• Journal of Audiology & Otology
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• v.23 no.2
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• pp.103-111
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• 2019

Background and Objectives: Dizzy patients with abnormal otolith function tests, despite a normal caloric response, are defined as having specific (isolated) otolith organ dysfunction. This study was performed to compare the differences in clinical presentation between isolated otolith dysfunction (iOD) patients with lab- and Sx-based iOD group and lab-based iOD symptoms. Subjects and Methods: The medical records of 23 iOD patients with normal caloric response but abnormal cervical vestibular evoked myogenic potential (VEMP), ocular VEMP, or subjective visual vertical were reviewed. Non-spinning vertigo was considered as otolith-related symptoms. The patients' age, onset of dizziness, Numeric Rating Scale on the severity of dizziness, and concomitant vestibular disorders were analyzed. Results: Patients in the lab-based iOD group were significantly older than those in the lab- and Sx-based iOD group. Known vestibular disorders were significantly more common in the lab-based iOD group (83.3%) compared to the lab- and Sx-based iOD group (18.2%). Despite the normal caloric response, catch-up saccade was found in the video head impulse test in more than half (54.5%) of the lab-based iOD group patients. There was no catch-up saccade in the lab- and Sx-based iOD group. There were no significant differences in gender ratio, frequency of dizziness attacks, and duration of illness. Conclusions: We propose new definitions of definite iOD (lab- and Sx-based iOD) and probable iOD (lab- or Sx-based iOD). These new definitions may help researchers to identify patients who are more likely to have true iOD, and facilitate comparisons of results between different studies.

• Korean Journal of Audiology
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• v.23 no.2
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• pp.103-111
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• 2019

Background and Objectives: Dizzy patients with abnormal otolith function tests, despite a normal caloric response, are defined as having specific (isolated) otolith organ dysfunction. This study was performed to compare the differences in clinical presentation between isolated otolith dysfunction (iOD) patients with lab- and Sx-based iOD group and lab-based iOD symptoms. Subjects and Methods: The medical records of 23 iOD patients with normal caloric response but abnormal cervical vestibular evoked myogenic potential (VEMP), ocular VEMP, or subjective visual vertical were reviewed. Non-spinning vertigo was considered as otolith-related symptoms. The patients' age, onset of dizziness, Numeric Rating Scale on the severity of dizziness, and concomitant vestibular disorders were analyzed. Results: Patients in the lab-based iOD group were significantly older than those in the lab- and Sx-based iOD group. Known vestibular disorders were significantly more common in the lab-based iOD group (83.3%) compared to the lab- and Sx-based iOD group (18.2%). Despite the normal caloric response, catch-up saccade was found in the video head impulse test in more than half (54.5%) of the lab-based iOD group patients. There was no catch-up saccade in the lab- and Sx-based iOD group. There were no significant differences in gender ratio, frequency of dizziness attacks, and duration of illness. Conclusions: We propose new definitions of definite iOD (lab- and Sx-based iOD) and probable iOD (lab- or Sx-based iOD). These new definitions may help researchers to identify patients who are more likely to have true iOD, and facilitate comparisons of results between different studies.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.63-67
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• 2005

Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.49-56
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• 2013

