PURPOSE: To analyze the imaging features of brain abscess. MATERIALS AND METHODS: MR studies of nine patients with surgically verified brain abscess were retrospectively reviewed. RESULTS: The shape of abscesses were round(n=6), multilobulated(n=2) or triangular(n=1). All lesions were located in corticomedullary junction and extended into white matter. On gadolinium-DTPA enhanced images, smooth rim-like(n=6) or irregular thick enhancement(n=3) of abscess wall was noted. Budlike projection from the abscess capsule was found in 4 cases. The signal intensity of abscess capsule was either hyperintense (n=5) or isointense(n=4) relative to white matter on Tl-weighted images, and hypointense(n=6), isointense (n=2) or mixed hypo and isointense(n=l) on T2-weighted images. Satellite nodules were found in 2 cases. PNS inflammation(n=2), meningitis(n=1), ventriculitis(=2) and subdural empyema(n=1) were associated CONCLUSION: The MR features of brain abscess included characteristic intensity of abscess capsule, budlike projection from the abscess wall, moderate amount of peripheral edema, satellite nodules, and associated meningitis, ventriculitis or PNS infection. The morphology of abscess wall was not specific for the diagnosis of brain abscess.
Abscess ; Brain Abscess* ; Brain* ; Diagnosis ; Edema ; Humans ; Meningitis ; Retrospective Studies

We report a case of Kyrles disease occuring in a 19-year-old man with chronic renal failure. The patient had multiple hyperkeratotic papules with central plug on the upper extremities, lower extremities and buttocks. Histopathological findings showed epidermal invagination filled with parakeratotic column and basophilic debris. Many dyskeratotic and vacuolated cells were present below the keratotic plug, and penetration of the parakeratotic column into the dermis was seen.
Basophils ; Buttocks ; Dermis ; Humans ; Kidney Failure, Chronic ; Lower Extremity ; Upper Extremity ; Young Adult

Reconstruction of soft tissue dejects on the lower leg and foot remains a difficult challenge for surgeons. If the deject was large and complicated by bone defects, an excellent result could be obtained with free tissue transfer. In case of no bony problem, no major infection and relatively small defect, a local flap is more Convenient and economic than free tissue transfer because of its simple, one-stage and reliable operation. The vascularization of the subcutaneous tissue reveals the predominance of the vascular network in this layer with regard to the dermal or fascial plane. The dermal vascular network at the donor site is sufficient to let the skin survive without its underlying subcutaneous vascular support. Distally based adipofascial flaps, nourished by the lower perforator originating from the major vessel as link pattern were. used successfully for reconstruction of the bone and/or tendon exposure of the lower leg and foot in 10 patients. Between February 1992 and December 1995, ten cases underwent this procedure to reconstruct soft tissue defect on the lower leg and foot. The average age of the patients was 50.6 years (range 5 - 73years). Follow-up was from 10 months to 38 months (mean 21 months). The average time of the operation was about 2 hours 18 minutes. The length to width ratio of adipofascial flap was 2.4 - 5.0 : 1 (mean 3.4 : 1). The advantages of this method are easy dissection, short operation, preservation of the major vascular pericles of the lower limb, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar, and versatility (it is supple and can adapt to every surface, and it can be grafted on the deep or the superficial side). In conclusion, this technique is an useful and alternative method for reconstruction of soft tissue defects on the lower leg and foot in selected cases.
Cicatrix ; Extremities ; Follow-Up Studies ; Foot* ; Humans ; Leg* ; Linear Energy Transfer ; Lower Extremity ; Skin ; Subcutaneous Tissue ; Tendons ; Tissue Donors ; Transplants

We report here a case of angioimmunoblastic lyinphadenopathy with dysprote inemia(AILD) in a 65-year-old male associated with skin nodules on the face. Physical examina.tion showed generalized lymphadenopathy, hepatosplenomegaly, erythematous maculopapular eruptions on the trunk and extremities, and er the matous nodules on the face. Lahoratory findings showed hemolytic anernia, arid polyclonal gammopathy. Histopathological findings of lymph node revealed typical features of AILD. I-iistopathological findings of maculopapules revealed lymphohistiocytic infiltra tion and extravasated erythrocytes around the blocked vessels, whereas histological picture of nodules on the face mirrorred that of the lymph node. After taking systemic chemotherapy, his general condition and skin lesions were improved.
Aged ; Drug Therapy ; Erythrocytes ; Extremities ; Humans ; Immunoblastic Lymphadenopathy* ; Lymph Nodes ; Lymphatic Diseases ; Male ; Skin*

The Klinefelter's syndrome is characterized by azoospermia, gynecomastia, a variable degree of eunuchoidism elevated urinary gonadotropins, atrophic testis and hyalinization of the seminiferous tubules in which Leydig cells were preserved. Reviewing some world literatures, we have reported a case of Klinefelter's syndrome associated with right inguinal hernia in 22 year-old Korean male.
Azoospermia ; Eunuchism ; Gonadotropins ; Gynecomastia ; Hernia, Inguinal ; Humans ; Hyalin ; Klinefelter Syndrome* ; Leydig Cells ; Male ; Seminiferous Tubules ; Testis ; Young Adult

