Vaginitis is one of the most common disease in gynecologic field in recent days. About 90% of these patients suffer from the infection of the vagina caused by Gardnerella vaginalis, Candida, or Trichomonas, either alone or in combination. For the effective diagnosis and management, it is essential to get an accurate identification of the causative agent. Applying simple and easy diagnostic methods such as pH of vaginal discharge, amine test and microscopic examination of wet mount preparation of normal saline and 10% KOH to 549 cases of randomly selected patients visiting Out-patient Department of Obstetrics and Gynecology of Yeungnam University Hospital through May 1st to Sept. 31st, 1987, the following results were obtained. 1. In the Gardnerella vaginitis vaginal pH was more than 5.0 in 81.0% of total cases, positive amine test in 62.8%, decreased lactobacilli in 77.4% & decreased WBC counts in 70.1%, In the Trichomonas vaginitis vaginal pH more than 5.0 was noted in 93.3% of the cases, negative amine test in 90%, decreased showed vaginal pH of 3.0~4.0 in 83.2%, negative amine test in 90%, decreased lactobacilli in 90% & increased WBC counts in 93.3%, whereas Candida vaginitis and normal groups showed vaginal pH of 3.0~4.0 in 83.2%, negative amine test in 100%, normal distribution of lactobacilli in 89.7%, normal WBC counts in 72.4%. 2. The accuracy rates of physical diagnosis by wet mount preparation of normal saline and 10% KOH revealed 26.3%, 47.5%, 70.0% in Gardnerella vaginitis, Candida vaginitis, and Trichomonas vaginitis, respectively. The vaginal pH and amine test showed 83.2% of accuracy rate in Candida vaginitis group, 60.6% in Gardnerella vaginitis group and 83.3% in Trichomonas vaginitis group. 3. In 23 cases of Gardnerella vaginitis showing vaginal pH of 3.0 or 4.0 and positive amine test, the clue cells were observed in 10% or less in 12 cases, 30% in 5 cases, 50% in 4 cases and 50% or more in 2 cases. In summary vaginal pH and amine test could be useful in screening and differentiating the different types of infectious vaginitis. Furthermore by adding microscopic examination of normal saline and 10% KOH wet mount preparation to them, they not only could obtain higher diagnostic accuracy rate but would be more valuable in selecting the patients requiring cultures to confirm the diagnoses.
Candida ; Diagnosis ; Gardnerella ; Gardnerella vaginalis ; Gynecology ; Humans ; Hydrogen-Ion Concentration* ; Mass Screening ; Obstetrics ; Outpatients ; Trichomonas ; Trichomonas Vaginitis ; Vagina ; Vaginal Discharge* ; Vaginitis*

Traditionally, the Rhododendron species has been used in gastrointestinal disorder or hypertension. Grayanotoxin exists in honey, flowers, pollen, and the nectar of the Rhododendron species. We experienced 3 cases of Grayanotoxin intoxication. The symptoms of intoxication were nausea, vomiting, hypotension, bradycardia, diplopia, dizziness, and chest discomfort. Generally, the treatment for Grayanotoxin intoxication is fluid resuscitation and injection of atropine sulfate. The patients who were intoxicated with Grayanotoxin were discharged without complication after supportive care.
Atropine ; Bradycardia ; Diplopia ; Dizziness ; Flowers ; Honey ; Humans ; Hypertension ; Hypotension ; Nausea ; Plant Nectar ; Pollen ; Resuscitation ; Rhododendron ; Thorax ; Vomiting

