Relationship Between Symptoms of Depression and Smoking and Obesity in Korean Office Workers Younger than 40 Years

BACKGROUND: Though many factors have been found to be associated with depression, still many others remain uncovered. There are few studies that have focused on the younger population whose depressive symptoms are socioeconomically more important than that of the older population. This study is designed to clarify if there is a relationship between depression and smoking and obesity in the young population. METHODS: Office workers from 40 companies who underwent medical check-ups in 2011 were initially selected. Of these, 65,309 subjects had responded to self-reported questionnaires on depressive symptoms with 4,187 subjects being excluded on the basis of past medical history and current medication. Logistic regression was performed to evaluate the relationship between depression and the selected variables. RESULTS: The proportion of high risk groups for depression was significantly high in females. Statistically significant results were only seen in females. Smoking and obesity were related to depression in females as assessed by the Center for Epidemiological Studies-Depression Scale score. Logistic regression analysis also showed that smoking (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.62-2.05) and obesity (OR, 1.48; 95% CI, 1.18-1.82) were related to depressive symptoms in females. CONCLUSIONS: Depressive symptoms in young female office workers under 40 years of age are related to smoking and obesity. By acting towards stopping smoking and being in a healthy weight category, females may lessen their risk for depression, and thereby lessen their socioeconomic losses.

Relationship Between Symptoms of Depression and Smoking and Obesity in Korean Office Workers Younger than 40 Years

BACKGROUND: Though many factors have been found to be associated with depression, still many others remain uncovered. There are few studies that have focused on the younger population whose depressive symptoms are socioeconomically more important than that of the older population. This study is designed to clarify if there is a relationship between depression and smoking and obesity in the young population. METHODS: Office workers from 40 companies who underwent medical check-ups in 2011 were initially selected. Of these, 65,309 subjects had responded to self-reported questionnaires on depressive symptoms with 4,187 subjects being excluded on the basis of past medical history and current medication. Logistic regression was performed to evaluate the relationship between depression and the selected variables. RESULTS: The proportion of high risk groups for depression was significantly high in females. Statistically significant results were only seen in females. Smoking and obesity were related to depression in females as assessed by the Center for Epidemiological Studies-Depression Scale score. Logistic regression analysis also showed that smoking (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.62-2.05) and obesity (OR, 1.48; 95% CI, 1.18-1.82) were related to depressive symptoms in females. CONCLUSIONS: Depressive symptoms in young female office workers under 40 years of age are related to smoking and obesity. By acting towards stopping smoking and being in a healthy weight category, females may lessen their risk for depression, and thereby lessen their socioeconomic losses.

Relationship Between Symptoms of Depression and Smoking and Obesity in Korean Office Workers Younger than 40 Years

BACKGROUND: Though many factors have been found to be associated with depression, still many others remain uncovered. There are few studies that have focused on the younger population whose depressive symptoms are socioeconomically more important than that of the older population. This study is designed to clarify if there is a relationship between depression and smoking and obesity in the young population. METHODS: Office workers from 40 companies who underwent medical check-ups in 2011 were initially selected. Of these, 65,309 subjects had responded to self-reported questionnaires on depressive symptoms with 4,187 subjects being excluded on the basis of past medical history and current medication. Logistic regression was performed to evaluate the relationship between depression and the selected variables. RESULTS: The proportion of high risk groups for depression was significantly high in females. Statistically significant results were only seen in females. Smoking and obesity were related to depression in females as assessed by the Center for Epidemiological Studies-Depression Scale score. Logistic regression analysis also showed that smoking (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.62-2.05) and obesity (OR, 1.48; 95% CI, 1.18-1.82) were related to depressive symptoms in females. CONCLUSIONS: Depressive symptoms in young female office workers under 40 years of age are related to smoking and obesity. By acting towards stopping smoking and being in a healthy weight category, females may lessen their risk for depression, and thereby lessen their socioeconomic losses.

