Cervicography is used commonly in cervical cancer screening with a Pap smear. Many reports shows that the combination of these two methods is more accurate and helpful in cervical cancer screening. OBJECTIVE: The purpose of this investigation was to evaluate the efficacy of conjoined methods in cervical cancer screening and to evaluate any difference between health care center and out-patient treatment. METHODS: Pap smear and cervicogram data were obtained for 699 patients who visited the Department of Obstetrics and Gynecology, Chungnam National University Hospital from January 1997 to December 1997. Of these patients, 551 patients visited the health care center and 148 were out-patients. We exmined all pertinent information, including biopsy results, for patients with detected abnormalities. A total of 62 patients received a biopsy. RESULTS: 1. Results for Papanicolaou smear were: sensitivity, 81.8%, specificity, 98.0%, positive predictive value, 83.7%, negative predictive value, 98.8%, false negative rate, 18.2%, and false positive rate, 2.0%. 2. Results for cervicography were: sensitivity, 86.4%, specificity, 97.8%, positive predictive value, 73.1%, negative predictive value, 99,1%, false negative rate, 13.6%, and false positive rate, 2.2%. 3. Results for the conjoined method were: sensitivity, 97.7%, specificity, 97.2%, positive predictive value, 70.5%, negative predictive value, 99.8%, false negative rate, 2,3%, and false positive rate, 2.8%. 4. When cervicography and Papanicolaou smear were used conjointly The sensitivity, specificity, negative predictive value, false negative rate, and false positive rate were statistically significant for Papanicolaou smear (P<0.05). 5. There was no statistical significance difference between cervicography and the conjoined method. 6. Compared with out-patients, Health care center patients showed increased diagnostic error and failure to follow-up. CONCLUSION: When cervicography and Papanicolaou smear were used conjointly, cervical cancer detection rates were increased.
Biopsy ; Chungcheongnam-do ; Delivery of Health Care ; Diagnostic Errors ; Follow-Up Studies ; Gynecology ; Humans ; Mass Screening* ; Obstetrics ; Outpatients ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

Pathological study was performed on the 135 cases (137 lesion) of early gastric cancer (EGC) diagnosed during the period from 1970 to 1988. The gastrectomy specimens were obtained from Pusan National University Hospital and Pusan Paik Hospital. The statistical analysis was applied on the point of pathological and epidemiological aspects. The results obtained were summarized as follows: 1) The proportion of patients with EGC of all gastric cancer diagnosed in Pusan area during the period of 1970 to 1974 was 1.3%, those during 1975 to 1979 was 1.7%, those during 1980 to 1984 was 7.8%, and those during 1985 to 1988 was 20.0% respectively. 2) The model age group was 6th decade in both sexes. The average age of patients with EGC was 50. 1-year-old in men and 47. 9-year-old in women respectively. The sex ratio (M/F) was 2 : 1 but it was lower for young people than for old people. 3) The proportion of sites involved by the EGC in the stomach was as follows : the antrum 61%, the body 39%, and the cardia and fundus 0.01%. The intestinal type cancer more frequently involved the lower portion than the upper portion of the stomach. 4) Regarding the distribution of the gross types of EGC, the elevated group (Type I, IIa) accounted for 14%, the flat type (Type IIb) accounted for 4%, and the depressed group (Type IIc, III) accounted for 82%. There was no correlation between the gross type and the depth of the lesion. The elevated group was more frequent in intestinal type than in diffuse type. 5) The size distribution of the EGC was as follows : 46% of the lesions were smaller than 2.0 cm in diameter, 47% were between 2.1 to 5.0 cm, and 7% were larger than 5.1 cm. There was no correlation between the size of the lesion and the gross type. 6) The intestinal type of EGC was 77 lesions (56.2%) and the diffuse type 60 lesions (43.8%). The ratio of both types (I/D) was 1.3 : 1, and it was lower for younger people than for old people. 7) Ten of 135 cases (7%) had lymph node metastases. The metastatic rate of EGC confined to submucosa was much higher than that of EGC confined to mucosa only, but the metastatic rate was not related with the size of the lesion.
Female ; Male ; Humans ; Neoplasm Metastasis ; Stomach Neoplasms

