Cryptococcus is native to the environment and thrives in any type of environment inhabited by birds. Cryptococcal genito-urinary infection has been reported in immunnocompromised patients and can involve the adrenal gland, kidney, prostate, or penis. To our knowledge, there have been no reports of cases where cryptococcal epididymo-orchitis infects an uncompromised healthy host. Here, we report a case of primary cryptococcal epididymo-orchitis in a healthy male.
Adrenal Glands ; Birds ; Cryptococcus ; Humans ; Kidney ; Male ; Orchitis ; Penis ; Prostate

This study shows a case of neoadjuvant chemotherapy application for the management of a 34-year-old male patient diagnosed with invasive intraductal papillary mucinous neoplasm (IPMN), for which curative margin-negative resection initially seemed challenging. Five cycles of the FOLFIRINOX regimen (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) were administered preoperatively, resulting in a significant reduction of the intraductal mass size and deformity of the main vessels. The patient subsequently underwent a successful robotic pylorus-preserving pancreatoduodenectomy. Postoperatively, the patient received adjuvant chemotherapy with FOLFIRINOX, and after 5 months, showed no signs of tumor recurrence or specific complications. These findings suggest that neoadjuvant therapy can be a potentially effective strategy even in advanced invasive IPMN. Further research is necessary to establish guidelines for its application.

OBJECTIVE: Recently, the incidence of elderly primipara is increasing. Thus, impact of old age on pregnancy outcomes became important. Our purpose was to assess the effect of maternal age on pregnancy outcomes. METHODS: 73 cases of the elderly primipara over 35 years at the department of obstetrics and gynecology, Chon-ju presbyterian medical center, from Jan. 1, 1995 to Dec. 31, 1998, were compared with 73 cases randomly chosen young primiparas during same period. RESULTS: Elderly primipara had higher rate of infertility and spontaneous abortion history, antenatal complications, cesarean section, poorer neonatal outcome than young primipara. CONCLUSION: The pregnancy outcome of elderly primipara is considered to be less favorable than those of young primipara. Careful antenatal and intrapartal care should be performed for the elderly primipara. We think that many clinical study of congenital anomaly in elderly primipara will be necessary.
Abortion, Spontaneous ; Aged* ; Cesarean Section ; Female ; Gynecology ; Humans ; Incidence ; Infertility ; Jeollabuk-do ; Maternal Age ; Obstetrics ; Pregnancy Outcome ; Pregnancy* ; Protestantism ; Statistics as Topic*

Kallmann's syndrome is characterized by hypogonadotrophic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia, which has been related to agenesis of olfactory bulbs. We experienced a case of 17 year-old Kallmann's syndrome woman and a case of successful pregnancy of 29 year-old Kallmann's syndrome woman with hMG and hCG treatment and present two cases with a review of literatures.
Adolescent ; Adult ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Hypogonadism ; Kallmann Syndrome* ; Olfaction Disorders ; Olfactory Bulb ; Pregnancy*

This study was performed to evaluate the relationship between biological markers of lead exposure and thyroid functions among male workers occupationally exposed to inorganic lead. 30 male workers exposed to inorganic lead at smelting and battery factories were investigated, and 30 male control workers who were not exposed to inorganic lead occupationally were chosen for this study. The data were obtained using direct interview and assessment of biological markers of lead exposure and thyroid indices. As biological markers for lead exposure, blood ZPP. blood lead, urine lead and hemoglobin were measured. As thyroid indices. TSH and FT4were determined. The results of the study were summarized as follows 1. Levels of ZPP, blood lead, and urine lead were significantly higher in lead-exposed group than in nonexposed control group(p<0.01 all). Hemoglobin level was significantly lower in lead-exposed group than in nonexposed group(p<0.01). 2. Study subjects had normal values of TSH and FT4 But TSH level was insignificantly lower in lead-exposed group than in nonexposed control group(p=0.11) and FT4 level was significantly lower in lead-exposed group than in nonexposed group(p<0.01). 3. As the result of simple regression analysis in lead-exposed group. FT4 level was negatively correlated with the amount of smoke, blood ZPP, and blood lead(p < 0.05 all). 4. In lead-exposed group, FT4 was used as a independent variable and age, the amount of smoke, blood ZPP, and blood lead were entered as a dependent variables in the model. As the result of multiple regression analysis with stepwise selection method, the amount of smoke and blood ZPP were negative predictors of FT4(p=0. 04, p=0.09, respectively). In conclusion, levels of TSH and FT4were lower in lead-exposed group than in nonexposed control group. In lead-exposed group, FT4 level was negatively correlated with amount of smoke, blood ZPP, and blood lead in simple regression analysis. To clarify this relation, further research between lead exposure and thyroid function may be required for worker with long-term lead exposure or high lead exposure.
Biological Markers ; Humans ; Male* ; Occupations* ; Osmeriformes ; Reference Values ; Smoke ; Thyroid Gland*

