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*

A 23 year-old female with skeleto-dentoalveolar protrusion of maxilla, minor broken contact points between anterior teeth, and missing of lower 1st molars, has been treated with multibanded edgewise technique. After treatment of 14 months, she has gained functional overbite-overjet relationship and facial harmony due to the retraction of upper anterior teeth. Root resorption was slight. Especially, us ing the space of missed lower 1st molars instead of extracting lower premolars, expected and favorable results were obtained.
Adult* ; Bicuspid ; Female ; Humans ; Maxilla ; Molar ; Prognathism* ; Root Resorption ; Tooth ; Young Adult

Wear of articular cartilage usually occurs at flexion zones (30°–60°) of the femorotibial articulation, which is demonstrable on the 45°posteroanterior (PA) weight-bearing view. The authors measured and evaluated the cartilage space on the non weight-bearing AP view, AP extension weight-bearing view and 45°PA flexion weight-bearing view, comparing operative findings in cases of 18 osteoarthritis, 7 rheumatoid arthritis and 2 spontaneous osteonecrosis of the lateral femoral condyle, who underwent total or hemiarthro plasty (1 case) of the knee. The results were as follows. l. Operative findings of 11 out of 18 osteoarthritis (61.1%) showed cartilage defect of middle 3/4–4/5 of the medial tibial condyle (sparing finger tip sized anterior & posterior edge) and corresponding femoral condyle. The cartilage space on the AP non weight-bearing, AP extension weight-bearing and 45°PA flexion weight-bearing view were normal to 20% decrease (4.1–5.0mm remained), 60–80% decrease (1.1–2.0mm remained) and 80–100% decrease (0–1.0mm remained), respectively, showing one grade increased cartilage space narrowing on the 45°PA flexion weight-bearing view comparing to AP extension weight-bearing view. 2. Uniform cartilage defect of medial compartment was found in 7(38.9%) osteoarthritic knees. The cartilage space on the non weight-bearing AP view were normal. Both AP & PA weightbearing views showed 60–80% decrease (1.1–2.0mm remained) in 3 knees & 80–100% decrease (0–1.0 mm remained) in 4 knees without any difference between the two views. 3. Uniform cartilage space narrowing of both medal & lateral compartment was noted in 7 rheumatoid knees. The cartilage space on the AP non weight-bearing view were 20–40% decrease (3.1–4.0mm remained) in all knees. The AP extension & 45°PA flexion view showed 40–60% decrease (2.1–3.0mm remained) in 2 knees, 60–80% (1.1–2.0mm remained) in 5 knees respectively without any difference between two groups. 4. The anterior horn of menisci was always intact. The presence of menisci didn't affect the radiological cartilage space. 5. The 45°PA flexion weight-bearing view functioned as a tunnel view showing bone defect and less than 20% decrease of cartilage space in cases of the spontaneous osteonecrosis of the lateral femoral condyle. From our results it was concluded that the radiologic cartilage space could be more accurately demonstrated with 45°PA flexion weight-bearing view in addition to the conventional AP extension weight-bearing view.
Animals ; Arthritis, Rheumatoid ; Cartilage ; Cartilage, Articular ; Clothing ; Fingers ; Horns ; Knee ; Numismatics ; Osteoarthritis ; Osteonecrosis ; Weight-Bearing

The effectiveness of alternate flexion and extension splint(splint group) in restoring the range of motion(ROM) following total knee arthroplasty(TKA) was evaluated, comparing with the continuous passive motion(CPM) group. One hundred and twenty knees of 87 patients(21–80 years old:12 males & 75 females) who were followed for 2.7 years(ranging from 1.2 to 5.3 years) were involved in this study. The ROM of following groups were compared each other and the results were analyzed statistically with Wilcoxon rank sum test and the differences between each prosthesis were compared with Kruskal-Wallis test. 1) Splint(51 knees, 42.5%) v.s CPM group(69 knees, 57.5%) 2) RA(43 knees, 35.8%) v.s. OA(77 knees, 64.2%) 3) Various types of prosthesis(PSCK, PCA, Tricon-M, M/G, Oxford Knee, PFC) The results were as follws:1. The ROM of splint group(average 132.2°, ranging from 85–145°) was significantly greater than that of CPM group(average 110.5°, ranging from 50–140°)(p<0.01). 2. The ROM of osteoarthritic knees(average 122.2°) was slightly greater than that of rheumatoid knees(average 115.8°) without statistical significance(p) 0.05). 3. There was statistically significant difference between ROM of the various types of implant(p < 0.01). However this difference seemed due to different methods of rehabilitation rather than different types of prosthesis. From this result it is suggested that the alternate flexion and extension splint following TKA is a useful method in restoring ROM, comparing to gradual ROM exercise with CPM.
Arthroplasty, Replacement, Knee ; Humans ; Knee ; Male ; Methods ; Passive Cutaneous Anaphylaxis ; Prostheses and Implants ; Rehabilitation ; Splints

