BACKGROUND: Whether the changes of risk factors (hypertension, diabetes mellitus, smoking, alcohol) can precipitate stroke remains unknown, and antecedent infection and psychologic stress are described insufficiently as predisposing risk factors for cerebral infarction. Therefore, we attempted to examine the roles of recent infection, psychologic stress, and the changes of risk factors as potential precipitants in each stroke subtypes. We also tested the temporal relationship between preceding exposure to coldness and stroke onset. METHODS: In this case-control study, 113 consecutive patients with acute cerebrovascular disease (38 small vessel disease, 43 large vessel disease, 11 cardiogenic infarction, 4 infarction of undetermined cause, and 17 intracerebral hemorrhage) and 23 control subjects were evaluated. Changes of the risk factors (and their management) were interviewed. A sign/symptom based questionnaire was used to characterize the prevalence of recent prior infection and exposure to coldness. Psychologic stress was measured with the use of Social Readjustment Rating Scale. RESULTS: The negative change of alcohol drinking was significantly higher in the stroke group. However, there was no significant difference between stroke and control groups in the changes of the other risk factors. The prevalence of previous (within 1 month) infection was significantly higher in the stroke group compared with control subjects (p=0.03). However, there were no significant differences among the stroke subtypes in the prevalence of infection(p=0.08). Upper respiratory tract infections constituted the most common type of infection. The exposure to coldness was significantly higher in the stroke group compared with control subjects (p=0.002). The level of stress within the prior 1 month/1 year was significantly higher in the stroke group than control group (p=0.01). CONCLUSION: Our data suggest that preceding infection, exposure to coldness, psychologic stress, and the negative change of alcohol drinking may be com.
Alcohol Drinking ; Case-Control Studies ; Cerebral Infarction ; Diabetes Mellitus ; Humans ; Infarction ; Prevalence ; Surveys and Questionnaires ; Respiratory Tract Infections ; Risk Factors* ; Smoke ; Smoking ; Stress, Psychological* ; Stroke*

Fifty-four marginal rotation procedures for cicatrical entropion and marginal entropion were performed in twenty-eight patients (8 males, 20 females). The age ranged from 4 to 74 years old (meant 51.1 years old). After the follow up periods of 6 to 48 months, excellent correction of the eyelid margin and good cosmetic appearance were noticed in most cases, but nine cases combined with severe trichiasis showed recurred trichiasis requiring reoperation.
Entropion ; Eyelids ; Follow-Up Studies ; Humans ; Male ; Reoperation ; Trichiasis

Drug-induced parkinsonism (DIP) is the second-most-common etiology of parkinsonism in the elderly after Parkinson's disease (PD). Many patients with DIP may be misdiagnosed with PD because the clinical features of these two conditions are indistinguishable. Moreover, neurological deficits in patients with DIP may be severe enough to affect daily activities and may persist for long periods of time after the cessation of drug taking. In addition to typical antipsychotics, DIP may be caused by gastrointestinal prokinetics, calcium channel blockers, atypical antipsychotics, and antiepileptic drugs. The clinical manifestations of DIP are classically described as bilateral and symmetric parkinsonism without tremor at rest. However, about half of DIP patients show asymmetrical parkinsonism and tremor at rest, making it difficult to differentiate DIP from PD. The pathophysiology of DIP is related to drug-induced changes in the basal ganglia motor circuit secondary to dopaminergic receptor blockade. Since these effects are limited to postsynaptic dopaminergic receptors, it is expected that presynaptic dopaminergic neurons in the striatum will be intact. Dopamine transporter (DAT) imaging is useful for diagnosing presynaptic parkinsonism. DAT uptake in the striatum is significantly decreased even in the early stage of PD, and this characteristic may help in differentiating PD from DIP. DIP may have a significant and longstanding effect on patients' daily lives, and so physicians should be cautious when prescribing dopaminergic receptor blockers and should monitor patients' neurological signs, especially for parkinsonism and other movement disorders.
Aged ; Anticonvulsants ; Antipsychotic Agents ; Basal Ganglia ; Calcium Channel Blockers ; Dopamine Plasma Membrane Transport Proteins ; Dopaminergic Neurons ; Humans ; Movement Disorders ; Organothiophosphorus Compounds ; Parkinson Disease ; Parkinsonian Disorders ; Tremor

OBJECTIVES: The purpose of the study was to examine the relationships between temperament and character dimensions and family environments, and to investigate the influences of those factors on the antisocial personality traits in delinquent adolescents. METHODS: The subjects consisted of 160 male adolescents detained at the public prosecutor's office on the suspicion of crimes. To assess personality dimensions and family environmental factors, the Temperament and Character Inventory(TCI) and the Family Environment Scale(FES) were completed. Antisocial personality traits were assessed by the number of antisocial personality disorder symptoms of the Personality Disorder Questionnaire-Revised. RESULTS: Most of the TCI dimensions except Reward Dependence(RD) were highly correlated with the subscales of FES. Among temperament dimensions, Novelty Seeking(NS) and Persistence(P) were significantly affected by Organization, and Harm Avoidance(HA) was influenced by Expressiveness of FES. Self-Directednss(SD) was best predicted by Organization and Achievement-Orientation. While the Independence had significant effect on Cooperativeness, Expressiveness and Achievement-Orientation best predicted the level of Self-Transcendence(ST). On factor analysis, NS, HA, SD and ST were allocated to the same factors with subscales of FES. The level of antisocial personality trait was best predicted by NS, P and SD scores of TCI, and conflict subscale scores of FES. CONCLUSION: The findings of this study suggest that not only the character dimensions but also the temperament dimensions have close relationships with family environmental factors, and that the antisocial personality traits of delinquent adolescents may developed by the interaction between temperament/character dimensions and family environments.
Adolescent* ; Antisocial Personality Disorder* ; Crime ; Humans ; Personality Disorders ; Reward ; Temperament*

