No abstract available.
Muscle, Smooth* ; Relaxation*

Cervical pregnancy is a rare form of ectopic gestation in which the blastocyst implants in the cervical mucosa below the histologic cervical os. Because of the serious vaginal bleeding, hysterectomy was usually done in the management of cervical pregnancy. Howerver, conservative treatment is desirable for women who want to be pregnancy in the future. Methotrexate has been utilized recently for conservative management of cervical pregnancy. We report a case of cervical pregnancy which was treated succesfully with intramuscular methotrexate injection.
Blastocyst ; Female ; Humans ; Hysterectomy ; Methotrexate* ; Mucous Membrane ; Pregnancy* ; Uterine Hemorrhage

No abstract available.
Cytosine Deaminase* ; Cytosine* ; Genetic Therapy* ; Osteocalcin* ; Prostate* ; Prostatic Neoplasms*

PURPOSE: The purpose of this study was to examine the academic achievement of the first year medical students at Gachon University of Medicine and Science based on their characteristics (i.e. age, gender, and academic degree types (bachelors/masters), field of major (biology/ non-biology), and admission variables (i.e. MEET, GPA, attitude, interview, and English test). METHODS: The admission scores and demographic information were obtained from 39 students who had entered the university in 2005. T-test was used to examine the differences in academic achievement according to the students' characteristics. Correlations between admission variables and academic achievements were examined while multiple regression analysis was used to decipher the influence of students' characteristics and admission variables on the academic achievements. RESULTS: This study showed that the academic achievements differed significantly depending on degree level, age, and field of study, but not gender. It was also found that both the Nature Science Reasoning (NSR) of MEET subscale score and GPA score correlated significantly with academic achievement in the first year students. Attitude, interview, and English test scores did not correlate significantly. The result of the multiple regression analysis revealed that NSR 1 and 2, field of major, and age accounted for a substantial amount of the variance in academic achievement. CONCLUSION: Students with higher scores in NSR 1 and 2 who majored in biology-related fieldsand who are younger tend to do better academically in their first year of medical school. The results of this study may be helpful to graduate medical schools in designing effective admissions strategies for recruiting students, as well as, in planning the curriculum to improve the academic achievements of medical students.
Curriculum ; Humans ; Schools, Medical* ; Students, Medical

PURPOSE: The aim of this study was to evaluate the efficacy of a combination therapy with PDE5 inhibitor and testosterone replacement therapy in erectile dysfunction patients with testosterone deficiency syndrome (TDS) after failure of PDE5 inhibitor mono-therapy. MATERIALS AND METHODS: From March 2004 to July 2008, we evaluated 38 men (aged 38 to 69 years) who showed no response to PDE5 inhibitor therapy at the maximal recommended dose and they had testosterone levels less than 350ng/dL. Testosterone replacement therapy (TRT) was subsequently started with injectable testosterone undecanoate (NEBIDO(R)) or transdermal testosterone (Testogel(R)) in those patients. They received TRT during an 18-week period. After 14 weeks of TRT alone, PDE5 inhibitor was added to the TRT for an additional 4 weeks. After treatment, we evaluated the patients' sexual function, which was primarily based on the International Index of Erectile Function (IIEF), and the serum testosterone levels. RESULTS: All patients showed elevated serum testosterone levels after TRT (range: 212 to 662ng/dl, mean level: 362.19 ng/dl). At week 18, almost all of the men reported improved potency with combination therapy. After treatment, the mean total IIEF score and each sub-domain score were increased significantly compared to the baseline score. CONCLUSIONS: Testosterone replacement therapy combined with PDE5 inhibitor may be beneficial in improving the erectile function in testosterone deficiency syndrome patients with erectile dysfunction and who are unresponsive to PDE5 inhibitor alone.
Erectile Dysfunction ; Humans ; Hypogonadism ; Male ; Testosterone

BACKGROUND: DHEA-S is the most abundant steroid hormone in circulation, and primarily secreted from the adrenal cortex, but its physiological role is little known. One of the characteristic features of DHEA-S is progressive decrement of plasma DHEA-S level with advancing age, in contrast, plasma levels of other adrenal hormones are not chaging or littie decreasing. To grasp the trends of plasma DHEA-S level and DHEA-S/cortisol ratio by age in healthy Korean, we measured the plasma DHEA-S levels and DHEA-S/cortisol ratios in healthy Korean. METHODS: Healthy Korean (men: 99, women: 102, age range: 15-97 year old)were studied. Subjects were not taking drugs (such as glucocorticoid or androgenic medication) or cigarettes known to modify the plasma level of DHEA-S and cortisol, and had no evidence of hepatic, renal disease or hyperlipidemia as determined by serum lipid, bilirubin, SGOT, SGPT, BUN, creatinine. Data were analyzed by 10-year age group for men and women: i.e, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89 and 90 year or more. Plasma DHEA-S levels were measured by using a commercially available RIA kit with 125I labeled-DHEA-SO4 (Coat-A Count DHEA-SO4), and for the measurement of plasma cortisol levels, commercial Gamma Coat TM[125I] Cortisol Radioimmunassay Kit was used. RESULTS:. 1) In both men and women, plasma DHEA-S level showed high interindividual variation within the same age group. 2) There were individual sex differences in plasma levels of DHEA-S, in all age groups, plasma DHEA-S levels were significantly higher values for men than for women. 3) Maximum plasma DHEA-S levels (men; 237+-3.35 ug/dL, women; 108+-17.5 ug/dL) were at third decade in both men and women. 4) Both men and women showed the continuous decline in plasma DHEA-S level with age. These age-related decline was more prominent in men than in women (men; y=-3.152 * +292.6, r2= 0.8459, P<0.05, women; y= -1.417 * +143.3, r2 = 0.7278, P< 0.05). 5) As an index of aging, there was no stastical difference between DHEA-S and DHEA-S/cortisol ratio. CONCLUSION: In healthy Korean, there were high interindividual variation of plasrna DHEA-S levels. In both men and women plasma DHEA-S level was peak at third decade, and from when it declined progressively with age. These results suggest that although the reliability of single plasma DHEA-S measurement are limited, the decline of DHEA-S with advancing age might be a specific marker of endocrinologic hormonal milieu (aging index). Also, concerning to individual adrenal secreting capacity, we measured DHEA-S/cortisol ratio. But we did not found that plasma DHEA-S/cortisol ratio is superior to the plasma DHEA-S level as an aging index.
Adrenal Cortex ; Aging ; Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; Creatinine ; Female ; Hand Strength ; Humans ; Hydrocortisone* ; Hyperlipidemias ; Male ; Plasma* ; Sex Characteristics ; Tobacco Products