Febrile morbidity after cesarean section is one of the major problems in obstetric practice. This morbidity is most often due to endometritis. Although parenteral prophylactic antibiotics or antibiotic irrigation has been reported to reduce the incidence of endometritis after cesarean section, its incidence remains high. Among the patients who were undergoing cesarean section at Yeungnam University Hospital from the beginning of March, 1985, three group were evaluated in the orders. 1) 30 cases as intrauterine irrigation group with cephradine solution, 2) 35 cases as intravenous injection group with cephradine, 3) 35 cases as control group are neither irrigated nor injected. Febrile morbidity was also evaluated by means of a fever index. The incidence of clinically diagnosed endometritis in the three group were 6.7%, 2.9%, and 22.9%. As these results, two study groups were markedly reduced the incidence of endometritis than control group. There was no significant difference between the intrauterine irrigation with cephradine and control, but significant difference between the intravenous cephradine injection and control (P<0.05). With the results of fever index analysis, both prophylactic intrauterine irrigation and intravenous injection markedly reduce the incidence of endometritis after cesarean section with statistical significance (P<0.05), and also markedly reduce the febrile degree.
Anti-Bacterial Agents ; Cephradine* ; Cesarean Section* ; Endometritis ; Female ; Fever ; Humans ; Incidence ; Injections, Intravenous* ; Pregnancy

BACKGROUND: In a circle system, gas that is to be reused is cleared of carbon dioxide by passing through a canister containing a chemical CO2 absorbent. In anesthesia textbooks the utilization time of carbon dioxide is nearly always specified to last about 5 hours. The soda lime used was noted to regenerate its efficiency for CO2 absorption after being exhausted. Two different types of soda lime (a ROK product and USA product) were analyzed in patients for their duration of carbon dioxide absorption from the anesthetic closed circle system and re-use time after being exhausted. METHODS: General inhalation anesthesia was performed using a PhysioFlex anesthesia machine. To determine the duration of carbon dioxide absorption by soda lime and the re-use time after being exhausted, twenty seven (ROK; 20 and USA; 7) and fifty (ROK; 22 and USA; 28) adult patients were studied. Duration of CO2 absorption was determined as the time for the inspired CO2 concentration to reach 0.5%. The color change of ethyl violet in soda lime was observed throughout the study. Duration of CO2 absorption was compared by unpaired t-test. Re-use time of each group was analysed by simple regression; p less than 0.05 was considered significant. RESULTS: Duration of CO2 absorption was 2.67 +/- 2.12 hrs for the ROK product and 9.52 +/- 0.68 hrs of USA product, and they were different significantly (P < 0.05). Regression equations of ROK- and USA-products werey (min) = 5.761x + 45.701 (r2 = 0.0438, P = 0.3496, x means day after being exhausted) and y = 0.6x + 33.179 (r2 = 0.0158, P = 0.5233) respectively. A color change of ethyl violet in ROK soda lime was not observed throughout the chemical reaction. CONCLUSIONS: From the above results we suggest that ROK soda lime is not effective yet to use for CO2 absorption in clinical anesthesia. It is marked shorter than that of the USA soda lime. A color change of ethyl violet was not observed throughout the chemical absorption reaction in ROK soda lime. Re-use time of both soda limes were not related with the duration after being exhausted.
Absorption* ; Adult ; Anesthesia ; Anesthesia, Inhalation ; Carbon Dioxide ; Citrus aurantiifolia ; Humans ; Viola

