No abstract available.
Nifedipine* ; Vasopressins*

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.
Gestational Age* ; Humans ; Infant, Newborn*

The pulsed laser lithotripsy has been used in the treatment of urinary calculi. We treated 153 patients of stones, via the pulsed dye laser(Technomed Pulsolith) with 7.5 and 6.5 F. rigid ureteroscope between January 1992 and January 1995. Stones were in bladder(4 cases), upper ureter(17), mid ureter(31) and lower ureter(101). The laser lithotripsies were applied for impacted stones and relatively large stones(more than 6 mm) The success rates according to location were 47%(8/17) in upper ureter, 77%(24/31)in middle ureter, 95%(96/101)in lower ureter and 100%(4/4) in bladder and mean success rate was 86% (132/153). There were 21 failures due to upward migration(9 cases), poor visual field(7), laser resistant stone(3) and malfunction of laser(2). Complications were showed in 28 cases that were gross hematuria(16 cases), ureteral perforation(6), fever(4) and ileus(2), but most of them might be related to ureteroscopy rather than laser, and all of them were resolved with conservative management. So laser lithotripsy is safe and effective method of middle and lower ureteral calculi, and upward migration of stones, the major cause of failure may be resolved by use of extracorporeal shock wave lithotripsy and flexible ureteroscope.
Humans ; Lithotripsy ; Lithotripsy, Laser* ; Shock ; Ureter ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy ; Urinary Bladder ; Urinary Calculi

OBJECTIVE: In a rabbit model using hysteroscopy-guided inoculation of E.coli with antibiotic administration, we determine the effects of persistent intrauterine infection on perinatal outcome including fetal death, congenital sepsis, and abnormal fetal-placental growth and amniotic fluid volume in live fetuses. METHODS: Rabbits with timed pregnancies underwent hysteroscopy at 20 to 21 days of gestation(70%). Animals were inoculated with E. coli (0.2 ml containing 10 cfu/ml) and administered ampicillin-sulbactam(100 mg/kg/day; Unasyn; Pfizer) every 8 hours beginning 30 minutes after microbial inoculation until they were killed 5 days after hysteroscopy. In the first study, the following outcome parameters were evaluated between fetuses with and without pe#rsistent intrauterine infection: fetal survival, congenital sepsis, maternal morbidity, and placental pathology. In second study was performed in 16 rabbits having only both live fetuses with and without persistent intrauterine infection in a rabbit simultaneously. We evaluate the effects of persistent intrauterine infection on fetal-placental weight and amniotic fluid volume in live fetuses. RESULTS: 1) Fetuses with persistent intrauterine infection had significantly fewer live fetuses, more positive cord blood cultures than those without (live fetuses: 44% vs 82%, p<0.000001; positive cord blood cultures: 44% vs 3%, p<0.000001, respectively; Fishers exact test). However the rates of maternal morbidity and placental inflammatory lesions were similar between the two groups. 2) The placental weight and amniotic fluid volume were significantly less in live fetuses with than in those without persistent intrauterine infection. Moreover the fetal weight was decreased in live fetuses with persistent intrauterine infection, but it was not statistically significant(placental weight: p<0.05; amniotic fluid volume: p<0.05; fetal weight: p 0.051, respectively; Wilcoxon matched-pairs signed ranks test). CONCLUSION: Fetal complications including fetal death, congenital sepsis, and decreased fetal-placental weight and amniotic fluid volume wae produced in utero when pasistent intrauterine infection was present with antibiotics administration after inoculstion of E. coli. Therefore, when treating with antibiotics in intrauterine infection, it is needed to observe and monitar the presence of persistent intrauterine infection, and if it is peristent, delivery may be considered for the improvement of pregnancy outcome.
Amniotic Fluid ; Animals ; Anti-Bacterial Agents ; Female ; Fetal Blood ; Fetal Death ; Fetal Weight ; Fetus ; Hysteroscopy ; Obstetric Labor, Premature ; Pathology ; Pregnancy ; Pregnancy Outcome ; Rabbits ; Sepsis

No abstract available.
Leiomyoma*

BACKGROUND: The autonomic nervous system plays a critical role in triggering ventricular arrhyhmia and sudden death early after acute myocardial infarction. This study was designed to determine whether or not vagal and sympathetic responses are impaired after myocardial infarction and to evaluate the utility of physiologic stress tests for assessing autonomic dysfunction after myocardial infarction. METHODS: 8 male patients with acute myocardial infarction(Group A) and old myocardial infarction(Group B) were studied with 8 control subjects of coinciding age and sex. 5 physiologic stress tests(deep breathing, sudden standing, Valsalva maneuver, ice bag application on the face, 70degrees headd-up tilt test) were performed. RESULTS: 1) Variation in heart rate during deep breathing, Standing-up, Valsalva maneuver, and ice bag application on the face was less in Group A than in Group B or Group C. 2) There was no significant difference in variation of heart rate between Group B and Group C. 3) Variation in heart rate caused by 70degrees tilt was not significantly different among the three groups. CONCLUSION: Early after myocardial infarction, parasympathetic responses were significantly impaired, whereas sympathetic responses remained intact. Heart rate variability using physiologic stress test may be provide a means of detecting autonomic dysfunction after acute myocardial infarction.
Autonomic Nervous System* ; Death, Sudden ; Exercise Test ; Heart Rate ; Humans ; Ice ; Male ; Myocardial Infarction* ; Respiration ; Valsalva Maneuver

