The consensus guideline development committee of Korean Society of Gynecologic Oncology was reconvened in March 2012. The committee consisted of 36 experts representing 12 university hospitals and professional organizations. The objective of this committee was to develop standardized guidelines for cervical cancer screening tests for Korean women and to distribute these guidelines to every clinician, eventually improving the quality of medical care. Since the establishment of the consensus guideline development committee, evidence-based guidelines have either been developed de novo considering specific Korean situations or by adaptation of preexisting consensus guidelines from other countries. Recommendations for cervical cancer screening tests, management of atypical squamous and glandular cells, and management of low-grade and high-grade squamous intraepithelial lesions were developed. Additionally, recommendations for human papillomavirus DNA testing and recommendations for adolescent and pregnant women with abnormal cervical screening test results were also included.
Adolescent ; Consensus ; DNA ; Female ; Hospitals, University ; Humans ; Mass Screening ; Pregnant Women ; Societies ; Uterine Cervical Neoplasms

Congenital hemangioma (CH), which is already fully formed at birth, is a rare clinical entity that is distinctly different from the common postnatally-occurring hemangioma of infancy (HOI). These two forms of CH have been described according to their clinical courses: apart from the clinical features of presentation at birth, there is the rapidly involuting congenital hemangioma (RICH) with rapid involution shortly after birth and the noninvoluting congenital hemangioma (NICH) with neither postnatal enlargement nor spontaneous involution. It is important to recognize this uncommon disease entity NICH in the early period because it has no tendency for spontaneous regression, so timely therapeutic intervention is needed, which is in contrast to that of HOI. We present 3 patients who were 1-, 3- and 13-year-old girls with red-stippled blue to blue gray vascular lesion. They all showed their lesions since birth and the lesions remained unchanged with no subjective symptoms. Doppler ultrasonography demonstrated a well-defined fast-flowed vascular lesion confined to the dermis and subcutis. The histology commonly showed lobular growth of capillaries, centrilobular irregular and often stellate vessels, extralobular large vessels and more conclusively, negative staining for GLUT-1, which is unlike HOI.
Adolescent ; Capillaries ; Dermis ; Hemangioma ; Humans ; Iodine Compounds ; Negative Staining ; Parturition ; Ultrasonography, Doppler

BACKGROUND: Hemangioma of infancy (HOI) is one of the most common tumors in childhood. Their clinical features can on occasion look like those of other vascular tumors and malformations, so the correct differentiation of HOI may not always be easy. OBJECTIVE: The purpose of this study was to review the clinicopathological features of HOIs and to particularlyexamine the usefulness of glucose transporter protein isoform-1 (GLUT-1) immunohistochemical stain (IHS) as a specific marker of HOI. METHODS: This study was conducted at the Vascular Anomaly Clinic of Kyungpook National University Hospital during 11 years (1998~2008). Sixty-two cases were selected in addition to selecting other tumors and malformation as a control group. We then reviewed their clinical features and the results of H&E and GLUT-1 IHS for making the differential diagnosis. RESULTS: The male to female ratio was 1 : 2.88. The head and neck were the most commonly involved sites. The complications included ulceration and/or bleeding (12.9%), scarring (9.7%), infection (4.8%), ocular complications (4.8%) like visual axis occlusion, and pain (1.6%). Three phases of proliferating, involuting and involuted of a HOI comprised 11.3%, 37.1% and 51.6% of the lesions, respectively, from the clinical view point and 11.3%, 48.4% and 40.3% of the lesions, respectively, from the pathological point of view. GLUT-1 was positively expressed on almost all of the HOIs (47/57, 82.5%), except for 10 HOIs of the involuted phase and the other controls. CONCLUSION: The clinicopathological findings of this study were similar with those of the previous reports. The expression of GLUT-1 by a HOI can be helpful to make the correct diagnosis from other vascular tumors and malformations.
Axis, Cervical Vertebra ; Cicatrix ; Female ; Glucose Transport Proteins, Facilitative ; Head ; Hemangioma ; Hemorrhage ; Humans ; Iodine Compounds ; Male ; Neck ; Ulcer

