Cytological Features That Differentiate Follicular Neoplasm from Mimicking Lesions

BACKGROUND: It is difficult to correctly diagnose follicular neoplasms (FNs) on fine-needle aspiration cytology (FNAC) because it shares many cytological features with other mimicking lesions. The aim of this study was to identify the cytological features that differentiate FNs from mimicking lesions. METHODS: We included the cytological slides from 116 cases of thyroid FN diagnosed on FNAC, and included their subsequent histological diagnoses. We evaluated the cytological architectural pattern and nuclear features of the lesions according to their histological groups. RESULTS: The final histological diagnoses of the 116 cases varied, and included 51 FNs (44%), 47 papillary thyroid carcinomas (40%) including follicular variant, and seventeen cellular nodular hyperplasias (15%). Regardless of the final histological diagnosis, microfollicular pattern was observed in most cases. On the other hand, trabecular pattern was identified in 34% of FNs, but not in any other lesions. Additionally, elongated nuclei and ground glass chromatin were found in only some papillary thyroid carcinomas. CONCLUSIONS: This study shows that the trabecular pattern is a representative cytological feature of FNs that can be used to distinguish FNs from mimicking lesions. In addition, nuclear shape and chromatin pattern can be used to further confirm the diagnosis of FNs from mimicking lesions through FNAC.

Importance of Individual Ghost Cells in Fine-Needle Aspiration Cytology Diagnosis of Pilomatricoma

BACKGROUND: Although histological diagnosis of pilomatricoma is not difficult because of its unique histological features, cytological diagnosis through fine-needle aspiration cytology (FNAC) is often problematic due to misdiagnoses as malignancy. METHODS: We reviewed the cytological features of 14 cases of histologically-proven pilomatricoma from Korea Cancer Center Hospital, with a discussion on the diagnostic pitfalls of FNAC. RESULTS: Among 14 cases of pilomatricoma, 10 (71.4%) were correctly diagnosed through FNAC, and two (14.3%) were misdiagnosed as carcinoma. Cytologically, all cases had easily recognizable clusters of basaloid cells and foreign body-type multinucleated cells. Although ghost cells were also found in all cases, some were inconspicuous and hardly recognizable due to their small numbers. CONCLUSIONS: An accurate diagnosis of pilomatricoma in FNAC is feasible with consideration of clinical information and close examination of ghost cells.

Development of a Korean Geriatric Suicidal Risk Scale (KGSRS)

PURPOSE: Increase in suicide rate for senior citizens which has become widespread in our society today. It is not a normal social phenomenon and is beyond the danger level. The contents of this study include Korean senior citizens' suicide related risk factors and warning signs, and the development of a simple Geriatric Suicide Risk Scale. METHODS: This study is Methodological Research to verify reliability and validity of the Geriatric Suicide Risk Scale according to the tool development process suggested by Devellis (2012). RESULTS: For predictive validity assessment, high suicide screening accuracy was showed with an Area under the ROC curve (AUC) of .93. For the optimal cutoff point of 11, sensitivity was 93.9%, and specificity, 75.7% which are excellence levels. Cross validity for assessment of generalization possibility showed the Area under the ROC curve (AUC) as .82 and in case of a cutoff point of 11, sensitivity was 73.7%, and specificity, 65.9%. CONCLUSION: When it comes to practical nursing, it is significant that the Korean Geriatric Suicide Risk Scale has high reliability and validity through adequate tool development and the tool assessment step to select degree of suicide risk of senior citizens. Also, it can be easily applied and does not take a long time to administer. Further, it can be used by health care personnel or the general public.

