1.A Study on the Febrile Illness in Autumn among Farmers in Gyeongju-si: Scrub typhus, Leptospirosis, HFRS
Dong Seob KIM ; Dilaram ACHARYA ; Seok Ju YOO ; Ji Hyuk PARK ; Kwan LEE
Journal of Agricultural Medicine & Community Health 2019;44(1):1-10
		                        		
		                        			
		                        			OBJECTIVES: This study aimed to assess the status of Scrub typhus, Leptospirosis and HFRS(hemorrhagic fever with renal syndrome) among farmers with febrile illness. METHODS: We involved a total of 841 farmers who had febrile illness(508 and 333 village residents were, respectively, three and four district of Gyeongju city) selected during autumn of 2014 and 2015. Data were collected by survey questionnaires and blood sample examination. RESULTS: Serum response rate for Scrub typhus and Leptospirosis was 1.5% each and 1.9% for HFRS. Serum response rate for Scrub typhus was significantly higher for tick-bite cases(38.5%), while Leptospirosis was significantly higher for those who were in fruit–planting work(23.1%). Similarly, serum response rate was significantly higher for HFRS who were working in venyl green house work(25.0%). CONCLUSIONS: Government authority should develop effective and efficient preventive strategies to create awareness of infectious diseases among farmers. Extending information, education and communication be reached to farmers that could change their perception and help early diagnosis and treatment and reduce the disease burden and its complication.
		                        		
		                        		
		                        		
		                        			Communicable Diseases
		                        			;
		                        		
		                        			Early Diagnosis
		                        			;
		                        		
		                        			Education
		                        			;
		                        		
		                        			Farmers
		                        			;
		                        		
		                        			Fever
		                        			;
		                        		
		                        			Gyeongsangbuk-do
		                        			;
		                        		
		                        			Hemorrhagic Fever with Renal Syndrome
		                        			;
		                        		
		                        			Leptospirosis
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Scrub Typhus
		                        			
		                        		
		                        	
2.A Case Report of Human Brucellosis Found by Zoonoses Surveillance System Based on One Health
Dong Seob KIM ; Sung Jun PARK ; Kwan LEE
Journal of Agricultural Medicine & Community Health 2019;44(2):90-93
		                        		
		                        			
		                        			Brucellosis is one of the zoonoses, and it is a disease that is almost eliminated in South Korea. This disease is also known as a representative disease of one health. We would like to introduce brucellosis found by one health in this study. One Health means an approach in which multiple sectors communicate and work together to achieve better public health outcomes. The Gyeongbuk Agricultural Safety and Health Center established a cooperation system between a Veterinary Service Laboratory and a Public Health Center, and found a case of human brucellosis in a farm with cattle brucellosis. Through this case, to be effective control of zoonoses as above case, epidemiological investigation for cattle and human should be concurrently conducted. And we once again recognized the need for multi-sectoral cooperation in prevention and management of zoonoses.
		                        		
		                        		
		                        		
		                        			Agriculture
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Brucellosis
		                        			;
		                        		
		                        			Cattle
		                        			;
		                        		
		                        			Gyeongsangbuk-do
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Public Health
		                        			;
		                        		
		                        			Zoonoses
		                        			
		                        		
		                        	
3.Status and Awareness of Excessive Heat Exposure among Agricultural Workers.
Dong Hyun LEE ; Dong Seob KIM ; Jin Wook CHUNG ; Kwan LEE ; Hyun Sul LIM
Journal of Agricultural Medicine & Community Health 2018;43(1):9-17
		                        		
		                        			
		                        			OBJECTIVES: This study was to assess the status and awareness of excessive heat exposure among agricultural workers. METHODS: We selected a total of 90 farmers from a villages of Gyeongju-si, during August, 2015. We carried out the temperature measurement for nine times and derived Health Index (HI) and Wet Bulb Globe Temperature (WBGT) index. We compared the HI, WBGT and excessive heat warnings. Status of high temperature exposure, lifestyle, medical history, and awareness about excessive health related exposure illness assessed using survey questionnaires. RESULTS: The matching rates between the WBGT and the HI during excessive heat warning were high, but when it was a non-excessive heat warning, there were days of excessive HI or WBGT. Out of 90 farmers surveyed, 78 cases (86.7%) were in their 60s and older age group. Slightly more than two third (71.1%) farmers were farming in the dawn-morning (71.1%), and the daily working hours were less than 4 hours (54.4 %), but only 23.3% among farmers took regular breaks. Of total, 14.4% farmers experienced excessive heat exposure related illness in order of tiredness, lethargy, dizziness, headaches, and sweating. Overall, the awareness of the danger for excessive heat and the heat wave warnings were high at 70.0% and 74.4%, respectively. CONCLUSIONS: Politically, the excessive heat warnings should not be taken into account the simple temperature measurement but, have to consider WBGT and HI standards at the same time. Farmers need to be promoted and educated to prevent the excessive heat related illness by periodically increasing their rest time during farming.
		                        		
