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

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

The aim of this study was to assess the feasibility and efficacy of laparoscopic myomectomy (LM) for large myomas. A subpopulation of 51 patients with myomas 8 cm or larger in diameter was selected from 155 patients who underwent LM at Kangbuk Samsung Hospital from July 2003 to November 2006. The mean age of the patients was 34.9+/-5.6 yr, mean parity was 0.6+/-0.9, and 8 patients had a previous operative history. The most common operative indication was a palpable abdominal mass (24 patients, 47%). The mean operating time was 85.6+/-38.9 min, and the mean diameter of the largest myoma was 9.3+/-1.8 cm. The mean change in hemoglobin concentration was 2.1+/-1.2 g/dL. Histopathological diagnosis included 49 patients of leiomyoma (96.1%) and 2 patients of leiomyoma with adenomyosis (3.9%). Postoperatively, a transfusion was done in 7 patients, and a case of subcutaneous emphysema was noted. None of the operations was switched to laparotomy. With the newly-developed screw and the port placement system that was modified from the Choi's 4-trocar method to obtain better surgical vision, LM of large myomas proved to be one of the efficient and feasible methods.
Adult ; Feasibility Studies ; Female ; Humans ; Laparoscopy/adverse effects/*methods ; Leiomyoma/pathology/*surgery ; Length of Stay ; Postoperative Complications/etiology ; Reproducibility of Results ; Subcutaneous Emphysema/etiology ; Treatment Outcome ; Uterine Neoplasms/pathology/*surgery

The gene for tyrosinase has been mapped to the long arm of chromosome 11 at 11q14-21. The gene is at least 50Kb in length and its coding region is divided into five exons. Until now several mutations of the tyrosinase gene have been identifed in patient with typical oculocutaneous albinism (OCA) who are responsible for tyrosinase negative OCA. It may be possible to determine the types of OCA by measuring the hairbulb tyrosinase activity. Hairbulb tyrosinase activity was examined in a Korean albino to determine the type of OCA. And also tyrosinase assay was carried out in normally pigmented individuals and all members of a Korean albino's family to examine the tyrosinase activities. Five exons of tyrosinase gene from a Korean albino were amplified by polymerase chain reaction. Each amplified exon segments were independently subcloned and DNA sequences of clones were determined. The results obtained were as follows : 1. A Korean albino had no measurable hairbulb tyrosinase activity and was identified as type IA (tyrosinase negative) oculocutaneous albinism. 2. Normally pigmented individuals had different ranges of hairbulb tyrosinase activity. 3. A Korean albino had two single base insertions within exon V (between 337bp and 338bp, 353bp and 354bp) of tyrosinase gene. These insertional mutations might disrupt tyrosinase function and were associated with a total lack of melanin biosynthesis.
Albinism* ; Albinism, Oculocutaneous ; Arm ; Base Sequence ; Chromosomes, Human, Pair 11 ; Clinical Coding ; Clone Cells ; Exons ; Humans ; Melanins ; Monophenol Monooxygenase* ; Polymerase Chain Reaction