BACKGROUND: The purpose of this study was to discover ways to screen urine culture specimens through Gram stains, urine stick analyses and microscopic examinations for the laboratory cost saving. METHODS: One hundred and fifty-eight urine specimens for culture were included. Fifty uL of urine were inoculated onto one well each of 10-well slide, dried on the hot plate, and Gram-stained. The results combined with routine urinalyses including urine nitrite and leukocyte esterase, and pyuria, were compared with the routine culture results. RESULTS: The screening of bacteriuria by Gram stains, urinalyses and microscopic examinations revealed the high sensitivity (91.9%) and negative predictive value(95.5%) with cost saving of 41.8% of inoculating media. Not considering the Gram stains, the screening revealed 83.8% sensitivity and 92.5% negative predictive value, even if the cost saving of inoculating media were as high as 50.1%. CONCLUSION: It was demonstrated that it was sensitive and economic and produced rapid preliminary results to screen bacteriuria by the Gram stains combined with urinalyses and microscopic examinations.
Bacteriuria ; Coloring Agents ; Cost Savings ; Leukocytes ; Mass Screening* ; Pyuria ; Urinalysis*

Mature cystic teratomas (MCTs) are benign ovarian tumors known to undergo malignant transformation in 1%–2% of cases. Most of these cases lead to squamous cell carcinomas (SCC), and the prognosis is often poor, particularly in advanced-stage disease. A 50-yearold postmenopausal woman presented with a large pelvic mass. The patient initially underwent suboptimal primary surgery and was later diagnosed with stage IIIA SCC arising from MCT. Following the first cycle of chemotherapy with carboplatin and paclitaxel, a computed tomography scan showed a rapidly growing large mass in the pelvic cavity after 4 weeks of primary surgery, leading to a second debulking surgery. However, the patient underwent only one cycle of chemotherapy after secondary debulking surgery because of her poor performance status. Subsequently, after 4 months of secondary debulking surgery, the patient developed rapidly progressive disease, leading to her death approximately after 8 months of diagnosis. While an appropriate multimodal treatment strategy has yet to be established, optimal cytoreductive surgery and adjuvant chemotherapy should be considered for treatment of advanced-stage diseases to improve survival outcomes.

OBJECTIVE: The purpose of this retrospective study was to evaluate the effect of neoadjuvant chemotherapy followed by radical surgery compared with conventional radical surgery in stage Ib1 cervical cancer as to operative complications, the rate of lymph node metastasis, recurrence and overall five-year survival rates. METHODS: The study materal (98 cases of stage Ib1 cervical cancer) was divided into two groups; The one group was neoadjuvant chemotherapy (Cisplatin + 5-FU) followed by radical surgery (n = 41) and the other was the conventional radical surgery (n = 57) group. Reviewing records of operative and pathological reports and clinical findings, the outcome was statistically analyzed and compared. RESULTS: As to the complication, bladder dysfuntion was more frequent in neoadjuvant chemotherapy group, statistically significant.(43.9% vs 22.8%, P=0.034). No significant difference was found in the incidence of lymphnode metastasis (17% vs 17.5%, P=0.779) and overall five year survial rates(85.3% vs 87.7%, P=0.735). CONCLUSION: No benefical effect of neoadjuvant chemotherapy could be found on stage Ib1 cervical cancer in this retrospective study. However, well controlled longterm prospective study will be need to get firm conclusion.
Drug Therapy* ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Uterine Cervical Neoplasms*

Schwannomas are benign nerve sheath tumors that can originate at any anatomic sites. These tumors are usually soitary, benign, and slow-growing masses attached to large nerve trunks. These tumors have been described as arising in the pelvic retroperitoneum. We present two cases of pelvic retroperitoneal Schwannomas with a brief review of literatures.
Nerve Sheath Neoplasms ; Neurilemmoma*