Various bacteria were isolated from the casing layer soil of the culture bed of P. ostreatus and their role in fruiting body induction of the edible mushroom, P. ostreatus, was investigated. Analysis of the bacterial community isolated from the casing layer soil revealed that the composition of genera and number of cultivable bacteria were different for each sterilizing treatment. Bordetella was predominant in the bulk soil whereas Flavobacterium was predominant after sterilization of the casing layer soil. Fluorescent Pseudomonas was predominant in the non-sterilized casing layer soil. Total number of the bacterial genera in the casing layer soil was higher than that in the bulk soil. In particular, an increase in the fluorescent Pseudomonas population was observed in the non-sterilized casing layer accompanied by induction of fruiting body and enhanced mushroom production yield. The results suggested that specific bacterial populations in the casing layer play an important role in the formation of primodia and the development of basidiome in P. ostreatus.
Agaricales ; Bacteria ; Bordetella ; Flavobacterium ; Fruit ; Pleurotus ; Pseudomonas ; Soil ; Sterilization

BACKGROUND/AIMS: The role of double balloon enteroscopy (DBE) is still evolving. The aim of this study was to compare the diagnostic yield of DBE with that of small bowel series (SBS). METHODS: We enrolled patients with suspected small bowel disease consecutively, and performed both DBE and SBS in all patients. RESULTS: Eighteen patients (M:F=12:6, 14-82 years) were included. Indications for small bowel evaluation were obscure gastrointestinal bleeding (10), abdominal pain (5), diarrhea (2) and abnormal CT finding (1). Of 10 obscure gastrointestinal bleeding patients, 6 showed the same findings in both studies. However, 4 showed negative findings in SBS while DBE detected erosions or ulcerations. Of 5 abdominal pain patients, 3 showed the same results in both studies. However, 2 demonstrated different results. One was suspected of early Crohn's disease in SBS, but proved to be normal in DBE, and the other was suspected of malignancy in SBS but was suspected of benign ulcers in DBE. Of 2 chronic diarrhea patients, one was diagnosed as Crohn's disease in both studies. The other was suspected of tuberculosis in SBS but diagnosed as lymphangiectasia by DBE with biopsy. One patient with jejunal wall thickening in CT proved to be normal in both DBE and SBS. There were no serious complications associated with DBE and SBS. CONCLUSIONS: DBE is better than SBS in terms of diagnostic accuracy. DBE may become an important method for the evaluation of small bowel diseases.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Endoscopes, Gastrointestinal ; *Endoscopy, Gastrointestinal ; Female ; Humans ; Intestinal Diseases/*diagnosis/radiography ; *Intestine, Small/pathology/radiography ; Male ; Middle Aged

BACKGROUND AND OBJECTIVES: Thromboembolism (TE) is a common complication of atrial fibrillation (AF). Although several serum markers for TE in AF patients have been reported, the mechanisms for TE have not been completely determined. SUBJECTS AND METHODS: Seventy four patients with persistent or permanent AF (M:F=39:35, mean age: 53+/-18 years) were enrolled. The epidemiologic risk factors for TE, including old age (> or =65 years), diabetes, hypertension, heart failure (HF), valvular heart disease, left ventricular (LV) dysfunction, and a history of TE were investigated. Serum markers for the endothelial function [von-Willebrand factor (vWF) and thrombomodulin (TM)], inflammation [quantitative and high sensitive C-reactive protein (CRP) and interleukin (IL)-6], coagulation [fibrinogen, fibrinogen degradation product (FDP), d-dimer] and platelet activity (p-selectin), and the echocardiographic parameters were measured. RESULTS: The vWF was increased in patients with old age, hypertension, HF and a history of TE, and the vWF was positively correlated with age and the left atrium dimension (LAD), respectively. TM was also increased in the patients with old age and a history of TE and the LV dysfunction, and it was positively correlated with age and the LAD. The quantitative CRP was increased with old age, hypertension and LV dysfunction, and it was positively correlated with age and the LAD. High sensitive CRP was increased with old age and LV dysfunction, and it was positively correlated with age and the LAD. IL-6 was increased in diabetic patients. Fibrinogen was increased with old age and hypertension, and it was positively correlated with age and the LAD. FDP and d-dimer were increased in the patients with a history of TE and LV dysfunction. P-selectin was neither increased nor correlated with any other parameters. All the analyzed serum markers, except the markers for coagulation and platelet activity, were correlated with age and the LAD. CONCLUSIONS: It was shown that endothelial dysfunction plays an important role for the TE in AF patients. The serum markers for endothelial function may be used to screen the AF patients who are at a high risk for TE.
Atrial Fibrillation* ; Biomarkers ; Blood Platelets ; C-Reactive Protein ; Echocardiography ; Fibrinogen ; Heart Atria ; Heart Failure ; Heart Valve Diseases ; Humans ; Hypertension ; Inflammation ; Interleukin-6 ; Interleukins ; P-Selectin ; Risk Factors ; Thromboembolism ; Thrombomodulin

