• Title/Summary/Keyword: 현병력

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Preoperative Factors of Immature First Permanent Molars Treated with Vital Pulp Therapy (생활치수치료를 시행한 미성숙 제1대구치의 술전 상태)

  • Lim, Heejung;Lee, Eungyung;Park, Soyoung;Jeong, Taesung;Shin, Jonghyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.2
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    • pp.176-183
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    • 2021
  • This study aimed to analyze the preoperative factors of immature first molars treated with vital pulp therapy and to find out their correlation in pediatric patients. From May 2014 to January 2020, 523 patients and 1,242 immature first molars were investigated. Factors including age, sex, tooth location, Molar-incisor hypomineralization (MIH), caries cavity location, and history of previous restoration were evaluated. As a result of the study, the vital pulp therapy group had 5.56 times more MIH, 3.39 times more mesial cavities, and 8.73 times more distal cavities. In order to avoid vital pulp therapy in immature first molar, early diagnosis and active management of MIH and preventive treatment of mesial and distal caries are necessary after its immediate eruption.

The Effect of working Noise Exposure and Military Background on the Hearing Threshold (특수병과의 과거 군 소음 노출이 소음 노출 작업자의 청력에 미치는 영향)

  • Chung, Ho-Keun;Kim, Kyoo-Sang
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.2
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    • pp.137-146
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    • 2003
  • Objectives : Impaired hearing is a prevalent occupational hazard, not only in industry, but also in the armed forces. In military life, noise has unusual characteristics, and constitutes a serious hazard to hearing. The aim of this study was to analyze the hearing threshold data in order to compare the hearing loss among shipyard workers, representing different workers, and a military service background. Methods : A cross-sectional audiological survey, combined with a questionnaire study, was conducted on a stratified random sample of 440 shipyard workers, with long-term exposure to noise. The employees were divided into four groups, according to their working and military service backgrounds, in relation to their exposure to noise. Results : As expected, the working and military noise exposure group (Group I) had significantly poorer hearing than the other groups. The high frequencies (2-8 kHz) showed the greatest difference in terms of poorer fearing in both ears. The prevalence of noise-induced hearing loss (NIHL) was highest in Group I. A logistic regression analysis was applied to determine the dependence of the NIHL in relation to age, smoking, drinking, working duration, ear protection, past history of ear diseases, and working and military sonics backgrounds, on the noise exposure The important factors found to be related to the NIHL, in relation to noise exposure were: age, work duration, and working and military service backgrounds. The adjusted odds ratio estimates for NIML in the right ear were 4.5 times greater (95% CI 1.7-11.6) for the military noise exposed group, and 7.9 times greater (95% CI 2.0-31.3) for the working noise exposed group than in the controls. The hearing thresholds at the pure-tone average and 4 kHz were significantly increased with age and work duration with both the working and military service backgrounds. Conclusions : From these results, specific preventive programs were planned, which should be assessed by epidemiological surveillance of the military noise exposed population.

Application of Text-Classification Based Machine Learning in Predicting Psychiatric Diagnosis (텍스트 분류 기반 기계학습의 정신과 진단 예측 적용)

  • Pak, Doohyun;Hwang, Mingyu;Lee, Minji;Woo, Sung-Il;Hahn, Sang-Woo;Lee, Yeon Jung;Hwang, Jaeuk
    • Korean Journal of Biological Psychiatry
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    • v.27 no.1
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    • pp.18-26
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    • 2020
  • Objectives The aim was to find effective vectorization and classification models to predict a psychiatric diagnosis from text-based medical records. Methods Electronic medical records (n = 494) of present illness were collected retrospectively in inpatient admission notes with three diagnoses of major depressive disorder, type 1 bipolar disorder, and schizophrenia. Data were split into 400 training data and 94 independent validation data. Data were vectorized by two different models such as term frequency-inverse document frequency (TF-IDF) and Doc2vec. Machine learning models for classification including stochastic gradient descent, logistic regression, support vector classification, and deep learning (DL) were applied to predict three psychiatric diagnoses. Five-fold cross-validation was used to find an effective model. Metrics such as accuracy, precision, recall, and F1-score were measured for comparison between the models. Results Five-fold cross-validation in training data showed DL model with Doc2vec was the most effective model to predict the diagnosis (accuracy = 0.87, F1-score = 0.87). However, these metrics have been reduced in independent test data set with final working DL models (accuracy = 0.79, F1-score = 0.79), while the model of logistic regression and support vector machine with Doc2vec showed slightly better performance (accuracy = 0.80, F1-score = 0.80) than the DL models with Doc2vec and others with TF-IDF. Conclusions The current results suggest that the vectorization may have more impact on the performance of classification than the machine learning model. However, data set had a number of limitations including small sample size, imbalance among the category, and its generalizability. With this regard, the need for research with multi-sites and large samples is suggested to improve the machine learning models.

