OBJECTIVE: The use of oral hypoglycemic drugs in pregnant women has been limited and therefore there is scanty information on their safety. Concern about possible adverse effects of these drugs on the fetus led us to collect the cases of unintentional fetal exposure to oral antidiabetic agent during embryogenesis for comparision with an appropriately matched control group from the same clinic population. METHODS: Eight type 2 diabetic pregnant women with accidental exposure to oral antidiabetic agent during early pregnancy and 20 type 2 diabetic pregnant women matched for age, weight, and glycemic control but not exposed to oral antidiabetic agent were studied retrospectively. RESULTS: Three neonates (38%) in the exposed group had congenital malformations and still birth, compared with 5 (25%) in the control group (Odds ratio 1.8 (0.2-13.8), P>0.05). In the control group, the mean of HbA1c of 5 mothers of neonates with anomalies and stillbirth were higher than that of 15 mothers of neonates without anomaly (8.8% vs 6.2%, p=0.1) and the anomalies were major congenital malformation including three congenital heart diseases (1 ventricular septal defect, 2 patent ductus arteriosus) and one renal agenesis. In the exposed group, the mean of HbA1c of 3 mothers of neonates with anomalies and stillbirth were higher than that of 5 mothers of neonates without anomaly (9.0% vs 6.3%, p=0.4) and the anomlies were urachal sinus and facial palsy which was not commonly described in diabetic embryopathy. CONCLUSION: Although this study, due to the limited number of pregnancies examined, does not exclude an association between treatment with oral antidiabetic agent at the time of embryogenesis and congenital malformations in the offspring, the risk of our results is lower than that of others. The final answer will demand a much larger number of pregnancies studied prospectively.
Embryonic Development* ; Facial Paralysis ; Female ; Fetal Diseases ; Fetus* ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Hypoglycemic Agents* ; Infant, Newborn ; Mothers ; Parturition ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Stillbirth

PURPOSE: The purpose of this study was to investigate the diametral tensile strength of polymer-based temporary crown and fixed partial denture (FPD) materials, and the change of the diametral tensile strength with time. MATERIAL AND METHODS: One monomethacrylate-based temporary crown and FPD material (Trim) and three dimethacrylate-based ones (Protemp 3 Garant, Temphase, Luxtemp) were investigated. 20 specimens (the empty set 4 mm x 6 mm) were fabricated and randomly divided into two groups (Group I: Immediately, Group II: 1 hour) according to the measurement time after completion of mixing. Universal Testing Machine was used to load the specimens at a cross-head speed of 0.5 mm/min. The data were analyzed using one-way ANOVA, the multiple comparison Scheffe test and independent sample t test (alpha = 0.05). RESULTS: Trim showed severe permanent deformation without an obvious fracture during loading at both times. There were statistically significant differences among the dimethacrylate-based materials. The dimethacrylate-based materials presented an increase in strength from 5 minutes to 1 hour and were as follows: Protemp 3 Garant (23.16 - 37.6 MPa), Temphase (22.27 - 28.08 MPa), Luxatemp (14.46 - 20.59 MPa). Protemp 3 Garant showed the highest value. CONCLUSION: The dimethacrylate-based temporary materials tested were stronger in diametral tensile strength than the monomethacrylate-based one. The diametral tensile strength of the materials investigated increased with time.
Acrylic Resins ; Bisphenol A-Glycidyl Methacrylate ; Collodion ; Composite Resins ; Crowns ; Denture, Partial, Fixed ; Methacrylates ; Polymethacrylic Acids ; Tensile Strength

