PURPOSE: The artificial erection is critical to chordee repair. We report the use of a natural erection induced by prostaglandin E(1)(PGE1) in the diagnosis and treatment of penile curvatu re as an alternative to artificial erection in children and adult patients. MATERIALS AND METHODS: Pharmacological erection was induced 14 children with a mean age of 5 years (range 1-10) and 8 adults with a mean age of 33 years (range 18-58) to diagnose and repair anomalies, such as simple penile curvature, chordee with or without hypospadias, webbed penis and Peyronie's disease. Alprostadil (1-16ng) as a agent for induce erection was used exclusively, but no agents were routinely given to reverse the erection was used exclusively, but no agents were routinely given to reverse the erections. The dose injected intracavernosally was dependent on the patient's age, penile size and response, and ranged from 0.5 to 10 micrograms. Time to and adequacy of erection, detumescence, changes in blood pressure and pulse rate were monitored. RESULTS: A dilatation of erectile tissue was achieved within 8 minutes and was judged adequate in 2 and excellent in 20. The mean duration of erection was 107 minutes, while a prolonged erection, for up to 2.5 hours, occured on 2 patients who were treated conservatively. Detumescence were occurred when the corpora were opened, but re-erected penis after closure of corpora in 7 cases who treated with Nesbit's corporeal plication or fibrous plaque excision and dermal graft. Although there were the impression of increased bleeding, there were no specific changes in blood pressure or pulse rate. CONCLUSIONS: Pharmacological erection in penile curvature is effective and reliable with no significant complications. Although PGE1 is expensive and induced slightly increased bleeding, pharmacological erection has the advantage of tumescence of the entire penis and consequently a constant and natural representation of chordee without corporeal or urethral injury. Therefore, the erection achieved by injecting PGE1 into the corpora cavemosa is a useful alternative to artificial erection in the diagnosis and treatment of penile anomalies.
Adult ; Alprostadil ; Blood Pressure ; Child ; Diagnosis ; Dilatation ; Female ; Heart Rate ; Hemorrhage ; Humans ; Hypospadias ; Male ; Penile Induration ; Penis ; Transplants

Reiters syndrome is an unusual disease characterized a triad of nongonococcal urethritis, conjunctivitis, and arthritis in association with the mircoutaneous lesions of keratoderma blenorrhagica and balarintis circinata. We present herein a case of Reiters syndome combined yiti lung cancer. A 39-year-old man has experienced naigrating polyarthralgia and high fever ilitermittently for about 20 years, Hyperkeratotic erythemnous patches and plaques, which dyeliped about 1 year ago, have aggravated and expanded to the whole body. Histopathologic sections from the plaque on the right forc ari showed characteristic findings including thickened parakeratotic horny layer and spongiform micropustules of Kogoji He was associated with HLA-B27. On the chest X-ray, a thumbtip size mass was incidently found. Chest CT and bone scan findings supported lung cancer and multiele metastases.
Adult ; Arthralgia ; Arthritis ; Conjunctivitis ; Fever ; HLA-B27 Antigen ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis ; Thorax ; Tomography, X-Ray Computed ; Urethritis

PURPOSE: The purpose of this study was to compare the radiation adaptive response (RAR) in peripheral lymphocytes (PL) of patients induced by Tc.-99m MDP and Tc-99m DTPA scintigraphies. MATERIALS AND METHODS: Lymphocytes from 45 patients (25 males, 20 females, mean age 44+/-18 years) were collected before and after scintigraphies using 740 MBq Tc-99m MDP (n=22) or Tc-99m L)TPA (n=23). Lympho-cytes from 20 controls (12 males, 8 females, mean age 43+/-7 years) were also callected. They were exposed to challenge dose of 2 Gy gamma-rays using a Cs-137 cell irradiator, Number of ring-form (R) and dicentric (D) chromosomes was counted under the light microscope. From them a representative score, Ydr, was calculated as Ydr=(D+R)/cells. Adaptation index (AI) was defined as difference of Ydr between unconditioned and conditioned lymphocytes. Ydr was also measured after an administration of cyclohexi-mide (CHM), a protein synthesis inhibitor, before challenge dose. RESULTS: RAR was induced in both groups of patients. CHM abolished the adaptive response in both groups. AI of Tc-99m MDP group was significantly higher than that of Tc-99m DTPA group. CONCLUSION: Tc-99m MDP induced RAR was more prominent than those induced by Tc-99m DTPA.
Chromosome Aberrations ; Female ; Humans ; Lymphocytes* ; Male ; Pentetic Acid* ; Technetium Tc 99m Medronate*

