Neural mass models are able to produce epileptic electroencephalogram (EEG) signals in different stages of seizures. The models play important roles in studying the mechanism analysis and control of epileptic seizures. In this study, the closed-loop feedback control was used to suppress the epileptic-form spikes in the neural mass models. It was expected to provide certain theory basis for the choice of stimulus position and parameter in the clinical treatment. With the influence of measurement noise taken into account, an unscented Kalman filter (UKF) was added to the feedback loop to estimate the system state and an UKF controller was constructed via the estimated state. The control action was imposed on the hyper-excitable population and all populations respectively in simulations. It was shown that both UKF control schemes suppressed the epileptic-form spikes in the model. However, the control energy needed in the latter scheme was less than that needed in the former one.
Computer Simulation ; Electroencephalography ; Epilepsy ; physiopathology ; Feedback ; Humans ; Models, Neurological

PURPOSE: We investigated reproducibility of the quantification of left ventricular volume and ejection fraction, and grading of myocardial wall motion and systolic thickening when we used gated myocardial SPECT and Cedars quantification software. MATERIALS AND METHODS: We performed gated myocardial SPECT in 33 consecutive patients twice in the same position after Tc-99m-MIBI SPECT. We used 16 frames per cycle for the gatingof sequential Tc-99m-MTBI SPECT. After reconstruction, we used Cedars quantitative gated SPECT and calculated ventricular volume and ejection fraction (EF), Wall motion was graded using 5 point score. Wall thickening was graded using 4 point score. Coefficient of variation for re-examination of volume and fraction were calculated. Kappa values (k-value) for assessing reproducibility of wall motion or wall thickening were calculated. RESULTS: Enddiastolic volumes (EDV) ranged from 58 mi to 248 ml (122 ml +/- 42 ml), endsystolic volumes (ESV) from 20 mi to 174 mi (65 ml +1- 39 ml), and EF from 20% to 68% (51% +/- 14%). Geometric mean of standard deviations of 33 patients was 5.0 ml for EDV, 3.9 ml for ESV and 1.9% for EF. Their average differences were not different from zero (p>0.05). k-value for wall motion using 2 consecutive images was 0.76 (confidence interval: 0.71-0.81). k-value was 0.87 (confidence interval:0.83-0.90) for assessment of wall thickening. CONCLUSION: We concluded that quantification of functional indices, assessment of wall motion and wall thickening using gated Tc-99m-MIBI SPECT was reproducible and we could use this method for the evaluation of short-acting drug effect.
Heart ; Humans ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: The aim of this study was to investigate treatment results, toxicity and efficacy of hyperfractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. MATERIALS AND METHODS: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hyperfractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 5 1 years. Initial FlGO stage was 1 stage IB1, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recur rent disease with superior margin at T 12, and inferior margin was between L5 and S 1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m to 30 mg/m (median, 25 mg/m'), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. RESULTS: Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75% and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30% and 3 7 months, respectively. At 1 month after treatment, 4 (40%) achieved a complete response and 6 (63%) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence in 2 patients after paraaortic node irradialion. There was 2 patients with grade 3 to 4 leukopenia and 8 patients with grade 1 to 2 nausea/ vom ting which was usually tolerable with antiemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. CONCLUSION: Hyperfractionated radiation therapy combined with paclitaxel as a radiosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer. Therefore, present results suggest that hyperfractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.
Abdomen ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Paclitaxel* ; Pelvis ; Radiotherapy ; Recurrence* ; Survival Rate ; Tolnaftate ; Uterine Cervical Neoplasms*

