OBJECTIVES: The diagnosis of ASCUS(atypical squamous cells of undetermined significance) and LSIL(low-grade squamous intraepithelial lesion) was introduced in 1988 by the Bethesda system for reporting cervical/vaginal cytologies. A significant proportion of women referred for colposcopy with low grade cervical cytologic abnormalities(ASCUS and LSIL) will have high grade cervical intraepithelial neoplasia(CIN II or CIN III) and therefore require adequate management. The purposes of this study were to evaluate the usefulness of high risk type HPV(human papillomavirus) DNA detection using PCR(polyerase chain reaction) in patients with low grade cervical cytologic abnormalities in the prediction of high grade CIN and invasive cancer and to determine the clinical triage in the management of low grade cervical cytologic abnormalities. METHODS: We reviewed 18,942 cases of Papanicolau smears that were performed at our hospital from Jan. 1995 to Mar. 1999. Colposcopically directed biopsy or LLETZ(large loop excision of transformation zone) or hysterectomy were performed on 318 patients with abnormal PAP smears of low degree. HPV PCR testing of high risk types(16 and 18) was also performed on 115 patients. RESULTS: Histologic outcome of ASCUS included 43 cases(38.4%) of high grade CIN and invasive cancer, and that of LSIL included 65 cases(47.5%) of high grade CIN and invasive cancer. In cases of high risk HPV type, 19 patients(73.1%) were at age over 30 years. A highly significant correlation was found between a positive test for high risk types of HPV and finding of high grade CIN and invasive cancer. Among 51 women with ASCUS, a positive test for high risk type had a sensitivity and specificity of 40.0% and 86.1%, and positive predictive value(PPV) and negative predictive value(NPV) of 54.5% and 77.5%, respectively. In 64 women with LSIL, a positive high risk type test was associated with sensitivity and specificity of 30.0% and 94.1%, and PPV and NPV of 81.8% and 60.4%, respectively. CONCLUSION: Our results suggest that high risk type HPV may be positively predictive of and may act as a surrogate marker for high grade CIN and invasive cancer in women with low grade cervical cytologic abnormalities. The management of women with a low grade cervical cytologic abnormalities should be active such as colposcopically directed biopsies.
Biomarkers ; Biopsy ; Colposcopy ; Diagnosis ; DNA* ; Female ; Humans* ; Hysterectomy ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Triage

No abstract available.
Colon* ; Rectum*

No abstract available.
Knee* ; Ligaments*

To evaluate usefulness of MR in assessment of tumor response to the chemotheraphy, we prospectively studied cases of cervical carcinoma with more then 2.5cm in diameter or stage IIb or more. Three courses of chemotherapy were performed with cisplatin and 5 F-U. MR images were obtained both before and after chemotherapy. Nine of 13 patients were undertaken radical hysterectomy after chemotherapy and MR examination. MR volumetry, stage and depth of stromal invasion were compared before and after chemotherapy. And in 9 patients who underwent radical hysterectomy, comparison of pathologic and MR imaging findings were also done. @ES The results were following. @EN 1) All tumors dectrased in volume (m=80.5%). 2) Five tumors (38.5%) reduced in stage, IB→CIS(1); IIA→CIS(1), IIA→IB(2), IIB→IB(1). 3) Depth of stromal invasion in MRI correlated well with that of histo-pathologic specimen in 7 of the 9 patients. Conclusively MR imaging is useful in assessement of tumor response to chemotherapy.
Cisplatin ; Drug Therapy* ; Humans ; Hysterectomy ; Magnetic Resonance Imaging* ; Prospective Studies

No abstract available.
Osteogenesis Imperfecta* ; Osteogenesis*

PURPOSE: It is known that cyclooxygenase (COX)-2 expression is increased in Barrett's esophagus and esophageal adenocarcinomas. We studied COX-2 expression and the effect sulindac has on the genesis of Barrett's esophagus and adenocarcinoma in rats undergoing esophagogastroduodenal anastomosis (EGDA). MATERIALS AND METHODS: Fifty-one rats were divided into a control group (n=27), a 500ppm sulindac-treated group (n=15) and 1000 ppm sulindac-treated group (n=9). Randomly selected rats were killed by diethyl ether inhalation at 20 and 40 weeks after surgery. RESULTS: At 40 weeks, rats treated with 1000 ppm sulindac showed narrower esophageal diameter and milder inflammation than the control rats. At 40 weeks, the incidence of Barrett's esophagus was similar between control and sulindac-treated groups, but the incidence of adenocarcinoma was significantly lower in the 1000ppm sulindac-treated group than either the control or 500 ppm sulindac-treated groups. COX-2 was significantly increased in the lower esophagus of control rats killed at 40 weeks. Cyclin D1 expression was negligible in the sulindac- treated group compared with the control group. CONCLUSION: We suggest that the chemopreventive effect of sulindac is related to decreased COX-2 and cyclin D1 expression, which may be influenced by reduced inflammation.
Adenocarcinoma/etiology/metabolism/*prevention & control ; Animals ; Antineoplastic Agents/therapeutic use ; Barrett Esophagus/etiology/metabolism/prevention & control ; Blotting, Western ; Cyclin D1/metabolism ; Cyclooxygenase 2/metabolism ; Duodenogastric Reflux/*complications ; Esophageal Neoplasms/etiology/metabolism/*prevention & control ; Immunohistochemistry ; Male ; Proliferating Cell Nuclear Antigen/metabolism ; Rats ; Rats, Sprague-Dawley ; Sulindac/*therapeutic use

