No abstract available.
Vibrio vulnificus* ; Vibrio*

No abstract available.
Vibrio vulnificus* ; Vibrio*

No abstract available.

No abstract available.

Fournier described five patients with gangrene of male external genitalia in 1883 and emphasized three characteristics: (1) abrupt onset in young healthy male, (2) rapid progression to gangrene,(3) absence of discernible cause. But more recent reports described genital gangrene as occurring in any age group and 4 patients in our cases, the mean age was 46 years with an age range of 31 to 59 years. Predisposing causes were as follows: case 1. prostatic calculi, Buerger's disease, case 2, perianal abscess, case 3, diabetes mellitus, case 4, tuberculous spondylitis accompanied by paraplegia and bed sores, liver cirrhosis. The duration of symptoms prior to the development of gangrene varied between 4 to 10 days. The cultured organisms were as follows : case 1. Alpha-hemolytic streptococcus, case 2. E. coli, Alpha-hemolytic streptococcus case 3. Alpha-hemolytic streptococcus, case 4, Mycobacterium tuberculosis, proteus species. Reconstructive surgery of defected scrotum was performed postoperative 8 to 41 days (mean 28.7) and total admission period was 25 to 83 days (mean 46 days).
Abscess ; Calculi ; Diabetes Mellitus ; Fournier Gangrene* ; Gangrene ; Genitalia ; Humans ; Liver Cirrhosis ; Male ; Mycobacterium tuberculosis ; Paraplegia ; Pressure Ulcer ; Proteus ; Scrotum ; Spondylitis ; Streptococcus ; Thromboangiitis Obliterans

Vibrio vulnificus infection is one of the most fatal diseases in Korea. This study was undertaken to determine the cellular fatty acid (CFA) compositions of ninety-five clinical strains of V. vulnificus isolated from Korea during 1985-1995. We compared these results with the CFA profile of V. vulnificus in the Microbial Identification System (MIS) (CLIN library version 3.9; Microbial ID Inc., Newark, Del.), and also evaluated the MIS ability to identify V. vulnificus. Subgrouping of V. vulnificus by CFA analysis was performed and its results were compared with those of serotyping. Most of the CFAs in V. vulnificus strains were similar to the CFA profile of V. vulnificus in the MIS, but some distinctive differences were observed. First, means of two major CFAs, 16:0 and 16:1w7c, were 22.16% and 18.26% in this study, but 23.52% and 25.44% in the MIS respectively. Second, all isolates had 11:Oiso3OH, which was not present in the MIS. Eighty-five strains (89.5%) disclosed the first choice identification of V. vulnificus by the MIS, but only two strains (2.1%) were identified with SI values of 0.6. Remaining ten strains (10.5%) showed 'NO MATCH' results. Cluster analysis of CFA could separate V. vulnificus into nine subgroups, and predominant subgroups were subgroup VII (45 strains) and V (36 strains). There was heterogeny between subgroups by CFA and serotypes of V. vulnificus. The strains of 04 serotype which accounted for 80% (76/95) of the isolates were distributed into six different subgroups such as VII (40 strains), V (27 strains), III (4 strains), I (2 strains) and VI (1 strain). These showed that V. vulnificus strains isolated from Korea had different characteristics in the CFA composition in comparison with the MIS V. vulnificus library. Subgrouping by the CFA analysis might be a useful tool for the epidemiological study of V. vulnificus infection in Korea.
Korea* ; Serotyping ; Vibrio vulnificus* ; Vibrio*

