PURPOSE: The overuse and misuse of antimicrobial agents and their resultant emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult. We studied the changes of antibiotic sensitivity to the causative organisms of urinary tract infection(UTI) for recent 5 years in order to give some useful informations about the choice of adequate drug in the treatment of UTI. MATERIALS AND METHODS: We analysed 1191 uropathogens and their antibiotic sensitivities of the 1132 patients who admitted or visited the National Police Hospital and had more than 105cfu/ml on urine culture from January 1994 to December 1998 retrospectively. RESULTS: The common pathogenic organisms were E. coli(51.5%), staphylococcus(15.7%), pseudomonas(9.1%), klebsiella(7.5%) and enterobacter(4.0%), enterococcus(3.4%), proteus(3.1%) in order. The incidence of E. coli decreased from 50.8% in 1994 to 41.3% in 1998 but the incidence of other gram negative organisms like pseudomonas, klebsiella, enterobacter, proteus and acinetobacter increased from 24.8% in 1994 to 42.6% in 1998. In E. coli isolates(the majority of positive cultures), resistance to six antibiotics changed significantly: ampicillin(19.4% to 15.5%), piperacillin(44.1% to 32.0%), cephalothin(70.6% to 58.6%), gentamicin(62.8% to 60.2%), tobramycin(95.0% to 88.1%), and ciprofloxacin(87.6% to 76.3%). The sensitivity rates of the gram negative organisms including E. coli were very low in 1998 (ampicillin 11.6%, piperacillin 36.6%, and trimethoprim/sulfamethoxazole 49.3%). CONCLUSIONS: We think that E. coli is still the most important organism in the UTI but we shoud be concerned about the increasing incidence of other gram negative organisms like pseudomonas, klebsiella, enterobacter, proteus and acinetobacter. And prior to receiving the bacteriological report, using ampicillin, trimethoprim/sulfamethoxazole as the first choice in the treatment of UTI shoud be reconsidered.
Acinetobacter ; Ampicillin ; Anti-Bacterial Agents ; Anti-Infective Agents ; Enterobacter ; Humans ; Incidence ; Klebsiella ; Piperacillin ; Police ; Proteus ; Pseudomonas ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract*

We report a case of male infertility secondary to pituitary apoplexy, which occurred as a sequela of korean hemorrhagic fever. A 32 years old male patient with past history of korean hemorrhagic fever was studied because of infertility and erectile impotence. The size of his testicles were about 8ml in Rt. and Lt. Semen analysis, endocrinologic studies, and brain MRI demonstrated hypogonadotrophic hypogonadism due to panhypopituitarism. The patient was treated with HCG (2,000 IU) administered intramuscularly three times per week for 6 months. After the treatment, improvement of male secondary sex characteristics such as hair growth and testicle size was noted. Promotion of sexual potency and improvement of semen quality were also noted. Following the treatment, his wife conceived after 6 months.
Adult ; Brain ; Erectile Dysfunction ; Hair ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hypogonadism ; Infertility ; Infertility, Male* ; Magnetic Resonance Imaging ; Male ; Male* ; Pituitary Apoplexy* ; Semen Analysis ; Sex Characteristics ; Spouses ; Testis

Von Recklinghausen`s neurofibromatosis is an unusual disorder with a wide variety Of manifestations. The initial findings may at times involve the female genitalia. When the phallus is affected, the urologist has an opportunity for the establishment of an accurate diagnosis as well as for cosmetic correction. We report a case of neurofibromatosis with an involvement of clitoris in 1l-year-old girl.
Clitoris ; Diagnosis ; Female ; Genitalia, Female ; Humans ; Neurofibromatoses* ; Neurofibromatosis 1

