No abstract available.
Drug Therapy* ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

Decreased sensitivity of N. gonorrhoeae to many existing antibiotics and the emergence and increase of penicillinase producing and of spectinomycin resistant N. gonorrhoeae necessitate intensive efforts to study on resistance. Male patients with uncomplicated gonococcal urethritis treated during the year 1990 at the VD clinic of Choong-ku Public Health Center in Seoul were included in this study. A total of 85 strains, 44 strains of non-PPNG and 41 strains of PPNG isolated from the patients were studied to evaluate their sensitivities to ampicillin, penicillin, cefoxitin, kanamycin, tetracycline, erythromycin, spectinomycin and cotrimazole. The results are summerized as follw: In non-PPNG strains, the range of MICs. MIC50 and MIC90 for both ampicillin and penicillin were 0.125-32, 2 and 16 mcg/ml respectively. For cefoxitin, they were 0.125-8, s and 16 mcg/ml respectively, and for kanamycin, 8--<64, 32 and 64 mcg/ml, respectively. For tetracycline, they were 1-64, 8 and 32 mcg/ml, while for erythromycin, 0.06-16, 2 and 8 mcg/ml respectively. For spectinomycin, they were 4--<64, 32 and 64 mcg/ml and for cotrimazole, 5--<160, 40 and 160 mcg/ml respectively. In the case of PPNG, the range of MICS, MIC50 and MIC90 for ampicillin were 8--<128, 32 and 128 mcg/ml respectively but for penicillin, 8--<128, 64 and 128 mcg/ml respectively. And for cefoxitin, they were 0.5-32, 4 and 16 mcg/ml while for kanamycin, 16--<64, 64 and >64 mcg/ml respectively. For tetracycline, the values were 2-64, 16 and 32 mcg/ml, and for erythromycin, they were 0.5-16, 4 and 8 mcg/ml respectively. for spectinomycin, they were 8--<64, 32, and 64 mcg/ml and finally for cotrimazole, 5--<160, 80 and 160 mcg/ml respectively. From these results, it is concluded that the MICs of both PPNG and non-PPNG were about 2 folds higher than the results of sensitivity tests at the same instituition in 1985. 2) The prevalence of PPNG among 35 gonorrhoeae patients who received treatment before the visit was 60% (21/35), while that among the patients without previous treatment was 40% (20/50). 3) In the cases of ampicillin, penicillin and cotrimazole, their MIC values were found to be significantly higher for the strains isolated from the patients with previous treatment history than those without previous treatment (p<0.05). 4) In non-PPNG strains, a significant positive correlation is found between the sensitivities to most pairs of ampicillin, penicillin, cefoxitin, kanamycin, tetracycline, erythromycin and spectinomycin. However this excludes some pairs such as : tetracycline-cefoxitin, erythromycin-penicillin, erythromycin-cefoxitin, spectinomycin-penicillin, and spectinomycincefoxitin (p<0.05). 5) In PPNG strains, a significant positive correlation is also found between the sensitivities to most pairs of ampicillin, penicillin, cefoxitin, tetracycline, erythromycin and spectinomycin. However, the exceptional cases include tetracycline-cefoxitin, erythromyoinpenicillin, erythromycin-cefoxitin, spectinomycin-penicillin, and spectinomycin-cefoxitin pairs. In addition, the sensitivity to kanamycin was found to be strongly correlated with that to tetracycline, erytheromycin and spectinomycin (p<0.05). Therefore it is essential for the management fo gonorrhoeae, together with a correct diagnosis, to use currently most effective treatment regimens which would also prevent the emergence of resistant strains. It is also suggested that when a treatment is failed, to use the durg which do not show correlation in sensitivities on re-treatment.
Ampicillin ; Anti-Bacterial Agents ; Antibodies* ; Cefoxitin ; Diagnosis ; Erythromycin ; Humans ; Kanamycin ; Male ; Penicillinase ; Penicillins ; Prevalence ; Public Health ; Seoul ; Spectinomycin ; Tetracycline ; Urethritis

