No abstract available.

Despite significant advances in obstetric and pediatric health care, Streptococcus agalactiae(Lancefield group B β-hemolytic Streptococcus, GBS) remains one 91 the most prevalent and devastating pathogens in peripartum women and their newborn infants. It may cause urinary tract infection, chorioamnionitis and endometritis, bacteremia, and cesarean wound infection in the peripartum period. It was Pasteur who first identified microbes in the blood and lorchia of septic women. After that, in 1938 the isolation of S. agalactiae from three mortally ill women was reported, thereby implicating it as another cause of puerperal sepsis. S. agalactiae is now one of the most common causes of neonatal sepsis and meningitis in the United States. However, in Korea there have been only twenty-three cases of neonatal meningitis and/or sepsis due to group B β-hemolytic streptococcus reported. Recent studies have noted other serious infections in adults, including bacteremia, pneumonia, cellulitis, osteomyelitis, meningitis, and endocarditis. In Korean adults no case of pneumonia due to S. agalactiae has been reported till now. As minimal inhibitory concentration of penicillin was reported to be higher for S. agalactiae than for S. pyogenes, minimal inhibitory concentration of penicillin for S. agalactiae should be tested. Herein we describe the course of a case of S. agalactiae pneumonia and bacteremia in a 74-year-old diabetic man, and we review the literatures.
Adult* ; Aged ; Bacteremia ; Cellulitis ; Chorioamnionitis ; Delivery of Health Care ; Endocarditis ; Endometritis ; Female ; Humans ; Infant, Newborn ; Korea ; Meningitis ; Osteomyelitis ; Penicillins ; Peripartum Period ; Pneumonia* ; Pregnancy ; Sepsis ; Streptococcus agalactiae* ; Streptococcus* ; United States ; Urinary Tract Infections ; Wound Infection

No abstract available.
Bacillus* ; Humans ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Although many approaches have been attempted in the evaluation of liver size such as measurement of length,area and volume, the linear measurements have been used most frequently because of simplicity. We measured theliver size using 4 linear measurements for evaluation of hepatic pliability on plain abdominal film in the erectand the supine position. Our cases consisted of 125 persons who have no symptom or signs clinically and havenormal liver function test. The results were as follows: 1. The measurements of the liver size using diagonaldiameter(DD), oblique diameter of right lobe(OD), midline vertical diameter(MD) and height of right dome of theliver(HD) were ; 19.6+-1.8cm, 13.7+-1.6cm, 2.03+-0.4cm in the supine position; and 20.5+-2.1cm, 21.9+-2.1cm,15.4+-2.1cm, 1.87+-0.4cm in the erect position, respectively. 2. The differences of each diameter between erectand supine position were 0.9+-1.0cm in DD, 0.9+-1.0cm in OD and 1.7+-1.4cm in MD, and they were longer in thesupine position (p<0.001). 3. The HD was slinghtly longer in the supine position than in the erect position(p<0.001). 4. Among the 4 measurements, the largest difference of linear diameter between the erect and the supineposition was by MD. 5. We found the change or size and shape of the normal liver in the different position.
Humans ; Liver ; Liver Function Tests ; Pliability ; Supine Position