Objectives: This study evaluated the effect of adjacent gingival blood flow on detection of pulpal blood flow (PBF) using ultrasound Doppler flowmetry (UDF) through animal study. Materials and Methods: The study included 36 right and left maxillary the third incisors and canines in 9 experimental dogs. The study included 2 main steps: In the first step, the pulse sound level (PSL) was recorded on the cervical part of each tooth without flap elevation (Group 1), with flap elevation (Group 2), and after it was repositioned in place (Group 3). In the second step, the PSL was recorded on the cervical part of each tooth (Group 4), after pulpotomy (Group 5), after partial pulp extirpation (Group 6), after complete extirpation (Group 7), and after canal filling (Group 8). In Groups 5–8, the study was performed with and without flap elevation in the left and right teeth, respectively. The PSL was graded as follows: 0, inaudible; 1, heard faintly; and 2, heard well. The difference between each group was analyzed using Friedman’s test with Wilcoxon signed-rank tests (α = 0.05). Results: In step 1, the PSL results were Group 1 > 2 and 3. In step 2, there was no significant difference between the groups when the flap was not elevated, while PSL results were Group 4 > 5 ≥ 6 and 7 ≥ 8 when the flap was elevated. Conclusions PBF is affected by gingival blood flow when measured with UDF. UDF measurements require isolation of gingiva from the tooth.

Traumatic rupture of the corpus cavernosum of the penis is rare and has been reported infrequently. We experienced 4 cases of penile fracture for recent 2 years. They occurred during coitus(1 case), masturbation(2 cases), and through blunt trauma(1 case). The former 3 cases were treated with immediate surgical intervention about 12 hours after injury. When the last case patient visited hospital 5 days after injury, the penile abscess treated immediately with surgical intervention had developed. Surgery consisted of complete evacuation of the hematoma or pus and repairing of the tear at the tunica albuginea. The results were excellent, with complete early recovery of erectile function. Delayed wound healing was observed only in a patient who underwent surgery about 5 days after injury, but this did not cause any complication afterward. In our experiences, immediate surgical treatment is recommended in patients with fracture of the penis.
Abscess ; Hematoma ; Humans ; Male ; Penis ; Rupture ; Suppuration ; Wound Healing

PURPOSE: To evaluate the clinical usefulness of 2-D Cine PC (phase contrast) technique in visualizing the pattern and the site of abnormal CSF flow and to assess the effect of a third ventriculostomy in patients with hydrocephalus. MATERIALS AND METHODS: The study group consisted of three normal controls and 13 patients with hydrocephalus, as shown on CT or MRI, and two patients who had undergone their third ventriculostomy. The technique was EKG-gated 2-D Cine PC MRI with velocity encoding 5cm/sec, TR 80msec, TE 12.3-15msec, and flip angle 15-60 degrees. Image quality was analyzed for variable sequences, and CSF flow was observed along the CSF flow pathway. We analyzed continuity and intensity of the CSF flow signal, and obstruction site and flow velocity degree were then defined. RESULTS: Systolic high and diastolic low signal intensity along the CSF flow-pathway, with normal asynchronicity and continuation, were clearly seen in normal controls. In three patients, there was obstruction at the ventricular level while others were either normal or showed a normal pattern with a weak signal. 'Normal' was defined as noncommunicating hydrocephalus and the latter as communicating hydrocephalus. In the two patients who had undergone ventriculostomy, a signal was in one case detected at the site of the third operation. CONCLUSION: A 2-D Cine PC CSF flow study enables us to see CSF flow signals noninvasively and to detect the site of obstruction of a CSF flow-pathway. It can therefore be useful for determining the application of a ventriculoperitoneal shunt and assessing the effect of a third ventriculostomy.
Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Ventriculoperitoneal Shunt ; Ventriculostomy

