Two hundreds and forty six preoperative endoseopic gastric biopsies from 236 conaecutive cases were subjected to the retrospective analyais of diagnostic accuracy among 597 tumor- bearing gastrectomy specimens confirmed by extended histotopographic investigations during a period of 1980 to 1981 at Seoul National University Hospital. The overall diagnostic accuracy of endoscopic gastric biopsy was 93.1% with 0.8% false positivity and 3.5% of false negative caaes; of those, the concordance rate of preoperative biopsy diagnosis based on the histotopographic investigation of the gastrectomy remained in 85.5%, whereas 75% of diagnostic discrepancy wae reaulted from inappropriate biopsy sampling or failure of neoplastic tissue obtainability; and the rest of 25% was mostly false negative cases. (continue...)
Biopsy* ; Diagnosis ; Gastrectomy ; Retrospective Studies ; Seoul

No abstract available.
Animals ; Carcinoma, Hepatocellular* ; Epidermal Growth Factor* ; Rats*

2 cases of Sprengel s deformity are presented as the first report of the country. This relatively uncommon congenital deformity was found not only scapula involved but also the adjacent spine and ribs as well. Even the patients are adult surgical intervention was tried because the disability was prominent with high scapula, and good range of the shoulder joint motions is restored.
Adult ; Congenital Abnormalities ; Humans ; Ribs ; Scapula ; Shoulder Joint ; Spine

OBJECTIVE: This study was performed to evaluate the usefulness of New cervicography by comparing cervicographic finding with Papanicolaou smear and result of colposcopically directed biopsy. METHODS: This study group consisted of 189 patients who visited the Department of Obstetrics and Gynecology, Chung-Ang University Pildong Hospital from September 1998 to August 1999. All women simultaneously underwent Papanicolaou smear and New cervicography. If either method was positive, the patient was referred for colposcopically directed biopsy. RESULTS: The New cervicography was significantly more sensitive than the Papanicolaou smear(92.2% vs 60.8%, p<0.01), whereas the Papanicolaou smear was significantly more specific than the New cervicography(99.3% vs 75.0%, p<0.05). The false positive rate of New cervicography was 75%, significantly higher than 0.7% of Papanicolaou smear. There was no significant difference between the negative predictive value of cervicography and Papanicolaou smear. When New cervicography and Papanicolaou smear were used together, the sensitivity was significantly higher than Papanicolaou smear used alone(98.1% vs 60.8%, p<0.01) and false negative rate was significantly lower than Papanicolaou smear(1.9% vs 39.2%, p<0.01). However the specificity, positive predictive value of the combined test were lower than Papanicolaou smear. CONCLUSION: Cervicography is one of the Papanicolaou smear adjunctive tests and a useful method to detect cervical cancer. Our study confirms the previously suspected low sensitivity of Papanicolaou smear and demonstrate that cervicography is more sensitive than Papanicolaou smear and less specific. From the above results, when New cervicography and Papanicolaou smear were used together, the detection rate of cervical cancer will be increased more easily since the cases missed by one method may be picked up by another.
Biopsy ; Female ; Gynecology ; Humans ; Mass Screening* ; Obstetrics ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

BACKGROUND: Pain is among the most prevalent symptoms experienced by patients with cancer. Severe pain is incompatible with quality of life. Although cancer pain can be effectively treated in 70-90% of patients with the principle of pain management, between 60% and 70% of cancer patients pain is inadequately treated. Both knowledge and attitudes of medical professionals are important for effective pain management. This study was designed to survey residents knowledge and attitudes toward cancer pain management in order to offer the basic data for researching the problems and education program of cancer pain management. METHODS: In February 1997, we surveyed 116 residents practising in 7 departments of one university hospital, including physicians and surgeons, with a case-oriented questionnaire assessing knowledge and attitudes toward cancer pain management. RESULTS: The percentage of residents choosing the correct answer for knowledge about pain management was, pain in the drug abuser(42.2%), equianalgesic dosing(47.4%), physical dependence(50.9%), WHO analgesic ladder(61.2%), neuropathic pain(62.9%), around the clock dosing(69.8%). The percentage of residents choosing answer for attitude toward cancer pain management ; upper limit to opioid prescription(46.5%), reluctance to prescribe morphine(45.7%), need of education for pain management(99.1%). Fear of side effects was the most frequent reason of their reluctance to prescribe opioids(80.4%.) Physicians had higher level of knowledge than surgeons(P=0.004). CONCLUSIONS: This study shows the presence of barriers to adequate pain control in Korea as identified in other countries. There is the lack of konwledge about cancer pain management and doctors are reluctant to prescribe because of negative attitudes towards pain management. This suggests a need for not simply offering knowledge but problemsolving education and training of pain management.
Education ; Humans ; Korea ; Pain Management* ; Quality of Life ; Surveys and Questionnaires

