Between January 1990 and February 1991, ureteroscopic removal of ureteral stone was performed in 40 cases at outpatient department under local anesthesia(36 cases) and epidural anesthesia(4 cases). The results were as follows. The success rate of ureteral stone removal was 82.1% (32 among 39 cases) in lower ureter, 86.7 %(26 among 30 cases) in female and 70.0%(7 among 10 cases) in male. Anesthetic methods were local(36 cases), and epidural(4 cases), Mean duration of hospitalization was 1.4 days(0-7 days). The associated complication rate was low, with most patients being treated conservatively. Therefore, we believe that the ureteroscopic stone removal at outpatient department can be done safely if we select patients properly(especially women). have adequate equipment and execute properly the basic technique.
Female ; Hospitalization ; Humans ; Male ; Outpatients* ; Ureter* ; Ureteroscopy

OBJECTIVE: The purpose of this study was to analyze the clinical study for patients with cervical cancer who had undergone radical hysterectomy. METHOD: The subjects of this study were one hundred and sixty two patients with cervical cancer who had undergone radical hysterectomy at Eulji Medical College Hospital, Taejon, Korea, from January 1983 to December 1992. We reviewed the medical record retrospectively and analyzed the data. RESULT: The distribution of patients by age was found in the order of 50 decade and 60 decade, 40 decade. Those by the clinical stages were as follows: Stage Ia, 12 cases(7.4%); Stage Ib, 84 cases(51.9%); Stage IIa, 39 cases(24.1%); Stage IIb 27 cases(16.7%). The results of histopathologic type were distributed as follows: squamous cell carcinoma was 91.9%, adenocarcinoma was 4.9% and adenosquamous cell carcinoma was 3.1%. The histologic subtypes of squamous cell carcinoma(149 cases) were as follows: Large cell non-keratinizing type was 75.9%, large cell keratinizing type was 14.8% and small cell type was 1.2%. The frequancy of lymph node metastasis was 22.9% in stage I and 31.8% in stage II. The overall incidence of lymph node metastasis was 26.4%. The frequency of external radiation therapy done after radical hysterectomy was 63.5% in stage I and 75.8% in stage II. The 5-year survival rate was as follows: The Ia was 100%; Stage Ib, 95.2%(4cases); Stage IIa, 87.2%(5cases); Stage IIb, 77.8%(6cases). The incidence of recurrence was 7.4% and recurrent sites were vaginal stump , rectum and pelvic wall. CONCLUSION: The highest incidence of cervix cancer in age distribution was 50 decade(30.9%) and 60 decade(30.9%). The most common clinical stage was Ib(51.9%) and most frequent pathologic type was squamous cell carcinoma(91.9%). The overall incidence of lymph node metastasis was 26.4% and The most common site of recurrence was vaginal stump. The 5-year survival rate was 100% in the stage Ia, 95.2% in the stage Ib, 87.2% in the stage IIa, 77.8% in the stage IIb.
Adenocarcinoma ; Age Distribution ; Carcinoma, Squamous Cell ; Daejeon ; Humans ; Hysterectomy* ; Incidence ; Korea ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

The skin, the largest organ in the body, undergoes age-related changes influenced by both intrinsic and extrinsic factors. The primary external factor is photoaging which causes hyperpigmentation, uneven skin surface, deep wrinkles, and markedly enlarged capillaries. In the human dermis, it decreases fibroblast function, resulting in a lack of collagen structure and also decreases keratinocyte function, which compromises the strength of the protective barrier. In this study, we found that treatment with γ-aminobutyric acid (GABA) had no toxicity to skin fibroblasts and GABA enhanced their migration ability, which can accelerate skin wound healing. UVB radiation was found to significantly induce the production of matrix metalloproteinase 1 (MMP-1), but treatment with GABA resulted in the inhibition of MMP-1 production. We also investigated the enhancement of filaggrin and aquaporin 3 in keratinocytes after treatment with GABA, showing that GABA can effectively improve skin moisturization. In vivo experiments showed that oral administration of GABA significantly improved skin wrinkles and epidermal thickness. After the intake of GABA, there was a significant decrease observed in the increase of skin thickness measured by calipers and erythema. Additionally, the decrease in skin moisture and elasticity in hairless mice exposed to UVB radiation was also significantly restored. Overall, this study demonstrates the potential of GABA as functional food material for improving skin aging and moisturizing.

