• Korean Journal of Clinical Laboratory Science
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• v.38 no.2
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• pp.99-104
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• 2006

Human Papilloma viruses (HPVs) are etiological agents for cervical cancer and are classified into low- and high-risk categories. The aim of this study was to determine the frequency of the HPV genotype in the HPV screening test of Korean women using PCR-direct sequencing. Consensus primers of L1 legion were used for the amplification of HPV DNA and the PCR products (450 bps) obtained were analyzed by automatic sequencing. Sequences were compared with those in GenBank by using the BLAST program. Cervical swab samples of 3,978 women (20-73 years) were tested and the average age was 37.6 years. In this study, 1,174 samples were HPV positive out of 3,978 cervical swab samples screened (29.5%) and 136 samples (11.6%) showed a double infection. A total of 1,310 HPV genotypes were analyzed. The HPV positive rate was the lowest in the 20 years group (69.5%) and most of the samples of the > 60 years group were found HPV positive. Among thirty seven different HPV types identified by sequencing, 21 were HPV high risk types and 16 HPV low risk types were 69.8% (914/1,310) and 26.0% (340/1,310), respectively. In HPV high-risk types, 16 (13.21%), was the most frequently found. HPV 53 (9.62%) and 58 (9.24%) were also frequently found. This group was followed by HPV types 70 (5.50%), 33 (4.73%), 66 (4.20%), 18 (4.05%), 52 (4.05%), 31 (3.97%) and 56 (3.51%) in descending order of frequency. Among HPV low-risk types, 62 (4.20%), 6 (3.59%), 81 (3.59%), 84 (3.51%), and 11 (2.6%) were frequently found. In conclusion, PCR-direct sequencing could be used for quick and reliable typing of known and novel HPVs from clinical specimens. This data could be useful for epidemiological study of HPV and it also allows type-specific follow-up of women who have been treated for cervical intraepithelial neoplasia.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.271-276
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• 1991

A series of 510 patients with carcinoma of the uterine cervix given the curative radiation therapy from March 1979 through December 1986 was evaluated to determine the value of intravenous pyelography (IVP), cystoscopy, sigmoidoscopy, and abdomino-pelvic CT as staging work-up prior to treatment. On IVP and cystoscopy, $10.7\%$(49/456) and $5.3\%$(24/452) showed abnormality, respectively, but only $0.7\%$(3/413) did on sigmoidoscopy. As a result of these work-ups prerequisite to FIGO staging, twenty six ($5.1\%$) out of 510 patients were upstaged from the stage determined by the findings of physical examination alone. The proportions of upstaging in each stage were as follows; none in stage IB (35), IIA (89) and IIIA (8), $7.9\%$(20/252) in stage IIB (14 patients to FIGO stage IIIB, 6 patients to FIGO stage IVA), and $4.8\%$(6/126) in stage IIIB (all to FIGO stage IVA). Positive findings of staging work-ups were found only in patients with advanced stages of stage IIB or over determined by physical examination alone but not in those with earlier stages. CT was performed in 337 patients. CT detected pelvic lymph node (LN) enlargement in $25.2\%$ (85/337) and paraaortic LN enlargement in $7.4\%$(25/337). Pelvic LN positivity was well correlated with increasing stage but paraaortic LN positivity was not. In the evaluation of parametrial involvement, CT findings were in accordance with those of physical examination only in $65.6\%$ (442/674). When compared with endoscopic studeies, CT had much lower positive predictive value than negative predicitive value in the evaluation of adjacent organ invasion. The staging work-ups should be individualized by the disease extent of each patient, and then the efficiency of work-uus may be increased without compromising the appropriate FIGO staging and treatment.

