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

Primary malignant melaomatosis of leptomeninges is uncommon, not reported in the Korea to this time. Primary melanomatosis of leptomeninges are not associated with any specific clinical or radiological symptoms. The diagnosis was made by ultrastructural demonstration of malignant melanoma cells from CSF. The patient is 23 years male, who has had meningeal irritating symptoms such as intermittent headache. Nausea, vomiting and disturbed consciousness. Brain CT and MRI showed no mass lesion but cytology of cerebrospinal fluid revealed malignant melanoma cells. There was no evidence of extracerebral melanoma.
Brain ; Cerebrospinal Fluid ; Consciousness ; Diagnosis ; Headache ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Melanoma ; Nausea ; Vomiting

We have investigated endocrine functions of 2 patients with Wilson's disease who showed oligomenorrhea or amenorrhea, The serum basal levels of hypothalamic, pituitary, thyroid, adrenal cortical and ovarian hormones were determined. Then stimulation tests were performed with GnRH(50 microgram/m2), TRH(7 microgram/Kg) and insulin(0.l U/Kg) in one intravenous bolus, Levels of LH, FSH, prolactin, GH, TSH, total testosterone, l7 beta-estradiol, free T3, T4, DHEA-S and cortisol were measured by standard radioimmunoassays. The endocrine profiles which represent functions of hypothalamus, pituitary, thyroid and adrenal cortex was all proved to be normal. Serum estradiol and total testosterone levels were 59.0 microgram/ml ( normal ; 60-130 microgram/ml) and 2.9 ng / dl (normal ; 0.l5-1.1 ng/dl) in one case, and 20.5 microgram / ml and 0.69 ng / dl in the other respectiviely. Low estradial and high total testosterone levels seen in these cases suggested ovarian dysfuncton. Interference of ovarian follicular aromatase activity due to passible copper intoxication could explain these findings as the cause of the menstrual irregularity of patients with Wilson's disease.
Adrenal Cortex ; Amenorrhea ; Aromatase ; Copper ; Estradiol ; Female ; Hepatolenticular Degeneration* ; Humans ; Hydrocortisone ; Hypothalamus ; Oligomenorrhea ; Prolactin ; Radioimmunoassay ; Testosterone ; Thyroid Gland

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

C-erbB-2, one of epidermal growth factor receptor gene family, may have an important role in progression of transitional cell carcinoma (TCC of the urinary bladder. We herein immunohistochemically examined 52 bladder TCC specimens for expression of c-erbB-2 gene product to investigate its prognostic value. Interrelationship between expression of c-erbB-2 and stage, grade, expression of proliferating cell nuclear antigen (PCNA), and clinical outcomes were analyzed. Overexpression of c-erbB-2 was significantly higher in invasive tumors as compared with superficial tumors and in high grade tumors as compared with low grade tumors (p<0.005). However, there were no significant correlations between the degree of expression of c-erbB-2 and progression-free survival in patients with superficial bladder TCC as well as actual-survival in patients with invasive bladder TCC. There also was no significant correlation between the expression of c-erbB-2 and PCNA. These results suggest that c-trbB-2 may be an important marker of malignant potentials and invasiveness of bladder TCC, but immunohistochemical study for its expression in bladder TCC may not provide additional prognostic information to stage and grade of the tumors.
Carcinoma, Transitional Cell ; Disease-Free Survival ; Genes, erbB-2 ; Humans ; Proliferating Cell Nuclear Antigen ; Receptor, Epidermal Growth Factor ; Urinary Bladder Neoplasms* ; Urinary Bladder*

