No abstract available.
Meningocele*

No abstract available.
Diagnosis* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

To a patient suffering from intractable pain due to the terminal state of cervix cancer, 7% phenol-glycerine solution was injected through the L2-L3 interspace. We obtained a good result of pain relief, but motor paralysis developed.
Humans ; Pain, Intractable ; Paralysis ; Uterine Cervical Neoplasms

No abstract available.
Blood Platelets* ; Carnitine* ; Humans* ; Platelet Activating Factor* ; Spermatozoa*

BACKGROUNDS : Infections due to vancomycin-resistant enterococci (VRE) have been reported with increasing frequency in many parts of the world. However, VRE infection is still very rare in Korea. To assess the potential risk of VRE infection in a hospital where such infection is rarely reported, we screened hospitalized patients for fecal colonization with VRE and performed a clinical and epidemiological investigation of VRE colonization. MATERIALS AND METHODS: We screened 405 stool specimens from in- and outpatients for the presence of enterococci using EnterococcoselTM agar (BBLR, USA). Dark-brown or black colonies were tested for enterococci and speciated, followed by confirmation for vancomycin resistance using brain-heart infusion agar containing vancomycin (6microgram/mL). Antimicrobial susceptibilities were determined by agar dilution, disk diffusion, and Vitek GPS-IZ. We also performed pulsed-field gel electrophoresis (PFGE) after SmaI digestion of DNA and polymerase chain reaction for detection of vanA, B and C. To define risk factors for colonization, we reviewed the medical records of patients colonized with VRE or vancomycin- susceptible enterococci (VSE). RESULTS: Twelve (4.1%) of 295 hospitalized patients were colonized with VRE. Six were identified as Enterococcus(E) faecium, 2 each as E. faecalis and E. gallinarum, and 1 each as E. casseliflavus and E. avium. In contrast, only one(0.9%) VRB (E. casseliflavus) was isolated from outpatients. Patients in the intensive careunit (5.4%) and patients whose stool specimens were submitted for Clostridium difficile toxin assay (6.8%) were colonized at higher rate than other inpatients (2.5%), but not at a statistically significant level. Three strains had high-level resistance to van comycin(minimum inhibitory concentration, MIC>256microgram/mL), and the others had low-level resistance (MIC8-16microgram/mL) by agar dilution. But disk diffusion method and Vitek system had problems in detecting some strains with low-level resistance. PFGE patterns of VRE were diverse, suggesting that VRE have been introduced from multiple sources. The vans gene was detected in 3 isolates and vanC gene was found in 9 isolates. Compared with the patients with VSE colonization, patients with VRE had a significantly longer hospital stay, had more frequent invasive procedures or therapeutic interventions such as ventilator, total parenteral nutrition and hemodialysis, showed renal insufficiency more frequently, and were more likely to have received ciprofloxacin or clindamycin therapy. CONCLUSIONS: Although the incidence of VRE infection remains low in Korea, the findings from this study indicate that VRE are not uncommon intestinal colonizers among hospitalized patients. Strict infection control measures including screening for VRE, especially those from patients at risk, close surveillance, judicious use of antibiotics and patient isolation must be implemented to prevent infection and transmission of VRE.
Agar ; Anti-Bacterial Agents ; Ciprofloxacin ; Clindamycin ; Clostridium difficile ; Colon* ; Diffusion ; Digestion ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Incidence ; Infection Control ; Inpatients ; Korea ; Length of Stay ; Mass Screening ; Medical Records ; Outpatients ; Parenteral Nutrition, Total ; Patient Isolation ; Polymerase Chain Reaction ; Renal Dialysis ; Renal Insufficiency ; Risk Factors ; Vancomycin ; Vancomycin Resistance ; Ventilators, Mechanical

BACKGROUNDS : Infections due to vancomycin-resistant enterococci (VRE) have been reported with increasing frequency in many parts of the world. However, VRE infection is still very rare in Korea. To assess the potential risk of VRE infection in a hospital where such infection is rarely reported, we screened hospitalized patients for fecal colonization with VRE and performed a clinical and epidemiological investigation of VRE colonization. MATERIALS AND METHODS: We screened 405 stool specimens from in- and outpatients for the presence of enterococci using EnterococcoselTM agar (BBLR, USA). Dark-brown or black colonies were tested for enterococci and speciated, followed by confirmation for vancomycin resistance using brain-heart infusion agar containing vancomycin (6microgram/mL). Antimicrobial susceptibilities were determined by agar dilution, disk diffusion, and Vitek GPS-IZ. We also performed pulsed-field gel electrophoresis (PFGE) after SmaI digestion of DNA and polymerase chain reaction for detection of vanA, B and C. To define risk factors for colonization, we reviewed the medical records of patients colonized with VRE or vancomycin- susceptible enterococci (VSE). RESULTS: Twelve (4.1%) of 295 hospitalized patients were colonized with VRE. Six were identified as Enterococcus(E) faecium, 2 each as E. faecalis and E. gallinarum, and 1 each as E. casseliflavus and E. avium. In contrast, only one(0.9%) VRB (E. casseliflavus) was isolated from outpatients. Patients in the intensive careunit (5.4%) and patients whose stool specimens were submitted for Clostridium difficile toxin assay (6.8%) were colonized at higher rate than other inpatients (2.5%), but not at a statistically significant level. Three strains had high-level resistance to van comycin(minimum inhibitory concentration, MIC>256microgram/mL), and the others had low-level resistance (MIC8-16microgram/mL) by agar dilution. But disk diffusion method and Vitek system had problems in detecting some strains with low-level resistance. PFGE patterns of VRE were diverse, suggesting that VRE have been introduced from multiple sources. The vans gene was detected in 3 isolates and vanC gene was found in 9 isolates. Compared with the patients with VSE colonization, patients with VRE had a significantly longer hospital stay, had more frequent invasive procedures or therapeutic interventions such as ventilator, total parenteral nutrition and hemodialysis, showed renal insufficiency more frequently, and were more likely to have received ciprofloxacin or clindamycin therapy. CONCLUSIONS: Although the incidence of VRE infection remains low in Korea, the findings from this study indicate that VRE are not uncommon intestinal colonizers among hospitalized patients. Strict infection control measures including screening for VRE, especially those from patients at risk, close surveillance, judicious use of antibiotics and patient isolation must be implemented to prevent infection and transmission of VRE.
Agar ; Anti-Bacterial Agents ; Ciprofloxacin ; Clindamycin ; Clostridium difficile ; Colon* ; Diffusion ; Digestion ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Incidence ; Infection Control ; Inpatients ; Korea ; Length of Stay ; Mass Screening ; Medical Records ; Outpatients ; Parenteral Nutrition, Total ; Patient Isolation ; Polymerase Chain Reaction ; Renal Dialysis ; Renal Insufficiency ; Risk Factors ; Vancomycin ; Vancomycin Resistance ; Ventilators, Mechanical

