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

No abstract available.
Female ; Humans ; Myiasis

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*

Actinomycosis is a rare entity which presents some difficulties in establishing a correct preoperative diagnosis. Many actinomycotic pelvic infections in women are related to IUD use and the colonization rate appears to increase in accordance with the duration of IUD use. So, all women in IUD use are recommended to make cervicovaginal smear and pelvic infection associated with IUD use should be suspected to have actinomycoses. We report a case which presented painful mass on right upper and lower quadrant of abdomen of a 40-year-old women. We identified sulfur granules by histopathologic exam of surgically resected specimen. Eventually it proved to be pelvic and abdominal actinomycosis associated with the use of an intrauterine device. Because variable clinical pictures and infrequency of the disease make the diagnosis more difficult, increased alertness of clinicians and microbiologists to the presence of anaerobic organism as the cause of infection are needed to make an earlier and more correct diagnosis of actinomycoses and to further avoid any inappropriate treatment.
Abdomen ; Actinomycosis ; Adult ; Colon ; Diagnosis ; Female ; Humans ; Intrauterine Devices ; Pelvic Infection ; Pelvis ; Sulfur

Sleep disturbance and restless legs syndrome (RLS) among uremic patients is known to be high, but data on the prevalence, clinical significance, and causative factors are limited. A semiquantitative sleep and RLS questionnaire was distributed to 62 chronic hemodialysis(HD) patients. 74.5N had sleep complaints and frequent awakening was the most frequent specific sleep complaints followed by daytime sleepiness. Presence of diabetes mellitus(DM), RLS, depres- sion, high CRP level, low intact parathyroid hormone level, low subjective global assessment score, and short HD duration were associated with more sleep complaints. 58.3N had RLS and presence of DM, low serum albumin level were also associated with more severe RLS. But Kt/V, protein catabolic rate, hematocrit, plasma bicarbonate level, use of erythropoietin and sleep medication were not associated with sleep complaints and RLS. Sleep problems and RLS are comrnon in HD patients and seem to be associated with malnutrition. Presence of DM, de- pression, and RLS are likely to contribute the high prevalence of sleep disturbance.
Erythropoietin ; Hematocrit ; Humans ; Malnutrition ; Parathyroid Hormone ; Plasma ; Prevalence ; Renal Dialysis* ; Restless Legs Syndrome ; Serum Albumin ; Surveys and Questionnaires

Atrophying pityriasis versicolor is a rare variant of pityriasis versicolor. Clinically, atrophying pityriasis versicolor is characterized by well defined, slightly scaly, depressed macules and patches with minimal symptoms. The etiology of the atrophy is unknown, though several hypotheses have been suggested, including immune reaction to antigens of Malassezia species. A 23-year-old male was presented with multiple, slightly brown colored macules and patches on the chest and back. In the potassium hydroxide preparation, lots of yeasts and hyphae were found. A histopathologic study showed multiple yeasts and hyphae on the stratum corneum, focal epidermal thinning, and perivascular lymphocytic infiltration on the upper dermis. The patient was treated with 100 mg itraconazole a day with topical antifungal agents. After 3 weeks of treatment, clinical improvement and mycological improvement were achieved. We present an additional case of atrophying piryriasis versicolor developed on the chest and back with the review of the relevant literature.
Antifungal Agents ; Atrophy ; Dermis ; Humans ; Hydroxides ; Hyphae ; Itraconazole ; Malassezia ; Male ; Pityriasis ; Potassium ; Potassium Compounds ; Thorax ; Tinea Versicolor ; Yeasts ; Young Adult

Background: Arthroscopic rotator cuff repair using human dermal matrix allograft augmentation has been widely used. We assessed the effect of acellular human dermal matrix augmentation after arthroscopic repair of large rotator cuff tears through a prospective, single-blinded, randomized controlled trial with a long-term follow-up. Methods: Sixty patients with large-sized rotator cuff tears were randomly assigned to two groups. Patients in the control group underwent arthroscopic rotator cuff repair. Allograft patch augmentation was additionally performed in the allograft group. All patients were subdivided into a complete coverage (CC) group or an incomplete coverage (IC) group according to footprint coverage after cuff repair. Constant and American Shoulder and Elbow Surgeons (ASES) scores were assessed preoperatively and at final follow-up. Magnetic resonance imaging was also performed at the same time to evaluate the anatomical results. Results: Forty-three patients were followed up for an average of 5.7 years. Clinical scores (Constant and ASES) increased significantly at the last follow-up in both groups. The increase in ASES score in the allograft group was statistically significantly greater than that in the control group. The degree of Constant score improvement did not differ significantly between the two groups. The retear rate was 9.1% in the allograft group, which was significantly lower than that in the control group (38.1%). In the control group, the CC subgroup had a statistically significantly lower retear rate (16.7%) than did the IC subgroup. There were no retear cases in the CC subgroup of the allograft group. Conclusions Long-term follow-up of arthroscopic repair of large rotator cuff tears with allograft patch augmentation showed better clinical and anatomical results. Footprint coverage after rotator cuff repair was an important factor affecting the retear rate. If the footprint was not completely covered after rotator cuff repair, allograft patch augmentation may reduce the retear rate.

Rotator cuff tears are common shoulder injuries that often necessitate surgical intervention, particularly when nonoperative treatments fail. Arthroscopic rotator cuff repair is the current gold standard; however, challenges, such as high retear rates, especially in large tears, persist. Traditional techniques, such as single-row and double-row repairs, have limitations in fully restoring the anatomical footprint and ensuring optimal healing. This review examines the novel double pulley-triple row technique, which aims to overcome these limitations by enhancing the footprint contact area, load distribution, and tendon healing. By evaluating the double pulley-triple row method in comparison to established techniques, this study explores the potential advantages, limitations, and future directions of rotator cuff repair.

Rotator cuff tears are common shoulder injuries that often necessitate surgical intervention, particularly when nonoperative treatments fail. Arthroscopic rotator cuff repair is the current gold standard; however, challenges, such as high retear rates, especially in large tears, persist. Traditional techniques, such as single-row and double-row repairs, have limitations in fully restoring the anatomical footprint and ensuring optimal healing. This review examines the novel double pulley-triple row technique, which aims to overcome these limitations by enhancing the footprint contact area, load distribution, and tendon healing. By evaluating the double pulley-triple row method in comparison to established techniques, this study explores the potential advantages, limitations, and future directions of rotator cuff repair.

Rotator cuff tears are common shoulder injuries that often necessitate surgical intervention, particularly when nonoperative treatments fail. Arthroscopic rotator cuff repair is the current gold standard; however, challenges, such as high retear rates, especially in large tears, persist. Traditional techniques, such as single-row and double-row repairs, have limitations in fully restoring the anatomical footprint and ensuring optimal healing. This review examines the novel double pulley-triple row technique, which aims to overcome these limitations by enhancing the footprint contact area, load distribution, and tendon healing. By evaluating the double pulley-triple row method in comparison to established techniques, this study explores the potential advantages, limitations, and future directions of rotator cuff repair.