The leiomyosarcoma of the spermatic cord is a rare malignant tumor which constitutes approximately about 10% of sarcomas of the spermatic cord and tunics. In Korea, only one case has been reported. Because the cases presented are too small to be mentioned, the efficacy of retroperitoneal lymph node dissection, radiotherapy and chemotherapy are not settled. The standard therapy for leiomyosarcoma has been radical orchiectomy with high ligation of the spermatic cord. Here, we report a case of the leiomyosarcoma of the spermatic cord and review the role of retroperitoneal lymph node dissection.
Drug Therapy ; Korea ; Leiomyosarcoma* ; Ligation ; Lymph Node Excision ; Orchiectomy ; Radiotherapy ; Sarcoma ; Spermatic Cord*

We studied 16 male patients complaining of impotence after trauma. Underlying causes of injury were posterior urethral injury (9 patients), pevic bone fracture (3 patients), perineal burn (2 patients), penile fracture (1 patient) and spinal cord injury (1 patient). Rigiscan was used for diagnostic test and compared with other erectile function tests (Papaverine injection test, Snap Gauge test, PBI(penile brachial index) and PDI (penile digital index) test, AVS (audiovisual stimulation) and Erectiometer tests. The results obtained were as follows: 1. In 9 patients shown normal rigiscan, the number of erection was 1.56+/-0.87 times per night, duration was 14.2+/-7.54 minutes at tip and 20.1+/-9.42 minutes at base, tumescence change was 2.30+/-1.64 cm at tip and 3.40+/-0.73 cm at base, rigidity was 66.28+/-13.33% at tip and 78.86+/-21.43% at base. 2. Among 9 patients shown normal rigiscan, 8 patients showed partial to full rigid erection in intracavernous Papaverine injection test. 3. In 7 patients shown abnormal rigiscan, the findings of Snap Gauge test, AVS test and Erectiometer test showed slight to absent responses, but 9 patients shown normal rigiscan presented variable findings. 4. 13 patients with PBI > or=0.75 and 15 patients with PDI > or =0.77 showed normal rigiscan. but patients shown abnormal rigiscan presented variable findings of PBI and PDI tests. Conclusively, rigiscan and intracavernous Papaverine injection test showed high corresponding rate, but other erectile function tests presented variable findings in patients complaining of impotence after trauma.
Burns ; Diagnostic Tests, Routine ; Erectile Dysfunction* ; Fractures, Bone ; Humans ; Male ; Papaverine ; Spinal Cord Injuries

We studied 16 male patients complaining of impotence after trauma. Underlying causes of injury were posterior urethral injury (9 patients), pevic bone fracture (3 patients), perineal burn (2 patients), penile fracture (1 patient) and spinal cord injury (1 patient). Rigiscan was used for diagnostic test and compared with other erectile function tests (Papaverine injection test, Snap Gauge test, PBI(penile brachial index) and PDI (penile digital index) test, AVS (audiovisual stimulation) and Erectiometer tests. The results obtained were as follows: 1. In 9 patients shown normal rigiscan, the number of erection was 1.56+/-0.87 times per night, duration was 14.2+/-7.54 minutes at tip and 20.1+/-9.42 minutes at base, tumescence change was 2.30+/-1.64 cm at tip and 3.40+/-0.73 cm at base, rigidity was 66.28+/-13.33% at tip and 78.86+/-21.43% at base. 2. Among 9 patients shown normal rigiscan, 8 patients showed partial to full rigid erection in intracavernous Papaverine injection test. 3. In 7 patients shown abnormal rigiscan, the findings of Snap Gauge test, AVS test and Erectiometer test showed slight to absent responses, but 9 patients shown normal rigiscan presented variable findings. 4. 13 patients with PBI > or=0.75 and 15 patients with PDI > or =0.77 showed normal rigiscan. but patients shown abnormal rigiscan presented variable findings of PBI and PDI tests. Conclusively, rigiscan and intracavernous Papaverine injection test showed high corresponding rate, but other erectile function tests presented variable findings in patients complaining of impotence after trauma.
Burns ; Diagnostic Tests, Routine ; Erectile Dysfunction* ; Fractures, Bone ; Humans ; Male ; Papaverine ; Spinal Cord Injuries

An ectopic ureteral orifice inserts at a point other than the trigone of the bladder. Ectopic ureteral orifices in a girl commonly are associated with complete ureteral duplication comprises only 10 to 12 per cent of such patients. Continuous incontinence in a girl with an otherwise normal voiding pattern after toilet training is the classic sign of an ectopic ureteral orifice. Here, we report a 3-years-old girl who was admitted to our hospital due to continuous urinary incontinence and managed with the diagnosis of bilateral ectopic ureteral orifices associated with bilateral complete ureteral duplication.
Diagnosis ; Female ; Humans ; Toilet Training ; Ureter* ; Urinary Bladder ; Urinary Incontinence

