OBJECTIVE: In a pregnant rabbit model using hysteroscopy-guided inoculation of E. coli, we investigated pregnancy outcome according to elapsing time with immediate antibiotic treatment after E. coli inoculation, and in turn determined which of the maintenance of pregnancy with antibiotic and tocolytic administration or prompt delivery in the management of preterm labor complicated with intrauterine infection offered the improvement of pregnancy outcome. METHODS: Timed-pregnant rabbits underwent hysteroscopy at 20-21 days of gestation(70%). Animals were inoculated with either E. coli(0.2 ml containing 10' cfu/ml) or saline, and administered ampicillin-sulbactam(100 mg/kg/day; Unasyn; Pfizer) in divided doses every 8 hours beginning 30 minutes after microbial inoculation until euthanasia with one of the following; 3 days(n 10), 5 days(n 8), or 7 days(n-8) after hysteroscopy. In the first study, which performed in animals with inoculation of E. coli, pregnancy outcome including fetal survival rate and results of microbial studies and placental pathology were compared among three groups. In second study, which performed in animals with inoculation with saline, pregnancy outcome were compared among three groups for the purpose of elucidating effects of antibiotic administration during inoculation-to-euthanasia interval on pregnancy outcome. RESULTS: Of rabbits inoculated with E. coli and receiving antibiotics immediately, the rate of fetal survival and positive intrauterine cultures in total and live fetuses decreased significantly, and the rate of placental inflammation in total and live fetuses increased significantly with time from intracervical inoculation with E. coli to euthanasia(p<0.05, respectively). Of rabbits inoculated with saline and receiving antibiotics immediately, the rates of fetal survival, positive intrauterine cultures in total and live fetuses, and placental inflammation in total and live fetuses have no difference with time from intracervical inoculation with saline to euthanasia. CONCLUSION: Fetal complications including fetal death could be induced in utero if persistent subclinical intrauterine infection was present in spite of earlier antibiotics administration initiated after inoculation of E, coli. Therefore, when treating with antibiotics in intrauterine infection, it is needed to observe and monitor the presence of persistent intrauterine infection, and if it is persistent, prompt delivery may be better than maintenance of pregnancy with antibiotic and tocolytic administration for the improvement of pregnancy outcome.
Animals ; Anti-Bacterial Agents* ; Euthanasia ; Female ; Fetal Death ; Fetus ; Hysteroscopy ; Inflammation ; Obstetric Labor, Premature ; Pathology ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rabbits ; Survival Rate

No abstract available.
Hydronephrosis* ; Teratoma*

No abstract available.
Dermatitis* ; Tacrolimus ; Tetracycline*

Although MR imaging is generally applicable to depict knee joint deterioration it, is sometimes occurred to mis-read and mis-diagnose the common knee joint diseases. In this study, we employed magnetization transfer ratio (MTR) method to improve the diagnosis of the various knee joint diseases. Spin-echo (SE) T2-weighted images (TR/TE 3,400-3,500/90?100 ms) were obtained in seven cases of knee joint deterioration, FSE T2-weighted images (TR/TE 4,500-5,000/100?108 ms) were obtained in seven cases of knee joint deterioration, gradient-echo (GRE) T2-weighted images (TR/TE 9/4.56/50degrees flip angle, NEX 1) were obtained in 3 cases of knee joint deterioration, In six cases of knee joint deterioration, fat suppression was performed using a T2-weighted short T1/tau inverse recovery (STIR) sequence (TR/TE =2,894-3,215 ms/70 ms, NEX 3, ETL 9). Calculation of MTR for individual pixels was performed on registration of unsaturated and saturated images. After processing to make MTR images, the images were displayed in gray color. For improving diagnosis, three-dimensional isotropic volume images, the MR tristimulus color mapping and the MTR map was employed. MTR images showed diagnostic images quality to assess the patients' pathologies. The intensity difference between MTR images and conventional MRI was seen on the color bar. The profile graph on MTR imaging effect showed a quantitative measure of the relative decrease in signal intensity due to the MT pulse. To diagnose the pathologies of the knee joint, the profile graph data was shown on the image as a small cross. The present study indicated that MTR images in the knee joint were feasible. Investigation of physical change on MTR imaging enables to provide us more insight in the physical and technical basis of MTR imaging. MTR images could be useful for rapid assessment of diseases that we examine unambiguous contrast in MT images of knee disorder patients.
Knee ; Knee Joint ; Magnets

