PURPOSE: The objective of this study is to review the clinical manifestations and acknowledge the prognostic factors in occipital lobe seizure and benign childhood epilepsy with occipital paroxysm (BEOP). METHODS: We reviewed retrospectively 253 cases who showed occipital epileptiform activity on EEG at the Pediatric Neurology Clinic, Yonsei University Medical Center from January 1997 to June 1999, and selected 72 cases who had been followed-up for over 2 years. According to the occurrence of seizure for recent 2 years, they were classified into 2 groups : favorable and unfavorable groups. Clinical manifestations were reviewed and analyzed in each group with chi-square and student t-test. RESULTS: 1) Symptomatic group was 16 out of 72 cases (22%), and cryptogenic group was 56 cases (78%). Seventeen out of 72 cases (24%) had the clinical manifestation of BEOP. 2) Early-onset variant is 9 out of 17 cases (52%), late-onset was 8 cases (48%) in BEOP patients. 3) Prognostic factors influencing unfavorable prognosis were prematurity, LBW, perinatal asphyxia and postictal headache in occipital lobe seizure. 4) Prognostic factors in BEOP were determined by age of onset, existence of visual symptom, oculomotor symptom, automatism, autonomic symptom, postictal headache, and diurnal or nocturnal seizure. CONCLUSION: Occipital lobe seizure manifests various clinical symptoms with various prognosis. Seventeen out of 72 cases were determined as BEOP: 9 cases of early variant and 8 cases of late onset. We acknowledge the prognostic factors in epilepsy with occipital lobe seizure as well as BEOP.
Academic Medical Centers ; Age of Onset ; Asphyxia ; Automatism ; Child* ; Electroencephalography ; Epilepsies, Partial* ; Epilepsy ; Headache ; Humans ; Neurology ; Occipital Lobe* ; Prognosis ; Retrospective Studies ; Seizures

The purpose of this study is to compare the antibacterial effect of Listerine(R) on two microorganisms (P. gingivalis and E. faecalis) with various root canal irrigants (NaOCl, CHX, EDTA) and to identify possibility of using Listerine(R) as a root canal irrigant. Porphyromonas gingivalis ATCC 3327 and Enterococcus faecalis ATCC 29212 were used in this experiment. For the test irrigants, 0.5%, 1%, 2.5%, 5.25% NaOCl, 0.1%, 0.2%, 1%, 2% CHX, 0.5M EDTA (18.6% EDTA) and Listerine(R) were prepared. Distiled water was used as control. Two methods-1) Comparison of turbidity in broth and 2) Agar diffusion test-were used to determine the extent of antibacterial effect of Listerine(R) and to compare it with that of NaOCl, CHX, and EDTA. All solutions tested were effective against two bacterial strains compared with control (p<0.001). Any concentration of NaOCl, CHX, and EDTA showed similarly high effectiveness against all bacterial strains. In all experiment, Listerine(R) showed significantly low antibacterial effect compared with the other root canal irrigants (p<0.05). In conclusion, the results reflect remarkably low antibacterial effect of Listerine(R) as compared with root canal irrigants in general so it is not suitable for the root canal irrigant.
Agar ; Dental Pulp Cavity ; Diffusion ; Edetic Acid ; Enterococcus faecalis ; Porphyromonas gingivalis ; Root Canal Irrigants ; Water

Hiatal hernia and Morgagni hernia are sorts of diaphragmatic hernias that are rarely detected on transthoracic echocardiography. Although echocardiographic findings have an important role for differential diagnosis of cardiac masses, we often might overlook diaphragmatic hernia. We report three cases of diaphragmatic hernias having specific features. The first case is huge hiatal hernia that encroaches left atrium with internal swirling flow on transthoracic echocardiography. The second case is a hiatal hernia that encroaches on both atria, incidentally detected on preoperative echocardiography. The third case is Morgagni hernia which encroaches on the right atrium only. So, we need to consider possibility of diaphragmatic hernia when we find a cardiac mass with specific echocardiographic features.
Diagnosis, Differential ; Echocardiography ; Heart Atria ; Hernia ; Hernia, Diaphragmatic* ; Hernia, Hiatal

