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

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

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

No abstract available.
Microsurgery*

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

The purpose of this study was to investigate the immunohistochemical reaction of calcitonin-gene-related peptide (CGRP) and type II collagen and also morphological changes of cartilage implants and cultured chondrocytes isolated from the articular and costal cartilages. The chondrocytes were isolated from the head of the femur and the 11th costal cartilage of the 6 months old rabbits. De novo implants were prepared from the chondrocytes cultured on the perichondrium by culturing isolated articular chondrocytes. Cultured chondrocytes and implants were evaluated by immunohistochemical staining of CGRP and type II collagen and electron microscopy. Articular chondrocytes maintained the typical phenotype in the 1st and 2nd subcultures, but the costal chondrocytes were transformed into fibroblast-like cells. The articular chondrocytes cultured on the perichondrium were more flattened and formed the cartilage. Most chondrocytes were no loss of type II collagen immunostaining by culturing. Implants replaced by the cultured articular chondrocytes were generally increased CGRP and decreased type II collagen immunoreaction. Electron microscopically the cultured articular chondrocytes had a large euchromatic nucleus, a few granules, and abundant vesicles. During culture, the nucleus became atropy and the cytoplasm contained many large vacuoles. The chondrocytes cultured on the perichondrium showed a lot of segmented rough endoplasmic reticulum and fine short microvilli. During culture, articular chondrocytes maintained typical phenotype and type II collagen reaction. The cultured articular chondrocytes had some organelles and euchromatic nucleus with prominent nucleolus. The chondrocytes cultured on the perichondrium showed active secretion of the matrix with small vesicles and well developed endoplasmic reticulum. The implanted articular chondrocytes showed the decrease of their organelles after secretion of the marix and became increased CGRP and decreased type II collagen immunoreaction.
Cartilage* ; Chondrocytes* ; Collagen Type II* ; Cytoplasm ; Endoplasmic Reticulum ; Endoplasmic Reticulum, Rough ; Femur ; Head ; Humans ; Infant ; Microscopy, Electron ; Microvilli ; Organelles ; Phenotype ; Rabbits ; Vacuoles

After a lobectomy the apearance of the chest roentgenogram may return so nearly to normal that it isfrequently very difficult to tell which lobe has been moved without refering to the thoracic surgeon's record. Thereriew of literature failed to disclose previous articles concerning the differential diagnosis between upper andlower lobectomy. Clues of a lobectomy may be found in the rib cage, hilar shadows, pleura and disphragms, but they do not specifically incidate which lobe has been removed. In the present study we anlaysed anatomico-spatialchanges of the pulmonary basal arteries, hilar point, vascular redistribution, diaphragm and rib cage on the plainchest films taken before and after a lobectomy in 33 cases seen at the Dept. of Radiology, St. Mary's Hospoital, Catholic Medical College. Firstly we observed the pulmonary basal artery after a lobectomy on plain chest film. In 12 cases of upper lobectomy the pulmonary basal artery was easily identified in every case. However in all of 21cases of lower lobectomy, the pulmonary basal artery was not identified. Next, a shift of the hilar point waschecked after a lobectomy. Regarding to vascular redistribution, the blood vessels was counted at upper and lowerlung fields by simon's method before and after a lobectomy, respectively. Finally, the level of the diaphragm wascompared in the pre. and post-opeative films and resected rib was scrutinized. The present study revealed that themost reliable sign to indicate specifically which lobe has been resected is persistence or disappearance of thepulmonary basal artery. Then i.e. in upper lobectomy the pulmonary basal artery was easily identified, but inlower lobectomy the pulmoanry basal artery was not dectable. Other findings such as vascular redistribution,elevated diaphragm and resected rib were not specific.
Arteries ; Blood Vessels ; Diagnosis, Differential ; Diaphragm ; Methods ; Pleura ; Ribs ; Thorax

