Perceptions of the Risk of Cardiovascular Disease in Middle-aged Male Taxi Drivers: Focus Group Interviews / 한국직업건강간호학회지

Purpose@#This study aimed to comprehensively examine middle-aged male taxi drivers' perceptions of the risk of cardiovascular disease. @*Methods@#A qualitative method was used, with focus group interviews. The participants were middle-aged male taxi drivers who had been driving for more than ten years and for more than six hours daily. @*Results@#The data were analyzed using qualitative thematic analysis. Middle-aged male taxi drivers' perceptions of the risk of cardiovascular disease were categorized into three main themes:　 “individual perceptions of cardiovascular disease”, “possibility of behaviors for cardiovascular disease” and “motivations of behaviors for cardiovascular disease”. Six sub-themes were extracted as follows: “perception of vulnerability”, “perception of seriousness”, “perception of profitability”, “perception of disability”, “self-awareness” and “advancing toward health care”. @*Conclusion@#It is necessary to invigorate support systems through measures including education, counseling, and web-based programs to prevent cardiovascular disease in middle-aged male taxi drivers.

Types of Parenting of Fathers during Early Childhood: A Q Methodological Approach

PURPOSE: The purpose of this study was to examine types of parenting among fathers. The characteristics of parenting each type in early childhood were identified by systematically analyzing and classifying father's perceptions of parenting using the Q-methodology, which places importance on the perspective of the performer. METHODS: The Q-method, which is effective for measuring individual subjectivity was used. The subjects in this study were 50 fathers with young children (2~36 months). RESULTS: Four parenting types were identified analyzing the subjective perceptions of fathers with young children about parenting. One type was centered on character development. Another was centered on social development. A third was centered on physical health and development. The fourth was centered on building values. CONCLUSION: Parenting education programs should be developed based on type-specific characteristics and further research should investigate the effects of father's parenting type.

Analysis of Chromosome-specific Aneusomy in Breast Tumor by Using Fluorescence in Situ Hybridization

PURPOSE: Several studies have used FISH (fluorescence in situ hybridization) to analyze aneuploids in various solid tumors. FISH, using chromosome-specific, alpha-stellite DNA probes, can be used to detect aneusomy in interphase and/or metaphase cells. The aims of this study were to compare the FISH cen tromere signals from benign breast tumors and to those from breast cancers and to evaluate the clinico pathologic parameters and the aneusomic patterns involving chromosomes 1, 11, and 17 in breast cancers. METHODS: FISH was performed on touch preparations from 15 benign breast-tumor and 29 breast-cancer specimens. The frequency of aneusomy, measured by nondisomy, was determined for chromosomes 1, 11, and 17 through the use of chromosome-specific alpha-stellite DNA probes. The frequency of chromosome- specific aneusomy was then correlated with clinicopathologic parameters, including tumor size, lymph- node involvement, estrogen receptor, and nuclear grade. RESULTS: Only one of the 15 benign breast tumors was shown to be aneusomic for chromosome 1. The other 14 cases of the benign breast tumors showed no evidence of aneusomy for any of the 3 chromosomes. In breast cancers, however, 26 of the 29 cases (90%) were exhibited aneusomy of at least 1 of the 3 chromosomes evaluated and chromosome 1 was most frequently aneusomic (26 of 29 cases (90%)). The present study also suggested a possible correlation between the numeric abnormality of chromosome 1 and estrogen receptor levels. No significant correlations with tumor size, regional lymph-node metastasis, and nuclear grade were observed. CONCLUSION: These findings suggest that chromosome-specific aneusomy is more frequently observed in breast cancers than in benign breast tumors and that aneusomy of chromosome 1 correlates with estrogen receptor levels.

Expression of p53 Protein and Ki-67 in Atypical Ductal Hyperplasia, Ductal Carcinoma in Situ, and Microinvasive Ductal Carcinoma of the Breast

Mutation of the p53 gene is one of the most common genetic alterations in invasive breast carcinoma. However, it is unclear that the mutation usually occurs in noninvasive breast lesions. It might be expected that there is a correlation between histologic progression of breast lesions and proliferative rate. We investigated the expression of p53 protein and Ki-67 labelling index (LI) using immunohistochemistry in 16 ductal carcinoma in situ with microinvasion (DCIS-Mi), 56 DCIS, 15 atypical ductal hyperplasia (ADH), and 7 intraductal hyperplasia (IDH). Expression of p53 protein was detected in 33.9% of DCIS and 56.3% of DCIS-Mi and was confined exclusively in Van Nuys DCIS group 2 and 3. In ADH and IDH, no expression of p53 protein was found. There was no significant correlation between Van Nuys DCIS groups and Ki-67 LI. In conclusion, p53 mutation may be involved in the neoplastic progression from ADH to DCIS and is directly related to high nuclear grade and associated necrosis of DCIS.

