Glossopharyngeal neuralgia, first discribed by Labat in 1928, is a very rare disease of unknown cause. This neuralgia is associated with a characteristic sharp pain of the posterior pharynx, tonsils and larynx, and especially triggered by swallowing action. It is said that this pain is more severe than that of trigerminal neuralgia and the pain may last several up to 30 minutes and the attack repeats intermittently. Diagnosis of glosspharyngeal neuralgia is made by the symptoms and by the elongation of the right side of the styloid process in this case. The glossopharyngeal nerve block by the deposition of local anesthetic solution is useful in the accurate diagnosis of the douleureux or neuralgia in which this nerve is involved and in providing anesthesia for operative intervention upon the posterior third of the tongue. This is a report of a case of glossopharyngeal neuralgia, which did not respond to Tegretol and other analgesic drugs and treated by glossopharyngeal nerve block with 0.5% bupivacaine l.5-2.0 ml. The block was performed every day for 15 days and the neuralgia disappeared without complication.
Analgesics ; Anesthesia ; Bupivacaine ; Carbamazepine ; Deglutition ; Diagnosis ; Glossopharyngeal Nerve ; Glossopharyngeal Nerve Diseases* ; Larynx ; Neuralgia ; Palatine Tonsil ; Pharynx ; Rare Diseases ; Tongue

We report two human cases of tick bite. A 63-year-old male had a pruritic pea-sized brownish nodule on the left popliteal area. Another 41-year-old male had an asymptomatic bean-sized black nodule in the pubic area. The ticks were identified as Ixodes nipponensis, which are the 18th and the 19th cases in Korea.
Adult ; Animals ; Bites and Stings/*parasitology/pathology ; Human ; *Ixodes/anatomy & histology ; Male ; Middle Aged ; Skin/*parasitology/pathology ; Tick Infestations/*parasitology/pathology

Acute pulmonary edema associated with direct current shock is a rare complication. Pulmonary edema with an increase in heart size following direct current shock have been previously reported and confirmed. The cause of this complication is unknown. This is not due to a sudden increase in the cardiac output with the establishment of sinus rhythm. It has been most commonly noted in the presence of mitral or aortic valvular diseases or ventricular dysfunction. It is likely that acute alteration or disparities in atrial or ventricular mechanical function consequent to electrical discharge precipitate pulmonary congestion. This is a case report of acute pulmonary edema following cardioversion with direct current shock which caused ventricullar fibrillation during tonsillectomy. He was treated with oxygen, iuretics, digitalis, steroid, dopamine and PEEP (positive end expiratory pressure). The patient recovered uneventful ventilation.

Aortic regurgitation is a common valvular heart disease, usually the result of rheumatic fever, or syphilis, and rarely of congenital origin. It is frequently associated with other valvular heart disease, especially mitral valve disease. It can be diagnosed by the presence of pulse pressure widening, a Corrigan pulse, and an early decreascendo diastolic murmur at the left sternal border between the second and third intercostal spaces. After the clinical application of cineaortography in the diagnosis of valvular disease, Segal et al (1964) first reported rheumatic aortic regurgitation without an audible murmur in patients having mitral valve disease. The importance of discovering aortic reguritation in patients with predominent mitral disease has begun to be appreciated recently, especially as commisurotomies for the relief of mitral stenosis are performed more frequently. Nowadays eventhough the severity of aortic regurgitation is often not evident preoperatively, aortic regurgitation can become very evident when mitral stenosis is relieved. This study was comprised of seventeen patients with silent aortic regurgitation which was confirmed by cineaortography at Severance Hospital from January, 1970 to August, 1976. 1. Of the seventeen patients, 12 patients were associated with mitral stenosis, 4 with mitral steno-insufficiency, and 1 with mitral insufficiency. 2. Silent aortic regurgitation was suggested from the accompanying clinical features such as chest pain, apical heaving, and left ventficular hypertrophy pattern on both roentgenogram of the chest and electrocardiogram. 3. The severity of the aortic regurgitation was mild to moderate; 7 of the 17 patients being grade I, and 10 patients being grade II on cineaortogram.
Aortic Valve Insufficiency* ; Blood Pressure ; Chest Pain ; Diagnosis ; Electrocardiography ; Heart Murmurs ; Heart Valve Diseases ; Humans ; Hypertrophy ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Rheumatic Fever ; Syphilis ; Thorax

