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Retrospective Study on Factors Influencing Facial Nerve Damage of Acute Peripheral Facial Palsy Patients: by Electromyography (급성 말초성 안면신경마비 환자의 안면신경 손상 정도에 영향을 미치는 요인에 대한 후향적 연구: 근전도검사를 이용하여)

  • Kim, Pil Kun;Sung, Won Suk;Goo, Bon Hyuk;Ryu, Hee Kyung;Suk, Kyung Hwan;Lee, Ju Hyeon;Kim, Min Jeong;Park, Yeon Cheol;Seo, Byung Kwan;Baek, Yong Hyeon;Park, Dong Suk
    • Journal of Acupuncture Research
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    • v.30 no.5
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    • pp.155-167
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    • 2013
  • Objectives : This research was conducted to investigate the factors that affect the level of facial nerve damage. Methods : From October 2009 to September 2013, the total number of 581 patients of Bell's palsy and Ramsay-Hunt syndrome visited Facial Palsy Center in Kyung Hee University Hospital at Gangdong for Traditional Korean and Western combined medical treatment. Of these, 453 patients of peripheral facial nerve palsy were selected for the research. After reviewing the medical records that have details of age, gender, diagnosis(Bell's palsy and Ramsay-Hunt syndrome), onset, underlying diseases(DM, HTN), and HbAlc value, the analysis on the influence factors on the level of facial nerve damage was drew out. Results : The axonal loss rate of oris branch and nasal branch were significantly higher than the axonal loss rate of frontal branch and oculi branch. In addition, the frequency of becoming a major damaged branch was also high in the oris branch nasal branch. The factors by month, weather, smoking, and alcohol did not influence EMG axonal loss rate. Male rather than female and patient with Rasmay-Hut syndrome rather than Bell's palsy had a higher axonal loss rate in all branches. Of those, front of branch of male was remarkably higher than female. Patient with DM as P/H had high axonal loss rate in all branches. Patient with HTN as P/H had high axonal loss rate in all branches except for oris branches. Patients with DM and HTN group had significantly higher value from the average of axonal loss rate than patients who are only with HTN and without DM/HTN. DM alone group had significantly higher value than patients who are without DM/HTN. However, HTN alone was not significantly high. By analysing HbAlc of the patients who were hospitalised regardless DM, axonal loss rate was high in the order of DM group, preDM group, normal group. Nevertheless, only DM group showed higher axonal rate statistically than normal group. Considering DM and HbA1c value, the patients can be divided into 4 different groups of hkDM, lkDM, hfDM and nDM. By analysing those groups, the average damaged value of the groups with diagnosis followed by treatment(lkDM, hkDM) were higher than the average rate of hfDM and statistically higher than the rate of the nDM. Conclusions : The influential factors of increasing the level of EMG damage are male(only for the frontal branch), age above sixties, HTN, DM, and HbAlc value above 6.5. Besides, the negligible factors are month, season, diagnosis, alcohol, and smoking. Further research including clinical prognosis should be conducted.

The Characteristics and Medical Utilization of Migrant Workers (외국인 노동자의 특성과 의료이용 실태)

