Carcinoma of the uterine cervix has been considered to be a sexually transmitted disease(STD) and at present time, particullary human papillomavirus (HPV) is considered as the most likely infectious causative agents of uterine cervical cancer. But less is known about the sexual transmission of HPV and the status of HPV infection of male partner. Therefore, screenng of couples for HPV is very important for understanding HPV infection as a sexually transmitted disease and prevention of cervical carcinoma. The polymerase chain reaction(PCR) was employed to detect HPV 16 and 18 in cytological samples from the uterine cervix of the patients with cervical carcinoma(4 CIS and 34 invasive cervical carcinoma) and from urethral metatus and glans sulcus of their male consorts. The results are as follows; 1. HPV 16 or 18 were detected in 31(81.6%) of 38 patients with cervical cancer(HPV 16; 78.9%(30/38), HPV 1S; 28.9%(11/38), HPV 16 and 18; 26.3%(10/38)), 2. HPV 16 was detected in 27(90,0%) of 30 males whose wives were positive for HPV 16. But HPV 18 was detected in only 3(27.3%) of 11 male consorts whose wives were positive for HPV 18. And HPV 1S was detected in all male consorts whose wives were positive for HPV 16. In addition, HPV 16 or 18 were positive in 3 of 7(42.9%) male consorts whose wives were negative for HPV 16 and 18. Conclusively, these results suggest that HPV might be transmitted by sexual contacts in heterosexual couples.
Cervix Uteri ; Family Characteristics* ; Female ; Heterosexuality* ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans* ; Male ; Polymerase Chain Reaction ; Sexually Transmitted Diseases ; Spouses ; Uterine Cervical Neoplasms

OBJECTIVES: As one of the possible mechanisms of viral evasion in the HPV-infected cervical cancer cells, the role of amino acid sequence change in epitope region has not been reported yet. In this study, sequence variations of HPV 16 E6, E7 gene, especially focused on epitope region, were analysed, the status of immunomodulatory factors were documented, and finally the possible correlation between the sequence variations and the loss of HLA class I expression was examined. METHODS: The entire ORF(open reading frame)s of HPV 16 E6, E7 were sequenced by the fluorescent dideoxy termination method. In addition proteins and transcripts of HLA-ABC, beta2-microglobulin(beta2-m), TAP (transporter associated with antigen processing), and LMP(large multi-functional proteasome) were evaluated by immunohistochemistry and RT-PCR, respectively in 40 clinical specimens of primary cervical cancer and 6 cervical cancer cell-lines. Medical records including pathologic reports were reviewed. RESULTS: Among the 27 cases confirmed as harboring HPV 16 DNA, only one(3.7%) found as a prototype. Among 11 kind of variants identified in total, 4 variants(5 nucleotide sites) which were never reported before has been found, registered firstly to GenBank. The most frequently found one(16 cases, 59.3%) contains D25E, N29S in E6, E7 region, respectively and the most common variation in E6, E7 ORFs found concurrently(p<0.05). Down-regulation of HLA-ABC and beta2-m was identified in 32(86.5%) and 35 cases(89.7%), respectively and transcripts of TAP, LMP were identified in over 85% of cases. However, there was no significant difference in HPV 16 infection, D25E in E6 and so on between HLA-ABC, beta2-m positive and negative groups. The well-known clinicopathologic parameters did not correlate with sequence variations and immunomodulatory factors. Five sequence variations in HPV 16 E6, E7 ORFs that were not previously reported worldwide were found, registered firstly to GenBank. CONCLUSION: It seems that multiple mechanisms are operated in down-regulation of HLA class I molecules and the phenotypic profile of immunomodulatory factors seems to be unrelated in vivo to the naturally occurring HPV 16 E6, E7 variations in epitope region.
Amino Acid Sequence ; Animals ; Databases, Nucleic Acid ; DNA ; Down-Regulation ; Ecthyma, Contagious ; Female ; Human papillomavirus 16 ; Humans* ; Immunohistochemistry ; Medical Records ; Open Reading Frames ; Uterine Cervical Neoplasms*

Carbamylated hemoglobin (CarHb) is formed by the reaction of hemoglobin with cyanate derived from the spontaneous dissociation of in vivo urea. Previous studies have shown that formation of CarHb depends upon both the severity and the duration of renal failure. To study the clinical significances of CarHb in Korean patients with chronic renal failure, we measured CarHb levels by high-performance liquid chromatography in 159 CRF patients and 46 normal controls. Patients with CRF had a higher CarHb concentration than normal controls (107.9+/-58.8 vs 35.1+/-14.2 microgramVH/gHb; P<0.001). In patients with CRF, nondialysis group had a higher value than dialysis group (129.8+/-77.9 vs 98.7+/-46.1 microgramVH/gHb; P<0.05). There were no siginificant difference in CarHb levels between hemodialysis (92.0+/-35.8microgramVH/gHb) and peritoneal dialysis (106.7+/-55.3microgramVH/gHb) groups. CarHb levels were not different between diabetic and nondiabetic patients in predialysis and hemodialysis groups. Although there was a significant difference in peritoneal dialysis group, the BUN levels were also lower in diabetic patients than nondiabetic patients. There were no correlation between CarHb and HbA1c percentage in patients with diabetes. CarHb levels were positively correlated with BUN (r=0.489; P<0.001) and creatinine (r=0.458; P<0.01) concentrations. There were negative correlations between CarHb and both Kt/V (r=-0.358; P<0.05) and URR (r=-0.415; P<0.05) in hemodialysis patients. In conclusion, CarHb may be a useful index of uremic control in patients with chronic renal failure, and are independent of the mode of dialysis and the presence of diabetes.
Chromatography, Liquid ; Creatinine ; Dialysis ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis ; Renal Dialysis ; Renal Insufficiency ; Urea

