Urethral duplication is rare congenital anomaly. It may be complete or partial, We report a case of PPNG urethritis which limited to the accessory urethra and treated with kanamycin (2. 0gm, im), ampicillin(3. 5gm, po) and probenecid(l pgm, po).
Kanamycin ; Urethra* ; Urethritis*

The treatment of gonorrhea caused by beta-strains of N. gonorrhoeae is quite different from that of non-beta-strains, but it is not always possible in general practice to take cultures of gonococci to detect p-lactamase producing organisms. Therefore treatment regimens commonly used for gonorrhoea should be effective against both PPNG non-PPNG strains. Eighty-seven male uncomplicated gonorrheal patients were treated with intramuscular kanarnycin 2gm in combilnation with talampicillin 2. 5 gm plus probenecid 1grn orally. Sixty-seven patients were followed up. All patients recovered. Ten patients among sixty-seven patients had PPNG. A regimen of intramuscular kanamycin 2 gm, talampicillin 2. 5 gm plus probenecid 1 0 gm orally seems to be one of the most cost effective regimens in Korea.
General Practice ; Gonorrhea* ; Humans ; Kanamycin* ; Korea ; Male* ; Probenecid ; Talampicillin*

PURPOSE: To evaluate the risk of vertebral compression fracture (VCF) after conventional radiotherapy (RT) for colorectal cancer (CRC) with spine metastasis and to identify risk factors for VCF in metastatic and non-metastatic irradiated spines. MATERIALS AND METHODS: We retrospectively reviewed 68 spinal segments in 16 patients who received conventional RT between 2009 and 2012. Fracture was defined as a newly developed VCF or progression of an existing fracture. The target volume included all metastatic spinal segments and one additional non-metastatic vertebra adjacent to the tumor-involved spines. RESULTS: The median follow-up was 7.8 months. Among all 68 spinal segments, there were six fracture events (8.8%) including three new VCFs and three fracture progressions. Observed VCF rates in vertebral segments with prior irradiation or pre-existing compression fracture were 30.0% and 75.0% respectively, compared with 5.2% and 4.7% for segments without prior irradiation or pre-existing compression fracture, respectively (both p < 0.05). The 1-year fracture-free probability was 87.8% (95% CI, 78.2-97.4). On multivariate analysis, prior irradiation (HR, 7.30; 95% CI, 1.31-40.86) and pre-existing compression fracture (HR, 18.45; 95% CI, 3.42-99.52) were independent risk factors for VCF. CONCLUSION: The incidence of VCF following conventional RT to the spine is not particularly high, regardless of metastatic tumor involvement. Spines that received irradiation and/or have pre-existing compression fracture before RT have an increased risk of VCF and require close observation.
Colorectal Neoplasms* ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Incidence ; Multivariate Analysis ; Neoplasm Metastasis ; Radiotherapy ; Retrospective Studies ; Risk Factors ; Spinal Fractures ; Spinal Neoplasms ; Spine*

Locoregional failure of rectal cancer is a troublesome problem and a major cause of morbidity and mortality following curative surgery. The mesorectum has been regarded as an important site in local failure after surgery of rectal cancer. Total mesorectal excision (TME) has been raised by some colorectal surgeons to prevent early local recurrence. This study was performed to ascertain the incidence of metastatic lymph nodes in the distal mesorectum (DMR) of the colorectal cancer patient. We also examined the clinicopathologic risk factors of distal mesorectal metastasis. Eight of 53 patients had positive metastatic lymph nodes in DMR. Twenty-seven patients were Dukes B and 26 patients were Dukes C stage. Out of 26 Dukes C patients, 8 patients (30.8%) had metastatic lymph nodes in the DMR. However, there was no significant difference in risk factors between DMR positive and DMR negative patients with Dukes C stage. In conclusion, the incidence of metastatic lymph nodes in DMR was about 30.8%, therefore the mesorectum especially the DMR should be removed completely by total mesorectal excision to eradicate the metastatic lymph nodes which may cause local recurrence.
Aged ; Female ; Human ; *Lymphatic Metastasis ; Male ; Middle Age ; Neoplasm Invasiveness ; Postoperative Period ; Rectal Neoplasms/pathology/*surgery ; Rectum/*surgery

Primary carcinoma of the fallopian tube is an extremely rare malignancy of the female genital tract. We have experienced two cases of primary carcinoma in the fallopian tube. One case with huge mass which was diagnosed incidentally on the basis of the biopsy findings, and the other case of the 3 years follow-up. We reported the cases with a brief review of the concemed literatures.
Biopsy ; Fallopian Tubes* ; Female ; Follow-Up Studies ; Humans

A 27-year-old parturient in her gestational age of 38(+4) weeks was admitted to the obstetric emergency room due to fetal distress and suspected pneumoperitoneum after a failed intubation during anesthetic induction for cesarean delivery, which occurred at an obstetric clinic. On admission, she was drowsy, her abdomen was excessively distended, and the fetal heart tone was inaudible. An emergency cesarean section was performed after a standard laryngeal mask airway (size 4) was inserted for general anesthesia. At the moment the peritoneum was opened, a great amount of free air escaped. A floppy baby was delivered with an Apgar score 1 at 1 min and 4 at 5 min. Before transfer to the neonatal intensive care unit, the baby was resuscitated and intubated. Immediately after the cesarean section was completed, an emergency exploratory laparotomy was carried out. During the laparotomy, a linear tear, 8.2 cm long, along the lesser curvature of stomach was identified and repaired. The patient and her baby recovered uneventfully and were dischargedon the 7(th) postoperative day.
Abdomen ; Adult ; Anesthesia, General ; Apgar Score ; Cesarean Section* ; Emergencies ; Emergency Service, Hospital ; Female ; Fetal Distress ; Fetal Heart ; Gestational Age ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Intubation* ; Laparotomy ; Laryngeal Masks ; Peritoneum ; Pneumoperitoneum ; Pregnancy ; Stomach ; Stomach Rupture* ; United Nations

