New Cervicography and HPV-DNA test, a adjunctive Pap Smear test, are an innovative cervical cancer surveillance system. The purpose of this study was to investigate the role of HPV-DNA test and cervicography as a pap smear in early detection of cervical cancer. Pap smear, cervicography, and HPV-DNA test data were obtained from 161 patients who visited the Department of Obstetrics and Gynecology, Chunan Hospital, Soonchunhyang University from November 1997 to April 1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either pap smear or cervicogram, and by naked eye. Specimens were taken either by colposcopically directed biopsy or large loop excision of the transformation zone. Results were as follows: 1. Pap smear results were normal in 40 cases (24.8%), RCC (reactive cellular change) or ASCUS (atypical squamous cells of undetermined significance) in 74 cases (46%), and abnormal (above low grade squamous intraepithelial lesion) in 47 cases (29.2%). 2. New Cervicographic findings were negative in 93 cases (57.8%), benign or suspicious atypical in 14 cases (8.7%), and positive in 54 cases (33.5%). 3. The sensitivity (94.6% vs 67.7%, p<0.01), and the false positive rate (19.8% vs 14.6%, p<0.01) of cervicography were significantly higher than for pap smear. The specificity (83.0% vs 86.2%, p<0.01), and the false negative rate (5.4% vs 32.3%, p<0.01) of cervicography were significantly lower than for pap smear. 4. When New Cervicography and Pap smear were used together, the sensitivity was higher than for pap smear in New Cervicography used alone (p<0.01) and the specificity was lower than for pap smear or cervicography used alone (p<0.01). 5. When cervicography and pap smear and HPV-DNA test were used concurrently, the sensitivity was higher than for cervicography and pap smear used together (p<0.01), and the specificity was lower than for cervicography and pap smear used together (p<0.01). The three screening test combination is a useful interval screening method to detect cervical cancer. The detection rate of cervical cancer will be increased. Thus, we believe that cervicography and HPV testing can be important adjuntive tests for cervical cytology, final tool in precancerous cervical lesions prevention. Combination of these three tests is sensitive enough to institute "interval screening" into society.
Biopsy ; Chungcheongnam-do ; Gynecology ; Humans* ; Mass Screening* ; Obstetrics ; Papilloma* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

New Cervicography and HPV-DNA test, a adjunctive Pap Smear test, are an innovative cervical cancer surveillance system. The purpose of this study was to investigate the role of HPV-DNA test and cervicography as a pap smear in early detection of cervical cancer. Pap smear, cervicography, and HPV-DNA test data were obtained from 161 patients who visited the Department of Obstetrics and Gynecology, Chunan Hospital, Soonchunhyang University from November 1997 to April 1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either pap smear or cervicogram, and by naked eye. Specimens were taken either by colposcopically directed biopsy or large loop excision of the transformation zone. Results were as follows: 1. Pap smear results were normal in 40 cases (24.8%), RCC (reactive cellular change) or ASCUS (atypical squamous cells of undetermined significance) in 74 cases (46%), and abnormal (above low grade squamous intraepithelial lesion) in 47 cases (29.2%). 2. New Cervicographic findings were negative in 93 cases (57.8%), benign or suspicious atypical in 14 cases (8.7%), and positive in 54 cases (33.5%). 3. The sensitivity (94.6% vs 67.7%, p<0.01), and the false positive rate (19.8% vs 14.6%, p<0.01) of cervicography were significantly higher than for pap smear. The specificity (83.0% vs 86.2%, p<0.01), and the false negative rate (5.4% vs 32.3%, p<0.01) of cervicography were significantly lower than for pap smear. 4. When New Cervicography and Pap smear were used together, the sensitivity was higher than for pap smear in New Cervicography used alone (p<0.01) and the specificity was lower than for pap smear or cervicography used alone (p<0.01). 5. When cervicography and pap smear and HPV-DNA test were used concurrently, the sensitivity was higher than for cervicography and pap smear used together (p<0.01), and the specificity was lower than for cervicography and pap smear used together (p<0.01). The three screening test combination is a useful interval screening method to detect cervical cancer. The detection rate of cervical cancer will be increased. Thus, we believe that cervicography and HPV testing can be important adjuntive tests for cervical cytology, final tool in precancerous cervical lesions prevention. Combination of these three tests is sensitive enough to institute "interval screening" into society.
Biopsy ; Chungcheongnam-do ; Gynecology ; Humans* ; Mass Screening* ; Obstetrics ; Papilloma* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

