The efficacy of HPV DNA chip test in the atypical squamous cell of undetermined significance / 부인종양

OBJECTIVE: This study was performed to investigate the efficacy of DNA chip method for detecting and genotyping of human papillomavirus (HPV) and screening of high-grade CIN (cervical intraepithelial neoplasia) or invasive cancer in the patients with atypical squamous cells of undetermined significance (ASC-US). METHODS: This study was based on 131 cases to be revealed ASC-US by Pap smear for the cervical cancer screening from July 2004 to Octorber 2004. They were evaluated by HPV DNA chip test, Cervical colposcopy and directed biopsy, and cone biopsy. The results of type 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 54, 56, 58, 59, 66 and 68 in HPV DNA chip test were categorized as high risk HPV. We evaluate the detection rate of the high-grade CIN and invasive cancer by HPV DNA chip test. RESULTS: The incidence of high risk HPV DNA was 51.1% (67/131). Twelve of 131 (9.2%) were diagnosed as high-grade CIN or CIS on histology. The detection rate of high risk HPV DNA in high-grade CIN and invasive cancer was 83.3% (10/12). The detection rate of high risk HPV DNA was 36.0% (31/86) in normal or reactive, and 83.3% (10/12) in CIN II or above on histology. Higher the grade of biopsy, more the detection rate of high risk HPV DNA by HPV DNA chip test. CONCLUSION: The use of HPV DNA chip test in patients with ASC-US may be useful in detection of high-grade CIN or invasive cancer.

Anesthetic Management of Bronchopulmonary Lavage in Pulmonary Alveolar Proteinosis: A case report / 대한마취과학회지

Pulmonary alveolar proteinosis (PAP) is a noninflammatory diffuse lung disease, characterized by a dense accumulation of lipoproteinaceous material within the alveoli, causing hypoxemia, restrictive lung disease, and abnormalities on chest radiograph. The etiology of PAP is uncertain and various forms, including idiopathic and disease secondary to dust or fume exposure. Bronchopulmonary lavage (BPL) is a safe and effective treatment in PAP, and a unique procedure which requires general anesthesia and separation of the lung with a double lumen endobronchial tube. We experienced anesthetic management of BPL for the successful treatment of a 33 years old female patient with PAP.

The Effect of Continuous Intravenous Infusion of Ketamine in the Treatment of Post-Herpetic Neuralgia: Three cases report / 대한마취과학회지

Herpes zoster infections are frequently complicated by a postherpetic neuropathy. Postherpetic neuralgia is one of the most troublesome disease in pain clinic. Current therapy includes tricyclic antidepressant, anticonvulsants, sympathetic and somatic nerve blocks, and transcutaneous electrical nerve stimulation(TENS). However, in a number of case, the illness dose not respond to treatment very well. The N-methyl-D-aspartate(NMDA) receptor is one of the receptor subtypes of the excitatory amino acids(EAA) glutamate, and seems to play a significant role in the pathogenesis of nerve injury pain and neuropathic pain. The non-competitive NMDA receptor blocker ketamine reduced continuous and evoked pain in patients with injury of the peripheral or central nervous system. We present three cases in which patients suffering from postherpetic neuralgia did not respond to conventional therapy and in whom continuous intravenous infusion of ketamine reduced severe pain.