OBJECTIVE: The kinetic indices of apoptosis and cell proliferation m a histopathologic spectrum of the cervical neoplasia were evaluated to clarify the correlation between cervical neoplasm and apoplasis. Specific lesioas included cervical intraepithelial neoplasia(CIN), catcinoma in situ(CIS), and invasive carcinama. METHODS: Archival samples from normal cervical epithelium(n=7), low-grade squamous intraepithelial lesions(LGSIL, n=17), high-grade squamous intraepithelial lesions(HGSIL, n=17), invasive squamaus carcinoma(n=7) were evaluated for apoptosis and cell proliferation. Apoptotic cells were identified with terminal deoxynucleotidyl transferase-labeling of the 3'-OH end of DNA nucleosomes, and then apoptotic index(A.I sum of apoptotic bodies/ 1000 tumor cells) and total cell count(* 400 magnification) were calculated. RESULTS: In normal squamous epitheliam, Apoptotic bodies were mainly localized in ial layers, for low-grade squamous intraepithelial lesions(HGSIL) in superficial and intermediated layers, for high-pade squamous intraepithelial lesions(HGSIL) in intermediated and parabasal layers, for invasive carcinoma in full thic of squamous epithelium. Apototic indces(AI) in invasive carcinoma(mean: 6.21) were significantly higher than indices for high-grade squamous intraepithelial lesions(HGSIL, mean: 0.98) and high-grade squamous intraepithelial lesions(HGSIL, mean: 0.98) were significantly higher than indices for low-grade squamous intraepithelial lesions(LGSIL, mean: 0.12)(p<0.01), the total cell counts increased significantly as the specimens progressed toward invasive disease. (p<0.01) CONCLUSION: Apoptosis in cervical neoplasia appears to be closely related to poliferation and progression of the cervical squamous epithelial cell. This phenotype may allow identification of premalignant lesions with the potential to transform to cervical cancer.
Apoptosis* ; Cell Count ; Cell Proliferation ; DNA ; Epithelial Cells ; Epithelium ; Nucleosomes ; Phenotype ; Uterine Cervical Neoplasms

Cervicography is used commonly in cervical cancer screening with a Pap smear. Many reports shows that the combination of these two methods is more accurate and helpful in cervical cancer screening. OBJECTIVE: The purpose of this investigation was to evaluate the efficacy of conjoined methods in cervical cancer screening and to evaluate any difference between health care center and out-patient treatment. METHODS: Pap smear and cervicogram data were obtained for 699 patients who visited the Department of Obstetrics and Gynecology, Chungnam National University Hospital from January 1997 to December 1997. Of these patients, 551 patients visited the health care center and 148 were out-patients. We exmined all pertinent information, including biopsy results, for patients with detected abnormalities. A total of 62 patients received a biopsy. RESULTS: 1. Results for Papanicolaou smear were: sensitivity, 81.8%, specificity, 98.0%, positive predictive value, 83.7%, negative predictive value, 98.8%, false negative rate, 18.2%, and false positive rate, 2.0%. 2. Results for cervicography were: sensitivity, 86.4%, specificity, 97.8%, positive predictive value, 73.1%, negative predictive value, 99,1%, false negative rate, 13.6%, and false positive rate, 2.2%. 3. Results for the conjoined method were: sensitivity, 97.7%, specificity, 97.2%, positive predictive value, 70.5%, negative predictive value, 99.8%, false negative rate, 2,3%, and false positive rate, 2.8%. 4. When cervicography and Papanicolaou smear were used conjointly The sensitivity, specificity, negative predictive value, false negative rate, and false positive rate were statistically significant for Papanicolaou smear (P<0.05). 5. There was no statistical significance difference between cervicography and the conjoined method. 6. Compared with out-patients, Health care center patients showed increased diagnostic error and failure to follow-up. CONCLUSION: When cervicography and Papanicolaou smear were used conjointly, cervical cancer detection rates were increased.
Biopsy ; Chungcheongnam-do ; Delivery of Health Care ; Diagnostic Errors ; Follow-Up Studies ; Gynecology ; Humans ; Mass Screening* ; Obstetrics ; Outpatients ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

