The following case report concerns a rare bone metastasis of malignant melanoma occurring in the 4th and 5th lumbar spines and adjacent iliac crests and sacrum. A 42-year-old woman was admitted with a 6 months history of severe lumbago ar right flank pain radiating to right lower extremity. Preoperative X-ray studies revealed stag horn stone in the right renal pelvis as spondylolisthesis of the 5th lumbar spine with bilateral isthmic defects. On physical examinations, dark brown colored nevus was noted at lower lumbar regio which was removed and subjected for biopsy. Surgical exploration demonstrated a melanoma metastasis to have invaded the spine process, lamina and transverse processes of the 5th lumbar spine, adjacent L4 and sacru and iliac crests. Surrounding soft tissues, however, were apparently normal. Postoperatively course of the patient seemed to follow a rapidly terminal clinical cours.
Adult ; Animals ; Biopsy ; Female ; Flank Pain ; Horns ; Humans ; Kidney Pelvis ; Low Back Pain ; Lower Extremity ; Melanoma ; Neoplasm Metastasis ; Nevus ; Physical Examination ; Sacrum ; Spine ; Spondylolisthesis

Penicillin is still the first choice of drug in the treatment of gonorrhea. The ever lowering sensitivity of Neisseria gonorrhoeae to penicillin and the emergence of PPNG (Penicillinase Producing Neisseria Gonorrhoeae) in the Far East and other parts of the world neceessitate reapprisal of treatrnent schedules with penicillin for gonococcal infections. In Korea, no authentical study in this regard has been done recently. The presence of intracellular gram r.egative diplococci in urethral smear as weIl as the presence of oxidase positive typical, round, convex, smooth, glistening, tratmslucent, greyish colonies of 0.5 to 2mm in diameter a 24 hours composed of grarn negative diplococci are used for presump'ive evidence of gonococccal infection 224 male patients with acnte uncomplicated gonococal infections were treated one of following regimens. Regimen A: 4.8mega unit combicillin (3.6mega unit procaine penicillin+l.2 mega unit sodium penicillin) i.m.. preceded by 1gm probenecid p.o., Regirnen B: 4.8 mega unit procaine penicillin i.m. preceded by 1gm probenecid P.O. Regimen A showed 14 failures(11.3% arnong 124. Regimen B showed 19 failures (19%) among 100 It is suggested that in Korea sesnsitivity to penicillin of Yeisseria gonorrhoeae is quite low.
Appointments and Schedules ; Far East ; Gonorrhea ; Humans ; Korea ; Male ; Neisseria ; Neisseria gonorrhoeae ; Oxidoreductases ; Penicillin G Procaine ; Penicillins* ; Probenecid ; Procaine ; Sodium

No abstract available.
Esophageal and Gastric Varices* ; Hypertension, Portal*

PURPOSE: This is to evaluate the clinical results and radiologic changes of the mandibular condyle fractures following the open reduction and fixation using the Lag-screws introduced by Eckelt and Martin Co. MATERIALS & METHODS: Ten patients who had been treated by the Lag-screw fixation for the unilateral fracture of the mandibular condyle at the high level and followed up for over 6 months(ranged from 24 weeks to 33 weeks). The incisal opening by time elapsed, displacement of the fragments, bone resorption around the Lag-screws, operating time consumed, and untoward complications were evaluated. The data were tested by repeated measure ANOVA and paired t-test. RESULTS: The maximum mouth opening was increased by time as follows ; 20.2+/-2.8mm soon after reduction. 26.3+/-3.9 at the 2nd week, 37.7+/-4.2mm at the 4th week, 44.4+/-4.3mm in PO 2 months(P<0.05). The bone resorption at anterior to lag-screw nut was measured to 1.9+/-1.0mm, while the posterior resorption was 2.6+/-1.9mm on average(P<0.05). Reduction and fixation of the fragments by Lag-screw were done within 80 minutes including the skin closure. The clicking sound of the TMJ(40%), weakness of the marginal branch(60%) were complicated but transient for 4-8weeks. There were no signs of bony displacement, but loosening of screws were observed at the time of removal. CONCLUSION: Open reduction and fixation with condylar Lag-screw(Martin co., Germany) thru the ramus can be a good option to reduce the high level(Kruger's Level III & IV) fracture of the mandibular condyle with anterior or medial displacement. However, this procedure requires 2nd surgery to remove the devices and it may complicate improper reduction for delayed fractures and in case of 's' curved mandibular ramus.
Bone Resorption ; Humans ; Mandibular Condyle* ; Mouth ; Nuts ; Prognosis* ; Skin

