OBJECTIVE: The purpose of this study is to survey the health and functional status of adult cerebral palsy. METHOD: This study included 47 patients who have cerebral palsy between the ages of 20 and 45 years. We evaluated the functional status by the interview and questionnaire, the medical status including a detailed medical history, with emphasis on the musculoskeletal system. RESULTS: 1) In the functional status, the number of non-functional ambulator increased from ten cases (21.3%) to fourteen cases (29.8%) in proportion to the incidence of fracture. 2) In the medical status, thirty-seven cases (78.8%) had more than one musculoskeletal complaint. Twenty-three cases (48.9%) had gastric discomfort, twenty-five cases (53.2%) had dental caries and thirty cases (63.9%) had speech disturbance. 3) Only eleven cases (23.4%) had undergone the comprehensive rehabilitation. CONCLUSION: To prevent and minimize the physical disabilities and musculoskeletal complications of adult cerebral palsy, we need more active medical intervention, active research on the methodology and comprehensive rehabilitation.
Adult* ; Cerebral Palsy* ; Dental Caries ; Humans ; Incidence ; Musculoskeletal System ; Surveys and Questionnaires ; Rehabilitation

PURPOSE: Novel influenza H1N1 A virus developed pandemic infection, and patients requiring hospitalization have rapidly increased because of severe clinical symptoms and signs. We describe the clinical features of hospitalized pediatric patients with novel influenza virus infection. METHODS: We reviewed the medical charts of 128 pediatric patients under the age of 16 who were hospitalized in Dongguk University Ilsan Hospital between September 2009 and February 2010. We compared the clinical features of the pneumonia and non-pneumonia groups of patients, and analyzed clinical difference according to M. pneumoniae coinfection and severity of pneumonia. RESULTS: The male to female sex ratio of the subjects was 2.2:1, and the average age was 6.2 years. Sixty-five patients (50.8%) had pneumonia and their average age was 6.7 years. Variables including duration of admission, total WBC counts, neutrophil percentage and CRP were significantly different between the 2 groups, however, the other variables were not. The number of patients diagnosed with severe pneumonia was 20 (30.8%). M. pneumoniae coinfection occurred in 24.6% of patients in the pneumonia group, however, it did not influence the severity of pneumonia. Underlying asthma was more significantly associated with severe pneumonia than with mild pneumonia. There was no death case. CONCLUSION: In this study, 2009 novel influenza infection was more prevalent in school-age boys. M. pneumoniae coinfection occurred frequently, however, it did not seem to influence disease severity. Patients with underlying asthma tend to develop severe pneumonia more frequently.
Asthma ; Coinfection ; Female ; Hospitalization ; Humans ; Influenza, Human ; Male ; Mycoplasma pneumoniae ; Neutrophils ; Orthomyxoviridae ; Pandemics ; Pneumonia ; Sex Ratio ; Viruses

PURPOSE: This study was performed to investigate whether therapeutic hypercapnia could attenuate systemic inflammatory responses in hemorrhagic shock in rats. METHODS: Male Sprague-Dawley rats were mechanically ventilated and underwent pressure-controlled (mean arterial pressure: 38+/-1 mmHg) hemorrhagic shock. At 10 minutes after the induction of hemorrhagic shock, the rats were divided into the normocapnia (PaCO2=35-45 mmHg, n=10) and the hypercapnia (PaCO2=60-70 mmHg) groups. The PaCO2 concentration was adjusted by using the concentration of inhaled CO2 gas. After 90 minutes of hemorrhagic shock, rats were resuscitated with shed blood for 10 minutes and were observed for 2 hours. The mean arterial pressure (MAP) and the heart rate were monitored continuously, and the results of arterial blood gas analyses, as well as the plasma concentrations of interleukin (IL)-6, IL-10, and nitrite/nitrate were compared between the normocapnia and the hypercapnia groups. RESULTS: The MAP and the heart rate were not different between the two groups. The plasma concentration of IL-6 was significantly lower in the hypercapnia group than in the normocapnia group (p<0.05). The IL-10 concentration was not different and the IL-6 to IL-10 ratio was significantly lower in the hypercapnia group compared to the normocapnia group. The plasma nitrite/nitrate concentration of the hypercapnia group was lower than that of the normocapnia group. CONCLUSION: Therapeutic hypercapnia attenuates systemic inflammatory responses in hemorrhagic shock.
Animals ; Arterial Pressure ; Blood Gas Analysis ; Cytokines ; Heart Rate ; Humans ; Hypercapnia ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Interleukins ; Male ; Nitric Oxide ; Plasma ; Rats ; Rats, Sprague-Dawley ; Shock, Hemorrhagic

