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

No abstract available.
Neurothekeoma*

No abstract available.
Methotrexate* ; Skin*

Intentional delay of aftercoming siblings in multiple gestation is an infrequent occurrence in obstetrics. After delivery of an immature twin, conventional treatment calls for induction and delivery of the aftercoming sibling. However, several case reports have documented the feasibility of an expectant management. And also, as in our case, an aggressive treatment consisting of cerclage, tocolysis, and broad-spectrum antibiotics has been shown to prolong pregnancy. We experienced an unavoidable delivery of a nonviable first twin after premature rupture of membranes at 16 weeks' of gestation. The placenta was left undisturbed. Twin B was confirmed to be alive within the intact second sac. Tocolysis was started and cervical cerclage was done directly after delivery of twin A. Pregnancy was successfully prolonged, which enabled the second fetus to remain in utero and grow for another 145 days. To our knowledge, this was the longest interval between deliveries in a twin pregnancy reported in the literature. A healthy 3,050 gm male was delivered by cesarean section at 37 weeks' of gestation. Below we present this case in detail and discussed with respect to the aggressive approach undertaken to prolong gestation.
Anti-Bacterial Agents ; Cerclage, Cervical ; Cesarean Section ; Female ; Fetus ; Humans ; Male ; Membranes ; Obstetrics ; Placenta ; Pregnancy* ; Pregnancy, Twin ; Rupture ; Siblings ; Tocolysis ; Twins*

PURPOSE: Endovenous laser treatment for incompetent great saphenous vein (GSV) has been recently proposed as an effective means of treatment. The aim of this study is to identify the complications and safety of EVLT as the main treatment for primary varicose vein incompetence when used concomitantly with miniphlebectomy and sclerotherapy. METHODS: We reviewed the records of 153 patients who underwent EVLT. Venous duplex scanning was performed 3 months after surgery in all the patients. The clinical outcomes were evaluated using questionnaires at the outpatient clinic or through phone calls. RESULTS: Considering the 97% satisfaction rate of EVLT, EVLT was an effective treatment for primary varicose vein. We observed complications such as paresthesia (20.9%), pain lasting more than 2 weeks (11.8%), ecchymosis or bruising (7.2%) that subsided spontaneously, superficial burn (5.2%) and phlebitis (2%) that was controlled by conservative treatment. The GSV recanalization rate 3 months after the procedure was 3.3%, resulting in a 96.7% success rate. CONCLUSION: The early results indicate that EVLT is an effective and safe procedure to eliminate the SFJ (sapheno-femoral junction) and obliteration of the GSV. However, long-term follow-up is necessary in our study. Better treatment outcomes are possible with accumulated experience and the establishment of strict indications for EVLT.
Ambulatory Care Facilities ; Burns ; Ecchymosis ; Follow-Up Studies ; Humans ; Paresthesia ; Phlebitis ; Surveys and Questionnaires ; Saphenous Vein ; Sclerotherapy ; Varicose Veins*

There are a lots of evidences that colorectal cancer arise as a result of multiple alterations of genes. Many attempts were made to understand the role of oncogenes and suppressor genes as a prognostic indicator, recently. Although histopathologic staging of tumor is the most important prognostic factor up to now, it is not enough to be used with full confidence. Apoptosis or programmed cell death represents a deletion of damaged or natural cell mechanism. The bel-2 proto-oncogene is known as a inhibitor of apoptosis that may allow accumulation and propagation of cells containing genetic alterations. Overexpression of bcl-2 probably plays a role in colorectal carcinogenesis. The aim of this study was to determine bcl-2 and p53 expression in colorectal carcinoma in correlation with apoptosis, clinical parameters, and histopathology, and to test their prognostic significance in patient with colorectal carcinoma. The bel-2 and p53 protein were identified by immunohistochemical staining using monoclonal and polyclonal antibody. The apoptotic index was detetermined by microscopic examination of hematoxyln and rosin-stained sections at x400. The materials subiected to this study were 54 paraffin-embedded colorectal carcinomas, which were collected randomly from January of 1992 to December of 1994 at Department of Surgery, Chosun University Hospital. Of 54 cases, 21 (38.9%) and 22(40.7%) showed positive expression of bel-2 and p53 protein respectively. Mean apoptotic index(AI) was 2.99% in colorectal carcinoma. Bcl-2 expression did not correlated with p53 expression or apoptotic index. Positive expression of p53 or AI was not correlate with any other clinical and pathologic parameters. An inverse correlation was found between bel-2 expression and increased tumor stage or Iymph node metastasis (P<0.05). In conclusion, these results suggest that bcl-2 expression is significant associated with early stage in colorectal carcinoma. But bcl-2 p53 and AI can`t be a independent prognostic factor in colorectal carcinoma. Further investigations to clarity its possible role in controlling the tumor decelopment and growth of colorectal carcinoma are needed.
Apoptosis ; Carcinogenesis ; Cell Death ; Colorectal Neoplasms* ; Genes, Suppressor ; Humans ; Neoplasm Metastasis ; Oncogenes ; Proto-Oncogenes