OBJECTIVES: It has been constantly reported that mismatch negativity (MMN) is impaired in patients with schizophrenia. However, the mechanism which relates impaired MMN and schizophrenia is not clear yet. The aim of this study is to investigate the association between MMN and clinical variables including functional status in patients with schizophrenia. METHODS: The present study assessed MMN using passive auditory oddball task in 26 patients with schizophrenia and 48 healthy controls. Repeated measures Analysis of Variance with age as a covariate was carried out for comparing peak amplitude and latency of MMN at 8 central line electrodes (FPz, Fz, FCz, Cz, CPz, Pz, POz, Oz) across groups. Pearson's correlation was performed to reveal the relationship between MMN and clinical variables including neurocognitive test results and the Global Assessment of Functioning score. RESULTS: MMN amplitude was significantly reduced in patients with schizophrenia compared with healthy controls. Pearson's correlation showed that subsets of short form of Korean Wechsler Adult Intelligence Scale scores and GAF scores were associated with MMN amplitude in patients with schizophrenia. CONCLUSION: These findings suggest that MMN amplitude is associated with current functional status including cognitive function in patients with schizophrenia.
Adult ; Analysis of Variance ; Electrodes ; Humans ; Intelligence ; Schizophrenia*

No abstract available.
Priapism*

No abstract available.
Priapism*

OBJECT: Accumulating evidence suggests a greater number of subcortical hyperintensities in the brain with bipolar disorder. We studied the Clinical correlates of subcortical hyperintensities on magnetic resonance imaging in patients with Bipolar Disorder. METHODS: Magnetic resonance images of the brain were obtained for 32 patients with bipolar disorder. The presence and location of hyperintensities were assessed. We compared clinical variables between with subcortical hyperintensities and patients without them. RESULTS: Seven Patients(21.8%) had subcortical hyperintensities, but among 8 patients who were or older, 5 patients(625) had them, Age and age of onset of patients with subcotical hyperintensities were significantly older than patients without them. Psychotic symptoms were more frequent in patients with hyperintensities. Patients without hyperintesities had more familial loading. CONCLUSION: Given the limitations of the study, our results should be seen as preliminary. This study, however, provides preliminary evidence supporting the notion that the onset, clinical feature and course of some bipolar disorders of late onset may be determined by underlying subcortical abnormalities, with such abnormalities being the consequence of factors related to aging or neurodegeneration(such as impaired cerebral circulation) rather than genetic factors which predispose to early-onset bipolar disorders.
Age of Onset ; Aging ; Bipolar Disorder* ; Brain ; Humans ; Magnetic Resonance Imaging*

OBJECTIVE: The purpose of this study was to compare the plasma amitriptyline and nortriptyline level between before and after fluoxetine addition with patients who were currently taking amitriptyline. METHOD: From the inpatient and outpatient unit of Soon Chun Hyang University Hospital, Chunan, fourteen subjects who were taking amitriptyline 25mg more than 1 week at least were given fluoxetine 20mg. Before and 2 weeks after fluoxetine addition the plasma level of amitriptyline and nortriptyline are analyzed simultaneously by High Performance Liquid Chromatography(HPLC) At the same times, HAM-D(Hamilton Rating Scale for Depression) score and the UKU(Uldvalg for Klinske Unders phi gelser) side effect scale were checked. RESULTS: After fluoxetine addition to the patients who were taking amitriptyline, the plasma level of amitriptyline, nortriptyline and sum of amitriptyline and nortriptyline had risen. The mean plasma amitriptyline level increased from 168.9+/-89.4ng/ml to 183.0+/-102.0ng/ml after fluoxetine addition(p=0.011) but the change was not statistically significant. The mean plasma nortriptyline level increased significantly from 114.3+/-70.2ng/ml to 168.0+/-86.2ng/ml after fluoxetine addition(p=0.011) In addition, the mean plasma level of total amitriptyline and nortriptyline increased significantly from 283.1+/-125.3ng/ml to 350.9+/-78.4ng/ml after fluoxetine addition(p=0.016) After fluoxetine addition, no significant change was noted in the UKU side effect scale score. CONCLUSION: As consequence of comparson of plasma amitriptyline and nortriptyline level before and after fluoxetine addition mean amitriptyline, nortriptyline and total plasma level was increased after fluoxetine addition. This suggests that coadministration of amitriptyline and fluoxetine may induce improvement of depressive symptom in depressive patients by way of increased plasma level of amitriptyline.
Amitriptyline* ; Chungcheongnam-do ; Depression ; Fluoxetine* ; Humans ; Inpatients ; Nortriptyline ; Outpatients ; Plasma*

