Obtaining a complete and accurate history is one of the most crucial steps in the initial diagnosis and subsequent management of the poisoned patients. This information can then be integrated with physical evidence, clinical examination, laboratory and toxicological data in designing a therapeutic approach. Such information may include patient data, product information, and nature of exposure. The basic treatment for acute poisoning, whether of drug or chemical, is mainly symptomatic and supportive. The four cardinal principles of good management are ① identification of the causative drug or chemical as quickly as possible, ② evacuation of the poison from the stomach, except when contraindicated, ③ administration of an antidote if available, and ④ symptomatic and supportive therapy as indicated. Management in most cases of toxicity consists of supportive care, symptomatic treatment, and avoidance of exposure to the toxic material. In cases of life-threatening toxicity, maintenance of cardiopulmonary function and fluid and electrolyte balance are important. There are limited specific methods of treatment, or "antidotes". Use of oxygen counters the foxic effect and enhances the elimination of carbon monoxide. In cases acute cyanide of hydrogen sulfide poisoning, nitrites may be used to generate formation of cyanmethemoglobin or sulfmethemoglobin. Hydroxocobalamin can also be used as an antidote for cyanide. Atropine and pralidoxime can be life-saying in reversing the acute cholinesterase-inhibiting effects of organophosphate pesticides. Chelating agents may reverse acute toxicity caused by some metals.
Atropine ; Carbon Monoxide ; Chelating Agents ; Diagnosis ; Humans ; Hydrogen Sulfide ; Hydroxocobalamin ; Metals ; Nitrites ; Oxygen ; Pesticides ; Poisoning* ; Stomach ; Water-Electrolyte Balance

No abstract available.
Emergencies* ; Emergency Medical Services*

No abstract available.
Catheters* ; Extremities* ; Replantation*

This dental anthropological study was performed to analyse male and female students of Che-ju high school students. Cephalometric X-rays and dental casts were obtained of 60 male and 60 female students and the Mean and Standard Deviation were obtained. There was no difference in craniofacial morphology between male and female students but the size of craniofacial skeleton of the male is bigger than that of the female. The distance from NB line to pogonion is longer in the male group, and it meant that mandibular symphysis of the male is well developed than the female. The size of teeth of the male is larger than that of the female and is significant in upper and lower canine and first molar. The size of upper arch width, intercanine width, basal arch width and lower basal arch width of the male is larger than that of the female, but arch length of the male and the female showed no significant difference.
Female ; Humans ; Jeju-do* ; Male ; Molar ; Skeleton ; Tooth

No abstract available.
Fibroma*

PURPOSE: Epilepsy is one of the most important morbidities in childhood, but its underlying causes can not be found even though extensive studies have been done. Advances in diagnostic modalities, including neuroimaging such as MRI reveal the apparent underlying causes of epilepsies. Therefore, we evaluated specific causes of symptomatic epilepsy and compared clinical features with idiopathic epilepsy. METHODS: Three hundred nine epileptic children visited the Pediatric Department of Pusan National University Hospital from January, 1991 to June, 1998. Of these, 79 patients were determined as symptomatic epilepsy and the analysis of various clinical features was undertaken retrospectively, according to the presence or absence of underlying causes. RESULTS: Two hundred and thirty two patients(75.1%) were idiopathic and 79 patients(24.9%) were symptomatic, the ratios of male to female and the ages at the onset of first seizure were 1.28 : 1, 1.48 1 and 3.24+/-5.65, 2.40+/-2.86 years(p>0.05, p<0.05), respectively. Causes of symptomatic epilepsy in order of frequency were birth asphyxia(29.9%), CNS malformation(27.3%), CNS infection(22.1%) and others(20.7%). The ratios of male to female and onset age of birth asphyxia, CNS malformation, CNS infection were 2.83 : 1, 1.91+/-2.64, 0.75:1, 2.35+/-2.92 and 1.43 : 1, 2.74+/-2.56, respectively. Seizure types in symptomatic group were classified as partial seizure in 22.1%, generalized seizure in 71.4% and unclassified in 6.5%, compared with those of idiopathic group classified as 46.6%, 51.7%, 1.7%, respectively. Intervals between medication start and seizure control in idiopathic and symptomatic groups were 146.5+/-148.7 days and 246.1+/-247.6 days, repectively(p<0.05). According to their etiology of birth asphyxia, CNS malformation and CNS infection were 364.5+/-315.0 days, 175.4+/-181.6 days, 199.9+/-215.3 days, respectively(p<0.05). CONCLUSION: CNS malformation, birth asphyxia, CNS infection were main causes of symptomatic epilepsy in childhood. In symptomatic epilepsy, generalized seizures was more common and occurred at a younger age. It takes more time to control seizure of symptomatic epilepsy.
Age of Onset ; Asphyxia ; Busan ; Child ; Epilepsy* ; Epilepsy, Generalized ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Neuroimaging ; Parturition ; Retrospective Studies ; Seizures

