The occurrence of a fistula between the duodenum and the colon is very rare, although these two structures commonly lie in intimate relationship to each other. It is not uncommon for tumor of the right colon and proximal transverse colon to involve the duodenum by continuity, but fistulous connection between the duodenum and colon are infrequent In most of the reported malignant cases, the fistulas follow carcinomas of the transverse colon or the hepatic flexure of the colon. We report a rare case of malignant duodenocolic fistula which was first suspected by endoscopic examination and confirmed by operation.
Colon ; Colon, Transverse ; Duodenum ; Endoscopy* ; Fistula*

The clinical review was done on 17 cases with the foreign body in the upper gastrointestinal tract who underwent endoscopic removal of foreign body at Kang Nam Sacred Heart Hospital from Dec. 1981 to Dec. 1991. The results were as follows: 1) The age distribution varies from 3 months to 72 years of age, being most prevalent under 5 years of age. 2) The incidence of foreign body in the order of frequency was coin, fish bone, safety pinring, peanut, keyring, food bolus, artificial teeth and medal. Among 17 cases, 9 cases(53.0%) were lodged in the esophagus and 8 cases(47.0%) were lodged in the stomach. 3) Dysphagia or globus was the common symptom in 8 cases(47.2%), followed by absence of symptom in 7 cases(41.2%), upper abdominal discomfort in 1 case(5.8%) and vomiting in 1 case (5.8%). 4) l0 cases(58.8%) of foreign body were removed within 72 hours and 7 cases(41.2%) of foreign body were removed after 72 hours.
Age Distribution ; Deglutition Disorders ; Esophagus ; Foreign Bodies* ; Heart ; Incidence ; Numismatics ; Stomach ; Tooth, Artificial ; Upper Gastrointestinal Tract* ; Vomiting

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

No abstract available.
Anthrax*

In this study, the effect of kanamycin sulfate was compared with fortified penicillin G in the treatment of uncomplicated penicillinase negative Neisseria gonorrhoeae(nonPPNG) urethritis in male. The subjects were 250 male patients with uncomplicated non-PPNG urethritis, at the Venereal Disease Clinic of Choong-ku Public Health Center in Seoul from May 1982 to August 1982. Among 103 patients treated with kanamycin sulfate, 2.0 gm, IM, 92 recovered and 11(10. 7%) failed. Among 100 patients treated with fortified penicillin G, 6 megaunits IM, plus probenecid, l.0 gm, 92 recovered and 8(8%) failed. No significant difference in the effect was found between these two regimens for non-PPNG urethritis. It is concluded that kanamycin sulfate as well as fortified penicillin G. have a good effect in the treatment of non-PPNG urethritis.
Gonorrhea* ; Humans ; Kanamycin* ; Male* ; Neisseria gonorrhoeae* ; Neisseria* ; Penicillin G* ; Penicillinase* ; Penicillins* ; Probenecid ; Public Health ; Seoul ; Sexually Transmitted Diseases ; Urethritis

Staphylococcus epidermidis and other coagulase-negative staphylococci (CNS), often dismissed previously as culture contaminants, are assuming great clinical importance as true pathogens. CNS infections are associated with indwelling foreign bodies and increase along with increasing use of catheters and artificial devices inserted through the skin. CNS from nosocomial infections, particularly S. epidermidis, are usually resistant to multiple antibiotics, with more than 80% resistant to methicillin. Methicillin-resistant. epidermidis (MRSE) can become resistant to all β-lactams, cephalosporins, and carbapenems by the aquisition of a chromosomal mecA gene, which encodes penicillin-binding proteins 2a that has low affinity for β-lactams. S. epidermidis universally attaches to surface of indwelling artificial devices and catheters and produces extracellular polysaccharides, resulting in the formation of a biofilm. Biofilms increase resistance of S. epidermidis to antimicrobial agents and the potential to cause infections in patients with indwelling medical devices. The drug of choice for MRSE infection is glycopeptide antibiotics (e.g. vancomycin and teicoplanin) and cure rates have been improved by addition of gentamicin or rifampin. Recently developed noble antibiotics for Gram-positive bacteria, quinupristin/dalfopristin and linezolid, will play an important role in the treatment of serious MRSE infections. However, antibiotics alone often fail for cure and removal of indwelling medical devices may be crucial.
Anti-Bacterial Agents ; Anti-Infective Agents ; Biofilms ; Carbapenems ; Catheters ; Cephalosporins ; Cross Infection ; Foreign Bodies ; Gentamicins ; Gram-Positive Bacteria ; Humans ; Linezolid ; Methicillin ; Methicillin Resistance* ; Penicillin-Binding Proteins ; Polysaccharides ; Rifampin ; Skin ; Staphylococcus epidermidis ; Staphylococcus* ; Vancomycin

