Kim, Young-Bok;Kim, Myung;Chung, Chee-Kyung;Lee, Won-Chul
Journal of Preventive Medicine and Public Health
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v.34
no.3
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pp.237-243
/
2001
Objectives : To examine the screening rate of cervical cancer in women and to find out the predictive factors for participation in cervical cancer screening programs within their life-time and within the last two years. Methods : The data was based on self-reported questionnaires from 1,613 women whose ages ranged from 26 to 60 years; this survey was peformed between December 1999 and January 2000. This study analyzed the predictive factors for participation in cervical cancer screening programs within their life-time and within the last two years. A logistic regression analysis was performed in order to derive the significant variables from the predisposing factors(demographic factor, health promotion behavior, reproductive factor), intervention factors(information channel, relation with medical stan, and proximal factors(attitude, social influence, self-efficacy). All analyses were peformed by the PC-SAS 6.12. Results : Our analyses showed that the screening rate for the women who received a cervical cancer screening(Pap smear) more than once within their life-time was 56.1% while those who had received one within the last two years was 34.5%. The significant factors for participation in cervical cancer screening program within their life-time were their income, married age, health promotion score, relation with medical staffs, social influence, and self-efficacy. On the other hand, age, number of pregnancies, menarche age, relation with medical staffs, social influences, and self-efficacy were significant factors for those being screened within the last two years. The predictive power of the logit model within their life-time was 68.8% and that within the last two years was 66.6%. Conclusion : The predictive factors for participation in cervical cancer screening program within their life-time are different from those for within the last two years. and that women's relations with medical staffs and social influences were the critical factors impacting on cervical cancer screening rates.
To investigate a population-based survey of the prevalence of human papillomavirus (HPV) infection in South Korea, we performed Papanicolaou smears and tests for HPV DNA and anti-HPV antibody detection in 909 sexually active general women (age range; 20-74 years, median 44 years) who were randomly selected residents from S district of Busan City. The presence of DNA of 36 different HPV types was detected by means of a GP 5+/6+ primer-mediated PCR enzyme immunoassay in cervical exfoliated cells, and IgG antibodies against L1 virus-like particles (anti-VLPs) of 5 HPV types 16, 18, 31, 33, and 58 were tested by means of enzyme linked immunoassay. The incidence of cytologic abnormality was 5.2% in Pap smear. The positive rate of HPV DNA was 10.4%, high in young women younger than 35 years old and proportionally increased according to the cytologic grades. The most often found HPV type was HPV 70, followed by HPV 16 and 33, and high-risk HPV types were more frequent in women younger than 35 years old. The most common HPV type in abnormal cytologic smears was HPV 16, followed by HPV 58 and 66. Anti-VLPs was positive in 19.7% and the frequent anti-VLPs type was against HPV 18, followed by HPV 31 and 16. The concordance between the markers for each specific HPV type was noted in 10 women and HPV 16 was the most frequent one. The incidence of multiple HPV infection was 18.9% and that of multiple anti-VLPs antibodies was 31%. Among 103 self-reported virgins, 4.9% had anti-VLP antibodies.
Poly-gamma-glutamic acid (γ-PGA) is a natural polymer that is synthesized by Bacillus species and has been reported to have antitumor activity. The aim of this study was to investigate the effect of γ-PGA on the treatment of vaginal intraepithelial neoplasia (VAIN). A retrospective observational study on γ-PGA therapy for biopsy-proven VAIN was conducted. The efficacy was assessed by evaluating the results of Pap cytology and the viral load of high-risk HPV at three time points: at enrollment, and at the first and second post-treatment visits. Of 17 patients treated with γ-PGA, only 12 patients who had a high-risk HPV infection were included in the analysis. Histology was VAIN1 in seven patients, VAIN2 in two patients, and VAIN3 in three patients. γ-PGA was administered for newly diagnosed VAIN in five (41.7%) patients and persistent VAIN in seven (58.3%) patients for the mean time of 4.5 months. At the first and second post-treatment visits, cytological regression was observed in five (41.7%) and six (50%) patients, respectively. Regarding the HPV load, the overall response rate was 66.7%, and the mean level was 670.6 ± 292.5 RLU at the first follow-up, which was lower than the initial viral load of 1,494.8 ± 434.5 RLU (p = 0.084). At the second follow-up, the overall response rate was 58.3%, and the mean viral load level was 924.2 ± 493.7 RLU. γ-PGA may be helpful for the cytological regression and reduction of viral load in patients with high-risk HPV-positive VAIN, suggesting that γ-PGA is a promising treatment option for primary or persistent VAIN.
