• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.12 no.1
• /
• pp.396-407
• /
• 1999

Although tinnitus is a common disease, it's reason, pathogenesis and treatment are not examined clearly. As tinnitus is a subjective complaint, it is not easy to evaluate objectively and to compare with another. In this study, we intend to estimate the effect of a variety of oriental medical treatments to tinnitus. We inquired about 30cases of tinnitus patients visited the Kwang-ju Oriental Medical Hospital of Wonkwang University from Apr. 1998 to Sep. 1998. We examined the 30cases in the view of sex, age, occupation, duration, etiologic factors, past history, associating symptoms, quality of tinnitus, and recovery rate after treatments. The results were as follows: 1. In distribution of sex, the ratio of male was $63.3\%$(19cases)and\;female\;was\;36.6\%$(11cases). 2. In distribution of age, the ratio of the 2th decade was $6.6\%(2cases),\;the\;3th\;decade\;was\;20.0\%(6cases),\;the\;4th\;decade\;was\;16.6\%(5cases),\;the\;5th\;decade\;was\;23.3\%(7cases),\;the\;6th\;decade\;was\;30.0\%\;(9cases),and\;the\;7th\;decade\;was\;3.3\%(1case)$. 3. In distribution of occupation, the ratio of employee was $23.3\%$(7cases), house-keeper was $63.3\%(11cases),\;farmer\;was\;16.6\%(5cases),\;teacher\;was\;13.3\%$ (4cases), and student, merchant, soldier was each $3.3\%$(1case). 4. In distribution of duration, the ratio of under 1month was $6.6\%$ (2cases), 1 month -6 months was $20.0\%$(6cases), 6 months- 12months was $30.0\%$(9cases), 12months-36months was $23.3\%$(7cases), and over 36months was $20.0\%$(6cases). 5. In etiologic factor of tinnitus, the ratio of unknown reason was $40.0\%$ (12cases), overwork was $16.6\%$(5cases), emotional stress was $10.0\%$(3cases), noise was $6.6\%$(2cases), cases of laying overwork upon stress was $13.3\%$(4cases), head trauma was $3.3\%$(1case), gun report was $3.3\%$ (1case), and after sickness was $6.6\%$(2cases). 6. 9 cases had experienced such a disease as meniere's disease, tympanitis, labyrinthitis, trauma of tympanum, hypertension, etc. 7. Commonly associated symptoms were dizziness, deafness, uneasiness, headache, ear fullness, fatigue, insomnia, nausea, vomiting, and forgetfulness. 8. Most frequent quality of tinnitus were buzzing, whistling, humming etc. 9. In $76.6\%$(23cases) of tinnitus patients, it was improved, but in $23.3%$(7cases) of them, not improved. Total recovery rate was $42.2\%$.

• Parasites, Hosts and Diseases
• /
• v.59 no.5
• /
• pp.507-512
• /
• 2021

Since 1993, vivax malaria has been recognized as a public health burden in Korea. Despite of pan-governmental malaria-control efforts and the dramatic reduction in the burden of this disease over the last 10 years, vivax malaria has not been well controlled and has remained continuously endemic. We focused interviewed and examined the charts of 28 confirmed vivax malaria patients given malarial therapy for whom daily records were kept from Gimpo-si, Gyeonggi-do of Korea. Various epidemiological characteristics of vivax malaria, including the incubation period, medication used, and recurrence, and an evaluation of the parasitic characteristics from the focused interviews of patients from this region are described here. Most of the participants indicated the 3 most common symptoms of malaria (headache, chills and fever). Of the 28 cases, 2 experienced a second attack and there were 17 and 11 cases with short- and long-term incubation periods, respectively, yielding a short-term to long-term ratio of 1.5. Based on the parasitemia stages, most of the participants were tested at 5 to 7 days (11 cases) and 7 to 15 days (11 cases) after initial wave of asexual parasites. In conclusion, public health authorities should consider developing management measures to decrease the time lag for diagnosis and drafting unified and robust guidelines for drug use for malaria and drawing up unified and robust guidelines on the use of medication for malaria. It also suggests that routine monitoring, surveillance, and precise medical surveys in high-risk vivax malaria endemic areas are pivotal to controlling this persistent public disease and finally eliminating it from Korea.

