The study was undertaken to assess the CT density of the antibiotics solution. CT scan of six antibioticssolution-streptomycin, chloramphenicol, Na-penicillin, ampicillin, kanamycin and cefamezine-in concentration ofabout 33% (approximatly single dose of intramuscular injection) was performed, using plastic syringes. Variousconcentrations of striptomycin, chloramphenicol and Na-panicillin were also examined for evaluation of relationbetween concentration and the CT density of the antibiotics. In addition, relationship between CT number andmathematically calculated effective atomic number and electron density of the antibiotics was evaluated. Theresults are as follows; 1. The CT densities of all antibiotics reveal high density (CT number 80–150) inconcentration of single intramuscular injection dose. 2. CT number of striptomycin, chloramphenicol andNa-penicillin gradually increased with increase of concentration of the antibiotics, producing linear proportionto concentration, effective atomic number and electron density of the antibiotics. 3. Therefore, density ofantibiotics should be included in differential diagnosis when high density on CT scan is observed.
Ampicillin ; Anti-Bacterial Agents ; Chloramphenicol ; Diagnosis, Differential ; Injections, Intramuscular ; Kanamycin ; Plastics ; Syringes ; Tomography, X-Ray Computed

PURPOSE: Dipyridamole stress myocardial perfusion SPECT could predict prognosis, however, long-term follow-up showed change of hazard ratio in patients with suspected coronary artery disease. We investigated how long normal SPECT could predict the benign prognosis on the long-term follow-up. MATERIALS AND METHODS: We followed up 1169 patients and divided these patients into groups in whom coronary angiography were performed and were not. Total cardiac event rate and hard event rate were predicted using clinical, angiographic and SPECT findings. Predictive values of normal and abnormal SPECT were examined using survival analysis with Mantel-Haenszel method, multivariate Cox proportional hazard model analysis and newly developed statistical method to test time-invariance of hazard rate and changing point of this rate. RESULTS: Reversible perfusion decrease on myocardial perfusion SPECT predicted higher total cardiac event rate independently and further to angiographic findings. However, myocardial SPECT showed independent but not incremental prognostic values for hard event rate. Hazard ratio of normal perfusion SPECT was changed significantly (p<0.001) and the changing point of hazard rate was 4.4 years of follow up. However, the ratio of abnormal SPECT was not. CONCLUSION: Dipyridamole stress myocardial perfusion SPECT provided independent prognostic information in patients with known and suspected coronary artery disease. Normal perfusion SPECT predicted least event rate for 4.4 years.
Coronary Angiography ; Coronary Artery Disease ; Dipyridamole* ; Follow-Up Studies ; Humans ; Perfusion ; Prognosis ; Proportional Hazards Models ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: An abridged 5-item version of the 15-item International Index of Erectile Function (IIEF) was developed and its validity has been proven in the western medical community. This study was designed to assess the validity of the abbreviated Korean version of the IIEF as a diagnostic tool for ED. MATERIALS AND METHODS: Patients who visited the Andrology Clinic of the Asan Medical Center with a chief complaint of ED fall into the patient group. Patients who visited the Family Medicine Clinic of the same hospital with chief complaints other than ED, and checked no ED in the self-assessment questionnaire, fall into the control group. Patients, both of the patient group and control group, were asked to fill out the self-administered IIEF-5 and the questionnaire asking the severity of the ED. RESULTS: Collected questionnaires from a total of 309 subjects (the patient group: 149; the control group: 160) were used for statistical analysis. Mean ages were 43 and 52 for the control group and the patient group, respectively. A Receiver Operating Characteristics (ROC) Curve analysis indicated that there is a close correlation between IIEF-5 total scores and the presence of ED (area under the ROC curve=0.961). The most appropriate cutoff score between ED and no ED was 17 (sensitivity=91.3%, specificity=86.3%). Substantial consistency existed between the predicted and the patient-answered ED severity levels (Weighted Kappa=0.681). CONCLUSIONS: The Korean version of IIEF-5 is highly effective in detecting the presence and assessing the severity of ED. The result of our study supports its validity as a diagnostic instrument in the clinical setting.
Andrology ; Chungcheongnam-do ; Diagnosis ; Erectile Dysfunction* ; Humans ; Male ; Surveys and Questionnaires ; ROC Curve ; Self-Assessment

