In 1989, the Bethesda System (TBS) was introduced as an attempt to standardize cervical/vaginal reporting systems. TBS nomenclature was created for reporting cytologic diagnoses to replace the currently used Cervical Intraepithelial Neoplasia (CIN) and Papanicolaou Class System, which are deemed less reproducible. The name for preinvasive squamous lesions was changed to squamous intraepithelial lesion (SIL), subdivided into low-grade and high-grade types. TBS recommends a specific format for cytologic report, starting with explicit statement on the adequacy of the specimen, followed by general categorization and descriptive diagnosis. Pathologic and epidemiologic studies performed over last 10 years have provided evidence that human papillomavirus (HPV) plays a significant role in the development of cervical neoplasia. TBS corresponds not only to currently held views of the behavior of preinvasive lesions and their HPV distribution, but also to the current guidelines for clinical management.
Azathioprine* ; Body Fluids ; Cadherins ; Cervical Intraepithelial Neoplasia ; Diagnosis ; Epidemiologic Studies ; Humans ; Immunohistochemistry ; Nephritis* ; Nephrotic Syndrome* ; Purpura, Schoenlein-Henoch*

Supernumerary isochromosome resulting in autosomal tetrasomy are rare and have been described only for 12P, 18P, and 9P. Tetrasomy 9P, initially described by Ghymer et al, is a rare chromosomal aberration that has been described in 20 patients. Affected subjects show both cytogenetic and ohenotypic variability. Some patients have the abnormal cell line in all cells, but many display tissue limited mosaicism. The phenotype varies in severity from prenatal death to mild developmental delay and minor anomalies. We reported a infant with mild manifestations of tetrasomy 9p with brief review of related literatures.
Cell Line ; Chromosome Aberrations ; Cytogenetics ; Humans ; Infant ; Isochromosomes ; Mosaicism ; Phenotype ; Tetrasomy*

No abstract available.
Child* ; Humans ; Neurilemmoma* ; Neurofibromatosis 1

PURPOSE: Rotavirus infection is a leading cause of severe gastroenteritis among infants and young children worldwide. In temperate regions, institutional outbreaks of the disease occur mainly in cold dry weather, whereas in tropical settings its seasonal course is less well defined. We studied the annual changes in the seasonal prevalence of rotavirus infection for 5 years. METHODS: The study was conducted on 502 patients who lived in Taejon city and its vicinity. They were diagnosed with rotavirus gastroenteritis by stool latex coagulation method in Eulji Medical College Hospital from July 1993 to June 1998. RESULTS: During the 5-years period, 502 fecal specimens were positive by rotavirus latex coagulation method. The peak of the infection occurred in 1994 (July 1994-June 1995), 152 cases (30.3%) from July 1994 to June 1995 and the next peak occurred in 111 cases (22.1%) from July 1993 to June 1994. The seasonal peaks of the infection occurred in December 1993 (17.1%) and January 1994 (21.1%) and in March 1996 (23.4%) and March 1997 (22.5%). CONCLUSOIN: We observed that the seasonal peak in rotavirus infection changed over a 5-year period. The timing of rotavirus activity peaked during December-January(1993 and 1994), Februray-March (1996), and March-April (1997).
Child ; Daejeon ; Disease Outbreaks ; Gastroenteritis ; Humans ; Infant ; Latex ; Prevalence* ; Rotavirus ; Rotavirus Infections ; Seasons* ; Weather

Favre-Racouchot syndrome is a disease of senile or actinic processes and another name is nodular elastosis with cysts and comedones. Clinically, facial skin shows, especially lateral to the eyes, multiple open and cystically dilatated comedones and can be defined as cutaneous disturbances characterized by a degenerative process of the dermis associated with cysts and comedones. Sunlight is a strong causative factor and dermal degenerative processes result in this condition. We report the case of a 78-year-old man who showed multiple yellowish papules on both sides of cheeks, the periorbital and, malar areas. He had had this condition for 25-years. His job used to involve physical labor and much exposure to sunlight. An excisional biopsy specimen from the facial malar lesion showed cystically dilated comedones with basophilically degenerated dermal tissue. We performed a therapeutic excision on the two large nodular lesions on both malar areas and applied topical tretinoin. The Patients clinical appearance was much improved 2 months later.
Actins ; Aged ; Basophils ; Biopsy ; Cheek ; Dermis ; Facial Dermatoses* ; Humans ; Skin ; Sunlight ; Tretinoin*