Telomerase Activity in Human Breast Tumors

BACKGROUND: Telomerase is a ribonucleoprotein enzyme that synthesizes telomeric DNA onto the ends of chromosomes, thereby preventing the replication-dependent shortening of those ends. Telomerase activity is detected in a wide range of cancers of various tissues, and its expression may be a critical step in tumor progression. Our objective was to determine if detection of telomerase activity may be an indicator for diagnosis of breast cancer and if any association exists between telomerase activity and prognostic factors of breast cancer. METHODS: Using a polymerase chain reaction-based telomerase activity assay, we examined telomerase activity in 30 breast cancer specimens (2 ductal carcinoma in situ, 28 invasive ductal carcinoma), 25 benign lesions (14 fibroadenomas, 11 fibrocystic diseases), and 24 normal breast tissues (13 adjacent to malignancy, 11 adjacent to benign lesion). RESULTS: Among surgically resected samples, telomerase activity was detected in 23 (77%) of 30 breast cancers. While telomerase activity was not detected in any of the 11 specimens of fibrocystic disease and the 11 normal tissues adjacent to benign lesion, surprisingly low levels of telomerase activity were detected in 5 (36%) of the 14 fibroadenomas and 1 (7%) of the 13 normal tissues adjacent to malignancy. There was no significant difference in expression of telomerase among prognostic factors of breast cancer. CONCLUSIONS: In summary, telomerase activity may be useful in the diagnosis of breast cancer. We found no correlation between telomerase activity and stage, tumor size, or LN status. Mechanisms of telomerase expression are still under investigation; therefore, the significance of telomerase expression in malignant tumors and their progression remains to be determined.

Test Performances of Three Diagnostic Procedures in Evaluating Thyroid Nodules: Physical Examination, Ultrasonography and Fine Needle Aspiration Cytology

BACKGROUND: A retrospective study was performed to determine the reliability of physical examination (P/E), ultrasonography (U/S), and fine needle aspiration cytology (FNAC) in the evaluation of thyroid nodules. This retrospective study was designed to disclose test performances and diagnostic implications of those three procedures carried out at Samsung Cheil Hospital from Mar. 1996 to Oct. 1998. METHODS: We reviewed the cases of 73 euthyroid patients who had had all three diagnostic procedures preoperatively and who had undergone surgery for thyroid nodules. The patients consisted of 16 with benign lesions and 57 with thyroid cancers. RESULTS: The sensitivities of P/E, U/S, and FNAC for malignancy were 66.7%, 61.4%, and 77.2%, respectively. The specificities of P/E, U/S, and FNAC for malignancy were 81.3%, 87.5%, and 93.8%, respectively. When all the test results were positive, the likelihood ratio favoring a thyroid carcinoma was 219.1. When all the test results were negative, the likelihood ratio favoring a thyroid carcinoma was 0.04. CONCLUSIONS: As we have no test that always provides a perfect answer, a combination of these test results seemed to be useful in the decision making.

Effect of ceramide on apoptosis and phospholipase D activity in FRTL-5 thyroid cells

Ceramide, a product of sphingomyelin hydrolysis, is now recognized as an intracellular lipid messenger, which mediates the effects of extracellular agents on cellular growth, differentiation and apoptosis. Recently, ceramide has been implicated in the regulation of phospholipase D (PLD). In this study, we examined the effects of ceramide on the activity and mRNA level of PLD during apoptotic process in FRTL-5 thyroid cells. C2-ceramide (N-acetyl sphingosine) induced apoptosis in FRTL-5 thyroid cells. Fluorescent staining showed that ceramide induced the typical features of apoptosis including condensed or fragmented nuclei. DNA fragmentation was also observed by agarose gel electrophoresis. Flow cytometric cell cycle analysis showed more clearly that ceramide induced apoptotic cell death in FRTL-5 thyroid cells. The treatment of FRTL-5 thyroid cells with thyroid-stimulating hormone (TSH) resulted in an increased PLD activity in a dose- and time-dependent manner. However, the TSH-induced increase in PLD activity was down-regulated within 2 h after ceramide treatment. Furthermore, the levels of PLD mRNA were found to be decreased throughout apoptotic process as inferred by reverse transcription-polymerase chain reaction. However, the decreases in PLD mRNA levels were not correlated with those in PLD activities after ceramide treatment. Taken together, these data suggest that ceramide inhibits the PLD activity in an early apoptotic phase and down-regulation of the levels of PLD mRNA may be implicated in apoptotic process in FRTL-5 thyroid cells.

