No abstract available.
Death Certificates* ; Korea*

BACKGROUND: We studied the accuracy, lateralization criteria of Wada test in patients with temporal lobe epilepsy(TLE). We also evaluated material specific memory and determined the stimulus which can classify best between right and left TLE among four different types of stimuli. METHODS: We examined Wada memory performance in 33 patients(15 left, 18 right) with TLE who underwent surgery and who were good seizure outcome at least 1 year follow-up. Twelve stimuli consited of figures, written words, geometric designs and real objects were presented after Amytal injection. The recognition memory test was performed at 10 minutes after the injection and hemisphere memory performance of each stimulus and total stimuli were obtained by(number of stimuli recognized / number of stimuli presented x 100%). Classification rate, best stimulus for lateralization, and suitable lateralization criteria were determined by discriminant analysis and Chi-square test. Hemispheric memory difference of each stimulus was analyzed by paired-sample Student's t-test in left temporal lobectomy(LTL) and right temporal lobectomy(RTL) groups. RESULTS: No significant difference was observed in pre-Wada memory score and in IQ between LTL and RTL group. The classification rate of Wada test in terms of lateralization by discriminant analysis was 81.82%. The accuracy was 75.8% at 10% and 15% lateralization criteria and was 63.6% and 45.5% at 20% and 25% lateraliza.
Amobarbital ; Classification ; Follow-Up Studies ; Humans ; Memory* ; Seizures ; Temporal Lobe

A brief episode of ischemia and reperfusion termed 'ischemic preconditioning' has been established as rendering muscle tolerance to damage during a subsequent prolonged ischemia. The effects of ischemic preconditioning in the cardiac muscle are related to the stimulation of adenosine A1 receptor and the opening of KATP channel. The effect and mechanisms of ischemic preconditioning in the skeletal muscle are not known clearly. The superoxide radical injures the skeletal muscle during the ischemia and reperfusion. There are two types of SOD, which metabolizes the superoxide radicals to H2O2 and O2, in the cell. One of them is Cu, Zn-SOD in the cytoplasm and the other is Mn-SOD in the mitochondria. The activities of SOD are increased against the formation of superoxide radical during the reperfusion. The author performed the present study to investigate the effect and the mechanisms of ischemic preconditioning by measuring the expression of SOD mRNA on timely reperfused ischemic muscles. The healthy Sprague-Dawley rats weighing from 300 g to 350 g were used as experimental animals. Under pentobarbital (50 mg/kg) anesthesia, lower abdominal incision was done and left common iliac artery was occluded by vascular clamp for 2 hours. Rectus femoris muscles were obtained respectively at 3, 6, 12, 24 and 72 hours after reperfusion. The ischemic preconditioning group underwent three episodes of 5 minute occlusion and 5 minute reperfusion of common iliac artery followed by 2 hours of ischemia and timely reperfusion. Adenosine (50 microgram/kg) or pinacidil (1 mg/kg) was administered intravenously before ischemia. 8-cyclopentyl-1, 3-dipropylxanthine (15 mg/kg) or glibenclamide (0.5 mg/kg) was administered intravenously before ischemic preconditioning. Paraffin sections with 4 micrometer thickness in all groups were obtained. The expression of Cu, Zn- and Mn-SOD mRNA was observed by use of in situ hybridization. The results obtained were as follows. 1. The expression of SOD mRNA was seen only in small muscle fibers of the rectus femoris muscle of the rat. 2. Weak expressions of Cu, Zn- and Mn-SOD mRNA were observed in the normal control rat. 3. After 2 hours of ischemia, moderate expression of Cu, Zn-SOD mRNA was observed until 72 hours of reperfusion. Weak or moderate expression of Mn-SOD mRNA at 3 hours and 6 hours of reperfusion, weak or trace expression at 12 hours of reperfusion, moderate expression at 24 hours of reperfusion and weak or moderate expression at 72 hours of reperfusion were observed. 4. After ischemic preconditioning, moderate expressions of Cu, Zn-SOD mRNA were seen in the groups of 3, 6, 12 and 24 hours of reperfusion. Moderate expressions of Mn-SOD mRNA were seen in the group of 0, 3, 6 and 12 hours of reperfusion and strong expression was seen in the group of 24 hours of reperfusion after ischemic preconditioning. 5. After 2 hours of ischemia with ischemic preconditoining, moderate expressions of Cu, Zn-SOD mRNA were seen in the groups of 0, 3, 6, 12, 24 hours of reperfusion. Moderate expressions of Mn-SOD mRNA were observed in the groups of 0, 3, 6, and 12 hours of reperfusion and moderate or strong expression was seen in the group of 24 hours of reperfusion. 6. After 2 hours of ischemia with the pretreatment of adenosine, moderate expressions of Cu, Zn-SOD mRNA were seen in the group of 0, 3, 6, 12 and 24 hours of reperfusion. Moderate expression of Mn-SOD mRNA in the groups and 3 hours of reperfusion, strong expression in the group of 6 and 12 hours of reperfusion and moderate expression in the group of 24 hours of reperfusion were seen. 7. After 2 hours of ischemia with the pretreatment of pinacidil, moderate expressions of Cu, Zn-SOD mRNA were seen in the groups of 0, 3, 6 and 12 hours of reperfusion and those of Mn-SOD mRNA were seen in the groups of 3, 6, 12 and 24 hours of reperfusion. 8. After 2 hours of ischemia with ischemic preconditioning and the pretreatment of 8-cyclopentyl-1, 3- dipropylxanthine, moderate expression of Cu, Zn-SOD mRNA were observed in the groups of 0, 3, 6, and 12 hours of reperfusion and those of Mn-SOD were seen in the groups of 6, 12 and 72 hours of reperfusion. 9. After 2 hours of ischemia with ischemic preconditioning and the pretreatment of glibenclamide, moderate expressions of Cu, Zn- and Mn-SOD mRNA were seen in all groups of reperfusion. Consequently, these results suggest that the expression of Cu, Zn and Mn-SOD mRNA increases during 2 hours ischemia and reperfusion with or without ischemic preconditioning. The effects of ischemic preconditioning are closely related to the stimulation of adenosine A1 receptor and KATP channel.
Adenosine* ; Anesthesia ; Animals ; Cytoplasm ; Glyburide ; Iliac Artery ; In Situ Hybridization ; Ischemia* ; Ischemic Preconditioning* ; Mitochondria ; Muscle, Skeletal ; Muscles ; Myocardium ; Paraffin ; Pentobarbital ; Pinacidil* ; Quadriceps Muscle* ; Rats* ; Rats, Sprague-Dawley ; Receptor, Adenosine A1 ; Reperfusion* ; RNA, Messenger* ; Superoxide Dismutase* ; Superoxides