The purpose of this study was to identify transition conditions, health behavior and indicators of healthy transitions among middle-aged women based on Schumacher & Meleis(1994) transition model for developing intervention program for their health promotion. A convenience sample of 221 women aged 40-60 was obtained in Jung-Gu, Seoul and they were asked to complete the questionnaires, which consisted of modified health-promoting lifestyle profile(HPLP), knowledge of menopause, physical well-being, emotional well-being, modified women's role integration protocol (WRIP), Beck's Depression Inventory(BDI), and indicators of healthy transition with subcategories such as subjective well-being, role mastery and well-being of interrelationship. The results were as follows: 1. Women had a mean age of 47.53 years. More than half(53.39%) of the women had jobs and 88.69 % had their spouses, Of 221 women, 51.13 % were premenopausal, 19.91% were perimenopausal, and 28.96% were postmenopausal. 2. Women scored lower on health responsibility and exercise than on self actualization, nutrition and interpersonal support among subcategories of health behavior measured the modified HPLP. Only 11.98% of respondents had breast-self examination and 42.66% had pap smear for screening cancer. 3. In transition conditions, women had poor knowledge about menopause and median level of physical well-being, emotional well-being and stress. 15.45% of the women had clinical depression. 4. As for the outcome index of the transition model, the mean of indicators of healthy transition was 3.69(possible range 1-5). 5. The levels of education and economic and the menstrual status were significantly related to physical well-being, depression and stress in the categories of transition conditions. The total score of health behavior correlated negatively with depression. The total score of indicators of healthy transition correlated with physical well-being, emotional well-being, stress, and depression in the categories of transition conditions. In conclusion, these findings suggested a profile of fragile middle-aged women and contributed to developing the community-based intervention program for health promotion.
Background: Most developing countries have been unable to implement well-organized health care systems, especially comprehensive Pap smear screening-based programs. One of the reasons for this is regional differences in medical services, and a low-cost portable cervical screening system is necessary. To improve regional discrepancies in cervical screening systems, we investigated the usefulness and acceptability of cervical selfsampling by liquid-based cytology (LBC) for 290 volunteers in the Lao PDR. Materials and Methods: Following health education with comprehensive documents, cervical self-sampling kits by LBC were distributed in three provincial, district, and village areas to a total of 290 volunteers, who were asked to take cytology samples by themselves. Subsequently, the acceptability of self-sampling was evaluated using a questionnaire. Results: The documents were well understood in all three regions. Regarding the acceptability of self-sampling, the selections for subsequent screening were 62% self-sampling, 36% gynecologist-sampling, 1% either method, and 1% other methods. The acceptability rates were higher in the district and the village than in the province. For the relationship between acceptability and pregnancy, the self-sampling selection rate was higher in the pregnancy-experienced group (75%) than in the pregnancy-inexperienced group (60%). For the relationship between selection of self-sampling and experience of screening, the self-sampling selection rate was higher in the screening-inexperienced group (62%) than in the screening-experienced group (52%). Conclusions: Our data show that this new way forward, involving a combination of self-sampling and LBC, is highly acceptable regardless of age, educational background, and residence in rural areas in a developing country.
Othman, Nor Hayati;Zaki, Fatma Hariati Mohamad;Hussain, Nik Hazlina Nik;Yusoff, Wan Zahanim Wan;Ismail, Pazuddin
Asian Pacific Journal of Cancer Prevention
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v.17
no.7
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pp.3489-3494
/
2016
Background: A major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is sub-optimal participation. Implementation of self-sampling method may increase the coverage. Objective: We determined the agreement of cytological diagnoses made on samples collected by women themselves (self-sampling) versus samples collected by physicians (Physician sampling). Materials and Methods: We invited women volunteers to undergo two procedures; cervical self-sampling using the Evalyn brush and physician sampling using a Cervex brush. The women were shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from these two sampling methods were analysed and compared. Results: A total of 367 women were recruited into the study, ranging from 22 to 65 years age. There was a significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). Using the cytological smears taken by physicians as the gold standard, the sensitivity of self-sampling was 71.9% (95% CI:70.9-72.8), the specificity was 86.6% (95% CI:85.7-87.5), the positive predictive value was 74.2% (95% CI:73.3-75.1) and the negative predictive value was 85.1% (95% CI: 84.2-86.0). Self-sampling smears (22.9%) allowed detection of micro-organisms better than physicians samples (18.5%). Conclusions: This study shows that samples taken by women themselves (self-sampling) and physicians have good diagnostic agreement. Self-sampling could be the method of choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.
The remote monitoring system including hemodynamic information and pump status of the implanted animal could be helpful during the in vivo experiment or clinical trial for an artificial heart Implantation. In order to monitor the course of the in vivo experiment continuously and anywhere, web-based remote monitoring system was developed, which can monitor pressures(AoP, LAP, RAP, PAP) and flow information as well as the pump operating conditions. The system consists of data sending, storing viewer part. The data sending part was constructed using component object model and the viewer part was constructed using the Java applet. In addition, the dialog box was introduced to communicate earth other instantly and the alarming function was also introduced when the hemodynamic values were out of the desired ranges. The developed remote monitoring system was applied during the in vivo experiment of the BVAD (Bi-ventricular Assist Device) implantation for 1 month and showed designed work without failure.
