OBJECTIVE: Although the use of cytology in screening has reduced morbidity and mortality from invasive cervical cancer, there has been limitation because of the low sensitivity and high false negative rate in the detection of preclinical or clinical disease of the cervix. This study was performed to explore the usefulness of Hybrid Capture System HPV DNA test as a diagnostic method of the cervical cancer. METHODS: Cervical cytology and Hybrid Capture System 1 (HCS1) HPV DNA test were performed in 1,023 women who visited Gynecologic Oncology Clinic in Guro Hospital, Korea University Medical Center. HPV DNA were retested by HCS1, HCS2 and Polymerase Chain Reaction(PCR), in randomly selected 200 women to compare these DNA tests. RESULTS: While the sensitivity and specificity of cervical cytology in detection of cervical lesion were 71.2% and 89.5%, those of HCS1 HPV DNA test were 63.0% and 86.9% respectively. There was significant difference in detection of cervical precancerous lesions between HCS1 and HCS2 (P<0.05), but not between HCS2 and PCR (P=0.14). And the sensitivity and specificity were improved with combining cytology and HCS1 HPV DNA test(82.2%, 86.9%~). CONCLUSION: HCS HPV DNA test may be considered as a useful adjunctive test with cervical cytology in cervical cancer screening.
Academic Medical Centers ; Cervix Uteri ; DNA ; Female ; Human Papillomavirus DNA Tests* ; Humans ; Korea ; Mass Screening* ; Mortality ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

Malignant Mixed Mullerian tumors(MMMTs) are unusual neoplasms occumng mostly in the uterus and, ralely, they arise in the ovary. The clinical features of malignant mixed mullerian tumor of the ovary are similiar to other ovarian malignancies. The clinical course is rapidly progressive and fatal. The optimal treatment modalities has remained elusive. The most reliable prognostic criterion is the initial tumor stage and the overall survival was poor. We experienced two cases of malignant mixed miillerian tumor of the ovary, so we report these cases with a brief review of the concerned literatures.
Female ; Ovary* ; Respiratory Sounds ; Uterus

No abstract available.
Classification* ; Uterine Cervical Neoplasms*

Respiratory bronchiolitis-associated interstitial lung disease has been described among current or former smokers and has features consistent with interstitial lung disease. Symptoms include cough, dyspnea on exertion. Lung pathology is characterized by the accumulation of pigmented macrophages within respiratory bronchioles and adjacent air spaces associated with mild thickening of the peribronchiolar interstitium. It must be separated from the other interstitial lung disease because of marked differences in treatment and prognosis. Recently we experienced a case of respiratory bronchiolitis -associated interstitial lung disease in a 48-year-old man. As far as we know, this is the first case in Korea.
Bronchioles ; Bronchiolitis ; Cough ; Dyspnea ; Humans ; Korea ; Lung ; Lung Diseases, Interstitial* ; Macrophages ; Middle Aged ; Pathology ; Prognosis ; Smoking

BACKGROUND: Recently, results of many trials that intend to decide the axillary status through more conservative procedures are reported. One of these is sentinel node biopsy. This method is regarded as reasonable and selective. Some investigators tend to omit axillary dissection in the patient who is determined to have negative node clinically and negative result in sentinel node biopsy procedure. This study was designed to know how accurate the sentinel node biopsy method can predict axillary nodal status. MATERIALS AND METHODS: The patients group was selected from Department of Surgery at SMC, consisting of 111patients with surgically curable breast cancer from Sept. 1995 to Apr. 1997. Isosulfan blue was injected in the center of mass and the margins of 4 quadrant under the general anesthesia. Axillary dissection was done 5 minutes after injection to identify the stained lymphatics. When stained lymphatics were identified, dissection was performed along the lymphatics bidirectionally to detect the stained lymph node nearest to the primary tumor (sentinel node). After frozen biopsy of sentinel node, routine axillary node dissection was performed. Results of frozen biopsy were compared with the final pathologic results. RESULTS: Sentinel node was detected in 80 of the 111 cases (72.1%) and there were 44 (55.0%) axillary metastasis cases in sentinel node detection group. In 14 of 44 cases, sentinel node was isolated positive node. In 5 of 44, sentinel node were falsely negative for malignancy. Sensitivity and specificity of the method are 88.6% (39/44), 100% (36/36), respectively. CONCLUSIONS: Sentinel node biopsy method can predict the axillary nodal status in patients with breast cancer. This method can lead to more conservative treatment, eventually omitting axillary nodal dissection in selected patients.
Anesthesia, General ; Biopsy* ; Breast Neoplasms* ; Breast* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Research Personnel ; Sensitivity and Specificity