  • Ju, Sun Me
    • Korean Journal of Occupational Health Nursing
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    • v.7 no.2
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    • pp.164-176
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    • 1998
  • This study deals with the current medical utilization for migrant workers and the characteristics of them. The purpose of this study is to provide the basic information to establish proper medical policy. For the study self-made questionnaire was used, which was answered by 453 migrant workers working in the area of manufacturing and non-technical work in 10 cities like Seoul, Inchon, Namyangju, Sungnam, Kwangju, Pyungchon, Kunpo, Kimpo, Masuk in Kyungki-do and Chunan in Chungchungnam-do. Besides, 303 medical records of those who had visited free medical check-up center were analyzed. The period of accumulating data is 6 months, from November 1st, 1996 to April 30th, 1997. The characteristics of migrant workers and current medical utilization are analyzed by percentage and the relation between characteristics and current medical utilization were analyzed using ${\chi}^2$-test, t-test, ANOVA. The finding of this study was as follows : 1) The number of nationality was 16. The first majority was Philippians as 32.0%. Among 16 nationalities Southeastern and Northern Asians were 48.9%, Southwestern Asian was 46.5%, the rest was 7.3%. Men were 81.0%, those who are aged from 26 to 30 were 39.0%, Graduatee from high school 92.7%, Christians 56.3%, unmarried 55.4% and salary from 600,000 Won to 800,000 Won 53.8% averaging monthly payment 669,810 Won. As for their residence, those who resided over 3 years were 31.9% and the illegal residence reached 77.4%. As for Korean language, those who speak in middle level were 5.6%. 2) As for kind of work and circumstances, manufacturing was 81.1%, 4 off-days per month 72.2% and 9-10 working hours per day 42.1%. As for accommodation, residence in fabric was 62.6% and one or two members as roommate 40.2%. 3) The characteristics of health behavior showed that 89.4% of migrant workers had 3 meals, 70.9% of them did not drink alcohol, 73.5% of them did not smoke. 4) As a characteristic of health status, 71.8% of them perceived of their health. 76.1% thought that they had no illness before coming Korea. Among them who recognized their illness, those who had problem in circulatory system was 35.3%, respiratory system ENT 19.1% and nervous system 19.1%.66.2% of those having illness had already had sickness when coming to Korea. 5) During last one month, 79.2% of them were known as ones having no illness. Among the sick, those who had problem in circulatory system was 31.6%, nervous system 23.7% and respiratory system 21.1%. 60.3% of the sick were not cured at that time. 6) Sorting the symptom of those who visited free medical check up, dental care was 24.2%, orthopedic 14.0% and digestive system 13.8%. Teethache was 34.4%, stomach problem 11.6%, upper respiratory inflammation 10.2% and back pain 5.9%. Averagely they visited free medical check up 1-2 times. According to symptom, epilepsy 25.5 times, heart and vascular disease 9 times, constipation 2.8%, neurosis 2.38 times and stomach problem 2.34 times. 7) The most frequently visited medical service by migrant workers was hospital. The most mentioned reason was good healing as 36.3%. The medical service satisfied migrant workers mostly was hospital as 64.3%. The reason of satisfaction was also good healing as 45.9%. 8) 77.2% of respondents did not spend money for medical check. Average monthly medical cost was 25,100 Won, 3.7% of income. Those who had no medical security was 73.4%. In their case, 67.7% got discount from hospital or support from working place and religious organization. 9) As for the difference of medical utilization according for the characteristics of migrant workers, legal workers and no-Korean speaker used hospital more frequently. 10) Those who were satisfied most of all with the service of hospital were female workers, hinduists and buddhists, legal workers or manufacture workers. 11) Christians, those who have 3 meals or recognize themselves as healthy ones mostly had no illness. As a result, the most of migrant workers in Korea are from Asia. They are good educated but are working in manufacturing and illegal. Their average income is under 700,000 Won which in not enough for medical cost. They have no medical security and medical fee is supported by religious organization or discounted. Considering these facts the medical policy by government is to be established.

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Isolation of Nontuberculous Mycobacteria by DNA Probe and Clinical Characteristics of Patients with NTM Pulmonary Disease (DNA probe를 이용한 비결핵항산균의 분리 및 폐질환자들의 임상적 특징)

  • Kim, Hee Kyoo;Kim, Yu Ri;Park, Jung Pil;Kim, Nang Hee;Ok, Chul Ho;Jung, Maan Hong;Jang, Tae Won;Jeong, Seok Hoon;Kim, Cheol Min;Park, Hee Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.248-256
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    • 2005
  • Background : Nontuberculous mycobacterial (NTM) infections are increasingly being recognized as a cause of chronic pulmonary disease. This study describes the prevalence of NTM species from clinical specimens and the clinical characteristics of NTM pulmonary disease. Material and Methods : The NTM isolated from March 2003 to December 2003 at the Kosin Medical Center were identified using an oligonucleotide chip containing the internal transcribed space (ITS) sequence. The medical records of the patients with the NTM isolates, who fulfilled the 1997 ATS diagnostic criteria for NTM pulmonary disease, were analyzed, retrospectively. Results : Twenty four species (24.2%) of NTM were isolated from 99 cultured AFB specimens. M. avium complex (MAC) (13 isolates), M. szulgai (3), M. kansasii (2), M. malmoense (2), M. abscessus (1), M. chelonae (1), M. scrofulaceum (1), and unclassified (1). Of the 23 patients with isolated NTM, 11 patients were found to be compatible with a NTM pulmonary infection according to the ATS criteria; MAC was found in 6 cases (54.5%), M. szulgai in 2 cases (18.2%), and M. abscessus, M. szulgai, M. kansasii and M. malmoense in 1 case each (9.1%). Ten patients (91%) were male and the median age at diagnosis was 61 years. In the pre-existing diseases, malignant disease was found in 6 cases including 5 patients with lung cancer, and history of old pulmonary tuberculosis was identified in 4 cases. The radiological patterns showed lung destruction lung in 3 cases, a cavitary mass in 3 cases, a nodular pattern in 2 cases, and reticulonodular, consolidation and a bronchiectasis pattern were in 1 case each. Conclusion : Various types of NTM pulmonary diseases were found in a tertiary hospital at Busan, Korea. The NTM pulmonary diseases were caused by MAC, M. szugai, M. kansasii, M. malmoense, M. abscessus, M. chelonae, and M. scrofulaceum in the order of frequency.