OBJECTIVE: It is generally accepted that ectopic pregnancy (EP) may adversely affected on the female fertility. However, it is not fully understood how it influences on the future fertility after treatment of an EP, so we intended to evaluate its effects, METHODS: This study was undertaken on 473 patients with clinically and pathologically proven diagnosis of ectopic pregnancies at the Department of Obstetrics and Gynecology, Anam Hospital, Kroea University Medical College hom Jan. 1, 1989 to Aug. 31, 1996. RESULTS: The incidence of ectopic pregnancy was 1 in 19.6 deliveries (5.1%). The overall spontaneous conception rate after treatment of ectopic pregnancy was 67.4%, and among them, the rate of intrauterine pregnancy (IUP) and repeat ectopic pregnancy (rEP) was 56.3% and 11.1% respectively. The occurrance rate of infertiity after treatment of EP was 32.6%. The mean time to IUP after treatment of EP was 16.5 months, and 79.0% of all IUP were conceived within 2 years after treatment. The mean time to repeat ectopic pregnancy was 15.9 months. With increasing maternal age, IUP rate was decreased and rEP rate was increased but they were statistically not signiTicant. Repeat EP rate was also increased in multiparous women but it was also statistically not significant. Overall PR (IUP and rEP) was decreased in women who have organic lesions (adhesions, endometriosis, PID etc.) in pelvic cavity(p=0.003). Patients who were treated with conservative surgery achieved a lower conception rate without statistical significance and it may be due to low cases. CONCLUSION: Future fertility rate was not significantly altered by EP itself, but rather affected by patient's age, organic lesions and previous history of pelvic surgery. Recently, the advent of assisted reproductive technology and its associated techniques improved the female fertility in women with such a problem.
Birth Rate ; Diagnosis ; Endometriosis ; Female ; Fertility* ; Fertilization ; Gynecology ; Humans ; Incidence ; Maternal Age ; Obstetrics ; Pregnancy ; Pregnancy, Ectopic* ; Reproductive Techniques, Assisted

OBJECTIVE: The prevalence of multifetal pregnancies has increased up to 30% as a result of the introduction of ovulation inducing agents for assisted reproductive teclmology(ART). An exttemely poor pognosis could be expected for viable pregnancies in multifetal gestation. So, to decrease the consequence of multiple pregnancies and prevent complications, especially premature baby irreversibly damaged, selective fetal reduction to the smaller number of fetuses should be considered in an early gestational period. METHODS: From May 1994 to Apr 1998, transvaginal selective fetal reduction in 13 pati including 9 triplet, 3 quadruplet and 1 quintuplet. Of the 13 patients, 4 were obtained by controlled ovarian hyperstimulation with intrauterine insemination (COH with IUI), 6 were by IVF-ET, 2 wae by controlled ovarian hyperstimulation with natural contact and 1 was by natural conception. Selective fetal reduction using intracardiac KC1 injection and aspiration of amniotic fluid carried out in 8-11 weeks of gestation. RESULTS: After procedures, 8 patients were remained as twin pregnancies, 5 patients as singleton pregnancies and 1 of the remaining twin embryos vanished after procedure. There have been 7 sets of twin delivery including 1 stillbirth and 3 singleton delivery. 1 cases are ongoing state. All of the singleton delivery were completed after 37 weeks of gestation. Of the twin delivery, 2 cases were delivered after 37 weeks of gestation, 2 cases in 35-37 weeks, and 3 cases before 35 weeks of gestation. Unfortunately, 1 stillbirth occurred in 20 weeks of gestation and 2 cases of singleton were aborted. As 3 losses(2 singleton, 1 twin) occurred, the delayed fetal loss rate in this selective fetal reduction was 25.0%(3/12). There was no fetal anomaly related to the procedure. CONCLUSION: Selective fetal reduction in multifetal pregnancies is a rather safe procedure and it may improve the outcome of multiple pregnancies.
Amniotic Fluid ; Embryonic Structures ; Female ; Fertilization ; Fetus ; Humans ; Insemination ; Ovulation ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Multiple ; Pregnancy, Twin ; Prevalence ; Quadruplets ; Quintuplets ; Reproductive Techniques, Assisted* ; Stillbirth ; Triplets

No abstract available.
Ultrasonography*

No abstract available.
Humans ; Patient Education as Topic* ; Spondylitis, Ankylosing*

During s period of rapid growth in adolescence, weakening of the epiphyseal plate and shearing stress of incumbent body weight may cause the femoral head to become displaced from its normal relation to the femoral neck. Slipped upper femoral epiphysis was firstly described by Ambrose Pare in 1572, and many cases have been reported in Europe and America, and extremely rare in Korea. This particular case is a 15-year-old boy. Slipping was evident on the initial X-ray taken at a local provincial hospital approximately 1 year prior to come to this hospital. Owing to the capital epiphysis subluxated with coxa magna deformity, we performed Herndons operation as the first step of treatment. And schedule to do subtrochanteric wedge osteotomy for correction of residual deformity on right hip later on. Varization of left hip is also considered.
Adolescent ; Americas ; Appointments and Schedules ; Body Weight ; Congenital Abnormalities ; Epiphyses ; Europe ; Femur Neck ; Growth Plate ; Head ; Hip ; Humans ; Korea ; Male ; Osteotomy ; S Phase