• Title/Summary/Keyword: 추적 관찰 연구

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Unprovoked seizures in children with complex febrile convulsion; short-term outcome (복합 열성 경련 후 간질 발생 환아의 임상적 고찰; 단기 추적 관찰 결과)

  • Choi, Ji Yeon;Cheon, Eun Jung;Lee, Young Hyuk
    • Clinical and Experimental Pediatrics
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    • v.50 no.8
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    • pp.757-760
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    • 2007
  • Purpose : Febrile convulsions (FC) were considered to be a benign seizure syndrome that is distinct from epilepsy. But it is thought that children with complex features i.e., partial or prolonged seizures or multiple episodes of FC would bear a higher risk of developing unprovoked seizures. The aim of this study is to look into the relative significance of each criteria that define complex febrile convulsions (CFC) as a predictor of subsequent epilepsy. Methods : All children were retrospectively identified for a febrile seizure through pediatric departments of the Konyang University Hospital. Information was collected from medical records and interviews with parents. Patients with abnormal neurological examinations at presentation were excluded. Results : This study was performed from March 2000 to December 2003. Sixty-three out of 314 children (20.0%) with febrile convulsion fulfilled the criteria for CFC and forty-four children of them have been followed for 12 months or more. Ten of these (23.2%) had unprovoked seizures for 14-62 months (median $34.2{\pm}11.6$ months). The patients with partial FC showed a trend toward a higher risk (57.1%) of developing epilepsy than the patients with multiple or prolonged febrile convulsions (26.7%, 24.1% respectively). Conclusion : We found that the partial feature of febrile convulsion is associated with subsequent epilepsy.

Hyperfractionated Radiotherapy with Concomitant Boost Technique for Unresectable Non-Small Cell Carcinoma of the Lung (절제 불가능한 비소세포 폐암의 다분할조사 방사선 치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.221-225
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    • 1991
  • Twenty five patients with unresectable non-small cell carcinoma of the lung have been treated with hyperfractionated radiotherapy with concomitant boost technique since September, 1989. Those patients with history of previous surgery or chemotherapy, pleural effusion or significant weight loss (greater than $10\%$ of body weight) were excluded from the study. Initially, 27 Gy were delivered in 15 fractions in 3 weeks to the large field. Thereafter, large field received 1.8 Gy and cone down boost field received 1.4 Gy with twice a day fractinations up to 49.4 Gy. After 49.4Gy, only boost field was treated twice a day with 1.8 and 1.4 Gy. Total tumor doses were 62.2 Gy for 12 patients and 65.4 Gy for remaining 13 patients. Follow up period was ranged from 6 to 24 month. Actuarial survival rates at 6, 12, and 18 month were $88\%,\;62\%,\;and\;38\%$, respectively. Corresponding disease free suwival rates were $88\%,\;41\%,\;and\;21\%$, respectively. Actuarial cumulative local failure rates at 9, 12 and 15 month were $36\%,\;43\%,\;and\;59\%$, respectively. No significant increase of acute or late complications including radiation pneumonitis was noted with maximum follow up of 24 month. Although the longer follow up is needed, it is worthwhile to try the prospective randomized study to evaluate the efficacy of hyperfractionated radiotherapy with concomitant boost technique for unresectable non-small cell lung cancers in view of excellent tolerance of this treatment. In the future, further increase of total radiation dose might be necessary to improve local control for non-small cell lung cancer.

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Tourists' Circulations and Behaviors in Dark Tourism Site (Focused on Seodaemun Prison History Hall) (다크투어리즘 관광자의 관람동선 및 관람행태(서대문형무소 역사관을 대상으로))

  • Triana, Lolitasari Ade;Yun, Hee Jeong
    • The Journal of the Korea Contents Association
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    • v.16 no.9
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    • pp.198-210
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    • 2016
  • The purpose of this study is to analyze the tourists' circulations and behaviors at one of the representative dark tourism sites in Seoul, named Seodaemun Prison History Hall. This study conducts direct observation and behaviour tracking or follow-up survey based on traffic circulation and visitors' Muse-Ethogram extracted from the previous studies. The result of tourists' actual circulations shows that main tourists' flows of study areas consist of 3 approaches; suggested, unstructured and directed approaches. And tourists' behaviors such as moving(M), stop looking(SL), and reading(RE) reveal with the highest frequency. This study finds the 'expressing feeling(EXP)' as a new visitor' behavior in dark tourism site. The highest frequency of visitors' movement patterns is stop looking-reading-move(SL-RE-M). The results of this study could be used as a planning and design guidelines of dark tourism related to exhibition circulation, visitors' behaviors and development of exhibition content.