Twenty-nail dystrophy is a rare entity in which all 20 nail are uniformly and simultaneously affected with excess longitudinal ridging and loss of luster. This condition is thought to be idiopathic but, many cases are associated with alopecia areata, lichen planus, psoriasis, and ichthyosis. In such cases, it has been hypothesized that immunplogical disorders could play a role in pathogenesis. A 29-year-old male patient presented with dystrophic nail chatge on his all finger and toe nails for 3 years. On phisical examination, all nails were uniformly affected with longitudinal ridging and loss of luster and all body hairs were lost. Thyroid scan showed a finding of chronic thyroiditis. Herein we report a case of twenty-nail dystrophy associated with chronic thyroiditis and alopecia areata.
Adult ; Alopecia Areata ; Fingers ; Hair ; Humans ; Ichthyosis ; Lichen Planus ; Male ; Psoriasis ; Thyroid Gland* ; Thyroiditis* ; Toes

OBJECTIVE: Frozen-section evaluation of gynecologic tumors has historically been used to establish a histopatholgic diagnosis and to guide surgeons in appropriate surgical procedure. this study is to assess the clinical appropriation and accuracy of frozen-section biopsy in gynecologic tumors. METHODS: This is a retrospective quality assurance study all of frozen-section biopsy done at Chungnam National University Hospital during a three year period (1995 to 1997). There were 125 cases out of 2310 surgical specimens for gynecologic tumors, and the results were compared with final diagnoses based on fixed tissue specimens. RESULTS: Frozen section biopsy was accurate in 95.2% of all cases, in 96.3% (104/108) of ovarian tumor cases, and in 88.2% (15/17) of uterine tumor cases. Analysis of 6 inaccuracy cases revealed that most cases were sampling errors and occurred in mucinous tumor, belonging to all cases of ovarian tumors. Sensitivity, specificity, positive predictive value, and negative predictive value of frozen-section biopsy in ovarian tumors were 0.94, 1.00, 1, 00, 0.97. CONCLUSION: Frozen section biopsy is an appropriate method as a basic guideline during operations of gynecologic tumors and this method can obtains the highest accuracy when there is cooperation between experienced surgeons and reliable and careful pathologists. The accuracy of frozen section diagnosis has important implications regarding the type and extent of the primary surgery for gynecologic tumors.
Biopsy* ; Chungcheongnam-do ; Diagnosis* ; Frozen Sections* ; Mucins ; Retrospective Studies ; Selection Bias ; Sensitivity and Specificity

Erythema multiforme can be induced by various causes, including infections like virus or fungus, drugs like sulfonamides and penicillins, internal malignences, connective tissue diseases, pregnancy, menstruation, and exoessive sun exposure ramoxone, one of the paraquat dichloride compounds, is the most commonly used weed-kiIler in Korea. It is sometimes used in suicides due to its fatal toxicity, and even weak transutaneous absorption can lead to death. Herein we report a case of erythema multiform in a 46-year-old man induced by accidental contact with the Gramoxone
Absorption ; Connective Tissue Diseases ; Erythema Multiforme* ; Erythema* ; Female ; Fungi ; Humans ; Korea ; Menstruation ; Middle Aged ; Paraquat ; Penicillins ; Pregnancy ; Solar System ; Suicide ; Sulfonamides