We encountered a case of neonatal altoimmune thrombocytopenia(NAIT) due to anti-HLA-B7+B60+B61. Bilateral cephal hematoma and umbilical hematoma were noted at the time of birth. Purpura developed at the third day. Platelet count was 110,000 at birth and decreased to 66,000/micro liter at the day 4. Prothrombin time and partial prothrombin time were within normal limit. The mother's platelet count was 220,000/micro liter and she had no history of abnormal bleeding. Platelet antibody tests empolying mixed passive hemagglutination and immunofluorescence revealed that the mother's serum was reactive against the platelets from the father and the neonate, but was not reactive with her own platelets. Platelets from eight volunteer group 0 donors were tested with the mother's serum; seven were reactive and one was negative. The positive reactions were lost after chloroquine treatment of platelets. Antigen capture ELISA(ACE) and modified antigen capture ELISA employing monoclonal antibodies against platelet glycoproteins In, IIa, IIb, and IIIa were negative. Mother's serum was tested for lymphocytotoxicity against 49 donor ]ymphocytes and the specificity was found to be anti-HLA-B7+B60+B61. At the 9th day, one unit of platelet concentrate from the mother was transfused and the platelet count of the neonate rose up to 340,000/micro liter. The neonate was discharged at the day of sixteenth and the platelet count remained high thereafter.
Antibodies, Monoclonal ; Blood Platelets ; Chloroquine ; Enzyme-Linked Immunosorbent Assay ; Fathers ; Fluorescent Antibody Technique ; Hemagglutination ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Membrane Glycoproteins ; Prothrombin Time ; Purpura ; Sensitivity and Specificity ; Thrombocytopenia* ; Tissue Donors ; Volunteers

PURPOSE: By using the micro-imaging unit modified from NMR spectrometer, the high resolution MRI protocols of finer than 100 micron in 5 minutes, is sought for mouse, which plays a central role in animal studies MATERIALS AND METHODS: C57BL/6 mouse, lighter than 50 gram, is used for the experiments. The superconducting magnet is vertical type with 89 mm inner diameter at 4.9 Tesla. The diameter of rf-coil is 30 mm. Mostly used techniques are the fast spin echo and the gradient echo pulse sequence. RESULTS: For 2D images, proton density and T2 weighted images are obtained and their optimum experimental variables were sought. Minute structure of mouse brain can be recognized and 3D brain image is also obtained additionally. 3D image will be useful particularly for the dynamic contrast study using various contrast agents. CONCLUSION: Like the case of human and other small animals, the high resolution of mouse brain is enough to recognize the minute structure of it. Recently, similar studies are reported domestically, but it seems only a beginning stage. Due to easiness of breeding /control, mouse MRI study will soon play a vital part in brain study.
Animals ; Brain ; Breeding ; Humans ; Magnets ; Mice ; Protons

No abstract available.
Cervix Uteri* ; Female ; Humans ; Mass Screening* ; Uterine Cervical Neoplasms*

BACKGROUND: Hepatitis B surface Antibody(anti-HBs) is the marker of success of Hepatitis B virus(HBV) vaccination and protective ability against HBV infection. Though quantification of anti-HBs using EIA methods based on mIU/mL unit is available in these days, passive hemagglutination(PHA) is still one of the most popular methods to test Anti-HBs in Asian areas including Korea because of its simple procedure and inexpensive costs. However, we have not yet known the exact meanings of positive or negative PHA results compared with EIA results based on mIU/mL units. We evaluated the PHA method compared with EIA method using 856 specimens for testing anti-HBs. METHODS: EIA measurements of anti-HBs were performed on an automated enzyme-immuno assay analyzer(Axsym, Abbott, USA). The Axsym is micro-particle EIA assay system and shows the test results as positive and negative according to the measured titer. The positive cut-off level of anti-HBs in Axsym is 10 mIU/mL. PHA measurements of anti-HBs were performed with manual microplate method(Fujirebio, Tokyo, Japan). RESULTS: Regarded the EIA method as gold standard, the sensitivity and specificity of PHA were 83.2% and 95.5% respectively. The positive and negative predictive values of PHA were 98.1% and 66.9% respectively. The usual lowest detection level of PHA method for anti-HBs seemed to be from 50 to 100 mIU/mL. CONCLUSIONS: Conclusively, we propose we should replace the PHA method with EIA method based on mIU/mL for testing anti-HBs regardless of costs. It is the way to save health cost associated with determination HBV vaccination or booster dose. It should be remarked in present that about 33% of anti-HBs negative cases with PHA method were adversely anti-HBs positive with titers of almost under 100 mIU/mL.
Asian Continental Ancestry Group ; Health Care Costs ; Hepatitis B ; Humans ; Korea ; Sensitivity and Specificity ; Vaccination

