BACKGROUND: Although the culture of urethral discharge using a cutton swab is regarded as one of the most sensitive and reliable diagnostic methods of gonorrhea, it may give pain or diagnostic methods of gonorrhea, it may give pain or discomfort to patients, and its detection rate may be influenced by the examiner's technical ability. OBJECTIVE: The purpose of this study was to compare the positive culture rates between ure4thral discharge and urinary sediment for the diagnosing of Neisseria gonorrheae. METHODS: We compared this technique with the culture of urethral discharge using the specimens from 357 male patients with gonococcal infection at VD clinic of Jungku Pvblic Health center in Seoul from Jan 1991 to Jun 1993. RESULTS: The culture of urinary sediment was positive in 339 of 357(94.95), whereas the culture of urethral discharge was positive in 346 of 357(96.95). However, these data have no statistical significance(P<0.05). The obe observed sensitivity and specificity of culture of urinary sediment comjpared to culture of urethral discharge were 97.75 and 90.9%, respectively. The predictive value of positive and negative test compared to the culture of urethral discharge were 99.7% and 55.65, respectively. As our data showed low negative predictive value, a negative culture result of urinary sediment does not always imply a negative culture result of urethral discharge. CONCLUSION: Therefore, at present, the previous method of the culture of urethral discharge is more highly recommended and further studies for this diagnostic and/or new method of gonorrhea based on larger group of patients is encouraged.
Gonorrhea ; Humans ; Male ; Neisseria gonorrhoeae* ; Neisseria* ; Sensitivity and Specificity ; Seoul

The isomorphic response of Koebner is a well-known phenomenon commonly associated with psoriafsis, but it has been also descrilbed in conjunction with a host of other disordered. We described five cases of erythema multiforme showing lesions of easily recognizsble Koebnei phenomena. Traumas to the skin do not cause erythema multiforme, however when a patient is in an active stage of the disease, physieal factor such as traumas occuring in normsl daly-life may contribute to the distribution of skin lesions as have been seen in our patients ; clinicians should aware of this point for better understanding of clinical features in erythema multiforme.
Erythema Multiforme ; Erythema* ; Humans ; Skin

No abstract available.
Pancreas*

One family with asymmetric septal hypertrophy was reported. The propositus of this family was 31 years old man who was admitted because of transient syncope. His father and one brother were affected but asymptomatic. His sister was suddenly died at age 21 years. The interventricular septal thickness to left ventricular posterior wall thickness ratios were measured using M-mode echocard ogram. In the affected family, echocardiogram revealed asymmetric septal hypertrophy (1.5:1, 2:1, 1.9:1 respectively). In the propositus, cardiac catheterization and simultaneous biventricular cineangiography were performed. Pressure study revealed mild peak systolic pressure gradient within left ventricular apex and left ventricular outflow tract (4mm Hg respectively). Biventricular cineangiogram showed the septal width increased inferiorly, and left ventricular endocardial surface of the septum was straight, while the right ventricular border convex toward the right ventricle.
Adult ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic* ; Cineangiography ; Fathers ; Heart Ventricles ; Humans ; Siblings ; Syncope