Crohn's disease, a major form of inflammatory bowel disease (IBD), is a chronic inflammatory condition that is characterized by microvascular and macrovascular involvement. Some extraintestinal complications can occur due to chronic systemic inflammation in IBD. Among them, a pulmonary thromboembolism is a rare manifestation of IBD but is associated with a high morbidity and mortality. To our best of knowledge, there is only one case report of a pulmonary thromboembolism as a complication of Crohn's disease in Korea. We present another rare case of pulmonary thromboembolism as complication in a 25-year-old man with underlying Crohn's disease.
Adult ; Crohn Disease ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Korea ; Pulmonary Embolism

BACKGROUND: Group B streptococcus (GBS) infection is a leading cause of neonatal morbidity and mortality worldwide. Here, we present the analytical and diagnostic usefulness of a new real-time PCR-based assay (Xpert GBS; Cepheid, USA) for rapid and accurate prenatal GBS screening. METHODS: We enrolled 175 pregnant women who were between 35 and 39 weeks of gestation. The analytical performance of the Xpert GBS assay was first tested using a reference GBS strain. Next, to test diagnostic performance, rectovaginal swabs were obtained from pregnant women who visited the hospital for regular antenatal screening after 34 weeks of gestation. The results of the Xpert GBS assay were compared to those of standard culture for the detection of prenatal GBS colonization. RESULTS: When any positive result from Xpert GBS or culture was considered a true positive, the sensitivity of the Xpert GBS assay and culture were 91% (20/22; 95% CI [confidence interval], 72-98) and 68% (15/22; 95% CI, 47-84), respectively. The specificity of both methods was 100% (153/153; 95% CI, 97-100). The sensitivity and specificity of the Xpert GBS assay, using the culture results as a reference, were 86.7% and 95.6%, respectively. In the Xpert GBS assay, the median threshold cycle of vaginally colonized samples was significantly lower than rectally colonized samples (P<0.01). CONCLUSIONS: The Xpert GBS assay is an accurate, rapid, easy-to-use test for the detection of maternal GBS colonization in prenatal screening that might be especially useful in clinical settings where standard culture is not feasible.
DNA, Bacterial/*analysis ; Female ; Gestational Age ; Humans ; Pregnancy ; Pregnancy Complications, Infectious/*diagnosis/microbiology ; Prenatal Diagnosis ; Reagent Kits, Diagnostic ; Real-Time Polymerase Chain Reaction ; Rectum/microbiology ; Sensitivity and Specificity ; Streptococcal Infections/*diagnosis/microbiology ; Streptococcus agalactiae/*genetics/isolation & purification ; Vagina/microbiology

PURPOSE: Primary gastrointestinal lymphoma is the most common form of extranodal lymphoma. The clinical features, histological distributions, treatment results and prognosis of the primary intestinal lymphoma were evaluated. METHODS: A retrospective study was performed on 62 patients with primary intestinal lymphoma, as defined by Lewin's criteria, from May 1990 to February 2002. The WHO classification and Ann Arbor staging system were used for histological classification and staging, respectively. RESULTS: The sex ratio of the patients was 43: 19 (male: female), and the median age was 54 years. Abdominal pain, a palpable mass, and bleeding were the most frequent symptoms on presentation. The ileocecal area was the most frequent pathological site. Fifty-three cases were non- Hodgkin's lymphoma of B-cell origination; all of the remaining were T-cell originated. The mean survival period of B-cell and T-cell originated were 59.3 and 14.3 months, respectively (P<0.05). The 5 year survival rates of the patients in stage IE and IIE, and stage IIIE and IVE, were 52.4 and 32.6%, respectively (P=0.03). Six patients received surgery, 17 chemotherapy, and 39 surgery with adjuvant chemotherapy. Among the patients confined to stage IE and IIE, the 3 year survival rates of the surgery and surgery with adjuvant chemotherapy groups were 34 and 84%, respectively (P=0.0049). CONCLUSION: Primary gastrointestinal lymphoma of B-cell origination was predominant in relation to the WHO classification and revealed a better prognosis when compared to the T-cell originated lymphoma. For the patients with localized intestinal lymphoma, multimodality treatment (surgery with adjuvant chemotherapy) is preferred to the sole administration of chemotherapy.
Abdominal Pain ; B-Lymphocytes ; Chemotherapy, Adjuvant ; Classification ; Drug Therapy ; Hemorrhage ; Hodgkin Disease ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Prognosis ; Retrospective Studies ; Sex Ratio ; Survival Rate ; T-Lymphocytes