Insulin therapy is indicated in the treatment of gestational diabetic women and overt diabetic pregnant women for hyperglycemia after failure to respond to the diets and exercise regimens. The insulin is administered to mimic normal pancreatic function. The normal pancreas secretes 50% of the total daily insulin as mealtime boluses. This delivery may be mimicked by four-injection-per-day of combination of NPH and regular insulin (RI). Hypoglycemia is a well-recognized complication of intensive insulin therapy in patients with Type II diabetes. Recently, it has been reported that insulin-lispro, an analogue of regular human insulin with a peak insulin action achieved with a 1 hour after injection improves postprandial glucose concentration in non-pregnant diabetic patients. Treatment of gestational or diabetic pregnant women with NPH and insulin-lispro has significantly lower postprandial glucose levels without an increase in hypoglycemic events. Here, we report 2 cases of hyperglycemic control with four times daily administration of NPH & insulin-lispro on diabetes in pregnancy, with brief reviews.
Diabetes Mellitus ; Diet ; Female ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia* ; Insulin Lispro* ; Insulin* ; Meals ; Pancreas ; Pregnancy* ; Pregnant Women

BACKGROUND: Melanocytic nevi are frequently found in acral skin. Benign melanocytic lesions on acral sites may be difficult to differentiate from early acral melanoma by visual examination even for experienced dermatologists. Dermoscopy is a noninvasive method for evaluating pigmented skin lesions. OBJECTIVE: The purpose of this study was to investigate the clinical and dermoscopic features of acral melanocytic nevi in Koreans. METHODS: We studied 57 patients with acral melanocytic lesions using standard clinical assessment and dermoscopy. The patients were examined for acral melanocytic nevi clinically and by using a dermoscope with a digital imaging system, and the acral nevi larger than 7 mm and the suspicious lesions were excised and examined histopathologically. RESULTS: Sixty five acral melanocytic nevi were observed in 57 patients. Individual lesions were located on the soles (n=32), palms (n=11), and volar aspect of the fingers or toes (n=22). The most common dermoscopic pattern was the parallel furrow pattern (52.3%). The other patterns seen were a latticelike pattern (21.6%), a fibrillar pattern (9.2%), a reticular pattern (6.2%), a globular pattern (4.6%), a nontypical pattern (4.6%) and a transition pattern (1.5%). The frequency of distribution of the fibrillar and reticular patterns was significantly different (p=0.033, p=0.015). CONCLUSION: Dermoscopy proved to be a useful instrument for the evaluation of acral melanocytic lesions. In our series of acral nevi, we observed 7 dermoscopic patterns with varying distributions on anatomical sites. We think that further studies on acral melanocytic nevi with digital follow-up are needed to clarify their evolution.
Dermoscopy ; Fingers ; Humans ; Melanoma ; Nevus ; Nevus, Pigmented ; Skin ; Toes

BACKGROUND: A reliable rapid assay for hepatitis C virus (HCV) may be helpful in various clinical settings. We evaluated the performance of the OraQuick HCV Rapid Antibody Test (OraSure Technologies Inc., Bethlehem, PA, USA). METHODS: Clinical sensitivity and specificity were evaluated with oral fluids and sera from 137 patients diagnosed with hepatitis C and 300 healthy blood donors in a multi-center collaborative study. The stored sera of 200 proven HCV-infected patients and 200 healthy subjects were also evaluated. Analytical sensitivity was estimated with 4 commercial seroconversion panels and 7 Korean reference panels. The performance of 4 laboratory-based tests (3 chemiluminescence assays and 1 enzyme immunoassay) and 4 rapid test kits was compared. We also assessed the interference due to bilirubin, hemoglobin, lipid, rheumatoid factor, multipara, and several viral infections. RESULTS: The clinical sensitivity and specificity of the OraQuick HCV test using oral fluid were 97.8% (95% confidence interval [CI], 93.2-99.4%) and 100% (95% CI, 98.4-100%), respectively. The clinical sensitivity using serum samples was 100%. Using the 4 seroconversion panels, the OraQuick HCV test showed results comparable to those of the laboratory-based assays; its analytical sensitivity was higher than that of the other rapid test kits. There was no cross-reactivity with common interfering factors. CONCLUSIONS: The clinical performance of the OraQuick HCV Test is comparable to that of laboratory-based tests with both serum and oral fluid. This supports the supplementary use of rapid HCV testing using oral fluid in various medical and non-medical settings.
Cross Reactions ; Hepacivirus/*immunology ; Hepatitis C/blood/*diagnosis ; Hepatitis C Antibodies/*blood ; Humans ; Immunoassay ; Reagent Kits, Diagnostic ; Saliva/immunology/virology ; Sensitivity and Specificity