The authors report two cases of high cervical spinal chordomas that were removed via the median labiomandibular glossotomy(MLG) approach. One patient was a 62-year-old female in whom an extradural chordoma was found at the level of C3 vertebra with huge prevertebral extension, and causing dyspnea and dysphagia; the other was a 47-year-old female, found to be suffering from a chordoma of C2 vertebral body, which was found incidentally. After removal of the tumors, ventral instrumented fusions were performed in both patients, who showed good recoveries with only minor complications. The MLG approach is radical, and rarely performed by neurosurgeons, but for treatment of an expanded high cervical lesion that needs ventral surgery and seems to be inaccessible via the conventional transoropharyngeal or anterolateral retropharyngeal route, it should be considered. The authors discuss the clinicopathological characteristics of spinal chordomas and general considerations of the MLG approach to high cervical lesions, and briefly describe the surgical techniques involved in this approach.
Chordoma* ; Deglutition Disorders ; Dyspnea ; Female ; Humans ; Middle Aged ; Spine

In order to observe the effects of Nicotine and NNK on cultured human gingival fibroblast, several factors were examined including mutagenicity, the number of cells attached culture plate surface through MTT test, the abundance of collagen & collagenase in mRNA level and collagenolytic activity in extracellular matrix. The results were as follows; 1. Regardless of the co-existence of S9, Nicotine did not show the mutagenicity by itself and NNK by itself showd the same result; However, dose related mutagenicity was shown in NNK with S9. 2. The number of fibroblasts attached cultured plate surface was measured by MTT procedure. The number of cells in Non-smokers increased at all time periods as compared to those of smoker. 3. Non-smoker's fibroblast treated by NNK or Nicotine was dose-dependently decreased in the number of cells when compared to untreated control. In higher dose, Nicotine showed the cellular toxicity , but NNK did not. 4. No change in the abundance of mRNA for proalpha1 and proalpha2 was shown in Nicotine treated group but in gingival fibroblasts following treatment with NNK, the abundance of mRNA for proalpha1, but not proalpha2 collagen was decreased. 5. The abundance of mRNA for collagenase was decreased when NNK was treated but no change occurred in Nicotine treated group. 6. The effect of NNK and Nicotine in collagenolytic activity showed that ,collagenase activity exclusively react to type I collagen, was increased in both group, but gelatinase exclusively react to type IV collagen was not influenced at all. Collagenase activity of smoker's fibroblast was also increased as much as Nicotine and NNK group. The findings suggest that both of Nicotine and NNK lead gingival fibroblast to decrease in the abundance of collagen. And it seems to be that Nicotine and NNK have independent pathway toward the gingival fibroblast.
Humans

