Acoustics ; Child ; Cleft Palate ; Humans ; Korea

OBJECTIVE: The objectives of this study were to evaluate the reliability of the Korean version of Spinal Cord Independence Measure (SCIM) and to compare the sensitivity of the SCIM to functional changes of spinal cord injury (SCI) patients with that of the Functional Independence Measure (FIM). METHOD: Seventeen subjects with SCI were studied. The SCIM was translated and modified to convert as SCIM Korean-version. All patients were evaluated with the SCIM and the FIM by two raters every other week. To determine inter-rater reliability, the relationship between the SCIM scores obtained by two raters was evaluated by Kappa coefficient and linear regression. To determine relative sensitivity of the test to functional changes, changes in the scores on the SCIM and FIM were compared by McNemar test. RESULTS: The Kappa coefficient of the various individual tasks in SCIM ranged between 0.63 and 1.00. High correlations were also found between the total SCIM scores for the paired raters (r=0.99, p<0.01). The SCIM detected all the functional changes detected by FIM total scoring, but in 3 (14%) of 22 sequential test batteries, the FIM missed changes detected by SCIM total scoring. CONCLUSION: These results demonstrated that the SCIM is reliable and more sensitive than the FIM in reflecting the functional changes of SCI patients.
Humans ; Linear Models ; Spinal Cord Injuries* ; Spinal Cord*

A total of 106 Penicillium species were tested to examine their ability of degrading cellobiose, pectin and xylan. The activity of beta-glucosidase was generally strong in all the Penicillium species tested. P. citrinum, P. charlesii, P. manginii and P. aurantiacum showed the higher ability of producing beta-glucosidase than other tested species. Pectinase activity was detected in 24 Penicillium species. P. paracanescens, P. sizovae, P. sartoryi, P. chrysogenum, and P. claviforme showed strong pectinase activity. In xylanase assay, 84 Penicillium species showed activity. Strong xylanase activity was detected from P. megasporum, P. sartoryi, P. chrysogenum, P. glandicola, P. discolor, and P. coprophilum. Overall, most of the Penicillium species tested showed strong beta-glucosidase activity. The degree of pectinase and xylanase activity varied depending on Penicillium species.
beta-Glucosidase ; Cellobiose ; Penicillium* ; Polygalacturonase

Surgical endarterectomy has been shown to be superior to medical treatment in the management of severe carotid stenosis. Endarterectomy, although effective, does have limitations, and percutaneous transluminal angioplasty with stent may offer an alternative modality of treatment. We report on a patient with severe coronary disease that femoral arterial cannulation was not possible due to aorto-femoral shunt operation and absent pulse. The transradial approach was used for aortography, bilateral carotid angiography and successful elective stent deployment in the left internal carotid artery. The transradial approach might be useful alternative in case of problems with femoral approach.
Angiography ; Angioplasty* ; Aortography ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Catheterization ; Coronary Disease ; Endarterectomy ; Humans ; Stents*

This study was designed to identify doxorubicin as a permanent chemomyectomy agent that overcomes reversible effect of botulinum toxin A. Doxorubicin was assessed for its ability to bring about a permanent chemomyectomy and the effects of pretreatment were observed to assess its ability to prevent any complications brought about by doxorubicin. A total of thirteen rabbits were assigned to the control group(n=3) and two experimental groups(n=5 for each group). To investigate the myopathic changes following the injections of the agent, both orbicularis oculi muscles of the lower eyelids of each rabbit in the control group were directly injected with single dose of 0.2ml normal saline. Group I were injected with 0.5mg/0.2ml of doxorubicin into the right eyelid and 1.0 mg/0.2 ml of doxorubicin into the left. Group II were given an intravenous injection of 35mg/kg of allopurinol as the pretreatment, then 30minutes later injected with 0.5mg/0.2ml of doxorubicin into the right and 1.0mg/ 0.2ml of doxorubicin into the left. The rabbits were examined daily to monitor the onset, duration and size of skin necrosis and histologically examined two and four months after initial injections. The myopathic change after doxorubicin injection was persistent and irreversible. The dose related effects of doxorubicin chemomyectomy were confirmed by the histologic finding. Skin necrosis occurred in all cases of doxorubicin injection(both 0.5mg and 1.0mg), however the allopurinol pretreatment decreased the size of the skin necrosis in case of the high dose(1.0mg) of doxorubicin. The combined use of allopurinol and doxorubicin reduced the myopathic change more effectively than doxorubicin use alone. Further study is needed to determine optimal dose and administration method, which we feel will contribute to safer and permanent chemomyectomy.
Allopurinol* ; Botulinum Toxins ; Doxorubicin* ; Eyelids ; Injections, Intravenous ; Muscles ; Necrosis ; Rabbits ; Skin

