OBJECTIVE: Some vaginal procedures may be safer, easier and more successful if they could be done under direct sonographic vision of the object. METHODS: All the procedures were done under the guidance of transrectal sonography. Suction curettage, after using curved plastic Karman's cannula, additional curettage was done only when there was probable remaining conceptal tissue seen on sonography. If additional curettage was needed curved metal cannula made in the same form as plastic Karman's cannula is used first and then usual metal curette if the former did not work. A high frequency cautery unit was used for myolysis. Insertion of the flexible curved cautery tip into the myoma mass was done through the uterine cavity and coagulation of the myoma tissue was performed. Myoma biopsies were done with thin loop high frequency cautery tip through laparoscopy and the vagina. RESULTS: Suction curettage in 156 cases of early pregnancy and 2 cases of previous cesarean incision site pregnancy, D&C in 11 cases, chorionic villus sampling in 13 cases, polypectomy in 1 case, myolysis in 1 case and myoma biopsy in 2 cases were done. CONCLUSION: Performing some vaginal procedures under the guidance of transrectal sonography may be better.
Biopsy ; Catheters ; Cautery ; Chorionic Villi Sampling ; Curettage ; Dilatation and Curettage ; Female ; Laparoscopy ; Myoma ; Plastics ; Pregnancy ; Ultrasonography* ; Vacuum Curettage ; Vagina

Correct discrimination of the first and the second twin is important. Case: (1) The first fetus, whose amnionic cavity was closest to the cervix at 19 weeks, even though its body was higher than the second fetus, was found to be closer to the cervix by 23 gestational weeks than its twin. (2) The result of the chromosomal study of dichorionic twins at 17 gestational weeks was male with 9 inversion of the presumed first, and female with trisomy 21 of the presumed second. AT 19 gestational weeks, the sex and order of the two were found to be reversed at sonography for selective termination. In diamnionic twins, the fetus in the amnionic sac closest to the cervix is nominated as the first.
Amnion ; Cervix Uteri ; Diagnosis* ; Discrimination (Psychology) ; Down Syndrome ; Female ; Fetus* ; Humans ; Male ; Pregnancy, Twin* ; Twins*

No abstract available.
Bronchopulmonary Dysplasia* ; Humans ; Infant, Newborn

RSK2 is a downstream signaling protein of ERK1 and ERK2 and plays a key role in physiological homeostasis. For this reason, RSK2 is a highly conserved protein among the p90RSK family members. In its location in the signaling pathway, RSK2 is a kinase just upstream of transcription and epigenetic factors, and a few kinases involved in cell cycle regulation and protein synthesis. Moreover, activation of RSK2 by growth factors is directly involved in cell proliferation, anchorage-independent cell transformation and cancer development. Direct evidences regarding the etiological roles of RSK2 in cancer development in humans have been published by our research group illustrating that elevated total- and phospho-RSK2 protein levels mediated by ERK1 and ERK2 are higher in skin cancer tissues compared to normal skin tissues. Notably, it has been shown that RSK2 ectopic expression in JB6 Cl41 cells induces cell proliferation and anchorage-independent cell transformation. Importantly, knockdown of RSK2 suppresses Ras-mediated foci formation and anchorage-independent colony growth of cancer cells. Kaempferol is a one of the natural compounds showing selectivity in inhibiting RSK2 activity in epidermal growth factor-induced G1/S cell cycle transition and cell transformation. Thus, ERKs/RSK2 signaling axis is an important target signaling molecule in chemoprevention.
Axis, Cervical Vertebra* ; Carcinogenesis ; Cell Cycle ; Cell Proliferation ; Cell Transformation, Neoplastic ; Chemoprevention ; Epigenomics ; Homeostasis ; Humans ; Intercellular Signaling Peptides and Proteins ; Phosphotransferases ; Skin ; Skin Neoplasms

