OBJECTIVES: The purpose of this study was to get help in order to diagnose orthopaedic disease, measure its activity and determine treatment plan by measuring the beta-glucuronidase activity in urine, serum and joint fluid. METHODS: The beta-glucuronidase activity was determined in the serum, urine and joint fluid of the patients with degenerative arthritis, rheumatoid arthritis, osteomyelitis and osteogenic sarcoma, and some other disease to study the change of the enzyme activity. These values of each specimen were calculated by standard curve and treated by statistical analysis. RESULTS: The results obtained were summarized as follows. 1. The beta-glucuronidase activity in the serum, urine and joint fluid was increased in patients with degenerative arthritis, rheumatoid arthritis, osteomyelitis and osteogenic sarcoma etc. 2. The increased beta-glucuronidase activity in the serum and joint fluid of each disease does not show a specific finding about respective disease, but the increased beta-glucuronidase activity was statistically significant in the urine of all disease groups(male:p=0. 0041, female:p=0. 0001). CONCLUSIONS: On the basis of these results, it was suggested that beta-glucuronidase activity was affected by the orthopaedic disease and differed according to each specimen.
Arthritis, Rheumatoid ; Glucuronidase* ; Humans ; Joints ; Osteoarthritis ; Osteomyelitis ; Osteosarcoma

BACKGROUND AND OBJECTIVES: The facial nerve grading system proposed by House and Brackmann is the most widely accepted for the clinical assessment of facial nerve injury. It is, however, subjective and discontinuous, and prone to interobserver variation. In order to remove subjectivity from analysis, we have therfore proposed the FEMA grading system at the Korean Otologic Study Group in 1995. This study describes the FEMA grading system and determines its reliability and usefulness by comparing it with the House-Brackmann system in assessing facial paralysis. MATERIALS AND METHODS: Ten experienced otolaryngologists using the FEMA and H-B systems studied 30 patients with various degrees of facial palsy. RESULTS: In the average of coincidence rate, the FEMA system showed 84.4% and the H-B system was 73.7% (p<0.05). The standard deviation in the grading by the FEMA system was lower than that by the H-B system (p=0.082). CONCLUSION: The study found that the FEMA grading system is more exact and objective in describing the severity of facial palsy than the House-Brackmann grading system. Especially, the FEMA grading system is more convenient to use in patients with partial weakness.
Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis ; Humans ; Observer Variation

Dense deposit disease (DDD) is a rare primary glomerulonephritis characterized by continuous band- like intramembranous dense deposits detectable on electron microscopy. We describe a case of DDD with sequential mesangial proliferative glomerulonephritis, membranoproliferative glomerulonephritis, minor glomerular alterations, and a second round of mesangial proliferative glomerulonephritis during a 13-year period. Electron dense deposits were typical of DDD in the first and second biopsies taken one year apart. However, deposits dissolved and the glomerular cellularity and basement membrane normalized with clinical remission, which was achieved by a course of immunosuppressive therapy lasting seven years. The fourth biopsy was performed due to recurrence of microscopic hematuria and showed predominant mesangial IgA deposits without glomerular capillary alteration, which was interpreted as development of IgA nephropathy after remission of DDD or coexistence with nearly healed DDD in this patient.
Basement Membrane ; Biopsy ; Capillaries ; Dichlorodiphenyldichloroethane ; Electrons ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Hematuria ; Immunoglobulin A ; Microscopy, Electron ; Recurrence

