• Title/Summary/Keyword: Genitourinary tract disease

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A Case of Pulmonary Trichomoniasis in a Young Healthy Male (건강한 젊은 남성에서 발생한 폐트리코모나스증 1예)

  • La, Sung Soo;Kong, Jae Hwan;Bang, Chang Seok;Hahn, Sung Hwhan;Myong, Na-Hye;Kim, Doh Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.5
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    • pp.387-391
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    • 2008
  • Bronchopulmonary infections caused by trichomonads have been reported principally in patients with pre-existing pulmonary diseases, such as bronchial carcinoma, lung abscess, or bronchiectasis. Pulmonary trichomoniasis is most often caused by Trichomonas tenax, which is usually regarded as a harmless commensal organism of the human mouth. However, pulmonary infection may rarely be caused by other trichomonas species, including Trichomonas vaginalis from the genitourinary tract and Trichomonas hominis from the intestines. Because of the rarity of trichomonas pulmonary infection, and because of its close association with underlying lung and systemic disease, pulmonary trichomoniasis is considered an opportunistic infection. We recently treated a case of pulmonary trichomoniasis occurring in a young, healthy male without obvious underlying pulmonary or systemic illness. To our knowledge, there has been only one reported case of pulmonary trichomoniasis in Korea, and there have been only two reported cases of pulmonary trichomoniasis occurring in normal lung worldwide.

ANTIMICROBIAL SUSCEPTIBILITY TEST ON STREPTOCOCCUS VIRIDANS IN CHILDREN'S ORAL CAVITY (소아의 구강내에서 검출된 Streptococcus viridans에 대한 항균제 감수성 연구)

  • Shin, Sang-Hun;Song, Jung-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.3
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    • pp.330-336
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    • 2000
  • A large number of streptococci that do not fit readily into any of the established classification schemes have been relegated to a large heterogeneous group called the Streptococcus viridans, which are members of the normal flora of the mucous membranes of the body, including the oral cavity, the nasopharynx, and genitourinary tract. This group includes S. mitis, S. oralis, S. sanguis, S. salivarius, S. milleri, etc. Surveying on the literature, it has been reported that infective endocarditis, meningitis, rhabdomyolysis, cholangitis, appendicitis caused by Streptococcus viridans, which were the most important pathogen in children with malignant hematologic disease. Various antibiotics has been chosen for treatment or prophylaxis for these infections, but were generally lower antimicrobial susceptibilities because of an abuse of antibiotics and advent of resistant group. Therefore, surveillant culture must be performed to evaluate personal antimicrobial susceptibilities of intraoral microbes for proper antimicrobial choice for dental procedures. This study examined sampling from subgingival plaque of 60 chidren's microbes. The cultured bacterial isolates, Streptococcus viridans were examined 10 antimicrobial drugs with the Kirby-Bauer agar disk diffusion method. The used drugs were Penicillin, Ampicillin, Oxacillin, Cephalothin, Imipenem, Gentamicin, Erythromycin, Vancomycin, Ciprofloxacin, Clindamycin. The results were as follows : 1. Sampling Streptococcus viridans were S. mitis(65%), S. oralis(22%), S. sanguis(5%), S. intermedius(3%), S. salivarius(2%), S acidominimus(2%), Unidentified streptococcus(2%). 2. The antimicrobial susceptibility of total Streptococcus viridans : Oxacillin< Erythromycin< Pencillin=Ciprofloxacin< Cephalothin< Ampicillin< Clindamycin< Gentamicin< Imipenem=Vancomycin. 3. The antimicrobial susceptibility of S. mitis : Oxacillin=Erythromycin< Ciprofloxacin< Cephalothin< Penicillin=Ampicillin< Gentamicin< Clidamycin< Imipenem=Vancomycin. 4. The antimicrobial susceptibility of S. oralis : Oxacillin< Erythromycin< Penicillin=Ciprofloxacin=Clindamycin< Cephalothin=Gentamicin< Ampicillin< Imipenem=Vancomycin. 5. There was no significant difference in the antimicrobial susceptibility among each Streptococcus viridans group.

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The Review of a Standardized Method in Retention-Enema: a Clinical Study (보류관장의 표준화된 방법을 위한 고찰: 임상논문을 중심으로)

