• 제목/요약/키워드: Cervical smear

검색결과 201건 처리시간 0.026초

상아세관 폐쇄에 대한 2종의 상아질 지각 과민 체치제와 Er,Cr:YSGG 레이저의 효과 (Effect of two dentin desensitizers and Er,Cr:YSGG laser for dentinal tubule occlusion)

  • 김나송;강정경;류재준
    • 대한치과의사협회지
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    • 제48권6호
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    • pp.469-477
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    • 2010
  • The purpose of this study was to evaluate the effect of two dentin desensitizers and Er,Cr:YSGG laser for dentinal tubule occlusion. Twenty recently extracted single-rooted human teeth were used to obtain root dentinal fragments. The crowns were cut approximately 1mm below the cementum enamel junction(CEJ). A second cut was used to remove the apex of the root. Subsequently, a longitudinal cut was made in order to obtain 2 fragments from each root sample. The cementum from the cervical portion was removed using a high-speed diamond-coated bur in order to expose the dentin. To open dentinal tubules, forty samples were treated with 50% citric acid for 2 min and then rinsed under distilled water for 1 min. These were divided into four groups of ten samples each. The first group served as a control group. In group 2, the samples were irradiated with the Er,Cr:YSGG laser(Waterlase MD, Biolase, USA). In group 3, the samples were treated with Bisblock and ONE-STEP PLUS(Bisco, USA). In group 4, the samples were treated with Gluma comfort bond & Desensitizer(Heraeus Kulzer, Germany). All the samples were examined using Scanning electron microscopy(Hitachi, S-4700, Japan) with two different magnifications(X2000, X5000). These images were assessed by one examiner who was blind to the experimental procedure, using the index of smear layer removal. The distribution of smear layer removal grades was tested using Fisher's exact test. On the order hand, in order to evaluate the occluding effect of two dentin desensitizers and Er,Cr:YSGG laser, the number of exposed dentinal tubules was counted in each group. These were evaluated using the Kruskal-Wallis test with significance predetermined $\alpha$=0.05. There were statistically significant differences between the three groups(Er,Cr:YSGG laser, Bisblock+ONE-STEP PLUS, Gluma comfort bond & Desensitizer) and control group.

자궁경부 이형성증과 암의 진단을 위한 액상세포 검체에서 p16INK4a/Ki-67 이중면역염색의 평가 (Evaluation of p16INK4a/Ki-67 Dual Immunostaining in Liquid-based Cytology for Diagnosis of Uterine Cervical Dysplasia and Cancer)

  • 성미희;이훈택;신민식;오서영;김욱연
    • 대한임상검사과학회지
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    • 제47권3호
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    • pp.132-139
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    • 2015
  • 최근 $p16^{INK4a}$/Ki-67 이중면역염색은 액상세포검사에서 자궁경부 이형성증과 암을 조기에 발견하기 위한 새로운 생체 표지자로 대두되고 있다. 저자들은 자궁경부질도말의 액상세포검체 총 109례에서 CINtec$^{(R)}$ PLUS kit를 사용하여 $p16^{INK4a}$/Ki-67 이중면역염색을 시행하였고, 그 결과를 액상세포검사, HPV hybrid capture II (HC II) 검사 그리고 조직학적 진단과 서로 비교하였다. $p16^{INK4a}$/Ki-67 양성 발현은 세포학적 진단에서 저등급 편평상피내병변 이상의 증례 그리고 조직학적 진단에서 자궁경부 상피내종양 1등급 이상의 증례에서 유의미하게 높았다. 액상세포검사상 비정형 편평 상피세포 소견을 보이는 46례 중, 31례 (67.4%)가 $p16^{INK4a}$과 Ki-67 양성 소견을 보였고, 이러한 양성 증례들은 조직검사에서도 대부분 자궁경부 상피내종양 1등급 이상의 병변에 해당하였다. 자궁경부 상피내종양 1등급 이상의 병변을 발견하기 위한 $p16^{INK4a}$/Ki-67 이중면역염색의 민감도는 액상세포검사보다 높은 89.0%였고, 특이도는 73.5%로 HC II 검사보다 높게 분석되었다. 따라서, $p16^{INK4a}$/Ki-67 이중면역염색 방법은 액상세포검사법의 민감도와 HC II 검사법의 특이도를 보완하기 위한 진단적 검사로 유용하다고 할 수 있다.

