefficient, and hierarchical multiple regression analysis and bootstrapping. Results: : Exhaustion has a statistically significant positive correlation with job stress (r=.40, p ＜.001) and a statistically significant negative correlation with emotional intelligence (r=-.26, p =.004). A partial mediating effect of emotional intelligence is found between job stress and exhaustion, however, there is no moderating effect. Conclusion : It is expected that to reduce the exhaustion of nurses in comprehensive nursing service units, it is necessary to assess job stress and emotional intelligence, and strengthen emotional intelligence along with job stress intervention.

BACKGROUND/AIMS: Hepatic fibrosis in rat induced by thioacet amide shares similar morphological and biochemical characteristics with human liver cirrhosis. Thioacetamide (T AA) initially induces accumulation of collagen in Disse space and eventually leads to macro- and micronodular cirrhos is. Ito cell was believed to play a main role in hepatic fibrosis. And it s activity was known to be regulated by the expression of various genes. But little has been discovered about the upstream signal trans duction pathway of these genes in hepatic fibrosis. The expression of genesrelated to Ito cell activity was regulated by many transcription factors , the activity of which was regulated by protein kinase C( PKC) is oforms. So it is s upposed that PKC could be as s ociated with fibrosis in liver. METHODS: We investigated the correlation of PKC is oforms and It ocell activity in the course of hepatic fibrosis using TAA induced rat liver cirrhosis model. We used six week- old male rats , and administered 0.03% TAA in drinking water. The animals were sacrificed at 9, 20, and 30 weeks after TAA administration. The degree of hepatic fibrosis was evaluated by measuring the total amount of collagen.-SMA immunohist ochemical st aining of liver tissue was done to determine the Ito cell activity. The expression pattern of PKC isoforms was investigated by West ern blotting. RESULTS: In TAA- treated group, collagen cont ent and Ito cell activity did not increase until 30 weeks and 20 weeks of treatment , respectively, while in control group collagen cont ent and Ito cell activity were not detected. Collagen content showed linear correlation with Ito cell activity. This implied that the proliferation of activated Ito cells was prior to the increase of collagen content. In view of expression pattern of PKC is oforms, PKC alpha showed no difference in TAA- treated group and control group. In TAA-treated group, PKCbeta1 exhibited increased level of expression in both particulate and cytosolic forms at 9 weeks, while PKCdelta and PKC epsilon showed striking shift to particulated form. After 20 weeks, all of the PKC beta1, delta, and epsilon degenerated and showed remarkably decreased level of expression. This suggested PKC alpha had no relation to hepatic fibrosis,while PKC beta1, delta, and epsilon, showing activity at 9 weeks, were related to fibrosis og liver. In response to fibrogenic factors, molecules engaged in intracellular signal transduction pathway like PKC beta1, delta, and epsilon, began to change prior to the increase of Ito cell activity, morphologic changes and alterations of collagen content. CONCLUSION: Our results strongly suggest that the activity of PKC isoforms play an important role in early step of hepatic fibrosis, while accompanying Ito cell activity do in later step.
Animals ; Collagen ; Cytosol ; Drinking Water ; Fibrosis ; Hepatic Stellate Cells ; Humans ; Liver Cirrhosis* ; Liver* ; Male ; Protein Isoforms ; Protein Kinase C-epsilon ; Protein Kinases ; Rats ; Signal Transduction ; Strikes, Employee ; Thioacetamide ; Transcription Factors

BACKGROUND/AIMS: Liver cirrhosis is an end-stage liver disease. Ito cell is known to have central role in fibrogenes is of liver cirrhosis. But collagen content and Ito cell activity in liver cirr hosis have received little attention. So Ito cell activity and hepatocyte proliferation activity according to collagen content was investigated. WAF-1 and c- met were studied to evaluate the effect of cell cycle. METHODS: We analyzed 56 cases of liver cirrhosis ( viral:41, biliary:11, alcoholic:2, Wilson' s disease:2). Collagen content was measured by spectrophot ometry. Ito cell activity and prolifer ation index was measured by-SMA and Ki- 67 immunohistochemistry. RESULTS: In viral cirrhosis, high collagen group showed increased Ito cell activity compared to low collagen group. There was no difference in hepatocyte prolifer ation activity bet ween high and low collagen group in viral cirrhosis. In biliary cirrhos is, high collagen group showed increased Ito cell activity in septal zones compared to low collagen group. WAF- 1and c- met were negative in most of cases. CONCLUSION: Collagen content of liver cirrhosis is closely related to increment of activated Ito cells . Ito cell activity was prominent in septal zones than in parenchymal areas of viral cirrhosis and that was only significant in septal zones of biliary cirrhosis. There is no correlation bet ween collagen content and hepatocyte proliferation activity.
Cell Cycle ; Collagen* ; Fibrosis ; Hepatic Stellate Cells ; Hepatocytes* ; Immunohistochemistry ; Liver Cirrhosis* ; Liver Cirrhosis, Biliary ; Liver Diseases ; Liver*