A Follow-Up Study after Discontinuation of Antiepileptic Drug Therapy in Children with Well-Controlled Epilepsy : The Factors that Influence Recurrence (항전간제로 조절된 간질 환아에서 약물 중지 후 추적 관찰 - 재발위험인자)

  • 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
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    • 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.

A Case of Late-onset Episodic Myopathic Form with Intermittent Rhabdomyolysis of Very-long-chain acyl-coenzyme A Dehydrogenase (VLCAD) Deficiency Diagnosed by Multigene Panel Sequencing (유전자패널 시퀀싱으로 진단된 성인형 very-long-chain acyl-coenzyme A dehydrogenase (VLCAD) 결핍증 증례)

  • Sohn, Young Bae;Ahn, Sunhyun;Jang, Ja-Hyun;Lee, Sae-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.20-25
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    • 2019
  • Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.

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A STUDY OF PSYCHOSOCIAL VARIABLES WITHIN ADHD WITH OR WITHOUT EXTERNALIZING SYMPTOM (ADHD 아동과 외면화 증후를 공존질환으로 갖는 ADHD 아동간의 심리사회적 변인에 관한 비교연구)

  • Lee, Kyung-Sook;Ryu, Yoon-Jung;Ahn, Dong-Hyun;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.2
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    • pp.203-212
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    • 1996
  • In this thesis, we investigate the psychosocial variables within the family environments of Attention Deficit Hyperactivity Disorder with (ADHD+CD/ODD) or without (ADHD) externalizing symptoms. The subjects in this research were 86 boys and girls(aged range 6 to 14 years) consisted of 20 ADHD, 22 comorbid ADHD(ADHD+CD/ODD) and 44 normal control group(NC). We have collected data on children and their mothers. The psychosocial variables included in the analysis are socioeconomic status, parent's educational level, life stress event, and the rate of psychiatric disorders in relatives. The self-reported questionnaires marital discord(MAS), parenting stress(PSI), and parenting attitute(MBRI) completed by mothers. The results indicated that ADHD+CD/ODD is supposed to have higher level of family adversity suggested by the lower SES, lower parental educational level, higher life stress events, and more psychic disorders in relatives compared with ADHD or normal control group. In MAS, ADHD+CD/ODD group has significantly the lowest scores on each factor of the measure of marital adjustment. Parents of ADHD+CD/ODD are much more likely to have positive parenting stress when compared with the parents of ADHD. Especially, mothers of ADHD+CD/ODD have the lowest tendency in the mean score on affective, accepted attitudd. In an inapropriate parenting attitude perceived by children, father of ADHD+CD/ODD have the most negative, contradictory attitude and mothers of ADHD+CD/ODD have the most restrictive, negative and contradictory attitude.

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A Study on Life Changes of Oral Lichen Planus Patients by SRRS (SRRS를 이용한 구강 편평태선 환자의 생활변화에 관한 연구)

  • Ko, Myung-Yun;Park, Su-Hyeon;Ok, Su-Min;Huh, Joon-Young;Ahn, Yong-Woo;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.9-17
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    • 2012
  • Lichen planus is a chronic inflammatory mucocutaneous disease that affects multiple sites of the body. Often it involves the oral mucosa, but also involve other sites such as skin, genitals, scalp and nails. There is no clear cause of oral lichen planus (OLP), current data suggest that OLP is a T-cell mediated autoimmune disorder which may have an altered self-peptide triggering apoptosis of oral epithelial cells. Usually OLP appears in middle-aged women which tends to be chronic with periods of exacerbation and remission. There are many theories those causes the OLP such as psychological and environmental factors, genetic tendency, drugs and more. 60-70% of lichen planus is accompanied by oral lesions, and more than half of its cases are not able to defined by their skin. In this study, among all the possibility(possible) theories, we tried to evaluate the influence of emotional stress in exacerbating OLP. There were thirty patients with a clinical or histological diagnosis of OLP and other thirty subjects who did not show any signs of systemic disorders include OLP. They were evaluated by using modified Holmes and Rahe's Social Readjustment Rating Scale (SRRS). As a result, a significantly higher level of stress was found in the OLP patients than the control group. Therefore it could be concluded that psychological stressors play an important role in the exacerbating OLP.

