OBJECTIVE: To investigate whether human papillomavirus (HPV) associated with cervical intraepithelial neoplasia was successfully eliminated after surgical therapy such as large loop excision of transformation zone (LLETZ) or type I extended hysterectomy. METHODS: Seventy four cervical intraepithelial neoplasia (CIN) patients with HPV infection who were admitted for LLETZ or type I extended hysterectomy were recruited into this prospective study. HPV infection was confirmed by HPV DNA genotyping using HPV DNA Chip (Biomedlab, Seoul, Korea) before and after surgical therapy. RESULTS: According to the assay used (HPV DNA Chip(R)) at the postoperative visit, 82.5% of treated patients were completely free from HPV infection. And there was no statistical difference between LLETZ and type I extended hysterectomy (p=0.452). However, there was persistent infection in 17.5% of treated patients after final surgical therapy. CONCLUSION: Although the HPV infection associated with CIN was effectively eliminated after LLETZ and type I extended hysterectomy, there was persistent infection in 17.5% of treated patients. Therefore, the careful followed-up examination of HPV infection should be taken in these patients.
Cervical Intraepithelial Neoplasia* ; DNA ; Humans* ; Hysterectomy ; Oligonucleotide Array Sequence Analysis ; Papillomavirus Infections* ; Prospective Studies ; Seoul

Since the epidural catheterization has been widely used for the purpose of anesthesia, diagnosis and pain control, there are various undesirable complications and hazards through the technical procedure or catheterization itself. Authors have experienced several hazards of location of the epidural catheter tip which were detected by epidurography performed the 1st. or 2nd. postoperative day with 50% Angiograffin. Hazards were as follows; 1) Single air bubble in the epidural space. 2) Inappropriate placement of the catheter tip. 3) Kinking of catheter in the epidural space. 4) Intravascular placement of the catheter.
Anesthesia ; Catheterization* ; Catheters* ; Diagnosis ; Epidural Space

PURPOSE: This study was conducted to investigate the effect of body mass index (BMI) and abdominal circumference (AC) on the diagnosis of appendicitis using ultrasonography (US). METHODS: Between January 1, 2007, and June 30, 2007, we recruited 170 patients who complained about right lower-quadrant pain and who had an Alvarado score greater than 7 points. We recorded the height, weight, and AC for each patient and calculated a BMI. All patients received US investigation by emergency department residents. The cases were categorized according to whether the appendicitis was visible or non-visible. The sensitivity, specificity, and accuracy for each group were assessed and compared. RESULTS: A total of 170 patients was enrolled. Of those 94 patients had visible signs of appendicitis, and 76 patients had non-visible appendicitis. The mean BMI and AC of visible group were 22.09+/-3.12 and 77.47+/-9.32, as compared with 22.43+/-4.05 and 83.83+/-9.48 for the non-visible group, and the groups had significant differences in BMI and AC (p<0.001). The sensitivity, specificity and accuracy of US in patients with BMI under 25 were 58%, 60%, and 58%, respectively, and for those with BMI over 25 were 35%, 50%, and 36%. The sensitivity, specificity, and accuracy of US for male patients with AC under 90 cm were 55%, 75%, and 56%, and for those with AC over 90 cm the numbers were 35%, 50%, and 33%. The sensitivity, specificity, and accuracy of US in females with AC under 80 cm were 75%, 75%, and 74% and for those with AC over 80 cm, 45%, 50%, and 47%. CONCLUSION: Increasing BMI and AC negatively affect the US sensitivity, specificity, and accuracy in an appendicitis diagnosis.
Appendicitis ; Body Mass Index ; Emergencies ; Female ; Humans ; Male ; Sensitivity and Specificity

