Many reports have been made concerning underlying and associated conditions causing pseudomembranous colitis and it has been documented that occurrence of pseudomembranous colitis is related with antibiotics administration. Recent study showed that Clostridium difficile produced enterotoxin by colonization in intestinal wall and leading into pseudomembranous colitis. Diagnosis is based on positive culture of Clostridium difficile, positive test of Clostridium difficile toxin and specific histological findings after observation of whitish plaque on colonoscopic or sigmoidoscopic examination. Authors have experienced one case of pseudomembranous colitis developing after long term ampicillin administration in a case with colon cancer associated with diarrhea and diagnosis was confirmed by typical pseudomembrane on biopsy following classical whitish plaque absevation on sigmoidoscopic examination. Symptoms have been ameliorated by discontinuation of antibiotics and administration of metron-idazole in four days and disappearance of whitish plaque on repeated sigmoidoscopic examination and improvement of clinical symptoms after 9 days of medication.
Ampicillin ; Anti-Bacterial Agents ; Biopsy ; Clostridium difficile ; Colon ; Colonic Neoplasms ; Diagnosis ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Enterotoxins

PURPOSE: Information has been limited on the genetic control of germ cell apoptosis and its role in the pathogenesis of male infertility. The object of this study was to investigate the effects of c-kit gene expression and apoptosis on human spermatogenesis. MATERIALS AND METHODS: Testicular specimens were obtained from 90 infertile males with nonobstructive azoospermia(NOA) due to primary testicular failure and from 9 healthy volunteers. The specimens of infertile men were divided into 4 groups according to hitopathologic findings: Sertoli cell only(SCO) syndrome(A), maturation arrest(B), hypospermatogenesis(C) and disorganization with sloughing(D). C-kit gene expression and apoptosis were detected with immunohistochemical stain. RESULTS: The frequency of c-kit expression was lower(p<0.05) and that of apoptosis was higher(p<0.01) in infertility groups B, C, and D compared to that of the control group. A significant inverse correlation was observed in the c-kit gene expression and apoptosis in groups B, C and D(p<0.05). A similar relationship was also observed in the Sertoli cells in group D and the control group. CONCLUSIONS: With the result, we suggest that variation in c-kit gene expression and apoptosis are associated with abnormal spermatogenesis and play a role in the pathophysiology of male infertility.
Apoptosis* ; Gene Expression ; Germ Cells ; Healthy Volunteers ; Humans ; Infertility ; Infertility, Male ; Male ; Sertoli Cells ; Spermatogenesis* ; Testis

Nerve conduction studies help delineate the extent and distribution of the neural lesion. The nerve conduction was studied on upper (median, ulnar and radial nerves) and lower (personal, posterior tibial and sural nerves) extremities in 83 healthy subjects 23 to 66 years of age, and normal values were established (Table 1). The mean motor terminal latency (TL): median, 3.6 (±0.6) milliseconds; ulnar, 2.9 (±0.5) milliseconds; radial nerve, 2.3 (±0.4) milliseconds. Mean motor nerve conduction velocity (MNCV) along distal and proximal segments: median, 61.2 (±9.1) (W-E) and 57.8 (±13.2) (E-Ax) meters per second; ulnar, 63.7 (±9.1) (W-E) and 50.6 (±10.0) meters per second. Mean sensory nerve conduction velocity (SNCV): median, 34.7 (±6.7) (F-W), 63.7 (±7.1) (W-E) and 62.8 (±12.3) (E-Ax) meters per second; ulnar, 38.0 (±6.7) (F-W), 63.4 (±7.5) (W-E) and 57.0 (±10.1) (E-Ax) meters per second; radial, 45.3 (±6.8) (F-W) and 64.2 (±11.0) (W-E) meters per second; sural nerve, 43.4 (±6.1) meters per second. The amplitudes of action potential and H-reflex were also standardized. Mean H latency was 28.4 (±3.2) milliseconds. And, the fundamental principles, several factors altering the rate of nerve conduction and clinical application of nerve stimulation techniques were reviewed.
Action Potentials ; Adult* ; Extremities ; H-Reflex ; Healthy Volunteers ; Humans ; Neural Conduction* ; Radial Nerve ; Reference Values ; Sural Nerve

