The widespread uae of colposcopy in the evaluation of abnormal cervical cytology has been accompanied by a trend toward decreased utilization of Papanicolaou smears and cone biopsy. But its accuracy is dependent on the criteria determining its limitations and the observer's experience. This study was performed to evaluate the diagnostic accuracy of Papanicolaau smear and eolposcopic finding and to campare these findinga with thase af colposcopically directed biopsy, conization and hysteretomy and to determine the value of endocervical curettage. Nine hundred twenty six patients were evaluated from Jan. 1, 1986 to Dec. 31, 1993 at the cancer detectinn center of the department of obstetrics and gynecology, Yonsei University, College of Medicine. Three major classes were involved in this study ; 662 cases with within normal limit Papanicolaou amears with cervical examination grossly suspicious for cancer, 187 cases with squamous intraepithelial lesion or greater, and 72 caees with reactiue or reparative change. The patients with inveaive rnalignancies of the cervix visihle to the naked eye were not included in this study. The majority of patients(75%) were 31 to 50 years of her age. The colposcopic examination wee deemed unsatisfactory in 45 cases in whom the upper limit, of the transformation zone could not be visualized. There were 881 cases each with a satisfactory colposcopie examination. We obtained the following results. In the satisfactory group with within normal limit Pap smears which had clinical impression of gross suspicion for cancer, 54 of 662 cases(8%) were diagnosed as more than cervical intraepithelial neoplasia I and 36(5.5%) were diagnosed as more than cervical intraepithelial neoplasia II with the histology of colposcopically directed biopsy. The analysis of the diagnostic values of Pap smears for cervical cancer screening showed that the sensitivity was 80.0%, the specificity was 93.8%, the false negative rate was 80.0%, the false positive rate was 15.2%, the negative predicitive value was 92.1%, and the positive predicitive value was 83.6%. In the satisfactory group with within normal limit Pap smears which had clinical impression of gross suspicion for cancer, 54 of 662 cases(8%) were diagnosed as more than CIN I and 36(5.5%) were diagnosed as more than CIN III with the histolgy of colposcopically directed biopsy. The accuracy of colposcopic impression when compared to histology of the colposcopically directed biopsy in the satisfactory group was 89.8% (within 1histologic degree) and 82.7% (precise agreement). Histologic comparision of colposcopically directed biopsy and final surgical specimen showed accuracy of 87.2% (within 1 histologic degree) and 66.5% (precise agreement). The accuracy of endocervical curettage with colposcopically directed biopsy when compared with final surgical specimen in unsatisfactory group was 82.2% (with 1 histologic degree) and 57.7% (precise agreement). In conclusion, satisfactory colposcopic evaluation in conjuction with Pap smear offers accurate method for cervical cancer detection. But endocervical curettage with colposcopically directed biopsy appears to be of less value in unsatisfactory group. Therefore futher evaluation is need.
Biopsy ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Colposcopy* ; Conization ; Curettage ; Female ; Gynecology ; Humans ; Mass Screening ; Obstetrics ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

This study was carried out in order to find out the valuable measure to kill the parasite eggs in night soil. The fresh eggs of Ascaris put into human stool were irradiated with Cobalt 60 of 200,000 to 1,000,000 rad and cultured in test tubes at 25-30 C, washing with 2 percent formalin solution every 24 hours. The continuous development of those eggs were observed under microscope and the proprotions of developed eggs were compared with those of control groups. The major result can be summarized as follows: In general, The eggs in stool developed poorly than the eggs in saline. If the eggs were irradiated with the larger dose of Cobalt 60, the proportion of developed eggs were reduced subsequently. The eggs irradiated with the dose of 1,000,000 rad in saline developed in the proportion of 15.5 percent, whereas irradiated with 200,000 rad 94 percent developed in 4 weeks. The 44.5 percent of eggs in stool irradiated with 200,000 rad developed after 4 weeks, 30.5 percent with 300,000 rad, 25 percent with 500,000 rad and 3.5 percent with 1,000,000 rad respectively. The effective minimum dose of Cobalt 60 irradiation to kill the Ascaris eggs in stool was estimated 1,000,000 rad. Further examination will be required to observe the infectivity of irradiated Ascaris eggs to animals and to evaluate the effect from the standpoint of sanitary engineerings.
parasitology-nematode-Ascaris lumbricoides ; Cobalt 60 ; radiology ; prevention ; egg ; infectivity

