Purpose : Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system and mostly develops after viral illness or vaccinations. We investigated the clinical differences and neurologic outcomes according to the distribution of the lesions on brain MRI. Methods : The study group was composed of 21 patients from January 1995 to August 2003 in Kyunghee University hospital. We grouped the patients according to the MRI findings as follows. Group I (14 cases): Multi- or unifocal lesions only in the cerebral white matter. Group II (7 cases): lesions in the gray matter with or without white matter involvement. Results : 1. Preceding events were as follows: no defined prodrome (38.1%), upper respiratory tract infection (28.6%), nonspecific febrile illness (19.0%), gastointestinal disturbance and vaccination. 2. Presenting symptoms were as follows: seizures (76.2%), headache/vomiting (47.6%), altered consciousness (38.1%), hemiparesis, cerebellar ataxia, visual disturbance and facial nerve palsy. 3. Laboratory findings were as follows: CSF pleocytosis (76.2%), leucocytosis (38.1%) and elevated CSF protein (28.6%). 4. Fifteen patients were recovered completely without neurological sequelae. Three patients in group I and 1 patient in group II had intractable seizures. Two patients in group I and 2 patients in group II had motor disturbance. Conclusion : There were no statistically significant differences in preceding events, presenting symptoms, and neurological outcomes according to the distribution of the lesions on brain MRI. However, the ADEM have quite diverse clinical manifestations and neuroimage findings. MRI plays an important role in making diagnosis of the patients who are suspected of ADEM.
Journal of agricultural medicine and community health
/
v.21
no.1
/
pp.61-73
/
1996
This study conducted to determine the attitude on environment pollution by Pohang city citizens. 1,059 Pohang city citizens in the age group 20 and over were chosen and surveyed by officials's interview at Up, Myun and Dong during the period 6 September to 20 September 1995. The issue problems to be solved in Pohang city were traffic control 47.3%, environment pollution 22.7%, cultural institutions 11.6%, water service 9.9%, education system 5.1% and community security 2.1%. The 55.1% of subjects responded that responsibility for environment pollution is every citizens duty. The trash from houses were 'garbage'(48.1%), 'waste of life'(21.8%), 'reuse trash'(15.6%) and 'one use thing'(14.5%) in order. The 66.9% of subjects responded that the trash's standard envelopes can be easily tear and its texture is not good. The respondents sometimes or often had experienced foreign bodies, sediment in the water service supply. The 45.9% of the respondents use natural water as drinking water, and the water service supply(26.7%), underground water(17.0%) and buying water(9.3%) were followed. Pertaining to the air pollution(by percent) was pollution of the steel industry complex 78.0%, combustive gas 16.6% and construction dust 1.7%. The respondents at southern district complained of respiratory tract by air pollution and the respondents at northern district complained of the visual disturbance and the offensive odor(P<0.05). Water pollution problem is factory's wastewater 56.2%, home wastewater 36.4% and livestock's wastewater 5.6% in order. The respondents at southern district complained of the noise pollution by airplanes and factories at the afternoon and the respondents at northern district complained of the noise pollution by vehicles(P<0.05).
This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.
Kim, Joon Young;Lee, Eun Seob;Bang, Ji Seok;Oh, Yeon Joung;Lee, Yong Ju;Sung, Tae-Jung;Lee, Kon-Hee;Lee, Jung Won
Childhood Kidney Diseases
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v.18
no.2
/
pp.71-76
/
2014
Purpose: Attention deficit hyperactivity disorder (ADHD) has been associated with impairments in frontal inhibitory function and the catecholaminergic system. ADHD is diagnosed in 3-5% of children. Children with ADHD seem develop various forms of urinary problems such as nocturnal enuresis, dysfunctional voiding, and diurnal incontinence. However, no data exist to confirm the presence of these problems in Korean children with ADHD. We investigated the clinical findings of voiding dysfunction in children with ADHD. Methods: Between October 2009 and March 2011, a total of 63 children (33 with ADHD, 30 with an upper respiratory infection, as a control group) were enrolled. ADHD was diagnosed using the diagnostic and statistical manual of mental disorders (DSM)-IV criteria. A comprehensive survey of voiding and defecation was administered. Results: The patient group included 28 boys and 5 girls; the control group comprised 20 boys and 10 girls. The mean age was $9.09{\pm}2.8$ years in the ADHD group and $8.58{\pm}3.1$ years in the control group. Children with ADHD had a statistically significantly higher incidence of urgency (P =0.017), urge incontinence (P =0.033), and constipation (P =0.045). There was no significant difference in the incidence of straining, intermittency, holding maneuvers, or nocturnal enuresis. Conclusion: Children with ADHD in Korea have significantly higher rates of urgency, urge incontinence, and constipation than those without ADHD.
