• Safety and Health at Work
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• v.3 no.4
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• pp.243-256
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• 2012

This article schematically reviews the clinical features, diagnostic approaches to, and toxicological implications of toxic encephalopathy. The review will focus on the most significant occupational causes of toxic encephalopathy. Chronic toxic encephalopathy, cerebellar syndrome, parkinsonism, and vascular encephalopathy are commonly encountered clinical syndromes of toxic encephalopathy. Few neurotoxins cause patients to present with pathognomonic neurological syndromes. The symptoms and signs of toxic encephalopathy may be mimicked by many psychiatric, metabolic, inflammatory, neoplastic, and degenerative diseases of the nervous system. Thus, the importance of good history-taking that considers exposure and a comprehensive neurological examination cannot be overemphasized in the diagnosis of toxic encephalopathy. Neuropsychological testing and neuroimaging typically play ancillary roles. The recognition of toxic encephalopathy is important because the correct diagnosis of occupational disease can prevent others (e.g., workers at the same worksite) from further harm by reducing their exposure to the toxin, and also often provides some indication of prognosis. Physicians must therefore be aware of the typical signs and symptoms of toxic encephalopathy, and close collaborations between neurologists and occupational physicians are needed to determine whether neurological disorders are related to occupational neurotoxin exposure.

• The Journal of Korean Medicine
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• v.29 no.5
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• pp.41-51
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• 2008

Objective : To observe the efficacy and safety of CheungYeolYiSeup-tang and Hwangbaek external dressings on dampness-heat pattern atopic dermatitis(AD) in a non-comparative study. Methods : 10 patients with AD were included for 4 weeks of treatment. Efficacy and safety assessment included the scoring atopic dermatitis index(SCORAD), typical signs and symptoms of AD, results of some laboratory tests related to toxicity, and the incidence of adverse events. Results : Improvements in efficacy parameters were observed and produced no significant changes in laboratory tests related to toxicity in these patients. Their SCORAD results significantly decreased after 4weeks(P value<.01, according to the Wilcoxon sum of ranks test). Similarly, significant reductions from baseline in subjective pruritus scores and (P value<.05 by the Wilcoxon sum of ranks test) and the mean average of individual signs and symptoms of AD were reported after 4 weeks(P value<.05, P<0.01 by the Wilcoxon sum of ranks test). There were no significant changes in eosinophil, neutrophil, lymphocyte, immunoglobulin E and ESR in blood serum by paired ttest. Conclusion :CheungYeolYiSeup-tang administration and Hwangbaek external dressings are an effective and safe treatment for the management of dampness-heat pattern atopic dermatitis.

• Journal of mucopolysaccharidosis and rare diseases
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• v.2 no.1
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• pp.23-26
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• 2016

Mucopolysaccharidosis (MPS) I is a rare, progressive and multisystemic disease with insidious initial signs and symptoms, and making an early diagnosis can be a challenge for the first-line general medical practitioner. We report a 6-month-old girl who was brought to our well baby clinic for regular immunization with the manifestations of lumbar gibbus, hirsutism, large Mongolian spots over back and buttock, and mild bilateral legs spasticity noticed by the general pediatrician, and then newly diagnosed with MPS I after referral to the geneticist in time. Her surgical history included inguinal hernia repair at 1 month old, $CO_2$ laser supraglottoplasty for laryngomalacia and tracheostomy due to chronic respiratory failure with ventilator dependence at 2 months old. Understanding and identification of the early signs and symptoms of this disease have the potential to early diagnosis and timely appropriate treatment, which could contribute to a better clinical outcome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.2
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• pp.113-124
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• 2024