BACKGROUND: The recent studies shows that LV relaxation abnormalities are the important factors of heart failure in elders. To determine the association between LV diastolic functions and heart failure, we assessed LV diastolic functions in elderly patients with pulmonary congestion and in asymptomatic elders by using pulsed doppler echocardiography. METHODS: In order to assess LV diastolic function, we performed pulsed doppler echocardiography to elderly patients with pulmonary congestion and asymptomatic elders from Mar.2001 to Sep.2001. The following parameters were used as indices of LV diastolic function; Mitral E wave(E), Mitral A wave(A), Deceleration time(DT), Isovolumic relaxation time(IVRT), Systolic pulmonary venous flow(PVs), Diastolic pulmonary venous flow(PVd). RESULTS: In elderly patients groups, there was significant increase in deceleration time compared with asymptomatic elders(255.83+/-54.41 vs 210.80+/-48.53, p<0.05). There was significant increase in isovolumic relaxation time in elderly patient group compared with asymptomatic elders(123.06+/-25.07 vs 98.78+/-15.12, p<0.01). Although there was no significant difference, decreased E/A ratio and increased PVs/PVd were noted in both groups. CONCLUSIONS: The results shows that the impairments of LV diastolic function were noted in both groups. Especially DT and JVRT were significant increase in elderly patient group with pulmonary congestion. Therefore these parameters, such as DT, IVRT, can be helpful as predictive indices of diastolic heart failure in elders.
Aged* ; Deceleration ; Echocardiography, Doppler, Pulsed ; Estrogens, Conjugated (USP)* ; Heart Failure ; Heart Failure, Diastolic ; Humans ; Relaxation

In order to find out possible causes and measures for prevention of intracerebral hemorrhage remote from the site of cerebral aneurysm surgery, the authors analyzed five patients who developed such a complication following aneurysm surgery among 720 surgical cases of cerebral aneurysm. The aneurysm sites were posterior communicating artery(Pcom) in two cases, anterior communicating artery(Acom) in two, and Acom and middle cerebral artery(MMCA) in one. The hemorrhages in three cases occurred in the cerebellum. One in the contralateral hemisphere and one in the ipsilateral hemisphere to the operation site. All hemorrhages except one occurred vasospasm preoperatively. Fluctuation of blood pressure with sudden elevation to high level was noticed in three cases preoperatively and in all cases postoperatively. We conclude that sudden elevation of blood pressure during the remission stage of vasospasm seems to be possible cause for remote hemorrhage. To prevent this complication, we recommend meticulous control of blood pressure during surgery and in the postoperative period, especially in cases that showed fluctuation of blood pressure preoperatively.
Aneurysm* ; Blood Pressure ; Cerebellum ; Cerebral Hemorrhage ; Hemorrhage* ; Humans ; Intracranial Aneurysm ; Postoperative Hemorrhage ; Postoperative Period

Pemphigus vegetans is a rare variant of pemphigus vulgaris and is characterized by vegetating lesions in the inguinal folds and mouth and by the presence of autoantibodies against desmoglein 3. Two clinical subtypes of pemphigus vegetans exist, which are initially characterized by flaccid bullae and erosions (the Neumann subtype) or pustules (the Hallopeau subtype). Both subtypes subsequently develop into hyperpigmented vegetative plaques with pustules and hypertrophic granulation tissue at the periphery of the lesions. Oral administration of corticosteroids alone does not always induce disease remission in patients with pemphigus vegetans. We report here on a 63-year-old woman with pemphigs vegetans. She had a 2-year history of vegetating, papillomatous plaques on the inguinal folds and erosions of the oral mucosa. The enzyme-linked immunosorbent assay was positive for anti-desmoglein 3, but it was negative for anti-desmoglein 1. She was initially treated with systemic steroid, but no improvement was observed. The patient was then successfully treated with a combination of systemic steroid and dapsone with a good clinical response.
Administration, Oral ; Adrenal Cortex Hormones ; Autoantibodies ; Blister ; Dapsone ; Desmoglein 3 ; Enzyme-Linked Immunosorbent Assay ; Female ; Granulation Tissue ; Humans ; Middle Aged ; Mouth ; Mouth Mucosa ; Pemphigus

