Kerion celsi is severe inflammatory type of tinea capitis. It occurs almost exclusively in pre-pubertal children. We report a case of Kerion celsi occuring in a 79-year-old woman. Culture of infected hair on Sabouraud glucose agar showed Microsporum canis Farnily history and fungus study suggested the importance of indirect route in Microsporum canis infection.
Agar ; Aged ; Child ; Female ; Fungi ; Glucose ; Hair ; Humans ; Microsporum* ; Tinea Capitis*

The authors analyzed 52 cases of spinal cord tumor who had been operated upon at the department of neurosurgery of the Koryo General Hospital from 1983 to 1992. The results were summerized as followings: 1) The spinal cord tumor was most common in the 6th decade of age(52 cases, 28.8%) and the ratio of male to female was 1.26:1. 2) The pathologic diagnosis was neurogenic tumor in 25 cases(48.1%), metastatic tumor in 12 cases(23.1%), glial tumor in 6 cases(11.5%), and meningeal tumor in 3 case(5.7%) in order frequency. 3) The tumors were located most frequently in the thoracic area(19 cases, 36.5%) and in the intradural extramedullary space(28 cases, 53.9%). 4) The most common initial presentation was pain(27 cases, 51.9%) and on admission 14 cases(26.9%) showed paraparesis. 5) The rate of abnormality of the plain radiologic study was 59.6% and the most common positive finding was the pedicle erosion(15 cases, 28.8%). 6) The computed tomographic scanning with water soluble contrast media was useful in planning of operation to provide the exact relationship between the tumor, spinal cord and location of dura. 7) The total removal was possible in 27 cases(51.9%). 8) The follow-up results after 19.4 months of the mean follow-up duration in 46 cases were recovery in 29 cases(63.0%), improvement in 12 cases(26.0%), stationary state in 3 cases(6.5%), worse in 2 cases(4.3%). It was excellent particulary in cases of intradural-extramedullary tumor. 9) The incidence of metastatic tumor was 23.1%(12 cases) and the lung was most common primary focus. The follow-up result of metastatic tumor was poor than the other tumors.
Contrast Media ; Diagnosis ; Female ; Follow-Up Studies ; Hospitals, General ; Humans ; Incidence ; Lung ; Male ; Meningeal Neoplasms ; Neurosurgery ; Paraparesis ; Spinal Cord Neoplasms* ; Spinal Cord*

We have had an opportunity to study a patient with acute sensory neuronopathy. The patient was a 32-yearold housewife; the rapidly spreaded tingling sensation along both arms and legs developed, rendering her severely ataxic. There was no history of antecedent illness, familial neurological disease, or exposure to toxins and special drugs. On examinations, there was no abnormality in her mental and cranial nerve function. There was no motor weakness. She showed the profound loss of kinesthetic sense which was acutely progressive and associated with severe sensory ataxia and pseudoathetosis. All tendon reflexes were absent. However, cutaneous senses were preserved. There was no significant abnormal laboratory finding except elevated CSF protein content. On electrophysiologic findings, the decrease in the amplitude of action potentials with only mild slowing of conduction velocities of sensory nerves were found even though motor nerve conduction studies were normal. Median and tibial somatosensory evoked potentials could be elicited, although the median N19 scalp response and tibial N45 waveforms were prolonged in latency. Plasmapheresis were provided; clinical features improved. However, the electrophy-siological abnormalites remained. Thus we wish to report an additional case of woman suffering from the acute sensory neuronopathy, complementing the cases described by Stemm, Schaumburg and Asbury.
Action Potentials ; Arm ; Ataxia ; Complement System Proteins ; Cranial Nerves ; Evoked Potentials, Somatosensory ; Female ; Humans ; Kinesthesis ; Leg ; Neural Conduction ; Plasmapheresis ; Reflex, Stretch ; Scalp ; Sensation

Neurilemmoma is the most frequent solitary tumor of the peripheral nerves. It may occur anywhere in the body, but their occurrence in the penis is rare and unusual. Treatment of this lesion is simple surgical excision. We report a case of neurilemmoma of the penis in a 27 year-old male and review the literature.
Adult ; Humans ; Male ; Neurilemmoma* ; Penis* ; Peripheral Nerves

Ceftriaxone is a commonly used antibiotic due to some of its advantages. Reversible gallbladder (GB) sludge or stone has been reported after ceftriaxone therapy. Most of these patients have no symptom, but the GB sludge or stone can sometimes cause cholecystitis. We experienced two patients who had newly developed GB stones after ceftriaxone therapy for diverticulitis and pneumonia, and this resolved spontaneously 1 month after discontinuation of the drug. Awareness of this complication could help to prevent unnecessary cholecystectomy.
Ceftriaxone ; Cholecystectomy ; Cholecystitis ; Cholecystolithiasis ; Diverticulitis ; Gallbladder ; Gallstones ; Humans ; Pneumonia ; Sewage ; Young Adult

