In 1982, we reported a case of recalcitrant urethritis caused by a strain of spectinomycin resistant PPNG. It caused a great fear that it might be the signal of an end of spectinomycin era, The disk-prediffusion method was used on all isolates from the Choong-Ku VD Clinic between August 1984 and December 1985 to screen out strains of N. gonorrhoeize resistant to spectinomycin, with disks containing 100pg of spectinomycin, Strains with inhibition zone greater tha.n 25 mm were considered susceptible, We could not disclose a single strain which wa.s resistant to spectinornycin, The reason why we do not see any more of spectinomycin. N. gonorrhoeae requires some speculation, It is possible that the mutant which had resistant to spectinornycin might not have teen quite stable and, after series of passage through human hosts, mutated back to original spectinornycin sensitive states. It is suggested that continual surveillance for spectinomycin resistant N. gonorrhoeae should be conducted.
Adolescent ; Humans ; Neisseria gonorrhoeae* ; Neisseria* ; Spectinomycin* ; Urethritis

Forty five gonococcal patients were treated with spectinomycin hydrochloride at the Department of Urology, St. Mary's Hospital from August 1. 1972 to December 32. 1972. All patients were male and confirmed as acute gonorrheal urethritis by gram stained smear or culture. The cure ability in this series was very satisfactory The results were as follows; 1. Gram negative ;intracellular diplococci was controlled in 29 patients (96.7%) among 3O patients with pure gonococcal infection with a single injection of spectinomycin hydrochloride. 2. Gram negative intracellular diplococci was controlled in 14 patients (93.3%) among 15 patient with mixed infection with a single injection of spectinomycin hydrochloride. 3. Only two in all patients were controlled in gram negative intracellular diplococci with repeat injection. 4. 4 patients (13.3%) of the pure gonoccoccal patients with a single injection were converted to non-specific urethritis, which were treated with combination of other antibiotics. 5. 5 patients (33.3%) of the mixed infected patients with a single injection were converted to nonspecific urethritis, which were treated with combination of other antibiotics. 6. No side effect was noted in all patients.
Anti-Bacterial Agents ; Coinfection ; Humans ; Male ; Spectinomycin* ; Urethritis* ; Urology

Forty five gonococcal patients were treated with spectinomycin hydrochloride at the Department of Urology, St. Mary's Hospital from August 1. 1972 to December 32. 1972. All patients were male and confirmed as acute gonorrheal urethritis by gram stained smear or culture. The cure ability in this series was very satisfactory The results were as follows; 1. Gram negative ;intracellular diplococci was controlled in 29 patients (96.7%) among 3O patients with pure gonococcal infection with a single injection of spectinomycin hydrochloride. 2. Gram negative intracellular diplococci was controlled in 14 patients (93.3%) among 15 patient with mixed infection with a single injection of spectinomycin hydrochloride. 3. Only two in all patients were controlled in gram negative intracellular diplococci with repeat injection. 4. 4 patients (13.3%) of the pure gonoccoccal patients with a single injection were converted to non-specific urethritis, which were treated with combination of other antibiotics. 5. 5 patients (33.3%) of the mixed infected patients with a single injection were converted to nonspecific urethritis, which were treated with combination of other antibiotics. 6. No side effect was noted in all patients.
Anti-Bacterial Agents ; Coinfection ; Humans ; Male ; Spectinomycin* ; Urethritis* ; Urology

The subject were 653 male patients with uncomplicated gonorrhea at the VD Clinic of Choong Ku Public Health Center in Seoul from January to November 1985. 653 male patients with uncomplicated gonococcal infection were treated one of the following regimens. Five treatment regimens used were 2, 0 gm spectinomycin single 1M, 4 0 mega unit fortified procain penicillin G+2. 0 gm kanamycin sulfate IM preceded by 1 pgm probenecid PO, 6.0 mega unit fortified procain penicillin G+2 pgm kanamycin sulfate IM preceded by 1. 0 gm probenecid PO, 5, 0 rnega unit aqueous crystaline penicillin+2. 0 gm kanamycin sulfate irn preceded by 1, 0 gm probenecid PO and 9 tablets of cotrimoxazole+ 2. 0 gm kanamycin sulfate IM. There were no significant differences in the incidence of PGU among the five treatment groups. The overall PGU rate was 67.3% 59.2% and 53.6% at 3~5, 7~10 and 14 days after treatment respectively. The incidence of PGU at 7-10 days was not significantly higher than that of at 14 days after treatment. It is suggested that it is best to test PGU at 7 days after treatment. Because the longer one waits, the harder to follow the patients, and in earlier period, post-inflammatory irritation might be too frequent. It is also suggested that at 3 5 days after treatment examination of urethritis might serve to compare the effect of treatment regimens on the incidence of PGU.
Gonorrhea ; Humans ; Incidence ; Kanamycin ; Male ; Penicillins ; Probenecid ; Public Health ; Seoul ; Spectinomycin ; Tablets ; Urethritis*

