We reported previously that, combined with l. 0 gm of probenecid, sodium penicillin G. 4, 0 m.u.i.m. was slightly less effective than procaine penicillin G. 4. 8 m.u. i.m. in the treatment of uncomplicated male gonorrhea. We now present the effect of double dose of sodium penicillin G. in the treatment of uncomplicated gonorrhea. The subjects were 262 male patients with uncomplicated gonoccccal urethritis at the VD clinic of Choong Ku Public Health Center in Seoul during 5 months period from January to May 198l. The following criteria were used to identify gonococcal infection - Gram negative intracellular diplococci in urethral smear and/or oxidase positive typical colony formation on Thayer-Martin media composed of Gram negative diplococci. They were given 4.0 m.u. sodium penicillin G. i.m. proceeded 15 to 30 min. by 1. 0 gm. probenecid p.o.. Four hours later, same amount of sodium peniciIlin G. i.m. was repeated. Concornitant eomparison of procaine penicillin G. was not done because of recent una,vailability of the drug in Korea. To avoid pain, the drug is dissolved in 6 ml of normal saline plus 2 ml of 2% lidacaine. One hundred eighty five patients were able to be followed 3 to 7 days after the treatment. There were .24 (13%) failures and 17 (10. 6%) postgonococcal urethritis. During this study, l4 strains of PPNG (Penicillinase Producing Keisseria Gonarrhoeae) were detected with chromogenic cephalosporin slide method. There were 10 (5. 8%) failures among 171 patients with urethritis caused by non-PPNG.
Gonorrhea* ; Humans ; Korea ; Male* ; Oxidoreductases ; Penicillin G Procaine ; Penicillin G* ; Probenecid ; Public Health ; Seoul ; Sodium* ; Urethritis

Although the penicillin is still the first choice of drug in the treatment of gonorrhea in most areas of the world, Neisseria gonorrhoea has become increasingly less sensitive to penicillin preparations. The proportion of such strains also varies from region to region. Sodium penicillin G. is a short acting preparation which enables to attain quick high blood level. The reason for combining the quick acting sodium penicillin G. with probenecid is that latter inhibits renal excretion of penicillin and maintains effective serum penicillin levela long enough to extinguish gonococcal infections. The subjects were 265 male patients with uncomplicated gonococcal urethritis at the VD clinic of Cboong Ku Public Health Center in Seoul during 5 months period from September 1980 to January 1981. The following criteria is used to identify gonococcal infection Gram negative intracellular diplococci in urethral smear and/or oxidase positive typical colony formation on Thayer-Martin media composed of Gram negative diplococci. The 265 patients were divided in two groups(A and B group). They were administered an oral dose of 1.0 gm. probenecid and, 15 to 30 min. later, 4.0 m.u. of sodium penicillin G. i.m. in A-group(152) and 4.8 m.u. procaine penicillin G. i.m. in B-group(113). Only those who were able to be followed up 3 to 7 days after treatment were contained for final analysis(A-group:108, B-group:88), A-group showed 22 failures(20.4%), and B-group 9 failures(10.2%). A significant difference is found between the two groups(P<0.05). Incidence of postgonococcal urethritis was 6(7.0%) in A-group and 5(6.3%) in B-group(P>0.05). We suggest a repeated injection 3 to 4 hours later or increased amonuts of sodium penicillin G. might give better result in the treatment of uncomplicated gonorrhea.
Gonorrhea* ; Humans ; Incidence ; Male* ; Neisseria ; Oxidoreductases ; Penicillin G Procaine ; Penicillin G* ; Penicillins ; Probenecid ; Public Health ; Seoul ; Sodium* ; Urethritis

The efficacy of Thayer-Martin media (abbreviated TM media) recently introduced by the government, is a great concern to us. The results of culture on TM media are compared with the results obtained from Gram stained filrn. The subjects were 235 male patients with urethral discharge who visited the VD clinic of Choong-ku Puhlic Health Center in Seoul during 3 months period from 21th May to 20th August 1979. CDC recommendations are closely followed for Gram staining as well as for cultural identification. Among 151 positives with Gram staining, 142 were also culture positive (94.0%) while 8 were negative(5.2%) indicating reasonably good correlation. One patient was culturally positive(0. 8%) while negative by Gram staining. TM media supplied by Seoul Metropolitian Institute of Public Health which was used for this study is considered to be adequate.
Centers for Disease Control and Prevention (U.S.) ; Gonorrhea* ; Humans ; Male ; Public Health ; Seoul

