The clinical role of tumor markers to detect the extent of tumor invasion and recurrence in cervical cancer has been debated. To evaluate the chncal significance of SCC, CEA and TPA as tumor markers in cervical, we studied 744 patients weith cervieal cancer from June 1990 to Mey 1994. The cut-off val ues of SCC, CEA and TPA were 1.5 ng/ml, 4.5 ng/mi and 110 U/I respectively. Followings were the results. 1. The serum concentration and positive rates of SCC before therapy(567 cases) were 3,0+/-7.0ng/ml(40.4%) for stage I,8.7+/-13.9 ng/ml(71.6%) for stage II, 10.8+/-14.7 ng/ml(85.7%) for stage III, 23.9+/-24.3 ng/ml(94.7%) for stage IV, and 13.4+/-19.1 ng/ml(75.0%) for recurrent cancer. It was increased with advancing clinical stage(p<0.01). 2. The seum levels and positive rate of CEA before therapy(627cases) were 3.4+/-4.3 ng/ml (18%) for stage I, 7.1+/-12.3 ng/ml(37.2%) for stage II, 8.4+/-9.6 ng/ml(57.9%) for stage III, 15.4+/-22.2 ng/ml(52.6%) for stage IV, and 10.3+/-16.2 ng/ml(46.4%) for recurrent cancer. It was increased with advancing clinical stage from stage Ito stage III(p<0.01). 3. The serum concentration and positiceive rate of TFA before therapy(301cases) were 51.7+/-53.8 U/l(9.5%) for stage I, 105.3+/-108.8 U/l(32.3%) for stage II, 186.3%+/-159.8 U/l(50%) for stage III, 191.3+/-l06.2 U/I(63.6%) for stage IV, and 135.4+/-117.0 U/l(46.4%) for recurrent cancer. It was increased with advencing clinical stage(p<0.01). 4. In 64 patients{24.2%) with lymph node invasion of 265 patients treated by operation, the mean serum levels of SCC, CEA and TPA were higher than lymph node negative group(p<0.05). 5. The serum levels of SCCand CKA after therepy were 82.8% in sensitivity. 94.3% in specificity, 67.9% in positive predictive value, 97.4% in negative predictive value.
Humans ; Lymph Nodes ; Recurrence ; Sensitivity and Specificity ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

Since Whitehead had described a circular hemorrhoidectomy in 1882, many surgeons adopted it for decades for patients with protruding anal deformity. After a few decades of performing Whitehead operation, devastating complications such as anal stricture, fecal incontinence, and wet anus with mucosal eversion had been reported on the literatures and then it was buried as an abandoned procedure by surgeons for a long period. Recently, a few prominent anal surgeons reported that they could avoid such devastating complications by introducing diverse modifications of the original Whitehead's operation. The authors analyzed 22 patients who had undergone original Whitehead circular hemorrhoidectomy with the technique of preserving most of the perianal skin and W-shaped circular incision during the period from 1991 to 1996, with special regard to the com plications such as anal stricture and anal mucosal eversion which have been debated on so far and reviewed the articles about these issues. In immediate postoperative period, suture failure and resultant non-surgery requiring, mild anal stricture were documented in 3 of the 22 cases(13.6%). On long-term follow-up with the mean period of 44 months (18~79 months) in 14 cases, except those 8 cases that were lost, with phone-call questionaire, 13 patients(93%) had quite normal anal functions. The authors would like to suggest that the original Whitehead's circular hemorrhoidec tomy is a valuable surgical technique to manage the protruding anal deformity if surgeons can avoid well known complications such as anal stricture and anal mucosal eversion by choosing a correct location of initial W-shaped incision to preserve as much perianal skin as possible.
Anal Canal ; Congenital Abnormalities ; Constriction, Pathologic ; Fecal Incontinence ; Follow-Up Studies ; Hemorrhoidectomy* ; Humans ; Postoperative Period ; Skin* ; Sutures

