BACKGROUND: The reproducibility in grading a cervical intraepithelial neoplasia (CIN) are not perfect. The aim of this study was to assess the value of the immunohistochemical expression of p63 and the other biomarkers for grading a CIN (dysplasia and in situ carcinoma), and diagnosing invasive carcinomas. METHODS: Sixty six cervical specimens were immunostained with the monoclonal antibodies against p63, Ki-67, p27Kip1, and p53 to determine the localization. RESULTS: The p63 positive cells are well linked with squamous cell maturation and the degree of dysplasia. In mild dysplasia, the p63 positive cells were localized to the basal and parabasal cells, which gradually extended into the middle and upper layers in moderate and severe dysplasia. p63 expression was strong in immature squamous epithelium and invasive squamous cells, but was constantly absent in an adenocarcinoma. The Ki-67 positive cells were scattered from the parabasal cells to the superficial cells in accordance with the degree of dysplasia. p27Kip1 expression was noted in the intermediate cells in the normal cervix. In CIN, the p27Kip1 positive nuclei tended to extend to the basal cells, but it showed no diagnostic consistency in an invasive carcinoma. p53 expression was also variable. CONCLUSION: p63 is a useful diagnostic adjunct for grading CIN as well as for detecting microinvasion and squamous differentiation in invasive carcinoma. However, immunohistochemical expressions for the p27Kip1 and p53 have no correlation with the grade of CIN and squamous cell carcinoma.
Adenocarcinoma ; Antibodies, Monoclonal ; Biomarkers ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Epithelium ; Female ; Uterine Cervical Neoplasms

OBJECTIVE: The purpose of this study was to analyze the clinical characteristics and prognosis of small cell uterine cervical carcinoma with neuroendocrine differentiation. METHODS: Patient's medical records were reviewed retrospectively who were diagnosed as small cell carcinoma of uterine cervix and were treated at Hanyang University Hospital between 1972 and 1997. RESULTS: Between 1972 and 1997, of 1164 patients who were diagnosed as invasive cervical cancer, there were 10 cases of small cell carcinoma of uterine cervix in the department of obstetrics and gynecology, Hanyang University Hospital. The incidence of small cell carcinoma in invasive cervical cancer was 0.9% (10/1164). Of 10 small cell carcinoma, seven(70%) were neuroendocrine types which were identified with several kinds of immunohistochemical stains (Chromogranin, Grimelius, and/or NSE). The age of these 7 patients ranged from 34 to 63 years (mean 49). Two were in stage Ib, 3 in stage lla, I in stage IIIb, and 1 in stage IVb. Patients with stage Ib-IIb (n 5) received 3-5 courses of neoadjuvant VBP chemotherapy (vinblastine, bleomycin and cis-platinum) followed by radical hysterectomy with pelvic and paraaortic node dissection. One IIIb patient was managed with concurrent chemo-radiation(3 cycles of cis-platinum & 5-FU) followed by 6 courses of chemotherapy. One IVb patient was treated by palliative chemotherapy with 8 cycles of VBP chemotherapy. Of 5 paticn(s who underwent surgery, none showed pelvic lymph node metastases. These 7 patients were folk>wed for 8 - 62 months (average: 20 months). During this period, 5 patients died of disease hetween 8 and 62 months later and 2 patients are still alive for 12 (stage Ib) and 26 months (stage Ib), respectively. In the contrary, of 3 patients without neuroendocrine differentiation, who underwent neoadjuvant VBP chemotherapy followed by radical hysterctomy with pelvic and paraaortic node dissetion or concurrent chemo-radiation, two stage IIb patients are still alive for 58 and 74 months, and one IIIb patient died of disease 12 months later. CONCLUSION: In summary, neuroendocrine differentiation seemed to adversely affect the prognosis and longterm survival of small cell carcinoma of uterine cervix. So, for this high risk group, more aggressive therapy would be need to improve outcome. However, as the number of patients were small in our study, further study with large number of patients are warranted.
Bleomycin ; Carcinoma, Neuroendocrine* ; Carcinoma, Small Cell ; Cervix Uteri* ; Cisplatin ; Coloring Agents ; Drug Therapy ; Female ; Gynecology ; Humans ; Hysterectomy ; Incidence ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Obstetrics ; Prognosis ; Retrospective Studies ; Uterine Cervical Neoplasms

