PURPOSE: To evaluate dysphagia objectively and quantitatively, and ta clarify the effect of neck position and viscosity changes in patients with aspiration and laryngeal penetration. MATERIALS AND METHODS: We studied 35 patients with dysphagia and 21 normal controls using videofluoroscopy and scintigraphy. Videofluoroscopy was performed with barium with three different viscosity, and scintigraphy was done, with water, yogurt, and steamed egg mixed with Tc-99m tin colloid. 1f aspiration was found during videofluoroscopic examination, patients neck position was changed and study repeated. Videofluoroscopy was analyzed qualitatively. We calculated 7 quantitative parameters from scintigraphy. According to the videofluoroscopic findings, we divided patients into 3 subgroups; aspiration, laryngeal penetration, and no-aspiration group. RESULTS: The result of videofluoroscopy revealed that the most cornmon finding was the delay in triggering pharyngeal swallow. Pharyrigeal transit time (PTT) and pharyngeal swallowing efficiency(PSE) in patients with aspiration were significantly different from other groups. After neck position change, aspiration could be reduced in all of 7 patients, and laryngeal penetration reduced hy about 82%. PTT ancl PSE were also improved after position change. Aspiration and laryngeal penetration occurred more frequently in thin liquid swallowing than in thick liquid and solid swallowing. CONCLUSION: PTT and PSE were useful for the evaluation of dysphagia. Aspiration and laryngeal penetration could be reduced when appropriate position assumed, We could decrease the chance of aspiration by changing the patient diet consisIency. Scintigraphy might be useful tool to quantitate and follow up these changes.
Barium ; Colloids ; Deglutition ; Deglutition Disorders* ; Diet ; Evaluation Studies as Topic* ; Follow-Up Studies ; Humans ; Neck ; Ovum ; Radionuclide Imaging* ; Steam ; Tin ; Viscosity ; Water ; Yogurt

Before impression making in the fixed restorations or other prosthesis, hemostatic solutions are used for hemostasis and moisture control. Hemostatic solutions effectively control bleeding but their major ingredients, acid removes smear layers which are formed in the tooth preparation, exposes the dentinal tubular orifices which are occluded by smear layers, makes dentinal tubular fluid displace more easily to the various external stimulus, and according to the hydrodynamic theory, consequently causes dentin hypersensitivity. To know the effect of hemostatic solutions on dentin permeability, coronal dentin discs, 1 mm in thickness, were prepared from extracted third molars free from decay and wear, and a spilt chamber device was used. Hydraulic conductance values and SEMs, which were measured before and after treatment with Astringedentr , Altract and Epri-dent , were compared and analyzed. The following conclusion were drawn : 1. Hydraulic conductance values which wee measured after the treatment of hemostatic solutions were increased in all groups(p<0.05). 2. %change values of hydraulic conductance were compared but no significant difference was found among the three hemostatic solutions(p<0.05). 3. on SEM observations of all groups, after treatment smear layers were removed and dentinal tubular orifices were partially exposed. on the basis of these conclusions, the reckless use of hemostatic solutions should be restricted, and when in use, various methods should be considered to protect dentin.
Dentin Permeability* ; Dentin Sensitivity ; Dentin* ; Hemorrhage ; Hemostasis ; Hydrodynamics ; Molar, Third ; Prostheses and Implants ; Tooth Preparation

Sinusitis manifested as symptomatic imflammation of the paranasal sinuses is a common pediatric diagnosis. Many studies have focused more directly on the question of relationship between allergy and sinusitis but the relevance of the relationship between allergy and sinusitis still needs further examination, The purpose of this study is to assess of relationship of allergy to extent or severity of sinusitis. A clinical evaluation was performed on 199 children, age 2 to 15 years, in whom the diagnosis of sinusitis was confirmed by paranasal sinus radiographic assessment at our hospital Pediatric OPD and in the ward from July 1991 to June 1993. The results were as follows: 1) Male was more prominent than female (M:F ratio 1.76:1). The age distribution, 100 cases(55.2%) of the total case were 4-7 year old. 2) The symptoms were coughing, most common (77,9%), rhinorrhea, nasal discharge and nasal stuffiness, in decreasing order. The clinical signs were postnasal drip (62.8%), most common, throat injection, wheezing sound, and allergic shiner in decreasing order. Eighty eight patients were evaluated acute and compared with 111 patients with chronic sinusitis. 3) Comparable study between two groups were summarized as follwos: (1) There was no significant difference in age and sex distribution between acute and chronic group. (2) The lowest seasonal incidence of acute group was seen in summer and autumn but there was no significant variation between both group (p>0.05). (3) Allergc disease was more prevalent in chronc group than acute group (p<0.05). Asthma incidence was higher in chronic group than acute group (p<0.05). (4) The frequency of total IgE level checked by PRIST higher than 200 IU/ml in acute group and chronic group was 23.2% and 42.3%, respectively (p<0.05). The incidence of positive skin prick test in acute group and chronic group was 25.0% and 46.5% respectively (p<0.05). (5) Otitis media, nasal polyp and adenoid hypertrophy incidence were higher in chronic group than acute group (p<0.05). (6) There was no significant difference if ESR between both groups. The eosinophilia in peripheral blood higher than 5% in the acute group and chronic group was 15.9% and 42.3% respectively (p<0.05). (7) The patients with chronic group had more severe involvement of the paranasal sinuses than acute group (p<0.05). (8) There were no significant difference in chest radiographic findings and follow up paranasal sinus radiographic findings after treatment (P>0.05).
Adenoids ; Age Distribution ; Asthma ; Child* ; Cough ; Cyprinidae ; Diagnosis ; Eosinophilia ; Female ; Follow-Up Studies ; Humans ; Hypersensitivity ; Hypertrophy ; Immunoglobulin E ; Incidence ; Male ; Nasal Polyps ; Otitis Media ; Paranasal Sinuses ; Pharynx ; Radiography, Thoracic ; Respiratory Sounds ; Seasons ; Sex Distribution ; Sinusitis* ; Skin

