No abstract available.
Giant Cell Tumors* ; Giant Cells* ; Ribs*

This study was performed to evaluate the diagnostic value of colposcopy by comparing colposcopic findings with cytology, histology of colposcopically directed biopsy and final biopsy result on hysterectomy. From January 1, 1988 to August 31, 1996, the colposcopic examinations was undertaken in 1200 patients, excluding grossly visible carcinoma of the cervix. The result were as follows : 1. Colposcopic examinations were satisfactory in 95.4% and unsatisfactory in 4.58%. 2. The accuracy rate of cytologic diagnosis was 73.1% and colposcopic impression was 93.1%. 3. The false negative rate of colposcopic impression was 2.6%, much less than 24,7% of cytologic examination. 4. The cytologic accuracy rate in cervicitis was higher than that of colposcopic impression but the accuracy rate of colposcopic impression in diagnosis of cervical intraepithelial neoplasia was higher than that of cytology. 5. Among 97 cases in which colposcopically directed biopsy were performed, more advanced lesion were disclosed in 12 cases(12.4%).
Biopsy ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Colposcopy* ; Diagnosis ; Early Diagnosis* ; Female ; Humans ; Hysterectomy ; Uterine Cervical Neoplasms* ; Uterine Cervicitis

No abstract available.
Diagnosis* ; Polycystic Kidney Diseases*

Cerulein-induced pancreatitis is similar to human edematous pancreatitis, characterized by the dysregulation of digestive enzyme production, edema formation, and an infiltration of inflammatory cells into the pancreas. We previously showed that the Janus kinase 2 (JAK2)/STAT3 pathway mediates inflammatory signaling in cerulein-stimulated pancreatic acinar cells. PPAR-γ has been implicated in the regulation of inflammatory responses in several cells. In the present study, we investigated the role of PPAR-γ in cerulein-induced activation of JAK2/STAT3 in pancreatic acinar cells. Treatment with cerulein induced the activation of JAK2/STAT3 and PPAR-γ expression in AR42J cells. Cerulein-induced PPAR-γ expression was inhibited by AG490, a JAK2/STAT3 inhibitor, in AR42J cells. An immunoprecipitation analysis showed that PPAR-γ binds to STAT3 in cerulein-stimulated AR42J cells. Down-regulation of PPAR-γ by siRNA increased STAT3 phosphorylation in AR42J cells stimulated with cerulein. These results show that PPAR-γ inactivates STAT3 by directly interacting with STAT3 in cerulein-stimulated pancreatic acinar cells. Overexpression of PPAR-γ may be beneficial for preventing pancreatitis by suppressing the activation of STAT3 in pancreatic acinar cells.
Acinar Cells* ; Ceruletide ; Down-Regulation ; Edema ; Humans ; Immunoprecipitation ; Janus Kinase 2 ; Pancreas ; Pancreatitis ; Peroxisomes* ; Phosphorylation ; RNA, Small Interfering

OBJECTIVE: To compare the ultrasonographic findings of chronic lateral epicondylitis of elbow with partial tear of common extensor tendon before and after prolotherapy. METHOD: The subjects were 12 cases of chronic lateral epicondylitis with partial tear of common extensor tendon, which were confirmed by ultrasonography. We examined the common extensor tendon with ultrasonography at initial visit. After injecting 15% dextrose solution monthly for five times, follow up ultrasonography was performed one month after last injection. RESULTS: Before prolotherapy, every case had anechoic focus without normal fibrillar pattern, which represented partial tear of tendon. Seven cases showed focal or diffuse hypoechoic foci with loss of normal fibrillar pattern of tendon, which represented tendinosis. After prolotherapy, initial anechoic foci were changed to smaller size with diffuse fibrillar pattern inside in 6 cases, to the same the sized hypoechoic foci with diffuse fibrillar pattern inside in 2 cases. And a few fibrillar pattern were seen within the initial anechoic focus in 1 case and most of anechoic foci were filled with fibrillar pattern except small anechoic foci in 3 cases. CONCLUSION: Prolotherapy can help the recovery process of chronic lateral epicondylitis. And ultrasonography can be a useful method to evaluate the therapentic effect of lateral epicondylitis.
Elbow ; Follow-Up Studies ; Glucose ; Tears* ; Tendinopathy ; Tendons ; Ultrasonography

OBJECTIVE: To determine the effect of prolotherapy on lateral epicondylitis, and the difference of treatment effect according to the findings of ultrasonography. METHOD: The subjects were 84 patients who were diagnosed as lateral epicondylitis. The pain score was evaluated by using VAS (Visual Analogue Scale) before treatment and 1 month and 6 months after the 3rd injection. Ultrasonography was done to 49 patients who were suspicious of tendinous tear. RESULTS: In the comparison of the VAS before treatment and after the 3rd injection, it was 6.79+/-0.88, 2.95+/-1.90, respectively, which demonstrated statistical significant decrease (p<0.01). We found more significant reduction of VAS in the subjects without tendinous tear (7.08+/-0.91 to 2.16+/-1.57) than those with partial tendinous tear (6.90+/-0.93 to 3.67+/-1.76) (p<0.01). Among 71 patients whose symptom was improved after the treatment, 57 patients (80.2%) demonstrated sustained improvement at 9 months and 14 patients (19.7%) relapsed at 9 months. CONCLUSION: Prolotherapy is an effective treatment method in the lateral epicondylitis of elbow. Ultrasonography could be a useful diagnostic method which could predict the effect of prolotherapy.
Elbow* ; Humans ; Tears ; Ultrasonography

