We experienced nutiple brain abscess in two neonates. Diagnosis was made CT scan, Which revealed multiple ring-like enhancing leason in both frontoparietal and left posterior parietal cerebral parenchyme. Therapy was consisted of systemic antibiotic treatment and CSF V-P shunt operation due to complicated hydrocephalus. One neonate was died and the other neonate has been followed up due to convulsion and neurological sequale.
Brain Abscess* ; Diagnosis ; Humans ; Hydrocephalus ; Infant, Newborn* ; Rabeprazole ; Seizures ; Tomography, X-Ray Computed

PURPOSE: We wanted to compare our experience and results with three different methods of treatment for varicocele. MATERIALS AND METHODS: Between January 1995 and December 2005, 154 patients with varicocele were retrospectively assigned into three groups according to the method of treatment. Group 1 included 73 patients who were treated by the retroperitoneal approach of Palomo's technique. Group 2 consisted of 37 patients who were treated by the retroperitoneal approach and who also underwent the internal spermatic artery preserving technique, and in group 3, 44 patients were treated by the microscopic inguinal approach of Ivanissevich's technique. We analyzed the operation time, recurrence, complications, the effect of surgical treatment and the results according to the surgical techniques. RESULTS: The mean operative time of group 3 was significantly longer among the three groups. The recurrence rate at follow-up was not significantly different among the three groups. The recurrence rate increased progressively with the increase of varicocles size from grade I to grade III for all the groups. The overall incidence of postoperative complications was significantly lower among the patients in group III. The postoperative spermiogram showed an increase in motility and sperm count for all the groups. There were no differences in the three techniques for resolution of pain, the duration of recovery and the spermiogram results. CONCLUSIONS: There was no significant difference in the rate of relapse after the surgery between the three different treatment techniques, and the factors involved in relapse were more related to the size and severity of the varicocele. Microsurgical varicocelectomy had a disadvantage of a prolonged operation time. However, there was a low rate of postoperative complications for all three techniques.
Arteries ; Follow-Up Studies ; Humans ; Incidence ; Operative Time ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Sperm Count ; Varicocele*

Tanshinone II-A is a derivative of phenanthrene-quinone isolated from Salvia miltiorrhiza BUNGE, a traditional herbal medicine that is known to induce antiinflammatory, anti-oxidative and cytotoxic activity. We have examined cellular effects of Tanshione II-A on HL60 human promyelocytic leukemic cells and K562 human erythroleukemic cells. Tanshione II-A induced a dose- and time-dependent DNA fragmentation into the multiples of 180 bp and specific proteolytic cleavage of poly(ADP-ribose) polymerase in both cell lines. PI-staining and flow cytometry analysis of K562 cells following Tanshione II-A treatment showed an increase of the cells possessing hypodiploid DNA indicative of apoptotic state of cells. Caspase-3 activity was significantly increased during Tanshinone II-A treatment of both HL60 and K562 cells, whereas caspase-1 activity was not changed. These results suggest that Tanshione II-A induced HL60 and K562 cellular apoptosis that may be associated with the selective members of caspase family. Copyright 2000 Academic Press.
Antineoplastic Agents, Phytogenic/pharmacology* ; Antineoplastic Agents, Phytogenic/chemistry ; Apoptosis/physiology* ; Caspases/metabolism* ; Caspases/drug effects* ; Cell Cycle/drug effects ; DNA Fragmentation/drug effects ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal/pharmacology* ; Drugs, Chinese Herbal/chemistry ; Enzyme Activation/drug effects ; HL-60 Cells/pathology ; HL-60 Cells/metabolism ; HL-60 Cells/drug effects ; Human ; Lamiaceae/chemistry ; Leukemia/pathology* ; Leukemia/metabolism ; Leukemia/drug therapy ; Leukemia, Erythroblastic, Acute/pathology ; Leukemia, Erythroblastic, Acute/metabolism ; Leukemia, Erythroblastic, Acute/drug therapy ; Phenanthrenes/pharmacology* ; Phenanthrenes/chemistry ; Tumor Cells, Cultured

