Distinguishing epileptic seizure from non-epileptic seizure is a common diagnostic problem. Neurogenic or cardiac syncope can appear similar to atonic and even convulsive seizures. Classic migraine and transient ischemic attacks may also resemble epileptic seizures. Sleep disorders including REM sleep behavior disorder, nocturnal paroxysmal dystonia, and narcolepsy likewise simulate an epileptic seizure. Movement disorders such as paroxysmal dyskinesia can be misinterpreted as epileptic seizures (reflex epilepsy or myoclonic seizures). Psychogenic seizures are often misdiagnosed as an intractable epilepsy. Prior to the definitive diagnosis of epilepsy, possible non-epileptic seizures should be excluded. For the correct decision, a thorough and systematic history taking is important. In addition, EEG, pseudoseizure induction test, head-up tilt test, EKG, sleep studies, and video-EEG monitoring may be necessary. Misdiagnosis of non-epileptic seizures as epilepsy may result in unnecessary anti-epileptic drug use. At the same time, we should let the patients understand what the epilepsy is and that epilepsy is a treatable disease.
Chorea ; Diagnosis ; Diagnostic Errors ; Drug Resistant Epilepsy ; Electrocardiography ; Electroencephalography ; Epilepsy* ; Humans ; Ischemic Attack, Transient ; Linear Energy Transfer ; Migraine with Aura ; Movement Disorders ; Narcolepsy ; Nocturnal Paroxysmal Dystonia ; REM Sleep Behavior Disorder ; Seizures* ; Sleep Wake Disorders ; Syncope

INTRODUCTION: Sleep has numerous important physiological and cognitive functions that may be particularly important to elite athletes. Sleep deprivation can have significant effects on athletic performance. However, there are few published data related to the amount of sleep obtained by elite athletes. We investigated sleep patterns of Korean women golfers using sleep-related questionnaires. METHODS: For this study, 98 Korean university women golfers and 46 age- and sex-matched controls were recruited. All subjects were asked to complete the self-administered sleep questionnaire consisting of questions about habitual sleep patterns (sleep onset time, sleep latency, awakening time in the morning, day time napping time), exercise habits, Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISS), Pittsburgh Sleep Quality Index (PSQI), validation of the Perceived Stress Scale (PSS), and Beck Anxiety Inventory (BAI). RESULTS: The sleep onset time was significantly earlier (pm 23 : 05 +/- 00 : 52 and 00 : 14 +/- 00 : 51 ; t = 5.287, p < 0.001), the waking time was later (am 07 : 21 +/- 01 : 09 and 6 : 35 +/- 00 : 32; t = -2.715, p = 0.008), the weekday total sleep time was greater (417.77 +/- 78.18 minute and 351.52 +/- 77.83 minute ; t = 4.406, p = 0.001), and the daytime nap time was greater (77.73 +/- 41.28 minute and 20.22 +/- 33.03 minute ; t = 7.623, p < 0.001) in the golf athletes compared to the controls. The PSQI scores were significantly lower, but estimated sleep latency and ESS, ISS, PSS, and BAI scores were not different among the two groups. CONCLUSION: This study suggests that Korean university women golfers have good sleep patterns resulting in no difference in sleep-related stress compared to age- and sex-matched control students.
Anxiety ; Athletes ; Athletic Performance ; Female ; Golf ; Humans ; Surveys and Questionnaires ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders

No abstract available.
Diagnosis* ; Epilepsy*

Death by drowning is a major cause of unnatural death worldwide. It is therefore important to conduct forensic examination of immersed bodies following drowning, in order to determine the diagnosis of drowning, because no specific methods have been established thus far. Therefore, we performed a series of rat experiments to compare autopsy findings between seawater and fresh water drowning cases, which included the presence of pleural effusion and histologic findings of the lung. The results showed that the volume of pleural effusion increased in the seawater drowning group compared to the fresh water drowning group, and the total weight of lung was affected by the type of drowning medium and postmortem interval. However, histologic findings of the lung showed no significant difference between the 2 types of drowning mediums.
Animals ; Autopsy ; Drowning ; Fresh Water ; Lung ; Pleural Effusion ; Rats ; Seawater