OBJECTIVE: To know the accuracy of caudal epidural steroid injection procedure without fluoroscopy guidance, and determine ascending level of injected solution according to injection volume. METHOD: The subjects were 35 patients with low back pain. Needle insertion was performed without fluoroscopy, then we confirm the position of needle with fluoroscopy. The level of injected solution was measured with fluoroscopy and x-ray after injecting every 5 ml of solution, which is mixture of triamcinolone, 2% lidocaine, contrast medium, and normal saline. The effect of treatment was measured by Visual Analogue Scale (VAS). RESULTS: Successful needle placement occurred in 27 cases without fluoroscopy. After injecting 20 ml of solution, the ascending level of solution were S1 in 8 cases, L5 in 12 cases, L4 in 8 cases, L3 in 1 case, L2 in 4 cases, L1 in 2 cases. In the comparison of the VAS before and after treatment, it was 6.3+/-1.2 and 2.9+/-1.3 respectively, which demonstrated statistically significant decrease (p+/-0.05). CONCLUSION: Caudal epidural injection could be performed more accurately under the fluoroscopic guidance. After injecting 20 ml of solution, the ascending level of the solution were restricted at lower lumbosacral area in most of cases.
Fluoroscopy ; Humans ; Injections, Epidural* ; Lidocaine ; Low Back Pain ; Needles* ; Triamcinolone

BACKGROUND AND OBJECTIVES: Neurocardiogenic syncope is believed to be caused by a transient imbalance of autonomic nervous system. Actually, there were significant differences in heart rate variability (HRV) indices during head-up tilt test between patients with neurocardiogenic syncope and normal controls. But there was no definite evidence for it during daily activity. So, we tried to evaluate HRV during daily activity with 24-hour ambulatory electrocardiography monitoring. MATERIALS AND METHODS: 27 patients with neurocardiogenic syncope or presyncope (mean age 45+/-3) and 25 normal volunteers (mean age 47+/-2) comparable for age and sex underwent 24-hour ambulatory electrocardiography. Head-up tilt test was used to diagnose neurocardiogenic syncope or presyncope in patients group. HRV was analysed over the whole 24 hours, using time and frequency domain parameters. Student's t-test was applied. ResultsThere were no significant differences in HRV measures between two groups, over 24-hour period and day-time and night-time period. But the hourly HRV measures showed a transient decrease of LF, LFnorm and LF/HF ratio in patients group compared to normal control group. CONCLUSIONS: These results indicate that patients with neurocardiogenic syncope or presyncope suffer from temporarily decreased sympathetic tone with normal parasympathetic tone. So, transient additive change of autonomic nervous tone may cause syncope or presyncope in these patients. (Korean Circulation J 2000;30 (6):716-723)
Autonomic Nervous System ; Electrocardiography, Ambulatory ; Healthy Volunteers ; Heart Rate* ; Heart* ; Humans ; Syncope* ; Syncope, Vasovagal*

Massive bleeding hemobilia occurs rarely in patients with hepatocellular carcinoma (HCC) without any invasive procedure. Upper gastrointestinal bleeding in patient with cirrhosis and abdominal pain with progressive jaundice in patient with HCC were usually thought as variceal bleeding and HCC progression respectively. We experienced recently massive bleeding hemobilia in patient with HCC who was a 73-year old man and showed sudden abdominal pain, jaundice and hematochezia. He had alcoholic cirrhosis and history of variceal bleeding. One year ago, he was diagnosed as HCC and treated with transarterial chemoembolization periodically. Sudden right upper abdominal pain occurred then subsided with onset of hemotochezia. Computed tomography showed bile duct thrombosis spreading in the intrahepatic and extrahepatic ducts, while an ampulla of vater bleeding was observed during duodenoscopy. Hemobilia could be one of the causes of massive bleeding in patients with cirrhosis and HCC especially when they had sudden abdominal pain and abrupt elevation of bilirubin.
Aged ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Bilirubin/analysis ; Carcinoma, Hepatocellular/complications/*diagnosis/therapy ; Duodenoscopy ; Embolization, Therapeutic ; Hemobilia/*etiology ; Humans ; Jaundice/etiology ; Liver Cirrhosis/complications ; Liver Neoplasms/complications/*diagnosis/therapy ; Male ; Severity of Illness Index ; Thrombosis/diagnosis ; Tomography, X-Ray Computed

Recent studies reported that early initiation of hemodialysis may increase mortality. However, studies that assessed the influence of early initiation of peritoneal dialysis (PD) yielded controversial results. In the present study, we evaluated the prognosis of early initiation of PD on the various outcomes of end stage renal failure patients by using propensity-score matching methods. Incident PD patients (n = 491) who started PD at SNU Hospital were enrolled. The patients were divided into 'early starters (n = 244)' and 'late starters (n = 247)' on the basis of the estimated glomerular filtration rate (eGFR) at the start of dialysis. The calculated propensity-score was used for one-to-one matching. After propensity-score-based matching (n = 136, for each group), no significant differences were observed in terms of all-cause mortality (P = 0.17), technique failure (P = 0.62), cardiovascular event (P = 0.96) and composite event (P = 0.86) between the early and late starters. Stratification analysis in the propensity-score quartiles (n = 491) exhibited no trend toward better or poorer survival in terms of all-cause mortality. In conclusion, early commencement of PD does not reduce the mortality risk and other outcomes. Although the recent guidelines suggest that initiation of dialysis at higher eGFR, physicians should not determine the time to initiate PD therapy simply rely on the eGFR alone.
Adult ; Aged ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Failure, Chronic/*mortality/therapy ; Male ; Middle Aged ; *Peritoneal Dialysis ; Prognosis ; Propensity Score ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Treatment Outcome