It is well estabilshed that the xerosis is closely related to diabeic pruritus. Although the causes of xerosis are thought to bie the abnormalities of sweating and autonomic nervous system, the exact mechanism of the xerosis in diabetic skin is still unknown. This study was designed to investigate the possible derangement of glucose metabolism in the skin of diabetes mellitus patients with xerosis. The epidemal glucose content and hexokonase activities were masured in the skin samples obtained from normal individuals and diabetes mellitus patients with xerosis The epidermal glucose content was measured by the enzymatic cycling method. The enzymatic activities of hexokinase were assayed by fluorometric method. The epidermal glucose content of diabetic patients increaed approximately twice [27.46+9.52 (mmole/kg /dry weight) that of normal individuals [13.90+4.79(mmole/kg /dry weight)] (p<0. 0001). The epidermal hexokinase activities of diabetes patients were significantly decreased [0.56+0.15(mole/hr/kg/dry weight)] compared to that of normal indivduals [0.96+0.24(mole/hr/kg dry weight)] (p<0.0001). There were no significant differences in the epidermal glucose content and enzyme activities of hexokinase between the diabetic patients with: erosis and diabetic patients without xerosis. These data indicated that decreased activities of hexokinase could reduce the glucose phopkiorylation and uptake into keratinocytes, and which could lead to accumulat. glucose in the interstitial space of diabetic epidermis. And the decreased hexokinase activities may exert on lipid metabolism and glycolysis of diabetic epiidermis, because hexokinase is a key enzyme of hexose monophosphate pathway and glycolysis.
Autonomic Nervous System ; Diabetes Mellitus ; Epidermis ; Glucose ; Glycolysis ; Hexokinase* ; Humans ; Keratinocytes ; Lipid Metabolism ; Metabolism ; Pruritus ; Skin ; Sweat ; Sweating

PURPOSE: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. MATERIALS AND METHODS: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. RESULTS: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. CONCLUSION: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.
Age of Onset ; Biopsy ; Bone Transplantation ; Child ; Curettage ; Diagnosis ; Eosinophilic Granuloma ; Follow-Up Studies ; Fractures, Spontaneous ; Histiocytosis, Langerhans-Cell ; Humans ; Medical Records ; Osteolysis ; Radiography ; Retrospective Studies ; Shoulder ; Torticollis ; Treatment Outcome*

PURPOSE: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. MATERIALS AND METHODS: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. RESULTS: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. CONCLUSION: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.
Amputation ; Disease-Free Survival ; Extremities ; Female ; Femur ; Fibula ; Follow-Up Studies ; Humans ; Humerus ; Joint Instability ; Limb Salvage ; Male ; Neoplasm Metastasis ; Osteosarcoma ; Periprosthetic Fractures ; Recurrence ; Replantation ; Retrospective Studies ; Survival Rate ; Tibia ; Ursidae

The degenerative arthritis following total menisectomy has led to consideration of the need for meniscal transplantation, this study evaluates the morphologic and histologic changes fol lowing fresh meniscal autograft and allograft in therabbits. Transplantation of the medial meniscus was carried out in two groups of 32 rabbits(autograft group=16 rabbits, allograft group=16 rabbits). The morphological and histological changes of the transplanted auto-and allografted menisci and the articular cartilage of the medial femoral and tibial condyle were observed at 2,4,6,8,10,12,22,28 weeks postoperatively. There were no significant differences between auto and allograft groups in gross appearance. Histologically, the fibrous adhesion was noted between grafted meniscus and joint capsule 2 weeks after operation, but complete healing was seen at the suture sites without rejection phenomenon at 6 weeks in both groups. There were prominent inflammatory reactions such as lymphocytes and inflammatory cells infiltration during early postoperative stages(2,4 weeks) only in the allograft group, and more prominent fibrotic reactions in the allograft group than auto-graft group. The results of this study suggest that meniscal allografts are able to adapt to the host tissues, survive within the joint environment, and provide a functional replacement for the removed meniscus, but further studies for graft-host immune response and a method to take the maintenance and deposits of graft must be needed to perform the meniscal allograft in human.
Allografts ; Autografts ; Cartilage, Articular ; Humans ; Joint Capsule ; Joints ; Knee Joint ; Knee ; Lymphocytes ; Menisci, Tibial ; Methods ; Osteoarthritis ; Rabbits ; Sutures ; Transplants

The lack of sufficient oral mucosa available for intra-oral reconstruction has been dealt with by the use of skin or oral mucosa grafts harvested from donor sites but grafts requires more than one surgical procedures and could cause donor site morbidity. Many investigators have attempted to increase available soft tissue by tissue engineered skin or oral mucosa replacements for clinical applications. But, reconstructed mucosa by several methods have low physical properties such as rolling and contraction. The aims of this study were to develope an in vitro experimental model that maintains an epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally cultured oral mucosa embedded with Polydioxanone mesh by histological and immunohistochemical analysis. The results were as follows; 1. Oral mucosa reconstructed by three-dimensional organotypic culture revealed similar morphologic characteristics to equvalent normal oral mucosa in the point that they show stratification and differentiation. 2. The expression of cytokeratin 10/13 and involucrin in the cultured tissue showed the same pattern with normal oral mucosa suggesting that organotypic co-culture condition is able to induce cellular differentiation. 3. After insertion of polydioxanone mesh, increased tensile strength were observed. These results suggest that three-dimensional organotypic co-culture of the oral mucosa cell lines with the dermal equvalent consisting type I collagen and fibroblasts reproduce the morphologic and immunohistochemical characteristics similar to those in vivo condition. And increased physical properties by use of polydioxanone mesh will helpful for clinical applications.
Cell Line ; Coculture Techniques ; Collagen Type I ; Fibroblasts ; Humans ; Keratins ; Models, Theoretical ; Mouth Mucosa* ; Mucous Membrane ; Polydioxanone* ; Research Personnel ; Skin ; Tensile Strength ; Tissue Donors ; Transplants

