To compare the efficiency, success rate and abortion time of applications of intravaginal misoprostol versus intravenous Sulprostone(Nalador) for mid-trimester pregnancy termination. Eighty three patients between 17-29 weeks of gestation with medical, obstetric, or genetic reasons for termination of pregnancy were randomized to receive either 50 ug tablets of misoprostol placed in the posterior vaginal fomix or 1,000ug sulprostone intravenously diluted I L of isotonic saline solution given as a 12-h infusion. Among eighty three patients recruited, fourty five patients received misoprostol and thirty eight patients received sulprostone intravenously. The average interval from start of induction to vaginal delivery was 13.35+/-3.34 hours in misoprostol group and 21.14+/-6.64 hours in the sulprostone group. The success rate of complete termination within 12 and 24 hours in misoprostol group were 57.7%, 93.3%, respectively, while in sulprostone group were 15.8%, 92.1% respectively. Oxytocin augumentation was 6.7% in misoprostol group and 7.9% in the sulprostone group. No serious complication occurred. Intravaginal misoprostol appears to be acceptably safe and effective agents for second trimester pregnancy termination. Misoprostol has the advantage of being inexpensive, easily stored and readily available. The regimen of 100 ug misoprostol inserted intracervicovaginally every 8 hours is the optimal method for pregnancy termination.
Female ; Humans ; Misoprostol* ; Oxytocin ; Pregnancy ; Pregnancy Trimester, Second* ; Sodium Chloride ; Tablets

No abstract available.

No abstract available.
Humans ; Hyperthyroidism* ; Procollagen*

OBJECTIVE: Aims of this study were to conclusively demonstrate apoptosis in the human placenta and to compare of placental apoptosis in normal pregnancy, preeclampsia and intrauterine growth restriction. METHODS: Placental samples obtained from 30 term, normal pregnancy, 30 pregnancies complicated intrauterine growth restriction, 30 pregnancies complicated preclampsia. The definition used to identify intrauterine growth restriction depends on fetal body weight ratio less than 10 percentile by ultrasonography. The definition used to identify preeclampsia depend on ACOG criteria. Light microscopy and polyclonal antibodies of Fas, Fas ligand, Bax, Bcl-2 were used to identify apoptosis. RESULTS: Apoptosis was conclusively demonstrated within placental tissue. Results of immunohis-tochemical analysis of Fas in the trophoblast of normal pregnancy, pregnancy induced hypertension and intrauterine growth restriction were negative of 86.7%, 26.7% and 13.3% respectively. Results of immunohistochemical analysis of Fas lgand in the trophoblast of normal pregnancy, pregnancy induced hypertension and intrauterine growth restriction were diffuse positive of 53.3%, 16.7% and 6.7% respectively. Results of immunohistochemical analysis of Bcl-2 in the trophoblast of normal pregnancy, pregnancy induced hypertension and intrauterine growth restriction were diffusely positive of 90.0%, 76.7% and 66.7% respectively. Results of immunohistochemical analysis of Bax in the trophoblast of normal pregnancy, preeclampsia and intrauterine growth restriction were diffuse positive of 40.0%, 40.0% and 50.0% respectively. CONCLUSION: Apoptosis and altered expression of Bcl-2 in trophoblast were conclusively demonstrated within placental tissue, suggesting that it may play a role in the normal development and aging of the placenta. Placental apoptosis and altered expression of Fas and Fas ligand in trophoblast might influence pathogenesis or pathophysiologic mechanism of preeclamsia and intrauterine growth restriction.
Aging ; Antibodies ; Apoptosis* ; Fas Ligand Protein ; Female ; Fetal Weight ; Humans ; Hypertension, Pregnancy-Induced ; Microscopy ; Placenta ; Pre-Eclampsia* ; Pregnancy* ; Trophoblasts ; Ultrasonography

