No abstract available.

The clinical state with EEG pattern similar to interval discharge of epileptics is named as latent epilepsy, which does not necessarily mean that the patient will develop epilepsy later. However, since there is possibility of developing epilepsy on later date, antiepileptic mainly dilantin was tried to control the abnormal EEG. Since January to October 1985, total 580 headache cases with more than moderately abnormal EEG visited the Neurology Clinic. Among them 162 cases with interval seizure pattern (ISP) of epilepsy were selected for the study. The main ISP was 1. diffuse theta and/or delta bursts and 2. spikes. Since the study in only analysis of clinical treatment of 162 cases without previous planning based on financial aid, about 30% of the patients did not return after the 1st EEG examination, in 42% failed to follow the EEG after the treatment and only remaining 28% of the cases were studied. Among 29 patients who were treated with Dilantin 100mg tid po, 16 improved and 13 not. Of the 13, 4 showed partial improvement and partial progression. Case1. In 4 weeks of antiepileptic therapy (AR), spikes disappeared but in 2 months developed bursts. Case2. In 17days of AR, spikes and bursts disappeared but in 3 months bursts reccured. Case3. In 1 week of AR, bursts disappeared but spikes developed. Case4. In 3 months of AR, no change of spikes and bursts and she discontinued the AR. In 6 months she developed grandma seizure. Eighteen cases, treated with other drugs except antiepileptics, all showed improvement. The other drugs were vincaprol, polygammalon, aronamin, ATP and hydergine. The improved cases had spikes more often than theta bursts. In view of the small number of the cases due to dropping most patients out of present study, it is considered meaningless to perform statistical analysis. Further well planned study with more patients is to be expected.
Adenosine Triphosphate ; Anticonvulsants ; Electroencephalography ; Epilepsy* ; Ergoloid Mesylates ; Headache ; Humans ; Neurology ; Phenytoin ; Seizures

No abstract available.
Humans ; Motor Vehicles*

Utile recently, osteotomy & reposition surgery of prominent zygoma have been performed by means of a coronal incision or intraoral preauricular incision. But penalties are paid, such as scar, the possibility of facial nerve injury and long operative time. Reflecting on our past experiences of facial bone surgery, we developed an alternative approach. In our method, the protrusion in the cheekbone is corrected by performing an osteotomy and reposition method through intraoral incision only. During the past 3 years we have operated on 23 patients of malar prominences. The amount of the bone to be removed is determined on preoperative interview, physical examination and x-rays. Intraoral incision provide access to the zygomatic body and lateral orbital rim. After L-shaped osteotomy, two paralle vertical and one transverse osteotomies, at medical part of the zygomatic body, the midsegment is removed. Posterior portion of zygomatic arch was approached through medical aspect and was outfractured using curved osteotome. After completion of triple osteotomy, the movable zygomatic complex was reduced medially and fixed with miniplates and screws on the zygomaticomaxillary buttress. The patients were followed for 9.5 months with acceptable result and little complication. The author concludes that this technique is effective and safe method in reduction malarpalsty.
Cicatrix ; Facial Bones ; Facial Nerve Injuries ; Humans ; Operative Time ; Orbit ; Osteotomy ; Physical Examination ; Zygoma

BACKGROUND: Exogenously administered epinephrine under enflurane anesthesia was known to have mild myocardial sensitizing effect. And N2O activates the sympathetic nervous system mildly. We planed this study to confirm cadiovascular effects of clinically administered epinephrine for hemostasis under the enflurane-N2O anesthesia during tonsillectomy. METHODS: Eighty children scheduled to have tonsillectomy were selected randomly and divided into 2 groups as follows; Group E: 1:100,000 epinephrine 2ug/kg and Group EL: 1:100,000 epinephrine containing 1% lidocaine 2 g/kg. Blood pressure, heart rate, and the occurrence of arrhythmia were evaluated before injection, at injection, 1 min, 2 min, 3 min, 5 min and 10 min after injection and 1 min after operation start. RESULTS: In both groups, systolic and diastolic blood pressure and heart rate are increased. But there are no significant statistical differences in each group and between groups. One min after operation, there are significant increases in systolic and diastolic blood pressure and heart rate in both groups (p<0.05), but there is no significant difference between groups. CONCLUSION: Under the enflurane-N2O anesthesia of children, 1:100,000 epinephrine 2ug/kg used for hemostasis could be used comparatively safe without any significant hemodynamic changes. But because there is always the possibility of myocardial sensitization, careful observation is necessary during epinephrine injection under the enflurane-N2O anesthesia.
Anesthesia* ; Arrhythmias, Cardiac ; Blood Pressure ; Child ; Enflurane ; Epinephrine* ; Heart Rate ; Hemodynamics ; Hemostasis* ; Humans ; Lidocaine ; Sympathetic Nervous System ; Tonsillectomy*