BACKGROUND: Neurofibroma, the hallmark of neurofibromatosis, is a cutaneous or subcutaneous lesion, with a variable clinical presentation. Histologically, neurofibroma consists of proliferation of nerve derived cellular elements, together with an abundant, collagenous extracellular matrix. Specifically, neurofibroma has been shown to contain 30-50% collagen in its matrix. Objective 5. METHODS: We examined the expression of extracellular matrix genes (collagen, fibronectin, laminin), TGF-b mRNA and Ha-ras oncogene mRNA by using Northern and slot-blot hybridization and immunoperoxidase stains. Result: In Northern blot analysis, Ha-ras and TGF-b genes revealed respectively, 8.8kb and 2. 5kb sized mRNA transcripts in neurofibroma. These parameters were normal in the control. The expression of these genes were 1.9, 2.0 fold increased in neurofibroma. In slot-blot analysis, expression of type I collagen showed fibronectin genes to be 2,401+210, 540+43, respectively, in neurofibroma. So there were 3.7 fold, 2.1 fold, differences respectively, compared to the normal control. However, there were no significant changes of type IV collagen and laminin Bl mRNA levels between neurofibroma and normal skin tissues. Irnmunoperoxidase staining by rnonoclonal anti type IV collagen antibody in neurofibroma showed type IV collagen to be diffusely and weakly stained in tissue. On staining by monoclonal anti-laminin antibody, laminin was stained in a matrix and around vessels. CONCLUSION: The increased expression of extracellular matrix genes may suggest that there is a subpopulation of fibroic cells in neurofibroma which are stimulated by TGF-b. Ha-ras genes which might have accumulated with the differentiation of neural tissue may be related to the pathogenesis of neurofibroma tissue formation. Further studies are needed to determine whether the other factors are related to the pathogenesis of neurofibroma.
Blotting, Northern ; Collagen ; Collagen Type I ; Collagen Type IV ; Coloring Agents ; Extracellular Matrix* ; Fibronectins ; Genes, ras* ; Laminin ; Neurofibroma ; Neurofibromatoses* ; RNA, Messenger ; Skin

Lupus vulgaris is most prevalent on exposed parts, especially the face but can also develop on exetremities. Lupus vulgaris originates from tuberculosis elsewhere in the body by hematogenous, lymphatic, or contiguous spread. A 19-year-old male patient came to our department. The patient had had many recurrent oozing and verrucous plaques and crusts on the left foot for one year. A skin biopsy from the lesion on the left dorsum of the foot showed scattered well defined granulomas consisting of the epithelioid cell clusters with Langerhans and foreign body type giant cells in the mid dermis. Caseation necrosis was slight. There were no bacilli on AFB staining. The multi test CMI for tuberculin was highly positive. A chest X-ray did not show any abnormal findings. The presence of Mycobacterium tuberculosis DNA was demonstrated by polymerase chain reactions (PCR) for detection of mycobacterial DNA from a routinely prepared paraffin-embedded skin specimen. Herein we report a very atypical case of lupus vulgaris confirmed by PCR.
Biopsy ; Dermis ; DNA ; Epithelioid Cells ; Foot ; Giant Cells, Foreign-Body ; Granuloma ; Humans ; Lupus Vulgaris* ; Male ; Mycobacterium tuberculosis ; Necrosis ; Polymerase Chain Reaction ; Skin* ; Thorax ; Transplants* ; Tuberculin ; Tuberculosis ; Young Adult

No abstract available in English.
Knee Prosthesis ; Knee

BACKGROUND AND OBJECTIVES: In acute myocardial ischemia, the conduction velocity of action potential is decreased by several electrophysiological and physical factors. The ventricular activation time(VAT) is a time duration of electrical impulse propagating from endocardium to epicardium. The goal of this study is to determine whether the reduction in conduction velocity in acute myocardial ischemia can lead a change in VAT. MATERIALS AND METHOD: Thirty patient, 18 males and 12 females, who had received percutaneous balloon coronary angioplasty(PTCA) were enrolled. The mean age was 59 years old. A twelve lead surface electrocardiogram(ECG) were obtained before, during, 1 minute, 5 minutes, and 10 minutes after the PTCA as digitized data by using Cardiolab EP 4.1 program. The magnitude of the QRS wave was amplified 3 to 4 folds and the speed was increased to 200mm/sec in order to get the VAT easily and accurately. The data was the mean of three consecutive VATs. The number of vessel treated with PTCA included left anterior descending artery(12), left circumflex artery(9), and right coronary artery(9). Among twelve chronic stable angina, sixteen unstable angina, and two acute myocardial infarction patients, twenty six had single and four had two vessel diseases. RESULTS: The significant increase in VAT during PTCA compared to that before PTCA was observed in eight of 12 leads. In addition, the significant decrease in VAT of 1, 5, and 10 minutes after PTCA compared to that during PTCA were noted. Furthermore, 10 minutes after PTCA, VAT decreased significantly compared to that before PTCA. The leads did not show a significant change of VAT depending on target vessels. The ECG of 16 patients showed changes of the ST segment during PTCA. The changes of VAT were not related to the ST segment change. CONCLUSION: The conduction delay from endocardium to epicardium in acute myocardial ischemia was presented as a prolongation of VAT in surface ECG. In addition, the conduction delay was recovered within 5 minutes after relief of ischemia. Therefore, the changes of VAT can possibly be used as one of the noninvasive parameters of myocardial ischemia.
Action Potentials ; Angina, Stable ; Angina, Unstable ; Electrocardiography ; Endocardium ; Female ; Humans ; Ischemia ; Male ; Middle Aged ; Myocardial Infarction ; Myocardial Ischemia* ; Pericardium ; Thoracic Surgery, Video-Assisted

