• Radiation Oncology Journal
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• 제34권3호
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• pp.168-176
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• 2016

Purpose: The purpose of current study is to evaluate the response of the patients with portal vein thrombosis (PVT) or hepatic vein thrombosis (HVT) in hepatocellular carcinoma (HCC) treated with three-dimensional conformal radiation therapy (3D-CRT). In addition, survival of patients and potential prognostic factors of the survival was evaluated. Materials and Methods: Forty-seven patients with PVT or HVT in HCC, referred to our department for radiotherapy, were retrospectively reviewed. For 3D-CRT plans, a gross tumor volume (GTV) was defined as a hypodense filling defect area in the portal vein (PV) or hepatic vein (HV). Survival of patients, and response to radiation therapy (RT) were analyzed. Potential prognostic factors for survival and response to RT were evaluated. Results: The median survival time of 47 patients was 8 months, with 1-year survival rate of 15% and response rate of 40%. Changes in Child-Pugh score, response to RT, Eastern cooperative oncology group performance status (ECOG PS), hepatitis C antibody (HCVAb) positivity, and additional post RT treatment were statistically significant prognostic factors for survival in univariate analysis (p = 0.000, p = 0.018, p = 0.000, p = 0.013, and p = 0.047, respectively). Of these factors, changes in Child-Pugh score, and response to RT were significant for patients' prognosis in multivariate analysis (p = 0.001 and p = 0.035, respectively). Conclusion: RT could constitute a reasonable treatment option for patients with PVT or HVT in HCC with acceptable toxicity. Changes in Child-Pugh score, and response to RT were statistically significant factors of survival of patients.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권1호
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• pp.125-137
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• 2001

학습장애를 가진 86명의 초등학교 남학생과 52명의 정상적인 초등학교 남학생의 자아상과 우울, 그리고 상태-특성 불안에 관하여 피어스-해리스 자아상 척도, 소아우울척도(이하 CDI), 상태-특성불안 척도(이하 STAI)를 이용하여 조사하였다. 피어스-해리스 자아상 척도의 총점에서는 두 군 사이에 차이가 발견되지 않았으나, 지적 및 학업 상태 항목과 신체적 외모, 행복과 만족 소척도에서는 두 군 사이에 의미 있는 차이가 관찰되었다. 소아우울척도의 총점과 그 소척도 중 부적합함, 무쾌감증, 부정적인 자기 존중 항목에서 학습장애 아동이 정상 아동보다 더 높은 점수를 나타내었다. 상태불안은 정상 아동보다 학습장애 아동에서 높게 보고되었으나 특성 불안에 대해서는 차이를 보이지 않았다. 정상 아동에서는 나이에 따른 자아상과 우울척도, 불안 척도의 의미 있는 변화가 관찰되지 않았으나, 학습장애 아동에서는 피어스-해리스 자아상 척도와 그 소척도의 대부분이 통계적으로 의미 있게 감소하였고, 소아우울척도의 부정적 감정과 무쾌감증, 부정적 자기 평가, 상태 불안, 특성 불안 등은 연령과 의미 있는 양의 상관관계를 나타내어서 학년이 올라갈수록 자아상은 저하되고 우울과 불안을 느끼는 강도와 범위가 증가하는 양상을 보였다. 두 군 모두에서 소아우울척도는 피어스-해리스 자아상 척도의 총점과 그 소척도들과 의미 있는 역의 상관관계를 나타내었고, 상태불안과 특성불안과는 정의 상관관계를 나타내었다. 조사 결과 학업과 관련된 자아상의 문제와 자신이 남들과 당당히 맞설 수 있는 자신감의 문제가 학습장애에서 더 많이 나타났고, 나이가 들수록 자아상이 저하되며 불안과 우울은 증가하는 것으로 나타났다. 회귀분석 결과 학습장애 아동의 자아상을 설명하는 변수들로는 나이와 자아상 척도의 행동문제, 지적 및 학업상태, 불안, 인기도, 행복과 만족, 그리고 소아우울척도의 부적합함, 대인관계문제, 부정적 자기-존중 및 상태 불안인 것으로 드러나서 학습 장애 아동의 자아상은 학업 문제와 자신을 또래와 비교하여 겪는 스트레스로 인해 부정적인 영향을 받는다는 것이 확인되었다. 결론적으로 학습장애를 가진 초등학교 남학생은 정상 초등학교 남학생보다 자아상이 낮고 우울과 불안을 더 많이 느끼며, 이런 차이는 학년이 올라갈수록 커졌다. 학습장애에서 우울증과 불안 장애가 많이 동반되기 때문에 임상에서 학습장애 아동을 치료할 때 정서 장애의 동반 여부를 확인하고 이를 적극적으로 치료하는 것이 중요한 과제이다.

