The authors analized the 98 cases of cervical spine injuries without fracture or dislocation by hyperflexion/hyperextension of the neck. The peak incidence of the age was in the second to fourth decades(69.4%). There was a male preponderance with a sex ratio of. 1.8 : 1. Sources of trauma were motor vehicle accident, object falling on and motorcycle accident in the order of frequency. The common mechanisms of injury were flexion-extension, extension and flexion injury in the order of frequency. There were 10 cases of cervical cord injury without fracture or dislocation and operative management was given in 6 cases of them. The most common preexisting disease was congenital cervical stenosis. Surgical modality such as laminectomy, laminoplasty and anterior decompressive procedure made them improved. The authors discuss the mechanism of injury and surgical management of the patients with cervical cord injury in the absence of concomittent fracture or dislocation.
Constriction, Pathologic ; Dislocations* ; Humans ; Incidence ; Laminectomy ; Male ; Motor Vehicles ; Motorcycles ; Neck ; Preexisting Condition Coverage ; Sex Ratio ; Spine*

We experienced two cases of occupational asthma induced by Elk dander in Elk-feeders and confirmed these cases by the bronchial provocation test with Elk dander. Both of them showed dual asthmatic response. They also showed positive reaction to the skin prick test with EIK dander. Now one of them has no asthmatic symptoms at all after complete avoidnce of EIK dander.
Asthma, Occupational* ; Bronchial Provocation Tests ; Dander ; Skin

No abstract available.
Rupture* ; Scrotum* ; Ultrasonography*

BACKGROUND: This study aims at making a survey on health care service providers' cultural competence and making an appraisal of Chinese medical tourists on service quality, health care service providers' cultural competence, perceived value, and satisfaction. METHODS: The data was collected from August until November, 2014 and 150 health care service providers and 65 Chinese medical tourists from 12 medical institutions in Daegu were enrolled in analysis. RESULTS: The results showed that health care service provider's knowledge on Chinese culture was very low with 33.5% of correct answer. Health care service providers were found to get 3.82 point on a 5 point-scale in cultural perception, 3.53 points in cultural sensitivity, and 2.85 points in cultural skills. Chinese medical tourists were analyzed to give 4.08 points on a 5-point scale to satisfaction on health care service, followed by 4.01 points to health care service quality, 4.00 points to perceived value of health care service, and last 3.85 points to a health care service providers' cultural skills. However, there was a difference in points in cultural skills between health care service providers and Chinese medical tourists. Chinese medical tourists' satisfaction with health care service in Daegu was found to be comparatively high, but in relation to satisfaction with communication, it was found to be relatively low. CONCLUSION: Through this research, health care service providers' knowledge level of Chinese culture and cultural skills were low while they seemed to take a half-hearted attitude towards educational experience for building up cultural competence and foreign patient service response.
Asian Continental Ancestry Group* ; Cultural Competency* ; Daegu* ; Delivery of Health Care* ; Health Personnel* ; Health Services Research ; Humans

The authors describe 2 cases of multiple thoracic disc herniations in the level of T5~6, T6~T7, T7~8 and T8~9, T9~10, T10~11. Thoracic disc herniations is rare and occurs in less than 4% of all diseases. Moreover, multiple thoracic disc herniations is very rare and only 7 cases were reported in the literatures, which occurred at two levels in 6 cases and five levels in one case. The lesions were determined by thoracic CT myelogram and MRI study. A microsurgical posterolateral approach made them curative. Surgical instruments such as downbite curette and surgical microscope were essential for successful treatment.
Magnetic Resonance Imaging ; Surgical Instruments

No abstract available.
Humans ; Korea ; Quality-Adjusted Life Years ; Stroke

PURPOSE: Recent years have witness a dramatic increase in public awareness of the health risks associated with lead exposure-particularly concerning young children. The lead poisoning in children was considered a rarity, usually resulting from unique circumstances such as in appropriate use of lead-based body cosmetics or direct administration of lead-containing folk medicine or contaminated atmosphere. The increasing concern about children with lower levels of lead exposure has developed, but there are no data regarding the mean blood lead levels and the incidence of lead poisoning in Korean children. So, this study was conducted to measure the blood lead and ZPP(zinc protoporphyrin) levels of 125 children around Cheonan city. METHODS: 125 children around Cheonan city (from 1 month to 15 year-old, 68 males and 57 females) were studied. We analyzed the mean blood Zinc Protoporphyrin(ZPP) and lead values and excluded children with hematologic disorders in this study. RESULTS: 1) The mean blood lead level was 4.15 microgram/dl (95% CI: 3.82-4.488) and the mean ZPP level was 53.48 microgram/dl (95% CI: 48.44-58.52). Both were within normal range. 2) The mean blood lead level of 68 males was 4.23 microgram/dl and 4.06 microgram/dl in 57 females. The mean blood ZPP level was 49.88 microgram/dl in males and 57.77 microgram/dl in females. There was no significant difference in males and females. 3) There was no siginificant correlation between blood lead and ZPP concentration. CONCLUSIONS: We concluded that the mean blood lead level of 125 children around Cheonan city was 4.15 microgram/dl. That was within normal range and the same values with United States. It is important that there must be a national counter plan and that pediatricians continue to pay attention to lead poisoning in children.
Adolescent ; Atmosphere ; Child* ; Chungcheongnam-do* ; Female ; Humans ; Incidence ; Lead Poisoning ; Male ; Medicine, Traditional ; Reference Values ; United States ; Zinc