BACKGROUND: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. MATERIAL AND METHOD: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. RESULT: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186+/-40cc, control group:409+/-69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317+/-53cc, control group: 671+/-133cc, P=0.024). CONCLUSION: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.
Adult* ; Aprotinin* ; Cardiopulmonary Bypass ; Creatinine ; Hemorrhage ; Humans ; Retrospective Studies ; Thoracic Surgery

PURPOSE: The purpose of this study is to describe and understand the meaning and the structure of subjective experiences of intensive care nurses with death of patients with do-not-resuscitate (DNR) orders. METHODS: Data were collected from eight intensive care nurses at general hospitals using individual in-depth interviews and analyzed by phenomenological research method. RESULTS: The nurses' experiences were grouped into four theme clusters: 1) ambiguity of death without correct answer, 2) a dilemma experienced at the border between death and work, 3) the weight of death that is difficult to carry and 4) death-triggered reflection of life. CONCLUSION: It is necessary to develop accurate judgment criteria for DNR, detailed regulations on the DNR decision process, guidelines and education on DNR patient care for nurses. It is also needed to develop an intervention program for DNR patients' families.
Critical Care* ; Education ; Hospitals, General ; Humans ; Intensive Care Units ; Judgment ; Methods ; Patient Care ; Qualitative Research ; Resuscitation ; Social Control, Formal

No abstract available.

BACKGROUND: Health illiteracy is a problem often unrecognized by health care providers. It influences medical costs and the health status of adults. The purposes of this study were to determine the level of health literacy in community-dwelling adults and to identify the factors influencing it. METHODS: A cross-sectional survey was conducted in Seoul, Gyeonggi and Chungcheong province. A total of 420 adults aged 18 or older were interviewed by trained nursing students between November 1 to December 30, 2011. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Data were analyzed using the PASW 18.0 program. RESULTS: The mean score of health literacy was 50.64+/-19.18. In the multiple linear regression analysis, health literacy was significantly associated with education (beta=0.17, P=0.001), alcohol use (beta=-0.12, P=0.010), and perceived health status (beta=0.11, P=0.029). These factors accounted for about 7% of health literacy. CONCLUSIONS: Health literacy is a very important public health issue. Our findings showed that educational level, alcohol use and perceived health status should be considered when assessing this issue in patients. Furthermore, the development of a standardized Korean assessment tool for health literacy and specified interventions for enhancing health literacy are needed to improve health outcomes.
Adult* ; Cross-Sectional Studies ; Education ; Gyeonggi-do ; Health Literacy* ; Health Personnel ; Health Status ; Humans ; Linear Models ; Literacy ; Primary Prevention ; Public Health ; Seoul ; Students, Nursing

PURPOSE: The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing. METHOD: 70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station. RESULT: There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048). CONCLUSION: Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.
Administration, Inhalation ; Adult ; Education, Nursing, Baccalaureate/*standards ; Educational Measurement ; Female ; Humans ; Lung Neoplasms/nursing ; Male ; Medical History Taking ; Physical Examination ; Postoperative Care ; Reproducibility of Results ; Task Performance and Analysis

PURPOSE: The purpose of this paper is to determine effects of auricular acupressure on knee pain, range of motion, and sleep in the elderly with knee osteoarthritis. METHODS: This is an experimental study designed with randomization and single-blind in a placebo-control approach. The subjects included the elderly with knee osteoarthritis who were using an elderly welfare facility. In each of the groups, 28 subjects were assigned. For the experimental group, auricular acupressure was applied to five pressure points related to the pain caused by osteoarthritis and sleep. In the case of the placebo-control group, auricular acupressure was applied to other five points than the former. The intervention lasted eight weeks. In order to examine intervention effects of auricular acupressure, joint pain, Pressure Pain Thresholds (PPTs), and extension and flexion range of motion (ROM) were measured weekly. As for the pre- and post-examinations, pain, sleep quality, and the time-by-sleep stage of the patients with knee osteoarthritis were measured. RESULTS: The VAS scores in the experimental group with auricular acupressure significantly decreased through time (p<.001) and WOMAC also significantly decreased (p<.01) compared with the placebo-control group. However, there were no significant differences in PPTs. The flexion (p<.01) and extension (p<.001) ROMs measured for eight weeks improved over time. Meanwhile, sleep quality improved significantly after the intervention termination (p<.01), but there was no significant difference found in the time-by-sleep stage. CONCLUSION: Auricular acupressure applied for eight weeks was found to be effective in reducing joint pain, improving knee ROM, and improving sleep quality in patients with degenerative knee arthritis.
Acupressure ; Aged ; Arthralgia ; Arthritis ; Humans ; Joints ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Pain Threshold ; Random Allocation ; Range of Motion, Articular ; Sleep Stages