Dried specimens of the genus Inocybe collected from mountain areas throughout the Korean country from 1982 to 1998 and preserved in NIAST were investigated. Out of them, Inocybe hystrix were confirmed as an unrecorded species in Korea. In 1991 Lee et al., previously recorded Inocybe kasukayamensis only with its scientific name and korean common name. In this study we report it with full descriptions of morphological characteristics and diagnosis of micro-structures of this species.
Diagnosis ; Korea* ; Porcupines

Apert syndrome is an uncommon congenital disorder characterized by malformation of the skull, most often acrocephaly or oxycephaly, in association with symmetrical syndactyly of both hands and feet. It is due to a disturbance in the growth of bone and soft tissue, affecting principally the head, hands, and feet. Recently we experienced a typical Apert syndrome expressed only in one neonate of dizygotic twin.
Acrocephalosyndactylia* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Craniosynostoses ; Foot ; Hand ; Head ; Humans ; Infant, Newborn* ; Skull ; Syndactyly ; Twins, Dizygotic*

PURPOSE: We investigated the causative organism and its antibiotic susceptibility of community acquired urinary tract infection (UTI) in children at a secondary hospital to test the adequacy of the current guidelines. METHODS: Children diagnosed with UTI at the Department of Pediatrics, Kwandong University Myongji Hospital by pyuria and bacterial growth of greater than 1.0x10(5) CFU/mL on clean catch midstream urine from January 2005 to December 2008 were studied retrospectively. The epidemiologic data, causative organism, and the antibiotic susceptibility were analyzed. RESULTS: Sixty two children were diagnosed with sixty four cases of UTI's. Two bacteria were isolated in one case and thus data on 65 urine cultures were analyzed. The male:female ratio was 1.6:1 and 78.1% were less than 12 months of age. Escherichia coli was the predominant cause consisting of 53 cases (82.8%) of the cases. K. pneumoniae (5), Enterobacter (4), Enterococcus (1), beta-streptococcus (1), Diphtheroides (1) were isolated. The antibiotic resistance of E. coli were as follows; ampicillin 69.8%, cefotaxime 1.9%, gentamicin 15.1%, amikacin 0.0%, levofloxacin 1.9%, and trimethoprim/sulfamethoxazole 26.4%. Only one case of the E. coli was extended spectrum beta-lactamase (ESBL) positive. CONCLUSION: Compared to prior reports from other tertiary hospitals in Korea, E. coli was the predominant cause in childhood UTI and the rate of ESBL positivity was low. The antibiotic resistance was also different compared to prior reports. We conclude that a difference in the cause and antibiotic resistance of childhood UTI exists between centers and this should be taken into consideration when prescribing antibiotics for childhood UTIs.
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Bacteria ; beta-Lactamases ; Cefotaxime ; Child ; Drug Resistance, Microbial ; Enterobacter ; Enterococcus ; Escherichia coli ; Gentamicins ; Humans ; Korea ; Ofloxacin ; Pediatrics ; Pneumonia ; Pyuria ; Retrospective Studies ; Tertiary Care Centers ; Urinary Tract ; Urinary Tract Infections

A retrospective study of 2,603 patients with gastric cancer who underwent a gastric resection at Yonsei University Hospital from 1987 to 1994 was performed to evaluate the clinicopathological characteristics and survival rates of patients with gastric cancer. There were 1721 males and 882 females (ratio=2:1) with a mean age of 54 years (range=22~85 years). All patients underwent gastric resection with curative intent, but 199 patients (7.6%) had a palliative resection. The types of operations were a subtotal gastrectomy in 1,917 patients (73.6%) and a total gastrectomy in 686 patients (26.4%). A D2 or a more extended lymph-node dissection was performed in 2530 patients (97.2%), and only 73 patients (2.8%) had less extensive surgery. The postoperative mortality was 0.9%. The mean diameter of a tumor was 5.6 cm. The most common location of a tumor was the lower third of the stomach (49.4%). Borrmann type III (64.7%) was the most common gross type. The major histologic type was a tubular adenocarcinoma (76.3%). The overall 5-year survival rate was 66.5%. The 5-year survival rates according to the stage were 94.3% in IA, 90.5% in IB, 76.6% in II, 60.1% in IIIA, 38.7% in IIIB, and 12.9% in IV. In the univariate analysis, poor survival was closely related to increasing age, tumor location in the upper one third, larger tumor size, Borrmann type IV tumors, increasing pT and pN classifications, an advanced tumor stage, and perforance of a total gastrectomy. The multivariate analysis revealed that distant metastasis, lymph-node metastasis, depth of invasion, gross type, age, and type of resection were significant prognostic factors. In conclusion, the prognosis for gastric cancer after a gastrectomy has remarkably improved, and the most significant prognostic factors were distant metastasis, lymph node metastasis, and depth of invasion. Therefore, early diagnosis of gastric cancer and aggressive multimodal therapy, especially in patients with stage IIIB and IV tumors might improve the quality of life and the survival of the patients with gastric cancer.
Adenocarcinoma ; Classification ; Early Diagnosis ; Female ; Gastrectomy* ; Humans ; Lymph Nodes ; Male ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Quality of Life ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; Survival Rate*