Purpose: IgA nephropathy (IgAN) is one of the major causes of end-stage renal disease. Mass school urine screening (SUS) has been performed to enable early detection of chronic renal diseases, including IgAN. We wanted to evaluate the patients with IgAN, including those diagnosed through SUS. Methods: Between 1998 and 2010, 64 children were diagnosed with IgAN based on renal biopsy results obtained at the Pediatric Nephrology Department, ${\bigcirc\bigcirc}$ University Hospital. We divided these patients into the SUS group (37 cases), diagnosed through SUS, and the symptomatic (Sx) group (27 cases), diagnosed clinically. The medical records of both groups were analyzed retrospectively. Results: The mean age of the SUS and Sx groups was $10.8{\pm}2.7$ and $9.5{\pm}3.4$ years (P >0.05), respectively. Both groups had a higher proportion of male patients. The time from the notification of an abnormal urinary finding to a hospital visit or renal biopsy was shorter in the Sx group than in the SUS group. Regarding clinical manifestations, there were fewer cases with gross hematuria (P <0.001) and edema (P =0.008) in the SUS group, but there were no differences in terms of the therapeutic regimen and treatment duration. Regarding laboratory parameters, the Sx group had a higher white blood cell count (P =0.007) and lower hemoglobin (P =0.007) and albumin (P =0.000) levels. There were no differences in the renal biopsy findings in both groups, based on the history of gross hematuria or the severity of proteinuria. However, in all 64 patients with IgAN, the light microscopy findings (Hass classification) were related to a history of gross hematuria or the severity of proteinuria. Conclusion: There were no significant clinical and histological differences between the groups, as both had early stage IgAN. Although SUS facilitates the early detection of IgAN, long-term, large-scale prospective controlled studies are needed to assess the benefits of early diagnosis and treatment in chronic renal disease progression.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.18 no.3
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• pp.84-94
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• 2005

Objective: In order to help clinical approach on OME patient in progress observation and decision on improvement by clinical research results using tympanometry. Methods: Data was collected from 163 ears of 96 patients who were treated in Dept. of Oriental Medical Ophthalmology & Otolaryngology & Dermatology, Kyung-Hee Medical Center from 2001-2-12 to 2005-4-29 for Otitis Media with Effusion(OME). Tympanometry was applied to all patients and the test result was used to evaluate progress and improvement. F/U cases below 3 times were excluded. Results & conclusion: 1. Age and sex distribution was as follows: Mean Age 5.5years old(Standard deviation: 2.1), age distribution 2-61years old, below 10years old 151cases(92.6%) and above 10years old 12cases(7.4%). Male and female ratio was 1.81:1. 2. There were 67people(69.8%) with bilateral affected ear. Unilateral was 29people(30.2%). Affected ear distribution according to sex came out similarly. 3. Affected period distribution was as follows: over 12weeks 71cases(43.6%), under 12weeks 92cases(56.4%). Out of under 12weeks cases, 2-4weeks was 34cases(20.9%), 0-1weeks and 5-8weeks 20cases(12.3%), 9-12weeks 18cases(11.0%). There was evident difference about affected period between male and female. 4. All patients who served previous Tx in medical clinic(118 cases) took antibiotics. Only 6cases took tube insertion. The period of Taking antibiotics was as fellows: over 6weeks 42cases(35.6%), under 5weeks 37cases(31.4%). unknown 25cases(21.2%), jntermittent 14cases(11.9%). 5. In Period of Tx distribution, 5-6weeks showed 40cases(24.5%) which was highest number. In Improved cases(85cases), 3-4weeks and 5-6weeks each 22cases(25.9%) which was highest number. 1-2weeks 3cases(3.5%), 7-8weeks 12cases(14.1%), 9-10weeks 9cases(10.6%), 11-12weeks 10cases(11.8%), over 12weeks 7cases(8.2%). 6. The cases which have gastrointestinal Sx were 71cases(43.6%), the others 92cases(56.4%). Details of gastrointestinal Sx were as follows: Sx associated with appetite 47cases(47.5%), constipation 15cases(15.2%), abdominal pain and diarrhea 14cases(14.1%), frequent vomitting Teases(7.1%), etc 4cases(4.0%). 7. The cases which have accompanying disease were 116case(71.2%), the other 47cases(28.8%). Details a accompanying disease were as follows: sinusitis 57cases(35%), rhinitis 55cases(3.7%), allergic rhinitis 20cases(12.3%), atopic dermatitis 19cases(1.7%), urticaria 4cases(2.5%), asthma 3cases(1.8%), nasal polyp and conjunctivitis 2cases(1.2%) each, laryngitis 1case(0.6%).