We reviewed the 43 medical records of patients with cellulitis or erysipelas who had been admitted at the depar1ment of dermatology of Seoul National University Hospital and followed them up for mean 21.6 months. The results were as follows. 1. The sex ratio of patients with cellulitis was 1:1.4 and the average age was 49 years. 2. The lower extremity as the most frequently invloved site of cellulitis with the frequency of 58.1% (25 cases), with the head and neck being involved in 16 cases(37.2%) and trunk and upper extremity in 1 case each(2.3% ). 3. The portals of infecticin were suspected in 33 cases(76% ), where tinea pedis was detect,ed in 18 cases(41.9%), previous skin infeection 10 cases(23.3%) and trauma in 9 cases(20.9%). 4. Initial systemic symptoms were fever(76.7%), chill(65.1%) and headache(37.2%). Erythema(100%), local heating(90,7%), tenderness(88.4%), swelling(86.0%), ulcer(16.3%), bulla(14.0%), lymphangitis(9.2%) and lymphadenit,is(9.2%) were found in the skin lesions. 5. The laboratory findings revealed leukocytosis in 35.7%, elevaed ESR in 86.8% positive 6. ASO titer in 63.0% and positive CRP in 80%, Microorganism. were detected in only 1 of 15 blood cultures, in 2 of 4 bulla fluid cultures and in 7 of 9 bus cultures. There was no growth of causative microorganisms in 3 tissue cultures and 9 saline needle aspiration cultures. Penicillin was used as primary antibiotics in 19 cases, which changed to another antibiotics due to lack of improvement in 3 cases and cefazolin was used in 21 cases, which changed in 2 cases due to the same reason. 7. Average admission priod was 11 days(range from 3 to 20 days) and 30.2% of patients wit.h cellulitis experienced recurrence, but 48% on low extrernity in contrast with 6.7% on head and neck.
Anti-Bacterial Agents ; Cefazolin ; Cellulitis* ; Dermatology ; Erysipelas ; Head ; Humans ; Leukocytosis ; Lower Extremity ; Medical Records ; Neck ; Needles ; Penicillins ; Recurrence ; Seoul ; Sex Ratio ; Skin ; Tinea Pedis ; Upper Extremity

