Epilepsy can be divided into idiopathic epilepsy and symptomatic epilepsy according to the existence ofunderlying organic disease. It has been said that the incidence of the symptomatic epilepsy caused by underlyingorgainic brain disease is higher in late-onset epilepsy after the age of 20 than in childhood-onset epoilepsy. CTis very sensitive and non-invasive method for detection of organic brain disease. 168 cases of late-onset epilepsyafter the age of 20 were studied by CT in recent 2 years were analyzed. The results were as follows; 1. The 3rddecade was the most frequent age group, and the ratio of male to female was 2.5;1. 2. Structural abnormality onbrain CT was demonstrated in 51.8% of hte patient. 3. The older the onset of age was, the higher the rate of theabnormal CT finding, except 5th decade which showed less CT abnormality than 4th decade. 4. The most frequenthistory related to epilepsy was trauma. 63.1% of the patients had no relevant history; and they showed CT findingsof brain tumor, atrophy and infarction in decreasing order of frequency. 5. Abnormal CT finding was demonstratedin 49.2% of normal neurologic examination and in 46.4% of normal EEG study. 6. The most frequent lesion ofabnormal CT scan in late-onset epilepsy was 30 cases(18.4% )of brain atrophy. The next frequent lesion was 18cases (10.7%) of brain tumor. Infarction, parasites and calcification were other frequnet lesions.
Atrophy ; Brain ; Brain Diseases ; Brain Neoplasms ; Electroencephalography ; Epilepsy ; Female ; Humans ; Incidence ; Infarction ; Male ; Methods ; Neurologic Examination ; Parasites ; Tomography, X-Ray Computed

Malignant gastrointestinal stromal tumors (GISTs) are rare non-epithelial, mesenchymal neoplasms of the gastrointestinal tract that metastasize or recur in 30% of patients who undergo surgical resection with curative intent. A 59-year-old man visited our hospital for an examination of a palpable mass in the left abdomen. Fourteen months prior to his visit, the patient underwent gastric wedge resection to remove a GIST of the gastric cardia. At the time of surgery, no evidence of metastatic disease was observed and the pathological interpretation was a high-risk GIST. A follow-up computed tomography scan of the abdomen revealed a partially necrotic solid mass (9.8 x 7.6 cm) and enhancing mass in the spleen (2.3 cm). On exploration, multiple masses were found in the liver, greater omentum, and mesentery. Here, we report a case of recurring GIST of the stomach that metastasized to the spleen. To the best of our knowledge, few reports of metastasis to the spleen exist.
Abdomen ; Cardia ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Liver ; Mesentery ; Middle Aged ; Neoplasm Metastasis ; Omentum ; Spleen ; Stomach

BACKGROUND: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled. METHODS: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups. RESULTS: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). CONCLUSIONS: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.
Arteries ; Embolism ; Humans ; Parents* ; Prognosis ; Recurrence ; Stroke ; Stroke, Lacunar*

No abstract available.
Colorectal Neoplasms* ; Loss of Heterozygosity*

No abstract available.
Postural Orthostatic Tachycardia Syndrome* ; Syncope

BACKGROUND: Exposure to organic solvents becomes a common problem to workers of heavy industries in Korea. A number of volatile organic solvents which are frequently used in painting can cause various derangements of the nervous system, especially cognitive impairments and peripheral neuropathy. METHODS: This study was carried out on 190 workers as a control group who had never been exposed to organic solvents and on 674 spray painters with long-term exposure to organic solvent mixtures. The major components of organic solvent mixtures were determined. All subjects underwent neurological examination as well as routine physical check-up after completing questionnaires on general, musculoskeletal, neuropsychiatric and neurological systems. Subjects with abnormal findings on neurological examination related with the exposure of organic solvent mixtures took further neuropsychological and neurophysiological tests. RESULTS: The prevalence rates of cognitive impairments and of peripheral neuropathy in the exposed group were significantly higher than the control group (9.5% vs 2.1% and 2.1% vs 0%, respectively). High exposure group (more than 2.64 of cumulative exposure index, CEI) showed also higher prevalence of cognitive impairments and of peripheral neuropathy than low exposure group (cognitive impairments; 12.3% vs 6.4%, peripheral neuropathy; 2.3% vs 1.8%). Most common cognitive impairments were attentional deficit, and abnormal sense on the extremities or face was most common symptom of the peripheral nervous system. CONCLUSION: This study is the first large-scale, case-control study extensively evaluating cognitive impairments and peripheral neuropathy related with volatile organic solvent mixtures in spray painters working in a shipbuilding industry in Korea. The results show that the prevalence rates of cognitive impairments and of peripheral neuropathy are relatively low, but clearly related with the exposure extent of organic solvents.
Case-Control Studies ; Extremities ; Korea ; Metallurgy ; Nervous System ; Neurologic Examination ; Paint ; Paintings ; Peripheral Nervous System ; Peripheral Nervous System Diseases* ; Prevalence ; Surveys and Questionnaires ; Solvents*