PURPOSE: We studied the changes in the antibiotic sensitivity to the causative organisms of urinary tract infection, between 1979 and 2001, in order to provide useful information on the choice of adequate drugs in the treatment of urinary tract infection (UTI). MATERIALS AND METHODS: We retrospectively analysed 1,370 uropathogens, and their antimicrobial sensitivities, in 647 patients admitted to, or visiting our hospital, between January 1979 and December 2001, that had more than 105cfu/ml in urine culture. RESULTS: The incidence of UTI increased with age, and was highest in the 6th decades (21.0%). Mixed infections increased from 6.1%, in 1979, to 18.4%, by 2001. The common pathogens were E. coli (37.8%), enterococcus (15.0%), Pseudomonas (10.1%) and Klebsiella (9.1%). E. coli was the most important uropathogen during the stated time period. However, the incidence of Gram positive organisms increased from 14.2%, in 1979, to 26.0%, by 2001. In the Gram negative stained uropathogens, the antibiotic sensitivity was changed: ampicillin (11.8 to 14.6%), cephalothin (40.6 to 46.3%) and amikacin (80.5 to 74.8%). For E. coli, trimethoprim/Sulfamethoxazole (TMP/SMX) and ampicillin showed decreased sensitivities of 37.3 and 18.5%, respectively. However, sulbactam/cefoperazone, cefepime and imipenem showed high sensitivities of 96.1, 97.5 and 100%, respectively. CONCLUSIONS: Prior to receiving the bacteriological report, the use of TMP/SMX and ampicillin, as the first choices of treatment for UTI, should be reconsidered. Our results implied that amikacin, which showed the best effects, and was cheaper than fluoroquinolones, can be used as an alternative to these drugs as a primary empirical antibiotic for UTI.
Amikacin ; Ampicillin ; Cephalothin ; Coinfection ; Enterococcus ; Fluoroquinolones ; Humans ; Imipenem ; Incidence ; Klebsiella ; Pseudomonas ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUNDS/AIMS: Early colorectal cancer is defined as carcinoma with invasion to mucosa or submucosa irrespective of involvement of lymph node. Gross morphology is divided into elevated and depressed type according to growth pattern. Until now, carcinomas with elevated type have been found more frequently than depressed type in Korea. It is necessary to classify the macroscopy of morphology and evaluate histo-pathologic findings of early colorectal cancers. METHODS: 33 patients (35 foci) with early colorectal cancers were analyzed, macroscopically and pathologically. Early colorectal carcinoma with mucosal invasion is 25 cases, and with submucosal invasion, 10. RESULTS: Macroscopic classification: Ip 12, Isp 6, Is 9, IIa 1, IIa IIc 4, Isp IIc 1, LST 2. Among them, Ip (34%) is most. Among cancers with mucosal invasion, Ip (36%) is common, and with submucosal invasion, Is (40%) is common. Most of early colorectal cancers with elevated type were accompanied with surrounding adenoma. It's ratio is 100% in early colorectal cancer with mucosal invasion, and 50% with submucosal invasion. CONCLUSIONS: Pedunculated type (Ip) is common in early colorectal cancer with elevated type. Surrounding adenoma was usually (85%) accompanied with those. It is suggested that early colorectal cancer with elevated type would be originated from adenoma.
Adenoma ; Classification* ; Colorectal Neoplasms* ; Humans ; Korea ; Lymph Nodes ; Mucous Membrane

