No abstract available.
Humans* ; Myelin Basic Protein* ; Myelin Sheath* ; Myelin-Associated Glycoprotein* ; Oligodendroglia*

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

Intramural implantation is among the rarest forms of ectopic pregnancy.Since the first description by Perli, 21 cases were reported in worldwide literatures.The pathologic criteria required for intramural pregnancy is that the product of conception is completely surrounded by uterine musculature and is separated from the uterine cavity and the fallopian tube or round ligament.The previous history of uterine injury or adenomyosis is known as possible etiology of intramural implantation. Because the early diagnosis is very difficult, most cases is found after onset of complication such as a uterine rupture or hemoperitoneum. We have recently experienced a case of intramural pregnancy diagnosed and treated by laparoscopy in a 9 weeks gestation nulliparous woman without previous history of uterine injury or disease, and report with a brief review of literatures.
Adenomyosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Fertilization ; Hemoperitoneum ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Uterine Rupture ; Round Ligaments

Postoperative colonoscopy is an effective tool for management of colonic adenomas. Authors analyzed the pattern of colonic adenomas detected during follow-up colonoscopy after colorectal cancer surgery and evaluated the characteristics of adenornas, risk groups, and effective fo1low-up schedule. Study group were 222 patients and colonoscopy was performed 389 times. Patterns of adenornas were analyzed by variables as age, sex, preoperative serum CEA level, location of primary colorectal cancer, Borrmann type, Duke's stage, histologic differentiation, DNA ploidy, recurrence and histology. Metachronous adenomas were detected in 79 patients(35.6%) and both metachronous and syachronous adenomas were observed in 29 cases(13.1%). High risk variables for adenomas were male, old age and presence of synchronous adenoma. There were 2 patients with maligant change of adenomas. Yearly follow-up by complete colonoscopy over 3 years or more is recommended and follow-up interval should be shortened in the high risk groups.
Adenoma* ; Appointments and Schedules ; Colon ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms* ; DNA ; Follow-Up Studies ; Humans ; Male ; Ploidies ; Recurrence

No abstract available.

No abstract available.
Constriction, Pathologic* ; Neurologic Manifestations* ; Spinal Canal*

No abstract available.
Head* ; Magnetic Resonance Imaging* ; Necrosis*

This study was undertaken to evaluate the efficacy and safety of orally administered ketoconazole in the treatment of onychomycosis. Thirteen patients with onychomycoiis were selected for this study. For evaluation of ketoconazole efficacy twelve patients received a 200 mg tablet of ketoconazole daily and one patient received a. 10() mg tablet of ketoconazole daily. All patients were studied monthly clinically and mycologically by KOH mount and culture on Sabourauds medium. The results were as follows: 1. Seven(53.8%) of thirteen cases achieved remission, marked improvement occurred in three cases(23.1%) and moderate improvement occurred in three cases (23. 1 %). 2. The mean duration of remission or clinical improvement was 5 months for all lesions and toenail lesions(5. 4 months) took longer to heal than finger nail lesions (4 months). 3. One hundred percent of patient who previously failed to respond to griseofulvin were cured or clinically improved by ketoconazole. 4. Two patients cornplained of indigestion and one of headache. In our study, ketoconazole was highly effective in the treatment of onychomycosis.
Dyspepsia ; Fingers ; Griseofulvin ; Headache ; Humans ; Ketoconazole* ; Nails ; Onychomycosis*