Lichen planus is rare in Korea. and oral lichen planus is even rarer. To our knowledge, this is the first case reporting in Korean dermatological literature. 57 year-old man was seen for erythema with white striation on the oral mucosa in December 1981. The initial lisior s appeared on the buccal mucosa of left side of oral cavity 10 months ago. Thereafter he noticed similar lesions on the right side of buccal mucosa, hard palate, left side of upper and lower gingiva and left side of the lower lip. Histopathological and direct immunofluorescence studies showed typical features of lichen planus. Administration of griseofulvin(0.5gm. of Fulvicin' daily) for 4 weeks resulted in no clinical improvement. Oral retinoid(25mg of Ro 10-9359 daily) for 11 weeks resulte3 in healing of lesions with no side effect except slight dryness of the mouth.
Erythema ; Etretinate ; Fluorescent Antibody Technique, Direct ; Gingiva ; Humans ; Korea ; Lichen Planus ; Lichen Planus, Oral* ; Lip ; Middle Aged ; Mouth ; Mouth Mucosa ; Palate, Hard

BACKGROUND: The prognosis for children with relapsed acute lymphoblastic leukemia remains dismal. Ifosfamide has previously been shown to be active as a single agent and in combination with doxorubicin, etoposide, and teniposide in pediatric solid tumors, recurrent acute lymphoblastic leukemia and adult acute leukemia. We assessed the efficacy and the toxicity of the drug combination with ifosfamide and etoposide in patients with relapsed refractory acute lymphoblastic leukemia. METHODS: Between April 1995 and May 1996, twenty children aged 1 to 14 years with ALL in Catholic Medical Center, all heavily pretreated and in bone marrow relapse, were enrolled in this study. Drugs were given intravenously each day for 5 days at the following doses ; ifosfamide 1.8 g/m2/day, etoposide 100 mg/m2/day and mesna 1440 mg/ m2/day(as a uroprotectant) ; Cycles were repeated every 28 days for two cycles. RESULTS: 1) Twenty heavily pretreated patients were entered on study. At study entry, seventeen patients were in first relapse, two were in second relapse and one was in third relapse. 2) Six patients(30%) achieved complete remission, and eight patients(40%) achieved partial remission. Overall response rate was 70%. 3) Duration of remission ranged from 30 days to 230 days. 4) The toxicity of the regimen was tolerated. Moderate or severe toxicity evaluated on a per cycle basis included : neutropenia 52.5%, thrombocytopenia 45%, hemorrhagic cystitis 12.5% and mucositis 2.5%. 5) Two patients went on to bone marrow transplantation with histocompatibility matched sibling donors while in remission. CONCLUSION: The combination of ifosfamide and etoposide with mesna uroprotection has significant activity in relapsed refractory childhood lymphoblastic leukemia with tolerable toxicity. We recommended bone marrow transplantation after successful reinduction because of short remission duration of this regimen.
Adult ; Bone Marrow ; Bone Marrow Transplantation ; Child ; Cystitis ; Doxorubicin ; Etoposide* ; Histocompatibility ; Humans ; Ifosfamide* ; Leukemia ; Mesna ; Mucositis ; Neutropenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis ; Recurrence ; Siblings ; Teniposide ; Thrombocytopenia ; Tissue Donors

Gold preparation had been used frequently in the past in the treatment of rheumatoid arthritis, tuberculosis and lupus erythematosua, etc. It is still used. when other more potent remedies, such as steroid, failed. We report a case of drug eruption following the use of gold preparation. A 38 year-old female was referred to our department from orthopedic surgery because of generalized, multiple, pin head sized, violaceous and flat topped papules of 1 x 2 mm in size and mucosal erosions and ulcers following gold therapy for rheumatoid arthritis. She had received 5 intramuscular injections of gold preparation (Myochrysine'), 220mg in total amounts. Our clinical impression was lichen planus like drug eruption, but histopathological picture disclosed nonapecific dermatitis. The eruption had disappeared gradually following oral administration of antihistaminics and prednisolone and daily starch tub baths.
Administration, Oral ; Adult ; Arthritis, Rheumatoid ; Baths ; Dermatitis ; Drug Eruptions* ; Female ; Head ; Humans ; Injections, Intramuscular ; Lichen Planus ; Orthopedics ; Prednisolone ; Starch ; Tuberculosis ; Ulcer