In this study, we compared the MIC by agar plate dilution method with the inhibition zone diameters by ordinary disc diffusion method and 24 hr-prediffusion disc method on five antibiotics, respectively. The results were summarized as follows; 1. The agar plate dilution method and the ordinary disc diffusion method gave a satisfactory degree of correlation by linear regression. The correlation coeffecients were highly significant for penicillin (r= -0.88) and ampicillin(r = -0.91) but less significant for tetracyclin(r= -0.34), kanamycin(r= -0.55) and spectinomycin (r = -0.46). 2. Between the agar plate dilution method and the 24 hour-prediffusion disc method the correlation coeffecients were highly significant for penicillin(r= -0.9) and ampicillin (r= -0.91) but less so for tetracyclin(r= -0.4), kanamycin (r=-0.57) and spectinomycin(r=-0.5), 3. In relation to the MIC values by agar pate dilution method, the correlation coefficients were slightly higher and the slopes of linear regression were steeper for the 24 hour-prediffusion disc method than the ordinary disc diffusion method, but the differences were statistically not significant.
Agar* ; Ampicillin ; Anti-Bacterial Agents ; Diffusion* ; Kanamycin ; Linear Models ; Neisseria gonorrhoeae* ; Neisseria* ; Penicillins ; Spectinomycin

When the hypopharynx is examined in the frontal view during modified Valsalva maneuver after barium swallow anoutpouching of the lateral wall of the hypopharynx resembling a deverticulum is commonly observed. Review of theliterature however fails to disclose provious documentation of systematic prospecative observation of this phenomenon. The present study has been undertaken to detemine the incidence and degree of outpouching according tothe age and sex and to assess the clinical implication of the outpouching. The clinical materials consist of 100 consecutive cases of routine upper GI series with a particular effort directed to induce hypopharyngeal out pouching by a modified Valsalva maneuver at the Department of Radiology, St. Mary's Hospital, Catholic Medical College during 6 months period from Jan. 1982. Technically, outpouching was best demonstrated in the erectposition with a slight extension of the neck during the pharyngeal phase of barium swallowing while the subjectwas instructed to blow through the closed lips. Observation were made ofhhte incidence and intensity of theoutpouching by an arbitrary line drawning to measure the depth of outpouchings. Our study revealed thathypopharyngeal outpouchings occure bilaterally in every case studied. There was definite dominancy on the rightside(p<0.01) and the outpouching was greater in intensity in male (p<0.05) and the depth varied from a few to 15mm. And there was no statistically significant difference according to the age. Outpouchings collapsed and disappeared completely after release of Valsalva maneuver and did not appear to produce any clinical symptoms. The reason of right-side dominancy should further be investigated.
Barium ; Deglutition ; Humans ; Hypopharynx ; Incidence ; Lip ; Male ; Neck ; Spectinomycin ; Valsalva Maneuver

