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 objective of the present study was to identify the characteristics of phospholipase C (PLC) isozymes purified from bovine brain and to investigate their interrelationship with G protein. The purified PLC isozymes β, γ and δ were obtained and the characteristics of PLC activity on various concentrations of free Ca²⁺ were observed. The activity of PLC was increased with increasing Ca²⁺ concentration and the activity PLC δ was increased higher in the presence of phosphatidyl choline (PC) than in the absence of PC. For vesicle formation as the structure of cell membrane, cholic acid and deoxycholic acid as detergent on phosphatidylinositol bisphosphate (PIP₂) substrate containing PC were used, and then the activity of PLC isozymes were increased with increasing concentration of cholate, from 0.2% to 1% and were increased slightly in deoxycholate. In the PIP₂ containing phospholipid and glycolipid as brain extract, the activity of PLC isozymes were checked in 0.2-1% cholic acid. The activities of PLC isozymes were continuously increased up to 1% cholic acid. The quantitation of PLC isozymes from several bovine organs by radioimmunoassay was made. Brain was the most sufficient organ in terms of amount of PLC β and δ. A large amount of PLC δ was existed in adrenal gland. The binding capacity of GTPrS and G protein was observed and other observations of the binding effect of GTPrS-G protein and PLC monoclonal Ab-Protein A from tissue homogenate with PLC were made. From the observation the binding capacity was revealed the range of 0.11-1.49%. The effects of each type of G protein on the percent activity of purified PLC isozymes were observed. From the observation, activities of isozymes were increased in Goa & Gmix, and the activities of PLC β and δ were increased in Gβγ and Gia. Activities of PLC β and γ were decreased in Gta but PLC δ increased.
Adrenal Glands ; Brain* ; Cell Membrane ; Cholates ; Cholic Acid ; Choline ; Deoxycholic Acid ; Detergents ; GTP-Binding Proteins* ; Isoenzymes ; Phosphatidylinositols ; Phospholipases* ; Radioimmunoassay ; Type C Phospholipases*

No abstract available.
Gastrectomy*

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

We report the results of field operation of TELEACE system between Kyung-Pook National University Hospital and Ul-Jin Goon Health Care Medical Center from December, 1990 to September, 1991, which had been operated as a kind of Integrated Services Digital Nework projects by KOREA TELECOMMUNICATION Inc. Ul-Jin Goon Health Care Medical Center transmitted 414 plain radiographs to our hospital in speed of 9600BPS. Each image was composed of 1024X1024 pixelsX8 bits/pixel. In our hospital, the image files were displayed on high resolution monitor (1280×1024 pixets). Text files of image interpretations were transmitted to the health care medical center. The two radiologists who had interpreted the transmitted images, went to the health care medical center and read radiographic film with blind test method. We obtained the following results: false negative rate of 6.3%, false postitve rate of 2.4%, mean sensitivity of 81.4%, mean specificity of 96.3%, and mean accuracy of 91.3%. In predictive value of 0.05, there was no significant difference between results of these two types of radiographs. In conclusion, TELEACE system was valuable to the clinicians isolated from services of radiologists.
Delivery of Health Care ; Korea ; Methods ; Sensitivity and Specificity ; Telecommunications ; X-Ray Film

