Decreased sensitivity of N. gonorrhoeae to many existing antibiotics and the emergence and increase of penicillinase producing and of spectinomycin resistant N. gonorrhoeae necessitate intensive efforts to study on resistance. Male patients with uncomplicated gonococcal urethritis treated during the year 1990 at the VD clinic of Choong-ku Public Health Center in Seoul were included in this study. A total of 85 strains, 44 strains of non-PPNG and 41 strains of PPNG isolated from the patients were studied to evaluate their sensitivities to ampicillin, penicillin, cefoxitin, kanamycin, tetracycline, erythromycin, spectinomycin and cotrimazole. The results are summerized as follw: In non-PPNG strains, the range of MICs. MIC50 and MIC90 for both ampicillin and penicillin were 0.125-32, 2 and 16 mcg/ml respectively. For cefoxitin, they were 0.125-8, s and 16 mcg/ml respectively, and for kanamycin, 8--<64, 32 and 64 mcg/ml, respectively. For tetracycline, they were 1-64, 8 and 32 mcg/ml, while for erythromycin, 0.06-16, 2 and 8 mcg/ml respectively. For spectinomycin, they were 4--<64, 32 and 64 mcg/ml and for cotrimazole, 5--<160, 40 and 160 mcg/ml respectively. In the case of PPNG, the range of MICS, MIC50 and MIC90 for ampicillin were 8--<128, 32 and 128 mcg/ml respectively but for penicillin, 8--<128, 64 and 128 mcg/ml respectively. And for cefoxitin, they were 0.5-32, 4 and 16 mcg/ml while for kanamycin, 16--<64, 64 and >64 mcg/ml respectively. For tetracycline, the values were 2-64, 16 and 32 mcg/ml, and for erythromycin, they were 0.5-16, 4 and 8 mcg/ml respectively. for spectinomycin, they were 8--<64, 32, and 64 mcg/ml and finally for cotrimazole, 5--<160, 80 and 160 mcg/ml respectively. From these results, it is concluded that the MICs of both PPNG and non-PPNG were about 2 folds higher than the results of sensitivity tests at the same instituition in 1985. 2) The prevalence of PPNG among 35 gonorrhoeae patients who received treatment before the visit was 60% (21/35), while that among the patients without previous treatment was 40% (20/50). 3) In the cases of ampicillin, penicillin and cotrimazole, their MIC values were found to be significantly higher for the strains isolated from the patients with previous treatment history than those without previous treatment (p<0.05). 4) In non-PPNG strains, a significant positive correlation is found between the sensitivities to most pairs of ampicillin, penicillin, cefoxitin, kanamycin, tetracycline, erythromycin and spectinomycin. However this excludes some pairs such as : tetracycline-cefoxitin, erythromycin-penicillin, erythromycin-cefoxitin, spectinomycin-penicillin, and spectinomycincefoxitin (p<0.05). 5) In PPNG strains, a significant positive correlation is also found between the sensitivities to most pairs of ampicillin, penicillin, cefoxitin, tetracycline, erythromycin and spectinomycin. However, the exceptional cases include tetracycline-cefoxitin, erythromyoinpenicillin, erythromycin-cefoxitin, spectinomycin-penicillin, and spectinomycin-cefoxitin pairs. In addition, the sensitivity to kanamycin was found to be strongly correlated with that to tetracycline, erytheromycin and spectinomycin (p<0.05). Therefore it is essential for the management fo gonorrhoeae, together with a correct diagnosis, to use currently most effective treatment regimens which would also prevent the emergence of resistant strains. It is also suggested that when a treatment is failed, to use the durg which do not show correlation in sensitivities on re-treatment.
Ampicillin ; Anti-Bacterial Agents ; Antibodies* ; Cefoxitin ; Diagnosis ; Erythromycin ; Humans ; Kanamycin ; Male ; Penicillinase ; Penicillins ; Prevalence ; Public Health ; Seoul ; Spectinomycin ; Tetracycline ; Urethritis

No abstract available.
Drug Therapy* ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