The role of glycine as an inhibitory neurotransmitter is well established, and glycinergic neurons appear to play an important role in the mammalian retinae[Ikeda & Sheardown, 1983 ; Bolz et al., 1985]. Though it has been reported that certain conventional and displaced amacrine cells and a few of bipolar cells are consistently labeled with anti-glycine antiserum in the mammalian retinae so far[W ssle et al., 1986 ; Pourcho & Goebel, 1987 ; Davanger et al., 1991 ; Yoo & Chung, 1992], little has been studied on the synaptic circuitry of glycinergic neurons to clarify mechanism of its action in the visual processing of the mammalian retinae. This study was conducted to localize glycinergic neurons and to define their synaptic circuitry in the rat retina by immunocytochemical method using anti -glycine antiserum. The results were as follows : 1. Glycinergic neurons of the rat retina were conventional and displaced amacrine cells, interstitial cells and bipolar cells. 2. Glycinergic amacrine cells could be subdivided into two types, that is, A II amacrine cells and other amacrine cells, according to their ultrastructures. Glycinergic A II amacrine and other amacrine cell processes comprised postsynaptic dyad at the ribbon synapse of rod bipolar axon terminals in the sublamina b of the inner plexiform layer of the retina. Glycinprgic A II amacrine cell processes made gap junctions with axon terminals of unlabeled invaginating cone bipolar cells in the sublamina b, and made chemical synapses onto axon terminals of unlabeled flat cone bipolar cells and onto dendrites of ganglion cells in the sublamina a of the inner plexiform layer. In the sublamina b of the inner plexiform layer, g1ycinergic amacrine cell processes were postsynaptic to axon terminals of unlabeled invaginating cone bipolar cells, and made chemical output synapses onto axon terminals of unlabeled invaginating cone bipolar and rod bipolar cells and onto the dendrites of ganglion cells. Such cases that pre- and post-synaptic processes of glycinergic amacrine cell processes were non- glycinergic amacrine cell processes were frequently observed throughout the inner plexiform layer. In some cases, glycinergic amacrine cell processes receiving synaptic inputs from other glycinergic amacrine cell process made synaptic outputs onto the non-glycinergic or glycinergic amacrine cell processes. 3. Glycinergic bipolar cells could be subdivided into invaginating and flat cone bipolar cells. Postsynaptic dyads of cone bipolar cells at the ribbon synapses were non-glycinergic amacrine and amacrine cell processes, glycinergic amacrine and amacrine cell processes, glycinergic amacrine and non-glycinergic amacrine cell processes, and dendrite and dendrite of ganglion cells. These results demonstrate that [1] glycinergic A II amacrine cell receiving synaptic input from rod bipolar cells inhibit flat cone bipolar cells and OFF ganglion cells via chemical synapse, and excite ON cone bipolar cells via electrical synapse ; thereby visual information in the darkness can be transmitted to ON ganglion cells via ON cone bipolar cells, and [2] glycine released from glycinergic neurons inhibits directly ON and OFF ganglion cells or indirectly ON and OFF ganglion cells via non-glycinergic amacrine or bipolar cells.
Amacrine Cells ; Animals ; Darkness ; Dendrites ; Electrical Synapses ; Ganglion Cysts ; Gap Junctions ; Glycine ; Neurons* ; Neurotransmitter Agents ; Presynaptic Terminals ; Rats* ; Retina* ; Synapses

BACKGROUND: Carcinoma of the uterine cervix is a theoretically preventable disease because its precursor lesions can be detected by cervical Papanicolau smears and appropriately treated, Although cervical cytology screening programmes have resulted in the redution of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. The focus of criticism has been the false-negative Pap smear, and the false-negative Pap smear is the major quality issue currently facing the physicians. To reduce the false-negative rate of Pap smear, it is essential to improve the accuracy of Pap smear. But false-negative rate of Pap smear has been reported variously. OBJECTIVE: This study was undertaken to evaluate accuracy of Pap smear by study false-negative and false-positive rate of Pap smear and to determine whether false-negative and false-positive rate had any correlations with clinical factors. STUDY DESIGN: The study population was comprised of 346 women, who were undertaken gynecologic operation at the Department of Obstetrics & Gynecology at Hanyang University hospital between March, 1997 and April, 1998. All patients were taken Pap smear before operation. In 93 women of these, preoperative diagnosis were cervical intraepithelial neoplasia and carcinoma in situ of uterine cervix, and in 253 women of these, preoperative diagnosis were benign disease as uterine myoma or adenomyosis, etc. All of their surgical specimen were examined. Pap smear, pathology, medical charts of all patients were reviewed retrospectively, and false-negative rate and false-positive rate were calculated. Clinical factors that associated with false-negative and false-positive rate were evaluated. Fishers exact test and Pearson chi-square test were used of statistical analysis, RESULTS: False-negative rate of Pap smear was 7.2%, false-positive rate was 4.6%, corresponding rate with histology was 88.2%. Sensitivity and specificity of PAP smear were 87.0% and 97.0% respctively. According to gross finding of uterine cervix, erosion was 46.6% in cervical intraepithelial neoplasia, 67.8% in carcinoma in situ, 66.6% in microinvasive carcinoma of uterine cervix and 55.3% of 103 erosion findings was cervical intraepithelial neoplasia, carcinoma in situ or microinvasive carcinoma. 23.1% of cervical lesion were normal gross finding. Menopause was associated with false-negative rate and previous vaginal infection history, previous cervical minor operation, delivery mode, contraception method, pelvic inflammatory disease history, vaginal bleeding at Pap smear and gross finding of cerbix were not associated. There were no clinical factors that were associated with false-positive rate. CONCLUSION: Compared with other reports, false-negative rate(7.2%) and false-positive rate(4.6%) of Pap smear was lower and corresponding rate(88.2%) was higher in Hanyand university hospital. Because of higher false-negative rate in menopausal women, it need more careful to take and interpretate Pap smear in these group.
Adenomyosis ; Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Contraception ; Diagnosis ; Female ; Gynecology ; Humans ; Incidence ; Leiomyoma ; Mass Screening ; Menopause ; Mortality ; Obstetrics ; Pathology ; Pelvic Inflammatory Disease ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; Uterine Hemorrhage