Purpose: Alarm symptoms (red flag signs) are crucial indications for management decisions on pediatric gastrointestinal endoscopy. We aimed to identify items in the alarm symptoms and pre-endoscopic investigations that predict abnormal endoscopy results. Methods: A retrospective descriptive study was conducted among children aged under 18 years undergoing endoscopy. The patients were classified into normal and abnormal endoscopic groups. The incidence of alarm symptoms and pre-endoscopic investigations were compared between the groups. Univariate and multivariate logistic regression analyses were performed to determine independent risk factors for abnormal endoscopy. Results: Of 148 participants, 66 were classified in the abnormal endoscopy group. Compared with the normal group, the abnormal group had a significantly higher prevalence of alarm symptoms. Moreover, hematemesis/hematochezia, anemia, low hemoglobin level, hypoalbuminemia, rising erythrocyte sedimentation rate, increased serum lipase, and blood urea nitrogen/creatinine ratio were significantly higher in the abnormal endoscopy group than in the normal group. Multivariate logistic regression analysis indicated that hematemesis/hematochezia and low hemoglobin level were independent risk factors for abnormal endoscopy. Conclusion: The alarm symptoms and pre-endoscopic investigations were evaluated using predictive factors for abnormal pediatric endoscopic findings. According to multivariate logistic regression analysis, hematemesis/hematochezia and low hemoglobin levels were independent risk factors for abnormal endoscopy.

• Korean Journal of Bronchoesophagology
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• v.17 no.2
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• pp.104-107
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• 2011

Background and Objectives Scope classification is designed to classify acute epiglottitis according to laryngoscopic findings. There is no report about the utility of classification; the difference between the diagnosis and the prognosis by the Scope classification was not found. The aim of this study was to evaluate the utility of Scope classification in patients with acute epiglottitis. Subject and Method 127 patients who had been admitted to our hospital were diagnosed with acute epiglottitis. The patients were classified by the Scope classification. We compared demographic characteristics, clinical symptoms and signs, laboratory findings, and clinical course among the patient groups and divided the results according to the Scope classification. Results There are no significant differences among the groups in demographic characteristics, clinical symptoms and signs, laboratory findings, and clinical course. Conclusion The Scope classification of acute epiglottitis does not seem to be a method to evaluate the severity of acute epiglottitis. Thus, we need to develop multidisciplinary approaches for acute epiglottitis.

• Archives of Craniofacial Surgery
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• v.18 no.3
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• pp.186-190
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• 2017

We report a case of free flap deterioration which may have been induced by pressure gradient resulting from cranial defect overlying a ventriculoperitoneal shunt (VP shunt). The patient, male and aged 78, had a VP shunt operation for progressive hydrocephalus. Afterwards, the scalp skin flap surrounding the VP shunt collapsed and showed signs of necrosis, exposing part of the shunt catheter. After covering the defect with a radial forearm free flap, the free flap site showed signs of gradual sinking while the vascularity of the flap remained unimpaired. An agreement was reached to remove the shunt device and observe the patient for any neurological symptoms, and after the shunt was removed and the previous cranial opening filled with fibrin glue by Neurosurgery, we debrided the deteriorated flap and provided coverage with 2 large opposing rotational flaps. During 2 months' outpatient follow-up no neurological symptoms appeared, and the new scalp flap displayed slight depression but remained intact. The patient has declined from any further follow-up since.

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.247-251
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• 2015

Purpose: This report describes a case of granulomatosis with polyangiitis (GPA) in which the gingival manifestation was crucial in both making an early diagnosis and possibly in deciding the approach to treatment. Methods: A 57-year-old sailor presented to the Department of Dentistry at Ulsan University Hospital complaining of gingival swelling since approximately 2 months. He had orofacial granulomatous lesions and the specific gingival manifestation of strawberry gingivitis. Results: The diagnosis of GPA was made on the basis of clinical symptoms and signs, and confirmed by the presence of the anti-neutrophil cytoplasmic antibody and a positive biopsy. The patient was admitted to the hospital and subsequently placed on a disease-modifying therapy regimen that included methotrexate and prednisone. Conclusions: Identification of the gingival manifestation of the disease permitted an early diagnosis and prompt therapy in a disease in which time is a crucial factor. Because of its rapid progression and potentially fatal outcome, an early diagnosis of GPA is important. Therefore, dentists should be aware of the oral signs and symptoms of such systemic diseases.