Factors Influencing Quality of Caregiving by Caregivers for Elders with Dementia

PURPOSE: The aim of the study is to determine factors influencing quality of caregiving by caregivers for the elderly with dementia. METHODS: Data were collected from 87 caregivers for elders with dementia who had visited in Busan Metropolitan Center for Dementia and D-University hospital outpatient center from July 10 to September 30, 2015. A self-reported questionnaire was used to assess the severity of the elders' dementia and knowledge of dementia, burdens and quality of caregiving by the caregivers. The SPSS 21.0 version program was used for data analysis. Data were analyzed using descriptive statistics, Pearson's correlation, t-test, ANOVA and multiple regression. RESULTS: Significant predictors of quality of caregiving by caregivers included caregivers' burdens (explanation power 25%), knowledge of dementia (explanation power 4%) and levels of education (explanation power 3%). These factors explained 32.3% of the variances in quality of caregiving. CONCLUSION: Burdens on caregivers were a major factor that decreased quality of caregiving, and knowledge of dementia was a factor that increased it. These findings show that educational programs and intervention for reducing burdens and improving knowledge of dementia are necessary to improve quality of caregiving by caregivers.

The Effect of Abuse Experience and Coping Styles on Suicidal Ideation in the Elderly

PURPOSE: The aim of this study is to determine the impact of abuse experience and coping styles on suicidal ideation in Korean elders. METHODS: Data were collected from the 2011 Korean National Survey on the Elderly. The participants were 10,537 elders aged 65 or older who had replied to the question on suicidal ideation. Socio-demographic and health related factors, abuse experience, and coping style were included as the influence factors of suicidal ideation. Data were analyzed using x2-test and logistic stepwise regression with the SPSS/WIN 21.0 program. RESULTS: The prevalence of abuse experience among the elders was 12.7% and that of suicidal ideation was 11.2%. Elders with abuse experience (OR=2.79, 95% CI=2.39~3.26) were more likely to have suicidal ideation but those with an active coping style (OR=0.69, 95% CI=0.57~0.84) were less likely to have suicidal ideation even with other influence factors controlled. CONCLUSION: Abuse experience of the elderly was a major risk factor that increased suicidal ideation, and active coping style was a protective factor that reduced suicidal ideation. These findings show that careful attention to elderly abuse and education for active coping style are necessary to reduce suicidal ideation among the elderly.

A Study on Factors Influencing Elders' Suicidal Ideation: Focused on Comparison of Gender Differences

PURPOSE: The purpose of this study is to describe the prevalence of suicidal ideation and to investigate related factors contributing to suicidal ideation in elderly people with focus on comparison of gender differences. METHODS: From the database of the Fourth Korean National Health and Nutrition Examination Survey (KNHANES-IV), the researchers selected 3,164 old adults aged over 65. The original study was a population-based epidemiological survey of health and nutrition in a stratified multistage clustered probability design. Data were analyzed by using chi2-test and t-test and multiple logistic regression with the SPSS/WIN18.0program. RESULTS: Suicidal ideation in women (37.5%) occurred more frequently than men (17.5%). Depression, stress, restriction on activities and quality of life were significant variables of suicidal ideation in both the men and women aged 65 over. Low educational levels and economic states were significantly associated with suicidal ideation in men but not in women. CONCLUSION: The development of a suicide prevention program for elders requires different approaches to the genders respectively. It is also recommended that programs be developed that can help control the variables identified in this study along with a follow-up study for verifying the model.

Health Literacy, Health Risk Perception and Health Behavior of Elders

PURPOSE: The aim of this study is to clarify the level of health literacy, health risk perception and health behavior of Korean elders and to determine the impact of their health literacy and health risk perception on their health behavior. METHODS: A descriptive correlation study was conducted with 188 elders aged 65 or older in senior welfare centers in Busan. Questionnaires were used to measure levels of health literacy, health risk perception, and health behavior. Descriptive statistics, t-test, ANOVA, Kruskal Wallis test, Pearson's correlation, and hierarchical regression were performed. RESULTS: 43.6% of the subjects had low levels of health literacy. There was a negative relation between health literacy and health risk perception, and between health risk perception and health behavior. There was a positive relation between health literacy and health behavior. Health concern, health literacy affected health behavior. Health literacy independently accounted for 24% of health behavior. Health risk perception didn't affect health behavior. CONCLUSION: Many of the Korean elders had low levels of health literacy and health literacy was independently associated with health behavior. These findings show that interventions for improving health literacy are necessary to enhance health behavior of the elderly.