No abstract available.
Renal Dialysis* ; Urea*

Congenital adrenal hyperplasia(CAH) is a recognized cause of precocious pseudopuberty. Some children with CAH also develop true precocious puberty with early maturation of the hypothalamic-pituitary-gonadal axis. We review a case of CAH who eventually developed central precocious puberty nine months after initial treatment with corticosteroid. A 3-year-old boy visited complaining of rapid growth, a large penis and frequent penile erections. This patient was diagnosed with CAH with elevated 17-OH progesterone and cortical hypertrophy of adrenal gland on CT scan. His gonadotropin levels were within the normal prepubertal range. Even on treatment with corticosteroid he grew rapidly and had testicular enlargement, pubic hair development and rapid bone maturation. At second admission, his gonadotropin levels were elevated both basally and in response to LHRH stimulation, suggesting that the CAH led to early activation of pubertal gonadotropin secretion(true precocious puberty). He was treated with monthly depot injections of a LHRH analog in addition to the hydrocortisone. His second sexual characteristics regressed gradually and rate of linear growth and bone maturation decreased.
Adrenal Glands ; Adrenal Hyperplasia, Congenital* ; Axis, Cervical Vertebra ; Child ; Child, Preschool ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hair ; Humans ; Hydrocortisone ; Hypertrophy ; Male ; Penis ; Progesterone ; Puberty, Precocious* ; Tomography, X-Ray Computed

No abstract available.
Female ; Humans ; Osteoporosis* ; Uterine Prolapse*

No abstract available.

No abstract available.
Hyperaldosteronism*

To elucidate the clinical avaiability of FNAB, we reviewed retrospectively medical records of 30 patients who had infiltrative pulmonary lesion or pulmonary nodule or mediastinal mass, and got percutaneous fine needle aspiration biopsy using Westcott needle, 20~22 gauge, at the department of Pediatrics, Hanyang university hospital from July, 1986 to June, 1993. The obtained results were as follows: 1) There were 30 patients, aged 6 months to 15 years. 2) There were 17 male patients and 13 female patients with sex ratio of 1.3:1 3) Among 30 cases, we discovered 16 cases of infiltrative lesions, 7 cases of pulmonary nodules and 7 cases of mediastinal mass lesions. In mediastinal there were 4 cases of anterior mediastinum and 3 cases of posterior mediastinum. 4) Overall success rate on fine needle aspiration biopsy was 60% (18/30). The success rate was 50% (8/16) in infiltrative lesions, 50% (8/15) in pulmonary nodules and 71% (5/7) in mediastinal mass lesions, respectively. 5) Eight infiltrative lesione were diagnosed as Pneumocystis carinii pneumonia. Five pulmonary nodules were diagnosed as aspergillosis (2 cases), tuberculosis (1 case), mucormycosis (1 case), lung metastasis of metastasis of neuroblastoma (1 case). Five mediastinal mass lesions were diagnosed as teratoma (2 cases), lymphoma (1 case), malignant neurogenic tumor (1 case), ganglioneuroblastoma (1 case). 6) The complications occured in 20% (6 cases) among 30 procedures. All cases were due to pneumothorax: 3 cases spontaneously resolved, and 3 cases needed chest tube insertion. There were no death related with this procedures.
Aspergillosis ; Biopsy* ; Biopsy, Fine-Needle* ; Chest Tubes ; Child* ; Diagnosis* ; Female ; Ganglioneuroblastoma ; Humans ; Lung ; Lymphoma ; Male ; Mediastinum ; Medical Records ; Mucormycosis ; Needles ; Neoplasm Metastasis ; Neuroblastoma ; Pediatrics ; Pneumonia, Pneumocystis ; Pneumothorax ; Retrospective Studies ; Sex Ratio ; Teratoma ; Tuberculosis