This study is a report about a specific patient whose primary stomach adenocarcinoma metastasized to uterine cervix adenocarcinoma. A thirty-nine year old female patient was initially diagnosed as having metastatic adenocarcinoma in the supraclavicular lymph node. Upon further examination, she was diagnosed with stomach adenocarcinoma. 8 months later, a cervix punch biopsy was performed. The stains used for examination were H&E stain, PAS stain, Alcian blue stain, Mucicarmine stain, Papanicolaou's (Pap.) stain, and as immunohistochemical stains, cytokeratin 7 and 20 were done. In the H&E stain, the tumor cells showed prominent and eccentric nuclei, thin nuclear membrane in abundant mucous cytoplasm, and cylinder shape. In the PAS stain, intracytoplasmic mucin vacuoles were stained with pink, and in Alcian blue and Mucicarmine stains, intracytoplasmic mucin vacuoles were stained with blue and red. As in the above results, she was diagnosed with undifferentiated adenocarcinoma. As found on the cytologic smear preparation of the uterine cervix stained by Papanicolaou's stains, the background was relatively clear, the number of malignant cells was relatively low, and large and eccentric nuclei in abundant cytoplasm were observed. Upon observing the tissue preparation of the uterine cervix biopsy by H&E stain, a clear background, large and eccentric nuclei, and a signet ring cell types were observed, and the number of malignant cells were fewer than in the primary uterine cervix adenocarcinoma. The vacuoles in cytoplasm were observed. The nuclear membrane and chromatin were thick and very rough, and upon observation by cytokeratin 7 and 20 of immunohistochemical stain, the tumor cells indicated a positive rate of 70% and 20%, respectively. According to these results, also she was diagnosed with metastasized uterine cervix adenocarcinoma. In summary of the results of pathologic findings on stomach biopsy and cytologic, histopathologic, and immunohistochemical finding on uterine cervix biopsy, the adenocarcinoma of her uterine cervix could assert the adenocarcinoma of signet ring cell type that was metastasized from the primary undifferentiated adenocarcinoma in stomach.
The regional distribution and relative frequencies of endocrine cells were studied immunohistochemically (PAP methods) in the alimentary tract and pancreas of the toad, Bufo bufo gargarizans Cantor using specific antisera against bovine Sp-1/chromogranin (BCG), serotonin, bombesin, gastrin, substance P (SP), somatostatin, insulin, glucagon, pancreatic polypeptide (PP), vasoactive intestinal polypeptide (VIP) and secretin. Nine kinds of endocrine cells were identified in this study. Spherical or spindleshaped immunoreactive (IR) cells were located in the gastric glands of stomach regions, in the basal portion of the epithelium of intestinal tract or esophagus, and in the exocrine or pancreatic islets with variable frequencies. In the alimentary tract, BCG-IR cells were found in the fundus and pylorus with rare and a few frequencies, respectively. Serotonin-IR cells were demonstrated in the whole alimentary tract including the esophagus. Bombesin- and SP-IR cells were restricted to the stomach regions and gastrin-IR cells were restricted to the pylorus. Somatostatin-IR cells were detected throughout the whole alimentary tract except for the large intestine, However, insulin-, glucagon-, PP-, VIP- and secretin-IR cells were not detected in the alimentary tract. In the pancreas of toad, the distribution and relative frequency of endocrine cells were similar to those of other mammals. Insulin-IR cells were located in the central portion of the pancreatic islets and interspaces of exocrine portions, and glucagon-, somatostatin- and PP-IR cells were detected in the marginal regions of the pancreatic islets and interspaces of exocrine. However, other IR cells were not found in the pancreas. In conclusion, the regional distribution and relative frequency of the endocrine cells in the alimentary tract and pancreas of the toad were similar to other anuran species but some differences which might be caused by feeding habits and species specification were also observed.
Purpose : Despite recent advances in pulmonary hypertension management and surgery, appropriate guidelines remain to be developed for operability in congenital heart disease with pulmonary artery hypertension (PAH). Our aim was to evaluate clinical outcomes of patients with severe PAH who underwent surgical closure of left-to-right shunt lesions (LRSL) on the basis of pulmonary reactivity. Methods : We retrospectively reviewed 21 patients who underwent surgical closure of LRSL with severe PAH (${\geq}8$ Wood unit) from January 1995 to April 2009. The median age at operation was 26 years. Atrial septal defect, ventricular septal defect (VSD), VSD and patent ductus arteriosus (PDA), and PDA was present in 11, 4, 4, and 2 patients, respectively. Results : Operability was based on vasoreactivity of PAH. Of the 21 patients, 5 showed response to pulmonary vasodilator therapy and 8 showed vasoreactivity after balloon occlusion of defects. The remaining 8 patients were considered operable because of significant left-to-right shunt (Qp/Qs ${\geq}1.5$). Five patients underwent total closure of defects and 16 were left with small residual shunts. The median follow-up duration was 32 months. There was no significant postoperative mortality or morbidity. Systolic pulmonary artery pressure (PAP) decreased in all but 2 patients. All patients except 1 showed improvement of New York Heart Association functional class. Conclusion : Closure of LRSL in patients with severe PAH on the basis of pulmonary vasoreactivity seems reasonable. PAP and clinical symptoms improved in most patients. Further research is needed for the evaluation of long-term results.
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