Suceinylcholine(SCC)-induced hyperkalemia due to mechanical neuromuscular defects sueh as burn, severe trauma, uremia, neuromuscular diseases and etc. is well recognized from 1950. The upper motor neuron diseases are categorized into these neuromuscular diseases. For cerebral palsy, one of the upper motor neuron diseases, there are many different opinions in hyperkalemia after the administration of SCC. To establish the effects of SCC on hyperkalemia, in children with cerebral palsy presenting for selective posterior rhizotomy under the monitoring of evoked EMG, serum potassium, sodium, calcium, chloride and creatine phosphokinase (CPK) were measured prior to, and 2, 5, 10 and 30 min after the administration of SCC. The results are as follows,; 1) The mean age and body weight in twenty patients were 4.4+/-1.4 years and 14.2+/-2.1 kg, respectively. 2) Fine fasciculation on the hand, 1 graded by Cullen, occurred only in five of twenty patients. 3) There is no significant increase in the concentrations of potassium (ranges of mean ; 4.16- 4.23 mEq/L) and CPK (ranges 2.43-295 mEq/L) with the administration of SCC until 30 min. . 4) No significant changes in sodium, calcium and chloride following SCC are revealed. In conclusion,succinylcholine does not produce an increase in plasma potassium in children with cerebral palsy. However, CPK levels trend to increase after the administration, even if there is no statistically significant difference in the levels at the different time sequences.
Body Weight ; Burns ; Calcium ; Cerebral Palsy* ; Child ; Creatine Kinase ; Fasciculation ; Hand ; Humans ; Hyperkalemia ; Motor Neuron Disease ; Neuromuscular Diseases ; Plasma ; Potassium ; Rhizotomy ; Sodium ; Succinylcholine* ; Uremia

PURPOSE: We sought to evaluate the feasibility and outcomes of laparoscopic resection of giant hepatic cysts and surgical success, focusing on cyst recurrence. METHODS: From February 2004 to August 2011, 37 consecutive patients with symptomatic hepatic cysts were evaluated and treated at Dong-A University Hospital. Indications were simple cysts (n = 20), multiple cysts (n = 6), polycystic disease (n = 2), and cystadenoma (n = 9). RESULTS: The median patient age was 64 years, with a mean lesion diameter of 11.4 cm. The coincidence between preoperative imaging and final pathologic diagnosis was 54% and half (n = 19) of the cysts were located in segments VII and VIII. Twenty-two patients had American Society of Anesthesiologists (ASA) classification I and II, and nine had ASA classification III. Surgical treatment of hepatic cysts were open liver resection (n = 3), laparoscopic deroofing (n = 24), laparoscopic cyst excision (n = 4), laparoscopic left lateral sectionectomy (n = 2), hand assisted laparoscopic procedure (n = 2), and single port laparoscopic deroofing (n = 2). The mean fellow-up was 21 months, and six patients (16%) experienced radiographic-apparent recurrence. Reoperation due to recurrence was performed in two patients. Among the factors predicting recurrence, multivariate analysis revealed that interventional radiological procedures and pathologic diagnosis were statistically significant. CONCLUSION: Laparoscopic resection of giant hepatic cysts is a simple and effective method to relieve symptoms with minimal surgical trauma. Moreover, the recurrence is dependent on the type of pathology involved, and the sclerotherapy undertaken.
Cystadenoma ; Hand ; Humans ; Laparoscopy ; Liver ; Multivariate Analysis ; Recurrence ; Reoperation ; Sclerotherapy

Prosthetic valve endocarditis(PVE), although uncommon, is associated with significant mortality if the infection spreads into the paravavular structures with later abscess formation. However, combined antibiotic and surgical treatment is often successful. Accurate diagnosis by on echocardiography, effective myocardial protection during operation and increased surgical experience have improved the short-term and long-term outcomes for patients with PVE. A 35-year-old male had a history of replacement of aortic and mitral valve, and tricuspid annuloplasty on August 1994, was admitted due to sudden onset of aphasia, leftward deviation of both eyeballs and spiking fever and diagnosed of having PVE by echocardiography. Reoperation was done after 6weeks of antibiotic treatment. On the operative field, we could notice circumferential vegetation along aortic valve annulus, paravalvular leakage and abscess pocket. The mitral valve annulus was healthy. The patient underwent redo aortic valve replacement using cryopreserved aortic homograft after radical debridement of infected tissue. During the follow up of 7 months period the homograft was well functioning without recurrence of symptoms.
Abscess ; Adult ; Allografts* ; Aortic Valve ; Aphasia ; Debridement ; Diagnosis ; Echocardiography ; Fever ; Follow-Up Studies ; Humans ; Male ; Mitral Valve ; Mortality ; Recurrence ; Reoperation