Chung, Sa Jun;Chung, Hye Jeon;Choi, Young Mi;Cho, Eu Hyun
Clinical and Experimental Pediatrics
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v.45
no.12
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pp.1559-1570
/
2002
Purpose : There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. Methods : One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept. of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. Results : Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. Conclusion : For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.
Based on 2009 Korea Health Panel, this study investigated socio-economic and clinical characteristics associated with emergency medical transport use, and analyzed a simple predictive model of emergency medical transport use. Analysis results were summarized as follows: First, emergency medical transports such as 119 ambulance were more used than private cars, taxis, or walk-in. Second, between a user group and a non-user group of emergency medical transports, there were statistically significant differences in age, the level of education, family composition, house type, household income, the relationship with the head of household, insurance types, the presence of handicap, the presence of chronic disease, reasons to emergency medical service use, and treatment after emergency medical service completed. Third, age, household income, the presence of handicap, reasons to emergency medical service use, and treatment after emergency medical service completed were statistically significant predictors associated with emergency medical transports use. To improve emergency medical service system, the characteristics and predictors associated with emergency medical transports are more concerned.
Kim, Jae Hyun;Lee, Sung Soo;Hong, Su Young;Chung, Hye Rim;Shin, Choong Ho;Yang, Sei Won
Clinical and Experimental Pediatrics
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v.48
no.2
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pp.191-196
/
2005
Purpose : Short stature is one of the characteristic features of Turner syndrome. We investigated the factors affecting final adult height(FAH) in patients with Turner syndrome. Methods : The study group was comprised of 60 patients who were diagnosed with Turner syndrome by chromosomal study and clinical phenotypes and attained FAH. Data were obtained from retrospective review of the medical records. We analyzed the factors influencing FAH in growth hormone(GH) treated and GH untreated groups. Results : Sixty patients were enrolled; 48 patients received GH treatment, and 12 patients did not. Mean duration of GH treatment was 35.8 months(range 4 to 120 months), and mean dosage of GH was $0.8{\pm}0.2IU/kg/wk$ in GH treated group. Mean growth velocity was $5.6{\pm}2.0cm/yr$, which was significantly higher than that during pretreatment period. In the GH treated group, mean chronological age, bone age, mean height, and height standard deviation(SD) score at GH treatment were $12.2{\pm}2.7yr$$10.3{\pm}2.5yr$$127.5{\pm}10.1cm$ and $-3.1{\pm}1.1$, respectively. In the GH treated group, the mean FAH and SD score of FAH were $146.9{\pm}5.8cm$ and $-2.7{\pm}1.2$, respectively, which showed significant differences compared with those of the GH untreated group. Analyzing the factors affecting FAH in GH-treated patients, only the SD score of height at the time of treatment was significantly related to FAH. Conclusion : GH treatment leads to an increment in FAH in patients with Turner syndrome. Average FAH gain was as much as 5.8 cm. SD score of height at the time of GH treatment was the only factor influencing FAH.
Min, Sae Ah;Jeon, Myung Won;Yu, Sun Hee;Lee, Oh Kyung
Clinical and Experimental Pediatrics
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v.45
no.12
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pp.1503-1511
/
2002
Purpose : Although the short- and long-term outcomes of low birth weight(LBW) neonatal intensive care unit(NICU) survivors have been extensively studied, much less information is available for normal birth weight(NBW) infants(greater than 2,500 gm) who require NICU care. Methods : We retrospectively examined the neonatal hospitalizations and one year health status of 302 NBW and 131 LBW admissions to our NICU. Information on the neonatal hospitalization was obtained from a review of medical records. Postdischarge health status was collected by using telephone surveys and medical records. Results : After initial discharge, 21.2% of the NBW infants and 23% of the LBW infants required rehospitalization during the first year of life and there was no significant difference between the two groups. The reasons for rehospitalization of the NBW infants included respiratory disorders (32.1%), G-I problems(26.2%), genitourinary problems(11.9%), surgery(10.7%), cardiac problems(7.1%), and congenital/developmental problems(1.2%). For the LBW infants, the order of frequency was the same, with the percentages slightly different. Neonatal risk factors related to the rehospitalization of the NBW infants included mechanical ventilation, duration of mechanical ventilation, and congenital anomaly. But no positive significant correlation of neonatal risk factors with rehospitalization of LBW infants was found. Conclusion : Low and normal birthweight NICU survivors were rehospitalized at similar rates. The most common cause of rehospitalization was respiratory problems. Neonatal risk factors related to rehospitalization of NBW infants were mechanical ventilation, duration of mechanical ventilation, and congenital anomaly. However, no positive significant correlation of neonatal risk factors with rehospitalization of LBW infants was found. The data suggests that NBW infant survivors, as well as LBW infant NICU survivors, require close follow up.
