• Clinics in Shoulder and Elbow
• /
• v.13 no.2
• /
• pp.293-298
• /
• 2010

Purpose: Since an injured elbow joint can disturb the activity of daily life by limiting motion, especially if the motion is restricted over 40 degree of flexion contracture and under 105 degree of further flexion, it is imperative to select the best method and the timing of treatment of the elbow stiffness. Therefore this review will discuss open surgical techniques for stiff elbows based on the literature. Materials and Methods: It is important to take sufficient clinical examination of the patient, including history taking. And, a surgeon should select appropriate procedure after accurately understanding about the status and cause of the stiff elbow with radiographic methods. Surgical methods include arthroscopic release open release, distraction arthroplasty, total elbow replacement and there are four approachs in the open release - anterior approach, medial "over the top" approach, limited lateral approach: column procedure, posterior extensile approach-. Results and Conclusion: Although at present the arthroscopic technique is emphasized for the treatment of elbow stiffness, a surgeon should know conventional open techniques.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.18 no.4
• /
• pp.253-260
• /
• 2015

Purpose: The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastroenteritis (EGE) in children. Methods: Our study enrolled 24 children who were diagnosed with EGE from 1993 to 2014 at the Department of Pediatrics, Seoul National University Children's Hospital. The patients' clinical manifestations, treatments, and outcomes were reviewed from the medical records. Results: The mean age at diagnosis was 5.3 years. Most patients had gastrointestinal symptoms including diarrhea (54.2%) and abdominal pain (45.8%). Peripheral eosinophilia was present in 91.7% of the patients. Thirteen patients (54.2%) showed anemia, and 15 patients (62.5%) had hypoalbuminemia. EGE was classified as mucosal, subserosal, or muscular in 75.0%, 20.8%, and 4.2% of cases, respectively. Three patients showed gastroduodenal ulcers upon endoscopic analysis. A history of allergy was reported in 13 patients, including atopic dermatitis, allergic rhinitis, and asthma. Five patients (20.8%) improved with food restrictions. Among the 19 patients treated with steroids, 11 (57.9%) discontinued steroid treatment without subsequent relapse, 4 (21.1%) relapsed after ceasing steroid treatment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent therapeutic surgery. The presence of gastroduodenal ulcers was significantly associated with relapse and steroid resistance. Conclusion: A high suspicion of EGE is warranted when children have nonspecific gastrointestinal symptoms and peripheral eosinophilia. Most patients improved with food restrictions or steroid treatment, although one-third of patients showed a relapse or steroid resistance.

• Pediatric Infection and Vaccine
• /
• v.27 no.1
• /
• pp.77-82
• /
• 2020

Ascariasis is the most common helminthic infection in humans. However, its prevalence has been very low in Korea since the 1990s. Recently, there have been several case reports on intestinal obstruction or pancreaticobiliary disease due to infection with Ascaris lumbricoides in adults. However, cases of ascariasis in children have rarely been reported in Korea. We report a case of ascariasis in a 2-year-old boy who experienced expulsion of an adult ascaris worm from his anus. His mother found the worm in his diaper in the morning. His medical history was nonsignificant for any previous illnesses. There were no specific symptoms, and no abnormal findings were found on physical examination. The worm was pink, elongated, and cylindrical; it was 25 cm long and 5 mm wide. Unfertilized eggs of A. lumbricoides were detected in his stool specimen. He was treated with albendazole and remained asymptomatic at follow-up. As long as the number of immigrants from endemic areas and people returning from overseas trips, and import of agricultural products keep increasing, ascariasis can still occur in Korea. Therefore, it is necessary to raise awareness regarding ascariasis.

• Journal of Preventive Medicine and Public Health
• /
• v.24 no.4 s.36
• /
• pp.496-506
• /
• 1991

A cross-sectional study was conducted to investigate the effect of long term noise exposure on blood pressure among steel mill workers. The workers participated in periodic medical examinations performed from August 27 to September 6 in 1990. Examined were 1,034 workers with high-level noise exposure(average $91.8{\pm}5.2dB(A)$) and 390 workers with low-level noise exposure(average $75.2{\pm}4.6dB(A)$). No significant difference was found in systolic or diastolic flood pressure between the two exposure groups. Prevalence of hypertension (${\geq}160mmHg\;systolic\;or{\geq}100mmHg\;diastolic$) was higher in a younger age group (${\leq}40$ years old) of high-level noise exposure than of low-level noise exposure. However, the difference was not statistically significant. Furthermore, in younger ages, prevalence of hypertension appeared to be higher in the hearing loss group (${\geq}25dB\;at\;1000Hz\;or{\geq}40dB$ at 4000Hz in at least one ear) than in the normal hearing group. From multiple regression analysis, hearing loss, body mass index, age, alcohol and family history of hypertension were proven to be predictors of diastolic blood Pressure (p<0.02). When regression was performed for each age group, hearing loss was a strong predictor of diastolic pressure in the younger age group (p<0.01).

