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

To evaluate the clinical significance of atrioventricular blocks in acute inferior myocardial infarction, we reviewed the clinical recordes of 75 patients who were diagnosed as acute inferior myocardial infarction with or without associated atrioventricular conduction blocks and compared the difference in clinical observation and laboratory data including coronary angiography between these two groups of patients. We also followed the clinical courses of atrioventrticualr block during admission among the patients with blocks. 1) 40% of 75 patients had atrioventricualr block associated with acute inferior myocardial infarction and there were 7 first-degree, 8 second-degree and 15 third-degree atrioventricular blocks. 2) There was no statistically significant differences between two groups in mean age ; Killip classification : incidence of previous prodromal angina ; incidende of associated initial symptoms such as dyspnea, nausea, and syncope ; risk factors such as smoking, hypertension and previous muocardial infarction and incidence of complication such as ventricular arrhythmias and heart faliure. 3) The peak serum CK(1,442.9+/-1,703.6 vs. 1,942.8+/-2,022.9IU/L, P<0.01)and LDH(1,014.7+/-429.7 vs. 1,579.2+/-1,544.9 IU/L, P<0.01) levels were significantly higher in the patients group with atrioventricualr blocks than in the patient grouop without blocks. 4) Left ventricualr resting ejection fraction obtained by radinuclide geted blood pool heart scan was significantly less in the patient group with atrioventricular blocks than in the patient group without blocks. 5) The prevalence of multivessel disease and that of associated left anterior descending artery lesion showe no differences between two patient groups. 6) Hospatal mortality of two patient groups were 9.8% and 16.6% respectively and had no statistical significance. 7) Among the patients who had associated atrioventricualr blocks, 70% of patients showed temporary course of block for mean 4.8days, and 6.7% developed permanent first degree block.
Arrhythmias, Cardiac ; Arteries ; Atrioventricular Block ; Classification ; Coronary Angiography ; Dyspnea ; Heart ; Humans ; Hypertension ; Incidence ; Infarction ; Inferior Wall Myocardial Infarction* ; Mortality ; Nausea ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Syncope

Hydrofluoric acid is a colorless gas or fuming liquid with a strong, irritating odor. Hydrofluoric acid burns are uncommon; however, if severe burn occur, they caused death from systemic effects, such as fatal cardiac arrthmia. We experienced two cases of hydrofluoric acid chemical burns on digits. These patients had typical clinical features of hydrofluoric acid chemical burns, such as pulsating pain at the burn site, as well as ischemic and necrotic skin changes. The hydrofluoric acid chemical burn was confirmed by a history of exposure. Subsequently, we made a calcium gluconate gel by mixing 20% calcium gluconate, an antagonist against hydrofluoric acid, with lubricant, and we injected 10% calcium gluconate subcutaneously when they complained of pain rated at higher than 5 on the pain scale. Simultaneously, we monitored the patients' electrocardiographs and checked their serum total calcium, ionized calcium, and magnesium levels serially. Clinical presentations and the emergency management of hydrofluoric acid chemical burns were reviewed along with the current literature. These patients were discharged without any significant complications.
Burns ; Burns, Chemical* ; Calcium ; Calcium Gluconate ; Electrocardiography ; Emergencies ; Humans ; Hydrofluoric Acid* ; Magnesium ; Odors ; Skin

Hydrofluoric acid is a colorless gas or fuming liquid with a strong, irritating odor. Hydrofluoric acid burns are uncommon; however, if severe burn occur, they caused death from systemic effects, such as fatal cardiac arrthmia. We experienced two cases of hydrofluoric acid chemical burns on digits. These patients had typical clinical features of hydrofluoric acid chemical burns, such as pulsating pain at the burn site, as well as ischemic and necrotic skin changes. The hydrofluoric acid chemical burn was confirmed by a history of exposure. Subsequently, we made a calcium gluconate gel by mixing 20% calcium gluconate, an antagonist against hydrofluoric acid, with lubricant, and we injected 10% calcium gluconate subcutaneously when they complained of pain rated at higher than 5 on the pain scale. Simultaneously, we monitored the patients' electrocardiographs and checked their serum total calcium, ionized calcium, and magnesium levels serially. Clinical presentations and the emergency management of hydrofluoric acid chemical burns were reviewed along with the current literature. These patients were discharged without any significant complications.
Burns ; Burns, Chemical* ; Calcium ; Calcium Gluconate ; Electrocardiography ; Emergencies ; Humans ; Hydrofluoric Acid* ; Magnesium ; Odors ; Skin