Telomerase Activity in Human Breast Tumors / 한국유방암학회지

Telomerase is a ribonucleoprotein enzyme that synthesizes telomeric DNA onto the ends of chromosomes. thereby preventing the replication-dependent shortening of these ends. Telomerase activity is detected in a wide range of cancers of various tissues, and its expression may be a critical step in tumor progression. Our objective was to determine if detection of telomerase activity may be an indicator for diagnosis of breast cancer and any association between telomerase activity and prognostic factors of breast cancer. Using a polymerase chain reaction-based telomerase activity assay, we examined telomerase activity in 30 breast cancer specimens (2 ductal carcinoma in situ, 28 invasive ductal carcinoma), 25 benign lesions (14 fibroadenomas, 11 fibrocystic diseases) and 24 normal breast tissues (13 adjacent to malignancy, 11 adjacent to benign lesion). Among surgically resected samples, telomerase activity was detected in 23 (77%) of 30 breast cancers. While telomerase activity was not detected in any of 11 specimens of fibrocystic disease and 11 adjacent normal tissues to benign lesion, surprisingly low levels of telomerase activity were detected in 5 (36%) of 14 fiboadenomas and 1 (7%) of 13 adjacent normal tissues to malignancy. There was no significant difference in expression of telomerase among prognostic factors of breast cancer. In summary, telomerase activity in breast cancer may be useful in diagnosis of breast cancer. We found no correlation between telomerase activity and stage, tumor size or LN status. Mechanisms of telomerase expression are still under investigation; therefore, the significance of telomerase expression in malignant tumors and their progression remains to be determined.

Needle Localization Biopsy of 546 Nonpalpable Breast Lesions

A retrospective review of 546 consecutive female patients who had undergone mammographically controlled needle localizations was performed to assess the effectiveness of the technique and to analyze the number and the characteristics of the criteria malignancies found in this group. Localization biopsy was recommended if one or more of the following criteria were present: evidence of a mass, microcalcifications, parenchymal distortion, and/or spiculation. Of those 546 patients who had undergone specimen mammography after needle localization biopsy, a lesion was detected on 544 cases and missed in 2 cases(0.3%). Fifty-five cancers were detected(10.1%) Histologically, the cancers included 23 invasive and 32 in-situ tumors. The predominant histologic cell type was ductal in origin with only three having lobular characteristics. Postoperative pathologic findings of the lymph nodes showed 3 of the 55 were positive for metastases. In summary, the technique of preoperative needle localization in this series had a 99.7% success rate. The cancer detection rates for a 'mass with a microcalcification', a 'microcalcification', and a 'mass' were 17.0, 14.0, and 5.1% respectively. As a conclusion, needle localization biopsy is a safe and effective method for definitely diagnosing nonpalpable breast lesions.

Needle Localization Biopsy of 546 Nonpalpable Breast Lesions

A retrospective review of 546 consecutive female patients who had undergone mammographically controlled needle localizations was performed to assess the effectiveness of the technique and to analyze the number and the characteristics of the criteria malignancies found in this group. Localization biopsy was recommended if one or more of the following criteria were present: evidence of a mass, microcalcifications, parenchymal distortion, and/or spiculation. Of those 546 patients who had undergone specimen mammography after needle localization biopsy, a lesion was detected on 544 cases and missed in 2 cases(0.3%). Fifty-five cancers were detected(10.1%) Histologically, the cancers included 23 invasive and 32 in-situ tumors. The predominant histologic cell type was ductal in origin with only three having lobular characteristics. Postoperative pathologic findings of the lymph nodes showed 3 of the 55 were positive for metastases. In summary, the technique of preoperative needle localization in this series had a 99.7% success rate. The cancer detection rates for a 'mass with a microcalcification', a 'microcalcification', and a 'mass' were 17.0, 14.0, and 5.1% respectively. As a conclusion, needle localization biopsy is a safe and effective method for definitely diagnosing nonpalpable breast lesions.

Evaluation of Mass Screening for Thyroid Cancer

Mass screening for detecting both thyroid and breast cancer in adult women was carried out in Samsung Cheil Hospital between March 31, 1996, and March 31, 1997. The total number of subjects during those 13 months was 3869. At first, the screening was by inspection and palpation using experienced surgeons. Thyroid abnormalities were found in 183 subjects through physical examination but thyroid nodules were identified by thyroid sonography in only 170 patients who were required to undergo a cytologic examination (FNAB). The total number of thyroid cancer cases detected was 23. The detection rate was 0.59%. In contrast, 8 cases of breast cancer were discovered during the same screening, with a detection rate of 0.21%. The size of the thyroid tumor was 2 cm or less in 20 patients (87%). The thyroid cancers detected by mass screening were discovered at an earlier stage and will show a better survival rate. As thyroid cancer can be found at an earlier stage by mass screening, the program is useful for the early detection and early treatment of thyroid cancer.

