Recent development of maxillofacial surgery has taken an interest in the regeneration of facial bone defects. For the reconstruction of facial bone defects, autogenous bone grafts have been widely used. However, there are some clinical problems : the morbidity of donor sites, resorption of autogenous bone graft and, the availability of the proper form and size. The purpose of this study is to find the effective solutions to above problems. The present study was designed to evaluate the roles and regenerating capacity of fibrin sealant. Fibrin sealant is a newly developed substance for hemostasis, tissue sealing and wound healing. I made the experimental study on the effects and roles of bibrin sealant in sutogenous bone graft procedure to minimize the above complications and problems. Twenty-five adult white rabbits were used as the experimental material. Three trephine defects were made by drilling on the parietal bone of each rabbit. Defect size was 8x8mm. First group consisted of the rabbits which had the artificial defect on the parietal bone as control. The defect in second group was sealed up with autogenous boon chip only. Last group comprised the rabbits autografted by mixing the bone chip with the fibrin sealant. The results were carefully examined grossly and microscopically from the 3rd day to the 28th day postoperatively. The following results were obtained ; 1. The mixture of fibrin sealant and bone chip was useful for regenerating the bone defects. Most of the defects were substituted by new bone. 2. In the case of the graft with bone chip only, most defects were also filled with new bone, but less than fibrin group. 3. In the control group, new bone was formed around the peripheral area only. A mixture of fibrin sealant and autogenous bone chip plays an effective role in forming new bone. find judging from the results of this experiment, it may be expected the much use of the fibrin sealant in maxillofacial orthopedic surgery.
Adult ; Autografts ; Bone Regeneration* ; Facial Bones ; Fibrin Tissue Adhesive* ; Fibrin* ; Hemostasis ; Humans ; Orthopedics ; Parietal Bone ; Rabbits ; Regeneration ; Surgery, Oral ; Tissue Donors ; Transplants ; Wound Healing

We investigated the detection rate of Chlamydia trachomatis by enzyme immunoassay technique in cases of 89 patients with nongonococcal urethritis, 20 patients with chronic nonbacterial prostatitis. 17 males with previously treated urethritis, and 38 female patients who visited due to husband with urethritis, profuse vaginal discharge, vulvar itching. urinary symptoms and postcoital bleeding. The results were summarized as follows : The detection rates of Chlamydia trachomatis were 24.7% (22/89) in nongonococcal urethritis patients. 20% (4/20) in chronic nonbacterial prostatitis patients, 5.9% (1/17) in previously treated urethritis males. In the female patients. the detection rate were 28.6% (2/7) in patients with urethritis husband. 43.5% (10/23) with profuse vaginal discharge, 28.6% (2/7) with vulvar itching. 22.2% (2/9) with urinary symptoms and 12.5% (1/8) with postcoital bleeding.
Chlamydia trachomatis ; Chlamydia* ; Female ; Hemorrhage ; Humans ; Immunoenzyme Techniques* ; Male ; Prostatitis ; Pruritus ; Sexually Transmitted Diseases* ; Spouses ; Urethritis ; Vaginal Discharge

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus oral dinoprostone for labor induction at term. METHODS: One hundred of patients at term were randomized to receive either 50microgram of misoprostol vaginally every 4 hours or dinoprostone 0.5mg orally every 1 hour for the maximum of six doses. Intravenous infusion of oxytocin was administered under such circumferences as the patient did not go into active labor after maximum dose, SROM was developed without an adequate contraction pattern, or the patient had arrest of dilatation(no change in cervical dilatation for 2 hours). We compared the frequency of oxytocin augmentation, administration to delivery interval, vaginal delivery rate within 12 hours and 24 hours, intrapartum complications, induction failure, mode of delivery, neonatal outcomes, and maternal complications between two groups. RESULTS: The average interval from administration to delivery was shorter in the misoprostol group(739.4+/-372.4min vs 1087.7+/-765.1min, p<0.05), but the interval from administration to vaginal delivery of each group was similar(724.3+/-375.4min vs 800.3+/-697.0min). Regarding the frequency of vaginal delivery within 24 hours, however, misoprostol group was higher than dinoprostone group(88% vs 56%, p<0.001). And oxytocin augmentation of labor occurred less commonly in misoprostol group than in dinoprostone group(20% vs 76%, p<0.05). Any statistically significant difference in intrapartum complications, mode of delivery, and neonatal or maternal adverse outcome was not appeared between these two group. CONCLUSION: Vaginal misoprostol is as effective and safe as oral dinoprostone for cervical ripening and induction of labor at term. In addition, vaginal misoprostol contributes the curtailment of labor induction expenditure due to its moderate price; misoprostol costs 100 won per 50microgram.
Cervical Ripening ; Dinoprostone* ; Female ; Health Expenditures ; Humans ; Infusions, Intravenous ; Labor Stage, First ; Misoprostol* ; Oxytocin ; Pregnancy