The objective of cancer screening is to reduce the risk of death, i.e., mortality from cancer among individuals subjected to screening. For cervical and colorectal cancer, the screening test is aimed at detection of preinvasive lesions. Therefore, reduction in the incidence of invasive disease also results from screening. In a national cancer control program, the programs should be orgainzed to ensure that a large proportion of the target group is screened and that those individuals in whom abnormalities are abserved receive appropriate diagnosis and therapy. Agreement should be reached on guidelines to be applied in the national cancer control program. When establishing appropriate cancer screening recommendations several factors should be considered. ① For establishing the starting age, age-specific incidence and mortality rate, life lost person-years, and cost-effectiveness can be considered. ② For frequency of screening, it is necessary to understand the natural history of disease. ③ For choosing the best test tool, sensitivity and specificity, compliance, cost, and adverse effects can be considered. It seems that doctors' willingness to participate is essential for a successful cancer screening program. They should understand the rationale of cancer secreening, its effectiveness, and the risk.
Colorectal Neoplasms ; Compliance ; Diagnosis ; Early Detection of Cancer* ; Incidence ; Korea* ; Mass Screening ; Mortality ; Natural History ; Sensitivity and Specificity

The eye is a common target organ of the allergy, and allergic conjunctivitis is the most common of eye diseases. Clinical manifestations of allergic conjunctivitis are acute bilateral red, itchy, and watery eyes. The presence of conjuncitival eosinophilia may be consided to be a diagnostic indicator of allergic conjunctivitis. ECP is a quantifiable toxic product secreted by activated cosinc phils. VCAM-1 promotes adhesion of leukocytes to endothelium in vitro and may promote imflammation in vivo. The objective of this study is to measure eosinophil count, ECP and sVCAM-1 levels of tears and sera in patients with acute allergic conjunctivitis and normal subjects and to assess the correlation of these mediators with the severity of the disease and the clinical usefulness. Seventeen subjects were selected on the basis of clinical manifestations, history, skin prick test, total IgE. A microcapillary tube was used to collect the tears from the inner canthus, conjunctival epithelia were obtained for eosinophil count by scraping the upper tarsal conjunctiva. The level of ECP was measured by CAP system (Kabi-Pharmacia, Sweden), sVCAM-1 was measured by ELISA (R&D, USA). Serum IgE and eosinophil count were in creased in 10 patients, allergic skin prick test were positive in 11 subjects (D.p: 9, D.f: 8), eosinophilia in conjunctival epithelium were present in 11 subjects (4 patients: > 3/HPF, 7 patients: 1-3/HPF). ECP in tears were increased in patients significantly (12.0+8.0 vs 3.9+3.8 ng/ml, p=0.01), but not in serum (52.5+43.1 vs 28.3+25.9 ng/ml). There is no significant correlation between eosinophil count and ECP in serum and tears (p>0.05, r-=0.19). Serum sVCA-M-1 level is significant different between patients and controls (1916.5+756.0 vs 1147.2+146.1 micro gram/ml, p=0.01), sVCAM-1 is significantly correlated to eosinophil count (p=0.01, r=0.56) and ECP (p<0.05, r=0.65). In conclusion, eosinophil and ECP in tears may be very important role in allergic conjunctivitis and are useful indicators of the disease. The elevation of sVCAM-1 in serum may be interpreted simply as marker of the presence of non-specific inflammation.
Cell Adhesion* ; Child* ; Conjunctiva ; Conjunctivitis, Allergic* ; Endothelium ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils* ; Epithelium ; Eye Diseases ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inflammation ; Leukocytes ; Skin ; Tears* ; Vascular Cell Adhesion Molecule-1