DISPLACEMENT OF MAXILLARY LATERAL INCISOR CAUSED BY IDIOPATHIC GINGIVAL FIBROMATOSIS (특발성 치은 섬유종증에 의한 상악 측절치의 변위)

  • Jung, Ji-Sook;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo;Lee, Suk-Keun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.296-302
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    • 2011
  • Idiopathic gingival fibromatosisrarely occurs, but frequently recurred after surgical removal. It usually occurs in generalized symmetrical pattern but sometimes in localized unilateral pattern. The localized pattern usually affects the maxillary molar and tuberosity area. This disease usually causes tooth migration, malocclusion, and problems in eating, speech, and esthetics. A boy showed dense gingival fibromatosis localized at primary maxillary right lateral incisor area at the age of 5 years, and his maxillary right lateral incisor become severely displaced at the age of 9 years. He had no medical and hereditary factors relevant to the gingival fibromatosis. However, the dense fibrous tissue was dominant in his labial gingiva of maxillary right incisors. In order to realign the displaced incisors by orthodontic treatment, the dense fibrous tissue covered the defect space between the central incisor and the displaced lateral incisor was surgically removed. The removed specimen was examined by simple immunohistochemical(IHC) array method. IHC array showed increased expression of CTGF, HSP-70, MMP-1, PCNA, CMG2, and TNF-${\alpha}$ in keratinocytes, fibroblasts, endothelial cells, and macrophages of gingival fibromatosis tissue. Therefore, it was suggested that the gingival fibromatosis be caused by the concomitant overexpression of CTGF, HSP-70, MMP-1, PCNA, CMG2, and TNF-${\alpha}$, and resulted in the fibroepithelial proliferation and the inflammatory reaction of gingival tissue.

Sick Sinus Syndrome (SSS) in a Maltese Dog Concurrent with Mitral Valve Endocardiosis (MVE) (말티즈견에서 발생한 Mitral Valve Endocardiosis (MVE)를 동반한 Sick Sinus Syndrome (SSS)에 대한 증례)

  • Park Chul;Jung Dong-in;Kim Ha-Jung;Kang Byeong-Teck;Kim Ju-Won;Lim Chae-Young;Yoo Jong-Hyun;Park Hee-Myung
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.396-400
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    • 2005
  • A 13-year old, female Maltese dog was presented due to a five-month history of episodic syncope. A diagnosis of sick sinus syndrome (SSS) with mitral valve endocardiosis (MVE) was made based on history takings, physical and cardiac examination, complete blood count (CBC), serum chemistry profiles, radiography, electrocardiography (ECG), atropine response test, hormonal assay, and echocardiography. In this case, SSS was definitely diagnosed by evaluation of ECG recording following atropine administration. Clinical signs were improved with medical management of theophylline (THEOLAN, KunWha Pharm, Seoul, Korea, 20 mg/kg, PO, BID). After 10 more month survival, the dog, died of respiratory distress and shock during the operation of abdominal mass removal in local animal hospital. Unfortunately, we were not able to perform necropsy after death due to owner's decline. This case demonstrates that theophylline can be used in management oF dog with SSS.

Malignant Transformation of Benign Giant Cell Tumor (양성 거대 세포종의 악성 변화)

  • Kong, Chang-Bae;Hong, Yun-Suk;Lee, Kwang-Youl;Cho, Sang-Hyun;Song, Won-Seok;Cho, Wan-Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.14-19
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    • 2012
  • Purpose: We analyzed the oncologic outcome of the malignant transformed benign giant cell tumor of bone. Materials and Methods: Between January 2000 and February 2012, 5 cases were referred with suspicious malignant transformation of benign giant cell tumor. No patients underwent radiation therapy. Results: After referral, all patients received the wide excision of the tumor and its' pathologic diagnosis were osteosarcoma. As classified by the location of tumor lesion, 3 cases were located in the distal femur, 1 case was in the distal radius and 1 case was in the proximal femur. The average latent period between diagnosis of benign giant cell tumor and diagnosis of secondary malignant giant cell tumor was 49.2 months. (range, 24-126 months) The mean follow-up period was 21.6 months. There were subsequent local recurrence in 2 cases and 3 patients developed distant metastasis. All patients with lung metastasis were dead. Conclusion: Malignant transformation of benign giant cell tumor of bone can be occurred within 5 years. Therefore, when benign giant cell tumor suspicious malignant transformation, it is necessary to do more aggressive treatment.