This study deals with the changes in the concentrations of blood glucose and electrolytes during open heart surgery. Blood glucose and electrolytes in connection with age, disease and anesthetic period were measured in 25 patients about to undergo heart surgery which were performed between June 1986 and August 1986 in Yeungnam University Hospital. Because glucose solution is commonly used as priming solution, and the priming solution is hyperglycemic and hyperosmolar, glucose level of priming solution in this study was adjusted to 100-200 mg% level to minimize hyperglycemic and hyperosmolar effect. The following results were obtained. 1. Glucose level of priming solution before extracorporeal circulation was 151.6+31.3 mg%. 2. With body cooing, blood glucose level was elevated. As duration of extracorporeal circulation is prolonged, blood glucose level was elevated more, but no difference between age and diseases were observed. On warning, blood glucose level was progressively lowered. 3. Despite the low serum potassium level during by-pass, the potassium level was progressively elevated following by pass, cut the serum potassium level was low compared to control values. Elevated calcium level was maintained during by pass.
Blood Glucose* ; Calcium ; Electrolytes ; Extracorporeal Circulation ; Glucose ; Heart* ; Humans ; Potassium ; Thoracic Surgery*

A 50-year-old female, who had been suffered from diabetes rielitus, showed typical cutaneous findinhs of dermatomyositis with only transient and mild proximal muscle weakness at sometime during the course of disease. She had Gottrons papules, Gottrons sign, heliotrope rash, macular violsceous erythema involving neck, anterior chest, back, extensor site of forearms and arms and dorsa of hands. However, he serum CPK, LDH and sGOP levels were within normal limits. Her fasting and 2 hours potprandial blood glucose levels were elevated. There were no histological abnormality in muscle biopsy. Histopathologic findigs of the skin lesion on her back were that of poikiloderma atrophicans vasculare. We diagnosed our patient as Rebeccas type 2 amyopathic dematomyositis which is chracterized by skin disease with subjective myalgias and musle weakness, but without laboratory evidence of muscle disease.
Arm ; Biopsy ; Blood Glucose ; Dermatomyositis* ; Erythema ; Exanthema ; Fasting ; Female ; Forearm ; Hand ; Humans ; Middle Aged ; Muscle Weakness ; Myalgia ; Neck ; Skin ; Skin Diseases ; Thorax

We report a case of experimental reproduction of the skin lesion of polymorphous light eruption by potent UVA irradiating instrument, metal halide mercury lamp. A 20-year-old female had complained skin lesion at sun-exposed area since childhood. The skin lesion was reproduced after repetitive exposure of high dose of UVA, and the histologic feaure of the lesion was consistent with polymorphous light eruption. Metal halide mercury lamp used in this patient has hight irradiance and exclusive of UVB and UVC. It can be convenient and precise one in phototest using high doses of UVA.
Female ; Humans ; Reproduction* ; Skin ; Young Adult

A case of circular eczematous dermatitis around seborrheic keratosis was presented. A 54-year-old man presented with two weeks history of a round pruritic eruption around a preexisting lesion of seborrheic keratosis. Microscopic findings showed central tumor nest composed mainly of basaloid cells with occasional spongtosis and exocytosis. A diffuse, dense, mononuclear cell infiltrate with increased contents of melanophages was seen beneath the tumor. The surrounding lesion of halo dermatitis showed mild dilatation of the capillaries and perivascular infiltration of mononuclear cells in the upper and mid-dermis. The lesion of halo dermatitis disappeared gradually over a three week period following excision of the central lesion. This peculiar phenomenon seemed to be different from that of Suttons halo nevus, and might be a manifestation of an eczematous condition which might have a dermatitis provoking factor.
Capillaries ; Dermatitis* ; Dilatation ; Eczema ; Exocytosis ; Humans ; Keratosis, Seborrheic* ; Middle Aged ; Nevus, Halo

A 53-year-old man had skin-colored linear serpiginous plaque within brownish patch on his left thigh for one year. He habitually drank natural spring water for 3 years. We diagnosed this case as sparganosis infiltrated within dermis by histologic and parasitologic diagnosis. The skin lesion mimicked the cutaneous larva migrans by showing dermal migration of sparganum to pro-duce itchy linear serpiginous plaque. We report an interesting case of sparganosis mimicking cutaneous larva migrans.
Dermis ; Diagnosis ; Humans ; Larva Migrans* ; Middle Aged ; Natural Springs ; Skin ; Sparganosis* ; Sparganum ; Thigh ; Water