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

BACKGROUND: This study aimed to identify the attitudes of adolescent girls towards menstruation, peri-menstrual symptoms, and coping. METHODS: A convenience sample of 521 adolescent girls was obtained from two middle schools and two high schools in M city. Data were collected through questionnaires about menstrual attitudes, menstrual symptoms, and coping. Data was analyzed by descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression using SPSS/WIN 17.0 program. RESULTS: Subjects showed both negative and positive attitudes toward menstruation. There were significant correlation between attitudes toward menstruation and peri-menstrual symptoms. Subjects having a positive attitude toward menstruation needed a nursing mediator to provide relief for menstrual symptoms during the peri-menstrual period. Attitudes toward menstruation explained 11.0% variance of menstrual symptoms, and factor 4, in particular, (event whose onset can be predicted and anticipated) correlated strongest with menstrual symptoms and explained 21.5% variance of menstrual symptoms. CONCLUSIONS: Our results show that evidence-based strategies for positive attitudes toward menstruation, menstrual symptom, and coping should be included in a comprehensive approach to a nursing intervention to help adolescent girls.
Adaptation, Psychological ; Adolescent ; Female ; Humans ; Menstruation ; Surveys and Questionnaires

Many operative techniques for the repair of cleft lip nasal deformities have been reported. However, the situation with regard to nasal deformity is less satisfactorily understood than lip deformity, in which we have experienced significant improvement led by enhanced understanding of the total anatomic deformity of the primary cleft lip and the consequent refinement of surgical techniques. Our purposes in tip plasty are the restoration of nasal tip symmetry and correction of the obtuse angle of the cleft side nostril. Additionally, an inconspicuous scar is one of the merits of our method. The alar cartilage war exposed through both the alar rim and transcolumella incision, and then interalar loose connective tissue based superiorly was dissected and elevated. Cleft side alar cartilage was cross-hatched(Lipsett technique) on the deformed dome and relocated superomedially by a 4-0 vicryl fixation suture. The elevated intera1ar loose areolar tissue was used for augmentation of the alar dome. Conchal cartilage graft on cleft side dome and septoplasty were carried out in cases of specific necessity. We have performed this procedure in 19 patients, aged between 15 to 19. Average follow-up period was one year. Results have been rated good to excellent by patients and surgeons. There has been no recurrence of this deformity.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Connective Tissue ; Follow-Up Studies ; Humans ; Lip ; Polyglactin 910 ; Recurrence ; Sutures ; Transplants

No abstract available.

BACKGROUND: Studies of human coronary plaque specimens have shown that T lymphocytes and macrophages are present in all types of lesions, from fatty streaks to advanced plaques. There is growing evidence for a pathogenic role for immune response in progression of atherosclerosis. This study was designed to investigate cytokine production by mononuclear leukocytes from patients with myocardial infarction. METHOD: We measured the kinetics of secretion of tumor necrosis factor-alpha (TNF-alpha) and interferon-r (IFN-r) by mononuclear leukocytes from 8 control subjects and 12 patients with acute myocardial infarction. Mononuclear leukocytes were isolated and incubated with plant lectin mitogen concanavalin-A for 24 and 48 hours. TNF-alpha and IFN-r secretions were measured by ELISA. RESULTS:There were no significant differences between TNF-alpha and IFN-r secretions by mononuclear leukocytes at and before 24 hours of incubation from both patients and control subjects, but TNF-alpha and IFN-r secretions at 48 hours of incubation were higher (p<0.005, p<0.05) in patients when compared with control subjects. TNF-alpha and IFN-r secretions by mononuclear leukocytes after incubation correlated with the peak level of creatine phosphokinase (CK) and CK-MB. CONCLUSION: Increased cytokine secretory capacity of mononuclear leukocytes may be due to the acute inflammatory response of myocardial infarction. Further trials may be needed to determined the effects of increase in secretory capacity of mononuclear leukocytes before myocardial infarction.
Atherosclerosis ; Creatine Kinase ; Enzyme-Linked Immunosorbent Assay ; Humans ; Kinetics ; Leukocytes, Mononuclear* ; Macrophages ; Myocardial Infarction* ; Plants ; T-Lymphocytes ; Tumor Necrosis Factor-alpha*

We report unusual 3 cases of adult coronary arteriovenous fistula(CAVF) diagnosed by coronary arteriography in Soonchunhyang University Hospital. In one patient with mitral stenoinsufficiency, multiple CAVFs originated from left anterior descending and left circumflex coronary areries. In another patient with significant stenosis(90%) in distal right coronary artery, new CAVF was seen in mid right coronary artery during consecutive coronary arteriography. In the remaining one, it was arose from contus branch of right coronary artery. Surgical correction was performed in two cases.
Adult* ; Angiography ; Arteriovenous Fistula* ; Coronary Vessels ; Humans

Osteogenesis imperfecta has been categorized as a heritable disorder of connective tissue affecting both bone and soft tissues and is characterized by fragility of bone, blue sclera, and deafness, less frequently by dentinogenesis imperfect and laxity of ligament. The goals of orthopedic management with osteogenesis imperfecta are the treatment of acute factures and long term rehabilitation in an effort to maintain ambulation. We report a case of osteogenesis imperfecta with anterior bowing of tibia which was successfully corrected by multiple osteotomies and intramedullary fixation by Sofield method and reviewed literatures.
Connective Tissue ; Deafness ; Dentinogenesis ; Ligaments ; Methods ; Orthopedics ; Osteogenesis Imperfecta* ; Osteogenesis* ; Osteotomy ; Rehabilitation ; Sclera ; Tibia ; Walking

No abstract available.
Knee* ; Menisci, Tibial*

Prevalent is the concept that tuberculosis has completely been put under control and the actual number of the patients is decreasing. This study has been undertaken in part to give substantial evidence to this general idea about the tuberculosis. Total 921 patients with skeletal tuberculous lesions, selected out of all the patients consulted to the department of orthopedic surgery during the 13 consecutive years from Jaunary of 1963 to December of 1975, were subjected to this analysis. 1. Overall incidence of patients with skeletal tuberculosis was 4.8% of all the patients visited during the 13 years. 2. Of 921 patients, males were 591 and females 330, which showed the men were affected 1.8 times more than women. 3. More than half of them (51,5%) occurred under the age of 19 years. 4. Three anatomical sites were predisposed to this affection; 58.5% in spine, 10.5% in hip, and 11.6% in knee. 5. With the above study it can be safely be said that the actual number and also the incidence of skeletal tuberculosis has not shown any trend of decline and accordingly its management should be more regulated and thorough.
Female ; Hip ; Humans ; Incidence ; Joints ; Knee ; Male ; Orthopedics ; Spine ; Tuberculosis ; Tuberculosis, Osteoarticular

No abstract available.
Carcinoma, Transitional Cell* ; Cystectomy* ; Urinary Bladder*