BACKGROUND: Although the culture of urethral discharge using a cutton swab is regarded as one of the most sensitive and reliable diagnostic methods of gonorrhea, it may give pain or diagnostic methods of gonorrhea, it may give pain or discomfort to patients, and its detection rate may be influenced by the examiner's technical ability. OBJECTIVE: The purpose of this study was to compare the positive culture rates between ure4thral discharge and urinary sediment for the diagnosing of Neisseria gonorrheae. METHODS: We compared this technique with the culture of urethral discharge using the specimens from 357 male patients with gonococcal infection at VD clinic of Jungku Pvblic Health center in Seoul from Jan 1991 to Jun 1993. RESULTS: The culture of urinary sediment was positive in 339 of 357(94.95), whereas the culture of urethral discharge was positive in 346 of 357(96.95). However, these data have no statistical significance(P<0.05). The obe observed sensitivity and specificity of culture of urinary sediment comjpared to culture of urethral discharge were 97.75 and 90.9%, respectively. The predictive value of positive and negative test compared to the culture of urethral discharge were 99.7% and 55.65, respectively. As our data showed low negative predictive value, a negative culture result of urinary sediment does not always imply a negative culture result of urethral discharge. CONCLUSION: Therefore, at present, the previous method of the culture of urethral discharge is more highly recommended and further studies for this diagnostic and/or new method of gonorrhea based on larger group of patients is encouraged.
Gonorrhea ; Humans ; Male ; Neisseria gonorrhoeae* ; Neisseria* ; Sensitivity and Specificity ; Seoul

The association between occupational asbestos exposure and the subsequent development of malignant mesothelioma of pleura is well recognized. We analyzed an asbestos body by energy dispersive X-ray analyser in a case of malignant mesothelioma of pleura who had a history of asbestos exposure 30 years ago. In transmission electron microscope, the asbestos body was composed of a core of refractile thin asbestos fiber bundle and beaded masses of electron-dense iron and protein complex. The core fibers were analyzed as an amphibole type crocidolite fiber [(Na2Fe3Fe2(Si8O22)(OH)2] which composed of high content of silicon, iron and sodium.
Asbestos* ; Asbestos, Crocidolite ; Iron ; Mesothelioma* ; Pleura ; Silicon ; Sodium

Trichomoniasis, a common and sometimes distressing condition in women, is caused by infection of the genitourinary tract by the pathogenic protozoan Trichomonris aginalis(T. vaginalis). Men may also be infected, although frequently without any symptoms, and most cases of trichomoniasis are sexually transmitted. The best evidence for an etiologic role for T. vaginalis is in nongonococcal urethritis(NGU). In epidemiologic studies, T,ginalis has been isolated from 1 to 68 percent in men with NGU. The nurnber of NGU is increasing rapidly than gonorrhea in deeloped nations, and in some developing countries, especially in Korea, In view of the difficulties in findng trichomonads by direct microsco by in men, urine culture and serodiagnosis plays an important role in the diagnostic work. Urine culture, indirect fluorescent antibody test(IFAT) and enzyme-linked immunosorbent assay (ELISA) were used to elecect T.vaginalis in 221 patients with male NGU. These patients visited the VD Clinic of ChoongKu Public Health Center in Seoul from May to August, 1989 and from March, 1990 to December, 1991. The results obtained were as follows.: 1. T. vaginalis was grown from only one of the 221 samples on TPS-1 meida. 2. In 208 NGU patients, there were 10(4.8%) positive reactions on IgG antibody in IFAT. 3. In 208 NGU patient, there were 14(6.7%) positive reactions to IgG antibody in ELISA. 4. No statistical significant correlation was found between then sults of IFAT and ELISA in individual patients. In conclusion, 1. Male trichomoniasis in patients with NGU was detected at a, significantly low rate. Due to the small number of patients in the test, further epidemiologic stidies of trichomoniasis in male NGU patient are necessary. 2. Serologic studies (IFAT and ELISA) have detected sorre trichomoniasis in male patients with NGU. These tests seem to be helpful in the diagnosis of male t-ichomoniasis.
Developing Countries ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay ; Epidemiologic Studies ; Female ; Gonorrhea ; Humans ; Immunoglobulin G ; Korea ; Male* ; Public Health ; Seoul ; Serologic Tests* ; Urethritis*

The lesions of central nervous system in tuberous sclerosis often calcify, especially those present in the perivascular region, allowing the computed tomography to make early and definite diagnosis, even when patients intelligence was normal, seizures were absent, or clinical findings were not specific, We report three cases of tuberous sclerosis, which showed pathognomic subependymal paraventricular calcification in brain CT.
Brain* ; Central Nervous System ; Diagnosis ; Humans ; Intelligence ; Seizures ; Tuberous Sclerosis*