Detection of Transferrin Receptor Over-Expression in a Rodent Model of Myocardial Ischemia/Reperfusion Injury Using Novel 99mTc Transferrin Conjugates: A Pilot Study

BACKGROUND AND OBJECTIVES: Reperfusion of ischemic myocardium is necessary to salvage tissue from eventual death. However, new pathophysiological changes are initiated after reperfusion. The aim of this study was to investigate one of the mechanisms of ischemia/reperfusion (I/R) injury, and we focused on transferrin. MATERIALS AND METHODS: Male Spragre-Dawley (SD) rats were used for the I/R model. Myocardial ischemia was produced by occlusion of the left anterior descending coronary artery for 30 minutes. 99mTc Transferrin-Chitosan-hydrazino nicotinate hydrochloride (HYNIC) (Tfc) (/37 MBq/mL) was injected once after the reperfusion was finished. Autoradiography, hematoxylin and eosin (H & E) staining and determination of the tissue myeloperoxidase (MPO) activity were performed. RESULTS: Autoradiography showed remarkable 99mTc-Tfc uptake in the left ventricular myocardium at the reperfusion period from 0 to 1.5 hours, whereas no uptake was demonstrated at 3 hours. The uptake was increased again at 6 and 24 hours. Western blotting showed that the transferrin receptor (TfR) proteins were increased at 0 to 1.5 hours compared with that of the control; this expression of TfR disappeared at 3 hours, and it showed up for the second time at 6 and 24 hours. The MPO activity only at 24 hours was significantly higher than that of the control and those MPO activities at 0 to 6 hours (p=0.001). CONCLUSION: In the rodent model of 30 minutes occlusion and reperfusion, our study revealed, with using 99mTc-Tfc, that the TfR expression increased in the myocardium till 3 hours after reperfusion. TfR-mediated entry of iron into the cardiomyocytes may represent that this process plays a role in the I/R injury during the early reperfusion period.

Peliosis Hepatis with Hemorrhagic Necrosis and Rupture: a Case Report with Emphasis on the Multi-Detector CT Findings

We report here on an uncommon case of peliosis hepatis with hemorrhagic necrosis that was complicated by massive intrahepatic bleeding and rupture, and treated by emergent right lobectomy. We demonstrate the imaging findings, with emphasis on the triphasic, contrast-enhanced multidetector CT findings, as well as reporting the clinical outcome in a case of peliosis hepatis with fatal hemorrhage.

The Impact of Appendiceal CT on Patients with Suggestive Appendicitis

PURPOSE: This study was performed to evaluate the contribution of appendiceal computed tomography (CT) in the more accurate diagnosis of acute appendicitis and decrease in the rate of negative appendectomies. METHODS: Between May and August 2005, 146 patients with right lower quadrant (RLQ) abdominal pain and tenderness were diagnosed using appendiceal CT. The appendiceal CT scans were performed with contrast media in the abdominal and pelvic areas. 7 mm slice scans were taken both before and after the contrast media injection, with a time delay. The control group was comprised of 99 patients, who were also checked by abdominal CT or ultrasonography, between December 2004 and April 2005, with the data analyzed retrospectively. RESULTS: In the study group, 85 of the 146 cases were diagnosed with acute appendicitis on appendiceal CT, and had undergone an appendectomy, including 42 men (mean age 39.9 yr) and 43 women (mean age 44.6 yr). The sensitivity and specificity of appendiceal CT in acute appendicitis were 95.3 and 98.4%, respectively. There were 4 (4.7%) negative appendectomy cases; 2 in men and 2 in women. The control group conprised of 47 men and 52 women. There were 13 (13.1%) negative appendectomy cases; 4 in men and 9 in women. CONCLUSION: The routine use of appendiceal CT, in patients with RLQ abdominal pain and tenderness, resulted in a significant decrease in the negative appendectomy rate.

A Case of MALT-lymphoma of the Ampulla of Vater / 대한소화기내시경학회지

Primary gastrointestinal lymphomas originating from the mucosa-associated lymphoid tissue (MALT) have been reported with increasing frequency. The stomach is the most frequent site of MALT lymphoma, and a relationship with Helicobacter pylori infection has been studied. However, primary MALT lymphoma arising from the ampulla of Vater is extremely rare, and its relationship with Helicobacter pylori infection is still obscure. We report here a case of a 71-year-old man with marginal zone B cell lymphoma of MALT with large B cell lymphoma of the ampulla of Vater that was not associated with Helicobacter pylori. A pancreaticoduodenectomy was performed, and the pathologic examination of the resected specimen confirmed the diagnosis. The patient tolerated just one course of systemic chemotherapy, but has been doing well for 18 months after surgery.

