Epidemic Trends of Imported Shigellosis Cases in Korea and Japan, 2016–2020 / 항공우주의학회지

Purpose@#To observe and compare the trends in epidemic aspects of imported shigellosis (Sg) cases from overseas travelers (OTs) in Korea and Japan between 2016 and 2020. @*Methods@#We analyzed the raw data of imported Sg cases from the Korea Diseases Control and Prevention Agency and the National Institute of Infectious Diseases in Japan between 2016 and 2020. @*Results@#In Korea, there were a total of 596 Sg infections, including 353 cases from overseas travel-associated imported cases, with a cumulative incidence rate (CIR) of 0.23 per 100,000 populations. The CIR of imported Sg cases was 0.32 per 100,000 OTs. In Japan, during the same period, there were a total of 757 Sg cases, including 388 imported cases, with a CIR of 0.12 per 100,000 populations. The CIR of imported Sg cases was 0.50 per 100,000 OTs. The CIR of total Sg cases in Korea was higher than in Japan, but the CIR of imported cases in Korea was lower than in Japan (P<0.01).Additionally, the imported-to-domestic cases ratio of Sg in Korea (1.45) was higher than in Japan (1.05) (P<0.05). @*Conclusion@#Based on the trends in the epidemiological aspects of domestic and imported Sg infection cases in both countries, a robust information system is needed to provide effective warnings and preventive measures for travelers visiting high-risk areas.

Epidemiological Aspects of Imported Melioidosis in Korea and Japan, 2011 to 2020 / 항공우주의학회지

Purpose@#Melioidosis is a zoonosis that can infect humans or animals. The disease is caused by the bacteria Burkholderia pseudomallei, which is found in contaminated soil and water. We investigated the epidemiological aspects of melioidosis cases among oversea travelers in Korea and Japan during 2011 to 2020. @*Methods@#Raw data were obtained from the website of melioidosis cases from the Korea Diseases Control and Prevention Agency, and the National Institute of infectiousDiseases in Japan, 2011−2020. @*Results@#There were 26 cases of melioidosis cases in Korea and 14 cases in Japan between 2011 and 2020. Cumulative incidence rate per 1,000,000 oversea travelers (OTs) of Korea (0.14) did not substantially differ that of Japan (0.09), respectively.The incidence of melioidosis in males (96.2% of total 26 cases) was much more common than in females (3.8%) in OTs of Korea (P<0.01), while there were significant differences level between males (85.7% of total 14 cases) and females (14.3%) in OTs of Japan (P<0.01). On the other hand, the distribution by adjusted-age groups for melioidosis cases were statistically similar distribution between Korean and Japanese that total cases occurred in the over 40-years old age, clearly showing a more infected of melioidosis (P<0.05). @*Conclusion@#This study demonstrates that there is a similar pattern of imported melioidosis cases in Korea and Japan. Therefore, to prevent melioidosis infections, greater attention should be paid to individuals who are planning to travel to the presumptive regions of melioidosis.

Space Environment and Space Medicine / 항공우주의학회지

The space environment is a harsh space for humans who have evolved for a long time by adapting to the earth environment. The cosmic conditions that humans experience in outer space including the moon and Mars, such as altered gravity, exposure to cosmic radiation, changes in atmospheric pressure, and lunar dust, not only make the human body uncomfortable but also threaten survival. Space medicine is one of a field of environmental medicine that aims to clarify the physiology and response of body to these harmful space conditions. The primary purpose of space medicine is to protect the health and life of astronauts, and to support mission performance to succeed in space exploration. In addition, it contributes to mankind by utilizing and industrializing the knowledge and technology acquired in the process of developing knowledge about medical countermeasures, basic life support in the space.

Investigation of the Status of Laboratory Tests Conducted during Aviation Medical Examination / 항공우주의학회지

Purpose@#The medical certification for pilots is required by the aviation safety authority based with the aviation safety act. @*Methods@#In this study, medical examination items of the year of 2021 performed during the aviation medical examination in Korea were reviewed by retrospective analysis. @*Results@#Data from a total of 27 hospitals were collected. The number of inspection items ranged from a minimum of 22 items to a maximum of 57 items, showing a difference of more than double. Data from tertiary general hospitals and large airlines showed a tendency to perform more items of test compared to clinic-level institutions. The ratios for each inspection item are as follows: 1) 100% inspection items: urine test, ophthalmic test (except fundus test), fasting blood sugar, general blood test (complete blood count), electrocardiogram, electoencephalography, chest posterior anterior, pure tone audiometry, and total cholesterol; 2) 65%–74% inspection items: triglyceride, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, blood urea nitrogen/creatinine, and hepatitis B surface antigen; 3) 57% inspection items: hepatitis B surface antibody, human immunodeficiency virus, and venereal disease research laboratory; 4) 50% inspection items: urate and fundus examination. @*Conclusion@#There have been many changes in the medical field over the past 40 years, but in terms of examination items, the aviation physical examination does not reflect the flow of change. Over the past years, the number of pilots has increased significantly, the flight environment has changed, and medical examination methods have been developed and diversified. In accordance with this, it is necessary to change the test items.

