Reliability and Validity of the Korean version of Short-Form Health Literacy Scale for Adults

Purpose@#The aim of this study was to evaluate the validity and reliability of the Korean version of Short-form Health Literacy Scale (HLS-SF-K12) for Adults. @*Methods@#The English HLS-SF12 was translated into Korean with forward and backward translation. Survey data were collected from 204 adults who visited two hospitals in Korea. Content validity, construct validity, and known-groups validity were evaluated. Cronbach's ⍺ for internal consistency and test-retest were used to assess reliability. SPSS 21.0 and AMOS 21.0 software were used for data analysis. @*Results@#The HLS-SF-K12 was composed of 12 items, and three subscales (health care, disease prevention, and health promotion). The instrument explained reliable internal consistency with Cronbach’s ⍺ for the total scale of .89, and .74~.81 for subscales. The model of three subscales for the HLS-SF-K12 was validated by confirmatory factor analysis (Normed x 2 =2.14 (p<.001), GFI=.92, RMR=.04, RMSEA=.08, CFI=.94, TLI=.92, IFI=.94). The hypothesis testing which analyzed the differences in health literacy by age and education level was satisfied. @*Conclusion@#The HLS-SF-K12 is a valid and reliable instrument for measuring health information comprehension for adults in Korea.

Reliability and Validity of the Korean version of Short-Form Health Literacy Scale for Adults

Purpose@#The aim of this study was to evaluate the validity and reliability of the Korean version of Short-form Health Literacy Scale (HLS-SF-K12) for Adults. @*Methods@#The English HLS-SF12 was translated into Korean with forward and backward translation. Survey data were collected from 204 adults who visited two hospitals in Korea. Content validity, construct validity, and known-groups validity were evaluated. Cronbach's ⍺ for internal consistency and test-retest were used to assess reliability. SPSS 21.0 and AMOS 21.0 software were used for data analysis. @*Results@#The HLS-SF-K12 was composed of 12 items, and three subscales (health care, disease prevention, and health promotion). The instrument explained reliable internal consistency with Cronbach’s ⍺ for the total scale of .89, and .74~.81 for subscales. The model of three subscales for the HLS-SF-K12 was validated by confirmatory factor analysis (Normed x 2 =2.14 (p<.001), GFI=.92, RMR=.04, RMSEA=.08, CFI=.94, TLI=.92, IFI=.94). The hypothesis testing which analyzed the differences in health literacy by age and education level was satisfied. @*Conclusion@#The HLS-SF-K12 is a valid and reliable instrument for measuring health information comprehension for adults in Korea.

A Comparison of Outcomes of Three Reconstruction Methods after Laparoscopic Distal Gastrectomy

PURPOSE: The aim of this study was to compare the short-term surgical and long-term functional outcomes of Billroth I, Billroth II, and Roux-en-Y reconstruction after laparoscopic distal gastrectomy. MATERIALS AND METHODS: We retrospectively collected data from 697 patients who underwent laparoscopic distal gastrectomy for operable gastric cancer between January 2009 and December 2012. The patients were classified into three groups according to the reconstruction methods: Billroth I, Billroth II, and Roux-en-Y. The parameters evaluated included patient and tumor characteristics, operative details, and postoperative complications classified according to the Clavien-Dindo classification. Endoscopic findings of the remnant stomach were evaluated according to the residue, gastritis, bile (RGB) classification and the Los Angeles classification 1 year postoperatively. RESULTS: Billroth I, Billroth II, and Roux-en-Y were performed in 165 (23.7%), 371 (53.2%), and 161 patients (23.1%), respectively. Operation time was significantly shorter (173.4+/-44.7 minute, P<0.001) as was time to first flatus (2.8+/-0.8 days, P=0.009), time to first soft diet was significantly faster (4.3+/-1.0 days, P<0.001), and postoperative hospital stay was significantly shorter (7.7+/-4.0 days, P=0.004) in Billroth I in comparison to the other methods. Postoperative complications higher than Clavien-Dindo grade III occurred in 61 patients (8.8%) with no statistically significant differences between groups (P=0.797). Endoscopic findings confirmed that gastric residue, gastritis, bile reflux, and reflux esophagitis were significantly lower in Roux-en-Y (P<0.001) patients. CONCLUSIONS: Roux-en-Y reconstruction after laparoscopic distal gastrectomy for middle-third gastric cancer is beneficial in terms of long-term functional outcome, whereas Billroth I reconstruction for distal-third gastric cancer has a superior short-term surgical outcome and postoperative weight change.