• Toxicological Research
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• v.11 no.1
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• pp.63-68
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• 1995

N-methyl-D-aspartate(NMDA) receptor has been well known as an important mediator of several forms of neural and behavioral plasticity. But different results were reported about the effect of MK-801 or dextromethorphan on opioid dependence. The present studies examined whether NMDA receptor antagonists can alter the opioid dependence and tolerance in rodents. Naloxone precipitated withdrawal symptoms and changes of locomotor activities were observed in MK-801 or dextromethorphan pretreated morphine-dependent rats. Tail-flick assay was used for morphine analgesia and tolerance was found after 4 day's consecutive injections (10 mg/kg, s.c., twice/day) of morphine in mice. Locomotor activity was increased and the withdrawal symptoms were decreased by the pretreatment of MK-801 in morphine-dependent rats. But 0.3 mg/kg i.p. of MK-801 intensified the body weight loss and produced severe ataxia and rotation although some withdrawal signs were attenuated. Morphine induced analgesic tolerance was inhibited by the pretreatment of MK-801 and dextromethorphan. Dextromethorphan was more potent than MK-801 in inhibiting the development of the analgesic tolerance in mice. These results suggest that NMDA system may be involved in opioid withdrawal and analgesic tolerance but appropriate caution should be requested when MK-801 is used in combination with opioid because of untoward neurologic signs.

• Clinical and Experimental Pediatrics
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• v.58 no.1
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• pp.8-14
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• 2015

In patients with a language developmental delay, it is necessary to make a differential diagnosis for autism spectrum disorders (ASDs), specific language impairment, and mental retardation. It is important that pediatricians recognize the signs and symptoms of ASDs, as many patients with language developmental delays are ultimately diagnosed with ASDs. Pediatricians play an important role in the early recognition of ASDs, because they are usually the first point of contact for children with ASDs. A revision of the diagnostic criteria of ASDs was proposed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) that was released in May 2013. The autism spectrum describes a range of conditions classified as neurodevelopmental disorders in the fifth edition of the DSM. The new diagnostic criteria encompasses previous elements from the diagnosis of autistic disorder, Asperger disorder, childhood disintegrative disorder, and pervasive developmental disorder-not otherwise specified. An additional change to the DSM includes synthesizing the section on social and communication deficits into one domain. In ASD patients, the appropriate behavioral therapies and rehabilitation treatments significantly affect the prognosis. Therefore, this makes early diagnosis and treatment very important. In conclusion, pediatricians need to be able to recognize the signs and symptoms of ASDs and be attentive to them in order to make an early diagnosis and provide treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2217-2220
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• 2013

Background: Knowledge regarding risk factors and primary signs of oral cancer in the general population can help them to avoid risky behaviour and seek timely advice from a physician. The aim of this study was to survey adult knowledge about risk factors and signs of oral cancer in Shiraz Dental University. Materials and Methods: In this descriptive cross-sectional study using an investigator-made questionnaire, 783 adults who were referred to Shiraz Dental University participated. Questionnaire data were analyzed by ANOVA and T-test. Results: The results showed that 32.3% of participants were aware of oral cancer and gained their knowledge from the media. The risk factors mentioned by these participants was as follows: sunlight 30.8%, hot and peppery food 40.7%, alcoholic drinks 47.4% and smoking 73.6% (there was significant relationship for drinking alcohol and gender, education and times of using dental service, p<0.05). They also mentioned the primary signs of oral cancer as follows: red patch without pain 27.8%, white patch without pain 13.5% and prolong scarring without pain 56.7% (there was significant relationship between these three signs and education and times of using dental service, p<0.05). The mean knowledge about the risk factors and signs of oral cancer were 1.94 from 5 with 1.14 standard deviation and 0.96 from 3 with 0.93 standard deviation. Conclusions: The observed low level of knowledge of people regarding both risk factors and signs of oral cancer emphasizes the need for more efforts to be made about the above mentioned issues by the media.