PURPOSE: This study was intended to evaluate the positional relationship between the hyoid bone and the mandible in patients with mandibular protrusion after mandibular set-back surgery by means of 3D-CT. MATERIALS AND METHODS: Preoperative(3 weeks before) and postoperative (6 weeks after) 3D-CT and cephalogram were taken on 32 patients(12 male, 20 female, mean age of 23.2) treated by bilateral sagittal split osteotomy with rigid fixation. The angular measurement on 3D-CT basilar view were deviation of Me and H, long axis angle of left and right cornu majus. The lineal measurement on 3D-CT basilar view were composed of intercondylar line and coordinates(x,y) of Me and H. The angular and lineal measurement of lateral cephalogram were composed of mandibular plane angle, SNA, SNB, ANB, FH-NA and FH-NB, and coordinates(x,y) of B, Pog, Me and H, PAS, Lpw, MPH and IAS. On the frontal cephalogram, deviation of Me were evaluated. RESULTS: The mean mandibular set-back was 8.0mm horizontally and mandibular plane angle was slightly increased. The hyoid bone was displaced postero-inferiorly, the distance between MP(mandibular plane) and H(hyoid bone) was increased and the posterior airway space values (PAS, Lpw, IAS) were decreased. The coordinates Me(x,y), H(x,y) and deviation angle Me' and H'were revealed the strong positive correlation. CONCLUSION: The results revealed that the horizontal, vertical and transverse relationship of the mandibular and the hyoid bone movements were significantly correlated in patients performed mandibular set-back surgery.
Axis, Cervical Vertebra ; Female ; Humans ; Hyoid Bone* ; Male ; Mandible* ; Orthognathic Surgery* ; Osteotomy

No abstract available.

Fat embolism is the presence of fat globules in the peripheral circulation and in the lung, brain, kidney, heart, and so on -not in the fine emulsion of a metabolic lipemia but in globules large enough to obstruct arterioles and capillaries. The fat droplets can derive from fractures of long bone due to disruption of the fatty marrow, from extensive bruising of the soft tissue, and from fat tissue in burns. Fat embolism has also been reported in patients suffering from various diseases including alcoholism, fatty liver, diabetes mellitus and pancreatitis. We investigated 19 autopsies with fatty liver of varying degrees to establish a correlation between fatty change of liver and pulmonary fat embolism. Among 19 cases, 3 cases with moderate to severe fatty change of liver, and 1 case with submassive hepatic necrosis and mild fatty change showed Grade II pulmonary fat embolism. In histologic section with Sudan III stain, the arteries and capillaries of lung were occupied and distended by round, oval, or staghorn fat globules. The alveoli may contain edema fluid and blood. Although the pulmonary fat embolism occuring in the presented cases didn't cause death on its own, one should be aware that a life-threatening mobilization of fat into the lungs and even into the systemic circulation is possible in fatty liver and submassive hepatic necrosis.
Alcoholism ; Arteries ; Arterioles ; Autopsy ; Bone Marrow ; Brain ; Burns ; Capillaries ; Diabetes Mellitus ; Edema ; Embolism, Fat* ; Fatty Liver* ; Heart ; Humans ; Hyperlipidemias ; Kidney ; Liver ; Lung ; Necrosis ; Pancreatitis ; Sudan

Fat embolism is the presence of fat globules in the peripheral circulation and in the lung, brain, kidney, heart, and so on -not in the fine emulsion of a metabolic lipemia but in globules large enough to obstruct arterioles and capillaries. The fat droplets can derive from fractures of long bone due to disruption of the fatty marrow, from extensive bruising of the soft tissue, and from fat tissue in burns. Fat embolism has also been reported in patients suffering from various diseases including alcoholism, fatty liver, diabetes mellitus and pancreatitis. We investigated 19 autopsies with fatty liver of varying degrees to establish a correlation between fatty change of liver and pulmonary fat embolism. Among 19 cases, 3 cases with moderate to severe fatty change of liver, and 1 case with submassive hepatic necrosis and mild fatty change showed Grade II pulmonary fat embolism. In histologic section with Sudan III stain, the arteries and capillaries of lung were occupied and distended by round, oval, or staghorn fat globules. The alveoli may contain edema fluid and blood. Although the pulmonary fat embolism occuring in the presented cases didn't cause death on its own, one should be aware that a life-threatening mobilization of fat into the lungs and even into the systemic circulation is possible in fatty liver and submassive hepatic necrosis.
Alcoholism ; Arteries ; Arterioles ; Autopsy ; Bone Marrow ; Brain ; Burns ; Capillaries ; Diabetes Mellitus ; Edema ; Embolism, Fat* ; Fatty Liver* ; Heart ; Humans ; Hyperlipidemias ; Kidney ; Liver ; Lung ; Necrosis ; Pancreatitis ; Sudan