PURPOSE: To evaluate the efficacy and safety of vinorelbine and carboplatin in advanced non- small-cell lung cancer (NSCLC). MATERIALS AND METHODS: Between August 1998 and July 1999, 25 patients were enrolled. The median age was 68 (range, 46~77) years and male:female ratio was 23:2. Two patients had stage IIIa, 15 had stage IIIb and 8 had stage IV. Sixteen patients had ECOG performance status of 0 or 1 and 9 had 2 or 3. Sixteen patients had squamous cell carcinoma, 8 had adenocarcinoma and 1 had undifferentiated NSCLC. Treatment consists of intravenous carboplatin 400 mg/m2 on day 1 and vinorelbine 25 mg/m2 on days 1 and 8. The treatment was repeated every 28 days. RESULTS: Twenty-three of 25 patients were evaluable. Partial response were observed in 11 patients. The overall response rate was 48% (95% confidence interval: 27~69%) and the median response duration was 19 (range 7 ~44 ) weeks. The median survival of 25 patients was 52 (range 3~53 ) weeks. Toxicities were evaluated by WHO criteria. During a total of 108 cycles, granulocytopenia worse than WHO grade 3 occurred in 2%, thrombocytopenia in 4% and anemia in 10%, respectively. Treatment-related death occurred in 1 patient due to sepsis during cytopenic period. Non-hematologic toxicity was minor and easily controlled. CONCLUSION: A combination chemotherapy of intravenous vinorelbine and carboplatin has relatively high activity with acceptable toxicities in patients with advanced NSCLC.
Adenocarcinoma ; Agranulocytosis ; Anemia ; Carboplatin* ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Lung Neoplasms ; Sepsis ; Thrombocytopenia

Persistent cloaca is a very rare congenital anomaly with a single common perineal opening for the genital, urinary and gastrointestinal tracts, which arises from defects in the embryonal process of descent of urorectal septum or fusion to cloacal membrane. Anomalies associated with persistent cloaca are found in the upper urinary tract, gastrointestinal tract, cardiovascular system, central nervous system and respiratory system, which are not easily detected through ultrasound during pregnancy. It has been reported that if those anomalies are diagnosed early, they can be corrected surgically. We present a case of persistent cloaca with hydrocolpos confirmed by autopsy after emergency cesarean section which was initially presented as a huge abdominal cystic mass and bilateral hydronephrosis by ultrasound at 34 weeks of gestation.
Autopsy ; Cardiovascular System ; Central Nervous System ; Cesarean Section ; Cloaca* ; Emergencies ; Female ; Gastrointestinal Tract ; Hydrocolpos* ; Hydronephrosis ; Membranes ; Pregnancy ; Respiratory System ; Ultrasonography ; Urinary Tract

Background: National reference standards for anti-HIV-1 antibody are needed to evaluate the performance and maintain the quality control of anti-HIV-1 antibody assays. The aim of this study was to prepare a mixed-titer performance panel and assess its suitability as a national reference standard for anti-HIV-1 antibody according to stability, collaboration, and other studies. Methods: Nineteen serum samples from different HIV patients were obtained, along with 15 units of fresh frozen plasma samples with negative anti-HIV-1 antibody results. Ten anti-HIV-1 antibody-positive candidate standards and two negative candidate standards were prepared based on the reactivity in the Alinity i HIV Ag/Ab combo assay (Abbott Laboratories, Wiesbaden, Germany). A collaborative study was conducted across eight laboratories using five anti-HIV-1 antibody assays. Real-time and accelerated stability were evaluated to assess the long-term stability. Results: In the collaborative study, results of all five anti-HIV-1 antibody assays were positive for all 10 candidate standards prepared using HIV patient samples. The CV of each assay for every candidate standard was within 10%, except for one assay result. No real-time and accelerated stability change trend was observed at −70°C or −20°C, supporting that the reference standards were maintained in a stable state at −70°C for long-term storage. Conclusions The overall results suggest that the 12 candidate standards could serve as national reference standards for anti-HIV-1 antibody.

BACKGROUND: In patients with chronic obstructive pulmonary disease(COPD), it is well known that hypoxemia increases the frequency of VPB, which is associated with the poor prognosis such as sudden death. The aim of this study is to evaluate the effect of short and long-term low flow oxygen therapy on the development of VPBs in patients with COPD by correcting the hypoxemia. METHOD: In 19 patients with COPD, oxygen saturation and VPB are monitored by pulse oxymeter and 24-hour Holter EKG, with room air and the 1st and the 8th day during oxygen therapy by nasal prong (2L/min). RESULTS: The arterial oxygen saturation was significantly higher on the 1st day of oxygen therapy compared with breathing room air, and also higher on the 8th day of oxygen therapy than on the 1st day. We found that there was significant correlation between the minimal value of the arterial oxygen saturation and the mean value of the arterial oxygen saturation. The number of VPBs per hour was significantly higher on the 1st day of oxygen therapy compared with breathing room air, and also higher on the 8th day of oxygen therapy than on the 1st day. There was no significant correlation between the decrease of the frequency of VPBs and the increase of the minimal arterial oxygen saturation. But, because of the low p value as 0.056, The correlation is highly suggested. CONCLUSION: With oxygen therapy, the arterial oxygen saturation was increased and the number of VPBs was decreased, and with long-term oxygen therapy more than 7days, the number of VPBs was more decreased in patients with COPD.
Anoxia ; Death, Sudden ; Electrocardiography ; Humans ; Oxygen* ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Respiration