While anomalies of the pancreaticobiliary system are not uncommon, drainage of the common bile duct into the bulb of the duodenum has rarely been reported. The awareness of ectopic drainage of the CBD is stressed to prevent surgical damage and improve medical management in this area. We reported one case of anomalous drainage of the CBD and pancreatic duct associated with nonvisible gallbladder or agenesis of gallbladder and cystic duct diagnosed by ERCP, ultrasonography and upper abdominal CT.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Cystic Duct ; Drainage* ; Duodenum ; Gallbladder ; Pancreatic Ducts* ; Tomography, X-Ray Computed ; Ultrasonography

While anomalies of the pancreaticobiliary system are not uncommon, drainage of the common bile duct into the bulb of the duodenum has rarely been reported. The awareness of ectopic drainage of the CBD is stressed to prevent surgical damage and improve medical management in this area. We reported one case of anomalous drainage of the CBD and pancreatic duct associated with nonvisible gallbladder or agenesis of gallbladder and cystic duct diagnosed by ERCP, ultrasonography and upper abdominal CT.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Cystic Duct ; Drainage* ; Duodenum ; Gallbladder ; Pancreatic Ducts* ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVE: The purpose of this study is to evaluate the effect of functional electrical stimulation (FES) on hemiplegic shoulder subluxation in post-acute stroke patients. METHOD: Forty-four patients who had shoulder subluxation as a consequence of their first stroke were included and randomly assigned to either a control group (22 subjects) or a study group (22 subjects). Patients in both groups received physiotherapy and used an arm sling. The study group received, FES therapy to shoulder muscles (supraspinatus and posterior deltoid) for 30 minutes, five days a week for 6 weeks. The effect of FES therapy was evaluated by assessment of the severity of subluxation using radiologic measurements before and after treatment. RESULTS: 1) The severity of subluxation was significantly increased after 6 weeks (p<0.05) in the control group. In the study group, it was reduced but the difference was not statistically significant (p>0.05). 2) In the group of patients with early treatment (onset duration, less than 6 months), the control group showed a significant increase in subluxation (p<0.05), but the study group showed significantly reduced (p<0.05) shoulder subluxation after treatment period. 3) In the group of patients with mild shoulder subluxation before treatment (less than 1 finger breadth), the control group showed a significant increase in subluxation (p<0.05), but the study group showed significantly reduced (p<0.05) shoulder subluxation after treatment period. CONCLUSION: The FES therapy is effective in preventing and reducing the severity of hemiplegic shoulder subluxation in post-acute stroke patients, especially if duration since stroke onset was less than six months and the severity of subluxation before treatment was mild.
Arm ; Electric Stimulation* ; Fingers ; Humans ; Muscles ; Shoulder* ; Stroke

OBJECTIVE: An orogastric tube is used frequently in infants because infants are obligate nose breathers and nasogastric tubes can cause partial nasal obstruction. This study examined whether the presence of an orogastric tube could affect the swallowing parameters assessed by a videofluoroscopic swallowing study in infants with dysphagia caused by a variety of reasons. METHODS: Tests were conducted in 15 infants aged less than 150 days after birth who used an orogastric tube due to dysphagia. Two tests were conducted. The first was conducted with an orogastric tube inserted. Subsequently, the orogastric tube was removed with a 5-minute break before the second test. Skilled physiatrists then analyzed the recorded video. The number of sucks required for one swallow, abnormalities of the pharyngeal phase, and penetration-aspiration scales were evaluated. RESULTS: After removing the orogastric tube, the number of sucks required for one swallow reduced significantly (2.50±1.73 vs. 3.45±2.54, P=0.04). On the other hand, no statistical significance was observed in the results of the pharyngeal phase and penetration-aspiration scale (5.60±3.16 vs. 5.9±3.81, P=0.41) with and without the orogastric tube. CONCLUSION: These findings showed that the insertion or non-insertion of an orogastric tube might not affect the swallowing abnormalities in the pharyngeal phase and the risk of aspiration. In addition, an orogastric tube may have a negative effect on the swallowing function in the oral phase.
Deglutition Disorders ; Deglutition ; Hand ; Humans ; Infant ; Nasal Obstruction ; Nose ; Parturition ; Weights and Measures

