• Title/Summary/Keyword: 임상적 연관성

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Clinical Findings of Mycoplasma Pneumonia in Children, from 1998 to 2003 (최근 6년간(1998-2003) 소아 Mycoplasma 폐렴의 임상 양상)

  • Kim, Ji-Hyun;Chae, Soo Ahn;Lee, Dong-Keun
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.969-975
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    • 2005
  • Purpose : We performed a study of clinical findings of Mycoplasma Pneumonia in children, to know differences between recent clinical manifestations of Mycoplasma pneumonia and previous studies. Methods : The subjects of this study were 393 children who were diagnosed as Mycoplasma pneumonia with high titers of Mycoplasma antibody(${\geq}1$ : 160) or fourfold rises of Mycoplasma antibody at Chung Ang University Hospital from January 1998 to December 2003. We practiced a retrospective study on the clinical manifestations of Mycoplasma pneumonia based on their medical records. Results : Male to female ratio was 1.06 to 1 and mean age was $4.32{\pm}2.94years$. The highest incidence was in the age of 2 to 3 years(18.6 percent). Most frequent months were October, and November in 2000, April in 2002, and October and, December in 2003. Twenty six point seven percent showed allergic diseases. Second degree relatives of 10.7 percent patients had allergic diseases. Forty three point three percent were admitted before this admission for pneumonia. Allergic tests were positive in 65.7 percent. Cough, and sputum were the most common symptoms and abdominal pain, and vomiting were the most frequent extrapulmonary symptoms. Atelectasis and pleural effusion were seen in 2.5 percent and 1.8 percent. Infiltrations were more common on the right side. Titers of each simultaneous test for cold agglutinin and mycoplasma antibody were not in proportion to each other (P=0.163). Conclusion : The onset age of mycoplasma pneumonia was found to be lower than it used to be. More patients had a past medical history or a family history of allergic disease, and more wheezing was heard and associated with recurrent pneumonia.

Parabiosis and Blood Exchange Techniques in Aging Research (개체병렬결합(parabiosis)실험모델과 혈액교환을 이용한 노화(aging)연구 분석)

  • Kyung Tae Chung
    • Journal of Life Science
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    • v.33 no.2
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    • pp.208-215
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    • 2023
  • In recent decades, the field of aging research has progressed from the genetic and cellular levels to in vivo models of blood exchange. Since genes capable of extending the lifespan in C. elegance have been reported, various potential target molecules have been discovered through genomics, proteomics, metabolomics, and transcriptomics. Accordingly, research on the interactions between target molecules has also been increasing. The parabiosis method, in which two experimental animals are surgically combined, was introduced, and a factor that could reverse the aging phenomenon was discovered using this method. The parabiosis method is used to find more accurate and effective aging-reversal factors that could exist in young blood. As more new evidence has been revealed, the parabiosis method has established a new paradigm for aging research. Moreover, a device capable of exchanging blood elaborately in laboratory animals was published in 2022 and presented new results necessary for aging reversal. Since GDF11, was reported, many other anti-aging candidates that are soluble factors in blood, such as β2m, TIMP2, VCAM1, Gpld1, and clusterin, have been discovered. In addition, mcicroglia cells and neuroinflammation have been directly proven to be aging factors. These latest research results were obtained by parabiosis, the newly designed device for plasmapheresis, and injecting young blood or conditioned blood methods. In this review, we discuss the latest research results using the device and young blood administration in old mice.

Characteristics of the Factor Structure of the Child Behavior Checklist Dysregulation Profile for School-aged Children (학령기 아동의 CBCL 조절곤란프로파일(Child Behavior Checklist Dysregulation Profile)의 요인구조와 특성)