Lymphangiomas result from a failure of lymphatic drainage into the venous system due to atresia or an insufficiency of the efferent lymphatic channels. The neck and axillary regions are most commonly affected, while the condition is rarely found in the inguinal area, scrotum, retroperitoneal space, abdominal viscera, arm, pelvis or bones. We report a case of a cystic lymphangioma of the lower abdomen, penis and scrotum in a 29-year-old man.
Abdomen* ; Adult ; Arm ; Drainage ; Humans ; Lymphangioma ; Lymphangioma, Cystic* ; Male ; Neck ; Pelvis ; Penis* ; Retroperitoneal Space ; Scrotum* ; Viscera

BACKGROUND: The opportunistic imperfect fungus Candida albicans causing life-threatening infections in immunocompromised patients is recognized to be one of important nosocomial pathogens. Recently, an outbreak of septicemia caused by C. albicans was occured in neonatal intensive care unit (NICU) of Chungbuk university hospital. To investigate the molecular epidemiology of these infections, we analyzed genotypes of C. albicans isolates from NICU and non-NICU. METHODS: Fourteen isolates of C. albicans were used for intraspecies genotyping, which were composed of 9 isolates from NICU and 5 isolates from non-NICU from January to April 1998. Each three isolates of C. albicans, C. parapsilosis and C. tropicalis were used for interspecies genotyping. The genotyping were analyzed by RAPD with four random primers. RESULTS: The genotypes of C. albicans isolates from immature neonates in NICU were identical with those from medical persons in NICU but different with those from patients in non-NICU. Interspecies RAPD profiles were more distinctive than intraspecies RAPD profiles. The reproducibility of RAPD showed good result. CONCLUSION: These results show that C. albicans isolated from NICU disclose the same RAPD genotype, which suggests the clonal origin, and RAPD can be the useful method for the epidemiological study of nosocomial infection caused by C.albicans.
Candida albicans* ; Candida* ; Chungcheongbuk-do ; Cross Infection ; DNA* ; Epidemiologic Studies* ; Fungi ; Genotype ; Humans ; Immunocompromised Host ; Infant, Newborn ; Intensive Care Units, Neonatal* ; Intensive Care, Neonatal* ; Molecular Epidemiology ; Sepsis*