Axillary dissection is still important for the management of breast cancer, even in conservative surgery. The status of axillary lymph nodes is the most valuable prognostic factor and marker for adjuvant therapy. Classical open surgery has led to significant morbidity such as big scar, limitation of shoulder motion, nerve damage, accumulation of seroma, and lymphedema. Recently, Suzanne et al(1996) reported endoscopic axillary dissection after liposuction. The advantage of this technique is the reduction of complications and a shortening of the hospital stay, as well as cosmetic effect. We report here the results of 25 breast cancer cases in which the patient received an endoscopic axillary dissection. A Partial mastectomy was done for 22 cases and a total mastectomy was performed for 3 cases. Average number of axillary lymph nodes removed was 15.4. Axillary drain tubes were removed 4.5 days postoperatively on average. Almost none of the cases were not experienced shoulder motion immediately after the operation. In conclusion, endoscopic axillary dissection has reduced morbidity compared with, and has revealed a similar number of axillary lymph nodes removed as classical open axillary dissection.
Breast Neoplasms* ; Breast* ; Cicatrix ; Endoscopy ; Humans ; Length of Stay ; Lipectomy ; Lymph Nodes ; Lymphedema ; Mastectomy, Segmental ; Mastectomy, Simple ; Seroma ; Shoulder

Ceramide, a product of sphingomyelin hydrolysis, is now recognized as an intracellular lipid messenger, which mediates the effects of extracellular agents on cellular growth, differentiation and apoptosis. Recently, ceramide has been implicated in the regulation of phospholipase D (PLD). In this study, we examined the effects of ceramide on the activity and mRNA level of PLD during apoptotic process in FRTL-5 thyroid cells. C2-ceramide (N-acetyl sphingosine) induced apoptosis in FRTL-5 thyroid cells. Fluorescent staining showed that ceramide induced the typical features of apoptosis including condensed or fragmented nuclei. DNA fragmentation was also observed by agarose gel electrophoresis. Flow cytometric cell cycle analysis showed more clearly that ceramide induced apoptotic cell death in FRTL-5 thyroid cells. The treatment of FRTL-5 thyroid cells with thyroid-stimulating hormone (TSH) resulted in an increased PLD activity in a dose- and time-dependent manner. However, the TSH-induced increase in PLD activity was down-regulated within 2 h after ceramide treatment. Furthermore, the levels of PLD mRNA were found to be decreased throughout apoptotic process as inferred by reverse transcription-polymerase chain reaction. However, the decreases in PLD mRNA levels were not correlated with those in PLD activities after ceramide treatment. Taken together, these data suggest that ceramide inhibits the PLD activity in an early apoptotic phase and down-regulation of the levels of PLD mRNA may be implicated in apoptotic process in FRTL-5 thyroid cells.
Animal ; Apoptosis/drug effects* ; Cells, Cultured ; DNA Fragmentation ; Enzyme Activation/drug effects ; Flow Cytometry ; Gene Expression Regulation, Enzymologic/drug effects ; Phospholipase D/metabolism* ; Phospholipase D/genetics ; RNA, Messenger/genetics ; Rats ; Rats, Inbred Strains ; Sphingosine/pharmacology ; Sphingosine/analogs & derivatives* ; Thyroid Gland/enzymology ; Thyroid Gland/drug effects* ; Thyrotropin/pharmacology

BACKGROUND: Fungus ball should always be considered in the differential diagnosis of chronic or recurrent sinusitis resistant to adequate medicinal treatment. MATERIALS AND METHODS: From January 1, 1995, to September 31, 1997, 32 patients were diagnosed with fungus ball based on the pathologic confirmation. We reviewed the 32 patients from the diagnostic point of view, evaluating clinical symptoms, signs, computerized tomography (CT) findings, and operative findings. We also reviewed five cases of clinical misdiagnosis, in which pathologic confirmation failed to identify fungus despite operative and radiologic findings suggesting its presence. RESULTS: Among 32 patients, 19 cases (59%) were suspected prior to surgery as having fungus ball. Eleven cases (34%) were suspected only upon historical and physical examination. CONCLUSION: A high index of suspicion is necessary for the diagnosis of fungus ball. A pathologic confirmation is necessary for a definite diagnosis.
Diagnosis* ; Diagnosis, Differential ; Diagnostic Errors ; Fungi* ; Humans ; Nose ; Physical Examination ; Sinusitis