• Title/Summary/Keyword: 진단 지연

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The Changes of VEP Values According to the Luminance Conditions and Refractive Errors in Normal Persons (정상인에서 조도와 굴절이상도에 따른 시유발전위 검사 값의 변화)

  • Leem, Hyun Sung;Lee, Koon Ja
    • Journal of Korean Ophthalmic Optics Society
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    • v.12 no.4
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    • pp.111-117
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    • 2007
  • The visual evoke potential(VEP) is the effective method to diagnose and treat the amblyopia or to check the infants visual ability. In order to evaluate the changes of P100 latencies and amplitudes of VEP by intensity of illumination and refractive errors, we measured latencies and amplitudes of 41 normal adults (20/20 VA) who have no ocular diseases and neurologic diseases. The results were as follows: In the scotopic condition, the latencies were N75$75.83{\pm}3.69$ msec, P100$103.48{\pm}5.34$ msec, the P100 amplitude was $14.86{\pm}2.43$ msec, and in the photopic condition, the latencies were N75$76.71{\pm}3.11$ msec, P100$107.26{\pm}5.54$ msec and the P100 amplitude was $10.35{\pm}1.75$ msec. The latencies and amplitudes of P100 in the photopic condition had higher values than those in the scotopic condition and the measures were significantly different between the scotopic and photopic condition (p<0.01). The P100 latencies were delayed both in the scotopic and photopic condition with the refractive errors and those measures were delayed more than in the photopic condition. The P100 amplitudes in the induced myopic and hyperopic conditionsreduced than in the emmetopes in both illumination conditions. The P100 latencies and amplitudes in emmetropes showed a correlation with the induced myopic conditions in the scotopic condition. Those results showed that P100 latencies and amplitudes are dependent on the illumination conditions and refractive errors. And we suggest that those results would be useful to determine and evaluate the normal range for the person considering patients' refractive errors and illumination of the test room.

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A Systematic Study of the Intervention Effect of Social Stories in Children with Sleep Disorders (수면장애 아동을 위한 사회적 이야기 중재 효과: 체계적 고찰)

  • Kim, Ji-Ho;Yoo, Eun-Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.2
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    • pp.69-83
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    • 2023
  • Objective : This study sought to systematically examine the intervention effect of social stories when applied in relation to children with sleep disorders. Methods : Studies available in the SCOPUS, ScienceDirect, PsycArticles, and PubMed databases that were published from 2001 to 2022 were searched. The keywords used for the search were as follows: ("social story" OR "social stories") AND ("sleep" OR "sleep disorders" OR "sleep wake disorder bedtimes" OR "sleep initiation and maintenance disorders" OR "sleep wake disorder" OR "sleep arousal disorders"). Based on the selection criteria, six experimental studies were selected and analyzed. Results : The selected studies were two randomized controlled trials, three individual trials, and one case study. The subjects were mostly children diagnosed with autism spectrum disorder who were school-aged or adolescent. The intervention types were often complex interventions, including social stories and other interventions, while the durations of the interventions varied from one day to more than 40 days. The interventions had a positive effect on the subjects' sleep quality, with night wakings, sleep onset delay, and sleep anxiety all being improved. As standardized assessment tools to evaluate the effectiveness of social stories, the Child Sleep Habits Questionnaire and the Child Behavior Checklist were used in two papers each, and were the most commonly used. As non-standardized assessment tools, each of the four papers used turbulence and sleep diaries as assessment tools. Conclusion : The effect of social story mediation can be divided into sleep quality and sleep-related behavior. In terms of sleep quality, studies showing improvements in night wakings, sleep onset delay, and sleep anxiety accounted for a large proportion of the sample. The detailed effect area of sleep quality showed a significant improvement after the interventions in most studies, and in all six studies analyzed in the present study, the continuation of the effect after the intervention was confirmed via follow-up tests. Thus, the findings of this study are expected to be helpful when applying social stories in children with sleep disorders in clinical practice due to presenting the intervention effects, outcome evaluation tools, and intervention periods in children with sleep disorders in prior investigations involving social stories.