		                        		
		                        		
		                        			Agriculture
		                        			;
		                        		
		                        			Dizziness
		                        			;
		                        		
		                        			Farmers*
		                        			;
		                        		
		                        			Gyeongsangbuk-do
		                        			;
		                        		
		                        			Headache
		                        			;
		                        		
		                        			Hot Temperature*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Infrared Rays
		                        			;
		                        		
		                        			Lethargy
		                        			;
		                        		
		                        			Life Style
		                        			;
		                        		
		                        			Sweat
		                        			;
		                        		
		                        			Sweating
		                        			
		                        		
		                        	
4.Clinical Efficacy of Acute Monitoring Cortical Activity Using Subdural Strip Electrode after Decompressive Craniectomy.
Ji Hye LEE ; Jun Seok HUR ; Beom Joon KIM ; Hong Joo MOON ; Jong Hyun KIM ; Joo Han KIM ; Taek Hyun KWON ; Youn Kwan PARK ; Heung Seob CHUNG
Korean Journal of Neurotrauma 2013;9(2):96-100
		                        		
		                        			
		                        			OBJECTIVE: Decompressive craniectomy is widely used in cases of uncontrolled intracranial hypertension, including traumatic brain injury or acute stroke. Physiological monitorings, such as intracranial pressure or electroenecephalography (EEG) are critical for patients in the acute phase. We retrospectively reviewed our experience of continuous electrocorticography (ECoG) monitoring by subdural strip electrode in patients who performed decompressive craniectomy and assessed its clinical efficacy. METHODS: Patients who underwent decompressive craniectomy because of severe intracranial hypertension were included. 4 Channel strip electrodes were inserted on the frontal cortex before closure. 24-hour continuous monitoring of ECoG was done to identify abnormal electrical activity. The level of consciousness was assessed according to Glasgow Coma Scale (GCS). In patients with malignant intracranial hypertension, barbiturate coma therapy was considered. RESULTS: Fifteen patients (9 men and 6 women) were included and the mean age was 55.7 years (from 17 to 80). The initial mean GCS score was 7.9 (from 3 to 14). In six out of fifteen patients, abnormal spike activities were identified, and one of these six patients was diagnosed as nonconvulsive status epilepticus (NCSE). Cortical spreading depression (CSD) was suspected in five. Three patients underwent barbiturate coma therapy and ECoG monitoring of these patients showed typical burst suppression pattern, which was used for indicator of therapeutic level. The mean duration of strip electrode and ECoG monitoring was 3.5 days, and there was no complication. CONCLUSION: Continuous ECoG monitoring using subdural strip electrode was useful to detect abnormal brain activity in the acute period after decompressive craniectomy.
		                        		
		                        		
		                        		
		                        			Barbiturates
		                        			;
		                        		
		                        			Brain
		                        			;
		                        		
		                        			Brain Injuries
		                        			;
		                        		
		                        			Coma
		                        			;
		                        		
		                        			Consciousness
		                        			;
		                        		
		                        			Cortical Spreading Depression
		                        			;
		                        		
		                        			Decompressive Craniectomy*
		                        			;
		                        		
		                        			Electrodes*
		                        			;
		                        		
		                        			Glasgow Coma Scale
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Intracranial Hypertension
		                        			;
		                        		
		                        			Intracranial Pressure
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Status Epilepticus
		                        			;
		                        		
		                        			Stroke
		                        			
		                        		
		                        	
5.Nonconvulsive Seizures of Traumatic Brain Injury Patients.
Ji Hye LEE ; Jun Seok HUR ; Hong Joo MOON ; Ji Hyun KIM ; Jong Hyun KIM ; Joo Han KIM ; Taek Hyun KWON ; Youn Kwan PARK ; Heung Seob CHUNG
Korean Journal of Neurotrauma 2013;9(2):64-68
		                        		