BACKGROUND: The implementation of intraoperative normovolemic hemodilution is a strategy used in an attempt to diminish the need for or obviate allogeneic transfusion and to avert the potential complications. The goal of this study was to evaluate the safety and efficacy of moderate intraoperative normovolemic hemodilution. METHODS: Fifteen patients scheduled for posterolateral spinal fusion underwent intraoperative normovolemic hemodilution with 10% pentastarch to a target hematocrit level of 25% (hemodilution group). All units of blood procured by hemodilution and additional allogeneic blood was transfused in the perioperative period to maintain the hematocrit level of>25%. We investigated the effect of hemodilution on whole blood coagulation as measured by the thromboelastography and, evaluated its efficacy of decreasing the need for allogeneic blood transfusion as compared to the nonhemodilution group, retrospectively. RESULTS: Hemodilution with pentastarch caused a decrease in response and coagulation time (p<0.01) but did not influence on the alpha angle and maximum amplitude on thromboelstogram. Amount of transfusion of allogeneic blood was 4.1 1.7 units for the hemodilution group and 5.0 1.5 units for the nonhemodilution group. Net red blood cell volume ""saved"" from hemodilution was about 120 ml. CONCLUSION: Moderate intraoperative normovolemic hemodilution with pentastarch does not affect the coagulability of whole blood. But its efficacy of decreasing the need for allogeneic blood transfusion is minimal.
Blood Coagulation ; Blood Transfusion ; Erythrocytes ; Hematocrit ; Hemodilution* ; Humans ; Hydroxyethyl Starch Derivatives ; Perioperative Period ; Retrospective Studies ; Spinal Fusion* ; Thrombelastography

The antimicrobial agents reduced infectious diseases significantly. However, antibiotic resistance has followed for almost every antimicrobial agent. Especially, Staphylococcus aureus was one of the most notorious for the multidrug resistance. Streptomyces sp. 681 has been selected for antibiotic-producing strain against methicillin-resistant Staphylococcus aureus (MRSA) from 1,000 strains of Actinomycetales which had been isolated from soil. In antimicrobial susceptibility test, all of the test strains were susceptible to vancomycin. However, most strains of Staphylococcus aureus were found to be resistant to methicillin. Ninety eight (75%) strains out of 129 strains showed multiple resistance pattern to more than 5 antimicrobial agents. The MIC values of the purified antibiotic (K-681) were 1-32 ug/ml against Gram-positive bacteria compared to >128 ug/ml against Grarn-negative bacteria or fungi. The MIC was 8 ug/ml for 90% of the 129 clinical isolates of S. aureus. The antibiotic showed no cytotoxicity against P 388, HeLa, and S180 at the concentration of 500 ug/ml.
Actinomycetales ; Anti-Infective Agents ; Bacteria ; Communicable Diseases ; Drug Resistance, Microbial ; Drug Resistance, Multiple ; Fungi ; Gram-Positive Bacteria ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Soil ; Staphylococcus aureus* ; Staphylococcus* ; Streptomyces* ; Vancomycin