Coronary stent embolization is a rare event but may result in clinically relevant cardiac ischemia or peripheral embolization during the procedure. We report a case of systemic embolizations of two coil stents during the primary PTCA in acute myocardial infarction, who were treated successfully with a double wire helix technique and a gooseneck snare. Although in our experience this rare complication did not produce any clinical complications, care should be taken to prevent this possibility, especially in patients with significant vessel tortuosity, calcification, total occlusion, or mild stenosis proximal to the target lesion.
Constriction, Pathologic ; Humans ; Iliac Artery* ; Ischemia ; Myocardial Infarction ; SNARE Proteins ; Stents*

OBJECTIVE: To compare the voice onset time (VOT) differences of Korean stops in the initial and intervocalic positions between the aphasic patients with peculiarities of aspiration and a control group. METHOD: We examined 15 aphasic patients (nine males, six females) who had suffered a stroke (average age 49.7 years) and 15 healthy controls (average age 47.4 years). An aphasia examination was made by an aphasia battery of three standard tests and VOT was analyzed instrumentally. Stop consonants in the initial and intervocalic position were measured to categorize them according to aphasia types, place of articulation, and manner of articulation. RESULTS: VOT of the aphasic patients with peculiarities of aspiration had a greater difference than that of the controls, indicating that the temporal non-coordination between the laryngeal adjustment and oral articulators of aphasic patients happens due to the VOT of stops in the initial and intervocalic positions (p<0.05). CONCLUSION: VOT of stop consonants in the initial position produced by aphasic patients tends to be proportional to their breathing. It can cause glottal width and make aphasic patients' VOT duration longer. Lastly, the method to measure the VOT of aphasic patients is more significant for the types of phonation than for the places of articulation, and makes it possible to induce abnormal VOT.
Aphasia ; Dental Articulators ; Humans ; Hypogonadism ; Male ; Mitochondrial Diseases ; Ophthalmoplegia ; Phonation ; Respiration ; Stroke ; Voice

The Kallmanns syndrome is the most common form of isolated hypogonadotropic hypogonadism in which anosmia or hyposmia resulting from agenesis of hypoplasia of the olfactory lobes is associated with LHRH deficiency, This syndrome is genetically heterogeneous and can be trans-mitted as an X-linked, autosomal dominant or autosomal recessive trait. The hypogonadotropic hypogonadism results in absent or incomplete pubertal development and may be associated with anosmia or hyposmia, mid-line defect(color blindness, cleft-lip or
Blindness ; Cryptorchidism ; Epiphyses ; Femur Neck ; Gonadotropin-Releasing Hormone ; Growth Plate ; Head ; Humans ; Hypogonadism ; Kallmann Syndrome ; Male ; Olfaction Disorders ; Olfactory Cortex ; Slipped Capital Femoral Epiphyses