• Journal of Preventive Medicine and Public Health
• /
• v.38 no.1
• /
• pp.45-52
• /
• 2005

Objectives : To investigate the fatigue subjective symptoms and VDT related risk factors in bank workers. Methods : A total of 2178 workers (62.8% male, 37.2% female) were surveyed with a self-administered and structured questionnaire consisting of 30 fatigue symptoms and other VDT related factors regarding work characteristics, work postures, work environments, personal medical histories, etc. Fatigue subjective symptoms were divided into 3 groups of 10 questions each: a dull, drowsy and exhausted feeling (Group I), a mental decline of working motivation (Group II), or a feeling of incongruity in the body and dysfunction of autonomic nervous system (Group III). Each question was weighted as 0 for 'none', 1 for 'sometimes', and 2 for 'always'. Results : Mean age was $35.8{\pm}7.2$ years ($38.9{\pm}6.0$ in males, $30.6{\pm}5.8$ in females), Mean work duration was $7.7{\pm}7.1$ years ($8.4{\pm}7.4$ in males, $6.5{\pm}6.4$ in females). Mean symptom score in males was $11.0{\pm}8.1$ ($4.9{\pm}3.1$ in Group I, $3.0{\pm}3.1$ in Group II, $3.1{\pm}2.8$ in Group III) and in females was $17.5{\pm}9.5$ ($7.0{\pm}3.8$ in Group I, $4.6{\pm}3.5$ in Group II, $5.9{\pm}3.4$ in Group III). Mean scores were higher in the order of Group I>III>II. Females had significantly higher scores than males in all three groups (p<0.001). Most common symptoms complained of as 'always' or 'sometimes' were feel strained in the eyes' (85.4%) among Group I, 'find difficulty in thinking'(54.2%) among Group II, and 'feel stiff in the shoulders (72.3%) among Group III. In multiple regression analysis, female, non-straight spine at workstation, more VDT work hours, history of physical therapy, glare of screen, overtime work, young age, and non-horizontal elbow position were significantly related with high score of symptoms. Conclusions : More supportive VDT work environment and education for correct work postures for VDT workers are recommended.

• Restorative Dentistry and Endodontics
• /
• v.36 no.5
• /
• pp.367-376
• /
• 2011

Early detection of carious lesions increases the possibility of treatment without the need for surgical intervention. Optical coherence tomography (OCT) is an emerging three-dimensional imaging technique that has been successfully used in other medical fields, such as ophthalmology for optical biopsy, and is a prospective candidate for early caries detection. The technique is based on low coherence interferometry and is advantageous in that it is non-invasive, does not use ionizing radiation, and can render threedimensional images. A brief history of the development of this technique and its principles are discussed in this paper. There have been numerous studies on caries detection, which were mostly in vitro or ex vivo experiments. Through these studies, the feasibility of OCT for caries detection was confirmed. However, further research should be performed, including in vivo studies of OCT applications, in order to prove the clinical usefulness of this technique. In addition, some technological problems must be resolved in the near future to allow for the use of OCT in everyday practice.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.3
• /
• pp.337-343
• /
• 2002

A tracheal bronchus, an aberrant bronchus arising directly from the trachea, is an infrequent congenital anomaly. The incidence of this anomaly ranges from 0.5 to 5%. It usually originates from the right lateral wall of the trachea at the level <2 cm above the tracheal bifurcation. These patients usually are asymptomatic, but some patients may experience recurrent pneumonia, chronic bronchitis, bronchiectasis, or asthmatic episodes. A tracheal bronchus may be associated with other anomalies such as a tracheal stenosis, pulmonary agenesis, pulmonary sequestration, congenital heart disease, a pulmonary venous anomaly and Down's syndrome. This anomaly is usually diagnosed incidentally during bronchoscopy in patients with respiratory problems. Here we report a case of a 20-year-old man with a past history of bronchial asthma, which was incidentally diagnosed as a tracheal bronchus during a medical examination prior to military service, and was associated with a bilateral superior vena cava anomaly.

