No abstract available.
Female ; Humans ; Insulin* ; Lipoproteins* ; Pregnant Women* ; Triglycerides*

OBJECTIVE: We performed the transvaginal ultrasonographic evaluation of uterine cervix and fetal fibronectin in cervicovaginal secretions in women after 37 complete weeks of gestation to predict the onset of labor. METHODS: Total 80 primiparous or multiparous women were divided into two groups on the duration between evaluation and onset of labor. The biometric analysis of uterine cervix(cervical index, endocervical length, funneling, funnel length and width) was done by transvaginal ultrasonography. The cervicovaginal fetal fibronectin was measured by fetal fibronectin immunoassay (ELISA kit, Adeza Biochemical, USA). The efficacy of these method was analyzed with Pearson chi-square test, receiver-operator characteristic curves, and multiple logistic regression test. RESULTS: 1) There were no significant differences in clinical characteristics between two groups. 2) Group 1(onset of labor within 7 days after evaluation) showed significantly shorter endocervical length(Group 1: 2.33+/-0.75cm,Group 2: 2.93+/- 0.42cm, p=0.013), higher value of cervical index(Group 1: 1.27+/-0.67, Group 2: 0.62+/-0.34, p=0.008) and higher level of fetal fibronectin(Group 1: 98.65+/-11.34ng/ml, Group 2: 13.37+/- 2.7ng/ml, p=0.004). 3) The ROC curve analysis showed that a level of endocervical length <2.64mm, cervical index> 0.7, fetal fibronectin> 60ng/ml had the diagnostic performance in predicting group 1. Fetal fibronectin level in cervicovaginal secretion> 60ng/ml showed the highest diagnostic index in predicting the onset of labor within 7 days(p<0,001, odds ratio=21.3). CONCLUSION: Cervicovaginal fetal fibronectin predicts delivery within 7 days more accurately than cervical index, endocervical length. Combine use of these tests improve the diagnostic efficiency and allowed prediction of onset of labor, identifying a subgroup of patients who may require aggressive treatment.
Cervix Uteri ; Chi-Square Distribution ; Female ; Fibronectins* ; Humans ; Immunoassay ; Logistic Models ; Pregnancy* ; ROC Curve ; Ultrasonography*

OBJECTIVE: To compare the efficiency, success rate and abortion time between the live and the dead fetus in second trimester pregnancy termination with intravag-inal misoprostol. SUBJECTS AND METHODS: A total of 45 pregnant women between 18-29 weeks of gestation with medical, obstetric, or genetic reasons for termination were recruited to receive 50 ug misoprostol inserted intravaginally (posterior fornix) every 4 hours. RESULTS: The success rate of complete termination(abortion) within 12 and 24 hours in dead fetuses were 78.2% and 95.6%, respectively, while in live fetuses were 36.3% and 90.9%, respectively. The mean abortion time of the dead fetus group (10.31+/-3.43 hours) was significantly less than that of the live fetus group (14.20+/-3.31 hours). No serious complications occurred in terms of hemorrhage, diarrhea, nausea and vomiting. CONELUSION: Intracervicovaginal misoprostol is a safe and effective method for second trimester pregnancy termination. The abortion time is less in dead fetus pregnancy than that in the live fetus pregnancy.We used 50 ug tablets of misoprastol every four hours. But, we suspect that the regimen of 100ug misoprostol inserted intracervicovaginally every eight hours will beis the proper and optimal method for pregnancy termination.
Diarrhea ; Female ; Fetus* ; Hemorrhage ; Humans ; Misoprostol* ; Nausea ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnant Women ; Tablets ; Vomiting

No abstract available.
Colorectal Surgery*

BACKGROUND: The differentiation between basal cell carcinoma(BCC) and trichoepithelioma(TE) is sometimes difficult clinically and histologically, and their differentiation is important since their treatment and prognosis are sometimes different. OBJECTIVE: Our purpose was to investigate whether there was a difference in CD34 staining patterns in the stromas (immediate and distant stromas from the tumor lobules) of BCC and TE, since the histopathologic characteristics of the stromas are one of the most important features to differentiate the two tumor. METHOD: We perfomed immunoperoxidase staining(modified ABC technique) by using a monoclonal anti CD34 antibody(QBEND10, IgG1) on the formalin-fixed, paraffin-embedded biopsy specimens of 11 BCC as and 10 TEs. RESULTS: 1. In the immediate strcimas, spindle-shaped cells were stained in 4 out of ll cases of BCC and in 9 out of 10 cases of TE. However, the staining patterns observed in the 4 cases of BCC were all loosely scattered, week staining, while those of the 9 cases of TE were all densely compact, strong staining. CD34 was not expressed in one case of TE. 2. In the distant stromas, all cases of BCC and TE showed staining of loosely scattered spindle-shaped cells, and there was no difference in staining patterns of the two tumors. 3. Papillary mesenchymed bodies were observed in 8 cases of TE and in none of BCC, and they expressed CD34 focally. CONCLUSION: CD34 sta ining patterns of the immediate peritumoral stromas of BCCs and TEs were different and could differentiate the two tumors.
Biopsy ; Carcinoma, Basal Cell* ; Prognosis

