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

Leiomyoma is commonly found in the female genital tract, but occurrence in the urinary bladder is very rare with only 235 cases reported in the literature. These tumors have been classified as intravesical (63%), intramural (7%) and extravesical (30%) depending on the direction of the growth. We report a case of intravesical leiomyoma of the urinary bladder in a 36 year-old woman who exhibited dysuria and urinary retention. The gross and microscopical findings of leiomyoma of the bladder are similar to those of the uterus. Immunohistochemical stains for estrogen receptor (ER) and progesterone receptor (PR) revealed diffuse nuclear staining in smooth muscle cells, supporting the hypothesis of hormonal influence in tumorigenesis.
Adult ; Carcinogenesis ; Coloring Agents ; Dysuria ; Estrogens ; Female ; Humans ; Leiomyoma* ; Myocytes, Smooth Muscle ; Receptors, Progesterone ; Urinary Bladder* ; Urinary Retention ; Uterus

We analyzed the results of the prostate biopsies of 64 patients with elevated serum PSA (>4ng/ ml) at Kangbuk Samsung Hospital from March 1993 to February 1996. Of 64 patients, 11 patients (17%) had prostate cancer and 53 patients (83%) were diagnosed as benign prostatic hyperplasia. Among the patients with prostate cancer, 1 patient had serum PSA between 4.1 to 10.0ng/ml, 2 patients between 10.1 to 20.0ng/ml and 8 patients above 20ng/ml The detection rates of prostate cancer in each serum PSA levels were 3%, 15% and 36% respectively. Two of 17 patients with both negative DRE and TRUS were diagnosed as prostate cancer Two of 21 patients with positive TRUS and negative DRE had prostate cancer but none of 8 patients with positive DRE and negative TRUS had prostate cancer. Seven of 18 patients with both positive TRUS and DRE had prostate cancer. The sensitivity, specificity, positive predictive value and overall accuracy of DRE and TRUS in patients with elevated PSA (>4ng/m1) were 64%, 64%, 27%, 64% and 82%, 43%, 23%, 50% respectively in patients with elevated serum PSA (>4ng/ml). In conclusion, these results suggest that prostate biopsy in early diagnosis of prostate cancer would be needed for the patients with elevated serum PSA (>4ng/ml) regardless of the results of DRE and TRUS.
Biopsy* ; Early Diagnosis ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Sensitivity and Specificity

No abstract available.
Epidural Abscess*

The spinal injuries were classified into bursting fracture, fracture-dislocation, seat-belt injury, compression fracture according to the three column theory by Denis. The bursting fracture and fracture-dislocation required the most careful planning. So, myelography, computerized tomography enabled us to diagnose the spinal fracture including retropulsed bony fragment into the spinal canal. There was much controversy as to appropriate treatment af unstable thoraco-lumbar fractures. The frequent surgical treatment of thoraco-lumbar spinal fractures was still posterior spinal instrumentation including Harrington rod system. Since 1964, the use of anterior spinal instrumentation had been started by Dwyer, Dunn, Kostrik, Slot, and Zielke used anterior spinal instrumentation in unstable thoraco-lumbar spinal fractures, but not popular. This study suggested the experience to accomplish the decompression of the neural elements and stabilization of the spine by using Kandea device in unstable thoraco-lumbar spinal fractures. 12 patients treated with this Kaneda device in unstable thoraco-lumbar spinal fractures were analyzed from Dec. 1988 to May, 1989 at the Department of Orthopaedic Surgery, Ewha Womans University Hospital. We obtained the following conclusions. The results were as follows. 1. The common injury mechanism was falling down in 5 cases, the frequent injury site was 1st lumbar vertebra. 2. According to Denis classification, the bursting fractures were in 8 cases(68% ), the fracture-dislocations were in 4 cases(33%). 3. The average preoperative kyphotic angulation was 24.5 degrees(range 8 to 45) and postoperative angulation was 5 degrees(range 2 to 15), the correction rate was 79.6% and correction degree was average 19.5 degrees. 4. The advantages were the fixation of one level above and below the injury site, sufficient neural decompression, firm spinal stabilization, early mobilization with a brace and elimination of the 2nd posterior procedure. 5. The fixation of vertebral plate was difficult due to the invariable size of vertebral plates, especially, in upper thoracic spinal fracture and children's fracture.
Accidental Falls ; Braces ; Classification ; Decompression ; Early Ambulation ; Female ; Fractures, Compression ; Humans ; Myelography ; Spinal Canal ; Spinal Fractures ; Spinal Injuries ; Spine

No abstract available.
Rectal Neoplasms*

No abstract available.
Arteritis* ; Lupus Erythematosus, Systemic* ; Nephritis*

No abstract available.
Carcinoma, Squamous Cell ; Esophageal Neoplasms ; Neoplasm Metastasis

Chlamydia trachomatis is known as a major causative microorganism in non-gonococcal urethritis(NGU) in men. We examined two kinds of specimens simultaneously, endourethral swab and urine, in each patient to determine the reliability of these two different specimens for the detection of the Chlamydia trachomatis antigen in male NGU patients using ELISA method. Tota1 273 patients entered this study were divided into two groups according to sampling order of urine and endourethral swab. In group A(141 patients), we took endourethral swab first, then first portion of voided urine was caught. In group B(132 patients), endourethral swab was performed after urine sampling. Twenty five out of 273 patients(9.2%) showed Chlamydia trachomatis antigen positive in endourethral swab sample and 1 out of 273 patients(0.4%) was positive in urine sample. There was no significant difference of antigen positive rate of endourethral swab examination between group A and group B. Our data suggest that examination of endourethral swab is more reliable method for the detection of the Chlamydia trachomatis antigen than urine examination in male NGU patient.
Chlamydia trachomatis* ; Chlamydia* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Male

Seven patients with aortic valve vegetation were examined by M-mode and two dimensional echocardiography. Underlying cardiac abnormalities were found in 6 patients, four had rheumatic heart disease, one had congenital bicuspid aortic valve, one had coexistence of asymmetrical septal hypertrophy and aortic regurgitation. Aortic regurgitation were found in all patients. One of seven patients had cerebral embolization and all patients had overt congestive heart failure. Of 5 patients medically treated, three became moribund, one died and one improved clinically. One patient underwent cardiac surgery, the aortic cusps were congenital bicuspid with vegetation, aortic valve replacement was successful. Echocardiogram of 7 patients with aortic valve vegetation showed characteristic shaggy, irregular mass of echoes produced by vegetation in the aortic valve during systole and diastole. Two of seven patients had abnormal mass of echoes in the left ventricular outflow tract. During systole, two had vegetation on the right coronary cusp and one had vegetation on the noncoronary cusp by M-mode echocardiography. In other patients we could not localize invoving aortic cusps by M-mode echocardiogram. All patients had left ventricular volume overload. For of seven patients had fluttering of anterior mitral valve. Two had fluttering of interventricular seputm. Five had premature mitral valve closure before QRS complex.
Aortic Valve Insufficiency ; Aortic Valve* ; Bicuspid ; Diastole ; Echocardiography* ; Heart Failure ; Humans ; Hypertrophy ; Mitral Valve ; Rheumatic Heart Disease ; Systole ; Thoracic Surgery