• Clinical and Experimental Pediatrics
• /
• v.48 no.10
• /
• pp.1107-1115
• /
• 2005

Purpose : An outbreak of ESBL-producing Shigella sonnei enteritis was unprecedented not only in Korea but throughout the world in the past. We intended to devise a management guideline for ESBL-producing shigellosis based on analysis of clinical manifestations and response to therapy. Methods : We analyzed 103 patients who were admitted to the hospital with acute GI symptoms and were shown positive result for S. sonnei on stool culture. We performed sensitivity test to the antibiotics and DNA sequencing of ESBL gene in the isolated S. sonnei colonies. In addition, we retrospectively analyzed their clinical characteristics, laboratory results, and clinical and microbiological responses to the antibiotics. Results : Among the clinical manifestations, fever was the most frequent(96.1%), followed by diarrhea(93.2%), abdominal pain(76.7%), headache(71.8%), vomiting(65.0%), and nausea(41.7%). The fever was sustained for average of 2.0 days and diarrhea for 3.9 days. Watery diarrhea was the most common(69%) followed by mucoid(26%), and bloody stool(5%). On peripheral blood smear, leukocytosis was noted in 53.4% of patients, and 78.6% of patients tested positive for serum CRP response. On stool direct smear, 11.7% of patients showed more than 50 WBCs/HPF, and 9.7% of patients between 5 to 20 WBCs/HPF. Stool occult blood was positive in 71% of patients. Production of CTX-M-14 type ESBL was reported for all S. sonnei strains isolated from this outbreak. Microbiological eradication rates to various antibiotics were as follows : 100%(9/9) to ciprofloxacin, 100% 5/5) to azithromycin, 6.9%(5/72) to cefdinir, 0%(0/8) to ceftriaxone, 12.5%(1/8) to ceftizoxime, 0%(0/ 8) to TMP/SMX, 42.9%(3/7) to ampicillin/sulbactam, 20%(1/5) to amoxicillin/clavulanic acid, and 68.8 %(11/16) to imipenem/cilastatin. Conclusion : It is presumed that azithromycin can be an attractive option for the treatment of ESBL-producing S. sonnei enteritis in pediatric population, given its cost-effectiveness and safety. Although ciprofloxacin is another cost-effective agent, its use in pediatric population may be a bit too premature.

• Radiation Oncology Journal
• /
• v.11 no.2
• /
• pp.241-247
• /
• 1993

Between July 1988 and December 1992, we treated 45 patients who had deep seated inoperable or residual and/or recurrent intracranial tumors using LINAC based stereotactic radiosurgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. Treated intracranial tumors included pituitary tumors (n=15), acoustic neurinomas (n=8), meningiomas (n=7), gliomas (n=6), craniopharyngiomas (n=4), pinealomas (n=3), hemangioblastomas (n=2), and solitary metastatic tumor from lung cancer (n=1). The dimension of treatment field varied from 0.23 to 42.88 $cm^3\;(mean;\;7.26\;cm^3)$. The maximum tumor doses ranging from 5 to 35.5 Gy (mean; 29.9 Gy) were given, and depended on patients' age, target volume, location of lesion and previous history of irradiation. There were 22 male and 23 female patients. The age was varied from 5 to 74 years of age (a median age; 43 years). The mean duration of follow-up was 35 months (2~55 months). To date, 18 $(39.1\%)$ of 46 intracranial tumors treated with SRS showed absent or decrease of the tumor by serial follow-up CT and/or MRI and 16 $(34.8\%)$ were stationary, e.g. growth arrest. From the view point of the clinical aspects, 34 $(73.9\%)$ of 46 tumors were considered improved status, that is, alive with no evidence of active tumor and 8 $(17.4\%)$ of them were stable, alive with disease but no deterioration as compared with before SRS. Although there showed slight increase of the tumor in size according to follow-up imagings of 4 cases (pituitary tumor 1, acoustic neurinomas 2, pinealoma 1), they still represented clinically stable status. Clinically, two $(4.4\%)$ Patients who were anaplastic astrocytoma (n=1) and metastatic brain tumor (n=1) were worsened following SRS treatment. So far, no serious complications were found after treatment. The minor degree headache which could be relieved by steroid or analgesics and transient focal hair loss were observed in a few cases. There should be meticulous long term follow-up inall cases.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.8 no.1
• /
• pp.163-176
• /
• 1995

