Human papillomavirus (HPV)infection are now generally accepted as the most important factor for development of uterine cervical cancer and its precursor lesions. With increasing evidences that the HPV E7 encodes for oncoproteins critical for viral replication, host cell immortalization and transformation. Based on the previous reports that the high risk HPV type 16 DNA is frequently detected in specimens from Korean women with cervical cancer and that there is the sequence variation and geographical dependence of HPV 16 E7 gene in preinvasive and invasive cervical lesions, it is crucial to determine the prevalence of HPV 16 variants in uterine cervical lesions of Korean women. This study was performed to identify sequence variations of HPV 16 E7 gene and an association between HPV 16 E7 variants and uterine cervical cancer. The author has determined nucleotide sequences of the E7 gene of HPV 16 isolated from uterine cervical tissues in Korean women. HPV 16 DNAs were detected by the nested PCR in 112 (24.5%) of a total of 457 samples. By direct sequencing of PCR-HPV 16 E7 positive cases, 79 samples (70.5%) showed variant sequences, while the prototype sequence was found in only 33 samples (29.5%). Twenty-three cases (57.5%) of 40 normal cervical samples showed sequence variation. Forty-eight (77.4%) of 62 cervical cancer cases showed sequence diversity from prototype HPV 16 E7 gene. There were four types of sequence variations. A single nucleotide change at position 647 (A-->G) was found in 52 cases (65.8%) of 79 HPV 16 E7 variants. Predicted amino acid change (Asn -->Ser) was found in the HPV 16 E7 oncoproteins at amino acid position at 29. And this KE7-1 variant was commonly detected in the uterine cervical cancer compared to the normal cervix. The second most common variant, detected in 16 cases (20.3%), had three silent mutations at nucleotide positions 732 (T-->C), 789 (T-->C) and 795 (T-->G). The third variant had a single nucleotide change at position 666 (G-->A), and the fourth had a change at position 796 (T-->C). Furthermore, PCR-SSCP clearly showed distinct bands compatible with HPV 16 E7 variants as with the direct-sequencing method. PCR-SSCP was also an effective and reliable tool in detecting HPV 16 E7 variants. This study showed that there were four variant types of HPV 16 E7 in uterine cervical tissues and KE7-1 with corresponding amino acid change was the most commonly detected type in E7 variants of HPV 16 isolated from uterine cervical cancer in Korean women.
Base Sequence ; Cervix Uteri ; DNA ; Female ; Human papillomavirus 16 ; Humans* ; Oncogene Proteins ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Prevalence ; Uterine Cervical Neoplasms*

No abstract available.
Hematoma*

Unfortunately, we have poor knowledge of medical technology in North Korea. This study has thus attempted to identify the level and status of medical technology development through analyzing the contents of medical textbooks currently in use. This study has assumed that three factors are influencing the level and status of medical technology in a society ; the level of socio-economic development in general, the level of scientific technology revolution and health policy. Forty textbooks are collected for this purpose. The main findings are summarized as follows: 1) North Korea has strengths in that (1) its herb drugs, which are in a broad use, are cheaper, more safe and more attainable than bio-equivalent chemical ones, and (2) the development of its medical technology was carried out with emphasis on the practical and basic health needs. 2) North Korea has weaknesses in that (1) its medical diagnostic method largely depends on manual procedures, (2) the R & D investment in the development of chemical drugs, especially antibiotics, is very small, (3) the amount of medical equipments is in a absolute shortage, and (4) the medical technology is destitute of specialty, caused mainly by the overemphasis on Juche-Uihak or herb medicine. 3) Medical technology has two faces, positive and negative so that it cannot be successfully evaluated by one. It eventually acts a positive function for public health through developments of drug, equipment and new medical treatment method. But it is also true that it has negative effects such as the dehumanization of high cost medical technology, cost hike due to over-investments in expensive equipments, and the absence of wholistic care from overspecialization. 4) We have to consider economic status and the social needs of medical care in order to evaluate the medical technology of a society. It is also the ease with North Korea. A whole picture of the North Korean medical technology could be understood only if further comprehensive studies of medical technology are to be carried out for North Korea.
Anti-Bacterial Agents ; Dehumanization ; Democratic People's Republic of Korea* ; Health Policy ; Herbal Medicine ; Investments ; Public Health