OBJECTIVE: Staphylococcus aureus has persisted and is now resurging as an important hospital and community pathogen. Nosocomial infection caused by methicillin-resistant S.aureus(MRSA) is a major problem which may be connected with heavy or prolonged use of antibiotics S.aureus bacteremia caused acute complications, which occasionally resulted in death, and infectious/suppurative complications, which necessitated prolonged antibiotic therapy, sometimes in conjunction with surgery. Therefore, S.aureus bacteremia is a serious medical problem in association with high morbidity and mortality. METHODS: 130 patients with S.aureus bacteremia who were admitted in the Kyung Hee University Hospital from January, 1991 to December, 1994 were analyzed retrospectively. We compared the clinical and laboratory characteristics, and antibiotics resistances between MRSA and MSSA bacteremia and also we evaluated risk factors that contribute to fatal outcome in patients with S.aureus bacteremia. RESULTS: 1) of 130cases, 80 were male and 50 were female. The mean age was 44.5+/-25.1 years. 2) 84(65%) of S.aureus bacteremia were nosocomial and 46(35%) were community-acpuired. The percentage of MRSA stains studied was 55%(71/130) and The percentage of MRSA bacteremia in hospital-acpuired and community-accquired S. aureus bacteremia were 64% (54/84) and 36%(17/46), respectively. Sources of bacteremia were uncertain in 85(65%) with intravascular catheter(20%) and skin wound sites (8%) being the most common sources in remainder(35%) 3) 110(85%) of 130 patients had one or more underlying diseases. Common underlying dieases were cerebrovascular disease(33%), malignancy(17%), Diabetes mellitus(15%), chronic renal failure(8%) and liver cirrhosis(6%). 4) Acute complications occurred in 35 patients and were fatal in 21 5) The risk factors associated with MRSA bacteremia were various severe underlying diseases, vairous invasive procedures, IV catheter-associated infection, hypoalbuminemia, previous use of antibiotics, male sex and old age. 6) The Case fatality rate for patients with S. aureus bacteremia was 18% and those for patients with MRSA and MSSA bactermia were 20% and 12%, respectively. The risk factors that contribute to the increment of mortality rate in patients with S. aureus bacteremia were acute complication, low serum level of total protein, hypoalbuminemia, various invasive procedures and IV catheter-associated infection, 7) In the antibiotic sensitivity test S. aureus was resistant to penicillin in 98.5%, ofloxacin in 73%, cefotaxime in 67%, erythromycin in 58%, aztreonam in 56%, clindamycin in 52%, vancomycin in 0%. 8) In the multiple antibiotic resistance of S. aureus, 43(68%) of MRSA was resistant to more than 10 antibotics, revealing multiply resistant nature of strains, While all but one MSSA was resistant to 1 to 4 antibiotics, one revealing resistance to 8 antibiotics. CONCLUSION: S. aureus bacteremia is a cause of considerable morbidity and mortality in hospitalized patients who especially, exposed to various risk factors. MRSA revealed higher resistance rate to most antibiotics tested and more marked multiply resistant nature than MSSA. But there was no significant difference in case fatality rate between patients with MRSA and MSSA bacteremia.
Anti-Bacterial Agents ; Aztreonam ; Bacteremia* ; Catheter-Related Infections ; Cefotaxime ; Clindamycin ; Coloring Agents ; Cross Infection ; Drug Resistance, Microbial ; Erythromycin ; Fatal Outcome ; Female ; Humans ; Hypoalbuminemia ; Liver ; Male ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Ofloxacin ; Penicillins ; Retrospective Studies ; Risk Factors ; Skin ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin ; Wounds and Injuries

PURPOSE: To investigate the changes of voiding methods according to the time after discharge and to clarify the reason of changing voiding method. MATERIALS AND METHODS: One hundred and seventeen patients with spinal cord injury were enrolled. We classified these patients into five groups such as normal voiding, reflex voiding, intermittent catheterization, Foley catheter, and suprapubic cystostomy group. We interviewed the patients for necessary information including current voiding method and reason of changing voiding method. RESULTS: 50% of intermittent catheterization patients changed to reflex voiding method. 66% of these patients changed the voiding method without consult with their physician. Higher percentage of the paraplegic patients with intermittent catheterization changed to reflex voiding than the quadriplegic patients. Moreover, female patients indwelt the catheters due to absence of external collecting device than males. CONCLUSION: It is necessary to follow up the voiding methods of patients with spinal cord injury more closely to avoid the following inadvertent complications.
Catheterization ; Catheters ; Cystostomy ; Female ; Follow-Up Studies ; Humans ; Male ; Reflex ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Catheterization