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 management of patients with severe head injury continues to present neurosurgeons with a major challenge. Despite of early diagnosis and aggressive treatment, it has showed still high mortality and morbidity. We analyzed the results of treatment of 50 cases with severly head injured-children who were treated during past 2 years for detection of predicting factors of outcome. Our conclusions are as follows ; 1) The Glasgow coma scale(GCS) on admission was an important predicting factor for outcome of severe head injury. In patients with 3, 4 of GCS, outcome was poor. In cases above 5 of GCS, outcome was better than the former. 2) The clinical features on admission(i. e., light reflex of pupils, oculocephalic responses and abnormal motor responses) were also important predicting factor of outcome. 3) There was no significant relation between outcome of severe head injury and age distribution in children. 4) The mass lesion occupied relatively small proportion in the types of lesion which was proved by CT scan(26%). 5) Overall outcome showed 28% of good recovery, 26% of moderately disabled, 12% of severly disabled, 12% of vegetative state and 22% of dead.
Age Distribution ; Child* ; Coma ; Craniocerebral Trauma* ; Early Diagnosis ; Head* ; Humans ; Intracranial Hypertension ; Mortality ; Persistent Vegetative State ; Pupil ; Reflex

BACKGROUND: Recently some countries such as U.S.A. and Canada where human immunodeficiency virus(HIV) infection is rather prevalent, included HIV-1 p24 antigen test as a routine donor blood screening. This study was performed to evaluate the advantage of additional p24 antigen testing for the prevention of transfusion-associated AIDS infection in Korea. METHODS: Blood collected from 1726 volunteer blood donors, 16 HIV-positive patients, 39 sera from 4 commercial seroconversion panels, 15 sera included in low titer performance panel were tested with HIV-1 p24 Antigen ELISA Test System(Ortho Diagnostic Systems, U.S.A.). Anti-HIV antibody was also measured in parallel employing commercial kits produced by two world-famous companies. For some sera, western blot testing was additionally done. RESULTS: False-positive rate of p24 antigen testing was 0.06%. In 2 examples from 4 seroconversion panels, the p24 antigen test detected HIV infection 1-25 days and 11-47 days earlier than anti-HIV tests. CONCLUSION: Additional p24 antigen testing was found to have a potential to reduce transfusion-associated HIV infections. Including the p24 antigen testing as a routine donor screening should be considered if the number of transfusion-associated HIV infections continues to grow in Korea.
Blood Donors ; Blotting, Western ; Canada ; Donor Selection ; Enzyme-Linked Immunosorbent Assay ; HIV Infections ; HIV-1 ; Humans* ; Korea ; Mass Screening ; Tissue Donors ; Volunteers

Emphysematous pyelonephritis is a rare, life-endangering suppurative infection of the renal parenchyma and perirenal tissues. The disease is encountered mainly in the diabetic patient with or without ureteral obstruction and is characterized by the production of intrarenal and occasionally, perirenal gas. We report a case of emphysematous pyelonephritis, treated by left nephrectomy, in 55-year-old diabetic woman.
Female ; Humans ; Middle Aged ; Nephrectomy ; Pyelonephritis* ; Ureteral Obstruction

The contour of mandibular angle is important for facial esthetics in the oriental population, because the wide and square face is thought to have had an unhappy life. A prominent mandibular angle produces a characteristics quardrangle, coase, and muscular appearance. So, uni- or bi-lateral mandibular angle reduction is usually performed. However, there is little guideline for bi-lateral angle reduction. So, this study was to investigate the pattern of Korean mandibular angle for bi-lateral mandibular angle reduction as guideline. This study was included 66 adult men and women over 19 years old who are having the normal mandibular angle. We measured the posterior border, angle, and inferior border of mandible using cephalometric view. The results of study was as followed : 1. The ratio of posterior mandible was 96.6, 97.3% in male, and 103.0, 106.0% in female. 2. The ratio of mandibular angle(R1-Go/R1-R2) was 120.2% in male, and 117.3% in female. 3. The ratio of inferior mandible(D5, 6, 7, E, F, G/D4) was 97. 3, 90.9, 79.5, 65.2, 57.8, 46.9% in male, and 98.5, 91.2, 80.5, 67.6, 59.1, 50.2 % in female. The results of this study should be useful to decide accurate amount of reduction.
Adult ; Esthetics ; Female ; Humans ; Male ; Mandible ; Young Adult

