The Her-2/neu protooncogene encodes a transmembrane tyrosine kinase that is structurally homologous to the receptor for epidermal growth factor. Its amplification and overexpression are associated with poor prognosis in breast cancer patients. Neu differentiation factor is a ligand for Her-2/neu protooncogene and was detected in ras-transformed rat fibroblasts. Heregulin (human homologue of neu differentiation factor) is a 44-kilodalton glycoprotein that stimulates tyrosine phosphorylation and induces growth arrest or stimulation and differentiation in human breast cancer cell lines. In this study we examined the expression of heregulin mRNA by nested reverse transcription (RT) PCR with fresh tissue, Her-2/neu protein, ICAM-1 and steroid receptors by immunohistochemistry, and DNA ploidy pattern by flow cytometry with paraffin-embedded tissue in invasive breast carcinoma. We compared the data with nodal status, lymphovascular invasion, steroid receptor status and DNA ploidy pattern. For RT-PCR to heregulin mRNA, 38 cases of fresh breast cancer tissue were obtained. Total 68 cases of invasive breast carcinoma tissue were fixed in formalin, which were used for routine histology, immunohistochemistry and flow cytometry. The results are as follows; 1) Heregulin mRNA was expressed in 86.1% of patients with invasive breast carcinoma and 100% of patients with benign breast lesion using nested RT-PCR analysis. 2) Her-2/neu protein was overexpressed in 50.0% of tumors using immunohistochemistry. The expression of Her-2/neu protein was significantly correlated with high counts of lymph nodes with metastasis (p<0.05), and high nuclear grade (p<0.05). 3) Her-2/neu protein overexpression was significantly correlated with a high DNA index(p<0.05). All of the tumors showing Her-2/neu protein overexpression and no heregulin mRNA expression revealed near tetraploid DNA content. However, both Her-2/neu overexpression and heregulin mRNA expressing tumors revealed near tetraploidy in 38.9% and diploidy in 50.0%. Based on these results, heregulin mRNA expression rate was 86.1% in human invasive breast carcinoma. Her-2/neu protein overexpression is associated with high positive lymph node number and DNA index. Statistically significant reverse correlation with lymph node metastasis is not present.
Animals ; Breast Neoplasms* ; Breast* ; Cell Line ; Diploidy ; DNA* ; Epidermal Growth Factor ; Fibroblasts ; Flow Cytometry ; Formaldehyde ; Glycoproteins ; Humans* ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Lymph Nodes ; Neoplasm Metastasis* ; Neuregulin-1* ; Phosphorylation ; Ploidies* ; Polymerase Chain Reaction ; Prognosis ; Protein-Tyrosine Kinases ; Rats ; Receptors, Steroid ; Reverse Transcription ; RNA, Messenger* ; Tetraploidy ; Tyrosine

PURPOSE: This study attempted to analyze problems of informed consent in the clinical setting and appraise ethical aspects inherent in such issues in order to boost awareness of informed consent and its implementation among healthcare professionals. METHODS: Study methods included identifying ethical meanings of informed consent in the clinical setting based on the principal ethics, and exploring the process of informed consent utilizing communicative ethics and feminine care ethics RESULTS: The ethical basis of informed consent encompasses not only respect for autonomy but also prohibiting malice, practicing beneficience, and establishing justice. These principles, however, are limited in illustrating the ethical aspects of communicative ethics and care ethics that are entailed in informed consent within clinical settings. The ethical meaning of informed consent involves a communicative and caring process between healthcare professionals, patients, and family built on mutual respect. CONCLUSION: Healthcare professionals must fully understand the ethical meanings of informed consent and in turn respect and protect the clients' right to know and making decisions. Nurses especially, must take on the role of mediator and advocate throughout the process of obtaining informed consent, and practice ethical caring by facilitating communication grounded in mutual understanding among the physician, patient, and family members.
Delivery of Health Care ; Ethics ; Humans ; Informed Consent* ; Social Justice

PURPOSE: The purpose of this study was to develop an empowerment program as a nursing intervention for the patients having an acute stroke and to determine the effects of the program on their motivation, depression, and activities of daily living(ADLs). METHODS: An non-equivalent control group pretest-posttest design was used in this study. Sixty subjects were recruited from two separated institutions: 31 patients were allocated into experimental group and 29 were into control group. Six week empowerment program was provided to the experimental group. The study was conducted from November 2006 to March 2007. RESULTS: After 6 week empowerment program, rehabilitation motivation was significantly increased in the experimental group in comparison to the control group(t=-2.173, p=.036). There were no significant differences in depression and ADLs between experimental and control groups. CONCLUSION: The empowerment program effectively increased rehabilitation motivation of patients with stroke, while did not improve the levels of depression and ADLs. Future long-term intervention may benefit the patients more in terms of depression and ADLs when considering the acute stage of the patients in this study.
Activities of Daily Living ; Depression ; Humans ; Motivation ; Power (Psychology) ; Stroke

