OBJECTIVE: To determine the significance of high risk human papilloma virus (HPV) infection and involvement of the resection margins of cervical cone biopsy specimens removed by loop electrosurgical excision procedure (LEEP) in the management of cervical intraepithelial neoplasia (CIN III). METHODS: Records of 506 LEEP procedures performed due to abnormal Pap result between December 1995 and December 1998 were reviewed. Among them, 232 cases with histologically proven as CIN III in LEEP and follow-up Pap smear more than 6 months was available were assessed. All patients were assigned according to HPV infection and resection margin involvement in LEEP, and recurrence rate in the follow-up was compared with reference to post-LEEP treatment regimen, observation or hysterectomy in each group. RESULTS: Of 232 cases reviewed, 10 cases(4.3%) were ASCUS, 19 cases(8.2%) were LSIL, 199 cases(85.8%) were HSIL, and 4 cases(1.7%) were invasive cancer in initial Pap smear. Abnormal Pap result in the follow-up was as follows: 4 cases of ASCUS, no case of LSIL, and 6 cases of HSIL. Excluding ASCUS, the overall recurrence rate in the follow-up was 2.6%(6/232). HPV positive was 164(70.7%) and HPV negative was 68(29.3%) in the LEEP specimen. Of 164 HPV positive, 41 were followed up without further treatment and 123 with hysterectomy. There was no significant difference in the recurrence rate between the two groups(P=0.41). Of 68 HPV negative, 27 were only followed up and in 41, hysterectomy was done. And also, there was no significant difference(P=0.32). Of 232 cases, resection margin was positive in 167(72.0%) and negative in 65(28.0%). Of 65 margin negative, 29 were followed up without further treatment and 36 with hysterectomy. There was no significant difference in the recurrence rate between the two groups(P=0.36). Among 167 margin positive, 39 were only followed up and in 128 hysterectomy was done. Recurrence rate was significantly higher in followed up only group(P=0.04). CONCLUSION: HPV infection in LEEP specimen was not helpful in deciding post LEEP treatment modality in CIN III patient. But, when resection margin was positive, hysterectomy should be performed because by doing so, recurrence rate was significantly lower than when only follow up was done.
Biopsy ; Cervical Intraepithelial Neoplasia ; Follow-Up Studies ; Humans ; Hysterectomy ; Papilloma ; Recurrence

We report a rare cause of lung cavities, occurring in a patient with intrapulmonary cystic teratoma. Computed tomography (CT) provided us more detailed informations about the tumor characteristics containing fat and calcification, which could not be distinguished on the plain radiographs. In addition, CTscans clearly demonstrated the dilated anterior segmental bronchus of the left upper lobe entering the posterior aspect of the cavity.
Bronchi ; Humans ; Lung* ; Teratoma*

PURPOSE: The study was to identify the relationship between the spiritual well-being, family support and depression in cancer patients. METHOD: Data were collected by questionnaires from 116 inpatients with cancer at one university hospital in J area using Spiritual Well-being Scale, Family Support Scale, and BDI. The collected data were analyzed by SPSS WIN 12.0 program. RESULT: 1) The mean scores of well-being, family support, and depression were 107.28, 41.14, and 16.79 respectively. 2) There were significant differences in the spiritual well-being by age, education, religion, and social group. There were significant differences in the family support by age, education, and number of admission. There were significant differences in the depression by occupation and social group. 3) Depression was significantly correlated with spiritual well-being, and family support. 4) The most signifiant predictor which influenced depression in cancer patients was spiritual well-being, followed by occupation, age, family support. CONCLUSION: These results suggested that providing spiritual nursing intervention and enhancing family support will effectively decrease depression in cancer patients.
Depression* ; Education ; Humans ; Inpatients ; Nursing ; Occupations ; Surveys and Questionnaires

Several studies have demonstrated the poor prognosis for young patients with gastric cancer. However few reports exist about the dependence of the survival rate on curative resection and cancer stage. Hospital records of 107 young gastric cancer patients who underwent operations from 1980 to 1996 were reviewed, and the results were compared with those from 3176 cases involving whole age gastric cancer patients. There were no significant differences in operation method, tumor invasion, and tumor stage between both age groups. In whole age patients, males were predominant; however in young patients, females were predominant (p=0.005). In young patients, the tumors more frequently occurred in the upper 1/3 than in whole age patients(p<0.0001). A comparison of histologic types showed that poorly differentiated histologic types, such as signet ring cells and diffuse types, according to Lauren's classification, were more frequently observed in young patients (p<0.0001). The 5- year overall survival rate revealed a difference, but with borderline significance, between the young and the whole age patients (39.4% vs 48.6%, p=0.0505). However, patients who had undergone a curative resection showed no statistically significant difference(56.9% vs 63.9%; p=0.264). And patients with noncurative resection showed a statistically significant difference(0% vs 11.7%, p=0.034). The survival rate according to TNM stage revealed a statistically significant difference at stages I b and III b (Stage I b - 100% vs 84.5%, p=0.047; Stage III b - 8.8%, vs 28.0%, p=0.049). In conclusion, young patients with stomach cancer who underwent a curative resection showed a similar survival rate to that of whole age patients, and the largest survival rate was for cancer in a relatively early stage. Hence curative resection and early diagnosis are mandatory in young patients with stomach cancer.
Classification ; Early Diagnosis ; Female ; Hospital Records ; Humans ; Male ; Prognosis ; Stomach Neoplasms* ; Stomach* ; Survival Rate