Recent studies have revealed that mossy fiber(MF) axons of dentate granule cells undergo synaptic reorganization in both electrical kindling models of temporal lobe epilepsy (TLE) and human TLE. This synaptic reorganization has been demonstrated by Timm histochemistry which selectively labels synaptic terminals of MF because of unusually high zinc content. Of MF. In electrical kindling model and human TLE Timm granules were distributed throughout the supragranular layer of dentate gyrus where they are not normally present. These supragranular Timm granules are regarded as MF synaptic reorganization. Kindling model of generalized epilepsy can be made by repeated intraperitoneal injections of subconvulsive dosage of pentylenetetrazol (PTZ). The present study is designed to test the hypothesis that MF synaptic reorganization might be developed in PTZ kindling model In this study, the supragranular Timm granules by Timm histochemistry were scored and depth EEG was recorded in dentate gyrus of various stages of PTZ kindling rats. The scores of supragranular Timm granules were 0. 33+0.17 in stage I seizure (n=9) ; 0. 38 + 0. 14 in stage II seizure (n=13) ; 0. 44 + 0. 18 in stage III seizure (n=9) ; 1. 40+0.16 in 3 consecutive or total 5-7 stage TV or V seizure (n=10) ; 1. 86+ 0.26 in 7-10 consecutive or total 10-15 stage IV or V seizure (n=7) ; 2.50+0.22 in 1215 consecutive or total 20-30 stage IV or V seizure (n=6) ; and 0. 30+0.15 in salinen controls (n=lo). Statistical analysis showed the supragranular Timm scorwere significantly higher in stage IV or V seizure than in control and in stage 1, I or, I seizure (p<0.05 ), and tended to increase with increasing numbers of stage IV or V seizure. Depth EEG recording from dentate gyrus showed 6-9Hz rhythmic waves in saline injected control, single or polyspikes or normal waves during stage I seizure, 4-6Hz slow waves or spike-waves complexes lasting 1-2 seconds during stage II seizure, 4-6Hz slow waves or spike-waves complexes lasting 3-6 seconds during stage III seizure, 8-15Hz spikes lasting over 10 seconds during stage IV seizure and 10-30HZ spikes lastmg over 20 seconds durmg stage V seizure The results demonstrate the development of MF synaptic reorganization and a sound correlation between MF synaptic reorganization and the progression of the kindlmg phenomenon in PTZ kindling models. These findings suggest that MF synaptic reorganization might be a critical event underlying the development and . Maintenance of kindling phenomenon and epileptic state.
Animals ; Axons ; Dentate Gyrus* ; Electroencephalography ; Epilepsy, Generalized ; Epilepsy, Temporal Lobe ; Humans ; Injections, Intraperitoneal ; Pentylenetetrazole* ; Presynaptic Terminals ; Rats* ; Seizures ; Zinc

Injuries to the pelvic nerve plexus following major pelvic ablative surgery are commonly observed conditions in urologic field and often related to voiding difficulty with flaccid type of neurogenic bladder. The pathophysiological background for voiding difficulty is unknown and also it is difficult to investigate in human. The present study was undertaken to investigate the functional changes on the bladder and urethra in major pelvic ganglion denervated rats (experimental group). Injury to the pelvic nerve plexus was created by selective removal of bilateral major pelvic ganglions of mature Sprague-Dawley rats (male, 250-300 gm). One week after operation, urodynamic evaluation and NADPH diaphorase histochemistry were performed in each rat. The whole bladder wet weight and residual urine of experimental group significantly increased to 1.6 times and 29 times that of control group, respectively. For urodynamic investigations, the bladder and the urethra were completely disconnected by means of ligation between the bladder neck and the proximal urethra, and simultaneous recordings of the intravesical and proximal urethral pressure were performed. During simultaneous urethro-vesical filling in experimental group, vesical contraction and urethral relaxation were not induced. However, an administration of L-arginine (120 mg/kg intravenously), a nitric oxide substrate, resulted in a gradual decrease in urethral pressure when the bladder pressure was reached at submaximal level. On NADPH diaphorase histochemistry in control group, a large number of NADPH positive nerve fibers were found in the proximal urethra, whereas those were found less commonly in the bladder. In experimental group, the number of NOS positive nerve fibers in the bladder was similar to that in control group. But in the proximal urethra, the number of NOS positive nerve fibers (84.7 +/- 12.7) decreased significantly in contrast to that (185.9 +/- 56.3) in control group. These results indicate that failure to empty in neurogenic bladder may be resulted from relaxation impairment of bladder outlet, which can be explained by the reduction of neuronal NOS in the proximal urethra in experimental group.
Animals ; Arginine ; Denervation ; Ganglion Cysts* ; Humans ; Ligation ; NADP ; NADPH Dehydrogenase ; Neck ; Nerve Fibers ; Neurons* ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type I* ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Urethra* ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urodynamics

Median raphe cyst is known as congenital lesion of the perineum and genitalia, but its etiology is unclear. Most investigators believe that the median raphe cyst represent defects in the embryologic developenient bf the male genitalia. Simple surgical excision is effective in most cases. We report our experience with two cases of median raphe cyst without specific symptoms. Even though median raphe cyst is asymptomatic, surgical therapy is worth applicable because it relieve a patient from cosmetic and psychotic problem.
Genitalia ; Genitalia, Male ; Humans ; Male ; Perineum ; Research Personnel

