• Tuberculosis and Respiratory Diseases
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• v.56 no.5
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• pp.485-494
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• 2004

Background : To assess the effects of mDOT implementation on sputum smear conversion for AFB (Acid fast bacilli) positive pulmonary tuberculosis patients, modified Directly Observed Treatment (mDOT) was started on October $8^{th}$ 2001 at a health center in Seoul. mDOT was defined through weekly interviewing and supervising of a patient by a supervisor (doctor, nurse, or lay health worker). The sputum smear conversion of a mDOT group was compared with that of a self-medication (self) group. Methods : This study included 52 AFB positive pulmonary tuberculosis patients registered at a health center in Seoul between October $8^{th}$ 2001 and April $23^{rd}$ 2002. 24 and 28 patients were enrolled in the mDOT and self medication groups, respectively. Paired (1:1) individual matching, by gender, extent of disease, relapse and age-matching variables, was performed between the two groups, resulting in 20 paired matches. This prospective study was planned as an unblinded, non-randomized quasiexperimental pilot project. Outcomes were identified from results of sputum smear examinations for AFB in both groups at 2 weeks, and 1 and 2 months. The paired matching data were analyzed using the SAS program version 8.1 by McNemar test. Results : At the end of 2 weeks of treatment, the sputum smear conversion of the mDOT group was somewhat higher than that of the self medication group (78.57 vs. 50%, p-value=0.289), and after 1 month of treatment no statistically significant difference was shown between the two groups (83.33 vs. 50, p-value=0.125). At the end of 2 months of treatment (initial intensive phase), the sputum smear conversions of the mDOT and self groups were 95 and 75%, respectively (p-value=0.219). Conclusions : The implementation of mDOT did not result in clinically significant increases in the sputum smear conversion at 2 weeks, and 1 and 2 months compared with that of the self medication group. However, the increases experienced might contribute to diminishing the infectious period of AFB positive patients, and this approach may act as a guide for a specific group of patients. In this study, mDOT was performed for one hundred percent of the intensive treatment phase. It can also be an effective treatment for pulmonary tuberculosis patients, and may be useful for some high risk tuberculosis patients.

• The Korean Journal of Cytopathology
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• v.15 no.1
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• pp.28-32
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• 2004

It was reported that the main cause of intraepithelial neoplasm and squamous cell carcinoma of the uterine cervix is human papilloma virus infection, and that the expression of p16 is increased in cells infected by human papilloma virus. We performed an immunocytochemical staining for protein p16 in 17 cases of cervocovaginal smears initially diagnosed as atypical squamous cells of undetermined significance, to know whether the staining could help the differentiation of neoplastic cells from reactive atypical cells. Of 17 smears, 6 were diagnosed finally as high grade intraepithelial neoplasm or invasive squamous cell carcinoma by follow-up biopsy and smear, and 5 of the 6 were positive for p16. Three were diagnosed as koilocytosis, and one of them was weakly positive for p16. Eight were diagnosed as reactive atypical cells, and all of them were negative for p16. We thought that immunocytochemical staining of p16 in cervocovaginal smears could help the differentiation of neoplastic cells from reactive atypical cells.

• Journal of Preventive Medicine and Public Health
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• v.37 no.2
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• pp.166-173
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• 2004