The Effects of Job Stress on the Autonomic Nerve Activity of Workers in Manufacturing Industry / 대한산업의학회지

OBJECTIVE: A cross-sectional study was conducted to evaluate the relationships between autonomic nerve activity (i.e., heart rate variability and urinary catecholamines) and job stress. METHODS: The study was conducted on 134 workers from a company producing consumer goods (i.e., diaper, paper towel) located in Cheonan, Korea. Job stress was assessed by Karasek's Job Content Questionnaire (JCQ). Autonomic function was assessed by heart rate variability (HRV) and urinary catecholamines (epinephrine, norepinephrine, and dopamine). Urine samplings, and measurings of HRV, were repeated three times for each shift. Information on demographic characteristics, previous job histories, past medical history, smoking and drinking were also collected. RESULTS: No statistically significant differences were observed in any HRV and urinary catecholamines among the four groups, which were categorized by the Job Strain Model. When data were stratified by work duration, low field HRV was borderline significantly higher in the high strain group in individuals with a shorter work duration (<48.5 months, N=28, p-value of 0.92 by analysis of variance). CONCLUSIONS: Neither HRV nor urinary catecholamines are significantly associated with job stress, as assessed by the Karasek's JCQ. However, HRV seems to be a potential physiological indicator of job stress only in the workers with a shorter work duration.

The Association of Workplace Cumulative Noise Exposure and Blood Pressure / 대한산업의학회지

OBJECTIVES: The association of workplace cumulative noise exposure and blood pressure was investigated in this study using cross-sectional design. METHODS: The study population comprised 852 manufacturing male workers of whom occupational health examination data, questionnaire and personnel records were available. Workplace ambient noise monitoring data was used for calculating individual cumulative noise exposure level. Mean of each systolic and diastolic blood pressure of occupational health examination data was used for individual systolic and diastolic blood pressure level. Possible confounding variables including family history of hypertension, smoking habit, alcohol drinking habit were collected by questionnaire. On the basis of job location and duration of work at the location, a cumulative time-weighted average noise level was calculated for each workers. According to this cumulative noise exposure level, each study subject was categorized as low noise exposure group, moderate noise exposure group, high noise exposure group, very high noise exposure group. Among noise exposure groups, mean of systolic and diastolic blood pressure was compared after adjusting possible confounding variables such as age, body mass index, serum cholesterol level, family history of hypertension, smoking history, alcohol drinking habit. RESULTS: After adjusting possible confounding variables, noise exposure group was significant explanatory variables for both systolic and diastolic blood pressure, and mean of both systolic and diastolic blood pressure of very high exposure group was higher than that of low exposure group. CONCLUSIONS: These findings suggested that the high cumulative noise exposure might elevate the blood pressure.

Occult Micrometastasis of Sentinel Lymph Node in Node-negative Breast Cancer

PURPOSE: Sentinel lymph node (SLN) biopsy is thought to be a highly accurate method of assessing axillary nodal status in breast cancer. Furthermore, it can improve axillary staging by providing a more detailed examination of selected lymph nodes with a high probability of metastasis rather than the entire axillary nodes. The purpose of this study was to assess the incidence of SLN micrometastasis in node-negative breast cancer. METHODS: SLN biopsy was performed in 40 patients with clinically node-negative breast cancer using vital blue dye and/or radioisotope methods; the blue dye method was used in 21 cases, the isotope method in 14 cases, and a combination of both methods in 5 cases. All lymph nodes were evaluated by routine pathologic examination, and a more detailed examination was performed on sentinel nodes in node-negative cases; sentinel nodes were serially sectioned at an interval of 40nm depth followed by H&E and cytokeratin immunohistochemical (IHC) staining. RESULTS: Sentinel nodes were detected in 35 of 40 patients (87.5%). The mapping technique used in the remaining 5 cases was vital blue dye method only. Axillary node metastasis was found in 16 of 40 patients. Sentinel node biopsy accurately reflected the axillary node status in all cases; the sensitivity, specificity, and overall accuracy were 100, 100 and 100%, respectively. In 11 of 16 node-positive patients (68.8%), sentinel nodes were the only metastatic nodes. Occult micrometastases were found in SLN by serial sectionand IHC staining in 4 of 19 patients diagnosed as node- negative by routine pathological examination (21.1%). Occult micrometastasis of SLN was not correlated with primary tumor size, histologic grade or lymphovascular invasion with the exception of the S-phase fraction (P=0.023). CONCLUSION: SLN biopsy was a highly accurate method of assessing axillary node metastasis in breast cancer. Serial sectioning and IHC staining of SLN were sensitive methods in the detection of occult lymph node metastasis.