  • Kim, Eun-young;Ha, Eun-hye
    • Korean Journal of School Psychology
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    • v.17 no.1
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    • pp.17-38
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    • 2020
  • This study examined the factor structure of the Child Behavior Checklist Dysregulation Profile(CBCL-DP) for school-aged children in Korea identified differences in the level of maladjustment and problematic behaviors between the clinical group which had characteristics of CBCL-DP and the control group which did not. Confirmative factor analysis was performed on three alternative models from the literature to determine which was the most appropriate factor structure for the CBCL-DP. The result showed that the bi-factor model fit the sample data better than both the one and second-factor models. To confirm that the bi-factor model was the most appropriate factor structure, regression paths with relevant variables examined. The showed that CBCL-DP with the bi-factor model was associated with executive function difficulty as reported by parents and with school adjustment and all sub-factors of strength and difficulty as reported by teachers. The results also showed that this model had a different relationship with anxiety/depression, aggressive behavior, and attention problems than the other models. The clinical group was shown to have more executive function difficulty, worse adjustment of school life and to be less likely to engage in desired behaviors than the control group. These results indicate the CBCL-DP is more related to negative outcomes than any other factor, and that the bi-factor model was found to best fit the sample data, consistent with other studies. The early discovery of CBCL-DP can be used to provide interventions for high-risk children who exhibit emotional and behavioral problems, making its detection a significant diagnostic tool. The implications of these result, the limitations of this study, and areas for future research are discussed in this paper.

Nonalcoholic Fatty Liver Disease in Children with Hypopituitarism (뇌하수체저하증 소아에서 발생한 비알코올성 지방간질환)

  • Yoon, Jung-Min;Ko, Jae-Sung;Seo, Jeong-Kee;Shin, Choong-Ho;Yang, Sei-Won;Moon, Jin-Soo;Yang, Hye-Ran;Chang, Ju-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.51-57
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    • 2010
  • Purpose: It has been reported that children with hypopituitarism have features of metabolic syndrome, including obesity, impaired glucose tolerance, and dyslipidemia. The aim of this study was to investigate the clinical features and liver histology of pediatric non-alcoholic fatty liver disease (NAFLD) associated with hypopituitarism. Methods: We reviewed the clinical data of 11 children diagnosed with NAFLD among patients with hypopituitarism. Results: The mean age at the time of diagnosis of hypopituitarism was 10.4${\pm}$3.2 years, and the mean age at the time of diagnosis of NAFLD was 13.1${\pm}$2.7 years. A craniopharyngioma was the most common cause of pituitary dysfunction. At the time of diagnosis of NAFLD, 9 patients (82%) had a body mass index greater than the 85th percentile, 5 patients (45%) had elevated fasting blood glucose levels, and 9 patients (82%) had hypertriglyceridemia. The mean height SD score was significantly lower at the time of diagnosis of NAFLD than at the time of diagnosis of hypopituitarism. Of the six patients who were biopsied, one had cirrhosis, two had non-alcoholic steatohepatitis (NASH) with bridging fibrosis, two had NASH with mild portal fibrosis, and one had simple steatosis. Conclusion: Children with hypopituitarism are at risk of short stature, obesity, dyslipidemia, and NAFLD. The early diagnosis of NAFLD is important in children with hypopituitarism because advanced fibrosis is common.

The Relation between Collateral Circulation and $^{99m}Tc$-MIBI Heart SPECT (심근경색에서 측부순환 유무에 따른 $^{99m}Tc$-MIBI 심근 SPECT 소견)

  • Kim, Jae-Man;Na, Deug-Young;Park, Eun-Kyung;Yang, Hyung-In;Kim, Deog-Yoon;Kang, Heung-Sun;Choue, Chung-Whee;Kim, Kwon-Sam;Kim, Myung-Shick;Song, Jung-Sang;Bae, Jong-Hoa
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.37-43
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    • 1994
  • The coronary collateral vessels have revealed their significance in terms of reduction of infarct size, preservation left ventricular function, and prevention of left ventricular aneurysm in patients with myocardial infarction. The purpose of this study were to evaluated the relation between collateral circulation and $^{99m}Tc$-MIBI Heart SPECT in patient with acute myocardial infarction and their clinical significance. The fifty six MI patients with antegrade TIMI perfusion grade 0 and 1 were studied. The patients were classified into two groups; Group I inclueded 30 patients with grade 2, 3 Collateral flow. Group II inclueded 26 patients with grade 0, 1 Collateral flow. Collateral filling were graded from 0 to 3: 0- none, 1- Filling of side branch only, 2- Partial filling of the epicardial segment, 3- Complete filling of epicardial segment. Clinical variables, left ventricular function, $^{99m}Tc$-MIBI Heart SPECT were analyzed with angiographic finding. Results were following: 1) Collateral visualization was found to be greater in patient with involvement of right coronary artery (RCA). The collateral development site of infarct related artery was RCA 15 cases, left anterior descending artery (LAD) 10 cases, left circumflex artery (LCX) 5 cases, and the collateral circulation from LAD to RCA was 13 cases (40.6%). 2) There was a tendency to be decreased in peak CK activity with group I. 3) The presence of good collateral channels was more frequently $^{99m}Tc$-MIBI reversible perfusion defect (83.4% vs 15.3%, p<0.05). 4) No differences of left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), ejection fraction (EF) were noted between group I and group II. The presence of good collateral channels did affect the frequency of occurrence of $^{99m}Tc$-MIBI reversible perfusion defect.