Bezoyl peroxide, a powerful oxidizing agent, has been uaed topically in the treatment of acne vulgaris as a cream or lotion and has been shown to he effective for this codition. In 1972 Fulton emphaaized the importance of the vehicles used to obtain. maximum potential of benzoyl peroxide and for this, the gel formulation has been examined in many clinical trials. The present study was undertaken to evaluate the therapeutic effect of Fanoxyl 2.5, a 2.5% . benzayl peraxide gel, in patients with acne vulgaris. A total of 31 patients entered this study at the Departrnent of Dermatology, Jeoul National University Hospital rluring 3 rnanths period, from Decemher, 1978 through February, 1979, All patienta were instructed to apply Fanoxyl 2.5' on their affected areas once or twice a day and the nurnber of lesions on two or three t fixed areas were counted before and onee weekly after initation of the treatment. The reaults observed in the 3I patients were as follaws; 1. The percentage decrease in total nurnber of lesions in 4 weeks after treatment was 56.9%. 2. The authors could follow up for 6 weeks in 6 cases. In 6 case, the mean percentage in total number of lesions in 6 weeks after treatment was 81.7%. 3. Clesed and open eomedones were gradually eliminated; and their numbers were decreased in 4 weeks after treatment by 46.5% and 56.8% respeetiveIy. The papules were rapidly eliminated and their numbers were decreased in 4 weeka, after treatment by 79.8%. 4. Although most patients felt a mild burning sensation and tightness at the begining of the treatment, only a minority of the patients complained of discomfort due to pain(l case), erytherna(l case), tightness(2 cases),burning sensation (1 case), scaling(1 case). But all were tolerable without taking any specific measures or discontinuance of application. In one case, contact dermatitis developed after 4 weeks treatment. The authors concluded through this experiment that Panoxyl 2.5' (2.5% benzoyl peroxide gel) is a very effective local therapeutic agent in the treatment of acne vulgaris patients.
Acne Vulgaris* ; Benzoyl Peroxide* ; Burns ; Dermatitis, Contact ; Dermatology ; Follow-Up Studies ; Humans ; Sensation

OBJECTIVES: The myelodysplastic syndromes (MDS) are a group of acquired clonal hematopoietic disorders characterized by peripheral cytopenias and a hypercellular or normocellular dysplastic bone marrow. The mechanisms responsible for development of MDS are not known. We performed this study to evaluate the hematopoietic abnormalities and apoptosis in MDS. METHODS: Long-term bone marrow culture (LTBMC) was performed for colony assays, cobblestone area assay, stromal morphologic changes from 7 patients with MDS and 7 normal controls. In situ nick end labeling (ISNEL) method was performed for detection of apoptosis from LTBMC in 7 patients with MDS and 7 normal controls. ISNEL method also performed in bone marrow cell bloc samples in 36 patients with MI3S. RESULTS: Viability of nonadherent cells from LTBMC of patients with MDS was not decreased compared with normal controls at 1 week, but significantly decreased at 2 and 3 weeks compared with normal controls (P<0.0001). Formation of the cobblestone areas from patients with MDS was slightly decreased compared with normal controls at 1st week, but significantly decreased at 2nd and 3rd weeks compared with normal controls (P<0.0001). Slightly decreased compared with normal controls at 1 week, but significantly decreased at 2 and 3 weeks compared with normal controls (P<0.0001). Stromal layers produced in LTBMC of normal controls and 1 patient with MDS were detected at 1 week and were formed confluent stroma from 3 weeks, but another patients with MDS who did not form a confluent stroma. Patients with MDS had significantly lower colony forming unit granulocyte-macrophage (CFU-GM) compared with normal controls at 1 (P<0.01) and 2 weeks (P<0.001) of LTBMC. Two weeks of LTBMC resulted more profound inhibition of CFU-GM formation than 1 week (P<0.0001). Apoptotic cell death was absent in adherent and non adherent cells from normal controls at 1 and 2 weeks, but massive apoptotic cell death was found in adherent and non adherent cells from patients with MDS at 1 and 2 weeks and the degree of apoptosis was profound at 2 weeks compared with 1 week. Among the 36 patients, fifteen patients demonstrated varying degrees of apoptosis positive cells, 4 having low, 8 intermediates, and 3 high scores. Remaining 21 patients showed absent apoptosis or only occasional positive cells. CONCLUSION: Hematopoietic abnormalities such as a failure of differentiation are caused by the stromal defects and the biologic basis of the apparent paradox of peripheral cytopenias in the face of hypercellular (or normocellular) marrow is related by intramedullary apoptotic cell death of the stromal and hematopoietic cells.
Apoptosis* ; Bone Marrow Cells ; Bone Marrow* ; Cell Death ; Granulocyte-Macrophage Progenitor Cells ; Humans ; In Situ Nick-End Labeling* ; Myelodysplastic Syndromes* ; Stem Cells