FOLLOWF-UP STUDY OF THE TIC DISORDERS (틱 장애 환자의 추적 조사)

  • Shin, Zong-Hun;Jung, Chul-Ho;Kim, Hee-Cheol
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.68-76
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    • 1996
  • 30 DSM-III or DSM-III-R tic patients were assessed by hospital records and Yale Global Tic Severity Scale to study the common characteristics, clinical course and longterm outcome of tic disorders after 3.1-18.1 years, 73.3% of the patients(treated or untreated) have recovered or partially improved. Identifical precipitating factors were found in 9 patients. Associated disorders were ADHD, sleep disorder, and so on. The outcome according to age of onset, duration of follow-up and diagnoses have no statistically significance. Increased age at follow up was influenced improvement of tic symptoms, though statistically not significant(p=0.327). These results suggest that the outcome of tic disorder is not ominous and they are relatively good social adjustment inspite of carrying the tic symptoms. But this study has some limitations such as retrospective study and sample size. Studies designed prospectively with large sample would be needed to generalize theses results.

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Longitudinal Effects of Peer Play Behavior during Toddlerhood on Social Competence and Adaptation to Elementary School (유아기의 또래놀이행동이 사회적 유능감 및 초등학교 적응에 미치는 종단적 영향)

  • Kim, Do-Hee
    • Journal of Digital Convergence
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    • v.19 no.9
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    • pp.361-371
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    • 2021
  • This study investigated the longitudinal effect of peer play behavior (PPB) during toddlerhood on social competence (SC), followed by the effect on adaptation to elementary school. Data were collected from the 4th to 9th Panel Study on Korean Children between 2011 to 2016, of which the data collected from 114 boys and 94 girls were finally analyzed. Multi-Mediator Model Analysis were performed using SPSS and PROCESS macro programs. First, PPB observed at the age of three significantly predicted PPB observed at ages four and five. It significantly affected SC observed at the age of six after transitioning through PPB at each stage. Second, PPB observed at the age of three significantly impacted the degree of adaptation in the first and second grades of elementary school. The medium identified in this second finding was PPB observed after the age of three and SC observed at the age of six.

Long-term Follow-up of Children with Idiopathic Hypercalciuria (혈뇨를 동반한 소아 특발성 고칼슘뇨증에 관한 장기 추적 관찰)

  • Lee Young-Seok;Shin Won-Hye;Ko Cheol-Woo;Koo Ja-Hoon
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.34-40
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    • 1998
  • Present study was conducted to determine the frequency, clinical characteristics and long-term outcome of children with idiopathic hypercalciuria. Study patients consisted of 150 children with isolated hematuria (recurrent gross or persistent microscopic), and hypercalciuria was defined as urinary calcium excretion over 4 mg/kg/day. During follow-up period up to $6{\sim}8$ years, serial check-up of renal sonogram for stone formation and Dipstick examination for hematuria were done. Forty-four (29%) out of 150 cases were diagnosed as idiopathic hypercalciuria, and in hypercalciuric children compared to normocalciuric children boys were more common than girls (9:35) and gross hematuria was more common than microscopic hematuria (37:7) (P<0.05). Oral calcium loading test showed renal type in 29 cases, absorptive type in 8 cases and in 7 cases type could not be definable. Among 3 types no differences could be found in 24 hour urinary calcium excretion and in clinical or laboratory data. Urolithiasis developed in 4 out of 44 cases (2 at the time of initial diagnosis and 2 within $1{\sim}2$ years of follow-up periods) and these children showed lower chronologic age ($3.7{\pm}2.7\;vs\;7.2{\pm}2.9\;yr$) and more girl than boys (3:1 vs 6:34) (P<0.05) compared to the rest of the hypercalciuric children. Follow-up urinalysis showed disappearance of hematuria in 56, 50, 66 and 75% of children at $1{\sim}2,\;2{\sim}4,\;4{\sim}6$ and $6{\sim}8$ years after initial diagnosis respectively. In conclusion, present study demonstrates that idiopathic hypercalciuria is a major cause of isolated hematuria in children so that in these children 24 hour urinary calcium excretion test seems to be an essential test to be performed. And serial renal sonography should be done to detect development of nephrolithiasis. However, clinical significance of dividing hypercalciuric children into two pathophysiologically distinct subtypes by oral calcium loading test seems to be in doubt and further study is needed to solve this problem.