No abstract available.
Leukemia*

PURPOSE: We reviewed the result of allogeneic bone marrow transplantation(BMT) from HLA-identical sibling donors in children with refractory stem cell disorder along with future implication. METHODS: Forty-two children with refractory stem cell disorder received BMT from HLA-identical sibling donors between Nov. 1983 and Feb. 1995. Out of 42 children, 23 cases were severe aplastic anemia(SAA) and 19 cases were refractory leukemias. There were 20 male and 22 female with median age of 13 years (range, 2-17) and median follow-up of 36 months (range, 4-139 months). RESULTS: 1) The overall survival rate of all patients was 73.8%. The survival rate for SAA cases was 87.0%, while that for leukemia was 57.9%. 2) Acute GVHD(> or = grade II) was observed in 16.7% of all patients, 8.7% of SAA patients and 26.3% of leukemia patients, respectively. Chronic GVHD developed in 9.5% of all patients, 4.8% of limited type and 4.8% of extended type. No death was directly attributable to GVHD. 3) The causes of death after allogeneic BMT were graft rejection(7.1%), relapse of leukemia(7.1%), thrombotic thrombocytopenic purpura(4.8%), veno-occlusive disease, sepsis and CMV pneumonia respectively 2.4%. 4) The most common complication except death after allogeneic BMT was herpes zoster(26.2%). The other complications were hemorrhagic cystitis(7.1%), bronchiolitis obliterans and measles respectively 2.4%. CONCLUSIONS: We confirmed that allogeneic BMT is the curable treatment for children with refractory stem cell disorder. The most important factors that influence the result of transplantation are interval between diagnosis and transplantation in severe aplastic anemia and remission state at transplantation in leukemia.
Anemia, Aplastic* ; Bone Marrow Transplantation* ; Bone Marrow* ; Bronchiolitis Obliterans ; Cause of Death ; Child* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Leukemia* ; Male ; Measles ; Pneumonia ; Recurrence ; Sepsis ; Siblings ; Stem Cells ; Survival Rate ; Tissue Donors ; Transplants

BACKGROUND: This study was carried out to evaluate the efficacy of desferrioxamine as a chelating agent in iron overloaded patients with severe aplastic anemia due to multiple transfusion. METHODS AND MATERIALS: From Oct. 1995 to Aug. 1996, 15 patients with aplastic anemia, diagnosed from May 1995 to Jan. 1996 at St. Mary's Hospital, who had a transfusional hemosiderosis were included in this study. They received 19 courses of high-dose desfer-rioxamine therapy for 6 days(20 to 30 mg/kg daily as a 24-hour intravenous infusion) . Before and after treatment, we measured serum ferritin, iron, TIBC, 24-hour urinary excretion of iron. RESULTS: 1) The range of iron load before treatment was between 4.5 and 20.0 gram. 2) Because of limit of detection(1,800 microgram/L), it was difficult to compare the changes of serum ferritin level after therapy to those of before therapy. 3) There was no significant differences between the levels of serum iron before and after therapy(214.3+/-62.8 vs 220.0+/-53.3). And there was no significant differences between TIBC before and after therapy(235.8+/-64.6 vs 259.4+/-60.1). 4) Iron/TIBC ratios were significantly deceased after desferrioxamine treatment compared to those of before therapy(0.90+/-0.04 vs 0.85+/-0.04, P<0.001) and mean urinary excretions of iron were increased by high-dose desferrioxamine compared to those by test dose(6.5+/-7.6 vs 29.1+/-14.3, P<0.001) CONCLUSION: High-dose desferrioxamine therapy is very effective for chelating and excretion of iron in iron overloaded patients with severe aplastic anemia due to multiple transfusion. A repeat administration of desferrioxamine is necessary for the iron overloaded patient to eliminate the risk of a transfusional hemosidersis.
Anemia, Aplastic* ; Deferoxamine* ; Ferritins ; Hemosiderosis* ; Humans ; Iron ; Iron Overload

The authors compared the basic characteristics of rural woman in relation to family planning for June 1967 and June 1969 in Kyung San Country Kyungpook Province, Korea. The statistics showed that these characteristics are gradually changing. The marriage age was slightly higher than the past year and the formal education of women increased. The ideal children number, and tile gravidity and mortality rates decreased. At the same time the number of induced abortions, the knowledge of family planning, and the acceptance rate of contraception increased. These phenomena seem to follow the present worldwide trend.
Abortion, Induced ; Child ; Contraception ; Education ; Family Planning Services* ; Female ; Gravidity ; Gyeongsangbuk-do ; Humans ; Korea ; Marriage ; Mortality