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.

OBJECTIVE: To determine the fetal aneuploidy in fetal blood cells from cordocentesis. METHODS: We analyzed their karyotype and performed fluorescence in situ hybridization(FISH) for chromosome 18, 21, X, and Y in 14 cases of fetal blood cells from cordocentesis at Department of Obstetrics & Gynecology, College of Medicine, Seoul National University and Hamchoon Women's Clinic. RESULTS: In all cases we obtained the consistent results in both methods and were able to rapidly detect aneuploidy in uncultured fetal blood cells using FISH before karyotyping with culture for 48 hr. The averages for accuracy of FISH were from 84.6 % to 93.9%. CONCLUSION: In this study we suggest that the rapid detection in uncultured fetal blood using FISH is possible and that this diagnostic method will be clinically useful when rapid result would be demanded.
Aneuploidy* ; Chromosomes, Human, Pair 18 ; Cordocentesis ; Fetal Blood* ; Fluorescence* ; Gynecology ; In Situ Hybridization* ; Karyotype ; Karyotyping ; Obstetrics ; Seoul

FISH is suggested as a possible method to detect the numerical and structural abnormalities of chromosomes in interphase nucleus. We performed this study to discuss the clinical usefulness of FISH in uncultured amniocytes and to set up the cut-off value for further study. We collected amniotic fluid samples from patients whose chromosome studies were recommended due to screen positive for Down and Edword syndrome in triple marker test using maternal serum. The centromeric probe for chromosome 18 and the locus-specific probe for chromosome 21 were used and the results were compared to their karyotypes. We could find 2 cases of trisony 21 and 2 cases of trisony 18 and the other cases represented normal karyotypes. The accuracies were 91% for disomy 18, 89% for trisomy 18, 92% for disomy 21 and 88% for trisomy 21. Therefore FISH technique is a possible method to detect the chromosomal abnormalities in uncultured amniocytes and the use of locus-specific probe for chromosome 21 would be more useful for detecting the aneuploidy of chromosome 21 than 13/21 centromeric probe.
Amniotic Fluid ; Aneuploidy ; Chromosome Aberrations ; Chromosomes, Human, Pair 18 ; Chromosomes, Human, Pair 21 ; Down Syndrome* ; Female ; Fluorescence* ; Humans ; In Situ Hybridization* ; In Situ Hybridization, Fluorescence ; Interphase ; Karyotype ; Trisomy

The authors have experienced a case of extrascleral extension of choroidal malignant melanoma. The patient has suffered from the ocular pain and proptosis of right eye. We performed Kronlein operation under the clinical impression of the retrobulbar mass and obtained the histopathological diagnosis of malignant melanoma. Fifteen days after the operation, we performed exenteration and the rotation flap of temporalis muscle was inserted into the right eye ball socket through the lateral wall of the orbit.
Choroid* ; Diagnosis ; Exophthalmos ; Humans ; Melanoma* ; Orbit

OBJECTIVE: To investigate cortical reorganization of the brain during voluntary activities of the hand in patients with subcortical cerebral infarction. METHOD: Twelve patients with first-ever subcortical brain lesion causing hemiparesis had been evaluated with functional MRI. Bilateral hand clenching was done to test voluntary hand activities. Recovery period ranged from 2 to 36 months. RESULTS: During the unaffected hand movement, activation of contralateral primary sensorimotor cortex (SMC) were recorded in all cases and supplmentary motor area (SMA) in 1 case. The affected hand movement showed activation of the cotralateral SMC in all cases, ipsilateral SMC in 4 cases, SMA in 4 cases and contralateral prefrontal area in 2 cases. As for the contralateral SMC, affected hand movement showed more increased activation than the unaffected. For the bilateral SMC activation during movement of the affected hand, contralateral SMC activation was greater than the ipsilateral. CONCLUSION: Ipsilateral activation of the SMC, SMA, prefrontal area and increased activation of the contralateral SMC during affected hand movement suggest that these may play an important role in the reorganization of sensory and motor system in stroke patients with subcortical lesion. Functional MRI studies of patients who recovered from subcortical stroke provide evidence for several process that may be related to restoration of neurologic function.
Brain ; Cerebral Infarction ; Hand* ; Humans ; Magnetic Resonance Imaging* ; Paresis ; Stroke*

