BACKGROUND AND OBJECTIVES: Crying is the only mode of communication, which simultaneously reflects a variety of complex neurophysiologic and laryngeal functions in neonates. Acoustic analysis of crying, as an early noninvasive screening measure of the neurophysiological integrity, can reveal important information about the biological status of neonate. The purpose of this research was to establish normative acoustic data on healthy neonatal crying. This study also attempted to find out the differences in the pattern of healthy neonatal crying according to body weight, sex and delivery type (normal spontaneous vaginal delivery and Cesarean section). SUBJECTS AND METHOD: Crying of 33 healthy full term neonates (19 males, 14 females) were sampled within 1 wk postpartum. All neonates were free of any respiratory, laryngeal, CNS pathology according to the charts reviewed at one month. All neonates were considered to have normal hearing as they passed a hearing screening test using Evoked Otoacoustic Emission (EOAE). Body weight, sex, delivery type and Apgar score (1 min, 5 min) were measured. The acoustic characteristics of neonatal crying were analyzed by CSL (Computerized Speech Lab) using parameters such as fundamental frequency (F0), Jitter (%), Shimmer (%), NHR and formant frequency (F1, F2, F3). Statistics were analyzed by independent T-test, pearson's correlation coefficients (p<0.05, by SPSS ver 10.0). RESULTS: Mean body weight and Apgar score (1 min, 5 min) of all subjects were within normal range. Mean fundamental frequency (F0) value of healthy full term neonatal crying was 411.1 Hz. This value showed a shift to higher frequencies in neonates born by spontaneous vaginal delivery (SVD) than Cesarean section (C-sec) delivery, and so, in males than females. But statistic significance in F0 between delivery types, and between sex were not found (p-value 0.158, 0.508). Mean Jitter (%), Shimmer (%) and NHR value were 2.02, 8.34 and 0.32, respectively. These values showed a shift to higher in neonates born by C-sec delivery than SVD, and also in males than females. But statistical significance in these parameters between delivery types, and between sex were not found (p-value 0.442, 0.841, 0.301, 0.082, 0.070, 0.244). Formant frequency F1, F2 and F3 were 1882.4 Hz, 3877.9 Hz and 6053.6 Hz, respectively. There was no statistically significant difference in these values between sex, and delivery types (p-value 0.619, 0.785, 0.953, 0.255, 0.698, 0.636). For the healthy full term neonates, F0 value had a tendency to decrease as the body weight increases. But there was no significantly strong negative correlations between them. (r=-0.324, p-value 0.066). Other acoustic parameters didn't show any statistically significant relevance with body weight, either. CONCLUSION: Body weight, sex and delivery type had little influence over acoustic parameters of healthy full term neonatal crying. However, this acoustic analysis of crying could be helpful in differentiating between normal and abnormal neonates, and in screening CNS dysfunction, neurophysiologic and laryngeal abnormality.
Acoustics* ; Apgar Score ; Body Weight* ; Cesarean Section ; Crying* ; Female ; Hearing ; Humans ; Infant, Newborn ; Male ; Mass Screening ; Pathology ; Postpartum Period ; Pregnancy ; Reference Values

BACKGROUND AND OBJECTIVES: The objective of this article is to evaluate the effectiveness and the compliance rates of immunotherapy, and to identify the factors affecting the compliance of immunotherapy. SUBJECTS AND METHOD: We evaluated the charts of 120 patients with allergic rhinitis and/or asthma, for which allergen immunotherapy was carried out from 1998 and 2000. Information was obtained via chart reviews and telephone surveys. RESULTS: Among the 120 patients with allergic rhinitis, 41 patients also had asthma. The common allergens identified by the skin prick test prior to immunotherapy were D. farinae, D. pteronyssinus, dog fur, cat fur, and cockroaches, et al. The skin prick test reactivity to common allergens is significantly lower after three years of immunotherapy than it is prior to immunotherapy. The satisfaction of patients after immunotherapy between the allergic rhinitis group and allergic rhinitis with asthma group are as follows: much satisfied (25.4%/27.3%), fairy satisfied (31.6%/33.7%), a little satisfied (15.2%/17.2%), not satisfied (17.1%/13.3%), and unsure (10.7%/8.5%). In our study, the compliance rates of immunotherapy were 65.7%. The reasons cited for discontinuance of allergen immunotherapy were inconvenience (45%), lack of improvement in symptoms (23%), improvement in symptoms (15%), greater improvement in symptoms through medication (11%), and other reason (7%). CONCLUSION: If we increase the compliance of immunotherapy through various researches on the compliance of immunotherapy and educating patients about it, allergen immunotherapy may become more effective in treating allergic disorders.
Allergens ; Animals ; Asthma ; Cats ; Cockroaches ; Compliance* ; Desensitization, Immunologic ; Dogs ; Humans ; Immunotherapy* ; Rhinitis* ; Skin ; Telephone