Lee, Kun Song;Son, Jae Sung;Chung, Eun Hee;Bae, Hong Ki;Lee, Mee Jeong;Yu, Jeesuk;Chang, Young Pyo;Park, Woo Sung;Kim, Jae Kyoung;Rheem, Insoo;Roh, Eui-Jung
Pediatric Infection and Vaccine
/
v.16
no.2
/
pp.175-182
/
2009
Purpose : A number of countries have experienced an increase in pertussis during the past decade. In particular, there has been an increase in the incidence rate among adolescents and adults. To learn more about the current epidemiology of pertussis, we studied the prevalence and clinical characteristics of pertussis in children in Cheonan, South Korea. Methods : We collected nasopharyngeal aspirates of 118 patients who were treated for respiratory symptoms at Dankook Univeristy Hospital between March 2008 and September 2009. We performed multiplex PCR for detection of Bordetella pertussis in those aspirates. Results : Of the 118 patients, 10 (8%) were positive by PCR for B. pertussis. Six episodes occurred during the period July to September 2009. Nine of the 10 patients were less than 3 months old. Seven of them had not received DTaP vaccine. The mean duration of coughing before diagnosis was 10.9${\pm}$5.2 days. Ten patients (100%) had paroxysmal cough and 8 (80%) had post-tussive vomiting. Only one patient had fever. One who had complications that include pneumonia, atelectasis and pneumomediastinum developed an absolute increase in leukocyte count (84,400/$mm^3$). There was a statistically significant relation between vaccine being received and development of complications (P =0.033). Conclusion : We suspect that there was an epidemic of pertussis between July and September 2009. Further investigation by a pediatric or nationwide surveillance system is needed to monitor the changing epidemiology for pertussis.
Korean Journal of Agricultural and Forest Meteorology
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v.11
no.2
/
pp.52-60
/
2009
This study was conducted to quantify the soil respiratory $CO_2$ emission (SR) in an apple orchard and to determine its relationship with key environmental factors such as air temperature, soil temperature and soil moisture content. Experiment was made over the period from 23 April 2007 to 31 March 2008 in 'Fuji' apple orchard of National Institute of Horticultural and Herbal Science in Suwon, Gyeonggi-do, Korea. The SR was measured by using the automatic opening/closing chamber system based on a closed method. Diurnal variations in SR showed an increase around 0700 hours with increasing soil temperature, its peak between 1400 and 1500 hours, and then a gradual decrease thereafter. Daily variations in SR depended largely on soil and air temperatures over the year, ranging from 0.8 to 13.7 g $CO_2$$m^{-2}d^{-1}$. During the rainy spell in summer (July$\sim$Autumn) with higher temperature and more precipitation, the SR was lower than that in the spring (May$\sim$June) with moderate temperature. The SR showed a significant exponential relationship with soil temperature ($r^2=0.800$) and air temperature ($r^2=0.805$), but not with soil moisture content ($r^2=0.160$). The $Q_{10}$ values of SR with annual soil temperature and air temperature were 2.0 and 1.9, respectively. The annually integrated SR was 19.6 ton $CO_2$$ha^{-1}$.
The purpose of this study was to describe quantitatively trophic structures and to analyze energy flows in the Lake Namyang using the Ecopath with ecosim (Walter et al., 1997). The sampling and analyses were carried out at 6 sampling sites of the Lake Namyang during May and November in 2007. A total of 10 groups were considered in this study (detritus, macrophytes, phytoplankton, zooplankton, zoobenthos, Cyprinus carpio, Carassius cuvieri, Carassius auratus, Pseudobagrus fulvidraco and other fishes) to assess the trophic relationship, energy flows and interactions between them. As a result, it was concluded that Lake Namyang was consisted of primary producers (Detritus, Macrophytes, Phytoplankton), primary consumers (Zooplankton, Zoobenthos, Cyprinus carpio, Carassius cuvieri, Carassius auratus, Other fishes) and secondary consumer (Pseudobagrus fulvidraco). The total system throughput was estimated at $14.1\;kg\;m^{-1}\;year^{-1}$ including a consumption of 39%, exports of 21%, respiratory flows of 12% and flows into detritus of 28%. MTI analyses indicate that Pseudobagrus fulvidraco have positive impact on Cyprinus carpio, Carassius cuvieri and Carassius auratus. On the other hand, other fishes have negative impact on Cyprinus carpio, Carassius cuvieri and Carassius auratus. All the functional groups except detritus had a negative impact on themselves and this may show within-group competition for the same resources.