The purpose of this study was to investigate knowledge and attitude about oral contraceptive between Korean and Japanese university students in order to provide better sex education programs and direcrion.Korean subjects of this study were 337 university students in M city, during the period from April 1 to April 20, 2001 and Japanese subjects 245, during the period from June to August, 2001. Collected data were analyzed using descriptive statistics, t-test, Pearson correlation coefficients with SPSS package. The results from this study were summarized as follows :1. The mean age of Koreans and Japanese students was 21.0+/-3.2 and 19.6+/-3.2 years old. The number of Japaneses youths having the parter with sexual intercourse was larger than that of Korean university students. 2. Comparison of knowledge and attitude about oral contraceptives between Korean and Japanese university students ;1) Comparison of sexual differences : Oral contraceptives related knowledge of Korean university students marked 55.7+/-7.5 of male students and 56.7+/-6.2 of females with a range of 15 to 75. The level of female students' knowledge was higher than that of male's but there is not statistically a significant difference (p= .080). Oral contraceptives related attitude of Korean university students marked 81.1+/-12.2 of male students and 76.9+/-10.3 of female's with a range of 24 to 120. The level of male students' attitude was higher than that of female's and there is statistically a significant difference(p= .002). Oral contraceptives related knowledge of Japanese university students marked 55.3+/-6.7 of male students and 57.0+/-6.3 of female students. The level of female students' knowledge was higher than that of male's but there is not statistically a significant difference (p= .159). Oral contraceptives related attitude of Japanese university students marked 80.3+/-10.1 of male students and 80.4+/-9.9 of female students. The level of female students' attitude was higher than that of male's and there is not statistically a significant difference(p= .928).2) Comparison between the country : Oral conceptives related knowledge of Korean university students marked 56.2+/-6.8 and 56.7+/-6.4 of Japanese university students with a range of 15 to 75. The level of Japanese university students' knowledge was higher than that of Korean's but there is not statistically a significant difference(p= .361). Oral conceptives related attitude of Korean university students marked 78.9+/-11.4 and 80.4+/-9.9 of Japaneses with a range of 24 to 120. The level of Japanese university studentss' attitude was higher than that of Korean's and there is not statistically a significant difference(p= .100). 2. Wanted age of oral contraceptives taking medicine and age was correlated positively (r=.178, p=.004) and total knowledge score of oral contraceptives and total attitude score were correlated positively(r=.467 p= .000) in Korean university students. Wanted age of oral contraceptives taking medicine and age was correlated positively (r=.289, p=.004), age and total attitude score were correlated positively(r=.196 p=.002) and total knowledge score of oral contraceptives and total attitude score were correlated positively (r=.671 p=.000) in Japanese university students. 3. Korean university students lifted side effect by the greatest factors in investigation about leading person that disturb work oral contraceptive, and the following appeared by knowledge insufficiency, sexual feeling inflammation worry, social prejudice, sexual morality decline, supernumerary prescription being not right, other person reverse and economical burden. Japanese university students can know that it is appearing by side effect, supernumerary prescription being not right, knowledge insufficiency, sexual feeling inflammation worry, economical burden, social prejudice, sexual morality decline and other person reverse. Think that this is result by dissimilar health medical system and cultural difference between two countries.
Adolescent ; Asian Continental Ancestry Group* ; Coitus ; Contraceptive Agents ; Contraceptives, Oral ; Female ; Humans ; Inflammation ; Male ; Morals ; Prejudice ; Prescriptions ; Sex Education

PURPOSE: The purpose of this descriptive study was to assess levels of stress, coping style, and nursing needs for hospitalized pregnant women diagnosed with preterm labor. METHODS: Data were collected from 125 pregnant women aged between 20 and 40 years and diagnosed with preterm labor by OBGY units at 3 hospitals. Data were analyzed by frequency, percentage, t-test, and ANOVA with Scheffe test. RESULTS: The level of stress among women was an average of 2.13 out of 4 points, the level of coping style was an average of 2.66, and nursing needs was an average of 2.83 out of 4 points. The level of stress was significantly different by job, length of hospital stay, type of hospital, and history of admission at obstetric unit. The level of coping style was significantly different by age and monthly income. The level of nursing needs was significantly different by type of hospital. Higher level of stress and coping style were related to higher level of nursing needs. There was no significant correlation between stress and coping style. CONCLUSION: The result showed the importance of nursing intervention dealing with stress, coping style and nursing needs for women with preterm labor. Nurses need to provide nursing interventions to reduce the stress, to strengthen the coping style, and to satisfy the nursing needs for pregnant women hospitalized due to preterm labor.
Female ; Humans ; Length of Stay ; Nursing* ; Obstetric Labor, Premature* ; Pregnancy ; Pregnant Women*