Protective effects of propofol against hydrogen peroxide-induced oxidative stress in human kidney proximal tubular cells / 대한마취과학회지

BACKGROUND: We investigated the protective effects of propofol in the HK-2 cell line of human kidney proximal tubular cells against hydrogen peroxide (H2O2)-induced oxidative stress. METHODS: After pretreatment with different concentrations of propofol (0 microM, 10 microM, 25 microM and 50 microM) for 30 minutes, HK-2 cells were exposed to 8 mM H2O2 for 4 hours. Cell death was assessed by measuring the percentage of lactate dehydrogenase (LDH) release and by counting viable cells. The nature of cell death was assessed by doubles-taining cells with fluorescein isothiocyanate-labeled Annexin V and propidium iodide, and then analyzing the cells using flow cytometry. RESULTS: After exposure to 8 mM H2O2 for 4 hours, the percentage of LDH release was 45.1 +/- 4.2% and the number of viable HK-2 cells was 5.2 +/- 6.0%. Pretreatment with propofol suppressed H2O2-induced LDH release in a concentration-dependent manner, reducing the percentage of LDH release to 38.1 +/- 5.6%, 33.5 +/- 6.3%, and 26.2 +/- 3.8% of the controls at 10 microM, 25 microM and 50 microM propofol, respectively. Numbers of viable cells increased following propofol pretreatment, with 11.4 +/- 10.9%, 19.5 +/- 16.1%, and 32.4 +/- 23.3% cell survival rates after pretreatment with 10 microM, 25 microM and 50 microM propofol, respectively. Analyses of flow cytometry showed that the propofol pretreatment decreased the percentage of necrotic and late apoptotic cells. CONCLUSIONS: Propofol protects HK-2 human kidney proximal tubular cells against H2O2-induced oxidative stress.

Comparison of Energy Expenditure and Walking Performance by Arm Cycling and Leg Cycling Exercise

OBJECTIVE: To investigate the effect of cycling ergometry and to compare energy expenditure and walking performance after arm cycling with those after leg cycling in patients with brain diseases. METHOD: Twenty-two adults with brain diseases (6 stroke, 4 traumatic brain injury, 4 brain tumor, 4 parkinsonism, 4 cerebral palsy) were recruited as subjects. They were randomly assigned to disease-matched groups; arm cycling and leg cycling (n=11 each). VO2 (L/min), VCO2 (L/min), VE (L/min), O2 rate (ml/kg, min), O2 pulse (ml/kg, bpm), O2 cost (ml/kg, m) and VO2 peak (ml/kg, min) during cycling test or walking test, and walking performance were evaluated after cycling training for 4~6 weeks. RESULTS: Arm cycling exercise did not improve any parameters such as VO2, VCO2, O2 rate and O2 cost during walking test, whereas it increased VCO2, VE and O2 pulse during cycling test. In contrast, leg cycling significantly improved walking velocity and distance, and decreased O2 cost during walking test. It also increased all parameters including VO2 peak during cycling test (p<0.05). CONCLUSION: Leg cycling exercise improved walking performance and energy efficiency of walking as well as cardiorespiratory fitness relative to arm cycling. Therefore, leg cycling promoted lower-extremity task such as walking in patients with brain diseases.

Anesthetic management of a patient with prune-belly syndrome : A case report

Prune-belly syndrome is characterized by absent abdominal wall musculature with wrinkled overlying skin, urinary tract dilatation and cryptorchidism. Prune-belly syndrome is also associated with diseases of the respiratory, cardiovascular, skeletal, gastrointestinal and central nervous system. Because the congenital disease is uncommon, it is difficult to collect the information of anesthetic management of prune-belly syndrome. We report a case of 4 year-old-boy with prune-belly syndrome who underwent abdominoplasty and Mitrofanoff operation under general anesthesia.

Unexpected Massive Bleeding during Liver Transplantation in Patients with Budd-Chiari Syndrome: A case report / 대한마취과학회지

Budd-Chiari syndrome (BCS) is a heterogenous group of disorders characterized by obstruction of hepatic venous outflow. Severe liver cirrhosis and limited cardiac reserve in patients with BCS makes them less tolerant to liver transplantation. We experienced two cases of massive bleeding during living donor liver transplantation in patients with BCS. Blood products and fluids were rapidly infused with a rapid infusion system, final infusion volume in these two patients were 177 L and 193 L, and the use of Cell Savers allowed for the patient's blood products to be saved. The patients were managed successfully and recovered uneventfully with advanced monitoring, including monitoring of their jugular venous oxygen saturation and continuous cardiac output. Therefore, rapid infusion systems and Cell Savers, along with advanced monitoring, are necessary in the event of massive bleeding during liver transplantation.

