A case of nevus syringocystadenoma papilliferus which resembles eclinically as nevus sebaceus in 17 year-old female is presented. The histopathological examination revealed characteristic features of the disease.
Adolescent ; Female ; Humans ; Nevus

BACKGROUND: Community-acquired pneumonia(CAP) remains a leading cause of morbidity and mortality worldwide. Recently, the evolution of drug-resistant microorganisms has become a serious problem in CAP management. Specific antimicrobial therapy is the cornerstone of CAP management. However, obtaining an accurate etiologic diagnosis clinically is not easy and empirical antimicrobial treatment is usually administered prior to the correct microbiologic diagnosis. In this study, the clinical usefulness of empirical CAP treatment was investigated. METHODS: A total 35 cases were studied prospectively over a 16-month period in Mokpo Catholic Hospital from Dec. 1995 to Mar. 1997. The microbiologic diagnosis was made by sputum, blood culture, a specific serum antibody test and an immunologic study. RESULTS: The causative organisms were isolated in 10 (30%) out of 33 cases: 8 cases and 1 case on the sputum culture and blood culture respectively, and 1 case by an indirect hemagglutinin test. 12 cases had underlying diseases: pulmonary tuberculosis 4, alcoholism 4, diabetes mellitus 3, and liver cirrhosis 1. Antimicrobial treatment was given empirically and all cases recovered. CONCLUSION: A definite microbiologic diagnosis before commencing the appropriate treatment in CAP is not straightforward. Empirical therapy according to a clinical assessment is important and helpful. However, every effort to make the correct etiologic diagnosis should be taken.
Alcoholism ; Diabetes Mellitus ; Diagnosis ; Hemagglutinins ; Jeollanam-do* ; Liver Cirrhosis ; Mortality ; Pneumonia* ; Prospective Studies ; Sputum ; Tuberculosis, Pulmonary

Since Jafferson has reported the atlantal fracture in 1920, and its mechanism and type of fracture in detail, a few authers have reported the cases in their literature because the atlantal fractures are one of rare case in cervical injuries. The clinical signs are sparse indeed after acute transection or contusion of medulla. One survived has had a minimal neurologic deficit on account of wide vertebral canal for the cervical cord. The patient has complained the occipital headache and limited motion of neck commonly, without any neurological disturbance. The cervical tracton has been applied for the case usually. Recently, we experienced a case of atlantal fracture with occipito-atlantal dislocation and atlanto-axial dislocation, associated-with quadriplegia for 2.5 years progressively after cervical injury. On simple films of lateral view of cervical spine, it revealed a separated posterior arch was anteriorly dislocated and impacted into the vertebral canal, and anterior arch was markedly displaced anteriorly and had a bony union with the axis in angulated form. The odontoid process of axis is upward translocation. No fracture was found in open mouth view for the axis. The occipito-atlantal and atlanto-axial dislocation were found. On myelogram, the contrast media was almost obliterated in the false occipito-axial joint level by the compression of the fragmented posterior arch of atlas. On vertebral angiogram, it revealed a reverse curve of 3rd. portion of vertebral artery, representing the anterior arch of atlas included the arch retracted the vertebral artery anteriorly. We performed the suboccipital craniectomy and lanimectomy on the atlas for removal of posterior arch of atlas without any spine fusion, Because of the dislocated atlanto-axial joint had a bony union alreadly. The post-operative recovery was very rapid and satisfactory.
Atlanto-Axial Joint ; Axis, Cervical Vertebra ; Contrast Media ; Contusions ; Dislocations* ; Headache ; Humans ; Joints ; Ligaments* ; Mouth ; Neck ; Neurologic Manifestations ; Odontoid Process ; Quadriplegia* ; Rupture* ; Spine ; Vertebral Artery

The post-traumatic leptomeningeal cyst, so-called growing fracture, is one of the complication of the skull fracture in childhood especially under the 3 years old, but very rare in the adult. Since Taveras and Ranschoff proposed the mechanism for production of the expanding fracture post-traumatically in 1953, many authers have explained the mechanism clinically and experimentally. Now we proposed a additional mechanism for producing the brain herniation into the expanding fracture as a case of post-traumatic leptomeningeal cyst reported. A 25 years old male patient was admitted to the department of Neurosurgery, Seoul Red Cross Hospital, because of headache, convulsion, and growing the mass with skull defect. The patient has had a history of skull fracture at the age of 2 years old. The simple skull films revealed a scalloped and saucerized margin of skull defect on left parietal bone. On electroencephalogram, we found a moderated abnormalities in the left parietal area. The left carotid angiogram showed a stretching of middle cerebral artery and elevation of left Sylvian point. The small capillary branches of middle cerebral artery has pushed out through the skull defect, which indented brain herniation into the skull defect. No cystic picture was found. We operated this case with the dura repair and grafting, and then cranioplasty with resion. On operative finding, we found that one edge on torn dura has impacted into the opposite edge of fractured skull tightly, which suggested the pulling up the dura and brain into the skull defect by growing rate of the skull bone. By the craniectomy for the bone, impacted dura, was free from the impacted bone and the above continued procedure had completely successful . The post-operative course was very satisfactory. According to the operative finding, the skull fracture with dural tearing are essential factors in producing the post-traumatic leptomeningeal cyst in infancy(usually under the 3 years old). When the one edge of torn dura is impacted into the edge of same side of fractured bone, or was left free, it will produce the simple leptomeningeal cyst during the improportional growing the skull bone and brain. On the other hand, when one edge of torn dura is impacted into the opposite edge of fracture bone, the growing parietal bone pulled up the encircled brain into the skull defect aperture gradually, which produced the brain herniation, a type of post-traumatic leptomeningeal cyst. We reported a case of the post-traumatic leptomeningeal cyst in adult very rarely, and proposed a mechanism for producing a brain herniation into skull defect, a type of post-traumatic leptomeningeal cyst.
Adult ; Arachnoid Cysts* ; Brain ; Capillaries ; Child, Preschool ; Electroencephalography ; Hand ; Headache ; Humans ; Male ; Middle Cerebral Artery ; Neurosurgery ; Parietal Bone ; Pectinidae ; Rabeprazole ; Red Cross ; Seizures ; Seoul ; Skull ; Skull Fractures ; Transplants