PURPOSE: To compare the usefulness of test bolus examination in three-dimensional contrast enhanced MR angiography of the carotid artery with that of the fixed delay time method. MATERIALS AND METHODS: Sixty consecutive patients (mean age, 60.1 years) in whom carotid arterial disease was suspected and who were examined during a 17-month period were divided into two equal groups. For group A, a fixed delay time of 5 secs was used, while for group B, the delay time of the test bolus examination was calculated from the signal intensity versus time curve of the carotid artery, obtained after the test injection of 1 ml contrast material into the right brachal vein. Overall image quality, discrimination between the arterial and the venous phase, and the contrast-to-noise ratio(CNR) of the carotid artery were compared between the two groups. Overall image quality was classified as excellent, good, moderate or poor, and discrimination between the two phases was graded IV-I according to the degree of jugular venous enhancement. RESULTS: In group A, overall image quality of the carotid artery was classified as excellent or good in 13 (43.3%)and 9 (30.0%) cases, respectively, while in group B the corresponding figures were 23 (76.7%) and 5 (16.7%). The differences between the two groups were statistically significant (p<0.05). In terms of discrimination between the arterial and venous phase, 20 (66.7%) of the 30 cases in group A were assigned grade IV or III, while 28 (93.3%) of the 30 in group B were assigned these same grades (p<0.05). The CNR of the carotid artery was higher in group B(67.1 +/-16.1) than in group A(27.3 +/-17.8), with statistical significance(p<0.05). CONCLUSION: For examination of the carotid artery, contrast enhanced MR angiography using a test bolus is su-perior to the fixed delay time method.
Angiography* ; Carotid Arteries* ; Carotid Artery Diseases ; Discrimination (Psychology) ; Humans ; Veins

OBJECTIVES: The aim of this study is to examine the cognitive function change related to aging, the incidence of cognitive impairment, and the association between apolipoprotein E polymorphism and cognitive impairment through a follow-up of the elderly with normal cognitive ability at baseline. METHODS: Two hundred and fifteen subjects aged 65 and over were surveyed in February, 1998 (baseline survey), and their cognitive function was assessed again in 2003 (1st follow-up) and the once again in 2006 (2nd follow-up). Ninety one subjects completed all surveys up through the 2nd follow-up and their cognitive function scores using MMSE-K (Korean Version of the Mini-Mental State Examination) and the distribution of apolipoprotein E allele were analyzed. RESULTS: The cognitive function scores decreased with aging and the difference between baseline and the 2nd follow-up scores of the study increased with the age group. The incidence rate of cognitive impairment through an 8-year follow-up was 38.5% and higher in older age groups. Age was the only significant factor for incidence of cognitive impairment, but there was no significant association between apolipoprotein E genotype and incidence of cognitive impairment. CONCLUSIONS: The cognition of the elderly decreased with aging and the association of apolipoprotein E genotype with incidence of cognitive impairment was not significant in this study. To confirm the association between apolipoprotein E polymorphism and incidence of cognitive impairment further studies will be needed.
Aged ; Apolipoproteins E/*genetics ; Cognition/physiology ; Cognition Disorders/etiology/*genetics ; Female ; Humans ; Korea ; Male ; Polymorphism, Genetic

OBJECTIVES: This prospective population-based cohort study was conducted to evaluate the risk factors of cognitive impairment and the degree of cognitive function change through a 5-year follow-up. METHODS: The baseline and follow-up surveys were conducted in 1998 and 2003, respectively. Among 176 subjects who had normal cognitive function in the baseline study, 136 were followed up for 5 years. The cognitive function was investigated using the Korean version of the Mini-Mental State Examination (MMSE-K). The collected data were analyzed using SPSS and Stata. RESULTS: Of the 136 subjects analyzed, 25 (18.4%) were cognitively impaired. Old age and low social support in the baseline survey were risk factors for cognitive impairment after 5 years. In the generalized estimating equation for 128 subjects except severe cognitive impairment about the contributing factors of cognitive function change, the interval of 5 years decreased MMSE-K score by 1.02 and the cognitive function was adversely affected with increasing age, decreasing education and decreasing social support. CONCLUSIONS: Although the study population was small, it was considered that the study results can be used to develop a community-based prevention system for cognitive impairment.
*Rural Health ; Neuropsychological Tests ; Male ; Korea ; Humans ; Follow-Up Studies ; Female ; Cognition Disorders/*diagnosis/physiopathology ; Aged, 80 and over ; Aged