• Journal of the Korea Institute of Information and Communication Engineering
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• v.11 no.10
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• pp.1992-1998
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• 2007

It is important to obtain conn cytodiagnosis to classify background, cytoplasm, and nucleus from the diagnostic image. This study mose an algorithm that detects and classifies carcinoma cells of the uterine cervix in Pap smear using features of cervical cancer. It applies Median filter and Gaussian filter to get noise-removed nucleus area and also applies Kapur method in binarization of the resultant image. We apply 8-directional contour tracking algorithm and stretching technique to identify and revise clustered cells that often hinder to obtain correct analysis. The resulted nucleus area has distinguishable features such as cell size, integration rate, and directional coefficient from normal cells so that we can detect and classify carcinoma cells successfully. The experiment results show that the performance of the algorithm is competitive with human expert.

• Journal of Biomedical Engineering Research
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• v.22 no.3
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• pp.231-239
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• 2001

This paper proposes a region segmenting method for the Pap-smear image. The proposed method uses a pixel classifier based on neural network, which consists of four stages : preprocessing, feature extraction, region segmentation and postprocessing. In the preprocessing stage, brightness value is normalized by histogram stretching. In the feature extraction stage, total 36 features are extracted from $3{\times}3$ or $5{\times}5$ window. In the region segmentation stage, each pixel which is associated with 36 features, is classified into 3 groups : nucleus, cytoplasm and background. The backpropagation network is used for classification. In the postprocessing stage, the pixel, which have been rejected by the above classifier, are re-classified by the relaxation algorithm. It has been shown experimentally that the proposed method finds the nucleus region accurately and it can find the cytoplasm region too.

• The Korean Journal of Cytopathology
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• v.12 no.1
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• pp.31-37
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• 2001

Whlie cytologic characteristics of squamous dysplasia, carcinoma in situ, and invasive squamous cell carcinoma of the uterine cervix are well documented, relatively few studios have dealt with the cellular features of microinvasive carcinoma. In order to describe the cellular characteristics of microinvasive squamous cell carcinoma, we retrospectively reviewed 45 cervovaginal smears(15 carcinoma in situ, 15 microinvasive cancer, 15 invasive cancer) which were confirmed by histologic examination of specimens obtained by hysterectomy at the Seoul National University Hospital during S years from 1995 to 1999. The cytologic features about tumor diathesis, inflammatory background, ceil arrangement, anisonucleosis, nuclear membrane irregularity, nuclear chromatin pattern, and nucleoli were observed. The cytologlc characteristics of microinvasive squamous cell carcinoma of the uterine cervix are syncytial pattern, mild tumor diathesis, the irregularity of nuclear membrane, irregularly distributed nuclear chromatin, and occurrence of micronucleoli. But, correlation between the depth of Invasion and the cytologic feature had limited value.

• Journal of Preventive Medicine and Public Health
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• v.7 no.2
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• pp.367-372
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• 1974

Authors reviewed 2,362 cases of consecutive vaginal and cervical smears submitted to the Department of Pathology, Pusan Gospel Hospital during one year period from Jan. 1, 1974 to Dec. 31, 1974. Prevalence of dysplasia, carcinoma in situ and invasive carcinoma of the uterine cervix was analyzed, and cost per a lesion was calculated. The followings are conclusions: 1. Prevalence of dysplasia, carcinoma in situ and invasive carcinoma was 2.88%, 0.34% and 2.58% restectively. 2. Cost per a lesion for dysplasia was calculated as 34,735 Won, for carcinoma in situ, as 295,250 Won and for invasive carcinoma as 38,721 Won. Cost per a lesion for dysplasia and carcinoma in situ was calculated as 31,079 Won and for dysplasia and for all the lesions as 17,248 Won. 3. The results obtained suggested that mass cytologic screeiding for detection of dysplasia, carcinoma in situ and invasive carcinoma was reasonable in the present status of economy.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• v.9 no.2
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• pp.403-407
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• 2005