OBJECTIVE: Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder. Chronic anovulation, hyperandrogenism, hirsutism, obesity, infertility and polycystic ovaries (PCO) are clinical hallmarks of PCOS. PCO can be induced in prepubertal rats by daily injection of dehydroepiandrosterone (DHEA). The aims of this study is to investigate cDNA array analysis of genes expressed in the rat PCO induced by DHEA. METHODS: To induce the hyperandrogenic PCO condition, 22-day old rats were injected each day s.c. with DHEA for 15 days. Total ovarian RNA was isolated from the DHEA induced rat PCO and control, and used to prepare radiolabeled cDNA probes, which were hybridized to cDNA arrays. Some of selected genes were further analyzed by reverse transcription-polymerase chain reaction (RT-PCR) or in situ hybridization. RESULTS: Quantitative analysis identified differential expression profiles of 31 genes including leukemia inhibitor factor receptor alpha (LIFR-alpha), alpha 1A adrenergic receptor (ADRA1A), heat shock 90-kDa protein A (HSP90A) and platelet-derived growth factor receptor alpha (PDGFR-alpha) genes. RT-PCR analysis was used to validate the changes in above four gene expressions by the cDNA array. The levels of ADRA1A and LIFR-alpha gene expressions were incresed in DHEA induced rat PCO than control, but HSP90A and PDGFR-alpha gene expressions were decresed in PCO. The mRNA of ADRA1A gene was mainly localized in granulosa cells of cystic follicles. CONCLUSION: Rat hyperandrogenic PCO was induced by daily injection of DHEA for 15 days. ADRA1A, LIFR-alpha, HSP90A and PDGFR-alpha gene expressions were differentially expressed in PCO induced by DHEA. The above four genes may be involved in the mechanism of follicular growth and ovulation processes. The precise relationship between the altered gene expressions and PCO is a matter of further investigation.
Animals ; Anovulation ; Dehydroepiandrosterone* ; DNA, Complementary* ; Female ; Gene Expression ; Granulosa Cells ; Hirsutism ; Hot Temperature ; Hyperandrogenism ; In Situ Hybridization ; Infertility ; Leukemia ; Obesity ; Oligonucleotide Array Sequence Analysis* ; Ovary* ; Ovulation ; Polycystic Ovary Syndrome ; Rats* ; Receptors, Adrenergic, alpha-1 ; Receptors, Platelet-Derived Growth Factor ; RNA ; RNA, Messenger ; Shock ; Staphylococcal Protein A

PURPOSE: The most common cause of failure after Steindler flexorplasty has been known insufficient power of the transferred muscles. We develop "effective muscle index" which is calculated from the actual strength of each muscle to predict postoperative flexion power of the elbow for preventing the failure of the surgery. MATERIALS AND METHODS: We reviewed 10 patients who received Steindler flexorplasty from Aug. 1983 to Jan. 1997. We calculated "effective muscle index" with power of each transferred muscle, tension fraction2) by Brand, 1981, correction index of the magnitude of transferring muscle and correlated the "effective muscle index" with postoperative elbow flexion power. RESULTS: Excluding 4 out of total 10 patients who had grade 1 or 2 power of biceps and brachialis, "effective muscle index" has borderline significance with the postoperative flexion power of the elbow (p=0.123) . CONCLUSION: The authors concluded that the "effective muscle index" is maybe considered as a useful index for predicting the postoperative flexion power of the elbow after Steindler flexorplasty.
Elbow* ; Humans ; Muscles

BACKGROUND: High-level gentamicin and streptomycin disks are not easily available, despite their critical role in detection of high-level resistance to aminoglycosides in enterococci. Therefore, the possibility of applicating home-made disks to test high-level resistance of enterococci to aminoglycosides was evaluated. METHODS: The disk diffusion method using home-made disks was compared with minimal inhibitory concentrations(MIC) in 53 clinical isolates of enterococci, and, the stability of the disks were also evaluated by disk diffusion testing, biweekly, for 14 weeks. RESULTS: The high-level resistance rates to gentamicin(GM) and streptomycin(SM) were 60% and 43%, respectively. Thirty eight % of the enterococci were highly resistant in both GM and SM. The results of the disk diffusion method were consistent with the MIC until 10 weeks after production of the disks. After 12 weeks, the inhibition zones of GM- or SM-susceptible strains decreased by 2.9-3.9 mm, and the discrepancy rates were 5-24% between the results of the MIC and disk diffusion method. The storage temperature of -20degrees C versus -70degrees C showed no difference in the inhibition zone. CONCLUSION: It has been demonstrated that home-made high-level GM and SM disks are stable at -20degrees C for 10 weeks, and the results of disk diffusion method on the disks show they are applicable for the test of susceptibility of aminoglycosides to enterococci.
Aminoglycosides ; Diffusion ; Enterococcus ; Gentamicins ; Streptomycin

