PURPOSE: To evaluate the clinical significance of the screening mammography in the detection of the breast diseases, especially breast carcinoma. MATERIALS AND METHODS: We analyzed 1,800 cases of mammography retrospectively. The mammography was done as a part of routine check in Health Counselling Center, Korea University Medical Center, during 9 months from November 1993 to July 1994. The age range was from 23 years to 76 years, mean 49.8 years, and the largest age group was 6th decade(31.4%). According to the mammographic findings, we divided the subjects into three groups; normal group, abnormal group in need of follow up study, abnormal group requiring biopsy. RESULT: On mammography, the normal group consisted of 1,534 cases(85%), and the abnormal group consisted of 266 cases(15%). The abnormal findings were benign-looking calcification(n=140), fibroadeno ma (n=29), fibrocystic changes (n=27), cyst(n=23), malignant lesion(n=15), lipoma(n=7), and others. In four of 15 cases, which were suspected to be malignant on mammograms, breast carcinoma was confirmed pathologically. In four cases of breast carcinoma, one was under 40 and the other 3 were over 50 years of age. All of the breast cancers were under 3cm in size, and the mammographic findings of breast cancer included spiculated margin(n=3), parenchymal disortion(n=3), malignant calcification(n=2) and enlarged axillary node (n=l). CONCLUSION: Screening mammogram is helpful for early detection of non-palpable breast cancer, especially for women over 50 years of age.
Academic Medical Centers ; Biopsy ; Breast Diseases* ; Breast Neoplasms ; Breast* ; Female ; Follow-Up Studies ; Humans ; Korea ; Mammography* ; Mass Screening* ; Retrospective Studies

OBJECTIVEPreviously documented indirect adjustment methods could only adjust for the confounding effects from cigarette smoking. The aim of this paper is to introduce a novel method for dealing with the effects of smoking in occupational, epidemiological cohort studies using a 'smoking adjustment factor'.

METHODSA retrospective cohort study among male silicotic workers purely exposed to silica dusts in Hong Kong (1981 - 1999) was used as an example. 'Smoking adjustment factor' in occupationally exposed smoking and nonsmoking sub-cohorts was expressed as 1/(1- PAR% )xRR and 1/1- PAR% respectively. Relative exposure effect and Synergy index were estimated to assess the multiplicative and additive interactions.

RESULTS'Smoking adjustment factor' for non-smoking and smoking silicotic workers was 1/0.33 and 1/1.62 respectively. Lung cancer standardized mortality ratio(SMR) of all cohort members was reduced from 1.61(95% CI: 1.22-2.10) to 1.08(95% CI:0.81-1.41) after indirectly adjusted for smoking effect. Results from our novel indirect method were in line with that from Axelson' s approach. Relative silicosis effect and synergy index were estimated to be 0.63 (95% CI:0.08-0.79) and 0.90 (95 % CI:0.42-1.94) ,suggesting a significant but negative multiplicative interaction between smoking and silicosis on the risk of lung cancer mortality.

CONCLUSIONThe merit of this new method was the ability to adjust for the confounding effect and evaluate the interactive effect with smoking. However, comparability of age distribution between occupationally exposed smoking and nonsmoking sub-cohorts was a prerequisite for the accurate estimations of the smoking indirectly adjusted SMR, relative exposure effect, and/or synergy index.

Cohort Studies ; Epidemiologic Methods ; Hong Kong ; epidemiology ; Humans ; Lung Diseases ; epidemiology ; mortality ; Male ; Occupational Exposure ; Retrospective Studies ; Silicosis ; epidemiology ; mortality ; Smoking ; adverse effects ; epidemiology

BACKGROUND: Hypertension and type 2 diabetes mellitus are major risk factors for cardiovascular disease. This study analyzed the changes in central aortic waveforms and pulse wave velocity as well as related parameters after treatment with valsartan, an angiotensin II type 1 receptor blocker, in patients with type 2 diabetes and hypertension. METHODS: We used pulse wave analysis to measure central aortic waveform in a total of 98 subjects. In 47 of these patients, pulse wave velocity measurements were obtained before and after 12 weeks of treatment with valsartan. RESULTS: In the central aortic waveform analysis, the aortic pulse pressure and augmentation index were significantly decreased after valsartan treatment, as was the aortic pulse wave velocity. Factors contributing to the improvement in pulse wave velocity were the fasting blood glucose and haemoglobin A1c levels. CONCLUSION: Short-term treatment with valsartan improves arterial stiffness in patients with type 2 diabetes and hypertension, and the glucose status at baseline was associated with this effect.
Angiotensins ; Arterial Pressure ; Blood Glucose ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Humans ; Hypertension ; Pulse Wave Analysis ; Receptor, Angiotensin, Type 1 ; Risk Factors ; Tetrazoles ; Valine ; Vascular Stiffness ; Valsartan