Understanding Peripheral Dizziness and Evaluating Suitability for Aviation Work / 항공우주의학회지

Aircraft accidents caused by dizziness of aviation workers are so common that they account for 5% to 10% of the total, and in most cases, have fatal consequences. Therefore, it is essential to diagnose and treat the dizziness of aviation workers properly. Common diseases caused by abnormal vestibular function include benign paroxysmal positional vertigo, Meniere’s disease, and vestibular neuritis. In this paper, we first proposed an overview of these diseases’ pathophysiology, diagnosis, and treatment. Also, we evaluated the importance of these diseases in aerospace medicine and presented aerospace medical dispositions for aviation medical examiners.

Review of the History of Animals that Helped Human Life and Safety for Aerospace Medical Research and Space Exploration / 항공우주의학회지

In 2019, the Aerospace Medical Association of Korea celebrated its 30th anniversary. On the other side of the world, it was also the 62nd anniversary of Russian launch Sputnik 1 of the world’s first artificial satellite on October 4, 1957. In additionally, the world, especially the United States was shocked, when on November 3, 1957, Sputnik 2 blasted into Earth orbit with a dog named “Laika”; it was the role of veterinarian’s activities for aerospace medical research and exploration. Veterinarians (Vets) are responsible for the health of all the animals for aerospace medicine whether on the ground or in space. Vets can enhance animal and public health and this knowledge of Vets and astronauts can extend their mission durations, go to nearby Earth Asteroids, Mars and other heavenly bodies to study their living and non-living characteristics. This review article is the brief history of the original growth of the veterinarian’s activities for the aerospace medical research, in order to stimulate future strategies for improvements in the space life sciences and exploration.

Effects of Microgravity on Human Physiology / 항공우주의학회지

Space exploration is one of the dreams of humankind. However, the intriguing environment was a challenge for the human body, where we must counter with many extreme conditions such as thermal support, radiation, microgravity. Life, as well as the human body, developed and evolved in the continuous presence of gravity, especially when living creatures transfer from the ocean to the land. Once this gravitational force doesn't impact on the body, the drastic changes occur. Some of these changes were observed immediately, while others progress only slowly. Since the first orbital flight was performed, several hazards for the organs of the human body were identified [1]. These changes in human physiology can reverse when astronauts return to Earth. This article will review the published findings of the effects of microgravity exposure on the human body.

The Factors Influencing the Accuracy of Head PositionDuring Canalith Reposition Procedure Using 9 AxisInertial Sensor / 대한이비인후과학회지

Background and Objectives@#The canalith reposition procedure (CRP) is used for the treatment of benign paroxysmal positional vertigo (BPPV) where the accuracy of position may affect the therapeutic efficacy. We investigate the accuracy of head position in CRP and its influencing factors during the procedure by measuring the position using inertial sensors and three dimensional remodeling.Subjects and Method We included 28 patients who were diagnosed as BPPV. To evaluate the accuracy of the CRP, we used the inertial sensor on the patient’s goggle used for videonystagmography. We evaluated the accuracy of the treatment compared to the textual treatment used during CRP. We also evaluated patient factors that affected the accuracy of head position as well as analyzing the correlation between the error rate and the successful treatment rate. @*Results@#While the average error rate was 12.6±5.8% for the PSCC group, it was 10.2±5.2% for the lateral semicircular canal (LSCC) group. For the posterior semicircular canal (PSCC) the group with body mass index (BMI), less than 25 patients had the lower error rate than the group with BMI greater than 25. There was no significant differences regarding the error rate according to BMI or age in the PSCC group. There is no significant differences regarding the error rate between those treated within 1 week and those over 1 week. For the LSCC delayed treatment group, there was no significant differences of error rate between the 1st and 2nd maneuver at each position. @*Conclusion@#For the Epley maneuver, the error rate of patients with high BMI is higher than those with low BMI. When the repeated barbeque maneuver was conducted, patients could have a more accurate position due to the learning effect. Care should be taken to ensure accurate CRP by considering various factors.