PURPOSE: To evaluate a role as over 35 years, maternal serum markers, and a false positive screen for Down syndrome were the predictor of adverse pregnancy outcome. Materials and METHODS: From Mar.1994, through Feb.1996, 5284 women were screened triple test to detect Down syndrome in the second trimester and were delivered Samsung Cheil hospital. The values of each maternal serum markers were measured with radioimmunoassay. And then, the screen positive of Down syndrome was calculated using alpha-software Version 4.0. The adverse outcome of the fetus and the mother included low birth weight(LBW) ( <2500gm), prematurity( <37 gestational weeks), placenta previa, preterm premature rupture of membranes(PPROM), pregnancy induced hypertension(PIH),abruptio placenta, and intrauterine fetal death(IUFD). The predictor markers included over 35years, elevated alpha-fetoprotein (AFP), elevated human chorionic gonadotropin(hCG), lowered unconjugated estriol (uE3), and a false positive screen for Down syndrome. RESULTS: Mean age and mean gestational weeks in the study were 30+/-4.8 years and 17.1 weeks respectively. The adverse pregnancy outcomes were 357 LBW(6.8%), 253 prematurity(4.8%), 108 placenta previa(2.0%), 68 PPROM(1.3%), 66 PIH(1.3%), 24 abruptio placenta(0.5%), and 20 IUFD(0.4%). In univariate analysis, over 35 years was significantly associated with abruptio placenta, prematurity, and placenta previa, elevated MS-AFP( >2.0 MoM) associated with IUFD, LBW, PIH, prematurity, and PPROM , elevated MS-hCG (>3.0 MoM) associated with IUFD, LBW, PIH, prematurity, and placenta previa, lowered uE3 (<0.75) associated with IUFD, abruptio placenta, LBW, and prematurity.(P <0.05). In multivariate logistic regression analysis, IUFD was significantly associated with only elevated MS-AFP, LBW associated with elevated MS-AFP, elevated MS-hCG, and lowered uE3, PIH associated with only elevated MS-AFP, PPROM only elevated MS-AFP, prematurity only elevated MS-AFP, and placenta previa over 35 years, elevated MS-hCG.(P <0.05). However, abruptio placenta was not significantly associated with predictor markers.(P >0.05) CONCLUSIONS: Some predictors such as over 35 year, elevated hCG, lowered uE3, a false positive screen for Down syndrome were significantly associated with adverse pregnancy outcome. Also in multivariate analysis, we identified especially elevated AFP to be the most reliable predictor for adverse pregnancy outcome.
alpha-Fetoproteins ; Biomarkers ; Chorion ; Down Syndrome ; Estriol ; Female ; Fetus ; Humans ; Logistic Models ; Mothers ; Multivariate Analysis* ; Parturition ; Placenta ; Placenta Previa ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, Second ; Pregnancy* ; Radioimmunoassay ; Rupture

PURPOSE: We wanted to investigate the usefulness of Mycofast (MYCOFAST(R) Evolution 2, International Microbio, France) for Ureaplasma urealyticum (U. urealyticum) and Mycoplasma hominis (M. hominis) in association with nongonococcal genitourinary infections. MATERIALS AND METHODS: 530 patients visited our department for genitourinary infection symptoms or for the evaluation of sexually transmitted disease. The genital swabs were first vortexed in Mycofast transport broth. A volume of 100mul of liquid sample was innoculated to each well of the Mycofast broths and 0.5mul of liquid sample was innoculated to A7 agar culture media (International Microbio, France). The Mycofast broths were incubated at 35-37 degrees C for 36 hrs, and the A7 agar culture media was incubated for 4 days. We compaired Mycofast with A7 agar culture for the sensitivity, specificity, the positive and negative predictive values and the antibiotic susceptable profiles. RESULTS: Of the 530 samples submitted, 165 samples were positive by the A7 agar culture and 162 samples were positive by Mycofast. 157 samples were positive by both methods. Of the 365 samples that were negative by the A7 agar culture, 360 samples were also negative by the Mycofast. In this study, Mycofast had a sensitivity and specificity of 95% and 98%, respectively, and a positive and negative predictive value of 96% and 97%, respectively. The Mycofast drug susceptibility tests indicate a high susceptibility to doxycyclin as follows: U. urealyticum: 86.3%; M. hominis: 85.0% and both organisms with simultaneous isolation: 75.8%. CONCLUSIONS: Mycofast was an easy test to perform and it proved to be a practical and reliable method for isolating the Mycoplasma and Ureaplasma species for making the diagnosis of nongonococcal genitourinary infections, and it showed the added benefit of determining the limited susceptibilities of the isolated strains.
Agar ; Culture Media ; Diagnosis* ; Humans ; Mycoplasma ; Mycoplasma hominis ; Sensitivity and Specificity ; Sexually Transmitted Diseases ; Ureaplasma ; Ureaplasma urealyticum

