BACKGROUND: This study was performed to develop a dietary self-efficacy questionnaire and to determine how dietary self-efficacy is related to selected biochemical markers and health-related quality of life in hemodialysis patients. METHODS: Participants included 172 patients who had been participating in a dialysis program for at least 6 months at two teaching hospitals. A questionnaire was used to assess socio-demographic factors, dialysis-related factors, dietary self-efficacy, and kidney disease quality of life (KDQOL). Serum levels of potassium and phosphorus and interdialytic weight gain were also measured. RESULTS: The internal reliability of dietary self-efficacy was 0.944 (Cronbach's alpha). Principal component analysis resulted in two factors, situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice. The correlation analysis showed a significant association between situational self-efficacy of compliance with dietary guidelines and serum potassium and KIDQOL. The average scores of situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice in the participants were 3.52+/-0.72 and 3.61+/-0.71 respectively. Multiple linear regression analysis showed that the situational self-efficacy of compliance with dietary guidelines was significantly associated with serum potassium level and KDQOL and self-efficacy of food choice was significantly associated with KDQOL. CONCLUSIONS: Based on our results, the developed dietary self-efficacy questionnaire may be a suitable survey tool for hemodialysis patients, which can play a role in predicting clinical indicators of patient and health-related quality of life. We recommend further research into clarifying whether the positive effects of increased dietary self-efficacy is maintained in long-term dialysis patients.
Biomarkers ; Compliance ; Dialysis ; Diet ; Hospitals, Teaching ; Humans ; Kidney Diseases ; Linear Models ; Phosphorus ; Potassium ; Principal Component Analysis ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Weight Gain

Heat shock protein of 72 kDa (HSP70) has a role in the functional modulation of sex steroid hormone receptors and in p53-associated oncogenesis and inhibits apoptosis associated with bcl-2. However, the exact role of HSP70 in the development of endometrial adenocarcinoma has not been well established. The aim of this study is to evaluate the role of HSP70 in relation with ER, PR, p53 and bcl-2 expressions and apoptosis in benign and malignant endometrial lesions. Immunohistochemical studies for HSP70, ER, PR, p53, bcl-2 and TUNEL method for apoptosis were performed in 30 cases of adenocarcinoma and 30 cases of benign endometrial lesions consisted of each 10 cases of disordered proliferative endometrium (DP), simple or complex hyperplasia (HP), and atypical hyperplasia (AH). There were no significant differences of HSP70 and bcl-2 expression rates and apoptotic index (AI) between DP, HP, AH, and adenocarcinoma. p53 expression rate in adenocarcinoma was 36.7%, but no p53 expression was identified in DP, HP and AH (p<0.05). In adenocarcinoma, HSP70 expression rate was higher in ER and PR negative adenocarcinoma (p<0.05), and p53 expression rate was higher in nonendometrioid type and FIGO grade II and III (p<0.05), but no significant difference of bcl-2 expression rate according to the histological type and FIGO grade. AI was higher in nonendometrioid type (p<0.05). There was no correlation between HSP70, p53 and bcl-2 expressions, and no significant difference of AI according to HSP70, ER, PR, p53, and bcl-2 expressions. In conclusion, higher HSP70 expression rate in poorly differentiated and ER and PR negative adenocarcinoma suggests that HSP70 inhibits ER and PR expression and may be involved in the development of poorly differentiated endometrial adenocarcinoma.
Adenocarcinoma* ; Apoptosis* ; Carcinogenesis ; Endometrium ; Female ; Heat-Shock Proteins ; Hyperplasia ; In Situ Nick-End Labeling

Ultrasonographic Doppler techniques have improved greatly over the years, allowing more sophisticated evaluation of breast tumor vascularity. Superb microvascular imaging (SMI) and contrast-enhanced ultrasound (CEUS) with second-generation contrast agents are two representative up-to-date techniques. SMI is a sensitive Doppler technique that adopts an intelligent filter system to separate low-flow signals from artifacts. With the development of second-generation contrast agents, CEUS has also emerged as a useful Doppler technique for evaluating tumor microcirculation. Both techniques can improve the diagnostic performance of gray-scale ultrasonography by providing vascular information useful not only for the morphologic assessment of microvessels, but also for the quantitative analysis of perfusion. In this review, we explain the imaging principles and previous research underlying these two vascular techniques, and describe our clinical experiences.
Artifacts ; Breast Neoplasms* ; Breast* ; Contrast Media ; Microcirculation ; Microvessels ; Perfusion ; Ultrasonography* ; Ultrasonography, Doppler

Microvascular ultrasound (US) techniques are advanced Doppler techniques that provide high sensitivity and spatial resolution for detailed visualization of low-flow vessels. Microvascular US imaging can be applied to breast lesion evaluation with or without US contrast agents. Microvascular US imaging without a contrast agent uses a sophisticated wall filtering system to selectively obtain low-flow Doppler signals from overlapped artifacts. Microvascular US imaging with secondgeneration contrast agents amplifies flow signals and makes them last longer, which facilitates hemodynamic evaluation of breast lesions. In this review article, we will introduce various microvascular US techniques, explain their clinical applications in breast cancer diagnosis and radiologic-histopathologic correlation, and provide a summary of a recent radiogenomic study using microvascular US.