The 4th Joint Meeting of Japan Society of Equilibrium Research and Korean Balance Society: A Conference Report / 대한평형의학회지

No abstract available.

Clinical Usefulness of Video Head Impulse Test-Comparison of Bithermal Caloric Test and Bedside Head Impulse Test / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Video head impulse test system (vHIT) is an easy-to-use test and there are numerous studies showing its efficacy. The aim of the study was to evaluate the clinical usefulness of vHIT as an initial test in determining vestibular hypofunction in patients with dizziness. SUBJECTS AND METHOD: The study recruited 103 outpatients who visited our ear clinic with dizziness. We performed both bedside head impulse test (bHIT), vHIT and bithermal caloric tests for 103 patients. Both bHIT and vHIT were consecutively performed in each subject on the same day by the same examiner. RESULTS: The sensitivity of bHIT and vHIT was determined based on the bithermal caloric test results, which showed that vHIT was more sensitive than bHIT. There was a significant negative correlation between vHIT gain and canal paresis (p < 0.05). Results of some patients indicated dissociation between vHIT and caloric test. CONCLUSION: T here is a significant correlation between the results of vHIT and caloric test. Although vHIT does not replace the caloric test, it would be useful to evaluate the initial vestibular loss in patients with dizziness.

Autoimmune Inner Ear Disease Mimicking Bilateral Ménière's Disease: A Case Report / 대한평형의학회지

Autoimmune inner ear disease (AIED) is a rare disease, accounting for < 1% of all cases of hearing impairment or dizziness. It is characterized by sensorineural hearing loss (SNHL) or vestibular dysfunction that results from an immunemediated process. Clinical features of AIED is SNHL that progresses over weeks to month with fluctuating hearing symptoms. Because there are no diagnostic laboratory and clinical feature, response to immunosuppressive therapy were important for diagnosis of AIED. Many diseases such as sudden SNHL and Meniere disease may also mimic AIED, a broad differential must be maintained in patients suspected of having AIED. We report a case of a 46-year-old female who presented with sudden hearing loss and vertigo. We could diagnose her as AIED with systemic lupus erythematous. The symptoms were improved treated with steroids.

Microbiological Results From Middle Ear Effusion in Pediatric Patients Receiving Ventilation Tube Insertion: Multicenter Registry Study on the Effectiveness of Ventilation Tube Insertion in Pediatric Patients With Chronic Otitis Media With Effusion: Part

OBJECTIVES: The aim of this multicenter registry study was to investigate the effectiveness of ventilation tube insertion and the microbiology of otitis media with effusion (OME) in children. This part I study was conducted to evaluate the microbiological profile of children with OME who needed ventilation tube insertion. METHODS: Patients < 15 years old who were diagnosed as having OME and received ventilation tube insertion were prospectively enrolled in 16 tertiary hospitals from June 2014 to December 2016. After excluding patients with missing data, the data of 397 patients were analyzed among a total of 433 enrolled patients. The clinical symptoms, findings of the tympanic membrane, hearing level, and microbiological findings were collected. RESULTS: In 103 patients (25.9%), antibiotics were used within 3 weeks before surgery. Ventilation tube insertion was performed in a total of 710 ears (626 in both ears in 313 patients, 55 in the left ear only, and 29 in the right ear only). Culture of middle ear effusion was done in at least one ear in 221 patients (55.7%), and in a total of 346 ears. Only 46 ears (13.3%) showed positive results in middle ear effusion culture. Haemophilus influenzae (17.3%, followed by coagulase-negative Staphylococcus and Staphylococcus auricularis) was the most common bacteria detected. CONCLUSION: H. influenzae was the most commonly found bacteria in middle ear effusion. Relatively low rates of culture positivity were noted in middle ear effusion of patients with OME in Korea.

Strategy for the Diagnosis and Treatment of Obstructive Sleep Apnea of the Aviation Workers / 항공우주의학회지

Obstructive sleep apnea syndrome (OSAS) can lead to severe complications if left untreated, and therefore should be adequately diagnosed and treated, especially in airline workers. The aviation medical examiner (AME) should induce the patient to cooperate for the diagnosis and treatment of OSAS, by notifying the subject that it does not cause disqualification of the air service and that it is a disease that can be sufficiently controlled and treated by various treatment options. AME should also warn about medical complications and the possibility of serious air accident risks when untreated, and encourage the subject to receive appropriate diagnosis and steady treatment such as continuous positive airway pressure and/or surgical treatment.