PURPOSE: To evaluate the safety and efficacy of CT-guided celiac plexus block (CPB) using an anterior approach, and to determine the role of CT in this procedure. MATERIALS AND METHODS: CPB was attempted in 15 patients (10 men and 5 women; mean age, 62.3 years) with intractable upper abdominal pain due to terminal malignancy of the pancreas, liver, bowel, and kidney. To permit an anterior approach, patients lied supine on the CT scan table during the procedure. One or two 21-guage needles were placed just anterior to the diaphragmatic crus at or between the levels of the celiac and superior mesenteric arteries and 10-40 ml of 99.9% alcohol was injected. Pain relief following the procedure was assessed and pain was graded on a visual analogue scale (VAS) from 0 to 10. RESULTS: There were no technical failures and no neurologic or hemorrhagic complications. Abdominal pain during alcohol injection occurred in all patients, and transient hypotension in three. One patient with recurrent cancer of the pancreatic head died of sepsis five days after the procedure; the cause of sepsis was difficult to determine, but there was thought to be a biliary source of infection. Two days after block, 13 of 15 procedures (86.7%) had produced at least partial pain relief ; in 12 patients, relief was good. With CT guidance, more directed positioning of the needle is possible, allowing alcohol to be deposited in specific ganglion areas. CONCLUSION: CT-guided celiac plexus block using an anterior approach was an easy and effective way of reducing intractable upper abdominal pain due to terminal malignancies. CT guidance allowed precise needle placement and a safer procedure.
Abdominal Pain ; Anesthesia ; Celiac Plexus* ; Ethanol* ; Female ; Ganglion Cysts ; Head ; Humans ; Hypotension ; Kidney ; Liver ; Male ; Mesenteric Artery, Superior ; Needles ; Pancreas ; Sepsis ; Tomography, X-Ray Computed

Uterine torsion, which most often occurs during pregnancy, is rare. Torsion of a nongravid uterus is extremely rare and is associated with pelvic adhesions, uterine leiomyomas, or uterine anomalies. We experienced a case of uterine torsion, with a huge subserosal leiomyoma and multiple intramural leiomyomas, in a postmenopausal woman, one that showed the most extreme degree of rotation among the known cases of uterine torsion. Necrosis of the uterus and both adnexae was observed. A total abdominal hysterectomy with a bilateral salpingo-oophorectomy was performed. We present this case with a brief review of the relevant literature.
Female ; Humans ; Hysterectomy ; Leiomyoma ; Necrosis ; Postmenopause ; Pregnancy ; Urogenital Abnormalities ; Uterus

PURPOSE: To evaluate the clinical and radiological results of total hip replacement arthroplasty using a cementless, sandwich (alumina-polyethylene-titanium) acetabular component and the cause of three ceramic liner fracture. MATERIALS AND METHODS: From June 1999 to December 2001, one hundred and twenty eight (110 patients) among 146 cases (129 patients) who were underwent total hip replacement arthroplasty using a sandwich type acetabular component, were followed up for minimum 24 months (range, 54-24 months). Among 110 patients, 85 patients (101 cases) were men and 25 patients (27 cases) were women. Their mean age was 48.8 years (range, 17-78 years) old. The patients were examined clinically and radiologically at postoperative 1 month, 3 months, 6 months, 1 year and every year, thereafter. RESULTS: At the median followup of 32 months, the average Merle d'Aubigne and Postel score had improved from 8.4 to 16.7. Results were graded as excellent in 110 hips (86%), and very good in 18 hips (14%). At the last followup, all component including acetabular cup and femoral stem acquired firm bony union. Neither component migration nor acetabular osteolysis was detected. Finally three fracture and dislocation of ceramic liner developed and the fractured liners were changed other sandwich type or polyethylene liner. CONCLUSION: Even though short-term clinical result of total hip replacement arthroplasty using sandwich type acetabular component is excellent, two percent of the ceramic liner fracture incidence is unexpected high. So we have to caution with using sandwich acetabular cup. In addition, ceramic acetabular cup need more precising surgical technique.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Ceramics ; Dislocations ; Female ; Follow-Up Studies* ; Hip ; Humans ; Incidence ; Male ; Osteolysis ; Polyethylene