BACKGROUN: Many studies have shown that diabetes mellitus does not modify the clinical features and treatment outcomes. However, to our knowledge, those surveys for clinical features and treatment outcomes in pulmonary tuberculosis with diabetics were performed 15 years ago and have not been confirmed by more recent reports. Therefore, the purpose of this study is to investigate the effect of diabetes mellitus on microbiologic findings in far advanced stage of pulmonary tuberculosis and so to make some suggestions for the management of pulmonary tuberculosis with diabetes mellitus. METHODS: This study population was composed of 47 patients with far advanced stage of culture-proven pulmonary tuberculosis hospitalized in our department from 2000 through 2002. None of patients was intractable. Patients were divided into 4 groups; group1;nondiabetics with initial treatment, group2;diabetics with initial treatment, group3;nondiabetics with retreatment, group4; diabetics with retreatment. Treatment regimens were individualized on the basis of susceptibility results. A retrospective review of the records of all 47 patients with pulmonary tuberculosis and diabetes mellitus was carried out. The clinical features, bacteriologic, radiographic findings and treatment outcomes were compared among 4 groups. RESULTS: Time to negative conversion of AFB in sputum smear was significantly increased in diabetics group than nondiabetics, but time to negative conversion of AFB in sputum culture was not significant. Also time to negative conversion of AFB in sputum smear or culture was not affected by treatment pattern. The effect of antituberculosis medication significantly delayed response in diabetics with retreatment and resistance rate was higher in diabetics or retreatment. Time to negative conversion of AFB in sputum smear was related to cavitary size in radiographic findings, but time to negative conversion of AFB in sputum culture was related to drug sensitivity. Natural course of cavity on radiographic findings after antituberculosis therapy was not significant. CONCLUSION: It seems that diabetes mellitus does not affect bacteriological negative conversion rates except negative conversion rate of AFB in sputum smear, which chiefly related to cavitary size, in far advanced stage of pulmonary tuberculosis. Therefore, because the presence of AFB in sputum smear after 5th months of therapy is not necessarily a treatment failure in far advanced stage of pulmonary tuberculosis with diabetics, any decision regarding prologation or change in therapy maybe required based on the results of culture and drug susceptibility tests.
Bacteriology ; Diabetes Mellitus* ; Humans ; Retreatment ; Retrospective Studies ; Sputum ; Treatment Failure ; Treatment Outcome ; Tuberculosis, Pulmonary*

PURPOSE: The purpose of this study was to compare the diagnostic efficacy of mammography, Ultrasonography(US) and T-scan in pathologically confirmed breast diseases. MATERIALS AND METHODS: Thirty-eight patients withpathologically confirmed breast diseases who had undergone T-scan and mammography and/or US were retrospectivelyreviewed. Cases were categorized as normal, benign, or malignant, and on the basis of disease entity and masssize, the results were compared with pathologic diagnosis. For the of t scans, the conductance ratio was alsoused. RESULTS: Twenty cases were benign and 18 were malignant. The sensitivity, specificity and positivepredictive value of mammography were 100%, 70%, 74%;respectively. For US, the corresponding figures were 100%,82%, 88%, and for T-scan, 33%, 85%, 67%. Between masses with a diameter of less than 2cm and more than 2cm, thesensitivity, specificity, and positive predictive value of mammography and US demonstrated no significantdifference, except in some cases ; for T-scan however, the respective results were 10%, 80%, 33% when lesion sizewas less than 2cm, and 56%, 90%, 83% when lesions were larger than 2cm. The diagnostic efficacy of T-scan was thusgreater for larger lesions than for smaller ones. With regard to the conductance ratio of T-scan no pathologicallymalignant lesions showed high suspicion of malignancy but 33% showed moderate suspicion. CONCLUSION: Mammographyand US were useful in diagnosing breast malignancy. T-scan was less efficient for the diagnosis of breastmalignancies smaller than 2cm, and of infiltrating ductal carcinoma and ductal carcinoma in situ. They may thus beconsidered a complementary to mammography and ultrasound examination.
Breast Diseases ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Humans ; Mammography* ; Sensitivity and Specificity ; Ultrasonography*