Forty eight female Sprague-Dawley rats received a subcutaneous implant containing 12.5 mg estradiol ant the age of 3 weeks. Three rats were killed in 1, 2, 3, 4, 6 weeks and in every month during 2~12 months after implantation, and the breasts were examined by light microscope. In all rats, enlargement of terminal end buds was obseved in 1~2 weeks, maximum development of hyperplastic alveolar nodules in 3 weeks, and marked dilatation and secretion of alveoli or ducts in 1~12 months after implantation. Ductal epithelial hyperplasia was observed in 27 rats and carcinomas developed in 23 rats in 2~12 months after implantation. It was thought that the changes induced by estradiol are more similar to the human breast lesions, compared with changes induced by chemical carcinogens such as dimethylbenzanthracene(DMBA), because breast carcinomas developed in close relationship with ductal epithelial hyperplasia in both estradiol-treated rats and humans, but not in DMBA-treated rats.
Female ; Humans ; Rats ; Animals ; Carcinogens

PURPOSE: To evaluate the relationship between the hormonal receptor status and the mammographic finding in breast cancer, thus to disclose whether the mammorgraphic findings would be the prognostic predictor or not. MATERIALS AND METHODS: Fifty breast cancer patients with hormonal receptor assay were included in this study. Hormonal status and mammographic findings were evaluated to disclose the relationship between the two variables. RESULTS: Among 26 positive estrogen receptor(ER) patients, 23 cases showed spioulations, 4 cases with increased parenchymal densities, 15 cases with calcifications, and 18 with mass-like lesions. Among 25 positive progesterone receptor(PR) patients, 22 cases showed spiculations, 6 with increased parenchymal densities, 12 with calcifications, 17 with mass-like lesions. Among 24 negative ER patients, 10 showed spiculations, 9 increased parenchymal densities, 12 calcifications, and 13 mass lesions. Among 25 negative PR patients, 17 showed spiculations, 8 increased parenchymal densities, 15 calcifications, and 13 mass lesions. CONCLUSION: Spiculation in mammography could related to the high incidence of positive estrogen receptor.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Incidence ; Mammography ; Progesterone

No abstract available.
Nephrotic Syndrome* ; Thrombosis*

Purpose: This study was conducted to identify the professional competency of nurses working in emergency medical institutions that use the Korean Triage Acuity Scale (KTAS), and to identify factors that affect them. Methods: This study collected data from 105 nurses working in emergency medical institutions from June to August 2020. For data analysis, descriptive analysis, t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression were performed using the SPSS 25.0 program. Results: As for the professional competency in triage, the higher the self-efficacy (β = 0.58, p < .001), the more experience they have in triage-related education (β = 0.30, p < .001), 2-4 years of clinical experience in emergency department (β = 0.19, p = .002), in case of triage alone (β = 0.24, p < .001), the higher the level of education a nurse has (β = 0.19, p = .003), the higher the professional competency in triage. These variables explained professional competency in a total of 64.2% of the participants (F = 38.30, p < .001). Conclusion To improve nurses’ professional competence in triage, introducing manpower expansion, financial support, and the provision of appropriate places is suggested. In addition, it is necessary to repeatedly provide educational opportunities in an environment similar to actual clinical practice by developing various scenarios and introducing simulations and web-based formats.

No abstract available.
Humans

OBJECTIVES: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. METHODS: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. RESULTS: Total homocysteine level was significantly higher in MTHFR 677TT genotype (9.80+/-3.87 mumol/L) than MTHFR 677CC genotype (8.14+/-1.74 mumol/L) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA (8.42+/-2.65 mumol/L) and 1298CC (6.09+/-0.32 mumol/L; p=0.2058) and, TSER 2R2R (8.61+/-1.68 mumol/L) and 3R3R (8.05+/-2.81 mumol/L; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest (11.47+/-4.66 mumol/L) in individuals with TSER 3R3R (8.05+/-2.81 mumol/L) and MTHFR 677TT (9.80+/-3.87 mumol/L) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes (7.69+/-1.77 mumol/L) had lower plasma homocysteine levels than TSER 2R2R (8.61+/-1.68 mumol/L) and MTHR 677CC (8.14+/-1.74 mumol/L) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. CONCLUSION: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
Abortion, Habitual ; Abortion, Spontaneous* ; Female ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma* ; Polymerase Chain Reaction ; Pregnancy ; Risk Factors ; Tandem Repeat Sequences ; Thymidylate Synthase*