Factors Associated with Sexual Debut among Korean Middle School Students

PURPOSE: The purpose of this study was to investigate factors associated with sexual debut among Korean middle school students. METHODS: From the database of the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBS), the researchers selected 37,297 middle school students aged 12-15 years. Data were analyzed using chi2 test and multiple logistic regression with the SPSS WIN 18.0 program. RESULTS: The proportion of middle school students who had a sexual debut was 2.1% of boys and 1.5% of girls. In multiple regression analysis, economic status, experience of part time work, smoking, drug use and depression were associated with an increased proportion of sexual intercourse for both boys and girls. Living with parents, drinking alcohol and suicidal ideation were associated with sexual debut for boys only. By contrast, formal sexual education was associated with a reduced risk of sexual debut. CONCLUSION: The results of this study show the factors associated with sexual debut among Korean middle school students. Gender-related interventions should be taken into consideration in school sexual education programmes, because of differences in related factors according to gender.

Factors Contributing to the Intention to Quit Smoking in Community-dwelling Elderly Smokers

PURPOSE: The purpose of this study was to investigate factors associated with the intention to quit smoking in community-dwelling elderly smokers. METHODS: From the database of the Fourth Korean National Health and Nutrition Examination Survey (KNHANES-IV), the researchers selected 448 elderly smokers over the age of 65. Data were analyzed with the chi2 test and multiple logistic regression using the SPSS/WIN 18.0 program. RESULTS: Of the respondents, 45.5% intended to quit. The factors associated with the intention to quit were relative youth, having limit of activity day living and having past attempts to quit. CONCLUSION: Population-based smoking cessation programs, especially those targeted at the elderly, should take these predictors into consideration in the design of interventions.

Correlation between Severe ALS Patient-Caregiver Couples' Characteristics and Caregivers' Health Related Quality of Life

PURPOSE: The purpose of this cross-sectional study was to examine the relationship between characteristics of severe ALS patient-caregiver couples and health related quality of life (HRQoL) in family caregivers. METHODS: The participants in this study were 89 pairs of ALS patients using ventilators and a family caregiver. The characteristics of the ALS patients and caregivers, Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, Zarit Burden Interview and SF-36 were measured in this study. The data were collected from August 2008 to April 2009. Descriptive statistics, Pearson correlation coefficients, and canonical correlation were used for data analysis. RESULTS: The physical component summary and mental component summary of the HRQoL score for family caregivers were 147.49+/-31.63 and 129.09+/-35.83, respectively. HRQoL for caregivers was related to characteristics of the ALS patient-caregiver couples, such as patient's gender, caregiver's age, gender, marital status, daily time spent in caregiving and burden with one significant canonical variable. The significant variate showed that the lower the age, the time spent in caregiving and the burden of caregivers, the higher the HRQoL of caregivers. CONCLUSION: The support systems for caregivers considering caregiver characteristics such as demographics and burden should be implemented to improve the HRQoL of caregivers.

Factors Contributing to Low Weight in Community-Dwelling Older Adults

PURPOSE: The purposes of this study were to describe the prevalence of low weight and to investigate related factors contributing to low weight in community-dwelling older adults. METHODS: From the database of the Fourth Korean National Health and Nutrition Examination Survey (KNHANES-IV), the researchers selected 2,964 older adults aged over 65. The original study was a population-based epidemiological survey of health and nutrition with a stratified multistage clustered probability design. Data were analyzed using chi2-test and multiple logistic regression with the SPSS/WIN 18.0 program. RESULTS: The prevalence of low weight in older adults was 4.7%. The prevalence of low weight was different according to demographic characteristics. That is, the rate was higher in male elders, older ones, and rural residents. In the cases of current smoking, frequent alcohol consumption and no chronic disease, the prevalence of low weight was higher. Age, gender, area of residence, and current smoking were found to be contributing factors to low weight in community-dwelling older adults. CONCLUSION: The result of this study provides important insights into possible reasons for low weight in community-dwelling older adults and suggests that low weight should be considered in promoting older adults' health.