Complications of penile prosthesis include malfunction, infection and patient dissatisfaction. Herein, a rare complication of a retained reservoir having eroded into the bladder after the removal of the penile components of a three-piece penile prosthesis, is reported. A 39-year-old man complained of irritative voiding symptoms. The symptoms had developed 4 years after the removal of the penile components of the prosthesis. The erosion of the reservoir into the bladder was discovered incidentally during the treatment of bladder calculi. The reservoir was removed by an open vesicolithotomy.
Adult ; Calculi ; Cytochrome P-450 CYP1A1 ; Humans ; Penile Prosthesis* ; Prostheses and Implants ; Urinary Bladder Calculi* ; Urinary Bladder*

Bifidobacterium longum, indigenous bacteria of the gastrointestinal tract, is a species of anaerobic non-spore-forming gram-positive bacilli, and appears to play an important role in preventing overgrowth of pathogenic bacteria. This organism is very rarely isolated from clinical specimens. It is known to be very difficult to identify Bifidobacterium longum due to not only the variability in aerotolerance, colony morphology and stainability on gram staining, resulting the failure of distinguishing from other anaerobic non-spore-forming gram-positive bacilli by the conventional biochemical tests. Definitive identification of genus Bifidobacterium requires the analysis of the end-products of metabolism, volatile and non-volatile fatty acids, by gas-liquid chromatography (GLC). We report a case of sepsis caused by Bifidobacterium longum in a 19-year-old male who developed high fever, jaundice and hepatomegaly after he had been introduced with many small gold needles. Anaerobic non-spore-forming gram-positive bacilli were isolated from his blood and identified as Bifidobacterium longum by performing biochemical tests and the analysis of the metabolic end-products by GLC. He has been completely recovered after ticarcillin and metronidazole therapy. To our knowledge, this is the first report of incidental sepsis by Bifidobacterium longum in the world.
Bacteria ; Bifidobacterium* ; Chromatography, Gas ; Fatty Acids ; Fever ; Gastrointestinal Tract ; Hepatomegaly ; Humans ; Jaundice ; Male ; Metabolism ; Metronidazole ; Needles ; Sepsis* ; Sulfalene* ; Ticarcillin ; Young Adult

Granular cell tumor is characterized by large eosinophilic cells with granular appearances. These are mostly benign. Approximately 1~2% are malignant, and establishment of reliable criteria for diagnosing malignant granular cell tumor has been difficult to establish because of the rarity. Reports on the cytologic features of this neoplasm are hardly found in Korea. We report a case of rarely-occurring granular cell tumor in the lower leg of a 40-year-old male, diagnosed on fine needle aspiration cytology, together with a review of the literature regarding significant adverse histology and prognostic factors. The aspirates revealed cellular smears of isolated cells, syncytial clusters, and occasionally stripped nuclei in a fine, bluish-purple, granular background. Tumor cells were polygonal, rounded, or slightly spindled, and showed ill-defined granular cytoplasm. Nuclei were small and round or oval, with inconspicuous or small, prominent nucleoli. The nuclei showed rare intranuclear cytoplasmic invagination. Occasionally, there were mild to moderate nuclear pleomorphisms with vesicular nuclei, with large, prominent nucleoi, but no mitosis. The immunocytochemical stain for S-100 was strongly positive in the cytoplasm of tumor cells with occasional nuclei.
Adult ; Biopsy, Fine-Needle* ; Cytoplasm ; Eosinophils ; Granular Cell Tumor* ; Humans ; Korea ; Leg* ; Male ; Mitosis

It is now well established that acute subarachnoid hemorrhage secondary to rupture of a cerebral aneurysm can precipitate life-threatening cardiac arrhythmia. We experienced a 60 year old patient with a subarachnoid hemorrhage (neurologic grade III) due to rupture of anterior communicating artery aneurysm who presented with such intraoperative electrocardiographic changes as ST segment elevation and T wave inversion which are hallmark of acute myocardial infarction. The operation was uneventfully ended. On the postoperative laboratory examination about suspected acute myocardial infarction, the patient was found to have normal triple enzyme study and echocardiographic finding. The electrocardiogram three days after subarachnoid hemorrhage due to cerebral aneurysm returned to normal sinus rhythm. This case suggests that this patient's electrocardiographic change simulating acute myocardial infarction is transient change due to subarachnoid hemorrhage.
Arrhythmias, Cardiac ; Echocardiography ; Electrocardiography* ; Humans ; Intracranial Aneurysm ; Middle Aged ; Myocardial Infarction* ; Rupture ; Subarachnoid Hemorrhage*

