Is screening and surveillance for early detection of gastric cancer needed in Korean Americans?

The incidence rate of gastric cancer in Korean Americans is over five times higher than that in non-Hispanic whites, and is similar to the incidence of colorectal cancer in the overall United States population. In Korea, the National Cancer Screening Program recommends endoscopy or upper gastrointestinal series for people aged 40 years and older every 2 years. However, the benefit of gastric cancer screening in Korean Americans has not been evaluated. Based on epidemiologic studies, Korean Americans appear to have more similar gastric cancer risk factors to Koreans as opposed to Americans of European descent, though the risk of gastric cancer appears to decrease for subsequent generations. Therefore, in accordance with recent recommendations regarding screening for gastric cancer in Korea, endoscopic screening for gastric cancer in Korean Americans should be considered, especially in those with known atrophic gastritis/intestinal metaplasia or a family history of gastric cancer. In the future, additional studies will needed to assess whether a screening program for gastric cancer in Korean Americans will result in a survival benefit.

Cultural Factors Associated with Breast and Cervical Cancer Screening in Korean American Women in the US: An Integrative Literature Review

PURPOSE: This study examined current research theories and methods, cultural factors, and culturally relevant interventions associated with breast and cervical cancer screening in Korean American (KA) women. METHODS: Based on Ganong's guidelines, the literature on cultural factors associated with breast and cervical cancer screening in KA women was searched using MEDLINE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Sixty-eight articles on breast cancer screening and 66 articles on cervical cancer screening were retrieved from both databases, and a total of 22 articles were included in the literature review based on the selection criteria. RESULTS: Of the 22 studies reviewed, 14 (63.6%) were descriptive and 8 (36.4%) were interventional. Many studies have used individual focused cognitive theories such as health belief model and different types of operationalization for measures of cultural beliefs. Cultural factors associated with breast and cervical cancer screening in KA women that were identified in descriptive quantitative and qualitative studies included family, embarrassment, preventive health orientation, fatalism, and acculturation. Most culturally relevant interventional studies used education programs, and all education was conducted by bilingual and bicultural health educators at sociocultural sites for KA women. CONCLUSIONS: Theories focusing on interpersonal relationships and standardized, reliable, and valid instruments to measure cultural concepts are needed to breast and cervical cancer screening research in KA women. Traditional cultural factors associated with cancer screening should be considered for practical implications and future research with KA women.

Changes in and Factors Affecting Second-hand Smoke Exposure in Nonsmoking Korean Americans in California: A Panel Study

PURPOSE: We evaluated changes in and factors affecting second-hand smoke (SHS) exposure in a panel study of nonsmokers. METHODS: This study was based on data from a larger study of tobacco use among a representative sample of adults of Korean descent residing in California. Participants included 846 males and 1,399 females who were nonsmokers at baseline (2005-2006) and at follow-up (2007-2009). Participants were selected by probability sampling and were interviewed by telephone. RESULTS: At baseline, 50.0% were exposed to any SHS, and at follow-up 2 years later, 60.4% were exposed to any SHS (p < .001). SHS exposure at baseline was associated with acculturation, employment, spousal smoking, and having a friend who smoked (p < .001). Employment, spousal smoking, and other family members smoking were associated with SHS at follow-up (p < .001). The odds ratio of SHS in the employed group declined from 2.01 at baseline to 1.53 at follow-up, that of the group having a smoking spouse increased from 1.88 to 2.36, and that of the group having other family members smoking increased from 1.20 to 1.69. CONCLUSIONS: We showed that SHS exposure increased among Korean American nonsmokers in California, and the most important variables explaining the change in SHS exposure involved smoking among others with whom the subject is associated. These findings could be used as objective evidence for developing public health policies to reduce SHS exposure.