Microvascular ultrasound (US) techniques are advanced Doppler techniques that provide high sensitivity and spatial resolution for detailed visualization of low-flow vessels. Microvascular US imaging can be applied to breast lesion evaluation with or without US contrast agents. Microvascular US imaging without a contrast agent uses a sophisticated wall filtering system to selectively obtain low-flow Doppler signals from overlapped artifacts. Microvascular US imaging with secondgeneration contrast agents amplifies flow signals and makes them last longer, which facilitates hemodynamic evaluation of breast lesions. In this review article, we will introduce various microvascular US techniques, explain their clinical applications in breast cancer diagnosis and radiologic-histopathologic correlation, and provide a summary of a recent radiogenomic study using microvascular US.

PURPOSE: To evaluate the clinical and radiologic findings of atypical ductal hyperplasia (ADH) using mammography and ultrasonography, and to correlate the radiologic and histopathologic findings. MATERIALS AND METHODS: Sixty-four pathologically proven lesions in 64 patients who were examined between March 2000 and March 2003 were the subject of this study. Mammography was performed in all 64 cases, and ultrasonography in 30. Two radiologists retrospectively evaluated the radiologic findings, classifying them as one of four types: mass, microcalcification, other finding, and no detected lesion. At mammography, masses were classified according to their shape, margin, and density and microcalcifications according to their shape and distribution. At ultrasonography, masses were evaluated in terms of their shape, margin, internal and posterior echotexture, ductal extension, and parallelism to skin. Geographic correlation between the radiologic and histopathologic findings was classified as direct, near direct, or remote correlation. RESULTS: Mammography demonstrated 37 cases of microcalcification (57.8%), 14 in which masses were present (21.9%), two in which there were other findings (3.1%), and 11 in which lesions were not detected (17.2%). The "other finding" was ductectasia. Microcalcifications were round in 19 cases, pleomorphic heterogeneous in 16, and branching linear in one. The most common distribution of microcalcification was clustered (29 cases; 78.4%). Masses were oval or round in nine cases and irregular in three, and in seven cases their margin was ill-defined. In 13 cases, the density of the masses was equal to that of breast tissue. Ultrasonography showed that the masses were round or oval in 15 cases and irregular in 14, and that the margin was ill-defined in 16 cases and circumscribed in ten. In 19 cases, the echotexture of the masses was low, and in 20 cases, heterogeneous. Parallel orientation was seen in 25 cases, and ductal extension in 22. Category 4 was the most common final assessed BI-RADS category, found in 75% of cases. Radiologic-histopathologic correlation was direct in 44 cases, near direct in 13, and remote in seven. Clinically, self or clinical examination of the breast revealed no abnormality in 47 cases, a palpable mass in seven, nipple discharge in seven, and breast pain in three. CONCLUSION: At mammography, the most common finding of ADH was clustered round or pleomorphic heterogeneous microcalcifications, and at ultrasonography, illdefined, round or oval, or irregular-shaped, hypoechoic masses with parallel orientation and ductal extension. Clinically, most ADH was incidentally discovered at radiologic examination. In this study, 17.2% of ADH cases were not demonstrated by mammography but were detected at ultrasonography, and for the detection of ADH, the use of this latter modality, alongside mammography, is thus feasible.
Breast Neoplasms ; Breast* ; Humans ; Hyperplasia* ; Mammography ; Mastodynia ; Nipples ; Retrospective Studies ; Skin ; Ultrasonography

Hematological malignancies rarely affect the breast, and the majority of those that do are lymphomas. In this review, we describe the clinical aspects and multimodal imaging findings of breast lymphoma. We also illustrate the key clinical and radiological findings that allow it to be distinguished from various other malignant and benign diseases of the breast. Breast lymphoma manifests as a breast mass, a change in the subcutaneous tissue or the skin, or enlargement of the associated lymph node on radiological examination. Radiological findings associated with other breast malignancies, such as calcifications, spiculations, or architectural distortions are extremely rare. Skin and subcutaneous changes frequently accompany T-cell lymphoma. Multimodal breast imaging characteristics may aid in the diagnosis of breast lymphoma.
Breast ; Hematologic Neoplasms ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell ; Magnetic Resonance Imaging ; Skin ; Subcutaneous Tissue