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Pediatric Urolithiasis: Our 22-year Experience at a Single Center (소아에서의 요로결석: 단일기관에서 22년간의 경험)

  • Kim, Su-Yon;Kim, Min-Jee;Lee, Joo Hoon;Kim, Kun Suk;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.101-109
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    • 2013
  • Purpose: Pediatric urolithiasis is uncommon in children but is a cause of significant morbidity and damage to the kidney. Although much information on adult urolithiasis is available in the literature, large studies on the pediatric population are still scarce. In this report, we review our experience with pediatric urolithiasis over 22 years at a tertiary referral center. Method: We retrospectively reviewed the records of children with newly diagnosed urolithiasis between January 1991 and May 2013. We assessed the age, sex, family history, initial symptoms, location of stones, underlying cause, stone analysis, treatment, and recurrence among the patients. Results: In total, 137 patients (96 male, 41 female) were assessed. The age range was 0-17 years (mean age, 6.0 years). Forty-three (31%) children were aged <1 year, and 37% (16/43) had a history of intensive care unit (ICU) admission. Thirteen patients (9.5%) had a family history of stones. The most common symptoms at presentation among the patients were gross hematuria (56/137, 41%) and flank or abdominal pain (46/137, 34%). The stones were located in the kidney (85/137, 62%), ureter (29/137, 21%), bladder (2/137, 1.4%), and multiple locations (20/137, 15 %). Congenital abnormalities of the genitourinary (G-U) tract, with or without metabolic abnormality, or urinary tract infection (UTI) was detected in 26 children (19%). Ninety-one patients (66%) underwent metabolic examination, and 38% of these patients exhibited an abnormality. UTI, with or without abnormalities of the G-U tract, or metabolic abnormality was detected in 26 children (19%). Of the 35 stones analyzed, the majority were calcium stones (20/35, 57%), followed by infected stones (5/35, 14%), uric acid stones (4/35, 11%), carbonate apatite stones (3/35, 7%), cystine stones (2/35, 6%), and phosphate stones (1/35, 3%). Five patients (4%) required open procedures, with or without non-open procedures, whereas 77 patients (56%) were managed conservatively; the remaining 55 patients (40%) received some other form of intervention. Eighteen patients (13%) had stone recurrence during the follow-up period. Conclusions: Pediatric urolithiasis is commonly associated with abnormalities of the G-U tract and/or metabolic disorders and/or UTI. Half of the patients will pass their stones spontaneously, and all the techniques of minimally invasive surgery are applicable in the treatment of children with stones. As the recurrence rates are high among this population, long-term follow-up is recommended and the complete clearance of stones is important.

Evaluation of Xerostomia Following Intensity Modulated Radiotherapy (IMRT) for Head and Neck Cancer Patients (세기조절방사선치료를 시행받은 두경부암 환자군에서 구강건조증지표 분석)

