PURPOSE: A clinical review was performed to evaluate the effectiveness of the partial neurectomy of the dorsal nerve of the penis on the treatment of premature ejaculation. PATIENTS AND METHODS: The study was made on 143 patients with premature ejaculation (mean age 38 years; range 22~53 years) who underwent the partial neurectomy of the dorsal nerve of the penis from January 1997 to September 1999. All patients were evaluated by change on pre- and post-operative ejaculatory latency and biothesiometry, postoperative satisfaction, management on unsatisfactory patients and postoperative complication. RESULTS: Pre- and post-operative vibration perception threshold of glans penis on biothesiometry was significantly decreased from mean 2~3 mA (range 1~6 mA) to 8~10 mA (range 3~15 mA) (p<0.01). Change on pre- and post-operative ejaculatory latency was prolonged from mean 1~3 minutes (55.2%) to 5~10 minutes (47.6%)(p<0.01). The postoperative results were satisfactory in 117 cases (81.8%). At follow-up 2 to 34 months postoperatively, 17 cases (11.8%) were complicated by glans pain, discomfort(7 cases), penile edema (6 cases), wound dehiscence(3 cases), and delayed ejaculation (1 case). CONCLUSION: The partial neurectomy of the dorsal nerve of the penis is an effective treatment in the comprehensive management of the premature ejaculation with glans hypersensitivity, for good results, a simple operative technique and a few postoperative complication. However, it must be followed up for long-term effectiveness and its complication.
Edema ; Ejaculation ; Follow-Up Studies ; Humans ; Hypersensitivity ; Male ; Penis* ; Postoperative Complications ; Premature Ejaculation* ; Vibration ; Wounds and Injuries

The orchid symbiotic fungi were isolated from the roots of Korean native orchid (Cymbidium goeringii) collected and Chinese orchid (C. sinense) obtained from greenhouses. They were identified as a species of Rhizoctonia, based on the sequences of 18r rDNA, the microscopic observations of mycelia, and the symbiotic relationships with commercial orchids. The isolate collected from Chinese orchids was revealed to be a species of Ceratobasidium endophytica, and to be different from the other isolates at the thickness of the mycelia stained in the root cells of Korean native orchids. The other isolates collected from the Korean native orchids were considered to be a species of Tulsanella repens (anamorphic: Epulorhiza repens) or its related one. The physiologic or microscopic variations were oftenly observed among them, but the tendency of grouping these in the 18s rDNA sequences were observed to be consistent with those of the localities collected. The further taxonomical segregating for Korean symbiotic fungi was not made because the information concerned were limited in this moment, but was recognized as based on the sequences of 18s DNA.
Asian Continental Ancestry Group ; DNA ; DNA, Ribosomal ; Fungi* ; Humans ; Mycorrhizae ; Rhizoctonia ; Symbiosis

Implant biological complications like peri-mucositis and peri-implantitis are still common in clinical practice. Peri-implantitis is a disease characterized by bleeding during the probe procedure, swelling, redness, or exudate of the gingiva around the implant, and bone loss. It is an irreversible disease, and while various treatments have been tried, the results have not always been positive. The implant can be placed in the alveolar bone on the buccolingual, vertical, or horizontal sides. Several studies have found a link between the position of the implant and peri-implantitis. Although the findings of the preceding studies are convincing in theory, the placement of implants in clinical practice is influenced by various circumstances. To overcome the difficulties that may arise during implant placement, dentists must make various efforts, from diagnosis to surgical procedures.

Implant biological complications like peri-mucositis and peri-implantitis are still common in clinical practice. Peri-implantitis is a disease characterized by bleeding during the probe procedure, swelling, redness, or exudate of the gingiva around the implant, and bone loss. It is an irreversible disease, and while various treatments have been tried, the results have not always been positive. The implant can be placed in the alveolar bone on the buccolingual, vertical, or horizontal sides. Several studies have found a link between the position of the implant and peri-implantitis. Although the findings of the preceding studies are convincing in theory, the placement of implants in clinical practice is influenced by various circumstances. To overcome the difficulties that may arise during implant placement, dentists must make various efforts, from diagnosis to surgical procedures.

Implant biological complications like peri-mucositis and peri-implantitis are still common in clinical practice. Peri-implantitis is a disease characterized by bleeding during the probe procedure, swelling, redness, or exudate of the gingiva around the implant, and bone loss. It is an irreversible disease, and while various treatments have been tried, the results have not always been positive. The implant can be placed in the alveolar bone on the buccolingual, vertical, or horizontal sides. Several studies have found a link between the position of the implant and peri-implantitis. Although the findings of the preceding studies are convincing in theory, the placement of implants in clinical practice is influenced by various circumstances. To overcome the difficulties that may arise during implant placement, dentists must make various efforts, from diagnosis to surgical procedures.