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Pulmonary tuberculosis misdiagnosed as lung Metastasis in childhood cancer patients (소아암 환자에서 암의 전이로 오인된 폐결핵)

  • Lee, Hyun-Jae;Kim, Dong-Whan;Lee, Kang-Min;Park, Kyung-Duk;Lee, Jun-Ah;Cho, Soo-Yeon;Kook, Yoon-Hoh;Kim, Hee-Youn;Kim, Dong-Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.904-909
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    • 2009
  • Purpose : The differential diagnosis for a pulmonary nodule is intriguing in cancer patients. Metastasis might be a preferential diagnosis, and yet possibilities of other medical conditions still exist. Pulmonary tuberculosis should be enlisted in the differential diagnosis for a pulmonary nodule in cancer patients in Korea. This study was aimed at analyzing the incidence and clinical features of pulmonary tuberculosis that were misdiagnosed as pulmonary metastasis during radiologic follow-up in pediatric cancer patients. Methods : We retrospectively studied 422 cancer patients less than 18 years old in the Korea Cancer Center Hospital from January 2001 to June 2007. We collected episodes of lung metastasis of primary tumor and tuberculosis during treatment or follow-up, and analyzed medical records. Results : There were 5 cases of tuberculosis confirmed after surgery which were initially regarded as cancer. Two patients had respiratory symptoms such as cough and sputum but the other 3 patients did not. One patient had a family history of tuberculosis. Acid-fast M. tuberculosis was found in one case upon tissue specimen analysis. Two cases were Mantoux positive and the sputum examination was negative in all cases. The polymerase chain reaction for tuberculosis on a pathologic specimen was used to differentiate M. tuberculosis from non-tuberculosis mycobacterium (NTM). It was positive in one case. Lung lesions in one case showed a concurrence of tuberculosis along with lung metastasis. One of these patients died after cancer recurrence. Conclusion : It is necessary to consider the possibility of tuberculosis when a lung mass is newly detected during treatment or follow-up in patients with childhood cancer.

The Natural Course and Size Change of Atrial Septal Defect Secundum (단순 이차성 심방 중격 결손의 자연 경과와 성장에 따른 결손의 크기 변화)

  • Choi, Deok Young;Choi, Jae Young;Kim, Mi Jin;Sul, Jun Hee;Lee, Sung Kyu
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.871-875
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    • 2003
  • Purpose : This study was performed to follow the natural course and size change of isolated atrial septal defect(ASD) secundum. Methods : Among the newly diagnosed with ASD secundum at the division of pediatric cardiology in Yonsei cardiovascular hospital from January 1996 to December 2000, 89 patients with pure ASD secundum were checked by the serial echocardiographic evaluation to measure the size change. Results : There was a statistical difference(P<0.05) in the rate of spontaneous closure and size change of the defect between the group of bigger defect(>8 mm) and the group of smaller defect (${\leq}8mm$). There was also a statistical difference(P<0.05) in the rate of spontaneous closure and size change of the defect between the group of younger than three years of age and the group of older than three years of age. The initial size of the defect and change of size were the significant influencing factors in the rate of spontaneous closing of ASD. In the group of patients who have persistent ASD, the size of defect showed a tendency of increasing size of defect with the age(P<0.005); however in the correction of these values by the body surface area of each patients, there was no statistical difference. Conclusion : The possibility of spontaneous closure of pure ASD secundum was higher in the group of patients who have smaller defect and who were younger. The ASD secundum that did not have spontaneous closure showed an increase in size with the growth of the patients; however when this size was corrected by the body surface area, there was no statistical difference. The closure of the defect was at 26.2 months of age so close follow-up of the patients is important.