Purpose: This qualitative study aimed to develop a substantive theory of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea. Methods: Individual, in-depth interviews were conducted from July to September 2017, with 18 women who emigrated of Korean ethnicity from Central Asia to Korea, and took care of their baby for at least a year after their first delivery in Korea. The interviews were audio-recorded and transcribed verbatim. Data from the transcriptions were analyzed through Strauss and Corbin's grounded theory method, and data analysis was conducted simultaneously with data collection. Results: As a result of categorizing the interview data through the process of open coding, 10 categories, with 31 subcategories and 102 concepts were drawn, and “growth as a Central Asian-Korean mother in an unfamiliar, historical hometown” was found to be the core category of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea. Conclusion A characteristic of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea, drawn from this study, is that it differs according to the level of initiative to carry out interaction strategies, and the use of various supportive social resources. The findings indicate the need for Medicare eligibility adjustment for antenatal care, the extension of the visa renewal period during childbirth, the development of web- or mobile application-based educational programs in Russian language, and the establishment of integrated visiting healthcare services, community service resources, and policy support to enable these women to utilize various supportive social resources.

PURPOSE: This qualitative study aimed to develop a substantive theory of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea.METHODS: Individual, in-depth interviews were conducted from July to September 2017, with 18 women who emigrated of Korean ethnicity from Central Asia to Korea, and took care of their baby for at least a year after their first delivery in Korea. The interviews were audio-recorded and transcribed verbatim. Data from the transcriptions were analyzed through Strauss and Corbin's grounded theory method, and data analysis was conducted simultaneously with data collection.RESULTS: As a result of categorizing the interview data through the process of open coding, 10 categories, with 31 subcategories and 102 concepts were drawn, and “growth as a Central Asian-Korean mother in an unfamiliar, historical hometown” was found to be the core category of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea.CONCLUSION: A characteristic of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea, drawn from this study, is that it differs according to the level of initiative to carry out interaction strategies, and the use of various supportive social resources. The findings indicate the need for Medicare eligibility adjustment for antenatal care, the extension of the visa renewal period during childbirth, the development of web- or mobile application-based educational programs in Russian language, and the establishment of integrated visiting healthcare services, community service resources, and policy support to enable these women to utilize various supportive social resources.
Adaptation, Psychological ; Asia ; Clinical Coding ; Data Collection ; Delivery of Health Care ; Emigrants and Immigrants ; Female ; Grounded Theory ; Humans ; Korea ; Medicare ; Methods ; Mothers ; Parturition ; Qualitative Research ; Social Welfare ; Statistics as Topic

To evaluate the effect of Morphine during spinal anesthesia with alpha-adrenergic agonist, we used 0.18 mg of epinephrine, 90 ug of clonidine and 0.3 mg of morphine with 12 mg of T-cain respectively and compared hemodynamic and analgesic effects of each drug. Eighty patients were divided into four groups as follows; Group I (n=20); T-cain with clonidine, Group II (n=20); T-cain with epinephrine, Group III (n=20); T-cain with clonidine and morphine, and Group IV (n=20); T-cain with epinephrine and morphine. The results were as follows; 1) The onset time of analgesia and the time reached to the highest level of sensory loss were most rapid in the epinephrine and morphine group. 2) The duration of analgesia was significantly prolonged in the group of epinephrine and morphine than the group of epinephrine and clonidine. 3) It was more likely complicated in the morphine groups than others but there was no significance. 4) Although the heart rate was gradually decreased over 60 min. after anesthesia, there was no significance between the groups. 5) Systolic and diastolic blood pressure were decreased mainly over 30~45 min. after anesthesia, but there was no significance. In conclusion, epinephrine can be sustituted for clonidine because analgesic duration was not significantly changed, and the duration of analgesia was prolonged by morphine.
Adrenergic alpha-Agonists ; Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Clonidine* ; Epinephrine* ; Heart Rate ; Hemodynamics ; Humans ; Morphine*