Left ventricular-right atrial shunt is a relatively uncommon defect, which permits as communication between the left ventricle and right atrium. This paper is fifth case report in our country. This patient was noted to have congenital heart disease in two years old. The pathology of this lesion was classified into four types by Perry. The type C is compatible with this case. The first successful surgical correction was made by Kirby in 1957. The pathology of this lesion was classified into four types by Perry. The type C is compatible with this case. The first successful surgical correction was made by Kirby in 1957. In 12 years old boy, we have experienced a case of left ventricular-right atrial shunt. In selective left ventricular angiocardiography, we found opacification to right atrium and main pulmonary artery simultaneously, and also opacified right ventricle later. Operation was performed during cardiopulmonary bypass. We opened right atrium and found out a defect just below the annulus of the tricuspid valve. The defect measuring 6mm in diameter communicate the left ventricle with right atrium through a segment of the septal leaflet fused to the margins of the septal defect. In the tricuspid valve, a cleft, 4mm in length and a isolated perforation(2mm in diameter) were found in the septal leaflet. Associated cardiac anomaly was a non-functioning patent foramen ovale. The recovery was uneventful and discharged healthily on fourteenth day after operation.
Angiocardiography ; Cardiopulmonary Bypass ; Child ; Foramen Ovale, Patent ; Heart Atria ; Heart Defects, Congenital ; Heart Ventricles ; Humans ; Male ; Pathology ; Pulmonary Artery ; Tricuspid Valve