OBJECTIVE: Alendronate, a widely used bisphosphonates, acts to inhibit bone resorption by interfering with the activity of osteoclasts. Recently, it has been reported that alendronate also may increase bone proliferation and osteoblastic differentiation. However, little is known about mechanism of the action of alendronate on osteoblast differentiation, especially in transcription level. Inhibitors of DNA binding/ differentiation (Ids) are helix-loop-helix (HLH) transcription factors and play an important role in BMP-induced osteoblast lineage-specific differentiation. Therefore, this study was aimed to investigate the effect of alendronate on osteoblast differentiation and expression of Id-1 and Id-2. METHODS: MC3T3-E1, pre-osteoblast cell line, were treated with alendronate of various concentrations (10(-9) M-10(-4) M) and time periods (24, 48 and 72 hours). And then, the effect of alendronate on osteoblast differentiation was examined by alkaline phosphatase (ALP) activity and RT-PCR for osteoblast differentiation markers such as ALP, type 1 collagen (Col 1), and osteocalcin (OCN). The expressions of Id-1 and Id-2 were measured by RT-PCR. RESULTS: Alendronate treatment increased not only ALP activity, but also expressions of ALP, Col 1, and OCN. Also, alendronate treatment up-regulated the mRNA levels of Id-1 and Id-2 genes. This alendronate-induced osteoblastic differentiation is more effective in lower doses rather than high doses. CONCLUSION: This study shows that the expression of transcription factor Id-1 and Id-2 was increased in a dose-dependent manner during alendronate-induced osteoblast differentiation.
Alendronate ; Alkaline Phosphatase ; Antigens, Differentiation ; Bone Resorption ; Cell Differentiation ; Cell Line ; Collagen Type I ; Delta Sleep-Inducing Peptide ; Diphosphonates ; DNA ; Osteoblasts ; Osteocalcin ; Osteoclasts ; RNA, Messenger ; Transcription Factors

PURPOSE: Radical cystectomy with pelvic lymphadenectomy is effective therapeutic modality in the management of invasive bladder cancer. We reviewed our experience in order to determine the prognostic factors on survival after radical cystectomy with pelvic lymphadenectomy. MATEIRALS AND METHODS: An analysis was performed of 113 patients with bladder cancer who underwent radical cystectomy with pelvic lymphadenectomy from 1988 to 1997. Ages ranged from 46 to 78-year-old, average age was 61.4+/-9.8 years old. The survival rate according to each factor was calculated by Kaplan-Meier method. Statistics was determined by the log-rank test. RESULTS: 3-year survival rate was 80% in the male patients and 66% in the female patients. Comparing between organ confined(< or =pT3a) and non-organ confined disease(> or =pT3b), 3-year survival rate was 86% for organ confined disease and 34% for non-organ confined disease. 3-year survival rate of the patients with grade I cancer was 96%, grade II cancer 86% and grade III cancer 66%. According to microscopic vascular invasion of the bladder tumor, 3-year survival rate in vascular invasion was 66% and 80% in non-vascular invasion. According to microscopic lymphatic invasion of the bladder tumor, 3-year survival rate was 62% in lymphatic invasion and 88% in non-lymphatic invasion. According to the states of lymph node invasion, 3-year survival rate in the N0 was 84%, in N1 74% and in N2< or = 0%. According to the metastasis, 3-year survival rate in the absence of metastasis was 90%, in nodal invasion 32% and in visceral organ metastasis 26%. There were statistical significant differences in sex, pathologic stage, grade, lymph node invasion and distant metastasis(p<0.05). CONCLUSIONS: From this study, we think the prognostic factors affecting survival after radical cystectomy with pelvic lymphadenectomy may be sex, pathologic stage, grade, lymph node invasion and distant metastasis. Therefore, careful and more frequent followup is needed in patients with poor prognostic factor.
Aged ; Cystectomy* ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Retrospective Studies* ; Survival Analysis* ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*