  • Song, Eun-Young;Lee, Eui-Ju;Bu, Yong-Min;Shin, Seung-Won;Chai, Kwang-Min;Yoo, Jung-Hee;Kim, Hyo-Jin;Baek, Jong-Heon;Lee, Jun-Hee;Koh, Byung-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.2
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    • pp.108-114
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    • 2013
  • Objectives This study was aimed to review a standardized method of retention enema by extracting elements associated with methods of retention enema from papers involved. Methods 1) Data sources : Retrieval was made, using 'Enema' or 'Retention Enema' as search words in MEDLINE, The Cochrane Library, KISS, RISS, and NDSL DB. 2) Study selection : Two authors excluded irrelevant papers and chose qualified abstracts in the rest of the papers. The chosen studies were reviewed fully by the authors so that they could screen the significant papers based on the exclusion criteria. 3) Data extraction : Data on the total number of subjects, the target disease, the type, quality, length, diameter of catheter, the insertion length of catheter, the sample, the sample volume, the process of retention enema and the number of performing retention enema were extracted from the selected studies. Results & Conclusions The retention enema can be applied to gastrointestinal diseases, genitourinary diseases, metabolic diseases such as hypertension and diabetes, headaches and neurological disorders. The standardized treatment method is as following: 1) inserting a rental tube of 18-28 Fr that measures 20 to 30 cm into the patient's anus, 2) injecting herbal medicines which have purgative action or benefit on stomach and intestinal tract at the rate of 4 ml/min, and 3) holding them for 10 to 15 minutes.

A Case of Pulmonary Intravascular Lymphomatosis (폐를 침범한 혈관내 림프종증 1예)

  • Park, Sang-Jong;Bae, Sang-Su;Cheon, Eun-Mi;Kwon, O-Jung;Rhee, Chong-H.;Han, Yong-Chol;Kim, Jin-Guk;Lee, Kyung-Soo;Ko, Young-Hye
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1390-1395
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    • 1997
  • Intravascular lymphomatosis(IVL) which was first described by pfleger and Tappeiner in 1959 is rare malignancy characterized by neoplastic proliferation of lymphoid cell lineage within the vascular lumen with little or no adjacent parenchymal involvement Its usual sites of involvement are central nervous system and skin or infrequently heart, lungs, pancreas, liver, spleen, kidney, adrenal glands, genitourinary tract, and bone marrow. Pulmonary involvement of IVL is not common. Symptoms of pulmonary involvement include dyspnea, cough and fever. Radiologicially, the disease is manifested with diffuse interstitial infiltrates. We report a recently experienced case of pulmonary intravascular lymphomatosis which was manifested with fever and chest pain.

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Clinical Outcome of Multicystic Dysplastic Kidney in 46 Children (다낭성 이형성 신 환아 46명의 예후와 관련한 임상적 고찰)

  • Jeong Il-Cheon;Hwang You-Sik;Ahn Sun-Young;Han Sang-Won;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.27-32
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    • 2006
  • Purpose : Conservative management of multicystic dysplastic kidney(MCDK) without nephrectomy has recently been advocated. The purpose of this study was to determine the clinical course of conservatively managed MCDK and to find out possible predictive factors for involution of MCDK by ultrasonography(US). Methods : A retrospective analysis was made on 45 patients(26 boys and 20 girls) in whom MCDK was detected and had been traced by US between Dec. 1993 and Aug. 2005 at Severance Hospital. Results : Median follow-up time was 30 months(range 2-102 months). All patients under-went radionuclide scans and voiding eystourethrograms. The serial follow-up US showed complete involution in 11(24%), partial involution in 19(41%), and no interval change or increased in cyst size in 13(28%) patients. Nephrectomy was done in 3 patients(7%) due to relapsing urinary tract infection(UTI) and severe abdominal distension. The mean age of complete involution of MCDK was 37 months(range 12-84 months). Episodes of UTI were present in 17 patients(37%) and additional genitourinary(GU) abnormalities were found in 22 patients(44%). Hypertension and renal insufficiency was complicated in one patient. No child developed malignant tumor. Univariate analysis showed that five variables were associated with complete involution of the MCDK; gender, site, UTI episode, additional GU abnormalities, and renal length on initial US. After adjusting using the Pearson model, the presence of additional GU abnormalities was exclusively associated with complete involution among the 5 variables(P=0.034). Conclusion : In our review of 46 cases of MCDK, non-surgical approach for patients with MCDK was advisable and we could predict poor prognosis when MCDK is associated with other GU anomalies.

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Predictive Value for Vesicoureteral Reflux in Children with Urinary Tract Infection (요로감염 환아에서 방광요관 역류를 예측할 수 있는 인자에 대한 연구)