Factors Contributing to Low Weight in Community-Dwelling Older Adults

PURPOSE: The purposes of this study were to describe the prevalence of low weight and to investigate related factors contributing to low weight in community-dwelling older adults. METHODS: From the database of the Fourth Korean National Health and Nutrition Examination Survey (KNHANES-IV), the researchers selected 2,964 older adults aged over 65. The original study was a population-based epidemiological survey of health and nutrition with a stratified multistage clustered probability design. Data were analyzed using chi2-test and multiple logistic regression with the SPSS/WIN 18.0 program. RESULTS: The prevalence of low weight in older adults was 4.7%. The prevalence of low weight was different according to demographic characteristics. That is, the rate was higher in male elders, older ones, and rural residents. In the cases of current smoking, frequent alcohol consumption and no chronic disease, the prevalence of low weight was higher. Age, gender, area of residence, and current smoking were found to be contributing factors to low weight in community-dwelling older adults. CONCLUSION: The result of this study provides important insights into possible reasons for low weight in community-dwelling older adults and suggests that low weight should be considered in promoting older adults' health.

Quality of Life and Care Burden of Caregivers of Ventilator-dependent Amyotrophic Lateral Sclerosis Patients

OBJECTIVE: To describe the quality of life (QOL) and care burden of caregivers of ventilator-dependent amyotrophic lateral sclerosis (ALS) patients and to compare the QOL of ALS caregivers with that of dementia caregivers. METHOD: Ninety-one pairs of ALS patients and their caregivers were interviewed. Patients were asked to provide their age, sex, time since diagnosis, and length of ventilator use, as well as complete the ALS functional rating scale-revised (ALSFRS-R). Caregivers were asked to provide baseline demographic data including age, sex, education level, marital status, link with the patient, occupation, care time, substitute caregiver, and personal caregiver. The short form-36 (SF-36) and burden interview (BI) were also administered to evaluate caregivers' QOL and care burden. T-tests, ANOVA, and Pearson correlation coefficients were used for data analysis. RESULTS: Ninety-one pairs of patients (men 69.2%, women 30.8%) and caregivers (men 24.2%, women 73.6%) completed the study. The mean SF-36 physical component summary (PCS), mental component summary (MCS), and total scores of caregivers were 131.5+/-13.2, 114.3+/-17.6, 245.8+/-28.2, respectively, which showed that the QOL of ventilator-dependent ALS patients was decreased. The BI score was 52.8+/-17.8, which meant that caregivers were heavily burdened. The SF-36 total and MCS were correlated with the BI. Care time was an important factor that influenced QOL and care burden. QOL was significantly lower for ventilator-dependent ALS caregivers than for dementia caregivers. CONCLUSION: This survey revealed the poor QOL and heavy burden of ventilator-dependent ALS caregivers, which necessitates social interventions including strategies about care time.

A Survey of Respiratory Care in Amyotrophic Lateral Sclerosis Patients Using Non-invasive Ventilatory Support

OBJECTIVE: To investigate the current status of respiratory care in community-dwelling amyotrophic lateral sclerosis (ALS) patients using non-invasive ventilatory support. METHOD: Trained investigators visited patients' homes in order to conduct the survey. Questions regarding the time since diagnosis and ventilatory support, department and type of ventilator were asked. The parameters of mechanical ventilation were noted. The presence of respiratory symptoms, frequency of oxygen saturation monitoring, maneuvers for sputum clearance and frequency of air stacking exercise were also investigated. RESULTS: Data from 169 individuals were analyzed. The mean age was 59.1+/-12.5 years, time since diagnosis was 48.0+/-42.8 months and duration of ventilatory support was 25.7+/-20.8 months. The types of ventilator used were significantly different according to the medical departments where they had been prescribed. More than 50% of the subjects had sleep awakening, shortness of breath or daytime drowsiness despite ventilatory support. Air stacking exercises were performed in 8.8%. Sputum clearing maneuvers such as manually assisted cough, mechanical in/ex-sufflation or postural drainage were used by 13.6% of the individuals. Only 16.0% of the patients checked their oxygen saturation level more than once a day. CONCLUSION: Current respiratory care is inappropriate in ALS patients using non-invasive ventilatory support at home. The current system for ventilator prescription and monitoring needs modification to improve the respiratory care status.