BACKGROUND: Obesity is defined as an excess accumulation of body fat. To measure body fat accurately is difficult, but body mass index (BMI, kg/m2) is easily available for routine clinical use. METHODS: A total of 4,966 (male; 2,580, female; 2,386) patients from January to September in 1997 and aged up to 90 years old were studied for BMI. Among these subjects, obstetric patients were excluded in our study. We calculated the BMI as weight (kg) per height squared (m2). The heights and weights of study subjects were obtained from anesthesia records. The BMI was analyzed by 4 different age groups: group 1 (less than 3 years), group 2 (between 3 to 7 years), group 3 (between 8 to 17 years), and group 4 (18 years or more), decade of age, 4 obesity categories according to BMI levels: underweight (less than 18 kg/m2), normal weight (19-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (30 kg/m2 or more), and surgical departments. RESULTS: Mean BMI values of group 1, 2, 3, and 4 were 16.1+/-2.9 kg/m2, 16.2+/-2.4 kg/m2, 19.2+/-3.7 kg/m2 and 23.3+/-4.6 kg/m2 in males and 15.7+/-3.9 kg/m2, 15.8+/-2.7 kg/m2, 19.4+/-3.5 kg/m2 and 23.6+/-3.7 kg/m2 in females, respectively. According to generations, the BMI under teen-age was 16.3+/-2.7 kg/m2 and 14.3+/-2.9 kg/m2 in males and females respectively while it was between 20.4+/-3.3 kg/m2 to 25.0+/-3.6 kg/m2 from 1st to 7th decade patients in both sex. The prevalence of overweight and obesity were nearly zero in group 1 and 2, but males in group 3 had them of 4.6% and 1.4% while 6.9% and 0.8% in females, respectively. In group 4 they were 25.3% and 2.2% in males and 28.8% and 4.8% in females, respectively. Obese patients increased in the order of neurosurgery, gynecology, orthopedic surgery, urology, and general surgery departments. CONCLUSIONS: This study revealed the guidelines of BMI of operating patients. We recognized that the prevalence of overweight and obesity of preschool aged and adolescent patients were nearly zero. Adult patients were the highest at 4th decade in males and 6th decade in females and the obesity rates were 27.4% and 33.6% in males and females, respectively.
Adipose Tissue ; Adolescent ; Adult ; Aged, 80 and over ; Anesthesia ; Body Mass Index* ; Family Characteristics ; Female ; Gynecology ; Humans ; Male ; Neurosurgery ; Obesity ; Orthopedics ; Overweight ; Prevalence ; Thinness ; Urology ; Weights and Measures

No disease-modifying therapies (DMT) for neurodegenerative diseases (NDs) have been established, particularly for Alzheimer's disease (AD) and Parkinson's disease (PD). It is unclear why candidate drugs that successfully demonstrate therapeutic effects in animal models fail to show disease-modifying effects in clinical trials. To overcome this hurdle, patients with homogeneous pathologies should be detected as early as possible. The early detection of AD patients using sufficiently tested biomarkers could demonstrate the potential usefulness of combining biomarkers with clinical measures as a diagnostic tool. Cerebrospinal fluid (CSF) biomarkers for NDs are being incorporated in clinical trials designed with the aim of detecting patients earlier, evaluating target engagement, collecting homogeneous patients, facilitating prevention trials, and testing the potential of surrogate markers relative to clinical measures. In this review we summarize the latest information on CSF biomarkers in NDs, particularly AD and PD, and their use in clinical trials. The large number of issues related to CSF biomarker measurements and applications has resulted in relatively few clinical trials on CSF biomarkers being conducted. However, the available CSF biomarker data obtained in clinical trials support the advantages of incorporating CSF biomarkers in clinical trials, even though the data have mostly been obtained in AD trials. We describe the current issues with and ongoing efforts for the use of CSF biomarkers in clinical trials and the plans to harness CSF biomarkers for the development of DMT and clinical routines. This effort requires nationwide, global, and multidisciplinary efforts in academia, industry, and regulatory agencies to facilitate a new era.
Alzheimer Disease ; Biomarkers* ; Cerebrospinal Fluid* ; Humans ; Models, Animal ; Neurodegenerative Diseases ; Parkinson Disease ; Pathology ; Therapeutic Uses

The vertebral artery is infrequently injured because it lies deep in the neck, surrounded for the most part by bony foramina. Vertebral artery injuries are caused by penetrating traumas, blunt traumas and iatrogenic injuries. Sequela of vertebral artery injury include arteriovenous (AV) fistulae, and pseudoaneurysms may appear months after injury. Angiography is currently the gold standard for evaluating vascular injuries, such as vertebral artery injuries, and can be therapeutic. A vertebral artery fistula can also be treated by operative ligation. We experienced a rare case of a vertebro-jugular AV fistula secondary to a cervical stab wound. In this case, the patient was successfully treated by coil embolization and glue injection during angiography, which was confirmed by a postangiograpy operation.
Adhesives ; Aneurysm, False ; Angiography ; Arteriovenous Fistula* ; Embolization, Therapeutic ; Fistula ; Humans ; Ligation ; Neck ; Vascular System Injuries ; Vertebral Artery ; Wounds, Stab