Individuals with autism spectrum disorder (ASD) have altered gut microbiota, which appears to regulate ASD symptoms via gut microbiota-brain interactions. Rapid assessment of gut microbiota profiles in ASD individuals in varying physiological contexts is important to understanding the role of the microbiota in regulating ASD symptoms. Microbiomes secrete extracellular membrane vesicles (EVs) to communicate with host cells and secreted EVs are widely distributed throughout the body including the blood and urine. In the present study, we investigated whether bacteria-derived EVs in urine are useful for the metagenome analysis of microbiota in ASD individuals. To address this, bacterial DNA was isolated from bacteria-derived EVs in the urine of ASD individuals. Subsequent metagenome analysis indicated markedly altered microbiota profiles at the levels of the phylum, class, order, family, and genus in ASD individuals relative to control subjects. Microbiota identified from urine EVs included gut microbiota reported in previous studies and their up- and down-regulation in ASD individuals were partially consistent with microbiota profiles previously assessed from ASD fecal samples. However, overall microbiota profiles identified in the present study represented a distinctive microbiota landscape for ASD. Particularly, the occupancy of g_Pseudomonas, g_Sphingomonas, g_Agrobacterium, g_Achromobacter, and g_Roseateles decreased in ASD, whereas g_Streptococcus, g_Akkermansia, g_Rhodococcus, and g_Halomonas increased. These results demonstrate distinctively altered gut microbiota profiles in ASD, and validate the utilization of urine EVs for the rapid assessment of microbiota in ASD.
Autism Spectrum Disorder* ; Autistic Disorder* ; DNA, Bacterial ; Down-Regulation ; Gastrointestinal Microbiome ; Humans ; Membranes* ; Metagenome ; Microbiota*

OBJECTIVES: To evaluate the patient satisfaction and its influencing factors after medical care for workrelated injuries. METHODS: A self-reported questionnaire was mailed to 921 workers who had experienced workers' compensation medical care. The data from 335 respondents (response rate was 36.4%) were merged and analysed with the data from the Korea Labor Welfare Corporation (KLWC) which contain other general information of the respondents. RESULTS: Dissatisfaction with their medical care was reported by 17.3% of the respondents. Overall patient satisfaction (OPS) was highly correlated with the medical treatment process such as hospital facility, medical therapy, surgical therapy, doctor's explanation and physical therapy. However, OPS was negatively influenced by three factors: 1) unsatisfactory hospital care during waiting period before the approval of workers' compensation, 2) forced end of the hospital care by the workers' compensation, and 3) end of the hospital care with no further improvement. CONCLUSIONS: To improve the satisfaction of patients with work-related injuries, both the practice of medical treatment and also the administrative process of workers' compensation must be reformed. These reforms are needed to improve the quality of workers' compensation medical care and prevent abnormal illness behavior such as inappropriate treatment seeking.
Data Collection ; Humans ; Illness Behavior ; Korea ; Patient Satisfaction* ; Postal Service ; Questionnaires ; Workers' Compensation*

BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD) may be one of the important causes of cryptogenic hepatocellular carcinoma (HCC). The aim of this study was to evaluate whether patients with cryptogenic HCC share clinical features similar to that of NAFLD. METHODS: Cryptogenic HCC was defined as HCC that occurs in patients with the following conditions: HBsAg(-), anti-HCV(-), and alcohol ingestion of less than 20 g/day. All patients diagnosed with cryptogenic HCC from 2005 to 2012 (cryptogenic HCC group), and all patients diagnosed with HBV associated HCC between 2008 and 2012 (HBV-HCC group) were enrolled in the present study. Clinical features, BMI, lipid profiles, presence of diabetes mellitus, hypertension, and metabolic syndrome were compared between the two groups. RESULTS: Cryptogenic HCC group was composed of 35 patients (19 males and 16 females) with a mean age of 70+/-11 years. HBV-HCC group was composed of 406 patients (318 males and 88 females) with a mean age of 56+/-7 years. Patients in the cryptogenic HCC group were older (p=0.001) and female dominant (p=0.042) than those in the HBV-HCC group. There were no differences in the laboratory test results including lipid profiles and Child-Turcotte-Pugh class between the two groups. Patients in the cryptogenic HCC group had higher prevalence of diabetes (37% vs. 17%, p=0.015), hypertension (49% vs. 27%, p=0.051), metabolic syndrome (37% vs. 16%, p=0.001), and higher BMI (25.3 kg/m2 vs. 24.1 kg/m2, p=0.042) than those in the HBV-HCC group. The tumor stage was more advanced (stage III and IV) at diagnosis in the cryptogenic HCC group than in the HBV-HCC group (60% vs. 37%, p=0.007). CONCLUSIONS: Cryptogenic HCC has clinical features similar to that of NAFLD and is diagnosed at a more advanced tumor stage.
Age Factors ; Aged ; Body Mass Index ; Carcinoma, Hepatocellular/*diagnosis/etiology/pathology ; Diabetes Complications ; Diabetes Mellitus/pathology ; Female ; Hepatitis B/complications ; Humans ; Hypertension/complications ; Lipids/blood ; Liver Neoplasms/*diagnosis/etiology/pathology ; Male ; Metabolic Syndrome X/complications ; Middle Aged ; Neoplasm Staging ; Non-alcoholic Fatty Liver Disease/*diagnosis/pathology ; Risk Factors ; Severity of Illness Index ; Sex Factors