Cost and Effectiveness Comparison of Immediate Colposcopy Versus Human Papillomavirus DNA Testing in Management of Atypical Squamous Cells of Undetermined Significance in Turkish Women

  • Kececioglu, Mehmet;Seckin, Berna;Baser, Eralp;Togrul, Cihan;Kececioglu, Tugban Seckin;Cicek, Mahmut Nedim;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.511-514
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    • 2013
  • Background: A small but significant proportion of cases with atypical squamous cells of undetermined significance (ASCUS) may harbour CIN 2-3, or even invasive carcinoma. Although immediate colposcopy, HPV-DNA testing or expectant management are three recommended options in ASCUS triage, a consensus does not currently exist on which one of these approaches is the most efficient. In this study, we aimed to compare the performance and cost of immediate colposcopy and colposcopy based on the human papillomavirus (HPV) testing for detecting histologically confirmed high-grade cervical intraepithelial neoplasia (CIN) in women with ASCUS. Materials and Methods: Records of 594 women with an index Papanicolaou smear showing ASCUS were retrospectively analyzed. Women in the immediate colposcopy arm were referred directly to colposcopy (immediate colposcopy group, n=255) and those in the HPV triage arm were proceeded to colposcopy if the high-risk HPV (hrHPV) test was positive (HPV triage group, n=339). High grade CIN (CIN2+) detection rate and treatment costs were compared between the groups. Results: The detected rate of CIN2+ was higher in the HPV triage group compared to immediate colposcopy group (8% vs. 1.6%, p=0.011). In the HPV triage group, the total cost, cost per patient, and the cost for detecting one case of high grade CIN were higher than the immediate colposcopy group (p<0.001). Conclusions: In women with ASCUS cytology, HPV DNA testing followed by colposcopy is more costly than immediate colposcopy, but this approach is associated with a higher rate of CIN2+ detection. This findings suggest that HPV DNA testing combined with cervical cytology could reduce the referral rate to colposcopy.

Performance of Siriraj Liquid-Based Cytology: a Single Center Report Concerning over 100,000 Samples

  • Sangkarat, Suthi;Laiwejpithaya, Somsak;Rattanachaiyanont, Manee;Chaopotong, Pattama;Benjapibal, Mongkol;Wongtiraporn, Weerasak;Laiwejpithaya, Sujera
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권5호
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    • pp.2051-2055
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    • 2014
  • Background: To evaluate the performance of Siriraj liquid-based cytology (LBC) for cervical neoplasia screening after increasing use of this technology. Materials and Methods: Cytological reports of 103,057 Siriraj-LBC specimens obtained in 2007-2009 were compared with those of 23,676 specimens obtained in 2006. Results: Comparing with the year 2006, the 2007-2009 patients were slightly older ($43.4{\pm}12.yr$ vs $42.7{\pm}12.2yr$, p <0.001), and their specimens had much lower proportion of unsatisfactory slides (OR=0.06, 95%CI 0.04-0.09) with comparable detection rates (3.96% vs 3.70%, p=0.052) but different proportions of various cytological abnormalities (p<0.001). The 2007-2009 Siriraj-LBC had a negative predictive value (NPV) for cervical intraepithelial neoplasia 2+ (CIN2+) of 97.6% and an overall positive predictive value (PPV) of 43.9%. The PPV for CIN2+ varied with types of abnormal cytology, from 13.7% to 93.8% in atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), atypical squamous cells cannot exclude HSIL (ASC-H), high-grade squamous intraepithelial lesion (HSIL), atypical glandular cells (AGC), to squamous cell carcinoma (SCC), respectively. The PPVs for CIN2+ in ASCUS and LSIL were comparable, but the PPV for CIN1 was higher for LSIL than for ASCUS (41.63% vs 16.32%). Conclusions: Siriraj-LBC has demonstrated a stable detection rate and NPV for CIN2+ of >95% since the first year of use. The comparable PPVs for CIN2+ of ASCUS and LSIL suggests that these two conditions may undergo similar management; other cytological abnormalities need immediate evaluation.

여우에서 피하지방종의 진단 (A Subcutaneous Lipoma in a Male Red Fox)

  • 정동혁;양정진;공주연;이배근;이제욱;박세진;이승용;석성훈;홍일화;이희천;연성찬
    • 한국임상수의학회지
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    • 제32권3호
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    • pp.278-281
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    • 2015
  • 국립공원관리공단 종복원기술원의 수컷 여우(8년령, 8.5 kg)에서 경부에 결절상의 증식물이 발견되었다. 진단을 위하여 방사선 검사와 초음파, 일반혈액검사, 혈청 화학분석, 혈액 도말 검사를 실시하였고 증식물은 외과적으로 절제하였다. 절제술 후 얻은 조직 샘플을 10% 중성 포르말린 고정 후 HE 염색하였다. 해당 동물의 혈액 수치는 일반 여우와 크게 다르지 않았다 증식물은 육안으로 보았을 때 주변조직과 잘 구획되어 있었으며 둥글고 하얀 형태였다. 조직 슬라이드 현미경 검사 후 이는 성숙 지방 조직으로 이루어진 지방종으로 진단되었다. 지방종은 반려동물에서 흔히 발생하는 양성 종양이나 현재까지 여우에서는 보고된 적이 없으며, 이 증례는 여우에서 지방종을 종합적으로 진단 평가한 최초 증례이다.

