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

No abstract available.
Animals ; Calcium ; Rats* ; Urinary Bladder*

Colposcopic examination and biopsy were performed on 197 patients with abnormal cervical cytology. The patients subsequently underwent electrocoagulation, LLETZ, conization and hysterectomy depending on their diagnosis from January, 1989 to December, 1994. The comparison between the diagnosis of cytology and that of colposcopic biopsy showed fair agreement with only 35% of cases(K=20%). The abnormal lesion was underestimated by cytology in 49.7% of cases. Thirty three cases(16.8%) were threated by LLETZ. Histological comparison between the colposcopic biopsies and LLETZ samples showed fair agreement with 39% of cases (K=25%). 5 cases(15%) of the colposcopic biopsy have been underestimated when compared to the LLETZ histology. Sixty two cases were done conization after colposcopic biopsy. Histological comparison between the colposcopic biopsies and conization samples showed fair agreement with 59% of cases(K=38%). The colposcopic biopsies were underestimated in 24.2% of cases compared to the cone biopsy specimen. The correct diagnosis rates of colposcopic biopsy of dysplasia, carcinoma in situ, and microinvasive carcinoma were 70%, 82%, and 20% respectively. (continue)
Biopsy ; Carcinoma in Situ ; Conization ; Diagnosis ; Electrocoagulation ; Humans ; Hysterectomy

Nitric oxide(NO) is known to act as an important neural mediator of penile erection. Nitric oxide synthase(NOS), which produces NO, has been recently identified in autonomic neurons supplying genitourinary organs including penis. The present study was undertaken to investigate the role played by NO in erectile physiology by correlating its action with the existence and activity of NOS. Initial experiments were performed to elucidate NOS expression in the human and rat penis. Western blotting analysis identified a protein of 155KDa molecular weight identical to neural form of NOS. The NOS blot density in the human and rat penis was similar each other, which was lower than that in the cerebellum. Additional studies of NOS using assay of NADPH diaphorase activity and nitrite measurement were performed in various organs of the rat. NOS activity regionally predominated in the cerebellum, urethra, penis, and urinary bladder in the order Subsequent investigations focused on the physiologic role of NO, which was determined using an in vivo electroerection model in the rat. ntracavernous injections of NOS inhibitor (L-NOARG or L-NAME from 0.000001M to 0.001M) were found to suppress the nerve-induced erection in concentration dependent manner. Subsequent intracavernous injection of L-arginine(0.01M) partially restored penile erection suppressed by L-NOARG or L-NAME(0.001M). These results indicate that the neural form of constitutive NOS in the corpora cavernosa of the penis synthesizes NO by its catalytic action, which mediates penile erection. Furthermore, determination of cavernosal NOS expression and/or activity may allow to characterize certain pathological conditions which cause neurogenic impotence.
Animals ; Blotting, Western ; Cerebellum ; Erectile Dysfunction ; Humans ; Male ; Molecular Weight ; NADPH Dehydrogenase ; Neurons ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Penile Erection* ; Penis ; Physiology ; Rats ; Urethra ; Urinary Bladder

We performed erotic stimulation that in 63 patients with erectile dysfunction in order to investigate erectile responses to visual sexual stimulation in patients with psychogenic and organic impotence and to elucidate valuable parameters for differential diagnosis between psychogenic and organic impotence. After the test using polygraph system and erotic film, subjective sexual drive in each patient was evaluated as grade I (poor), grade II (moderate), grade III (good). Following parameters were statistically analyzed : degree of maximal rigidity, degree of maximal tumescence, T -up phase (time taking place from the beginning of the erection to maximal level). The T-max phase (time taking place for the plateau phase of maximal erection). The results obtained were summarized as follows. Regardless of sexual drive of each patient, psychogenic impotence group showed better maximal rigidity and shorter T-up phase of rigidity than organic impotence group (p<0.05}. Of patients with psychogenic impotence, good sexual drive group showed better maximal rigidity and maximal tumescence than poor sexual drive group (p<0.06). Psychogenic impotence group showing good sexual drive revealed much better maximal rigidity and shorter T-up phase of rigidity than organic impotence group with same degree of sexual drive (p<0.05). These results indicate erotic stimulation test is highly valuable method for differential diagnosis between psychogenic and organic impotence, especially when the patient shows sexual drive in moderate or good degree. And it is suggested that maximal rigidigity and T-up phase of erection parameters in erotic stimulation test provide high validity for the differention.
Diagnosis, Differential ; Erectile Dysfunction* ; Humans ; Male

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