Primary myelofibrosis is characterized by replacement of bone marrow with fibrotic tissue and the development of extramedullary hematopoiesis. Extramedullary hematopoiesis primarily involves the spleen and liver, but can also occur in the lungs. We report the case of an 80-year-old male who was admitted for evaluation of a lung mass and persistent thrombocytopenia. A percutaneous needle aspiration from the mass in the right lower lung showed myelopoietic cells with fatty tissue. A bone marrow biopsy revealed a hypercellular marrow with an increased number of atypical megakaryocytes. The final diagnosis was a prefibrotic stage of primary myelofibrosis leading to extramedullary hematopoiesis in the lung.
Adipose Tissue ; Aged, 80 and over ; Biopsy ; Bone Marrow ; Hematopoiesis, Extramedullary ; Humans ; Liver ; Lung ; Male ; Megakaryocytes ; Needles ; Primary Myelofibrosis ; Spleen ; Thrombocytopenia

Cytomegalovirus (CMV) infection is prevalent worldwide, although the symptomatic illness is usually confined to immunocompromised individuals. It can produce stomatitis, esophagitis, gastritis, duodenitis, and ulceration of the esophagus, stomach, duodenum, ileum, and colon within the gastrointestinal tract. Bleeding and perforation can also occur at these sites. The most common site of intestinal perforation is the colon, followed in frequency by the distal ileum and appendix. Herein, a recently experienced case of ileal perforation due to a CMV infection, in a patient with acquired immunodeficiency syndrome is reported, with a review of the literature.
Acquired Immunodeficiency Syndrome* ; Appendix ; Colon ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Duodenitis ; Duodenum ; Esophagitis ; Esophagus ; Gastritis ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Intestinal Perforation ; Stomach ; Stomatitis ; Ulcer

PURPOSE: There has been debate on the use of peritoneal irrigation and drainage following gastric cancer surgery. This study was conducted to evaluate the usefulness of routine peritoneal irrigation and drainage following gastric cancer surgery, especially with regard to the perioperative leukocyte count. METHODS: Of 298 patients, 153 were enrolled in the test group (without peritoneal irrigation & drainage), between October 2001 and August 2002, and 145 in the control group (with peritoneal irrigation and drainage), between January 2001 and September 2001. The demographics, range of dissection, pathological staging, operation times, anesthesia times, fever, perioperative leukocyte counts and operative complications were retrospectively analyzed in these consecutive patients. RESULTS: It was found that there was no difference in the demographics, range of dissection, pathological staging and operative complications between the two groups. However, the operation times, anesthesia times, and mean length of hospitalization in the test group were significantly shorter than those in the control group. No significance differences were found between the two groups with regard to the perioperative leukocyte counts. CONCLUSION: The routine usage of peritoneal irrigation and drainage was found to be neither safe nor effective in gastric cancer surgery patients.
Anesthesia ; Demography ; Drainage* ; Fever ; Hospitalization ; Humans ; Leukocyte Count* ; Leukocytes* ; Peritoneal Lavage* ; Retrospective Studies ; Stomach Neoplasms*

OBJECTIVE: To investigate the long-term outcomes of cardiac rehabilitation (CR) on exercise capacity in diabetic (DM) and non-diabetic (non-DM) patients with myocardial infarction (MI). METHODS: Of the MI patients who received hospital-based CR from February 2012 to January 2014, we retrospectively reviewed the medical records of the patients who continued follow-up through the outpatient clinic and community-based self-exercise after CR. A total of 37 patients (12 with DM and 25 without DM) were included in this study. Exercise capacity was measured by symptom-limited exercise tests before and after hospital-based CR and 1 year after the onset of MI. RESULTS: Before the CR, the DM group had significantly lower exercise capacity in exercise times, peak oxygen consumption (VO2peak), and metabolic equivalent tasks (METs) than did the non-DM group. After the CR, both groups showed significantly improved exercise capacity, but the DM group had significantly lower exercise capacity in exercise times, submaximal rate pressure products (RPPsubmax), VO2peak, and METs. One year after the onset of the MI, the DM group had significantly lower exercise capacity in exercise times, RPPsubmax, and VO2peak than did the non-DM group, and neither group showed a significant difference in exercise capacity between before and after the CR. CONCLUSION: As a result of continued follow-up through an outpatient clinic and community-based self-exercise after hospital-based CR in patients with MI, the DM group still had lower exercise capacity than did the non-DM group 1 year after the onset of MI, but both groups maintained their improved exercise capacity following hospital-based CR.
Ambulatory Care Facilities ; Diabetes Mellitus ; Exercise Test ; Follow-Up Studies ; Humans ; Medical Records ; Metabolic Equivalent ; Myocardial Infarction* ; Oxygen Consumption ; Rehabilitation* ; Retrospective Studies