• Radiation Oncology Journal
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• v.27 no.1
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• pp.15-22
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• 2009

Purpose: This study was designed to evaluate the effects on bone mineral density (BMD) and related factors according to the distance from the radiation field at different sites. This study was conducted on patients with uterine cervical cancer who received pelvic radiotherapy. Materials and Methods: We selected 96 patients with cervical cancer who underwent determination of BMD from November 2002 to December 2006 after pelvic radiotherapy at Kosin University Gospel Hospital. The T-score and Z-score for the first lumbar spine (L1), fourth lumbar spine (L4) and femur neck (F) were analyzed to determine the difference in BMD among the sites by the use of ANOVA and the post-hoc test. The study subjects were evaluated for age, body weight, body mass index (BMI), post-radiotherapy follow-up duration, intracavitary radiotherapy (ICR) and hormonal replacement therapy (HRT). Association between the characteristics of the study subjects and T-score for each site was evaluated by the use of Pearson's correlation and multiple regression analysis. Results: The average T-score for all ages was -1.94 for the L1, -0.42 for the L4 and -0.53 for the F. The average Z-score for all ages was -1.11 for the L1, -0.40 for the L4 and -0.48 for the F. The T-score and Z-score for the L4 and F were significantly different from the scores for the L1 (p<0.05). There was no significant difference between the L4 and F. Results for patients younger than 60 years were the same as for all ages. Age and ICR were negatively correlated and body weight and HRT were positively correlated with the T-score for all sites (p<0.05). BMI was positively correlated with the T-score for the L4 and F (p<0.05). Based on the use of multiple regression analysis, age was negatively associated with the T-score for the L1 and F and was positively correlated for the L4 (p<0.05). Body weight was positively associated with the T-score for all sites (p<0.05). ICR was negatively associated with the T-score for the L1 (p<0.05). HRT was positively associated with the T-score for the L4 and F (p<0.05). Conclusion: The T-score and Z-score for the L4 and F were significantly higher than the scores for the L1, a finding in contrast to some previous studies on normal women. It was thought that radiation could partly influence BMD because of a higher T-score and Z-score for sites around the radiotherapy field. We suggest that a further long-term study is necessary to determine the clinical significance of these findings, which will influence the diagnosis of osteoporosis based on BMD in patients with cervical cancer who have received radiotherapy.

• 건강소식
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• v.19 no.8 s.201
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• pp.14-17
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• 1995

한국건강관리협회 경기도지부가 경기도비의 지원을 받아도 보건과, 한양의대 예방의학교실과 함께 수원시 김포군을 비롯한 8개 지역 주민 5천명을 대상으로 각종 성인병, 자궁경부암, 위암 이동검진을 실시하고 있다. 지난 7월까지 3천7백여 명의 주민이 이검진에서 건강검사를 받았다. 지난 해7월 도비지원으로 국내 최초로 특수검진장비까지 장착된 이동검진버스를 도입함으로써 지역주민 건강검진에 큰 성과를 거둔 건협 경기지부는 이번 사업을 통해 우리나라의 체계적인 집단검진 실시에 새로운 계기를 마련했다는 평가를 받고 있다. 특히 이번 검진사업에서는, 결과를 토대로 지역주민 위암 발병률 조사와 이상자에 대한 관리대책 등도 수립될 계획이어서 앞으로 우리나라 위암 검진 및 관리에 많은 도움을 줄 것으로 기대된다.

• Proceedings of the Korea Information Processing Society Conference
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• 2006.11a
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• pp.609-612
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• 2006

본 연구는 진단용 DNA 칩의 자동판독 시스템을 제안하는 것을 목적으로 한다. 일반적인 자동판독 시스템의 사양을 정의하고 그 구현방법을 제안하였다. 응용 예로서 자궁경부암 진단용 DNA 칩을 대상으로 GenePix 스캐너 프로그램 환경에 적용하였다. 영상획득은 GenePix 의 라이브러리를 사용하여 HTML 언어로 구현하였고, 영상의 판단과 보고서 생성은 Microsoft Visual C++ 6.0를 사용하여 COM 형태로 구현하였다. 결과 보고서는 한글 2002 문서에 환자 정보와 결과 정보 등에 해당하는 곳에 미리 정의된 표지문자열들을 삽입하여 템플릿을 만들었다. 판독 시스템은 템플릿을 읽어들여 처리 결과의 내용으로 표지문자열들을 치환하여 보고서를 생성하였다. 제안한 시스템을 통해서 스캐닝을 통한 영상획득, 영상읠 판독, 결과 보고서 생성으로 구성된 전체 판독과정이 사용자의 개입 없이 자동으로 처리될 수 있었다. 본 시스템은 기존에 수작업을 자동화여 판독 시간을 단축하고 판독 기준을 정량화하여 진단용 DNA 칩이 대량검사 활용되는 공헌할 것으로 기대된다.

