Driving restrction for people with seizure disorder is intended to ensure the public's safety, but such resrictions may unduly harm the welfare of many people with seizures. There is a trend toward greater liberalization of driving standards for people with seizure disorder. The present survey indicates the current driving status of 194 male patients which were managed at the Yeungnam University Hospital from Jan. 1994 to JarL 1995. The result was as follows: 33% of the epileptic patients held traffic licences, 21% actually driving, 5% holding the licences and driving the truck and bus commercially; 72% of the patients took licences after onset of the disease, 29% disclosed by traffic authorities due to their military services; Over the half of the patients had complex partial seizure, 68% was seizure-free over one year, 91 % had no history of trabbic accident. Our traffic road regulations prohibited driving cars by epileptic patients, but practically the authorities permitted epileptic patients to drive cars case by case according to the medical certifications which were issued by the physician. In conclusion, we insist that new traffic road regulation, medical standards for permission and regulation, medico-legal- administrative committee, and thorough detection and regular follow-up of the patients were essential for safety of patients and other peoples.
Certification ; Epilepsy ; Follow-Up Studies ; Humans ; Male ; Military Personnel ; Motor Vehicles ; Seizures ; Social Control, Formal

To evaluate the intractability of partial epileptic patients by variables, the author studied 113 patients (uncontrolled: 45, controlled: 68) who were admitted to the Department of Neurology, College of Medicine, Yeungnam University from January, 1991 to August, 1993. The results were as follows. The items related to complex partial seizures, multiple seizure types and a histories of status epilepticus or clusters of seizures were significantly associated with drug-refractoriness (p<0.01). A high frequency of seizures before evaluation was associated with a poor outcome(p<0.01). The presences of known etiology of seizures, neurologic abnormalities and psychiatric disturbance were associated with limited treatment responses(p<0.01, p<0.05, p<0.01). An abnormal EEG findings such as background slowing, focal slowing, epileptiform discharges or secondarily bilateral synchrony were statistically significant (p<0.01). Age at onset, sex, distribution of epileptic foci, duration of seizure before evaluation, family history and abnormal neuroradiologic findings were not statistically significant. By these results, it was suggested that having at least four factors of the above variables were associated with limited treatment response.
Electroencephalography ; Epilepsies, Partial* ; Humans ; Neurology ; Risk Factors ; Seizures ; Status Epilepticus

The author studied 20 healthy adults (20 hands) as a control and 30 patients (40 hands) with carpal tunnel syndrome to evaluate the clinical usefulness of measuring nerve conduction velocity after wrist flexion in diagnosis of carpal tunnel syndrome. The median nerve conduction velocity over wrist to finger segment was measured before and after wrist flexion for 1, 2 and 5 minutes, using belly-tendon method for motor nerve distal latency (MNDL) and antidromic method for sensory nerve conduction velocity (SNCV). The results were as follows: 1. In control group, MNDL increased in 1 hand and SNCV decreased in 2 hands after wrist flexion. In patient group, MNDL increased in 2 hands and SNCV decreased in 3 hands after wrist flexion. 2. In both control and patient group, there were no significant changes in mean values of SNCV and MNDL between before and after wrist flexion. 3. Phalen's wrist flexion test was positive in 5 percent of control and 60 percent of patient group. 4. Tinel's sign was present in 10 percent of control and 33 percent of patient group.
Adult ; Carpal Tunnel Syndrome* ; Diagnosis ; Fingers ; Hand ; Humans ; Median Nerve ; Methods ; Neural Conduction* ; Wrist*