To investigate the genetic variation within pspA from 17 clinical isolates of Streptococcus pneumoniae representing 12 capsular serotypes, we used specific PCR primers LSM12 and LSM2 derived from the DNA sequence of pspA of S. pneumoniae Rxl (type 2). We have found that all 17 isolates of S. pneumoniae have a pspA gene whose size ranges from 1.8 to 2.3 kb. RFLP analysis of the PCR-amplified pspA genes of the isolates exhibited distinct restriction patterns. Even within the same capsular type, the individual isolates of S. pneumoniae generally differed in PspA molecular masses and showed variabilities in the pspA gene locus. The nucleotide sequence of the pspA gene of S. pneumonaie KNIH1156 (type 19F) isolated from a blood specimen was determined. The sequence revealed an open reading frame of 1,827 bp nucleotides. Predicted size of the mature PspA was approximately 63 kDa. Deduced amino acid sequence of PspA of S. pneumonaie KNIH1156 revealed 57.0% identity with that of S. pneumonaie Rxl. Comparison of the nucleotide and amino acid sequences of PspA S. pneumoniae KNIH1156 (type 19F) with those of Rxl (type 2) showed considerable differences in the a-helical coiled-coil region of the two PspAs. These results suggest that the PspA of S. pneumoniae KNIH1156 has antigenic variations distinguished from those of Rxl strains.
Amino Acid Sequence ; Base Sequence ; Cloning, Organism ; Genetic Variation ; Korea* ; Nucleotides ; Open Reading Frames ; Pneumonia ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Sequence Analysis* ; Staphylococcal Protein A* ; Streptococcus pneumoniae* ; Streptococcus*

Systemic CD30 positive anaplastic large cell lymphoma (ALCL), a subtype of non-Hodgkin lymphoma (NHL), developes in the internal organs and invades the skin. There have been many cases of primary cutaneous CD30 positive T-cell lymphoproliferative disorder, but reports of systemic ALCL have been rare. We describe herein CD30 positive ALK negative systemic ALCL in a 90-year-old woman with multiple masses and nodules on the skin, lung and liver, as well as enlargement of the hilar and abdominal lymph nodes, of 3 months duration. She died of sudden aggravation of the general condition after 7 days.
Aged, 80 and over ; Female ; Humans ; Liver ; Lung ; Lymph Nodes ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Lymphoproliferative Disorders ; Receptor Protein-Tyrosine Kinases ; Skin ; T-Lymphocytes

Scrofuloderma, also called tuberculosis cutis colliquativa, is a subacute form of cutaneous tuberculosis, which is characterized by subcutaneously-located, cold abscess formation and secondary changes of the overlying skin. Recently, the occurrence of cutaneous tuberculosis has decrease due to improved quality of life and development of effective anti-tuberculous drugs. However, the tendency of diminution of scrofuloderma has grown smaller because the number of old and immunocompromised patients has increased. We report a rare case of scrofuloderma derived from tuberculous sternoclavicular osteoarthritis in a 71-year old woman.
Abscess ; Aged ; Female ; Humans ; Immunocompromised Host ; Osteoarthritis* ; Quality of Life ; Skin ; Tuberculosis ; Tuberculosis, Cutaneous*

Subungual exostosis is a benign, acquired tumor of cartilaginous bone which occurs beneath the nail of the distal phalanx, and can often lead to displacement and deformity of the overlying nail. Complete surgical excision is a curative treatment for subungual exostosis. Since there have been no case reports of complete surgical removal of subungual exostosis in the Korean dermatologic literature, we report four cases of subungual exostosis that were successfully treated through complete excision or excision in combination with additional curettage.
Congenital Abnormalities ; Curettage ; Exostoses*