We have experienced 43 cases of the hypertensive intracerebral hemorrhage who were admitted to the Catholic medical Center, Seoul from November 1969 to February 1973. All these cases were diagnosed by clinical findings and cerebral angiography and assessed the prognostic factors on the result of treatment. The results of the analysis were summarized as follows: 1. Age distribution was ranged from 26 to 67, and 79 per cent of them were in fourth and fifth decade. The ratio of male to female was about 3 to 1. 2. The most frequent site of the hypertensive intracerebral hemorrhage was in the basal ganglia in 76.7 per cent, 27.2 percent of them in the thalamic hemorrhage and 39.5 per cent in the external capsular hemorrhage. The remainder were 9.3 per cent in the subcortical hemorrhage, 11.6 per cent in the pontine hemorrhage and 2.4 per cent in the cerebellar hemorrhage. 3. In the past history, hypertension was noted in 88.3 per cent of them. Simple chest X-ray showed cardiomegaly in 58.1 per cent and left ventricular hypertrophy was found in 41.1 per cent on E.C.G. findings. 4. All of 43 cases had unconscious state with various level at the onset of illness. For 43 cases, 46.5 per cent was in transient impairment of consciousness or drowsy state and 53.6 per cent in stuporous or comatous state. Headache was experienced in 81.3 per cent and 58.1 per cent of them was associated with vomiting. 5. During hospital course improvement of conscious level to alert state was found in 25.6 per cent and drowsy state in 18.6 per cent of all cases. On the aspect of the site of hemorrhage, 81.3 % of the thalamic hemorrhage and all pontine hemmorhage cases had shown stuporous or comatous conscious level. On the other hand, 70.6 per cent of the external capsular hemorrhage and all of the subcortical hemorrhage was found in alert or drowsy state. 6. On the neurological findings, anisocoria was noted in 18.8 per cent, miotic pupil in 20.7 per cent of all cases and pin-point pupils in pontine hemorrhage exclusively. Normal extraocular movement was noted in 60.4 per cent, conjugate deviation in 9.7 per cent of all cases. Inward and downward deviation of the eye-ball was found in 50 per cent of the thalamic hemorrhage. Dissociated eye-ball movement and occular bobbing were noted in the pontine hemorrhage. Motor impairment developed in all cases except one of the subcortical hemorrhage. Hemiplegia or hemiparesis was noted in 86.1 per cent of all cases and quadriplegia in 60 per cent of the pontine hemorrhage. Speech disturbance was noted in 27.9 per cent of all cases. 7. In the hypertensive intracerebral hemorrhage 24 cases were treated surgically and 19 cases were managed conservatively. Mortality and disability rate increased steadily with deepening of level of consciousness. The result of surgical treatment was better in alert and drowsy patients. 8. In addition to conscious level, the site of intracerebral hemorrhage did strongly influence to surgical outcome. Surgical treatment of 9 cases of thalamic hemorrhage resulted 8 death and one with severe disability. On the other hand, of 17 patients of the external capsular hemorrhage 12 were treated surgically and 8 cases showed improvement. 5 patients of pontine hemorrhage was managed conservatively but resulted fatal outcome in 2 cases. 9. There is a conflict of opinion as to the optimal time to operate the hypertensive intracerebral hemorrhage. Early surgery after ictus probably increase the mortality rate. Of 10 cases who were treated with surgical intervention within 48 hours following ictus, seven cases were succumbed. On the contrary, 0f 12 cases who had received operative treatment after 72 hours following ictus, 9 showed improvement and 3 death. 10. The amount of the hematoma seem to somewhat influence to surgical result.
Age Distribution ; Anisocoria ; Basal Ganglia ; Cardiomegaly ; Cerebral Angiography ; Cerebral Hemorrhage ; Consciousness ; Fatal Outcome ; Female ; Hand ; Headache ; Hematoma ; Hemiplegia ; Hemorrhage ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Intracranial Hemorrhage, Hypertensive* ; Male ; Mortality ; Paresis ; Pupil ; Quadriplegia ; Seoul ; Stupor ; Thorax ; Unconsciousness ; Vomiting

We have experienced 20 cases of the cerebral rete mirabile from 1969 to 1975. All were proved by bilateral carotid angiography, and clinical assessment and angiographical analysis were attempted. The results were summarized as follows: 1. Age distribution was ranged from 5 to 55. The majority of 20 cases were age over 20 as 15 cases who were distributed evenly in each decade and 5 cases were age below 20. 12 cases were male and 8 female. 2. Authors classified the cases as the group of subarachnoid hemorrhage and non-subarachnoid hemorrhage conveniently. All cases of age below 20 comprised in the group of non-subarachnoid hemorrhage while majority of subarachnoid hemorrhage group were age over 20. 3. There were no contributory factors to cerebral rete mirabile with regard to past history and family background. 4. There were considerable differences in the symptoms and signs between the groups of subarachnoid hemorrhage and non-subarachnoid hemorrhage. Clinical manifestations were mainly headache and impairment of consciousness with meningeal sign in the group of subarachnoid hemorrhage. On the other hand, motor disturbance such as hemiparesis or monoparesis was occurred in the majority of non-subarachnoid hemorrhage and the minority showed speech impairment, seizure and choreiform movement. 5. All cases showed the characteristic angiographic findings of cerebral rete mirabile, which are occlusion or stenosis at the supraclinoid portion of internal carotid artery with abnormal fine vascular network around the base of brain and poor or non-visualizing anterior cerebral and middle cerebral arteries. The interesting picture was rete formation of ophthalmic artery in the orbit of 2 cases. There were no abnormal angiographic findings on the vertebral angiogram except retrograde filling to anterior cerebral and middle cerebral arteries through collateral channel from the posterior cerebral artery. 6. The prognosis of the cerebral rete mirabile seem to be favorable with regard to mortality. There were no death in our 20 cases during the period of observation.
Age Distribution ; Angiography ; Brain ; Carotid Artery, Internal ; Chorea ; Consciousness ; Constriction, Pathologic ; Female ; Hand ; Headache ; Hemorrhage ; Humans ; Male ; Middle Cerebral Artery ; Mortality ; Ophthalmic Artery ; Orbit ; Paresis ; Posterior Cerebral Artery ; Prognosis ; Seizures ; Subarachnoid Hemorrhage