PURPOSE: To evaluate the efficacy of superselective intra-arterial fibrinolysis for acute cerebral stroke and the usefulness of pre- and postfibrinolysis diffusion-weighted MRI (DWI). MATERIALS AND METHODS: In 41 patients with acute ischemic stroke whose treatment involved intra-arterial fibri-nolysis, the occlusion site, degree of recanalization, and clinical results were compared. In 12 patients, diffusion weighted MRI was performed before fibrinolysis, and eight of these also underwent diffusion-weighted MRI after fibrinolysis. Using diffusion-weighted MRI, neurological outcomes were compared with signal intensity ratio (SIR, or the average signal intensity within the region of interest divided by that in the contralateral, nonischemic, homologous region). RESULTS: Twenty patients showed complete recanalization, nine partial recanalization, and in twelve there was no recanalization. Fourteen patients (34 %) improved neurologically. No relationship existed between occlusion sites, degree of recanalization, and clinical outcome. Among 12 patients who underwent DWI before fibrinolysis, complete recanalization was noted in eight. Neurological improvement was seen in four patients with low SIR(<1.55),while in four with high SIR(>1.7 ), neurological outcome was poor despite complete recanalization. CONCLUSION: Although superselective intra-arterial fibrinolysis for acute cerebral stroke is a good therapeutic method for recanalization, the clinical outcome can be disappointing. We therefore suggest that in cases of acute cerebral ischemic infaret, SIR-as seen on DWI-might be useful for predicting the benefits of recanalization. In such cases, further investigation of the use of DWI prior to fibrinolysis is therefore needed.
Diffusion Magnetic Resonance Imaging ; Diffusion* ; Fibrinolysis* ; Humans ; Magnetic Resonance Imaging ; Stroke

PURPOSE: To develop optimal microbubble contrast agents (MBCAs) for performing ultrasound microscopy when examining small animals. MATERIALS AND METHODS: We prepared three types of MBCAs. First, a mixture of three parts of 40% dextran and one part of 5% human serum albumin were sonicated with perfluorocarbon (PFC) (MB1-D40A5P). Second, three parts of 40% dextran and one part of 1% human serum albumin were sonicated with PFC (MB2-D40A1P). Third, all parts of 1% bovine serum albumin were sonicated with PFC (MB3-A1P). We measured the microbubbles' sizes and concentrations with using image analysis software. The acoustic properties of the microbubbles were assessed both in vitro and in vivo. RESULTS: The majority of the MB1-D40A5Ps had a diameter of 2-5 um, the mean diameter of the MB2-D40A1Ps was 2.5 um, and the mean diameter of the MB3-A1Ps was less than 2.0 um. Among the microbubbles, the MB1-D40A5Ps and MB2-D40A1Ps showed increased echogenicity in the abdominal vessels, but the duration of their contrast effect was less than 30 sec. On the contrary, the MB3-A1Ps exhibited strong enhancement in the vessels and their duration was greater than 120 sec. CONCLUSION: A microbubble contrast agent consisting of all parts of 1% serum albumin sonicated with PFC is an effective contrast agent for ultrasound microscopy.
Acoustics ; Animals ; Contrast Media* ; Dextrans ; Humans ; Microbubbles* ; Microscopy* ; Microspheres ; Serum Albumin ; Serum Albumin, Bovine ; Ultrasonography*

Transient ischemic attacks or embolic strokes caused by the cardiac myxoma are very rare in its freguency. To detect cardiac myxoma, as a source of cerebral embolism originating from the heart, has a great significance because of the occurrence and recurrence of the possible stroke can be prevented by surgical procedure. We present a patient who showed typical clinical symptoms and signs of the left atrial myxoma which was subsequently diagnosed by 2-dimensional real time echocardiography and confirmed by sugery. Following the successful removal of the left atrial myxoma, now, the patient is in stable neurological condition.
Echocardiography ; Heart ; Humans ; Intracranial Embolism* ; Ischemic Attack, Transient ; Myxoma* ; Recurrence ; Stroke

The lesion of the global aphasia often involves both Broca's and Wernicke's speech area, and is shown as broad lesion in the Brain CT However, practically there were several reports about the Brain CT findings of the global aphasia, which suggested atypical patterns that did not involve both language centers, simultaneously. Therefore we subdivided the patterns of Brain CT finding of the 17 global aphasic patients into 4 subtypes according to whether or not the cortical language area was involved. We obtained the following results; 1. Type A : Involvement of the both language areas : 9 cases (53%) 2. Type B : Involvement of only Broca's area with sparing of Wernicke's area : 3 cases(17%) 3. Type C : Involvement of only Wernicke's area with sparing of Broca's area : 1 case (6%) 4. Type D : Involvement only of subcortical area with sparing of cortical language areas : 4 cases (24%).
Aphasia ; Brain* ; Humans