Breast Cancer Screening of 13,791 Women by Physical Examination and Mammography

This study is to clarify the efficacy of breast cancer screening by physical examination and mammography and to compare the diagnostic outcome of breast cancers detected by screeening with that of breast cancers found at out-patient clinic. Between March 1995 and July 1996, A total of 13,791 women were screeened for breast cancer annually by physical examination and mammography at Samsung Cheil Hospital Breast Center and 20 breast cancers were detected. In the same period, another 166 breast cancers were found at out-patient clinic. These two groups of breast cancers were analyzed and compared. Of those 13,791 screened women, the recall rate for further examination was 9.8%(n=1,350) and the biopsy rate was 1.06%(n=146) respectively. Twenty breast cancers were detected so that the breast cancer detection rate was 0.15%. T-stages of screened group were T0;25%, T1;55%, T2;15% and T3;5%, while those of out-patient clinic cases were T0;4.8%, T1;43.4%, T2;44.6%, T3;7.2%.(p<0.05). Axillary lymph node metastasis was negative in 80% of screened group but in 59% of out-patient clinic cases.(p<0.05). Pathological stages of screened group were; stage0;25%, stageI;40%, stageII;35% and those of out-patient clinic cases were stage0;4.8%, stageI;24%, stageII;56%, stageIII;14.4%, stageIV;1.2%(p<0.05). Early breast cancers were significantly more frequent in the patients detected by screening at breast center than those of out-patient cilinic cases. The breast conservation surgery was done in 40% of screened group but only in 12.7% of out-patient clinic cases(P=0.00029).This study indicated that the efficacy of breast cancer screening by physical examination and mammography was significant for the early detection of breast cancers.

The Carpal compression Test for Diagnosing Carpal Tunnel Syndrome / 대한정형외과학회잡지

he carpal tunnel syndrome is the most common perripheral nerve entrapment syndrome. Many tests have been used for diagnosis of carpal tunnel syndrome. A new test, called the instrumented carpal tunnel and the Tinel percussion test, the Phalen wrist-flexion test, tourniquet test, and the trodiagnostically proved carpal tunnel syndrome and in a group of 49 patients(79 hands) during the period from October 1994 to July 1995. The results were as follows; 1. The sensitivity, specificity and accuracy results of each provocative test were 53%, 88%, 70% on Tinel test, 72%, 66%, 69% on tourniquet test, 62%, 91%, 76% on Phalen test, 85%, 95%, 90% on the instrumented carpal compression test. 2. For the diagnosis of carpal tunnel syndrome, the instrumented carpal compression test was found to be the most sensitive, specific and accuracy results. 3. As a results, the new, instrumented carpal compression test with Durkan's CTS gauge was thought to be the most useful provocative diagnostic method & a simple, rapid & inexpensive technique for screening for carpal tunnel syndrome, and consisted of lightweight device.

Analysis of Containment of Femoral Head by Arthrographic findings in Legg-Calve-Perthes Disease / 대한정형외과학회잡지

The subluxation of the femoral head is one of important prognostic factors in LCPD and current treatment of LCPD is based on the premise that adequate containment of the vulnerable femoral head within the acetabulum during the process of repair should result in a more spherical femoral head and a more congruous joint than if treatments were not provided.We analised the arthrographic findings of 18 hips in unilateral LCPD in order to determine the changes of the femoral head and acetabulum, degree of the subluxation and containment of the femoral head in various position of hip. The results were as follows: 1. According to the result of sphericity, the femoral head was deformed mainly in coronal plane in LCPD. 2. Average medial joint space of normal hip was about 3.8mm in the AP view of hip, but it was more increased in any position of LCPD. 3. In abduction with internal rotation, average subluxation ratio was 7.5% in normal hip and 10.9% in LCPD. In abduction with external rotation, it was 8.3% in normal hip and 12.4% in LCPD. 4. In normal hip, the containment ratio was more than 1.0 in any position of hip, but the containment ratio was 1.03 in abduction with internal rotation and 0.95 in abduction with external rotation of hip in LCPD. 5. On the basis of these results, efficacy of the Scottish Rite orthosis was doubtful in most hips of LCPD.