Persistent ectopic pregnancy (PEP) is defined as persisting pregnancy after conservative surgical treatment of ectopic pregnancy. PEP usually occurs in the original implantation site after incomplete removal of the trophoblast, but rarely may occur in other sites within the abdominal cavity, i.e., extratubal secondary trophoblastic implantation (ESTI). A 35-year old patient visited our clinic 40 days after laparoscopic surgery for ectopic pregnancy. She was diagnosed with hemoperitoneum and had then undergone a laparotomy procedure. Her operative findings revealed secondary implantation of the trophoblast in her greater omentum, which presented acute bleeding from the ruptured implanted trophoblast. In order to prevent the occurrence of ESTI, management must include minimizing any possible remnant trophoblast during the operative procedure, close and regular follow up of postoperative hCG, and consideration of postoperative prophylactic methotrexate. The patient must be well informed about all possible complications after treatment of ectopic pregnancy.
Abdominal Cavity ; Female ; Follow-Up Studies ; Hemoperitoneum ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy ; Methotrexate ; Oligopeptides ; Omentum ; Pregnancy ; Pregnancy, Ectopic ; Surgical Procedures, Operative ; Trophoblasts

BACKGROUND: Rocuronium can cause pain on injection in awake patients. We compared the effect of ketamine at three different small doses (0.1 mg/kg, 0.2 mg/kg, 0.3 mg/kg) and saline (placebo) for reducing pain on injection in awake patients. METHODS: 80 patients (aged 19-63 yr) scheduled for elective surgery were randomized to four groups in double-blind manner. Patients received the study drug intravenously, with venous occlusion for 20 seconds, followed by rocuronium 0.6 mg/kg into the dorsal vein over 10 seconds. Patient's response torocuronium injection was graded by four-point verbal rating scale. RESULTS: The incidence of pain was significantly less in patients receiving ketamine 0.3 mg/kg (55%) than in patients receiving saline (85%)(P < 0.05). But, No difference was found between ketamine 0.1 mg/kg, 0.2 mg/kg and saline groups. The pain score was significantly less in patients receiving ketamine 0.2 mg/kg and 0.3 mg/kg than in patients receving saline (P < 0.05). CONCLUSIONS: We concluded that pretreatment of ketamine 0.3 mg/kg with venous occlu-sion for 20 seconds, effectively decreases the incidence of pain caused by rocuronium injection.
Humans ; Incidence ; Ketamine* ; Veins