Clinical manifestations and neuroimaging findings of schizencephaly in children (소아 뇌갈림증의 신경영상학적 소견 및 임상 양상)

  • Lee, Jae Rang;Kim, Seung;Lee, Young Mock;Lee, Joon Soo;Kim, Heung Dong
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.458-463
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    • 2009
  • Purpose : Schizencephaly is a uncommon congenital brain anomaly characterized by congenital clefts spanning the cerebral hemispheres from pial surface to lateral ventricles and lined by gray matter. In this study, we investigated the clinical manifestation and radiologic findings of pediatric schizencephaly. Methods : The data of 13 patients who were diagnosed with schizencephaly in Severance Childrens Hospital and Yongdong Severance Hospital from January 2005 to December 2007 were analyzed retrospectively. Results : The mean age at diagnosis was $9.08{\pm}2.67$ months old and ranged from 1 to 30 months. The ratio of male to female patients was 3.33:1. Five (38.5%) patients had bilateral clefts, while 8 (61.5%) had unilateral clefts. Five (38.5%) patients had closed lip clefts, and 4 (30.8%) had opened lip clefts. Four (30.8%) patients had multiple clefts. Associated anomalies showed in all cases. The clinical features consisted of mild unilateral weakness in 7 (53.8%) cases and a hemiparesis was present in 3 (23.1%) patients. A tetraparesis was in 3 (23.1%) patients. There was no difference in motor deficit between unilateral and bilateral clefts. Delayed development was observed in all cases. Epilepsy was present in 7 (53.8%) patients, 5 patients with unilateral clefts and 2 patients with bilateral clefts. Three (42.8%) patients showed intractable seizures. Conclusion : Schizencephaly showed variable clinical manifestations and radiologic findings in association with the types and locations of the clefts. It is necessary to diagnose schizencephaly early and to detect the development of epilepsy. Intensive and large studies of the correlation of clinical outcomes and radiologic findings should be continued for more effective treatment.

Study for Reliability of Interpretation of the Three Phase Bone Scintigraphy in Patients with Post-traumatic Complex Regional Pain Syndrome (외상 후 복합부위통증증후군 환자에서 시행한 삼상 뼈 스캔의 판독 신뢰도에 관한 연구)

  • Park, Jung-Mi;Kim, Seon-Jung;Chung, Seung-Hyun;Lee, Yong-Taek
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.44-51
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    • 2008
  • Purpose: We performed this study to evaluate reliability on interpretation of three phase bone scintigraphy (TPBS) in patients with post-traumatic complex regional pain syndrome (PT-CRPS). Methods: Based on International Association for the Study of Pain guideline in 1994, 34 patients with PT-CRPS were selected for this study. Two nuclear medicine physicians evaluated identical TPBS according to the uptake pattern, extent and intensity of the lesion, and their agreements (kappa values) were analysed. The final diagnosis based on arbitrary criteria of each physician were compared with those obtained by the criteria for PT-CRPS established in this study, which are hyperactivity on all phases (criteria 1), hyperactivity of whole joints on delayed phase (criteria 2), and hyperactivity of either whole or FDGal joints on delayed phase (criteria 3). Results: Intra-observer agreements were good for uptake pattern, intensity, and extent on TPBS. Inter-observer agreements were also good, except extent on blood pool phase (0.55). The inter-observer agreements on final diagnosis improved when criteria 1-3 were applied (0.77-0.88), compared to when physician's own criteria were used (0.63). Those also improved from 0.29 to 0.47-0.82 for acute stage, and from 0.37 to 1.0 for chronic stage. The sensitivities of chronic stage were relatively lower to those of acute stage. Conclusions: Inter-observer's variations in diagnosis of the patients with PT-CRPS using TPBS were observed. These results were attributed to different criteria set by observers. In order to improve agreement on interpretation of TPBS, common positive criteria should be established, especially considering uptake pattern and clinical stages.