단계적 행위변화 모형을 이용한 자궁경부암 검진행위 관련 요인 분석 - 국가 조기 암검진 대상자들을 중심으로 - (Analysis of Behavioral Stage in Pap Testing by Using Transtheoretical Model)

  • 이혜진;정상혁;신해림;오대규;이선희
    • Journal of Preventive Medicine and Public Health
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    • 제38권1호
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    • pp.82-92
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    • 2005
  • Objective : To evaluate the relationships among sociodemographic characteristics, health behaviors, levels of pros and cons and stages of change in Pap testing for uterine cervical cancer. Methods : A questionnaire survey was performed on 560 randomly sampled people who were assigned to participate in a Pap testing program by the National Cancer Screening Project in 2003' between 25 September and 10 October in Gyeonggi, Korea. Data about the behaviors and intentions of Pap testing, sociodemographic characteristics, health behaviors, and levels of acknowledged benefit (pros) and barrier (cons) for Pap testing was collected. The stages of change were grouped according to behaviors and intentions of Pap testing as passive, active, and relapse. Results : Logistic analysis between the passive and active groups showed that city dwellers, 'high' and 'middle' groups in terms of the individual s health belief, those who had undergone a health examination within the past 2 years, and those who had undergone hormone replacement therapy had a higher odds ratios to be in the active group. As the 'benefit' scores increased and the 'Unnecessity' scores decreased, the probabilities to be in the active group increased. According to the logistic analysis results between the active and relapse groups, those who were 60 years or older, members of the National Heath Insurance, and those who had not undergone a health examination within the past 2 years had a higher odds ratio to be in the relapse group. The 'Benefit' scores were not significant in this relationship. The probabilities of being in the relapse group increased as the Unnecessity and 'Shamefulness' scores increased. Conclusions : In conclusion, health planners should inform women in the passive group of the benefits and necessity of Pap testing. It would be better to reduce the barriers to the active group of undergoing Pap smear. This study might be a useful guide for future planning of Pap testing program.

In vivo와 in vitro에서 상아세관을 통한 색소침투의 차이 (DIFFERENCE IN DYE PENETRATION INTO DENTINAL TUBULES IN VIVO AND IN VITRO)

  • 장인호;김명수;이광원;손호현
    • Restorative Dentistry and Endodontics
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    • 제21권1호
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    • pp.242-253
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    • 1996
  • Penetration degree of several dyes into dentinal tubules in vivo was compared with in vitro, and experimental sensitivity of those dyes was investigated in 64 canines of 16 cats. Dentin 1mm below cusp tip was exposed by cross-sectioning with diamond disc. Pulp of 32 canines were extirpated through cervical cavities. In the presence of smear layer or after add-etching with 37% phosphoric acid to the exposed dentin surface, acrylic collar and resin cap was attached to keep dyes. 52 mmol/$\ell$ Evans' blue, 2% Methylene blue, 10 % Silver nitrate and 5% Fluorescene were then applicated on each 4 canines respectively for 30 minutes. After rinsing, the canines were ground-sectioned longitudinally and linear dye penetration was measured under microscope. The results obtained were as follows ; 1. Evans' blue and Methylene blue penetrated significantly(P<0.05) more in vitro than in vivo only in the cases that exposed dentin surfaces were not etched with acid. 2. Silver nitrate penetrated significantly(P<0.05) more in vitro than in vivo in both cases that exposed dentin surfaces remained intact and were etched with acid. 3. The penetration degree of Fluorescene did not show statistical significance between in vivo and in vitro or in acid-etched and in not acid-etched cases.

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Diagnostic Value of Protein Ki67 (MIB-1) in Atypical Pap Smears of Postmenopausal Women

  • Fakhrjou, Ashraf;Dastranj-Tabrizi, Ali;Ghojazadeh, Morteza;Ghorashi, Sona;Velayati, Atefeh;Piri, Reza;Vahedi, Amir;Sayyah-Melli, Manizhe;Smaeili, Heydar-Ali;Bonakdari, Amir;Halimi, Monireh;Naghavi-Behzad, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권8호
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    • pp.4815-4818
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    • 2013
  • Background: Atrophic epithelium of cervix sampled from postmenopausal women may mimic high-grade cervical intraepithelial neoplasia in Papanicolaou-stained (Pap) smears. Ki-67 (MIB-1) protein presents on proliferating cells, and percentage of cells with positive nuclei provides a reliable tool for rapid evaluation of the growth fraction. The aim of this study was to determine the diagnostic value of protein Ki67 staining in atypical pap smears of postmenopausal women. Methods: In a case-control setting, pap smears of 75 women with an atypical pap smear (case group) and 75 with normal pap smears (controls) were obtained before and after estrogen treatment. Afterward, samples were exposed to the monoclonal antibody Ki-67 (MIB-1) and the immunohistochemically demonstrated Ki-67+ cells were compared. Results: Mean ages of cases and controls were $60.4{\pm}4.5$ and $59.9{\pm}4.3$ years respectively (P=0.50). There was one (2.7%) positive Ki-67 specimen in the case group, without any positive Ki-67 specimen in the control group (P=0.50). Conclusions: Measurement of proliferative activity index in Pap smears restrained with MIB1 is a simple, reliable, and cost-effective method for excluding negatives. This would imply that it might allow a substantial reduction of diagnostic estrogen courses and subsequent Pap smears in postmenopausal women with atypical findings.

