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

Recently we performed arthrography in 10 cases of ankle injuries and obtained abnormal findings roentgenographically suspected to be ligamentous injury in only 8 cases. In two cases surgical exploration was done. Although two arthrographys is not completely reliable and sufficiently specific to justify the use of this technique in elucidating injuries to the lateral ligament complex, it has value in the diagnosis of diastasis (hidden sprains of the anterior or posterior tibio-fibular ligament), in distinction between old and recent lesions and in diagnosing some sprains of the deltoid and lateral ligaments of the ankle.
Ankle Injuries ; Ankle Joint ; Ankle ; Arthrography ; Collateral Ligaments ; Diagnosis ; Ligaments ; Sprains and Strains

Total release of the hamstrings of the knee from their origin was performed In nine cerebral plasied children. Eighteen procedures were performed in nine patients whose age ranged from three to sixteen years with an average of ten years. The average follow-up period was twenty one months from ten to thirty-six months. The spastic knee flexion was correction adequately; in mest instances the crouch posture was corrected, gait was improved, and a long stride was possible. The power of the hamstrings was assessed in the fourteen limbs of the children who could walk or cooperate in musicle testing. The power was graded as good in six knees and as normal in one. Seven showed improvement in gait; six patients who had never walked were able to do so after hamstring release; and one patient was able to stand up for the first time in his life after the operation. Eight out of nine cases are now able to stand up with or without support of a brace, and to walk with a brace in five cases and without support in two. However, increased lumbar lordosis and genu recurvatum has occurred in two cases each.
Animals ; Braces ; Cerebral Palsy ; Child ; Extremities ; Follow-Up Studies ; Gait ; Humans ; Knee ; Lordosis ; Muscle Spasticity ; Posture

BACKGROUND/AIMS: Transfection of the hepatitis B virus (HBV) genome requires the cloning of tandem HBV sequences inserted into a plasmid vector, which is usually screened for by the restriction enzyme digestion of plasmid minipreparation from at least a dozen of bacterial colonies. The aim of this study was to develop a simple alternative screening method for bacterial colonies harbouring tandem HBV sequences by a PCR. METHODS: A set of polymerase chain reaction (PCR) primer was designed to detect the bacterial colonies harbouring "head to tail" dimeric HBV DNA. PCR which amplifies the head to tail junction site of two tandem HBV molecules was performed. RESULTS: PCR products with appropriate size (1.2kb) were obtained. The accurate detection by PCR screening technique was confirmed by enzyme digestion. CONCLUSIONS: These results suggest that PCR screening technique is a simple and rapid method for the identification of bacterial colonies containing tandem HBV sequences.
Clone Cells ; Cloning, Organism ; Digestion ; DNA ; Genome ; Head ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans* ; Mass Screening* ; Plasmids ; Polymerase Chain Reaction* ; Transfection

OBJECTIVE: The effects on spermatogenesis by expression of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) were investigated. MATERIALS AND METHODS: Testicular specimens were obtained from 40 infertile males due to primary testicular failure and from 10 fertile males with other urologic problems. The specimens of infertile males were devided into 4 groups according to histologic findings; Sertoli cell only syndrome (A), maturation arrest (B), hypospermatogenesis (C) and sloughing and disorganization (D). VEGF and ET-1 expression were detected with immunohistochemical stain. RESULTS: VEGF expression on Leydig cell was detected in all cases. But, VEGF expression rates on germ cell were significantly higher in infertile group B, C, D compared to that of the control group (p<0.05). ET-1 expression rates on Leydig cell was significantly lower in all infertile group compared to that of the control group (p<0.05). But, ET-1 expression rates on Sertoli cell was significantly higher in all infertile group compared to that of the control group (p>0.05). In germ cell of infertile group, LH, FSH and prolactin were significantly decreased, and estradiol is increased in positive stain group on ET-1 immunohistochemical stain (p<0.05). VEGF and ET-1 expression were not correlated mean seminiferous tubule diameter (p>0.05). CONCLUSIONS: Abnormal spermatogenesis would be reflected in VEGF expression in germ cell.
Endothelin-1* ; Estradiol ; Germ Cells ; Humans ; Male ; Oligospermia ; Prolactin ; Seminiferous Tubules ; Sertoli Cell-Only Syndrome ; Spermatogenesis ; Testis* ; Vascular Endothelial Growth Factor A