No abstract available.
Angiotensins ; Diabetes Mellitus, Type 2 ; Humans ; Hypertension ; Vascular Stiffness

BACKGROUND AND OBJECTIVES: 'Partial deafness' characterized by normal or slightly impaired hearing in the low frequency band and nearly total deafness in the high frequency range, is difficult to assess with conventional behavioral tests in infants and young children. Therefore, this study aimed to assess the usefulness of objective hearing tests, such as auditory brainstem response (ABR) and auditory steady state response (ASSR) in evaluating patients with partial deafness. SUBJECTS AND METHOD: One hundred thirty three patients who underwent ASSR in Ajou University Hospital from January 2008 to January 2013 were enrolled to this study. Correlations between ASSR, ABR and pure tone audiometry (PTA) thresholds were analyzed. RESULTS: ASSR thresholds of 133 patients were highly correlated with both ABR and PTA thresholds in majority of the tested frequencies. Partial deafness was detected in 9 out of 133 patients, based on the results of PTA and ASSR. ASSR thresholds of patients with partial deafness were significantly correlated with PTA thresholds in all frequencies, with especially high correlation found at 1 and 4 kHz. However, there was no significant correlation between ASSR and ABR thresholds. ABR thresholds of partial deafness patients were measured at 65 dB in one patient, 70-90 dB in 3 patients, and no response at 90 dB in 5 patients, respectively. In 8 (6%) out of 124 patients, ABR thresholds were measurable with profound hearing loss and residual hearing was observed at low frequencies. CONCLUSION: ASSR is useful for predicting residual hearing at low frequencies of infants and young children for whom assessment of hearing is difficult using conventional behavioral tests.
Audiometry ; Child ; Deafness* ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; Hearing Tests* ; Hearing* ; Humans ; Infant ; Mass Screening*

The human heart is a complex organ in which many complicated congenital defects may happen and some of them require surgical intervention. Due to the vast complexity of varied anatomical presentations, establishing an accurate and consistent nomenclature system is utmost important to facilitate effective communication among pediatric cardiologists, cardiothoracic surgeons and radiologists. The Van Praagh segmental approach to the complex congenital heart disease (CHD) was developed in the 1960s and has been used widely as the language for describing complex anatomy of CHD over the decades. It utilizes a systematic and sequential method to describe the cardiac segments and connections which in turn allows accurate, comprehensive and unambiguous description of CHD. It can also be applied to multiple imaging modalities such as echocardiogram, cardiac CT and MRI. The Van Praagh notation demonstrates a group of three letters, with each letter representative for a key embryologic region of cardiac anatomy: the atria, ventricles and great vessels. By using a 3-steps approach, we can evaluate complex CHD precisely and have no difficulties in communicating with other medial colleague. This pictorial essay revisits the logical steps of segmental approach, followed by a pictorial illustration of its application.
Congenital Abnormalities ; Heart ; Heart Defects, Congenital* ; Humans ; Logic ; Magnetic Resonance Imaging