Blood-borne metastatic involvement of the gastric mucosa as a result of cancer is a rare occurrence. The tumors which were most commonly reported to metastasize to the stomach include melanoma, breast carcinoma, and lung carcinoma. Some reports document that large cell carcinoma and squamous cell carcinoma of the lungs have a higher pre- dilection for gastrointestinal tract metastases. Upper gastrointestinal endoscopic findings of metastatic lesions may vary but often produce a characteristic single or multiple bulls eye or target lesion. Therefore, whenever single or multiple target lesions are seen in the stomach on upper gastrointestinal endoscopy or barium study, the examination should include careful radiographic evaluation of the chest. Moreover, when the patient is known to have lung cancer, metastatic disease should be suspected. With a correct diagnosis and proper treatment, relief of symptoms and prolongation of life can sometimes be achieved, A case in reported involving squamous cell lung cancer with stomach metastasis in a 73 year-old woman. The patient was diagnosed by bronchoscopy, upper gastrointestinal endoscopy, chest CT, and abdominal CT. The chest and abdominal CT revealed a poorly marginated, lobulated, and 4 x 3 cm sized mass lesion in the right lower lobe causing obstruction of right lower lobe bronchus with invasion to the left atrium. right inferior pulmonary vein, and superior vena cava. Mediastimal lymph node enlargement and liver metastasis was also detected. Upper gastrointestinal endoscopy showed two "bulls eye" lesions with different sizes and two nodules without tip ulceration.
Aged ; Barium ; Breast Neoplasms ; Bronchi ; Bronchoscopy ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Endoscopy, Gastrointestinal ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Heart Atria ; Humans ; Life Support Care ; Liver ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Melanoma ; Neoplasm Metastasis* ; Pulmonary Veins ; Stomach* ; Thorax ; Tomography, X-Ray Computed ; Ulcer ; Vena Cava, Superior

BACKGROUND: It is generally accepted that the most spontaneously-arising epidermal cysts might be related to follicular infundibulum and palmoplantar epidermal cyst (PPEC) has been suggested to be caused from traumatic implantation of epidermal fragments. In addition there were several recent reports of human papillomavirus (HPV) implicating in formation of PPEC and also similar reports in Korean dermatologic literature. But the latter failed to reveal the presence of HPV in PPEC or a specific type of HPV by molecular biologic methods. OBJECTIVE: We tried to identify the presence of HPV and its subtype in PPEC. METHODS: After reviewing routine histopathologic findings recalling HPV infection in 8 PPECS, we undertook immunohistochemistry using polyclonal HPV antibody and polymerase chain reactions with 3 sets of HPV primers. To confirm the actual location of HPV in cyst in situ hybridization with HPV 60 probe was also done. RESULTS: All cases showed more than one feature of HPV infection. The positive reactions were 3 out of 8 on immunohistochemistry and 5 out of 8 on polymerase chain reaction. All cases (4 of 4) were positive on in situ hybridization and they were found in the horny layer and/or wall of cysts. CONCLUSION: PPEC in Korea may show similar typical histopathologic features with those reported in Japan. The HPV were detected in almost PPEC by molecular methods and their subtype was all HPV 60.
Epidermal Cyst* ; Gammapapillomavirus* ; Humans* ; Immunohistochemistry ; In Situ Hybridization ; Japan ; Korea ; Polymerase Chain Reaction

