OBJECTIVE: We performed immunohistochemistry for the evaluation of follicle stimulating hormone receptor (FSHR), luteinizing hormone receptor (LHR) expression in the ovarian tumors and examined the blood level of the gonadotropins in ovarian cancer patients to investigate ovarian carcinogenesis process related to gonadotropins. METHODS: Between January 2002 and July 2003, 25 patients with ovarian tumors were treated in the Hallym University Sacred Heart Hospital. 25 ovarian tumors including 7 borderline tumors, 1 sex cord stromal tumor, 1 germ cell tumor, and 16 carcinomas were examined for FSHR, LHR expression by immunohistochemistry. Serum gonadotropins were collected from 13 cases of 25 ovarian tumors who were not taking hormones at the time of blood collection. RESULTS: Followings are results summarized. 1. Mean FSH levels were lower among cases compared with controls. LH levels were lower among cases than controls, but the difference was not statistically significant. 2. The steady decline of FSHR, LHR expression from borderline tumor (86%, 100%) to carcinoma (56%, 43%) is observed. 3. Patients showing significant gonadotropins receptors expression showed lower serum FSH and LH levels when compared with patients with no detectable gonadotropins receptors. CONCLUSION: The presence of FSHR, LHR in ovarian tumors provide additional evidence supporting the relation of gonadotropins and ovarian carcinogenesis. But, this study did not support the hypothesis that pituitary goandotropins increase the risk of ovarian cancer. The decline of receptor expression from borderline tumors to carcinoma suggests that FSH, LH may be needed in early ovarian cancer development. If further studies of gonadal peptides and gonadotropins are done, we can suggest the cut-off value of gonadotropins on ovarian carcinogenesis.
Carcinogenesis ; Gonadotropins* ; Gonads ; Heart ; Humans ; Immunohistochemistry ; Neoplasms, Germ Cell and Embryonal ; Ovarian Neoplasms* ; Peptides ; Receptors, FSH ; Receptors, Gonadotropin ; Receptors, LH ; Sex Cord-Gonadal Stromal Tumors

OBJECTIVE: The purpose of this retrospective study is to evaluate the efficacy of Loop Electrosurgical Excision Procedure (LEEP) in the diagnosis and in the treatment of CIS (carcinoma in situ). METHODS: Between Jan. 1999 and Apr. 2000, 94 patients with CIS were treated in the Hallym University Sacred Heart Hospital. Three procedures were performed: cytology, punch biopsy and LEEP (loop electrosurgical excision procedure). And the results of cervical cytology, punch biopsy, phathologic diagnosis of LEEP specimens were evaluated in comparison with the pathologic diagnosis of hysterectomy specimens. RESULTS: Followings are results summarized. 1. The concordance rate of LEEP histology with punch biopsy was 60% (53 cases). In comparison to punch biopsy, the higher LEEP histologic rate was 22% (19 cases), and lower LEEP histologic rate was 18% (16 cases), respectively. 2. 67 patients were diagnosed CIS and among them 58 patients underwent hysterectomy. In histologic comparison between LEEP and hysterectomy, there were on 1 (1.7%) patient who had more advanced diagnosis after operation. 3. 67 patients were diagnosed CIS and among them 58 patients underwent hysterectomy. The residual lesion was identified in 19 of 58 patients (33%). CONCLUSION: LEEP was useful diagnostic tool in CIS. But, in therapeutic efficacy, simple LEEP seems to be incomplete. Therefore, when we use LEEP for CIS as therapeutic tool, additional procedure, such as wide excision or endocervical deep resection may be asked. And careful follow up asked in therapeutic LEEP.
Biopsy ; Cervix Uteri* ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Humans ; Hysterectomy ; Retrospective Studies