The clinicopathological findings in 9 patients with germ cell tumors originating in the basal ganglia and thalamus are presented. The incidence of germ cell tumors of the basal ganglia and thalamus was 16.4% of all 55 cases of primary intracranial germ cell tumors. These included 6 cases of germinomas and 3 cases of malignant mixed germ cell tumors(MGCT). The average age at diagnosis was 16.9 years(range 9.5-39 years). The sex incidence showed male dominance(8:1). The clinical course of germinoma in the basal ganglia and thalamus was slowly progressive and the average duration of symptoms before diagnosis was 29 months. The most common symptom and sign was hemiparesis and which was not normalized in all cases in spite of complete response to irradiation or chemotherapy. In case of germinomas, symptoms of increased intracranial pressure were found in only 1 case. Germinomas in the basal ganglia and thalamus had characteristic radiological findings different from that of pineal or suprasellar germinomas : irregular mixed density or signals. Therapy consisted of stereotactic biopsy and irradiation in 6 cases, subtotal removal followed by irradiation and chemotherapy in 1 case, irradiation alone in 1 case and chemotherapy alone in 1 case. Of the 6 patients with germinoma, 5 are alive and disease free for 5 to 111 months after diagnosis(mean 57 months, median 62 months), but one patient died of recurrence on the primary site, temporal lobe, and cerebellum 87 months after cranial irradiation. Only 1 of 3 patients with malignant MGCT is still living 6 months after diagnosis, he showed complete response to chemotherapy and is now under maintenance of chemotherapy. There was no recovery of hemiparesis in patient with advanced germinoma in this region, early detection and treatment on the basis of biopsy, radiological findings and tumor marker study are essential in the management of germ cell tumors originating in the basal ganglia and thalamus.
Basal Ganglia* ; Biopsy ; Cerebellum ; Cranial Irradiation ; Diagnosis ; Drug Therapy ; Germ Cells* ; Germinoma ; Humans ; Incidence ; Intracranial Pressure ; Male ; Neoplasms, Germ Cell and Embryonal* ; Paresis ; Recurrence ; Temporal Lobe ; Thalamus*

No abstract available.
Endometriosis* ; Female ; Humans ; Hyperplasia* ; Leiomyoma*

OBJECTIVE: Transabdominal cervico-isthmic cerclage(TCIC) may increase the fetal salvage rate and pregnancy outcome in selected women when poor obstetric outcome is related to previously failed transvaginal cervical cerclage and an anatomically defective cervix. Our purpose was to evaluate the outcomes after transabdominal cervicoisthmic cerclage during pregnancy. STUDY DESIGN: A retrospective review was done from patients who had been received transabdominal cervicoisthmic cerclage during pregnancy at Hanyang University Medical Center from October, 1989 to April 1997. The fetal salvage rate before and after post-conceptional transabdominal cervicoisthmic cerclage were compared and analysed. RESULTS: The seventy-eight patients had 95 successful pregnancies out of a total of 97. Thus the fetal salvage rate of TCIC during in pregnancy was 97.9 %. Of 78 patients, nineteen patients had the second succesful pregnancies and repeat cesarean deliveries after TCIC. CONCLUSION: We conclude that the transabdominal cervicoisthmic cerclage during pregnancy offers a high fetal salvage rate with a minimal complications in patients with extremely poor obstertric histories as a result of cervical incompetence, where vaginal cerclage is not warranted.
Academic Medical Centers ; Cerclage, Cervical ; Cervix Uteri ; Female ; Humans ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Retrospective Studies ; Uterine Cervical Incompetence

PURPOSE: To investigate the patterns of locoregional recurrence of pathologic T3N0 (pT3N0) lower rectal cancer omitting postoperative radiotherapy (RT) and explore the potential of modification of a RT field. MATERIALS AND METHODS: From Jan 2003 to Nov 2011, 35 patients omitting preoperative or postoperative RT for pT3N0 lower rectal cancer were included. We defined the lower rectal cancer as the tumor with the inferior margin located below the virtual line-a convergent level between rectal wall and levator ani muscle. All patients had radiologic examinations for recurrence evaluation during the follow-up duration. RESULTS: The median follow-up duration was 66.4 months (range, 1.4 to 126.1 months). Eight (22.9%) of the 35 patients had recurrence. Three (8.6%) was local recurrence (LR) only, 3 (8.6%) was distant metastasis (DM) only, and 2 (5.7%) was LR with DM. All LR were located at primary tumor sites. The overall survival rate, LR-free survival rate, and DM-free survival rate at 5 years was 79.8%, 83%, and 87%, respectively. All LR developed from tumors over 5 cm. However, there was no statistical significance (p = 0.065). There was no other risk factor for LR. CONCLUSION: Even though the patients included in this study had pathologically favorable pT3N0 rectal cancer, LR developed in 14.3% of patients. Most of the LR was located at primary tumor sites prior to surgery. Based on these findings, it might seem reasonable to consider postoperative RT with a smaller radiation field to the primary tumor site rather than the conventional whole pelvic irradiation.
Follow-Up Studies ; Humans ; Muscles ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Radiotherapy, Adjuvant ; Rectal Neoplasms ; Recurrence ; Risk Factors ; Survival Rate