PURPOSE: The purpose of this study is to illustrate MR patterns of signal intensity of proximal femur in normal subjects according to the age distribution. METHOD AND MATERIAL: Tl-weighted MR images of the proximal femur in 125 subjects, aged 13 days to 25 years, were retrospectively analyzed. Age distribution was classified to 4 groups;below 4 months, 5 months to 4 years, 5 years to 14 years, and 15 years to 25 years. RESULTS: By the age of 4 months, the non-ossified femoral epiphysis was seen as intermediate-signal-intensity cartilage. At 5 months-4 years, the ossified fernoral capital epiphysis was seen within intermediate-signal-intensity cartilage and appeared as decreased or increased signal-intensity red or yellow marrow surrounded by a rim of low-signal-intensity cortical bone. At 5-14 years, the ossified femoral capital and greater trochanteric epiphysis were seen within the intermediate-signal-intensity cartilage and appeared as decreased or increased signal-intensity red or yellow marrow. At 15-25 years, the proximal metaphyseal marrow showed increased signal intensity. Four patterns of the metaphyseal marrow were recognized by Ricci et al. The frequency of pattern la progressively decreased with age. Pattern 2 and 3 were visible in the 15-25 years age group. CONCLUSION: An understanding of the spectrum of normal age-related change of the proximal femoral cartilage and marrow patterns serves as the foundation for interpretation of proximal femur pathologies.
Age Distribution ; Bone Marrow ; Cartilage ; Epiphyses ; Femur* ; Humans ; Magnetic Resonance Imaging* ; Pathology ; Retrospective Studies

A 65-year-old woman visited our hospital with a complaint of acute onset dyspnea and radiological manifestations of pulmonary thromboembolism. The patient underwent an exploratory surgery to find a whitish-blue colored mass occupying almost the whole lumen of the main pulmonary arteries. Based on the pathological and radiological findings, the patient was diagnosed to have a pulmonary arterial intramural hematoma. Intramural hematomas are usually observed in the walls of the aorta, and we believe that an isolated intramural hematoma in the pulmonary artery has not been described previously.
Aged ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Female ; Hematoma/*diagnosis/*surgery ; Humans ; Magnetic Resonance Imaging ; *Pulmonary Artery ; Thromboembolism/diagnosis ; Tomography, X-Ray Computed

BACKGROUND: Etomidate is short-acting non-barbiturate intravenous anesthetic with minimal cardiovascular depression. As a small change in venous capacitance significantly alters venous return and thus cardiac output, it is important to know the effects of intravenous anesthetics on venous capacitance. The purpose of this study was to examine the effect of etomidate or pentobarbital (control agent) on venous capacitance. METHOD: All twenty rats (etomidate group: 10, pentobarbital group: 10), weighing 350-450 gram, were anesthetized with pentobarbital 50 mg/kg given intraperitoneally for surgical preparation. Mean arterial pressure (MAP), heart rate (HR), and mean circulatory filling pressure (MCFP) were measured in the awake state(recovered from pentobarbital anesthesia for surgical preparation) as well as during anesthesia with etomidate or pentobarbital. Venous capacitance was assessed before and during anesthesia with etomidate or pentobarbital by measuring MCFP. MCFP was measured during a brief period of circulatory arrest produced by inflating a balloon inserted in right atrium. RESULTS: As compared with MCFP in the corresponding awake state, MCFP was not significantly altered by etomidate but significantly decreased by pentobarbital. As compared with MAP in the corresponding awake state, MAP was not significantly altered by etomidate but significantly decreased by pentobarbital. CONCLUSION: The results suggest that unaltered venous capacitance by etomidate may contribute to a maintained MAP but increased venous capacitance by pentobarbital decrease in MAP of the normovolemic rat.
Anesthesia ; Anesthetics, Intravenous ; Animals ; Arterial Pressure ; Cardiac Output ; Depression ; Etomidate* ; Heart Atria ; Heart Rate ; Pentobarbital ; Rats*