Purpose: To report a squamous cell carcinoma in the lacrimal sac of a young patient.Case summary: A 30-year-old female patient who had a history of conjunctival squamous papilloma resected at 15 years of age complained of pain and a mass around the right lacrimal sac that had occurred 1 week prior. Antibiotic treatment for 10 days under suspicion of dacryocystitis did not relieve her symptoms. After being diagnosed with lacrimal sac obstruction after dacryocystography, a 1.7 × 1.7 cm round mass was found on orbit non-contrast computed tomography. Endonasal dacryocystorhinostomy and excisional biopsy were performed. Histopathological examination revealed the initial invasive squamous cell carcinoma. An additional resected tissue biopsy was performed later. The mass diagnosed as carcinoma was completely resected and it was confirmed that there were no malignant cells around the resected area. Conclusions Squamous cell carcinoma of the lacrimal sac is rare and is known to be less common in young patients. It is believed that this case should not exclude the possibility of malignant tumors of the lacrimal sac regardless of age. Given that squamous cell carcinoma of the lacrimal sac is associated with a high-risk of human papillomavirus, this disease should be considered if there is a history of papilloma.

Purpose: To report a squamous cell carcinoma in the lacrimal sac of a young patient.Case summary: A 30-year-old female patient who had a history of conjunctival squamous papilloma resected at 15 years of age complained of pain and a mass around the right lacrimal sac that had occurred 1 week prior. Antibiotic treatment for 10 days under suspicion of dacryocystitis did not relieve her symptoms. After being diagnosed with lacrimal sac obstruction after dacryocystography, a 1.7 × 1.7 cm round mass was found on orbit non-contrast computed tomography. Endonasal dacryocystorhinostomy and excisional biopsy were performed. Histopathological examination revealed the initial invasive squamous cell carcinoma. An additional resected tissue biopsy was performed later. The mass diagnosed as carcinoma was completely resected and it was confirmed that there were no malignant cells around the resected area. Conclusions Squamous cell carcinoma of the lacrimal sac is rare and is known to be less common in young patients. It is believed that this case should not exclude the possibility of malignant tumors of the lacrimal sac regardless of age. Given that squamous cell carcinoma of the lacrimal sac is associated with a high-risk of human papillomavirus, this disease should be considered if there is a history of papilloma.

OBJECTIVE: The aim of this study was to evaluate clinicopathologic characteristics of squamous cell carcinoma arising from ovarian mature cystic teratoma and to determine whether SCC Ag and CA 125 are useful serum markers for diagnosing this tumor. METHODS: From January 1990 to December 2005, 1266 patients diagnosed with ovarian mature cystic teratoma were reviewed. Of the 1266 patients, 8 patients which had squamous cell carcinoma arising from mature cystic teratoma were evaluated in this study. A retrospective analysis of clinicopathologic characteristics and disease-free survival rate was performed. RESULTS: The incidence of squamous cell carcinoma arising from ovarian mature cystic teratoma was 0.7% (8/1266). The mean age of the patients was 47.3 years (range, 32-72 years). Five patients (62.5%) had clinical FIGO stage I disease and three patients (37.5%) had stage III disease. The mean tumor diameter was 13.3 cm. The mean SCC Ag level was 0.3 ng/mL which was normal and the mean CA 125 was slightly increased to 68.5 U/mL. The mean disease free survival was 58.4 months and 2-year disease-free survival was 62.5% (5/8). Out of 8 patients, one patient died and one out of 7 patients who survived had recurrence. Age, clinical FIGO stage, grade, residual tumor, postoperative treatment were not significant prognostic factor for disease-free survival. CONCLUSION: The incidence of squamous cell carcinoma arising from ovarian mature cystic teratoma in our institute was lower and survival rate was relatively higher compared to previous studies. SCC Ag and CA 125 were not helpful tumor markers in diagnosing squamous cell carcinoma arising from ovarian mature cystic teratoma. Age, grade, residual tumor, postoperative treatment were not significant prognostic factor for disease-free survival.
Biomarkers ; Carcinoma, Squamous Cell* ; Disease-Free Survival ; Female ; Humans ; Incidence ; Neoplasm, Residual ; Ovary* ; Recurrence ; Retrospective Studies ; Survival Rate ; Teratoma* ; Biomarkers, Tumor