PURPOSE: To analyze the MR imaging features of multiple sclerosis (MS) in spinal cord. MATERIALS AND METHODS: Nine MR (magnetic resonance) images of six patients with suspected MS were retrospectively evaluated in active phase (n=6) and inactive phase (n=3) before and after Gadolinium-DTPA administration. RESULTS: In all patients with clinically active phase, plaques of spinal cord appeared as high signal intensity on T2-weighted image with isointense cord swelling on Tl-weighted images. All lesions were enhanced on Gd-DTPA enhanced Tl-weighted images. The patterns of enhancement were nodular, circumferential rim-like, and segmental. On follow-up images in 3 patients who became clinically stable, all enhancing lesions disappeared. CONCLUSION: MR is a good modality in detection of spinal MS, and Gd-DTPA-enhanced MR is valuable in differentiating active MS from stable MS.
Follow-Up Studies ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Multiple Sclerosis* ; Retrospective Studies ; Spinal Cord*

PURPOSE: To analyze the characteristies of traumatic brainstem injury by CT and MR MATERIALS AND METHODS: CT and MR studies of 10 patients with traumatic brainstem lesion in MR were retrospectively reviewed, particularly attended to location, signal intensity and associated lesions. RESULTS: CT failed to depict 8 of 10 brainstem lesions. All lesions were detected in MR images with T2-weighted images showing higher detection rate (n=10) (100%) than Tl-weighted images (n=3) (30%) or CT (n=2) (20%). The brainstem lesions located in the dorsolateral aspects of the rostral brainstem(mid brain and upper pons)in 7 (70%) cases, in ventral aspects of rostral brain in 2 (20%) cases and in median portion of pons in 1 (10%) case. Corpus callosal (n=5), Iobar white matter(n=5) diffuse axonal injury, and 2 hemorrhagic lesions in basal ganglia were the associated findings. CONCLUSION: MR imaging is more helpful than CT in the detection of brainstem injury, especially T2 weighted images. Primary brainstem lesions were typically located in the dorsolateral aspect of rostral brainstem(midbrain and upper pons). Corpus callosum and white matter lesions were frequently associated.
Basal Ganglia ; Brain ; Brain Stem* ; Corpus Callosum ; Diffuse Axonal Injury ; Humans ; Magnetic Resonance Imaging ; Pons ; Retrospective Studies

We report a case of paraneoplastic acrokeratosis(Bazex syndrome) occurring in a 70 year old man with small cell carcinoma of the lung. The skin lesions showed violaceous erythema and psoriasiform scaling of the face, aural helices, scalp, and palmoplantar regions with severe nail dystrophy, Histcipathological findings revealed hyperkeratosis, acanthosis and spongiosis in the epiderrnis, and lyrnphocytic infiltration in the upper dermis. He was treated with cis-diamine dichloroplanum(Cisplan), 4 o-demethy-l-o-epipodo- phyllotoxin (Etoposide ) and steroid onitrnent. But eight months later, he died of lung carcinoma.
Aged ; Carcinoma, Small Cell ; Dermis ; Erythema ; Humans ; Lung ; Scalp ; Skin

PURPOSE: Palatal myoclonus(PM) is an involuntary cyclic movement of the soft palate and is known to be caused by the hypertrophic degeneration of the inferior oilvary nucleus of the medulla, secondary to the dentato-rubro-tegmental tract lesions. Our purpose is to describe the brain magnetic resonance(MR) imaging findings in palatal myoclonus. MATERIALS AND METHODS: We retrospectively analyzed the locations and causes of primary lesions in the dentato-rubro-tegmental tract and correlated them with changes in MR signal intensity and size of the inferior olive on T2-weighted MR images in 10 patients with palatal myoclonus. RESULTS: All cases showed hyperintensity in one or both inferior olive and six cases showed accompaning enlargement. The locations of the primary lesions were dorsal aspect of pons(central tegmental tract) in eight patients and the dentate nucleus in one, and no lesion was found in the dentato-rubro-tegmental tract in one. Among eight patients who had lesions in the ports, the ipsilateral inferior olivary nuclei showed changes in five and bilateral olive were involved in three. In the case with a lesion in the dentate nucleus, the contralateral inferior olivary nucleus was involved. The causes of primary lesions were hemorrhage in eight cases and traumatic brain stem injury in one. CONCLUSION: MR specifically showed enlargement and hyperintensity of the inferior olivary nucleus on T2-weighted images and matching lesions in the ports or the dentate nucleus in patients with palatal myoclonus.
Brain ; Brain Stem ; Cerebellar Nuclei ; Hemorrhage ; Humans ; Myoclonus ; Olea ; Olivary Nucleus ; Palate, Soft ; Retrospective Studies

Intrathoracic meningocele is a protrusion of the spinal meninges through an intervertebral foramen into thethoracic cavity. The majority occur in association with neurofibromatosis. The authors experienced a case ofintrathoracic meningocele in 26 years old male patient associated with neurofibromatosis, and present conventional CT and CT metrizamide myelographic findings.
Humans ; Male ; Meninges ; Meningocele ; Metrizamide ; Myelography ; Neurofibromatoses