No abstract available.
Adenocarcinoma* ; Carcinoma* ; Female ; Ovary* ; Teratoma*

Organic causes of astasia or asterixis have been described in the literature. However, concurrent unilateral manifestation of the two symptoms is extremely rare. We report two cases presenting with astasia and asterixis due to infarcts involving the ventrolateral nucleus of the left thalamus. Acute onset of astasia or asterixis in patients without significant metabolic disorder should alert the clinician on the possibility of acute stroke involving the thalamus.
Dyskinesias* ; Humans ; Infarction* ; Stroke ; Thalamus

For many years it had been universally taught that administration of the commonly used analgesic agents retards the progress of labor. It was therefore advised that these agents should not be administered until the labor was active and progress was rapid. In recent years, more scientific analysis of the progress of labor and accurate recording of uterine contractility revealed that this classical teaching was inaccurate. Despite the increasing use of regional analgesia during labor, systemic medications are still widely used to relieve pain and anxiety. There is no ideal, generally applicable analgesic agent for use during childbirth. All systemic medications used for pain relief in labor cross the placenta and may have a depressant effect on the fetus and injudicious administration of an overdose can cause some depression of uterine activity. It is suggested that elimination of pain or anxiety will decrease adrenal medullary release of epinephrine. Since epinephrine is a known inhibitor of uterine activity, a decrease in its serum level should lead to increased uterine activity. Thus it was decided to make an objective estimation of the effects of morphine, meperidine, diazepam and ketamine upon uterine contractility of pregnant rat uteri, in vitro. The results are as follows: 1) Morphine caused a significant concentration dependent decrease in the contractility of pregnant rat uteri. 2) Meperidene did not cause any significant change in the contractility of pregnant rat uteri. 3) Diazempam caused a concentration dependent decrease in the contractility and the contraction disappeared at a concentration of 80 ug/100ml. 4) Ketamine caused a significant concentration dependent decrease in the contractility of pregnant rat uteri. 5) Addition of CaCl2 to the K-H solution did not cause any significant change in the result.
Analgesia ; Analgesics ; Animals ; Anxiety ; Depression ; Diazepam* ; Epinephrine ; Fetus ; Ketamine* ; Meperidine* ; Morphine* ; Parturition ; Placenta ; Rats* ; Uterus*

The bilirubin formed in utero by the fetus can cross the placena and be excreted by the maternal liver. After birth, however, the infant must excrete its own bilirubin and hepatic clearance is not sufficient to prevent its accumulation during first week of life This transition has been physiologic jaundice and defined as an elevation of serum bilirubin that does not exceed 12mg% that occurs in first week of life in the absence of hemolytic disease. It is becoming increasingly apparent that several factors act in concert and that no single mechanism is soly responsible for producing physiologic jaundice in the new born. A simple micromethod technique for the analysis of small samples has made it possible to record the changes in the level of bilirubin in the serum by means of daily observation a large number of infants. So, serial observations for serum bilirubin concentrations on 40 healty fullterm infants from birth to 7 day. The study revealed that 14 infants(38%) exhibited the bilirubin levels of 12mg% or higher. The means of the peak bilirubin concentrations were obtained and revealed most higher on the forth dey. Positive correlations were found between the intensity and the duration of physiologic icterus, between the degree of hyperbilirubinemia and the age at which the process attains its maximum intensity and between the maximum height of the bilirubin level and the total duration of elevated levels of bilirubin in the serum. The mean total bilirubin level of the physiologic jaundice in the Korean new born infants was remarkably higher than those observed in the white iufants. So, the definition of physiologic jaundice by zeuzer is not of use in the Korean full term in fants.
Bilirubin* ; Fetus ; Humans ; Hyperbilirubinemia ; Infant* ; Jaundice* ; Liver ; Parturition

No abstract available.
Animals ; Dogs ; Mandible

Incontinentia pigmenti (IP) is an uncommon genodermatosis that occurs mostly in female infants, but is rarely found in male infants. Male patients with incontinentia pigmenti are usually more severely affected than their female counterparts. IP is characterized by ectodermal, mesodermal, neurological, ocular, and dental manifestations. Herein, we report a case of IP in a male infant who presented with a typical course of skin manifestation, dental defects, and recurrent partial seizures. However, he did not show any signs or symptoms for ocular or cardiovascular anomalies.
Ectoderm ; Female ; Humans ; Incontinentia Pigmenti* ; Infant* ; Male* ; Mesoderm ; Seizures ; Skin Manifestations