BACKGROUND: Patients with chest pain are common among outpatients. Several researches shows that chest pain patients can suffer from psychiatric illnesses such as hypochondriasis, depression, anxiety, somatization, panic disorder and so on. This study aims to examine the pschogenic symptoms in patients with noncardiac chest pain METHODS: In this study, the 98 people who have undergone treadmill test for chest pain during the three months from June 1st to September 30 of 1998 were selected, and the 98 patients were asked to respond to the prepared questionnaire and SCL-MPD(symptom check list-minor psychiatric disorders) before they underwent treadmill test. And then, they were classified into two groups. One group consisted of patients with noncardiac chest,pain, and the other group of patients with cardiac chest pain. These two groups were compared in 10 measures, and the compared results were analyzed by t-test. RESULTS: Among the 25 patients with cardiac chest pain, 15 patients were males and 10 patients (38%) were females, and among the 44 patients with noncardiac chest pain, 31 patients (70%) were males, 13 patients (30%) were females. The average age was 47 years old. The average age in patients with noncardiac chest pain was 48, and the 46 for those patients with cardiac chest pain . In the statistical analysis between the patients with cardiac chest pain and those with noncardiac chest pain, significant difference(p<0.005) was shown in the measures such as somatization, depression, phobic anxiety, obsessive-compulsive, neurasthenic, hypochondriacal, anxiety, anger-hostility, interpersonal sensitivity. CONCLUSIONS: As in the analysis the patients with noncardiac chest pain showed significant difference in the symptom check list-minor psychiatric disorder compared to those with cardiac chest pain. We conclude that primary care physician should take more interest in evaluating psychiatric symptoms in patients with noncardiac chest pain.
Anxiety ; Chest Pain* ; Depression ; Exercise Test ; Female ; Humans ; Hypochondriasis ; Male ; Middle Aged ; Outpatients ; Panic Disorder ; Physicians, Primary Care ; Thorax* ; Surveys and Questionnaires

This study aimed to investigate the prevalence of depression among Koreans living in urban and rural areas, stratified by socioeconomic status. The study included 216,765 participants from the 2017 Korean Community Health Survey. Depressive symptoms were assessed using the PHQ-9, with a score of 10 or higher indicating depressive symptoms. Residences with the words Eup and Myeon in their addresses were categorized as rural areas, and residences with Dong in their addresses as urban areas. Socioeconomic status was evaluated by household income and education level. A Poisson regression analysis with sampling weights was conducted and adjusted for demographic, lifestyle, socioeconomic status, and comorbidity. The adjusted prevalence rate of depressive symptoms was 3.33% (95% CI, 3.21-3.45) in urban areas and 2.59% (95% CI, 2.43-2.74) in rural areas. The prevalence of depressive symptoms in urban areas was 1.29 times (95% CI, 1.20-1.38) higher than in rural areas. The prevalence rate ratio for depressive symptoms in urban areas compared to rural areas sorted by monthly incomes was 1.39 (95% CI, 1.28-1.51) for less than 2 million won, 1.22 (95% CI, 1.06-1.41) for 2 to 3.99 million won, and 1.09 (95% CI, 0.90-1.32) for more than 4 million won, and the urban-rural difference was more evident in lower household income subjects (p for interaction=0.033). However, urban-rural differences did not differ according to sex, age, or education level. In conclusion, we found urban-rural differences in depressive symptoms in a representative sample of Koreans, and revealed that these differences may vary according to income level. These results suggest that mental health policy must consider the health disparities according to residence and income.

No abstract available.
Cervix Uteri* ; Female ; Lymph Nodes* ; Neoplasm Metastasis*

