No abstract available.
Coronary Vessels*

OBJECTIVE: To evaluate common symptoms and severities of swallowing disorders in pediatric patients with a central nervous system disorder. METHOD: Twenty six pediatric patients with age ranging from 1 month to 3 years who had complained feeding and swallowing difficulties were studied. The subjects were divided into two groups according to the presence or absence of a central nervous system disorder. After taking the history and physical examination, a bedside swallowing test and a videofluoroscopic swallowing study were done. The parameters of oral preparatory phase, oral phase and pharyngeal phase were evaluated. RESULTS: In the bedside swallowing test, the patients with a central nervous system disorder showed a significantly higher incidence of decreased swallowing reflex, postural abnormality, tendency of poor secretion control and absent gag reflex. In the videofluoroscopic swallowing study, patients with a central nervous system disorder showed delayed oral transport time, poor oral control, pharyngeal triggering, aspiration, nasal regurgitation and esophageal reflux. Compared to the patients without a central nervous system disorder, the patients with a central nervous system disorder showed a significantly higher incidence of decreased pharyngeal peristalsis and delayed pharyngeal triggering. The patients with a central nervous system disorder also showed a more profound swallowing disorder than that of the patients without a central nervous system disorder, having more chances of a non-oral feeding than those without a central nervous system disorder. CONCLUSION: The children with a swallowing disorder and central nervous system disordershowed the different features from those without a central nervous system disorder in the bedside swallowing test and videofluoroscopic swallowing study. So that a complete swallowing evaluation including the videofluoroscopic a swallowing study will be helpful to children with swallowing disorder and central nervous system disorder for the evaluation and treatment of pharyngeal stage swallowing dysfunction.
Central Nervous System Diseases* ; Central Nervous System* ; Child ; Deglutition Disorders* ; Deglutition* ; Gastroesophageal Reflux ; Humans ; Incidence ; Peristalsis ; Physical Examination ; Reflex

A food allergy is an adverse health effect arising from a specific immune response that occurs reproducibly upon exposure to a given food. In those with food allergies that are thought to cause aggravation of eczema, food avoidance is important. The objective of this study was to research the nutritional status of patients with food allergies. A total of 225 subjects diagnosed with atopic dermatitis underwent a skin prick test as well as measurement of serum immunoglobulin E. Food challenge tests were conducted using seven food items: milk, eggs, wheat, soybeans, beef, pork, and chicken. At post-food challenge visits to the test clinic, participants completed a three-day dietary record, which included two week days and one weekend day, in order to evaluate energy intake and diet quality during the challenge. We analyzed nutrient intake based on differential food allergens. Subjects with a food allergy to milk showed lower intake of Ca, Zn, and vitamin B2, and subjects with a food allergy to egg showed lower intake of vitamin A, B1, B2, niacin, and cholesterol. Subjects with a food allergy to wheat and soybean showed lower intake of Ca, P, Fe, K, Zn, vitamin B2, vitamin B6, and niacin; and subjects with a food allergy to beef, pork, and chicken showed lower intake of Fe and higher intake of K, vitamin A, B2. Subjects with atopic dermatitis were lacking in several nutrients, including vitamin A and vitamin C. A greater number of food allergies showed an association with a greater number of nutrient intake deficiencies. Allergen avoidance is the basic treatment for atopic dermatitis. However, when the allergen is food, excessive restriction can lead to nutrition deficiency. Findings of this study suggest the necessity for enhanced nutritional education in order to provide substitute foods for patients with food allergies who practice food restriction.
Allergens ; Ascorbic Acid ; Chickens ; Cholesterol ; Dermatitis, Atopic* ; Diet Records ; Diet* ; Eczema ; Education ; Eggs ; Energy Intake ; Food Hypersensitivity ; Humans ; Immunoglobulin E ; Immunoglobulins ; Milk ; Niacin ; Nutritional Status* ; Ovum ; Riboflavin ; Skin ; Soybeans ; Triticum ; Vitamin A ; Vitamin B 6