In order to develop antitumor agent which indicates weak side effects and strong antitumor activity, cytotoxicity and antitumor effects of MG was evaluated by MTT assay and SRB assay of colorimetric assay methods on the cultured NIH 3T3 fibroblasts and human oral epithelioid carcinoma cells (KB cells). KB cells were cultured in EMEM and RPMI 1640 media containing 10% fetal bovine serum, antibiotics and fungizone. After incubation for 24 hrs, the cells were treated with MG by dose dependent manner for 48 hrs under the same condition. The MTT and SRB quantity were measured by ELISA reader (Spectra Max 250, USA). The microscopic study was carried out to observed morphological change, Ag-NORs (argyrophylic nucleolar organizer region) number and PAS positive reacton of cultured KB cells. The results were as follows; 1. The MTT50 were 16677 micrometer in NIH 3T3 cell and 65.55 micrometer in KB cells treated with MG. 2. The SRB50 were 8701.23 micrometer in NIH 3T3 cell and 168.81 micrometer in KB cells treated with MG. 3. The number of Ag-NORs was not significant in cultured NIH 3T3 cells, but the number of Ag-NORs was significantly decreased in cultured KB cells treated with MG. 4. PAS reaction of cultured NIH 3T3 cells was not changed, but PAS reaction of cultured KB cells was changed to negative reaction. 5. Morphological changes of cultured NIH 3T3 cells treated with MG was weak, but KB cell treated with MG was severe. These results indicate that MG have noncytoxicity on NIH 3T3 fibroblasts and high cytotoxicity on KB cells.
Amphotericin B ; Anti-Bacterial Agents ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts ; Humans ; KB Cells ; NIH 3T3 Cells ; Nucleolus Organizer Region ; Periodic Acid-Schiff Reaction

Purpose: The purpose of present study was to evaluate the effect of changing structural stability of wax disc on the fit of prosthesis when the milling proceeded in order. Materials and methods: Prepared maxillary left first molar was used to fabricate a Ni-Cr alloy reference model. This was scanned to design crown and then wax pattern was milled, invested and cast to fabricate prosthesis. The wax patterns located in a row centrally within a single wax disc were set into a total of five groups ranging from WM1 group that was first milled to WM5 group that was last milled and the number of each group was set as 10. Silicone replica technique was used to measure the marginal gap, axial internal gap, line angle internal gap, occlusal internal gap. Data was evaluated with one-way ANOVA with significance level set at α = .05 and then Tukey HSD test was conducted for post analysis. Results: Marginal gap measured in each group, it was 40.41 ± 2.15 µm in WM1group, 40.44 ± 2.23 µm in WM2 group, 39.96 ± 2.25 µm in WM3 group, 39.96 ± 2.48 µm in WM4 group, and 40.57 ± 2.53 µm in WM5 group. No significant difference was found between groups. The significant difference between the groups was also not found in the axial internal gap, line angle internal gap, and occlusal internal gap. Conclusion Internal and marginal fit of single crown to the sequential order of milling processing in the single machinable wax disc did not seem to be affected by the sequence.

The demand for intravenous sedated upper gastrointestianl endoscopy is currently increasing steeply. Despite this trend, patient status complication due to this procedure is largerly neglected by most physicians. Recently, in three patients, mouthpiece fragment were left within the patients' body after intravenous sedated upper gastrointestinal endoscopy. They were transferred to our institution for the removal of the fragment. The patients complained of an uneasy sensation from within their body, around their necks and chests. After conducting therapeutic endoscopy, the fragment could be located around the distal part of their esophagus and within their stomach. The fragment were removed successfully by using snare in two patients, and by using forceps in another patient.
Eating* ; Endoscopy ; Endoscopy, Gastrointestinal* ; Esophagus ; Humans ; Neck ; Sensation ; SNARE Proteins ; Stomach ; Surgical Instruments ; Thorax

PURPOSE: The aim of this study was to compare the film thicknesses of several resin cements as a function of time after mixing and to examine the effect of working time on the film thicknesses. MATERIALS AND METHODS: The film thickness (microm) of 4 resin cements (n=10), 1 composite resin (Panavia F 2.0), 3 self-adhesive resin (Clearfil SA luting, Zirconite, RelyX U200) cements was measured at 20-second intervals after mixing of the cements up to 200 seconds under a load of 50 N. Linear regression was fitted to verify the effect of working time on the film thickness of each cement. Data were compared to the working time recommended by manufacturers using Wilcoxon test (alpha=.05). RESULTS: All of the materials showed a positive linear correlation between the film thickness and working time. There was no statistically significant difference between the working time based on our results and the values recommended by the manufacturers even though there was a discrepancy between those two values. CONCLUSION: The film thickness of resin cements could increase with the increase of working time. Working time to meet the ISO standard of 50-microm maximum film thickness could be different from the manufacturer's recommended value.
Linear Models ; Resin Cements ; Resins, Synthetic*