		                        			
		                        			OBJECTIVE: Seizures are common consequence of traumatic brain injury and have been reported in clinical series as an incidence of 15% to 22%. Among them, nonconvulsive seizures (NCS) are often unrecognized during the early period of neurosurgical hospitalization because their clinical presentations can be misunderstood as consequent symptoms of clinical course, and the diagnosis can be confirmed only by the electroencephalographic (EEG) recording. METHODS: We retrospectively reviewed our clinical database of traumatic brain injury (TBI) patients admitted between March 2008 and September 2012. Twenty one patients with suspicious symptoms of NCS, such as decrease of consciousness, aphasia or irritability, were included. Routine wake and sleep EEG or bedside continuous EEG monitoring were done in all patients. RESULTS: Ten out of twenty-one patients showed abnormal activities on EEG. Ictal discharges were documented on four patients. Based on clinical symptoms and EEG findings, these four patients were diagnosed as NCS. Two out of four NCS patients showed EEG findings of nonconvulsive status epilepticus (NCSE). Another six patients with abnormal EEG activities were considered as 'suspicious NCS' because only interictal activities were recorded on EEG but increasing dose or adding on antiepileptics relieved their symptoms. All NCS/NCSE were successfully controlled by appropriate antiepileptic therapy. CONCLUSION: Our result showed that NCS was diagnosed in about 20% of patients with suspicious symptoms. There's a possibility that actual NCS might have happened more. Because untreated NCS/NCSE might cause worse clinical outcome, careful observation and urgent EEG recordings should be considered in a patient with suspicious NCS symptoms.
		                        		
		                        		
		                        		
		                        			Anticonvulsants
		                        			;
		                        		
		                        			Aphasia
		                        			;
		                        		
		                        			Brain Injuries*
		                        			;
		                        		
		                        			Consciousness
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Electroencephalography
		                        			;
		                        		
		                        			Hospitalization
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Seizures*
		                        			;
		                        		
		                        			Status Epilepticus
		                        			
		                        		
		                        	
6.The Relationship between Stud Morphology and 5th Metatarsal Proximal Stress Fractures on Soccer Players.
Jun Young LEE ; Gwang Chul LEE ; Young Kwan LEE ; Yi Kyu PARK ; Sang Soo PARK ; Jun Seob SONG
The Korean Journal of Sports Medicine 2012;30(1):41-46
		                        		
		                        			
		                        			This research sets out to define the relationship between stud morphology of soccer shoes and 5th metatarsal proximal stress fractures on soccer players by comparison and analysis. After the pre-survey of 132 soccer players in Gwangju, 107 players who seem to have a 5th metatarsal fracture were selected. We investigated the shape of the studs and asked whether they had ever had a 5th metatarsal proximal stress fracture. We also asked them some questions on factors, which cause stress fracture, such as what position they play, how long they have been playing soccer as athletes and average playing time. And we analyzed correlation between these several factors and whether they had ever had stress fracture using chi-square (x2) test and Logistic regression analysis. We concluded that soccer players who wore bar type studs shoes had a much greater possibility of stress fracture than soccer players who wore the round type. Also we learned that soccer players who play mid-fielder have a much greater possibility of stress fracture than soccer players who play other positions. And the result of logistic regression analysis of relevance between soccer shoes stud morphology and stress fracture shows a statistically significant odd ratio, 6.840. It has been suggested that the morphology of the soccer shoes stud has relevance to the occurrence of stress fracture. Therefore, according to the result of this study, soccer shoes with the round shape are more helpful in preventing 5th metatarsal proximal stress fracture than soccer shoes with the bar shape.
		                        		
		                        		
		                        		
		                        			Athletes
		                        			;
		                        		
		                        			Fractures, Stress
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Metatarsal Bones
		                        			;
		                        		
		                        			Shoes
		                        			;
		                        		
		                        			Soccer
		                        			
		                        		
		                        	
7.A Case of Crossed Fused Renal Ectopia with Multicystic Dysplasia.
Eun Min SEO ; Eun Jung SHIM ; Kwan Seob LEE
Journal of the Korean Society of Pediatric Nephrology 2008;12(2):262-266
		                        		
		                        			
		                        			Crossed renal ectopia is a congenital malformation in which both kidneys lie on the same side of the spine, usually side by side longitudinally. More often on the right side. Fusion of the two renal units is eight times more common than nonfusion. Although crossed renal ectopia is uncommon, this unusual entity must be considered in an infant when cystic mass in the abdomen or pelvis paticularly if no kidney can be found on the opposite side. In many cases of crossed fused ectopia with multicystic dysplastic kidney(MCDK), the diagnosis can be strongly suspected from the sonogram, and no other studies may be necessary. However, both intravenous urography and isotope renography is useful to assess the function of the crossed kidney. Crossed renal ectopia and MCDKs are associated with a greater incidence of ureteropelvic junction obstruction and reflux. So, screening voiding cystourethrography should be performed. Very few studies of MCDK in the setting of crossed fused ectopia have been reported. We have experienced a 3-year-old boy with crossed fused renal ectopia with multicystic dysplasia.
		                        		