BACKGROUND: This study was done to validate the three single questions about binge drinking for identifying problem drinkers. METHODS: Two hundred sixty-one patients (133 men) were interviewed by family physicians for the presence of problem drinking which was defined as at-risk drinking or alcohol use disorders according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guideline and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The three single questions (the largest amount of drinking in a day; days of drinking 1.5 bottle [1 bottle in women] or more of Soju [Korean alcoholic beverage, 56 g of alcohol/bottle]; and days of getting drunk during the recent 3 months) were validated against the interview results. RESULTS: Among 261 interviewees, 31.4% were at-risk drinkers, 30.2% had a current alcohol use disorder, and 36.8% had either or both conditions. The first question, considering 4 drinks or more for men and 3 drinks or more for women as positive, showed a sensitivity of 93.8% and specificity of 75.0% in men, and 86.6% and 86.7% in women, respectively. The second question with cut-point of 1 in both gender showed 81.3% and 86.5% in men, respectively and 80.0% and 89.4%, respectively in women. The third question with cut-point of 3 in both gender showed 61.7% and 92.3% in men, respectively and 46.7% and 91.2%, respectively in women. The area under the Receiver Operating Characteristic curve of the first question was 0.937 in men and 0.970 in women, for the second question, 0.906 and 0.915, and for the third question, 0.768 and 0.764, respectively. CONCLUSIONS: The first question (the largest amount of drinking in a day during the recent 3 months) and the second question (days of drinking 1.5 bottle [1 bottle in women] or more of Soju during the recent 3 months) were considered useful in detecting problem drinkers.
Alcoholic Beverages ; Binge Drinking ; Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Female ; Humans ; Male ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Physicians, Family ; ROC Curve ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: When the impairment of nasal airway patency in patients with chronic sinusitis such as mucosal edema or nasal polyps is resolved after functional endoscopic sinus surgery (FESS), it is expected that patients no longer complain of hyponasal voice. However, patients who have undergone FESS sometimes complain of more hyponasal voice, or thick voice. The purpose of this study was to examine the effect of FESS on voice in terms of nasality. MATERIALS AND METHODS: Thirty-three patients who underwent FESS and thirty normal adults who had no sinus or nasal pathology were selected for this study. We performed nasalance test for patients group before and 3 months after the operation and for the control group without any medication. RESULTS: Patients' preoperative mean nasalance were not low compared with that of control group in all sentences. It was different from perceptual hyponasality they had complained. Postoperative mean nasalance in patients showed statistically significant increase. Higher change ratio of nasalance was noted in Mamma passage than the other passages. CONCLUSION: There was significant increase in nasalance scores after FESS. Thus, we must consider the possibility of voice changes postoperatively in professional voice users.
Adult ; Edema ; Humans ; Nasal Polyps ; Pathology ; Sinusitis ; Voice

BACKGROUND AND OBJECTIVES: Many clinical and experimental methods have been developed to evaluate human olfactory function, but there is not a standard test which can be used clinically in Korea. CC-SIT (Cross-Cultural Smell Identification Test) is a smell identification test that consists of 12 items well known in most non-English-speaking cultures. So, authors evaluated the usefulness of CC-SIT in assessing olfactory function in Korea. MATERIALS AND METHODS: One hundred ninety patients who visited clinics complaining of smell loss were categorized to 3 groups (mild hyposmia, moderate hyposmia, severe hyposmia) by questionnaire and 41 healthy subjects were chosen for the normal control group. CC-SIT and a smell threshold test was performed to both patients and controls. The statistical analysis was performed using ANOVA and the Pearson correlation method. RESULTS: There were significant differences in the CC-SIT scores among 3 groups and the severity of hyposmia was correlated with the CC-SIT score. Also, the CC-SIT scores were correlated significantly with the smell threshold. In addition, the difference of familiarity among 12 items was observed. CONCLUSION: CC-SIT is a convenient, practical smell function test which can tell olfactory tunction loss and can he used clinically in Korea.
Humans ; Korea* ; Olfaction Disorders ; Surveys and Questionnaires ; Recognition (Psychology) ; Smell*

We carried out coronary artery bypass grafting using saphenous vein on 8 patients from May, 1987 through January, 1988 at Hanyang University Hospital in Seoul. There were 4 men and 4 women and the mean age was 58.3 years. Except for 1 patient, they were all diagnosed as unstable angina not responding to medical therapy. The average ejection fraction was 66.9%, and no operative death was found. Two sequential anastomoses were performed in one patient. There was no significant event to influence adversely on postoperative prognosis. During the mean follow up period of 6.3 months, none of the patients experienced new symptoms and all of them remain relatively well off the medications used pre and perioperatively execpt for aspirin and persantin.
Angina, Unstable ; Aspirin ; Coronary Artery Bypass* ; Coronary Vessels* ; Dipyridamole ; Female ; Follow-Up Studies ; Humans ; Male ; Prognosis ; Saphenous Vein ; Seoul