  • Lee, Seung-Hyun;Noh, Sung-Hoon;Oh, Jeung-Eun;Kim, Min-Sun;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.62-69
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    • 2008
  • Purpose: The most concerning issue in children with urinary tract infection(UTI) is the probability of underlying genitourinary anomalies and vesicoureteral reflux (VUR), which is frequently associated with renal scarring and eventually end-stage renal disease. Therefore, voiding cystourethrography(VCUG) is usually recommended at the earliest convenient time for children with UTI. However, VCUG is an invasive procedure that requires catheterization and exposure to X-ray. In this study, we aimed to determine the predictability of clinical, laboratory and imaging parameters for VUR in children with UTI. Methods: Data of children with bacteriologically proven UTI who underwent VCUG were evaluated retrospectively for clinical(age, gender, fever), laboratory(leukocytosis, ESR, CRP, pyuria, blood urea nitrogen, serum creatinine) and imaging(renal ultrasound and DMSA renal scan) findings. First, children with UTI were divided into two groups according to the presence of VUR as non-VUR group and with VUR group, and clinical, laboratory variables were compared between these groups. Second, patients who had VUR were reclassified as low-grade VUR(grade I-II) group and high-grade(grade III-V) VUR group according to grading of VUR, and clinical, laboratory and imaging variables were compared between these groups. Results: Among 410 children with UTI, 137 had VUR and 78 high-grade VUR. Fever, leukocytosis, ESR, CRP, pyuria were associated with VUR. In addition, abnormal findings of ultrasonography and DMSA renal scan were closely related to VUR. However, these clinical and laboratory variable in patients with high grade VUR were not different significantly, compared to those with low-grade VUR group. Conclusion: Fever, leukocytosis, ESR, CRP seems to be potentially useful predictors of VUR in pediatric patients with UTI. In addition, renal ultrasonography and DMSA renal scan findings supported the presence of VUR. Further study of these findings could limit unnecessary VCUG in patients with UTI.

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The Results of Curative Radiotherapy for the Uterine Cervical Cancer (자궁경부암의 근치적 방사선치료 성적)

  • Kim, Hyoung-Jin;Kim, Jung-Soo;Kwon, Hyoung-Cheol;Kim, Jin-Kee;Oh, Byung-Chan
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.191-199
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    • 1996
  • Purpose : To evaluate 5-year survival rate, patterns of failure and complications of cervical cancer treatment, fifty nine patients treated by curative radiotherapy for the uterine cervical cancer were analyzed retrospectively. Materials and Methods : From March 1986 to May 1990, fifty nine patients with histologically proven uterine cervical cancer were analyzed. According to FIGO stage, there were 2 patients ($3.4\%$) in stage Ib, 2 patients ($3.4\%$) in stage IIa, 31 patients ($52.5\%$) in stage IIb, 15 patients ($25.4\%$) in stage IIIb, 9 patients ($15.3\%$) in stage IV. External RT was per formed by 6 MVLINAC with daily 1.8 Gy, 5 times per week and followed by ICR. A point dose of ICR was calculated to 30-43.66 Gy (median: 34.6 Gy). These techniques delivered total A Point dose of 80.4 to 109.8 Gy (median: 85 Gy). Patients had been followed up from 2 to 110 months (median: 61 months) Results : The overall 5-year survival rate & disease free survival rate were $55.9\%$ and $55.0\%$ respectively. According to FIGO stage, the 5-year survival rate for less than IIa, IIb, IIIb, IV were $75.0\%$, $74.8\%$, $26.7\%$, $33.3\%$, respectively. In univariate analysis, the 5-year survival rate for stage IIb and below versus stage IIIa and above revealed $74.8\%$, $29.2\%$ respectively (P<0.005). According to the hemoglobin level during RT, the 5-rear survival rate of was $73.3\%$ for patients with Hg 10 gm/dL or higher, in contrast to $0\%$ for those with lower than 10 gm/dL (p<0.005). In 18 patients with nonbulky tumor (<5cm), the 5-year survival rates were $71.8\%$. The 5-rear survival rates for 18 patients with 5 cm or greater in tumor diameter were $22.2\%$ (p<0.005). The 5-year survival rate for Patient age of above 50 years and below were $65.3\%$ $34.2\%$ respectively (p<0.05). ECOG performance status. pathologic finding, total dose, total treatment time were not statistically significant factors. The significant prognostic factors affecting overall 5-year survival rate by multivariate analysis showed the hemoglobin level during RT (P=0.0001), tumor size (p=0.0390), FIGO stage (p=0.0468). Total recurrence rate was $23.7\%$ local failure $15.2\%$ (9/59), distant metastasis $6.8\%$ (4/59), local and distant metastasis $1.7\%$ (1/59). According to the RTOG/EORTC Soma Scales, the late complication rate was $23.8\%$ (14/59) The late complication rate of colorectum and genitourinary tract were $15.3\%$ (9/59), $8.5\%$ (5/59), respectively: 10 patients ($17.0\%$) were grade 2, 3 Patients ($5.1\%$) were grade 3 and one patient ($1.7\%$) was grade 4. The late complications were radiation proctitis, rectal bleeding, radiation colitis, diarrhea and radiation cystitis in decreasing order. Conclusion : For improvement of therapeutic results, prospective randomized trials are recomended to discover new prognostic factors and more aggressive radiation therapeutic methods are needed for poor prognostic patients. The adjuvant chemotherapy or radiation-sensitizing agents must be considered to inhibit regional and distant metastasis.

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