OBJECTIVE: To investigate the effect of environmental factors on the ability of mobility in subjects with chronic stroke who can perform nearly independent activities of daily living (ADL). METHOD: Sixty one patients were divided into three groups (superior, middle, and inferior) by the degree of independent walking. Modified self-administered questionnaire was completed to report how well the patients encountered the environmental elements faced in community mobility. In addition, all patients were assessed to find out the difference of ADL performance, Berg balance scale (BBS), 10 m walking time (10 mWT) and patterns of 'going out' among the three groups. RESULTS: The group 1 (superior group) had shown better performance than group 2 (middle group) and group 3 (inferior group) in performance of ADL, BBS, 10 mWT. Secondly, the group 1 visited more places or destinations per day than the group 2 and 3, and they used more various transportation systems than other groups. Finally, there were significant differences in the distance dimension, the temporal dimension, terrain dimension (except for a 'getting on a elevator' component), and density dimension among the groups. CONCLUSION: Environmental factors as well as functional abilities could affect the mobility of subjects with chronic stroke. This result suggests that any kinds of compensation and the supports of social institutions are needed even in subjects of nearly independent ADL for their improvement of mobility and convenience.
Activities of Daily Living ; Compensation and Redress ; Humans ; Surveys and Questionnaires ; Stroke ; Transportation ; Walking

PURPOSE: Diverticular disease of the cecum and ascending colon is a relatively uncommon disease and there are some difficulties in the accurate preoperative diagnosis and the proper surgical treatment. This study is aimed to determine what is the proper procedure during the emergency operation of right colon diverticulitis. METHODS: This study is a retrospective clinical analysis of 86 cases of the right colon diverticulitis from January 1992 to December 1999. RESULTS: 1) The incidence of right colon diverticulitis (RCD) was 2.1% of that of appendicitis and the RCD to sigmoid colon diverticulitis ratio was 9.6:1.2) The highest incidence was noted at the fourth decades and average age was 37 years. Male to female ratio was 1.9:1. 3) Most patients (73 cases, 85%) had right lower quadrant abdominal pain. 4) The duration of symptom was less than 3 days in 54 cases (63%). 5) The preoperative confirmation by radiologic work-up was not decisive, but barium enema might be more accurate than other studies and CT was more accurate method than ultrasound. 6) The correct preoperative diagnosis was made only in 13 cases (15%) and the remaining misdiagnoses were appendicitis with or without complications in 72 cases (83%). 7) Operative procedures varied markedly according to multiplicity, extent of inflammation and complications; diverticulectomy and appendectomy in 48 cases (56%), ileocecectomy in 15 cases (17%) and right hemicolectomy in 11 cases (13%). 8) The most commom postoperative complication was wound infection. 9) Among the 30 cases who took diverticulectomy or diverticulectomy and appendectomy, remained diverticulums were found in 14 cases (47%), especially 11 cases (37%) on the right colon. And so multiplicity of right colon reached about 37%. CONCLUSIONS: The authors suggest that one should suspect RCD in fourth decade patients with right lower quadrant pain for more than 3 days with unusual clinical findings. Barium enema can be used because of the high accuracy rate but CT is a safe tool in complicated or urgent situation. The operative modalities should be selected on the extent of the disease and it is sufficient to treat a single diverticulitis with diverticulectomy or diverticulectomy and appendectomy but right hemicolectomy should be recommanded in the suspicious multiplicity or malignancy.
Abdominal Pain ; Appendectomy ; Appendicitis ; Barium ; Cecum ; Colon* ; Colon, Ascending ; Colon, Sigmoid ; Diagnosis ; Diagnostic Errors ; Diverticulitis* ; Diverticulum ; Emergencies ; Enema ; Female ; Humans ; Incidence ; Inflammation ; Male ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative ; Ultrasonography ; Wound Infection