BACKGROUND: This study was aimed to elucidate the effect of ketamine anesthesia on circulatory response to hemorrhage in rats by power spectral analysis of heart rate and blood pressure variability. METHODS: Nineteen male Sprague-Dawley rats weighing 290~475 g were divided into ketamine (100 mg/kg, im)-anesthetized(K, n=10) and conscious(C, n=9) groups. Hemorrhage was induced with a withdrawal pump from the femoral artery at 3 ml/kg/min for 5 min. Arterial pressure was measured with a pressure transducer connected to the contralateral femoral artery for 5 min before, during and after hemorrhage. The blood pressure signal digitized at 500 Hz through a data acquisition system was analyzed with fast Fourier transform algorithm to yield power spectra of sytolic(SP) and diastolic(DP) blood pressure and instantaneous heart rate(HR). Powers of very low frequency(VLF, 0.02~0.26 Hz), low frequency (LF, 0.26~0.75 Hz) and high frequency(HF, 0.75~5.00 Hz) band were expressed as percent of total power. RESULTS: Before hemorrhage blood pressure was higher in K(152.4+/-3.7/99.9+/-4.9 mmHg) than in C(143.3+/-5.7/95.5+/-4.1 mmHg) rats, but was changed by hemorrhage in both groups. Before hemorrhage HR in K and C rats were 361.4+/-17.5 and 363.4+/-18.5 beats/min . HR were significantly increased to 403.2+/-20.3 and 396.2+/-18.9 beats/min during and after hemorrhage in K rats, and increased to 409.1+/-20.9 beats/min during hemorrhage in C rats. Before hemorrhage total powers of blood pressure and HR variability were higher in K than in C rats. During hemorrhage, total powers of blood pressure and heart rate variability tended to increase in both groups. Before hemorrhage, percent powers of systolic pressure variability of HF and VLF were higher in K than in C rats and LF was lower in K than in C rats. During hemorrhage, K group showed no significant changes but C group showed significant changes. Before hemorrhage, percent powers of diastolic pressure variability of VLF was higher in Kthan in C rats, and HF and LF were lower in K than in C rats. During and after hemorrhage, K group showed no significant changes, but C group showed significant decrease in LF and increase in VLF. Before hemorrhage, percent powers of heart rate variability of K rats showed higher HF and VLF, and lower LF than C rats. During and after hemorrhage HF and VLF of both groups showed no significant changes except significant increase in VLF after hemorrhage in C rats, but LF of both groups showed significant decrease. CONCLUSIONS: It was concluded that autonomic activity, especially cardiac sympathetic activity, was increased in response to hemorrhage in K rats. Ketamine anesthesia stimulated overall autonomic activity, especially sympathetic activity and vasomotor tone. In C rats hormonal factor contributed to blood pressure and heart rate variability during hemorrhage.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure* ; Femoral Artery ; Fourier Analysis ; Heart Rate* ; Heart* ; Hemorrhage* ; Humans ; Ketamine ; Male ; Rats* ; Rats, Sprague-Dawley ; Transducers, Pressure

OBJECTIVES: The prevalence of malaria is increasing in recent years and also multidrug resistant malaria is increasing around the world and there is an increasing concern about imported malaria in nonendemic areas. Now many drugs are tried to find out effect on multidrug resistant malaria. We performed this study to investigate the thrapeutic effect of halofantrine in the treatment of chloroquine resistant imported malaria. METHODS: From Feb. 1992 to May 1995, we experienced 35 patients infected with malaria and treated 14 patients among 35 patients with halofantrine. RESULTS: 1) All 14 patients were sailor with a mean age of 39.4 years and infected with malaria. 2) The majority of patients were infected with malaria at Africa. 3) 10 patients were infected with Plasmodium falciparum and the remainder were undetermined. 4) In the 11 cases of chloroquine resistant malaria treated with quinine plus tetracycline combination therapy or Fansidar, 4 cases could not be tolerable due to side effects and resistance to the therapy, we substituted halofantrine for above regimens. 5) In the 10 cases, treated after May 1994, halofantrine was the first choice of treatment because they were the cases of malaria infected in the mid-Africa where the prevalence of chloroquine resistant malaria is high. 6) With halofantrine, all 14 cases were treated with minimal side effects suc4 as nausea, vomiting, anorexia, abdominal pain and fatigue. CONCLUSION: We think halofantrine is a simple and effective regimen against chloroquine resistant malaria and consider this agent as an alternative therapeutic regimen on chloroquine resistant malaria.
Abdominal Pain ; Africa ; Anorexia ; Chloroquine* ; Fatigue ; Humans ; Malaria* ; Military Personnel ; Nausea ; Plasmodium falciparum ; Prevalence ; Quinine ; Tetracycline ; Vomiting

OBJECTIVES: We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. METHODS: Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1: 1. Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test. RESULTS: Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, and systolic blood pressure. From multivariate regression analysis, there was significant difference (p< 0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. CONCLUSIONS: We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier detection for neurological abnormality in lacunar infarction.
Blood Pressure ; Case-Control Studies* ; Cerebrovascular Disorders ; Drinking ; Education ; Female ; Humans ; Magnetic Resonance Imaging ; Multivariate Analysis ; Reaction Time ; Seoul ; Stroke, Lacunar*