Various dermatological complications have been reported following the BCG vaccination although this vaccination has been recommended to all healthy infants in our country. A 4-months-old boy, who had a BCG vaccination three weeks after birth, developed erythematous papules and pustules on the whole body, especially on the face and upper extremities. Two erythematous subcutaneous soft nodules were also noted on the left side of the neck. A biopsy specimen from the right forearm revealed caseous necrosis surrounded by a granulomatous inflammation consisting of epithelioid cells and lymphocytes. It was centered along the axis of the damaged pilosebaceous follicle. No acid-fast bacilli could be demonstrated by AFB stain. A marked improvement of his skin eruptions was observed after anti-tuberculosis medication. However, nod-ules in the cervical area perforated spontaneously and healed leaving scars several months after the cutaneous eruptions subsided. The clinical and histologic findings and a good response to anti-tuberculous therapy support the diagnosis of papular tuberculid and suppurative lymphadenitis after BCG vaccination.
Axis, Cervical Vertebra ; Biopsy ; Cicatrix ; Diagnosis ; Epithelioid Cells ; Forearm ; Humans ; Infant ; Inflammation ; Lymphadenitis* ; Lymphocytes ; Male ; Mycobacterium bovis ; Neck ; Necrosis ; Parturition ; Skin ; Tuberculosis, Cutaneous* ; Upper Extremity ; Vaccination*

Dysregulation of TGF-beta that is a modulator of cell growth and differentiation can result in uncontrolled growth and tumor formation. Monitoring these pattern of genes and protein expression during tumor development will provide a basis for understanding normal growth and distortion of osteochondrogenesis. Our comparative studies on the experssion of TGF-beta protein indicate that TGF-beta may primarily be a regulator of epithelial differentiation during tooth development (between 4 weeks and 40 gestational weeks) and tumorigenesis of odontogenic neoplasm (ameloblastoma). In early human tooth germ (cap/early bell stage) TGF-beta protein was found in the epithelial dentallamina and enamel orgen. TGF-beta experessions were seen in inner and outer dental epithelium during bell stage. During enamel and cementum appositional stage, TGF-beta expression shifted from the ameloblast to the odontoblast. In eruption stage, TGF-beta expressions look like moderate positive pattern in odontoblast and rare pattern in enamel, dentin and cementum. TGF-beta expressions of follicular and plexiform amelobalstoma are moderate positive reaction in ectodermal tumor components and mild positive in vessels of stroma tissue. In acanthomatous type, TGF-beta expression was shown severely positive finding in stellate reticulum cell. TGF-beta expressions were noted moderate reaction in margin of tumor epithelium and stellate reticulum cell of granular ameloblastoma. In unicystic ameloblastoma, TGF-beta expression was rare feature in cystic luminal epithelium. With these result, I should be suggested that TGF-beta may play an important role in epithelial-mesenchymal interactions in human tooth morphogenesis and development of odontogenic epithelial tumors.
Ameloblastoma* ; Ameloblasts ; Carcinogenesis ; Dental Cementum ; Dental Enamel ; Dentin ; Ectoderm ; Embryonic Structures* ; Epithelium ; Fetus* ; Humans* ; Morphogenesis ; Odontoblasts ; Phenobarbital ; Reticulum ; Tooth Germ* ; Tooth* ; Transforming Growth Factor beta*

Some of the techniques for bone grafting for delayed union or nonunion of the long bone are used currently. In 1991, at arthroscopy workshop in Phoenix, Arizona, Lanny L. Johnson, M.D. reported a case of endoscopic bone grafting for the delayed union on the humerus. He suggested the possibilities of endoscopic bone grafting such as minimal incision, magnified visualization, accurate debridement, accurate graft placement, vascular preservation, outpatient surgery and reduced cost. The author performed endoscopic bone grafting and extra-articular adhesionlysis on the delayed union of femur with extra-articular ankylosis. The patient was a 28 year old housewife with blood type Rh(-). The duration after initial operation was more than 9 months. The result of the graft was satisfactory. In the future endoscopic bone grafting could be performed for nonunion, delayed union and congenital bone defect.
Ambulatory Surgical Procedures ; Ankylosis ; Arizona ; Arthroscopy ; Bone Transplantation ; Debridement ; Education ; Femur ; Humans ; Humerus ; Transplants