Altered Gravity and Immune Response / 항공우주의학회지

It is essential to study the effects of hypergravity on the human body in the research field of aerospace medicine. Previous studies have shown that hypergravity could act in a harmful way to the human body. However, recent studies have shown that moderate degree of hypergravity can act in a beneficial way to the human body. The authors have in particular been studying the effects of hypergravity on immune diseases, especially allergic asthma and rhinitis. Therefore, this review paper will introduce the results of recent studies on hormetic (health promotion) effect of hypergravity. In addition, this review paper also examines the mechanism by which hormetic effect of hypergravity could be possible. Furthermore, we will also discuss how to apply these hormetic effects in clinical practice.

Usefulness Assessment of Cochlear Hydrops Analysis Masking Procedure Test in Progress of Ménière's Disease / 대한평형의학회지

OBJECTIVE: There were few recent study concern about usefulness of cochlear hydrops analysis masking procedure (CHAMP) in progression of Ménière's disease. The purpose of this study is to analyze changes in the CHAMP as advancement of Ménière's disease. METHODS: We studied 19 cases of ‘ Definite’ group of Ménière's disease. We assumed progression of Ménière's disease would be checked by pure tone threshold by four tone average (4PTA), low tone average (LPTA). We also compared electrocochleography (ECoG), dizziness handicap inventory (DHI), tinnitus handicap inventory (THI) as parameters for progression of Ménière's disease to CHAMP latency delay and amplitude ratio. Chi-square test was used as a statistical method. RESULTS: In the group of patients had abnormal amplitude ratio, ECoG value were not improved, but there was not statistically significant (odds ratio [OR]=5.727, p>0.05). Better DHI and THI score were not necessarily construed as the improvement value in the CHAMP (p>0.05). In amplitude ratio abnormal group, 4PTA was aggravated, but not statistically significant (OR=1.5, p>0.05). In the group of patient had abnormality in both latency delay and amplitude ratio, LPTA was relatively aggravated (OR in latency delay: 2, OR in amplitude ratio: 10); however, reveals no statistically significance between them (p>0.05). Change of ECoG, hearing threshold including 4PTA and LPTA with progression of Ménière's disease were not correlated significantly with latency delay or amplitude ratio of CHAMP. CONCLUSION: We conclude that CHAMP does not reflect clinical features with progression of Ménière's disease.

Why Diagnosis of Meniere's Disease is Difficult? Understanding of the Diagnostic Criteria / 대한이비인후과학회지

The Best clinical approaches for Meniere's disease starts from the proper diagnosis which is based on the clinical symptoms, including the characteristic features of vertigo and auditory symptoms. After first criteria has been made in 1972 by the American Academy of Otolaryngology-Head and Neck Surgery, it has been revised two times in 1985 and 1995. Japanese criteria have been made in 1974 and revised 2008. Most recent criteria of the Barany Society has been established in 2015. The basic notion is almost similar among these criteria, but detailed descriptions has been gradually changed in characteristics of vertigo and auditory symptoms based on the updated research data and consensus. Understanding of how the diagnostic criteria of Meniere's disease has been evolved is very important in terms of good clinical practice because they contain the development of knowledge about the disease. This article reviewed all the diagnostic criteria, and compared the differences.

Causes of False Negative Bedside Head Impulse Test / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The bedside head impulse test (bHIT) in bare eyes often overlooks possible vestibular losses by missing the corrective saccade. This is why it is necessary to compare bHIT against video head impulse test (vHIT), which is more accurate in identifying vestibular losses than the bedside test. SUBJECTS AND METHOD: A total of 51 vHIT positive ears underwent the study, and out of those, 47 were diagnosed with dizziness. bHIT and vHIT were performed for patients, and the occurrence rate of overt saccade (OS) was calculated. RESULTS: Among the 51 vHIT positive ears, 33 (64.7%) were bHIT positive ears and 18 ears (35.3%) were bHIT negative. Patterns of positive vHIT were classified as A: no corrective saccade, B: covert saccade (CS) only, C: OS only, and D: CS with OS (CS+OS), which were 45 out of 51 ears (88%). The occurrence rate of OS was higher in the bHIT positive group than in the bHIT negative group (p=0.05), and higher in the CS negative group (CS-) than in the CS positive group (CS+) (p<0.001). CONCLUSION: Possible causes of false negative results of bHIT are seen as following: the absence of corrective (covert and overt) saccade, the occurrence of CS only, and missing the OS during the bHIT (probably due to low occurrence rate of OS). The occurrence of CS should be considered as an important factor in false negative bHIT when lowering the occurrence rate of OS.