PURPOSE: To determine the sustaining effects of orthokeratology. METHODS: This study enrolled 58 eyes with moderate myopia. LK-DM lenses (Lucid Korea Dream Lens(TM)) were fitted daily for at least eight hours on an overnight regimen. The effects of orthokeratology and it's sustainability throughout the day were recorded twice; immediately after removal in the morning and eight hours later. Sustainability was measured by comparing the changes from morning to afternoon for best uncorrected visual acuity, apical corneal power, keratometric values, spherical equivalent and induced astigmatism. RESULTS: UCVA demonstrated improved values at all follow up periods. Fluctuations during the day stabilized after 4 weeks of lens wear. K values averaged a mean of 42.4 mm at baseline, and reduced to 40.9 mm by week 12. Unaided logMAR visual acuity changed from 0.94+/-0.14 at baseline to -0.11+/-0.17 by week 12. The sustainability of orthokeratology, defined as the difference between morning and afternoon values of unaided logMAR visual acuity, increased from -0.82 on day 1 to -0.11 on week 12. CONCLUSIONS: UCVA and spherical refractive error did not change to a significant degree after 4 weeks. Although statistically insignificant minute fluctuations during the day were observed up to week 12, these fluctuations decreased to a statistically significant level after week 4.
Adolescent ; Adult ; *Contact Lenses, Extended-Wear ; Cornea/*pathology ; *Corneal Topography ; Equipment Design ; Follow-Up Studies ; Humans ; Myopia/pathology/physiopathology/*therapy ; Refraction, Ocular/physiology ; Severity of Illness Index ; Surface Properties ; Treatment Outcome ; Visual Acuity/physiology

PURPOSE: To determine the sustaining effects of orthokeratology. METHODS: This study enrolled 58 eyes with moderate myopia. LK-DM lenses (Lucid Korea Dream Lens(TM)) were fitted daily for at least eight hours on an overnight regimen. The effects of orthokeratology and it's sustainability throughout the day were recorded twice; immediately after removal in the morning and eight hours later. Sustainability was measured by comparing the changes from morning to afternoon for best uncorrected visual acuity, apical corneal power, keratometric values, spherical equivalent and induced astigmatism. RESULTS: UCVA demonstrated improved values at all follow up periods. Fluctuations during the day stabilized after 4 weeks of lens wear. K values averaged a mean of 42.4 mm at baseline, and reduced to 40.9 mm by week 12. Unaided logMAR visual acuity changed from 0.94+/-0.14 at baseline to -0.11+/-0.17 by week 12. The sustainability of orthokeratology, defined as the difference between morning and afternoon values of unaided logMAR visual acuity, increased from -0.82 on day 1 to -0.11 on week 12. CONCLUSIONS: UCVA and spherical refractive error did not change to a significant degree after 4 weeks. Although statistically insignificant minute fluctuations during the day were observed up to week 12, these fluctuations decreased to a statistically significant level after week 4.
Adolescent ; Adult ; *Contact Lenses, Extended-Wear ; Cornea/*pathology ; *Corneal Topography ; Equipment Design ; Follow-Up Studies ; Humans ; Myopia/pathology/physiopathology/*therapy ; Refraction, Ocular/physiology ; Severity of Illness Index ; Surface Properties ; Treatment Outcome ; Visual Acuity/physiology

OBJECTIVE: To investigate the influencing factors on the discharge destinations of the patients who were treated in the rehabilitation department of acute hospital for the major disabilities. METHOD: Medical records of the 108 patients with stroke, spinal cord injury and traumatic brain injury were reviewed after the discharge from acute rehabilitation care. The demographic factors, socioeconomic status, disease characteristics and functional status of the patients were evaluated to investigate the affecting factors to the discharge destinations. RESULT: Discharge destinations were subdivided into homes 67 (62%), transfer to other hospitals 31 (29%) and transfer to oriental medicine hospitals 10 (9%). The Functional independence measure (FIM) score, length of rehabilitation care, type of payment, operation and diagnosis significantly influenced discharge destinations (p<0.05). The patients who were transferred to other hospital showed significantly lower FIM score and longer length of rehabilitation care compared with patients who were discharged to home or transferred to oriental medicine hospital (p<0.05). CONCLUSION: The FIM score, length of rehabilitation care, type of payment, operation, and diagnosis significantly influenced the discharge destinations of patients after rehabilitation. It is necessary to increase the subacute or chronic rehabilitation facilities for the case of patients with severe physical disabilities.
Brain Injuries ; Demography ; Diagnosis ; Humans ; Medical Records ; Medicine, East Asian Traditional ; Rehabilitation* ; Social Class ; Spinal Cord Injuries ; Stroke