No abstract available.
Carcinoma, Adenosquamous* ; Lung*

The diagnostic importance of finding an appendicolith in the plain x-ray of the abdomen has been well documented. However, most of the papers so far published have stressed x-ray findings of the preoperative abdomenin acute appendicitis. In the present study we have attempted to correlate incidences of appendicoliths insurgical specimen and plain x-ray of the abdomen. The materials were 37 surgical specimens of the appendix removed for acute appendicits at St. Mary's Hospital, St. Paul's Hospital, Kang Nam Hospital, Holy Family Hospital and Our Lady of Mercy Hospital of Catholic Medical College during the period of 6 months from August 1980. Each surgical specimen was subjected to soft tissue radiography to detect calcified appendicolith. Then the preoperative x-raysof abdomen were retrospectroscopically analysed for the presence of radiographically demonstrable appendicoliths.Our study revealed that in as many as 32% of 37 surgical specimens one or more calcified appendicoliths were demonstrated radiographically whereas only one of these was identified as such in the preoperative x-ray film ofthe abdomen. Such a great discrepancy between the incidences of appendicoliths in the surgical specimen andpreoperative x-ray films of the abdomen are ascribed to (1) relative smallness of appendicoliths (87% of the stones measured less than 1cm in diameter in radiographs of surgical specimen in our series), (2) overlapping of these small stones on the right iliac bone and (3) underpenetrating of the iliac bone area in x-ray films of theabdomen. For improving detctability of appendicoliths therefore it is recommended that the technique of radiography of plain abdomen should be such that a small appendicolity overlying the iliac bone can be brought outof trabecular shadows.
Abdomen ; Appendicitis ; Appendix ; Humans ; Incidence ; Radiography ; X-Ray Film

No abstract available.
Female ; Ovary*

Loss of best corrected visual acuity(BCVA)is a landmark of safety, as one of important complications of refractive surgery. To evaluate causes of 2 lines or more loss of BCVA after laser in situ keratomileusis(LASIK), 206 eyes of 139 patients, who had undergone LASIK and had been followed up for 6 months or more, were included in this study. During the follow-up, nineteen eyes(9.2%, 19/206)showed 2 lines or more loss of BCVA postoperatively. The causes of BCVA were irregular astigmatism(15 eyes, 7.3%), retinal complications(3 eyes, 1.5%), and infectious keratitis(1 eye, 0.5%). All irregular astigmatisms had occured within 1 month postoperatively and 13 eyes of all 15 eyes spontaneously recovered after postoperative 3 months. The persistent loss of BCVA occurred in 5 eyes(2.4%, 5/206). Three cases of all 5 persistent losses of BCVA were due to retinal complications. In conclusion, our results suggest that the most common cause of loss of BCVA after LASIK is irregular astigmatism. Irregular astigmatism is a temporary situation which has a tendancy of spontaneous recovery. Thus careful observation is recommended in irregular astigmatism after LASIK. The retinal complications of LASIK may lead to permanent loss of BCVA. Therefore it is needed to examine preoperative fundus closely and to explain possible postoperative complicaitons to the patients and their family.
Astigmatism ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ* ; Refractive Surgical Procedures ; Retinaldehyde ; Visual Acuity*

PURPOSE: This study was retrospectively conducted to evaluate the clinical results of consecutive 167 myopic eyes of 117 patients undergoing laser in situ keratomileusis(LASIK) for myopia with either of the two excimer lasers, which differ in the method of laser delivery: flying spot scanning versus broad beam. METHODS: According to the laser used, the treated eyes were divided into two groups: Group I, 84 eyes of 58 patients with LaserScan LSX(R)(Lasersight Inc., USA); Group II, 83 eyes of 59 patients with OmniMed II(R)(Summit, USA). Each patient had been followed up for more than 6 months after surgery. Only single procedure outcomes were included. Mean preoperative spherical equivalents(SE) were -5.67+/-1.79 D(range:-1.50~-9.75 D) in group I and -6.40+/-1.79 D(range:-3.50~-9.75 D) in group II. RESULTS: At postoperative 6 months, mean uncorrected visual acuity increased to 0.94 in group I and 0.88 in group II. Uncorrected visual acuity of 20/40 or better occurred in 100% of group I and 96.4% of group II, and of 20/20 or better, in 57.2% and 48.2%, respectively. No eye in either group lost more than 1 line of best-corrected visual acuity. Mean SEs at postoperative 6 months were -0.28+/-0.50 D in group I and -0.55+/-0.60 D in group II(P<0.05). Manifest SEs were within +/-1.00 D in 97.6% of group I and 84.3% of group II, and +/-0.50 D in 73.8% and 60.2%, respectively. Intra- or postoperative complications were subconjunctival hemorrhage(4 eyes, group I; 5 eyes, group II), Sands of Sahara syndrome(7 eyes, group I; 5 eyes, group II), epithelial ingrowth(1 eye, group II only) and infectious keratitis(1 eye, group II only). No case had a central island or irregular astigmatism postoperatively. CONCLUSIONS: Our study suggests that LASIK using the LaserScan LSX(R)excimer effectively reduces myopia compared with OmniMed II(R). However, its predictability decreased as the attempted correction increased. LASIK for myopia less than -10 D with the LaserScan LSX(R)provided satisfactory refractive results that compare well with other reports in the literature.
Africa, Northern ; Astigmatism ; Diptera ; Humans ; Keratomileusis, Laser In Situ* ; Lasers, Excimer* ; Myopia ; Postoperative Complications ; Retrospective Studies ; Silicon Dioxide ; Visual Acuity

