BACKGROUND: Various ictal manifestations of temporal lobe epilepsy have possibly the value of both lateralizing and localizing the epileptogenic zone. Some ictal manifestations such as hand automatism, dystonic limb posture, head turning, and speech phenomenon might distinguish patients with good surgical outcomes from patients with poor out-comes. METHODS: To determine ictal behavioral differences in patients from these groups, we analyzed 207 seizures from 75 patients (group A) who were seizure free after surgery and 172 seizures from 60 patients (group B) who experienced seizures after surgery. All patients had received an anterior temporal lobectomy with amigdalohippocampectomy, and were followed up for at least 1 year. RESULTS: The lateralizing value of ictal semiology was evaluated in group A. Head turning (HT) was shown in 42% of seizures and had a lateralizing significance. Forced HT indicated a contralateral epileptogenic region. Non-forced HT suggested an ipsilateral epileptogenic region. Unilateral dystonic limb posture with or without automatism of the other side occurred in 53% of seizures and had a lateralizing significance, localizing the seizure onset to the contralateral hemisphere. Abnormal speech and vocalization did not have any lateralizing significance. Contralateral dystonic limb posture without ipsilateral automatism was significantly more frequent in group B (p=0.003) as abnormal speech was more frequent in group A (p=0.001). Non-versive head turning had a higher tendency to occur in group A (p=0.0051). There were no statistically significant differences between the two groups in incidences of versive head turning, unilateral hand automatism without dystonic limb posture, vocalization, and normal speech. CONCLUSIONS: Some ictal manifestations might be helpful in predicting the surgical outcome of temporal lobe epilepsy(TLE) patients. The presence of unidentifiable ictal speech could reflect good surgical outcome in TLE patients. When presurgical video analysis reveal an ictal semiology of contralateral dystonic arm posture without ipsilateral hand automatism, careful presurgical evaluation of the epileptogenic region should be contemplated.
Anterior Temporal Lobectomy ; Arm ; Automatism ; Epilepsy, Temporal Lobe* ; Extremities ; Hand ; Head ; Humans ; Incidence ; Posture ; Seizures ; Temporal Lobe*

A case of huge endometrioma at right ovary in 31-year old woman treated with pelviscopic surgery is presented with a brief review of literature. This tumor was measured 15 X 15 X 16 cm and its content amount was about 1800 cc. The pathologic diagnosis was endometrioma of right ovary.
Adult ; Diagnosis ; Endometriosis* ; Female ; Humans ; Ovary

A clinical study was done on 29 cases of spontaneous pontine hemorrhage which were confirmed by brain CT scan at Keimyung university Dongsan hospital from Jan. 1981 to Feb. 1986. The results are summarized as follows. 1. The incidence of pontine hemorrhage was 7.4% of all spontaneous intracranial parenchymal hemorrhage. 2. The most prevalent age group were 40th and 50th decades and male to female ratio was 2.2:1. 3. The most common precipitating factor was hypertension and most of pontine hemorrhage occurred during daily routine or increased activities. 4. Symptoms on onset were headache, altered consciousness, vomiting, dizziness, motor weakness, dysarthria, sensory disturbance and generalized convulsion, in order of frequency. 5. Cardinal neurologic signs on admission were loss of consciousness, ocular signs e.g. Pinpoint or miotic pupil absent horizontal doll's eye movement ocular bobbing skew deviation MLF syndrome, motor weakness e.g. quadriparesis hemiparesis decerebrate rigidity, positive Babinski sign. 6. Mean size of hematoma on CT was 6.8cc and 44% was under 5cc. Hematoma of 4th ventricle was seen in 36% of pontine hemorrhage. 7. 25 cases of pontine hemorrhage were divided into 3 groups according to the location of hematoma on CT-basilar (2 cases), tegmental (15 cases), diffuse (8 cases). 8. All 29 cases of pontine hemorrhage were treated medically, 21% were improved, and 79% hopeless discharge or death. 9. Mild disturbance of consciousness on admission, small size (under 5cc) of hematoma and absence of hematoma in the 4th ventricle seem to be good prognostic indicators.
Brain ; Consciousness ; Decerebrate State ; Dizziness ; Dysarthria ; Eye Movements ; Female ; Headache ; Hematoma ; Hemorrhage* ; Humans ; Hypertension ; Incidence ; Male ; Neurologic Manifestations ; Ocular Motility Disorders ; Paresis ; Precipitating Factors ; Pupil ; Quadriplegia ; Reflex, Babinski ; Seizures ; Tomography, X-Ray Computed ; Unconsciousness ; Vomiting

