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

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

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*

We report two cases of dyschromatosis symmetrica hereditaria. One is a 12-year- old female and her family had five individuals with similar pigmentary disorder through three generation. The other is a 22-yesr-old female who had no family history of similar disease. Fontana-Masson stain revealed increased and decreased melanin granules in the basal cell layers in the pigmented and depigmented lesions respectively.
Female ; Humans ; Melanins

No abstract available.
China* ; Depression* ; Republic of Korea*

An important aspect of plastic surgery is skin flap survival. Among the prostaglandins, PGE4 is used clinically to improve peripheral circulatory disturbances due to its action of augmenting blood flow by vascular smooth muscle relaxation and its strong inhibitory action of platelet aggregation. Clinically, many investigators found that the effect of PGE4 was prolonged for a long period even after short-term application. So a new hypothesis emerges that the prolonged effect of PGE4 may be due to neovascularization and not due to vasodilatation alone. This study was designed to clarify the mechanism of the prolonged effect of topical PGE4 with regard to angiogenesis. A total of 9 male hairless mice were treated with a topical application of PGE4 onitment (PGE4 powder mixed in hydrogen base) on the experimental side and only a hydrogen base on the contralateral control side of the back skin, respectively, for 7 days, once a day. Then they were divided into 3 groups. In group 1, specimens were obtained on the 7th day post-treatment using 3 mm size punch biopsy from both sides. In group 2, specimens were obtained on post-treatment 14th day. In group 3, specimens were obtained on post-treatment 28th day. The number of blood vessels were compared between the experimental side and control side with respect to neovascularization after PGE4 application using an image-analysis program under hemtoxyline-eosin stain. Treatment on the experimental side did not affect its contralateral mate, since there was no evidence of a systemic effect. From our experimental data, we could conclude that PGE4 may induce angiogenesis by topical application without systemic effect.
Animals ; Biopsy ; Blood Vessels ; Humans ; Hydrogen ; Male ; Mice ; Mice, Hairless* ; Muscle, Smooth, Vascular ; Platelet Aggregation ; Prostaglandins ; Relaxation ; Research Personnel ; Skin ; Surgery, Plastic ; Vasodilation

Malignant fibrous histiocytoma is the most common soft tissue sarcoma in adult life and shows a mixed proliferation of both fibroblsstic & histiocytic cells. We report a case of myxoid malignant fibrous histiocytoma involving right lower leg in a 68-year-old male patient, who presented with a childs palm-sized nodular mass of 3 years duration. Histoapthologically, the tumor had varying proportion of myxoid cellular components. The myxoid areas showed spindle and pleomorphic cells arranged in a vague storiform pattern, abrupt transition between a solidly cellular area and a myxoid area, and lipoblast-like cells. The cellular areas showed spindle cells arranged in a storiform pattern characteritic of the typical pleomorphic malignant fibrous histiocytorna.
Adult ; Aged ; Child ; Histiocytoma, Malignant Fibrous* ; Humans ; Leg ; Male ; Sarcoma