유두상 미성숙 화생의 자궁경부 세포진 소견 (Cytologic Features of Papillary Immature Metaplasia of Uterine Cervix)

  • 김혜선;선미임;김의정;김희숙
    • 대한세포병리학회지
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    • 제13권1호
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    • pp.21-27
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    • 2002
  • Papillary immature metaplasia (PIM) of the uterine cervix (Immature condyloma) is a subset of low grade squamous intraepithelial lesion (LSIL) which is frequently associated with human papilloma virus (HPV) types 6 and 11. The histologic features of PIM include filiform papillae lined by evenly spaced immature metaplastic-type cells with frequent nucleoli, mild anisokaryosis, and a low mitotic index. To characterize the cytologic changes associated with PIM, we analyzed 14 cases of PIM from our file. We reviewed biopsy slides and the cervicovaginal smears taken proximate to the time of blopsy. Histologically, nine cases had either flat condyloma (7 cases) or high grade squamous intraepithelial lesion (HSIL) (2 cases). Cytologic changes included cells in various stages of maturation with karyomegaly (14 cases), cells with irregularities in the nuclear membrane (13 cases), intermediate cells with karyomegaly(13 cases), cells with binucleatlon (13 cases), and aborted koliocytes (11 cases) Cervicovaginal smears from all cases were interpreted as atypical squamous cells of undetermined significance (ASCUS), NOS or ASCUS, rule out squamous intraepithelial lesion (SIL) or LSIL in two cases with flat condyloma or HSIL in a case with severe dysplasia. PIM is a distinct histologic entity that can present with a spectrum of cytologic findings, but cytologic findings may resemble variable reactive conditions and immature HSIL. Therefore, it is difficult to diagnose PIM by cytology alone. However, the meticulous efforts for making the cytologic diagnoses which can Induce active management of patients are recommended because PIM is a variant of LSIL and frequently has a flat condyloma or HSIL.

상아질 지각과민 처치제의 적용 중에 일어나는 상아세관액 유동의 실시간 측정 (Real-time measurement of dentinal fluid flow during desensitizing agent application)

  • 김선영;김은주;이인복
    • Restorative Dentistry and Endodontics
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    • 제35권5호
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    • pp.313-320
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    • 2010
  • 연구목적: 본 연구의 목적은 미세 유체 흐름 측정장치를 이용해서 각 상아질 지각과민 처치제의 적용 과정 중 발생하는 상아 세관액 흐름의 유동을 관찰하고, 상아질 지각과민 처치제 간 적용 후 투과도 감소의 차이를 비교하고자 하는 것이다. 연구 재료 및 방법: CEJ 5 mm 하방에서 절단한 소구치를 미세 흐름 측정장치에 연결하여 20 cm $H_2O$의 정수압을 가하였다. 치경부에 상하 3 mm, 근원심 4 mm, 깊이 2 mm의 V자 형태의 5급 와동을 형성하고 smear layer를 제거하기 위해 15초 동안 산 부식한 후 상아질 지각과민 처치제를 적용하였다. 사용된 상아질 지각과민 처치제는 Seal&Protect (SP), SuperSeal (SS), BisBlock (BB), Gluma desensitizer (GL), Bifluoride 12 (BF) 이다. 상아세관액의 흐름은 지각과민 처치제 도포 전부터 도포 후 5분까지 실시간으로 측정되었다. 결과: 실험에 사용한 모든 상아질 지각과민 처치제는 적용 후의 상아세관액 흐름율이 적용 전에 비해 유의하게 감소하였다(p < 0.05). SP는 GL과 BF에 비해 유의하게 투과도 감소가 나타났다 (p < 0.05). SS와 BB는 BF에 비해 유의하게 투과도 감소를 보였다 (p < 0.05). 결론: 지각과민 처치제의 도포 과정 동안 각 처치제의 특징적인 상아세관액의 유동을 미세 유체 흐름 측정장치를 통해 관찰 할 수 있었다.