Bacterial infection has been implicated in premature labor in human. But it is impossible to undergo human study of bacteria-induced preterm delivery. If we carry out animal experiment which simulate human preterm delivery induced by bacteria, studies for mechanism, diagnosis, and treatment of preterm delivery will be progressed rapidly. To elucidate mechanisms and potential intervention strategies in preterm pregnancy loss, we observed bacteria-induced preterm labor and the protecting effect of administration of antibiotics with hysteroscopy-guided intracervical inoculation of Escherichia coli. Sterile saline solution(group I, n=5) or 2x10(7)cfu (colony-forming units) of E. coli bilaterally in the cervix of pregnant New Zealand White rabbits on day 20 or 21(70% of gestation) by hysteroscopy was inoculated and rabbits were assinged to ampicillin-sulbactam therapy beginning at 0hr(group II, n=4), 2 hr(group III, n=4), 4 hr(group IV, n=2), and 16 hr(group V, n=2) after inoculation with E. coli, or to no antibiotic therapy(group VI, n=3). Unasyn(ampicillin-sulbactam) was used and its daily dosage was 100 mg/kg/day. The occurrence of vaginal bleeding or preterm birth was observed every two hours. If one rabbit fetus was found to be delivered, exploratory laparotomy was done. Amniotic fluid culture on each sac, decidual culture on each uterine cavity, and pathologic examinations on each placenta were done. The results of experiments are as follows. In control group(0.2cc sterile saline inoculation only), there was no preterm labor and no bacterial growth in culture. In all three rabbits in group VI, preterm delivery occurred and the culture results were all positive in maternal blood, decidua, and amniotic sacs. Preterm delivery also occurred in group V, but results of maternal blood culture were all negative. Increased trend in the occurrence of preterm delivery was statistically significant in the order(p < 0.05) : group I(0/5), group II(0/4), group III(0/4), group IV(0/2), group V(2/2), and group VI(3/3). Pregnancy outcomes on the basis of the number of living fetus, dead fetus, and macerated fetus, have significant trend in the above order. Amniotic fluid culture results also had significant relationship(p < 0.05) : group I(0.20), group II(20/26), group III(18/30), group IV(10/11), and group VI(7/7). In group V, amniotic fluid fail to be obtained due to severe oligohydramnios. Decidual culture results also had an increased trend; group I(0/32), group II(21/29), group III(20/30), gorup IV(16/16), gorup V(11/11), and group VI(25/25). It is statistically significant(p < 0.05) Incidence of histologic chorioamnionitis was also significantly increased from group I to VI. These results indicate that E. coli inoculation has induced preterm delivery and antibiotic therapy has somewhat prevented preterm birth, amniotic fluid infection, decidual infection, and histologic chorioamnionits. Antibiotic effects were attenuated in cases of delayed antibiotic administration.
Amniotic Fluid ; Animal Experimentation ; Anti-Bacterial Agents* ; Bacteria ; Bacterial Infections ; Cervix Uteri ; Chorioamnionitis ; Decidua ; Diagnosis ; Escherichia coli ; Female ; Fetus ; Humans ; Hysteroscopy ; Incidence ; Laparotomy ; Models, Animal ; Obstetric Labor, Premature ; Oligohydramnios ; Placenta ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Prognosis* ; Rabbits ; Uterine Hemorrhage

BACKGROUND: The purpose of this study is to evaluate the functional outcomes of reverse total shoulder arthroplasty (RTSA) and to assess factors affecting the patients' subjective satisfaction after RTSA. METHODS: Forty-three patients (mean age, 75.0 ± 5.2 years) who underwent RTSA for cuff tear arthropathy or irreparable cuff tears with preoperative magnetic resonance imaging and pre- and postoperative radiographs at 1 year, and whose various functional outcomes including pain visual analogue scale (VAS), simple shoulder test, Constant score, American Shoulder and Elbow Surgeons score, and active range of motion were evaluated preoperatively and at the last follow-up (>12 months) were enrolled. The outcome parameter was set as a satisfaction scale. Various clinical and radiographic factors were analyzed, and their correlations with postoperative satisfaction were evaluated. RESULTS: All functional scores, VAS pain score, and active forward flexion showed significant improvement after surgery (all p<0.001). Twenty-nine patients were satisfied with the results and 14 were dissatisfied. The presence of pseudoparalysis (p=0.028) and worse preoperative function (all p<0.05) were related with higher satisfaction. Any radiologic parameters did not affect patients' postoperative satisfaction. CONCLUSIONS: All patients showed a good functional outcome after RTSA, however the patients' subjective postoperative satisfaction was affected by preoperative functional status (higher satisfaction in poor preoperative function), not by radiological findings.
Arthroplasty* ; Elbow ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Shoulder* ; Surgeons ; Tears

In children, snapping knee syndrome and joint pain with the loss of physiological hyperextension strongly suggests a diagnosis of a torn discoid meniscus. We performed arthroscopic meniscectomy to treat torn discoid lateral meniscus on 19 knees and open meniscectomy on 9 knees of 26 children(average age: 10.9 yrs) from September, 1983 to October, 1993 at Guro hospital. According to Ikeuchi's grading system', excellent results were obtained in 14, good in 11, fair in 2 knees and poor in 1 knee which was associated with osteochondritis dissecans. The knees treated by partial meniscectomy showed less Fairbank's radiologic changes than those by total meniscectomy during the average follow-up 4.2 years(minimum 1 year, maximum 7 year 11 months).
Arthralgia ; Child ; Diagnosis ; Follow-Up Studies ; Humans ; Knee ; Menisci, Tibial ; Osteochondritis Dissecans

No abstract available.
Gonadotropin-Releasing Hormone* ; Gonadotropins*

No abstract available.
Pregnancy*

No abstract available.
Antibodies* ; Endometriosis* ; Female ; Humans

No abstract available.
Chorionic Gonadotropin* ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans* ; Progesterone* ; Superovulation*

No abstract available.
Oocyte Donation* ; Oocytes*

No abstract available.
Fertilization* ; Oocytes*

No abstract available.
Fertilization in Vitro* ; Superovulation*