• Radiation Oncology Journal
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• v.7 no.1
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• pp.59-70
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• 1989

Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still $44\%$ of patient will develop recurrent cancer. This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen Which is $5500\~1000 CGy$ higher than Other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was $46\%$, but only 1 patient $(1\%)$ had operative treatment because of incomplete obstruction of small bowel. Most symptoms appeared within 12 months and most common complaints were frequent bowel movement. Barium enema and sigmoidoscopy were performed for persistent symptomatic patients. Only one patient had abnormal finding in barium enema which showed inefficiency of this method for detecting bowel complication. Patient's age, total tumor dose, total TDF, rectal dose were not significant risk factors for complication, but boost dose, previous history of operation had some relationship with complication risk. Even though dose of point A and rectum is $500\~1,000cGy$ higher than other institution, such a low rate of severe complications may suggest that fear of complications should not be overestimated than cure rate and the possibility of more aggressive treatment for better local control should not be underestimated.

• Journal of Korean Public Health Nursing
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• v.31 no.1
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• pp.135-148
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• 2017

Purpose: This study was conducted to predict the effects of behavioral intention on pap screening tests in unmarried college women using a path model. Methods: The study subjects were 216 university students and data were collected through self-report questionnaires including knowledge, attitude, subjective norms, perceived behavioral control, behavioral intentions to take the Pap test, and health responsibility. Results: Knowledge regarding the Pap test was moderate. The factors of knowledge, attitude, and perceived behavioral control negatively influenced the behavioral intention of the Pap test. However, the factors of subjective norms and health responsibility positively influenced behavioral intention. Conclusion: Subjective norms are the most importance factor to increase the intentions of the Pap test among unmarried college women. It is also necessary to eliminate barriers to undergoing pap testing, as well as to provide nursing intervention to obtain correct knowledge and a positive attitude regarding the Pap screening test.

• Women's Health Nursing
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• v.16 no.4
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• pp.317-325
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• 2010

Purpose: This study was to examine the differences in health belief variables and HPV (Human Papillomavirus) knowledge in Pap smears according to the stages of change using Trans-theoretical Model (TTM) among married nurses. Methods: The research design was a cross sectional survey. Participants were 387 married nurses working in general hospital located metropolitan city. Measurement variables were perceived threatening, perceived severity, benefits of Pap, HPV knowledge and stages of the change in Pap smear. Results: Classified stages were pre-contemplation 3.9%, contemplation 17.8%, relapsing 29.5%, action 31.0%, and maintenance 17.8%. Accuracy rate of HPV knowledge were low ranging from 15% to 45%. Among the variables, perceived threatening (F=3.56, p=.007), perceived severity (F=9.73, p<.001) and HPV knowledge (F=7.52, p<.001) were significantly different by stages of change. Conclusion: Application of TTM to Pap smears was efficient to know the nurse's level of health behaviors, Health belief variables and HPV knowledge were main factors to identify the stages of change. The continuation of Pap smears and the education in relation to HPV knowledge should be encouraged for married nurses.

• 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 the Korea Institute of Information and Communication Engineering
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• v.13 no.8
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• pp.1699-1704
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• 2009

If detected early enough, cervical cantor may have a good survival rate due to its preneoplastic state. However, the process is so time consuming that a medical expert can handle only a small amount of such examinations. In this paper, we propose a new nucleus extraction algorithm for uterine cervical pap smears in order to mitigate such burdens of medical experts. In the preneoplastic state cytodiagnosis images, it is important to differentiate three main areas - background, cytoplasm and nucleus. Thus, we apply lighting compensation and $3{\times}3$ mask of B channel in order to restore damaged image and remove noises respectively. The cell object is obtained from those clean binarized images with Grossfire algorithm. When there are clusters of cells, the target nucleus can be obtained with repetitive binarization of R channel brightness. In our experiment of using uterine cervical pap smears of 400 magnifications that is common in the diagnostic cytology, our method is able to extract 40 nucleus out of 45 population successfully.