Clinical Significance of Extended-Spectrum ${\beta}$-Lactamase Producing $Escherichia$ $coli$ in Pediatric Patients with Febrile Urinary Tract Infection (발열성 소아 요로감염에서 Extended-Spectrum ${\beta}$-Lactamase 생성 $Escherichia$ $coli$의 임상적 의의)

  • Park, Cheol;Kim, Min-Sang;Kim, Mi-Kyung;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.16 no.1
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    • pp.38-45
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    • 2012
  • Purpose: The incidence of community-acquired urinary tract infection (UTI) due to extended-spectrum ${\beta}$-lactamase producing $Escherichia$ $coli$ (ESBL(+) $E.$ $coli$) has increased worldwide. ESBL causes resistance to various types of the newer ${\beta}$-lactam antibiotics, including the expanded spectrum cephalosporins and monobactams. We aimed to investigate the severity of UTI and associated genitourinary malformations in children with febrile UTI caused by ESBL(+) $E.$ $coli$. Methods: We retrospectively reviewed the medical records of 290 patients diagnosed as febrile UTI caused by $E.$ $coli$ between January 2008 and October 2010 at Korea University Medical center. We classified the patients into two groups with ESBL(+) and ESBL(-) $E.$ $coli$ group according to the sensitivity of urine culture. Fever duration, admission period, white blood cell (WBC) counts and C-reactive protein (CRP) in peripheral blood, the presence of hydronephrosis, cortical defects, vesicoureteral reflux (VUR) and renal scar were compared between the two groups. Results: Patients with ESBL(+) $E.$ $coli$ were 32, and those with ESBL(-) $E.$ $coli$ were 258. If we excluded those tested with a sterile urine bag, patients with ESBL(+) $E.$ $coli$ were 22, and those with ESBL(-) $E.$ $coli$ were 212. Whether the results of sterile urine bag tests were included or not, there was no significant difference in all parameters between the two groups statistically. Conclusion: Our data shows that ESBL(+) $E.$ $coli$ may not be related to the severity of UTI and associated genitourinary malformations.

Severe Skin Lesions or Arthritis May be Associated with Coronary Artery Lesions in Kawasaki Disease (가와사끼병에서 피부 병변과 관절염의 중증도와 관상동맥질환의 연관성)

  • Youn, Song Ee;Ju, Hee Young;Lee, Kyung Suk;Cha, Sung Ho;Han, Mi Young;Yoon, Kyung Lim
    • Pediatric Infection and Vaccine
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    • v.23 no.2
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    • pp.102-108
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    • 2016
  • Purpose: Kawasaki disease (KD) shows a variety of clinical signs of multi-system involvement, including clinical diagnostic criteria. It is unknown that the severity of the clinical signs is associated with the risk of coronary artery lesions (CALs). We wanted to evaluate clinical characteristics and the risk of CALs in the patient groups who had severe skin lesions or those with arthritis. Methods: We retrospectively reviewed the medical records of 220 KD patients who were treated with intravenous immunoglobulin (IVIG). We compared clinical and laboratory data between the group with severe skin lesions (n=52) and those with mild or no skin lesions (n=168), and between the group with arthritis (n=6) and those without arthritis (n=214). Results: The mean age of total patients was $2.23{\pm}1.87years$ of age, and the male-to-female ratio was 1.5:1 (138/82). Among 220 patients, 52 patients had CALs (23.6%), and 29 patients (13.2%) showed incomplete KD. The patients with CALs had a higher mean age, longer total fever duration, and higher rate of IVIG non-responsiveness. The patient group with severe skin lesions showed a higher mean age (P<0.001), more prolonged fever duration (P=0.041), higher frequency of CALs (P=0.033), higher WBC, neutrophil, and neutrophil-to-lymphocyte ratio levels, compared to the patient group without severe skin lesions. The patients with arthritis had a tendency of further treatment with methylprednisolone or infliximab. Conclusions: The frequency of CALs was higher in patient group with severe skin lesions. Our results suggest that the intensity of clinical signs of KD such as skin rash, cervical lymphadenopathy and possibly arthritis may be associated the risk of CALs.

