OBJECTIVE: This study was performed to evaluate the clinical efficacy of high-risk HPV DNA test using Hybrid Capture System in the detection of high-grade cervical intraepithelial neo- plasia(CIN II, III) from patients with atypical squamous cells of undetermined significance(ASCUS) or a low-grade squamous intraepithelial lesion(LGSIL) on referral Papanicolaou smear. STUDY DESIGN: Fifty-four patients referred to our hospital with a Papanicolaou smear report of atypical squamous cells of undetermined significance or a low-grade squamous intraepithelial lesion underwent repeat Papanicolaou smear, cervical colposcopy and directed cervical biopsy. In addition, high-risk human papillomavirus(HPV) test by Hybrid Capture System was done. A comparison of detection rate of the high-grade CIN between positive and negative results of HPV test according to repeat Papanicolaou smear report was done. Biopsy result according to HPV test result in total patients was also compared. RESULTS: HPV of high-risk type was detected in 22 of 54 women(40.7%) by Hybrid Capture System. Prevalence rate of high-risk HPV in no CIN, CIN I, and CIN II, III was 13.6%, 18.2% and 68.2% respectively. As expected, high-risk HPV was detected with greater frequency in relation to increasing severity of CIN. In 18 women, the repeat smear obtained in our clinic was reported as negative. High-risk HPV types were found in 16.7% of theses women. In the HPV-negative women, 40% had CIN II or III confirmed on cervical biopsy. In comparison, 66.7% of those with a positive result of the HPV test had CIN II or III on biopsy(P<0.05). Among the women with ASCUS or LGSIL on repeat smear, there was no significant difference in the frequency of biopsy-proved CIN II or III between positive and negative results of high-risk HPV test. In total patients, the group that had positive results for high-risk HPV showed higher incidence of CIN II or III than group with negative results(P<0.05). CONCLUSION: From these results testing women with Papanicolaou smears showing ASCUS or LGSIL for infection with high-risk HPV types would identify the patients who are at risk for HGSIL or invasive carcinoma and who require aggressive intervention. High-risk HPV DNA test using Hybrid Capture System may be a usefule method in supplement the pitfalls of cervical cytology. This test might also have prgnostic value in the management of patients with cervical intraepithelial lesions.
Biopsy ; Colposcopy ; Female ; Human Papillomavirus DNA Tests ; Humans* ; Incidence ; Papanicolaou Test ; Papilloma* ; Prevalence ; Referral and Consultation

PURPOSE: We analyzed the correlation of the Lysholm score, anterior displacement of tibia on stress radiography and muscle strength around the knee with postural control after anterior cruciate ligament reconstruction and also compared them with the normal subjects. MATERIALS AND METHODS: Twenty-five patients after ACL reconstruction were evaluated with Lysholm knee score, anterior displacement on stress radiography with Telos, muscle strength around the knee with Biodex dynamometer and postural control with posturography. RESULTS: The postural control had significant correlation with the Lysholm knee score & anterior displacement on stress radiography(r=0.565, r=0.783, p<0.01), but not with muscle strength around the knee(p>0.05). Patients group with 5mm instability under anterior displacement on stress radiography showed no significance compared with normal control group, while the group with instability more than 6mm showed significant differences in some conditions com- pared with control group. CONCLUSION: Postural control after ACL reconstruction have significant correlation with Lysholm score and we presumed that the acquisition of mechanical stability of the knee after ACL reconstruction may be one of the important factors associated with the recovery of postural control by improvement of the proprioception.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Humans ; Knee ; Muscle Strength ; Proprioception ; Radiography ; Tibia

We report computed tomography (CT) and magnetic resonance (MR) findings of a patient with polyostotic Paget disease and multicentric giant cell tumor (GCT). Brain CT scan showed widening of diploic space, cortical thickening and enhancing soft tissue mass in occiput with underlying calvarial destruction. Ill-defined soft tissue masses were also detected in maxillary sinus and buttock with underlying bony destruction on CT. MR image showed multifocal nodules in wide diploic space with low signal intensity on T1 -weighted image and bright signal intensity on T2-weighted image. Mass in occiput showed homogeneous hypointensity to bone marrow on T1-weighted image and homogeneous iso- intensity on T2-weighted image. Multiple nodules in diploic space and occipital mass showed contrast enhancement following administration of Gd-DTPA. Biopsy was performed at scal p, maxillary sinus and buttock, and histologic analysis revealed GCT.
Biopsy ; Bone Marrow ; Brain ; Buttocks ; Gadolinium DTPA ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Maxillary Sinus ; Tomography, X-Ray Computed

No abstract available.
Abortion, Spontaneous* ; Chorion* ; Chorionic Villi* ; Female ; Humans ; In Situ Hybridization ; Pregnancy

Choroidal metastatic carcinoma is very rare. We recently experienced a case of lung adenocarcinoma which presented to the clinic with ocular symptoms. This 57-year-old Korean male patient visited the department of ophthalmology due to decreased visual acuity and pain of the left eye. On MRI scan, a nodule was attached to the retina of the left eyeball. On simple chest radiograph, a large amount of pleural effusion was noted in the left pleural cavity. Emergency enucleation of the left eyeball was done with an impression of malignant melanoma causing an intractable ocular pain. Grossly, the lesion in the eyeball was rising from the choroid. On histologic examination, tumor cells formed many irregular, small gland-like structures. The tumor cells showed alcian blue-positive mucin in the cytoplasm and glandular lumens and were positive for CEA. Chest CT scan was performed postoperatively and showed a huge mass in the left lower lobe and multiple nodular opacities in both lung fields. Bronchoscopic biopsy revealed moderately differentiated adenocarcinoma similar to that of the eyeball.
Adenocarcinoma* ; Biopsy ; Choroid* ; Cytoplasm ; Emergencies ; Humans ; Lung Neoplasms ; Lung* ; Magnetic Resonance Imaging ; Male ; Melanoma ; Middle Aged ; Mucins ; Neoplasm Metastasis* ; Ophthalmology ; Pleural Cavity ; Pleural Effusion ; Radiography, Thoracic ; Retina ; Tomography, X-Ray Computed ; Visual Acuity

