The recent discovery of plasmid derived beta-lactamase production by N. gonorrhoeae has changed the outlook of treatment of gonococcal infections and may well become the single most important factor in gonorrhoea control. Penicillinase is a beta-lactamase that splits the beta-lactam ring of penicillin hetween the C and N atoms to form penicilloic acids. We have been trying to assess the prevalence of PPNG in Korea since May 1980. We report here 7 strains of beta-lactamase producing N. gonorrhoae detected by chrornogenic cephalosporin method from Jan. 1981 to Mar. 1981 at the Joong Ku puhlic health center in Seoul. In January, I strain (l.3%); February, 2 strains (5.0%); and March, 4 strains .(6 4%) have been isolated. All restrains were confirmed by sugar feriventation test. Previously only one strain of PPNG had been reported among Korean laymen. The sudden appearance of PPNG among Korean laymen in 1981 may mean the barruer between U.S. Army enc1aves and Korean public has been broken recently and/or direct irnport of PPNG frorn abroad especially from South East Asia.

No abstract available.
Hyperthyroidism* ; Muscular Diseases*

No abstract available.
Forehead* ; Hamartoma*

No abstract available.
Darier Disease* ; Friction* ; Keratosis* ; Minocycline

Carcinoid tumors arising in the extrahepatic bile duct are very rare, accounting for only 0.2%~2% of all gastrointestinal carcinoid tumord. We experienced one case of a carcinoid tumor in the common bile duct. A 43-years-old man was unexpectedly found to have a carcinoid tumor of the common bile duct. This patient had no obstructive jaundice, yet we thought that this tumor was a clinically malignant tumor, so we performed pylorus preserving pancreatoduodenectomy. Pathologically, an ill-demarcated mass that measured 1.5x1.5cm in size had invaded into the pancreas. Immunohistochemically, the mass was founded to be chromogranin, synaptophysin and CD56 positive. The patient who underwent curative resection is alive and disease-free at time of this publication. This report also reviews the relevant literature on carcinoid tumors in the common bile duct.
Bile Ducts, Extrahepatic ; Carcinoid Tumor* ; Common Bile Duct* ; Humans ; Jaundice, Obstructive ; Pancreas ; Pancreaticoduodenectomy ; Publications ; Pylorus ; Synaptophysin

No abstract available.
Heterografts*

PURPOSE: Surgical excision of the subcutaneous tissues, with or without skin excision in the axillary hair-bearing area, has been the treatment of choice in treating osmidrosis for several decades. However, long periods of postoperative immobilization of a shoulder joint, partial necrosis of skin flaps or the possibility of hematoma and scars have occurred frequently. So we used XPS(R) microresector(Shaver) in procedure which requires removal of soft tissue for comparing results between surgical excision and the laters. METHODS: From January 2007 to February 2008, a total of 20 patients(8 male and 12 female) underwent XPS(R) microresector(Shaver) assisted aspiration for treating osmidrosis. The mean age of the subjects was 21.9, and we tried to analyze some advantages of XPS(R) microresector(Shaver). RESULTS: The average operation time was 61.6 minutes. This results can show that the patients who received XPS(R) microresector(Shaver) assisted aspiration can accomplish better outcomes than any other procedures in terms of operation time at least. Moreover, no significant postoperative complications occurred in our studies. Subjects have been followed up from 2 months to 1 year and among these patients, no one suffered from critical complications. CONCLUSION: In brief, XPS(R) microresector(Shaver) is able to shorten the time of operation and simplify the procedures relatively and this device has more superiorities in wound healing by maintaining of vascularized dermal skin flaps. It means that XPS(R) microresector (Shaver) can prevent flap necrosis, axillary hair loss and minimalize scarring and bleeding. Thus, we expect that these advantages can lead to better patient's comfort and self-confidence than several previous procedures.
Cicatrix ; Hair ; Hematoma ; Hemorrhage ; Humans ; Immobilization ; Male ; Necrosis ; Postoperative Complications ; Shoulder Joint ; Skin ; Subcutaneous Tissue ; Wound Healing