Fatigue Severity and Factors Associated with High Fatigue Levels in Korean Patients with Inflammatory Bowel Disease

BACKGROUND/AIMS: Many patients with inflammatory bowel disease (IBD) often complain of fatigue. To date, only a few studies in Western countries have focused on fatigue related to IBD, and fatigue has never been specifically studied in Asian IBD patients. The aim of the present study was to investigate the fatigue level and fatigue-related factors among Korean IBD patients. METHODS: Patients in remission or with mild to moderate IBD were included. Fatigue was assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue and the Brief Fatigue Inventory. Corresponding healthy controls (HCs) also completed both fatigue questionnaires. RESULTS: Sixty patients with Crohn disease and 68 patients with ulcerative colitis (UC) were eligible for analysis. The comparison group consisted of 92 HCs. Compared with the HCs, both IBD groups were associated with greater levels of fatigue (p<0.001). Factors influencing the fatigue score in UC patients included anemia and a high erythrocyte sedimentation rate (ESR). CONCLUSIONS: Greater levels of fatigue were detected in Korean IBD patients compared with HCs. Anemia and ESR were determinants of fatigue in UC patients. Physicians need to be aware of fatigue as one of the important symptoms of IBD to better understand the impact of fatigue on health-related quality of life.

Can Western Based Online Prostate Cancer Risk Calculators Be Used to Predict Prostate Cancer after Prostate Biopsy for the Korean Population?

PURPOSE: To access the predictive value of the European Randomized Screening of Prostate Cancer Risk Calculator (ERSPC-RC) and the Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) in the Korean population. MATERIALS AND METHODS: We retrospectively analyzed the data of 517 men who underwent transrectal ultrasound guided prostate biopsy between January 2008 and November 2010. Simple and multiple logistic regression analysis were performed to compare the result of prostate biopsy. Area under the receiver operating characteristics curves (AUC-ROC) and calibration plots were prepared for further analysis to compare the risk calculators and other clinical variables. RESULTS: Prostate cancer was diagnosed in 125 (24.1%) men. For prostate cancer prediction, the area under curve (AUC) of the ERSPC-RC was 77.4%. This result was significantly greater than the AUCs of the PCPT-RC and the prostate-specific antigen (PSA) (64.5% and 64.1%, respectively, p<0.01), but not significantly different from the AUC of the PSA density (PSAD) (76.1%, p=0.540). When the results of the calibration plots were compared, the ERSPC-RC plot was more constant than that of PSAD. CONCLUSION: The ERSPC-RC was better than PCPT-RC and PSA in predicting prostate cancer risk in the present study. However, the difference in performance between the ERSPC-RC and PSAD was not significant. Therefore, the Western based prostate cancer risk calculators are not useful for urologists in predicting prostate cancer in the Korean population.

SNP in differentially methylated region upstream of H19 gene in Chinese Korean nationality / 法医学杂志

OBJECTIVE@#To investigate SNP and distribution of haplotypes in differentially methylated region (DMR) upstream of H19 gene in Chinese Korean nationality in order to provide basic data for forensic application and population genetics research.@*METHODS@#One hundred and one blood samples from unrelated Chinese Korean individuals and 14 blood samples from 5 Chinese Korean intergenerational families which known genetic relationship were collected. The SNP in DMR upstream of H19 gene were investigated by PCR-cycle sequencing and McrBC digestion followed by PCR. The haplotypes detected by parentally imprinted allele (PIA) method and relevant genetic parameters were calculated.@*RESULTS@#Thirteen SNPs (rs10840167, rs2525883, rs12417375, rs4930101, rs2525882, rs2735970, rs2735971, rs11042170, rs2735972, rs10732516, rs2071094, rs2107425, and rs4930098) and five haplotypes were detected in 1 174 bp target product in DMR upstream of H19 gene, with 9 SNPs having high discrimination power as good genetic markers. The average gene diversity (GD) of haplotypes was 0.714. The maternal haplotype was confirmed correctly by PIA method from McrBC-digested products of genomic DNA.@*CONCLUSION@#High polymorphisms exist in DMR upstream of H19 gene in Chinese Korean nationality. And determination of the maternal haplotype could furthermore enhance the forensic identification efficiency of imprinted gene.

