No abstract available.
Holoprosencephaly*

OBJECTIVE: The PapSure test, a combination of Papanicolaou smear cytology and speculoscopy, is a direct visual cervical cancer screening method. Speculoscopy, or magnified chemiluminescent examination (MCE), is a new visual method for the detection of cervical neoplasia. It utilizes low magnification and a special "blue-white" chemiluminescent light. The purpose of this study was to evaluate the effectiveness of PapSure test for cervical cancer detection, as compared with the Pap cytology alone. METHODS: This prospective, randomized, university hospital-based clinical study was performed in the outpatient clinic of the Department of Obstetrics and Gynecology at Dankook University Medical Center from July 1, 2002 to November 30, 2003. Of the 508 patients aged 17-81 years who had undergone conventional Papanicolaou cervical cytologic test, speculoscopy, and colposcopy, 254 cases underwent histopatologic diagnoses. RESULTS: Of the 508 patients, there were 131 (25.8%) PapSure diagnoses of positive, 377 (74.2%) of negative. Of the 254 histologic diagnoses, there were 166 (65.4%) diagnoses of benign, 37 (14.6%) of LSIL, 30 (11.8%) of HSIL, and 21 (8.3%) of carcinoma. Pap smear showed sensitivity of 79.5%, and specificity of 91.6%, whereas PapSure test showed sensitivity of 89.8%, and specificity of 77.1%. The addition of speculoscopy to the routine Pap smear resulted in finding 2 of the 30 (7%) women with HSIL which was not statistically significant, and 7 of the 28 (25%) women with LSIL which showed statistically borderline significance. CONCLUSION: PapSure test showed a higher sensitivity rate and a lower false negative rate than Pap smear only as a screening test. Pap smear cytology and speculoscopy seem to be additive, and so the PapSure test is thought to be a very effective method for detecting cervical neoplasia.
Academic Medical Centers ; Ambulatory Care Facilities ; Colposcopy ; Diagnosis ; Female ; Gynecology ; Humans ; Mass Screening ; Obstetrics ; Papanicolaou Test ; Prospective Studies ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

The tarsal tunnel is located beneath the flexor retinaculum, which connects the medial malleolus and calacaneus. The tarsal tunnel contains the posterior tibialis tendon, flexor digitorum longus tendon, posterior tibial artery and vein, posterior tibial nerve, and flexor halluces longus tendon. Tarsal tunnel syndrome is a compressive neuropathy of posterior tibial nerve and its branches under the flexor retinaculum. The etiologies of tarsal tunnel syndrome are space-occupying lesion, hypertrophied flexor retinaculum, osteophytes, tarsal coalition, varicose vein, and trauma. The symptoms are foot pain and hypoesthesia or paresthesia at dermatome according to involving nerve branches. Clinical diagnosis can be obtained from a detailed history and physical examination such as compressive test at the tarsal tunnel area. Ultrasonography and magnetic resonance imaging can reveal the space-occupying lesion, such as ganglion, lipoma, and neuroma. The initial treatments of tarsal tunnel syndrome are conservative management, such as physical therapy, night splint, and steroid injection. Surgical decompression is indicated after failure of conservative managements. Variable results of surgical treatment have been reported. Favorable result after decompression could be obtained from young patients, early onset symptoms, and space-occupying lesion.
Decompression ; Decompression, Surgical ; Diagnosis ; Foot ; Ganglion Cysts ; Humans ; Hypesthesia ; Lipoma ; Magnetic Resonance Imaging ; Neuroma ; Osteophyte ; Paresthesia ; Physical Examination ; Splints ; Tarsal Tunnel Syndrome* ; Tendons ; Tibial Arteries ; Tibial Nerve ; Ultrasonography ; Varicose Veins ; Veins

No abstract available.
Thrombocythemia, Essential*

BACKGROUND/AIMS: We sought to increase our understanding of the rhinitis-asthma relationship and improve strategies for the treatment of patients with these diseases. The aim of this study was to identify a connection between upper airway inflammation and lower airway responsiveness. METHODS: We counted eosinophils on nasal smears, and performed spirometry, allergic skin tests, and methacholine challenge tests in 308 schoolchildren plus a questionnaire on respiratory symptoms. The methacholine concentration causing a 20% fall in forced expiratory volume in 1 second (PC20 < 25 mg/mL) was used as the threshold of bronchial hyperresponsiveness (BHR). RESULTS: In total, 26% of subjects had positive nasal eosinophils on a smear, and 46.2% of subjects had BHR at < 25 mg/mL methacholine PC20. Nasal symptoms were higher in subjects with than without nasal eosinophils (p = 0.012). Asthma symptoms did not differ between subjects with and without nasal eosinophils. Nasal eosinophils were higher in subjects with atopy than those without (p = 0.006), and there was no difference in PC20 methacholine according to atopy (15.5 +/- 1.07 vs. 17.5 +/- 0.62; p > 0.05). No difference in BHR was detected when comparing subjects with and without nasal eosinophils. There were significant differences in the PC20 between subjects with greater than 50% nasal eosinophils and without nasal eosinophils (11.01 +/- 2.92 mg/mL vs. 17.38 +/- 0.61 mg/mL; p < 0.001). CONCLUSIONS: These findings demonstrated that nasal eosinophilic inflammation might contribute to lower airway responsiveness in schoolchildren, based on an epidemiological survey.
Adolescent ; Age Distribution ; Age Factors ; Asthma/diagnosis/*epidemiology/physiopathology ; Bronchial Hyperreactivity/diagnosis/*enzymology/physiopathology ; Bronchial Provocation Tests ; Child ; Eosinophilia/diagnosis/*epidemiology/immunology ; Eosinophils/immunology ; Female ; Health Surveys ; Humans ; Intradermal Tests ; Leukocyte Count ; Lung/*physiopathology ; Male ; Nasal Mucosa/*immunology ; Republic of Korea/epidemiology ; Rhinitis/diagnosis/*epidemiology/immunology ; Spirometry ; Surveys and Questionnaires