OBJECTIVE: Our purpose was to determine the clinical value of human papilloma virus deoxyribonucleic acid testing with the hybrid capture test, specifically to examine whether human papillomavirus testing could identify which women with Papanicolaou smears read as atypical squamous cells of undetermined significance were most likely to have histologically confirmed cervical intraepithelial neoplasia. STUDY DESIGN: Hybrid capture testing for high-risk human paillomavirus types(type 31, 33, 35, 45, 51, 52, 56), repeat Papanicolaou smears and colposcopically directed biopsies were performed concurrently on 55 women refered to chosun university hospital with a previous Papanicolaou smear read as atypical squamous cells of undetermined significance. RESULTS: Human papillomavirus eoxyribonucleic acid positivity was associated with a six fold increased likelihood of histologic confirmation of cervical intraepithelial neoplasia. The sensitivity of hybrid capture for any cervical intraepithelial neoplasia was 92% (12/13) and specificity was 86%(36/42), whereas the corresponding values for the repeat Papanicilaou smear was 85%(11/13) and 38%(16/42), respectively. CONCLUSIONS: Testing for human papillomavirus deoxyribonucleic acid with hybrid capture appears to offer an effective means by which patients whose cervical Papanicolaou smears have been read as atypical squamous cells of undetermined significance could be triaged for colposcopy. In particular, high sensitivity and specificity for cervical intraepithelial neoplasia could be maintained.
Biopsy ; Cervical Intraepithelial Neoplasia ; Colposcopy ; DNA ; Female ; Humans* ; Papanicolaou Test ; Papilloma* ; Sensitivity and Specificity

Mullerian agenesis or dysgenesis, rare developmental anomaly presenting as primary amenorrhea, is characterized by absence of vagina and absence or rudimentary development of the uterus. Anatomic anomalies of the axial skeleton and kindney often accompany this psychologically devatating condition. There are various methods of surgical treatment for congenital absence of the vagina. The six cases reviewed in this paper were all treated with McIndoe technique. All of 6 women experienced satisfactory sexual activity and were satisfied with vaginal depth following vaginal creation using a split thickness skin graft technique. Despite the existence of several alternative methods, the McIndoe technique is a relatively simple and highly successful procedure and hence is still prefered by many surgeons.
Amenorrhea ; Female ; Humans ; Sexual Behavior ; Skeleton ; Skin ; Transplants ; Uterus ; Vagina*

Porencephaly is relatively rare condition defined by an defect or a defect or cavity in the cerebrum owing to a developmental malformation or to a destructive lesion. Fory-five porencephaly patients diagnosed by Brain CT were clinically analyzed and the following results were obtained. 1) By the age group presenting initial symptoms, the peak incidence was from 1 month to below 3 years old. 2) In initial symptoms, seizure, spastic weakness, headache were showed in order of frequency. But 7 cases (15.5%) were asymptomatic. 3) The latency of diagnosis after presenting initial symptoms from the symptom onset time to 10 years. 4) The subsequent symptoms were as follows: spastic weakness, speech disturbance, gait disturbance, mental retardation, sensory loss and seizure showed independently or combined. 5) As etiologic factor, 21 cases (46.7%) were congenital, 16 cases (35.5%) were post-traumatic or post-operative and 8 cases (17.8%) were perinatal. 6) The prognosis was seen various from mild to severe. Out of 45 cases, 29 cases (64.4%) were no complications. But the prognosis in patients with post-traumatic or postoperative etiological factors was poor. With the advent of brain CT and the resultant capability of detecting structural defect and cerebral lesions responsible for epilepsy or focal neurologic signs, porencephaly was seen to be readily recongizable by CT examination. Since porencephaly is a significant contributor to the spectrum of CNS lesion and benign condition, ist recognition is important in determining prognosis and therapy.
Brain ; Cerebrum ; Child, Preschool ; Diagnosis ; Epilepsy ; Gait ; Headache ; Humans ; Incidence ; Intellectual Disability ; Muscle Spasticity ; Neurologic Manifestations ; Prognosis ; Seizures