Objectives : Cervical cancer is the second most frequent cancer among women in Busan. The Pap smear test could have a significant effect on detecting cervical cancer, and enhancing their rate of use is an important strategy for reducing the incidence and mortality of cervical cancer. This study aimed to evaluate the factors associated with the past use of the Pap smear test in Korean women. Methods : A population-based survey was carried out in Busan between November 1999 and March 2000. 1,673 participants were randomly selected from 2,684 women in Busan, using a 2-stage cluster sampling method, and interviewed in their homes. Their socio-demographic characteristics, smoking, drinking, familial cancer history, Pap smear screening history, reproductive and menstrual factors, sexual habits and use of contraceptive methods data were collected by a trained interviewer using a questionnaire. The use of the screening test was defined by a self-report from the participants on how many times they had had a Pap smear test in their lifetime, and when they had received their latest examination. Results : Of the 1,673 respondents (62.3% response rate), 57.6% had had a Pap smear test during her life (mean number, 2.3). Among the health examination participants(1,064), 961(90.3%) reported having sexual experience and 70.9% of these had had a Pap smear test. In a multiple logistic regression analysis, statistically significant relationships were observed for age groups and the Pap smear test rate (odds ratio, OR for 35-44 years=2.45; OR for 45-54 years=3.41; OR for 55 years=2.60; reference, under 34 years). The married or cohabiting women were more likely to have used the Pap smear test than those separated or widowed (OR=1.73). Among the reproductive behavioral measures, the number of births (OR for 3 births=4.22; OR for 2 births=3.95; OR for 1 births=3.38; reference, 0 births) and husband's extra-marital affairs (OR=1.50) were associated with the rates of use of Pap smear tests. Conclusion : It appears that the most important contributing factors to cervical cancer screening were age, marital status and number of births. A positive association was also observed for the husband's extra-marital affairs. This study enabled us to systematically assess the relationship between Pap smear rates and risk factors for cervical cancer. It is hoped that this study will make a significant contribution to the accumulating scientific evidence on the identification of factors associated with cervical cancer screening in Korea.

• Parasites, Hosts and Diseases
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• v.23 no.2
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• pp.285-292
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• 1985

The present study has been designed as a basic study on laboratory diagnosis of giardiasis and to demonstrate a more effective method for the detection of Giardia lamblia cyst with the inherent advantages of minimizing both the number of stool examinations required and the interval of stool collections for estimating the real state of prevalence in the shortest time possible. There were 3 subject groups of 75 children each currently residing in an orphanage in Gunsan city, Jeonbuk province from which stool specimens were collected every day, every other day, and every 3 days. The procedure is as follows: 1) resuspend the InKed sample after fixation with SAF solution 2) centrifuge the sediment for 1 min. at 2, 000 rpm after straining through gauze into a tube 3) divide the sediment into 3 parts and use them for direct fecal smear, formalin-ether concentration (MGL) and zinc sulfate ($ZnSO_4$) floatation techniques. The results are summarized as follows: 1. Overall infection rate after 10 trials showed a 60% positive indication. The positive rate among children under 4 years old was significantly higher than the rate in children over 4 years old. No significant difference in rate by sex was observed. 2. The results of eBaminations by direct fecal smear and MGL techniques appeared more accurate than that obtained by $ZnSO_4$ ftoatation method as indicated by a higher positive rate. Of all three methods concerned, combinations of two demonstrated a higher positive rate than that shown by any one alone. 3. In three consecutive examinations under varying conditions such as different days, the cyst detection rate by MGL technique indicated 83%. In 5 examinations under the same varying conditions, the indicated rate was 94%. 4. The interval of stool collection proved to be insignificant for the cyst detection rate. In conclusion, both MGL method and modified fecal direct smear can provide a good cyst detection rate of G. lamblia provided that more than 3 consecutive examinations of stool under varying conditions are carried out.

• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1001-1010
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• 1997

Background : PCR technique is useful in diagnosis of pulmonary tuberculosis. But, its sensitivity and specificity is some different among several studies. Our aim is compare our PCR results with other's previous PCR results in AFB smear negative patients. Methods : PCR were performed in patients that their disease were suspected as active pulmonary tuberculosis and that their initial serial sputum AFB smear results were negative. Total number of patients studied by PCR technique was 177. Also, we analyzed the data only in patients whose bronchial washing fluid AFB smear was negative. And the primer had been used was IS 6110. Results : In our retrograde study, the number of patients who are diagnosed as having active pulmonary tuberculosis, inactive pulmonary tuberculosis and nontuberculous pulmonary disease was 99, 28, 50, respectively. In the sputum study, the sensitivity of PCR is 41.5% (27 PCR positive cases/65 active TBc cases). And the sensitivity of TB culture is 53.8% (35 TB culture positive cases/65 active TBc cases). In the bronchial washing specimen study, the sensitivity of PCR is 53.8% (21 PCR positive cases/39 active TBc cases). And the sensitivity of TB culture is 43.6% (17 TB culture Positive cases/39 active TBc cases). The specificity of PCR in our study is 94.9%. (74 PCR negative cases/78 inactive TBc or nontubereulous cases) In the cases of patients who were never takened anti-TBc medication, the sensitivity of PCR (45.6%--25 positive cases/55 cases) is some lower than culture (58.2%--32 positive cases/55 cases). In the cases of patients who had been takened anti-TBC medication. the sensitivity of PCR (60%--18 positive cases/30 cases) is some superior than culture (50%--15 positive cases/30 cases). Conclusion : We think that PCR results in cases of sputum AFB smear negative patients is nearly same as culture. And PCR is especially useful in patients who had been takened anti-TBc medication on admission.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.263-268
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• 2016