For evaluating the boosting (anamnestic) effects of the most recent commercially produced plasma derived heat-inactivated hepatitis B vaccine (A. Co.), 117 adults with naturally acquired antibody to hepatitis B surface antigen (anti-HBs) were selected at random. In addition, out of case immunized at zero and 1 month, and boosted at 6 months (primary booting) by conventional vaccine (B.Co), inactivated by pepsin digestion and formalin treatment, 11 cases who showed elevated titer after primary boosting were also submitted to the study. The results were as follows: 1) Out of the 117 subjects with naturally acquired anti-HBs, 6(5.1%) showed isolated anti-HBs and the titers were below 10 ratio units (RU). Negative seroconversion was seen in 4 (3.4%) of the 117 cases at 12 months after the screening and, of these cases, 3 showed isolated anti-HBs below 10 RU (increased GMT, 28.04) at one month after primary booster injection with 3 microgram dose of A. Co. Vaccine at all, but 90% of the other subjects responded. 3) The anti-HBs titers of all the 11 cases who showed a rise of more than 10 RU (increased GMT, 28.04) at one month after primary booster injection by 20 microgram dose of B. Co. vaccine decreased at 19 months after the primary booster. And 3 subjects (27.3%) of the 11 reached negative seroconversion. All of the 11 cases, who had secondary booster injection with 3 microgram dose of A. Co. vaccine at 19 months after primary boosting, showed increased anti-HBs titer at least 20 RU or more (increased GMT, 57.72) at one month after the boosting. According to the above results in the anti-HBs screening survey for the purpose of immunization with hepatitis B vaccine, subjects with isolated anti-HBs below 10 RU should be regarded as being in an unimmunized state. In cases who are in risk circumstances, immunized primarily with a 20 microgram dose of B. Co. vaccine, a secondary booster injection should be given within 2 years after initiation of primary immunization and a 3 microgram booster dose of A. Co. vaccine can be reliably used.
Adult ; Digestion ; Formaldehyde ; Hepatitis B Surface Antigens* ; Hepatitis B Vaccines ; Humans ; Immunization* ; Mass Screening ; Pepsin A ; Plasma

BACKGROUND: Postherpetic neuralgia is usually defined as pain persisting for more than one month after the onset of the eruption of herpes zoster, although there is a overlap between this and the pain of the acute zoster. Many approaches have been proposed to treat postherpetic neuralgia, however, it remains a source of frustration for both patients and physicians. OBJECTIVE: The purpose of this study was to determine more precisely the relationship between the effects of continuous epidural blockade and the time of treatment on postherpetic neuralgia. METHODS: We analyzed the results of 5 patients with postherpetic neuralgia for whom continuous epidural blockade was performed within 1 month after the onset of postherpetic neuralgia, and compared them with the results of 5 patients for whom continuous epidural blockade was performed after 1 month after the onset of postherpetic neuralgia. RESULTS: Continuous epidural blockade performed within 1 month after the onset of postherpetic neuralgia reduced pain significantly, compared to the results of continuous epidural blockade performed after 1 month after the onset of postherpetic neuralgia. CONCLUSION: Continuous epidural blockade performed within 1 month after the onset of postherpetic neuralgia may be the treatment of choice for the pain.
Frustration ; Herpes Zoster ; Humans ; Neuralgia, Postherpetic*

Clinically evident metastases of carcinomas to the thyroid gland are rare, particularly from a colorectal primary tumor. We present a case of colonic adenocarcinoma metastatic to the thyroid gland with histopathologic and immunohistochemical findings. A 68-year-old woman with a history of Dukes' stage B colon carcinoma presented a mass in the thyroid gland. The tumor was confirmed to be metastatic adenocarcinoma from the colon. The immunohistochemical findings demonstrated positive staining for cytokeratin 20, low-molecular-weight cytokeratin, villin and carcinoembryonic antigen, but stains were negative for cytokeratin 7 and thyroglobulin.
Adenocarcinoma/secondary* ; Adenocarcinoma/radiography ; Aged ; Carcinoembryonic Antigen/analysis ; Carrier Proteins/analysis ; Case Report ; Colonic Neoplasms/pathology* ; Female ; Human ; Immunoenzyme Techniques ; Intermediate Filament Proteins/analysis ; Keratin/analysis ; Microfilament Proteins/analysis ; Thyroid Neoplasms/secondary* ; Thyroid Neoplasms/radiography ; Thyroid Nodule/radiography ; Thyroid Nodule/chemistry ; Tomography, X-Ray Computed ; Tumor Markers, Biological

The Cornelia de Lange syndrome is characterized by severe growth and mental retardation; typical facies; low-pitched, weak, growling cry, and various bone abnormalities, as was first described by Cornelia de Lange in 1933. On the other hand, Legg-Perthes disease is the condition, in which avascular necrosis of the femoral head develops, as was first described by Legg, Calve and Perthes in 1910. Review of the worlds literature disclosed only one case of Legg-Perthes disease associated with Cornelia de Lange syndrome. We experienced a case of Legg-Perthes disease associated with Cornelia de Lange syndrome in a 8 years old boy, which was treated surgically for Legg-Perthes disease. A brief review of literature was made.
De Lange Syndrome ; Facies ; Hand ; Head ; Humans ; Intellectual Disability ; Legg-Calve-Perthes Disease ; Male ; Necrosis