The skin is a frequently involved organ in graft-versus-host disease(GVHD). Various skin lesions including erythematous eruption, bullae, desquamation, lichenoid, and sclerodermoid lesions have been reported in GVHD, but vitiligo-like lesions were. We present two cases of chronic GVHD presenting multiple hypopigmented patches following allogenic bone marrow transplant(BMT) due to severe aplastic anemia. The histopathologic studies showed focal vacuolar degeneration of basal cells, absence of melanocytes in the epidermis, and perivascular lymphocytic infiltration consisting of T cells in the upper dermis, These cases suggest that vitiligo-like lesions may develop due to marked melanocyte- lymphocyte interaction after BMT.
Anemia, Aplastic ; Bone Marrow ; Dermis ; Epidermis ; Lymphocytes ; Melanocytes ; Skin* ; T-Lymphocytes ; Vitiligo

PURPOSE: To evaluate further the right minor and major fissure on thin-section narrow-interval CT scans with particular emphases on orientation, degree of completeness. MATERIALS AND METHODS: Thin section CT scans from 10 mm distal to carina to the proximal basal segmental bronchus were obtained at 5 mm invervals in 50 consectutive subjects. Orientation, degree of completeness, and the relationship of the minor and major fissure on thin-section CTscans were analyzed. RESULTS: Four principal types of the minor fissure could be identified according to the highest point of the upper surface of the middle lobe. At bronchus intermedius level, the major fissure appeared with its medial end anterior to lateral end in 45 subjects. The minor fissure was complete in only 10 subjects (20%). Completely absent minor fissure was noted in four subjects (8%). The major fissure was incomplete in 17 subjects (34%) at bronchus intermedius level. the minor and major fissure intersected each other in only 27 subjects (54%). The hig best point of intersection was variable. CONCLUSION: There are much more variations in the fissural complex in our study than in previous reports and these variations can be visualized well on thin-section CTscans.
Bronchi ; Lung* ; Tomography, X-Ray Computed*

The shortage of internal medicine residents depict the contradictions and perversions in Korean medical system. Internal medicine is the foundation of medicine and the fact it serves as the most essential medical services for the people adds severe gravity to the issue. The fundamental problem derives from the contradictions in health insurance system. In fact, the poor medical fee and the failure of medical delivery system are the core drawbacks to the current crisis. Unless above matters are addressed to draw a constructive resolution, it is an undeniable fact that this may become a serious threat to the national health system and people's wellbeing.
Fees, Medical ; Gravitation ; Insurance, Health ; Internal Medicine*

The CT findings were reviewed in two patients with injuries to the gallbladder following blunt trauma. In one patient high attenuation of intraluminal blood clot within the gallbladder and associated hemoperitoneum were identified. Another patient was represented hemoperitoneum and bile leakage into the peritoneal cavity due to laceration of the fundus of the gallbladder which appeared contrasted.
Bile ; Gallbladder ; Hemoperitoneum ; Humans ; Lacerations ; Peritoneal Cavity

No abstract available.
Nasal Cavity* ; Neurilemmoma*

The Laugier-Hunziker syndrome represents a rare, acquired, benign, pigmentary disorder of the lips, oral mucosa, and nails. The nails are often involved with the development of melanonychia, which may be due to focal melanocyte activation. The lips and the mucous membranes show a variable number of flat, gray to brown-black lenticular spots, which are usually asymptomatic. We report the third case of Laugier-Hunziker syndrome in the Korean literatures.
Lip ; Melanocytes ; Mouth Mucosa ; Mucous Membrane

BACKGROUND: Adult with congenital heart disease represents a new category of specialized cardiovascular interest that requires the cooperation of a number of medical and surgical disciplines, and also requires the interactions among traditional departmental jurisdiction. Uninterrupted, long-term continuity care is essential if the concerns inherent in this new and increasing patient population are to be addressed. The purpose of this study was to analyze the clinical characteristics of congenital heart disease in adolescents and adults. METHODS: Between October 1994 and July 1996, retrospective follow-up records and registry chart of 229 consecutive patients with congenital heart disease for over 16 years in GUCH (grown-up congenital heart) clinic were reviewed by a physician and a nurse specialist. RESULTS: There were 126 female and 103 male GUCH patients with the mean age of 34+/-14.6 years old. Among the 229 patients, there were 179 natural survivors, those without cardiac repair, and 50 postoperative survivors. Congenital heart defects were 167 shunt legions, 17 obstructive and valvular legions, 14 tetralogy of Fallot, 15 complex congenital heart anomalies and 16 others. Among the 179 natural survivors; 122 (68%) required heart surgery or continuous medical surveillance, and among the 50 surgically repaired survivors; 37 (74%) required reoperation for residual heart defects, constant medical treatment or consultation from other medical divisions. The reasons for the hospital vistis were:cardiac operation or cardiac diagnosis in 128 (56%) patients, symptomatic heart conditions in 43 (19%), routine heart examinations since childhood in 31 (14%) and others in 27 (11%). Also, the patient compliances were higher in the GUCH clinic than the traditional departmental jurisdiction (p<0.001). CONCLUSIONS: To achieve continuing care for the patients with congenital heart disease in adolescents and adults, it is important to develope a specialized clinic addressing the specific needs of the congenital heart disease in adolescents and adults.
Adolescent* ; Adult* ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Heart Defects, Congenital* ; Humans ; Male ; Reoperation ; Retrospective Studies ; Specialization ; Survivors ; Tetralogy of Fallot ; Thoracic Surgery