Numerous drugs are known to cause seizures with therapeutic use or overdose. However, the relative frequency of such complications has rarely been studied, and little is known about the relationship of drug-induced seizures to eventual medical outcome. This study was performed to determine the causes and consequences of seizure associated with poisoning and drug intoxication. We analyzed about 786 cases of drug intoxication visited to Chung-Ang Gil hospital during recent 4 years from Jan. 1993 to Dec. 1996. The results were summarized as follows: 1. The total number of cases of drug intoxication was 786 and the most common drug of intoxication was antihistamines(291 cases, 36.3%); insecticides(113 cases, 14.7%); caustics(90 cases, 11.8%); herbicides(47 cases, 6.1%); NSAID(38 cases, 4.9%); rodenticides(36 cases, 4.6%); acetaminophens(34 cases, 4.4%); anticonvulsants(18 cses, 2.3%); neuroleptics(13 cases, 1.6%); hydrocarbons(9 cases, 1.2%); sympathomimetics(8 cases, 1.0%). 2. The leading causes of seizures were antihistamines(12 cases, 42.8%); insecticides(7 cases, 25.0%); sympathomimetics(3cases, 10.7%); neuroleptics(2 cases, 7.2%); others(4 cases, 14.3%). 3. Seizures associated with antihistamines were generally brief(11 cases, 92.0%) and uncomplicated(3 cases, 25.0%). 4. Seizures incidence by drug intoxication was relatively high in sympathomimetics(3 cases, 35.7%); and neuroleptics(2 cases, 15.4%). 5. Poisoning associated with seizure had relatively high risk compared with non seizure poisoning for medical complication.
Drug Overdose* ; Histamine Antagonists ; Incidence ; Poisoning* ; Seizures*

Kasabach-Merritt syndrome is the association of thrombocytopenia, disorder of coagulation, spontaneous bleeding and enlargement of a hemangima or extensive hemangiomatosis, which can be often life threatening. We experienced a three years-old girl with suddenly enlarging hemangioma of right cheek, complicated by severe thrombocytopenia, consumptive coagulopathy and hemorrhagic cystitis. Generalized petechia and ecchymosis were noted on the overlying skin of hemangioma, trunk and extremities. But the study of MRI and angiography, hypevascular was located within the right masseter muscle extending to temporalis muscle and anterior to parotid gland. So selective embolization with PVA (polyvinyl alcohol) was performed through the distal branch of internal maxillary artery and facial artery. She was medicated with oral corticosterioid for 3 weeks. After embolizationn, blood flow to hemangioma and facial swelling were markedly decreased. Patient was followed up for 7 years and she showed normal contour of face and no bleeding diathesis.
Angiography ; Arteries ; Cheek ; Cystitis ; Disease Susceptibility ; Ecchymosis ; Extremities ; Female ; Hemangioma ; Hemorrhage ; Hemorrhagic Disorders* ; Humans ; Kasabach-Merritt Syndrome* ; Magnetic Resonance Imaging ; Masseter Muscle ; Maxillary Artery ; Parotid Gland ; Skin ; Thrombocytopenia

Acute mountain sickness is an illness caused by climbing to a high altitude without prior acclimatization. Neurological consequences, like parkinsonism following acute mountain sickness without lesion of brain MRI have been reported rarely. A healthy 56-year-old man presented with dysarthria and gait disturbance. Neurological examination revealed tremor of hands, limb rigidity, and bradykinesia. The symptoms developed approximately 30 days following a 3,500 m climb of the Annapurna in the Himalayas. Brain MRI did not reveal any abnormalities including globus pallidus. The parkinsonism symptoms persisted for about 3 months before a complete recovered was made. We suggest that parkinsonism can develop after climbing to a high altitude but that the symptoms can be transient if a brain MRI detects no abnormalities.

Trichilemmal carcinoma is a rare malignant neoplasm of the hair follicle, which is derived from or differentiates towards cells of the outer root sheath. We report a case of trichilemmal carcinoma in an 83-year-old female patient. She presented with a tender dome-shaped crusted papule showing a feature of cutaneous horn on the forehead, which was first detected 6 months before. nstopathologically, lobular patterned tumor cells with peripheral palisade of basaloid cells, nuclear atypia, and clear or pale, PAS-positive, diastase-sensitive cytoplasm were observed beneath the marked hyperkeratosis. After the diagnosis, total excision was done. The patient has been free of recurrence or metastasis till now.
Aged, 80 and over ; Animals ; Cytoplasm ; Diagnosis ; Female ; Forehead ; Hair Follicle ; Horns* ; Humans ; Neoplasm Metastasis ; Recurrence