Combined resection of the spleen during total gastrectomy for gastric cancer is usually performed to remove the lymph nodes adequately and thereby achieving surgical radicality. However there is still controversy whether a total gastrectomy combined with a splenectomy can improve the survival rate. The authors retrospectively analyzed 557 gastric cancer patients, who underwent total gastrectomy at the Department of Surgery of Yonsei University during the 7-year period between 1987 and 1993, in order to investigate the influence of combined resection of the spleen upon the patients' survival. The patients were followed until March 1996, and the rate of follow up was 90.6%. The number of cases in which the spleen was saved was 101(the spleen conservation group, SC) and the number of cases in which the spleen was resected was 431(the spleen resection group, SR). Twenty-five cases were excluded due to incomplete data. Among the 431 cases for whom splenectomy was done, 343 were cases in which spleen was the only organ removed other than the stomach (SOR). For the other 88 cases, at least 1 more organs were resected along with the stomach and the spleen(Sp combined). There were no significant differences in the clinical characteristics such as age, sex ratio, tumor size, depth of invasion, nodal stage, TNM stage and histological type between SC and SOR group. In terms of the nodes removed during operation, there was significant difference between the SC and the SOR groups. Also, the Sp combined group showed significant differences in terms of tumor size, depth, nodal stage, TNM stage, and removed nodes. The overall 5-yr survival rate for the spleen conservation group(SC, N=101) was 61.2% and the survival rates according to TNM stage were 94.0% for stage I, 94.1% for stage II, 30.0% for III, and 0.0% for stage IV. The overall 5-yr survival rate for the 343 patients with splenectomy(SOR) was 51.9%, and the survival rates according to TNM stages were 88.7% for stage I, 57.0% for II, 44.0% for III, and 10.8% for stage IV. The overall 5-yr survival rate for the 431 patients with splenectomies or with splenectomies and multiple organ resection(SR) was 48.2%, and the survival rates according to the stages were 88.2% for stage I, 60.2% for II, 41.5% for III, and 6.8% for stage IV. The overall 5-yr survival rate was higher in SC group than in the SOR or the SR groups, but there was no statistical significance to this difference (p>0.05). In a compared according to the TNM stage, the SC group showed better survival rates in the relatively early stages (I, II) than the SOR or the SR groups did; in advanced stages (III, IV), the SOR and the SR groups showed better survival rates than the SC group. However, there was no statistically significant differences in survival among the three groups. These results suggest that during a total gastrectomy, it may be better to save the spleen in early stages of gastric cancer and that it may be better to resect the spleen for adquate lymphadenectomy in grossly advanced stages. To identify statistical difference in survival, it might be necessary to perform a randomized prospective study.
Follow-Up Studies ; Gastrectomy* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Retrospective Studies ; Sex Ratio ; Spleen* ; Splenectomy ; Stomach ; Stomach Neoplasms* ; Survival Rate