OBJECTIVE: To evaluate the pattern of developmental delay of language and to correlate the language with other developmental areas in cerebral palsy children. METHOD: Sequenced Inventory of Communication Development (SICD) was studied in 31 children with cerebral palsy of age ranging from 11 months to 48 months. Korean Denver Developmental Screening Test (DDST) was also performed in 18 children simultaneously. RESULTS: On SICD, 10 children (32.3%) showed the receptive language delay and 13 children (41.9%) showed the expressive language delay. Among 15 spastic quadriplegic children, 40% showed the delay of receptive language development, 53.3% showed the delay in expressive language development. Among 10 spastic diplegic children, 30% showed the delay of both receptive and expressive language development. One spastic right hemiplegic child showed a delay of expressive language development, but 4 left hemiplegic children showed the normal language development. One hypotonic cerebral palsy child showed a delay of both receptive and expressive language development. The expressive language was delayed more than the receptive language. SICD correlated highly with the language sector of DDST. And both SICD and DDST language sectors correlated with the other sectors of DDST (personal-social, fine motor-adaptive, gross motor), especially with the fine motor sector (r=0.912, 0.918, 0.976, p<0.001). CONCLUSION: There is a considerably high incidence of developmental delay of language in cerebral palsy children, especially among spastic quadriplegic children. The early evaluation and treatment for the developmental delay of language need to be included in a general rehabilitation program for the cerebral palsy children.
Cerebral Palsy* ; Child* ; Humans ; Incidence ; Language Development ; Language Development Disorders ; Mass Screening ; Muscle Spasticity ; Rehabilitation

We examined the precision, accuracy, and capability of detecting changes of Dual-Energy X-ray Absorptiometry (DXA) for the measurements of total-body weight (TBW), total-body fat weight (TBFW), and total-body lean weight (TBLW) in an 8-week follow-up study of rats. Twenty male rats (4-week) were divided into 2 diet groups. For 8 weeks, we measured body composition (TBW, TBFW, TBLW) by DXA and TBW by an electronic scale once a week. In week 8, we measured body composition 5 times by DXA and TBFW by dissecting experiment (EXP) of euthanized rats (12-week). Total-body fat ratio (TBFR) was defined as TBFW/(TBFW+TBLW). The precision of DXA was evaluated by measuring the coefficient of variation (CV) and accuracy was evaluated by comparing DXA-derived data with EXP data. The capability of detecting changes of DXA in follow-up study was verified by analyzing the trend of DXA-derived values over the 8 weeks. For TBW, TBFW, TBLW of DXA, CVs were 0.02 ± 0.01, 0.10 ± 0.05, 0.03 ± 0.02 and errors were − 6.996 ± 3.429 (r = 0.999), + 14.729 ± 3.663 (r = 0.982), − 21.725 ± 4.223 (r = 0.991), respectively. Prediction models were [EXP TBW = − 31.767 + 1.085 (DXA TBW), R2 = 0.998, root mean square error (RMSE) = 1.842] and [EXP TBFR = − 0.056 + 1.177 (DXA TBFR), R2 = 0.948, RMSE = 0.007]. Over 8 weeks, DXA TBW and DXA TBLW steadily increased, DXA TBFW steadily increased followed by saturation or declination, difference of DXA TBFW between 2 diet groups steadily increased. In conclusion, our study verified that DXA (iNSiGHT VET DXA, OsteoSys, Korea) is accurate and precise enough to measure body composition of rats. Additionally, we confirmed the possibility that DXA could be used for the long-term follow-up studies.
Absorptiometry, Photon ; Animals ; Body Composition ; Diet ; Diet, High-Fat ; Follow-Up Studies ; Humans ; Male ; Obesity ; Rats

Japanese encephalitis (JE) cases have been increasingly reported recently especially in Seoul and its vicinity. Pigs are known as amplifying host of JE virus (JEV), but do not play an important role in these recent events because pig-breeding is not common in Seoul. The distribution and the density of migratory birds are correlated with JE cases in cities and they might be highly potential hosts contributing to transmit JEV in metropolitan areas. JE genotype and sero-prevalence in birds should be determined for the verification of the transmission route of JEV in the recent sporadic occurrence of JE cases in Seoul.
Asian Continental Ancestry Group ; Birds ; Encephalitis, Japanese ; Genotype ; Humans ; Korea ; Seoul ; Swine