BACKGROUND: Laparoscopic cholecystectomy (LC) has traditionally been performed under general anesthesia, however, owing in part to the advancement of surgical and anesthetic techniques, many laparoscopic cholecystectomies have been successfully performed under the spinal anesthetic technique. We hoped to determine the feasibility of segmental epidural anesthesia for LC. METHODS: Twelve American Society of Anesthesiologists class I or II patients received an epidural block for LC. The level of epidural block and the satisfaction score of patients and the surgeon were checked to evaluate the efficacy of epidural block for LC. RESULTS: LC was performed successfully under epidural block, with the exception of 1 patient who required a conversion to general anesthesia owing to severe referred pain. There were no special postoperative complications, with the exception of one case of urinary retention. CONCLUSIONS: Epidural anesthesia might be applicable for LC. However, the incidence of intraoperative referred shoulder pain is high, and so careful patient recruitment and management of shoulder pain should be considered.
Anesthesia, Epidural ; Anesthesia, General ; Cholecystectomy, Laparoscopic ; Feasibility Studies ; Humans ; Incidence ; Pain, Referred ; Patient Selection ; Postoperative Complications ; Shoulder Pain

Objective: Doctors or public health doctors at the nearest institution to a disaster scene often have to treat the casualties at the scene. Therefore, disaster medical education is necessary for medical students and doctors, but such education is not properly implemented. This study investigated the status of disaster medical education in Korean medical schools and the professors' thoughts on the appropriateness and necessity of disaster medical education. Methods: A survey was conducted on working-level professors in charge of student education in emergency medicine in 40 medical schools. The survey asked the professors the current status of disaster medical education at each school and the professors' thoughts on the appropriateness and necessity of disaster medical education. Results: Thirty-seven professors (92.5%) responded to the survey. Twenty-seven schools (73.0%) had a regular curriculum of disaster medicine. Disaster drills were conducted at 34 training hospitals (91.9%), while students of 10 schools (29.4%) were officially participating in the drill. Of the responders, 31 (83.8%) responded that disaster medicine is necessary for clinicians. Thirty-seven professors (100%) thought disaster medical education was necessary for medical students, and 20 (54.1%) of them responded that their schools did not provide adequate disaster medical education. Conclusion Many schools did not have a proper course on disaster medical education. Disaster medical education is necessary for medical students, but such education is not properly implemented.

Objective: Doctors or public health doctors at the nearest institution to a disaster scene often have to treat the casualties at the scene. Therefore, disaster medical education is necessary for medical students and doctors, but such education is not properly implemented. This study investigated the status of disaster medical education in Korean medical schools and the professors' thoughts on the appropriateness and necessity of disaster medical education. Methods: A survey was conducted on working-level professors in charge of student education in emergency medicine in 40 medical schools. The survey asked the professors the current status of disaster medical education at each school and the professors' thoughts on the appropriateness and necessity of disaster medical education. Results: Thirty-seven professors (92.5%) responded to the survey. Twenty-seven schools (73.0%) had a regular curriculum of disaster medicine. Disaster drills were conducted at 34 training hospitals (91.9%), while students of 10 schools (29.4%) were officially participating in the drill. Of the responders, 31 (83.8%) responded that disaster medicine is necessary for clinicians. Thirty-seven professors (100%) thought disaster medical education was necessary for medical students, and 20 (54.1%) of them responded that their schools did not provide adequate disaster medical education. Conclusion Many schools did not have a proper course on disaster medical education. Disaster medical education is necessary for medical students, but such education is not properly implemented.