Carcinoma Originating from Aberrant Breast Tissue of the Right Upper Anterior Chest Wall : A Case Report

Aberrant breast tissue is usually found in proximity to the normal breast, that is, in the axillary, sternal or clavicular regions. Carcinoma occurs more frequently in the aberrant tissue of the axilla than the extra-axillary site though the overall incidence of tumors of aberrant breast tissue is low. To our knowledge, studies regarding the carcinoma of aberrant breast tissue of the extra-axillary site have been reported rarely. Here we report a recent case of carcinoma originating from the extra-axillary aberrant breast tissue, presenting as a subcutaneous nodule on the right upper anterior chest wall. It is suggested that subcutaneous nodules of uncertain origin around the periphery of the breast should be suspected for breast carcinoma as a differential diagnosis and treated properly.

Relationship between Cathepsin D Expression and Other Prognostic Factors in Primary Breast Cancer

PURPOSE: Cathepsin D, a lysosomal protease has been proposed to play a role in the local invasion and metastatic dissemination in primary breast cancer. Although there are many conflicting results, the overexpression of cathepsin D has been considered to be related with a poorer prognosis of breast cancer. This study was designed to verify whether cathepsin D expression is related to other prognostic factors in breast cancer. METHODS: Cathepsin D was assessed by immunohistochemistry using murine monoclonal anti-cathepsin D antibody (ZyMED) in 79 paraffin-embedded primary breast cancer specimens. Cathepsin D expression was compared to other prognostic parameters such as tumor size, axillary lymph node metastasis, tumor histologic grades, hormone receptors (ER & PR), p53, c-erb B2, Ki-67, MVD (microvessel density), and Pgp (P-glycoprotein). RESULTS: A high-expression of cathepsin D was found in 35 of 79 patients (44.3%) with primary breast cancer. Cathepsin D expression was not related to tumor size, axillary lymph node metastasis, tumor histologic grades, hormone receptors, p53, Ki-67, or CD31. However, a significant relationship was found between cathepsin D expression and c-erb B2 (p=0.007), and between cathepsin D expression and Pgp (p=0.003). CONCLUSION: These results suggest that cathepsin D expression may be an indicator of a poor prognosis in breast cancer. However, further studies are required to verify the exact role of cathepsin D in the prognosis of breast cancer.

Micrometastasis of Sentinel Lymph Node in Breast Cancer / 한국유방암학회지

PURPOSE: Sentinel lymph node (SLN) biopsy is thought to be a highly accurate method of assessing axillary nodal status in breast cancer. Furthermore, it can improve axillary staging by providing a more detailed examination of selected lymph nodes with a high probability of metastasis rather than the entire axillary nodes. The purpose of this study was to assess the incidence of SLN micrometastasis in node-negative breast cancer. METHODS: SLN biopsy was performed in 40 patients with clinically node-negative breast cancer using vital blue dye and/or radioisotope methods; the blue dye method was used in 21 cases, the isotope method in 14 cases, and a combination of both methods in 5 cases. All lymph nodes were evaluated by routine pathologic examination, and a more detailed examination was performed on sentinel nodes in node-negative cases; sentinel nodes were serially sectioned at an interval of 40micrometer depth followed by H&E and cytokeratin immunohistochemical (IHC) staining. RESULTS: Sentinel nodes were detected in 35 of 40 patients (87.5%). The mapping technique used in the remaining 5 cases was vital blue dye method only. Axillary node metastasis was found in 16 of 40 patients. Sentinel node biopsy accurately reflected the axillary node status in all cases; the sensitivity, specificity, and overall accuracy were 100, 100 and 100%, respectively. In 11 of 16 node-positive patients (68.8%), sentinel nodes were the only metastatic nodes. Occult micrometastases were found in SLN by serial section and IHC staining in 4 of 19 patients diagnosed as node- negative by routine pathological examination (21.1%). Occult micrometastasis of SLN was not correlated with primary tumor size, histologic grade or lymphovascular invasion with the exception of the S-phase fraction (P=0.023). CONCLUSION: SLN biopsy was a highly accurate method of assessing axillary node metastasis in breast cancer. Serial sectioning and IHC staining of SLN were sensitive methods in the detection of occult lymph node metastasis.