The aim of this study is to review the protective effect of a bicycle helmet on each facial location systematically. PubMed was searched for articles published before December 12, 2014. The data were summarized, and the odds ratio (OR) between the locations of facial injury was calculated. A statistical analysis was performed with Review Manager (The Nordic Cochrane Centre). Bicycle helmets protect the upper and middle face from serious facial injury but do not protect the lower face. Non-wearers had significantly increased risks of upper facial injury (OR, 2.07; P<0.001) and of middle facial injury (OR, 1.97; P<0.001) as compared to helmet users. In the case of lower facial injury, however, only a slightly increased risk (OR, 1.42; 95% confidence interval (CI), 0.67-3.00, P=0.36) was observed. The abovementioned results can be attributed to the fact that a helmet covers the head and forehead but cannot cover the lower face. However, helmets having a chin cap might decrease the risk of lower facial injury.
Bicycling ; Chin ; Facial Injuries* ; Forehead ; Head ; Head Protective Devices* ; Odds Ratio

PURPOSE: To assess the usefulness of three-dimensional spiral CT angiography in the diagnosis and as a guide for the treatment of arteriosclerosis obliterans of the lower extremity. MATERIALS AND METHODS: During a recent one-year period, CTA and conventional angiography were performed in 12 patients with suspected ASO. From the upper margin of the third lumbar vertebral body to below the knee joint, helical CT scanning was performed 30-45 seconds after the injection of Ultravist 370(150-180ml) by a power injector at the rate of 2.5-3.0ml/sec via the antecubital vein. The resulting data were reformatted by SSD after reconstruction of 5mm intervals, and CTA was compared with CA for site and degree of stenotic or occlusive lesion. RESULTS: On CTA and CA, twenty-three occlusive lesions above the tibioperoneal artery were detected in 12 patients. On CA, three mild seven moderate and eight severe stenoses were seen, as well as five occlusions. There were three cases of overgrading and three of undergrading. Overall diagnostic accuracy was 73.9%(17/23). Calcifications were detected at on axial CT scanning in the two of three underestimated lesions. Migration of the thrombi was noted in one case. CONCLUSION: CTA may be useful in the evaluation of the arteries of the lower extremities, and valuable in the planning and follow-up of treatment.
Angiography* ; Arteries* ; Arteriosclerosis Obliterans ; Constriction, Pathologic ; Diagnosis ; Humans ; Knee Joint ; Lower Extremity* ; Silver Sulfadiazine ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Veins

Neurenteric cyst is a rare bronchopulmonary foregut malformation, originating from notochord defect. Characteristics of this anomaly are the intrathoracic cyst associated with vertebral abnormalities, such as hemivertebrae, anterior and posterior spina bifida, absence of vertebrae and diastematomyelia. The most common symptom is respiratory distress and treatment is surgical excision of mass. We report a case of neurenteric cyst in a neonate presented with asymptomatic huge mediastinal cystic mass.
Humans ; Infant, Newborn ; Mediastinal Cyst ; Neural Tube Defects* ; Notochord ; Spinal Dysraphism ; Spine

Plasma cell cheilitis is a rare, idiopathic, benign inflammatory disease of lips, characterized by dense plasma cell infiltrates in the upper dermis. It presents as erythematous patches with erosion usually on the lower lip of elderly people. Although, various therapeutic options, including topical steroids, intralesional injection of glucocorticoids, oral nystatin and topical antibiotics have been tried, none of them is promising. A 68-year-old woman presented with a 4-month history of erosive patches with crusts on her lower lip, which was resistant to topical corticosteroids. A histopathologic examination revealed dense inflammatory cell infiltration mainly consisting of plasma cells in the dermis, consistent with plasma cell cheilitis. She was treated with topical pimecrolimus and after 2 weeks of application, the lesion started to get better. After 7 weeks it had almost disappeared. Herein, we present a case of plasma cell cheilitis treated with topical application of pimecrolimus.
Adrenal Cortex Hormones ; Aged ; Anti-Bacterial Agents ; Cheilitis ; Dermis ; Female ; Glucocorticoids ; Humans ; Injections, Intralesional ; Lip ; Nystatin ; Plasma ; Plasma Cells ; Steroids ; Tacrolimus