Perception of aging among Korean undergraduate nursing students

OBJECTIVE: To explore perceptions of aging among Korean undergraduate nursing students. METHODS: The participants for the study were 102 undergraduate nursing students, selected from two universities in Korea. The questions were non-structured, open-ended in order for the students to make sufficiently complete statements regarding their experiences with aging. RESULTS: The collected materials were classified into 4 themes, 13 sub-themes and 30 meaning units. Four themes emerged: fullness, emptiness, transference, and desirability. Most nursing students perceived aging positively as fullness and desirability, which are influenced by Confucianism. CONCLUSION: In conclusion, Confucianism as a cultural context should be considered to develop strategies for promoting a positive perception of aging in Korea.

OBJETIVO: Explorar a percepção sobre envelhecimento entre alunos de graduação em Enfermagem de duas universidades da Coréia do Sul. MÉTODOS: Pesquisa de abordagem qualitativa, do tipo descritivo com amostra de 102 graduandos em Enfermagem, selecionados com base em duas universidades desse país. As cinco questões utilizadas na pesquisa foram abertas, não estruturadas para possibilitar que os estudantes relatassem de modo completo suas experiências sobre envelhecimento; os relatos, obtidos entre os meses de setembro e novembro de 2010, foram submetidos à análise de conteúdo. RESULTADOS: Os materiais coletados foram classificados em quatro temas: plenitude, vazio, transferência e conveniência. A maioria dos estudantes de enfermagem percebeu o envelhecimento de forma positiva em relação à plenitude e conveniência, que são influenciados por valores do confucionismo. CONCLUSÃO: O confucionismo deve ser considerado como um contexto cultural para desenvolver estratégias de promoção de percepção positiva do envelhecimento na Coréia do Sul.

OBJETIVO: Explorar la percepción sobre el envejecimiento entre alumnos de pregrado en Enfermería de dos universidades de Corea del Sur. MÉTODOS: Investigación con abordaje cualitativo, de tipo descriptivo realizado con una muestra de 102 graduandos en Enfermería, seleccionados en dos universidades de ese país. Las cinco preguntas utilizadas en la investigación fueron abiertas, no estructuradas para posibilitar que los estudiantes relaten de modo completo sus experiencias sobre envejecimiento; los relatos, obtenidos entre los meses de setiembre y noviembre del 2010, fueron sometidos al análisis de contenido. RESULTADOS: Los materiales recolectados fueron clasificados en cuatro temas: plenitud, vacío, transferencia y conveniencia. La mayoría de los estudiantes de enfermería percibió al envejecimiento de forma positiva en relación a la plenitud y conveniencia, que son influenciados por valores del confucionismo. CONCLUSIÓN: El confucionismo debe ser considerado como un contexto cultural para desarrollar estrategias de promoción de percepción positiva del envejecimiento en Corea del Sur.

Spirometric Standards for Healthy Children and Adolescents of Korean Chinese in Northeast China

In China there are 1,923,842 Korean Chinese, who live mostly (92.27%) in the country's three northeast provinces. In spite of this sizeable number, no spirometric data are available at present on them. The present study investigated normal spirometric reference values for the Korean Chinese children and adolescents. Spirometry was performed in 443 healthy Korean Chinese children and adolescents aged 8-18 yr with measurements of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF) and maximum mid-expiratory flow (MMEF). Reference equations for FEV1, FVC, PEF and MMEF were derived by using multiple regression analysis. All of the measured spirometric parameters correlated positively with height and age significantly (P < 0.001). The predicted values of FVC and FEV1 were higher than values obtained by using Caucasian and other Asian equations (P < 0.001). A set of spirometric reference equations has been derived using a relatively large, healthy, non-smoking young Korean Chinese population with a wide range of ages and heights, the results of which differ from those gained from several other reference equations. These reference equations should be used for evaluation of lung function in this population.

The Meaning of Illness among Korean Americans with Chronic Hepatitis B

PURPOSE: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. METHODS: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. RESULTS: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. CONCLUSION: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.