BACKGROUND: The aim of this study was to investigate the prevalence, clinical and laboratory findings of hereditary hemolytic anemia (HHA) in Korea from 1997 to 2006 and to develop the appropriate diagnostic approach for HHA. METHODS: By the use of questionnaires, information on the clinical and laboratory findings ofHHA diagnosed from 1997 to 2006 in Korea was collected and analyzed retrospectively. A total of 431 cases were enrolled in this study from 46 departments of 35 hospitals. RESULTS: The overall frequency of HHA did not change through the 10-year period for pediatrics but did show an increasing tendency for internal medicine. The overall male to female sex ratio did not show sex predominance (1.17:1), but a significant male predominance with a ratio of 1.49:1 was seen for pediatrics while a significant female predominance with a ratio of 1:1.97 was seen forinternal medicine. Of the total cases, 74.2% (282/431) were diagnosed before the age of 15 years. The etiologies of HHA were classified as red cell membrane defects, hemoglobinopathies, red cell enzyme deficiencies and unknown causes. There were 382 cases (88.6%) of red cell membrane defects with 376 cases (87.2%) of hereditary spherocytosis and 6 cases (1.4%) of hereditary elliptocytosis, 20 cases (4.6%) of hemoglobinopathies with 18 cases (4.2%) of beta-thalassemia, a case (0.2%) of alpha-thalassemia and a case (0.2%) of Hemoglobin Madrid, 7 cases (1.6%) of red cell enzyme deficiencies with 5 cases (1.2%) of glucose-6- phosphate dehydrogenase (G-6-PD) deficiency, a case (0.2%) of pyruvate kinase (PK) deficiency and a case (0.2%) of enolase deficiency, and 22 cases (5.1%) of unknown causes. The most common chief complaint in pediatric patients was pallor and that in adult patients was jaundice. In the red cell membrane defect group of patients, the level of hemoglobin was significantly higher than in adult patients. The mean corpuscular volume, mean corpuscular hemoglobin, corrected reticulocyte count, total and indirect bilirubin level and lactate dehydrogenase levels in the hemoglobinopathy group of patients were significantly lower than the values in the red cell membrane defect group of patients. The mean concentration of G-6-PD was 0.8+/-0.7U/1012RBC in the G-6-PD deficient patients, PK was 1.7U/1010 RBC in the PK deficient patient, and the level of enolase was 0.04U/g of Hb in the enolase deficient patient. CONCLUSION: The most prevalent cause of HHA in Korea during 1997 to 2006 was hereditary spherocytosis, but HHA by other causes such as hemoglobinopathy and red cell enzyme deficiency gradually increased with the development of molecular diagnostic methods and increasing general interest. However, the etiologies of HHA need to be pursued further in 5.1% of the patients. An systematic standard diagnostic approach is needed in a nationwide prospective study for correct diagnoses and appropriate management of HHA.
Adult ; alpha-Thalassemia ; Anemia, Hemolytic, Congenital* ; beta-Thalassemia ; Bilirubin ; Cell Membrane ; Diagnosis ; Elliptocytosis, Hereditary ; Erythrocyte Indices ; Female ; Hemoglobinopathies ; Humans ; Internal Medicine ; Jaundice ; Korea* ; L-Lactate Dehydrogenase ; Male ; Oxidoreductases ; Pallor ; Pathology, Molecular ; Pediatrics ; Phosphopyruvate Hydratase ; Prevalence ; Pyruvate Kinase ; Reticulocyte Count ; Retrospective Studies* ; Sex Ratio ; Surveys and Questionnaires