OBJECTIVE: Several abbreviated versions of the Alcohol Use Disorder Identification Test (AUDIT) have been developed and are widely used in clinical settings. In this study, we provide evidence supporting the use of abbreviated versions of AUDIT by comparing the utility of various abbreviated versions and determining cut-off values for the population of South Korea. METHODS: Data were obtained from the 4th to 6th Korean National Health and Nutrition Examination Surveys. After calculating the whole AUDIT score, we applied the cut-off value of at-risk drinking proposed by the World Health Organization and divided the study sample into normal and at-risk drinking groups. Receiver operating characteristic curves were drawn for AUDIT-3rd question (Q3) alone, AUDIT-quantity and frequency (QF), AUDIT-consumption (C), AUDIT-4, and AUDIT-primary clinic (PC), and optimal cut-off values were obtained for each group. RESULTS: A total of 46,450 subjects were analyzed. The at-risk drinking group comprised 29.2% of all subjects. The area under receiver operating characteristic curve (AUROC) of the abbreviated versions of AUDIT increased from 0.954 to 0.991 as the number of questions increased from one to four. The differences in AUROC between the abbreviated versions of AUDIT were statistically significant. The most appropriate cut-off values for AUDIT-Q3 alone, AUDIT-QF, AUDIT-C, AUDIT-4, and AUDIT-PC for adults over age 19 were 2, 4, 5, 6, and 4 points, respectively. CONCLUSION: As the number of items analyzed increased from one to four items, the AUROC increased to a statistically significant level. Cut-off values for abbreviated versions of AUDIT are similar in South Korea to other countries.
Adult ; Alcohol-Related Disorders ; Alcoholism ; Drinking ; Humans ; Korea ; Nutrition Surveys* ; ROC Curve ; World Health Organization

OBJECTIVE: Several abbreviated versions of the Alcohol Use Disorder Identification Test (AUDIT) have been developed and used widely in clinical settings. This paper provides evidence supporting the use of abbreviated versions of AUDIT by comparing the utility of various abbreviated versions and determining the cut-off values for the population of South Korea. METHODS: Data were obtained from the 4th to 6th Korean National Health and Nutrition Examination Surveys. After calculating the whole AUDIT score, the cut-off value of at-risk drinking proposed by the World Health Organization was applied and the study sample was divided into normal and at-risk drinking groups. Receiver operating characteristic curves were drawn for the AUDIT-3rd question (Q3) alone, AUDIT-quantity and frequency (QF), AUDIT-consumption (C), AUDIT-4, and AUDIT-primary clinic (PC), and the optimal cut-off values were obtained for each group. RESULTS: A total of 46,450 subjects were analyzed. The at-risk drinking group comprised 29.2% of all subjects. The area under the receiver operating characteristic curve (AUROC) of the abbreviated versions of AUDIT increased from 0.954 to 0.991 as the number of questions was increased from one to four. The differences in the AUROC between the abbreviated versions of AUDIT were statistically significant. The most appropriate cut-off values for AUDIT-Q3 alone, AUDIT-QF, AUDIT-C, AUDIT-4, and AUDIT-PC for adults over age 19 were 2, 4, 5, 6, and 4 points, respectively. CONCLUSION: As the number of items analyzed increased from one to four, the AUROC increased to a statistically significant level. The cut-off values for the abbreviated versions of AUDIT were similar in South Korea to other countries.
Adult ; Alcohol-Related Disorders ; Alcoholism ; Drinking ; Humans ; Korea ; Nutrition Surveys* ; ROC Curve ; World Health Organization