No abstract available.
Fractures, Open*

PURPOSE: Providing an adequate amount of energy is important in patients with depleted nutrition. Indirect calorimetry is a portable tool that can measure the resting energy expenditure, the respiratory quotient, and the ratio of substrate utilization. Another way of getting the energy expenditure is through the use of equations, and that has been a more common way to get the basal energy expenditure. However, there has been a controversy that the energy expenditures calculated from equations are not the same as the values measured by indirect calorimetry. METHODS: Our study was to clarify this difference in two different groups with different physical conditions and growth. One was a normal-adult group (n=18), and their energy expenditure was calculated using the Harris-Benedict equations. The other was a normal-newborn group (n=7), and their energy expenditure was calculated using the Schofield equations. Calculated values were compared with the resting energy expenditure from indirect calorimetry (Deltatrac Metabolic Monitor, Datex Inc. Finland). RESULTS: In the adults, the basal energy expenditure was 1703.3+/-100.2 kcal/d according to the Harris-Benedict equations, and the resting energy expenditure was 1701+/-289.6 kcal/d according to indirect calorimetry (p>0.1). VO2 was 245.7+/-42.8 ml/min, VCO2 was 210+33.4 ml/min, and RQ was 0.86+/-0.05. In the neonates, the basal energy expenditure was 184.1+/-15.1 kcal/d according to the Schofield equations, and the resting basal energy expenditure was 154.3+/-32.1 kcal/d (p<0.05). VO2 was 21.9+/-4.3 ml/min, VCO2 was 18.7+/-4.0 ml/min, and RQ was 0.85+/-0.02. The ratios of substrate utilization were 192.1+/-58.8 g/d (48.03+/-16.8%) for carbohydrates, 69.7 +/-35.6 g/d (37.8+/-17.2%) for fats, and 55.8+/-14.9 g/d (14.3+/-3.9%) for proteins in the adults. In the neonates, the ratios were 18.6+/-5.6 g/d (50.3+/-7.0%) for carbohydrates, 18.6+/-1.1 g/d (47.7+/-6.2%) for fats, and 1+/-0 g/d (3.0+/-0.73%) for proteins. CONCLUSION: The difference between the basal energy expenditure obtained from equations and the resting energy expenditure obtained from indirect calorimetry could be identified only in the neonate group, but not in the adult group. It is speculated that resting energy expenditure was more reliable than the basal energy expenditure in neonates. Indirect calorimetry canbe a useful tool to correct the errors in the values obtained from equations, and other parameters, such as the respiratory quotient and the ratio of substrate utilization, should be evaluated in nutritional support.
Adult ; Calorimetry, Indirect* ; Carbohydrates ; Energy Metabolism* ; Fats ; Humans ; Infant, Newborn* ; Nutritional Support ; Young Adult*