OBJECTIVES: This study aims to compare home care dental devices for their dental plaque removal ability. METHODS: A single blinded randomized crossover clinical study design was used to measure plaque index (Turesky Modification Quigley-Hein Plaque Index). RESULTS: All 3 groups showed a statistically significant decrease in the plaque index after usage (P<0.001). In manual tooth-brushing group, the teeth on the right dental arch showed a greater decrease in the plaque index than on the left arch (P=0.041). All appliances showed greater plaque reduction in the upper right posterior teeth than in the lower right posterior teeth (P=0.009, 0.004, 0.007). CONCLUSIONS: The results of this study support development of more effective oral hygiene appliances and emphasis on oral hygienic education.
Dental Arch ; Dental Devices, Home Care ; Dental Plaque Index ; Dental Plaque* ; Education ; Health Education ; Oral Hygiene* ; Tooth ; Vibration*

WPW syndrome is the most common variaty of preexcitaton syndrome in which whole or part of ventricular muscle is activated by the atrial impulse earlier than would be expected if the impulse reached the ventricle by way of normal conduction system alone. WPW syndrome result from existence of accessory muscle bridge(atrio ventricular connection) between atrium and ventricle. The ventricular complex observed in WPW syndrome during periods of sinus rhythm is the result of fusion, with intial phase of ventricular activation representing excitation via accessory pathway and later forces produced by excitation of residual portions of ventricle via normal His-purkinje system. The variations in QRS aberrancy in WPW syndrome depend on varying degree of preexcitation. This experimental study was undertaken to increase our knowledge on the ventricular fusion in WPW syndrome through epicardial mapping after experimental induction of ventricular preexcitaion of WPW type. In 5 normal dogs, the heart was widely exposed through transverse thoracotomy and positioned in a pericardial cradle, then electric wires were fixed on the epicardium of right atrium and ventricular bases(anterobasal and posterobasal) areas of right ventricle, anterobasal and poaterobasal areas of left ventricle for atrial and ventricular pacing. Epicardial mapping was then performed during atrial pacing alone and during atrioventricular sequential pacing at the same rate. Atrioventricular sequential pacing was done with various short AV intervals(60-110 msec) for the purpose of premature stimulation on ventricular base. In mapping we used the grid system which consisted of 29 areas to cover the right ventricle and 23 areas to cover the left ventricle. We drew 9 epicardial ishochrone maps in 5 dogs. The epicardial data during atrio-ventriclar sequential pacing were then compared with those during atrial pacing at an identical rate to study the ventricular fusion in WPW syndrome. The results were as follows; 1) The preexciting wave spread radially from the stimulated basal area to the right and left(or anterior and posterior wall) and the apex. 2) Preexciting wavefronts collided with the normal wavefronts in a wide range of ventricular activation time. 3) Preexcitation widened according to the degree of the shortening of the AV interval. 4) The duration of ventricular activation was greater in preexcited ventricles than in normally activated ventricles. The more prematurely the ventricle was stimulated, the greater the duration of ventricular activation was.
Animals ; Dogs ; Epicardial Mapping ; Heart ; Heart Atria ; Heart Ventricles ; Pericardium ; Thoracotomy ; Wolff-Parkinson-White Syndrome*

BACKGROUND: The interest of patients with chest pain and normal coronary arteries has been increased since 1960. From the year 1973, the syndrome representing these characteristics has been classified as syndrome X. Treadmill test and exercise TI-201 SPECT are important in the diagnosis of syndrome X. This study was designed to evaluate the clinical value of exercise TI-201 SPECT and the difference of clinical characteristics between exercise TI-201 SPECT positive(Group A) and negative (Group B) in patients with chest pain and normal coronary angiogram. METHODS: Twenty seven patients with chest pain and normal coronary angiogram underwent echocardiogram and exercise TI-201 SPECT. Patients received 2 mCi of thallium intravenously during exercise, redistribution images were performed 4 hour later and second dose of 1 mCi of thallium was injected at rest immediately thereafter. These three sets of image(stress, redistribution and reinjection) were analyzed. RESULTS: 1) 12 of 16 patients in Group A, none of 11 patients were positive on exercise treadmill test(p<0.005). 2) The incidence of systemic hypertension in Group A was significant greater than Group B(p<0.05). 3) The left ventricular end diastolic pressure was significantly higher in Group A than in Group B (p<0.05). CONCLUSION: The exercise TI-201 SPECT is a useful method to evaluate the patients with chest pain and normal coronary angiogram and the reversible perfusion defects on the exercise TI-201 SPECT might be related to systemic hypertension and elevated left ventricular end diastolic pressure.
Blood Pressure ; Chest Pain* ; Coronary Vessels ; Diagnosis ; Exercise Test ; Humans ; Hypertension ; Incidence ; Perfusion ; Thallium ; Thorax* ; Tomography, Emission-Computed, Single-Photon*