The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners' situation and preferences.

An intramural hematoma of the stomach usually results from trauma. Gastric intramural hematomas may also occur in patients with bleeding disorders who are receiving anticoagulation therapy or after an endoscopic procedure. Here, we describe a case of a gastric intramural hematoma after endoscopic hemostasis for gastric ulcer bleeding in a patient medicated with aspirin.
Aspirin ; Epinephrine ; Hematoma ; Hemorrhage ; Hemostasis, Endoscopic ; Humans ; Stomach ; Stomach Ulcer

BACKGROUND AND OBJECTIVES: Drug-eluting stents (DES) have been shown to substantially reduce both angiographic and clinical restenosis. Cypher(R) (sirolimus-eluting stent, Cordis, Johnson and Johnson, Florida, USA) and Taxus(R) (paclitaxel-eluting stent, Boston Scientific, Boston, USA) are the two most widely used DESs, and they both have distinct pharmacological properties and release kinetics. It has been not studied whether these two DESs show different angiographic outcomes when they are simultaneously implanted in the same patient. SUBJECTS AND METHODS: We retrospectively analyzed the angiographic findings of the short-term follow-up in 34 patients (average age: 63 year old, 9 women) in whom both Cypher and Taxus stents were implanted at the same time for the treatment of obstructive coronary lesion. RESULTS: There was no significant difference in the basal angiographic characteristics of the lesions that had two stents deployed in terms of the AHA/ACC classification, reference diameter, the percent diameter stenosis and minimal luminal diameter. The post-procedure results were similar between the two stents. At 6 months follow-up, the Cypher stent displayed significantly less in-stent lumen loss compared with the Taxus stent (0.16+/-0.04 mm vs 0.27+/-0.04 mm; respectively, p=0.040) and a smaller percent diameter stenosis (15.9+/-1.3% vs 19.9+/-2.2%, respectively, p=0.049). CONCLUSION: The Cypher stent showed significantly less luminal loss during short term follow-up compared with the Taxus stent when implanted in the same patient. This result suggests that in a given individual patient, the Cypher stent induces less neointimal proliferation than does the Taxus stent.
Classification ; Constriction, Pathologic ; Coronary Restenosis ; Drug-Eluting Stents ; Florida ; Follow-Up Studies ; Humans ; Kinetics ; Middle Aged ; Paclitaxel ; Phenobarbital ; Retrospective Studies ; Sirolimus ; Stents* ; Taxus*

PURPOSE: To characterize the typical radiologic appearance of ganglioneuromas of the adrenal gland and extra-adrenal retroperitoneum. MATERIALS AND METHODS: The findings of diagnostic imaging studies (CT, n=5; ultrasound, n=1) involving six patients aged 19-58 years with pathologically proven ganglioneuroma were retrospectively analyzed by three radiologist in terms of the lesions' size, shape, margin, location, CT attenuation (unenhanced/contrast-enhanced), necrosis, calcification, relationship with adjacent vessels, and US echogenicity. RESULTS: The maximum diameter of the six tumors ranged from 10 to 14 (mean, 11.3) cm, and the margin was well-defined in all cases. The homogeneous or slightly heterogeneous attenuation demonstrated at unenhanced CT was less than that of muscle. Dense nodular calcification was present in one case. At contrast-enhanced CT, enhancement was poor (n=5), mild and septum-like, or delayed, heterogeneous and focal (n=3), or involved subtle foci (n=1). In no case was there evidence of necrosis or hemorrhage. Local invasion was absent, but adjacent vascular encasement (n=2) or displacement (n=2) occurred. Ultrasonic examination demonstrated low echogenicity and mild heterogeneity (n=1). CONCLUSION: A ganglioneuroma is an uncommon benign neural crest tumor which should be included in the differential diagnosis of a retroperitoneal mass which presents as a well-defined tumor, tend to encase or displace adjacent major blood vessels, and shows low attenuation at unenhanced CT and poor or septum-like focal enhancement at contrast-enhanced CT.
Adrenal Glands ; Blood Vessels ; Diagnosis, Differential ; Diagnostic Imaging ; Ganglioneuroma* ; Hemorrhage ; Humans ; Necrosis ; Neural Crest ; Population Characteristics ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography

BACKGROUND: The aim of the study was to develop an accurate, convenient, and easy microplate system for the identification of enterococcal species from clinical specimens. METHODS: The microplate identification method was composed of twelve biochemical tests and identification programs. The tests comprised in microplate were initially screened by a two-tube method, NaCl-esculin hydrolysis and pyrrolidonyl-beta-naphthylamide test; arginine dihydrolase, acid production from mannitol, sorbitol, sucrose, arabinose, raffinose, methyl-alpha-D-glucopyranoside, and ribose in the microplate; and pigment production and hemolytic pattern in blood agar plate. The performance of the microplate for identifying enterococci to the species level was evaluated in comparison with conventional reference tests and commercial kits. RESULTS: Among the 111 clinical isolates of Enterococcus species, the microplate system correctly identified 100% to genus level, and 91.0% to species level. All of E. casseliflavus, E. durans, and E. hirae were correctly identified by the microplate. The diagnostic sensitivity and specificity for identification of Enterococcus species were as follows: 100% and 96.7% in E. faecium, 93.5% and 100% in E. faecalis, 100% and 97.2% in E. raffinosus, and 33.3% and 98.1% in both E. avium and E. gallinarum. CONCLUSIONS: It is concluded that the microplate method offers a simple, cost-effective, rapid, and accurate identification system for the identification of most clinical isolates of Enterococcus species.
Agar ; Arabinose ; Arginine ; Enterococcus* ; Hydrolysis ; Mannitol ; Raffinose ; Ribose ; Sensitivity and Specificity ; Sorbitol ; Sucrose