Japanese neurosurgeons have recently reported number of disorder having typical angiographic findings, which showed abnormal cerebrovascular network at the base of the brain related with the occlusion of the internal carotid arteries in Japanese race. Since the authors have observed five cases of the similar vascular abnormalities in Korea by cerebral angiography from 1969 to 1971, the clinical findings and angiographic features of these cases were presented. The results were summarized as follows; 1. Of the 5 patients, 4 cases were over 20 years of age and one 5-year-old child. 4 cases were male and one female. 2. There were considerable differences in the initial symptoms of these patients. Authors classified these as the group of subarachnoidal hemorrhage and non-subarachnoidal hemorrhage. The former was 3 cases and later 2. The most frequent clinical manifestations in the hemorrhagic group was headache, impairment of consciousness and sings of meningeal irritation, while hemiparesis and speech disturbance was mainly seen in the nonhemorrhagic group. Similar clinical pictures were reported in Japanese cases. 3. Characteristic cerebral angiographic findings of these cases were; 1) Narrowing of the cervical portion of both internal carotid arteries. 2) Occlusion or stenosis of bilateral internal carotid arteries at the supraclinoid portion. 3) Abnormal vascular network at the base of the brain around the occlusive area. 4) Anterior and middle cerebral arteries were no visualized in all cases and superficial temporal arteries or ophthaemic artery was prominent in a few cases. The etiological possibility of these disorder, radiological features and symptomatology were discussed.
Arteries ; Asian Continental Ancestry Group ; Brain* ; Carotid Artery, Internal* ; Cerebral Angiography ; Child ; Child, Preschool ; Consciousness ; Constriction, Pathologic ; Continental Population Groups ; Female ; Headache ; Hemorrhage ; Humans ; Korea ; Male ; Middle Cerebral Artery ; Paresis ; Temporal Arteries

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

BACKGROUND: Pleural effusion is a common clinical problem and many clinical and laboratory evaluations, such as tumor marks, have been studied to discriminate malignant pleural fluid from benign pleural fluid. However their usefulness in the diagnosis of pleural effusion is still not established fully. We studied the diagnostic value of cyfra 21-1 in diagnosis of malignant pleural effusion. METHODS: Pleural fluid was obtained from 45 patients with malignant diseases(32 lung cancer patients, 13 metastatic malignant diseases) and 47 patients with benign diseases. The level of cyfra 21-1 in the pleural fluid and serum were determined using a CYFRA 21-1 enzyme immunoassay kit(Cis-Bio International Co.). The t-test was used for comparison between two diseases groups and receiver operating characteristic(ROC) curves were constructed by calculating the sensitivities and specificities of the cyfra 21-1 at several points to determine the diagnostic accuracy of the cyfra 21-1. RESULTS: In patients with primary lung cancer, the level of cyfra 21-1 in the pleural fluid was significantly higher than those of patients with benign diseases and had positive correlations between the level of cyfra 21-1 in the pleural fluid and serum levels. In the ROC curve analysis of the pleural fluid, the curve for primary lung cancer group was located closer to the left upper corner and the cut off value, sensitivity and specificity of the cyfra 21-1 of the primary lung cancer group was determined as 22.25ng/ml, 81.8% and 78.7% respectively. CONCLUSIONS: Our data indicates that the measurement of cyfra 21-1 level in pleural effusion has useful diagnostic value to discriminate malignant pleural effusion in primary lung cancer from benign pleural effusion.
Diagnosis ; Diagnosis, Differential* ; Humans ; Immunoenzyme Techniques ; Lung Neoplasms ; Pleural Effusion* ; Pleural Effusion, Malignant ; ROC Curve