OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus intracervical dinoprostone (prostaglandin E2 gel) for cervical ripening and labor induction. METHODS: 60 patients with indication for labor induction and unfavorable cervices were randomly assigned to receive either intravaginal misoprostol or intracervical dinoprostone. 50 microgram tablets of misoprostol were placed in the posterior vaginal fornix every 4 hours for a maximum of 3 doses or dinoprostone 0.5mg was placed into the endocervix every 6 hours for a maximum of 2doses. No more medication was given after either spontaneous rupture of membranes or beginning of active labor. RESULTS: Among 60 patients enrolled, 30 received misoprostol and 30 received dinoprostone. The average interval from start of induction to active labor was shorter in misoprostol group (6.5+/-3.2 hours) than in the dinoprostone group (10.7+/-7.3 hours) (p<0.05). Oxytocin augmentation of labor occurred more often in the dinoprostone group (36.7%) than in the misoprostol group (10.0%) (p<0.05). There was a higher prevalence of fetal distress (23.3% versus 3.3%) and tachysystole (16.6% versus 6.6%) in the misorprostol group than in the dinoprostone group(p<0.05). CONCLUSIONS: Vaginally administered misoprostol is an effective agent for cervical ripening and induction of labor. Furthermore, the cost of misoprostol ( 360/200microgram) is much less than that of dinoprostone ( 42,000/0.5mg). Cost benefits from administration of misoprostol are evident, especially in clinics under system of diagnosis-related group (DRG) : however when given at this dosage, it is associated with a higher prevalence of fetal distress and tachysystole than dinoprostone. Further studies to compare the safety of misoprostole to that of dinoprostone and to delineate an optimal dosing regimen for misoprostol are needed.
Cervical Ripening* ; Cost-Benefit Analysis ; Diagnosis-Related Groups ; Dinoprostone* ; Female ; Fetal Distress ; Humans ; Membranes ; Misoprostol* ; Oxytocin ; Pregnancy ; Prevalence ; Prospective Studies* ; Rupture, Spontaneous ; Tablets

Epidermal cyst in the fibroadenoma of the breast is very rare. A 29-year-old woman presented with a lump in the upper outer quadrant of the right breast. Clinically it was a fibroadenoma and the excisional specimen showed an encapsulated, firm lobulated lesion with a cystic area on cut surface. The cystic area showed squamous metaplasia of the ductal epithelium and keratinous cyst formation in the fibroadenoma. We report this unusual case with review of literatures.
Adult ; Breast ; Epidermal Cyst* ; Epithelium ; Female ; Fibroadenoma* ; Humans ; Metaplasia

No abstract available.
Echocardiography, Transesophageal*

Development of antibody-based cancer therapies will be greatly facilitated if antibodies are better standardized in two fundamental issues that are specificity analysis of antibody reactivity and the detailed biodistribution and pharmacokinetic profile of antibodies. In the current endeavor we attempted to use an antibody binding specificity to target the tumor in a syngeneic carcinoembryonic antigen (CEA) tumor model. CEA, a 180 kDa glycoprotein, expressed at high levels on the surface of nearly all tumors of the gastrointestinal tract was used a potential target for antibody immunotherapy of gastrointestinal carcinomas. Using the CEA model antibody-based cancer therapy directed against CEA has been evaluated in a syngeneic animal model of disseminated disease. We constructed mouse/human chimeric anti-CEA IgG3, which has been evaluated for the specificity for CEA and the detailed biodistribution and pharmacokinetic profiles. Anti-CEA IgG3 heavy chain was expressed with the expected 180kDa molecular weight, assembled as H2L2 forms with a co-expressed mouse/human chimeric anti-CEA light chain, and were secreted. On FACS the purified anti-CEA IgG3 specifically recognized the mouse colon adenocarcinoma cell line MC-38 transduced with CEA (MCA32a), but not MC 38 without expressing CEA. After subcutaneous injection in C57BL/6 mice the half- lives of anti-CEA IgG3 and an irrelevant anti-dansyl IgG3 showed the bi-phasic kinetic patterns, and their pharmacokinetics of the distribution and the elimination were similar in mice. However, the biodistribution patterns of anti-CEA IgG3 were very different from those of anti-dansyl IgG3. Anti-dansyl IgG3 was mainly distributed into kidney until 72 hours, but anti-CEA IgG3 was slowly rernoved from blood and distributed into liver, kidney, spleen, and tumor. It is note worthy that anti- CEA IgG3 increased in targeting MCA32a tumor expressing human CEA by time, but the targeting to MC38 tumor was negligible. Thus, the increased targeting of anti- CEA IgG3 made MCA32a tumor grow slowly
Adenocarcinoma ; Animals ; Antibodies ; Carcinoembryonic Antigen ; Cell Line ; Colon ; Gastrointestinal Tract ; Glycoproteins ; Humans ; Immunoglobulin G* ; Immunotherapy ; Injections, Subcutaneous ; Kidney ; Liver ; Mice ; Models, Animal ; Molecular Weight ; Pharmacokinetics ; Sensitivity and Specificity ; Spleen

No abstract available.
Axilla ; Syringoma

No abstract available.
Humans ; Parents* ; Siblings*

Nine cases of primary localized cutaneous amyloidosis were studied by immunoperoxidase technique (ABC method) employing anti-keratin antibodies. All specimens were examined using consecutive paraffin sections to confirm the correspondence between amyloid existing area and reactive sites. Anti-keratin antibody 34pE which recognize 68, 58, 56.5, 56kd keratin peptides reacted with amyloid deposits in both lichen amyloidosus and macular amyloidosis. However, anti-keratin antibodies 34pB4 and 35pH did not react with amyloids. In general, Dylon staining positive material, keratin reacted with 34pE and amyloid P showed similar distribution in serial sections, but did not show the same one. Several keratin bodies reacted with 34pE, which were not stained with Dylon staining or antiamyloid P were found in the dermis of one specimen. These results suggest that immunohistochemical staining with antikeratin antibody 34pE using formalin-fixed, paraffin-embedded sections appeared to be a useful method in studying the histogenesis of primary localized cutaneous arnyloidosis.
Amyloid* ; Amyloidosis* ; Antibodies* ; Catalytic Domain ; Dermis ; Immunoenzyme Techniques ; Lichens ; Paraffin ; Peptides ; Plaque, Amyloid*

BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

The cysteine proteases of Paragonimus westermani metacercariae are involved in metacercarial excystment, host immune modulation, and possibly in tissue penetration. In order to clarify the origin of the enzymes, 28 and 27 kDa cysteine proteases in metacercarial excretory-secretory products were purified through the FPLC system using Mono Q column chromatography. The polyclonal antibodies to the enzymes were produced in BALB/c mice. Immunolocalization studies revealed that both cysteine proteases were distributed at the linings of excretory bladder and excretory concretions of the metacercariae. It was suggested that the excretory epithelium of P. westermani undertake the secretory function of metacercarial cysteine proteases, in addition to its role as a route for eliminating waste products.
Animals ; Chromatography, Liquid ; Computational Biology ; Cysteine Endopeptidases/analysis/isolation & purification/*physiology ; Immunohistochemistry ; Mice ; Mice, Inbred BALB C ; Paragonimus/anatomy & histology/*enzymology ; Support, Non-U.S. Gov't

No abstract available.
Erythema Multiforme* ; Erythema* ; Lymphoma*