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: 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: 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: 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

Rendu-Osler-Weber disease is characterized by hereditary transmission, and by the presence of multiple telangiectases of the skin, mucous membranes, and internal organs. We present a case of Rendu-Osler-Weber disease with bleeding from gastric telangiectases that was successfully treated by endoscopy with the use of argon plasma coagulation (APC). A 65-year-old woman presented with melena. Endoscopy disclosed multiple telangiecatses in the whole stomach. APC was performed at an output of 50 W and with an argon gas flow rate of 2 L/min. Only multiple ulcers at the treated sites were seen 7 days after the procedure and fibrotic scars with contracted mucosal folds without active bleeding signs were noted 2 months later.
Aged ; Argon ; Argon Plasma Coagulation ; Cicatrix ; Contracts ; Endoscopy ; Female ; Hemorrhage ; Humans ; Melena ; Mucous Membrane ; Skin ; Stomach ; Telangiectasia, Hereditary Hemorrhagic ; Telangiectasis ; Ulcer

We report herein a case of 35-years-old woman in whom portal hypertension (esophageal varix and splenomegaly) developed after 12 cycles of oxaliplatin based adjuvant chemotherapy for rectal cancer. She was transferred for the evaluation of etiology of new-onset portal hypertension. The esophageal varix and splenomegaly were absent before the oxaliplatin based adjuvant chemotherapy. Thorough history taking and serological exam revealed no evidence of chronic liver disease. Liver biopsy was done and there was no cirrhotic nodule formation. Instead, perivenular fibrosis was noted. Considering new development of esophageal varices and splenomegaly after 12 cycles of oxaliplatin-based adjuvant chemotherapy, we could conclude that portal hypertension in this patient were due to sinusoidal injury by oxaliplatin. Finally, we recommend regular follow-up with endoscopy and radiologic examination for checking the development of varices and for screening of varices and splenomegaly in patients with colo-rectal cancer who receive oxaliplatin-based chemotherapy.
Adult ; Antineoplastic Agents/*adverse effects/therapeutic use ; Chemotherapy, Adjuvant ; Esophageal and Gastric Varices/chemically induced ; Female ; Fibrosis ; Humans ; Hypertension, Portal/chemically induced/*diagnosis ; Liver/pathology ; Organoplatinum Compounds/*adverse effects/therapeutic use ; Positron-Emission Tomography ; Rectal Neoplasms/*drug therapy/surgery ; Splenomegaly/chemically induced ; Tomography, X-Ray Computed

We report herein a case of 35-years-old woman in whom portal hypertension (esophageal varix and splenomegaly) developed after 12 cycles of oxaliplatin based adjuvant chemotherapy for rectal cancer. She was transferred for the evaluation of etiology of new-onset portal hypertension. The esophageal varix and splenomegaly were absent before the oxaliplatin based adjuvant chemotherapy. Thorough history taking and serological exam revealed no evidence of chronic liver disease. Liver biopsy was done and there was no cirrhotic nodule formation. Instead, perivenular fibrosis was noted. Considering new development of esophageal varices and splenomegaly after 12 cycles of oxaliplatin-based adjuvant chemotherapy, we could conclude that portal hypertension in this patient were due to sinusoidal injury by oxaliplatin. Finally, we recommend regular follow-up with endoscopy and radiologic examination for checking the development of varices and for screening of varices and splenomegaly in patients with colo-rectal cancer who receive oxaliplatin-based chemotherapy.
Adult ; Antineoplastic Agents/*adverse effects/therapeutic use ; Chemotherapy, Adjuvant ; Esophageal and Gastric Varices/chemically induced ; Female ; Fibrosis ; Humans ; Hypertension, Portal/chemically induced/*diagnosis ; Liver/pathology ; Organoplatinum Compounds/*adverse effects/therapeutic use ; Positron-Emission Tomography ; Rectal Neoplasms/*drug therapy/surgery ; Splenomegaly/chemically induced ; Tomography, X-Ray Computed

Recent global warming trends may have a significant impact on vector-borne viral diseases, possibly affecting vector population dynamics and disease transmission. This study measured levels of hemagglutination-inhibition (HI) antibodies against Japanese encephalitis virus (JEV) and neutralizing antibodies against Akabane virus (AKAV) and Aino virus (AINV) for Thoroughbred horses in Korea. Blood samples were collected from 989 racehorses in several provinces, between October 2005 and March 2007. Sera were tested using either an HI assay or a virus neutralization test. Approximately half (49.7%; 492/989) of the horses tested were antibody-positive for JEV. The HI titer against JEV was significantly correlated with racehorse age (p < 0.05). Horses with an HI antibody titer of 1: 160 or higher accounted for 3.9% of the animals tested, indicating that vectors transmitting arthropod- borne viruses bit relatively few horses. In contrast, 3.8% (19/497) and 19.5% (97/497) of horse sera collected in March 2007 were positive against AKAV and AINV, respectively. The presence of antibodies against AKAV and AINV may indicate the multiplication of AKAV and AINV in these horses.
Aging ; Animals ; Encephalitis Virus, Japanese/*isolation & purification ; Hemagglutination Inhibition Tests/veterinary ; Horse Diseases/blood/*epidemiology ; Horses ; Korea/epidemiology ; Orthobunyavirus/*isolation & purification ; Seroepidemiologic Studies

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

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