Background: The Korea National Health and Nutrition Examination Survey (KNHANES) is a well-designed survey to collect national data, which many researchers have used for their studies. In KNHANES, although portable spirometry was used, its reliability has not been verified. Methods: We prospectively enrolled 58 participants from four Korean institutions. The participants were classified into normal pattern, obstructive pattern, and restrictive pattern groups according to their previous spirometry results. Lung function was estimated by conventional spirometry and portable spirometry, and the results were compared. Results: The intraclass correlation coefficients of forced vital capacity (FVC) (coefficient, 9.993; 95% confidence interval [CI], 0.988–0.996), forced expiratory volume in 1 second (FEV1) (coefficient, 0.997; 95% CI, 0.995–0.998), FEV1/FVC ratio (coefficient, 0.995; 95% CI, 0.992–0.997), and forced expiratory flow at 25–75% (FEF25–75%; coefficient, 0.991; 95% CI, 0.984–0.994) were excellent (all p<0.001). In the subgroup analysis, the results of the three parameters were similar in all groups. In the overall and subgroup analyses, Pearson’s correlation of all the parameters was also excellent in the total (coefficient, 0.986–0.994; p<0.001) and subgroup analyses (coefficient, 0.915–0.995; p<0.001). In the paired t-test, FVC, FEV1/FVC, and FEF25–75% estimated by the two instruments were statistically different. However, FEV1 was not significantly different. Conclusion Lung function estimated by portable spirometry was well-correlated with that estimated by conventional spirometry. Although the values had minimal differences between them, we suggest that the spirometry results from the KNHANES are reliable.

Background: The Korea National Health and Nutrition Examination Survey (KNHANES) is a well-designed survey to collect national data, which many researchers have used for their studies. In KNHANES, although portable spirometry was used, its reliability has not been verified. Methods: We prospectively enrolled 58 participants from four Korean institutions. The participants were classified into normal pattern, obstructive pattern, and restrictive pattern groups according to their previous spirometry results. Lung function was estimated by conventional spirometry and portable spirometry, and the results were compared. Results: The intraclass correlation coefficients of forced vital capacity (FVC) (coefficient, 9.993; 95% confidence interval [CI], 0.988–0.996), forced expiratory volume in 1 second (FEV1) (coefficient, 0.997; 95% CI, 0.995–0.998), FEV1/FVC ratio (coefficient, 0.995; 95% CI, 0.992–0.997), and forced expiratory flow at 25–75% (FEF25–75%; coefficient, 0.991; 95% CI, 0.984–0.994) were excellent (all p<0.001). In the subgroup analysis, the results of the three parameters were similar in all groups. In the overall and subgroup analyses, Pearson’s correlation of all the parameters was also excellent in the total (coefficient, 0.986–0.994; p<0.001) and subgroup analyses (coefficient, 0.915–0.995; p<0.001). In the paired t-test, FVC, FEV1/FVC, and FEF25–75% estimated by the two instruments were statistically different. However, FEV1 was not significantly different. Conclusion Lung function estimated by portable spirometry was well-correlated with that estimated by conventional spirometry. Although the values had minimal differences between them, we suggest that the spirometry results from the KNHANES are reliable.

PURPOSE: We aimed to examine the effectiveness of the head-up tilt test (HUT) for the diagnosis of syncope or presyncope in children and adolescents. METHODS: HUT results and clinical features of 160 children and adolescents with syncope or presyncope were studied from May 2003 through March 2008 at the Chonbuk National University Hospital. The children and adolescents were subjected to 70degrees HUT for 45 minutes. The testees were divided into 2 groups: group I (children) comprising 39 children in the age range 7-12 years (mean, 10.59+/-1.60 years) and group II (adolescents) comprising 121 adolescents in the age range 13-20 years (mean, 15.93+/-2.28 years). Positive result rates of the HUT and types of hemodynamic response to the test in the 2 groups were compared. RESULTS: Of the 160 testees, 92 (57.5%) showed positive HUT results; they showed 3 patterns of response to tilting. Twelve patients showed a predominantly vasodepressor response; 10 patients showed a cardioinhibitory response; and 70 patients showed a mixed response. The positive result rates were 43.6% (17/39) and 62.0% (75/121) in groups I and II, respectively. Mixed response was the predominant positive hemodynamic response in both the groups. CONCLUSION: The HUT is a useful diagnostic tool for evaluating the condition of pediatric patients, including adolescents, with syncope. Further, it may be considered as the first step for evaluating the condition of such patients.
Adolescent ; Child ; Hemodynamics ; Humans ; Resin Cements ; Syncope