BACKGROUND: Patients with Parkinson's disease (PD) experience various types of sleep disturbances, and exhibit multiple risk factors for sleep disturbances. However, few studies have considered the demographic and psychosocial factors related to sleep disturbances in Korean PD patients. This study investigated the characteristics of sleep disturbance and related factors, including demographic and psychosocial factors, in Korean PD patients. METHODS: A population of 181 PD patients was studied; all agreed to be interviewed using structured questionnaires. RESULTS: The Parkinson's Disease Sleep Scale (PDSS) score was not correlated with sex, age, educational level, marital status, household income, or the presence of religion, a job, or a hobby. With regard to psychosocial factors, the PDSS score was positively correlated with the Self-Esteem Score and the Social Support Score. The PDSS score was negatively correlated with the Parkinson Fatigue Scale score, the pain score, the Beck Depression Index, and the Spielberger Anxiety Score. On stepwise multiple regression analysis, the most significant factors contributing to low PDSS scores were severe anxiety, a shorter duration of levodopa therapy, severe fatigue, and a higher daily levodopa dosage, in that order. CONCLUSIONS: Sleep disturbance in PD patients was significantly associated with anxiety, fatigue, and daily levodopa dosage, suggesting that these factors should be carefully managed in PD patients.
Anxiety ; Depression ; Family Characteristics ; Fatigue ; Hobbies ; Humans ; Levodopa ; Marital Status ; Parkinson Disease* ; Psychology ; Surveys and Questionnaires ; Risk Factors

Hand tremor is one of the most frequent movement disorders and embarrassing symptoms of a wide spectrum of diseases. Hand tremor can be classified by form in which the hand tremor occurs, the main distinction being whether the hand tremor occurs at rest or is produced by voluntary muscle contractions. Essential tremor is the most common pathologic tremor in humans. The clinical features of essential tremor are heterogeneous across patients. Parkinson's disease is a common disease in the elderly with increasing prevalence over the last decade. Rest tremor is one of the cardinal motor features of Parkinson's disease. Drug-induced hand tremor is also common and should be diagnosed accurately. Hand tremor in Wilson's disease is very important to identify because the disease can be treatable. Here, the diagnosis and treatment of hand tremor were reviewed to provide a practical guide for managing patients with hand tremor.
Aged ; Contracts ; Essential Tremor ; Hand ; Hepatolenticular Degeneration ; Humans ; Movement Disorders ; Muscle, Skeletal ; Parkinson Disease ; Prevalence ; Tremor

The purpose of educational effort for career planning in medical school is to help students develop identity as a competent physician and to assist them in selecting their future career properly. To achieve the above, the specific education programs for career plan together with an individual counselling and problem solving approach are required. We proposed an education model for career planning in Gachon Medical School which would be directed by cooperative system consisted of medical school, faculty mentor and student counselling office. Career education should not be limited to several lectures or short-term counselling, but it requires a continuous and consistent program implemented throughout 6 years of medical school life. At the same time, an opportunity to explore future career and to consult their problems in accord with needs and characteristics of individual students must be provided. Further study should be directed to examine the usefulness and problems of this education model. In addition, a persistent attention to the problems in career planning of medical students and efforts to solve them is needed.
Education* ; Humans ; Lectures ; Mentors ; Problem Solving ; Schools, Medical* ; Students, Medical

No Abstract Available.
Cell Line* ; Humans* ; Vascular Endothelial Growth Factor A*

No Abstract Available.
Cell Line* ; Humans* ; Vascular Endothelial Growth Factor A*

PURPOSE: The purpose of this study is to find some points that may help the differential diagnosis of ring lesions in magnetic resonance (MR) imaging of the liver through recognition of the characteristics of the morphology and the signal intensities of the ring lesions. MATERIALS AND METHODS: T1- and T2-weighted axial spin-echo images and gadolinium-enhanced Tl-weighted images were obtained with a 1.0 T superconducting MR imager. We reviewed the MR findings of 23 hepatic ring lesions which were confirmed as hepatocellular carcinomas (13), metastases (4), liver abscesses (4), hydatid cyst (1), and hematoma (1). RESULTS: There were 19 single rings and 4 double rings (all the cases were liver abscesses) on Tl-weighted images, and 8 single rings and 14 double rings on T2-weighted images. The signal intensity of the ring was low in hepatocellular carcinoma on Tl-weighted images and in hydatid cyst on T2-weighted images. It was high on Tl-weighted images in subacute hemaroma. Target lesion as an inner high-signal-intensity ring surrounded by a high-signal-intensity ring on T2-weighted images was seen in metatasis, liver abscess, and hepatocellular carcinoma. CONCLUSION: It is helpful to recognize the chracteristics of morphology and signal intensities of the ring lesions in the differential diagnosis of hepatic focal lesions.
Carcinoma, Hepatocellular ; Diagnosis, Differential ; Echinococcosis ; Hematoma ; Liver Abscess ; Liver* ; Magnetic Resonance Imaging* ; Neoplasm Metastasis