Microcystic meningioma is a rare variant of meningiomas. This unusual variant was originally described by Masson, who labeled it "humid". The computed tomographic scan or magnetic resonance images of these tumors resemble those of a glial or metastatic tumor with cystic or necrotic changes. There is no definitive method for differentiating cystic meningiomas from these more common tumors. But immunohistochemically, they share a similar pattern of positive staining for epithelial membrane antigen and vimentin with other meningiomas. Our case was a 34-year-old woman with a tumor mass on the right frontal area. She was admitted to hospital because of generalized tonic seizure. Grossly all of the tumor could be removed, and histopathologically this tumor was revealed to be a microcystic meningioma.
Adult ; Female ; Humans ; Meningioma* ; Mucin-1 ; Seizures ; Vimentin

It is generally considered that enteral feeding is superior to parenteral nutritional support. Thus enteral meal should be given whenever patients have proper gastrointestinal function to take enteral feeding. Because the morbidity and mortality for surgical jejunostomy have been reported as high as 50% and 10% respectively, direct percutaneous endoscopic jejunostomy has been developed to reduce the morbidity and mortality. A 55-year-old male patient, who was suffering from dysphagia and oropharyngeal aspiration, was transferred to the division of gastroenterology to be done permanent enteral feeding. His stomach was resected (subtotal gastrectomy with billroth II anastomosis) due to peptic ulcer hemorrhage 10 years before. We performed direct percutaneous endoscopic jejunostomy without any complication. Herein, we report a successful case.
Deglutition Disorders ; Enteral Nutrition ; Gastrectomy* ; Gastroenterology ; Gastroenterostomy ; Humans ; Jejunostomy* ; Male ; Meals ; Middle Aged ; Mortality ; Nutritional Support ; Peptic Ulcer Hemorrhage ; Stomach

PURPOSE & METHOD: To evaluate clinical pattern and operative outcome of the ischemic lower extremity, 142 patients who were admitted to Yeungnam University Hospital between January 1996 to December 1998 were analyzed. RESULTS: The patients were 125 males and 17 females ranging from 21 to 88 years of age. The mean age was 59, with the highest incidence among people in their 60s, followed by those in their 70s and then in their 50s. The causes of arterial occlusive disease were artherosclerotic obliterans (ASO) in 87 cases (61.2%), thromboangitis obliterans (TAO) in 44 cases (30.9%), thromboembolism in 10 cases and superficial femoral aneurysm in 1 case. Associated diseases in ASO were hypertension in 37 cases (42.5%), diabetes mellitus in 17 cases (30.9%), cardiac disease in 24 cases (27.5%) and cerebrovascular disease in 7 cases (8.0%). History of smoking was noted in 77.4% of the cases. The major arterial occlusive site of ASO were femoral artery in 36 cases (41.3%), aortoiliac artery in 26 cases (29.8%), iliofemoral artery in 9 cases (10.3%), popliteal artery in 5 cases (5.7%), tibial artery in 6 cases (6.8%) and multi-level occlusion in 5 cases (5.7%). The major arterial occlusive site of TAO were tibial artery in 35 cases (79.5%), pedal artery in 8 cases (18.1%) and popliteal artery in 1 case. According to the Fontaine classification of clinical symptoms, the distribution was as follows: Grade 0 0 case, Grade I 48 cases (33.8%), Grade II 46 cases (32.3%) and Grade III 48 cases (33.8%). The operative procedures of arterial occlusive disease were bypass graft operation in 72 cases, thromboembolectomy in 12 cases, endarterectomy in 2 cases and percutaneous transluminal angioplasty (PTA) was performed in 9 cases. Arterial bypass operation with autogenous or artificial prosthesis were done in 72 cases, which included aortobifemoral or aortobipopliteal bypass in 12 cases, iliofemoral bypass in 5 cases, femoropopliteal bypass in 26 cases, femorotibial bypass in 5 cases, popliteotibial bypass in 8 cases. axillobifemoral bypass in 4 cases and femorofemoral bypass in 12 cases. In over 90% of the operative cases, the early outcome was good with 3+ to 2+ rating according to Rutherford criteria. Mortality for 114 cases was 2.6% (3 cases), including 2 resulting from associated cardiac condition and 1 resulting from ARDS. CONCLUSION: Strategies for successful revascularization and long term patency may be made by consideration of the extent of diseases, associated diseases, clinical symptoms and status of distal perfusion.
Aneurysm ; Angioplasty ; Arterial Occlusive Diseases ; Arteries ; Classification ; Diabetes Mellitus ; Endarterectomy ; Female ; Femoral Artery ; Heart Diseases ; Humans ; Hypertension ; Incidence ; Ischemia* ; Lower Extremity* ; Male ; Mortality ; Perfusion ; Popliteal Artery ; Prostheses and Implants ; Smoke ; Smoking ; Surgical Procedures, Operative ; Thromboangiitis Obliterans ; Thromboembolism ; Tibial Arteries ; Transplants ; Troleandomycin