Testicular biopsy is an important tool in the diagnosis and management of male infertility. Other types of analysis such as plasma hormonal assay, chromosomal studies and biochemical determination of ejaculate components have also a role in characterizing male infertility. There were 53 infertile males who received testicular biopsy in our department during the period from January, 1972 to June, 1982. A clinical investigation was undertaken in aspect of testicular size, past history, testicular biopsy findings and plasma hormonal level. The following results were obtained: 1. On semen analysis, oligospermia was found in 5 cases, azoospermia in 48 cases and the most common age group was 4th decade. 2. The biopsy findings of 41 cases with normal size testis were normal in 20 cases. hypospermatogenesis in 8 cases, peritubular fibrosis with reduced spermatogenesis in 4 cases. maturation arrest in 4 cases germinal aplasia in 4 cases, hyalinized seminiferous tubule with Leydig cell hyperplasia in 1 case. 3. The biopsy findings of 12 cases with small size testis were hypospermatogenesis in 3 cases. hyalinized seminiferous tubule with Leydig cell hyperplasia in 6 cases, peritubular fibrosis with reduced spermatogenesis in 1 case, maturation arrest in 1 case, germinal aplasia in 1 case. 4. There were 20 cases which had induration on epididymis or vas deferens. On their past history, gonorrheal urethritis in 7 cases, nonspecific epididymitis in 4 cases, tuberculous epididymitis in 3 cases, undetermined cause in 6 cases were observed. 5. The biopsy findings of 20 cases with indurated epididymis or vas deferens were normal in 13 cases, peritubularfibrosis with reduced spermatogenesis in 4 cases, hypospermatogenesis in 3 cases. 6. The plasma hormonal assay (FSH, LH, Testosterone) was performed in 8 cases.
Azoospermia ; Biopsy* ; Diagnosis ; Epididymis ; Epididymitis ; Fibrosis ; Humans ; Hyalin ; Hyperplasia ; Infertility, Male ; Male ; Oligospermia ; Plasma ; Semen Analysis ; Seminiferous Tubules ; Spermatogenesis ; Testis ; Urethritis ; Vas Deferens

We aimed to investigate the effect of in vitro allergen challenge on activation of eosinophils and expression of intercellular adhesion molecule-1(ICAM-1) in the epithelial and endothelial cells of the nasal mucosa of allergic rhinitics. MATERIALS AND METHODS: Inferior turbinate mucosal specimens which were obtained from 16 perennial allergic rhinitics and sensitized to D. farinae during conchotomy operations were used. Each mucosal specimen was divided into six pieces. The first two pieces were used as basic control group without culture, the second two pieces as culture-control group which was cultured with diluent only, and the last two pieces as antigen-challenge group cultured with D. farinae solution for 24 hours. Specimens were immunohistochemically stained using monoclonal antibody against eosinophil cationic protein(EG1 for all eosinophils and EG2 for activated forms) and ICAM-1. RESULTS: Average counts of EG1 cells and EG2+ cells within 1 mm of lamina propria of nasal mucosa were 14 and 11 respectively in the basic control group, 17 and 19 in culture control group, and 16 and 16 in the antigen-challenge group. ICAM-1 expression on vessels was observed more than half of t,he vessels in the nasal mucosa and there was no significant difference between groups, however, its expression on the epithelial cells was most prominent in the antigen-challenge group (2.1 in basic control group, 3.3 in culture control group, and 6.2 in antigen-challenge group). CONCLUSION: Most of the eosinophils infiltrating into the nasal mucosae out of vessels in allergic rhinitics are activated forms. Significant up-regulation of epithelial ICAM-1 expression by antigen-challenge suggests that ICAM-1 contributes to the transmigration of eosinophils from the subepithelial tissue into the epithelial cell layer and then finally into the nasal secretion.
Endothelial Cells ; Eosinophils* ; Epithelial Cells ; Intercellular Adhesion Molecule-1* ; Mucous Membrane ; Nasal Mucosa* ; Turbinates ; Up-Regulation

No abstract available.
Appendicitis* ; Child* ; Humans

No abstract available.
Fentanyl ; Intensive Care Units ; Miliaria*