Asymptomatic unilateral absence of a portion of a fallopian tube with or without adjacent ovarian agenesis is a very rare condition. The true incidence is unknown. Two etiologic causes are possible. Asymptomatic segmental torsion of the uterine tube and ovarian pedicle may occur for certain reasons during adulthood, in childhood, or even during the fetal stages. Consequently, torsion may give rise to necrosis and autoamputation. Alternatively, the absence of these organs may be congenital. Ovarian pregnancy is a rare form of ectopic pregnancy occurring in 0.5~1% of all ectopic pregnancies. Moreover, ovarian pregnancy in patient with congenital unilateral tubal and ovarian agenesis has not been reported. But, the presenting symptom is very similar and difficult to distinguish with other forms of ectopic pregnancy. Early detection is important role in preserving fertility to avoid the ablation of functional ovarian tissue. We report a case of congenital unilateral tubal and ovarian agenesis diagnosed during laparoscopic treatment of ovarian pregnancy.
Fallopian Tubes ; Female ; Fertility ; Humans ; Incidence ; Laparoscopy ; Necrosis ; Ovary ; Pregnancy ; Pregnancy, Ectopic

Placental abruption is defined as the early separation a normal placenta from the wall of the uterus before delivery of the fetus. The incidence of it is known 1% of all pregnancies and perinatal mortality rates from abruption range from 20% to 40% in recent studies. The most common symptom is vaginal bleeding. The causes are associated with preeclampsia, other hypertensive disorders, and premature rupture of membranes. It is diagnosed by clinical symptom, sign, and ultrasonography. Recently we have experienced a case of placental abruption diagnosed at 31 weeks by ultrasonography in bicornuate uterus with a brief review of the literature.
Abruptio Placentae ; Female ; Fetus ; Incidence ; Membranes ; Perinatal Mortality ; Placenta ; Pre-Eclampsia ; Pregnancy ; Rupture ; Uterine Hemorrhage ; Uterus

To provide a basis for studying the pharmacological actions of tetracaine.HCl, we analyzed the membrane activities of this local anesthetic. The n-(9-anthroyloxy) stearic and palmitic acid (n-AS) probes (n = 2, 6, 9, 12 and 16) have been used previously to examine fluorescence polarization gradients. These probes can report the environment at a graded series of depths from the surface to the center of the membrane bilayer structure. In a dose-dependent manner, tetracaine.HCl decreased the anisotropies of 6-AS, 9-AS, 12-AS and 16-AP in the hydrocarbon interior of synaptosomal plasma membrane vesicles isolated from bovine cerebral cortex (SPMV), and liposomes derived from total lipids (SPMVTL) and phospholipids (SPMVPL) extracted from the SPMV. However, this compound increased the anisotropy of 2-AS at the membrane interface. The magnitude of the membrane rotational mobility reflects the carbon atom numbers of the phospholipids comprising SPMV, SPMVTL and SPMVPL and was in the order of the 16, 12, 9, 6, and 2 positions of the aliphatic chains. The sensitivity of the effects of tetracaine.HCl on the rotational mobility of the hydrocarbon interior or surface region was dependent on the carbon atom numbers in the descending order 16-AP, 12-AS, 9-AS, 6-AS and 2-AS and on whether neuronal or model membranes were involved in the descending order SPMV, SPMVPL and SPMVTL.
Anisotropy ; Carbon ; Cell Membrane ; Cerebral Cortex ; Fluorescence Polarization ; Liposomes ; Membranes ; Neurons ; Palmitic Acid ; Palmitic Acids ; Phospholipids ; Stearic Acids