BACKGROUND: Palonosetron is a recently introduced 5-hydroxytryptamine-3 (5-HT3) receptor antagonist useful for postoperative nausea and vomiting prophylaxis. However, 5-HT3 receptor antagonists increase the corrected QT (QTc) interval in patients who undergo general anesthesia. This retrospective study was performed to evaluate whether palonosetron would induce a QTc prolongation in patients undergoing general anesthesia with sevoflurane. METHODS: We reviewed a database of 81 patients who underwent general anesthesia with sevoflurane. We divided the records into palonosetron (n = 41) and control (n = 40) groups according to the use of intraoperative palonosetron, and analyzed the electrocardiographic data before anesthesia and 30, 60, 90, and 120 min after skin incision. Changes in the QTc interval from baseline, mean blood pressure, heart rate, body temperature, and sevoflurane concentrations at each time point were compared between the two groups. RESULTS: The QTc intervals at skin incision, and 30, 60, 90, and 120 min after the skin incision during general anesthesia were significantly longer than those at baseline in the two groups (P < 0.001). The changes in the QTc intervals were not different between the two groups (P = 0.41). However, six patients in the palonosetron group showed a QTc interval > 500 ms 30 min after skin incision, whereas no patient did in the control group (P = 0.01). No significant differences were observed between the two groups in mean blood pressure, body temperature, heart rate, or sevoflurane concentrations. CONCLUSIONS: Palonosetron may induce QTc prolongation during the early general anesthesia period with sevoflurane.
Anesthesia ; Anesthesia, General* ; Arrhythmias, Cardiac ; Blood Pressure ; Body Temperature ; Electrocardiography ; Heart Rate ; Humans ; Incidence* ; Isoquinolines ; Laparotomy* ; Methyl Ethers ; Patient Safety ; Postoperative Nausea and Vomiting ; Quinuclidines ; Receptors, Serotonin, 5-HT3 ; Retrospective Studies ; Skin

There has been considerable controversy over the prognosis of mucinous gastric enocarcinoma (MGC). In this study we analyzed the clinicopathologic fferences between MGC and non-mucinous gastric carcinoma (NMGC). In addition, e relationship between mucin content and other clinicopathologic variables, cluding prognosis in MGC, was also investigated. We reviewed 2118 patients th pathologically-confirmed gastric cancer who underwent gastrectomy at the partment of Surgery, Yonsei University College of Medicine, during the period tween Jan. 1987 and Dec. 1993. Among them, 130 patients had gastric carcinoma th extracellular mucin (MGC) and 1988 patients had gastric carcinoma without tracellular mucin (NMGC). We placed the MGC patients into two groups according mucin content: mucin content involving over 50% of the tumor (dominant type, = 94) and mucin content involving less than 50% of the tumor area (partial pe, n = 36). The results were as follows: MGC was more common in males than GC. The size of the tumor in MGC (mean 5.3 cm) was larger than that of NMGC ean 4.4 cm). The patients with MGC had a higher incidence of Borrmann type IV GC: 16.1%, NMGC: 9.9%), more frequent serosal invasion (MGC: 75.4%, NMGC: .6%), lymph-node metastasis (MGC: 75.4%, NMGC: 50.7%), and peritoneal tastasis (MGC: 10.0%, NMGC: 3.5%) than patients with NMGC. The patients with C were more advanced in stage at the time of diagnosis and had a worse overall -year survival rate (44.9%) than patients with NMGC (54.7%). However, the -year survival rate according to the stage of MGC was similar to that of NMGC. ere were no significant differences between the mucin content and other thologic variables, including prognosis, i.e. similar biologic behavior tween dominant type MGC and partial type MGC. In conclusion, we suggest that C was more frequently diagnosed in advanced stage than NMGC with a poorer ognosis and that it is reasonable to consider the carcinoma with mucin content volving more than 30% of the tumor area as MGC.
Adenocarcinoma/pathology ; Adenocarcinoma/metabolism ; Adenocarcinoma, Mucinous/pathology* ; Adenocarcinoma, Mucinous/metabolism* ; Adult ; Aged ; Aged, 80 and over ; Female ; Human ; Male ; Middle Age ; Mucins/metabolism ; Neoplasm Staging ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/metabolism*