Cervical cancer is the fourth common cancer among women worldwide. Pap smear screening has resulted in deceasing incidence of cervical cancer in developed countries but low uptake of Pap smear screening among women in developing countries is still a public health challenge. The aim of this cross-sectional study was to assess the relationship between self-efficacy and timely uptake of Pap smear among Iranian women. A total of 580 married women referred to primary health care centers covered administratively by Shahid Beheshti University of Medical Sciences in Tehran were administered a questionnaire by trained staff. Data were analyzed with SPSS (version 16) software, using univariate and multivariate logistic regression. The mean age for participants was $33.1{\pm}8.8years$. There was a significant association between self-efficacy and Pap smear screening (P<0.01). There was also a positive correlation between duration of marriage and husband's education with Pap smear uptake (P<0.01). In univariate analysis, there was a significant association between Pap smear uptake and level of selfefficacy (OR = 15.3 for intermediate and OR=7.4 for good level), duration of marriage (OR = 5.7 for 5-14 years and OR=10.4 for more than 15), age (OR =2.7 for 27-34 years and OR=7.4 for more than 35 years) and husband education level (OR=2.3 for more than 12 years of education). In multivariate analysis, significant associations persisted between Pap smear uptake and self-efficacy (OR = 23.8; 95% CI: 8.7, 65.5), duration of marriage (OR = 5.9; 95% CI: 2.8, 12.2), age (OR = 3.9; 95% CI: 1.2, 12.9) and husband's education (OR = 2.5; 95% CI: 2.0, 10.3). Efforts are needed to increase women's knowledge about cervical cancer and improve their self-efficacy and perceptions of the Pap smear screening in order to reduce cervical cancer incidence and mortality rates.

• Restorative Dentistry and Endodontics
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• v.25 no.4
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• pp.527-535
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• 2000

The purpose of this study was to evaluate effects of smear layer and dentin primers on the sealing ability of root canals. 126 extracted human teeth with single, straight canals and mature apices were used. The Samples were first classified into six groups as follows: presence of smear layer; absence of smear layer; Scotchbond Bond Multi-Purpose; All Bond 2; Mac Bond 2; Clearfil Liner Bond 2. A Positive control was also established. All teeth except the control group were then obturated with thermoplasticized gutta-percha and AH26. Electrochemical and dye penetration technique were later used to evaluate the degree of micro leakage through the root canal. Seventy teeth were then immersed in a 1% potassium chloride solution and An external power supply(DC 10 V) was then applied to the circuit for the electrochemical microleakage test. The degree of Microleakage was determined over period of 28 days before being evaluated. In total, 48 teeth were submitted to the dye infiltration technique. All specimen were suspended in 2% methylene blue dye for 1 week before being longitudinally split. The degree of dye infiltration was measured under a stereo microscope at ${\times}10$ magnification and evaluated. The results were as follows: 1. Apical microleakage increased throughout the test period in all group and one group having a smear layer showed a dramatic increase under electrochemical test (p<0.05). In the group having smear layer, the degree of apical microleakage was the highest, and the micro leakage was much higher than in the smear layer removed group in electrochemical test (p<0.05). Scotchbond Multi-Purpose, All Bond 2, Mac Bond 2 and Clearfil Liner Bond 2 showed lower micro leakage than one group having smear layer. The All Bond 2 and Clearfil Liner Bond 2 treated groups showed the lowest microleakage in electrochemical test (p<0.05). 2. There was no significant difference between the experimental groups in dye penetration technique. These results suggested that the removal of the smear layer from root canal and concomitantly the application of dentin primer into root canal could improve the sealing ability of root canal obturation.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.2013-2018
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• 2015