• Journal of Chest Surgery
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• v.31 no.1
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• pp.13-19
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• 1998

Aortic aneurysm has poor prognosis and high mortality, but the incidence of aortic aneurysm is in increasing state. From July, 1986 to July, 1996, we operated on 25 patients with aortic aneurysm and analysed the clinical results and relations between the duration from symptoms onset to operation(Sx-Op), the duration from admission to operation(Adm-Op), preoperative blood pressure, preoperative heart rate and postoperative mortality, retrospectively. The patients were classified as dissecting aneurysm(10 cases), abdominal aortic aneurysm(9 cases), Marfan's syndrome(3 cases), descending thoracic aortic aneurysm(3 cases). The operative technique were graft interposition in 17 cases, Bentall's operation in 4 cases, aneurysm bypass in 2 cases, and wrapping of aorta in 2 cases. Seven patients died of several causes, bleeding in 5 cases, acute renal failure in 1 case and respiratory failure in another one case. Before 1992, the early stage of operation, 6 mortality among 14 operated patients occurred, and after then 1 mortality among 11 operated patients occurred. Eighteen survivors were followed up from 1 to 118 months(mean 50.6 months), and total follow up was 911 patient-months. During the follow up period one patient died of melena 30 months after operation. The other patients did not complain chest pain or dyspnea. The surgical mortality was improved in the late period, and the major cause of death was intraoperative or postoperative bleeding. The Sx-Op duration, the Adm-Op duration, preoperative blood pressure and preoperative heart rate were proven to have no statistical relations with postoperative mortality.

• Journal of Korean Physical Therapy Science
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• v.9 no.2
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• pp.159-170
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• 2002

Parkinson's disease(PD) is a progressive neurodegenerative disease that affects the functioning of the basal ganglia, a brain area that contributes to the control of movement. The disease is caused by the death of nerve cells in the brain that produce dopamine, a chemical messenger. The cells affected usually produce a neurotransmitter(a chemical that transmits nerver impulses) called dopamine, which acts with acetylcholine, another neurotransmitter, to fine-tune muscle control. In Parkinson's disease, the level of dopamine relative to acetylcholine is reduced, adversely affecting muscle control. When the supply of dopamine is depleted, the function of the basal ganglia is disrupted and its ability to control movement-deteriorates. The result is that PD patients experience moderate rigidity, difficulty in initiating movements and slowness in executing them, and a rhythmical tremor at rest. Although the cause of Parkinson's disease is not known, genetic factors may be involved. About 3 in 10 people with the disorder have an affected family member. About 1 in 100 people over the age of 60 in the US have Parkinson's disease. And Parkinson's disease is slightly more common in men. The course of the disease is variable, but drags may be the best effective in treating the symptoms and improving quality of life. But, The doctor may arrange physical therapy to help with physical mobility problems. It is important to continue to exercise and take care of your general health. Try to take a walk each day. Stretching exercises can help you maintain your strength and mobility. So, This papers will serve about the information of PD for clinical physical therapist. Finally, The aim of review is increasing approach method and technique for PD patients by the view of physical therapy.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.8 no.2
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• pp.73-87
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• 2002

Parkinson's disease(PD) is a progressive neurodegenerative disease that affects the functioning of the basal ganglia, a brain area that contributes to the control of movement. The disease is caused by the death of nerve cells in the brain that produce dopamine, a chemical messenger. The cells affected usually produce a neurotransmitter(a chemical that transmits nerver impulses) called dopamine, which acts with acetylcholine, another neurotransmitter, to fine-tune muscle control. In Parkinson's disease, the level of dopamine relative to acetylcholine is reduced, adversely affecting muscle control. When the supply of dopamine is depleted, the function of the basal ganglia is disrupted and its ability to control movement deteriorates. The result is that PD patients experience moderate rigidity, difficulty in initiating movements and slowness in executing them, and a rhythmical tremor at rest. Although the cause of Parkinson's disease is not known, genetic factors may be involved. About 3 in 10 people with the disorder have an affected family member. About 1 in 100 people over the age of 60 in the US have Parkinson's disease. And Parkinson's disease is slightly more common in men. The course of the disease is variable, but drugs may be the best effective in treating the symptoms and improving quality of life. But, The doctor may arrange physical therapy to help with physical mobility problems. It is important to continue to exercise and take care of your general health. Try to take a walk each day. Stretching exercises can help you maintain your strength and mobility. So, This papers will serve about the information of PD for clinical physical therapist. Finally, The aim of review is increasing approach method and technique for PD patients by the view of physical therapy.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.11 no.1
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• pp.88-98
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• 2011