BACKGROUND AND OBJECTIVES: We hypothesized that simultaneous assessment of myocardial perfusion and a regional wall motion abnormality, using real-time myocardial contrast echocardiography (MCE), provides more useful information than routine two-dimensional echocardiography (2DE) in the diagnosis of acute coronary syndrome in patients with a non-diagnostic ECG. SUBJECTS AND METHODS: We prospectively enrolled 101 patients (age:61+/-10 years, 57 men) who presented with acute chest pain. A routine 2DE was performed to evaluate the regional wall motion abnormality, and a MCE to assess the perfusion defect. Coronary angiography was performed in all patients. The cardiac events (myocardial infarction, revascularization and death) were analyzed. RESULTS: Of the 101 patients studied, 64 had significant coronary artery disease (diameter stenosis >0%). Cardiac events occurred in 58 patients;21 myocardial infarction, 48 revascularization. The sensitivities of 2DE and MCE for significant coronary artery stenosis were 57.8 and 73.4%, and the specificities were 83.8 and 81.1%, respectively. Of the 58 patients with cardiac events, a regional wall motion abnormality was observed in 34 (59%), and a perfusion defect in 44 (76%). The specificities of 2DE and MCE for cardiac events were 79 and 77%, respectively. Cardiac events were more frequent in males, smokers and in those with an abnormal ECG (p<.05), but only a perfusion defect independently predicted cardiac events (p<.001, odds ratio=8.37). CONCLUSION: Real time MCE, in patients with acute chest pain, reasonably predicts significant coronary artery stenosis, and identifies those who will have cardiac events.
Acute Coronary Syndrome ; Chest Pain* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Diagnosis ; Echocardiography* ; Electrocardiography ; Humans ; Infarction ; Male ; Myocardial Infarction ; Myocardial Ischemia ; Perfusion ; Prospective Studies ; Thorax*

PURPOSE: To investigate the effect of pretreatment with intravenous nicorandil on the incidence of contrast-induced nephropathy (CIN) in patients with renal dysfunction undergoing coronary angiography. MATERIALS AND METHODS: This randomized controlled multicenter study enrolled a total of 166 patients (nicorandil n=81; control n=85) with an estimated glomerular filtration rate <60 mL/min. Nicorandil 12 mg dissolved in 100 mL of 0.9% saline was administered intravenously for 30 minutes just prior to coronary angiography in the nicorandil group. The same volume of only saline was given to the control group. The primary end-point was the incidence of CIN, defined as >0.5 mg/dL increase or >25% rise in serum creatinine (SCr) concentration within 48 hours of contrast exposure compared to baseline. RESULTS: The final analysis included 149 patients (nicorandil n=73; control n=76). The baseline characteristics and the total volume of the used contrast (Iodixanol, 125.6+/-69.1 mL vs. 126.9+/-74.6 mL, p=0.916) were similar between the two groups. The incidence of CIN also did not differ between the nicorandil and control groups (6.8% vs. 6.6%, p=0.794). There was no difference between the two groups in the relative change in SCr from baseline to peak level within 48 hours after coronary angiography (-1.58+/-24.07% vs. 0.96+/-17.49%, p=0.464), although the nicorandil group showed less absolute change in SCr than the control group (-0.01+/-0.43 mg/mL vs. 0.02+/-0.31 mg/mL, p=0.005). CONCLUSION: Prophylactic intravenous infusion of nicorandil did not decrease the incidence of CIN in patients with renal dysfunction undergoing coronary angiography.
Administration, Intravenous ; Aged ; Contrast Media/*adverse effects ; Coronary Angiography/*adverse effects/methods ; Creatinine/blood ; Female ; Glomerular Filtration Rate ; Humans ; Incidence ; Kidney Diseases/*chemically induced/epidemiology/physiopathology/*prevention & control ; Male ; Middle Aged ; Nicorandil/*administration & dosage/therapeutic use

PURPOSE: The aim of this study is to estimate one mouthful volume in a single swallow and average volume per swallow (AVS) in multiple swallows in the situation of toxic liquid poisoning. METHODS: Thirty five men and 35 women were included in this study. Each subject was asked to drink one swallow and three consecutive swallows from bottle containing water and a bottle containing saline separately. We calculated one mouthful volume in a single swallow and AVS in three swallows. One mouthful volume and AVS were compared according to sex and content, respectively. One mouthful volume of water and saline was then compared with AVS of each. RESULTS: Sixty seven adults(34 men; 26.9+/-3.2 years, 33 women; 25.6+/-2.4 years) completed the study. Men had larger one mouthful volume of water(49.1+/-19.9 ml vs 39.7+/-10.2 ml, p=0.02) and saline(20.7+/-10.9 ml vs 14.0+/-4.6 ml, p=0.004) and AVS of water(28.5+/-11.9 ml vs 21.5+/-5.9 ml, p=0.004) and saline(11.9+/-6.3 ml vs 7.9+/-2.0 ml, p=0.001) than women. One mouthful volume and AVS of saline swallow were lower than those of water swallow. AVS of three consecutive swallows was lower than one mouthful volume in water and saline swallow. CONCLUSION: We suggest that one mouthful volume in a single swallow is 21 ml in men and 14 ml in women and AVS in multiple swallows is 12 ml in men and 8 ml in women. AVS in multiple swallows is two-threefold lower than reference values(20~30 ml) commonly used in poisoning study.
Adult ; Deglutition* ; Female ; Humans ; Male ; Mouth ; Poisoning ; Swallows ; Water ; Young Adult*