OBJECTIVE: The aim of this study was to investigate the interpersonal violence (IPV) epidemiology and mortality according to the violence victim-perpetrator relationships. METHODS: A retrospective cross-sectional study was done using the comprehensive data of the emergency department (ED)-based Jeju Injury Surveillance System from all EDs in Jeju Island. The demographic characteristics of the victims, the types of perpetrators (spouse, family members, acquaintance, and stranger), injury characteristics and clinical outcomes from the injury were collected. The IPV epidemiology was reported by descriptive statistics. Multivariate Poisson regression was used to analyze the association between the mortality and violence victim-perpetrator relationships. RESULTS: Among the 23,508 violent injury patients enrolled from January 1, 2008, and December 31 of 2016, 19,879 (84.6%) were analyzed; 16 (0.08%) died at the ED. The types of perpetrators were the spouse (10.1%), family members (3.9%), acquaintances (43.4%), and strangers (42.7%). The mortality of the violence victims was increased significantly by the spouse (incidence rate ratio [IRR], 6.336; P=0.043) or family members (IRR, 11.089; P=0.016) compared to strangers. On the other hand, there was no difference between the acquaintances and strangers. CONCLUSION: The epidemiology and mortality of IPV were associated with the violence victim-perpetrator relationships. Therefore, it is necessary to develop and apply prevention programs considering these differences, particularly for intimidate/ family violence because of its high fatality.
Cross-Sectional Studies ; Domestic Violence ; Emergency Service, Hospital ; Epidemiology ; Friends ; Hand ; Humans ; Interpersonal Relations ; Mortality ; Retrospective Studies ; Spouses ; Violence

Objective: This study aimed to determine whether there is a difference in mortality and medical resource utilization between geriatric (aged ≥65 years) and super-geriatric patients (aged ≥80 years) with traumatic brain injury (TBI). Methods: We obtained comprehensive data (demographics, injury characteristics, injury severities, and outcomes) of geriatric and super-geriatric TBI patients from an emergency department-based injury surveillance system database from 2011 to 2016. Multivariate logistic regression analysis was performed to compare the mortality and nonroutine discharge (NRDC) status between both groups. Results: Among 442,533 TBI patients, 48,624 were older than 65 years. A total of 48,446 patients (37,140 geriatric and 11,306 super-geriatric) without exclusion criteria were included in the final analysis. Both overall in-hospital mortality (adjusted odds ratio, 1.88; 95% confidence interval [CI], 1.28 to 2.74; P=0.001) and NRDC (adjusted odds ratio, 1.35; 95% CI, 1.07 to 1.71; P=0.011) were significantly higher in the super-geriatric group. In the stratified analysis, there were no significant differences in NRDC rate for all stratifications of treatment timing (emergency department vs. ward admission), but mortality remained to be significant for all stratifications. Conclusion Super-geriatric TBI patients showed a significantly higher risk-adjusted overall mortality and more inadequate medical resource utilization than did geriatric TBI patients. However, super-geriatric patients were more likely to undergo NRDC after admission; thus, further research about age-related health inequalities is needed in the treatment of super-geriatric patients.

Objective: This study aimed to determine whether there is a difference in mortality and medical resource utilization between geriatric (aged ≥65 years) and super-geriatric patients (aged ≥80 years) with traumatic brain injury (TBI). Methods: We obtained comprehensive data (demographics, injury characteristics, injury severities, and outcomes) of geriatric and super-geriatric TBI patients from an emergency department-based injury surveillance system database from 2011 to 2016. Multivariate logistic regression analysis was performed to compare the mortality and nonroutine discharge (NRDC) status between both groups. Results: Among 442,533 TBI patients, 48,624 were older than 65 years. A total of 48,446 patients (37,140 geriatric and 11,306 super-geriatric) without exclusion criteria were included in the final analysis. Both overall in-hospital mortality (adjusted odds ratio, 1.88; 95% confidence interval [CI], 1.28 to 2.74; P=0.001) and NRDC (adjusted odds ratio, 1.35; 95% CI, 1.07 to 1.71; P=0.011) were significantly higher in the super-geriatric group. In the stratified analysis, there were no significant differences in NRDC rate for all stratifications of treatment timing (emergency department vs. ward admission), but mortality remained to be significant for all stratifications. Conclusion Super-geriatric TBI patients showed a significantly higher risk-adjusted overall mortality and more inadequate medical resource utilization than did geriatric TBI patients. However, super-geriatric patients were more likely to undergo NRDC after admission; thus, further research about age-related health inequalities is needed in the treatment of super-geriatric patients.