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

Because of increasing resistance of circulating N. gonorrhoeae and frequent failures in the treatment of gonorrhoea, intensive work on gonorrhoea has become of paramount importance. During January 1980-April 1984, at the Choong-Ku VD Clinic in Seoul, 3,340 male patients with uncomplicated gonococcal urethritis were treated with various treatment regimens. Diagnosis of gonorrhoea and declaration of a treatment failure were made on the basis of positive urethral culture. In 1984, the prevalence of Penicillinase Producing N. gonorrhoeae (PPNG) was about 30%, The pretreatment minimun inhibitory concentration of various antibiotics were quite high. Even for non-PPNG urethritis standard penicillin regimens gave unsatisfactory results. For PPNG urethritis, only spectinomycin, cefoperazone and cefotaxim-probenecid regimens gave satisfactory results. No spectmomycin resistant strain of N. gonorrhoeae has been found since 1982 at the Choong-Ku VD Clinic. As an agent of single drug therapy, spectinomycin seems to be one of the most cost effective drugs in the treatment of uncomplicated gonorrhoea in men.
Anti-Bacterial Agents ; Cefoperazone ; Diagnosis ; Drug Therapy ; Humans ; Male ; Penicillinase ; Penicillins ; Prevalence ; Seoul ; Spectinomycin ; Treatment Failure ; Urethritis

The knee joint is one of the most susceptable joint to ligamentous injury. For good results, it is very important to make an early diagnosis and to give prompt management. The aim of treatment is to restore the ligaments to their previous anatomic position and tension. The authors reviewed 420 cases of ligamentous injuries in 400 patients who were admitted and managed for 6 years from March, 1981 to February, 1987. The results were as follows : 1. The athletic injury was the most commcn cause of injury(55%), and fall-down was next(26%). 2. The most common ruptured individual ligament was the medial collateral ligament. Combined ligament rupture was more common in medial collateral ligament and anterior cruciate ligament. 3. The ruptured sites of the individual ligament were found to be the following ; a) the medial collateral ligament was ruptured most frequently at the femoral attachment(43%), with the superficial layer ruptured in the midsubstance and the deep layer at the femoral attachment; b) the lateral collateral ligament torn at the fibular attachment(51%); c) the anterior cruciate ligament torn at the femoral attachment(39%); d) the posterior cruciate ligament torn at the femoral attachment(64%). 4. Many ligamentous injuries were associated with fracture(44%) and tear of meniscus- (42%). 5. In stress-radiogram, the significance of ligament injuries was present in more than 10 and 10 mm. 6. Excellent and good results were obtained in 94% by non-surgical treatment and in 92% by surgical treatment. 7. Early surgical repair of the ligament within 2 weeks after injury, gave much better result than later repairs.
Anterior Cruciate Ligament ; Athletic Injuries ; Clinical Study ; Collateral Ligaments ; Early Diagnosis ; Humans ; Joints ; Knee Joint ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Posterior Cruciate Ligament ; Rupture ; Tears

Triple arthrodesis is performed to obtain stable stature and walking, to eliminate pain, to correct the deformities of the foot. This is the result of 92 feet triple arthrodesis over a period from 1976 to 1991 at the Department of Orthopaedic Surgery, Yonsei University College of Medicine. The results are as follows 1. Mean age was 17.6 years, ranged from 10 to 51 years. 2. Of the total of 92 feet, sequelae of poliomyelitis was the most common etiology with 58 feet(63%). 3. Most common type of foot deformity was talipes equinovarus with 52 feet(56%). 4. Internal fixation was done with staple or Steinmann pin combined with autogenous bone graft. Among them, using of 2 staples was the most common fixation method, 47 cases(51%). 5. As necessary, triple arthrodesis was combined with tendo-calcaneus lengthening, plantar fasciotomy, posterior capsulotomy, modified Jones operation and tibiotalar arthrodesis. 6. Final results were ideal. in 22 cases(24%), good in 51 cases(56%), fair in 16 cases(17%) and fail in 3 cases(3%). 7. There were 2 cases of pseudoarthrosis and 1 case of residual equinus deformity after operation. In conclusion, triple arthrodesis was the efficient method of treatment for the deformed feet in skeletally matured patients.
Arthrodesis ; Clubfoot ; Congenital Abnormalities ; Equinus Deformity ; Foot Deformities ; Foot ; Humans ; Methods ; Poliomyelitis ; Posterior Capsulotomy ; Pseudarthrosis ; Transplants ; Walking