BACKGROUND: Experience of awareness and recall during general anesthesia would be most distressing for patients. Especially for the cesarean section, medical team must consider both maternal awareness and fetal safety. Authors tried to know the possibility of propofol use as induction and maintenance agent of anesthesia for the cesarean section in respect of maternal awareness, recall and fetal safety. METHODS: Forty patients (ASA physical status 1, 2) were allocated randomly to either propofol (n=20) (P) or thiopental-enflurane (n=20) (T-E) group. We checked B.P, pulse rate, and the incidence of maternal awareness using the isolated forearm technique (IFT). The postoperative interview was conducted between 12~24h after operation. RESULTS: The incidence of maternal awareness signaled by flexing fingers in response to voice commands were significantly lower in the T-E group (20% after induction, no response during other times) than the P group (45% after induction, then 35%, 30%, after 5, 10 min delivery respectively). Seven patients had postoperative recall of introspective awareness in the P group but no patients in the T-E group. The 1 min Apgar score of the newborn were significantly lower in the P group than the T-E group but both groups were within normal range. CONCLUSIONS: Our date indicated that, in comparison with thiopental-enflurane, propofol infusion (6 mg/kg/h) were associated with a greater incidence of awareness during surgery and recall.
Anesthesia* ; Anesthesia, General ; Apgar Score ; Cesarean Section* ; Female ; Fingers ; Forearm ; Heart Rate ; Humans ; Incidence ; Infant, Newborn ; Pregnancy ; Propofol ; Reference Values ; Voice

We report a case of pityriasis rotunda occurring in a patient with pancreatic adenocarcinoma. The patient was a 64-year old female who had a pancreatic adenocarcinoma. The skin lesions were asymptomatic, multiple, various sized (1 to 15cm in diameter), isolated or confluent and finely scaly light brownish to grayish colored patches on the lower abdomen, back and thigh. Histopathologic findings shawed mild hyperkeratosis, atrophy, loss of granular layer, increased melanin pigments in basal layer of the epidermis and mild perivascular monocytic infiltration in the upper dermis.
Abdomen ; Adenocarcinoma* ; Atrophy ; Dermis ; Epidermis ; Female ; Humans ; Melanins ; Middle Aged ; Pancreas* ; Pityriasis* ; Skin ; Thigh

The gate control theory was proposed by Melzack & Wall in 1965. This theory implies that selective stimulation of cutaneous afferent fibers of large diameter inhibits pain. Transcutaneous electrical stimulation(TNS) is a practical employment of this concept. TNS was used on 14 herpes zoster patients to relieve associated pain. Good effeet was obtained in 13 patients. They experienced relief of their pain for 1-4 hours after 20 minutes of application. TNS has many advantages over analgesic drugs in the control of pain in herpes zoster.
Analgesics ; Employment ; Herpes Zoster* ; Humans

No abstract available.
Bacteria, Anaerobic*

No abstract available.

BACKGROUND: Recent data suggest that the colonization rate of group B streptococci(GBS) in pregnant women and the incidence of neonatal infections by GBS is increasing trend in Korea, but the antimicrobial susceptibilities and serotypes in pregnant women have not been reported in Korea. So, we studied to define the antimicrobial susceptibility patterns and frequency of serotypes of GBS in pregnant women. METHODS: The susceptibility and serotyping of 60 GBS isolates from 27 pregnant women and four isolates from their two neonates were tested by an agar dilution method and agglutination test, respectively. The typing sera used in this study were Ia, Ib, II, III, IV, and V. RESULTS: Minimal inhibitory concentration range of 60 GBS from pregnant women were penicillin G 0.015-0.12 microgram/ml, vancomycin 0.5-2 microgram/ml, clindamycin 0.015-4.0 microgram/ml, chloramphenicol 2-4 microgram/ml, erythromycin 0.015-2 microgram/ml, tetracycline 0.5-256 microgram/ml, cephalothin 0.12-0.25 microgram/ml, ceftriaxone 0.03-0.12 microgram/ml, respectively. The resistance rate of GBS were 6.7% to clindamycin, 0% to erythromycin, and 98.3% to tetracycline. Most of GBS serotypes from pregnant women in decreasing order were Ib(48.3%), Ia(24.1%), III(20.7%). CONCLUSION: All GBS strains isolated from pregnant women are highly susceptible to commonly used antimicrobial agents with the exception of tetracycline. The low prevalence of severe neonatal GBS infections in Korea is not due to the absence of serotype III, but probably due to a low genital carriage rate of GBS by pregnant women.
Agar ; Agglutination Tests ; Anti-Infective Agents ; Ceftriaxone ; Cephalothin ; Chloramphenicol ; Clindamycin ; Colon ; Erythromycin ; Female ; Humans ; Incidence ; Infant, Newborn ; Korea ; Penicillin G ; Pregnant Women* ; Prevalence ; Serotyping ; Tetracycline ; Vancomycin