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*

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

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

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

Although Guglielmi Detachable Coil (GDC) endovascular treatment of intracranial aneurysms has become an alternative to surgery, the main complication continues to be thromboembolic events. In our patient, we found thrombus at the third branch of the right middle cerebral artery after coil embolization. We added intravenous heparin and gave abciximab, an antiplatelet agent through the catheter. We then elevated the blood pressure and administered intravenous colloid solution to maintain adequate collateral circulation. One day later, the patient presented with acute focal infartion in the right frontal lobe and we treated her with low molecular weight heparin. After seven days, the patient's symptoms disappeared, and there was no residual neurological deficit. Therefore, we believe potential clinical complications can be avoided through early recognition of thrombus and appropriate medical therapy. Furthermore, it is necessary to prevent hypotension and to maintain proper hematocrit levels during operations in patients having risk factors for thrombosis.
Aneurysm ; Antibodies, Monoclonal ; Blood Pressure ; Catheters ; Cerebral Infarction ; Collateral Circulation ; Colloids ; Frontal Lobe ; Hematocrit ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Hypotension ; Immunoglobulin Fab Fragments ; Intracranial Aneurysm ; Middle Cerebral Artery ; Risk Factors ; Thrombosis