PURPOSE: Characteristic signs – the susceptibility vessel sign (SVS) and the prominent hypointense vessel sign (PHVS) – on T2*-based magnetic resonance imaging (T2*MRI) can be seen for acute ischemic stroke with large artery occlusion. In this study, we investigated the evidence to support our hypothesis that these findings may help to predict outcomes after reperfusion therapy. MATERIALS AND METHODS: We searched for papers describing SVS and PHVS in patients treated with reperfusion therapy for acute ischemic stroke, and their functional/radiologic outcomes were systematically reviewed. RESULTS: Nine studies on the SVS and six studies on the PHVS were included. The pooled odds ratio (OR) of recanalization after intravenous thrombolysis or mechanical thrombectomy was not significantly different with the presence of SVS (OR, 0.615; 95% confidence interval [CI], 0.335–1.131 and OR, 0.993; 95% CI, 0.629–1.567). The OR of favorable functional outcome after reperfusion therapy in terms of the presence of PHVS varied (0.083 to 1.831) by study. CONCLUSION: Our meta-analysis of the published data showed that a SVS was not a predictive factor for recanalization after reperfusion therapy for acute ischemic stroke. Currently, the data available on T2*MRI are too limited to warrant reperfusion therapy in routine practice. More data are needed from studies with randomized treatment allocation to determine the role of T2*MRI.
Arteries ; Humans ; Magnetic Resonance Imaging ; Odds Ratio ; Reperfusion* ; Stroke* ; Thrombectomy

Homocysteine (Hcy) is thought to play an important role in the development of osteoporosis and fracture. Methionine synthase reductase (MTRR) is an enzyme involved in the conversion of Hcy to methionine. We hypothesized that certain genetic polymorphisms of MTRR leading to reduced enzyme activity may cause hyperhomocysteinemia and affect bone metabolism. We therefore examined the associations of the A66G and C524T polymorphisms of the MTRR gene with bone mineral density (BMD) and serum osteocalcin levels in postmenopausal women. Although we did not detect any significant associations between MTRR polymorphisms and BMD or serum osteocalcin levels, we found that the 66G/524C haplotype, which has reduced enzyme activity, was significantly associated with serum osteocalcin levels in a gene-dose dependent manner (P=0.002). That is, the highest osteocalcin levels (34.5+/-16.8 ng/ml) were observed in subjects bearing two copies, intermediate osteocalcin levels (32.6+/-14.4 ng/ml) were observed in subjects bearing one copy, and the lowest levels of osteocalcin (28.8+/-10.9 ng/ml) were observed in subjects bearing no copies. These results suggest that the 66G/524C haplotype of the MTRR gene affect bone turn over rate.
Postmenopause/*blood ; *Polymorphism, Genetic ; Osteocalcin/*blood ; Middle Aged ; Lumbosacral Region/radiography ; Humans ; Genotype ; Ferredoxin-NADP Reductase/*genetics/physiology ; Femur Neck/radiography ; Female ; Bone Density ; Aged, 80 and over ; Aged

BACKGROUND: The purpose of this study is to know the healthcare-associated infection (HAI)s in small and medium sized hospitals, less than 400 beds. METHODS: We had web based surveillance for HAIs in 27 hospitals from August to October 2010. The surveillance performed in 1-2 ICUs and 1 general ward in each hospitals by CDC definition. And for the multi-drug resistant organisms (MDROs), we reviewed all of blood culture results. RESULTS: We identified 319 HAIs among 269,436 patients days. The HAIs rate was 1.18 (CI 1.05-1.32)/1,000 patient-days. Urinary tract infection was the most common HAI (52.4%) in this study followed by pneumonia (18.9%), blood-stream infections (14.2%), surgical site infection (7.9%), and others (6.6%). There were 76.5% of device associated infections in UTI, 46.7% in BSI, and 18.3% in pneumonia. The rate of HAIs in ICU was higher than that of in general ward (4.6 vs 0.9/1,000 patient-days). However, the indwelling catheter associated urinary tract infection rate was lower in ICU (2.6 vs 4.4/1,000 device days). There were no significant differences in central line-associated blood stream infection rate (1.5 vs 1.8) and ventilator-associated pneumonia rate (3.0 vs 0.0). The common microorganisms found in HAIs were Escherichia coli (19.8%), Staphylococcus aureus (13.1%), and Pseudomonas aeruginosa (12.7%). Moreover, 90.9% of S. aureus were resistant to methicillin, and 38.2% of P. aeruginosa and 44.4% of Acinetobacter baumannii were resistant to imipenem. Total of 66 MDROs were isolated from blood culture and the result shows that the MRSA was 84.6% (56 case), carbapenmen-resistant Acinetobacter spp. was 10.6% (7 case), and vancomycin-resistant enterococci was 4.6% (3 case). CONCLUSION: The characteristics of HAIs in small and medium sized hospitals will be contributed to the decision making of governance policy for infection control and to provide comparable data for these hospitals.
Acinetobacter ; Acinetobacter baumannii ; Catheters, Indwelling ; Centers for Disease Control and Prevention (U.S.) ; Decision Making ; Escherichia coli ; Humans ; Imipenem ; Infection Control ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Patients' Rooms ; Pneumonia ; Pneumonia, Ventilator-Associated ; Pseudomonas aeruginosa ; Rivers ; Staphylococcus aureus ; Urinary Tract Infections