BACKGROUND: The accurate and rapid identification of enterococci can provide clinician's decision making of antimicrobial therapy because enterococci are usually multiresistant to commonly used antimicrobial agents and antimicrobial resistance patterns are different according to enterococcal species. Accuracy of identification system depends mainly on data base such as positive rate of biochemical reactions, relative frequency of occurrence of biotype, and isolation frequency of microorganisms. The purpose of this study was to analyze the isolation rate and biotype frequency of enterococci isolated from clinical specimens. METHODS: We used a simplified identification system for the identification of the enterococci from clinical specimens during the period of June 1998 to November 1998. Biochemical phenotypes of 500 isolates of enterococci were also analyzed by a simplified identification system consisting of eight conventional biochemical tests. RESULTS: Enterococci were isolated from urine (36.4%), wound (35.0%) and blood (7.2%) in order of decreasing frequency. Among the isolates, 67.8% were E. faecalis, 23.0% E. faecium, 2.2% E. hirae/durans, 2.0% E. casseliflavus, and 1.0% E. hirae. The simplified identification system of enterococci identified 93.6% of all isolates to species level. The system identified 98.5% of E. faecalis but only 89.6% of E. faecium. CONCLUSIONS: Our simplified identification system based on eight biochemical tests offer a simple, reliable and economic method for the identification of clinical isolates of enterococci, but further studies are needed for the improvement of accuracy and identification rate.
Anti-Infective Agents ; Decision Making ; Enterococcus ; Phenotype ; Wounds and Injuries

D variant of encephalomyocarditis (EMC-D) virus causes diabetes in susceptible mice by direct infection and cytolysis of pancreatic beta cells. cDNA covering the major outer capsid protein (VP1) of EMC-D virus was cloned into Mycobacterium bovis bacillus Calmette-Guerin (BCG). None of the SJL/J male mice, immunized with live recombinant BCG-VP1, became diabetic when challenged with highly diabetogenic EMC-D virus. But the control mice inoculated with normal BCG or rBCG transformed with vector alone developed diabetes in the same challenge. VP1-specific antibodies including neutralizing antibodies were markedly increased as time went on and reached to the maximum titer at week 10 after a single immunization. The plateau of the titer lasted longer than following 4 weeks. Guinea pigs immunized with the live rBCG-VP1 showed strong delayed type hypersensitivity (DTH) to the VP1of EMC-D virus. It means that the live rBCG-VP1 elicit efficient humoral and cell-mediated imrnune responses against EMC-D virus, resulting in prevention of virus-induced diabetes in susceptible mice.
Animals ; Antibodies ; Antibodies, Neutralizing ; Bacillus ; Capsid Proteins ; Clone Cells ; DNA, Complementary ; Guinea Pigs ; Humans ; Hypersensitivity ; Immunization* ; Insulin-Secreting Cells ; Male* ; Mice* ; Mycobacterium bovis*

Pulmonary embolism from metallic mercury is rare. It may occur after a deliberate intravenous injection of mercury as a suicide gesture, in the presence of drug abuse or severe psychiatric disturbance, with the hope of increasing athletic and sexual performance, and accidentally during right heart catheterization while sampling blood with mercury containing syringes. We have experienced the first case of pulmonary embolism associated with intravenous mercury injection in Korea. The blood mercury level remain elevated within the toxic range to date. This may be due to the continued absorption of embolized mercury. Multifocal areas of patchy perfusion defects are in both upper lung fields on perfusion scan of lung. Few of the abnormalities of respiratory or renal function reported previously were demonstrated. We report the case of a young male patient presenting with a clinical picture of pulmonary embolism, in whom widespread deposit of metallic mercury were demonstrated throughout both lungs and elsewhere in the body.
Absorption ; Cardiac Catheterization ; Cardiac Catheters ; Gestures ; Hope ; Humans ; Injections, Intravenous ; Korea ; Lung ; Male ; Perfusion ; Pulmonary Embolism* ; Sports ; Substance-Related Disorders ; Suicide ; Syringes

No abstract available.
Animals ; Herpes Simplex* ; Mice* ; Simplexvirus* ; Skin* ; Vagina*

BamHI restriction patters and genomic library of Herpes simplex virus type 2 (HSV-2) stram G were constructed, and locations of the glycoproteins gB and gD, and it genes on the fragments were detected by Southern blot analysis. HISV-2 genomic DNAs were cleaved into twenty-seven fragments by BamHI enzyme in the range of 0.72 to 15.08 (total 150.44 kb), which were cloned into the BamHI site of pBluescript SK(+) to construct genome library of the HSV-2. The library was named by the order of the fragment size from smallest one to largest one. HSV-2 glycoprotein gD gene was located in PHLA2-21 and PHLA2-22 recombinant plasmids, gB gene in PHLA2-24 plasmic, and it gene in PHLA2-11 clone by Southern blot analysis.
Blotting, Southern ; Clone Cells ; DNA ; Genomic Library ; Glycoproteins* ; Herpes Simplex* ; Herpesvirus 2, Human* ; Phosphotransferases* ; Plasmids ; Simplexvirus*