자궁 경부 세포진 영상의 핵 영역 분할은 자궁 경부암 자동화 검색 시스템의 가장 어렵고도 중요한 분야로 알려져 있다. 본 논문에서는 자궁 경부 세포진 영상에서 HSI 모델을 이용하여 세포진 핵 영역을 추출한다. 추출된 세포진 핵 영역은 형태학적 정보(morphometric feature)와 명암 정보(densitometric feature), 색상 정보(colorimetric feature), 질감 정보(textural features)를 분석하여 핵의 특징을 추출한다. 또한 Bethesda System에서의 분류 기준에 따라 핵의 분류 기준을 정하고 추출된 핵의 특징들을 퍼지 c-Means 클러스터링 알고리즘에 적용하여 실험한 결과, 제안된 방법이 자궁 세포진 핵 추출과 인식에 있어서 효율적임을 확인하였다.

• The Korean Journal of Cytopathology
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• v.13 no.1
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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.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.3997-4003
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• 2014

Background: Infection with certain human papillomavirus (HPV) genotypes is the most important risk factor related with cervical cancer. The objective of the present study was to investigate the prevalence of HPV infection, the distribution of HPV genotypes and HPV E6/E7 oncogene mRNA expression in Turkish women with different cervical cytological findings in Mersin province, Southern Turkey. Materials and Methods: A total of 476 cytological samples belonging to women with normal and abnormal cervical Pap smears were enrolled in the study. For the detection and genotyping assay, a PCR/direct cycle sequencing approach was used. E6/E7 mRNA expression of HPV-16, 18, 31, 33, and 45 was determined by type-specific real-time NASBA assay (NucliSENS EasyQ$^{(R)}$HPV v1.1). Results: Of the 476 samples, 106 (22.3%) were found to be positive for HPV DNA by PCR. The presence of HPV was significantly more common (p<0.001) in HSIL (6/8, 75%) when compared with LSIL (6/14, 42.9%), ASC-US (22/74, 29.7%) and normal cytology (72/380, 18.9%). The most prevalent genotypes were, in descending order of frequency, HPV genotype 66 (22.6%), 16 (20.8%), 6 (14.2%), 31 (11.3%), 53 (5.7%), and 83 (4.7%). HPV E6/E7 oncogene mRNA positivity (12/476, 2.5%) was lower than DNA positivity (38/476, 7.9%). Conclusions: Our data present a wide distribution of HPV genotypes in the analyzed population. HPV genotypes 66, 16, 6, 31, 53 and 83 were the predominant types and most of them were potential carcinogenic types. Because of the differences between HPV E6/E7 mRNA and DNA positivity, further studies are required to test the role of mRNA testing in the triage of women with abnormal cervical cytology or follow up of HPV DNA positive and cytology negative. These epidemiological data will be important to determine the future impact of vaccination on HPV infected women in our region.

• The Korean Journal of Cytopathology
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• v.18 no.1
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• pp.1-12
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• 2007