Leiomyoma is a benign tumor, which usually occur at the smooth muscle of the gastrointestinal tract and uterus but rarely occurs on the corpus cavernosum of the penis. We experienced a patient with leiomyomas on the bilateral corpus cavernosa of the penis accompanied with impotence in a 60-year-old man. The patient was treated with complete local excision and has remained well without recurrence for l year, So we report this case with review of literatures.
Erectile Dysfunction ; Gastrointestinal Tract ; Humans ; Leiomyoma* ; Male ; Middle Aged ; Muscle, Smooth ; Penis* ; Recurrence ; Uterus

It is well known that the plasma concentration is important in determining the rate of recovery from neuromuscular block. However, nondepolarizing neuromuscular blockade are retained at the neuromuscular junction and are not readily displaced in response of changes in plasma drug concentration, for instance, the neuromuscular block induced by mivacurium appears to considerably outlast the theoretical plasma half-life of the drug and is continued long after the plasma level has fallen to subparalytic levels due to rapid metabolism by pseudocholinesterase. It has been suggested that although plasma concentration may be the key determinant of recovery from neuromuscular block, recovery will depend upon the dissociation from the affinity of drug in the effect compartrnent and not upon its plasma concentration. In an attempt to confirm these evidences, we have investigated the response of changes in neuromuscular block after releasing tourniquet at 50% twitch depression using the isolated forearm experiment with various neuromuscular blocking agents. The results of this study demonstrated the further increase of block after early toumiquet release in the isolated forarm in all agents; 66+/-14% in vecuronium, 90+/-9% in atracurium, 92+/-7% in pancuronium, and 73+/-18% in mivacurium Conclusively, the further block continued to increase in spite of the negligible plasma drug concentration after early tourniquet release may be caused by more in affinity of drugs in binding sites than plasma drug concentration. Therfore, it is evident that both the affinity of drug to the receptor and the plasma drug concentration have influenced on the recovery from the neuromuscular block.
Atracurium ; Binding Sites ; Depression ; Forearm ; Half-Life ; Metabolism ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents* ; Neuromuscular Junction ; Pancuronium ; Plasma ; Pseudocholinesterase ; Tourniquets ; Vecuronium Bromide

BACKGROUND: Rocuronium bromide can elicit a high incidence of pain when administered by intravenous injection. Several methods have been suggested to minimize the incidence and severity of this pain. In this study, we evaluated the quantitative effect of ketamine pretreatment on the incidence and severity of pain induced by intravenous rocuronium. METHODS: Sixty healthy female patients scheduled for general anesthesia were randomly divided into three groups; a saline group (n = 20), a ketamine 0.2 mg/kg group (n = 20), and a ketamine 0.5 mg/kg group (n = 20). Each patient received 2 ml of pretreatment solution via an 18 G angiocatheter inserted in a hand dorsal vein. After 30 seconds, 0.6 mg/kg of rocuronium bromide was administered intravenous. Anesthesia was induced by 2 mg/kg of propofol. Pain was assessed during rocuronium injection and pain severity was classified as none, mild, or severe. RESULTS: The incidence of pain was significantly lower in the ketamine 0.5 mg/kg group than in the saline or ketamine 0.2 mg/kg groups. Patients administered ketamine at 0.2 mg/kg were found to be less likely to suffer severe vascular pain than those in the saline group. CONCLUSIONS: Pretreatment with intravenous ketamine 0.5 mg/kg is more effective than ketamine 0.2 mg/kg at alleviating the incidence and severity of pain associated with rocuronium injection without significant side effects.
Anesthesia ; Anesthesia, General ; Female ; Hand ; Humans ; Incidence ; Injections, Intravenous ; Ketamine* ; Propofol ; Veins