Background: The transmission mode of severe acute respiratory syndrome coronavirus 2 is primarily known as droplet transmission. However, a recent argument has emerged about the possibility of airborne transmission. On June 17, there was a coronavirus disease 2019 (COVID-19) outbreak in Korea associated with long distance droplet transmission. Methods: The epidemiological investigation was implemented based on personal interviews and data collection on closed-circuit television images, and cell phone location data.The epidemic investigation support system developed by the Korea Disease Control and Prevention Agency was used for contact tracing. At the restaurant considered the site of exposure, air flow direction and velocity, distances between cases, and movement of visitors were investigated. Results: A total of 3 cases were identified in this outbreak, and maximum air flow velocity of 1.2 m/s was measured between the infector and infectee in a restaurant equipped with ceiling-type air conditioners. The index case was infected at a 6.5 m away from the infector and 5 minutes exposure without any direct or indirect contact. Conclusion Droplet transmission can occur at a distance greater than 2 m if there is direct air flow from an infected person. Therefore, updated guidelines involving prevention, contact tracing, and quarantine for COVID-19 are required for control of this highly contagious disease.

To evaluate the usefullness of SPECT thallium-201 exercise myocardial perfusion scan in coronary artery disease, polar maps processing SPECT images were compared to the exercise treadmill test and the findings of coronary angiographies in 12 normal subjects and 27 patients with the coronary artery disease. The following results were obtained : 1) Sensitivity and specificity of thallium-201 exercise myocardial perfusion scan was 96% and 83%, higher than that of exercise treadmill test(81% abd 61%). 2) In the branches of coronry artery, the sensitivity, specificity and positive predicitive values were 82%, 88%, 90% in left anterior descending artery, 33%, 88%, 57% in left circumflex artery and 69%, 81%, 90% 64% in right coronary artery. 3) The good correlation was observed between the degree of perfusion defect in polar map of thallium-201 myocardial scan in stress and 'myocardial ischemic score' predicted in coronary angiography(p<0.001). Also the degree of reversible perfusion defect had significant correlation with the durtion of exercise. 4) The pulmonary to myocardial ratio of thallium-201 uptake in coronary artery disease group higher than that of angina group. And the perfusion defect with stress and double product at maximal exercise had strongest assocition with the pulmonary to myocardial ratio of thallium-201 uptake by stepwise multiple linear regression. In conclusion, SPECT thallium-201 exercise myocardial perfusion scan is superior to the exercise treadmill test in diagnosing the coronary artery disese and is useful for predicting the sites and degree of coronary arterial stenosis. Also the pulmonary to myocardial ratio of thallium-201 uptake is thought to be good new test index in evaluating the left ventricular function of patients with coronary artery disease.
Arteries ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Exercise Test ; Humans ; Linear Models ; Perfusion* ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon* ; Ventricular Function, Left