OBJECTIVE: To compare the efficacy and safety of intravaginal administerd misoprostol and PGE2 (dinoprostone) with oxytocin for inducing labor in women with an unfavorable cervix. METHODS: One hundred thirteen patients with indicated for labor induction and unfavorable cervix were randomly assigned and received either misoprostol 50microgram intravaginal with oxytocin intravenous injection or prostaglandin E2(dinoprostone) 3mg intravaginal with oxytocin intravenous injection. RESULTS: Thirty-nine subjects were assigned to misoprostol with oxytocin group and 74 to the PGE2 with oxytocin group. The median interval from induction to vaginal delivery was significantly shorter in the misoprostol with oxytocin group(1274+/-496 versus 1512+/-501 minutes)(p<0.001). No significant difference between two groups were mode of delivery, neonatal and maternal outcomes. CONCLUSION: Intravaginal misoprostol and PGE2 vaginal insert appear to be safe agents for cervical ripening and labor induction. Misoprostol is more effective than PGE2 vaginal insert with oxytocin injection.
Cervical Ripening* ; Cervix Uteri* ; Dinoprostone* ; Female ; Humans ; Injections, Intravenous ; Misoprostol* ; Oxytocin ; Pregnancy ; Pregnancy*

The etiology of nephrotic syndrome in unknown. The characterization were proteinuria, hypoalbuminemia, generalized edema and hyperlipidemia. To assess the recurrence factors in the nephrotic syncrome, we measured serum immunoglobulin (IgG, IgA, IgM), albumin, complement, cholesterol and the 24-hour total urine protein at the initial relapse of nephrotic syndrome. Each data of frequent and infrequent relapsed nephrotic syndrome were compared. In total 67 cases, 18 cases were frequent relapsers and 26 cases were infrequent relapsers and 23 cases were normal control without renal disease. The levels of IgG and albumin in frequent relapser were 304 mg/dl and 1.59 g/dl as compared with 440 mg/dl and 2.06 g/dl in infrequent relapsers. The levels of IgG and albumin were signifecantly lower in frequent relapser than infrequent relapsers (p<0.05). This study might be useful to predict that very low levels of IgG and albumin at the first relapse might be related to high risk chances of frequent relapse in children with nephorotic syncrome.
Child ; Cholesterol ; Complement System Proteins ; Edema ; Humans ; Hyperlipidemias ; Hypoalbuminemia ; Immunoglobulin A ; Immunoglobulin G* ; Immunoglobulins ; Nephrotic Syndrome* ; Proteinuria ; Recurrence*

Chronic ulcerative colitis is a systemic inflammatory disease with uncertain etiology primarily involving the colonic mucosa. The mucosal biopsy interpretation is important for an evaluation of the disease state and further medical or surgical treatment. However, few clinical and pathological studies of the endoscopic diagnosis of this disease are available in Korea. Therefore, we evaluated the clinical and pathological characteristics of it diagnosed by endoscopic biopsy and analysed the reasons for the discrepancy between clinical and pathologic diagnosis for a more accurate endoscopic mucosal biopsy diagnosis in the future. A total of 702 cases of colonic mucosal biopsy specimens during Feb. 1994 and Jan. 1995 at Severance hospital, Yonsei University College of Medicine were reevaluated for the study. A clinical diagnosis of ulcerative colitis, after endoscopic examination, was made in 61(8.7%) cases. A pathological diagnosis was made when there is an increased inflammatory cell infiltration in the mucosa with evidences of a chronic crypt injury in the biopsy specimens. Using this criteria, a diagnosis was made in 32(52.3%) cases. In 29 cases the diagnosis was made in the first biopsy specimen and in the remaining 3 cases the diagnosis was made in the second or third biopsy specimens. No pathologic diagnosis of ulcerative colitis was made in the cases that clinical diagnosis was not. In the 32 cases diagnosed as ulcerative colitis, 14 cases were involved the rectum and sigmoid colon, 9 cases were involved up to the descending colon, 1 case was involved up to the transverse colon and 8 cases showed pancolonic involvement. In 29 cases, which ulcerative colitis was suspected clinically but was not consistent with it pathologically, 8 cases were proved to be ischemic colitis, 5 cases were acute infectious colitis and one case was Crohn's disease by repeat examination and follow up. Ten cases were histologically within normal range and lesions subsided spontaneously with no recurrence. A conclusive diagnosis could not be made in 5 cases during this study period. From these results, we conclude that ulcerative colitis can be diagnosed accurately by endoscopic biopsy, and clinical follow up and repeat examination are valuable in the differential diagnosis of this disease.
Diagnosis, Differential ; Biopsy

BACKGROUND: The morphalogy of fibroblast in culture is important in the discrimination of normal and abnormal cells as well as in recogniring general physiologic status of the cells. There have been many reports on the morphologic clialges in various skin diseases and in response to various drugs. However, we couldnt find any report on the time-sequential morphologic changes of normal fibroblasts in early subculture using light microscopy. OBJECTIVE: The purpose of this study is to describe the time-sequential morphologic changes of normal fibroblhst in early subculture. METHODS: The fibroblaats from 4 normal donors were cultured. We observed the morphologic changes of fibrolMasts in the third passage of subculture using light microscopy at 0-, 30-, 60-, 90-, 120-minutes, 3-, 5-, 24-, 72-hours and days after trypsinization, and electron microscopic exarriioation was done at 21 day-culture. RESULTS & CONCLUSION: Just after trypsinization, the cell were small and round, which divided and increased in number as time went by. At 120-minute culture, many cells had long and thin cytoplasmic elongations and they took stellae,shape at 5-hour culture. At 24-hour culture, several spindle-shaped cells were observec with cell-cell contacts. At 72-hour culture, many spindlle-shaped cells were arranged in medirection, with the appearance of parallel or whorl patterns and showed prominent cell-cell contacts. On electron microscopic examination, there were prominent RER, residial bodies and microfilaments.
Actin Cytoskeleton ; Cytoplasm ; Discrimination (Psychology) ; Fibroblasts* ; Humans ; Microscopy ; Skin Diseases ; Skin* ; Tissue Donors ; Trypsin

No abstract available.
Empyema* ; Muscle, Skeletal*