A clinical observation was made on 48 cases of benign prostatic hyperplasia, admitted during the period from January 1975 to June 1981 were studied clinically in the Department of Urology, Seoul Adventist Hospital. The results are summarized as follows. 1. The incidence of benign prostatic hyperplasia was 5.88% of total in-partients (1,227) and there was an increasing tendency of annual distribution from 3 patients (3.89%) in 1975 to 10 patients (11.62%) in June 1981. 2. The youngest age was 50 and the oldest 83. The mean age of 48 cases was 69.65 years and the seventh decade was most prevalent (54.17%). 3. The presenting symptoms of 48 cases, 43 cases (89.6%) were dysuria, 32 cases (66.7%) were acute urinary retention, 5 cases (52.1%) were frequency, 22 cases (45.8%) were hematuria, 17 cases (35.4%) were lower abdominal pain, 6 cases (12.5%) were pyuria, 5 cases (10.4%) were incontinence and 3 cases (6.3%) were nocturia. 4. The mean duration of symptom was 2.28 years. 5. The mean volume of residual urine was 502 ml. 6. Pyuria revealed in 28 cases (58.3%), Hematuria in 39 cases (81.3%), Culture positive in 24 cases (50.0%), Azotemia in 9 cases (18.8%). 7. Performed I.V.P. in all cases, and hydronephrosis was found in 7 cases (14.6%). 8. Performed endoscopy in all cases, and most common finding was trabeculation (81.3%). 9. Associated diseases present were cardiovascular in 5 cases, respiratory in 6 cases, gastrointestinal tract in 7 cases, urologic in 18 cases, and miscellaneous in 7 cases. 10. The mean weight of resected prostatic tissue was 9.75 gm. 11. The mean period of urethral catheter drainage was 6.5 days. 12. The mean period of postoperative gross hematuria was 5.25 days. 13. The mean period of postoperative hospitalization was 7.83 days. 14. Postoperative complications were cystitis in 22 cases (45%), temporary incontinence in 8 cases (16.7%), epididymitis in 3 cases (6.3%), delayed bleeding in 3 cases (6.3%), urethral strictures, vesical hematoma and delayed wound healing in each 2 cases (each 4.2%) and pyrexia in 1 case (2.1%). 15. Retrograde urethrography was performed on postoperatively about 1 month later. The mean length of the prostatic urethra was 5.72 cm preoperative, postoperative length was shortened to 4.77 cm.
Abdominal Pain ; Azotemia ; Cystitis ; Drainage ; Dysuria ; Endoscopy ; Epididymitis ; Fever ; Gastrointestinal Tract ; Hematoma ; Hematuria ; Hemorrhage ; Hospitalization ; Humans ; Hydronephrosis ; Incidence ; Male ; Nocturia ; Postoperative Complications ; Prostatic Hyperplasia* ; Pyuria ; Seoul ; Transurethral Resection of Prostate* ; Urethra ; Urethral Stricture ; Urinary Catheters ; Urinary Retention ; Urology ; Wound Healing

A clinical observation was made on 253 cases of lower one-third ureteral calculi among the total number of 1,438 in-patients admitted in the Department of Urology, Seoul Adventist Hopsital during the 7 years and 5 months from January 1975 to May 1982. The results of this observation are summarized as follows: 1. Among the total admissions (1,438 cases), those with urolithiasis were 406 cases (28.2%) and with lower 1/3ureteral calculi were 253 cases (62.3%). 2. The highest incidence on age distribution showed in 21 to 40 years (58.5%) and the sex ratio of male and female was about 1.3:1. 3. The most favored predirection of ureteral stone was lower 1/a of ureter in approximately 62.3% of all casesand the ratio between right and left was about 1.13:1. 4. The clinical symptoms of lower 1/3 ureteral stone showed lower abdominal pain in 93.7%, flank pain in 90.5%, nausea and vomiting in 56.1%, gross hematuria in 47.4% and vesical irritability in some cases. 5. Microscopic hematuria was presented in 87.7% and pyuria in 63.6%. 6. In lower 1/3 ureteral stones, hydronephrosis with or without functional deterioration was detected in 87.7%on excretory urograms, among them, moderate or marked hydronephrosis presented in 45.9%. 7. The most common size, below 0.5 cm in its diameter. 8. The Treatments of lower 1/3 ureteral stone were primary stone dislodger application and indwelled Dormia stone basket in 100 cases (39.5%), ureterolithotomy in 80 cases (31.6%), conservative treatement and spon-taneous expelling in 73 cases (28.9%). 9. The success rate of primary stone dislodger and indwelling of Dormia stone basket showed former in 45.8%, latter in 87.8%. 10. The mean duration of hospitalization was primary stone dislodger in 2.4 days, indwelled Dormia stonebasket in 4.8 days, ureterolithotomy in 13.4 days and conservative treatment in 3.6 days.
Abdominal Pain ; Age Distribution ; Calculi ; Female ; Flank Pain ; Hematuria ; Hospitalization ; Humans ; Hydronephrosis ; Incidence ; Male ; Nausea ; Pyuria ; Seoul ; Sex Ratio ; Ureter* ; Ureteral Calculi* ; Urolithiasis ; Urology ; Vomiting