BACKGROUND: A reliable rapid assay for hepatitis C virus (HCV) may be helpful in various clinical settings. We evaluated the performance of the OraQuick HCV Rapid Antibody Test (OraSure Technologies Inc., Bethlehem, PA, USA). METHODS: Clinical sensitivity and specificity were evaluated with oral fluids and sera from 137 patients diagnosed with hepatitis C and 300 healthy blood donors in a multi-center collaborative study. The stored sera of 200 proven HCV-infected patients and 200 healthy subjects were also evaluated. Analytical sensitivity was estimated with 4 commercial seroconversion panels and 7 Korean reference panels. The performance of 4 laboratory-based tests (3 chemiluminescence assays and 1 enzyme immunoassay) and 4 rapid test kits was compared. We also assessed the interference due to bilirubin, hemoglobin, lipid, rheumatoid factor, multipara, and several viral infections. RESULTS: The clinical sensitivity and specificity of the OraQuick HCV test using oral fluid were 97.8% (95% confidence interval [CI], 93.2-99.4%) and 100% (95% CI, 98.4-100%), respectively. The clinical sensitivity using serum samples was 100%. Using the 4 seroconversion panels, the OraQuick HCV test showed results comparable to those of the laboratory-based assays; its analytical sensitivity was higher than that of the other rapid test kits. There was no cross-reactivity with common interfering factors. CONCLUSIONS: The clinical performance of the OraQuick HCV Test is comparable to that of laboratory-based tests with both serum and oral fluid. This supports the supplementary use of rapid HCV testing using oral fluid in various medical and non-medical settings.
Cross Reactions ; Hepacivirus/*immunology ; Hepatitis C/blood/*diagnosis ; Hepatitis C Antibodies/*blood ; Humans ; Immunoassay ; Reagent Kits, Diagnostic ; Saliva/immunology/virology ; Sensitivity and Specificity

BACKGROUND: The precise etiology of seborrheic keratosis (SK) is unknown. Genetics, sun exposure and infection have all been implicated as possible factors. Because of its clinical and histopathological similarities to verrucae vulgaris and condyloma acuminatum, human papillomavirus (HPV) has been suggested as a possible causative agent. In the previous studies, HPV were frequently detected in the genital lesions or hair follicles of immunocompromised hosts. OBJECTIVE: A newly introduced HPV detection technique, the HPV DNA Chip analysis, contains 24 HPV probes and it has the advantage of being able to detect 24 types of HPV at once. The purpose of this study was to evaluate the presence of HPV DNA in the nongenital SK of immunocompetant individuals. METHODS: We analyzed 31 biopsy specimens that were taken from patients with nongenital SK, and these specimens were compared with genital warts (the positive control) and distilled water in place of DNA (the negative control) with using HPV DNA Chip analysis and a polymerase chain reaction-based DNA microarray system as the HPV genotyping method. RESULTS: By polymerase chain reaction (PCR), HPV DNA was detected in 2 of the 31 nongenital SK biopsies (6.5%). HPV DNA Chip analysis revealed that 3 of 31 nongenital SKs (9.7%) contained HPV DNA. Two distinct HPV genotypes were detected: HPV type 16 (n=2) and HPV type 42 (n=1). The duration of SK in the HPV positive group was longer than that of the SK in the negative group. The mean age of the patients in the HPV positive group was also older than the mean age of the negative group. There were no different histopathologic findings between the HPV positive and negative SK. CONCLUSION: This study did not provide any concrete evidence that HPV infection might directly play a part in the pathogenesis of nongenital SK. However, two distinct HPV DNA types were identified as types that have never been reported before. Further studies with a larger number of cases of SK are needed to confirm the presence of HPV DNA in nongenital SK and also to determine the role of HPV in the origin of nongenital SK.
Biopsy ; Condylomata Acuminata ; DNA ; Genotype ; Hair Follicle ; Humans ; Hypogonadism ; Imidazoles ; Immunocompromised Host ; Keratosis, Seborrheic ; Mitochondrial Diseases ; Nitro Compounds ; Oligonucleotide Array Sequence Analysis ; Ophthalmoplegia ; Polymerase Chain Reaction ; Solar System ; Warts ; Water