The authors presented a family whose 4 siblings had been suffered from oculopharyngeal muscular dystrophy of autoscmal recessive trend, with symptoms of progressive ptosis, external ophthalmoplegia, dysarthria, dysphagia and facial muscle atrophy, and we performed HLA study on these 9 family members which showed no interrelationship between oculopharyngeal muscular dystrophy and HLA Haplotypes.
Atrophy ; Deglutition Disorders ; Dysarthria ; Facial Muscles ; Haplotypes ; Histocompatibility Testing* ; Humans ; Muscular Dystrophy, Oculopharyngeal* ; Ophthalmoplegia ; Siblings

Jeong Jongmyung (1896-?) was born in Seoul and could have 4 years of formal education in a missionary girls' school. She learned Chinese writing, English, Korean, Japanese, History, Geography, and Science there, which was very rare and high education for Korean girls. But she had to quit it for poverty, and married when she was 17. Her marriage was unhappy and her husband died after 3 years. Jeong entered Severance Hospital Training School for Nurses in 1917 to have economic independence. During her training for 3 years, she studied western science and medicine and learned how to cooperate with other working girls. In 1919, Korean launched Samil Independence Movement. Jeong helped other independence activists as a nursing student and her mother had to be in prison for 3 years. After graduation, she entered the Midwifery School of General Hospital of Government General of Korea to have better position than nurse. As soon as she got midwifery license, she opened her own clinic which gave her social respect income, because there were only 25 Korean midwives in Korea. In 1922 Jeong established and became the leader of the Support Group for Working Girl Students. She continuously established and leaded social movement organizations, in 1924, the Korean Association of Nurses and the Women Comrades Society, in 1926 Jeongwoohoe, in 1927 Geunwoohoe and Shinganghoi. From 1923 Jeong got more fame by public speeches. The main contents of them were the women's problem in Korea. As the first Korean woman communist, she analyzed the Korean society and women's problem as a communist and insisted that the women's liberation movement should be gained in class struggle in cooperation with the proletariat. She was very active and aggressive in public lecture, and in everyday lives, Jeong was so warm hearted and eager to help other activists with her energy and income, so others called her their "sister, housemaid, lover, and mother". The Japanese rulers oppressed her by stopping or forbidding her lectures. In 1931 Jeong was prosecuted for the trial of reconstruction of communist party in Korea. She was sentenced to be guilty and had to be in prison until 1935. Even in prison, she helped other prisoners in labor and continued her job as a midwife after discharge. Jeong could not be active as before because of the worse ruling policy than before, but after the liberation in 1945 she went to North Korea and participated in the women's movement.
Asian Continental Ancestry Group ; Democratic People's Republic of Korea ; Female ; Geography ; Heart ; Hospitals, General ; Humans ; Korea ; Lectures ; Licensure ; Marriage ; Midwifery ; Missions and Missionaries ; Mothers ; Oxytetracycline ; Poverty ; Prisoners ; Prisons ; Self-Help Groups ; Spouses ; Students, Nursing ; Women's Rights ; Writing

