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*

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

A diagnosis of shoulder pain is varied and difficult to make. The initial onset of liver cancer is difficult to detect and patients typically do not complain of symptoms as most tumors are asymptomatic. If the symptoms of the patients develop, the first symptom is usually pain that extends from the abdomen to the back and shoulder. A suprascapular nerve block is used in the treatment of the referred shoulder pain due to a metastatic hepatoma, but the effectiveness of the treatment has been limited because of its short duration. Recently, the advent of pulsed radiofrequency (PRF) lesioning has proved a successful treatment for chronic refractory pain involving the peripheral nerves. We experienced a case of a 66-year-old male patient complaining of referred right shoulder pain due to metastatic liver cancer, which was relieved after PRF lesioning of the suprascapular nerve.
Abdomen ; Aged ; Carcinoma, Hepatocellular ; Diagnosis ; Humans ; Liver Neoplasms* ; Liver* ; Male ; Nerve Block ; Pain, Intractable ; Peripheral Nerves ; Shoulder Pain* ; Shoulder*

Hallux valgus is a lateral deviation of the first phalanx and medial deviation of the first metatarsal at the first metatarsophalangeal (MP) joint. Its incidence has increased due to developing footwear. The etiologies include fashion footwear, genetic causes, anatomical abnormality around the foot, rheumatoid arthritis, and neuromuscular disorders. Physiologic alignment of the first MP joint is maintained by congruent and symmetric alignment of the articular surface of the first proximal phalanx and first metatarsal head, physiologic relationship of the distal first metatarsal articular surface and the first metatarsal shaft axis, and stable balance of soft tissue around the first MP joint and stable tarsometatarsal joint. Several factors have been associated with hallux valgus, including pes planus, hypermobility of the first tarsometatarsal joint, flattened shape of the first metatarsal head, increased distal metatarsal articular angle, and deformation of the medial capsular integrity. History and physical examination are very important to diagnosis of hallux valgus. Simple radiography provides information on deformity, particularly in weight-bearing anteroposterior and lateral radiographs. Understanding the etiologies and pathophysiology is very important for success in treatment of patients with hallux valgus.
Arthritis, Rheumatoid ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Diagnosis* ; Flatfoot ; Foot ; Hallux Valgus* ; Head ; Humans ; Incidence ; Joints ; Metatarsal Bones ; Physical Examination ; Radiography ; Weight-Bearing

Permanent electrostimulation is the therapy of choice for syncope due to bradycardic rhythm disturbance. In maintaining optimal hemodynamic function, the role of atrial systole has been well recorgnized and the time relationship between atrial and ventricular systole have great relation with cardiac output. Assessment of optimal mode of cardiac pacing by nonivasive method is very important for the best hemodynamic effect. To evaluate the usefulness of systolic time interval for optimal pacing mode, we calculated systolic time interval by using ventricular pacing spike on electrocardiogram to aortic opening time/left ventricular ejection time by aortic pressure curve (invasive PEP/LVET) in various modes of cardiac pacing and measured cardiac output by thermodilution method simultaneously in 9 mongrel dogs. Basal pacing cycle length were 300 msec, and the atrioventricular (AV) and ventriculoatrial (VA) interval during AB & VA sequential pacing were set at 30 msec, 60 msec and 90 msec. The result were as follows: 1) The cardiac output at AV interval of 90 msec (1.65+/-0.23 L/min) is significantly higher than 30 msec (1.38+/-0.19 L/min) in AV sequential pacing. 2) The cardiac output in ventricular pacing is higher than VA sequential pacing, but no significant changes noted among VA interval 90 msec, 60 msec and 30 msec. 3) The invasive PEP/LVET at VA interval of 90 msec (0.85+/-0.17) is significantly lower than 60 msec (0.97+/-0.16) and 30 msec (1.01+/-0.16) in AV sequential pacing. 4) The invasive PEP/LVET among VA sequential pacing with 90 msec, 60 msec, 30 msec interval and ventricular pacing did not show any significant difference. 5) When AV interval changes from 90 msec to 30 msec during AV sequential pacing, cardiac output decreased and invasive PEP/LVET increased. 6) In VA sequential pacing, there were no changes of cardiac output and invasive PEP/LVET when VA interval changes from 90 msec to 30 msec. In conclusion, systolic time interval can be used for estimation of hemodynamic changes during AV sequential pacing considering our results and other authors' results of high correlation between invasive & noninvasive PEP/LVET.
Animals ; Arterial Pressure ; Cardiac Output ; Dogs ; Electrocardiography ; Hemodynamics ; Syncope ; Systole* ; Thermodilution