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Characteristics of Recent 10 Cases of Fournier's Gangrene
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Myeong Heon Jin, Mi Mi Oh, Jae Hyun Bae, Hong Soek Park, Duck Ki Yoon, Du Geon Moon
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Korean J Urogenit Tract Infect Inflamm 2007;2(2):203-208. Published online October 31, 2007
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Abstract
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- "Purpose: Fournier’s gangrene is a rare and potentially fatal infectious disease characterized by necrotic fasciitis of the perineum and abdominal wall, along with the scrotum and penis in men and the vulva in women. The aim of this study is to share our recent experience with the management of this difficult infectious disease. Materials and Methods: The authors reviewed retrospectively the clinical records of a series of 10 patients with Fournier’s gangrene between the years 2004 and 2007 who, after initial treatment. The patient’s age, predisposing etiological factors, interval between onset of symptoms and diagnosis, lesion site, results of bacteriologic cultures, treatment and reconstructive procedures, length of hospital stay, treatment and outcome were analyzed. Results: The patients' ages ranged between 46 and 84 years (mean 59 years). Of the 10 patients, 1 (10%) died and 9 (90%) survived. The predisposing factors included diabetes mellitus (10 cases, 100%), hypertention (3 cases, 30%), liver cirrhosis (2 cases, 20%), CVA (1 case, 10%). All 10 patients had positive culture results, with 9 (90%) of these being polymicrobial. The most common organisms isolated were Escherichia coli (n=6), Staphylococcus aureus (n=4) and Streptococcus agalactiae (n=2). The important finding wass the fact that quinolone-resistant extended spectrum beta-lactamase (ESBL) Escherichia coli (E. coli) was detected in two cases (20%). The mean length of hospital stay was 41.1 days (7-70). Conclusions: There is no differences between current study and previous, butit is important that ESBL producing E. coli was appeared. It may have influence on length of hospital stay and wound healing. However, more studies are required to conclusively prove the effect of ESBL on prognosis of Fournier’s gangrene."
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Multicenter Clinical Outcome of Gatifloxacin for Chronic Prostatitis (NIH Category II or IIIa) in Korea
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Sang Don Lee, Seung Ju Lee, Tae Kon Hwang, Duck Ki Yoon, Kyu Sung Lee, Luck Hee Sung, Myung Soo Choo, Bong Suk Shim, In Rae Cho, Min Eui Kim, Soo Bang Ryu, Chul Sung Kim, Young Gon Kim, Chun Il Kim, Hyun Yul Rhew, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2007;2(1):53-60. Published online May 31, 2007
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Abstract
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- "Purpose: The objective of this study was to investigate the efficacy and safety of gatifloxacin for patients with chronic prostatitis (NIH category II or IIIa) in Korean urologic practice. Materials and Methods: A total of 16 outpatient urology clinics at tertiary care medical centers in Korea participated. Gatifloxacin (400 mg/day) treatment (S.D.) of 149 patients (20 patients with category II and 129 patients with category IIIa) with prostatitis (mean age 45.8±13.3 years) was carried out for 41.7 (33.1) days. A 4-glass test according to Meares and Stamey or two glass test was carried out at study entry and one month after the end of treatment. Clinical response, safety and bacteriological response were assessed before treatment (within 48 hours of initiation of the study medication) and at one month after treatment completion. Results: In a otal of 149 patients, the total NIH-CPSI score was significantly reduced from 20.5 to 10.0 (response rate 86.7%; 95% CI 80.2-93.2%) (p<0.05). Sub-scores of pain, urinary symptoms and impact on the quality of life were also significantly reduced from 8.9 to 3.8 (response rate 83.8%; 95% CI 76.8-90.9%), from 4.2 to 2.0 (response rate 73.3%; 95% CI 64.9-81.8%) and from 7.4 to 4.2 (response rate 79.0%; 95% CI 71.3-86.8%), respectively (p<0.05). In terms of the overall clinical efficacy assessment by investigators, out of 149 patients with prostatitis, 71.2% were assessed to be responders. Bacteriological studies in expressed prostatic secretion (EPS) or post prostate massage urine (VB3) at 1 month after treatment completion demonstrated that the overall eradication rates of pathogens was 85% and the pyuria (≥10 WBC/HPF) rates in the NIH category II and IIIa were 35% and 18.6%, respectively (overall rate 20.8%). There were 16.1% of patients that presented with some adverse events considered by investigators to be related to the drug. The majority of adverse events were considered to be of mild (87.5%) or moderate (8.3%) intensity. Conclusions: These results suggest that gatifloxacin in Korean urologic practice is well tolerated and improves the clinical outcomes in the patientswith chronic prostatitis (NIH category II or IIIa)."
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