BACKGROUND: Hyperhomocysteinemia is considered as a risk factor for coronary artery disease (CAD). In this study, we investigated the relationship between plasma homocysteine concentration and coronary artery disease. METHODS: We measured plasma homocysteine concentration by fluorescent polarization immunoas-say (IMx, Abbott) in 58 healthy controls (39-72 years) and in 37 patients (42-84 years) who were diagnosed with stable angina (11), unstable angina (14), acute myocardial infarction (8), old myocardial infarction (1) and silent myocardial ischemia (3). RESULTS: The risk of CAD was independently associated with old age, decreased HDL cholesterol and hyperhomocysteinemia (P >or=12.8 nmol/L) and adjusted odds ratios were 2.8, 3.4, and 6.0, respec-tively. The risk for CAD in the upper two homocysteine quartiles (P >or=10.8 nmol/L and 8.1- 10.7 nmol/L) was 11.1 (95% CI, 2.5- 49.4) times and 6.3 (95% CI, 1.4- 27.7) times higher than in the lowest quar-tile (<6.9 nmol/L) (P=0.002 and 0.014, respectively). The mean plasma homocysteine values (M +/- SD) were higher in CAD patients (11.8 +/- 7.4 nmol/L) than in the control group (8.0 +/- 2.4 mol/L) (P=0.0006). In the control group, the mean plasma homocysteine concentration in men was signifi-cantly igher than in women (9.1 vs. 7.2 mol/L, P=0.002). Age and logarithmically transformed plasma homocysteine levels exhibited significant positive correlation in controls (r=0.43, P=0.001), ut no significant correlation in CAD patients (r=-0.024, P=0.9). Plasma homocysteine levels were significantly higher in the elderly, male subjects and smokers in the univariate analysis. CONCLUSIONS: Hyperhomocysteinemia is one of the independent risk factors for CAD.
Aged ; Angina, Stable ; Angina, Unstable ; Cholesterol, HDL ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Male ; Myocardial Infarction ; Myocardial Ischemia ; Odds Ratio ; Plasma ; Risk Factors*

Maternal weight gain during pregnancy has been consistently associated with infant birth weight and pregnancy outcome. Our purpose was to determined the relationship between maternal weight gain pattern and birth weight. Consequently, maternal weight gain is monitored carefully and is encouraged during prenatal care in order to improve pregnancy outcome. Our study group included both 424 uncomplicated women and infant delivered at the Yeungnam University Hospital between 1993-1996. All recorded prenatal weight gain measurements were used to estimate maternal trimester weight gain, pattern of gain (based on low versus not-low gain at each trimester), and total gain at delivery. Multiple linear regression analysis was used to assess the relationship between these weight gain measurements and fetal birth weight. Each kilogram of maternal gain in the first, second, and third trimesters was associatedwith statistically related to the increase in fatal birth weight by 31.3, 19.0, and 24.5g, respectively. When compaired with the pattern of gain that was not low in any trimester, patterns with low gain in the first trimesters were associated with significant decreases in birth weight, but no important change in birth weight was seen for the group whose gains were not low in the first trimester. The results suggest that specific patterns of maternal weight gain, particularly weight gain during the first trimester, are related to fetal birth weight.
Birth Weight* ; Female ; Humans ; Infant ; Linear Models ; Parturition* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Prenatal Care ; Weight Gain*

Typhoid fever is an acute systemic febrile disease caused by Salmonella typhi. The classic picture of the disease consists of prolonged continuous or remitting fever, abdominal pain, diarrhea, rose spots and delirium. Salmonella infection can lead to diffuse organ involvement, including bone, lung, thyroid, kidney, liver, spleen, heart, pericardium, intestine and skin and cause a variety of complications. Pulmonary manifestations occur in only 1 percent of the patients. Mild cough with sticky sputum is the earliest symptom and bronchitis, pneumonia and lung abscess were presented. Recenfly we experienced a case of typhoid fever complicated by bronchitis, dysplasia in a 37-year-old male physician who was improved with ceftriaxone and ciprofloxacin We report this case with a review of the literature.
Abdominal Pain ; Adult ; Bronchitis* ; Ceftriaxone ; Ciprofloxacin ; Cough ; Delirium ; Diarrhea ; Fever ; Heart ; Humans ; Intestines ; Kidney ; Liver ; Lung ; Lung Abscess ; Male ; Pericardium ; Pneumonia ; Salmonella Infections ; Salmonella typhi ; Skin ; Spleen ; Sputum ; Thyroid Gland ; Typhoid Fever*