No abstract available.
Cervix Uteri* ; Female

No abstract available.
Cervix Uteri* ; Female

OBJECTIVE: Heart rate variability(HRV) is helpful to diagnosis autonomic disturbance and sympathetic-parasympathetic imbalance in patients with myocardial infarction and diabetes mellitus. Patients with liver cirrhosis demonstrate reduced blood pressure despite increased heart rate and increased cardiac output, indicating a fall in peripheral vascular resistance. Autonomic disturbance may contribute to this phenomenon. The aim of the present study is to evaluate the degree of autonomic disturbance and the circadian rhythm of autonomic nervous system by estimating HRV with 24 hour-Holter recorder, METHODS: 24 hour-HRV with Del Mar Avionics 563 Holter recorder and cardiovascular reflex tests were carried out on 32 patients with liver cirrhosis and 20 control subjects. We evaluated the presence of autonomic disturbance, and assessed quantitatively the autonomic disturbance. RESULTS: 1) Among cardiovascular reflex tests, Valsalva test, standing test and deep breathing test were showed a significantly decreased response in liver cirrhosis compared with control groups. 2) The standard deviation of 24hours average R-R intervals were showed a significantly decrease in liver cirrhosis than control groups(P<0.0001). The HRV of low frequency(LF. P<.D.001), high frequency(HF, P<0.0001) and total power spectral density (P<0.0001) in liver cirrhosis were statistically lower than control. 3) The LF/HF ratio of patients with liver cirrhosis was showed higher than control at night CONCLUSION: Non-invasive assessment of 24 hour-HRV has a few advantages in the diagnosis and degree of autonomic disturbance, evaluation of diurnal variation of autonomic tone.
Autonomic Nervous System ; Blood Pressure ; Cardiac Output ; Circadian Rhythm ; Diabetes Mellitus ; Diagnosis ; Heart Rate* ; Heart* ; Humans ; Liver Cirrhosis* ; Liver* ; Myocardial Infarction ; Reflex ; Respiration ; Vascular Resistance

OBJECTIVE: To determine a diagnostic cut-off value for the cross-sectional area (CSA) of the radial nerve using ultrasonography for radial neuropathy located at the spiral groove (SG). METHODS: Seventeen patients with electrodiagnostic evidence of radial neuropathy at the SG and 30 healthy controls underwent ultrasonography of the radial nerve at the SG . The CSAs at the SG were compared in the patient and control groups. The CSA at the SG between the symptomatic and asymptomatic sides (ΔSx–Asx and Sx/Asx, respectively) were analyzed to obtain the optimal cut-off value. The relationship between the electrophysiological severity of radial neuropathy and CSA was also evaluated. RESULTS: Among the variables examined, there were statistically significant differences in the CSA between the patient and control groups, ΔSx–Asx, and Sx/Asx at the SG. In a receiver operating characteristics analysis, the cut-off CSA was 5.75 mm² at the SG (sensitivity 52.9%, specificity 90%), 1.75 mm² for ΔSx–Asx (sensitivity 58.8%, specificity 100%), and 1.22 mm² for Sx/Asx (sensitivity 70.6%, specificity 93.3%) in diagnosing radial neuropathy at the SG. There was no significant correlation between CSA and electrophysiological severity score for either patient group. CONCLUSION: The reference value obtained for CSA of the radial nerve at the SG may facilitate investigation of radial nerve pathologies at the SG.
Diagnostic Imaging ; Humans ; Pathology ; Radial Nerve ; Radial Neuropathy* ; Reference Values ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography*

Background: We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Methods: Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients. Results: The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65–0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72–1.36; p=0.94). Conclusion Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.