A prominent cause of death in patients with advanced gastric cancer is peritoneal metastasis or recurrence. There is no definite preventive surgery or treatment in such cases. Cancer tissue is more heat labile than normal tissue, and the administration of anticancer drugs interacts synergically with hyperthermia. The ability of anticancer drugs to eradicate the malignant cells is dependent not only on the dose of the antineoplastic drug but also on the number of tumor cells. Therefore, for success, the combination therapy of cytoreductive surgery and IPHC may be necessary in advanced gastric cancer. We performed this study to evaluate the toxicity and the clinical efficacy of IPHC in far-advanced gastric cancer and to assess the concentration of CDDP. Twenty one patients (11 females and 10 males) with gross serosal invasion (with or without peritoneal metastasis) underwent cytoreductive surgery and were treated with IPHC via hyperex-GHT-cpl (Green Cross Med. Corp. Korea) before closure of the abdominal wound. The IPHC was done using CDDP (200~400 mg/m2) and MMC (30~50 mg/m2) with 10 liters of normal saline as the perfusate. The peritoneal temperature during the IPHC was maintained at 42oC for 60 minutes. We used a modified peritoneal cavity expander to achieve free flow of the perfusate. The concentrations of the plasma and the perfusate were measured by atomic absorption spectrometry (Varian 300 A). Sixteen patients were stage IV, 3 were IIIb, and 2 were IIIa. The plasma concentraton of CDDP was 1.8 ug/ml at 10 minutes after perfusion and reached a maximal concentration (MXC) of 3.6 ug/ml. The area under the time-concentration curve (AUC) of the plasma at the 48th hour after perfusion was 3031.1 ug.min/ml. At the 24th hour, the maximum concentration of CDDP in the perfusate was 16.2 ug/ml. The AUC of the perfusate was 1703.3 ug min/ml at the 24th hour and 1817.7 ug min/ml at the 48th hour. The ratio of AUC of perfusate and the AUC of the plasma were 0.92 at the 24th hour and 0.59 at the 48th hour. The postoperative compllications were lymphatic leakage (2), pneumonia (1), and paralytic ileus (1). The most common drug-related complications of IPHC were anemia (WHO grade I), hematuria, leukopenia, jaundice, and thrombocytopenia in such order. These side effects were eliminated by conservative treatment within 4 weeks postoperatively. We could not determine the long term survival rate because of the short follow up period. However, the mean survival of the cases was about 12.0 months. The three deaths among the resected cases were due to extraperitoneal recurrences. The combination therapy of IPHC and cytoreductive is available for clinical use with a high AUC, high intraperitoneal CDDP concentration with a reasonable plasma concentration and has no threatening complications or mortality.
Absorption ; Anemia ; Area Under Curve ; Cause of Death ; Female ; Fever ; Follow-Up Studies ; Hematuria ; Hot Temperature ; Humans ; Intestinal Pseudo-Obstruction ; Jaundice ; Leukopenia ; Mortality ; Neoplasm Metastasis ; Perfusion ; Peritoneal Cavity ; Plasma ; Pneumonia ; Recurrence ; Spectrum Analysis ; Stomach Neoplasms* ; Survival Rate ; Thrombocytopenia ; Wounds and Injuries

Recently we experienced a case of embryonal rhabdomyosarcoma of the bladder in a 38 years-old female. She complained of total painless gross hematuria and diagnosis was made by cystoscopy and TUR biopsy. Partial cystectomy and pelvic lymph node dissection performed on July 1989, and then she received the chemotherapeutic agents under the diagnosis of Intergroup Rhabdomyosarcoma Study Group I, the post-operative 8 months, she is in good condition without recurrence of tumor.
Adult* ; Biopsy ; Cystectomy ; Cystoscopy ; Diagnosis ; Female ; Hematuria ; Humans ; Lymph Node Excision ; Recurrence ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Embryonal ; Urinary Bladder*

Gitelman's sydnrome is a heritable renal disorder characterized by hypomagnesemia, hypokalemia and hypocalciuria. As compared to those with Bartter's syndrome, reduced urinary excretion of calcium and magesium wasting are essential features of Gitelman's syndrome. Interestingly, we have experienced a case of 32-year old man with a mixed type of Gitelman's syndrome and Bartter's syndrome, which includes normomagnesemia, normal renal magnesium excretion, and hypocalciuria. Herein we report the case of atypical Gitelman's syndrome with brief review of related literature.
Adult ; Bartter Syndrome ; Calcium ; Gitelman Syndrome* ; Humans ; Hypokalemia ; Magnesium*