Redundant nerve root syndrome(RNRS) is a rare case. It was first reported by Verbiest in 1951. Thereafter a few cases were reported in neurosurgical field, but they were not reported in neurological field. We report a case of RNRS of the cauda equina. The clinical featuresl of the patient were chronic lumbago, radicular pain, leg weakness & atrophy, and intermittent neurogenic claudication. Myelography revealed characteristic serpentine filling defects in the cauda equina.
Atrophy ; Cauda Equina* ; Humans ; Leg ; Low Back Pain ; Myelography

BACKGROUND: To review the experience that used both ventricular assist device(VAD) and extracorporeal membrane oxygenation(ECMO) for children with congential heart disease requiring postcardiotomy mechanical circulatory support. MATERIAL AND METHOD: Between March 1993 and May 1995, we applied mechanical assist device using centrifugal pump to the 16 patients who failed to be weaned from cardiopulmonary bypass(n=15) or had been in cardiogenic shock in intensive care unit(n=1). The diagnosis were all congenital heart diseases and the ages of patients ranged from 20 days to 10 years (mean age=2.5+/-3.5 years). RESULT: The methods of mechanical circulatory support were LVAD(n=13), BVAD (n=1), and ECMO(n=2). The mean assist times were 54.0+/-23.7 hours. Post-assist complications were in orders: bleeding, acute renal failure, ventricular failure, respiratory failure, infection, and neurologic complication. It was possible for 9 patients(56.3%) to be weaned from assist device and 5 patients(31.3%) were discharged from hospital. There was no statistical significant between hospital discharged group and undischarged group by age, body weight, cardiopulmonary bypass time, and assist time. CONCLUSIONS: The ventricular assist device is an effective modality in salvaging the patient who failed to be weaned from cardiopulmonary bypass, but multiple factors must be considered for improving the results of mechanical circulatory support ; such as patient selection, optimal time of starting the assist device, and prevention and management of the complications.
Acute Kidney Injury ; Body Weight ; Cardiopulmonary Bypass ; Child ; Diagnosis ; Extracorporeal Membrane Oxygenation ; Heart Defects, Congenital ; Heart Diseases* ; Heart* ; Heart-Assist Devices ; Hemorrhage ; Humans ; Critical Care ; Membranes ; Patient Selection ; Respiratory Insufficiency ; Shock, Cardiogenic

We investigated the conjunctival sensitivity of bleb area after successful trabeculectomy for 3 to 6 months in 19 eyes of 16 patients using Cochet-Bonnet aesthesiometer(diameter=0.12mm). The conjunctival sensitivity of bleb area was decreased significantly from 68.78mg/S to 171.05mg/S compared to the preoperative values. This decrement was maintained during the follow-up period and not related to the type, height and vascularity of the bleb. This results shows that the conjunctival sensitivity of bleb area after successful trabeculectomy is significantly decreased and maintained at least 3 months after operation. Therefore the conjunctival sensitivity of bleb area might be considered possible indicator of success or failure during follow-up period after trabeculectomy.
Blister ; Follow-Up Studies ; Humans ; Trabeculectomy*

No abstract available.

Creutzfeldt-Jakob disease (CJD) is a rare dementing illness that usually affects older adults and is characterized by a rapidly progressive dementia, ataxia, and myoclonus. The disease is due to an unusual transmissible protein called a prion. The diagnosis is often suspected on the basis of electroencephalographic (EEG) and clinical findings. Our case was 62-year-old woman, who presented acute onset rapid progressive dementia, myoclonus, heightened startle reaction, extrapyramidal symptoms, and died about 2.5 months after onset of disease. We diagnosed this case as CJD with typical EEG pattern and clinical features.
Adult ; Ataxia ; Creutzfeldt-Jakob Syndrome* ; Dementia* ; Diagnosis ; Electroencephalography ; Female ; Humans ; Middle Aged ; Myoclonus ; Startle Reaction

OBJECTIVES: This study was conducted to delineate the long-term natural change of cognitive functions in aged community residents, using the Korean version of the mini-mental state examination (MMSEK) METHODS: The first MMSEK was administered to as the screening test for identification of dementia between January and December, 1990 in a total of 702 persons. They were residents of a Myun area, Pohang, Kyungpook Province and 65 or more as of December 31. 1990. The MMSEK was repeated from November, 1995 to June, 1996, using the Cognitive Impairment Diagnosing Instrument and was successful in 440. RESULTS: The 6-year mean(+/-SD) decline of the total MMSEK score was 1.52+/-3.45 and 6.42%. Of the subtests, memory registration showed no significant decline while comprehension/judgement improved significantly. The decline was most prominent in attention/calculation and memory recall, and then language, orientation in time and orientation in place in order. Change of the total score was not related to sex, education and the first total score. Decline of language function was more severe in the educated than in the noneducated-illiterate. Performances of all subtests declined significantly with aging and improvement of the comprehension/judgement was less prominent in the group aged 75 or more. Relations of the change with the first total score were inconsistent among the subtests. The stepwise multiple regression analysis revealed that age, the first total score and education were the variables significantly affecting the decline of MMSEK score. However, they could account for only 16.4% of the variance of decline of the total MMSEK score. CONCLUSIONS:Decline of the cognitive function was small during the 6-year period, and the change pattern was not homogenous among the subtests. Age, the first total MMSEK score and education were idenrified as significant, but not so important, factors accounting for the variance of the cognitive decline.
Aged* ; Aging ; Cognition ; Dementia ; Education ; Follow-Up Studies* ; Gyeongsangbuk-do ; Humans ; Mass Screening ; Memory

