The syndrome of acute bilateral basal ganglia lesions in diabetic uremia is uncommon and usually affects Asian patients. The underlying pathogenesis of this syndrome is not clear. We searched PUBMED using the keywords "bilateral basal ganglia", "diabetic", and "uremia", and found a total of 34 cases from 1998 to 2016. In most cases, blood sugar levels were normal. Here we report two Taiwanese cases presenting with dyskinesias. In one case the syndrome was triggered by hyperglycemia, and in the other by severe hypoglycemia. Their neuroimaging findings were unusual as compared with previously reported cases, presenting as mixed hypo- and hyperintensity on T1-weighted magnetic resonance imaging. We think these new finding would shed some light on the underlying pathophysiology of this syndrome. For treatment, it is advisable to keep glucose levels as stable as possible in diabetic uremic patients to prevent this syndrome. A rapid correction of hyper- or hypoglycemia after the onset may help recovery.

Today, patients generate a massive amount of health records through electronic health records (EHRs). Extracting usable knowledge of patients’ pathological conditions or diagnoses is essential for the reasoning process in rule-based systems to support the process of clinical decision making. Association rule mining is capable of discovering hidden interesting knowledge and relations among attributes in datasets, including medical datasets, yet is more likely to produce many anomalous rules (i.e., subsumption and circular redundancy) depends on the predefined threshold, which lead to logical errors and affects the reasoning process of rule-based systems. Therefore, the challenge is to develop a method to extract concise rule bases and improve the coverage of non-anomalous rule bases, i.e., one that not only reduces anomalous rules but also finds the most comprehensive rules from the dataset. In this study, we generated non-anomalous association rules (NAARs) from a cerebrovascular examination dataset through several steps: obtaining a frequent closed itemset, generating association rule bases, subsumption checking, and circularity checking, to fit production rules (PRs) in rule-based systems. Toward the end, the rule inferencing part was performed by PROLOG to obtain possible conclusions toward a specific query given by a user. The experiment shows that compared with the traditional method, the proposed method eliminated a significant number of anomalous rules while improving computational time.

Medication is designed to cure diseases, but serious risks can arise from severe adverse drug reactions (ADRs). ADRs can lead to emergency room visits and hospitalization, straining healthcare resources and, thus, they have strong implications for public health. Stevens–Johnson Syndrome (SJS) is one ADR and comprises the highest proportion of all drug relief cases in Taiwan. Pharmacovigilance involves the collection, detection, assessment, monitoring, and prevention of ADRs, including SJS. Most medical specialists are not fully aware of the risk of drug-induced SJS. Consequently, various drugs may be prescribed to susceptible patients for a great variety of diseases and, in turn, cause SJS. In this research, medical records of SJS patients were retrieved from the Taiwan National Health Insurance Research Database, and the Generalized Sequential Patterns (GSP) algorithm was used to find the sequential patterns of diseases before SJS onset. Then we mined the sequential patterns of medications prescribed in each disease pattern. Afterwards, we detected significant associations of each pattern of diseases and medications prescribed among age groups with statistical analysis. We found that, first, most patients developed SJS after being prescribed the causative medications fewer than four times. Second, Respiratory System Diseases (RSDs) appeared in disease sequential patterns of all lengths. Patterns involving RSDs were more frequent than others. Third, NSAIDs, H2-antagonists for peptic ulcer, penicillin antibiotics, theophylline bronchodilators, and cephalosporin antibiotics were the most frequent medications prescribed. Fourth, we found that patients in certain age groups had higher risks of developing SJS. This study aimed to mine the sequential patterns of diseases contracted and medications prescribed before patients developed SJS in Taiwan. This useful information can be provided to physicians so that they can stop the administration of suspected drugs to avoid evolution towards more severe cases.

Foreign body embolization can cause intracranial artery occlusion with ischemic stroke. Reported etiologies include post cerebrovascular interventions, migration of esophageal foreign body and neck trauma. We reported a case with punctured wound at left neck, X-ray and computed tomography revealed a foreign body located in the carotid region. The patient eventually developed stroke symptoms in the next day after operation. Non-contrast brain Computer tomography at that time revealed that porcelain fragment located at the suprasellar area, and infarction of the left anterior basal ganglion. Our patient is the first reported case having an embolic stroke secondary to distal migration of a foreign body from the carotid artery after neck trauma. We call attention to this rare neurologic complication of neck trauma with foreign body retention. Appropriate and prompt identification of concurrent vascular injuries with retention of foreign body is strongly advised in neck trauma patients.