  • Lee, Seok-Ho;Kim, Tae-Hyun;Chie, Eui-Kyu;Im, Hyun-Shun;Im, En-Shil;Ryu, Jun-Sun;Jung, Yoo-Seok;Park, Sung-Yong;Kim, Joo-Young;Pyo, Hong-Ryull;Shin, Kyung-Hwan;Kim, Dae-Yong;Cho, Kwan-Ho
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.106-114
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    • 2004
  • Purpose : This study was done to evaluate xerostomia fellowing intensity modulated radiotherapy for patients with head and neck cancer, and to analyze the correlation between the dosimetric parameters and xerostomia parameters. Materials and Methods : From February till October 2003, 13 patients with 3 months of follow-up were evaluated for xerostomia after being treated for head and neck cancer with IMRT. Their median age was 57 years(range: 43$\~$77). Xerostomia were assessed with a 4-question xerostomia questionnaire score (XQS) and a test for salivary flow rates (unstimulated and stimulated). The patients were also given a validated LENT SOMA scale (LSC) questionnaire. The evaluations were completed before radiation therapy (pre-RT) and at 1 and, 3 months after radiation therapy (RT). We evaluated xerostomia at pre-RT, 1 and, 3 months after RT. The association between the xerostomia parameters (XQS and LSC) and salivary flow rates (unstimulated and stimulated: USFR and SSFR) was assessed at 1 and 3 months after RT. Resrlts : All 13 patients showed no significant changes in XQS, LSC and Salivary Flow rates. As a result, we couldn't find out about xerostomia development. Based on the total mean parotid dose, 3,500 cGy, we divided these patients into two groups. The 8 patients (<3,500 cGy) showed no significant changes in XQS, LSC and Salivary Flow rates However, in 5 Patients ($\geq$3,500 cOGy), there was a significant increase in USFR and, SSFR at 3 months after RT, and for the XQS and, LSC at 1 and 3 months after RT. The correlation between XQS and, LSC, and USFR and, SSFR in ail patients (13) was significant at 3 months after RT. The correlation had a tendency to the decrease for USFR and, SSFR in proportion to the increase of XQS and, LSC. Conclusion : Based on the results of this study, IMRT seem to be an effective treatment to significantly decrease the xerostomia. XQS and, LSC seem to be a effective tool for predicting the xerostomia. A total parotid gland mean dose of <3,500 cGy should be a planning goal if substantial sparing of the gland function is desired. Furthermore, patients should be enrolled in a study to define a more accurate threshold dose for the parotid gland.

Ventilator-Associated Pneumonia in Neonatal Intensive Care Unit : Clinical Manifestations, Ddiagnostic Availability of Endotracheal Tip Culture (신생아 집중치료실에서 인공 환기요법 관련 폐렴의 임상양상과 기관내 삽관의 유용성에 관한 연구)

  • Kim, Nam Young;Sung, Tae Jung;Shin, Seon Hee;Kim, Sung Koo;Lee, Kon Hee;Yoon, Hae Sun
    • Pediatric Infection and Vaccine
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    • v.12 no.1
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    • pp.67-74
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    • 2005
  • Purpose : The incidence of mortality associated with respiratory difficulties is decreasing nowadays contributed to the development of neonatology. However, complications associated with mechanical ventilator are increasing. This study is to determine clinical manifestations, diagnositc availability of the endotracheal tip culture in patients with Ventilator-Associated Pneumonia(VAP) in neonatal intensive care unit(NICU). Methods : A retrospective analysis of 50 neonates who were admitted to the NICU of Kangnam Sacred Heart Hospital and had given mechanical ventilator from 1 January 2000 to 30 June 2003. VAP group defined as neonates who had pneumonia with mechanical ventilation longer than 48 hours. They were classified into VAP group(n=13) and control group (n=37) and the prevalence, microorganisms cultured from the endotracheal tube tip and risk factors were investigated. Results : The prevalence of VAP was 26.0%(n=13) and the most dominant microorganism cultured in our NICU was methicillin-resistant coagulase negative staphylococcus(MR-CNS) in 4 cases. Other microorganisms were Pseudomonas, Enterobacter, methicillin-resistant Staphylococcus aureus(MRSA) and Klebsiella. Gestational age, birth weight, Apgar score, respiratory distress syndrome, retinopathy of prematurity, bronchopulmonary dysplasia, sepsis, renal failure, pulmonary hemorrhage, pneumothorax were not different significantly between two groups except intraventricular hemorrhage(P<0.001) and patent ductus arteriosus(P<0.05). Duration of hospital stay and mortality rate were also not different significantly. Conclusion : VAP occurred at a significant rate among mechanically ventilated NICU patients. Despite of limitation of encotracheal tip culture, the most common microorganism was MR-CNS. We should be aware of occurrence of VAP in NICU neonate who were with mechanical ventilator and should treat with great care.