Introduction: Osteoporosis, the most common metabolic bone disorder, is a condition of reduced bone density and increased susceptibility to fractures. Osteoporosis is a major public health problem and a significant cause of morbidity in postmenopausal women. Therefore family physicians as primary care physicians are in a key position for preventing and treating this disorder. So we studied the factors affecting to bone mineral density in postmenopausal women. Materials and Methods: A total of 136 spontaneous postmenopausal women were participated in the study. They have measured spinal bone mineral density by dual energy x-ray absorptiometry from January 1992 to June 1995 at Yeungnam University Hospital. Age, height, weight, age at menarche and menopause, number of child and breast feeding child, history of oral pill ingestion, family history of osteoporosis, amount of milk and coffee ingestion, consumption of tobacco and alcohol and physical activity were assessed by qustionnaire and medical records. Results: The mean age is 55.2 and mean age at menopause is 47.9. Height, weight and physical activity were significantly positive correlated to bone mineral density. But age, duration after menopause and number of child were significantly negative correlated. Also age, height, weight, physical activity and duration after menopause were significantly correlated to % age-matched bone mineral density. In multiple regression analysis, which dependent variable is bone mineral density, duration after menopause, physical activity and weight were significant contributors. Duration after menopause is most the largest contributor. In multiple regression analysis, which dependent variable is % age-matched bone mineral density to adjust the age effect, physical activity and weight were significant contributors. Physical activity is most the largest contributor. Conclusions: Among factors affecting to BMD in postmenopausal women, physical activity and weight were more important factors. Therefore continuous physical activity is significant factor to prevent osteoporosis in postmenopausal women.
Purpose : Graves' disease is the most common cause of hyperthyroidism in children and adolescents. In this study, we investigated the natural course and the prognostic factors of Graves' disease in Korean children and adolescents. Methods : One-hundred thirteen (88 girls and 25 boys) patients were included in this study. A retrospective analysis was made of all patients who were diagnosed with Graves' disease. The following parameters were recorded and analyzed: patient's sex, age at diagnosis, duration of disease, laboratory findings, symptoms and signs, and family history of autoimmune thyroid disease. Results : All patients were initially treated with antithyroid drugs, either methimazole (93.8%) or propylthiouracil (6.2%). Antithyroid drugs had been discontinued in 75 (66.4%) of 113 patients. Of these 75 patients, 23 (20.4%) relapsed after $25.5{\pm}33.7$ months. Thirteen (11.5%) of 23 patients, who experienced the first relapse, showed a second remission. However, 2 (1.8%) of 13 patients relapsed again. Euthyroid state could not be achieved by antithyroid drugs in 1 patient, and radioactive iodine therapy was performed. The older the patient at diagnosis, the greater the likelihood of remission ($P$=0.034). Conclusion : Age at diagnosis seems to be a prognostic factor in Korean children and adolescents with Graves' disease, and should be taken into account in treatment plan determination.
Journal of the Korea Academia-Industrial cooperation Society
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v.12
no.7
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pp.3130-3137
/
2011
The present study was to elucidate such a relationship by comparing the coronary risk factors with and without fatty liver adjusted for age and/or BMI. Study subjects were 665 women of 30 years and over, who underwent health package check-up at the health promotion center of an university hospital from July, 2009 to June, 2010. As a results, the prevalence rates of fatty liver of study subjects were 11.6%, and the rates were significantly higher in older age group, in the group of higher level of BMI. The group of subjects with fatty liver had significantly lower mean HDL-cholesterol and higher levels of body fat rate, TG, TC, LDL-cholesterol, FBS and ALT, then those parameters in subjects without fatty liver, even after adjustment for age and/or BMI. In age and BMI adjusted logistic regressions, The odds ratio of fatty liver was increased significantly as there is an increase in the abnormal group with TG, TC, LDL-C and ALT.