Consultations to Department of Dentistry for Child and Adolescent Inpatients with Dental Trauma (치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰)

  • Jo, Chanwoo;Kim, Jihun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.4
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    • pp.403-411
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    • 2017
  • The purpose of this research is analyzing present condition, and pursuing developmental direction of consultation to department of dentistry for medical inpatient with dental trauma. This research conducted a retrospective analysis of consultation to department of dentistry for medical inpatient at Wonju Severance Christian Hospital from March 2011 to February 2017. This research analyzed chief complaint and dental diagnosis, referring department, time of consultation after dental trauma, relation between hospitalization period and time of consultation after dental trauma, relation between dental trauma and admission in the medical department due to trauma, cause and age of dental trauma occurrence, treatment of dental trauma, and revisiting rate of inpatient with dental trauma after discharge. Among all the chief complaint and dental diagnosis, dental trauma was the highest. Among all the referring departments, departments of surgery were the highest. In relation to being delayed of consultation term after dental trauma, it turned out that there's pretty high mutual relation between the hospitalization period and the consultation term after dental trauma, and the hospitalization period had the quantitative influence on the consultation term. Statistically, dental trauma and admission in the medical department due to trauma had significant relations. In case of those patients due to car accidents, they had dental trauma without exception. Statistically, patient's group with dental trauma in hospital room was younger than patient's group with dental trauma in non-hospital room. Statistically, dental trauma and treatment in hospitalization had no significant relations, and dental trauma and revisiting department of dentistry after discharge had no significant relations. For the child and adolescent inpatients hospitalized for car accidents, there is high possibility of accompanying dental trauma, and dental consultations can be delayed. For the young child inpatients, the possibility of dental trauma occurrence in hospital room is high. Moreover, treatments during hospitalization and revisiting department of pediatric dentistry after discharge are not performed well for inpatients with dental trauma. Regarding these results, it can be an alternative that improving of consultation system, dedicated workforce placement and having dental facilities and equipment in the hospital ward, education to medical doctor and dentist, communication between medical doctor and dentist. This research can be used as a study material of medical and dental departments, and it's expected to be committed to developing of consultations to department of dentistry for child and adolescent inpatients with dental trauma.

Identification of Characteristics and Risk Factors Associated with Mortality in Hydrops Fetalis (태아수종의 특성 및 사망률과 연관된 위험인자)

  • Ko, Hoon;Lee, Byong-Sop;Kim, Ki-Soo;Won, Hye-Sung;Lee, Pil-Ryang;Shim, Jae-Yoon;Kim, Ahm;Kim, Ai-Rhan
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.221-227
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    • 2011
  • Purpose: The objectives were to identify the characteristics of neonates with hydrops fetalis, and to identify the risk factors associated with mortality. Methods: A retrospective review of AMC (Asan Medical Center) dataset was performed from January 1990 to June 2009. The characteristics of 71 patients with hydrops fetalis were investigated and they were divided into two groups: the survived group and the expired group. Various perinatal and neonatal factors in two groups were compared to find out risk factors associated with mortality based on univariate analysis, followed by multiple regression analyses (SPSS version 18.0). Results: Of those 71 neonates (average gestational age: 33 weeks, birth weight: 2.6 kg), 38 survived, 33 died, resulting in overall mortality rate of 46.5%. The most common etiology was idiopathic followed by chylothorax, cardiac anomalies, twin-to-twin transfusion, meconium peritonitis, cardiac arrythmias, and congenital infections. Factors that were associated independently with mortality in logistic regression analyses were low 5-minutes Apgar score, hyaline membrane disease and delayed in achieving 50th percentile ideal body weight for appropriate gestational age by 10 days. Conclusion: In this study, 5-minutes Apgar score, hyaline membrane disease and delayed in achieving 50th percentile ideal body weight for appropriate gestational age by 10 days were significant risk factors associated with mortality in hydrops fetalis. Therefore, the risk of death among neonates with hydrops fetalis depends on the illness immediately after birth and severity of hydrops fetalis. Informations from this study may prove useful in prediction of prognosis to neonates with hydrops fetalis.