BACKGROUND: In these days of increasing need for medical treatment, and the trend of changing lifestyles for personal health care, the position of medical treatment has led to the increase of careful and various services to every member of the community. But the reality of medical treatment, including the present situation of the emergency room in general hospital is recognized as the cause of those dissatisfactions and complaints of both patients and their caregivers. So this study aims at contributing to the harmonious relation between doctor and patient. METHODS: This study has been carried out by the questionnaire method on the basis of the relatively reasonable 331 papers among 430 questionnaire papers of the patients and their caregivers hospitalized by way of the emergency room in Cheonju Yeong Dong Hospital from Sep. 1994 to Apr. 1995. RESULTS: Among 331 subjects of this questionnaire, there were 121 male patients(36.6%), 76 female patients(23.0%), 80 male caregivers(24.2%), 54 female caregivers. The subjects were compaced of 23 teenagers(7.8%), 74 in their twenties(22.4%), 135 in their thirties(40.8%), 52 in their fourties(15.7%), 29 in their fifties(8.8%), 12 in their sixties(3.6%), 6 in their seventies(1.8 %). Both patients and their caregivers seemed to have a great dissatisfactions and complaints, which can be extraneous to medical treatment. Many patients complained of the unbearable situations such as delayed pain control before after a first-aid treatment, as well as various poor condition of medical treatment in emergency room. Their caregives complained of the lack of a thought explanation of diagnosis and prognosis, as well as the tedious waiting time before taking medical teratment. There were many cases where the emergent patients took medical treatment with some dissatisfa'ctions and complaints of medical staffs or medical donditions. CONCLUSIONS: When using the emergency room in a general hospital, both patients and their caregivers experiance a great deal of dissatisfactions and complaints, which can be followed by a distrust of the hospital and an obstacle of medical treatment. The medical staff, such as the hospital authorities, doctors, and nurses should make various improvements upon the medical conditions of the emergency room in general hospital.
Caregivers ; Delivery of Health Care ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Hospitals, General ; Humans ; Life Style ; Male ; Medical Staff ; Prognosis ; Surveys and Questionnaires

The cause of essential hypertension is yet unknown, but in general is caused by interaction of hereditary factors, diet, obesity, lack of exercise and stress. The aging process influences various physiological mechanism related to regulation of blood pressure. So elderly hypertensives have a tendancy to consider the disease as a result of the physiological aging process. This attitude causes many complications, worsening of the disease and even early death because of inappropriate care. In order to improve self-management of elderly hypertensives in this study the researcher examined the effect of blood pressure regulation by an education program that improves self-care behavior, through increasing self-efficacy. The education program consisted of group education on hypertension and self-care strategies, and encouraging and reinforcing self-efficacy resources such as verbal persuation, performance accomplishment and vicarious experiences. A quasi-experimental pre-and post-test design was used. Thirty-two elderly hypertensives participated in the study. Eighteen in the education group and fourteen in the control group. The education program consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Data were analysed using SPSS for Windows(Version 8.0). The results were as follows. 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of self-care behavior between the experimental group and control group over three different times, and interaction by groups and over time. 3. There was significant difference in self-efficacy of experimental and control group, depending on the measuring period, but there was no difference between these groups on interaction by groups and over time. 4. There was positive correlation between self efficacy and self care behavior depending on the measuring period. There was negative correlation between diastolic blood pressure and self-care behavior on the posttest of the program, and between systolic blood pressure and self-care behavior on the follow-up test of the program. Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.
Aged* ; Aging ; Blood Pressure* ; Diet ; Education* ; Follow-Up Studies ; Humans ; Hypertension ; Nursing ; Obesity ; Self Care* ; Self Efficacy