No Abstract Available.
Drug Resistance* ; Korea*

The authors report a xase of primary non-gestational choriocarcinoma(PNGCO) of the ovary in a prepubertal female patient and reviewed. It is an extremely rere disease of which incidence is one in 369 million. Major clinical symptom is abdominal pain, precociois puberty and it can be misdiagneosed as ectopic pergnancy. Distinction from gestational choriocarcinoma(GCO) of the ovary is important because of the worse prognosis of PNGCO. But no distinctive ultrastructural or immunohistochemical differences are found between PNGCO and GCO. Most acceptable treatment modality is an aggressive surgical therapy and systemic chemotherapy, but its progrosis is poor.
Abdominal Pain ; Adolescent ; Choriocarcinoma, Non-gestational* ; Drug Therapy ; Female ; Humans ; Incidence ; Ovary* ; Prognosis ; Puberty

No Abstract Available.
Cell Line* ; Humans* ; Vascular Endothelial Growth Factor A*

No Abstract Available.
Cell Line* ; Humans* ; Vascular Endothelial Growth Factor A*

No abstract available.
Adult* ; Humans ; Lower Extremity*

The authors analyse the ultrasonographic findings of 10 cases of appendiceal mucocele retrospectively. In atotal of 10 cases, 6 cases showed only cystic masses with posterior reinforcement. The remaining 4 cases showedinternal echoes in the cystic masses. Differential diagnosis of mucocele from periappendiceal abscess is notpossible in ultrasound. The possibility of mucocele shold be considered if cystic mass in right lower quadrantabdomen is observed in ultrasound.
Abscess ; Diagnosis, Differential ; Mucocele ; Retrospective Studies ; Ultrasonography

One of the patellar function is to protect the femoral condyle from direct blowing to knee, so it is known that ligament injuries of the knee are rare in the presence of patellar fracture. We experienced four cases of posterior cruciate ligament injury associated with patellar fracture. Unfortunately, three cases were initially neglected, and one case was identified by visualization on avulsed posterior tibial spine in plain X-ray film. We reviewed these cases and obtained several results as follows; 1. Among four cases, three cases(75%) are fractured at the lower pole of patella without displacement and one case is a longitudinal fracture. 2. We consider possible two mechanisms of this injury; first, in flexed knee, posteriorly directed force on the proximal tibia produces posterior cruciate ligament injury followed by avulsed fracture at the lower pole of patella. Second, by fall on a flexed knee, the load is sustained on the inferior pole of the patella first and continuously drives the tibia backwards producing posterior cruciate ligament injury. We recommend that all surgeon should be aware of possibility of the ligament injury in the presence of patellar fracture, especially in lower pole fracture.
Knee ; Ligaments ; Patella ; Posterior Cruciate Ligament ; Spine ; Tibia ; X-Ray Film

There are many procedures for the treatment of acute A-C injury which have many complications such as limitation of shoulder motion, post traumatic arthritis, recurrence of dislocation etc. From September 1985 to February 1992 at Haesung Hospital, Ulsan, 62 patients with grade I complete A-C dislocation had been treated surgically by modified Phemister method. We report 42 cases with at least 1 year follow up. The following results are obtained. 1. There are no limitation of shoulder motion in all cases. 2. The comparision of coraco-clavicular interval after surgery(1.43mm) with that of follow up (2.13mm) shows no significant difference. 3. We experience 15 cases who have resorption of distal clavicle or arthritic change in x-ray film. 4. Clinical results shows that excellent in 20 cases, good in 10 cases, fair in 11 cases, poor in 1 case. From the above result, we suggest the modified phemister method is good procedure in the treatment of acute A-C dislocation.
Arthritis ; Clavicle ; Dislocations ; Follow-Up Studies ; Humans ; Methods ; Recurrence ; Shoulder ; Ulsan ; X-Ray Film