PURPOSE: Until several years ago, gastric or hepatic resection was seldom indicated for metastatic gastric cancer because of the expected dismal prognosis. Recently, some studies have reported benefits from gastric or hepatic resection for metastatic gastric cancer. We performed this retrospective study to see the prognosis after aggressive surgery in gastric cancer patients with hepatic metastasis. MATERIALS AND METHODS: A total of 112 gastric cancer patients were confirmed to have liver metastasis at the time of initial surgery or preoperative evaluation during the 8-year period from January, 1987 to December, 1994 at the Department of Surgery, Yonsei University, College of Medicine. Thirty eight cases (33.9%) underwent gastrectomy (total gastrectomy: 15, subtotal gastrectomy: 23). Of these 38 cases, 12 underwent a combined resection of metastatic hepatic tumors (segmentectomy: 7, wedge resection: 3, lobectomy: 1 and enucleation: 1). RESULTS: The locations of primary lesion were most common in the lower 1/3 of the stomach in all of the nonresected, the gastrectomy only, and the gastrectomy & hepatectomy group. Most of the cancers belonged to Borrmann type III and IV. Histologically, dedifferentiated cancer (poorly differentiated cancer, signet ring cell cancer, mucinous cancer) was more frequent in the nonresected group (67.4%) while differentiated cancer (papillary cancer, well differentiated cancer, moderately differentiated cancer) was more frequent in the resected group (60.9%). The number of metastatic hepatic nodules were less than two in the resected group and the location of metastatic lesions tended to be limited to one lobe. Concerning the prognosis, the mean survival of the resected group was better than the nonresected group (nonresected group: 8.4 months, gastrectomy only group: 18.4 months, gastrectomy & hepatectomy group: 35.5 months). The mean score of QOL (quality of life) according to Spitzer index was better in the resected group (nonresected group: 5.1, gastrectomy only group: 6.0, gastrectomy & hepatectomy group: 7.5). CONCLUSION: Resection of both the primary gastric lesion and the metastatic hepatic lesion should be considered in selected cases to improve the survival and the quality of life in patients with hepatic metastasis.
Gastrectomy ; Hepatectomy ; Humans ; Liver* ; Mucins ; Neoplasm Metastasis* ; Prognosis* ; Quality of Life ; Retrospective Studies ; Stomach ; Stomach Neoplasms*

Carcinosarcoma of the pancreas is a rare malignant tumor that shows a combined or mixed proliferation of carcinomatous and sarcomatous cells. This tumor has been variously called carcinosarcoma, pleomorphic large cell carcinoma, giant cell carcinoma, and undifferentiated carcinoma. A 52-year-old man was hospitalized for evaluation of his epigastric pain and jaundice. An abdominal computed tomography revealed the presence of a poorly enhancing mass, arising from the head of the pancreas. Pylorus preserving pancreaticoduodenectomy was performed. The final pathologic diagnosis was undifferentiated carcinoma with 2 distinct components. One component was a conventional infiltrating pancreatic ductal adenocarcinoma, and the other component was sarcoma. We present here a case of carcinosarcoma of the pancreas along with a review of the literatures.
Adenocarcinoma ; Carcinoma ; Carcinoma, Giant Cell ; Carcinoma, Large Cell ; Carcinosarcoma* ; Diagnosis ; Head ; Humans ; Jaundice ; Middle Aged ; Pancreas* ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Pylorus ; Sarcoma

Objectives: This study aimed to assess the antibacterial, bactericidal, and mouth freshener effects of lysozyme hydrochloride 0.01%, sodium fluoride 0.02%, and cetylpyridinium chloride 0.05%. Methods: Eight oral disease-related bacteria were cultivated anaerobically. Four samples were prepared with or without 0.5% cetylpyridinium chloride, 0.2% sodium fluoride, and 0.1% lysozyme hydrochloride. Antimicrobial activity was tested in 96-well microplates. After assessing the bacterial count, the bacterial suspension was mixed with samples and spread on agar. The bactericidal rate was calculated by counting and comparing treated and untreated colonies. Results: Lysozyme hydrochloride 0.01%, sodium fluoride 0.02%, and cetylpyridinium chloride 0.05% mouth fresheners sterilized 99.99% of 8 oral bacteria, including Streprococcus mutans. Lysozyme hydrochloride 0.01%, sodium fluoride 0.02%, and cetylpyridinium chloride 0.05% mouth fresheners showed 99.97% bactericidal activity against Lactobacillus acidophilus. Conclusions Lysozyme hydrochloride 0.01%, sodium fluoride 0.02%, and cetylpyridinium chloride 0.05% mouth fresheners confirmed the sterilization and antibacterial effects on oral disease-causing bacteria.