Since the pancreas and the spleen lie in close proximity, splenic complications during the course of pancreatitis are possible, but uncommon. No previously published report in Korean has described splenic subcapsular hematoma due to pancreatitis, and we now report one such case.
Hematoma* ; Pancreas ; Pancreatitis ; Pancreatitis, Chronic* ; Spleen*

OBJECTIVE: This study was performed to evaluate the influence of maternal age on embryo quality and the frequency of multiple pregnancy in IVF-ET program. METHOD: 86 conventional IVF-ET cycles were divided into three groups according to the age by 5 year (group A: 26-30, group B: 3135, group C: 36-40 yrs). The in vitro fertilization and development outcome (fertilization, cleavage and high quality embryo rate) and the pregnancy outcome (pregnancy, implantation, G-sac/high quality embryo and multiple pregnancy rate) were examined. And then, these results were compared among the groups. RESULTS: The rates of fertilization (62.7, 68.5 and 65.4%, respectively) and cleavage (95.6, 97.6 and 98.0%, respectively) were not different among the groups. And the high quality embryo (HQE) rate also was not different among the groups (61.8, 62.9 and 62.8%, respectively). The pregnancy rate of group C (23.3%) was significantly lower than that of group A (41.2%) and B (48.7%). And the implantation rate was significantly decreased to group B (32.2%) and C (14.3%) when compared to group A (71.4%) and B (36.8%). CONCLUSION: The pregnancy rate was significantly decreased over 35 years. The G-sac/HQE and multiple pregnancy rate were significantly high below 31 years. Thus, these results suggest that the number of high quality embryo transferred should be limited by the age and another criteria for embryo quality evaluation were required for single embryo transfer.
Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro ; Maternal Age* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Pregnancy, Multiple* ; Single Embryo Transfer

Pulmonary embolism is a fatal complication of major operation. But early detection of pulmonary thromboembolism during general anesthesia is not easy because clinical manifestations of pulmonary thromboembolism are nonspecific during general anesthesia. So the prevention of pulmonary thromboembolism is important for the high risk patients. We experienced a case of pulmonary thromboembolism which occurred in an old female patient with femur fracture immediately after leg elevation following induction of general anesthesia.
Anesthesia, General ; Female ; Femur ; Humans ; Leg ; Orthopedics ; Pulmonary Embolism

BACKGROUND: Ventrlcular tachyarrhythmias are major cause of sudden cardiac death in patients after myocardial infarction and their accurate detection seems to be important in prevention of sudden cardiac death. Clinical findings, treasmill test, holter monitoring and coronary angiography have been used to search for high risk group in sudden cardiac death. Recently electrographysiologic stimulation has been to this, but it is not practical, because of high cost and invasiveness. Signal averaged electrocardiogram(SAECG) may be helpful in prediction of high risk group in sudden cardiac death. So we try to know the values of SAECG in Korean patients without heart disease. RESULTS: 1) The mean value and standard deviation of Time domain analysis is as follows ; fQRS : 106.8+/-12.3ms, RMS : 36.2+/-21.5(micro)V, LAS : 27.2+/-8.1ms. 2) The mean value and standard deviation of Spectral turbulence analysis is a follows ; LSCR : 58.6+/-3.9, ISCM : 95.2+/-0.8, ISCSD : 71.8+/-15.7, SE : 6.9+/-1.8. CONCLUSION: There was no significant difference between male and female. Time domain analysis shows significant differences among each hour but spectral turbulence analysis did not. Spectral turbulence analysis shows high specificity.
Coronary Angiography ; Death, Sudden, Cardiac ; Electrocardiography* ; Electrocardiography, Ambulatory ; Female ; Heart Diseases* ; Heart* ; Humans ; Male ; Myocardial Infarction ; Sensitivity and Specificity ; Tachycardia

Kohler's disease is an uncommon idiopathic osteochondrosis of the tarsal navicular. The diagnosis is clinical and the natural history is benign. The treatment is symptomatic, including shoe supports when the symptoms are mild and initial cast immobilization for at least 8 weeks when the symptoms are more intensive. The final clinical outcome is always favorable. Although it has been fully described both clinically and radiologically, There have been a few long-term follow-up reports in worldwide. This case report presents a Kohler's disease of the tarsal navicular with long-term follow-up of 12 years.
Diagnosis ; Follow-Up Studies* ; Immobilization ; Natural History ; Osteochondrosis ; Shoes