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*

BACKGROUND: Several studies have demonstrated that quantitation of hepatitis B virus (HBV) DNA in sera of HBsAg-positive patients is more useful test for the assessment of infectivity and for the evaluation of disease status than previously utilized numerous serological markers and qualitative polymerase chain reaction for the detection of HBV DNA. We tried to measure serum HBV DNA using a branched DNA (bDNA) signal amplification assay, which is recently introduced and known to be a simple and nonradioisotopic method. METHODS: Total forty patients with HBsAg were randomly selected and serum HBV DNA was measured with duplication using bDNA signal amplification assay (QUANTIPLEXTM HBV DNA ASSAY, Chiron, USA). Quantitation was determined from a standard curve and expressed as HBV DNA equivalents/mL (Eq/mL; 1 Eq = 1 molecule of the primary HBV DNA standard). Serum HBeAg, aspartate aminotransferase (AST), alanine aminotransferase (ALT) , and soluble interleukin-2 receptor (sIL-2R) were compared with HBV DNA. RESULTS: Serum HBV DNA was quantitated in 13 patients (32.5%) (range 6.4x106-7.4x109 Eq/mL, mean 1.8x109 Eq/mL, CV 8.1%). All eleven patients (100%) with both HBsAg and HBeAg an4 2 of 29 patients (6.9%) with HBsAg but not with HBeAg showed measurable HBV DNA (p < 0.001). In addition, serum levels of AST, ALT, and sIL-2R were significantly higher in HBV DNA measured patients compared with those of unmeasured patients. CONCLUSIONS: Above results show that more than half the HBsAg-positive patients do not have enough HBV DNA which is measurable with boNA signal amplification assay but all of HBeAg-positive patients and some of HBeAg-negative patients do. In addition, HBV DNA quantitation might be correlated with the disease activity in HBsAg-positive patients because serum levels of AST, ALT, and sIL-2R are higher in patients measured with HBV DNA than unmeasured.
Alanine Transaminase ; Aspartate Aminotransferases ; Branched DNA Signal Amplification Assay* ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Interleukin-2 ; Polymerase Chain Reaction

BACKGROUND: T cell mediated immune destruction is an important mechanism of liver injury in patients with chronic hepatitis C. Serum levels of soluble interleukin-2 receptor(sIL-2R) seem to serve as a marker for the T cell activation and progressive liver injury, This study examined serum levels of sIft-2R and hepatitis C virus (HCV) RNA in patients with chronic HCV infection to determine the correlation with the severity of chronic hepatocellular damage. METHODS: Serum levels of sIft-2R in 73 patients with HCV infection (chronic hepatitis 52, liver cirrhosis 9, hepatocellular carcinoma 12) and 40 healthy controls were measured by sandwich enzyme immunoassay (CELLFREE, T Cell Sciences, USA). HCV RNA was quantified by QUANTIPLEX(TM) HCV RNA 2.0 assay (Chiron, USA) with duplication. This assay is a sandwich nucleic acid hybridization procedure using branched DNA amplification for the quantitation of HCV RNA. RESULTS: The sIL-2R levels of 52 patients with chronic hepatitis (591.4+/-238.7U/mL), 9 with liver cirrhosis(949.4+/-721.9 U/mL), and 12 with hepatocellular carcinoma (1,167.4+/- 554.4 U/mL) were significantly higher than those of healthy controls(370.8+/-71.8 U/mL) (p<0.001). A progressive and significant increase occurred in sIL-2R levels with chronic hepatitis C, liver cirrhosis and hepatocellular carcinoma (HCC) in order (p(0.001). The HCV RNA was detected in all patients and the means of HCV viral load were 3.3 MEq/mL in chronic hepatitis, 2.8 MEq/mL in cirrhosis, and 3.7 MEq/mL in HCC. There was no significant correlation between HCV RNA and the severity of liver injury in chronic HCV infection. There were no correlations among sIL-2R, HCV RNA and serum ALT. CONCLUSIONS: These results suggest that chronic hepatocellular injury by HCV progress mainly by T cell mediated immune response, not by direct cytopathic injury. Also, sIL-2R can be useful as a marker in monitoring the patients with HCV infection at high risk of getting HCC.
Carcinoma, Hepatocellular ; DNA ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis C, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoenzyme Techniques ; Interleukin-2* ; Liver ; Liver Cirrhosis ; Nucleic Acid Hybridization ; RNA ; Viral Load