Lesch-Nyhan syndrome is a X-linked recessive disorder caused by a deficiency of the enzyme hypoxanthine-guanidine phosphoribosyltransferase (HPRT), enzyme to recycle purines. Case history: born induced vaginal delivery at 40 weeks complicated by premature membrane ruputure, body weight 2.820 gm. He showed failure to thrive showing severe protein aversion like milk products and pink daper. Developmental delay revealing rolling over at 10.5 month, followed by regression. Seizure at 2 months, His poor oral feeding was lifelong problem. Weak crying, spastic, choreoathetoid movement. Self mutilating behavior noted and diagnosed at age 3 years. No family history of consanguinity and neurological disorders. Method: Laboratory test, physical exam, imaging study and molecular. Clinical follow up Treat ment with allopurinol. Result: uric acid 10.5 mg/dL (N 3.5-7.9), APRT 151.1uM/ min/ml pro(25.7-101), HPRT 7.6 (N 233.5-701) and c.151C>T hemizygote (p,Arg51X). Abdominal sonogram showed staghorn calculi in both kidneys, brain MRI brain atrophy. Clinical follow up showed, seizure at 2 mo, developmental delay (head control and, rolling over at at 11mo, pointing body part at 2 yr 7 mo, eye hand coordination at 2 y 11mo,creeping at 3 y 7 mo, speaking words at 6 y 6 mo ),and developmental regression at 3 yr of age. Sleeping problem including insomnia and severe constipation. Self mutilating behavior (lip bite) started at 2.5 yr, neurologic sx including intermittent upward gaze accompanied by swallowing difficulty at 3 y 7 mo grand mal seizure at 4.5 yr and spastic extremity and trunchal hypotonia and choleoathetoid movement and ataxia at 6.5 yr. Scoliosis with severe spasticity at 9 yr 9 mo. Acute life threatening episode with irregular breathing at 9 yr and 9 mo, Emaciation and nephrolithiasis and recurrent pneumonia. Died suddenly at 10 yr 3 mo. Conclusion: life long feeding problem, chronic gut motility dysfunction, sleeping difficulty and progressing neurologic deterioration and nephrolithiasis despite normal serum uric acid maintence by allopurinol treatment.

• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.87-93
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• 1988

The diagnosis of OPCA could be made clinically with important aid of brain CT scanning, although the definite and conclusive diagnosis only by postmortem pathological determination. We reviewed, clinically and with brain CT examination, 12 cases of patients with OPCA who were admitted to the Yeungnam University Hospital for a recent 5 years. The result were as following. : 1. The distribution of age is from 49 to 72, mainly 50 to 60. Man is more frequent than women at the 4.5 times. 2. The interval period from Sx. onset to diagnosis is 1 year to 6 years. 3. The usual initial Sxs. were dizziness(58%), ataxia(33%), and other less frequent Sxs. were weakness of low extremities, dysarthria, headache and urinary incontinence. The clinical manifestations at the initial diagnosis were cerebellar disturbance(100%), dysarthria(83%), and increased deep tendon reflexes(58%). 4. The results of brain CT finding are like this : ${\cdot}$ the width of cerebellar sulci is more than 1mm, other 4 cases more than 2mm. ${\cdot}$ the width of cerebellar pontine cistern of the patient if usually 3 to 4mm, other 2 cases extended to the 5mm. ${\cdot}$ the A. P and lateral lengths of 4th. ventricle is 4mm and 4 to 8mm respectively. ${\cdot}$ 6 cases of whole patients show coincidentally cerebral atrophy.