No abstract available.
Radiation Oncology*

PURPOSE: To evaluate the role of the MRI after the stereotactic radiofrequency ventralis intermedius nucleus (VIM) thalamotomy for the treatment of tremor. MATERIALS AND METHODS: 156 cases of the postthalamotomy MR findings were analized retrospectively. The sagittal T1 weighted image(WI), axial and coronal Proton and T2WI were obtained by using 0.38 T(Resonex Sunnyvale, U. S. A) machine. The interval between thalamotomy and MR examination was from 3 days to 2 months. The MR characteristics and complications related to thalamotomy were reviewed. In 16 cases, a follow-up MR was done 3 to 13 months after the initial MR study. We also reviewed the follow-up MR findings. RESULTS: The mean size of the thalamus lesion was 16 mm. The thalamus lesions were noted as a single layer in 23 cases and as layers of different signal intensity in 100 cases;(2 layers in 84 cases, and 3 or more layers in 16 cases). In 74 cases of the 84 cases with 2 layers, the inner layer was isointense with gray matter on T1WI, hypointense on T2WI, and the outer layer was hypointense on T1WI, hyperintense on T2WI. There were extrathalamic lesions that were related to mistargetting of stereotactic radiofrequency. The locations of the extrathalamic lesions were the posterior limb of the internal capsule(119 cases), the posterior limb of the internal capsule and the midbrain(39 cases), the posterior limb of the internal capsule and the basal ganglia(11 cases), and the midbrain(9 cases). In 5 cases of the mistargetting, double radiofrequency lesions were visualized because of the repeated coagulation. The other complications were intracerebral hemorrhage(2 cases), subdural hemorrhage(2 cases), epidural hemorrhage(1 case), and intraventricular hemorrhage(1 case). On the follow up MR studies(16 cases), 2 cases showed the hemosiderin deposition in periphery of the lesion. CONCLUSION: The MRI was useful for the evaluation of the thalamic lesions and complications after the stereotactic radiofrequency VIM-thalamotomy for the treatment of tremor.
Extremities ; Follow-Up Studies ; Hemosiderin ; Internal Capsule ; Magnetic Resonance Imaging ; Protons ; Retrospective Studies ; Thalamus ; Tremor

PURPOSE: Torus palatinus is a bony prominence at the middle of the hard palate. The size varies from barely discernible to very large, from flat to lobular. This oral exostosis is not a disease or a sign of disease, but if large, may be a problem. So, we present the clinical and histopathologic features and applied therapy and provide a comprehensive review of the rare case of the symptomatic exostoses. METHODS: A 37-year-old woman had slowly growing exophytic nodular mass of the bone that arises the midline suture of the hard palate. The patient was concerned about discomfort associated with movement of her tongue and about frequent irritation of the palatal mucosa during mastification of the hard food. The patient had a large, unilobulated torus palatinus. It extended from the area adjacent to the canine to a point beyond the junction with the soft palate. The mass was oblong in shape, measuring about 3cm long, 2cm wide, and 0.8cm in height. RESULTS: Before surgical intervention a CT was obtained for the sake of estimating the thickness of the bone between the exostoses and the maxillary antrum and floor of the nose. The surgical procedure was performed with the patient under general anesthesia. Removal of the exostosis was performed after midline mucoperiosteal incision with osteotome and diamond burr. Histologic finding revealed decalcified dense bony tissue, the presence of lacunae, and normal osteocytes. CONCLUSION: Surgical removal is recommended when one or more of the following condition exist: interference with the construction of prosthesis, interference with oral function, irritation or pathology of the overlying tissue, inability of the patient to maintain proper oral hygiene, and fear of malignancy or other psychologic trauma. We report a rare case of the torus arising in hard palate with symptoms.
Adult ; Anesthesia, General ; Diamond ; Exostoses ; Female ; Floors and Floorcoverings ; Humans ; Hyperostosis ; Maxillary Sinus ; Mucous Membrane ; Nose ; Oral Hygiene ; Osteocytes ; Palate ; Palate, Hard ; Palate, Soft ; Prostheses and Implants ; Sutures ; Tongue