BACKGROUND: The precise etiology of seborrheic keratosis (SK) is unknown. Genetics, sun exposure and infection have all been implicated as possible factors. Because of its clinical and histopathological similarities to verrucae vulgaris and condyloma acuminatum, human papillomavirus (HPV) has been suggested as a possible causative agent. In the previous studies, HPV were frequently detected in the genital lesions or hair follicles of immunocompromised hosts. OBJECTIVE: A newly introduced HPV detection technique, the HPV DNA Chip analysis, contains 24 HPV probes and it has the advantage of being able to detect 24 types of HPV at once. The purpose of this study was to evaluate the presence of HPV DNA in the nongenital SK of immunocompetant individuals. METHODS: We analyzed 31 biopsy specimens that were taken from patients with nongenital SK, and these specimens were compared with genital warts (the positive control) and distilled water in place of DNA (the negative control) with using HPV DNA Chip analysis and a polymerase chain reaction-based DNA microarray system as the HPV genotyping method. RESULTS: By polymerase chain reaction (PCR), HPV DNA was detected in 2 of the 31 nongenital SK biopsies (6.5%). HPV DNA Chip analysis revealed that 3 of 31 nongenital SKs (9.7%) contained HPV DNA. Two distinct HPV genotypes were detected: HPV type 16 (n=2) and HPV type 42 (n=1). The duration of SK in the HPV positive group was longer than that of the SK in the negative group. The mean age of the patients in the HPV positive group was also older than the mean age of the negative group. There were no different histopathologic findings between the HPV positive and negative SK. CONCLUSION: This study did not provide any concrete evidence that HPV infection might directly play a part in the pathogenesis of nongenital SK. However, two distinct HPV DNA types were identified as types that have never been reported before. Further studies with a larger number of cases of SK are needed to confirm the presence of HPV DNA in nongenital SK and also to determine the role of HPV in the origin of nongenital SK.
Biopsy ; Condylomata Acuminata ; DNA ; Genotype ; Hair Follicle ; Humans ; Hypogonadism ; Imidazoles ; Immunocompromised Host ; Keratosis, Seborrheic ; Mitochondrial Diseases ; Nitro Compounds ; Oligonucleotide Array Sequence Analysis ; Ophthalmoplegia ; Polymerase Chain Reaction ; Solar System ; Warts ; Water

OBJECTIVE: Frozen section evaluation of gynecologic tumors can be used to establish a histopathologic diagnosis and guide the surgeon to perform the appropriate surgical procedure. A retrospective study was conducted to determine the accuracy of frozen section diagnosis of gynecologic tumors. METHODS: We compared the result of 459 consecutive gynecologic frozen section diagnosis with their final diagnosis by paraffin sections from January 1996 to August 2001. RESULTS: 459 gynecologic tumors that underwent frozen section evaluation were studied. Frozen section was accurate in 94.9% of 390 ovarian tumors and inaccurate in 5.1%. The sensitivity, specificity, positive predictive value, and negative predictive value for frozen section in ovarian tumors were 86.7%, 97.8%, 84.4%, 97.7%. There was three false-positive and twelve false-negative cases. And frozen section was accurate in 68 of 69 uterine tumors. CONCLUSION: Frozen section diagnosis has important implications regarding the type and extent of surgery performed at the initial operation and this method can obtain the highest accuracy when there is cooperation between experienced surgeons and reliable, careful pathologists. Most incompatible frozen section diagnosis occurred especially in mucinous ovarian tumor. Performing multiple section is recommended in the frozen section diagnosis of mucinous ovarian tumors.
Biopsy* ; Diagnosis* ; Frozen Sections* ; Mucins ; Paraffin ; Retrospective Studies ; Sensitivity and Specificity