In Korea, Kerion celsi caused by T. verrucosum was first reported by Kim et al in the Honam province in 1986. Since then three mare cases have been reported in the Young Nam province. Herein present a case of kerion celsi caused by T. verrucosum from Chungcheong province. The patient, a 7-year old female, showed a 4x 4cm sized, oval, yellow crusted and boggy patch with alopecia on the scalp. She was living on a farm in a rural area of Chungcheong province. Cows on the farm also exhibited similar skin lesions on the buttock. The same T. verrucosum was identified by a characteristic colony morphology on Sabourauds dextrose agar and chains of chlamydoconidia with mycologic stain from scales of lesions of patient and cows. This skin lesion was successfully treated with griseofulvin.
Agar ; Alopecia ; Buttocks ; Child ; Female ; Glucose ; Griseofulvin ; Humans ; Korea ; Scalp ; Skin ; Tinea Capitis* ; Weights and Measures

Kerion celsi caused by Trichophyton(T.) rubrum is rare endemically and there has been no report of it in Korean literatures. We report a case of karion celsi caused by T. rubrum in a 71-year-old male, who showed anindurated, swollen, boggy mass exuding pus on the right parietal scalp for about 7 weeks. The colonies and microconidia were identified as T. rubrum by fungus culture in potato dextrose agar. After administration of itraconazole for 11 weeks, the lesion was healed and the regrowing of new hairs was observed.
Adult* ; Agar ; Aged ; Fungi ; Glucose ; Hair ; Humans ; Itraconazole ; Male ; Rabeprazole ; Scalp ; Solanum tuberosum ; Suppuration ; Tinea Capitis* ; Trichophyton*

In fusion of lumbar spine, every fused motion segments shows varisble limitation of motion in flexion, extension and lateral bending according to their types and level of fusion. The motion segment of lumbar spine is three joint complex which consists of posterior two articular facet joints and an anterior intervertebral disc. Nowadays, orthopedic surgeon prefer anterior fusion due to direct identification and removal of diseased tissue, reduction of fractured fragments, restoration of intrevertebral space, early rehabilitation and no damage of nerve root and cord, and is prefered short Segmental Spinal Instrumentation(e.g. Cotrel Dubousset Instrumentation, etc.) due to short and rigid fusion, no necessity of external support and low limitation of motion. We studied 58 cases of fused lumbar spine which had been operated since Sep.1983, by X-ray overlay method and 20 cases of healthy lumbar spine as eontrol group. In this study, we obtained following results ; 1. Harrington Rod Instrumentation reveals the most remarkable limitation of motion, whereas, C.D.I. and A.I.F. reveal the least limitation of motion. 2. Distinct differencies of motion are repersented by its range of fusion and range of motion in 2 segmental fusion reveals remarkable decreasement from range of motion in single segmental fusion. 3. In single segmental fusion, the most limitation of motion was represented in Harrington Rod Instrumentation and posterior fusion with bone graft. There is remarkable decreasement of flexion at lumbosacral junction by its site of fusion. 4.In double segmental fusion, the most limitation of motion was represented in Harrington Rod Instrumentation and there is no significant difference of motion by its site of fusion.
Intervertebral Disc ; Joints ; Methods ; Orthopedics ; Range of Motion, Articular ; Rehabilitation ; Spine ; Transplants ; Zygapophyseal Joint

Human papillomavirus (HPV) 16/18 is a causative agent of uterine cervical carcinoma. HPV 16/18 can alter cell cycle regulation through apoptosis. Bcl-2 is an important regulatory gene of apoptosis. A study was done to evaluate the relation between HPV 16/18 and bcl-2 and apoptosis in 21 cases of carcinoma in-situ (CIS), 5 cases of microinvasive carcinoma and 23 cases of invasive squamous cell carcinoma. HPV 16/18 was detected by hybrid capture system (HCS), bcl-2 protein by immunohistochemical method and apoptosis by using the hematoxylin-eosin stained slide. The results were as follows: Expression of the bcl-2 protein was 43% (9/21) in CIS and 26% (6/23) in invasive carcinoma. Expression of the bcl-2 protein was 42% (5/12) in CIS with HPV 16/18 infection, 44% in CIS without HPV 16/18 infection, 20% (2/10) in invasive carcinoma with HPV 16/18 infection and 31% (4/13) in invasive carcinoma without HPV 16/18 infection. Mean apoptotic index (mAI) was 3.36 in CIS, 5.23 in microinvasive and 6.25 in invasive carcinoma. mAI was 3.66 in CIS with HPV 16/18 infection, 2.86 in CIS without HPV 16/18 infection, 6.18 in invasive carcinoma with HPV 16/18 infection and 6.30 in invasive carcinoma without HPV 16/18 infection. Based on these results, we conclude that there are no correlation between HPV infection and bcl-2, and between HPV infection and apoptosis in invasive and in situ carcinoma of the uterine cervix, and apoptosis is increased according to tumor progression.
Apoptosis* ; Carcinoma, Squamous Cell* ; Cell Cycle ; Cervix Uteri* ; Female ; Genes, Regulator ; Humans