BACKGROUND: Carcinoma of the uterine cervix is a theoretically preventable disease because its precursor lesions can be detected by cervical Papanicolau smears and appropriately treated, Although cervical cytology screening programmes have resulted in the redution of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. The focus of criticism has been the false-negative Pap smear, and the false-negative Pap smear is the major quality issue currently facing the physicians. To reduce the false-negative rate of Pap smear, it is essential to improve the accuracy of Pap smear. But false-negative rate of Pap smear has been reported variously. OBJECTIVE: This study was undertaken to evaluate accuracy of Pap smear by study false-negative and false-positive rate of Pap smear and to determine whether false-negative and false-positive rate had any correlations with clinical factors. STUDY DESIGN: The study population was comprised of 346 women, who were undertaken gynecologic operation at the Department of Obstetrics & Gynecology at Hanyang University hospital between March, 1997 and April, 1998. All patients were taken Pap smear before operation. In 93 women of these, preoperative diagnosis were cervical intraepithelial neoplasia and carcinoma in situ of uterine cervix, and in 253 women of these, preoperative diagnosis were benign disease as uterine myoma or adenomyosis, etc. All of their surgical specimen were examined. Pap smear, pathology, medical charts of all patients were reviewed retrospectively, and false-negative rate and false-positive rate were calculated. Clinical factors that associated with false-negative and false-positive rate were evaluated. Fishers exact test and Pearson chi-square test were used of statistical analysis, RESULTS: False-negative rate of Pap smear was 7.2%, false-positive rate was 4.6%, corresponding rate with histology was 88.2%. Sensitivity and specificity of PAP smear were 87.0% and 97.0% respctively. According to gross finding of uterine cervix, erosion was 46.6% in cervical intraepithelial neoplasia, 67.8% in carcinoma in situ, 66.6% in microinvasive carcinoma of uterine cervix and 55.3% of 103 erosion findings was cervical intraepithelial neoplasia, carcinoma in situ or microinvasive carcinoma. 23.1% of cervical lesion were normal gross finding. Menopause was associated with false-negative rate and previous vaginal infection history, previous cervical minor operation, delivery mode, contraception method, pelvic inflammatory disease history, vaginal bleeding at Pap smear and gross finding of cerbix were not associated. There were no clinical factors that were associated with false-positive rate. CONCLUSION: Compared with other reports, false-negative rate(7.2%) and false-positive rate(4.6%) of Pap smear was lower and corresponding rate(88.2%) was higher in Hanyand university hospital. Because of higher false-negative rate in menopausal women, it need more careful to take and interpretate Pap smear in these group.
Adenomyosis ; Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Contraception ; Diagnosis ; Female ; Gynecology ; Humans ; Incidence ; Leiomyoma ; Mass Screening ; Menopause ; Mortality ; Obstetrics ; Pathology ; Pelvic Inflammatory Disease ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; Uterine Hemorrhage

We evaluated the effects of guanosine 5′-monophosphate (GMP)-chelated calcium and iron (CaFe-GMP) on health and egg quality in layers experimentally infected with Salmonella Gallinarum. In this study, a CaFe-GMP feed additive was added to a commercial layer feed and fed to layers over a four-week period. All were inoculated with Salmonella Gallinarum. Body weight, mortality, clinical symptoms, and poultry production including feed intake, egg production, egg loss, and feed conversion rate were observed, and Salmonella Gallinarum was re-isolated from the liver, spleen, and cecum of the layers. All tested internal organs for the CaFe-GMP additive group exhibited significantly lower re-isolation numbers of Salmonella Gallinarum and less severe pathological changes than those in the control group, indicating that the CaFe-GMP feed supplement induced bacterial clearance and increased resistance to Salmonella Gallinarum. Additionally, due to the inhibitory action of CaFe-GMP on the growth of Salmonella Gallinarum, the CaFe-GMP additive group exhibited better egg production, including a higher laying rate and fewer broken eggs. The results suggest that a 0.16% CaFe-GMP additive may help prevent salmonellosis in the poultry industry.
Body Weight ; Calcium* ; Cecum ; Eggs ; Guanosine* ; Iron* ; Liver ; Mortality ; Ovum* ; Poultry ; Poultry Products ; Salmonella Infections ; Salmonella* ; Spleen