Response of Measles-specific Antibody in Children with Measles During Measles Epidemic in Seongnam, 1993 (1993년도 성남지역에서 유행한 홍역 환아에서의 홍역 특이 항체 반응)

  • Kim, Ji Youn;Park, Yoon Hyung;Kim, Soon Ki;Choi, Yun Hwa;Lee, Hoan Jong;Son, Byong Kwan
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.126-132
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    • 1997
  • Measles outbreak in the world was decreased since measles vaccine had been introduced. Although vaccination rate is high, measles was not eradicated and measles reappeared among vaccinated children. We measured measles-specific antibody from the vaccinated and unvaccinated groups who had experienced apparent measles in the Seongnam city in 1993. The results were as follows. 1) The data included total 126 children (M:F=1 : 1). Age distribution of measles outbreak revealed 6 children in 5yr, 11 in 6yr, 20 in 7yr, 39 in 8yr, 22 in 9yr, 11 in 10yr, 11 in 11yr, and 6 in 12yr. 2) MMR vaccination rate was 78.6%(99/126) in the children who had experienced measles. Positive rate of measles-specific IgM Ab was 80.8% (80/99) among the vaccinated group and among 9E.6.% (25/27) the unvaccinated. 3) Positive rate of measles-specific IgG Ab was 90.9% (90/99) among MMR-vaccinated group, and 85.2% (23/27) in unvaccinated group. In conclusion, measles-specific IgM antibody have been detected more than 1 month in most patients. The relatively high proportion of measles-specific IgM positivity may mean primary vaccine failure. To booster the antibody titers and to prevent measles epidemic in school-aged children, revaccination of measles should be considered.

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Quantification of endothelin-1 in human umbilical venous endothelial cell culture supernatants of small for gestational age and preeclampsia neonates (부당 경량아 및 전자간증 산모의 신생아 제대혈관내피세포의 endothelin-1 발현 비교)

  • Cho, Won Kyoung;Kim, So Young;Chun, Chung Sik
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1194-1199
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    • 2007
  • Purpose : It was generally accepted now a days that the pathogenesis of preeclampsia, small for gestational age (SGA), intrauterine growth retardation and fetal origin of adult diseases were related with a endothelial cell dysfunction. The purpose of this study was to know the relation of such diseases by assessing the level of endothelin-1. Methods : SGA babies, newborns of preeclampsia and normal control mother were included in this study. Isolated endothelial cells were centrifugated and mixed with media in $37^{\circ}C$, 5% $CO_2$ to obtain confluent monolayer of cultured human umbilical venous endothelial cell (HUVEC). Endothelin-1 levels were determined by Endothelin-1 colorimetric (EIA) Kits. We examined the endothelin-1 level in the HUVEC supernatants from SGA baby, and newborns from preeclampsia as well as normal mother. Also, we compared the endothelin-1 level of cultured normal HUVEC incubated with serum from cord blood of SGA, babies of preeclampsia or normal control mother. Results : The endothelin-1 levels in cultured HUVEC supernatants of three groups showed no significant difference but the endothelin-1 levels of cultured normal HUVEC incubated with serum from preeclampsia mother or SGA mother was significantly higher than those from newborns of control mothers (P<0.05). Conclusion : These findings suggest that there may be the factor which affect the endothelin-1 level in serum of cord blood from SGA and preeclampsia.

