Cricopharyngeal dysfunction (CPD) has various treatment options, such as balloon dilatation (BD), botulinum toxin injection, and myotomy of the cricopharyngeal muscle. BD is less invasive, easier to implement, and economical compared to other treatments. In this study, the effectiveness and mechanism of repeating BDs in patients with CPD were verified through a videofluoroscopic swallowing study (VFSS) and high-resolution manometry (HRM). A 44-year-old male developed dysphagia after large epidural hemorrhage in the left-brain hemisphere concurrent with diffuse axonal injury. CPD was confirmed in a videofluoroscopic swallowing study, which he first performed 10weeks after a traumatic brain injury. Repetitive BDs were performed at 11, 12, 15, 18, 40, and 52 weeks after injury. Before and after the procedure, successive physiological changes were observed by HRM. The UES nadir pressure decreased from 6.4 mmHg to −2. 1 mmHg after the first procedure. The pharyngeal residue after swallowing also decreased below 50% due to relaxation of the upper esophageal sphincter (UES), and the decrease in UES pressure was maintained at 52 weeks. The patient showed improved symptoms and could eat a regular diet. This report supports repetitive videofluoroscopic guided BDs as a therapeutic option for CPD.

PURPOSE: The aim of this study was to determine the causes of hemoptysis in a pediatric age group. METHODS: We conducted a retrospective chart review of all patients who were admitted to Samsung Medical Center between 1996 and 2008 with a chief complaint of hemoptysis. Patients with trauma or underlying bleeding tendency such as leukemia were excluded. Patients were divided into three groups according to age (0 to 5 yr, 6 to 10 yr, and 11 to 18 yr). The amount of hemoptysis was classified as mild (< or =20 mL/day), moderate (20-100 mL/day), or massive (>100 mL/day). Causes and duration of hemoptysis, disease course, and mortality were also investigated. RESULTS: A total of 40 patients (18 males and 22 females) were identified. Their median age was 6.3 yr (range, 10 months to 18 yr). Twenty-five patients manifested mild hemoptysis; moderate and massive hemoptysis were found in nine and six patients, respectively. Respiratory tract infection was the most common cause of hemoptysis. Other causes included congenital heart disease, Heiner syndrome, neoplasm in the airway, vasculitis syndrome, and bronchiectasis. In most patients (87.5%), hemoptysis disappeared during medical treatment that included antibiotics or transfusion. Hemoptysis recurred in 12 patients, and the overall mortality rate was 5%. CONCLUSIONS: The most common cause of hemoptysis in children was respiratory tract infection. Most cases had a benign course, but recurrence and mortality occurred in a minority of patients. An accurate diagnosis of the underlying etiology is essential for treatment.
Anti-Bacterial Agents ; Bronchiectasis ; Child ; Heart Diseases ; Hemoptysis ; Hemorrhage ; Humans ; Leukemia ; Male ; Recurrence ; Respiratory Tract Infections ; Retrospective Studies ; Vasculitis

PURPOSE: The aim of this study was to determine the causes of hemoptysis in a pediatric age group. METHODS: We conducted a retrospective chart review of all patients who were admitted to Samsung Medical Center between 1996 and 2008 with a chief complaint of hemoptysis. Patients with trauma or underlying bleeding tendency such as leukemia were excluded. Patients were divided into three groups according to age (0 to 5 yr, 6 to 10 yr, and 11 to 18 yr). The amount of hemoptysis was classified as mild (< or =20 mL/day), moderate (20-100 mL/day), or massive (>100 mL/day). Causes and duration of hemoptysis, disease course, and mortality were also investigated. RESULTS: A total of 40 patients (18 males and 22 females) were identified. Their median age was 6.3 yr (range, 10 months to 18 yr). Twenty-five patients manifested mild hemoptysis; moderate and massive hemoptysis were found in nine and six patients, respectively. Respiratory tract infection was the most common cause of hemoptysis. Other causes included congenital heart disease, Heiner syndrome, neoplasm in the airway, vasculitis syndrome, and bronchiectasis. In most patients (87.5%), hemoptysis disappeared during medical treatment that included antibiotics or transfusion. Hemoptysis recurred in 12 patients, and the overall mortality rate was 5%. CONCLUSIONS: The most common cause of hemoptysis in children was respiratory tract infection. Most cases had a benign course, but recurrence and mortality occurred in a minority of patients. An accurate diagnosis of the underlying etiology is essential for treatment.
Anti-Bacterial Agents ; Bronchiectasis ; Child ; Heart Diseases ; Hemoptysis ; Hemorrhage ; Humans ; Leukemia ; Male ; Recurrence ; Respiratory Tract Infections ; Retrospective Studies ; Vasculitis

