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

PURPOSE: This study was done to identify differences in awareness and ethical attitudes associated with Do-Not-Resuscitate (DNR) and decision about advance directives among the general populations. METHODS: Participants were 193 ordinary people from 2 provinces and data were collected from December 23, 2013 to January 30, 2014. Structured questionnaires included awareness measuring tool and ethical attitudes measuring tool. Data were analyzed with descriptive analysis using descriptive statistics, t-test, and chi2-test with SPSS/WIN 18.0 program. RESULTS: Most of the participants responded that they agreed on the necessity of DNR and needed to do it by guidelines, while 47.2% responded that patients and their families should make a decision about the DNR. After the decision about DNR, they also agreed that efforts should be made to give the best treatment even if a DNR decision had been made by the patient. In general, there was a significant difference in advance directives for CPR depending on gender and living with family or not. CONCLUSION: For a professional and systematic approach to the problem, DNR guidelines sufficient to elicit social consensus are needed.
Advance Directives* ; Cardiopulmonary Resuscitation ; Consensus ; Humans ; Surveys and Questionnaires ; Resuscitation Orders

Sphenoid sinus aspergillosis is notorious for its serious complications, such as permanent cranial nerve deficits and possible death. The most common associated symptoms are headache, followed by visual changes, and cranial nerve palsies. Because of an insidious onset, frequently resulting in missed and delayed diagnosis, sphenoid sinus aspergillosis is a potentially lethal medical condition. We report a case of visual loss secondary to isolated sphenoid sinus aspergillosis. A 69-year-old man presented to our hospital with the complaint of headache. The headache started one year previously and was described as severe dull pain localized bilaterally to the temporo-orbital region. The patient took daily NSAIDs for the pain. The neurological examination was normal. The MRI of the brain showed a left sphenoid sinusitis. A transnasal endoscopic superior meatal sphenoidotomy was performed. Aspergillosis was confirmed after a surgical biopsy was obtained. The patient was discharged from hospital without antifungal therapy. One month later, the patient complained of headache and loss of vision bilaterally. The orbital MRI showed a left cavernous sinus and bilateral optic nerve invasion. The loss of visions was permanent. In our case, the diagnosis was delayed; antifungal agents were not administered after surgery and the patient lost his vision as a result. Therefore, early diagnosis and proper treatment are important. Although the treatment of an invasive type of aspergillus has not been established, surgical removal of a nidus and aggressive antifungal therapy are recommended.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Antifungal Agents ; Aspergillosis* ; Aspergillus ; Biopsy ; Blindness* ; Brain ; Cavernous Sinus ; Cranial Nerve Diseases ; Cranial Nerves ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis ; Headache* ; Humans ; Magnetic Resonance Imaging ; Neurologic Examination ; Optic Nerve ; Orbit ; Sphenoid Sinus* ; Sphenoid Sinusitis

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

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*

Natural killer/T-cell lymphoma (NKTL) usually involves the nasal cavity or paranasal sinuses during the initial stage, and may invade the orbit or brain in the advanced phase. Thus, most patients with NKTL present with nasal symptoms. We report a case of NKTL that presented with ophthalmoplegia. MRI revealed pansinusitis and a mass lesion in the right maxillary sinus. An endoscopic biopsy revealed NKTL. NKTL should be included in the differential diagnosis of ophthalmoplegia.
Biopsy ; Brain ; Diagnosis, Differential ; Humans ; Lymphoma ; Maxillary Sinus ; Nasal Cavity ; Natural Killer T-Cells ; Ophthalmoplegia ; Orbit ; Paranasal Sinuses

PURPOSE: The study was done to identify the construct validity and reliability of the life transition scale (LTS) for parents who have children with autism. METHODS: Exploratory factor analysis (EFA) and confirmative factor analysis (CFA) were conducted to identify the most adequate measurement model for structural validity. Convergent validity and discriminant validity were also conducted for structural validity. Data were collected from 208 parents through self-reported questionnaires and analyzed with SPSS/WIN 15.0 and AMOS 20.0 version. RESULTS: A four factor-structure was validated (chi2=541.23, p<.001, GFI=.82, RMSEA=.07, IFI=.89, CFI=.89, PNFI=.73, Q (chi2/df)=2.20) at the 3rd order of EFA and CFA, and factors were named as denying, wandering, despairing, and accepting. Both convergent and determinant validity for LTS were 100%. Cronbach's alphas for the reliability of each structure were .77-.90 and .83 for total structure. CONCLUSION: The four structures, 24-item instrument showed satisfactory reliability and validity. LTS has the potential to be appropriate for assessing the transition process of life for parents who have children with autism and provides basic directions for differentiated support and care at each stage.
Adaptation, Physiological ; Adult ; Autistic Disorder/diagnosis/*pathology ; Child ; Child, Preschool ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Middle Aged ; Parents/*psychology ; Quality of Life ; Questionnaires ; Severity of Illness Index