We examined the characteristics of food allergy prevalence and suggested the basis of dietary guidelines for patients with food allergies and atopic dermatitis. A total of 2,417 patients were enrolled in this study. Each subject underwent a skin prick test as well as serum immunoglobulin E (IgE) measurement. A double-blind, placebo-controlled food challenge was conducted using milk, eggs, wheat, and soybeans, and an oral food challenge was performed using beef, pork, and chicken. Food allergy prevalence was found among 50.7% in patients with atopic dermatitis. Among patients with food allergies (n = 1,225), the prevalence of non-IgE-mediated food allergies, IgE-mediated food allergies, and mixed allergies was discovered in 94.9%, 2.2%, and 2.9% of the patients, respectively. Food allergy prevalence, according to food item, was as follows: eggs = 21.6%, milk = 20.9%, wheat = 11.8%, soybeans = 11.7%, chicken = 11.7%, pork = 8.9% and beef = 9.2%. The total number of reactions to different food items in each patient was also variable at 45.1%, 30.6%, 15.3%, 5.8%, 2.2%, and 1.0% for 1 to 6 reactions, respectively. The most commonly seen combination in patients with two food allergies was eggs and milk. The clinical severity of the reactions observed in the challenge test, in the order of most to least severe, were wheat, beef, soybeans, milk, pork, eggs, and chicken. The minimum and maximum onset times of food allergy reactions were 0.2-24 hrs for wheat, 0.5-48 hrs for beef, 1.0-24 hrs for soybeans, 0.7-24 hrs for milk, 3.0-24 hrs for pork, 0.01-72 hrs for eggs, and 3.0-72 hrs for chicken. In our study, we examined the characteristics of seven popular foods. It will be necessary, however, to study a broader range of foods for the establishment of a dietary guideline. Our results suggest that it may be helpful to identify food allergies in order to improve symptoms in patients with atopic dermatitis.
Chickens ; Dermatitis, Atopic ; Eggs ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Milk ; Ovum ; Prevalence ; Skin ; Soybeans ; Triticum

Various symptomatic complaints, including dysphagia, have been reported by patients with whiplash injury, which greatly impacts their life. There are few reports on the treatment and progression of dysphagia following whiplash injuries. This case report describes a patient who presented with delayed dysphagia after a whiplash injury. A 37-year-old female visited the Department of Rehabilitation Medicine of our institution and presented with delayed dysphagia one year after a traffic accident. At the time of the accident, the patient was diagnosed with a whiplash injury and had no symptoms of dysphagia. A videofluoroscopic swallowing study revealed decreased laryngeal elevation and impaired upper esophageal sphincter opening in the pharyngeal phase. The Penetration-Aspiration Scale score was 3 for pureed food and 7 for liquid food. Laryngeal needle electromyography showed abnormal spontaneous activity in both cricothyroid muscles. The patient underwent swallowing rehabilitation for oropharyngeal dysphagia. There were recurrences of improvement and deterioration during the treatment period. However, after five months, problems related to swallowing improved until there were no complaints. Our study indicates a differentiated treatment approach and the importance of continuous rehabilitation for dysphagia after a whiplash injury.

Although hanging is the most common method of suicide in Korea, there are few reports of dysphagia following laryngeal injuries due to near-hanging. This is a case report of a patient who complained of dysphagia after a complex fracture of the neck structures caused due to attempted suicide by hanging. A 51-year-old male visited our hospital with neck injuries after a near-hanging episode. Laryngoscopy suspected dislocation of the right arytenoid cartilage. A computed tomography (CT) scan revealed fractures of the right hyoid bone and thyroid cartilage, as well as soft tissue emphysema. A closed reduction for the dislocation of the right arytenoid cartilage was performed. After surgery, oral feeding was attempted five days after surgery but stopped due to a large amount of aspiration. After two weeks, a videofluoroscopic swallowing study (VFSS) revealed a decreased laryngeal elevation and severe impairment of the upper esophageal sphincter opening. The patient was then given rehabilitation for oropharyngeal dysphagia to restore swallowing function. Four months after the injury, VFSS showed that the residue in the pyriform sinus after multiple swallowing attempts decreased compared to the previous studies. However, oral diet and enteral feeding were combined due to the patient experiencing early fatigue due to swallowing difficulties.Our observations, in this case, show that it was necessary to provide treatment through a multidisciplinary approach coupled with long-term follow-up for patients with dysphagia after complex fractures by near-hanging.

Lymphocele is a complication of pelvic surgery that infrequently leads to compressive neuropathy. We present a case of compressive obturator neuropathy resulting from lymphocele development after pelvic surgery. Electrodiagnostic studies revealed severe axonal disruption in the left obturator nerve, which is associated with poor functional recovery. This case underscores the role of electrodiagnostic testing in the diagnosis and rehabilitation of patients experiencing lower limb weakness following gynecological pelvic surgery.