BACKGROUND: Nonobstertic surgery during pregnancy needs special considerations by the surgeon in relation to the maternal and the fetal outcomes. Although there are many studies about appendicitis in pregnant women, nonobstetric surgery, in general, during pregnancy has not been sufficiently analyzed. In this clinical study, we reviewed the incidences of nonobstetric surgical diseases during pregnancy and observed the maternal and the fetal outcomes of surgery, including the effects of anesthesia and antibiotics. METHODS: We retrospectively analyzed 80 patients who were pregnant at the time of operation and who had undergone operations during an 11-year period from March 1986 to April 1997 at Shinchon- and Inchon-Severance Hospital. The distributions of age, disease, and delivery history were analyzed, and the diagnostic characteristics, and the fetal and the maternal outcomes were observed with respect to anesthesia and antibiotic usage. RESULTS: The average age of the patients was 32, and 53% of the patients were over 30. The numbers of patients in the first, the second, and the third trimester were 24 (30%), 36 (45%) and 20 (25%), respectively. The most frequent surgical disease was appendicitis with 52 patients (65%). The average duration of hospitalization was 14.4 days. Twenty-two patients (27.5%) had postoperative preterm labor and were successfully managed with tocolytic agents except for one preterm delivery. The total number of preterm deliveries was 10 (12.5%), and still birth occurred in 3 cases (3.8%). The cases of still birth involved severe original diseases, such as rectal carcinomas, pancreatic carcinomas, and sepsis. Among the antibiotics that were used during surgical care, monotherapy with ampicillin was the most frequently used mode. The incidence frequencies of delivery complications according to the used antibiotics were not significantly different from each other. General endotracheal anesthesia was used in 40 cases, spinal and epidural anesthesia was inducted in 25 and 13 cases, respectively. The incidences of fetal complications according to the methods of was administering anesthesia were not significantly different. CONCLUSIONS: The maternal and the fetal risks of nonobstetric surgery during pregnancy depend on the risk of the original surgical disease of the patient. Modes of anesthesia or antibiotic usage do not increase the incidences of obstetric complications.
Ampicillin ; Anesthesia ; Anesthesia, Epidural ; Anti-Bacterial Agents ; Appendicitis ; Female ; Hospitalization ; Humans ; Incidence ; Obstetric Labor, Premature ; Parturition ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women ; Retrospective Studies ; Sepsis ; Tocolytic Agents

BACKGROUND: The purpose of this study was to assess the intra-articular patterns in the rotational deformities of bucket handle meniscal tears (BHMTs) based on arthroscopic findings and their clinical relevance. METHODS: From 2004 to 2009, 42 patients with a BHMT diagnosed by magnetic resonance imaging underwent arthroscopic surgery. The arthroscopic data (all procedures were recorded) were evaluated retrospectively, and BHMTs were classified according to the rotational directions of centrally displaced fragments. To assess the reliability of the agreement in this classification, 2 orthopedic surgeons re-classified BHMTs, 1 week after first trial. Intra- and interobserver reliabilities were assessed using kappa statistics. In addition, we address specific tear patterns, associated anterior cruciate ligament injury, medio-lateral difference, reducibility, chronicity, and reparability. RESULTS: Most of the tears could be categorized into one of 3 morphologic patterns. Of the tears, 4.8% could not be categorized. BHMTs were classified, based on the rotational directions of centrally displaced fragments, as follows; the upward rotation group (type 1), the downward rotation group (type 2) and the reverse group (type 3). The most common intra-articular pattern was type 1 (29 patients, 69%). The occurrence of the other patterns was: type 2 in 7 patients (16.7%), type 3 in 4 patients (9.5%); we were not able to make a classification of type in 2 patients (4.8%). Intra-observer reliability was 0.86 in terms of kappa statistics, which implies almost perfect agreement. Mean interobserver reliability (0.73) showed substantial agreement. Type 1 and 2 tears were easily reduced, whereas all type 3 tears (4/4) needed additional procedures to achieve reduction. CONCLUSIONS: Based on arthroscopic findings, we describe a comprehensive BHMT classification scheme that encompasses 95.2% of all tears. Tear type was correlated with reducibility.
Adolescent ; Adult ; Anterior Cruciate Ligament/*injuries/pathology/surgery ; Arthroscopy/*methods ; Female ; Humans ; Knee Injuries/classification/*pathology/surgery ; Magnetic Resonance Imaging ; Male ; Menisci, Tibial/*injuries/pathology/surgery ; Middle Aged ; Reproducibility of Results ; Retrospective Studies