Implant biological complications like peri-mucositis and peri-implantitis are still common in clinical practice. Peri-implantitis is a disease characterized by bleeding during the probe procedure, swelling, redness, or exudate of the gingiva around the implant, and bone loss. It is an irreversible disease, and while various treatments have been tried, the results have not always been positive. The implant can be placed in the alveolar bone on the buccolingual, vertical, or horizontal sides. Several studies have found a link between the position of the implant and peri-implantitis. Although the findings of the preceding studies are convincing in theory, the placement of implants in clinical practice is influenced by various circumstances. To overcome the difficulties that may arise during implant placement, dentists must make various efforts, from diagnosis to surgical procedures.

BACKGROUND: Hemophagocytic lymphohistiocytosis(HLH) is a rare and fatal disorder in children. Recently its clinical characteristics and etiology of uncontrolled activation of cellular immune system in genetically predirected patients have keen elucidated. The authors analyzed the clinical characteristics and response to immunosuppressive agents of HLH patients in single institute. METHODS: The authors retrospectively analyzed various clinical data including CSF and bone marrow examination at diagnosis and follow up period in the 6 patients who were diagnosed as HLH at Asan Medical Center during last 2 years. Antithymocyte globulin(ATG : 10 mg/kg/day) and methylprednisolone(methyl-PD: 5 mg/kg/day) for 5 consecutive days as induction treatment and cyclosporin A(CsA) as maintenance treatment after induction with weekly intrathecal methotrexate for 5-6 weeks were given to the recently diagnosed 3 patients. RESULTS: All the patients except one were infants. Persistent fever, hepatosplenomegaly and pancytopenia were observed in all the patients. Family history of suspicious HLH was observed in 4 patients(67%). The characteristic elevated serum triglyceride(TG) level and/or decreased fibrinogen level were noted in all. Mild to moderate CSF pleocytosls with increased lymphocytes and monocytes was also observed in all during the disease course. Variable degree of nonqr-Langerhans cell histiocytic infiltration and hemophagocytosis were observed in all the cases. Of the 3 patients treated with ATG and methyl-PD, one achieved complete remission and the others achieved partial remission within 2 weeks of treatment, but all expired after 5 months, remission with CsA. Regardless of treatment regimen, all the 6 patients expired due to CNS sequelae of HLH. CONCLUSIONS: HLH mainly developed in infants. Persistant fever, hepatosplenomegaly and pancytopenia were observed in most cases with the characteristic change of serum TG and/or fibrinogen level. HLH should be included in the differential diagnosis in patients with these features especially when the family history of suspicious HLH is present, and histologic comfirmation of HLH could be easily accomplished with bone marrow study in most cases. Remission induction of HLH could be achieved with immunosuppressive treatment but it was difficult to maintain long term remission.
Bone Marrow ; Bone Marrow Examination ; Child ; Chungcheongnam-do ; Cyclosporine ; Diagnosis ; Diagnosis, Differential ; Fever ; Fibrinogen ; Follow-Up Studies ; Humans ; Immune System ; Immunosuppressive Agents ; Infant ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic* ; Methotrexate ; Monocytes ; Pancytopenia ; Remission Induction ; Retrospective Studies

BACKGROUND: Despite the development of empiric antibiotics in treatment of neutropenic fever(NF) in pediatric cancer patients, bacterial infection is still the most important cause of death in these patients. In this study the authors analyzed clinical characteristics and tried to find out the possible risk factors of the pediatric cancer patients who succumbed to the documented bacterial infection after episodes of neutropenic fever. METHODS: 17 pediatric cancer patients expired after episodes of neutropenic fever(NF) in the pediatric department of Asan Medical Center from Mar. 1990 to Feb. 1996 were grouped by the results of bacterial culture. 7 cases (Group A) had documented bacterial culture results and 10 cases (Group B) had negative culture results. The clinical characteristics of these two groups were analyzed retrospectively. RESULTS: There were no differences in the types of cancer between the two groups. All the documented bacteria were gram negative organisms and all cultured from the blood. There were no differences between the two groups in the treatment duration, known risk factors of infection before and at the onset of fever, antibiotics administered, and interval from the onset of NF to the administration of antibiotics. The response rate of initial empiric antibiotics was lower in group A(14%) compared to Group B(40%), even though all the cultured organisms except 2 cases in Group A were sensitive to initial empirical antibiotics. Septic shock was the cause of death in 86% of Group A patients, but only in 10% of Group B patients. The other causes of death were progression of cancer, bleeding, hepatic failure, adult respiratory distress syndrome and multiple organ failure, which showed no difference between the 2 groups. The interval from the onset of fever to death was significantly shorter in Group A(6.2+/-2.3 days) compared to Group B(24.9+/-18.6 days). CONCLUSIONS: Bacterial infection is still the most frequent cause of death after NF. Most patients succumbed to the documented bacterial infection showed rapid progression of bacteremia to septic shock despite administration of sensitive antibiotics. The known risk factors of infection before the onset of NF and other treatment factors shows no differences between the two groups in this study. These results suggest that the bacteremia is obvious risk factor of poor outcome after NF episode, and antibiotics alone may be insufficient to prevent the rapid progression of septic shock in these patients.
Anti-Bacterial Agents ; Bacteremia ; Bacteria ; Bacterial Infections ; Cause of Death* ; Chungcheongnam-do ; Fever* ; Hemorrhage ; Humans ; Liver Failure ; Multiple Organ Failure ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Risk Factors ; Shock, Septic