Intravesical Bacillus Calmette-Guerin(BCG) Has been shown to be effective therapy and prophylaxis against recurrent tumor in patients with superficial bladder cancer(stages O and A), including carcinoma in situ. Tice-Chicago strain bacillus Calmette-Guerin was used to treat superficial transitional cell carcinoma of the bladder in 26 patients between July, 1985 and March, 1988. A variety of different BCG treatment regimens have been used that vary in intensity. In general, treatment results have been more favorable with intensive regimens. However, the toxicity also has been substantially greater with intensive regimens. The optimal regimen has yet to be determined. Our treatment regimen of 120mg. Tice-Chicago strain BCG weekly for 6 weeks and then monthly for 3 months was well tolerated. 20 patients had a complete response and 6 patients had a tumor recurrence at 21 months mean follow-up, resulting in 77% of response rate. Side effects during or shortly after treatment were minor and self- limiting in the majority of patients(fever, bladder irritability and hematuria). This experience supports the efficacy of bacillus Calmette-Guerin as a cost-effective, well- tolerated treatment modality for patients with superficial transitional cell carcinoma of the bladder.
Bacillus ; Carcinoma in Situ ; Carcinoma, Transitional Cell* ; Follow-Up Studies ; Humans ; Mycobacterium bovis ; Recurrence ; Urinary Bladder Neoplasms ; Urinary Bladder*

Recently, it is well established that nitric oxide synthase (NOS) produces nitric oxide (NO), which is known to act as an important neural mediator of smooth muscle relaxation in various organs. The present study was undertaken to investigate the role played by NO in relaxing bladder outlet by correlating its action with the existence, distribution and activity of NOS. The experiments consisted of nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining for the identification of NOS containing nerve fibers, NADPH diaphorase activity with spectrophotometric assay for NOS catalytic activity, Western blot analysis with polyclonal antibrain NOS antibody for the expression of neuronal NOS, and in vivo isovolumetric bladder contraction (IBC) and reflex urethral .relaxation (RUR) for the physiologic role of NO. On NADPH diaphorase histochemistry in the rat, NADPH positive staining was localized in neurons innervating the lower genitourinary tract including the urinary bladder and the proximal urethra. NADPH positive nerve fibers were mainly found in urethral area, whereas they were less common in detrusor. In assay of NADPH diaphorase activity on various organs of the rat, the NOS activity regionally predominated in the cerebellum, proximal urethra, and urinary bladder in the order of frequency, which were correlated with the RESULTS of Western blot. Subsequent investigations were focused on the physiologic role of NO in the reflex changes in bladder outlet activity during micturition in the rat. During IBC, the urethra exhibited reflex responses characterized by a decrease in RUR in conjunction with a rise in IBC. Administration of NOS inhibitor, Nw-nitro-L-arginine, reversibly decreased the magnitude and duration of RUR, and this effect was reversed by administration of L-arginine. From these RESULTS, it is suggested that the neuronal form of constitutive NOS in the bladder outlet synthesizes NO by its catalytic action, which mediates relaxation of bladder outlet during micturition.
Animals ; Arginine ; Blotting, Western ; Cerebellum ; Muscle, Smooth ; NADP ; NADPH Dehydrogenase ; Nerve Fibers ; Neurons ; Nitric Oxide Synthase ; Nitric Oxide* ; Rats* ; Reflex ; Relaxation* ; Urethra ; Urinary Bladder ; Urination

A clinical observation was made on the injuries of genitourinary tract of the in-patient in the Department of Urology, Medical School of Chosun University during the period from January, 1972 to December, 1976. The results are as followings. 1) Of 429 cases hospitalized, 59 cases were injury of genito-urinary tract, giving a ratio of 13. 8%. 2) The most favorable age was in from 21 to 50 years for 69.4%. 3) The sex ratio, male to female, was about 5.5 : 1. 4) The most frequent cause of injury was traffic accident (39. 0%) and the next was straddle injury kick and blow etc. 5) The urethra was involved most frequently in 45.8%, the kidney in 25.4%, the bladder in 15. 3%, the external genitalia in 8.4% and the ureter in 5.1%. 6) Nephrectomy was performed in 4 cases of 15 renal injuries. 7) Four of 7 bladder injuries and 13 of 27 urethral injuries were accompanied with pelvic bone fracture.
Accidents, Traffic ; Female ; Genitalia ; Humans ; Kidney ; Male ; Nephrectomy ; Pelvic Bones ; Schools, Medical ; Sex Ratio ; Ureter ; Urethra ; Urinary Bladder ; Urology