No Abstract available.
Diagnosis* ; Sleep Apnea, Obstructive*

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

Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon* ; Ankle ; Braces ; Calcaneus ; Electricity ; Exercise ; Female ; Follow-Up Studies ; Foot ; Humans ; Hydrotherapy ; Immobilization ; Leg ; Male ; Membranes ; Needles ; Orthotic Devices ; Rehabilitation ; Rupture* ; Suture Techniques ; Sutures ; Tendons ; Ultrasonography ; Weight-Bearing

Resorcin is widely being used in the fields of the therapeutics, cosmetics, industry, but allergic contact dermatitis is an infrequent adverse reaction. We have experienced a case of allergic contact dermatitis to resorcin. A 59-year-old male with Kaposi's sarcoma on the right foot developed linear erythematous vesicular eruption along the marking areas 4 days after application of Castellanis paint, used as a skin marking solution for radiation therapy. He showed patch test positive reaction to Castellani's paint as well as its individual components, resorcin and phenol.
Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Foot ; Humans ; Male ; Middle Aged ; Paint ; Patch Tests ; Phenol ; Sarcoma, Kaposi ; Skin*

No abstract available.
Funnel Chest*

Hyperplasia*

BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

Excessive daytime sleepiness (EDS) is a prevalent complaint among patients in psychiatric and medical care. Patients with EDS have often been misdiagnosed with depression due to their complaints of lack of energy and poor concentration. Also, they have even been diagnosed erroneously with a psychotic disorder in case of coexistence with hypnagogic hallucination. EDS can seriously affect the person's quality of life by causing decreased academic achievement or work performance, low self esteem, and social withdrawal. EDS is also frequently associated with various medical and psychiatric conditions, and often fatal traffic or on-the-job accidents. The causes of EDS range from insufficient sleep to central nervous system-originated hypersomnia. The conditions that can lead to EDS include circadian rhythm disorders, primary disorders of alertness such as narcolepsy, sleep-related breathing disorders such as obstructive sleep apnea syndrome, sleep-related movement disorders such as periodic limb movement disorder and restless legs syndrome, chronic medical conditions such as cancer, and medications causing sleepiness. Treatment options should be tailored according to the underlying condition and include sufficient sleep time, light therapy, sleep scheduling, wakefulness-promoting medications, or mechanical airway managements such as nasal continuous positive airway pressure (CPAP).
Achievement ; Chronobiology Disorders ; Continuous Positive Airway Pressure ; Depression ; Diagnosis, Differential ; Disorders of Excessive Somnolence ; Hallucinations ; Humans ; Movement Disorders ; Narcolepsy ; Nocturnal Myoclonus Syndrome ; Phototherapy ; Psychotic Disorders ; Quality of Life ; Respiration ; Restless Legs Syndrome ; Self Concept ; Sleep Apnea, Obstructive

No abstract available.
Erythema Multiforme* ; Erythema* ; Lymphoma*

We report a case of angiosarcoma of the face and scalp in a 76-year-old man. Immunochemical staining with factor 8-related antigen and ultrastructural find ings confirm that this tumor was origined from endothelium. The patient had a good initial response to treatment with radiotherapy.
Aged ; Endothelium ; Factor VIII ; Hemangiosarcoma* ; Humans ; Radiotherapy ; Scalp*