BACKGROUND:Rocuronium is a non depolarizing muscle relaxant of rapid onset and of intermediate action duration. It is particularly suitable for short operation and rapid control airway. But, intravenous rocuronium cause pain and a withdrawal movement. The purpose of this study was to evaluate the effect of intravenous lidocaine on pain and withdrawal movement in patients receiving rocuronium. METHODS: The study was approved by our institutional review board, and informed consent was obtained from all patients. One hundred and twenty patients, ASA physical status 1-2 undergoing general anesthesia for elective surgery were randomly enrolled. Allergy history to trial drug, chronic pain, pregnancy, patient on analgesics, difficult vein access and deeply sedated patients were excluded. Patients were not premedicated, and had a 20-18 G intravenous catheter inserted into a hand dorsum before operation. On arrival in the operation room, routine non-invasive monitors were placed and the free flow of intravenous fluid without edema, redness or hardness was confirmed. A subparalyzing dose of rocuronium 0.06 mg/kg (RS group) or vecuronium 0.01 mg/kg (VS group) was administered after 2 ml of 0.9% NaCl in one group, and a subparalyzing dose of rocuronium 0.06 mg/kg (RL group) or vecuronium 0.01 mg/kg (VL group) was administered after 2 ml of 2% lidocaine injection in a second group. All patients then received 5 mg/kg of 2.5% thiopental sodium and 0.6 mg/kg rocuronium (RS and RL group) or 0.1 mg/kg of vecuronium (VS and VL group). Muscle relaxant-induced pain and withdrawal movements were assessed using 4-grade scales (0-3). Vein redness was measured just after administration and vein hardness five minutes after intubation using 4-grade scales (0-3). RESULTS: Incidence of pain (8.2 times) and withdrawal movement (6.2 times) was more frequent in the rocuronium group than in the vecuronium group (P< 0.01). Lidocaine pretreatment decreased the incidence of pain significantly (5.7 times, P < 0.01). CONCLUSIONS: Rocuronium causes more pain and withdrawal movements than vecuronium. Lidocaine pretreatment significantly reduced the incidence and severity of pain, and withdrawal movements in both groups.
Analgesics ; Anesthesia, General ; Catheters ; Chronic Pain ; Edema ; Ethics Committees, Research ; Hand ; Hardness ; Humans ; Hypersensitivity ; Incidence ; Informed Consent ; Intubation ; Lidocaine* ; Pregnancy ; Thiopental ; Vecuronium Bromide ; Veins ; Weights and Measures

Mucormycosis is a rare invasive and highly aggressive fungal infection, which shows rapid progression with life threatening complications in immunocompromised patients. Therefore, it is important to quickly recognize fungal infection in immunocompromised patients and start treatment with antifungal agents or perform surgical debridement. Most nasal septal abscesses are caused by post-traumatic hematoma and subsequent bacterial infection. In immunocompromised patients, nasal septal abscess can develop without trauma and may involve atypical pathogens like fungus. Herein we report a case of mucormycosis presenting with abscesses of nasal septum and gingivobuccal mucosa in an immunocompromised patient.
Abscess ; Antifungal Agents ; Bacterial Infections ; Debridement ; Fungi ; Hematoma ; Immunocompromised Host ; Mouth ; Mucormycosis ; Mucous Membrane ; Nasal Septum

Mucormycosis is a rare invasive and highly aggressive fungal infection, which shows rapid progression with life threatening complications in immunocompromised patients. Therefore, it is important to quickly recognize fungal infection in immunocompromised patients and start treatment with antifungal agents or perform surgical debridement. Most nasal septal abscesses are caused by post-traumatic hematoma and subsequent bacterial infection. In immunocompromised patients, nasal septal abscess can develop without trauma and may involve atypical pathogens like fungus. Herein we report a case of mucormycosis presenting with abscesses of nasal septum and gingivobuccal mucosa in an immunocompromised patient.