PURPOSE: To investigate the epidemiology and clinical characteristics of centipede bite injuries. METHODS: We conducted a retrospective study of clinical manifestations in patients who were identified between April 2005 to April 2007 as having suffered from centipede bites. Factors evaluated included sex, age, location and time of bite, part of body affected, clinical signs and symptoms, treatment modalities and complications. RESULTS: A total of 179 cases of centipede bite were identified. Centipede bites occurred between spring and autumn. 69.3% of bites happened at night. All patients were bitten on an exposed body parts, and the digit of both the handsand feet were the sites most often involved. Pain, swelling, erythema were the most frequent symptoms and signs. Most cases showed minor manifestations but, three patients needed to be admitted because of anaphylaxis. CONCLUSION: Centipede bites are relatively common in the summer season in rural and island areas, especially at night. Though the clinical symptoms of centipede bites are generally minor symptoms, emergency physicians need to possess accurate knowledge of the clinical manifestations in order to properly identify severe cases.
Anaphylaxis ; Arthropods ; Bites and Stings ; Emergencies ; Erythema ; Foot ; Human Body ; Humans ; Korea ; Retrospective Studies ; Seasons

Primary malignant lymphoma of the breast constitutes less than 1% of malignant breast neoplasms. There is general agreement that this lymphoma is usually of a non-Hodgkin's histology. Unfortunately, failure to recognize this possibility may result in unnecessarily radical surgery. Radical surgery is to be avoided and radiation therapy with limited surgery provides exellent local regional control. The addition of systemic, combined chemotherapy is warranted in the more aggressive histologic subtypes because death is generally due to subsequently disseminated disease. We present case reports for a 33-year-old and a 38-year-old female with malignant, large cell type, non-Hodgkin's lymphoma diffuse, of the right breast who were treated with a modified radical masectomy and lumpectomy with ipsilateral axillary dissection at Holy Family Hospital, College of Medicine, the Catholic University of Korea.
Adult ; Breast Neoplasms ; Breast* ; Drug Therapy ; Female ; Humans ; Korea ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Mastectomy, Segmental

Emphysematous prostatic abscess is a very rare form of prostatitis. Emphysematous prostatic abscess due to Klebsiella pneumoniae may have a poor prognosis according to a few previous reports. We report a rare case of successfully treated emphysematous prostatic abscess with cystitis due to Klebsiella pneumoniae in a 50-yr-old man with 15-yr history of diabetes mellitus. The patient was referred to the emergency room of our hospital. The KUB film revealed gas shadows in the lower pelvic area suggestive of emphysematous cystitis or emphysematous prostatic abscess. The gas was mainly occupying the prostate and was also seen in the bladder on pelvic CT. The patient was successfully treated with long-term antibiotic use and additional percutaneous drainage of the abscess. Emphysematous prostatic abscess may be misdiagnosed as emphysematous cystitis due to the similar location of gas shadows on radiography. Computerized tomography and transrectal ultrasonography are helpful in making the diagnosis of emphysematous prostatic abscess. Appropriate use of effective antibiotics with drainage of pus is the best treatment. This case emphasizes the importance of timely and accurate diagnosis followed by appropriate treatment in emphysematous prostatic abscess in diabetic patients.
Abscess ; Anti-Bacterial Agents/therapeutic use ; Cystitis/diagnosis ; Diabetes Mellitus/complications ; Drainage ; Emphysema/diagnosis/*microbiology ; Human ; Klebsiella Infections/*diagnosis/drug therapy ; Klebsiella pneumoniae/*metabolism ; Male ; Middle Aged ; Prostate/*microbiology ; Prostatic Diseases/*diagnosis/microbiology/radiography