The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. The injuries to the ankle joint result in a severe functional disturbance because of complex anatomical characteristics around the ankle joint. 284 patients of the ankle fracture that were treated in orthopedic Dept. Capital Armed Forced General Hospital from march 1985. to march 1988. were analized in clinical and radiological aspects. The following results were obtained: 1. The main cause of the injuries was falling from a height and the other were sports injury and slipping down in order. 2. The most common type by Lauge-Hansen classification was supination-external rotation type(122 case, 42.9%). 3. 211 case(74.3%) were treated with open reduction and internal fixation, and 73 case(25.7%) were treated with closed reduction. Poor outcome seemed closely related to the severity of the injury and degree of fracture displacement. 4. Accurate reduction and rigid internal fixation of the lateral malleolus with shortening was important factor. 5. Classification of Lauge-Hansen was useful in the diagnosis and treatment of the ankle fractures.
Accidental Falls ; Ankle Fractures ; Ankle Joint ; Ankle ; Arm ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Hospitals, General ; Humans ; Musculoskeletal System ; Orthopedics ; Walking

Urinomas can occur after renal trauma or perforation of the collecting system during an endosurgical procedure. However, spontaneous urinomas are very rare. Here we report a case of a spontaneous perinephric urinoma following the removal of a Foley catheter in an 18-year-old girl with acute kidney injury caused by septic shock. The patient had been treated for septic shock, acute kidney injury, and acute respiratory distress syndrome, and had a Foley catheter in place for seven days. After Foley catheter removal, the patient complained of consistent voiding difficulty. An abdominal computed tomography scan showed a large amount of left perinephric fluid, and the aspirated fluid included urothelial cells, confirming the diagnosis of a urinoma. The urinoma was successfully treated by insertion of a double-J stent into the left ureter. This report discusses the available literature on urinomas, and their clinical features, diagnosis, and treatment.
Acute Kidney Injury* ; Adolescent ; Catheters* ; Diagnosis ; Female* ; Humans ; Respiratory Distress Syndrome, Adult ; Shock, Septic ; Stents ; Ureter ; Urinary Retention ; Urinoma* ; Vesico-Ureteral Reflux

PURPOSE: Urinary tract infection (UTI) caused by gram-positive uropathogens is usually hospital-acquired and associated with predisposing conditions. However, the incidence of gram-positive bacteria in community-acquired UTIs has recently increased worldwide. We aimed to investigate the clinical significance of UTI and associated genitourinary malformations in young children with febrile UTIs caused by gram-positive bacteria. METHODS: We retrospectively reviewed the medical records of 566 patients (age, <1 year) who visited the Korea University Medical Center for febrile UTIs between January 2008 and May 2013. We classified the patients into the following two groups: gram-positive (P group) and gram-negative (N group), according to the results of urine culture. The fever duration; white blood cell (WBC) counts and C-reactive protein (CRP) levels in peripheral blood; and the presence of hydronephrosis, cortical defects, vesicoureteral reflux (VUR), and renal scarring were compared between the two groups. RESULTS: The number of patients with gram-positive bacteria was 23 (4.1%) and with gram-negative bacteria was 543 (95.9%). The most common pathogen was Escherichia coli, and Enterococcus faecalis showed the highest incidence among gram-positive uropathogens. Patients with gram-positive bacteria showed longer fever duration compared to that in patients with gram-negative bacteria (P vs. N, 3.4+/-1.2 vs. 2.9+/-1.6 days, P<0.05). The incidence of VUR was increased in the gram-positive group compared to that in the gram-negative group (P vs. N, 55.6 vs. 17.8%, P<0.05). However, there were no significant differences in other laboratory and radiologic findings. CONCLUSION: The findings of our study show that community-acquired UTIs in patients younger than 1 year of age, caused by gram-positive uropathogens, can be associated with prolonged fever duration and the presence of VUR.
Academic Medical Centers ; C-Reactive Protein ; Child ; Cicatrix ; Enterococcus faecalis ; Escherichia coli ; Fever ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Hydronephrosis ; Incidence* ; Korea ; Leukocytes ; Medical Records ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

No abstract available.
Humans* ; Saponins* ; Skin*

Erythromelanosis follicularis faciei et coli is a pigmentary disorder of unknown cause originally described by Kitamura et al in 1960. We describe two cases of erythromelanosis follicularis faciei et colli occured in adolescence. Clinical features of these patients were consistent with the clinical changes described in previous cases having clinical triad of erythema, hyperpigmentation and follicular papules. This pigmentary disorder may not be an uncommon disease, however it might be neglected from the concern of the dermatologists.
Adolescent ; Erythema ; Humans ; Hyperpigmentation

A survey of the literature on the treatment of ruptures of deltoid ligament associated with fracture of distal part of fibula is controversial. Some authors advocated surgical repair of the ruptured deltoid ligament based on the theoretical consideration, while others advocated non-operative treatment based on the clinical consideration. We studied the results in forty-five patients who were treated for disruption of the deltoid ligament and a distal fibular fracture. The length of follow-up in our series was twelve to twenty-four months, with an average of fifteen months. When the fibular fracture was adequately reduced and medial clear space was returned to its normal width, the 91 percents both of patients of being treated with repair of deltoid ligament and patients of being treated without repair had a good or excellent results.
Clinical Study ; Fibula ; Follow-Up Studies ; Humans ; Ligaments ; Rupture