Prognosis of Acute Poststreptococcal Glomerulonephritis (APSGN) in Children (소아 연구균 감염 후 급성 사구체 신염의 예후)

  • Shin, Yun-Hye;Lee, Ji-Yeon;Pai, Ki-Soo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.137-142
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    • 2005
  • Purpose : Acute poststreptococcal glomerulonephritis(APSGN) follows infection of group A$\beta$-hemolytic streptococci. The prognosis of APSGN has been reported as favorable. However, several studies have reported that some patients progress to chronic renal failure. In an attempt to clarify this, we analyzed the clinical course of patients with APSGN. Methods : Between January 2000 and December 2004, a total of 48 children who were diagnosed with APSGN according to the presence of hematuria, transient hypocomplementemia and evidence of group A $\beta$-hemolytic streptococcal infection were evaluated. Results : Six(12.5$\%$) patients showed elevation of serum creatinine level but there was no patient with Persistent renal dysfunction. Blood pressure was controlled with ease in all patients and there was no case of persistent hypertension. Renal biopsy was done in 5 patients who showed heavy proteinuria or renal insufficiency and the outcomes showed findings consistent with ordinary APSGN except one with findings of rapidly progressive glomerulonephritis(RPGN). Serum complement levels normalized within 8 weeks(92.9$\%$). Hematuria disappeared within 6 months(79$\%$) and proteinuria within 6 months(100$\%$) from the disease onset. Conclusion : Prolonged renal dysfunction or heavy proteinuria found in five patients(10.4$\%$) led to renal biopsy. All these problems resolved within 6 months. Our data support that the prognosis of childhood APSGN is favorable without any serious sequoia. (J Korean Soc Pediatr Nephrol 2005;9:137-142)

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Factors Affecting on Final Adult Height and Total Height Gain in Children with Idiopathic and Organic Growth Hormone Deficiency after Growth Hormone Treatment (특발성과 기질성 성장호르몬 결핍증 환아에서 성장호르몬 치료 후 최종 성인신장과 신장 증가에 영향을 미치는 인자)

  • Choi, Im Jeong;Hwang, Jin Soon;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.803-810
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    • 2003
  • Purpose : The purpose of this study was to evaluate the factors affecting the final adult height and total height gain in idiopathic and organic growth hormone deficient(GHD) children after growth hormone(GH) treatment. Methods : Thirteen patients with idiopathic GHD and 22 patients with organic GHD who had been treated with GH and attained adult final height were included in this study. Factors which could affect the final adult height(FAH) and total height gain, were evaluated. Results : Height SDS(standard deviation score) at initial GH treatment in idiopathic GHD was significantly shorter than that in organic GHD($-4.13{\pm}1.28$ vs $-1.66{\pm}1.06$, P<0.001). Growth velocity during the first year of GH treatment was $9.69{\pm}3.19cm$(idiopathic GHD) and $7.87{\pm}3.65cm$(organic GHD). Height(SDS) at puberty in organic GHD was significantly greater than in idiopathic GHD ($-0.55{\pm}1.25$ vs $-2.28{\pm}0.95$, P<0.001). Final adult height(SDS) was significantly greater in organic GHD than in idiopathic GHD($0.22{\pm}1.06$ vs $-1.44{\pm}0.84$, P<0.001). In idiopathic GHD, total height gain (SDS) was most significantly correlated with midparental height minus initial height(MPH-IH)(SDS) (r=0.886, P<0.001). Total height gain(SDS) was more significantly correlated with MPH-IH(SDS) and prepubertal height gain(SDS) in idiopathic GHD(r=0.640, P=0.01, r=0.801, P<0.001). Conclusion : Final adult height was greater in organic GHD than in idiopathic GHD patients. While total height gain(SDS) was more pronounced in children with lower initial height compared to MPH, absolute final adult height was influenced by height at puberty. To improve the final adult height in children with GHD, height at onset of puberty must be increased by early diagnosis and continuous treatment with optimal doses of GH. There results should be evaluated with more patients.