BACKGROUND AND OBJECTIVES: Magnetic resonance (MR) imaging has resulted in a tremendous advance in the technology of medical diagnosis. However, even with all positive advances, there are usually some negative aspects, especially noise. It is well known that loud sounds can induce a hearing loss. This study was performed to determine the acoustic characteristics of MRI noise and whether or not the sound exposure resulting from routine MRI examinations is capable of altering the auditory thresholds of patients. MATERIALS AND METHOD: Digital Impulse Sound Level Meter was placed at patient's head level and at a 2m distance. Frequency of MRI noise was recorded by Digital audio tape and analyzed by Computerized Sound Lab (CSL). A total of 53 adults (106 ears) who were scheduled for MR imaging studies were included in the study. Pure-tone air-conductive auditory threshold was determined bilaterally in each patient before and after MRI. RESULTS: The noise levels at head level ranged from 80.8 dB to 86.0 dB, and at a 2 m distance, from 71.9 dB to 75.9 dB. The frequency ranged from 60 Hz to 2500 Hz. Nine of the 106 ears had a hearing loss of at least 10 dB at one frequency. CONCLUSION: The noise generated by the MRI is sufficiently intense to cause some temporary threshold shifts (TTS). TTS may transform to permanent threshold shifts. Therefore, it is important to devise a method to minimize the risk of these shifts, for example, by using earplug.
Acoustics* ; Adult ; Auditory Threshold ; Diagnosis ; Ear ; Ear Protective Devices ; Head ; Hearing Loss* ; Hearing* ; Humans ; Magnetic Resonance Imaging* ; Noise*

BACKGROUND AND OBJECTIVES: Although children's personality and behavior change caused by adenotonsillar hypertrophy have been thought to significantly relate with children's growth and learning capability, it has not been substantiated by any available standarized assessment. We aim to uncover the impact of adenotonsillar hypertrophy on children's personality and behavior by K-CBCL (Korean Child Behavior Checklist) and KPI-C (Korean Personality Inventory for Children). MATERIALS AND METHOD: Children aged 5 through 15 years old, a total of 33 (M: 18 F: 15) who were scheduled for T & A (Tonsillectomy and Adenoidectomy), were studied. The control group consisted of 42 healthy children (M: 22 F: 20) of the same age. Two standard questionnaires, K-CBCL and KPI-C, were given to the parents of the children to complete and then a statistical analysis carried out by a clinical psychologist for interpretation (p<0.05, by SPSS v10.0). RESULTS: According to K-CBCL, internalizing problems and total behavior problems were of statistical significance for the patient group compared to healthy children (p<0.05). KPI-C test revealed statistical significance on ERS (ego resilience scale), ANX (anxiety), SOM (somatization) and FAM (familial relationship)(p<0.05). In both groups, the results between gender were quite different. In female patient group, the total behavior problems were indicated, while in the male patient group, the total behavior problem, internalizing problem as well as somatic complaints were indicated. Especially, indications of ERS and SOM were of statistical significance (p<0.05). CONCLUSION: Children with adenotonsillar hypertrophy have difficulty in adaptation, and lack the ability to respond to situation, and easily get broken down by stress, and experience frequent anxiety.
Adenoids ; Adolescent ; Anxiety ; Child Behavior ; Child* ; Female ; Humans ; Hypertrophy* ; Learning ; Male ; Palatine Tonsil ; Parents ; Personality Inventory ; Psychology ; Surveys and Questionnaires

To characterize the genetic diversity of bovine viral diarrhea viruses (BVDV) circulating in Korea, 11 BVDV isolates were obtained from 467 field samples collected during 2005~2006 in Korea. All of the BVDV isolates were identified as non-cytopathic (non-cp) BVDV biotypes. The 5' noncoding region (NCR) genes of the isolates were sequenced and analyzed. In total, ten BVDV isolates were typed as BVDV-1 by comparing the genomic sequences to the 5' NCR. One isolate (05R169) showed 98.6% nucleotide sequence identity with the BVDV-2 reference strain and was therefore typed as BVDV-2. Our results indicate that BVDV-1 is the main genotype circulating in the cattle population of Korea.
Animals ; Base Sequence ; Cattle ; Diarrhea Virus 1, Bovine Viral ; Diarrhea Virus 2, Bovine Viral ; Diarrhea Viruses, Bovine Viral* ; Genetic Variation ; Genotype ; Korea*

BACKGROUND: Liver fibrosis by the progression of the chronic processes of the liver diseases induces deforrned microcirculations of the hepatic lobules. And this eventually resolted in portal hypertension. On the other hands, angiogenic stimu4nt factors are physiologically activated in order to repair the tissue damage. Overexpression of angiogenic factors, however, can stimulate neovascularization as in a fonnation of the tumor that liberates uncontrolled overgrowing of the tumor cells. METHODS: To elucidate the dynamic changes of the serum concentration of angiogenin in chronic liver diseases, this study is intended to employ an ELISA in 44 pathologically proven patients. Quantikiae human angiogenin kit (R and D,systems Inc. Mmneapolis, MN) was used for this investigation. RESULTS: Mean value and standard error of angiogenin concentration (ng/ml) of the sera was 238.92+/-50.95 in 5 cases of chronic persistent hepatitis, 184.47+/-12.75 in 6 cases of chronic active hepatitis, 131.36+/-10.99 in 19 cases of liver cirrhosis, and 211.03+/-19.08 in 14 cases of hepatocellular carcinoma, respectively. Serum angiogenin level in the liver cirrhosis was significantly lower than in chronic persistent hepatitis(p=0.00336), and than in chronic active hepatitis(p=0.018673). Angiogenin concentration in hepatocellular carcinomas was significantly higher than the level of the liver cirrhosis investigated(p=0.00569). CONCLUSIONS: These data support that persistent inflammatory insults in the chronic hepatitis were compensated by the elevation of angiogenin but complete fibrosis as in liver cirrhosis showed the depressed level. And emerging of the hepatocellular carcinoma is accompanied by the elevated stimuli of angiogenin for the neovascularization.
Angiogenesis Inducing Agents ; Carcinoma, Hepatocellular ; Enzyme-Linked Immunosorbent Assay* ; Fibrosis ; Hand ; Hepatitis, Chronic ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Liver Diseases* ; Liver*