Analysis of the Kinematic Characteristics at Entrance to the Straight Course from the Curvilinear Course in the 200m-Track Game (육상 200m 경기의 곡선주로에서 직선주로 진입 시 운동학적 특성분석)

  • Oh, Sei-Jin
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.51-63
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    • 2002
  • This study sought to identify the kinematic characteristics at entrance to the straight course from the curvilinear course in the 200m-track game. For this purpose, this study was conducted for 4 sprinters by setting the 10m-section combined from the curvilenear track to the straight course and shooting them with the camcorder. It was set up to include all the sections of analysis by using the framework of the control point knowing the coordinate of the space and actual analysis was conducted on the motion showing the best records by conducting it for each subject five times. As a result, the following conclusion was drawn: It was found that the subjects showed the average stride of 4.5${\pm}$0.41 times at the 10-meter section and the required time of 1.42${\pm}$0.04sec. They showed the ratio average stride to height of 1.25${\pm}$0.20% and the average speed of 7.06${\pm}$0.19m/s. The displacement in the center of gravity of the human body at the section combined from the curvilinear course to the straight course was moving along the inward course of the curvilinear course, and the displacement of the leg located at the outward direction(right) was found to be larger than that of the leg located at the inward direction(left). In the speed of the left and right hand segments, it was found that the speed of the right hand located in the outward direction was faster than that of the left hand located at the inward, and it was found that the subjects progressed in the curvilinear course. The subjects showed the larger angle of the shoulder joint when the upper arm was located in the forward direction than when the it was located in the backward direction. In the curvilinear course, they showed the lower value of the lateral angle of the trunk when the right foot located at the outward direction left the ground than when the left foot located at the inward direction left the ground. And it was found that the lateral angle of the trunk became lower with approaching the straight course.

Coronary Fistulas -20 years experience - (관상동맥루)

  • Lee Jeong Ryul;Jung Yo Chun;Choi Chang Hyu;Kim Woong Han;Kim Yong Jin;Bae Eun Jung;Noh Chung Il
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.609-615
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    • 2005
  • Background: Some controversy still exists concerning the operative indications of coronary fistulas. Nevertheless, a short-term and long-term outcomes are excellent with surgical interventions. In this study, we assessed our surgical results on this disease entity during the last 20 years. Anatomic diversity was described as well. Material and Method: From April 1986 to March 2005, 20 patients with coronary fistulas underwent surgical correction in Seoul National University Children's Hospital. Their medical records were reviewed retrospectively. Result: Twelve patients ($60\%$) were asymptomatic prior to surgery. All had electrocardiogram and echocardiogram and all but 3 had coro-nary angiogram preoperatively. Anatomically, none of them had two or more coronary fistulas. The sites of origin were left coronary system in 11 patients and right in 9. The draining sites were right ventricle in 11, right atrium in 3, left ventricle in 3, main pulmonary artery in 2, and superior vena cavae in 1. All of the involved, the coro-nary arteries were dilated or aneurismal. In 1 case, there was atherosclerotic change but no ischemic evidence in preoperative electrocardiogram. Operative techniques included external obliteration (13), internal obliteration (5), and both (2). External obliteration was done by ligation of the fistulous tract only in T patients, by fstula ligation plus plication in 3 and by plication or patch closure via fistulotomy in 3. There was no operative mortality. All of postoperative morbidities including transient sinus arrhythmia (2), complete atrioventricular block (1), decreased left ventricular function (2), ventricular tachycardia (1), pericarditis (1), and seizure (1) improved on discharge. The mean follow-up was 55.1$\pm$50.2 months (4.0 months${\~}$18.0 years) and there were no recurrences of fistula. There was 1 second operation for aortic root aneurysm, which developed after external patch closure of right coronary fistula. Conclusion: We demonstrated here that coronary fistulas can be cured with excellent clinical outcome and low operative risk under precise diagnosis. Understanding the anatomic diversity will help to construct surgical plans.

Clinical Entities and Etiology of Invasive Bacterial Infections in Apparently Healthy Children (기저 질환이 없는 소아에서 발생한 침습성 세균 감염의 임상 양상과 원인균)