BACKGROUND AND OBJECTIVES: Circulating endothelial progenitor cells (EPC) with an endothelial phenotype contribute to the regeneration and repair of arteries. The number of circulating EPCs has an inverse correlation with chronic smoking and endothelial dysfunction. Green tea cathechin many improve endothelial dysfunction. The effect of green tea cathechin on the number of circulating EPCs and the endothelial dysfunction in chronic smokers is not known. Subjects and METHODS: In 20 young healthy smokers (27.6+/-3.6 years, all male), the endothelial functions that were defined by flow-mediated endothelium dependent vasodilation (FMD) of the brachial artery, as well as the number of EPC isolated from peripheral blood, were determined at baseline and also at 2 weeks after taking green tea (8 g/day). The circulating EPCs were quantified by flow cytometry as CD45low CD34+ KDR2+ cells and as acyl-LDL and FITC-lectin double positive cells after culture for 7 days. RESULTS: The changes of the clinical characteristics and the laboratory findings were not different between baseline and at 2 weeks after green tea intake. The EPC levels were inversely correlated with the number of smoked cigarettes. Circulating EPCs, as determined-by flow cytometry, and the cultured EPCs increased rapidly at 2 weeks after green tea consumption (78.6+/-72.6/mL vs. 156.1+/-135.8/mL, respectively, p<0.001; 118.2+/-35.7/10 field vs. 169.31+/-58.3/10 field, respectively, p<0.001). The FMD was significantly improved after 2 weeks (7.2+/-2.8 vs. 9.3+/-2.4, respectively, p<0.001). The FMD was correlated with the EPC count before treatment (r=0.67, p=0.003) and after 2 weeks (r=0.60, p=0.013). CONCLUSION: The number of circulating EPCs and the FMD are reduced in chronic smokers. Green tea induces rapid improvements of the EPC levels and the FMD. A short-term of consumption of green tea may be effective for reducing the cardiovascular risk in chronic smokers.
Arteries ; Brachial Artery ; Endothelium ; Flow Cytometry ; Phenotype ; Regeneration ; Smoke ; Smoking ; Stem Cells* ; Tea* ; Tobacco Products ; Vasodilation

BACKGROUND: Constipation occurs frequently in diabetes mellitus (DM). However, there are few reports that investigated the characteristics of constipation associated with DM. The purpose of this study was to evaluate the clinical features of constipation associated with DM. METHODS: Among constipated patients who visited Asan Medical Center from January 2000 to December 2004, 45 patients with DM (DM group) and 104 patients without DM (non-DM group) were included in this study. We reviewed the clinical presentation, results of anorectal manometry, colon transit time study, and defecogram. We also analyzed the response to biofeedback therapy. RESULTS: The severity of constipation symptoms before treatment was not different between DM and non-DM group. Patients with colon transit time over 56 hours were more frequent in DM group than in non-DM group (21/45, 46.7% vs. 31/104, 29.8% ; p=0.047). Among DM group, colon transit time and the duration of DM showed positive correlation (r=0.431, p=0.003). The resting anal sphincter pressure was significantly lower in DM group than in non-DM group (43.5+/-21.5 mmHg vs. 51.7+/-22.6 mmHg ; p=0.048). The results of defecography were similar between DM and non-DM group. Successful responses to biofeedback therapy were not different between DM and non-DM group (19/34, 55.9% vs. 43/79, 54.4% ; p=0.887). CONCLUSIONS: Slow transit constipation was more frequent in DM group than in non-DM group. The successful responses to biofeedback therapy appear to be similar between DM and non-DM group.
Anal Canal ; Biofeedback, Psychology ; Chungcheongnam-do ; Colon ; Constipation* ; Defecography ; Diabetes Mellitus* ; Humans ; Manometry ; Time and Motion Studies