		                        		
		                        		
		                        			Abdomen
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Kidney
		                        			;
		                        		
		                        			Mass Screening
		                        			;
		                        		
		                        			Multicystic Dysplastic Kidney
		                        			;
		                        		
		                        			Pelvis
		                        			;
		                        		
		                        			Preschool Child
		                        			;
		                        		
		                        			Radioisotope Renography
		                        			;
		                        		
		                        			Spine
		                        			;
		                        		
		                        			Urography
		                        			
		                        		
		                        	
8.Percutaneous Nephrostomy Combined with Antifungal Agent Therapy for Both Hydronephrosis and Obstructive Uropathy in VLBW Infant.
Yoon Jin CHOI ; Ji Seung HEO ; Eun Jung SIM ; Do Jun CHO ; Dug Ha KIM ; Ki Sik MIN ; Ki Yang YOO ; Kwan Seob LEE
Journal of the Korean Society of Neonatology 2007;14(1):87-92
		                        		
		                        			
		                        			With increasing survival of smaller, more immunocompromised preterm infants, the incidence of invasive fungal infection is increasing among NICU patients, with highly associated morbidity and mortality. The most common site of end organ dissemination in premature infants with fungemia is the renal system. Renal fungal infection is followed by acute pyelonephritis and renal cortical abscess, and leads to obstructive nephropathy and renal failure. We recently experienced a case of VLBW infant who was dignosed as both hydronephrosis and obstructive uropathy due to Candida albicans that was treated intravenous amphotericin B combined with direct daily irrigation into the renal pelvis via percutaneous nephrostomy catheter.
		                        		
		                        		
		                        		
		                        			Abscess
		                        			;
		                        		
		                        			Amphotericin B
		                        			;
		                        		
		                        			Candida albicans
		                        			;
		                        		
		                        			Catheters
		                        			;
		                        		
		                        			Fungemia
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hydronephrosis*
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Infant*
		                        			;
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Infant, Premature
		                        			;
		                        		
		                        			Kidney Pelvis
		                        			;
		                        		
		                        			Mortality
		                        			;
		                        		
		                        			Nephrostomy, Percutaneous*
		                        			;
		                        		
		                        			Pyelonephritis
		                        			;
		                        		
		                        			Renal Insufficiency
		                        			
		                        		
		                        	
9.C-1 Root Schwannoma with Aggressive Lateral Mass Invasion.
Joo Han KIM ; Ju Han LEE ; Youn Kwan PARK ; Taek Hyun KWON ; Hung Seob CHUNG
Yonsei Medical Journal 2005;46(4):575-578
		                        		
		                        			
		                        			Schwannomas are relatively common, benign tumors that are thought to arise from the nerve sheath cell. Schwannomas of the C1 root are extremely rare and seldom invade lateral masses because they gradually increase in size and can extend through the wide space behind the lateral mass instead of the intervertebral foramen. We present here an unusual case of a benign schwannoma that aggressively invaded the lateral mass of C-1.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Neoplasm Invasiveness
		                        			;
		                        		
		                        			Neurilemmoma/*pathology
		                        			;
		                        		
		                        			Spinal Neoplasms/*pathology
		                        			;
		                        		
		                        			Spinal Nerve Roots/*pathology
		                        			
		                        		
		                        	
10.Delayed Primary Repair of Perforated Epiphrenic Diverticulum.
Ju Hyeon LEE ; Hiun Suk CHAE ; Kwan Hyoung KIM ; Jin Woo KIM ; Young Pil WANG ; Sun He LEE ; Keon Hyon JO ; Jae Kil PARK ; Sung Bo SIM ; Jeong Seob YOON ; Seok Whan MOON ; Yong Hwan KIM
Journal of Korean Medical Science 2004;19(6):887-890
		                        		
		                        			
		                        			A 68-yr-old man complaining of sudden, postprandial chest pain visited the emergency room. His symptom had been aggravated during the preceding two days. Upper gastrointestinal contrast study with gastrographin showed leakage of dye from the epiphrenic diverticulum in the lower third of the esophagus. The primary repair was urgently carried out. Upper gastrointestinal contrast study 14 days after operation revealed an esophageal leakage which was small and confined. The patient was managed with conservative treatments such as intravenous hyperali-mentation and broad-spectrum antibiotics. Forty-two days after the operation, a gastrographin swallow study showed the absence of leaks. This is the first report-ed case of a perforated epiphrenic esophageal diverticulum repaired by delayed primary repair in Korea.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Diverticulum, Esophageal/complications/*diagnosis/*surgery
		                        			;
		                        		
		                        			Esophageal Perforation/*diagnosis/etiology/*surgery
		                        			;
		                        		
		                        			Esophagectomy/*methods
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Research Support, Non-U.S. Gov't
		                        			;
		                        		
		                        			Time Factors
		                        			;
		                        		
		                        			Treatment Outcome
		                        			
		                        		
		                        	
            
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