BACKGROUND: Total knee replacement is often accompanied by severe post-operative pain. Oxycodone has sufficient analgesic effects and somewhat greater, but tolerable side effects compared to fentanyl. However, most studies on the topic evaluate visceral pain relief. In this study, we determine the effectiveness of oxycodone for somatic pain and evaluate the incidence of side effects. METHODS: Sixty-nine patients were involved in a randomized control trial. Analgesic agents were administered to two experimental groups at a post anesthetic care unit (PACU) 15 min after PACU admission: a 50 µg fentanyl group (n = 40) and a 4 mg oxycodone group (n = 29), both with severe pain (numeric rating scale, NRS > 5). Changes in NRS at the PACU were measured. Additional analgesic agents were administered at 0–6, 6–12, 12–24, and 24–48 h after surgery. RESULTS: Total fentanyl consumption and the number of patients who required additional opioids were significantly lower in the oxycodone group than in the fentanyl group. Incidence of side effects was not significantly different between the two groups. CONCLUSIONS: Oxycodone shows a better analgesic effect than fentanyl in somatic pain in the acute phase of post-operative pain. The side effects of oxycodone are not significantly different from those of fentanyl.
Analgesics ; Analgesics, Opioid ; Arthroplasty, Replacement, Knee* ; Fentanyl* ; Humans ; Incidence ; Nociceptive Pain ; Oxycodone* ; Visceral Pain

PURPOSE: To evaluate the relationship between the hormone receptor status, histologic grade and, the film-mammographic findings in primary breast cancer. MATERIALS AND METHODS: 198 breast cancer patients with hormonal receptor assay were included in this study. Estrogen receptor (ER) and progesterone receptor (PR) were determined by immunohistochemical method and enzyme-immunoassay. And film-mammographic findings were evaluated to disclose the relationship among the three variables (film-mmamographic findings, histologic grade and hormonal receptor status). Film- mammographic findings of the breast cancer are classified as spiculation, increased parenchymal density, calcification and mass. RESULTS: There is no correlation between estrogen receptor and histologic grade in 154 patients. Some correlation between estrogen receptor by enzyme-immunoassay and by immunohistochemistrical methods with 28 available data were observed (R=0.428). Among high estrogen receptor (ER) patients, there is a high possibility of spiculation or mass in mammography with 79 available data (Modified t-test, P<0.01). CONCLUSION: Spiculation or/and mass of the mammography can be related to the high possibile factor of the positive estrogen receptor or high level of estrogen receptor in primary breast cancer.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Mammography ; Receptors, Progesterone

Extradural hematomas are usually acute and rapidly progressing and the lucid intervals generally varies from a few moments to several hours. However, not uncommonly, an epidural hematoma may have a lucid interval lasting weeks, months or even years, which may present as a chronic epidural hematoma. Two cases have recently come under our care, demonstrating a paucity of objective neurologic abnormalities, but with extensive compressive extradural hemorrhage, which were found incidentally during the screening examination with the CT scanning.
Hematoma* ; Hemorrhage ; Mass Screening ; Tomography, X-Ray Computed

Mesoblastic nephroma is an uncommon renal tumor reported in infants but rarely in adults. We describe a case of calcified mesoblastic nephroma occurring in an adult. It is difficult, on the basis of radiologic images, to differentiate between calcified mesoblastic nephroma and calcified renal cell carcinoma.
Adult* ; Carcinoma, Renal Cell ; Humans ; Infant ; Nephroma, Mesoblastic*