PURPOSE: The purpose of this study was to describe the status of the functional health literacy of the elderly living in a rural community and to identify the influencing factors on the functional health literacy. METHODS: Subjects (n=238) aged over 60 years were selected for data collection. Functional health literacy was measured by Korean Health Literacy, which consisted of 15 items including eight numeracy and seven comprehension items. Descriptive statistics, t-test, ANOVA with Scheffe test, and stepwise multiple regression were used to analyze the data. RESULTS: The mean score of total functional health literacy was 6.66+/-3.31, numeracy was 3.52+/-1.76, and comprehension was 3.41+/-2.10. Of the subjects, 39.1% showed a low score below the median split. In the results of stepwise multiple regression, the factors affecting functional health literacy were basic literacy, age, number of chronic diseases, self-reported health status, and gender. These factors accounted for 33.0% of functional health literacy. CONCLUSION: These results suggest that interventions for improving functional health literacy are necessary to enhance elders' ability of self-care management. In addition, it is needed to take into account the individual characteristics of the subjects depending on their gender, age, and health status.
Aged* ; Chronic Disease ; Comprehension ; Data Collection ; Health Literacy* ; Humans ; Rural Health Services ; Rural Population ; Self Care

No abstract available.
Adenine/*analogs & derivatives ; Antiviral Agents/*therapeutic use ; Female ; Hepatitis B virus/*drug effects ; Hepatitis B, Chronic/*drug therapy ; Humans ; Male ; Phosphorous Acids/*therapeutic use

PURPOSE: To investigate the frequency of breakfast skipping and affecting factors in children in poverty. METHODS: The subjects were 644 children who were receiving the services of community child center or delivery meal-box. They were asked about their socio-demographic characteristics, health behaviors and breakfast-skipping status in the survey. RESULTS: Breakfast-skippers were 17.4% of the subjects. The count of negative health behaviors in breakfast skippers was higher than that in eaters, and the behaviors of exercise, screen time, alcohol experience, and smoking experience were worse in skippers than in eaters. The odds ratio of breakfast skipping was higher in female children (OR=2.53, p<.001), those with single father (OR=3.76, p<.001) or single mother (OR=1.83 p=.030), those with alcohol experience (OR=1.82, p=.022) and smoking experience (OR=2.80, p=.003), and under-weight ones (OR=2.54, p=.048). CONCLUSION: Breakfast skipping is associated with gender, family structure, alcohol experience, smoking experience and BMI. Children in poverty need comprehensive health promotion programs including interventions for breakfast skipping and health behaviors.
Breakfast* ; Child Health ; Child* ; Fathers ; Female ; Food Habits ; Health Behavior ; Health Promotion ; Humans ; Mothers ; Odds Ratio ; Poverty* ; Smoke ; Smoking

No abstract available.
Epidermal Cyst*

No abstract available.
Trichothiodystrophy Syndromes*

PURPOSE: To evaluate the effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health service for older people. METHODS: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), Pain and the number of Clinical Assessment Protocols (CAP). RESULTS: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression (odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL (OR: 4.423, CI: 1.151-16.999) and the number of CAP (OR: 11.443, CI: 3.805-34.410). CONCLUSION: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.
Activities of Daily Living ; Aged ; Aged, 80 and over ; *Case Management ; Cognition ; Demography ; Depression ; Female ; Geriatric Assessment ; *Health Services for the Aged ; *Home Care Services ; Humans ; Male ; Pain Measurement

Familial hyperkalemic periodic paralysis (HYPP) is an autosomaldominant channelopathy characterized by transient and recurrent episodes of paralysis with concomitant hyperkalemia. Mutations in the skeletal muscle voltage-gated sodium channel gene SCN4A have been reported to be responsible for this disease. Here, we report the case of a 16-year-old girl with HYPP whose mutational analysis revealed a heterozygous c.2111C>T substitution in the SCN4A gene leading to a Thr704Met mutation in the protein sequence. The parents were clinically unaffected and did not have a mutation in the SCN4A gene. A de novo SCN4A mutation for familial HYPP has not previously been reported. The patient did not respond to acetazolamide, but showed a marked improvement in paralytic symptoms upon treatment with hydrochlorothiazide. The findings in this case indicate that a de novo mutation needs to be considered when an isolated family member is found to have a HYPP phenotype.
Acetazolamide ; Adolescent ; Channelopathies ; Humans ; Hydrochlorothiazide ; Hyperkalemia ; Muscle, Skeletal ; Paralysis ; Paralysis, Hyperkalemic Periodic ; Parents ; Phenotype ; Sodium ; Sodium Channels