The cilinical study was done in 340 patients with allergic rhinitis who had been dosed with HYUNG GAE YUN GYO TANG GAMI. The results were summarized as follows 1. Distridution by Sex and Age $64\%\;of\;them\;were\;man,\;and\;36\%$ of them were women(It was common to men than to women) Of those who were attacted(very diverse), $25.0\%$ of them were between 10 and 19 years of age(most frequent), $23.8\%$ were between 30 and 39, $18.2\%$ between 20 and 29, $14.1\%$ between birth and 9, $12.6\%$ between 40 and 49, and $6.2\%$ of them were 50 years and over. 2. Duration $47.6\%$ of them suffered from this disease for 1 to 5 years, $13.8\%$ for 10 years or longer, $24.1\%$ for both 5 to 10 years and $7.4\%$ for 6 months to 1 years, and $6.5\%$ shorter than 6 months. 3. Symptom that appeared to them were nasal obstruction($91.5\%$,top), sneezing($90\%$), rhinorrhagir($77.4\%$), headache ($30.9\%$), itch($26.8\%$), nasal discharge through gullet($15.3\%$), and pharyngitis($15.3\%$). 4. Other diseases that occured with it were sinusitis(most often), Atopic keratoconjunctivitis, allergic dermatitis, asthma, otitis media, tonsillitis, hepertropic rhinitis, nasal polyp, and atropic rhinitis(most unusual). 5. Time and Improvement After 6 months 2 cases($20\%$) were improved excellently, 3 cases($30\%$) considerablely, after 6 months to 1 year 5 case($38.5\%$) considerably, after 1 year to 5 year 10 cases($13\%$) excellently, 20 cases ($26\%$) considerably, after 5 year to 10 years 4 cases($8.7\%$) excellently, 13 cases($28.3\%$) considerable, and after 10 years 2 cases($10\%$) improved excellently, 2 cases($10\%$) considerab. 6. Dosage and Improvemont With 10 papers 6 cases($7.8\%$) were improved excellently, 22 cases($27.8\%$) considerably, with 20 papers 4 cases($10.3\%$) were improved excellently, 6 cases($15.4\%$) considerably, with 30 papers 3 cases($15.8\%$) excellently, 2 ($10.5\%$) considerably, with 40 papers 3 cases($23.1\%$) excellently, 5($38.5\%$) considerably, with 50 papers 1 cases($10\%$) excellently, 4($40\%$) considerably, with 60and 70 papers one cases($33.3\%,\;100\%$) for each was improved considerable, with 80 papers 1 cases($100\%$) excellently, and 90 papers 2 cases($66.6\%$) considerable. 7. Improvement with additional outward application With external application 8 cases($16.6\%$) were improved excellently, 9 cases($18.7\%$) considerably without external application 10 cases($8.4\%$) were improved excellently, 34 cases($28.8\%$) considerably. 8. General Improvement 18 cases($10.8\%$) were improved excellently, 43 cases($25.9\%$) improved considerably, and 40 cases($24.0\%$) improved quite a little.thus has improvement shown in 60.8 per cent of case, and proved its efficacy.

• Journal of Hospice and Palliative Care
• /
• v.7 no.2
• /
• pp.248-257
• /
• 2004

Purpose: To evaluate the efficacy of dolasetron mesylate in controlling nausea and vomiting in the first 24 hours and to extend these comparisons over the next 4 days in patients receiving moderately emetogenic chemotherapy. Methods: This was a single center, open-labeled study with single arm. Dolasetron (1.8 mg/kg) was given intravenously (I.V.) prechemotherapy with 10 mg of dexamethasone IV, followed 24 hours later by oral dolasetron (200 mg once daily) for the subsequent 4 days. The frequency of vomiting, severity of nausea and the presence of rescue antiemetics were assessed daily. Results: Of 30 patients enrolled, 28 were eligible and evaluable for the efficacy. Four out of 28 patients had complete control of nausea and vomiting without any rescue antiemetics through 5 days. The complete control got better as time went by with the rates of 17.9/46.4/42.9/53.6/60.7% on days 1 to 5. Vomiting was better controlled than nausea in both cisplatin-containing and non-containing chemotherapy. The adverse events were mild to moderate degrees of headache, diarrhea and fever, but were recovered spontaneously. Conclusion: Dolasetron was effective and safe for the control of nausea and vomiting in the patients with moderately emetogenic chemotherapeutic agents.