OBJECTIVES: To study of the effects of gender, age and education on the MMSEK performances in the elderly. METHOD: The MMSEK was administered to a total of 702 persons aged 65 or more in a rural area. The effects on the total and subtest MMSEK scores of the 3 independent variables were analyzed by Student t-test, Pearson's correlation, oneway analysis of variance, analysis of covariance, and stepwise multiple regression. RESULTS: The total and all subtest scores of MMSEK were found to be affected by age. All subtest, except memory registration and memory recall, scores were affected by education and sex. 39.6% of the variance of total MMSEK score could be accounted for by the 3 variables. CONCLUSIONS: 40% of the variance of the total MMSEK score could be accounted for by age, gender and education while the remaing 60% is assumed to be affected by other variables than age, sex, and education. Memory registration and memory recall seems to be resistant to sex and education effect, but sensitive to aging.
Aged* ; Aging ; Cognition ; Education* ; Humans ; Memory ; Rural Population*

OBJECTIVE: Elucidation of questionable dementia of the Alzheimer type(QDAT) is important far accurate estimation of prevalence and incidence of dementia of the Alzheimer type, understanding of its natural history and evaluation of treatment strategies for dementia of the Alzheimer type. Subject and METHODS: Performances neuropsychological tests were compared between non-demented controls and 14 elderly people in a community diagnosed as having questionable senile dementia of the Alzheimer type. They lived in a rural community and their sex, age and education were controlled. RESULTS: The two groups were not significantly different comprehension and digit span of the Wechsler Memory Scale. Performances on arithmetic, similarity and block design were significantly lower in QDAT subjects. Scores on associate learning of the Wechsler Memory Stale and immediate and delayed recalls of logical memory were lower in QDAT subjects with statistical significance. performance on the semantic verbal fluency tended to the lower for the QDAT subjects. CONCLUSION: These findings suggest that QDAT may be early dementia of the Alzheimer type.
Aged* ; Aging ; Alzheimer Disease ; Cognition ; Comprehension ; Dementia* ; Education ; Humans ; Incidence ; Learning ; Logic ; Memory ; Natural History ; Neuropsychological Tests ; Prevalence ; Rural Population ; Semantics

Purpose: Clinical nurses who are mothers of preschool-aged children experience extreme parenting stress linked to their hospital work environment and shift work, differing from that generally experienced by mothers. This study aimed to develop and validate a parenting stress scale that considers the clinical nurses’ form of work and its characteristics. Methods: The scale items were initially derived from in-depth interviews and a literature review and were revised and modified based on the results of content validity testing by experts. The developed instrument was evaluated using data from 157 clinical nurses in South Korea who were mothers of preschool-aged children. Results: In the instrument validation stage, 19 items categorized in four factors (psychological burden, physical and mental fatigue, work shift, and work environment) were derived from construct validity, and the cumulative explanatory power was 56.6%. Furthermore, the convergent and discriminant validity and external construct were confirmed. Cronbach’s α of the final instrument was .86 (range: .81–.86). The validity and reliability of the newly developed parenting stress scale for clinical nurses were established in this study; it uses a 4-point Likert scale. A higher mean score by factor indicates a higher level of parenting stress experienced by clinical nurses. Conclusion This instrument would be beneficial to measure the level of parenting stress among nurses who work in hospitals and evaluate factors related to their parenting stress to devise effective interventions.

OBJECTIVES: This study was conducted in order to evaluate reliability and diagnostic validity of the CIDI. METHODS: 64 patients with DSM-IV dementia and 90 elderly patients with other mental disorders entered this study. Inter-subtest Pearson's correlations, corrected subtest-total correlations and Cronbach's alpha were computed for reliability while correlations of the total scores on CIDI with the performances on other scales relating to dementia, sensitivity and specificity, area under curve using the receiver operating characteristic curve, and group comparison were used for the assessment of validity. RESULTS: The CIDI's inter-subtest correlations ranged from 0.596 to 0.813, with a mean of 0.707. The corrected subtest-total correlations were between 0.759 and 0.890. Cronbach's alpha of the subtests was 0.941 and the Cronbach's alpha were between 0.928 and 0.948 when any subtest was deleted. In the demented subjects, the correlation coefficients of the total CIDI score with the performances on S-SDQ, IADL, BADL, BDRS, and MMSEK were around 0.5. Area under the receiver operating curve of CIDI was 0.933 with the standard error of 0.021(95% CI, 0.891-0.975). At the CIDI cutoff point of 65/66, sensitivity and specificity were 95.3% and 85.6%, respectively. The corresponding values of MMSEK were 0.930, 0.020 (95% CI, 0.891-0.969), 22/23, and 89.1% and 85.6%. The demented scored much poorer in all CIDI subtests than the nondemented mental patients, and the differences were highly significant. CONCLUSIONS: The CIDI was satisfactory regarding to reliabilities and diagnostic validities. The CIDI and MMSEK are thought to be reciprocal in assessment of cognitive functions: CIDI is preferable for clinical assessment of cognitive dysfunction and MMSEK for as a screening test.
Aged ; Area Under Curve ; Cognition ; Dementia ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening ; Mental Disorders ; Mentally Ill Persons ; ROC Curve ; Sensitivity and Specificity ; Weights and Measures