Micro-Structural Profiles of Trabecular Bone at the Ankle Joint / 대한족부족관절학회지

PURPOSE: This study aimed to investigate and compare the micro-structural profiles of trabecular bone from different facets at the ankle joint. MATERIALS AND METHODS: In a fresh cadaver ankle, four cored 10 mm of diameter cylindrical specimens of trabecular bone were harvested from the distal tibia, the talar dome, the medial malleolus, and the lateral malleolus. Using a micro-computed tomography, two-dimensional and three-dimensional micro-structural indices of the trabecular bone were analyzed. RESULTS: Each specimen from the tibia, talus, medial malleolus, and the lateral malleolus showed unique micro-structural pattern. Tibia versus talus, the talus was seen a higher bone volume fraction and a wider supporting zone subchondrally whereas the tibia was seen a relatively lower bone volume fraction and a much narrower supporting zone subchondrally. Lateral malleolus versus medial malleolus, the lateral malleolus was seen the thicker but sparse trabeculae pattern whereas the medial malleolus was seen the thinner but more compact trabecular pattern. CONCLUSION: Each four locations from the different facet at the ankle joint have distinct own micro-structural patterns of the trabecular bone, suggesting different mechanical properties.

Difference of the Sagittal Configuration of the Ankle Joint between the Lateral and the Medial Segment / 대한족부족관절학회지

PURPOSE: Anatomic configuration of the ankle joint is useful information during various ankle procedures. This study was prospectively designed to investigate the sagittal inclination pattern of the ankle joint. MATERIALS AND METHODS: Lateral standing ankle radiographs from one-hundred people (age: 17~68, M:F=45:55) and magnetic resonance (MR) sagittal ankle images from twenty-four people (age: 16~65, M:F=14:10) were studied. Post-traumatic, arthritic, or grossly deformed ankles at any reason were excluded. The posterior inclination angle (PIA) of the distal tibia was measured and compared between the lateral and the medial segment. RESULTS: On plain radiographic data, the average PIA of the distal tibia was 6.14 degrees +/-3.56 degrees (range 0 degree to 14 degrees) in the lateral segment and 13.16 degrees +/- 3.05 degrees (range 6 degrees to 22 degrees) in the medial segment. On MR imaging data, the average PIA of the distal tibia was 5.08 degrees +/- 4.26 degrees (range 1 degree to 10 degrees) in the lateral segment and 10.16 degrees +/- 4.87 degrees(range 5 degrees to 17 degrees) in the medial segment. The PIA between two segments was significantly different. CONCLUSION: The sagittal configuration of the medial area ankle joint and the lateral area ankle joint has difference in the degree of posterior inclination and shape of curvature.

PAP Smear: Analysis of 10 Years Results (1992-2001) / 대한산부인과학회잡지

OBJECTIVE: To investigate the efficacy of PAP smear as a screening tool for cervical cancer by evaluating the result of a review of 34,970 cases of PAP smear at Pohang St. Mary's Hospital. METHODS: From January, 1992 to December, 2001 cytologic examination of 34,970 women were analysed and the results were reviewed. RESULTS: 1. The average of annual screening rate was 14.8%. 2. Abnormal cytology rate was 2.02% including 1.02% of ASCUS, 0.99% of class III, 0.20% of class IV and 0.30% of class V. 3. 8.28% of the women screened were aged less than 30 years, 31.8% or=70 years respectively. 4. Of the 188 patients who had a cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS), 127 (68%) were followed up, 99 (78%) were normal and 28 (22%) had squamous intraepithelial lesion. 5. The prevalence rate of cervical neoplasia confirmed by histopathology for the past 10 years was 1.53%. Of those the rate of invasive cervical cancer was 0.65%. 6. The false negative rate was 17.3% and false positive rate was 4.5%. 7. The sensitivity and specificity and positive predictive value of PAP smear were 82.7%, 95.5% and 90.2%. CONCLUSION: For PAP smear to be early detecting tool for cervical cancer, continuous effort is required to raise annual screening rate, to lower the false negative rate, and to raise the sensitivity of PAP smear.

A Case Report of Arteriovenous Malformation of Uterus / 대한산부인과학회잡지

Although arteriovenous malformation (AVM) of the uterus is a very rare cause of menometrorrhagia or postmenopausal vaginal bleeding, it is notable to think in the assessment of a woman with abnormal uterine bleeding because correct diagnosis can yield proper therapy to be designed and avoid hysterectomy in women who want to continue their reproductive capacity. AVM may be congenital or acquired. In times past, the diagnosis is usually made after hysterectomy, but currently it may be made before treatment by ultrasound, pelvic angiography, or magnetic resonance imaging. We have experienced one case of AVM of uterus, which is diagnosed after hysterectomy.

The Role of Cold Knife Conization in Cervical Neoplasia / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study is to evaluate the role of cold knife conization in the diagnosis and treatment of cervical neoplasia. METHODS: Sixty patients were divided into diagnostic and therapeutic conization group and then indication of conization, PAP smear, colposcopy directed biopsy, cone margin and residual lesion of each group were compared respectively. RESULTS: If the difference of PAP and colposcopy directed biopsy was 2 grades or more, upper limit of the lesion was invisible, squamocolumnar junction was not seen, PAP V or invasive cancer was suspected, diagnostic conization was performed in 22 patients. Six cases of follow-up group had cone margin (-) and no recurrence. Sixteen cases of immediate TAH (total abdominal hysterectomy) group had 2 cases of cone margin (+) with residual disease. There were 4 cases of cone margin (-) with residual lesion. If the difference of PAP and colposcopy directed biopsy was 1 grade or less, upper limit of the lesion was visible, squamocolumnar junction was seen and invasive cancer was ruled out, therapeutic conization was performed in 38 cases. All of therapeutic conization group had cone margin (-). Thirty two cases were follow up group and six cases were immediate TAH group. Three of follow up group had recurrences and delayed TAH was performed. There was no residual lesion in the specimen of immediate TAH group. CONCLUSION: The precise dignosis and treatment of cervical neoplasia was capable with cold knife conization. The more aggressive lesion or the more cases of cone margin (+) was diagnosed, the more residual lesion was found. Thorough follow up should be done after treatment of cervical neoplasia because of the possibility of residual disease even after documentation of cone margin (-).