The urogenital tract manifestations of acquired immune deficiency syndrome (AIDS) include the entire array of voiding symptoms; infections, neurogenic bladder problems, impotence, infertility, neoplasma and AIDS associated renal syndromes. Tuberculosis occurs in approximately 4% of patients with AIDS, and involves at least one extrapulmonary site in nearly 50% of cases. However, tuberculous infection of the testicle in AIDS is rarely seen. Herein, we report a case of tuberculosis epididymoorchitis, which developed as a result of reactivation in an AIDS patient. To the best of our knowledge, this is the first reported case of AIDS presenting as tuberculous epididymoorchitis in Korea.
Acquired Immunodeficiency Syndrome* ; Erectile Dysfunction ; Humans ; Infertility ; Korea ; Male ; Testis ; Tuberculosis ; Urinary Bladder, Neurogenic

Bladder leiomyoma is a very rare tumor, and only 0.43% of bladder tumors are of this type. Bladder leiomyoma may cause various symptoms depending on its anatomical location and size. The most common voiding symptoms manifested by leiomyoma are the obstructive symptoms. We report a case of a 42 year old woman who had voiding symptoms for 3 years while visiting the outpatient department of genito-urology due to acute urinary retention. We performed ultrasonography, computed tomography, MRI and transurethral resection, and from these test, the pathologic diagnosis revealed a leiomyoma of bladder.
Adult ; Diagnosis ; Female ; Humans ; Leiomyoma* ; Magnetic Resonance Imaging ; Neck* ; Outpatients ; Ultrasonography ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Retention*

BACKGROUND/AIMS: Propofol is an effective sedative drug in endoscopic procedures, but it has potentially serious adverse effects, so close monitoring of the vital signs should be performed during endoscopy. This study was undertaken to determine the adequate induction dose of propofol for safe and effective sedation during esophagogastrodudenoscopy (EGD) in persons 60 years or older. METHODS: Three hundred patients who visited our hospital for EGD were randomly assigned to three groups (A,B and C). An initial induction dose of 0.5 mg/kg, 0.75 mg/kg and 1.0 mg/kg of propofol was allocated to groups A, B and C, respectively. RESULTS: The 0.5 mg/kg, 0.75 mg/kg and, 1 mg/kg dose of propofol were all safe as an initial dose of propofol for achieving sedation during EGD in persons 60 years or older. There was no difference in the total amount of propofol among the three groups. Group C had a significantly shorter induction time and a lower dose was required for an additional injection of propofol without increasing adverse events, as compared to the two other groups. CONCLUSIONS: We suggest that 1 mg/kg of propofol is an effective induction dose for sedation during EGD in persons 60 years or older.
Aged ; Conscious Sedation ; Endoscopy ; Endoscopy, Digestive System ; Humans ; Propofol ; Vital Signs

PURPOSE: Community-Acquired Pneumonia (CAP) is a common cause of mortality and serious morbidity. Regardless of the condition of the patients, almost all are hospitalized. And it seems to be a standard procedure to obtain blood cultures before the administration of antibiotics in suspected pneumonic patients. Recent studies show that the blood cultures don't affect the treatment of the patients with CAP. Accordingly, this study was designed to examine the usefulness of the blood cultures routinely performed and to evaluate the stratification of the patients with CAP by Pneumonia Severity Index (PSI) in the Emergency Department (ED). METHODS: Research subjects were patients over 16 years old who had been diagnosed with CAP in a general hospital between January and December 2008 and were admitted by way of the ED. We evaluated their records retrospectively. RESULTS: A total of 261 patients were diagnosed with CAP. According to the PSI, 155 (59%) of the 261 were classified as being in the low risk group and 106 (41%) in the high risk group. Blood cultures were positive in 13 of 261 (5%). Three of 13 patients belonged to the low risk group, and 10 to the high risk group. Antibiotics were changed in 43 of 261 patients. Nineteen of those belonged to the low risk group and 24 to the high risk group. Of the 13 bacteremic patients, blood cultures results altered therapy for 4 patients. CONCLUSION: Most often, blood cultures performed in the ED do not alter the therapy of patients with CAP. But we do recommend blood cultures for the high risk group.
Anti-Bacterial Agents ; Community-Acquired Infections ; Emergencies ; Hospitals, General ; Humans ; Pneumonia ; Research Subjects ; Retrospective Studies ; Severity of Illness Index