No abstract available.
Enophthalmos* ; Transplants*

Distal foot defect is frequently encountered as an output site in high-tension electrical burn injuries, and proper treatment methods should be applied in order to achieve a properly-functioning foot. However, in distal foot defects around the metatarsal heads or metatarsophalangeal joints, conventional methods have not been ideal, replaced by such methods as secondary healing, amputation or skin graft because there was insufficient tissue in the distal foot and the general condition of the patient was unsuitable for distant or free flap surgeries. So, in order to establish convenient, promising methods for the reconstruction of distal foot defects in severe electrical burns, we classified the distal foot into four zones according to their blood supply and we defined or created ideal reverse flaps in each zone. From April 1996 to March 1999, we reconstructed 43 cases of distal foot defects in fourth-degree high voltage electrical burn wounds. In 19 cases of MP(medial plantar) zone injuries, we used reverse medial plantar island flap and in 5 cases of DP(dorsalis pedis) zone, we created a reverse dorsalis pedis island fascia flap, In 11 cases of P(peroneal) zone, we created reverse peroneal fascia flap and in 8 cases of I (intermediate) zone, we modified a reverse posterior tibial island flap, There was partial flap necrosis or grafted skin loss in five cases, but those were extremely minor problems and we successfully reconstructed distal foot defects in all 43 cases. In conclusion, proper reverse flaps according to the zone of the distal foot are ideal reconstructive methods because they provide good vascularization, sufficient tissue from the proximal parts and they require short operative time with relatively easy procedures.
Amputation ; Burns* ; Fascia ; Foot* ; Free Tissue Flaps ; Head ; Humans ; Metatarsal Bones ; Metatarsophalangeal Joint ; Necrosis ; Operative Time ; Skin ; Transplants ; Wounds and Injuries

Distinguishing epileptic seizure from non-epileptic seizure is a common diagnostic problem. Neurogenic or cardiac syncope can appear similar to atonic and even convulsive seizures. Classic migraine and transient ischemic attacks may also resemble epileptic seizures. Sleep disorders including REM sleep behavior disorder, nocturnal paroxysmal dystonia, and narcolepsy likewise simulate an epileptic seizure. Movement disorders such as paroxysmal dyskinesia can be misinterpreted as epileptic seizures (reflex epilepsy or myoclonic seizures). Psychogenic seizures are often misdiagnosed as an intractable epilepsy. Prior to the definitive diagnosis of epilepsy, possible non-epileptic seizures should be excluded. For the correct decision, a thorough and systematic history taking is important. In addition, EEG, pseudoseizure induction test, head-up tilt test, EKG, sleep studies, and video-EEG monitoring may be necessary. Misdiagnosis of non-epileptic seizures as epilepsy may result in unnecessary anti-epileptic drug use. At the same time, we should let the patients understand what the epilepsy is and that epilepsy is a treatable disease.
Chorea ; Diagnosis ; Diagnostic Errors ; Drug Resistant Epilepsy ; Electrocardiography ; Electroencephalography ; Epilepsy* ; Humans ; Ischemic Attack, Transient ; Linear Energy Transfer ; Migraine with Aura ; Movement Disorders ; Narcolepsy ; Nocturnal Paroxysmal Dystonia ; REM Sleep Behavior Disorder ; Seizures* ; Sleep Wake Disorders ; Syncope

In order to compare the changes of dentofacial skeleton, teeth and soft tissue profile in Class I malocclusion patients treated with and without extraction, cephalometric radiographs were taken in 22 female patients as extraction group and 23 female as nonextraction group who were treated in the Department of Orthodontics in Chonnam National University Hospital. The results were as follows. 1. At the beginning of treatment, average age was 19.0 years in extraction group and 15.9 years in nonextraction group. Duration of treatment was 2.8 years in extraction group and 1.7 years in nonextraction group. 2. Before treatment, there were significant difference between 2 groups in the amount of protrusion and proclination in upper and lower central incisor and lower lip protrusion. After treatment, these differences were decreased. 3. In comparison before and after treatment in extraction group, upper and lower central incisor protrusion and lower lip protrusion were significantly improved. In nonextraction group, retrusion and improvement of inclination of upper and lower central incisor were not found.
Female ; Humans ; Incisor ; Jeollanam-do ; Lip ; Malocclusion ; Orthodontics ; Overbite ; Skeleton ; Tooth