PURPOSE: A tumor and mature ovarian cystic teratoma rarely coexist, but since it may affect treatment andprognosis, appropriate pre-surgical diagnosis is important. The purpose of this study was to evaluate thedifference in CT findings between a tumor coexisting with a mature ovarian cystic teratoma and a simple matureovarian cystic teratoma. MATERIALS AND METHODS: CT scans of seven cases of tumor coexisting with mature ovariancystic teratoma were reviewed. In each case, size, margin, nature, septation, solid portion, ascites, invasion,and metastasis were analysed. RESULTS: Coexistent tumors were histopathologically diagnosed as squamous cellcarcinoma in three patients, carcinoid in three, and fibrothecoma in one. In contrast with a simple matureteratoma, a tumor coexisting with a mature cystic teratoma developed in older patients and had a more solidportion, which showed contrast enhancement but did not show calcification or a fat component. Where a tumor andmature cystic teratoma coexisted, ascites and the invasion of adjacent structures were also common. CONCLUSION: If, in an older patient, CT scanning reveals an ovarian cystic tumor with a large solid portion but nocalcification or fat, coexistent tumor should be suspected.
Ascites ; Carcinoid Tumor ; Diagnosis ; Female ; Humans ; Neoplasm Metastasis ; Ovarian Cysts ; Teratoma* ; Tomography, X-Ray Computed

Direct injection of foreign material, such as liquid paraffin and silicone, into the breast can induce a foreign body granulomatous reaction and fibrosis, resulting in hard, nodular breast masses and architectural distortion that can mimic neoplasm. Conventional methods, including physical examination, mammography, and ultrasonography are of little use to differentiate between foreign body-induced mastopathy and breast cancer. In patients with foreign body injection such as breast augmentation, dynamic contrast enhanced MR imaging is an excellent imaging modality. Here, the authors report the MR imaging and pathological findings of ductal carcinoma in situ (DCIS) with multicystic changes in a 41-year-old woman with a previous history of interstitial mammoplasty by paraffin injection.
Adult ; Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating* ; Female ; Fibrosis ; Foreign Bodies ; Humans ; Magnetic Resonance Imaging* ; Mammaplasty* ; Mammography ; Mineral Oil ; Paraffin* ; Physical Examination ; Silicones ; Ultrasonography

PURPOSE: To evaluate the differences in MR findings of metastatic adenocarcinoma and non-adenocarcinoma of thebrain. MATERIALS AND METHODS: We retrospectively analyzed MR findigns of metastatic brain tumors in 32 patients;in all cases, pathologic diagnosis was estabilished by biopsy or surgical resection. The signal intensities ofbrain lesions on multiple pulse sequences were compared. The enhancement patterns, degree of peritumoral edema,and number and size of brain lesions were also compared. RESULTS: The study group consisted of 19 patients withmetastatic adenocarcinoma and 13 with metastatic non-adenocarcinoma ; there were 64 adenocarcinomas and 45non-adenocarcinomas. On T1WI, the signal intensity of the lesions was hypointense, isointense, and hyperintense in57.8%, 39.0%, and 3.2% of adenocarcinomas; and 84.5%, 13.3%, and 2.2% of non-adenocarcinomas, respectively. OnT2WI, signals were hyperintense, isointense, hypointense, and heterogeneous in 67.2%, 10.9%, 17.2%, and 4.7% ofadenocarcinomas ; and 80%, 0%, 8.9%, and 11.1% of non-adenocarcinomas, respectively. On T2WI, seven of 19 patientswith adenocarcinoma and two of 13 with non-adenocarcinoma were either hypo- or isointense relative to the whitematter. In the adenocarcinoma group, hypo- or isointensity was seen in four cases of gastrointestinal cancer, twoof lung cancer, and one of endometrial cancer ; in the non-adenocarcinoma group, this was seen in retroperitonealembryonal carcinoma and small cell carcinoma of the lung. Two cases of adenocarcinoma showed hypointensity on T2WIand hyperintensity on TIWI, and this was probably related to the presence of blood products. On histopathology,one case of adenocarcinoma showing hypointensity on T2WI was shown to contain mucin. CONCLUSION: When brainmetastasis shows hypo- or isointensity on T2WI, adenocarcinoma is more likely than non-adenocarcinoma.
Adenocarcinoma* ; Biopsy ; Brain Neoplasms ; Brain* ; Carcinoma, Small Cell ; Diagnosis ; Endometrial Neoplasms ; Female ; Gastrointestinal Neoplasms ; Humans ; Lung ; Lung Neoplasms ; Mucins ; Retrospective Studies