BACKGROUND: CSF can be leaked from the nose or ear due to fractures, tumors or surgical procedures in the skull base region, and the threat of impending meningitis necessitates early identification of it. Since 2-transferrin occurs practically in cerebrospinal fluid (CSF) and not in other body fluid, its detection from the rhinorrhea or otorrhea can be used for the diagnosis of CSF leakage. We carried out immunofixation-silver stain (IF-SS) method for detection of 2-transferrin in the CSF in order to know optimal identification condition of specific cerebrogenic marker. METHODS: The fresh CSF sample was collected by spinal tapping. 2-Transferrin was estimated by quantifying the total transferrin by nephelomertry (Behring, Germany). 2-Transferrin of CSF was identified by electrophoresis using Titan gel high resolution protein system (Beckman, USA), immunofixation with anti-human transferrin antibody (Dako, Denmark) and then stained with silver nitrate. Serial dilutions of CSF were performed to know the detection limit of 2-transferrin. To know the influence of blood mixing, tests for mixed specimen of serum and hemolysate in CSF were performed. To evaluate the specimen storage condition, tests for different temperature and storage time were performed . RESULTS: By IF-SS method, identification limit of 2-transferrin was 0.5 mg/dL in 1:4 diluted CSF with distilled water. And 2-transferrin could be detected in condition of mixing serum protein (7.5 g/dL) or hemoglobin (13 g/dL) with CSF up to 6 : 4. At various sample storage condition, such as 37degrees C, room temperature, and 4degrees C, band intensity decreased abruptly after 1 day, and it was not detected 5 days later. Mean while, in -20degrees C and -70degrees C, 2-transferin band was detected after 10 days. CONCLUSIONS: IF-SS method was sufficiently sensitive and specific for invalidation by blood contamination, and seems to be used as effective identification of 2-transferrin in the CSF without sample concentration, less diagnostic test for CSF leakage.
Body Fluids ; Cerebrospinal Fluid* ; Diagnosis* ; Diagnostic Tests, Routine ; Ear ; Electrophoresis ; Limit of Detection ; Meningitis ; Nose ; Saturn ; Silver Nitrate ; Skull Base ; Spinal Puncture ; Transferrin* ; Water

While renovating our traditional medical curriculum to integrated curricular system in 1996, we planned to introduce a course of problem-based learning (PBL) on tutorial basis after finishing 14 courses of the integrated medical curriculum for two years. One tutorial group was composed of one tutor and eight students, and 105 students of the second grade were divided into thirteen small tutorial groups. The period of PBL course was two weeks from December 1 to 14 in 1997. There were three interrelated steps for design of PBL course: course preparation, implementation, and evaluation which were conducted by PBL subcommittee consisted of nineteen teachers. Students were exposed to four clinical case modules, and they met in small tutorial room three times per week for two weeks. The PBL programme was evaluated by questionnaire survey method at the end of PBL course. We obtained satisfactory and positive results from reply of faculty and students. Since many teachers participated in planning, implementing, and evaluation of PBL, we could accumulate lots of knowledge and skills regarding the PBL, and it was a good opportunity to train expertise for PBL, test the feasibility changing to PBL curriculum. At this moment, our present integrated medical curriculum will be gradually converted to PBL system totally, and our experience will provide a good aid for other medical schools appling traditional medical curriculum to introduce PBL in their medical education.
Curriculum ; Surveys and Questionnaires ; Education, Medical ; Humans ; Problem-Based Learning* ; Schools, Medical