OBJECTIVE: To evaluate the efficacy of low dose gonadotropin releasing hormone agonist(GnRH-a) therapy combined with high dose human menopausal gonadotrpin(hMG) following estrogen & progesteron therapy for poor responders. METHODS: From May 1997 to Feb 1999, 36 patients who were defined as poor responders on previous consecutive two and more superovulation cycles were randomly allocated to lowdose GnRH-a short protocol with high dose hMG protocol pretreated with estrogen & progesterone(E/P therapy)(n=16)(study group) and the clomiphene citrate with hMG(n=20)(control group). All patients were planned to undergone in-vitro- fertilization(IVF) and embryo transfer(ET) after controlled ovarian hyperstimulation(COH). RESULTS: Two groups were similar with respect to clinical features and basal FSH and E2 levels. The mean level of E2 on day 5, 304.3+/-148.ng/ml in study group was significantly higher than that in control group, 182+/-34.9ng/ml. The mean levels of E2 on hCG day was also significantly higher in study group than control group(1324+/-320ng/ml, vs 414+/-168ng/ml). The mean day of hCG day in study group, 12.3+/-0.3 was shorter than that in control group, 13.8+/-0.4. The concellation rates of cycles were significantly lower in study group than control group(13.2% vs 84.2%). But clinical pregnancy rates did not showed the significant difference between two groups. CONCLUSION: The study suggested that a lowdose GnRH-a short protocol with high dose hMG pretreated with estrogen & progesterone can improve the ovarian response in poor responder group.
Clomiphene ; Embryonic Structures ; Estrogens ; Gonadotropin-Releasing Hormone* ; Humans ; Pregnancy Rate ; Progesterone ; Superovulation

In order to obsetve the effect of stroke on hypothalamic-pituitary axis, TRH stimulabon test and dexamethasone suppression test(DST) were performed in 52 patients with stroke(cerebral infarction, 16 cases; intracerebral hemorrhage, 15 cases: subarachnoid hemorrhage, 21 cases) and 15 age-sex matched patients control without intracrania disease at Keimyung University Dongsan Hospital from April 1987 to August 1988. The results summarized as follows. 1. The frequency of blunted response on TRH stimulation test is significantly higher in total stroke and patients with cerebral infarction than in control(P<0.06, P<0.05). 2. The frequency of DST non-suppression in patients with cerebral infarction is significantly higher than in control, patients with cerebral hemorrhage and patients with subarachnoid hemorrhage(P<0.001, P<0.01, P<0.01). 3. Patients with left hemispheric stroke tend to show more frequent abnormal neuroendocrine test results than patient with right hemispheric stroke. 4. There are no correlation between abnormal neuroendocrine test results and age, sex, size of stroke and Barthel ADL scale. These results suggest stroke can influence on hypothalamic-pituitary axis, more marked in cerebral infarction and left hemispheric lesion.
Activities of Daily Living ; Axis, Cervical Vertebra ; Cerebral Hemorrhage ; Cerebral Infarction ; Dexamethasone ; Humans ; Infarction ; Stroke* ; Subarachnoid Hemorrhage

Temporal lobe epilepsy is characterized by complex partial seizures with either primary intracranial neoplasms or other non-neoplastic lesions. We reviewed 64 cases of surgically resected temporal lobes and amygdalo-hippocampal regions for temporal lobe epilepsy ansed by non-neoplastic lesions to elucidate the incidence and histologic features of each histologic group for a period of 2 years. The patient's age ranged from 12 to 49 years and the ratio of male to female was 42:22. There were 37 cases(57.8%) with single pathology and an additional 20 cases(31.3%) with dual pathology. The emaining 7 cases(10.9%) had no structural alternations. The most common temporal lobe pathology was hippocampal sclerosis in 41 cases(64.1%), diagnosed alone in 21 cases and as dual lesions in 20 cases. The hippocampal neuron loss was most pro,omemt in CA1, followed by CA4, CA3, and CA2. Amygdaloid sclerosis was present in 28 cases(43.8%), lases had 13 dual lesions, 25 cases also had hippocampal sclerosis. The 20 dual lesions showed that 6 cortical dysplasia, 10 microdysgenesis, 1 chronic non-specific inflammatory lesion, and 3 cysticercosis were associated with the various degree of mesial temporal sclerosis. Neuronoglial malformative lesions were identified in 21 cases(32.8%) including 16 dual lesion cases, which composed of 15 microdysgenesis and 6 cortical dysplasia. Neurofilament immunostain for cortical dysplasia revealed abnormally beaded disarray of axons in dysplastic pyramidal cells. The remaining pathologic lesions observed were 1 cysticercosis, 1 chronic non-specific inflammatory lesion, 3 arteriovenous malformation, 2 fibrous nodule, and 1 fibrous adhesions of the arachnoid.
Female ; Male ; Humans ; Incidence

