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

We have performed percutaneous extraction of renal and upper ureter stones in 54 cases with use of the Storz percutaneous universal nephroscope(26Fr). With the patient under general anesthesia, a percutaneous tract was dilated up to 24Fr and the stone was immediately removed at one session. A variety of grasping and fragmentation techniques under fluoroscopic and endoscopic control were used to extract stones. Overall success rate was 65%. With increasing proficiency from accumulation of experience, rate of stone extraction has been increasing from 40% early in the series to 83% in the most recent cases. The advantage of this technique is that only 1 to 2cm skin incision is required to remove the stone with minimal postoperative morbidity, rapid convalescence, and sooner return to work. We conclude that percutaneous nephrolithotripsy appears to be an appropriate alternative to an open operation in most patients with symptomatic urolithiasis.
Anesthesia, General ; Convalescence ; Hand Strength ; Humans ; Return to Work ; Skin ; Ureter ; Urinary Calculi ; Urolithiasis

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

PURPOSE: It has been suggested in our previous study that the serum level of xanthine oxidise(XO) activity, glutathione(GSH), malonyldialdehyde(MDA) could be used as marker of oxidant stress in association with renal ischemia/reperfusion(I/R) injury. The present study was undertaken to establish the early marker of renal 1/R injury and to investigate the effect of deferoxamine on renal 1/R injury. MATERIALS AND METHOD: In Sprague-Dawley rats(male, 200-250gm, n=60), bilateral renal arteries were clamped for 60mins after pretreatment with deferoxamine(group A) or saline(group B). After 30min of bilateral renal recirculation, left nephrectomy and blood sampling in inferior vena cava were performed for in-vitro spectrophotometric study. Control animals(group C) did not undergo I/R operation. In-vivo renal function studies were performed in both group A and B with measurement of creatinine clearance rate(Ccr) at 7th day of experiments a%or renal ischmia for 60min. RESULTS: The levels of XO activity and XO type conversion ratio in renal tissue (RT) and serum(5) were measured. These levels were significantly high in group B, but were lower in group A compared to those of control group. The values of GSH(micrometer/g tissue), a scavenger of OFR, were decreased in group A (RT:0.183+/-0.019,5:0.201+/-0.029) and greatly decreased in group B(RT:0.159+/-0.009,5:0.164+/-0.022) compared to control group(RT:0.201+/-0.006,5:0.224+/-0.031). The values of MDA(nM/g tissue), a stable end product of lipid peroxidation, were increased in group A(RT:0.149+/-0.003, 5:0.058+/-0.004) compared to control group(RT:0.128+/-0.013, 5;0.055+/-0.005), but the values were significantly lower in group A compared to group B(RT:0.171+/-0.005, 5:0.070+/-0.003). Subsequent investigation was focused on the established renal function study after 1/R, which was determined using Ccr(ml/min). The Ccr in group A(2.06+/-0.03) was significantly higher compared to that of group 8(1.48+/-0.18), although it was slightly lower than in control group(2.18+/-0.05). CONCLUSIONS: From these results, it is suggested that renal I/R injury is highly correlated with the production of OFR. The levels of GSH and MDA in renal tissue and serum seem to be probable markers of oxidant stress in association with renal I/R injury. Furthermore, deferoxamine could reduce the degree of renal damage resulting from ameliorating the production of OFR following renal I/R injury.
Animals ; Creatinine ; Deferoxamine* ; Lipid Peroxidation ; Nephrectomy ; Rats* ; Rats, Sprague-Dawley ; Renal Artery ; Vena Cava, Inferior ; Xanthine

Multilocular renal cyst having an entity of uncertain nature, is an uncommon benign lesion. As a treatment modality of renal multilocular cyst, simple or radical nephrectomy has been performed because of the difficulty in its accurate diagnosis and the documented association with malignancy. Herein, we report a case of renal multilocular cyst which was successfully treated by extirpation of the cystic mass only with preservation of the remaining normal renal parenchyma.
Diagnosis ; Nephrectomy

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

Patients with advanced urothelial tumors that relapse or persist following conventional therapy have poor prognosis. Management of the patients with recurrent local or disseminated urothelial tumors presents a difficult clinical problems. In 1985 Sternberg et al reported 71% of significant tumor regression and 50% of complete clinical remission with M-VAC (methotrexate, vinblastine, doxorubicin and Cisplatin) combination chemotherapy for treatment of advanced urothelial transitional cell carcinomas. Herein, we have experienced 13 cases of M-VAC combination chemotherapy in advanced urothelial tumors. Complete and partial remission was in achieved 46.2 per cent of the patients clinically, while 15.4 percent had a minor response and 38.4 per cent had progression with median survivals of 11.5, 8.5 and 7.4 months. Toxicity was significant. 15.4 per cent of the patients having experienced nadir sepsis, 30.8 per cent mucositis and 7.6 per cent cardiac toxicity. Median cycle length varied from 31.6 to 41.7 days for the first and 5th cycle respectively. This regimen has been efficacious in selected patients with advanced urothelial tumors.
Carcinoma, Transitional Cell ; Doxorubicin* ; Drug Therapy, Combination ; Humans ; Mucositis ; Prognosis ; Recurrence ; Sepsis ; Vinblastine*