Journal of the korean academy of Pediatric Dentistry
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v.40
no.1
/
pp.66-71
/
2013
Muscular dystrophy is a genetically heterogeneous group of disorders characterized by progressive muscle weakness of variable distribution and severity. Fukuyama type congenital muscular dystrophy (FCMD) is an unusual form of muscular dystrophy with autosomal recessive inheritance and is clinically characterized by an early age of onset, severe central nervous system involvement, facial muscle weakness, and multiple joint contractures. Muscular dystrophy is susceptible to perioperative respiratory, cardiac and other complications. Patients with FCMD have upper airway muscle weakness, therefore general anesthesia is preferred to sedation regarding maintaining the airway when treating these patients. The development of malignant hyperthermia in general anesthesia for patients with muscular dystrophy is a concern. Total intravenous anesthesia should be used instead of inhaled anesthetics because of the risk of malignant hyperthermia. A 3-year-9-month old, 13kg girl with Fukuyama type congenital muscular dystrophy was scheduled for dental treatment under general anesthesia. She had multiple caries and 14 primary teeth needed caries treatment. Prior to general anesthesia, oral premedication with 9 mg midazolam was given. General anesthesia was induced and maintained with target controlled infusion of propofol $3{\sim}3.5{\mu}g/mL$. The patient with progressive muscular dystrophy was successfully treated under total intravenous anesthesia with a target controlled infusion of propofol. There were no complications related to anesthesia and dental treatment during or after the operation. This case suggests that target controlled infusion of propofol is a safe and appropriate anesthetic technique in FCMD patients for dental treatment.
In this experiment American Summer Pairman apple was selected as test fruit in order to study the effect of sub-atmospheric pressure storage in the apple. keeping a certain pressure condition, a new sub-atmospheric pressure system was designed and constructed in which fruits were stored at $25^{\circ}C$ under two different atmospheric pressure conditions such as Normal Atmospheric Pressure (NAP) and Sub-Atmospheric Pressure (SAP). Moreover, they were divided into plots of 5% and 0% of $CO_2$, on the basis of gas composition. Under these conditions, the amount of respiration and ethylene evolution, and the changes of intercellular gas composition and organic components were investigated throughout the storage. The results obtained are as follows: (1) The intercellular gas was exhausted so rapidly by the SAP treatment that the gas equilibrium in the tissues reached within 5 minutes. (2) The amount of respiration was found to be higher in plots of NAP than SAP, and under the conditions, controlling $CO_2$ content, plots of $CO_2$ 5% were lower in the amount of respiration than $CO_2$ 0%. The climateric rise was revealed more slowly in plots of the SAP than NAP. These results indicate that the SAP treatment was an efficient method for controlling the respiration of fruits. Furthermore, these results were also realized with the results of the respiratory quotient (R.Q) and intercellular gas composition. (3) Evolution of ethylene, the ripening hormone in plant, was shown the similar tendency to the climacteric pattern of respiration; at the stage of climacteric maximum, the maximun amount of ethylene was found earlier in plots of NAP than SAP, and post climacteric stage was prolonged in the plots of the SAP compared to those of the NAP. The ethylene concentration in tissue appeared lower in plots of the SAP than NAP, which might suggest that the SAP treatment was caused to restriction of ethylene evolution. (4) Effects of the SAP treatment mentioned hitherto were proved also with the test of the external appearance such as changes of color and freshness, firmness, rotting and weight loss. (5) In the investigation of organic components, vitamin C and organic acids varied less in plots of SAP than NAP. Specially, it was remarkable that the loss of malic acid was least decreased by the SAP treatment. These effects of the SAP treatment were distinctive in the changes of the ratios of malic and citric acid to total acid, and the ratios of free sugar to free acid.
Pseudomonas aeruginosa is a Gram (-) opportunistic human pathogen causing a wide variety of infections on lung, urinary tract, eyes, and burn wound sites and quorum sensing (QS), a cell density-sensing mechanism plays an essential role in Pseudomonas pathogenesis. In order to investigate the importance of QS in the Pseudomonas infections of Korean patients, we isolated 189 clinical strains of P. aeruginosa from the patients in Pusan Paik Hospital, Busan, South Korea. The QS signal production of these clinical isolates was measured by signal diffusion assay on solid media using reporter strains. While most clinical strains (79.4%) produced the QS signals as similar level as a wild type strain, PAO1 did, where LasR, the initial QS signal sensor-regulator was fully activated, a minority of them (4.2%) produced much less QS signals at the level to which LasR failed to respond. Similarly, while 72.5% of the clinical isolates produced QS signals enough to activate QscR, an another QS signal sensor-regulator, some few of them (9%) produced the QS signals at much lower level where QscR was not activated. For further analysis, we selected 74 clinical strains that were obtained from the patients under suspicion of Pseudomonas infection and investigated the total protease activity that is considered important for virulence. Interestingly, significant portion of them showed very low protease activity (44.6%) or no detectable protease activity (12.2%). When the biofilm-forming ability that is considered very important in chronic infection was examined, most isolates showed lower biofilm-forming activity than PAO1. Similarly, significant portion of clinical isolates showed reduced motility (reduced swarming activity in 51.4% and reduced twitching activity in 41.9%), or non-detectable motility (swarming-negative in 28.4% and twitching-negative in 28.4%). Our result showed that the clinical isolates that produced QS signals at the similar level to wild type could have significantly reduced activities in the protease production, biofilm formation, and motility, and some clinical isolates had unique patterns of motility, biofilm formation, and protease production that are not correlated to their QS activity.
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