BACKGROUND: Cardiogenic embolic infarction is the most preventable type of ischemic stroke. This study was under-taken to compare the infarct size, prognosis, and risk factors between cardiogenic embolic infarction (CE) and large artery atherosclerotic infarction (LAA). METHODS:We reviewed the medical records and brain computed tomography/magnetic resonance image (CT/MRI) scans of patients with CE or LAA during the period between January 1996 and May 1998. Patients with lacunar and posterior circulation infarctions were excluded. A slice of brain CT/MRI scan showing the largest lesion was selected in each patient and the area of infarction was then measured. Prognosis was determined by the Modified Rankin Disability Scale (MRDS) and was grouped as either good (MDRS 0, 1, 2) or poor (MDRS 3, 4, 5). RESULTS: The study included 103 patients : 50 with CE (NVAF in 23, VHD with or without AF in 13, prosthetic valve in 6, and others in 8) and 53 with LAA (large artery thrombosis in 29, and artery to artery embolism in 24). The infarct size of CE (23.2+/-14.7 cm2) was significantly larger than that of LAA (11.4+/-10.5 cm2) (p<0.001). The infarct size of NVAF (29.0+/-19.1 cm2) was significantly larger than that of VHD with or without AF (19.2+/-11.5 cm2) (p<0.05). Patients with CE had a worse prognosis (poor in 46%) than those with LAA (poor in 23%) (p<0.05). CONCLUSIONS Our results showed that CE led to larger lesions and worse outcomes. Therefore, we emphasize the importance of primary and secondary preventions of stroke in patients with cardiogenic embolic sources.
Arteries* ; Brain ; Embolism ; Heart Valve Diseases ; Humans ; Infarction* ; Medical Records ; Prognosis* ; Risk Factors ; Secondary Prevention ; Stroke ; Thrombosis

BACKGROUND: Pilomatricoma(Benign calcifying epithelioma of Malherbe) is a uncommon benign tumor with differentiation toward hair cortex cells. It commonly manifests itself as a firm, deep seated nodule with normal Overlying skin, However, anetodermic cutaneous changes have also been described in the literature since 1943. Although the authors hypothesized this phenomenon as a chronic mechanical irritation or a step of transepidermal elimination of the tumoral mass, distinctive elucidation of pathomechanism of it remained. OBJECTIVE: The purpose of this study was to characterize the clinical and histopathologic features of 25 cases with pilomatricoma and to elucidate pathomechanism of the anetodermic cutaneous changes through the comparison of the anetodermic pattern of overlying skin with the changes of the tumoral mass or collagen and elastic fibers in the dermis. METHODS: Twenty-five cases with pilomatricoa have been collected at Chunganam National University Hospital and Kongju Medical Center during 15 years and 5 years, respectively, And we studied the clinical and histopathological characteristics of patients and tried to reveal the relationship between the cutaneous manifestations and the histologic changes through the test for independence. RESULTS: 1. In the age distribution, the patients lesser than 30 years old was 23 cases(92%). The mean age was 18.9 years old. The ratio of males to females was 1 : 2.6. 2. The duration of lesions was from 2 months to 7 years, with the mean duration of 11 months. The predilection sites were arm(40%), face(28%), neck(12%), shoulder(8%), scalp(4%) and back(4%) in order. All lesions were hard in consistency, and were from bean to walnut sized. Clinically, 10 cases (40%) showed reddish discoloration and/or anetodermic cutaneous changes. 3. Histopathologically, the typical patterns of pilomatricoma were commonly located at the dermis (23 cases) and consisted of the shadow cells predominantly(21 cases). Calcium deposits(21 cases, 84%) were noted within the shadow cells. Eight cases(32%) had the tumoral maese demarcated with fibrous capsules, and the foreign body reaction with giant cells and chronic mononuclear cell infiltrations around the shadow cells ruptured the fibrous capsules in 17 cases(68%). 4. When we compared the relationship between the inflammatory cell infiltrations around the tumoral mass and the changes of dermal collagen and elastic fibers, we observed that the changes of dermal fibers and foreign body reaction and mononuolear cell infiltrations were statistically co-related. When compared the cutaneous changes with the inflammatory cell infiltrations of the tumoral masses, we could also reveal that the anetodermic cutaneous changes of the overlying skin might be influenced by the foreign body reactions with chronic mononulcer cell. Based on the status of foreing body reaction, the average of onset was inversely proportional to the average of age. CONCLUSION: Pilomatricomas are slowly growing, firm, deep seated benign tumor which occurs commonly on the arm, face and neck. However, they often showed the anetodermic changes on the overlying skin. Anetodermic cutaneous changes or discoloration may be correlated with the degree of foreign body reactions without the evidences of transepidermal elimination histopathologically.
Adult ; Age Distribution ; Arm ; Calcium ; Capsules ; Carcinoma ; Chungcheongnam-do ; Collagen ; Dermis ; Elastic Tissue ; Female ; Foreign Bodies ; Foreign-Body Reaction ; Giant Cells ; Hair ; Humans ; Juglans ; Male ; Neck ; Pilomatrixoma* ; Skin