BACKGROUND: The number of the elderly living in a home for the aged is increasing as the socio-culture changes, but health management for the institutionalized elderly has been discontinuos, centered on the single treatment of the disease. The aim of this study is to collect baseline data which is for development of the health maintenance program for the elderly living in a house for the aged. METHODS: We reviewed the journals related to the health maintenance program for the elderly. We selected the contents about health management program for the elderly. 3 domain of the contens were done. The 3 domain were physical health (interview for health habit, physical exam, clinical test), mental health (Korean version of geriatric depression scale, Korean version of mini mental status examination), assessment of functional status (katz activities of daily living, lawtons instrumental activities of living).. 158 elderly people living in a home for the aged in Seoul have been researched since August 1996. RESULT: Total subjects were 158 (men 73, women 85). The average age was 78.1(+/-7.2). The rate of smoking, alcohol drinking, exercise were 32%, 20.4%, 34.4%, each. The rate of assitive device use was 28.3%. The prevalence of sleep distur-bance, urinary incontinence were 69.7%, 17.3%. The prevalence of gait disturbance was 38.4%. The occurrence rate of falling for last 1 year was 29.6%. The prevalence of fear of falling was 57.2%. The positive rate of VDRL was 12.3%, the prevalence of anemia was 48.7%. The prevalence of degenerative arthritis, hypertension were 44.2%, 31.3%, each. The prevalence of depression, dementia were 71.3%, 56.7%, each. The rate of elderly person dependent on one and more ADL was 8.1%. CONCLUSION: We found the health status of the elderly living in a home for the aged. On the basis of the results of the study, it is needed that continuous application of the program for management of the elderly in a home for the aged, keeping searching proper contents of examination and methods of measurement.
Activities of Daily Living ; Aged* ; Alcohol Drinking ; Anemia ; Dementia ; Depression ; Female ; Gait ; Humans ; Hypertension ; Mental Health ; Osteoarthritis ; Prevalence ; Seoul ; Smoke ; Smoking ; Urinary Incontinence

PURPOSE: It has been reported that neovascularization of the optic disc (NVD) occurs in ocular ischemic syndrome, sickle cell hemoglobinopathy, ocular sarcoidosis, Eales' disease, and central retinal artery occlusion. However, NVD in acute ophthalmic artery occlusion had not been reported. Therefore, we report one unusual case of NVD in acute ophthalmic artery obstruction. METHODS: A 56 year-old man with complaint of abrupt decrease of visual acuity and periorbital discomfort underwent medical history taking, periorbital examination, fundus examination, and fluorescein angiography. He was followed up for 5 months RESULTS: Fundus examination showed segmentation of blood flow and diffuse retinal whitish opacity on the posterior pole around the center of the macula, without any cherry red spots in the perifoveal area. Fluorescein angiography showed a marked filling delay in the nasal retinal and choroidal circulations with a definite watershed zone involving the peripapillary choroid and macula. The retinal arteries filling and arteriovenous transit time were delayed. There was no light-perception vision and low intraocular pressure. Diabetes was found on systemic examination. Five weeks later, NVD and choroidal atrophy around the optic disc were detected. Panretinal photocoagulation was performed for the regression of NVD. NVD was regressed, but recurred.
Atrophy ; Choroid ; Fluorescein Angiography ; Hemoglobinopathies ; Humans ; Intraocular Pressure ; Light Coagulation ; Medical History Taking ; Middle Aged ; Ophthalmic Artery* ; Prunus ; Retinal Artery ; Retinal Artery Occlusion ; Retinaldehyde ; Sarcoidosis ; Visual Acuity

The spindle and epithelioid cell nevus, is known also as Spitz's nevus or benign juvenile melanoma. The histologic picture of the lesion often closely resembles that of a malignant melanoma, but spindle and epithelioid cell nevus hehaves benignly. Criteria for accurate histological diagnosis of this nevus now exist. However, a difficult lesion occasionally brings one to the worrisome situation even now. We experienced four cases (three children and one adult) of spindle and epithelioid cell neveus with nodular or macular skin lesions. In children (7/F, 9/F, 4/M), all of the lesion show a solitary pinkish red or light brown nodular firm masses, 0.7 cm to 1.0 cm in greatest dimension, which are located at the left posterior thigh, posterior neck and right anterior neck region, respectively. In adult (36/F), the lesion shows a light brown, erythematous macule, 0.8 cm in greatest diameter, in the skin of the back. Microscopically, both spindle and epithelioid cells are found in all the four cases, but epithelioid cells predominate in children and spindle cells predominate in adult.
Child ; Adult ; Male ; Female ; Humans