BACKGROUND: The aim of this study was to determine a nation-wide prevalence of Ambler class A and D extended-spectrum-lactamases (ESBL) in Klebsiella pneumoniae isolates in Korea. METHODS: During the period of April to May 2005, 189 isolates of K.pneumoniae were collected from 11 Korean hospitals. Antimicrobial susceptibilities to ceftazidime and cefotaxime were tested by the disk diffusion method, and ESBL production was determined by double-disk synergy test. Determinants of ceftazidime or cefotaxime-resistance were transferred to Escherichia coli J53 (azide-resistant) by transconjugation. Genotypes of class A and D ESBL genes were determined by PCR amplification and sequencing. RESULTS: One hundred-sixty isolates of K.pneumoniae showed positive results in double-disk synergy test. The most prevalent ESBL was SHV-12 (n=148). Also detected were genes encoding ESBLs including TEM-52 (n=1), SHV-2a (n=2), CTX-M-3 (n=15), CTX-M-9 (n=6), CTX-M-12 (n=2), CTX-M-14 (n=9), CTX-M-15 (n=1), PER-1 (n=1), GES-5 (n=3), and OXA-30 (n=2) beta-lactamases. CONCLUSION: With the emergence of CTX-M-12, PER-1, and OXA-30 beta-lactamases, the ESBLs in K.pneumoniae isolates are becoming more diverse in Korea.
beta-Lactamases ; Cefotaxime ; Ceftazidime ; Diffusion ; Escherichia coli ; Genotype ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Polymerase Chain Reaction ; Prevalence

BACKGROUND: Multiple myeloma is a clonal B-cell malignancy manifested by the accumulation of terminally differentiated plasma cells. The disease is characterized by clinical heterogeneity, with survival ranging from a few months to more than 10 years. The purpose of this study is to evaluate the prognostic value of specific chromosomal abnormality in multiple myeloma. METHODS: We analyzed the clinical records of 40 patients who were diagnosed as multiple myeloma, between April, 1995 and August, 2004. Cytogenetic analysis was conducted by metaphase karyotype analysis. Patients were grouped into normal cytogenetic group (arm A), complete or partial deletion of chromosome 13 and hypodiploidy group (arm B) and other cytogenetic abnormality group (arm C). RESULTS: Median follow up duration was 13.1 months (range 1.5-92.1). Overall response rate to chemotherapy was 58.8% and response rate among arm A, B and C were 56.3%, 33.3% and 75%, respectively (p=0.229). The prognostic factors affecting survival were clinical stage, performance status, serum creatinine level, sex and chromosomal abnormality. The median overall survival was significantly different among arm A, B and C (34.9 months, 8.5 months and 19.8 months, respectively, p=0.0125). CONCLUSION: chromosomal abnormality, especially, complete or partial deletion of chromosome 13 and hypodiploidy at initial diagnosis is significantly associated with survival duration.
Arm ; B-Lymphocytes ; Chromosome Aberrations* ; Chromosomes, Human, Pair 13 ; Creatinine ; Cytogenetic Analysis ; Cytogenetics ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Karyotype ; Metaphase ; Multiple Myeloma* ; Plasma Cells ; Population Characteristics ; Prognosis

PURPOSE: We investigated the clinicopathologic information of patients with gastric cancer with multiple primary cancers (GC-MPC) of three or more sites. MATERIALS AND METHODS: Between 1995 and 2009, 105,908 patients were diagnosed with malignancy at Severance Hospital, Yonsei University Health System. Of these, 113 (0.1%) patients with MPC of three or more sites were registered, and 41 (36.3%) of these were GC-MPC. We retrospectively reviewed the clinical data and overall survival using the medical records of these 41 GC-MPC patients. We defined synchronous cancers as those occurring within 6 months of the first primary cancer, while metachronous cancers were defined as those occurring more than 6 months later. RESULTS: Patients with metachronous GC-MPC were more likely to be female (p=0.003) and young than patients with synchronous GC-MPC (p=0.013). The most common cancer sites for metachronous GC-MPC patients were the colorectum, thyroid, lung, kidney and breast, while those for synchronous GC-MPC were the head and neck, esophagus, lung, and kidney. Metachronous GC-MPC demonstrated significantly better overall survival than synchronous GC-MPC, with median overall survival durations of 4.7 and 14.8 years, respectively, and 10-year overall survival rates of 48.2% and 80.7%, respectively (p<0.001). CONCLUSION: Multiplicity of primary malignancies itself does not seem to indicate a poor prognosis. The early detection of additional primary malignancies will enable proper management with curative intent.
Breast ; Esophagus ; Female ; Head ; Humans ; Kidney ; Lung ; Medical Records ; Neck ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate ; Thyroid Gland