OBJECTIVE: To investigate the association of the muscle contraction with gating of the sensory input at central and peripheral levels according to the intensity of muscle contraction and location of the muscles, somatosensory evoked potentials (SSEPs) studies were evaluated at different levels of isometric contraction in the different muscles. METHOD: Median nerve SSEPs were recorded at Erb's point and scalp in the ten healthy adult subjects with isometric contraction of ipsilateral abductor pollicis brevis (APB), ipsilateral abductor digiti minimi (ADM) and contralateral APB. Median nerve SSEPs were recorded in each of these conditions during precontraction, weak contraction, strong contraction and 4 minutes after contraction. RESULTS: 1) N9 amplitudes of median SSEPs recorded at Erb's point were augumented during weak contraction and these amplitude augumentations were statistically significant in the ipsilateral APB contraction (p<0.05). 2) N20 amplitudes recorded at scalp were inhibited during strong isometric contraction and these amplitude inhibitions were statistically significant in the ipsilateral APB contraction (p<0.05). 3) The latencies of N9 and N20 potentials were not significantly changed during isometric contraction. CONCLUSION: Therefore peripheral nervous system as well as central nervous system is responsible for gating, so the subject should be asked for the best relaxation possible for higher reliability of SSEPs.
Adult ; Central Nervous System ; Evoked Potentials, Somatosensory* ; Humans ; Isometric Contraction ; Median Nerve ; Muscle Contraction* ; Muscles ; Peripheral Nervous System ; Relaxation ; Scalp

OBJECTIVE: To study the acromial type, acromial angle, acromial tilt and subacromial distances which known as extrinsic factors of subacromial impingement syndrome in groups of subacromial impingement syndrome and normal control. METHOD: The radiography of shoulder named shoulder series composed of AP view, arch view and impingement view was performed in thirty patients with subacromial impingement syndrome and ninety persons with normal adult and we measured the acromial type, acromial angle, acromial tilt, subacromial distances and subacromial spur. RESULTS: Mean subacromial distances of impingement group were 11.3+/-2.4 mm in AP view, 11.1+/-2.5 mm in arch view and those of normal control group were 11.1+/-2.2 mm in AP view, 10.4+/-1.9 mm in arch view. Incidences of acromial type I,II,III in impingement group were 15 (50%), 10 (33.3%), 5 (16.7%) respectively and those in normal control group were 20 (22.2%), 46 (51.1%), 24 (26.7%) respectively. Incidence of subacromial spur was 19 (63.3%) in impingement group and 52 (57.8%) in normal control group. Mean subacromial spur size was 10.0+/-5.4 mm in impingement group and 12.4+/-4.5 mm in normal control group. Mean acromial angle was 27.1+/-8.3 degree in impingement group and 29.1+/-8.7 degree in normal control group. Mean acromial tilt was 28.0+/-6.39 degree in impingement group and 31.8+/-3.4 degree in normal control group. CONCLUSION: No significant statistical difference between subacromial impingement syndrome group and normal control group in acromial type, acromial angle, acromial tilt and subacromial distance known as extinsic factors of subacromial impingement syndrome.
Adult ; Humans ; Incidence ; Radiography ; Shoulder ; Shoulder Impingement Syndrome*

OBJECTIVE: To observe the change of sympathetic skin response (SSR) before and after sympathectomy in patients with idiopathic palmar hyperhidrosis and to find the usefulness of SSR for assessment of the effects of sympathectomy. METHOD: The SSR was measured in 20 patients with palmar hyperhidrosis and 20 normal control group. Ten days after thoracoscopic sympathectomy, SSR was also measured. A 50~150 V stimulus was applied over the median nerve and SSR was recorded on bilateral palms and soles with Viking IV (Nicolet Biomedical Ins., U.S.A.). Patient's satisfaction with operation was assessed by questionnaire. RESULTS: Absent or unstable SSR recordings rate was increased and amplitudes of SSR were significantly decreased in patients with palmar hyperhidrosis compared with control group. After sympathectomy, SSR was absent in all cases on bilateral palms and these results were correlated with clinical improvment. All patients who had undergone surgery showed significant clinical improvement for palmar hyperhidrosis and about 75% of the cases were found to have compensatory sweating from other site of the body. CONCLUSION: Abnormal sympathetic nerve system responses were observed in patients with palmar hyperhidrosis. SSR recordings and clinical manifestations were influenced by sysmpathectomy.
Humans ; Hyperhidrosis* ; Median Nerve ; Surveys and Questionnaires ; Skin* ; Sweat ; Sweating ; Sympathectomy