Five hundred seventeen male patients with gonococcal urethritis at the VD clinic of Chocng-ku Public Health Center between Feb. 27 and Oct. 27, 1984 the were source cf this study. Forty-five of seventynine patients who had practiced cunnilingus were actual subjects of this study. Aeiss.ria gonorrhoeae were cultured from the pharynx of five patients: one was found to be PPNG. All 5 pharyngeal gonorrhea patients were asymptornatic and their throat appeared to be normal, except injection of the pharynx in one patient. Two patients infected by non-PPNG were administered an oral dose of 1. 0 gm probenecid plus 2 5 gm talampicillin and 2. Ogm Kanamycin sulfate, IM and one patient infected by non-PPNG was administred an oral dose of l. Ogm probenecid and, 3i) minutes later, 6. 0 m.u. fortified procaine penicillin G IM. One gatient infected by PPNG was administered an oral dose of 1, 0 gm probenecid and 30 minutes later, 1 vial of sulbactam sodium/ampicillin sodium, IM. All four pharyngeal gonorrgeal patients were cured, One patient was lost from further evaluation, We consider it important to have pharyngeal cultures done on all gonorrheal patients, at least on those who admit having had orogenital contact in recent episode, because pharyngeal gonococci may be the source of disseminated gonococcal disease and in rare circumstances, the source of mfection for sexual partners, and single lose spectinomycin and orally administered penciillin regimens that are effective against anogenital gonorrhea, had been known to have high rates of failure when used in the pharyngeal gonrorhea.
Gonorrhea* ; Humans ; Kanamycin ; Male ; Penicillin G Procaine ; Pharynx ; Probenecid ; Public Health ; Sexual Behavior ; Sexual Partners ; Sodium ; Spectinomycin ; Sulbactam ; Talampicillin ; Urethritis

Although penicillin still remains the drug of choice in the treatment of gonorrhoea in many countries, treatment failures are becoming more and more coramon. Recently, the prohlem cauaed, by antibiotic resistant strains of N. gnorrhoeae has been aggravated by appearance of penicillinase producing N. gonorrheeae. Good results were reported with the use of spectinomycin, cefuroxime and efotaxime. These drugs are, as yet, quite expensive. A lower cost regimen has to be sought. In this study, the effect of fortified penicillin G was compared with kanarnycin in the treatment of uncomplicated male gonorrhoeae. The subjects were 446 rnale patients with uncomplieated gonocoacal urethritis at VD clinic of ChoongKu Public Health Center in Seoul between June and November, 1981. The patients are assigned randomly to one of the regimens. Among 181 patients treated with kanamycin, 2. 0 gm, IM, 148 recovered with 27 (19%) postgonococcal urethritis (PGU) and 39(21,6%) failed. Among 168 patients treated with fortified penicillin G, 6 mega-units IM, plus probenecid, l. 0 gm, PO., 100 recovered with 31(81%) PGU and 68(40. 5%) failed. -countinue-
Cefuroxime ; Gonorrhea* ; Humans ; Kanamycin* ; Male* ; Penicillin G* ; Penicillinase ; Penicillins* ; Probenecid ; Public Health ; Seoul ; Spectinomycin ; Treatment Failure ; Urethritis

Two hundreds and ninty-four prostitutes of foreign soldiers of K2 area in Taegu were investigated for their general circumtances, clinical and bacteriological studys from Mar. 1978 to May 1979. The results were as foIIows: The age group of 20-24 year-old constituted highest proportion at the level of about 53.4% Averge age of total casea was about 26.2. The propartion of those who were more than 35 occupied about 7.2%. The positive rate of Cram negative displococci (GND) on dirert smers showed highest in December and, January and lowest in-April. Wcekly distribution shwed a higher in second and fourth week. Nongonococcal infect.ions occupied about 45.4%. and total raes. The causative oanism. were niostly Gram negative and Gram positive bacilli. The mothly spells and perons with gonorrhea priod prevaIence rate showed a higher rate in Becember, January and July. The prevalence ratio of gonorrhea and syphilis was 13: 1. The examined cases occupied about 34.3, during first 2 month is after registration. The seasoal vari tion of registrators and cancellators were both most in winter. The positive rate of GND was ahout 53.1% in new comers less than two month-examinations after regiatration. Cervical erosion or chronic cervicitis .;howed about 44.8% among the examined 96% cases. Gonococci were isoIated about 25.6% among the ones with cervical lesions on Thayer-Martin media. On the other hand, the ones without lesions were about 11.3% comparatively. Syphilis period prevalence rate was about 8. 5 A. The titers of VDRL slide test were low (1; 8 or less). Two-thirds of positive cases of GND were treated by penicillin, although tetracycline and spectinomycin were also used in a few cases. The penicillin hypersensitivity sho- wed positive results in 9.7% of all treated cases.
Daegu ; Gonorrhea ; Hand ; Humans ; Hypersensitivity ; Military Personnel* ; Penicillins ; Prevalence ; Sex Workers* ; Sexually Transmitted Diseases* ; Spectinomycin ; Syphilis ; Tetracycline ; Uterine Cervicitis

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