In analyzing the postoperative results or evaluating the velopharyngeal incompetence after palatoplasty, speech evaluation is the inevitable factor. However, a standardized method for evaluating the speech problem in Korean cleft palate patients has not been available until now. So, the authors tried to establish a method of speech evaluation which is simple, economic and applicable to young patients, and to make a scoring method of the speech results in cleft palate patients based on the 'hypernasality diagnosing tool for cleft palate patient (OK Ran Jung)' which is commonly used by domestic speech therapists. The authors adopted the 'hypernasality diagnosing tool for cleft palate patients (OK Ran Jung)' male and female of children and adults, each consisting of 10 patients and make them speak according to the items about hypernasality and misarticulation evaluation, and record the results. We also calcuted the degree of the formants of the vowels (/a/, /o/, /u/)using sound spectrography. We examined the interjudge and intrajudge reliance of speech evaluation among the 10 inverstigators, revised the evaluation tool, devised the scoring method according to the above results, and compared the scoring results with those of sound spectrography to prove the reliance of our speech evaluation tool. With the scoring method, the authors could estimate the degree of hypemasality and misarticulation in cleft palate patients with evidence of reliability based on point-to-point agreement in two items. In comparing the results of our scoring method with the formant of vowels using sound spectrography, staistical significance existed except /u/F2 and that meant that our scoring method was reliable. We suggest that this simple, economic and reliable method of speech evaluation in cleft palate patients can create the basis for speech evaluation in patients of cleft palate and velopharyngeal incompetence under circumstances in which the results of various speech treatments are evaluated in comparison to various methods of speech evaluation.
Adult ; Articulation Disorders ; Child ; Cleft Palate* ; Female ; Humans ; Male ; Research Design ; Sound Spectrography ; Velopharyngeal Insufficiency

Many methods of correcting secondary cleft lip nose deformity have been introduced, but a single best method that can be uniformly adjusted for all cases does not exist. Since it is difficult to make the nostril of the cleft side symmetric with that of normal side, the authors tried to formulate the basis for correction of unilateral secondary cleft lip nose deformity according to the varying amounts of deformed nostril. We then adopted 4 different methods of correcting the soft tissue and nostril deformity in 63 patients from 1996 to 1998 and surveyed the results. Our principles were as follows: 1) Alar rim incision was done in cases of different-shaped cleft-side nostrils with nearly the same measured area in comparison to the normal side. 2) When deformity of the alar-columellar web was severe, we performed modified Z-plasty. 3) When the nostril of the cleft-side nostril was smaller than the normal side with slight asymmetry, reverse W-plasty was done. 4) We adopted a reverse-U incision when there was a discrepancy in height with moderate asymmetry compared with the normal nostril. After dissection, repositioning of alar cartilage was done by same method in each case. A nasal stent was kept in position for at least 6 months postoperatively in almost all cases. After follow-up of 6 to 24 months, we concluded that our choice was correct in selecting the optimal operative method, considering the characteristics of deformity of the cleft side nostril in an effort to make it symmetric with that of the normal side.
Cartilage ; Cleft Lip* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Nose* ; Stents

We have analysed 72 cases of geriatric patients over 70 year of age who underwent anesthesia in our Aospital from Jan. 1970 to May 1979 and the results were as follows; 1) Male patients were more than female(1.05: 1). (Male, 37 cases(51.4%) and female, 35cases (48. 6%). 2) By ASA classification, physical status was class II in 32 cases, E II in 24 cases, III in 12 cases, E III in 2 cases and IV in 2 eases. 3) The number of the patients of general surgery department(46.63%) was highest. 4) Preoperative problems were cardiovascular diseases including hypertension (11cases) and LVH(25 cases), arrhythmia(6cases), tachycardia(4cases), RBBB(2cases) and bradycardia (2 cases) in EKG. 5) Preoperative pulmonary disease including pulmonary tbc(14 cases), chronic bronchitis (6 cases), and emphysema(4 cases) was revealed in the chest PA. 6) There was no mortality during the operative or postoperative period.
Anesthesia ; Bradycardia ; Bronchitis, Chronic ; Cardiovascular Diseases ; Classification ; Electrocardiography ; Female ; Humans ; Hypertension ; Lung Diseases ; Male ; Mortality ; Postoperative Period ; Thorax