We experienced a case of cutis laxa in a 17-year-old man. The skin showed diminished elasticity with loose folds, wrinkling, and sagging on the abdomen, lower back, and both inner thighs. There was no history of any inflammatory skit diseases prior to the appearance of the wrinkling. Family history revealed to be negative for the skin diseases showing wrinkling and laxity. The biopsy specimen from the skin of the abdomen showed shortened, fragmented elastic fibers in the dermis. The serum copper level was normal(92 ug/dl).
Abdomen ; Adolescent ; Biopsy ; Copper ; Cutis Laxa* ; Dermis ; Elastic Tissue ; Elasticity ; Humans ; Skin ; Skin Diseases ; Thigh

Fracture of the tibial shaft is one of the most common fractures of the long bones and frequently followed by malunion, delayed union and nonunion. We experienced the cases of further increase in the angulation after clinical union of the tibial shaft fractures treated by conservative method. So we analyzed 39 cases of tibial shaft fractures which were followed up from 12 weeks to 37 weeks after clinical union in adults. The results were as follows; l. 7 of the 39 cases(18%) showed the increase in the angulation, and all of them were male. 2. Increase in the angulation occurred more frequenlty in the comminuted fractures than simple fractures. 3. The increment of angulation was more marked in group of patients with higher angulation at the time of clinical union. 4. Increase in the angulation occurred more commonly in the cases not associated with fibula fracture than in the cases associated with fibula fracture. 5. Further increase in the angulation was less common in the cases in whom early weight bearing with PTB cast was started.
Adult ; Fibula ; Fractures, Comminuted ; Humans ; Male ; Methods ; Tibia ; Weight-Bearing

The courses of the progression in the fibrous dysplasia are characterized by asymptomatic progression or spontaneous regression in some cases after the growth has ceased and the aims of treatment for a fibrous dysplasia are prevention of the pathologic fractures and correction of the deformities. The osteogenic potentiality of the cambium layer in the periosteum and the beneficial effect on the osteogenesis of the impregnating bone graft with autologous red marrow are well documented. We experienced an extensive fibrous dysplasia with cortical thinning and pathologic fracture and it was managed with subperiosteal combined xenograft of Kiel bone with autologous red marrow for the induction of cortical thickening and prevention of the pathologic fractures because of the inoperability of curettage due to extensive lesion over the entire femur, limitations in obtaining large amount of autogenous cancellous bone for the graft and lack of the facilities of the bone bank. This subperiosteal composite xenograft with autologous red marrow for a fibrous dysplasia gave an excellent result of a remarkable cortical thickening and we think this can be a type of management for a entensive fibrous dysplasia. So we are reporting this case with bibliographic reviews.
Bone Banks ; Bone Marrow ; Cambium ; Congenital Abnormalities ; Curettage ; Femur ; Fractures, Spontaneous ; Heterografts ; Osteogenesis ; Periosteum ; Transplants

Wide resection is an acceptable alternative to amputation for the management of primary sarcomas of the long bones or pelvis. The resected bone can be debrided of gross tumor tissue, autoclaved, and than replaced to reconstruct the limb anatomically. The procedure can be combined with prosthetic reconstruction of adjacent joints with sufficient strength to allow early unprotected weight-bearing. We had an experience of a large segmental defect in the shaft of the humerus after wide resection due to.a low grade malignant chondrosarcoma without extension to the surrounding soft tissues and this case had been managed by reimplantation after autoclaving the locally resected segment and autogenous iliac bone graft with a sound union and the favorable functional outcomes. So we are reporting this case with bibliographic reviews as a possible method of reconstruction for the management of the segmental defect which was produced by a local resection for a low grade malignancy.
Amputation ; Chondrosarcoma ; Extremities ; Humerus ; Joints ; Methods ; Pelvis ; Replantation ; Sarcoma ; Transplants ; Weight-Bearing

Since osseous healing in the fracture of the femoral neck is carried out by endosteal bone formation, the size of contact area of the fracture fragments and impaction are of prime importance. It is not uncommon to be faced with the problem of back out of the internal fixation devices during healing period. It seems unnecessary to emphasize the benefit of sliding to close the gap between the fracture fragments. We report a retrospective study of 25 cases of the femoral neck fractures treated by closed reduction and fixation with multiple Knowles pins, paying particular attention to the amount and duration of sliding back out of the fixation devices and relating these to the final results of fracture union. Our clinical study led us to the following conclusions; 1. The shortoning of the femoral neck over 3mm occurred in 16 cases(64%) out of 25 cases. The average amount of back out of Knowles pin is 6mm. 2. Most of the shortening occurred during the first 8 weeks after surgery and extrusion of the nail is frequent findings in unstable fractures and osteoporoses. 3. Backing out over 12 weeks after surgery was associated frequently with delayed union and non-union. 4. Collapse or shortening is nceessary to promote a bone to bone contact and bone healing.
Clinical Study ; Femoral Neck Fractures ; Femur Neck ; Internal Fixators ; Osteogenesis ; Osteoporosis ; Retrospective Studies