OBJECTIVES: SCC Ag(Squamous cell carcinoma antigen) is so far the most useful tumor marker in assisting clinical diagnosis of cervical cancer and follow-up after therapy. Elevated levels of cytokeratin 19-fragments(CYFRA 21-1) have recently been detected in large proportion of patients with non small cell cancer of the lung, and in particular those with squamous cell carcinoma. This study is to assess the clinical efficacy of CYFRA 21-1 with SCC Ag as the clinicopathologic parameter in cervical cancer. METHOD: Retrospective analysis of the serum tumor markers CYFRA 21-1 & SCC Ag in eighty cervical cancer patients was performed. RESULTS: Cut off values for SCC Ag & CYFRA 21-1 were 1.94 ng/ml, 3.11 ng/ml respectively. Using the cut-off point, the sensitivity, specificity, positive predictive value(PPV), and negative predictive value(NPV) of serum SCC were 55, 95, 97, 46%, respectively. Serum CYFRA 21-1 showed a sensitivity of 45%, specificity of 91%, PPV of 87%, and NPV of 55%. The combination of SCC and CYFRA 21-1 increased the sensitivity to 62%, with a specificity, PPV, and NPV of 72, 75, 58%. Serum levels of both markers were compared with tumor stage, lesion size and were significantly related. In FIGO stage Ib-IIa, the serum levels of SCC Ag & CYFRA were 2.2+/-3.9, 2.5+/-3.6 ng/ml and in FIGO stage IIb-IV, 12.2+/-15.2, 10.8+/-11.2 ng/ml. In < or =4cm of lesion size the serum levels of SCC Ag & CYFRA were 3.3+/-9.0, 4.5+/-7.6 ng/ml and in >4cm of lesion size, 11.8+/-11.9, 7.7+/-9.3 ng/ml. CONCLUSION: These data seems to show that serum CYFRA 21-1 may be of additional value in assessing the state of disease in some patients with cervical cancer. The prediction of recurrent cervical cancer with SCC Ag were improved by the combination with CYFRA 21-1 but further investigation is needed.
Carcinoma, Squamous Cell ; Diagnosis ; Follow-Up Studies ; Humans ; Keratins ; Retrospective Studies ; Sensitivity and Specificity ; Small Cell Lung Carcinoma ; Biomarkers, Tumor ; Uterine Cervical Neoplasms*

Salmonella-triggered reactive arthritis appears one to three weeks after the onset of salmonella infection and presents with asymmetric, usually migratory, oligo- or polyarthritis. The course is usually self-limiting and symptoms last two to six months. We experienced a 10-year-old male patient who presented to a local pediatric center with long-lasting fever and right ankle joint pain. The pain migrated to the left ankle joint, both wrists, and both knees and he was diagnosed as juvenile rheumatoid arthritis and was medicated with NSAIDs and corticosteroid. In the meantime, 20 days prior to the transfer to our hospital he was febrile with nausea and abdominal pain and the antibody titer of S. typhi O Ag by Widal test was 1 : 320, and an antibiotic therapy was followed. Soon after, the fever subsided but the migrating joint symptoms continued and he was transferred to our hospital. Widal tests were weekly checked and the antibody titers of S. typhi O Ag were 1 : 160, 1 : 320, 1 : 320, 1 : 160, 1 : 160, respectively. ESR was 55 mm/hr, CRP 9.18 mg/dl, HLA-B27 positive and his endoscopic findings of the colon showed mild lymphoid hyperplasia and mucosal nodularities in the cecum and ileocecal area. Stool cultures and duodenal juice culture for Salmonella and Shigella were all negative. He was treated with ibuprofen and bactrim and the joint symptoms were gradually mitigated. After discharge, he maintained mildly elevated CRP levels and antibody levels by Widal tests, but was free from symptoms except for several episodes of finger pains for 11 months.
Abdominal Pain ; Ankle Joint ; Anti-Inflammatory Agents, Non-Steroidal ; Arthritis ; Arthritis, Juvenile* ; Arthritis, Reactive* ; Cecum ; Child* ; Colon ; Fever ; Fingers ; HLA-B27 Antigen ; Humans ; Hyperplasia ; Ibuprofen ; Joints ; Knee ; Male ; Nausea ; Salmonella ; Salmonella Infections ; Shigella ; Trimethoprim, Sulfamethoxazole Drug Combination ; Wrist