Edwards syndrome is first introduced by Edwards and characterized by facial anomalies, multiple cardiovascular, gastrointestinal, urogenital, and skeletal malformations. It results from triplication of part or all of chromosome 18 in some or all of the patient's cells. It has an incidence of 1 in 4,500 live births or less and short life expectancy. Recently we experienced a case of 3-day-old female new born infant with this syndrome. Post mortem examination showed progeric face with prominent occiput, large flabby ears, microphthalmia, and micrognathia, bilateral clenched hands with flexion contraction of middle fingers, and bilateral rockerbottom feet. Internal examination revealed horseshoe kidney, esophageal atresia with tracheoesophageal fistula, two accessory spleens, and multiple cardiac anomalies. A trisomy 18 was confirmed by the cytogenetic study.
Infant ; Male ; Female ; Infant, Newborn ; Humans ; Incidence

BACKGROUND: The eosinophil chemotactic and activating effects of eotaxin and the known association of eosinophils with asthma suggest that eotaxin expression is increased during an asthma attack. This study was aimed to determine whether the plasma eotaxin levels are higher in patients during as asthma attack and to correlate the eotaxin levels with the disease activity, severity and response to therapy. METHOD: A case-control study of the plasma eotaxin levels was performed in 100 patients with exacerbated asthma and 48 age-and sex-matched subjects with stable asthma. RESULTS: The plasma eotaxin levels were significantly higher in the 100 patients with exacerbated asthma (233±175 pg/ml) than in the 48 subjects with stable asthma(169±74 pg/ml). A tread toward higher eotaxin levels was observed in asthmatic subjects who were taking oral steroids (332±225 pg/ml) than in those who were not (214±159 pg/ml) and higher levels were found in those admitted to the hospital (275±212 pg/ml) than in those discharged after receiving only emergency treatment (190±115 pg/ml). The eotaxin levels inversely correlated with the FEV1 (r=-0.25, p<0.01). The eotaxin levels were higher in moderate persistent (323±256 pg/ml) and severe persistent asthmatics (276±170 pg/ml) than in mild intermittent asthmatics (160±60 pg/ml). CONCLUSION: Eotaxin expression is directly associated with asthma exacerbation, impaired pulmonary function and the disease severity.
Asthma* ; Case-Control Studies ; Emergency Treatment ; Eosinophils ; Humans ; Plasma* ; Steroids

Saccharomyces is an ascospore-producing yeast that is commonly employed in the brewery and bakery industries. We report a case of opportunistic skin infection with Saccharomyces in a 62-year-old female whose defense was impaired by immunosuppression. Previously reported cases have been treated with amphotericin B or ketoconazole and our patient respbnded to fluconazole.
Amphotericin B ; Female ; Fluconazole ; Humans ; Immunosuppression ; Ketoconazole ; Middle Aged ; Saccharomyces* ; Skin* ; Yeasts

BACKGROUND: Prevention of postherpetic neuralgia as well as management of the symptoms of the acute stage is an important therapeutic goal in the treatment of herpes zoster. Corticosteroid, acyclovir and sympathetic block have all been advocated as effective therapeutic tools for the treatment of the disease. OBJECTIVE: This study was conducted to evaluate the necessity of sympathetic block for prevention of postherpetic neuralgia in acute herpes zoster. METHODS: The author observed the duration and degree of pain and the incidence of postherpetic neuralgia in 54 patients with herpes zoster treated with three different therapeutic measures. Group A was treated with triamcinolone acetonide 80mg three times, acyclovir and sympathetic blockade, group B with triamcinolone acetonide 80mg three times and acyclovir, and group C with triamcinolone acetonide 40mg three times and acyclovir. RESULTS: 1. Addition of sympathetic blockade to corticosteroid and acyclovir therapy did not seem to reduce the duration of pain and incidence of postherpetic neuralgia. 2. The Incidence of postherpetic neuralgia was higher in the elderly, especially with underlying systemic disease including diabetes melitus, hypertension, etc. Al] the therapeutic measures could not completely prevent the development of postherpetic neuralgia in those patients. 3. Regarding corticosteroid dosage, daily triamcinolone acetonide 80mg for three consecutive days showed no better effect than daily 40mg for consecutive days. CONCLUSION: When herpes zoster was treated with proper dosages of corticosteroid and acyclovir in its acute stage, sympathetic block showed no additional beneficial effect.
Acyclovir ; Aged ; Herpes Zoster* ; Humans ; Hypertension ; Incidence ; Neuralgia, Postherpetic ; Triamcinolone Acetonide