BACKGROUND: The occurrences of pressure sores have an extensive impact on patients and the medical team. Pressure sores decrease quality of life and productivity, as well as increase the overall cost of treatment. The purpose of this study was to identify the risk factors associated with pressure ulcers among surgical patients. METHODS: Data were collected from 588 patients who underwent general anesthesia. The data included age, gender, weight, height, body mass index, ASA status, surgical position, anesthesia time, pre-and postoperative hemoglobin concentration, serum albumin, NYHA class, co-morbidity, steroid use, body temperature, use of warming water mattress and preoperative hospital admission day. The patient's skin was inspected closely before surgery and again within 24 hours after surgery and the locations and severity of skin breakdowns were assessed. RESULTS: Twenty-five patients (4.3%) developed pressure sores during surgery. The hemoglobin concentration change between the preoperative and postoperative period (> or =2 g/dl), position during surgery, length of stay before operation (> or =4 days), anesthesia time (> or =5 hours) and decrease in body temperature (> or =0.5degrees C) were significantly related to the development of pressure sores (P < 0.05). CONCLUSIONS: Five risk factors for pressure ulcers were confirmed. The anesthesiologist can decrease hemoglobin and modify body temperature; therefore, attention should be given to these risk factors during the operation.
Anesthesia ; Anesthesia, General* ; Body Height ; Body Temperature ; Efficiency ; Humans ; Length of Stay ; Postoperative Period ; Pressure Ulcer* ; Quality of Life ; Risk Factors* ; Serum Albumin ; Skin ; Water

Screening is for the early detection and treatment of diseases in prior to development of symptoms, so that more favourable prognosis could be obtained. To evaluate efficiency of screening test for cervical neoplasms, we compared the histopathologic stages of asymptomatic cervical neoplasm patients diagnosed by screening test, with those of symptomatic patients confirmed by pathology. Total 1,120 cases of cervical neoplasm patient, diagnosed at Kang-nam St. Mary's hospital from Jan. 1990 to Dec. 1996, were reviewed by chart, and classified as asymptomatic and symptomatic group based on the presence of subjective symptoms on their hospital visit. Their histopathologic stages were analysed. The results were as follows, 1. From the total of 1,120 patient, asymptomatic group comprised 264 cases (25.5%). Asymptomatic proportion increased 15.3% in 1991 to 34.7% in 1996. 2. Mean age for the occurrence of cervical neoplasm was 44.3 +/- 10.4 years for the asymptomatic group, and 49.3+/-13.2 years for the symptomatic group, showing statistically significant differences(p=0.001). 3. Among the study subjects, 465 cases(45.0%) had CIS(carcinoma in situ), and 569 cases(55.0%) had invasive cancers. 4. Percentage of cervical neoplasm patient diagnosed at asymptomatic stages were 45.8% in twenties, 32.0% in thirties, 27.7 % in forties, 21.7% in fifties, 18.7% in sixties and 1.8% in above seventies, showing statistically significant differences according to age group(p=0.001). 5. In thirties, 87.2% of the asymptomatic patients were diagnosed as CIS and 45.0% of symptomatic patient were diagnosed as CIS. With increment of ages, CIS proportion were markedly decreased. 6. 76.9% of asymptomatic patients were diagnosed as CIS, and 34.0 % of symptomatic patients were diagnosed as CIS, suggesting screening test at asymptomatic stage can increase CIS proportion. 7. CIS proportion of asymptomatic patient was highest in thirties(40.4%) and 2nd highest in forties(34.0%). Screening test for cervical neoplasm should be actively carried out from the thirties.
Humans ; Mass Screening ; Pathology ; Prognosis ; Uterine Cervical Neoplasms*