BACKGROUND: T cell mediated immune destruction is an important mechanism of liver injury in patients with chronic hepatitis C. Serum levels of soluble interleukin-2 receptor(sIL-2R) seem to serve as a marker for the T cell activation and progressive liver injury, This study examined serum levels of sIft-2R and hepatitis C virus (HCV) RNA in patients with chronic HCV infection to determine the correlation with the severity of chronic hepatocellular damage. METHODS: Serum levels of sIft-2R in 73 patients with HCV infection (chronic hepatitis 52, liver cirrhosis 9, hepatocellular carcinoma 12) and 40 healthy controls were measured by sandwich enzyme immunoassay (CELLFREE, T Cell Sciences, USA). HCV RNA was quantified by QUANTIPLEX(TM) HCV RNA 2.0 assay (Chiron, USA) with duplication. This assay is a sandwich nucleic acid hybridization procedure using branched DNA amplification for the quantitation of HCV RNA. RESULTS: The sIL-2R levels of 52 patients with chronic hepatitis (591.4+/-238.7U/mL), 9 with liver cirrhosis(949.4+/-721.9 U/mL), and 12 with hepatocellular carcinoma (1,167.4+/- 554.4 U/mL) were significantly higher than those of healthy controls(370.8+/-71.8 U/mL) (p<0.001). A progressive and significant increase occurred in sIL-2R levels with chronic hepatitis C, liver cirrhosis and hepatocellular carcinoma (HCC) in order (p(0.001). The HCV RNA was detected in all patients and the means of HCV viral load were 3.3 MEq/mL in chronic hepatitis, 2.8 MEq/mL in cirrhosis, and 3.7 MEq/mL in HCC. There was no significant correlation between HCV RNA and the severity of liver injury in chronic HCV infection. There were no correlations among sIL-2R, HCV RNA and serum ALT. CONCLUSIONS: These results suggest that chronic hepatocellular injury by HCV progress mainly by T cell mediated immune response, not by direct cytopathic injury. Also, sIL-2R can be useful as a marker in monitoring the patients with HCV infection at high risk of getting HCC.
Carcinoma, Hepatocellular ; DNA ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis C, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoenzyme Techniques ; Interleukin-2* ; Liver ; Liver Cirrhosis ; Nucleic Acid Hybridization ; RNA ; Viral Load

We have attempted to define the acetabular remodelling after varus derotation osteotomy and limitations of pelvic osteotomy in the treatment of DDH. We studied the case of thirty eight patients (42 hips) who were divided into three groups according to age at operation and into two groups, subluxation with acetabular dyaplasia and complete dislocation. The cases were evaluated the influence of femoral remodeling, age, acetabular response and instability and requirement of other additional surgery. The length of follow up ranged from two to fourteen years. A return to a valgus femoral neck shaft angle by remodeling was observed in case without avascular necrosis of femoral head. Acetabular correction by remodeling occurred in case of well reduced the femoral head in the socket. Acetabular remodeling was observed even in age of 8. Twenty eight of 42 hips which were complete dislocation required no pelvic osteotomy. A varus derotation osteotomy is a necessary procedure for hip stability and open reduction in treatment of DDH. Good results should be anticipated in patient whose femoral head was well seated in the acetablum.
Acetabulum ; Dislocations ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Necrosis ; Osteotomy

No abstract available.
Abdominal Wall* ; Diagnosis* ; Fetus*