No abstract available.
Brain* ; Schizophrenia ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. MATERIALS AND METHODS: Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring, SPGR MRI, and SPECT subtraction with MRI co-registration. RESULTS: The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH (60.0%) and three bilateral hemispheric CH (12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1%). The basal ganglia hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). CONCLUSION: The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH.
Basal Ganglia* ; Cerebellum* ; Epilepsy, Temporal Lobe* ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Perfusion ; Seizures ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: HBsAg carriers are 6-12% of population in Korea. The patients knowledge on hepatitis B and regular follow-up tests are important, because HBsAg carriers have infectivity and the disease may progress without symptoms. We surveyed their knowledge on the hepatitis B and the frequency of follow-up blood test and sonogram. METHODS: From March 1993 through September 1994, 630 patients who were diagnosed as HBsAg positive and Anti-HBs negative in a health promotion center of college hospital were surveyed by mailing questionnaire. The questionnaire included the result of HBV viral marker test, transmission routes, complications, and prevention methods of Hepatitis B, frequency of follow-up test, and doctors recommendation. RESULTS: Of the 490 questionnaires excluded the 140 questionaires returned due to wrong address, 100 were answered, making the reply rate 20.4%. As for the result of HBV marker test, 64% answered their HBV marker as HBsAg positve, 10% answered HBsAg negative, and 26% answered I dont know. 65% answered that they are HBV carrier. As for the mode of transmission, 59% answered that HBV is transmitted by blood, 57% from carrier mother at birth, 29 % by sexual intercourse. 76% of responders know that vaccination is needed for preventing vertical transmission. When making score on their knowledge, significant differences were showed according to education, income and doctors recommendation about regular follow-up test. The number of persons who took regular blood test every 6 to 12 months were 56(56%), and the number of persons who took regular abdominal ultrasonogram were 39(39%). The number of patients who were recommended regular follow-up by doctor was 76%. In this group, 51 persons(67.0%) took regular blood test and 35 persons(35%) took regular sonogram so this frequency is significantly higher than the other group(each 20.8%, 16.7%). CONCLUSIONS: The knowledge on hepatitis B in HBsAg positive patients is relatively low and the frequency of regular follow-up test is significantly higher in the group who took doctors recommendation. So it is very important that HBsAg carriers must be educated about the infectivity, preventive methods, and regular follow-up for early detection of complication like hepatocellular cancer.
Biomarkers ; Coitus ; Education ; Follow-Up Studies* ; Health Promotion ; Hematologic Tests ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Liver Neoplasms ; Mothers ; Parturition ; Postal Service ; Ultrasonography ; Vaccination ; Surveys and Questionnaires

BACKGROUND: We assessed the effectiveness of arthroscopic capsular release for the treatment of adhesive capsulitis. Further, we tried to ascertain the clinical benefits, if any, of pancapsular release over selective capsular release, where the two differ by performing or not performing a posterior capsular release, respectively. METHODS: Thirty-five consecutive patients with either primary or secondary adhesive capsulitis who failed conservative treatment for more than 6 months were enrolled in the study. A total of 16 patients allocated in group 1 received a pancapsular release that comprises the release of the rotator interval, anteroinferior capsular, and the posterior capsular release, whereas 19 patients in group 2 received a selective capsular release that comprises only the release of the rotator interval release and anteroinferior capsular release. The clinical outcomes, visual analogue scale (VAS) score, Constant score, and range of motion, were assessed preoperative and postoperatively. RESULTS: In both groups, the preoperative VAS score, Constant score, and ROM showed a significant improvement by the 6-month follow-up. We found that the immediate postoperative internal rotation was significantly higher in group 1 than group 2. Despite significant differences seen between the two groups at the initial postoperative period, there were no significant differences in Constant score, VAS score, and the ROM at all the subsequent follow-ups between the two groups. CONCLUSIONS: Arthroscopic capsular release for the treatment of adhesive capsulitis is very effective. However, pancapsular release did not show any advantage over selective capsular release in terms of overall clinical outcome.
Bursitis* ; Follow-Up Studies ; Humans ; Joint Capsule Release* ; Postoperative Period ; Range of Motion, Articular