No abstract available.
Magnetic Resonance Imaging* ; Magnetic Resonance Spectroscopy* ; Neoplasms, Neuroepithelial*

PURPOSE: The preoperative prediction of malignant potential in patients with gastric submucosal tumors (SMTs) plays an important role in decisions regarding their surgical management. METHODS: We evaluated the predictors of malignant gastric SMTs in 314 patients with gastric SMTs who underwent surgery in Chonnam National University Hospital. RESULTS: The malignant SMTs were significantly associated with age (odds ratio [OR], 1.067; 95% confidence interval [CI], 1.042 to 1.091; P < 0.0001), presence of central ulceration (OR, 2.690; 95% CI, 1.224 to 5.909; P = 0.014), and tumor size (OR, 1.791; 95% CI, 1.483 to 2.164; P < 0.0001). Receiver operating characteristic curve analysis showed that tumor size was a good predictor of malignant potential. The most relevant predictor of malignant gastric SMT was tumor size with cut-offs of 4.05 and 6.40 cm. CONCLUSION: Our findings indicated that age, central ulceration, and tumor size were significant preoperative predictors of malignant SMTs. We suggest that 4 cm be selected as a threshold value for malignant gastric SMTs. In patients with a gastric SMT larger than 4 cm with ulceration, wide resection of the full thickness of the gastric wall or gastrectomy with adequate margins should be performed because of its malignant potential.
Gastrectomy ; Humans ; ROC Curve ; Stomach Neoplasms ; Ulcer

PURPOSE: The relationship between the prognosis and the age of patients with gastric carcinoma is controversial. This study examined the clinicopathologic features of elderly gastric carcinoma patients with serosal invasion. METHODS: We reviewed the hospital records of 136 elderly gastric carcinoma patients with serosal invasion retrospectively to compare the clinicopathologic findings in the elderly (aged > 70 years) and young (aged < 36 years). RESULTS: The 5-year survival rates of elderly and young patients with curative resection did not differ statistically (33.9% vs. 43.3%; P = 0.318). Multivariate analysis showed that two factors were independent, statistically significant parameters associated with survival: histologic type (risk ratio, 1.805; 95% confidence interval [CI], 1.041 to 3.132; P < 0.05) and operative curability (risk ratio, 2.506; 95% CI, 1.371 to 4.581; P < 0.01). CONCLUSION: This study demonstrated that elderly gastric carcinoma patients with serosal invasion do not have a worse prognosis than young patients. The important prognostic factor was whether the patients underwent curative resection.
Aged ; Hospital Records ; Humans ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Survival Rate

Lung transplantation in the treatment of end-stage emphysema has been increasing in number since the recent rise in the 5 year survival rate. For the shortage of donor lungs, the single lung transplantation or transplantation in ABO compatible, nonidentical recipients has also been increasing. The lung transplantation in compatible, nonidentical recipients show good results as with identical recipients with the proper application of immunosuppressive agents. We transplanted the left lung of a 41 year-old male donor to a 35 year-old female recipient who had been suffering from severe dyspnea due to end-stage emphysema. For postoperative immunosuppression, we applied conventional triple immunotherapy(cyclosporine, azathioprine, prednisolone) and we could suppress the rejection response of transplanted lung by adding the anti-CD3 antibody(OKT3) during the operation. The patient could be discharged without any specific problem at 18th postoperative day.
Adult ; Azathioprine ; Dyspnea ; Emphysema ; Female ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Lung Transplantation* ; Lung* ; Male ; Survival Rate ; Tissue Donors