No abstract available.
Dental Enamel* ; Lasers, Solid-State*

BACKGROUND: The electrocardiogram may provide valuable information regarding the identity of the culprit coronary artery and the location of obstructing lesion within the artery, which may be of guidance in selecting the therapeutic modality. Previous studies have concluded that changes in lateral leads (I, aVL, V5, V6) are predictive of left circumflex coronary artery obstruction in inferior wall acute myocardial infarction. Elect-rocardiographic criteria for determining the location of the obstructing lesion, however, have not been well established. The purpose of this study is to investigate the patterns of ST segment depression in lateral leads in inferior wall acute myocardial infarction and the obstruction site of culprit artery according to ST segment depression in lateral leads. METHODS: We examined 78 patients with inferior wall acute myocardial infarction analizing their electrocardiogram and coronary angiography which performed during acute hospitalization. RESULTS: Of the fifty-five patients in which the culprit artery could be determined, 1)in 41 the culprit artery was the right coronary artery (19 proximal to the right ventricular branch and 22 distal), and in 14 the left circumflex coronary artery (7 proximal to the first obtuse marginal branch or involving a high first obtuse marginal branch, and 7 with distal obstruction). 2)Significant ST depression (ST< or =1 mm) in leads I and aVL was more common in right coronary artery obstruction (p<0.05 and p=0.01 respectively) than left circumflex artery. 3)It was difficult to define the location of obstruction with ST segment change of lateral precordial leads (V5, V6). CONCLUSIONS: In acute inferior wall myocardial infarction, ST segment depression in lateral limb leads (I, aVL) can be indicative of the right coronary artery obstruction and the ST segment depression pattern in lateral precordial leads was not indicative of the site of obstruction.
Arteries ; Coronary Angiography ; Coronary Vessels ; Depression* ; Electrocardiography ; Extremities ; Hospitalization ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction*

No abstract available.
Fructosamine* ; Hyperthyroidism*

The purpose of this study was to evaluate the propriety of making use of the light-cured resin base in indirect bracket bonding technique by study of shear bond strength and failure patterns according to the material of resin base. Metal brackets were bonded to the stone models of specimens involving bovine lower incisor with chemical-cured(Excel), light-cured(Light-Bond) and thermal-cured(Therma-Cure) resin. They were transferred to the specimens and bonded using sealant. The shear bond strength was tested on Instron. After bracket removal, the bracket base was examined and assessed with the adhesive remnant index(ARI). The results were as follows: 1. No significant differences in shear bond strength were found among the three groups (P>0.05). 2. No significant differences in Alts score were found among the three groups (P>0.05). The above results suggest that light-cured resin base in addition to chemical-cured and thermal-cured resin bases is useful in the indirect bonding technique.
Adhesives ; Incisor

The occurrences of pneumothorax and pneumomediastinum are rare, but considered to be potentially life-threatening conditions in patients undergoing functional endoscopic sinus surgery under general anesthesia. Tracheobronchial rupture may results in serious complications, such as pneumothorax and pneumomediastinum. It may occur accidentally by endotracheal tube when the patient's neck is flexed or extended. We report the case of a 48-year-old female patient who developed massive subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumoperitoneum seven hours after functional endoscopic sinus surgery under general anesthesia.
Anesthesia, General ; Female ; Humans ; Mediastinal Emphysema ; Neck ; Pneumoperitoneum ; Pneumothorax ; Rupture ; Subcutaneous Emphysema ; Valsalva Maneuver

BACKGROUND: Unplanned extubation is a common occurrence in mechanically ventilated patients even in spite of careful attention. It is important to decide on reintubation or the retention of the extubated state especially in the critically ill patients. We tried to formulate general guideline for evaluation and safe management in unplanned extubated liver transplant patients with high risk of multiple organ failure and high mortality rate. METHODS: We reviewed all medical records of 5 unplanned extubated cases from 27 liver transplantation cases. We checked delayed extubation criteria which included United Network Organ Sharing (UNOS) class 1 or 2, preoperative Na (below 130 mEq) and albumin (below 3.0) level, transfusion amount in operating room, severity of postreperfusion syndrome (PRS) and need of vasopressor agents in the 5 unplanned extubated cases. We also checked direct intubation determining factors such as PaO2/FiO2 ratio, respiration rate and pattern, mental state and mode of ventilation. Finally, we reviewed additional factors influencing reintubation. RESULTS: We found a rate of 18 percent of unplanned extubation (5 of 27 events), and 80 percent of reintubation incidence (4 of 5 events). CONCLUSIONS: It is rational to reintubate immediately in unplanned extubated cases which meet 3 or more delayed extubation criteria. The direct reintubation determining factors are PaO2/FiO2 ratio (below 300) and the presence of paradoxical respiration with a high respiration rate (over 28/minute).
Critical Illness ; Humans ; Incidence ; Intubation ; Liver Transplantation ; Liver* ; Medical Records ; Mortality ; Multiple Organ Failure ; Operating Rooms ; Respiration ; Respiratory Rate ; Vasoconstrictor Agents ; Ventilation