Rett syndrome is progressive neurodegenerative disorder in female patients, characterized by autistic behavior, mental retardation, loss of purposeful hand skills, stereotypic hand movement, breathing dysfunction, severely impaired language, ataxia, and seizure. The diagnosis of Rett syndrome is based on its characteristic clinical manifestation and course. The electroencephalographic (EEG) findings of Rett syndrome are nonspecific, but a progressive deterioration in the EEG, characterized by a slowing of background activity and spike sharp wave discharges, may be observed. We experienced one case of Rett syndrome in a 5 year old girl having mental retardation, loss of purposeful hand skills, stereotypic hand movements (clapping, washing, hand-to-mouth), breathing dysfunction (hyperventilation/apnea). Her EEG findings on Video-EEG monitoring are excessive slowing waves during awake state and frequent spike discharges from left or centrotemporal area during sleeping. We report a case of Rett syndrome with brief review of related literatures.
Ataxia ; Child, Preschool ; Diagnosis ; Electroencephalography ; Female ; Hand ; Humans ; Intellectual Disability ; Neurodegenerative Diseases ; Respiration ; Rett Syndrome* ; Seizures

No abstract available.

A 36-year-old woman was presented with extensive anterior wall myocardial infarction. We tried to perform direct coronary angiography for the purpose of primary stenting. However, coronary angiogram revealed normal coronary arteries without intracoronary thrombi. We continued further evaluations to find out the cause of normal coronary myocardial infarction. The findings of severe hypertensive retinopathy and concentric left ventricular hypertrophy suggested that she had secondary hypertension. The detailed history, laboratory and radiological findings revealed the pheochromocytoma. The tumor was successfully removed by operation.
Adult ; Anterior Wall Myocardial Infarction ; Coronary Angiography ; Coronary Vessels ; Female ; Humans ; Hypertension ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Myocardial Infarction* ; Pheochromocytoma* ; Stents

BACKGROUNG AND OBJECTIVES: Diabetes mellitus is a significant risk factor for adverse outcome after PTCA, which is associated with an increased late mortality and target lesion revascularization (TLR) rates. The beneficial role of coronary stenting on the clinical and angiographic outcomes of diabetic patients is not clearly defined. The aim of this study was to evaluate the early and mid-term outcomes in diabetic patients undergoing elective stenting of native coronary lesions compared with those in non-diabetic patients. MATERIALS AND METHODS: Between July 1997 and June 1998, coronary stenting was performed on 46 lesions in 38 diabetic patients and 126 lesions in 117 non-diabetic patients. Follow-up angiography at mean day of 189+/-45 was performed in 58.7% (91 patients) and analysed by quantitative coronary angiography (QCA). RESULTS: There was a higher incidence of multi-vessel disease in diabetic patients than non-diabetic patients but not statistically significant (71.1% vs 51.3%, p=0.106). There were no differences in major procedural complications and in-hospital events (myocardial infarction, angina and death) in diabetics and non-diabetics. During the follow-up, the incidence of target lesion revascularizton (TLR) and cardiac event free survival did not differ between two groups. CONCLUSION: Coronary stenting in diabetics resulted in a low rate of immediate procedural com-plications and early major adverse cardiac event (MACE), similar to non-diabetics. There were no differences in the mid-term clinical and angiographic outcomes in diabetics and non-diabetics.
Angiography ; Coronary Angiography ; Diabetes Mellitus ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Infarction ; Mortality ; Risk Factors ; Stents*

BACKGROUND: It has been generally accepted that Cisapride (Prepulsid?or propulsid?), a widely used gastrointestinal prokinetic agent, is associated with Torsades de Points, a life-threatening arrhythmia. Recently, cisapride-induced APD (action potential duration)-prolongation was inhibited by glibenclamide, a KATP channel blocker. But the direct effect of cisapride on K(ATP) channels has not been studied until now. Therefore, we investigated cisapride's effects on KATP channels of isolated rat ventricular myocytes. METHODS: After the isolation of rat ventricular myocytes, we analysed the single channel current with patch pipettes. The method of analysis was the student t-test. RESULTS: 1) Cisapride (10(-6) M- 10(-4) M) inhibited KATP channel opening without changing channel conductance Ki was about 20micronM, and Hill coefficient was 0.75. 2) Cisapride inhibited pinacidil-induced KATP channel opening in the cell attached mode. CONCLUSIONS: These results suggest that cisapride-induced APD prolongation and arrythmic effects may be partly related to KATP channel inhibition.
Animals ; Arrhythmias, Cardiac ; Cisapride* ; Glyburide ; Humans ; KATP Channels ; Muscle Cells ; Rats

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