Plasmodium vivax malaria, which used to be endemic in the past, re-emerged in 1993 and the number of cases has increased annually. Though there has been no proven endemic drug-resistant malaria case reported, widespread use of anti-malarial chemoprophylaxis for the military personnel could cause emergence of resistance. We herein report a case of tertian malaria, which recurred three times despite the standard chloroquine-primaquine therapy. The patient is 40-year-old male, lives in Dongducheon city, Gyeonggy province, and has never been abroad. He visited hospital in September 2000, because of fever. His blood smear revealed ring forms and trophozoites of P. vivax. He took hydroxychloroquine for 3 days and primaquine for 14 days. His symptoms disappeared then. After 7 months he got fever for 2 days and his blood smear revealed schizonts of P. vivax. He took the same medicines and got well next day. Fever recurred 4 month later, and trophozoites were observed on the blood smear. Hydroxychloroquine and primaquine were prescribed in the same way and fever disappeared. Forty three days later, he had fever and positive blood smear of P. vivax trophozoite. Fever disappeared on the day drug was administered and no malaria was detected in follow up smear of 7 and 14 days. He was free of fever in follow up at 3 months later.
Adult ; Chemoprevention ; Chloroquine ; Fever ; Follow-Up Studies ; Gyeonggi-do ; Humans ; Hydroxychloroquine ; Malaria* ; Malaria, Vivax ; Male ; Military Personnel ; Plasmodium vivax ; Primaquine ; Recurrence ; Schizonts ; Trophozoites

Acute promyelocytic leukemia (APL/AML- M3) is a distinct subtype of acute myelogenous leukemia, which is characterized by unique morphologic, cytogenetic, molecular, and clinical features. In almost all APL patients, a characteristic t(15;17)(q22;q21) is found, resulting from the fusion of the PML gene and retinoic acid receptor alpha (RAR ) gene. This chromosomal translocation in APL may present variant translocations, and may be associated with secondary chromosomal abnormalities. The most frequent accompanying karyotypic aberration is trisomy 8 in APL. We are reporting a case of a 17-year-old woman who was diagnosed with APL. Cytogenetic study revealed that 46, XX, del(5)(q23)/47, XX, del(5)(q23), +8 chromosomal abnormality but without t(15;17). However, the presence of PML/RAR chimera was found with reverse transcriptase PCR. It is well known that the association of trisomy 8 on top of t(15;17) in APL cases. However, in our review, the mosaicism of del(5)(q23) with trisomy 8 in APL might be the first case. Whether this patient will behave the typical APL cases having good prognosis or not will be interesting to see.
Adolescent ; Chimera ; Chromosome Aberrations ; Cytogenetics ; Female ; Humans ; Leukemia, Myeloid, Acute ; Leukemia, Promyelocytic, Acute* ; Mosaicism ; Prognosis ; Receptors, Retinoic Acid ; Reverse Transcriptase Polymerase Chain Reaction ; Translocation, Genetic ; Trisomy

BACKGROUND AND OBJECTIVES: Vascular brachytherpy known to be an effective method in the prevention of restenosis following percutaneous coronary intervention (PCI). In this study we observed the effects of a radioisotope-loaded stent in a porcine model. MATERIALS AND METHODS: Holmium-166 ((166)Ho) was loaded onto the stent surface using impregnated polyurethane, and placed the stents into 7 porcine coronary arteries. Four weeks after stent overdilation injury, histopathological examination was performed. RESULTS: The absorbed dose of (166)Ho to the coronary artery, from the 158.5+/-140.9 microCi (166)Ho stent, was about 141 Gy at a depth of 0.5 mm, which was calculated by Monte Carlo EGS 4 Code. The mean external, and internal elastic lamina areas, the luminal and neointimal areas and the histopathological area stenosis in the 7 porcine coronary arteries were 7.6+/-2.8 mm2, 4.7+/-1.6 mm2, 2.4+/-1.4 mm2, 2.3+/-1.6 mm2 and 49.4+/-24.9%, respectively. The histopathological findings revealed remarkable inflammatory reactions and thrombosis in two of the porcine coronary arteries. CONCLUSION: (166)Ho radioactive loaded stents, using impregnated polyurethane, may inhibit neointimal hyperplasia, but the problems of stent thrombosis and inflammation should be solved.
Constriction, Pathologic ; Coronary Restenosis ; Coronary Vessels ; Hyperplasia ; Inflammation ; Percutaneous Coronary Intervention ; Phenobarbital ; Polyurethanes ; Radioisotopes ; Stents* ; Thrombosis