This study investigated the symptoms, medical and occupational history of 424 workers of 5 reactive dye Industries in the Inchon area in Korea. The study was performed on March 6 and July 19, 1989. The tests applied to the subjects were: serum total IgE, skin prick test with 7 inhalatory antigens, pulmonary function test, chest X-ray, methacholine test, and bronchoprovocation test. The workers were classified according to these tests into 4 groups (healthy, realitively healthy, need careful medical observation, and occupational asthma), and were compared in terms of the group characteristics and the symptom prevalence. The prevalence of occupational asthma of workers in reactive dye was 5.9%. Significant differences were observed among the 4 groups. The groups were significantly different in the variables of sex and duration of smoking among their general characteristics ; asthma, bronchitis, and other respiratory diseases with respect to their past medical history. This study suggests that we should pay special attention to the workers exposed to the risk of occupational asthma.
Asthma ; Asthma, Occupational ; Bronchitis ; Immunoglobulin E ; Incheon ; Korea ; Methacholine Chloride ; Prevalence ; Respiratory Function Tests ; Skin ; Smoke ; Smoking ; Thorax

Objective: To investigate the usefulness of goal attainment scaling (GAS) in intensive stroke rehabilitation during the subacute stage. Methods: Medical records of subacute post-stroke patients who had undergone intensive rehabilitation under hospitalization, before and after the application of GAS, were collected. GAS was conducted at the initial evaluation of each patient. Specific goals were suggested by physical and occupational therapists and were determined by the responsible physiatrist. A 5-point scale was used for the GAS score after 4 weeks of rehabilitation according to the preset criteria of each goal. To evaluate the influence of GAS in rehabilitation practice, functional improvements were compared between two patient groups before (n=121) and after (n=141) GAS. To assess progress in GAS practice, the standard GAS score was calculated, and the changes were observed over a 3-year period. The standard GAS score converged to 50 points when the goal was achieved. The therapists who used GAS also completed a survey regarding its usefulness. Results: There were no statistical differences in the motor and cognitive outcomes of the patient groups before and after applying GAS scoring. Successive yearly changes in the standard GAS scores showed progressive convergence to 50 points, signaling that the patient’s goal-setting abilities improved. According to the survey, most therapists felt that GAS enhanced the quality of therapies (84.6%). Conclusion GAS improved goal-setting for the rehabilitation of subacute post-stroke patients and might have a positive effect on rehabilitation.

Purpose: . The purpose of the study was to fabricate a prototype robotic simulator for dental education, to test whether it could simulate mandibular movements, and to assess the possibility of the stimulator responding to stimuli during dental practice. Materials and methods: . A virtual simulator model was developed based on segmentation of the hard tissues using cone-beam computed tomography (CBCT) data. The simulator frame was 3D printed using polylactic acid (PLA) material, and dentiforms and silicone face skin were also inserted. Servo actuators were used to control the movements of the simulator, and the simulator’s response to dental stimuli was created by pressure and water level sensors.A water level test was performed to determine the specific threshold of the water level sensor. The mandibular movements and mandibular range of motion of the simulator were tested through computer simulation and the actual model. Results: . The prototype robotic simulator consisted of an operational unit, an upper body with an electric device, a head with a temporomandibular joint (TMJ) and dentiforms. The TMJ of the simulator was capable of driving two degrees of freedom, implementing rotational and translational movements. In the water level test, the specific threshold of the water level sensor was 10.35 ml. The mandibular range of motion of the simulator was 50 mm in both computer simulation and the actual model. Conclusion . Although further advancements are still required to improve its efficiency and stability, the upper-body prototype simulator has the potential to be useful in dental practice education.