STATEMENT OF PROBLEM: Major objective in making on implant-supported prosthesis is the production of superstructure that exhibits a passive fit when connected to multiple abutments. One requirement to ensure passive fit is to make an accurate impression. PURPOSE: The purpose of this study was to compare the accuracy of master cast fabricated by using different impression methods at the different impression levels. MATERIAL AND METHOD: The master model used in this study was resin block having four implant analogs. Impression method studied were 1) direct method on fixture level (Group FIX-D), 2) indirect method on fixture level(Group FIX-I), 3) modified indirect method on fixture level(Group FIXM) 4) direct method on abutment level(Group AB-D) and 5) indirect method on abutment level(Group AB-I). Each of the five groups took 10 impressions. Fifty impressions were made for master cast by using Impregum F. impression material loaded on individual tray. Three dimensional measuring microscope was used to measure the inter-implant distance. Error rate of each inter-implant distance were calculated and evaluated. RESULTS: The results were as follows. 1. Group FIX exhibited higher accuracy than group AB. 2. In group FIX, modified indirect method showed the highest accuracy, while indirect method showed the lowest accuracy. In group Ab, indirect method showed the higher accuracy than direct method. 3. Group FIX showed larger horizontal error than group AB. But, group AB showed the larger vertical error than group FIX. 4. Group Fix-M showed smallest vertical and horizontal error. CONCLUSION: An impression method have more effect on accuracy of master model than an impression level. A modified indirect method showed smallest vertical and horizontal error.
Prostheses and Implants*

BACKGROUND/AIMS: Although interferon-a(IFNa) is currently the most effective antiviral agent for treating patients with chronic hepatitis C, its efficacy is not always reliable. Factors suggested to infruence outcome of IFN-a therapy for chronic hepatitis C are histological activity, level of viremia and HCV genotype, etc. The aim of this study was to determine the relationship between several pretreatment factors and response to IFN-a therapy in patients with chronic HCV infection. METHODS: Fifty-four patients with chronic HCV infection(47 with chronic hepatitis and 7 with liver cirrhosis) who received IFN-a(2a or 2b) therapy(3 6 MU, three times a week, for 3 12 months) were included. Level of serum HCV RNA(50 patients), HCV genotype(27 patients) and IgM anti- HCV(21 patients) during pretreatment period were assayed. RESULTS: Overall, 19(35%) subjects achieved sustained response(SR), 12(22%) had transient response(TR) and 23(43%) did not respond (nonresponse;NR). Mean age of patients with SR, TR and NR was 46+ 10, 51+ 7.5 and 54+ 9.7 years, respectively(p<0.05 between SR and NR). Among 30 patients with biopsy-proven chronic hepatitis, 13(43%) achieved SR;but only one(14%) in 7 patients with liver cirrhosis. Mean serum HCV RNA level(X10' copies/ml) was higher in nonresponders(7,7+ 13.0) compared with SR(2.3+ 2. 7) or TR(3.1+ 4.9), although statistically insignificant HCV genotyping in 27 patients revealed type la in 5(18.5%), 1b in 14(52%), 2a in 5(18.5%), 2b in 1(3.7%) and 4 in 2(7%), respectively. In non-1b patients, SR rate was significantly higher than 1b patients(69.2% vs. 21.4%, p=0.03). Although IgM anti-HCV was positive in 12(57%) among 21 patients studied, the positive rate and the titer of IgM anti-HCV was not significantly different in three groups. CONCLUSION: Our results suggest that in patients with chronic hepatitis C, infection with genotype 1b, old age, high serum HCV RNA level and the presence of cirrhosis would predict poor response to IFN therapy.
Fibrosis ; Genotype ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Immunoglobulin M ; Interferons* ; Liver ; Liver Cirrhosis ; RNA ; Viremia

No abstract available.
Miller Fisher Syndrome

The Laugier-Hunziker syndrome is a rare syndrome characterized by macular hyperpigmentation of the lips and buccal mucosa associated with melanonychia. Onset is usually in adult life and no consistent systemic associations have been reported. Here we report a 39-year-old wonam with a longitudinal pigmented band on a finger and pigmented macules on the lip. We suggest that this is the first report in Korea and the syndrome is presumably more common than recognized.
Adult ; Fingers ; Humans ; Hyperpigmentation ; Korea ; Lip ; Mouth Mucosa