Dysplasia epiphysialis punctata is a rare congenital disorder of infancy affecting in particular cartilage, muscle, jointtcapsules and the eyes. A case of dysplasia epiphysialis punctata with involvement of all epiphyses of extremities, spine and pelvis in 2 days old male is to be reported with review of literature.
Cartilage ; Chondrodysplasia Punctata ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Epiphyses ; Extremities ; Humans ; Male ; Pelvis ; Spine

Thirty-three cases of the fracture of the femur and tibia on the same limb were treated at the Orthopedic Department of the Chosun University Hospital during the period from January 1977 to December 1983. The following results were obtained. 1. The incidence of trauma was high in the young man, most frequent in the third decade (45.4%). 2. The most common cause of the fracture was traffic accident (81;8%). 3. The most common shape of the fracture was comminuted in both femur and tibia. 4. The common fracture site were middle one-third in both femur and tibia. 5. Eight patients were treated by conservative means on both femxr and tibia. The patients were treated by internal fixation on femur and by conservative means on tibia. Internal fixation was .done in ten patients on both femur and tibia. Two patients were treated by inteinal fixation on tibia and by conservative means on femur. Three patients were amputated. 6. Average healing time of fracture was 21 weeks in femur and 24.2 weeks in tibia. 7. Functional end results were assessed and rated with satisfactory results in rigid internal fixation of the femur and tibia.
Accidents, Traffic ; Clinical Study ; Extremities ; Femur ; Humans ; Incidence ; Inteins ; Orthopedics ; Tibia

An analytic study on 431 cases of cardiac conduction disturbance has been made by review of the clinical records and electrocardiograms taken from the adult patients registered at Kyung Hee University Hospital for 3 years from May, 1973 to April, 1976. 1. The total incidence of conduction disturbance was 6.50%, the atrioventricular block 3.14% and the intraventricular block was 3.36% of total 6,616 cases of E.C.G. reviewed. Among of these, the first degree atrioventricular block was 3.02% which was the most common occurred one, the incomplete right bundle branch block was 2.25% and the complete right bundle branch block was 0.57%. 2. The ratio of male to female was 1.6:1 for the first degree atrioventricular block, and 1.6:1 for the incomplete right bundle branch block, 2.5:1 for the complete atrioventricular block, 2:1 for the left bundle branch block, and 1.7:1 for the complete right bundle branch block. The first degree atrioventricular block was seen most frequently in the fifth and sixth decade of age group, and the third degree block was over 40 years. The incomplete right bundle branch block in order was forth decade, third decade and fifth decade. The complete right bundle branch block and left posterior hemiblock were common in the sixth decade. The left bundle block and the posterior hemiblock were common in fifty years of age group. 3. The cardinal underlying diseases of the first degree atrioventricular block among cardiac diseases group in order of frequency were: hypertensive heart disease (25.0%) arteriosclerotic heart disease (8.0%) and rheumatic valvular heart disease (5.0%). The most common etiology of those non-cardiac disease group was neuropsychiatry disorder (11.5%) and the next was infection (11.0%). 4. All of the complete atrioventricular block were associated with the cardiac disease, that is, 57.0% with arteriosclerotic heart disease, 28.5% with pericarditis and 14.3% with hypertensive heart disease, respectively. 5. The cardinal underlying disease of the incomplete right bundle branch block in order of frequency were: hypertensive heart disease (10.7%), arteriosclerotic heart disease (8.1%) among the cardiac disease group, and infections (15.4%) among the non-cardiac disease group. The incidence of healthy persons was 14.1%. 6. Those of complete right bundle branch block in order of frequency were: arteriosclerotic heart disease (13.2%), and hypertensive heart disease (10.1%) among the cardiac disease group, and infection(13.2%) and neurosis (10.1%), respectively among the non-cardiac disease group. 7. The major etiologies of the left bundle branch block was hypertensive heart disease and arteriosclerotic heart disease (33.3% each), and that of left posterior hemiblock was showed arteriosolerotic heart disease and cor-pulmonale. The most common etiological disease of the left anterior hemiblock was hypertensive heart disease in cardiac disease group, and infection and gatrointestinal disease in non-cariac disease group. 8. The abnormal electrocardiographic findings with the first degree atrioventricular block were left ventricular hypertrophy (24.8%), sinus tachycardia (11.0) and sinus bradycardia (5.8%). Those with the complete atrioventricular block were right ventricular hypertrophy (15.8%) and left bundle branch block (15.8%). In complete right bundle branch block, the majority (52.5%) showed single sign without other abnormality on E.C.G. In the left bundle branch block, there were 18.9% of left ventricular hypertrophy and 15.7% of first degree atrioventricular block. In the left anterior hemiblock, there were 28.5% of right bundle branch block, and 19.0% of right ventricular hypertrophy. In the left posterior hemiblock, there were 40.0% of atrial fibrillation and 20.0% of left atrial hypertrophy.
Adult ; Male ; Female ; Humans ; Incidence

