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

BACKGROUND/AIMS: Upper gastrointestinal endoscopy is usually recommended for the evaluation of esophageal varices in patients with liver cirrhosis. However, the prevalence of varices is extremely variable. We performed this study to determine the predictive values for esophageal varices and to select eligible patients for screening endoscopy. METHODS: Fifty-two patients were enrolled in this study. Laboratory tests including liver biochemistry and complete blood count along with ultrasonography with Doppler measurements and endoscopy were performed. RESULTS: Esophageal varices were present in 25 patients (48%). Variables associated with the presence of esophageal varices on univariate analysis were serum albumin, total bilirubin, prothrombin time and platelet count (p<0.05). Significant variables in ultrasonography with Doppler measurement were diameter of spleen (13.04+/-2.1 cm vs. 10.39+/-1.6 cm, p<0.001), peak velocity of portal vein (30.2+/-7.5 cm/sec vs. 36.1+/-8.0 cm/sec, p<0.01) and portal vein diameter (1.26+/-0.28 cm vs. 1.13+/-0.18 cm, p<0.05). On multivariate analysis, independent variables were platelet count (odds ratio (OR) 0.922; 95% confidence interval (CI), 0.86-0.99), diameter of spleen (OR 5.4; 95% CI, 1.63-17.88) and platelet count/spleen diameter ratio (OR 1.007; 95% CI, 1.01-1.02). The optimal critical value for the diameter of spleen was 11 cm. The sensitivity and specificity with this value were 84% and 63%, respectively. CONCLUSIONS: Doppler measurement was not helpful in distinguishing the presence of varices. However, clinical tests including biochemistry and ultrasonography would be useful in selecting eligible patients for screening endoscopy. Endoscopic screening for esophageal varices is recommended in cirrhotic patients with splenomegaly.
Adult ; Aged ; Blood Chemical Analysis ; Blood Flow Velocity ; Chronic Disease ; Esophageal and Gastric Varices/complications/*diagnosis/ultrasonography ; Female ; Humans ; Liver Cirrhosis/complications ; Liver Diseases/*complications ; Male ; Middle Aged ; ROC Curve ; Severity of Illness Index ; *Ultrasonography, Doppler

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

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

BACKGROUND/AIMS: Obesity tends to be associated with increased mortality and morbidity in acute pancreatitis. However, in Asian populations, higher morbidity and mortality have been reported in patients with low body mass indexes (BMIs). This study was undertaken to evaluate the relation between obesity and outcome, and to investigate the occurrence of complications by overweightedness in acute pancreatitis. METHODS: The medical records of 403 patients with acute pancreatitis were reviewed retrospectively, and Ranson's scores, modified Glasgow scores, Acute Physiology and Chronic Health Evaluation (APACHE) II scores and computed tomography severity indexes were calculated. Patients were categorized by BMI for the analysis. RESULTS: When compared with normal patients (BMI 18.5 to 22.9), all categories with a BMI > or =23 had an increased risk of developing a severe form of acute pancreatitis (p=0.003) and all categories with a BMI > or =25 significantly predicted severity (p<0.001). Patients with class 1 obesity (BMI 25 to 29.9) developed significantly more systemic and metabolic complications. CONCLUSIONS: Overweightedness and obesity were found to be associated with a higher risk of developing severe pancreatitis. Further studies are needed to establish the precise prognostic value of obesity in members of the population with low BMIs.
APACHE ; Asian Continental Ancestry Group ; Body Mass Index ; Humans ; Medical Records ; Obesity ; Overweight ; Pancreatitis ; Retrospective Studies

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

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*