Analysis of Service Occupation Types and Training Programs of Services for the Aged in Busan

PURPOSE: The purpose of this study was to analyze service occupation types and to develop training programs for the aged. METHODS: This study used descriptive study design. The research process consisted of three stages: first, identified the demand of service manpower for the aged; second, investigated present jobs and education programs in Korea and Japan; and last, developed service jobs and education programs for the aged. RESULTS: Potential users considered "health management" to be the most important area. They thought "providing job" as second most important. According to the result of analyzing Korean policies, there were 9 service occupations in 5 domains. So, we derived 10 occupations such as 'daily living manager', 'care manager', 'care worker', 'health manager', 'education specialist', 'leisure manager', 'good manager', 'housing manager', 'financial specialist' and 'retirement consultant' in 5 domains as healthcare, leisure, goods, housing and finance. Finally, we developed their tailored training programs. CONCLUSION: According to this study, there should be various occupations qualified by the government, and training programs should be settled. And healthcare providers must included in developing standardized training programs.

Effectiveness of Public Health Center Smoking Cessation Counseling Program using the Transtheoretical Model

PURPOSE: The purpose of this study was to identify the effectiveness of public health center smoking cessation counseling program using the transtheoretical model on the process of change, smoking temptation, decisional balance and stage change transition. METHODS: A nonequivalent control group non-synchronized design was used for this study. The study population was 115 adult smokers. The counseling program was administered to the experimental group and a smoking cessation program from the Korean Ministry of Health & Welfare was administered to the control group. Descriptive analysis, chi-square-test, t-test, and ANCOVA were used with the SPSS 12.0 program to analyze the data. RESULTS: After treatment with this program, the experimental group showed significantly higher scores for process of change (t=4.148, p<.001), smoking temptation (t=-2.988, p=.003), and stage change transition (chi-squre=5.871, p=.031) compared to the control group. Experimental group members also showed significantly lower score for Pros of smoking (t=-3.151, p=.002). CONCLUSION: The findings indicate that this program could have positive effect on process of change, smoking temptation, decisional balance and stage transition for adult smokers. Based on these findings, the authors suggest additional counseling program focusing on smokers in specific stages.

Relationships among Lifestyle, BMI, BP, and Serum Lipid Profiles in Working Men / 성인간호학회지

PURPOSE: The purpose of this study was to examine lifestyle, BMI, BP, and lipids profiles in male subjects and to explore the relationships among variables. METHODS: A total of 148 male subjects were recruited from one life insurance company from December 1, 2005 to February 28, 2006. Data collection methods were structured questionnaire, anthropometry and serum analysis. The relationships among lifestyle, BMI, BP, and serum lipid profiles were assessed by descriptive analysis, t-test, ANOVA, and partial Pearson's correlation coefficient of variables after controlling for age, educational level, and economic status. RESULTS: The mean BMI of the participants was relatively high as 25.38(range: 18.38 - 32.83). The differences of serum lipid profiles according to age, educational level, and economic status were significant. 'Use of caffeine and drugs'(r = -.187, p < .05) and 'consciousness of safety'( r= -.200, p < .05) was negatively related to BMI. Higher score of 'type of personality' domain was correlated with lower systolic BP(r = -.221, p < .01) and lower diastolic BP(r = -.195, p < .05) and was positively correlated with HDL(r = .191, p < .05). CONCLUSION: 'Use of caffeine and drugs', 'consciousness of safety' and 'type of personality' of lifestyle as well as 'dietary habit' and 'exercise' played a key role in circulatory disease.