Evaluation of Various Formulae for Glomerular Filtration Rate Estimation and Proposal of New Formulae for the Korean Population / 대한진단검사의학회지

BACKGROUND: Some researchers have questioned the necessity of adjusting glomerular filtration rate (GFR) by body surface area (BSA). We compared the relationship between estimated GFR (eGFR) and radionuclide GFR (rGFR) with or without BSA adjustment by comparing the results obtained using various formulae with those obtained using 2 new proposed formulae. METHODS: A retrospective study was performed using 204 Korean individuals whose GFR had been estimated by the (99m)Tc-diethylenetriaminepentaacetic acid method between March 2004 and July 2008. We used the modification of diet in renal disease (MDRD) II formula, Mayo clinic quadratic (MCQ) formula, Cockcroft-Gault (CG) formula, and lean body mass-adjusted CG formula. Two new formulae, skeletal muscle mass index (SMI)-adjusted CG formula and SMIx3.4/SCr, were proposed by us. We analyzed each parameter with Pearson's correlation coefficient and also obtained the bias values. RESULTS: BSA did not satisfy the fundamental prerequisites of an adjustment factor for rGFR. MDRD II and MCQ GFR estimates demonstrated higher Pearson's correlation coefficient with BSA-unadjusted rGFR than they did with BSA-adjusted rGFR. The other GFR formulae estimates showed better correlation with rGFR and more favorable bias (P<0.001) when both GFR estimates and rGFR values were BSA-unadjusted. SMI-adjusted CG and SMIx3.4/SCr GFR estimates demonstrated correlation with rGFR and bias values similar to those of the MDRD II and CG GFR estimates. CONCLUSIONS: We suggest that absolute, non-corrected GFR and GFR estimate be preferred in daily practice. The absolute, non-corrected GFR and GFR estimate are considered helpful for patients with eGFR< or =60 mL/min/1.73 m2. We also recommend the clinical use of the new formulae, SMI-adjusted CG and SMIx3.4/SCr (BSA-unadjusted).

A Structural Equation Model on Mental Health of Korean Immigrants in Canada

PURPOSE: The aim of this study was to construct a structural equation model that would further explain the mental health status of Korean immigrants living in Canada. METHODS: Survey using a structured questionnaire was conducted with 386 people in Canada (Vancouver and Toronto). Six instruments were used in this model. The analysis of data was done with both SPSS 14.0 for descriptive statistics and AMOS 5.0 for covariance structure analysis. RESULTS: Based on the constructed model, physical health status, immigrant life stress, self esteem, and quality of life were found to have significant direct effect on mental health. In addition, factors such as physical health status, immigrant life stress, quality of life, English proficiency, family cohesion and social support were found to indirectly affect mental health. The final modified model yielded Chi-square=34.79 (p<.001), df=13, Chi-square/df=2.68, GFI=0.98, AGFI=0.94, NFI=0.95, PNFI=0.44, PGFI=0.35, RMSE=0.07 and exhibited good fit indices. CONCLUSION: This structural equation model is a comprehensive theoretical model that explains the related factors and their relationship with mental health in Korean immigrants. Findings of this study can contribute to the designing of an appropriate prevention strategy to further improve the mental health of immigrants in Canada.

Ethnic Coefficients for Glomerular Filtration Rate Estimation by the Modification of Diet in Renal Disease Study Equations in the Korean Population

Race and ethnicity are influential in estimating glomerular filtration rate (GFR). We aimed to find the Korean coefficients for the Modification of Diet in Renal Disease (MDRD) study equations and to obtain novel proper estimation equations. Reference GFR was measured by systemic inulin clearance. Serum creatinine (SCr) values were measured by the alkaline picrate Jaffe kinetic method, then, recalibrated to CX3 analyzer and to isotope dilution mass spectrometry (IDMS). The Korean coefficients for the 4 and 6 variable MDRD and IDMS MDRD study equations based on the SCr recalibrated to CX3 and to IDMS were 0.73989/0.74254 and 0.99096/0.9554, respectively. Coefficients for the 4 and 6 variable MDRD equations based on the SCr measured by Jaffe method were 1.09825 and 1.04334, respectively. The modified equations showed better performances than the original equations. The novel 4 variable equations for Korean based on the SCr measured and recalibrated to IDMS were 107.904xSCr-1.009xage-0.02 (x0.667, if woman) and 87.832xSCr-0.882xage0.01 (x0.653, if woman), respectively. Modified estimations of the MDRD and IDMS MDRD study equations with ethnic coefficients and the novel equations improve the performance of GFR estimation for the overall renal function.