Obstructive sialadenitis is one of common disease in salivary gland, and most common histologic features are loss of acinar cell and ductal dilatation associated with fibrosis, and infiltration of inflammatory cells. Although many experimental studies has been accomplished for the salivary acinar cell change in obstructive salivary gland disease, studies for myoepithelial cell were deficient. This study is designed for salivary gland tissue change, especially myoepithelial cell when nonspecific chronic sialadenitis or salivary duct injury by duct obstruction or cut can be occurred that is common encounted clinically. After ligation and cutting of submandibular gland of rabbit, groups of aminmal were sacrificed at 1, 2, 4 weeks postoperatively, submandibular gland were removed. The histopathologic evaluation was done with light microscopy. And, with immunohistochemical staining with alpha-smooth muscle actin, characteristics of myoepithelial cell were examined. With transmission electron microscopy, ultrastructure of myoepithelial cell were examined for distribution and ultrastructure of myoepithelial cell. The results were obtained as follows: 1. In the histopathologic evaluation, ligation and cutting group of 1 week, linkage of myoepithelial cell associated with acinar atrophy and degeneration were disappeared in both group. 2. More prominent squamous metaplasia was seen in acinar cells of ligation group of 2 weeks experimental rabbit than cutting group. 3. Acinar cells are nearly disappeared in both ligation and cutting group of 4 weeks, and myoepithelial cell also disappeared associated with acinar cell atrophy, and duct-like structure composed by squamous cells by squamous metaplasia in acinar cells were distributed. 4. In immunohistochemical study, both ligation and cutting group alpha-SMA distribution were diminished at 1 week experimental rabbits, but myoepithelial cell was more diminished in ligation group than cutting group, which were distributed around cells of squamous metaplasia. 5. Nuclear condensation, chromosome margination, and cytoplasmic vaculoation were appeared in myoepithelial cell of both cutting and ligation group after 1 week with transmission electron microscopy. But degenerative substance were seen in cytoplasm of myoepithelial cell of ligation group of 4 weeks. From the results obtained in this study, atrophy and degeneration of myoepithelial cell was more prominent in duct ligation group than duct cutting group, and myoepithelial cells were seen around cells squamous metaplasia of acinar cell.
Acinar Cells ; Actins ; Atrophy ; Cytoplasm ; Dilatation ; Fibrosis ; Ligation* ; Metaplasia ; Microscopy ; Microscopy, Electron, Transmission ; Rabbits ; Salivary Ducts ; Salivary Gland Diseases ; Salivary Glands ; Sialadenitis ; Submandibular Gland*

Obstructive sialadenitis is one of common disease in salivary gland, and most common histologic features are loss of acinar cell and ductal dilatation associated with fibrosis, and infiltration of inflammatory cells. Although many experimental studies has been accomplished for the salivary acinar cell change in obstructive salivary gland disease, studies for myoepithelial cell were deficient. This study is designed for salivary gland tissue change, especially myoepithelial cell when nonspecific chronic sialadenitis or salivary duct injury by duct obstruction or cut can be occurred that is common encounted clinically. After ligation and cutting of submandibular gland of rabbit, groups of aminmal were sacrificed at 1, 2, 4 weeks postoperatively, submandibular gland were removed. The histopathologic evaluation was done with light microscopy. And, with immunohistochemical staining with alpha-smooth muscle actin, characteristics of myoepithelial cell were examined. With transmission electron microscopy, ultrastructure of myoepithelial cell were examined for distribution and ultrastructure of myoepithelial cell. The results were obtained as follows: 1. In the histopathologic evaluation, ligation and cutting group of 1 week, linkage of myoepithelial cell associated with acinar atrophy and degeneration were disappeared in both group. 2. More prominent squamous metaplasia was seen in acinar cells of ligation group of 2 weeks experimental rabbit than cutting group. 3. Acinar cells are nearly disappeared in both ligation and cutting group of 4 weeks, and myoepithelial cell also disappeared associated with acinar cell atrophy, and duct-like structure composed by squamous cells by squamous metaplasia in acinar cells were distributed. 4. In immunohistochemical study, both ligation and cutting group alpha-SMA distribution were diminished at 1 week experimental rabbits, but myoepithelial cell was more diminished in ligation group than cutting group, which were distributed around cells of squamous metaplasia. 5. Nuclear condensation, chromosome margination, and cytoplasmic vaculoation were appeared in myoepithelial cell of both cutting and ligation group after 1 week with transmission electron microscopy. But degenerative substance were seen in cytoplasm of myoepithelial cell of ligation group of 4 weeks. From the results obtained in this study, atrophy and degeneration of myoepithelial cell was more prominent in duct ligation group than duct cutting group, and myoepithelial cells were seen around cells squamous metaplasia of acinar cell.
Acinar Cells ; Actins ; Atrophy ; Cytoplasm ; Dilatation ; Fibrosis ; Ligation* ; Metaplasia ; Microscopy ; Microscopy, Electron, Transmission ; Rabbits ; Salivary Ducts ; Salivary Gland Diseases ; Salivary Glands ; Sialadenitis ; Submandibular Gland*