OBJECTIVE: The object of this study was to compare the cure rate and confirm the clinical efficacy of three most frequent surgical procedures for stress urinary incontinence (Burch colposuspension, pubovaginal sling operation, tension-free vaginal tape). MATERIALS AND METHODS: We collected datas from the records of ninety-one patients who were diagnosed as stress urinary incontinence from Jan. 1999 to May 2001. Burch colposuspension was performed by department of gynecology, Severance hospital in thirty-three patients, pubovaginal sling operation was performed by department of urology in twenty-eight patients, and tension-free vaginal tape was performed by department of urology in thirty-one patients. We investigated the characteristics of patients, preoperative urodynamic study results, cure rates and complication rates for the result, and compared them by x2-test. RESULTS: There were statistically no significant differences between the cure rate of each operation after 3, 6 month of operation but after 12 months of follow up, the cure rate of pubovaginal sling operation was significantly higher than that of Burch operation and tension-free vaginal tape. CONCLUSION: The cure rate of pubovaginal sling operation was significantly higher after 12 months of follow up after surgery. There was no significant difference between cure rates of Burch operation and tension- free vaginal tape. We propose randomized prospective study with larger population in the future.
Female ; Follow-Up Studies ; Gynecology ; Humans ; Suburethral Slings* ; Urinary Incontinence* ; Urodynamics ; Urology

OBJECTIVE: Ultrasonography is screening modality of choice and plays an important role in prenatal diagnosis of various diseases and neoplasm of fetus. Recently, Magnetic Resonance Imaging was used as a diagnosis tool to fetal disease. We would like to evaluate efficacy of ultrasonography and magnetic resonance imaging for the diagnosis of fetal abdominal solid tumor. METHODS: Among 2,055 cases of abnormal ultrasonography findings detected by prenatal ultrasonography from January 1996 and June 2002, a comparison between the diagnosis made by prenatal ultrasonography, fetal magnetic resonance imaging (MRI), postnatal radiological studies and histopathologic studies was made in four cases with fetal abdominal solid tumor. RESULTS: The first case was diagnosed as adrenal tumor or hepatic tumor by US, hemangioedothelioma of liver by fetal MRI, and confirmed as hemangioendothelioma postnatally. The second case showed concordance with mesoblastic nephroma among the diagnosis made by US, fetal MRI, and postnatal histopathologic studies. The third case was diagnosed as extrathoracic pulmonary sequestration by US and MRI, and the same diagnosis was made by postnatal histopathologic studies. The fourth case was suspected as kidney tumor by US and was diagnosed as adrenal as adrenal neuroblastoma postoperatively. CONCLUSION: Fetal solid tumor is not a common disorder, but the location, size and orgin of tumor plays important role in the prognosis of neonatal period; additional workup by fetal MRI would improve the diagnosis of such tumors.
Bronchopulmonary Sequestration ; Diagnosis* ; Fetal Diseases ; Fetus ; Hemangioendothelioma ; Kidney ; Liver ; Magnetic Resonance Imaging ; Mass Screening ; Nephroma, Mesoblastic ; Neuroblastoma ; Prenatal Diagnosis ; Prognosis ; Ultrasonography ; Ultrasonography, Prenatal

Primary mediastinal nonseminomatous germ cell tumor associated with Klinefelter's syndrome is a rare disorder. We experienced a case of recurred primary mediastinal nonseminomatous germ cell tumor developed in a 24-year-old patient with Klinefelter's syndrome. The patient had been treated with surgery and combination chemotherapy under the diagnosis of primary mediastinal nonseminomatous germ cell tumor before. A round mass was found on the right lower lung field in the chest X-ray during follow up. The patient was diagnosed as recurred primary nonseminomatous germ cell tumor and Klinefelter's syndrome through tumor markers, peripheral blood karyotyping, and other tests including hormonal assay and was treated with combination chemotherapy and surgery again. When the patient is diagnosed as primary mediastinal nonseminomatous germ cell tumor, Klinefelter's syndrome and hematologic malignancies should be considered to be associated diseases and vice versa.
Diagnosis ; Drug Therapy, Combination ; Follow-Up Studies ; Germ Cells* ; Hematologic Neoplasms ; Humans ; Karyotyping ; Klinefelter Syndrome* ; Lung ; Neoplasms, Germ Cell and Embryonal* ; Thorax ; Biomarkers, Tumor ; Young Adult