Underlying caustive diseases were observed on 108 patients with dementia diagnosed on DSM-III, who were admitted to Keimyung university Dongsan hospital during January 1985 to September 1988. The results were summarized as follows. 1. Male to female ratio was approximately 5 to 1. In all diseases causing dementia, male outnumbered female. In particular, alcoholic dementia, multi-infarct dementia, posttraumatic dementia, infection, hydrocephalus and subdural hematoma were almost limited to males. 2. The important causative diseases were alcoholic dementia (21.3%), multi-infarct dementia(18.5%), postanoxic encephalopathy (14.8%), dementia of Alzheimer type (12.1%), head trauma(8.3%), brain tumor (6.5%), pseudodementia(6.5%), infection(4.6%), hydrocephalus (4.6%), and subdural hematoma(2.8%) in the order of frequency. 3. Cerebral trauma was the most common cause of dementia in young adulthod, and alcoholic dementia, multiinfarct dementia and dementia of Alzheimer type were important in middle adulthood. In old age, multiinfarct dementia was noted to be the most common cause. 4. Thorough diagnostic evaluation has uncovered reversible disorders in 19.4% of the total patients and disorders which, though not reversible, nevertheless require active therapeutic intervention in an additional 60.2%.
Alcoholics ; Brain Neoplasms ; Dementia* ; Dementia, Multi-Infarct ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Head ; Hematoma, Subdural ; Humans ; Hydrocephalus ; Male

Clinical studies were made on 37 cases with thalamic hemorrhage diagnosed by computed tomographic scan and only localized on the thalamic area, were admitted to the Keimyung University Dongsan hospital from January 1981, to December 1985. The age and sex distribution, symptoms and neurologic signs on admission, relationship between the hospital course and many factors affecting the prognosis such as age, side of lesion, level of consciousness, volume of the hematoma, degree of hydrocephalus and ventricular hemorrhage were analysed. The results were summarized as follows; 1. The most prevalent age group was above 51 years of age with 41-50 years, 21-30 years and 31-40 years of age in the order of frequency. Male to female ratio was 15:22. 2. The clinical symptoms on admission in the order of frequency were the impairment of consciousness, headache, nausea and vomiting, speech disturbance and hemiparesis, dizziness and voiding difficulties. The neurologic signs on admission showed hemiparesis, hyperreflexia, and positive Babinski sign, impaired consciousness, hemisensory deficit, central facial nerve palsies, dysarthria, sluggish and unreactive light reflex, small pupil and absent gag reflex, impaired vertical gaze, papilledema, aphasia and abducens nerve palsies in that order. 3. The hospital course had no significant relationship with the age of the patients and the side of hematoma but there was a significant relationship between the alert-drowsy group and the stuporcoma group (P<0.01). 4. The hospital course had no significant relationship with the degree of volume of hematoma and hydrocephalus. The hospital course had a significant relationship with ventricular hemorrhage (P<0.05) but the hospital course of the improved group had no significant tendency to the rate of improvement.
Abducens Nerve Diseases ; Aphasia ; Consciousness ; Dizziness ; Dysarthria ; Facial Nerve ; Female ; Headache ; Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Male ; Miosis ; Nausea ; Neurologic Manifestations ; Papilledema ; Paralysis ; Paresis ; Prognosis* ; Reflex ; Reflex, Abnormal ; Reflex, Babinski ; Sex Distribution ; Vomiting