PURPOSE: The purpose of this study was to examine the effectiveness of Participatory Action-Oriented Training (PAOT) programs in korean manufacture workers with metabolic syndrome for three years. METHODS: A total of 890 workers with risks of metabolic syndrome were recruited from one workplace. The experimental group (n=51) received PAOT program for the preventive management on metabolic syndrome, while the control group (n=51) received conventional program. RESULTS: In the experimental group who participated in PAOT program, percentage of achieved action plans was 73.4% at three months, 75.8% at six months, 82.8% at three years. After three years, the rate of risk factor in the experimental group has significantly decreased from 1.94±1.77 to 0.76±1.25 for moderate exercise, and from 1.72±2.01 to 1.04±1.59 for the strenuous exercise. Systolic and diastolic blood pressure has significantly decreased from 125.06±11.83 to 117.65±19.94, from 83.45±13.38 to 76.39±8.09 mmHg. In addition, risk factor score also decreased from 3.31±0.61 to 1.41±0.89. CONCLUSION: To improve the effectiveness of PAOT program for the management of risk factors of metabolic syndrome, there is a need to continue implement programs and analyze the long-term effects are required in the workplace.
Blood Pressure ; Methods* ; Risk Factors

PURPOSE: This study aimed to examine the factors associated with behavior that reduces exposure to environmental hormones among nursing students.METHODS: Data were collected from 160 nursing students in D and B cities, using self-report questionnaires. Data were analyzed using SPSS 22.0, and the analyses included descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient test, and stepwise multiple regression.RESULTS: Behavior that reduces exposure to environmental hormones differed significantly in terms of the participants' knowledge about environmental hormones. Behavior that reduces exposure to environmental hormones was negatively correlated with knowledge of environmental hormones, attitude towards pro-environmental behavior, and environmental self-efficacy; these factors were significant predictors of behavior that reduces exposure to environmental hormones, and accounted for 27.0% of the variance.CONCLUSION: Environmental self-efficacy was identified as the most significant factor affecting behavior that reduces exposure to environmental hormones in nursing students. Therefore, it is necessary to develop programs to improve pro-environmental behavior and environmental self-efficacy in nursing students.
Humans ; Nursing ; Students, Nursing

PURPOSE: This study aimed to examine the factors associated with behavior that reduces exposure to environmental hormones among nursing students. METHODS: Data were collected from 160 nursing students in D and B cities, using self-report questionnaires. Data were analyzed using SPSS 22.0, and the analyses included descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient test, and stepwise multiple regression. RESULTS: Behavior that reduces exposure to environmental hormones differed significantly in terms of the participants' knowledge about environmental hormones. Behavior that reduces exposure to environmental hormones was negatively correlated with knowledge of environmental hormones, attitude towards pro-environmental behavior, and environmental self-efficacy; these factors were significant predictors of behavior that reduces exposure to environmental hormones, and accounted for 27.0% of the variance. CONCLUSION Environmental self-efficacy was identified as the most significant factor affecting behavior that reduces exposure to environmental hormones in nursing students. Therefore, it is necessary to develop programs to improve pro-environmental behavior and environmental self-efficacy in nursing students.

BACKGROUND: The epidermal growth factor receptor (EGFR) is known to be involved in many tumor promoting activities. EGFR inhibition has been tried as a therapeutic modality in many human malignancies. METHODS: The expression of EGFR protein and the gene copy number changes were studied in 135 clear cell carcinomas and 16 papillary renal cell carcinomas (RCCs), and these tumors were diagnosed between 1995 and 1997. RESULTS: An EGFR protein expression (2+ and 3+) was found in 54.1% of the clear cell RCCs and in 43.8% of the papillary RCCs. In the clear cell RCCs, its expression was associated with male gender, the tumor size (> or =4 cm) and high T stages (T2 and T3), with statistical significance. Trisomy and polysomy of the EGFR gene were found in 27 (25.7%) and 40 (38.1%) of 105 clear cell RCCs, respectively. Trisomy and polysomy were correlated with an EGFR protein expression and a high clinical T stage, with statistical significance. Among 15 papillary RCCs, 13 tumors showed trisomy (86.7%) and one showed polysomy (6.7%). Amplification was not found in both the clear cell and papillary type RCCs. CONCLUSIONS: A considerable numbers of RCCs showed an overexpression of EGFR protein and increased EGFR gene copy numbers, yet the clinical significance of conducting a FISH study in RCC patients seems to be limited.
Carcinoma, Renal Cell ; Coat Protein Complex I ; Gene Dosage ; Genes, erbB-1 ; Humans ; Male ; Ploidies ; Receptor, Epidermal Growth Factor ; Trisomy

Abnormally located liver tissue has been described in the vicinity of the liver proper, near anatomical structures such as the gallbladder, the umbilical fossa, the adrenal gland, the pancreas, and the spleen. Supradiaphragmatic ectopic liver is a rare finding, but has been reported to have been found in the intrathoracic cavity and in the pericardium. In the majority of supradiaphragmatic ectopic liver cases, there was an accompanying transdiaphragmatic pedicle of the main liver body into the abdominal cavity. In a minority of supradiaphramatic ectopic liver cases, the liver was completely separated from the abdominal cavity without a connection between the thorax and the abdomen, with accompanying diaphragmatic anomalies. We describe one case of intrathoracic ectopic liver in a patient with a previous history of lower chest wall trauma, and a brief review of the English-language medical literature on this topic.
Abdomen ; Abdominal Cavity ; Adrenal Glands ; Diaphragm ; Gallbladder ; Humans ; Liver ; Pancreas ; Pericardium ; Spleen ; Thoracic Wall ; Thorax