• Pediatric Infection and Vaccine
• /
• v.4 no.1
• /
• pp.64-72
• /
• 1997

Purpose : The incidence of tuberculous meningitis in Korean children has been markedly decreased after 1980s, but this disease has still occurred with low rate. Therefore, it may be suspected that delayed diagnosis and treatment will be happened because of lacking of clinical experiences and indistinguishable other meningitis, so it is important to make early diagnosis and treatment of tuberculous meningitis concerning with the prognosis. In this aspect, we conducted study to concern and investigate sustainly about the diagnostic criteria, clinical characteristics, radiological findings, complications, and prognosis of typical or atypical tuberculous meningitis in children. Methods : Forty four children who were hospitalized and treated due to tuberculous meningitis in pediatric wards of Our Lady of Mercy Hospital, St. Holy Hospital, St. Vincent Hospital and Uijungbu St. Mary Hospital from January 1985 to June 1996 were included in this study. We reviewed medical records of these patients retrospectively. Results : 1) The tuberculous meningitis has occured continuosly since mid-1980s. The highest 2) The diagnosis was made by contact history of active tuberculous patients, positive tuberculin test, responses of antituberculous antibiotics and discovery of Mycobacterium tuberculosis from CSF or other specimens. Among patients, 7 children(16%) were not vaccinated with BCG, and only 18 children(40%) were positive in tuberculin test. 3) The symptoms and signs of our patients on initial examinations were fever, vomiting, headache, lethargy, poor feeding, weight loss, neck stiffness, convulsion, abdominal pain and motor deficits. 4) The findings of initial CSF samples revealed leukocyte $239.5/mm^3$(mean) with lymphocyte predominant, elevated protein levels(mean;259.5mg%) and low sugar level(mean;40.7mg%). And the ratio of CSF/blood sugar was 0.407. But, atypical CSF findings were seen in 31.8% patients. 5) On brain imaging study, 34 out of 39 children had findings of hydrocephalus, basilar meningeal enhancement, infarction and subarachnoidal inflammations etc. On chest X-ray, the findings of miliary tuberculosis(34.1%), normal finding(29.5%), parenchymal infiltrations (11.4%) and calcifications(9.1%) were showed. 6) In neurological clinical stage, there were twenty-six children(59%) in stage 1, fourteen children(32%) in stage 2 and four children(9%) in stage 3. The late sequeles were encountered by 29.5% with mild and 4.6% with severe neurological injury. The most common neurological injury was quadriplegia and the mortality rate was 6.8%. 7) The SIADH was developed in 20 children(45.5%) after the 4th hospital day. Half of all SIADH patients were symptomatic. Conclusion : Tuberculosis meningitis is still an important extrapulmonary disease with high morbidity and mortality. Early diagnosis with clinical contact history of active tuberculosis and radiological imaging examinations and early treatments are essential in order to prevent and decrase the rate of late sequeles and death.

• Radiation Oncology Journal
• /
• v.9 no.1
• /
• pp.47-52
• /
• 1991

From April,1983 through April,1989, we have treated histologically proven 21 patients with oligodendroglioma using 6 MV linear accelerator at the Division of Radiation Therapy, Kangnam 51. Mary's Hospital Catholic University Medical College. These are 8% of the irradiated 246 primary brain tumors during the same period. To investigate influencing factors on the survival of irradiated U patients with oligodendroglioma, we analyzed the cerebral location of the involvements, initial symptoms, CT findings and survival rates, retrospectively. One case was lost to follow up and excluded from survival data. Of the 28 patients, thirteen were male and 8 female. Ages ranged from 5 to 68 years with a median age of 38 years. Radiation doses varied from 3900 cGy to 0480 cGy and were given for 5 to 8 weeks. All but one were supratentorial. The involvement of the frontal and parietal lobes were 10 (48%) patients in each and temporal lobe in 8 (38.1%). Histological diagnosis was made by stereotactic biopsy in 3 and postoperatively in 18. The type of surgery was divided into partial, subtotal and total resection in 7,9 and 2 cases respectively. In 6 cases, chemotherapy was also tried during or after radiation therapy. Major presenting symptoms were headache, cerebral motor, nausea & vomiting and epilepsy in 18,12, 7 and 5 respectively in decreasing order. In CT analysis, low density (02%), cystic mass (33%), calcifiestion (66%) and positive contrast enhancement (42.8%) were observed as the highest frequency. Mean survival duration after radiation therapy was 38 months (K-M methods). We could not achieve statistically significant factors influencing on the survival rate after radiation therapy for oligodendrogliomas by one or two tail test.

• Clinical and Experimental Pediatrics
• /
• v.53 no.2
• /
• pp.262-266
• /
• 2010

Tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) is a major proinflammatory cytokine involved in the pathophysiology of juvenile rheumatoid arthritis. Etanercept is an effective inhibitor of $TNF-{\alpha}$ and has shown a beneficial effect in patients with JRA. However, the most important cause of concern related to etanercept administration is infection. We report a case of encephalitis in a JRA patient receiving long-term treatment with etanercept. The patient was a 4-year-old boy with refractory JRA, and he received etanercept subcutaneously at a dose of $0.4\;mg\;kg^{-1}\;day^{-1}$ twice a week for 14 months, along with non-steroidal anti-inflammatory drugs, methotrexate, oral steroids, and sulfasalazine. The patient presented with sudden fever, headache, vomiting, a generalized tonic seizure, and changes in mental status. We suspected a central nervous system infection, and simultaneously administered antibiotics, an antiviral agent, and steroids. After 2 days of hospitalization, his mental function returned to normal, and he showed no further seizure-like movements. Brain magnetic resonance imaging scan of the patient showed a multifocal cortical lesion on both sides of the temporoparietooccipital lobe, which indicated encephalitis. Although we were unable to identify the causative organism of encephalitis, we think that the encephalitis may be attributed to infection, and the use of etanercept may have increased the risk of severe infection. Therefore, etanercept was discontinued and the patient recovered shortly after. To the best of our knowledge, this is the first case of encephalitis in a juvenile rheumatoid arthritis patient treated with etanercept.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.10 no.1
• /
• pp.383-402
• /
• 1997

