No abstract available.
Anxiety* ; Arachnoid*

The alcoholic neuropathies developed in approximately 34% of chronic alcoholics and the sexual dysfunction had been experienced in 8-54% of male alcoholics(Schiavi 1990). The aims of this study were to identify the prevalence of subclinical polyneuropathies and sexual disorders in alcohol dependence, and to evaluate the association between them. The nerve conduction velocity(NCY), electromyography(EMG), and pudendal somatosensory evoked potentials(SEPs were tested for the male alcoholics(N=34) and controls(N=17 for NCV & EMG, N=25 for pudendal SEPs). The pudendal SEPs were measured by the following procedures, in which we simulated the dorsal nerve of penis attached by the ring electrode(stimulus intensity, three times of threshold ; stimulus rate, 1-4.7Hz: stimulus duration, 0.1 or 0.2msec), and recorded at the scalp(active electrode, 2cm behind Cz ; reference electrode, Fz. The NCV and EMG detected signs of peripheral neuropathies in 79.4% of alcoholics. Among the alcoholics, 64.7% were abnormal on the pudendal SEPs. Among the alcoholics who revealed abnormality on EMG and NCV, 81.4% were abnormal on the pudendal SEPs, in which 51.9% were not responded. The P1 latencies between peripheral neuropathies and sexual disorders in the alcoholic. The prevalence of subclinical neuropathies and sexual disorders seemed to be much higher in alcohol dependence that expectation, and these two problems were relatively correlated, and our results suggested that the peripheral polyneuropathies were one of the prerequisites of sexual disorders.
Alcoholic Neuropathy ; Alcoholics ; Alcoholism* ; Electrodes ; Humans ; Male ; Neural Conduction ; Peripheral Nervous System Diseases* ; Polyneuropathies ; Prevalence ; Pudendal Nerve

BACKGROUND: The number of patients of doxylamine overdose has increased, but there were little clinical reports. The purpose of this study is review the patients of doxylamine overdose for aid clinical decision making of patients disposition. METHODS: We reviewed medical records of patients who ingested doxylamine succinate retrospectively from Jan. 1, 1996 to Dec. 31. 1996. Data that was recorded were followed: age, sex, psychiatric history, amounts of ingestion, time interval from ingestion to arrival to hospital, initial vital signs and symptoms, EKG, chest PA, Lab. findings, treatment, patients disposition, length of hospital stay, complication. RESULTS : 1) Total number of patients was ninety and average dosage of ingestion was 1062mg. 2) Tachycardia was the most frequent anticholinergic symptom(46%). 3) Routine lab. findings was not abnormal except one patient who was diagnosed as Rhabdomyolysis. 4) Gut decontamination was performed in patients who had arrived at hospital in 2-3 hours, and who had ingested large dose of drug. 5) Five patients were admitted to Psychiatric dept. and one patient was admitted to emergency dept. for treatment of rhabdomyolysis. 6) The mean duration of hospital stay was 6.5 hours. CONCLUSION: The patients who ingested overdose of doxylamine was managed safely in emergency department, but we should warn against the possibility of rhabdomyolysis.
Decision Making ; Decontamination ; Doxylamine* ; Eating ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Humans ; Length of Stay ; Medical Records ; Retrospective Studies ; Rhabdomyolysis ; Succinic Acid* ; Tachycardia ; Thorax ; Vital Signs

Association of the hepatoid and choriocarcinomatous components in adenocarcinoma of the stomach is extremely unusual and raises a possibility of new approach understand the histogenesis of gastric hepatoid adenocarcinoma. This paper describes a Borrmann type III adenocarcinoma of the stomach with both choriocarcinomatous and hepatoid components in composite tumor pattern in a 50-year-old man. Tubular arrangement of differentiated embryonalcarcinoma was encountered in choricarcinomatous and hepatoid areas, which showed strong immunoreactivity to beta-HCG and AFP, respectively. The findings suggest that gastric adenocarcinoma may have a potential of differentiation toward embryonal carcinoma. from which both choriocarcinoma and hepatoid variant of gastric adenocarcinoma may develop by retrodifferentiation.
Adenocarcinoma