No abstract available.
Apoptosis* ; Caspase 3* ; Endothelial Cells* ; Perforin* ; Vibrio vulnificus* ; Vibrio*

To evaluate the diagnostic efficacy of dacryoscintigraphy, we examined Hones dye test and dacryoscintigraphy in 24 eyes of 18 patients who were suspected to have junctional block in lacrimal drainage system. Among 18 eyes that were negative to Jones I dye test, 3 showed punctal stenosis and 6 typical pattern of lax lid and 2 partial obsturction of nasolacrimal duct on dacryoscintigraphy. In evaluation of lacrimal drainage system, physiological aspect is as important as anatomical information since lacrimal pumping action of lid and tear flow as well as the patency of lacrimal passage contribute to the lacrimal drainage. Compared to Jones dye test, dacryoscintigraphy is more useful with certain advantages : It gives less discomfort to patients, provides anatomical information and does not depend on examiner`s skills.
Constriction, Pathologic ; Drainage* ; Humans ; Nasolacrimal Duct

Dural shunts are vascular communications in which blood flows through small meningeal branches of the carotid arteries to enter the venous circulation near the cavernous sinus. The clinical characteristics of 13 eyes[12 patients] with dural cavernous sinus fistula are described. Of these patients, 84.6%[11 eyes]were women with dilated conjunctival and episcler-al vessels, exophthalmos, retinal hemorrhage and venous engorgement, elevation of intraocular pressure, swelling of lid and orbital area, limited eye movement and diplopia, and bruit, in order of frequency. Decreased vision had occurred in only 1 eye, due to central retinal vein obstruction during follow-up periods after embolization. CT or MRI scan showed the enlargement of the extraocular muscle and superior ophthalmic vein. Two eyes had resolved spontaneously. Ten eyes of dural cavernous sinus fistula had the resolution of clinical symptoms after carotid angiography with embolization. The complications after embolization had occurred in one eye with transient sensory deficit of face.
Angiography ; Carotid Arteries ; Cavernous Sinus* ; Diplopia ; Exophthalmos ; Eye Movements ; Female ; Fistula* ; Follow-Up Studies ; Humans ; Hyperemia ; Intraocular Pressure ; Magnetic Resonance Imaging ; Orbit ; Retinal Hemorrhage ; Retinal Vein ; Veins

OBJECTIVE: The study was made in order to inverstigate the clanical and mycological status of dermatophytosis in Chungchong province, incidence and friquency of disease, sex and month distribution of the disease, varieties of the causative organism. METHODS: We performed clinical and mycological studies of 86 cases of dermatophytosis which have showed positive on KOH examination and/or positved result in culture among out- patients of Dermatologic Clinics of Chungnam National Univesy during 7 years, from 1986 to 1993. RESULTS & CONCLUSION: 1. The ratio of male to female patients 330: 256 and make little ifference. 2. The incidence rate was bighest in the third decade(25.4%) 3. The seasonal prevalence of dermatophytosis was highest in the summer 4. The incidence of dermaiophytosis was T. pedis(30.2%), T. (22.9%), T. ungium(13.1%), T. corPoris(10.1%), T. capitis(9.0%) in decreasing order of freqercy 5. A mean positive rate for the KOH mount examination A. 5. 83.8%, T. 90.2%, T. corporis 89.8%, T. ungium 86.5% in decreasing order of frequency 6. A mean positive rate of culture was 77.1%; T. capities 94.3, . faciale 87.0%, T. cruris 84.3 %, T. cpor6 78.0% in decreasing order of frequency 7. T. rubrum was the mot common causative organism of cernatophytosis(69.5%), with T. mentagroPhyte(16.1%), M. canis(13.5%), M floccosum(0.7%), 4 gypseam(0.2%) presenting in decreasing order of frequency
Chungcheongnam-do ; Female ; Humans ; Incidence ; Male ; Prevalence ; Seasons ; Tinea*