Previous studies implied association of osteoporosis with estrogen deficiency, immobilization and low calcium absorption only through epidemiological studies. There have been only a few experimental studies verifying the etiologic factors of osteoporosis in vivo condition. Authors conducted an experimental study using white rats(Sprague Dawley) in order to find out what the endocrinological and biochemical changes of experimentally induced osteoporosis are and how they behave with or against each other. White rats, eighty five in number of 3 to 6 months females and weighing 220±12.7gm were divided into four groups. They consisted of Group I(n=10) for control, Group II(n=25) for bilateral oophorectomy, Group III(n=25) for bilateral division of sciatic nerve and hip spica cast immobilization, and Group IV(n=25) for bilateral oophorectomy and bilateral division of sciatic nerve plus hip spica cast immobilization. Blood samples were taken preoperatively and postoperatively at six weeks to check Estradiol and Osteocalcin levels there of. And then, rats were sacrified immediately after the second sampling to retrieve femora for bone mineral density measurement and torsional stress test. Estradiol levels before operation were 21.4±13.3pg/ml for Group I, 31.6±3.1pg/ml for Group II, 25.6±4.5pg/ml for Group III and 33.7±4.5pg/ml for Group IV, respectively. There were no significant differences observable among the groups. Estradiol levels at six weeks postoperatively were 42.3±18.8pg/ml for Group I, 5.4±2.7pg/ml for Group II, 40.8±5pg/ml for Group III and 6.2±2.3 pg/ml for Group IV, respectively. Apparent reductions in group II and IV were proved of statistical significance. Osteocalcin levels preoperatively were 1.2±0.6ng/ml for Group I, 1.7±0.4ng/ml for Group II, 1.5±0.1lng/ml for Group III and 1.5±0.1.lng/ml for Group IV, respectively. At six weeks postoperatively they were 1.6±0.1lng/ml for Group I, 1.7±0.3ng/ml for Group II, 1.8±0.3ng/ml for Group III and 1.2±0.1lng/ml for Group IV, respectively. The differences and changes among the groups and measurements were not of statistical significance. Bone mineral contents at six weeks postoperatively were 0.248±0.03g for Group I, 0.177±0.03g for Group II, 0.226±0.04g for Group III and 0.092±0.01g in Group IV, respectively. Low values of Group II and IV compared to those of Group I and III were of statistical significance.(P=0.0001) Torsional strength of bones at six weeks postoperatively were 4.0±0.2N/m for Group I, 1.5±0.1N/m for Group II, 1.5±0.1N/m for Group III and 1.4±0.1N/m for Group IV, respectively. Decreases of experimental groups(II, III, IV) compared to that of control group(I) were of statistical significance, but differences among the experimental groups were not of significance(p>0.05). For above observations, it was possible to conclude that osteoporosis measurable by bone mineral content and torsional stress test was caused by oophorectomy and immobilization in vivo, the former of which was more rapid and profound than the latter during early phase. When both factors, i.e., oophorectomy and immobilization are exerated simultaneously. the resultant osteoporosis was found in higher degree than either factor only, but not at incremental degree as one may expect.
Absorption ; Animals ; Bone Density ; Calcium ; Epidemiologic Studies ; Estradiol ; Estrogens ; Exercise Test ; Female ; Hip ; Humans ; Immobilization ; Osteocalcin ; Osteoporosis ; Ovariectomy ; Rats ; Sciatic Nerve

Osteoblastoma is a rare benign bone tumor and is characterized hitologically by an abundant number of osteoblasts and by the presence of s large amount of osteoid tissue in a highly vascular matrix. The lesion is frequently encountered in children and adolescents with most of the cases occuring between the ages of 10 and 25 years. There is significant sex prevalence (M.: F.=2: 1). Up to now there has been few reports of a benign osteoblastoma occuring in the cervical spine. This report describes a boy of a benign osteoblastoma which involved the cervical vertebral arch and spinous process, presenting with pain and limitation of motion. He was given en-bloc resection of tumor mass and confirmed by histological examination. Postoperation result was good and he goes school without any problem in about 12 months of follow up.
Adolescent ; Child ; Follow-Up Studies ; Humans ; Male ; Osteoblastoma ; Osteoblasts ; Prevalence ; Spine