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: 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

PURPOSE: Gynecomastia is an abnormal increase in the volume of the male breast. Subcutaneous mastectomy was the first surgical treatment for gynecomastia. But because of the complications such as nerve injury and scar formation, subcutaneous mastectomy has been substituted with liposuction. Recently various techniques including ultrasound-assisted liposuction has been used for treatment of gynecomastia. The purpose of this study is to evaluate the results of XPS(R) microresector (Shaver) for treatment of gynecomastia. METHODS: 17 patients, 33 breasts of gynecomastia, Simon grade I or II have been treated with XPS(R) microresector (Shaver). The mean age was 24.5. The subcutaneous tissue and glandular tissue were removed with XPS(R) microresector (Shaver). The operation time, the weight of removed tissue and patients' satisfaction score were accessed. RESULTS: The mean operation time was 78.2 minutes. The mean weight of removed tissue was 113.8 g. There were no significant complications such as necrosis, hematoma, infection or scar contracture. Patients' satisfactory score of scar, shape and confidence were 8.4, 8.2 and 8.4 respectively. As the average score was 8.3, most of the patients were satisfied with their breasts. CONCLUSION: The authors have treated 17 patients suffering from gynecomastia with XPS(R) microresector (Shaver). We obtained short operation time, early recovery, minimal operative scar and less complications with XPS(R) microresector (Shaver) for the treatment of gynecomastia, and patients were satisfied with the results of our method. We concluded that XPS(R) microresector (Shaver) is an alternative option for the treatment of gynecomastia.
Breast ; Cicatrix ; Contracture ; Gynecomastia ; Hematoma ; Humans ; Lipectomy ; Male ; Mastectomy, Subcutaneous ; Necrosis ; Stress, Psychological ; Subcutaneous Tissue

The glenohumeral bone deficiency plays an important role in the failure of arthroscopic shoulder stabilization procedures. Recently, several authors have described more novel approaches to treat the engaging Hill-Sachs lesion. Presented the 'Remplissage' technique that consists of an arthroscopic posterior capsulodesis and infraspinatus tenodesis to fill the Hill-Sachs lesion in addition to an arthroscopic Bankart repair. We report an arthroscopic technique in recurrent shoulder instability with large Hill-Sachs lesion with posterior capsulodesis and infraspinatus tenodesis.
Arthroscopy ; Shoulder ; Tenodesis

PURPOSE: Approximately 29% of patients visiting the emergency department are children and teens. Training emergency medicine (EM) residents for treatment of pediatric emergency patients is essential. We conducted a survey of the status of pediatric emergency medicine (PEM) education and made recommendations with regard to the direction of educational programs for PEM using the Delphi method. METHODS: We conducted a survey of 93 emergency medicine training hospitals and conducted the Delphi study with the first and second round. Variables of educational status included general information on the hospital, educational contents, and method for PEM. The Delphi method was used to obtain the consensus of experts with regard to which objectives, essential procedures, and necessary components for PEM training should be included. RESULTS: The rate of response for PEM educational status was 60(62.4%). The type of pediatric department rotation was essential 40.5%, optional 21.4%, and no rotation 38.1%. Capability of EM residents was 33.3% in PEM objectives and 45% in PEM procedures. Each rate of response for the Delphi study was 65% in the first round and 56.9% in the second round. We obtained the consensus of experts, with 52 of 59 objectives and 18 of 20 procedures. The appropriate period for pediatric emergency rotation was three months and the appropriate staff members for pediatric emergency education were the pediatric emergency physician, pediatric physician, and emergency physician, in order. CONCLUSION: Pediatric emergency training was not appropriate for an EM residency program. Experts agreed with 52 objectives and 18 procedures for PEM training of EM residents. We recommended a training period of three months and the appropriate staff member for PEM was the pediatric emergency physician.
Adolescent ; Child ; Consensus ; Curriculum ; Delphi Technique ; Educational Status ; Emergencies ; Emergency Medicine ; Humans ; Internship and Residency ; Pediatrics