No abstract available.
Female ; Lactation*

Chronic alcohol use may have direct or indirect neurotoxic effects on the brain that can lead to cognitive impairment. However, the precise relationship between alcohol and dementia remains unclear. There are several epidemiological studies suggest that the protective effect of light-moderate alcohol drinking in dementia. But obviously the heavy alcohol drinking can lead to brain damage and increase the risk of various types of dementia. The clinicopathological issues and criteria regarding so-called 'alcoholic dementia' remain under debate. Alcohol-induced persisting amnestic disorder, alcohol-induced persisting dementia, and Wernicke-Korsakoff syndrome (thiamine deficiency) may constitute distinct disease entities, but they may also share some common features. Based on this theory, Oslin and colleagues proposed the broader diagnostic scheme and criteria for Alcohol Related Dementia (ARD), which may include cases of Wernicke-Korsakoff syndrome and also other cases of dementia that appear to be alcohol-related. In pathogenesis of the alcoholic dementia, the chronic exposure to ethanol results in the adaptive up-regulation of NMDA receptor sensitivity, which can result in an increased vulnerability to glutamate induced excitotoxicity. Despite the clinical importance of ARD, few medical treatments for ARD have been proposed and studied. Most of all, the gold standard of the treatment in alcoholic dementia is the maintaining abstinence. Some therapeutic trials with cholinesterase inhibitors (donepezil and rivastigmine) and memantine (NMDA receptor antagonist) have been conducted for the patients with Wernicke-Korsakoff syndrome and alcohol-related dementia, and these studies reported favorable outcomes. Especially memantine can be a more effective agent in the treatment of alcoholic dementia because of anti-craving effect reported in several studies.
Alcohol Amnestic Disorder ; Alcohol Drinking ; Alcoholics ; Brain ; Cholinesterase Inhibitors ; Cognition ; Dementia ; Ethanol ; Glutamic Acid ; Humans ; Korsakoff Syndrome ; Memantine ; N-Methylaspartate ; Up-Regulation

No abstract available.
Carcinoma, Small Cell* ; Female ; Ovary*

By means of a sensitive radioirnrnunoassay method,ferritin was assessed in the cerebrospinal fluid (CSF) of 50 hospitalized subjects to evaluate its potential value for the diagnosis of tuberculous rneningititis. The rnean ferritin value obtained in the controls was 4.29ng /rnl with ranging between 1.7 and7.4ng/rmL The differences of CSF ferritin content between controls and patients with aseptic rneningitis as well as other non-infectious neurologic disorder were not significant. But rnarked elevation ranging 14 and 88ng/rnl (rnean, 37.4ng/rnl) were observed in patients with tuberculous rneningitis. And the ratio of CSF ferritin to serum ferritin in paients with tuberculous rneningitis was elevated significantly rnore than those in other groups inculuding controls, patients with aseptic rneningitis and other non-infectious neurologic disorder. The level in the serurn and CSF were independent, but that in CSF correlated vrith its total protein content. Results of this study suggest rneasuring CSF ferritin level are a valuable adjunct in differentiating aseptic meningitis from uncomplicated tuberculous meningitis.
Cerebrospinal Fluid ; Diagnosis ; Ferritins* ; Humans ; Meningitis* ; Meningitis, Aseptic ; Nervous System Diseases ; Tuberculosis, Meningeal

Aortic transection or interruption is a rare condition which developed after an acute deceleration injury. Its occurrence depends on the location and direction of the force applied and is usually from motor vehicle accident or falling down. The exact incidence of aortic transection in trauma is not known but, when develops, only about 10-15% of the victims can furtive and be transported to the hospital. Even in the survivors, majority of them will be fatal within a few days if a prompt diagnosis and surgical treatments are not made. Aggressive diagnostic work-up is recommended for the patients with high suspicious index, which would salvage the victims with this fatal condition. We report the experience of two cases of aortic transection or interruption following motor vehicle accidents.
Deceleration ; Diagnosis ; Early Diagnosis* ; Humans ; Incidence ; Motor Vehicles ; Survivors ; Thorax* ; Wounds and Injuries*

BACKGROUND: Do-Not-Resuscitate(DNR) order has been used without specific legislation commonly in hospitals of Korea. We designed this study to assess the current use of DNR order in the emergency department and to make a database for establishing a policy for DNR order, especially in ER. METHODS: We retrospectively reviewed medical records of 164 patients who expired in the emergency department of Severance hospital from Sep. 1996 to Aug. 1997. We evaluated age, sex, diagnosis, specific department involved, whether written orders were made and medical care after decision of DNR. The patients were divided into 2 groups : DNR vs CPR. To determine factors influencing DNR decision, we searched for presence of malignancy, irreversible shock, unconsciousness and chronic illness. The logistic regression analysis was used for statistical significance. RESULTS: We found that 102(62.2%) out of 164 expired patients had a DNR order. But only in 59% of cases, were written DNR order on the chart. Factors which had the most influence on decision of DNR were malignancy and age. The sex, chronic illness, irreversible shock, and unconsciousness were not significant factors. CONCLUSION: We found malignancy and old age as an important factor when DNR order had been made. But further evaluation of other factors may be necessary to establish definitely a policy for DNR order.
Cardiopulmonary Resuscitation ; Chronic Disease ; Diagnosis ; Emergency Service, Hospital ; Humans ; Korea ; Logistic Models ; Medical Records ; Retrospective Studies* ; Shock ; Unconsciousness