Abnormally located liver tissue has been described in the vicinity of the liver proper, near anatomical structures such as the gallbladder, the umbilical fossa, the adrenal gland, the pancreas, and the spleen. Supradiaphragmatic ectopic liver is a rare finding, but has been reported to have been found in the intrathoracic cavity and in the pericardium. In the majority of supradiaphragmatic ectopic liver cases, there was an accompanying transdiaphragmatic pedicle of the main liver body into the abdominal cavity. In a minority of supradiaphramatic ectopic liver cases, the liver was completely separated from the abdominal cavity without a connection between the thorax and the abdomen, with accompanying diaphragmatic anomalies. We describe one case of intrathoracic ectopic liver in a patient with a previous history of lower chest wall trauma, and a brief review of the English-language medical literature on this topic.
Abdomen ; Abdominal Cavity ; Adrenal Glands ; Diaphragm ; Gallbladder ; Humans ; Liver ; Pancreas ; Pericardium ; Spleen ; Thoracic Wall ; Thorax

BACKGROUND: The goal of this study was to investigate the expression of p16, retinoblastoma (Rb) and fragile histidine triad (FHIT) proteins in urothelial carcinomas of the urinary bladder, and to evaluate the relationship between clinicopathlogic parameters and each protein expression level. METHODS: The expression of p16, Rb, and FHIT proteins were studied in 176 patients with urothelial carcinoma of the urinary bladder by immunohistochemistry. RESULTS: The diffuse positive expression of the p16 protein was significantly associated with high grade and advanced tumor depth (p=0.007 and p=0.020). The loss of the Rb protein was significantly associated with old age and disease recurrence (p=0.020 and 0.037). The loss of the FHIT protein was significantly associated with advanced tumor depth (p=0.002). CONCLUSION: Our data suggest that p16 and FHIT proteins may be involved in the progression of urothelial carcinoma. In addition, p16 may be a useful prognostic marker for individual urothelial carcinoma patients.

BACKGROUND: The aim of this study was to determine the cytologic features of anaplastic lymphoma kinase (ALK) expressing pulmonary adenocarcinoma. METHODS: We analyzed the cytopathological findings of 15 cases of endobronchial ultrasound guided aspiration and a case of bronchial washing. These cases were selected based on the histomorphology of ALK-rearranged lung adenocarcinoma. RESULTS: Cytology showed mucinous (81.3%) and hemorrhagic (50%) backgrounds. The cells were arranged in tubulopapillary or tubulocribriform patterns (93.8%), and clusters (56.3%) admixed with signet ring cell features (87.5%). The tumor cells were monotonous and uniform with vesicular nuclei and a small nucleolus. CONCLUSIONS: The characteristic findings were sheets showing a tubulopapillary or tubulocribriform appearance, with vesicular nuclei and a bland chromatin pattern (p<0.001). Scattered signet ring cells were helpful in suggesting ALK-positive adenocarcinoma (p<0.001).
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Chromatin ; Lung ; Lymphoma ; Mucins ; Phosphotransferases ; Receptor Protein-Tyrosine Kinases

This study aimed to explore the status of food service outsourcing behavior of long-term care institutions (LTCIs) through a cross-sectional survey using a questionnaire administered between July 16th and August 7th, 2020. The survey respondents were either dietitians or facility managers, who worked at 731 nursing homes, 477 group homes, and 673 day-care centers. Approximately 25.9% of nursing homes, 11.7% of group homes, and 33.1% of day-care centers used a managed-services company to operate their food service units.The main reason for outsourcing food service by nursing homes was related to the staffing of dietitians and cooks, whereas group homes and day-care centers outsourced food services due to factors relating to meal costs and the cooking process. Almost all the LTCIs entered into private contracts for outsourced food services. Only a few food service contracts included the types of meals, nutrition standards such as protein and calories per meal, and the parameter or ratio of food cost. Of the respondents, 84.5% from nursing homes, 87.5% from group homes, and 87.1% from day-care centers agreed that the quality of outsourced food services of the LTCIs should be regulated. Meals are essential for maintaining the health and functional status of LTCI users. As more LTCIs outsource their food services, we suggest the following: (1) Increasing the minimum dietitian staffing standards for LTCIs as per the Welfare of Senior Citizens Act and requiring at least one dietitian for every nursing home, (2) Making it mandatory to use a standard food service contract template when drafting food service contract, and (3) Developing realistic standards for food service operations considering the size and operation type of the LTCIs.

Metastasis to the breast from medullary carcinoma of the thyroid is extremely rare. We report a case of metastatic medullary carcinoma of the thyroid which presented as multiple breast masses with ipsilateral axillary lymphadenopathy in a 48-year-old woman. Six years ago, she underwent total thyroidectomy and neck dissection because of palpable neck masses, with a diagnosis of medullary thyroid carcinoma. Histological features of breast masses showed single- file or linear-cord arrangements, with plasmacytoid appearance, and the initial diagnosis was invasive lobular carcinoma. She underwent modified radical mastectomy. The tumor cells were diffusely positive for E-cadherin, calcitonin and thyroid transcription factor-1 (TTF-1) and were metastatic medullary carcinoma of thyroid. In the patients with a history of medullary carcinoma of the thyroid, a careful examination is necessary for a breast mass composed of solid and cord-like clusters of small round to ovoid cells with plasmacytoid appearance. Immunohistochemical staining for E-cadherin, calcitonin and TTF-1 could be helpful for differential diagnosis.
Breast* ; Cadherins ; Calcitonin ; Carcinoma, Lobular* ; Carcinoma, Medullary* ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Lymphatic Diseases ; Mastectomy, Modified Radical ; Middle Aged ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy