Early Diagnosis of Aseptic Meningitis in Ramsay Hunt Syndrome on 10-Minute Delayed CE 3D FLAIR Image: a Case Report

Ramsay Hunt syndrome (RHS) is a disease caused by varicella-zoster virus (VZV) infection that can be diagnosed through clinical symptoms with or without imaging evaluations. The typical features of RHS on imaging evaluation include signal changes and enhancement in the internal auditory canal (IAC) nerves, and the labyrinthine segment of cranial nerve VII (CN VII) and cranial nerve VIII (CN VIII). In some patients, inner ear structure (cochlear and vestibular apparatus) is involved in RHS. Neurologic complications, such as encephalitis and meningitis, are rare in RHS, but are known to occur. Therefore, magnetic resonance imaging (MRI) is necessary to detect both abnormal signal intensity in the IAC, CN VII, CN VIII, inner and ear structure, and CNS complications. We report an RHS patient with CN VII, VIII, and leptomeningeal enhancement within the cerebellar folia on 10-min delayed, contrast-enhanced (CE), three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging.

Early Diagnosis of Aseptic Meningitis in Ramsay Hunt Syndrome on 10-Minute Delayed CE 3D FLAIR Image: a Case Report

Ramsay Hunt syndrome (RHS) is a disease caused by varicella-zoster virus (VZV) infection that can be diagnosed through clinical symptoms with or without imaging evaluations. The typical features of RHS on imaging evaluation include signal changes and enhancement in the internal auditory canal (IAC) nerves, and the labyrinthine segment of cranial nerve VII (CN VII) and cranial nerve VIII (CN VIII). In some patients, inner ear structure (cochlear and vestibular apparatus) is involved in RHS. Neurologic complications, such as encephalitis and meningitis, are rare in RHS, but are known to occur. Therefore, magnetic resonance imaging (MRI) is necessary to detect both abnormal signal intensity in the IAC, CN VII, CN VIII, inner and ear structure, and CNS complications. We report an RHS patient with CN VII, VIII, and leptomeningeal enhancement within the cerebellar folia on 10-min delayed, contrast-enhanced (CE), three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging.

Primary Central Nervous System Involvement in Peripheral T-Cell Lymphoma:A Case Report

Primary central nervous system T-cell lymphoma (PCNSTL) is an extremely rare type of brain tumor. There are only few reports on the imaging findings of patients with PCNSTL. Herein, we report the imaging findings of a patient with peripheral T-cell lymphoma-not otherwise specified that presented with numerous small nodular and patchy strongly enhancing lesions on MRI.

Clinical Changes after Switching from Ranibizumab/Aflibercept to Bevacizumab in Exudative Age-related Macular Degeneration

PURPOSE: This study was performed to investigate the changes in clinical findings after switching from ranibizumab or aflibercept to bevacizumab due to the limited number of insured injections in patients with exudative age-related macular degeneration (ARMD). METHODS: The study population consisted of patients who had undergone intravitreal injection of ranibizumab or aflibercept for ≥ 6 months and were then treated with bevacizumab for ≥ 6 consecutive months for exudative ARMD. We evaluated best-corrected visual acuity, central subfield macular thickness, disease activity, and the number of injections for one year at the time of switching the drugs. RESULTS: Forty patients (26 men and 14 women) were included in the analysis. The mean age was 71.9 (56-89) years old, with typical ARMD in 23 eyes, polypoidal choroidal vasculopathy in 15 eyes, and retinal angiomatous proliferation in two eyes. The number of injections for 6 months increased from 2.3 to 2.9 after switching the drugs (p < 0.001). Visual acuity was not significantly different between 6 months before and at the time of switching (LogMAR 0.55 ± 0.34 and 0.52 ± 0.27, respectively) (p = 0.300), but decreased significantly to 0.57 ± 0.34 at 6 months after switching (p = 0.018). There were no significant differences in central subfield macular thickness or disease activity. CONCLUSIONS: Bevacizumab required more injections to achieve similar anatomical outcomes in patients with exudative ARMD treated with ranibizumab or aflibercept, and visual acuity decreased despite anatomical stability.

Human papillomavirus genotype-specific risk in cervical carcinogenesis / 부인종양

OBJECTIVE: To evaluate the risk of genotype-specific human papillomavirus (HPV) infections for the spectrum of cervical carcinogenesis and the distribution of HPV types according to age and different cervical lesions METHODS: This study included HPV-positive women who underwent cervical biopsy at the Cheil General Hospital & Women's Healthcare Center between July 1, 2011 and December 31, 2017. HPV genotyping was conducted using a Cheil HPV DNA chip kit. RESULTS: The study sample consisted of 400 normal, 399 cervical intraepithelial neoplasia (CIN) 1, 400 CIN 2, 400 CIN 3, and 389 cervical cancer cases. HPV 16 was the most common type found with a prevalence of 9.5% in normal, 6.8% in CIN 1, 15.0% in CIN 2, 44.5% in CIN 3, and 64.3% in cervical cancer. The most common HPV types were 16, 52, 58, 53, 51, 56, 68, and 18 in all study samples. HPV 16, 31, 33, and 58 were more common in CIN 2/3 and cancer, and HPV 39, 51, 53, 56, 66, and 68 were more common in CIN 1 and normal cases (p<0.001). In CIN 3 and cervical cancer, HPV 16 was the most common type in all age groups. HPV 52 was the most common type in CIN 2 (all age groups) and in CIN 1/normal (age ≤30 years) cases. Among the high-risk HPV types, 16, 31, 33, 52, and 58 showed significant risk for high-grade disease. CONCLUSIONS: HPV 16, 31, 33, 52, and 58 showed the significant risk of high-grade disease for cervical carcinogenesis.

Effects of fetal position on maternal hemodynamics after spinal anesthesia for cesarean delivery

BACKGROUND: Aortocaval compression by the gravid uterus is a known physiological phenomenon that is classically claimed to cause supine hypotension in full-term pregnant women. This study aimed to investigate the effects of fetal position on maternal hemodynamics after spinal anesthesia during cesarean delivery. METHODS: In total, 71 women with intrauterine pregnancy over 36 weeks of gestation who were scheduled for elective cesarean delivery under spinal anesthesia were enrolled in the study. Based on the fetal position, the women were divided into two groups: right position group (group R) and left position group (group L). Occurrence of hypotension, requirement for rescue bolus injections of phenylephrine, and the total amount of infused phenylephrine before delivery were recorded in each group. RESULTS: There was no statistically significant difference in the occurrence of hypotension between the two groups (P = 0.075); however, the amount of phenylephrine required before delivery was significantly greater in group R (P = 0.028). There was a statistically significant decrease in the systolic blood pressure compared with the baseline values in group R, and this change persisted until 15 min after spinal anesthesia. CONCLUSIONS: There was no difference according to fetal position in the number of patients who showed hypotension before delivery after spinal anesthesia.

Scleritis in a Patient with Castleman Disease

PURPOSE: To report a case of multicentric Castleman disease that presented with scleritis. CASE SUMMARY: A 42-year-old male presented with decreased visual acuity in the left eye. Castleman disease had been diagnosed 21 months before and treated with systemic steroids and combined chemotherapy. Best-corrected visual acuity (BCVA) of the left eye was 0.02 and the intraocular pressure was 42 mmHg. Scleral edema and corneal edema were noted using a slit lamp examination. The anterior chamber cell was 2+ according to Standardization of Uveitis Nomenclature criteria. The fundus was invisible due to the anterior segment lesion. After one month, scleritis developed in the right eye and the patient complained of ocular pain. Topical steroids and non-steroidal anti-inflammatory drugs were prescribed. Due to recurrent scleritis and anterior uveitis, cataract extraction and laser iridectomy were performed on the left eye, and systemic steroids and the antimetabolite methotrexate were started. After 9 years of follow-up, all medications were stopped and there was no recurrence of inflammation, with a BCVA of 1.0 in both eyes. CONCLUSIONS: Treatment of a patient with scleritis accompanied with Castleman disease using systemic steroids and methotrexate resulted in a good prognosis.

Change in Axial Length in Highly Myopic Adults Using Partial Coherence Interferometry

PURPOSE: To investigate the change in axial length (AL) in highly myopic adults using partial coherence interferometry, and to identify the factors associated with the increase in AL. METHODS: Medical records of highly myopic adults (≥ −6 diopters [D] or AL ≥ 26.0 mm) were retrospectively reviewed. The AL of each patient was measured using partial coherence interferometry at least three times over 2 years, and the yearly change in AL was calculated. Associations between age, AL, choroidal thickness, and the rate of AL change were evaluated using multiple regression analysis. RESULTS: In total, 24 patients (4 males, 20 females) and 44 eyes were included in this study. The mean age was 54.9 ± 10.4 years, the initial AL was 29.335 ± 2.006 mm, the choroidal thickness was 72.7 ± 41.80 µm, the average spherical equivalent was −11.86 ± 3.85 D (−5.1~−22.0 D), and the mean follow-up period was 2.2 ± 0.5 years. A significant increase in AL of ≥0.05 mm was observed in 38 eyes (86.4%) at 2 years. The mean AL was significantly increased, to 29.409 ± 2.007 mm (p < 0.001), at 1 year and to 29.476 ± 2.028 mm (p < 0.001) at 2 years. The average rate of AL change was 0.071 ± 0.049 mm (−0.01~0.19 mm) per year. None of the included factors showed an association with the rate of AL change in multiple regression analysis. CONCLUSIONS: In this study, an increase in AL in highly myopic adults was more frequent than in previous reports using A-scan. Periodic measurements are therefore recommended for the early detection of complications.

Risk factors for cytological progression in HPV 16 infected women with ASC-US or LSIL: The Korean HPV cohort

OBJECTIVE: This study was to identify the risk factors for cytological progression in women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL). METHODS: We analyzed data from women infected with the human papillomavirus (HPV) who participated in the Korean HPV cohort study. The cohort recruited women aged 20–60 years with abnormal cervical cytology (ASC-US or LSIL) from April 2010. All women were followed-up at every 6-month intervals with cervical cytology and HPV DNA testing. RESULTS: Of the 1,158 women included, 654 (56.5%) and 504 (43.5%) women showed ASC-US and LSIL, respectively. At the time of enrollment, 143 women tested positive for HPV 16 (85 single and 58 multiple infections). Cervical cytology performed in the HPV 16-positive women showed progression in 27%, no change in 23%, and regression in 50% of the women at the six-month follow-up. The progression rate associated with HPV 16 infection was higher than that with infection caused by other HPV types (relative risk [RR], 1.75; 95% confidence interval [CI], 1.08–2.84; P=0.028). The cytological progression rate in women with persistent HPV 16 infection was higher than that in women with incidental or cleared infections (P < 0.001). Logistic regression analysis showed a significant relationship between cigarette smoking and cytological progression (RR, 4.15; 95% CI, 1.01–17.00). CONCLUSION: The cytological progression rate in HPV 16-positive women with ASC-US or LSIL is higher than that in women infected with other HPV types. Additionally, cigarette smoking may play a role in cytological progression.

A Comparative Histopathological Study of Lens Capsule and Epithelial Cells in Various Types of Cataract

PURPOSE: To evaluate the histopathological changes of anterior capsule and lens epithelial cells in various types of cataract. METHODS: Patients scheduled for cataract surgery of phacoemulsification with intraocular lens implantation were enrolled in this study. Anterior capsule tissues sized 5 mm were obtained at the time of continuous curvilinear capsulorhexis during surgery. Histological examination of the obtained tissue was performed by transmission electron microscope. RESULTS: Nuclear cataract showed a uniform cuboidal monolayer of epithelial cells firmly attached to the anterior capsule. But, the mitochondria, Golgi apparatus, and endoplasmic reticulum were damaged and replaced with vacuoles. Anterior subcapsular cataract showed multilayers of epithelial cells with irregular intracellular structures. Epithelial cells of mature cataract were severely damaged and detached from the anterior capsule, accompanied by expansion of intra-cellular space and a large amount of vacuoles. Epithelial cells were irregular and severely damaged, and intracellular structures were hardly observed in traumatic cataract. Deposition of pseudoexfoliation materials on the anterior capsule was observed in pseudoexfoliation cataract. CONCLUSIONS: Changes in epithelial cells caused by fluid accumulation and electrolyte imbalance in the lens attributes more to cataract formation than do changes the in lens capsule.

Effects of Human Serum on Human Corneal Epithelial Cells in Vitro

PURPOSE: To investigate the effect of human serum on corneal epithelial cells. METHODS: Changes of corneal epithelial cells were evaluated after 1, 4, 12, and 24 hours (hrs) of exposure to various concentrations of human serum (3, 5, 8, and 16%). Cellular metabolic activity and the extent of cellular damage were measured. Effect of human serum on cell migration was also examined. Concentration of procollagen type-I COOH-terminal peptide (PIP), epidermal growth factor (EGF), and laminin after exposure to human serum was further observed. RESULTS: In every concentration of human serum, metabolic activity of the corneal epithelial cells temporarily decreased at 4 hrs of exposure and recovered to baseline levels afterward. With the same exposure time, there was no statistically significant difference in metabolic activity between the human serum-exposed group and the control group. Cellular toxicity of human serum exhibited a time- and dose-dependent relationship. Cellular migration was observed after 24 hrs of exposure to 5% concentration of human serum and after 12 hrs of exposure to 8% and 16% concentration of human serum. The PIP, EGF, and laminin titers increased in time- and dose-dependent manners. CONCLUSIONS: Human serum does not decrease the metabolic activity of corneal epithelial cells as the concentration and exposure time increase, but it can induce cytotoxicity. Considering cellular migration, a serum concentration of 5% or higher should be used.

Management of Women with Abnormal Pap Smear Tests in Pregnancy

Pregnancy provides a unique opportunity for young women to begin participating in the National Cancer Screening Program. The incidence of abnormal Pap smear test results during pregnancy is approximately 5%, and is comparable to that in non-pregnant women. However, normal physiological changes of the cervix during pregnancy can complicate the diagnostic accuracy of the Pap smear test, and prevent appropriate management in women who yield an abnormal test result. To date, no large, prospective clinical trials evaluating the management of women with abnormal Pap smear tests in pregnancy have been performed. Herein, we review and summarize a large series of literature and consensus guidelines on the evaluation of abnormal Pap smear test results and the management of cervical neoplasia in pregnancy.

Primary mucinous adenocarcinoma of the vulva, intestinal type

Primary vulva malignancy is a rare gynecologic malignancy. Most of them are squamous cell carcinomas and adenocarcinomas are much less common. Intestinal type is a rare variant of primary adenocarcinoma of the vulva. It histologically resembles mucinous colonic carcinomas. Origin from cloacal remnants has been suggested but remains speculative. A 64-year-old woman was referred to our clinic with a 1-month history of an itching vulva mass. An incisional biopsy was performed at other hospital and disclosed adenocarcinoma of intestinal type. Extensive workups were performed to detect other underlying carcinomas but revealed nothing abnormal. She underwent wide local excision without lymph node dissection for a primary vulva carcinoma. She received no adjuvant therapy and has been free from recurrent disease for 12 months after surgery. The authors report a rare case and review the relevant literature.

Vascular Displacement in Idiopathic Macular Hole after Single-layered Inverted Internal Limiting Membrane Flap Surgery

PURPOSE: To compare vascular displacement in the macula after surgical closure of idiopathic macular hole (MH) after single-layered inverted internal limiting membrane (ILM) flap technique and conventional ILM removal. METHODS: This retrospective study included patients who underwent either vitrectomy and ILM removal only or vitrectomy with single-layered inverted ILM flap for idiopathic MH larger than 400 µm from 2012 to 2015. A customized program compared the positions of the retinal vessels in the macula between preoperative and postoperative photographs. En face images of 6 × 6 mm optical coherence tomography volume scans were registered to calculate the scale. Retinal vessel displacement was measured as a vector value by comparing its location in 16 sectors of a grid partitioned into eight sectors in two rings (inner, 2 to 4 mm; outer, 4 to 6 mm). The distance and angle of displacement were calculated as an average vector and were compared between the two groups for whole sectors, inner ring, outer ring, and for each sector. RESULTS: Twenty patients were included in the ILM flap group and 22 in the ILM removal group. There were no statistical differences between the groups for baseline characteristics. The average displacement in the ILM flap group and the ILM removal group was 56.6 µm at −3.4° and 64.9 µm at −2.7°, respectively, for the whole sectors (p = 0.900), 76.1 µm at −1.1° and 87.3 µm at −0.9° for the inner ring (p = 0.980), and 37.4 µm at −8.2° and 42.7 µm at −6.3° for the outer ring (p = 0.314). There was no statistical difference in the displacement of each of the sectors. CONCLUSIONS: Postoperative topographic changes showed no significant differences between the ILM flap and the ILM removal group for idiopathic MH. The single-layered ILM flap technique did not appear to cause additional displacement of the retinal vessels in the macula.

Effects of infections with five sexually transmitted pathogens on sperm quality / 대한생식의학회지

OBJECTIVE: This study investigated the prevalence of infections with human papillomavirus, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, and Mycoplasma genitalium in the semen of Korean infertile couples and their associations with sperm quality. METHODS: Semen specimens were collected from 400 men who underwent a fertility evaluation. Infection with above five pathogens was assessed in each specimen. Sperm quality was compared in the pathogen-infected group and the non-infected group. RESULTS: The infection rates of human papillomavirus, C. trachomatis, U. urealyticum, M. hominis, and M. genitalium in the study subjects were 1.57%, 0.79%, 16.80%, 4.46%, and 1.31%, respectively. The rate of morphological normality in the U. urealyticum-infected group was significantly lower than in those not infected with U. urealyticum. In a subgroup analysis of normozoospermic samples, the semen volume and the total sperm count in the pathogen-infected group were significantly lower than in the non-infected group. CONCLUSION: Our results suggest that infection with U. urealyticum alone and any of the five sexually transmitted infections are likely to affect sperm morphology and semen volume, respectively.

Hydrogel and Platelet-Rich Plasma Combined Treatment to Accelerate Wound Healing in a Nude Mouse Model

BACKGROUND: Platelet-rich plasma (PRP) contains high concentrations of growth factors involved in wound healing. Hydrogel is a 3-dimensional, hydrophilic, high-molecular, reticular substance generally used as a dressing formulation to accelerate wound healing, and also used as a bio-applicable scaffold or vehicle. This study aimed to investigate the effects of PRP and hydrogel on wound healing, in combination and separately, in an animal wound model. METHODS: A total of 64 wounds, with 2 wounds on the back of each nude mouse, were classified into 4 groups: a control group, a hydrogel-only group, a PRP-only group, and a combined-treatment group. All mice were assessed for changes in wound size and photographed on scheduled dates. The number of blood vessels was measured in all specimens. Immunohistochemical staining was used for the analysis of vascular endothelial growth factor (VEGF) expression. RESULTS: Differences in the decrease and change in wound size in the combined-treatment group were more significant than those in the single-treatment groups on days 3, 5, 7, and 10. Analysis of the number of blood vessels through histological examination showed a pattern of increase over time that occurred in all groups, but the combined-treatment group exhibited the greatest increase on days 7 and 14. Immunohistochemical staining showed that VEGF expression in the combined-treatment group exhibited its highest value on day 7. CONCLUSIONS: This experiment demonstrated improved wound healing using a PRP–hydrogel combined treatment compared to either treatment individually, resulting in a decrease in wound size and a shortening of the healing period.

Prognostic assessment of sarcomatous histologic subtypes of ovarian carcinosarcoma

OBJECTIVE: Ovarian carcinosarcoma is a rare subtype of this disease that has not been thoroughly investigated. The aim of this study was to evaluate the prognostic factors and out comes in patients with ovarian carcinosarcoma. METHODS: All patients with histologically confirmed ovarian carcinosarcoma who were treated at Cheil General Hospital and Women's Healthcare Center between January 2000 and December 2015 were identified and analyzed. Data were extracted from medical records, and statistical analyses were performed to determine correlations between clinicopathological parameters and survival outcomes. RESULTS: Of the 822 patients diagnosed with ovarian cancer over 16 years, 11 (1.3%) had ovarian carcinosarcoma histology. Every patient underwent surgery as the initial treatment followed by intravenous adjuvant chemotherapy. Only 18.1% of cases were early stage (I or II) while 81.8% were advanced stage (III or IV) according to the FIGO (International Federation of Gynecology and Obstetrics) classification. Six cases were of the homologous subtype (54.5%) and five were of the heterologous subtype (45.5%). There was no significant difference in survival according to stage (P=0.24). The heterologous subtype and residual disease were associated with poor disease-free survival (P=0.02 and P=0.04) and overall survival (P=0.02 and P=0.04), On multivariate analysis, the histological subtype was an independent prognostic factor (P=0.02). CONCLUSION: Optimal cytoreduction without gross residual disease and a homologous subtype are favorable prognostic factors in terms of disease relapse and survival.

Surgical and obstetrical outcomes after laparoscopic radical trachelectomy and pelvic lymphadenectomy for early cervical cancer

OBJECTIVE: The aim of this study was to evaluate the surgical and obstetrical outcomes of patients with early cervical cancer who underwent laparoscopic radical trachelectomy and pelvic lymphadenectomy. METHODS: We analyzed data from women who underwent laparoscopic radical trachelectomy and pelvic lymphadenectomy between July 2000 and October 2014. RESULTS: Of a total of 12 patients, 91.7% were FIGO (International Federation of Gynecology and Obstetrics) stages IA2 and IB1. Seven patients (58.3%) had squamous cell carcinoma. The median tumor size was 1.87 cm (range, focal to 4.6 cm) and two patients (16.7%) had a tumor lager than 2 cm. Lymphovascular space invasion in the tumor lesion was reported in six patients (50%). The following surgical complications were observed: neurogenic bladder (one patient), hemoperitoneum (one patient), and infection (one patient). A total of 33.3% had attempted to conceive, resulting in two pregnancies and two healthy babies. All pregnancies were achieved by in vitro fertilization and embryo transfer. Each woman underwent cesarean delivery because of premature pre-labor rupture of membranes at gestational weeks 27.3 and 33.3. After a median follow-up time of 4.4 years (range, 1 to 8 years), there were no recurrences or deaths. CONCLUSION: Laparoscopic radical trachelectomy and pelvic lymphadenectomy should be offered as an alternative treatment for women with early stage cervical cancer who want to preserve their fertility.

Surgical and obstetrical outcomes after laparoscopic radical trachelectomy and pelvic lymphadenectomy for early cervical cancer

OBJECTIVE: The aim of this study was to evaluate the surgical and obstetrical outcomes of patients with early cervical cancer who underwent laparoscopic radical trachelectomy and pelvic lymphadenectomy. METHODS: We analyzed data from women who underwent laparoscopic radical trachelectomy and pelvic lymphadenectomy between July 2000 and October 2014. RESULTS: Of a total of 12 patients, 91.7% were FIGO (International Federation of Gynecology and Obstetrics) stages IA2 and IB1. Seven patients (58.3%) had squamous cell carcinoma. The median tumor size was 1.87 cm (range, focal to 4.6 cm) and two patients (16.7%) had a tumor lager than 2 cm. Lymphovascular space invasion in the tumor lesion was reported in six patients (50%). The following surgical complications were observed: neurogenic bladder (one patient), hemoperitoneum (one patient), and infection (one patient). A total of 33.3% had attempted to conceive, resulting in two pregnancies and two healthy babies. All pregnancies were achieved by in vitro fertilization and embryo transfer. Each woman underwent cesarean delivery because of premature pre-labor rupture of membranes at gestational weeks 27.3 and 33.3. After a median follow-up time of 4.4 years (range, 1 to 8 years), there were no recurrences or deaths. CONCLUSION: Laparoscopic radical trachelectomy and pelvic lymphadenectomy should be offered as an alternative treatment for women with early stage cervical cancer who want to preserve their fertility.

Associations between sexually transmitted infections, high-risk human papillomavirus infection, and abnormal cervical Pap smear results in OB/GYN outpatients / 부인종양

OBJECTIVE: This study aimed to examine the meaning and usefulness of sexually transmitted infection (STI) test when caring for patients who have abnormal cervical cytology and/or positive high-risk human papillomavirus (HPV) DNA test results. METHODS: Among patients who underwent liquid-based cervical cytology and HPV DNA tests at the Obstetrics and Gynecology outpatient clinic, 800 patients who showed abnormal cervical cytology were compared with 200 patients in the control group. Both groups were simultaneously tested via multiplex real-time polymerase chain reaction for seven types of STI-causative microorganisms. RESULTS: The positive rate of high-risk HPV infection in total STIs positive group was 1.47 times higher than that of total STIs negative group. The probability of a cytological diagnosis of a grade equal to or higher than atypical squamous cells-cannot exclude high grade squamous intraepithelial lesion (ASC-H) was significantly higher in patients testing positive for total STIs (1.46 times), Chlamydia trachomatis (3.21 times), or Mycoplasma genitalicum (3.58 times) than in those testing negative. The total STIs positive rate was significantly higher for those having a cytological diagnosis of a grade equal to or higher than atypical squamous cells of undetermined significance (ASC-US) when high-risk HPV test result was negative. CONCLUSION: Correlations were present not only between STIs and high-risk HPV infection but also between abnormal cervical cytology and STIs. Therefore, additional evaluation of STIs will be helpful to appropriately diagnose and treat patients with abnormal cervical cytology, positive results on high-risk HPV DNA test, or a cytological diagnosis of ASC-US despite negative high-risk HPV DNA test result.