PURPOSE: To determine the sonographic findings of degenerative change in femoral articular cartilage of the knee by comparative study of specimen sonography and pathology. MATERIALS AND METHODS: We obtained 40 specimens of cartilage of the femur (20 medial and 20 lateral condylar) from 20 patients with osteoarthritis of the knee who had undergone total knee replacement. The specimens were placed in a saline-filled container and sonography was performed using a 10MHz linear transducer. Sonographic abnormalities were evaluated at the cartilage surface, within the cartilage, and at the bone-cartilage interface, and were compared with the corresponding pathologic findings. In addition, cartilage thickness was measured at a representative portion of each femoral cartilage specimen and was compared with the thickness determined by sonography. RESULTS: 'Dot 'lesions, irregularity or loss of the hyperechoic line, were demonstrated by sonography at the saline-cartilage interface of 14 cartilages. Pathologic examination showed that these findings corresponded to cleft, detachment, erosion, and degeneration. Irregularities in the hyperechoic line at the bone-cartilage interface were revealed by sonography in eight cartilages and were related to irregularity or loss of tidemark, downward displacement of the cartilage, and subchondral callus formation. Dot lesions, corresponding to cleft and degeneration, were noted within one cartilage. Cartilage thickness measured on specimen and by sonography showed no significant difference (p=0.446). CONCLUSION: Specimen sonography suggested that articular cartilage underwent degenerative histopathological change. Cartilage thickness measured by sonography exactly reflected real thickness.
Arthroplasty, Replacement, Knee ; Bony Callus ; Cartilage ; Cartilage, Articular* ; Femur ; Humans ; Knee* ; Osteoarthritis ; Pathology* ; Transducers ; Ultrasonography

PURPOSE: Recombinant ScFv lym-1 was produced, using pET vector system for large scale production. METHODS: ScFv lym-1 gene inserted pET-22b (+) vector, was expressed in E.coli BL-21 strain. ScFv lym-1 antibody extracted from periplasm, was purified with His-Taq column. To evaluated immunoreactivity with Raji cell, ScFv lym-1 was labeled with I-125 and I-125 ScFv lym-1 was purified with desalting column. Raji cell was injected into the C57BR/cdJ SCID mice. Gamma camera imaging were taken time point at 1, 8, 24, and 48 hr with 8 mm pinhole collimator. RESULTS: An active scFv lym-1 could be produced in E.coli with soluble from using pET vector system. Immunoreactivity and affinity constant of IgG lym-1 were 54% and 1.83 x 10(9) M(-1), respectively, and those of scFv lym-1 were 53.7% and 1.46 x 10(9) M(-1), respectively. Biodistribution of I-125 scFv lym-1 antibody showed faster clearance in blood, spleen, kidney and than I-125 IgG lym-1 antibody. Gamma camera image of I-125 scFv lym-1 antibody showed faster clearance and tumor targeting liver than I-125 IgG lym-1 antibody. CONCLUSIONS: In vitro properties of scFv lym-1 were similar to those of IgG lym-1. ScFv lym-1 showed faster blood clearance than IgG lym-1. These results suggest that scFv lym-1 antibody can be useful for tumor imaging agent.
Animals ; Gamma Cameras ; Immunoglobulin G ; Kidney ; Liver ; Lymphoma* ; Mice ; Mice, SCID ; Periplasm ; Radionuclide Imaging ; Spleen