Background: The aim of the study was to assess the extent of knowledge, attitudes and practical behavior of women in Bojnourd conerning the Pap smear test. Materials and Methods: This cross-sectional and population-based study was conducted with 1000 Iranian women aged 15-60 years old in Bojnourd city. In order to collect the data, a validated questionnaire was provided in four sections covering demographic information and questions about knowledge, attitude and practice about the Pap smear. Statistical analysis was performed with the Statistical Package for Social Sciences (version 17.0) applying a 0.05 significance level. Results: Evaluation of knowledge showed that 146 women (14.6%) had very weak, and 594 women (59.4%) had weak knowledge. In contrast, most of the women studied, 873 (87.3%), had a positive attitude toward the Pap smear test. According to the findings, 375 women (37.6%) had done this test so far. Findings indicated that the extent of knowledge had a meaningful relationship with the attitude status (p<0.0001). Also, there was a meaningful relationship between knowledge and practice, so that the weakest practice was seen in women who had weak knowledge (61.1%), (p<0.0001). Conclusions: According to findings of this research, most women do not have an appropriate knowledge about the necessity of having the Pap smear test, so that only a low percentage of women had undergone this test.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7317-7320
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• 2014

Background: A cytologic reading of a Papanicolaou (pap) smear followed, if the result is positive, by a colposcopic search for abnormal cells is the most common screening method for cervical cancer used worldwide. We aimed to present the correlation of smear and colposcopic findings with 6- to 12-month follow-up results and related factors in women who underwent colposcopy in Turkey. Materials and Methods: The study population consisted of women who attended the gynecology department and were referred for colposcopic evaluation in 2011-2012. A total of 232 women between ages 17 and 68 years were included. Colposcopy indications were ASCUS and higher lesions at cervical smear, macroscopic suspicious lesions, post-coital bleeding history with suspicious smear, and repeated cervical inflammation. All patients were recalled for 6- to 12-month follow-ups. Results: The most common colposcopy indication was ASCUS, and the most common biopsy result was inflammation. Nearly half of the patients returned for the control 6-month follow-up, and almost 20% of patients for a 1-year follow up. Conclusions: Colposcopic biopsy is an effective method in indicated patients but is not sufficient in itself if awareness of the subject is not raised in the population. One of the most important aims of cancer screening programs should be enabling patients in developing countries to take responsibility. Patients must be encouraged to apply to the hospital for better disease control.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4977-4980
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• 2015

Background: ASC-US cases are managed according to the current American Society for Colposcopy and Cervical Pathology (ASCCP) guideline in which a human papillomavirus (HPV) test and repeat Pap smear are performed in the next 1 year. Colposcopy in cases of positive high risk HPV and persistent ASC-US or more in subsequent Pap smear is recommended. The HPV test is more expensive and still not currently a routine practice in Thailand. Objective: To identify the risk factors of persisted abnormal Pap smear and the colposcopic requirement rate in women with ASC-US. Materials and Methods: During 2008-2013, this study was conducted in Prapokklao Hospital, Chanthaburi, Thailand. Participants were women who attended gynaecology clinic for cervical cancer screening. Women who had cytological reports with ASC-US were recruited. During the study period, 503 cases were enrolled. Colposcopic requirement was defined as those who were detected with an ASC-US or more in subsequent Pap smears up to 1 year follow-up. Results: The colposcopic referral rate was 23.2 (85/365) percent at 12 months. Prevalence of cervical intraepithelial neoplasia (CIN) 2/3 was 3.3 (12/365) percent. Loss follow-up rate of subsequent Pap smear and colposcopic appointment were 27.4 (138/503) and 48.2 (41/85) percent, respectively. There was no invasive cancer. High risk factors for persisted abnormal Pap smears in subsequent test were premenopausal status, HIV infected patients and non-oral contraceptive pills (COC) users. Conclusions: Referral rate for colposcopy in women with ASC-US reports was rather high. Loss to follow-up rate was the major limitation. Immediate colposcopy should be offered for women who had high risk for silent CIN.