Approximately 70% of cervical cancers are caused by HPV types 16/18 and thus the implementation of vaccination programmes with vaccines against HPV types 16/18 will have a major impact on the incidence of cervical cancer worldwide. However, this reduction will not be seen until several decades after full implementation of such vaccination programmes since the vaccines must be given to young adolescents before exposure to the virus and women who are already sexually active are not likely to be protected. Both GSK and Merck insist that even vaccinated women must continue to participate in regular cervical screening by the most sensitive method available since the vaccine can only give protection against up to 70% of cervical cancers. It is unlikely that the current vaccines will be modified to include additional high risk HPV types in the foreseeable future. While HPV testing is highly sensitive, it is not recommended for women under 30 years of age nor for vaccinated women. Additionally, HPV testing has poor specificity. The Digene Hybrid Capture 2 test is licensed for use only in conjunction with a cytology test, not as a stand-alone test, and the high risk panel has recognised cross reactivity with low risk HPV types. None of the other HPV test methods currently commercially available are FDA approved and all must be internally validated before use. This makes comparison of test results between laboratories difficult. The most sensitive and specific screening test currently available for women of all ages is the Cytyc ThinPrep System consisting of the ThinPrep Pap Test (TPPT) and the ThinPrep Imaging System (Imager). The TPPT was the first LBC system approved by the US FDA in 1996 and there are about 4,000 processors in use worldwide. The Imager was FDA approved in 2003 and over 350 systems are in routine use, mainly in the US. 40% of TPPT in the US are processed on Imager. There is clear evidence in peer reviewed literature that the Imager increases laboratory productivity by 100% and growing evidence that Imager detects more high grade SIL than the conventional smear or manual evaluation of TPPT. This aspect is particularly important since the number of cytological abnormalities will decrease as vaccination programmes are implemented. Cytotechnologists will see fewer and fewer abnormal smears and their skills will be put at risk. By doubling throughput, Imager will allow cytotechnologists to maintain their skills.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.579-583
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• 2015

This study was conducted on female patients with different gynecological problems attending the gynecology out-patient departments of two tertiary care hospitals in Peshawar city of Khyber Pakhtunkhwa, Pakistan between August 2012 and October 2013. The 200 patients had an age range of 21-65 years. Smears were taken with cervical brushes and preserved in preservative medium and processed for manual liquid based cytology (MLBC) for Pap staining. Out of 200 collected samples, 30 samples were found inadequate on cytology. Of the remaining 170 samples, 164 (96.47%) were normal, 5 (2.94%) were of atypical squamous cells of unknown significance (ASCUS) and 1 (0.6%) was of high grade squamous intraepithelial lesion (HSIL). On PCR all the samples were positive for beta globin gene fragment including those reported inadequate on cytology. Out of the 5 ASCUS samples, 2 samples were positive for HPV, one each for HPV 16 and HPV 18, and the rest of the 3 samples were negative for HPV DNA. The 1 sample of HSIL was positive for HPV 16 on PCR. Out of 164 normal samples on cytology, only 1 sample was HPV 16 positive. So overall, 4 (2%) out of 200 samples were positive for HPV DNA, where 3 were HPV 16 (1.5%), and 1 was HPV 18 (0.5%) positive, and thus the ratio of infection with of HPV 16 to HPV 18 was 3:1 in the general population. In conclusion, PCR based HPV detection is a more sensitive method for screening of HPV infection than cytology as sample inadequacy does not affect the results. However, it can be combined with cytology methods in a HPV positive female to achieve the maximum results.

• The Korean Journal of Cytopathology
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• v.18 no.1
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• pp.87-91
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• 2007

Langerhans cell histiocytosis (LCH) is a pleomorphic disease entity characterized by local or disseminated atypical Langerhans cells (LCs) found most commonly in bone, lungs, mucocutaneous structures and endocrine organs. Among different sites, unifocal disease confined to a lymph node (LN) is rare. We report a case of LCH confined to a LN in a 38-year-old male who presented with a 2 cm-sized cervical mass. The fine needle aspiration (FNA) smears of cervical LN showed high cellularity having isolated LCs with contorted nuclei and nuclear grooves mixed in multinucleated giant cells, small lymphocytes and eosinophils. Charcot-Leyden crystals were also seen, as were a few dendritic-like cells and intranuclear inclusions. Confirmation of LCH was made by histopathologic studies, positive reactions for S-100 protein and CD1a immunohistochemical staining and by the demonstration of Birbeck granules on electron microscopy. The differentials to be considered include dermatopathic lymphadenitis, sinus histiocytosis with massive lymphadenopathy, Hodgkin's lymphoma and malignant histiocytosis. The characteristic cytomorphologic pattern of LCH in a LN FNA smear plays an important role in suggesting the diagnosis of LCH.