The Effect of Halothane on Hearing Loss and Apoptosis in Noise Exposing Mouse / 대한마취과학회지

BACKGROUND: In large clinical series, noise induced hearing loss (NIHL) following middle ear surgery has been demonstrated in 1.2% to 4.5% of patients and it is associated with a lower incidence than expected. The aim of the present work was to analyze the effect of halothane anesthesia on NIHL and hair cell morphological change. METHODS: We used 40 BALB/c mice with normal Preyer's reflex to investigate the effect of halothane on the NIHL. Control (n = 20) and halothane group (n = 20, respectively) were exposed to 120 dB SPL (sound pressure level), broad band white noise 3 hours daily for 3 consecutive days. The halothane group was anesthetized with halothane while exposed to noise. Hearing thresholds were determined with the auditory brainstem response (ABR). On day 7 post-noise, mice were sacrificed and the cochlea were collected for the histological study. RESULTS: ABR thresholds in the halothane group were less elevated after noise exposure than in the control group and then gradually recovered. In control group, the damage to the outer hair cell and supporting cell was noticeable, but not in halothane group. The expression of Bcl-2 protein was detected in halothane group, the expression of Bax protein was seen in control group. As a result in TUNEL stain, the result is positive in the control group but negative in the halothane group. CONCLUSIONS: The occurrence of NIHL decreased and the tissue damage was suppressed while anesthetized by halothane. And the noise-induced cell death of hair cell was also suppressed during anesthesia.

The Effect of Increased FIO2 before Removal of the Laryngeal Mask Airway on Postanesthetic Arterial Partial Oxygen Pressure / 대한마취과학회지

BACKGROUND: The administration of 100% oxygen at the end of general anesthesia before tracheal extubation has been shown to worsen postanesthetic pulmonary gas exchange. Because the laryngeal mask airway (LMA) and the endotracheal tube (ETT) are very different, it remains uncertain whether emergence on oxygen has the same results on lung function as ETT. Therefore, the aim of this study was to evaluate whether the use of 100% oxygen before LMA removal worsens gas exchange after inhalation or total intravenous general anesthesia. METHODS: Eighty ASA physical status I-II patients scheduled for elective surgery of the extremities were randomly assigned to receive either sevoflurane or propofol during general anesthesia with LMA. At the end of surgery, patients were randomized to an inspiratory fraction of oxygen of 0.3 in sevoflurane (n = 20), of 0.3 propofol (n = 20) or of 1.0 in sevoflurane (n = 20) or of 1.0 in propofol (n = 20) during emergence from anesthesia and LMA removal. Postoperative blood gas measurements were taken immediately and 60 min after arrival in the recovery room. RESULTS: No significant differences in PaO2 (propofol groups: 87.5 +/- 14.4 vs 88.5 +/- 10.5 mmHg, sevoflurane groups: 86.7 +/- 11.3 vs 90.7 +/- 9.9 mmHg) or alveolar - arterial oxygen tension difference (AaDO2) were found between the two groups at 30 min after LMA removal (propofol groups: 12.0 +/- 12.4 vs 10.3 +/- 8.3 mmHg, sevoflurane groups: 8.6 +/- 7.1 vs 7.1 +/- 9.4 mmHg). No differences were observed between the sevoflurane and propofol groups when FIO2 levels were similar. CONCLUSIONS: Breathing 100% oxygen during emergence from general anesthesia does not worsen postanesthetic pulmonary gas exchange when an LMA is used.

A Case of Eruptive Vellus Hair Cyst: Facial Variant / 대한피부과학회지

Eruptive vellus hair cysts(EVHCs) are small, red or brown colored cystic papules that usually occur on the chest and proximal extremities of children and adults. Although EVHCs, facial variant, is rare and chracteristic in its location and color, histopathological findings of facial variant are not different from those of typical EVHC. We report a case of EVHC, facial variant which occured on the face of 23-year-old man with asymptomatic, bluish papules. The lesions first appeared at the age of 19 years and had increased in number thereafter.