The Analysis of Failure Pattern in Locally Advanced Stomach Cancer Treated with Surgery and Post-Op Chemotherapy: To Explore The Role of Post-Op Irradiation (수술과 항암요법으로 치료한 국소 진행된 위함 환자에서의 치료실패 양상분석 : 수술후 방사선 치료의 역할에 대한 연구)

  • Choi, Eun-Kyung;Chang, Hye-Sook;Suh, Cheol-Won;Lee, Kyoo-Hyung;Lee, Jung-Shin;Kim, Sang-Hee;Kim, Hae-Ryun;Kim, Myung-Hwan;Min-Young-Il;Kim, Jin-Cheon;Lee, Sung-Gyu;Park, Kun-Choon
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.249-252
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    • 1991
  • A Retrospective study to analyze the failure pattern in locally advanced stomach cancer, treated with radical surgery and post-op chemotherapy was perfomed. Among 107 patients who underwent radical gastrectomy in Asan Medical Center between June 1989 and August 1990. there were 20 stage II(T2NO, T2N1) and 87 stage III(T3N1, T3N2) and 91 patients were eligible for study. 57 patients treated with 6 cycles of postop adjuvant chemotherapy. Among 57 patients treated with postop adjuvant chemotherapy, local failure occurred in $21\%$ and distant failure in $12\%$. Among 34 patients who were not treated with postop chemotherapy, local failure occurred in $24\%$ and distant failure in $26\%$. Among 29 failures including 13 locoregional, 9 distant metastasis and 7 locoregional and distant metastasis, 11 cases recurred in the anastomotic site, 3 in the gastric bed,7 in the regional lymph nodes and peritoneal seeding occurred in 6 cases. The true incidences of gastric bed, nodal and peritoneal failures may be higher in the longer follow-up or reoperative or autopsy series. Our data sugest that postop chemocherapy is beneficial by reducing distant failure rate. Our data suggest that postop chemocherapy is beneficial by reducing distant failure rate. Postop adjuvant locoregional radiotherapy in addition to the systemic adjuvant therapy may reduce the local failure rate and potentially benefit in at least $20\%$ of patients who developed the local failure only.

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A Clinical Study for Gall Bladder Stones in Children (소아 담석증에 대한 임상적 연구)

  • Eun, Ho Seon;Baek, Seoung Yon;Chung, Ki Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.194-201
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    • 2005
  • Purpose: Gall bladder (GB) stones in children are rarely observed, and so reports of them have been quite limited in Korea. Therefore, we tried to assess the epidemiology and clinical features of children with GB stone diagnosed at Severance Hospital. Methods: A clinical study was performed on 18 patients below 15 years of age diagnosed with GB stone by abdominal ultrasonography or CT scan at Severance hospital from January 1999 to May 2005. Results: Concerning patients' profile, their sex ratio of male to female in total 18 cases was 2 : 1 with the mean age of $6{\pm}4.3years$. 15 patients (83.3%) were asymptomatic. Inducing factors were found in 14 children (77.8%) including ceftriaxone therapy in 6 cases (33.3%), infection in 4 cases (22.2%), spherocytosis in 3 cases (16.7%), Down syndrome and abdominal operation in 1 case (5.6%) respectively. Single stone was found in 13 cases (76.5%) and multiple in 4 cases (23.5%). 15 cases (88.2%) had the stones less than 5 mm in size, and 2 cases (11.8%) between 5 and 10 mm. 17 patients received conservative treatment, and one patient had cholecystectomy due to Meckel diverticulum. Conclusion: In this report, Pediatric GB stones are predominant in male children, without typical symptoms, having inducing factors, single and small. Recently the diagnosis of them has been increased because of the development of imaging study. But the reports for them were still rare in Korea. Therefore the study for them is more necessary to find it's clinical characteristics.

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