PURPOSE: A clinical review was performed to evaluate the importance and effectiveness of early nephrectomy & the result of short-term chemotherapy on unilateral, nonfunctioning tuberculous kidneys. METHODS: Retrospective study was made on 34 patients with nonfunctioning tuberculous kidneys who underwent nephrectomy from February 1986 to December 1998. All patients were evaluated by annual frequency, age, sex and site distribution, presenting symptoms, tuberculous lesion on organs other than kidney, cystoscopic finding, urinalysis and urine AFB smear & culture, urine Tb-PCR, CBC & ESR finding, perioperative morbidity and mortality, treatment distribution(Group 1 and 2) and drug toxicity. RESULTS: In pathologic findings of the 39 cases in which nonfunctioning tuberculous kidneys were suspected, 5 cases had no evidence of tuberculosis. Those were xanthogranulomatous pyelonephritis(2 cases), chronic pyelonephritis with hydronephrosis(2 cases) and complicated multilocular cyst(1 case). Coexisting renal cell carcinoma was found in 1 case. 4 cases(11.7%) were hypertensive at the time of presentation and 3 cases of them had a decrease in blood pressure after nephrectomy. 7 cases(20.5%) had febrile symptom, 5 cases of them had renal & perirenal abscess(4 cases) and cutaneous fistula(1 case). No perioperative mortality occurred and perioperative complications(sinus arrhythmia, wound infection, wound dehiscence, ileus) were in 5 cases(14.7 %). There was no evidence of recurrence during follow-up periods(Follow-up mean periods : 18.5 months). CONCLUSION: Early nephrectomy is an effective treatment in the comprehensive management of the unilateral, nonfunctioning tuberculous kidneys, for accurate diagnosis, removal of infection focus, early control of presenting symptoms and prevention of tuberculosis recurrence. And this should be followed by postoperative, acceptable short-term antitubercul ous chemotherapy.
Arrhythmias, Cardiac ; Blood Pressure ; Carcinoma, Renal Cell ; Diagnosis ; Drug Therapy* ; Drug-Related Side Effects and Adverse Reactions ; Follow-Up Studies ; Humans ; Kidney* ; Mortality ; Nephrectomy* ; Pyelonephritis ; Recurrence ; Retrospective Studies ; Tuberculosis ; Urinalysis ; Wound Infection ; Wounds and Injuries

The main goal for the treatment of periodontal diseases is the regeneration of lost cementum, bone and connective tissue. Clinical and histological research suggests that it is possible to restore periodontal structures. Seeds of Carthamus tinctorius L. has been used for the treatment of bone fracture and osteoporosis in traditional Korean medicine. The purpose of this study is to examine the effect of extract of seeds of Carthamus tinctorius L. on mineralization in periodontal ligament cells and osteoblastic cells. Periodontal ligament cells were primarily obtained from a extracted premolars with non-periodontal diseases. Osteoblastic cells were obtained from calvariae of a fetal rat. Cells were cultured with DMEM at 37degrees C with 5% CO2 in 100% humidity incubator. Alkaline phosphatase(ALP) level and the number of calcification nodules were examined and western blot analysis using osteonectin was performed. Measurements of ALP levels and calcification nodules showed that extract of seeds of Carthamus tinctorius L. had significantly higher activity than control in all of both cells. In western blot analysis, protein expression of osteonectin indicated that extract of seeds of Carthamus tinctorius L. showed an increased pattern than control in all of both cells. From the above results, it seems that extract of seeds of Carthamus tinctorius L. has excellent effect on mineralization in periodontal ligament cells and osteoblastic cells.
Animals ; Bicuspid ; Blotting, Western ; Carthamus tinctorius* ; Carthamus* ; Connective Tissue ; Dental Cementum ; Fractures, Bone ; Humidity ; Incubators ; Osteoblasts* ; Osteonectin ; Osteoporosis ; Periodontal Diseases ; Periodontal Ligament* ; Rats ; Regeneration ; Skull