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Analysis of Prognostic Factors in Esophageal Perforation. (식도 천공의 예후 인자 분석)

  • 정인석;송상윤;안병희;오봉석;김상형
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.477-484
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    • 2001
  • Background: Initial symptoms for esophageal perforation have not been clarified, but when there is no early diagnosis and proper treatment to follow immediately after the diagnosis, it is fatal for the patients. Therefore, this study attempted to discover the factors that influence the prognosis of esophageal perforation to contribute to the improvement of the treatment result. Material and Method: The subjects of this study are 32 patients who came to the hospital with esophageal perforation from October, 1984 to June, 2000. This study examined the items for clinical observation such as patients' sex, age, cause of the perforation, perforation site, the time spent until the beginning of the treatment, symptoms caused by the perforation and its complication, and treatment methods. This study tried to find out the relationship between the survival of patients and each item. Result: There were 24 male and 8 female patients and their mean age was 49.7+16.4. For the causes of perforation, there were 14 cases(43%) of iatrogenic perforation, which ranked first, caused by the medical instrument operation and surgical damage. As for the perforation sites, thoracic esophagus was the most common site(26 cases of 81.2%) and chest pain was the most frequent symptom. The complication caused by esophageal perforation showed the highest cases in the order of mediastinitis, empyema, sepsis and peritonitis. After the treatment, there were 23 cases of survival and 9 cases of mortality. The total mortality rate was 28.1% and the main causes of mortality were sepsis and acute respiratory distress syndrome(ARDS). As for the treatment, 8 cases(25.0%) treated the perforation successfully using conservative treatment only. As for the surgical treatment, there were 5 cases(15.6%) of cervical drainage, 7 cases (21.8%) of primary repair and 12 cases(37.5%) of esophageal reconstruction after performing an exclusion-diversion. There were 18 cases(56.2%) of complete treatment of esophageal perforation at its initial treatment and in 14 cases(43.8%) of treatment failure at its initial treatment, patients were completely cured in the next treatment stage or died during the treatment. The cases of perforation in thoracic esophagus, complication into severe mediastinitis or sepsis and the cases of failure at initial treatment showed a statistically significant mortality rate (p<0.05).

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The Effects of Vitamin C on the Activity of Liver Enzymes and Hepatic Damage in Rats Treated with Radiation and Aflatoxin $B_1$ (Vitamin C가 방사선과 Aflatoxin $B_1$을 투여한 흰쥐의 간 기능 효소 활성 및 간 손상에 미치는 효과)

  • Kang, Jin-Soon
    • The Korean Journal of Food And Nutrition
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    • v.23 no.1
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    • pp.30-38
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    • 2010
  • This study was conducted to determine the effects of vitamin C on the activity of liver function enzymes and electromicrographic changes in white rats treated with aflatoxin $B_1(AFB_1)$ or X-ray and $AFB_1$. Six week-old male Sprague-Dawley rats were randomly divided into five groups: a control group, $AFB_1$ treated group, $AFB_1$ treated group with vitamin C, X-ray and $AFB_1$ co-treated group, X-ray and $AFB_1$ co-treated group with vitamin C. On the first day of the experiment, only one dose of X-rays was exposed to the entire liver at 1,500 cGy. Next, vitamin C was injected at 10 mg/kg body weight by intraperitoneal injection, followed 1 hr later by the administration of 0.4 mg/kg of $AFB_1$ by intraperitoneal injection. These treatments were then administered every three days over a period of 15 days. On the 16th day of treatments, the animals were sacrificed. Analysis of the activity of the liver function enzymes, GOT, ALK phatase and LDH, in the sera of rats revealed that they were somewhat increased by $AFB_1$ treatment, X-ray and $AFB_1$ co-treatment when compared to the control group. Furthermore, the activity of these enzymes decreased in response to administration of vitamin C. Especially, the levels of GOT were remarkably decreased in the $AFB_1$ treated group treated with vitamin C when compared to the group treated with $AFB_1$ alone(p<0.001). Electromicrographic analysis revealed cloudy swelling, necrosis, vesicular degeneration and fat accumulation of hepatocytes in response to treatment with $AFB_1$ or co-treatment with X-ray and $AFB_1$. However, the destruction of hepatic cells was considerably lower in the vitamin C-treated group. These results indicate that vitamin C had ameliorating effects on the hepatic cell damage.