Duodenal duplication cysts are rare congenital malformations. Most symptomatic cases are diagnosed in children and usually present with obstructive findings or bleeding symptoms. Treatment traditionally involves surgical resection, which can be often difficult because of the close proximity of the cysts to the papilla and bilopancreatic confluence. Endoscopic therapy has been used as an alternative to open surgery in a few selected cases. We report a case with a duodenal duplication cyst containing a brown pigmented stone within the cystic lumen. He was visited because of sudden right upper quadrant abdominal pain. An abdominal computed tomography revealed the presence of a cyst with a stone, which was finally removed by endoscopic resection.
Abdominal Pain ; Ampulla of Vater ; Child ; Hemorrhage ; Humans

Rotor syndrome is a rare, benign familial disorder characterized by chronic fluctuating, nonhemolytic and predominantly conjugated hyperbilirubinemia with normal hepatic histology. In contrast to Dubin-Johnson syndrome, there is no liver pigmentation in Rotor syndrome. A 36-year-old man was admitted due to asymptomatic persistent jaundice. His siblings had jaundice with direct hyperbilirubinemia. Physical examination revealed icteric sclerae without hepatosplenomegaly. Laboratory findings showed increased serum bilirubin with direct bilirubinmia. Hepatic uptake and storage capacity of indocyanine green was markedly reduced, while excretion into bile was slightly suppressed. Markedly decreased hepatic uptake and poor visualization of the gallbladder and biliary tract were shown in 99mTc-DISIDA scan. Histology of the liver showed mild steatosis without pigmentation. We report a case with the review of literature.
Adult ; Coloring Agents/*diagnostic use/pharmacokinetics ; Humans ; Hyperbilirubinemia, Hereditary/diagnosis/genetics/radionuclide imaging ; Indocyanine Green/*diagnostic use/pharmacokinetics ; Jaundice, Chronic Idiopathic/*diagnosis/radionuclide imaging ; Liver/radionuclide imaging ; Liver Function Tests ; Male ; Radiopharmaceuticals/*diagnostic use ; Technetium Tc 99m Disofenin/*diagnostic use

Epithelioid hemangioendothelioma is a rare vascular origin tumor which usually occurs in soft tissues, liver, and lung. It usually affects adult women and presents as multiple hepatic nodules with mainly peripheral distribution. It is difficult to diagnose and treat because of non-specific clinical manifestations and findings on the imaging study. Moreover, pathological misdiagnosis is common. We report a case of this rare tumor that was detected incidentally. Final diagnosis was based on histological evidence. A 52-years old man suffered from right upper quadrant abdominal pain for 3 months, and was initially misdiagnosed as a metastatic carcinoma. Physical examination revealed superior cervical lymphadenopathy with mild hepatomegaly. Finally, hepatic epithelioid hemangioendothelioma was diagnosed on the basis of positive immunohistochemical staining for factor VIII, CD34, and VEGF. Our case highlights the importance of a histological diagnosis to avoid misdiagnosis.
Antigens, CD34/analysis/immunology ; Carcinoma/secondary ; Diagnosis, Differential ; Factor VIII/analysis/immunology ; Hemangioendothelioma, Epithelioid/*diagnosis/pathology ; Humans ; Immunohistochemistry ; Liver Neoplasms/*diagnosis/pathology ; Male ; Middle Aged ; Positron-Emission Tomography

A lymphoepithelial cyst of the pancreas is a rare, benign disease. A 58-year-old man with no abdominal symptoms was found to have a cystic mass in the pancreas. Computed tomography showed a multi-septated cystic mass in the tail of the pancreas. We performed a distal pancreatectomy with a splenectomy. Histological examination revealed that the cyst wall was lined with squamous epithelium and surrounded by lymphoid tissue. Keratinous material was present in the cyst. A lymphoepithelial cyst of the pancreas should be considered in the differential diagnosis of all cystic pancreatic lesions. Fine-needle aspiration biopsy may be a useful strategy, but local surgical resection of the cyst, for most patients, should be considered to exclude malignancy.
Biopsy, Fine-Needle ; Diagnosis, Differential ; Epithelium ; Humans ; Keratins ; Lymphoid Tissue ; Middle Aged ; Pancreas ; Pancreatectomy ; Splenectomy