The author analyzed 155 cases of Facial Palsy, excluding lesions caused by cerebrovascular attacks, who were treated in the Kwang-ju Oriental Medical Hospital of Wonkwang University from March 1996 to September 1996. I've examined the 155 cases in the view of the etiologic distributions, the age, the relationship of the sex and paralytic side, attended symptoms and analyzed 95 cases who were treated over ten times in the view of the ratio of recovery according to the age, anatomic focus, the relations of sex and paralytic side. The following results are obtained. 1. The ratio of punghan(風寒) was $20.64\%$(32 cases), overwork was $18.70\%$(29 cases), stress was $6.44\%$(10 cases), excessive drinking was $3.23\%$(5 cases), teeth pain was $1.93\%$(3 cases), and idiopathy was $38.05\%$(59) and etc. 2. The ratio of stylomastoid pain was $15.48\%$(24 cases), auricular pain was $10.32\%$(16 cases), headache was $4.51\%$(7 cases), eyedried was $4.51\%$(7 cases), taste paralysis was $2.57\%$(4 cases), tinnitus was $2.57\%$(4 cases) and non-significant symptoms was $50.97\%$(79) and etc. 3. The ratio of 2th and 5th decade were $20.00\%$(31 cases), 4th decade was $18.71\%$(29 cases), 3th decade was $16.71\%$(26 cases), 6th decade was $11.61\%$(18 cases), teenagers in $5.81\%$(9 cases), over seventy and under teenagers were $3.23\%$(5 cases), and infant was $0.65\%$(1 case). 4. The ratio of the male-right was $28.39\%$(44 cases), female-right was $25.82\%$(40 cases), male-left was $23.23\%$(36 cases), female-left was $20.65\%$(32 cases) and male-both side was $1.94\%$(3 cases) in order. 5. Topographically, The ratio of the infrachordal lesion was $72.90\%$(113 cases), transgeniculate lesion was $16.13\%$(25 cases), suprageniculate lesion was $5.81\%$(9 cases), infrastapedial lesion was $3.87\%$(6 cases) and suprastapedial lesion was $1.29\%$(2 cases) in order. 6. When we examined the degree of recovery about the 95 patients who were treated over ten times after on attack, normal improvement was seen in $46.32\%$(44 cases), excellent in $7.37\%$(7 cases), good in $12.63\%$(12 cases), fair in $13.68\%$(13 cases), poor in $20.00\%$(19 cases). The total remedial value of the 95 patients who were treated over ten times was revealed $61.58\%$. 7. When we examined the 95 patients who were treated over ten times, the remedial value of the infant was $50.00\%$, under teenagers $43.75\%$, teenagers $37.50\%$, 2th decade $56.82\%$, 3th decade $64.06\%$, 4th decade $55.00\%$, 5th decade $73.53\%$, 6th decade $77.50\%$, over seventieth $68.75\%$. The remedial value of 3th decade, 5th decade, 6th decade, 7th decade and over seventieth were higher than the total remedial value($61.58\%$) 8. In the point of topographical lesion, when we examined the 95 patients who were treated over ten times, the remedial value of infrachordal lesion was $66.78\%$, infrastapedial lesion $58.33\%$, suprastapedial lesion $50.00\%$, transgeniculate lesion $48.44\%$, suprageniculate lesion $31.25\%$, in order. Only the remedial value of Infrachordal($66.78\%$) was higher than the total remedial value($61.58\%$). 9. In the point of the relationship of the sex and the paralytic side, when we examined the 95 patients who were treated over ten times, the remedial value of male-left was $57.29\%$, male-right $61.54\%$, male-both side $58.33\$%, female-left $57.81\%$ and female-right $68.27\%$. Only the remedial value of female-right($68.27\%$) was higher than the total remedial value($61.58\%$). These results demonstrated that in the point of prognostic view there was more concerned with the topographical lesion, body condition than the traditional rule of sex-paralytic relationship that man is awed left paralysis and woman right paralysis.