Micrometastasis of Sentinel Lymph Node in Breast Cancer / 한국유방암학회지

PURPOSE: Sentinel lymph node (SLN) biopsy is thought to be a highly accurate method of assessing axillary nodal status in breast cancer. Furthermore, it can improve axillary staging by providing a more detailed examination of selected lymph nodes with a high probability of metastasis rather than the entire axillary nodes. The purpose of this study was to assess the incidence of SLN micrometastasis in node-negative breast cancer. METHODS: SLN biopsy was performed in 40 patients with clinically node-negative breast cancer using vital blue dye and/or radioisotope methods; the blue dye method was used in 21 cases, the isotope method in 14 cases, and a combination of both methods in 5 cases. All lymph nodes were evaluated by routine pathologic examination, and a more detailed examination was performed on sentinel nodes in node-negative cases; sentinel nodes were serially sectioned at an interval of 40micrometer depth followed by H&E and cytokeratin immunohistochemical (IHC) staining. RESULTS: Sentinel nodes were detected in 35 of 40 patients (87.5%). The mapping technique used in the remaining 5 cases was vital blue dye method only. Axillary node metastasis was found in 16 of 40 patients. Sentinel node biopsy accurately reflected the axillary node status in all cases; the sensitivity, specificity, and overall accuracy were 100, 100 and 100%, respectively. In 11 of 16 node-positive patients (68.8%), sentinel nodes were the only metastatic nodes. Occult micrometastases were found in SLN by serial section and IHC staining in 4 of 19 patients diagnosed as node- negative by routine pathological examination (21.1%). Occult micrometastasis of SLN was not correlated with primary tumor size, histologic grade or lymphovascular invasion with the exception of the S-phase fraction (P=0.023). CONCLUSION: SLN biopsy was a highly accurate method of assessing axillary node metastasis in breast cancer. Serial sectioning and IHC staining of SLN were sensitive methods in the detection of occult lymph node metastasis.

Relationship between Cathepsin D Expression and Other Prognostic Factors in Primary Breast Cancer / 한국유방암학회지

PURPOSE: Cathepsin D, a lysosomal protease has been proposed to play a role in the local invasion and metastatic dissemination in primary breast cancer. Although there are many conflicting results, the overexpression of cathepsin D has been considered to be related with a poorer prognosis of breast cancer. This study was designed to verify whether cathepsin D expression is related to other prognostic factors in breast cancer. METHODS: Cathepsin D was assessed by immunohistochemistry using murine monoclonal anti-cathepsin D antibody (ZyMED) in 79 paraffin-embedded primary breast cancer specimens. Cathepsin D expression was compared to other prognostic parameters such as tumor size, axillary lymph node metastasis, tumor histologic grades, hormone receptors (ER & PR), p53, c-erb B2, Ki-67, MVD (microvessel density), and Pgp (P-glycoprotein). RESULTS: A high-expression of cathepsin D was found in 35 of 79 patients (44.3%) with primary breast cancer. Cathepsin D expression was not related to tumor size, axillary lymph node metastasis, tumor histologic grades, hormone receptors, p53, Ki-67, or CD31. However, a significant relationship was found between cathepsin D expression and c-erb B2 (p=0.007), and between cathepsin D expression and Pgp (p=0.003). CONCLUSION: These results suggest that cathepsin D expression may be an indicator of a poor prognosis in breast cancer. However, further studies are required to verify the xact role of cathepsin D in the prognosis of breast cancer.