No abstract available.
Female ; Humans ; Pregnant Women*

PURPOSE: In order to study the frequency and the site of pain with shoulder impingement syndrome accompanied by myofascial pain syndrome (MPS), and to see how the treatment of impingement syndrome effects the improvement in myofascial pain. MATERIALS AND METHODS: Among patients diagnosed with shoulder impingement syndrome with MPS and who complained around of shoulder muscle pain 53 subjects were selected as subjects for this study. Patients were divided into three groups according to method of treatment; the first group was the cases who received impingement injection test, the second group were only carried out isometric strengthening exercise of the periscapular muscles and the rotator cuff, and the third group was the cases who failed conservative treatment and had a surgical operation. All subjects had a physical examination before treatment to see if the MPS was present in the muscles around the shoulder, the range of motion of shoulder, and the American Shoulder and Elbow Society (ASES) shoulder score were measured. RESULTS: There was no relation to between age, gender, impingement signs, tenderness around the joints, the range of motion and ASES shoulder score. The VAS was reduced from 6.2+/-2.3 to 1.2+/-1.5 (p<0.01), and ASES shoulder score increased from 32.1+/-15.3 to 87.5+/-17.7 (p<0.05). The differences among treatments of the three groups were not significant in pain and treatment outcome (p>0.05). CONCLUSION: Treatment of shoulder impingement syndrome reduced the symptoms of MPS, thus shoulder impingement syndrome can be the one of the causes of MPS.
Elbow ; Humans ; Joints ; Muscles ; Myalgia ; Myofascial Pain Syndromes* ; Physical Examination ; Range of Motion, Articular ; Rotator Cuff ; Shoulder Impingement Syndrome* ; Shoulder* ; Treatment Outcome ; Trigger Points

BACKGROUND: Indomethacin is a potent inhibitor of prostaglandins biosysnthesis. Sunburn erythema is mainly mediated by prostaglandins. OBJECTIVE: Our purpose was to compare objectively the effectiveness of topical indomethacin with topical corticosteroid on the suppression of UVB erythema METHODS: Sixteen male medical students who had not exposed their back skin during the last year were included in this study. According to the individual´s MED, 1,2, and 3 MED of UVB were irradiated on each back in triplicate lines. Immediately after UVB irradiation, 2.5% indomethacin solution and 0.25% desoximethasone were applied to each row with one row left for control. 24 hours after the initial application the intensity of each erythema was measured by the naked eye and by colorimeter. RESULTS: The suppressive effectiveness of 2.5% indomethacin solution on UVB induced erythema was superior to that of 0.25% desoximethasone. The L* and a* value of colorimeter were significantly correlated to the differencies of UVB induced erythema among the experimental and control groups is a useful and rapid method to evaluate the UVB induced erythema, and can give a numerical expression to eye perception. CONCLUSION: Our data confirm that topical indomethacin has a stronger suggestive effect on UVB erythema than that of topical corticosteroid.. We suggest that the suppressive effect of indomethacin is mainly due to the inhibition of prostaglandins biosynthesis. The colorimeter CR-200(MINOLTA) is well correlated with the naked eye score and is a useful instrument for objective measurement of the degree of erythema.
Erythema* ; Humans ; Indomethacin* ; Male ; Methods ; Prostaglandins ; Skin ; Students, Medical ; Sunburn