PURPOSE: T cells play a central role in cell-mediated immunity, atopic disease, and asthma. The balance of CD28/cytotoxic T-lymphocyte antigen 4 (CTLA4)-derived signal transduction plays an important role in the activation of T cells and an increased immunoglobulin E (IgE) response. The aim of the current study was to investigate the association between polymorphisms in the genes encoding both CTLA4 and the high-affinity IgE receptor 1B (FCER1B) and serum IgE levels in Korean children with asthma. METHODS: We enrolled 238 controls and 742 children with asthma. The CTLA4 +49A/G and FCER1B -654C/T polymorphisms were genotyped by PCR-restriction fragment length polymorphism analysis. RESULTS: We observed no difference in the distribution of CTLA4 +49A/G among controls, children with asthma, and those with atopic asthma. In contrast, the GA genotype of CTLA4 +49A/G in children with atopic asthma was significantly higher compared to that in those with non-atopic asthma. Moreover, significantly higher log Dp/Df-specific IgE levels were found in children with asthma and those with atopic asthma carrying one or two copies of the CTLA4 +49A versus those homozygous for +49G. Gene-gene interactions between CTLA4 and FCER1B with the heterozygote and homozygote of variant genotypes were associated with the log Dp/Df-specific IgE levels, but not asthma development. In addition, children with Dp/Df (+) asthma carried an elevated combined genotype of risk allele compared to those with Dp/Df (-) asthma. CONCLUSIONS: The CTLA4 +49A/G polymorphism may contribute to the production of IgE in Korean children with asthma, especially in Dp/Df-specific IgE levels, but not in the direct development of asthma. In addition, Dp/Df-specific IgE levels with a FCER1B -654C/T polymorphism may involve additive effects.
Alleles ; Asthma ; Child ; Coat Protein Complex I ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Genotype ; Heterozygote ; Homozygote ; Humans ; Immunity, Cellular ; Immunoglobulin E ; Immunoglobulins ; Lifting ; Signal Transduction ; T-Lymphocytes

PURPOSE: T cells play a central role in cell-mediated immunity, atopic disease, and asthma. The balance of CD28/cytotoxic T-lymphocyte antigen 4 (CTLA4)-derived signal transduction plays an important role in the activation of T cells and an increased immunoglobulin E (IgE) response. The aim of the current study was to investigate the association between polymorphisms in the genes encoding both CTLA4 and the high-affinity IgE receptor 1B (FCER1B) and serum IgE levels in Korean children with asthma. METHODS: We enrolled 238 controls and 742 children with asthma. The CTLA4 +49A/G and FCER1B -654C/T polymorphisms were genotyped by PCR-restriction fragment length polymorphism analysis. RESULTS: We observed no difference in the distribution of CTLA4 +49A/G among controls, children with asthma, and those with atopic asthma. In contrast, the GA genotype of CTLA4 +49A/G in children with atopic asthma was significantly higher compared to that in those with non-atopic asthma. Moreover, significantly higher log Dp/Df-specific IgE levels were found in children with asthma and those with atopic asthma carrying one or two copies of the CTLA4 +49A versus those homozygous for +49G. Gene-gene interactions between CTLA4 and FCER1B with the heterozygote and homozygote of variant genotypes were associated with the log Dp/Df-specific IgE levels, but not asthma development. In addition, children with Dp/Df (+) asthma carried an elevated combined genotype of risk allele compared to those with Dp/Df (-) asthma. CONCLUSIONS: The CTLA4 +49A/G polymorphism may contribute to the production of IgE in Korean children with asthma, especially in Dp/Df-specific IgE levels, but not in the direct development of asthma. In addition, Dp/Df-specific IgE levels with a FCER1B -654C/T polymorphism may involve additive effects.
Alleles ; Asthma ; Child ; Coat Protein Complex I ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Genotype ; Heterozygote ; Homozygote ; Humans ; Immunity, Cellular ; Immunoglobulin E ; Immunoglobulins ; Lifting ; Signal Transduction ; T-Lymphocytes

When study on epidemiological causation is carried out,logistic regression has been commonly used to estimate the independent effects of risk factors.as well as to examine possible interactions among individual risk factor by adding one or more product terms to the regression model.In logistic or Cox's regression model.the regression coefficient of the product term estimates the interaction on a muhiplicative scale while statistical significance indicates the departure from multiplicativity.Rothman argues that when biologic interaction iS examined,we need to focus on interaction as departure from additivity rather than departure from multiplicativity.He presents three indices to measure interaction on an additive scale or departure from additivity.using logarithmic models such aS logistic or Cox's regression model.In this paper,we use data from a case-control study of female lung cancer in Hong Kong to calculate the regression coefficients and covariance matrix of logistie model in SPSS.We then introduce an Excel spreadsheet set up by Tomas Andersson to calculate the indices of interaction on an additive scale and the corresponding confidence intervals.The results can be used as reference by epidemiologists to assess the biologic interaction between factors.The proposed method is convenient and the Excel spreadsheet is available online for free.