Mullerian adenosarcoma is an uncommon variant of MQllerian mixed tumors of the uterus and a mixed, biphasic neoplasia in which the mesenchymal component is malignant and the epithelial component is benign. In contrast to typical malignant Miillerian mixed tumor(MMMT), Miillerian adenosarcomas are usually tumors of low malignant potential. These tumom usually present as pedunculated endometrial masses in postmenopausal women with vaginal bleeding. We experienced a case of Miillerian adenosarcoma of the uterus with squamous cell carcinoma of the uterine cervix and report with a brief review of literatures.
Adenosarcoma* ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Humans ; Uterine Hemorrhage ; Uterus*

To provide the information necessary for the insurance medicine management plan, price discount rates among the insurance medicines were studied. A total of 2,107 items of insurance medicine of which prices were discounted via government inspections of real transactional process of insurance medicine were analysed. The conclusions are as follows; 1. Among the variables relevant to the characteristics of manufacturers, price discount rates of insurance medicines were statistically significant with production rankings of manufacturers, incorporation year, existence of investments by foreign corporation, existence of a research institute, and enrollment in the exchange. And among the variables relevant to the properties of medicines, the number of enrolled items which have the same components, classification, the date of new enrollment, the sales of items, and the number of raw materials in the items were statistically significant. 2. Stepwide multiple regression was done to identify the factors which affect the price discount rates of insurance medicines. The number of enrolled items which have the same components, production rankings of manufactures, classification number (medicines for function of tissue cells), incorporation year (1940-1949), existence of investments by foreign corporations, classification number (anti-germ medicines), number of raw materials in the items, the sales of items, and medicines whose major objective is not treatment were significant variables and the R2-value for these variables was 21.2%. Considering all of the above results, for management of insurance medicines, it seems important that the real transactional prices of insurance medicines should be identified systematically, focusing on the properties which affect the price discount rates of insurance medicines.
Academies and Institutes ; Classification ; Commerce ; Insurance* ; Investments

Lichen planus is rare in Korea. and oral lichen planus is even rarer. To our knowledge, this is the first case reporting in Korean dermatological literature. 57 year-old man was seen for erythema with white striation on the oral mucosa in December 1981. The initial lisior s appeared on the buccal mucosa of left side of oral cavity 10 months ago. Thereafter he noticed similar lesions on the right side of buccal mucosa, hard palate, left side of upper and lower gingiva and left side of the lower lip. Histopathological and direct immunofluorescence studies showed typical features of lichen planus. Administration of griseofulvin(0.5gm. of Fulvicin' daily) for 4 weeks resulted in no clinical improvement. Oral retinoid(25mg of Ro 10-9359 daily) for 11 weeks resulte3 in healing of lesions with no side effect except slight dryness of the mouth.
Erythema ; Etretinate ; Fluorescent Antibody Technique, Direct ; Gingiva ; Humans ; Korea ; Lichen Planus ; Lichen Planus, Oral* ; Lip ; Middle Aged ; Mouth ; Mouth Mucosa ; Palate, Hard

There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on qPality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.
Delivery of Health Care ; Female ; Health Services ; Humans ; Inpatients ; Logistic Models ; Marketing ; Middle Aged ; Outpatients ; Patient Selection