No abstract available.
Neural Plate* ; Neuroectodermal Tumors*

OBJECTIVE: This study was designed to evaluate the efficiency of tumor markers level for early diagnosis of ovarian malignancy and for differentiation between benign and malignant ovarian tumors. MATERIALS AND METHODS: We determined preoperative serum tumor markers level in patients who were going to have an operation due to ovarian tumor in OB & GY Dept. of Chonnam University Hospital from April 1993 to September 1999. RESULTS: 1) The average values of serum tumor markers in patients with malingnant ovarian tumors were statistically higher than those of benign ovarian tumors. among malignant ovarian tumors, positive rate of all serum tumor markers was highest in epithelial ovarian carcinoma group. and among ovarian tumor markers, and positive rate of CA 125 was highest in epithelial ovarian carcinoma. 2) Dermoid cyst and endometioma were correlated to CA 19-9, CA 125 levels respectively. for malignant tumors, mucinous ovarian adenocarcinoma and non-mucinous ovarian adenocarcinoma were CA 19-9, CA 125 levels respectively. 3) Among ovarian tumor markers, CA 125 was the most in sensitivity and CA 72-4 was the most in specificity and diagnostic efficiency. 4) For postmenopausal women with ovarian tumors, elevated levels of at least one of the 4 tumor markers were present in the serum in 85.7% of the women who developed cancer, 62.5% of women with borderline, 27.8% of women with benign ovarian tumors. Conclusion; It is suggested that determination of serum tumor markers in patient suspected of ovarian tumor may be helpful to clinician for early diagnosis, differentiation between malignant and benign ovarian tumors.
Adenocarcinoma ; Dermoid Cyst ; Early Diagnosis ; Female ; Humans ; Jeollanam-do ; Mucins ; Sensitivity and Specificity ; Biomarkers, Tumor*

PURPOSE: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. METHODS: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. RESULTS: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was 3.6+/-2.8 year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period (4.18+/-2.10 vs 4.79+/-1.49 days, P=.17) and total fever duration (5.32+/-2.07 vs 6.41+/-3.25 days, P=.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. CONCLUSION: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.
Bacterial Infections ; Bronchiolitis ; Bronchitis ; Child* ; Croup ; Fever ; Hospitalization ; Hospitals, University* ; Humans ; Influenza B virus* ; Influenza, Human ; Inpatients ; Medical Records ; Oseltamivir* ; Outpatients ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Thorax

OBJECTIVE: The aim was to assess the value of resistance index(RI) and pulsatility index(PI) to differentiate between benign and malignant ovarian tumors by color and pulsed Doppler ultrasound. METHODS: 129 ovarian tumors identified with ultrasound were referred for color and pulsed Doppler ultrasound evaluation to calculate the lowest RI and PI, and the corresponding histopathologic diagnosis was recorded. RESULTS: The intratumor artery waveforms were obtained in 37.1%(36 of 97) of benign tumors and in 91.0%(29 of 32) of the malignant group. RI and PI were lower in malignant tumors than in benign tumors(p<0.01). Also, there was a significant incremental decrease in both indices value from the benign tumor toward borderline malignancy(p<0.05) and to invasive ovarian cancer(p<0.01). But, there was no significant difference in both indices value according to the FIGO stage of ovarian malignancy. For RI cut-off value of 0.6, sensitivity and specificity were 89.7% and 91.7%; for PI cut-off value of 1.1, 86.2% and 91.7%. Therefore, the most accurate cut-off values of RI and PI were 0.6 and 1.1, respectively. CONCLUSION: RI and PI calculated by color and pulsed Doppler ultrasound can help in the diagnosis and selection of treatment plan of ovarian tumors, especially when the morphological finding of ovarian tumor is equivocal. And during the follow up of benign tumors, both indicies can give us the clue of malignant potential of benign tumors.
Arteries ; Diagnosis* ; Follow-Up Studies ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography

This study was performed ta evaluate difference of colposcopic findings between carcinoma in situ and microinvasive carcinoma. From August l, 1988 through November 30,1989, the conixation was undertaken in 138 patients. We compeied colposcpic findings with hiatologic diagnoiis on 1656 seetions. Comparison between the microinvasive carcinorna and the carcinoma in situ groups showed a significant higher incidence of large exoeervtcal lesion size(>3/2 33.9% vs. 1.2%), circumscribved location around external cervical os.(75.0% vs, 51.2%), combined abnormal colposcopic findings(19.6/a vs. 3. 7%) and deep endocervical involvement( >lcm : 23,2% vs. 7. 3%). (P<0.01) Granular area was showed 11% incidence of the worst histologic diagnosis.
Carcinoma in Situ* ; Cervix Uteri* ; Diagnosis ; Female ; Humans ; Incidence