BACKGROUND: Palmar hyperhidrosis is a common disorder of excessive sweating. A number of studies have demonstrated the effectiveness of iontophoresis in the treatment of palmar hyperhidrosis. However, controlled clinical studies on iontophoresis for palmar hyperhidrosis have been limited. OBJECTIVE: To determine the efficacy and safety of iontophoresis in the treatment of palmar hyperhidrosis with a randomized, sham-controlled, single-blind, and parallel-designed study. METHODS: Twenty nine patients with significant palmar hyperhidrosis were enrolled in this study. They received active iontophoresis treatment (group A) or sham treatment (group B). Iontophoresis was performed 20 minutes each time, five times per week, for 2 weeks. Its efficacy was assessed with starch-iodine test, mean sweat secretion rate, and hyperhidrosis disease severity scale. RESULTS: Twenty-seven of the 29 patients completed the 2-week treatment. After completion of 10 times of treatment, results of the starch-iodine test showed clinical improvement in 92.9% of patients in group A and 38.5% of patients in group B (p=0.001). The mean sweat secretion rate was reduced by 91.8% of patients in group A and by 39.1% of patients in group B (p<0.001). Improvement in quality of life was reported by 78.6% of patients in group A and by 30.8% of patients in group B (p=0.028). In group A, one case of localized adverse event was noted, although no adverse event was encountered in group B. CONCLUSION: Tap water iontophoresis could be used as an effective and safe treatment modality for palmar hyperhidrosis.
Humans ; Hyperhidrosis* ; Iontophoresis* ; Placebos ; Quality of Life ; Sweat ; Sweating ; Water*

PURPOSE: The goal of this study was to identify baseline prognostic factors of outcome in ankle osteoarthritis patients after intra-articular hyaluronic acid injection. MATERIALS AND METHODS: Patients with ankle osteoarthritis who received hyaluronic acid injection therapy were retrospectively reviewed. Each patient received weekly intra-articular hyaluronic acid injections (2 mL) for 3 weeks. Six predictors including gender, age, symptom duration, radiographic osteoarthritis stage, radiographic subchondral cyst, and fracture history were evaluated. Visual analogue scale (VAS) and patient satisfaction were evaluated as outcome measures. These predictors and outcome measurements were included in a logistic regression model for statistical analysis. RESULTS: Total of 40 consecutive patients (21 male, 19 female) were included in this study. Mean age was 60.6. Average follow up period was 13 months. The mean VAS recorded 3, 6, and 12 months after the first injection was 3.6 (SD 2.54, p<0.001), 4.33 (SD 2.9, p<0.001), and 5.3 (SD 2.7, p=0.0071), respectively, when compared to baseline VAS. Early stage disease was identified as an independent predictor associated with 'positive VAS outcome' at 3 and 6 months. Early stage disease and duration of pain less than 1 year were independent predictors associated with higher satisfaction. CONCLUSION: While hyaluronic acid injection for ankle osteoarthritis is a safe and effective treatment, careful selection of patients should be made according to the above prognostic predictors.
Adult ; Aged ; Aged, 80 and over ; Ankle Joint/drug effects/*pathology/*physiopathology ; Female ; Humans ; Hyaluronic Acid/administration & dosage/*therapeutic use ; *Injections, Intra-Articular ; Male ; Middle Aged ; Osteoarthritis/*drug therapy/pathology/physiopathology ; Prognosis ; Range of Motion, Articular/physiology

PURPOSE: Breast cancer is second most common cancer in women. Most of the patients with breast cancer treated with mastectomy take breast reconstruction. Nipple reconstruction is an important step in breast reconstruction. Many surgeons have investigated of nipple reconstruction using the flap technique after breast reconstruction with the autologous tissue. The objective of this study is to evaluate the results of nipple reconstruction using the C-V flap technique after breast reconstruction only with the breast expander. METHODS: From April 2006 to May 2008, the authors treated 17 patients of nipple reconstruction using C-V flap technique, who received breast reconstruction only with the breast expander. As we have predicted decrease in the size of reconstructed nipple, we designed flap a little larger than wanted nipple size. Nipple splint was applied for 4-6 months for minimizing decrease of the size of reconstructed nipple. The diameter and height of the reconstructed nipple were measured and patient's satisfaction score was assessed. RESULTS: Mean follow-up duration was 12.5 months. Among the 17 patients, the average absorption rate by height of nipple was 47.0%. Partial necrosis was noted in 1 case, and treated well with conservative management. There were no other significant complications noted. Patient's satisfactory score was assessed by the height, design and location of the nipple. The average of satisfaction score was 85%, 68%, 62% and total average was 83%. CONCLUSION: The authors experienced 17 patients of nipple reconstruction using the C-V flap technique after breast reconstruction only with the breast expander. The absorption rate of the size of the nipple, complications and patient's satisfactory score of this study were similar to those of nipple reconstruction after breast reconstruction with the autologous tissue. It is expected that nipple reconstruction after breast reconstruction only with the breast expander is safe and reliable. It is considered that a long-term study is necessary.
Absorption ; Breast ; Breast Neoplasms ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Mastectomy ; Necrosis ; Nipples ; Splints