Cytologic Evaluation of CellPrep(R) Liquid-based Cytology in Cervicovaginal, Body Fluid, and Urine Specimens: Comparison with ThinPrep(R) / 대한세포병리학회지

This study purposed to evaluate a CellPrep(R) (CP) of liquid-based cytology (LBC) to search for a less expensive and automated alternative cytologic preparation technique applicable to usually encountered cytologic specimens. Cervicovaginal direct-to-vial split samples from 457 gynecologic patients, 40 body fluid samples, and 34 urine samples were processed with the CP technique and the results were compared with those of currently used ThinPrep(R) (TP) method. Both CP and TP methods provide evenly distributed thin layers of cells with little cellular overlaps or significant obscuring elements in most of cases. Staining quality of both preparations showed a little difference due to the difference of fixative solutions without significant distractions in cytologic interpretation. On the supposition that TP was a gold standard, sensitivity, specificity, positive predictive value, and negative predictive value of CP cytology were 89%, 98%, 86%, and 99% in the cervicovaginal smear, 89%, 82%, 80%, and 90% in body fluid, and all of these values were 100% in urine samples. To testify the availability of immunohistochemistry on CP preparations, cytokeratin, vimentin, and Ki-67 were applied on body fluid specimens, and all of these antibodies were specifically stained on targeted cells. Conclusively, the CP method gave comparable results to those of TP in terms of smear quality and cytologic diagnostic evaluation, and was available on immunohistochemistry. The CP method could offer a cost-effective and automated alternative to the current expensive techniques of liquid- based cytology on popular cytologic materials including cervicovaginal, body fluid, and urine specimens.

Discriminating Power of Socio-demographic and Psychological Variables on Addictive Use of Cellular Phones Among Middle School Students / 간호학회지

PURPOSE: The purpose of this study was to examine the degrees of cellular phone usage among middle school students and to identify discriminating factors of addictive use of cellular phones among sociodemographic and psychological variables. METHODS: From 123 middle schools in Busan, potential participants were identified through stratified random sampling and 747 middle school students participated in the study. The data was collected from December 1, 2004 to December 30, 2004. Descriptive and discriminant analyses were used. RESULTS: Fifty seven percent of the participants were male and 89.7% used cellular phones at school. The participants were grouped into three groups depending on the levels of the cellular phone usage: addicted (n=117), dependent (n=418), non-addicted (n=212). Within the three groups, two functions were produced and only one function was significant, discriminating the addiction group from non-addiction group. Additional discriminant analysis with only two groups produced one function that classified 81.2% of the participants correctly into the two groups. Impulsiveness, anxiety, and stress were significant discriminating factors. CONCLUSION: Based on the findings of this study, developing intervention programs focusing on impulsiveness, anxiety and stress to reduce the possible addictive use of cellular phones is suggested.

Health-Related Quality of Life among Women Caregivers of Older Adults with Dementia / 성인간호학회지

PURPOSE: The objective of this study was to define the predictors of health related quality of life(HRQoL) of women caregivers of the demented elderly patients. METHODS: The subjects of this study were 140 pairs of patients with dementia and their caregivers. The characteristics of dementia patients and caregivers, Barthel index and SF-36 were measured in this study. T-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regression were used for data analysis. RESULTS: The health related quality of life(HRQoL) score of women caregivers was 288.35+/-66.10 for norm based scoring. HRQoL of women caregivers was correlated with patients' ADL, severity of dementia, caregivers' age, burden, and family support. The major factors that affected the physical components of women caregivers of patients with dementia was the age of the caregiver, burden, and ADL which explained 36.0% of HRQoL. The main predictors of women caregivers' emotional state was the caregiver's burden. CONCLUSION: Patients' support systems must be implemented to improve the physical HRQoL of caregivers. A caregivers' burden relief program needs to be prepared to increase their emotional HRQoL and further studies and efforts will be needed to evaluate those effects.