PURPOSE: While there are a number of studies on children with disabilities, there have been few studies on mothers of children with autism. The purpose of this study was to explore the process of life transition of mothers who have children with autism. METHODS: From June 2007 to May 2009, the researcher interviewed 15 mothers of children with autism living in Seoul City, Gyeonggi or Chonbuk Provinces, and then analyzed the data gathered using the constant comparative method of grounded theory. RESULTS: "Living together holding a string of fate" was a core category showing along the continuum of life. The basic social process of life transition encompassed 5 stages: stages of denying, wandering, devoting, mind controlling, and finally accepting. These five stages proceeded in phases, though returned back to the wandering stage occasionally. CONCLUSION: This study has opened the door to understanding how mothers of children with autism experienced life transition. The findings suggest that differentiated support and care at each stage should be given and there is the need to develop transition assessment tools for mothers of children with autism.
Adaptation, Psychological ; Adolescent ; Adult ; Autistic Disorder/*diagnosis ; Child ; Child, Preschool ; Female ; Humans ; Internal-External Control ; Interviews as Topic ; Middle Aged ; Mothers/*psychology ; Parenting/psychology ; Young Adult

PURPOSE: The purpose of this research was to develop a scale to measure the life transition process of parents of children with autism, against the backdrop of a lack of research on this topic. METHODS: Seventy preliminary items were drawn from previous qualitative research, and content validity was tested by three professors as well as three parents of children with autism. A questionnaire survey was also done between August 2011 and February 2012. Data were collected from 207 parents of children with autism and analyzed using descriptive statistics, item analysis, Cronbach's alpha, Pearson correlation coefficients, and factor analysis with the SPSS Win 15.0 program. RESULTS: Twenty-nine items were selected to constitute the appropriate measuring scale and categorized into 5 factors explaining 63.2% of the total variance. The 5 factors were named; stages of denial (5 items), wandering (6 items), devotion (7 items), frustration (3 items), and finally acceptance (8 items). Cronbach's alpha for the 29 items was .80. CONCLUSION: The results of this study not only suggest assessment criteria for the life transition process of parents who have children with autism but also provide basic directions for program development to provide differentiated support and care at each stage.
*Adaptation, Psychological ; Adolescent ; Adult ; Autistic Disorder/*pathology ; Child ; Child, Preschool ; Depression/pathology ; Fathers/*psychology ; Female ; Humans ; Male ; Middle Aged ; Mothers/*psychology ; *Program Development ; Qualitative Research ; Questionnaires ; Young Adult

BACKGROUND: When using the data based on history, ECG and cardiac enzyme, two to eight percent of patients with acute chest pain are incorrectly perceived as being at low risk and therefore sent home mistakenly. It is known that changes of Doppler parameters appear first, before regional asynergy in 2D-echocardiography, electrocardiographic change and chest pain. however, the clinical application of Doppler information in the diagnosis of acute myocardial infarction remains uncertain, especially in elderly patients. METHODS: From March 1998 to March 1999, pulsed wave Doppler echocardiography was performed in patients with acute myocardial infarction within 6 hours, and Doppler parameters were evaluated. Each Doppler parameters were compared between elderly (age > or =65) and young(age < 65) groups. RESULT: E peak velocity & E/A ratio showed significant differences between two groups(p<0.05). especially, Stroke volume, isovolumic relaxtion time & myocardial performace index showed marked difference(p<0.01). CONCLUSION: Diastolic Doppler parameters of elderly group were significantly changed than younger group. however systolic Doppler parameters were relatively preserved. Among Doppler parameters, myocardial performance index is a conceptrally new, simple and reproducible Doppler index of combined systolic and diastolic myocardial performance, and it may be useful as screening test for patients with AMI in elderly patients.
Aged ; Chest Pain ; Diagnosis ; Echocardiography, Doppler ; Electrocardiography ; Humans ; Mass Screening ; Myocardial Infarction* ; Stroke Volume