Usefulness of Allerkin House Dust Mite Extract for Nasal Provocation Testing

OBJECTIVES: We evaluated the clinical usefulness of Allerkin (Lofarma) for nasal provocation testing (NPT) in patients with rhinitis symptoms, by examining changes in nasal symptoms and acoustic parameters after exposure to house dust mite (HDM) extract. METHODS: Twenty patients (16 males and 4 females, mean age: 29.6±14.6 years) were enrolled. We performed skin prick test (SPT) before and 15 and 30 minutes after intranasal challenge with Allerkin HDM extract, and we evaluated symptom changes (nasal obstruction, rhinorrhea, sneezing, and itching) using a visual analogue scale. We also evaluated changes in acoustic parameters such as total nasal volume (TNV) and minimal cross-sectional area (MCA) before and after challenge. RESULTS: Group A (the nonallergic group, n=8) showed negative results for all tested aeroallergens in SPT and nonprovocative results ( 29% decrease in TNV/MCA from the baseline value). Patients in group C showed significant aggravation of nasal obstruction compared to those in group A (P < 0.05). Thirty minutes after HDM challenge, patients in groups B and C showed significantly greater decreases in MCA compared to those in group A (P < 0.01). CONCLUSION: Allerkin HDM extract can be a useful provocative agent in NPT for diagnosing allergic rhinitis and local allergic rhinitis.

Vestibular Neuritis With Minimal Canal Paresis: Characteristics and Clinical Implication

OBJECTIVES: To analyze the clinical characteristics of vestibular neuritis patients with minimal canal paresis (canal paresis <25%). METHODS: Patients clinically diagnosed with vestibular neuritis and treated at our institute (n=201) underwent otoneurological examination and vestibular function tests. Patients were categorized in terms of the results of caloric testing (canal paresis<25%, n=58; canal paresis≥25%, n=143). Clinical characteristics and laboratory outcomes were compared between two groups. RESULTS: Existence of underlying diseases, preceding symptoms, and direction of spontaneous nystagmus were not different between the groups. The mean duration of spontaneous nystagmus was shortest in the minimal canal paresis group (P<0.001) and the direction of spontaneous nystagmus changed more frequently in this group (P<0.001) during recovery. Among the subgroup with minimal canal paresis, only 29.5% had an abnormal finding on the rotatory chair test, as compared to 81.5% of the canal paresis group. The minimal canal paresis group showed higher sensory organization test scores in computerized dynamic posturography. CONCLUSION: Patients with minimal canal paresis (canal paresis <25%) show similar clinical manifestations as conventional vestibular neuritis patients, but have faster recovery of symptoms and a higher incidence of recovery nystagmus. This finding support that the minimal canal paresis could be considered as a milder type of vestibular neuritis.

The Linear Transmission of the Vestibular Neural Information by Galvanic Vestibular Stimulation / 대한평형의학회지

OBJECTIVE: Growing hypotheses indicate the galvanic vestibular stimulation (GVS) as an alternative method to manage the symptoms of parkinson's disease (PD). GVS is easy and safe for use, and non-invasive. However, it is elusive how the neural information caused by GVS is transmitted in the central nervous system and relieves PD symptoms. To answer this question, we investigated the transmission of neural information by GVS in the central vestibular system, focused on vestibular nucleus (VN). METHODS: Twenty guinea pigs were used for this study for the extracellular neuronal recordings in the VN. The neuronal responses to rotation and GVS were analyzed by curve-fitting, and the numerical responding features, amplitudes and baselines, were computed. The effects of stimuli were examined by comparing these features. RESULTS: Twenty six vestibular neurons (15 regular and 11 irregular neurons) were recorded. Comparing the difference of baselines, we found the neural information was linearly transmitted with a reduced sensitivity (0.75). The linearity in the neural transmission was stronger in the neuronal groups with regular (correlation coefficient [Cor. Coef.]=0.91) and low sensitive units (Cor. Coef.=0.93), compared with those with irregular (Cor. Coef.=0.86) and high-sensitive neurons (Cor. Coef.=0.77). CONCLUSION: The neural information by GVS was linearly transmitted no matter what the neuronal characteristics were.