OBJECTIVES: The vocal changes after a thyroidectomy are temporary and nonsevere, therefore, obtaining accurate analytical results on the pathological vocal characteristics following such a procedure is difficult. For a more objective acoustic analysis, this study used the cepstral analysis method to examine changes in the patients' voices during the perioperative period regarding sustained vowel phonation. METHODS: The sustained phonation of the five vowels (i.e., /a/, /e/, /i/, /o/, and /u/) by 35 patients with thyroidectomy were recorded by using a Multi-Speech program. Of the 35 patients, 10 were men and 25 were women, with an average age of 51.5 years. Voice data were collected a total of 3 times (preoperatively, 5-7 days after the operation, and 6 weeks after the operation) and were edited according to each fragment (on-set, mid, and off-set) for cepstral analysis. RESULTS: The cepstral analysis on the patients' voices revealed no significant differences between the examination periods of all vowel phonations. However, analysis of the on-set fragment of the vowel /i/ revealed pathological characteristics in which the cepstral measurements of the voice were significantly lower after the operation than before the operation, with the cepstral measurements of the voice increasing further 6 weeks following surgery. CONCLUSION: The results of the acoustic analysis on the on-set fragment of the vowel /i/ will be important data for characterizing the vocal changes during the perioperative period. This study contributes to future research on the mechanisms underlying changes in the voice of patients with a history of thyroid or neck surgery.
Acoustics ; Female ; Humans ; Male ; Methods ; Neck ; Perioperative Period ; Phonation ; Thyroid Gland ; Thyroidectomy* ; Voice*

Retinal degeneration caused by a hereditary defect in the genome is reported in a few animals and it leads to blindness. rd mouse is one of the well studied animal models for retinal degeneration. The retinal degeneration of rd mouse is caused by a mutation on cGMP-phosphodiesterase(PDE). Caspase activation has been implicated for apoptosis. In this study, we examined the activation of caspase-3 during photoreceptor degeneration in rdmouse. Photoreceptor degeneration of rd mouse occured at PD 9 and disappeared at PD 21.In addition, we observed the active form of caspase-3 in the retinal degeneration of rd mouse. In conclusion, the cell death pattern of photoreceptor degeneration in rd mouse seemed to be an apoptosis rather than necrosis.
Animals ; Apoptosis ; Blindness ; Caspase 3* ; Cell Death ; Genome ; Mice* ; Models, Animal ; Necrosis ; Retina* ; Retinal Degeneration

To determine the clinical and prognostic significance of EEG study in acute carbon monoxide intoxication, the EEGs of 107 patients, whom the study was performed relatively early in the course of intoxication, were analyzed and compared with the clinical courses and CT brain scans retrospectively. The final outcome of the patients consisted of 78 cases of recovery, 20 cases of prolonged coma and 9 cases with delayed neurologic sequeles. Statistically, there was no evidence of the age and sex influencing the clinical outcome or EEG finding. The EEG abnormalities depended upon the level and duration of unconsciousness, showing more abnormal EEG in the patient with deeper and longer coma. Many serial EEGs revealed almost parallel improvement to the clinical recovery but not always. Usually the EEG abnormality had the tendency to persist a little longer than the clinical. The patterns and grades of EEG abnormalities were also important to provide the prognostic significance. Almost all of the patients revealing, rarly in the course, some normal alpha background or high amplitude regular 1.5-2.5 Hz slow waves which looked like triphasic wave would be recovered soon or later. The irregular geneeralized delta slow waves, not responding to the outer stimuli suggested poor prognosis and prolonged coma. The abnormal CT brain scan such as low density in basal ganglia and/or white matter also showed some prognostic value, but not that of EEG studies. The development of delayed neurologic sequeles, however, could not be predicted by EEG or CT brain scan.
Basal Ganglia ; Brain ; Carbon Monoxide* ; Carbon* ; Coma ; Electroencephalography* ; Humans ; Prognosis ; Retrospective Studies ; Unconsciousness

No abstract available.
Child* ; Gait* ; Humans