  • Lee, Joon Ho;Song, Eun Kyoung;Lee, Jin A;Kim, Nam Hee;Kim, Dong Ho;Park, Ki Won;Choi, Eun Hwa;Lee, Hoan Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1193-1200
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    • 2005
  • Purpose : Invasive bacterial infection is a major cause of morbidity and mortality in children. Previously, we reported etiology of invasive infections in healthy children in 1985-1995. This study was performed to update etiology of invasive bacterial infections in the previously healthy children. Methods : We reviewed medical records of 98 episodes of invasive bacterial infections in immunocompetent children at the Seoul National University Children's Hospital in 1996-2004. Results : The frequent pathogens identified over all age groups were Streptococcus pneumoniae (33%) and Staphylococcus aureus(33%). The proportion of Salmonella species and Haemophilus influenzae has been declined to 4% each from 23% and 14%, respectively, compared to previous study. S. agalactiae was the most common isolate in the infants ${\leq}3$ months. Among the infants and children aged 3 months to 2 years and children of 2-5 years, S. pneumoniae(57%, 52%, respectively, in each group) was the most common isolates followed by S. aureus(17% and 24%, respectively). S. aureus was the most common isolates(73%) in children >5 years. Primary bacteremia was the most common clinical diagnosis(27%). S. pneumoniae was responsible for 42% of primary bacteremia, 50% of meningitis, and 69% of bacteremic pneumonia and empyema. S. aureus accounted for 80% of bone and joint infections. The case fatality rate was 8.1% for all invasive infections. Conclusion : We reviewed frequency of bacterial agents of invasive infections in children. The data may be useful for pediatricians to select adequate empirical antibiotics in the management of invasive bacterial infections.

Predictive factors for Relapse in Children with Steroid Responsive Nephrotic Syndrome (소아 스테로이드 반응성 신증후군에서 재발과 관련된 예측인자)

  • Cho Min Hyun;Lee Dong Won;Lee Tae Ho;Ko Cheol Woo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.167-174
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    • 2005
  • Purpose : Relapses are a major problem in children with steroid responsive nephrotic syndrome(SRNS). This study has been performed to determine the predictive factors for relapse in children with SRNS. Methods : The study group consisted of 7,3 children with SRNS who had been admitted to the Department of Pediatrics, Kyungpook National University Hospital, over 6 years from 1996 to 2001. The medical records were reviewed retrospectively and analyzed to determine significant relationships between selected variables[age at onset, sex, laboratory data, the rapidity of response(days to remission), interval to first relapse] and the frequency of relapse. Results : The age($mean{\pm}SD$) of patients was $4.53{\pm}2.53$ years old. The male to female ratio was 52:21. In 95$\%$, 39 out of the 41 children had a renal biopsy, and the final diagnosis was minimal change nephrotic syndrome. There was no significant correlation between the frequency of relapse and the following variables age at onset, sex, and presence of hematuria. However, the rapidity of response correlated well with the frequency of relapse, especially during the first year after the onset of the disease(P=0.005). Conclusion : The rapidity of response is expected to be one of the predictive (actors for relapse in children with SRNS. (J Korean Soc Pediatr Nephrol 2005;9:167-174)

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The Impact of Milk Production Level on Profit Traits of Holstein Dairy Cattle in Korea (국내 Holstein종 젖소의 생산수준이 젖소의 수익형질에 미치는 효과)

  • Do, Changhee;Park, Suhun;Cho, Kwang-Hyun;Choi, Yunho;Choi, Taejeong;Park, Byungho;Yun, Hobaek;Lee, Donghee
    • Journal of Animal Science and Technology
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    • v.55 no.5
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    • pp.343-349
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    • 2013
  • Data including 1,372,050 milk records pertaining to 438,019 cows from 1983 to 2011 collected during performance tests conducted by the National Livestock Cooperative Dairy Improvement Center were used to calculate milk income and profit of individuals and investigate the effects of production levels of early lactation (parity 1 and 2, respectively). Individuals with a moderate level of early lactation stayed longer in herds. Among parity 1, the 9,000 kg or higher group had a lower mean number of lactations than the overall mean of 3.13. The 7,000 kg or lower and 10,000 kg or higher groups had lower mean life time milking days than the overall mean of 1,076.8 days. Standard deviations of lifetime traits tended to decrease as production levels increased. For parity 2, the 11,000 kg or higher group had a lower mean number of lactation than the overall mean of 3.43. The lifetime milking days was highest in the 12,000 kg group (1,212.0 days), and generally smaller in the lower groups. Profit increased as the production level of groups increased for both parity 1 and 2. In groups with low production levels, profit of parity 1 was higher than that of parity 2, while the reverse was true in groups with high production levels. These results suggest that individuals in the low production groups had a greater likelihood to be culled due to reproductive or other problems. Furthermore, the accuracy of the prediction of lifetime profit of individuals with a milk yield of 305 days seems to be higher for parity 2 than parity 1; therefore, it is desirable to predict lifetime profit using the 305d milk yield of parity 2. In conclusion, breeding goals are based on many factors in functions for the estimation of profit; however, production levels during early lactation (parity 1 and 2) can be used as indicators of profit to extend profitability.