Journal of the Korean Society of Food Science and Nutrition
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v.33
no.8
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pp.1320-1326
/
2004
The purpose of this study is to verify the relation between vegetarian diet and the risk factors of cardiovascular disease. Results were summarized as follows: Levels of total cholesterol, LDL-cholesterol, atherogenic index (AI), diastolic blood pressure, blood sugar and HDL-cholesterol were significantly higher (p<0.01) in non-vegetarians than those of vegetarians, but ratio of HDL cholesterol/total-cholesterol was lower in non-vegetarians. The number of subjects with abnormal serum total-cholesterol, LDL-cholesterol, atherogenic index (AI) and systotic blood pressure were much more in non-vegetarians than those in vegetarians, it were confirmed clearly as the increment of ages. In the multiple regression analysis, we acknowledged that the main factors affecting on total-cholesterol in vegetarians were age, BMI and the systolic blood pressure (R-square: 0.21), while important factors were age, BMI, the systolic blood pressure and physical activity (R-square: 0.81) in the non-vegetarians. In the vegetarians, age and BMI were the main factors having influence on LDL-cholesterol (R-square: 0.18), while age, BMI, systolic blood pressure and the physical activity (R-square: 0.82) were main factors in the non-vegetarian. In conclusion, vegetable diet may improve blood lipid level, blood pressure, blood sugar.
Objeitives. The surgical mortality of congenital heart defects has been reduced (or the very young age group. Especially, young age at repair is an important risk factor for mortality after repair of tetralogy of Falloff. Some risk factors were analyzed Methods. Three hundred and sixty six patients underwent surgical Intervention. Ages ranged from 5 days to 64 years, and 80 patients were adults(over 15 years of age). The defects consisted of 313(84.2%) acyanotic and 53(15.8%) cyanotic anomalies. The surgical mortalities were evaluated by univariate and multivariate analysis. Results. The overall surgical mortality was 10.4%. Mos deaths occurred in the infant group younger than 6 months(20/38 deaths) and in cyanotic group(21/38 deaths). Surgical infant mortality younger than 12 months was 24.8%(25/101). Risk factors of mortality in open heart surgery were age(p< 0.0001), body weight(p< 0.0001), pump time(p< 0.0001), aortic cross clamp time(p< 0.0001), use of total circulatory arrest(p<0.0001) and cyanotic disease(p<0.0001) by univariate analysis. But by multivariate analysis, the risk factor of mortality in open heart surgery was disease entity(p=0.002) only. A disease group with the highest risk was a cyanotic group(odds ratio was 15.3 relative to ventricular septal defect) excluding tetralogy of Falloff(odds ratio=0.27). Conclusions. Even though the most important risk factor was disease entity, we should conentrate our efforts on the technically improvable factors affecting surgical mortality indicated by univarlate analysis.
Serum gamma-glutamyltransferase (GGT) has been widely used as a marker of alcohol intake and liver failure. Recently, the relativity between GGT and various diseases has been identified with growing interest. In this study, we examined relativity between GGT value and risk factors of coronary heart diseases among those with normal GGT value, excluding heavy drinkers. Specifically, we compared the differences based on age and gender. Data from the 2011 KNHNES were used (N=3,619). When the subjects were categorized according to quartile based on the serum GGT levels, there was 10~20, 21~27, 28~38, 39~71 IU/L in men, and 6~12, 13~16, 17~22, 23~42 IU/L in women. The mean of most variables was the highest in the $4^{th}$ quartile (Q4), however age and LDL Cholesterol were the highest in the $2^{nd}$ quartile (Q2) in men. The FRS and 10-year CHD risk was the highest in the $2^{nd}$ quartile in men, and the highest in the $4^{th}$ quartile in women. Increased GGT was correspondingly linked with age in women but age was the highest in GGT in the $2^{nd}$ quartile in men. In the 70's, the highest Q1 and Q2 was in men and the highest Q3 and Q4 in women. Although GGT value was within the normal range, increased GGT showed correlation with various risk factors. The FRS and 10-year CHD risk showed different patterns according to age and gender along with increased GGT value.
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