OBJECTIVE: To investigate the difference of outcome variables and demographic features between traumatic and non-traumatic spinal cord injury (SCI) patients. METHOD: Medical records of 87 spinal cord injured patients were retrospectively reviewed. The patients were divided into traumatic and non-traumatic groups. The etiology, level and completeness of SCI were investigated. The functional evaluation was performed by Frankel's classification, American spinal cord injury association (ASIA) motor and sensory scores, and modified Barthel scores at the time of admission and discharge. Bladder function and emptying method were also investigated. RESULTS: Spinal cord injury of non-traumatic etiology was more likely to result in a incomplete injury and more prevalent in females. At admission, the ASIA motor and sensory scores and modified Barthel index of non-traumatic spinal cord injury patient were higher than those of traumatic patients. At discharge, same results were observed for ASIA motor and sensory scores, but the modified Barthel scores showed no difference between the two groups. The changes of the scores between time of admission and discharge showed no significant difference in the two groups. There was no significant difference of bladder type and bladder emptying method. CONCLUSION: This study suggest that favorable outcome in non-traumatic spinal cord injury patients might be due to better functional status at the time of admission and not due to the degree of recovery.
Asia ; Classification ; Female ; Humans ; Medical Records ; Retrospective Studies ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Bladder

Purpose: Candidemia is a common cause of nosocomial bloodstream infections associated with high mortality rates. Its incidence varies significantly across countries and hospitals, and its epidemiology is a subject of continuous investigation. This review aims to provide a comprehensive analysis of candidemia in Korea, addressing its changing epidemiology, species distribution, antifungal resistance, and clinical implications.Current content: In Korea, Candida albicans remains the most common isolate in blood cultures; however, infections caused by non-albicans Candida species are increasing. The 30-day mortality rates for patients with candidemia vary considerably across different Candida species, with Candida tropicalis at 47.0%, C. albicans at 36.4%, Candida glabrata at 34.7%, and Candida parapsilosis at 22.5%. Recent Korean studies have highlighted the clonal spread of bloodstream infections caused by C. parapsilosis with the Erg11p Y132F mutation, and certain isolates are becoming endemic to specific healthcare settings. C. glabrata poses a significant threat; this species is increasingly resistant to antifungal medications and multidrug-resistant isolates are emerging. Whole-genome sequencing analysis elucidates the transmission dynamics of clonal bloodstream isolates of C. glabrata among patients receiving antifungal therapy. This analysis demonstrates varying degrees of fluconazole susceptibility and distinct Pdr1p mutation profiles, identifying the molecular mechanisms underlying multidrug resistance. Furthermore, the first nosocomial outbreak of Candida auris underscores the importance of multicenter surveillance for identifying and managing C. auris outbreaks. Conclusion The changing epidemiology of candidemia, along with the continued emergence of antifungal resistance among bloodstream isolates of non-albicans Candida species warrants continuous monitoring of candidemia in Korea. By integrating clinical, microbiological, and public health perspectives, healthcare systems can develop robust strategies to optimize therapeutic approaches, prevent nosocomial transmission, and ultimately reduce morbidity and mortality associated with these life-threatening infections.