PURPOSE: To experimentally investigate the effect for muscle weakness after superior rectus Z-myotomy and histological changes. METHODS: Superior rectus muscle fibers of rabbits (16 rabbits, 32 eyes) were cut transversely with scissors across 75% of the muscle in two different positions on opposite sides. In group 1 (16 eyes), myotomies were performed at 2 and 7 mm from the muscle insertion (5 mm gap) and in group 2, performed at 2 and 5 mm (3 mm gap). The change of mark, eyeball position, and muscle tension after myotomy and 4 weeks postoperatively was evaluated, the location of the mark was examined, and muscle tissue biopsy was performed. RESULTS: After Z-myotomy, the marks of the two groups moved significantly posteriorly from insertion within groups (p<0.05), with no significant differences between groups (p=0.469). Eyeball positions of the two groups moved significantly inferiorly (p<0.05); the amount of position change of group 1 was greater than group 2 (p<0.05). When the globe was pulled in opposite directions for muscle action, the degree of change decreased with significant difference within groups (p<0.05), but there were no significant differences between groups (p=0.32). CONCLUSIONS: Z-myotomy of the superior rectus muscle affected the recession of eyeball position and weakened the muscle action. Muscle weakening affected by the different gaps between myotomies did not show consistent results.
Biopsy ; Muscle Tonus ; Muscle Weakness ; Muscles ; Rabbits

Castleman's disease (CD) is a rare benign disorder of unknown etiology characterized by proliferation of lymphoid tissues. Seventy percent of this tumor occurs in the mediastinum and it is seldom found in neck, pancreas or pelvis. We report a case of asymptomatic pelvic CD initially presenting as an adnexal tumor in a 27-year-old woman. Initial transvaginal sonography revealed 7-cm-sized hyperechoic mass adjacent to the right ovary and the following abdominal computed tomography scanning showed the same sized mass located on the right extraperitoneal pelvic cavity. Laparoscopic mass excision was performed without any complication and pathological diagnosis was made as CD. CD should be included in the differential diagnosis of female pelvic masses which are noted in the pelvic cavity. In this report, we review the clinicopathological findings in a presentation of CD.
Adult ; Diagnosis ; Diagnosis, Differential ; Female ; Giant Lymph Node Hyperplasia* ; Humans ; Lymphoid Tissue ; Mediastinum ; Neck ; Ovary ; Pancreas ; Pelvis

PURPOSE: A pelvic organ prolapse (POP) has various pelvic symptoms, including urinary and fecal incontinence. However, the accurate prevalence and problems in South Korea are not well known. The purpose of this study was to determine the relationship of pelvic floor symptoms in patients with a POP. MATERIALS AND METHODS: Between March 2003 and March 2004, 74 consecutive patients, with over stage II POP quantification (POP-Q) staging, were enrolled. No abnormal neurological signs were detected in 66 women after evaluation. On physical examination, these 66 patients were divided into 3 groups (A=cystocele only, B=rectocele only and C=cystocele rectocele). RESULTS: The prevalence of urinary incontinence was 28.8%, and with fecal incontinence was 9.1%. The prevalence of fecal incontinence and fecal symptoms, with the exception of fecal incontinence were 28.8 and 74.2%, respectively. With regard to the stage of POP-Q, fecal incontinence (II= 25.0%, III=27.8%, IV=75.0%) and fecal symptoms (II=77.3%, III=66.7%, IV =75.0%) were observed. Each group presented with fecal incontinence (A=38.4%, B=44.4%, C=20%) and fecal symptoms (A=56.3%, B=100%, C=74.3%). CONCLUSIONS: In this study, the prevalence of urinary incontinence was 28.8%, that of fecal incontinence was 28.8% and that of both urinary and fecal incontinence was 9.1%. The mixed symptoms may cause a dilemma in relation to the formal treatment. Our study suggests urologists should be aware of coexisting fecal symptoms associated with a pelvic organ prolapse.
Fecal Incontinence ; Female ; Humans ; Korea ; Pelvic Floor ; Pelvic Organ Prolapse* ; Physical Examination ; Prevalence* ; Prolapse ; Urinary Incontinence

The purpose of this paper was to report a successful treatment of transluminal Nd:YAG laser embolysis (NYE) for branch retinal artery occlusion (BRAO) with visible emboli. Two patients with acute, severe vision loss secondary to a branch retinal artery occlusion with visible emboli in one eye underwent NYE. A complete ocular examination was performed which included biomicroscopy of the posterior pole of the retina, intraocular pressure measurement, fundus color photographs, and fluorescein angiography (FA). After the NYE, the two patients showed dramatic improvements in best-corrected visual acuity, as well as, immediate and dramatic restorations in flow past the obstructed arteriole in FA. NYE is a treatment modality to be considered in patients with BRAO who present acutely with severe vision loss and a visible embolus.
Aged ; Aged, 80 and over ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Laser Coagulation/*methods ; Lasers, Solid-State/*therapeutic use ; Microscopy, Acoustic ; Retinal Artery Occlusion/diagnosis/*surgery ; Thrombectomy/*methods ; Visual Acuity