Peters' anomaly is a rare form of anterior segment dysgenesis in which abnormal cleavage of the anterior chamber occurs. It is defined as a congenital central corneal opacity with corresponding defects in the posterior corneal stroma, Descemet's membrane, and endothelium. Peters' anomaly may be associated with other ocular or systemic abnormalities like microphthalmos, colobomata, retinal and optic nerve dysplasia, developmental delay, central nervous system defects, craniofacial abnormalities, seizure disorders, genitourinary malformations, and cardiopulmonary defects. Peters' anomaly may also have an inherited pattern, mostly autosomal recessive and dominant inheritance. Mutations involve the PAX6 gene, RIEG1 gene, and other genes. Management of infants with congenital corneal opacity is quite difficult, but penetrating keratoplasty is known as the effective treatment for visual outcome if it is performed within the first 3 months of life. We recently experienced a case of Peters' anomaly in association with atrial septal defect & chromosomal abnormality, therefore herein present it with a brief review of relevant literature.
Anterior Chamber ; Central Nervous System ; Chromosome Aberrations ; Corneal Opacity ; Corneal Stroma ; Craniofacial Abnormalities ; Descemet Membrane ; Endothelium ; Epilepsy ; Heart Septal Defects, Atrial ; Humans ; Infant ; Keratoplasty, Penetrating ; Microphthalmos ; Optic Nerve ; Retinaldehyde ; Wills

Peters' anomaly is a rare form of anterior segment dysgenesis in which abnormal cleavage of the anterior chamber occurs. It is defined as a congenital central corneal opacity with corresponding defects in the posterior corneal stroma, Descemet's membrane, and endothelium. Peters' anomaly may be associated with other ocular or systemic abnormalities like microphthalmos, colobomata, retinal and optic nerve dysplasia, developmental delay, central nervous system defects, craniofacial abnormalities, seizure disorders, genitourinary malformations, and cardiopulmonary defects. Peters' anomaly may also have an inherited pattern, mostly autosomal recessive and dominant inheritance. Mutations involve the PAX6 gene, RIEG1 gene, and other genes. Management of infants with congenital corneal opacity is quite difficult, but penetrating keratoplasty is known as the effective treatment for visual outcome if it is performed within the first 3 months of life. We recently experienced a case of Peters' anomaly in association with atrial septal defect & chromosomal abnormality, therefore herein present it with a brief review of relevant literature.
Anterior Chamber ; Central Nervous System ; Chromosome Aberrations ; Corneal Opacity ; Corneal Stroma ; Craniofacial Abnormalities ; Descemet Membrane ; Endothelium ; Epilepsy ; Heart Septal Defects, Atrial ; Humans ; Infant ; Keratoplasty, Penetrating ; Microphthalmos ; Optic Nerve ; Retinaldehyde ; Wills

We experinced 2 cases of reversible leukoencephalopathy, caused by 5-Fluorouracil derivatives(carmoful), presenting as akinetic mutism. Each patient was diagnosed as colon cancer and stomach cancer respectively and received operations. Their outcome was good without metastatic evidences, and carmoful was started orally 400mg in 1 case and 600mg in the other. Their clinical pictures were akinetic mutism, one and two months after the administration of carmoful. There were no metastatic lesions in the brain CT but bilaterally symmetric diffuse low densities of cerebral whites matter, predominantly in the frontal area, were noted. Carmoful was discontinued and replaced by conservative treatment. One and two months later, their clinical symptoms improved without specific treatment. Follow up brain CT was done in case 2, which revealed attenuation of the previous low densities.
Akinetic Mutism* ; Brain ; Colonic Neoplasms ; Fluorouracil* ; Follow-Up Studies ; Humans ; Leukoencephalopathies* ; Stomach Neoplasms