Typhoid fever is an acute systemic febrile disease caused by Salmonella typhi. The classic picture of the disease consists of prolonged continuous or remitting fever, abdominal pain, diarrhea, rose spots and delirium. Salmonella infection can lead to diffuse organ involvement, including bone, lung, thyroid, kidney, liver, spleen, heart, pericardium, intestine and skin and cause a variety of complications. Pulmonary manifestations occur in only 1 percent of the patients. Mild cough with sticky sputum is the earliest symptom and bronchitis, pneumonia and lung abscess were presented. Recenfly we experienced a case of typhoid fever complicated by bronchitis, dysplasia in a 37-year-old male physician who was improved with ceftriaxone and ciprofloxacin We report this case with a review of the literature.
Abdominal Pain ; Adult ; Bronchitis* ; Ceftriaxone ; Ciprofloxacin ; Cough ; Delirium ; Diarrhea ; Fever ; Heart ; Humans ; Intestines ; Kidney ; Liver ; Lung ; Lung Abscess ; Male ; Pericardium ; Pneumonia ; Salmonella Infections ; Salmonella typhi ; Skin ; Spleen ; Sputum ; Thyroid Gland ; Typhoid Fever*

OBJECTIVE: The aim of the this study was to compare the effects of clonidine (a alpha2-adrenoceptor and imidazoline receptor agonist), yohimbine (a selective alpha2-adrenoceptor antagonist) and idazoxan (a alpha2-adrenoceptor and imidazoline receptor antagonist) on extracellular monoamines and their metabolites by using the awakening animal microdialysis and high-performance liquid chromatography with electrochemical detection (HPLC-ECD) in brain regions, which are suggested to have regulatory role in depression. METHODS: We used intracerebral microdialysis in awakening rats by inserting probe through the dorsal hippocampus and occipital cortex especially in primary visual cortex, We studied respective effects of 2.0 mg/kg of clonidine, 5.0 mg/kg of yohimbine, and 5.0 mg/kg of idazoxan on the release of MHPG (a major metabolite of norepinephrine), norepinephrine (NE), DOPAC (a major metabolite of dopamine), and 5-HIAA (a main metabolite of serotonin) by intraperitoneal administration. RESULTS: Clonidine decreased the release of MHPG, NE, DOPAC, and 5-HIAA in both dorsal hippocampus and occipital cortex regions, and there were no significant differences in releasing pattern of all monoamines and their metabolites. Both yohimbine and idazoxan enhanced the release of MHPG, NE, DOPAC, and 5-HIAA in both brain regions, but there were significant differences in releasing pattern of NE and 5-HIAA. Idazoxan induced the delayed and higher efflux of NE and 5-HIAA in the primary visual cortex than yohimbine, but not in the hippocampus. CONCLUSION: This study shows that the selective alpha2-adrenoceptor antagonists increase basal monoamine output and enhance the metabolism of them in the hippocampus and primary visual cortex, and the imidazoline receptor has modulatory role in the regulation of monoamine release in primary visual cortex than hippocampus. It also suggests that high turnover rate of serotonin and norepinephrine in primary visual cortex may contribute to the pathophysiological role in depression.
3,4-Dihydroxyphenylacetic Acid ; Animals ; Brain ; Chromatography, Liquid ; Clonidine ; Depression ; Hippocampus* ; Hydroxyindoleacetic Acid ; Idazoxan ; Metabolism ; Methoxyhydroxyphenylglycol ; Microdialysis ; Norepinephrine ; Rats* ; Serotonin ; Visual Cortex* ; Yohimbine