• Clinical and Experimental Reproductive Medicine
• /
• v.25 no.2
• /
• pp.115-122
• /
• 1998

The maintenance of a viable pregnancy has long been viewed as an immunological paradox. The deveolping embryo and trophoblast are immunologically foreign to the maternal immune system due to their maternally inherited genes products and tissue-specific differentiation antigens (Hill & Anderson, 1988). Therefore, speculation has arisen that spontaneous abortion may be caused by impaired maternal immune tolerance to the semiallogenic conceptus (Hill, 1990). Loss of recall antigen has been reported in immunosuppressed transplant recipients and is associated with graft survival (Muluk et al., 1991; Schulik et al., 1994). Progesterone $(10^{-5}M)$ has immunosuppressive capabilities (Szekeres-Bartho et al., 1985). Previous study showed that fertile women, but not women with unexplained recurrent abortion (URA), lose their immune response to recall antigens when pregnant (Bermas & Hill, 1997). Therefore, we hypothesized that immunosuppressive doses of progesterone may affect proliferative response of lymphocytes to trophoblast antigen and alloantigen. Proliferative responses using $^3H$-thymidine ($^3H$-TdR) incorporation of peripheral blood mononuclear cells (PBMCs) to the irradiated allogeneic periperal blood mononuclear cells as alloantigen, trophoblast extract and Flu as recall antigen, and PHA as mitogen were serially checked in 9 women who had experienced unexplained recurrent miscarriage. Progesterone vaginal suppositories (100mg b.i.d; Utrogestan, Organon) beginning 3 days after ovulation were given to 9 women with unexplained RSA who had prior evidence of Th1 immunity to trophoblast. We checked proliferation responses to conception cycle before and after progesterone supplementation once a week through the first 7 weeks of pregnancy. All patients of alloantigen and PHA had a positive proliferation response that occmed in the baseline phase. But 4 out of 9 patients (44.4%) of trophoblast antigen and Flu antigen had a positive proliferative response. The suppression of proliferation response to each antigen were started after proliferative phase and during pregnancy cycles. Our data demonstrated that since in vivo progesterone treated PBMCs suppressed more T-lymphocyte activation and $^3H$-TdR incorporation compare to PBMCs, which are not influenced by progesterone. This data suggested that it might be influenced by immunosuppressive effect of progesterone. In conclusion, progesterone may play an important immunological role in regulating local immune response in the fetal-placental unit. Furthermore, in the 9 women given progesterone during a conception cycle, Only two (22%) repeat pregnancy losses occured in these 9 women despite loss of antigen responsiveness (one chemical pregnancy loss and one loss at 8 weeks of growth which was karyotyped as a Trisomy 4). These finding suggested that pregnancy loss due to fetal aneuploidy is not associated with immunological phenomena.

• Journal of Veterinary Clinics
• /
• v.22 no.2
• /
• pp.148-152
• /
• 2005

An intact female, 5-year-old, Pekingese, weighing 3.5kg with a history of a palpated abdominal mass was referred to Veterinary Medical Teaching Hospital, Seoul National University. In laboratory examination, there were no remarkable abnormalities. Radiographic findings included a left mid-abdominal mass with ill-defined margin, serosal detail loss of peritoneal space, non-uniform opacity of retroperitoneal space, and a radiopaque cystic calculus. On abdominal ultrasonography, a heterogeneous parenchymal mass with irregular contour in the left renal region was found. Computed tomographic findings showed a tumor embolus within the caudal vena cava and an invasion into mesentery, small bowel loops, spleen and pancreas around the large left renal mass. Unilateral nephroureterectomy was performed. Histopathologic examination of the resected mass confirmed the diagnosis of renal cell carcinoma. The dog died one day after surgery. Although ultrasonography could give diagnostic information about mass characteristics, computed tomography (CT) can provide key imaging features of mass characteristics.

• Journal of Veterinary Clinics
• /
• v.25 no.1
• /
• pp.31-36
• /
• 2008

One year old, male beagle dog was presented with acute onset of severe dyspnea, cyanosis, and anorexia. He had no trauma history. Five days earlier, the dog had been diagnosed as bacterial pneumonia caused by Pseudomonas aeruginora and E. coli. He exhibited a restrictive respiratory pattern and at admission, immediately oxygen supplementation given. On a ventrodorsal(VD) radiographic view, right lung was collapsed and contrasted with the air-filled pleural space. The mediastinum, heart, and great vessels were shifted to the left. On a right-lateral radioraphic view, the heart appeared to be elevated from the sternum. The dog was diagnosed as secondary spontaneous pneumothorax resulting from bacterial pneumonia. The chest tubes were placed on the right and left pleural cavity under general anesthesia. At 3 days after treatment, on a VD radiograph, air of right pleural cavity disappeared while left pleural cavity showed radiolucent area filled with air, and the heart was shift to the right. Therefore, the left tube thoracostomy was performed too. The right chest tube was maintained for 5 days and the left chest tube was maintained for 45 days. During the period, antibiotics and vitamin I were used for managing of bacterial pneumothorax and preventing of retroinfection through the tubes. As the result, bacterial pneumonia was well managed by medicines and secondary SP was completely treated that air in bilateral pleural cavity disappeared on radiographs. During the follow-up for 2 years, patient showed normal condition without recurrence.