We experienced nutiple brain abscess in two neonates. Diagnosis was made CT scan, Which revealed multiple ring-like enhancing leason in both frontoparietal and left posterior parietal cerebral parenchyme. Therapy was consisted of systemic antibiotic treatment and CSF V-P shunt operation due to complicated hydrocephalus. One neonate was died and the other neonate has been followed up due to convulsion and neurological sequale.
Brain Abscess* ; Diagnosis ; Humans ; Hydrocephalus ; Infant, Newborn* ; Rabeprazole ; Seizures ; Tomography, X-Ray Computed

Chronic subdural hematoma usually occurs as a consequence of minor trauma. But, chronic subdural hematoma of occupational origin has not been reported yet in Korea. We experienced a case of chronic subdural hematoma induced by repeated trauma to the head. The patient was a 45-year-old male. He complained of repeated headache and nausea. By the computed tomogram, he diagnosed as chronic subdural hematoma and took the operation. He was not an alcoholism and had no intracranial disease nor coagulopathy. We studied all possibilities through working environment and personal environment survey. As a result, we decided the case as an example of cumulative trauma disorder to the head by occupational origin. We report a case of chronic subdural hematoma in the worker exposed repeated head trauma of occupational origin.
Alcoholism ; Craniocerebral Trauma ; Cumulative Trauma Disorders ; Head* ; Headache ; Hematoma, Subdural, Chronic* ; Humans ; Korea ; Male ; Middle Aged ; Nausea

BACKGROUND: The appearance of multiple-drug-resistant Mycobacterium tuberculosis strains has been seriously compromising successful control of tuberculosis. Rifampin-resistance, caused by mutations in the rpoB gene, can be indicative of multiple-drug-resistance, and its detection is of great importance. The present study aimed to develop an oligonucleotide chip for accurate and convenient screening of drug-resistance. METHODS: In order to detect point mutations in the rpoB gene, an oligonucleotide chip was prepared by immobilizing specific probe DNA to a microscopic slide glass by a chemical reaction. The probe DNA that was selected from the 81 bp core region of the rpoB gene was designed to have mutation sites at the center. A total of 17 mutant probes related to rifampin-resistance including 8 rifabutin-sensitive mutant probes were used in this study. For accurate determination, wild type probes were prepared for each mutation position with an equal length, which enabled a direct comparison of the hybridization intensities between the mutant and wild type. RESULTS: Mycobacterial genomic DNA from clinical samples was tested with the oligonucleotide chip and the results were compared with those of the drug-susceptibility test in addition to sequencing and INNO-LiPA Rif. TB kit test in some cases. Out of 15 samples, the oligonucleotide chip results of 13 samples showed good agreement with the rifabutin-sensitivity results. The two samples with conflicting result also showed a discrepancy between the other tests, suggesting such possibilities as existence of mixed strains and difference in drug-sensitivity. Further verification of these samples in addition to more case studies are required before the final evaluation of the oligonucleotide chip can be made. CONCLUSION: An oligonucleotide chip was developed for the detection of rpoB gene mutations related to drug-susceptibility. The results to date show the potential for using the oligonucleotide chip for accurate and convenient screening of drug-resistance to provide useful information in antituberculosis drug therapy.
DNA ; Drug Therapy ; Glass ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Point Mutation* ; Rifabutin ; Rifampin ; Tuberculosis

BACKGROUND: Laryngoscopy and tracheal intubation for general anesthesia are potent stimuli to the cardiovascular system due to sympathetic stimulation. The aim of this study was to compare the hemodynamic responses with different administration routes of lidocaine on blood pressure and heart rate changes associated with tracheal intubation. METHODS: Sixty patients were randomly assigned to spray group (Group 1, n=20) received 10% lidocaine 1.5 mg/kg spray to intratracheally immediately before tracheal intubation, IV group (Group 2, n=20) received 2% lidocaine 1.5 mg/kg intravenously before 90 sec tracheal intubation and control group (Group 3, n=20). Anesthesia was induced with thiopental 5 mg/kg IV, vecuronium 0.1 mg/kg and 50% N2O-O2- 2vol % enflurane. After 5 minutes, tracheal intubation was performed. Mean arterial pressure and heart rate were measured at preintubation and immediately postintubation, 1, 3, 5 mins after tracheal intubation. RESULTS:The differences of mean arterial pressure which were measured at preintubation and immediately postintubation and 1 minute after intubation in group 1 were significantly lower than those in other group (p<0.05). The differences of heart rate which measured at preintubation and 1 minute after intubation were lower than those in group 3 (p<0.05). CONCLUSIONS: For the suppression of sympathetic stimulation following tracheal intubation, 10% lidocaine spray to the laryngotrachea is an effective method to suppress cardiovascular response.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Enflurane ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Laryngoscopy ; Lidocaine* ; Thiopental ; Vecuronium Bromide