Tokmak, Aytekin;Guzel, Ali Irfan;Ozgu, Emre;Oz, Murat;Akbay, Serap;Erkaya, Salim;Gungor, Tayfun
Asian Pacific Journal of Cancer Prevention
/
v.15
no.16
/
pp.6639-6641
/
2014
Background: To evaluate the clinical significance of atypical squamous cells of undetermined significance (ASCUS) in PAP test in post-menopausal women and compare with reproductive age women. Materials and Methods: A total of 367 patients who referred to our gynecologic oncology clinic were included to the study between September 2012 and August 2013. Data for 164 post-menopausal (group 1) and 203 pre-menopausal (group 2) women with ASCUS cytology were evaluated retrospectively. Immediate colposcopy and endocervical curettage was performed for both groups and conization for all women with a result suggestive of CIN2-3. Histopathological results and demographic features of patients were compared between the two groups. Results: Mean age of the patients was $54.6{\pm}6.5$ years in group 1 and $38{\pm}6.6$ years in group 2. Some 14 (8.5%) of post-menopausal women and 36 (17.7%) of pre-menopausal women were current smokers (p=011). Totals of 38 (23.2%) post-menopausal and 64 (31.5%) pre-menopausal women were assessed for HPV-DNA. High risk HPV was detected in 7 (4.3%) and 21 (10.3%), respectively (p=0.029). Final histopathological results recorded were normal cervix, low grade cervical intra-epithelial neoplasia (CIN 1), and high grade cervical intra-epithelial neoplasia (CIN2-3). In group 1 results were 84.8%, 12.2% and 1.8%, respectively, and in group 2 were 71.9%, 23.2% and 4.9%. There were no cases of micro invasive or invasive cervical carcinoma in either group. Two cases were detected as endometrial carcinoma in the menopausal group (1.2%). Conclusions: In current study we found that preinvasive lesions were statistically significantly higher in pre-menopausal women than post-menopausal women with ASCUS. Cervicitis was more common in menopausal women. Therefore, we think that in case of ASCUS in a post-menopausal woman there is no need for radical management.
Joung, You Hyun;Lee, Jun Min;Kim, Jong-Wan;Kim, Jae Kyung
Journal of the Korea Convergence Society
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v.13
no.1
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pp.119-129
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2022
Cervical cytology has been widely used as a screening tool for cervical cancer. However, Human papillomavirus (HPV) detection and subtype testing are suggested to overcome the high false-negative rate associated with cytology. We aimed to investigate the clinical usefulness and infection rate in the HPV polymerase chain reaction (PCR) test performed in hospitals. HPV PCR data from 217 patients were analyzed. Analysis of variance revealed a significant difference in the infection rate among different age groups (P=0.015). The biopsy results showed that epithelial cell abnormalities and high HPV-positivity rate was observed in 1 (100%) subject aged <29 years, in 4 out of 5 (80%) patients in their 30s, and in 3 out of 4 (75%) patients aged ≥70 years. The prevalence of HPV infection was very high (46.1%). The highest prevalence (87.5%) was observed among patients in their <29, followed by those in their 30s (67.7%) and those in their 40s (31.9%).A high rate of epithelial cell abnormalities (≥ cervical intraepithelial neoplasia type 1, mild dysplasia) was observed in HPV-infected women aged<30 years. Therefore, extensive research and prevention activities are needed in this age group. HPV PCR testing is recommended to complement cervical cytology
Hwang, Yong Il;Park, Geun Min;Kwon, Sung Youn;Yoon, Ho Il;Lee, Choon-Taek;Han, Sung Koo;Shim, Young Soo;Lee, Jae Ho
Tuberculosis and Respiratory Diseases
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v.63
no.4
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pp.346-352
/
2007
Background: Pulmonary hypertension is one of the cardiovascular complications of in COPD. However, a diagnosis of pulmonary hypertension requires an invasive test, such as right heart catheterization. NT-proBNP is a cardiac hormone that is elevated when a cardiac volume or pressure overload is present. It was hypothesized that NT-proBNP might play a role in detecting of pulmonary hypertension in COPD patients. Method: The 31 COPD patients, who underwent all of NT-proBNP, echocardiography, and spirometry in Seoul National University Bundang Hospital during the period from November 2003 to July 2005, were retrospectively analyzed. Result: Of the 31 COPD patients, 9 patients had pulmonary hypertension. A significant positive correlation was observed between the NT-proBNP and pulmonary arterial pressure (r=0.589, p=0.002). However, there was no significant correlation observed between the $FEV_1$ and NT-proBNP and $FEV_1$ and pulmonary arterial pressure. Conclusion: NT-proBNP might indicate the presence of pulmonary hypertension in COPD patients.