OBJECTIVE: We designed this study to understand the physiologic effects and secretory pattern of IGF-I and IGF-II in human serum and changes in expression of IGF-I and IGF-II in human ovarian tissues during menstrual cycle, and to know which one is more important on human ovarian function between IGF-I and IGF-II, related to FSH, LH and estradiol. METHODS: IGF-I, IGF-II, FSH, LH and estradiol levels were measured in 80 serum samples by ELISA from normal reproductive women. We also examined the immunohistochemical staining of the IGF-I and IGF-II in the ovarian tissues of 14 normal reproductive women. The mean age was 35.6+/-9.15 years-old, ranged from 20 to 45. The average menstrual cycle was 27 to 29 days. RESULTS: 1. The average serum concentration of IGF-I was 204.43+/-50.92 ng/mL, and that of IGF-II was 1381.56+/-292.56 ng/mL. 2. The regular pattern or relationship on serum IGF-I and IGF-II concentrations were not observed (P=0.19). 3. To cross-correlation of serum concentrations of FSH, LH, estradiol and IGF-I, IGF-II, IGF-II was thought to effect on human ovarian menstrual cycles, affected by action of FSH (P=0.048). 4. In the normal reproductive ovaries, we observed immunohistochemical staining for IGF-I in primary, secondary, mature follicle, corpus luteum and stroma, but not in corpus albicans. 5. In the normal reproductive ovaries, we observed immunohistochemical staining for IGF-II in primary, secondary, mature follicle, and corpus luteum but not in corpus albicans and stroma. 6. Stronger immunohistochemical staining was observed in ovaries for IGF-II, rather than IGF-I. CONCLUSION: IGF-I and IGF-II were produced by ovarian tissues, and participated in ovarian folliculogenesis according to menstrual cycles by paracrine, autocrine functions. IGF-II, rather than IGF-I, was thought to effect greater on human ovarian menstrual cycles, affected by action of FSH.
Corpus Luteum ; Enzyme-Linked Immunosorbent Assay ; Estradiol ; Female ; Humans ; Immunohistochemistry ; Insulin-Like Growth Factor I* ; Insulin-Like Growth Factor II ; Menstrual Cycle* ; Ovarian Follicle ; Ovary

BACKGROUND:Rocuronium is a non depolarizing muscle relaxant of rapid onset and of intermediate duration. It is useful for short operations and for rapid control of the airway in pediatric patients. However the intravenous injection of rocuronium cause pain and a withdrawal movement. The purpose of this study was to evaluate the effect of lidocaine pretreatment in pediatric patients receiving rocuronium (10 mg/ml) and diluted rocuronium (1 mg/ml) on withdrawal movement METHODS: The study was approved by our institutional review board, and informed consent was obtained from all parents. One hundred and twenty five patients, aged from 4 months to 10 years, ASA physical status 1-2 undergoing general anesthesia for elective surgery were randomly enrolled in the study. Allergy history to a trial drug, pediatric patients on analgesics, difficult vein access and severely crying pediatric patients on arrival were excluded. All patients were non-premedicated and had a 22 G i.v. catheter inserted into the dorsum of hand before operation. On arrival in the operation room, routine non invasive monitors were placed and a free flow of i.v. fluid without edema, redness, hardness or pain was confirmed. After the administration of glycopyrrolate 0.004 mg/kg, inhalational induction was performed with 4-8 vol% sevoflurane by face mask fitting. One group received rocuronium 0.3 mg/kg (RS group) or vecuronium 0.05 mg/kg (VS group) was administered after 0.5 ml of 0.9% NaCl. A second group received rocuronium 0.3 mg/kg (RL group) or vecuronium 0.5 mg/kg (VL group) after lidocaine 1 mg/kg. A third group received rocuronium 1 mg/ml diluted with 0.9% NaCl (1:9) (RD group). Muscle relaxant-induced withdrawal movements were assessed by using a 4-grade scales (0-3). We also observed pulse rate alterations. Vein redness was evaluated just after administration and vein hardness five minutes after intubation by using a 4-grade scale (0-3). RESULTS: Withdrawal movements were more intense in the rocuronium group (R group, 3.8 times, P < 0.01) than in the vecuronium group (V group). Lidocaine pretreatment (L group, 1.8 times, P < 0.01) or diluted rocuronium (RD group, 1.9 times, P < 0.01) decreased withdrawal movement incidence. Withdrawal movement incidence was positive correlated with a change in pulse rate (Spearman's rho = 0.36, P < 0.01). CONCLUSIONS: Lidocaine pretreatment in patients receiving rocuronium (10 mg/ml) or diluted rocuronium (1 mg/ml) effectively reduces withdrawal movement during the administration of rocuronium.
Analgesics ; Anesthesia, General ; Catheters ; Crying ; Edema ; Ethics Committees, Research ; Glycopyrrolate ; Hand ; Hardness ; Heart Rate ; Humans ; Hypersensitivity ; Incidence ; Informed Consent ; Injections, Intravenous ; Intubation ; Lidocaine* ; Masks ; Parents ; Vecuronium Bromide ; Veins ; Weights and Measures