BACKGROUND AND OBJECT: Cheiro-oral syndrome (COS) is characterized by a sensory disturbance in the unilateral hand and ipsilateral mouth corner. It is usually due to a lesion in the parietal cortex, thatamocortical projections, thalamus, or rarely brain stem. However, the syndrome is relatively unknown and rarely mentioned in most neurological textbooks. We presented ten cases of COS with a review of the clinical symptoms and signs and the neuroradiological methods used to demonstrate the responsible site. METHODS AND RESULTS: We studied 10 patients with stroke who showed restricted sensory disturbance on the one hand and ispilateral mouth. The study forms consisted of clinical manifestaion, neurological examination, electrophysiological, and neuroradiologic studies. Computed tomography and/or magnetic resonance imaging identified lesion in the thalamus in 5, brain stem in 3, and corona radiata in 1 patient. But, the anatomical responsible site for one case was not founded. Infarction had occurred in nine cases and hemorrhage in one. Seven of the 10 patients showed sensory disturbances restricted to the perioral area, hands, fingers when they were first examined; the remaining patients complained more diffuse sensory disturbances at first, but it had become restricted to perioral and fingers, usually within 2-3 weeks. The durations of symptom varied from 5 days to more than 15 months and these symptoms were improved within 2-3 weeks to 4 months in treated patients. CONCLUSION: When the symptoms and signs of the COS were presented, especially if a history of migraine is lacking, neuroradiological methods such as CT or MRI should be undertaken to localize and diffentiate the nature of lesion.
Brain Stem ; Fingers ; Hand ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Migraine Disorders ; Mouth ; Neurologic Examination ; Rabeprazole ; Stroke ; Thalamus

PURPOSE: A retrospective analysis was performed to evaluate the incidence of radiation induced lung damage after the radiation therapy for the patients with carcinoma of the lung. MATHOD AND MATERIALS: Sixty-six patients with lung cancer (squamous cell carcinoma 27, adenocarcinDma 14, large cell carcinoma 2, small cell carcinoma 13, unknown 10) were treated with definitive, postoperative or palliative radiation therapy with or without chemotherapy between July 1987 and December 1991. There were 50 males and 16 females with median age of 63 years(range: 33~80 years). Total lung doses ranged from 500 to 6,660 cGy (median 3960 cGy) given in 2 to 38 fractions (median 20) over a range of 2 to 150 days (median 40 days) using 6 MV or 15 MV linear accelerator. To represent different fractionation schedules of equivalent biological effect, the estimated single dose(ED) model, ED=D.N-0.377.T-0.058 was used in which D was the lung dose in cGy, N was the number of fractions, and T was the overall treatment time in days. The range of ED was 370 to 1357. The endpoint was a visible increase in lung density within the irradiated volume on chest X-ray as observed independently by three diagnostic radiologists. Patients were grouped according to ED, treatment duration, treatment modality and age, and the percent incidence of pulmonary damage for each group was determined. RESULT: In 40 of 66 patients, radiation induced change was seen on chest radiographs between 11 days and 314 days after initiation of radiation therapy. The incidence of radiation pneumonitis was increased according to increased ED, which was statistically significant (p=0.001). Roentgenographic charges consistent with radiation pneumonitis were seen in 100% of patients receiving radiotherapy after lobectomy or pneumonectomy, which was not statistically significant. In 32 patients who also received chemotherapy, there was no difference in the incidence of radiation induced charge between the group with radiation alone and the group with radiation and chemotherapy, among the sequence of chemotherapy. No correlation was seen between incidence of radiation pneumonitis and age or sex. CONCOUSIONS: The occurrence cf radiation pneumonitis varies. The incidence of radiation pneumonitis depends on radiation total dose, nature of fractionation, duration of therapy, and modifying factors such as lobectomy or pneumonectomy.
Appointments and Schedules ; Carcinoma, Large Cell ; Carcinoma, Small Cell ; Drug Therapy ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Particle Accelerators ; Pneumonectomy ; Radiation Pneumonitis ; Radiography, Thoracic ; Radiotherapy ; Retrospective Studies ; Thorax

Intradural ruptured discs are very rare occurrences and the incidence is reported to be 0.13% among total herniated discs, 90% of intradural ruptured discs are known to occur in the lumbar area. The symtoms and signs of the intradural disc are much more severe than those of the usual extradural herniated disc. MR imagings of the intradural disc demonstrate several typical findings, but intradural tumors must be ruled out. The authors present a case of intradural ruptured lumbar disc L4-L5 level in a 46-year-old female. Characteristic MR and operative findings of this case are reported. Pathogenetic mechanisms and differential diagnoses with certain intradural tumors and the extradural ruptured disc with similar MR findings are discussed.
Diagnosis, Differential ; Female ; Humans ; Incidence ; Intervertebral Disc Displacement ; Middle Aged

Repetitive nerve stimulation test(RNS) was performed on 32 patients with myasthenia gravis who showed positive response to the tensilon test. The result of the repetitive stimulation test before and after the tensilon injection was compared with the point of improvement of the CMAP and decremental response. The results were as follows: 1. All patients with myasthenis gravis showed decremental responses to the low rate of stimulation in RNS. 2. The results after tensilon injections showed significant improvements of the CMAP in ocularis oculi(OOC), flexor carpi ulnaris(FCU)(P <0.0005), deltoid and abductor digiti quinti muscles(ADQ)(P < 0.005). 3. There were improvements of decremental responses after tensilon injection. 1) At 2/sec, there were significant improvements in the muscles of ADQ(P <0.005), deltoidl OOC and FCU(P < 0.0005). 2) At 3/sec, there were significant improvements in the muscles of OOC(P <0.005), deltoid, FCU and ADQ(P < 0.0005). 3) At 5/sec, there were also significant improvements in all the muscles of OOC, deltoid, ADQ, FCU(P <0.0005). These results showed that tensilon improves the RNS abnorrnalities in myasthenic patients with positive tensilon test. We think these findings before and after the tensilon injection are helpful to diagnose and differentiate a patient with suspected myasthenia gravis who has a negative tensilon test or insignificant RNS findings.
Edrophonium* ; Humans ; Muscles ; Myasthenia Gravis*