This study was aimed to study the effects of adolescents' outdoor sports and e-sports activities on their holistic health. In order for this, adolescent holistic health has been divided into three categories: physical health, mental health, and social health; and reviewed existing research on outdoor sports and e-sports. The research has found several variables for measuring the correlation between the two types of sports. The variables cover four areas: 1) General Information, determined by gender, age, preferred sport, and length of play; 2) Physical Health, as measured by six questions in the basic PAPS (Physical Activity Promotion System) survey; 3) Mental Health, as measured by stress index, self-efficacy, subjective health, and self-esteem; and 4) Social Health, as measured by variables relating to family, friends, school, and society. A total of 36 questions were devised, with 1-4 questions in each area. Primarily it examined the mental health social health. As a result, it was found that three factors have a difference such that the significance of self satisfaction. family relationships, friendships is 0.064, 0.012, 0.088 respectably.
Background: From January 1989 to December 1996, we analyzed 22 cases of ventricular septal defect associated(VSD) with aortic valvular prolapse. Material and Method: The mean age of the patients was 7 years with a range of 6 months to 22 years . Thirteen patients were male and 9 were female. The types of VSD were Kirklin type I in 13 , Kirklin type II in 8 and Kirklin type I+II in one. Result: The preoperative echocardiographic findings were aortic valvular prolapse in 10 patients, aortic valvular prolapse associated with aortic regurgitation in 6, and only aortic regurgitation in 2. Aortic valvular prolapse were found in operation field in 4 that was not be in preoperative echcardiography. Preoperative mean Qp/Qs, systolic PAP, systolic RVP were 1.48${\pm}$0.42, 27.9${\pm}$9.87, 32.9${\pm}$10.87 mmHg, respectively. Twenty patients underwent patch closure of VSD, and two patients with moderate aortic regurgitation and prolapsed of the aortic valve underwent patch closure of VSD and aortic valvuloplasty. Short and long term echocardiographic follow-up in 8 patients who had preoperative aortic regurgitation were found to have improved or not aggravated by performing VSD patch closure only and patch closure with valvuloplasty in 2. Twelve patients who had only preoperative aortic valvular prolapse had no change in prolapsed valve in postoperative echocardiography. Conclusion: Early closure of VSD with patch is necessary in VSD with aortic valvular prolapse even in associated with mild regurgitation. But in moderate regurgitation, VSD closure with valvuloplasty is recommended.
The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.
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.
This study was attempted to investigate reliability and validity of premenstrual assessment form(PAF). PAF was administered to 230 high school students who had reported premenstrual changes. PAF revealed considerable diversity in premenstrual symtom changes of the subjects. The items with most frequent reported premenstrual changes were 21 items out of 95. Cronbach's internal consistency was .95, and test-retest reliability was .80. Validity test was performed by constructional validation analysis. 8 factors(impulsive & unstable factor, depressive factor, withdrawal & social functioning impairment factor, anxiety & cognitive dysfunction factor, physiological factor, general discomfort factor, increased well-being factor, other factor) emerged at factor analysis. Each of them accounted for 33.97, 5.10, 3.70, 2.93, 2.64, 2.46, 2.12, 2.03 of total variance respectively. High school students experienced impulsive & unstable features of premenstrual symptoms more frequently. This study suggests PAF can be a reliable and valid tool as a initial screening and evaluation of premenstrual changes. finally, factor analysis result was compared with PAF typological categories.
Background: High risk human papillomaviruses (HPVs) are the leading cause of cervical cancer (CC) and Pap smear screening has not been successful in preventing CC in Tunisia. HPV vaccination that targets HPV16 and 18 offers a new efficient prevention tool. Identification of HPV types in CC is thus essential to determine the impact of HPV vaccine implementation. The aim of this study is to provide specific data from Tunisia. Materials and Methods: A total of 89 histological confirmed paraffin embedded samples isolated from patients with CC diagnosed between 2001 and 2011 were collected from five medical centres from Northern and Southern Tunisia. HPV DNA was detected using a nested PCR (MY09/MY11-GP5+/GP6+) and genotyping was assessed using a reverse blot line hybridisation assay that enables the detection of 32 HPV types. Results: HPV DNA was detected in all samples. Twelve high risk types were detected; HPV16 and/or 18 were predominant, accounting together for 92.1% of all the CC cases (HPV16: 83.1%). Single infections accounted for 48.8% of the cases and were mostly linked to HPV 16 (32.6%) and less frequently to HPV 18 (2.4%). The other high risk HPV single infections were linked to HPV 35 (4.6%), 45 (4.6%), 58 (2.3%) and 59 (2.3%). Multiple infections with mixing of 2 to 4 genotypes predominately featrued HPV16 and/or 18 with HPV 35 and 45 (96.6 %) and less frequently with HPV 59, 40, 66, 73 and 58. There was no statistically significant variation in the relative distribution of HPV types with age. Conclusions: These results strongly indicate that prophylactic HPV vaccines can have a major impact in preventing CC in Tunisia.
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.
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