No abstract available.

In 1910 Purtscher first presented his original report of "angiopathia retinae traumatica" before the German Congress of Ophthalmology in Heidelberg. Since then many varying fundus pictures have been described as "Purtscher's Disease" and many theories have been advanced as to the cause. In 1962 Marr and Marr provided an extensive review of the literature on traumatie retniopathy and pointed out that the cause of Purtscher's retinopathy was an abrupt rise of intravascular pressure in the vessel entering and leaving the orbit, and in most cases the mechanism of the injury was a sudden and violent compression of the chest. Recently we have experienced a case of bilateral Purtscher's traumatic retinal angiopathy leading to optic nerve atrophy and macular degeneraion. Our patient is a 36-year-old previously healthy Korean male. who had his left chest compressed by a truck when he was working in the country farm. Just after the accident he fall into an unconscious state for a short time. Two days after admission he was referred to our ophthalmologic department because of visual impairment. Funduscopic examination revealed Purtscher's retinopathy in both eyes. His chest X-ray examination showed several fractured ribs anterolaterally. Within several days after the accident the whitish retinal exudates and hemorrhages gradually disappeared in the left ocular fundus, but in the right fundus the retinal edema, situated at posterior pole, persisted for about 7 months duration. During this period optic nerve atrophy developed ill the right fundus. As soon as the retinal edema subsided, retinal degeneration of the macular area appeared in the right fundus. Five months after the accident temporal optic nerve atrophy appeared and the patient complained of marked visual impairment in the left eye. We could not find any similar cases in the literature, that is, after the retinopathy and impaired vision recovered, later, the vision was markedly impaired again due to secondary optic nerve atrophy and development of macular Degeneration. In a survey of literature we want to say that the pathogenesis of Purtscher's traumatic retinal angiopathy is due mainly to the result of a sudden and severe increased intravascular pressure. particularly in the upper portion of body. Following points influenced our thought. 1. The ocular fundus changes similar with Purtscher's retinopathy could be seen in hydrostatic pressure syndrome and compression cyanosis syndrome. 2. Purtscher's retinopathy could developed in minor chest compression which is not strong enough to fracture ribs or other banes. 3. Usually Purtscher's retinopathy is developed in both eyes. If unilateral development occurs, it is almost on the right eye. If bilaterally the right eye is more severe than the left. This is postulated due to the shorter venous path to the rijsht eye. In addition, the prognosis of Purtscher's retinopathy seems to be good but poor result such as in our case and other previously reported cases are also possible.
Adult ; Atrophy ; Cyanosis ; Exudates and Transudates ; Hemorrhage ; Humans ; Hydrostatic Pressure ; Macular Degeneration ; Male ; Motor Vehicles ; Ophthalmology ; Optic Nerve ; Orbit ; Papilledema ; Prognosis ; Retina ; Retinal Degeneration ; Retinaldehyde* ; Ribs ; Thorax ; Unconsciousness ; Vision Disorders