Interaction between Genetic Polymorphisms of CYP2E1 & NAT1 and Smoking in Lung Cancer Development (Preliminary report) / 대한암학회지

PURPOSE: The interactive effects of genetic polymorphisms of cytochrome P4502E1 (CYP2E1) & N-acetyltransferase 1 (NAT1) and smoking on lung cancer development were evaluated in hospital based case-control study. MATERIALS AND METHODS: Male lung cancer patients (N= 157) and the male patients with no present or previous history of systemic illnesses who visited the urology department (N=138) were recruited (1998-1999). CYP2E1 & NAT1 genotypes were determined by PCR-RFLP method using RsaI and MboII digestion, respectively. RESULTS: CYP2E1 c2 or NAT1 *10 allele did not increased the risk of lung cancer. Heavy smokers (35

A Case of Complete Response by Hormonal Therapy with Tamoxifen and Progesterone in Recurrent Endometrial Cancer to Metastasis to Lung / 대한산부인과학회잡지

Endometrial carcinoma has been the most common female pelvic malignancy in the U.S.A. Approximately one-fourth of patient treated for early endometrial cancer will develop reccure-nt disease. Kelly and Baker first descibed that the use of progestational agents for treatment of met- astatic endometrial cancer in 1961. Response of progesterone therapy in metastatic endometrial cancer is related to several factors. Higher response rates are observed in well differentiated tumors, longer disease free interval and tumors that positive for estrogen and progesterone re- ceptors. We experienced a case of complete response in recurrent endometrial cancer to metastasis to lung treated by tamoxifen and progesterone, we present this case with a brief review of lite- rature.

A Case of Complete Response by Combination Chemotherapy with BEP Regimen in Endodermal Sinus Tumor of Ovary / 대한산부인과학회잡지

Endodermal sinus tumors(EST) have also been referred to as "yolk sac tumors" because they are derived from the primitive yolk sac. These lesions are the third most frequent malignant germ-cell tumors of the ovary. Recent advances in treating the endodermal sinus tumor of the ovary with the combination chemotherapy result in improvement of the prognosis. We had experienced a case of the endodermal sinus tumor of 15 year old woman. We report this case with a brief review of literatures.

A Comparative Study on MIB-1, AgNORs and PCNA Expressions in Astrocytic Tumors

Cell cycle associated nuclear proteins such as proliferating cell nuclear antigen(PCNA), argyrophilic nucleolar organizer regions(AgNORs) and the family of nuclear proteins identified by the Ki-67 epitope, have been primarily utilized for estimating of growth potential of neoplasms. Although PCNA and AgNORs staining are possible in the paraffin-embedded tissue, Ki-67 staining had been only possible on frozen sections. Recently monoclonal antibody MIB-1 is available, and reacts with the Ki-67 epitope in paraffin-embedded tissue. Twenty eight astrocytic tumors in paraffin-embedded, archival materials were stained by immunohistochemical technique for the MIB-1, PCNA, and by silver colloid stain for AgNORs. The MIB-1 labeling indicies(LI) ranged from 2 to 25%(10+/-7.58) for 10 glioblastomas; from 2 to 15%(7+/-3.74) for 11 anaplastic astrocytomas; and from 1 to 5%(3+/-1.91) for low grade astrocytomas. Glioblastomas and anaplastic astrocytomas exhibited significantly higher MIB-1 LI than their benign counterparts(p<0.05). The AgNORs count per cell ranged from 1.3 to 3.1(1.96+/-0.57) for 10 glioblastomas: from 1.2 to 3.1(1.9+/-0.64) for 11 anaplastic astrocytomas: and from 0.8 to 1.5(1.2+/-0.26) for low grade astrocytomas. Glioblastomas and anaplastic astrocytomas exhibited significantly higher AgNORs count than their benign counterparts(p<0.05). The PCNA LI ranged from 10 to 40%(24.5+/-10.39) for 10 glioblastomas; from 5 to 20%(11.6+/-5.24) for 11 anaplastic astrocytomas; and from 5 to 10%(7.1+/-2.67) for low grade astrocytomas. The differences of PCNA LI between glioblastomas and anaplastic astrocytomas(p<0.01), and between glioblastomas and low grade astrocytomas(p<0. 001) were statistically significant. Linear regression analysis showed correlations between MIB-1 LI and AgNORs count(Spearmans r=0.4306, p<0.05), between PCNA LI and AgNORs count(Spearman's r=0.586, p<0.05) and between PCNA and MIB-1 LI(Spearman's r=0.4523, p<0.05). These findings suggest that LI of MIB-1, PCNA and AgNORs count are correlated each other, and can be used as helpful markers for differentiating astrocytic tumors in addition to conventional staining methods.