• 대한한방소아과학회지
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• 제28권3호
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• pp.17-30
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• 2014

Objectives The purpose of this study is to report the effectiveness of Korean medicine treatment on 69 infant and young child atopic dermatitis patients. Methods 69 infants and young child atopic dermatitis patients who had visited oriental medical clinics from 2011.1.9 to 2012.1.31 were studied. All of them were continually treated for 3 to 9 months, and were analyzed by Objective SCORAD Index (OSI). A detailed analysis of OSI was done according to gender, age, using of topical steroid ointment, family history of atopic disease, treatment period, and intensity. Results 1. Male and female percentage of the study group was 56.5%: 43.5%. The average period of treatment was 6.09 months. 71.0% used topical steroid ointment, and 65.2% had family history of atopic disease. 2. The average period of treatment was significantly longer in patients who used topical steroid ointment, or who had family history of atopic disease. 3. 95.7% of total patients reported decrease in OSI score at the final visit. OSI was significantly lowered after 3, 6, and 9 months of treatment. The longer period of treatment, the lower average post-treatment OSI. 4. 85.5% of the study group had severe dermatitis, and 14.5% was moderate case based on the OSI intensity assessment at initial visit. These percentages got changed at the final visit as 34.8% of severe, 58.0% of moderate, and 7.2% of mild cases. The average treatment period of patients who were diagnosed as severe at the initial visit was 6.18 months, and their final OSI improvement rate was 39.58%. 58% of them were improved to be mild or moderate at the final visit. Conclusion The Korean medicine treatment is effective in treating infant and young child atopic dermatitis patients. There was significant decrease in OSI score after 3, 6, and 9 months of treatment. The difference increase with the treatment period.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권1호
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• pp.72-78
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• 2005

목 적 : 종합병원에서의 소아청소년을 대상으로 한 정신과 자문의 임상적 특징을 알아보고자 하였다. 방 법 : 4년 동안 한 종합병원에서 소아정신과에 의뢰된 302명의 환자의 병원기록을 조사 분석하였다. 결 과 : 학령기 아동과 청소년의 소아정신과 자문비율은 $2.15\%$였다. 중, 고등학생에서는 여자에서 더 많이 자문이 의뢰되었으나 학령전기 아동에서는 남자에서 더 많이 의뢰되었다. 자문의 $50\%$가 내과와 소아과로부터 의뢰되었다. 자문의뢰의 주된 이유는 정신과적 평가$(31.1\%)$, 우울$(11.6\%)$, 그리고 불안$(11.3\%)$이었다. 가장 자주 행해진 치료 목적의 정신과적 처치는 정신과적 교육과 지지적 정신치료였다$(21.2\%)$. 결 론 : 정신과 자문 의뢰의 임상적 양상은 성인과 소아청소년 사이에 차이가 있다. 소아 및 청소년을 위한 자문서비스를 강화시키기 위하여 더 많은 연구가 필요하다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제2권1호
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• pp.160-175
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• 1991

본 연구의 목적은 가족의 기본이 되는 부부관계에 초점을 맞추어 부부관계와 부모자녀 관계 사이의 연관성을 알아보고자 1987년 7월부터 9월사이에 소아 정신과에서 치료받은 환아의 부모들과 일반 아동이 부모들을 대상으로 결혼 만족도 검사(Marital Satisfaction Inventory ; MSI)와 부부 적응도 척도(Dvadic Adjustment Scale ; DAS)의 두가지 설문지를 이용하였다. 환아 부모군은 환아의 진단면에 따라 정신증, 신경증, 틱, 자폐증, 정신지연의 5군으로 분류하였고 각군의 결과가 평가되었다. 1) 환아부모군은 대조군보다 결혼만족도가 낮다. 2) 환아부모군은 대조군보다 부부 적응도가 유의하게 낮다(P<0.01). 3) 환아부모군, 대조군에서 여자가 남자보다 역할개념이 더 진보적이며 환아부모군에서 역할부담이 여자에게 편중됨으로써, 양육갈등(conflict in child rearing)은 모성 우월현상과 연관됨을 시사한다. 4) 원래 가족의 고통스러운 가족력(Family History of Distress)는 결혼의 정서적 의사소통, 성생활, 자녀양육과 연관이 깊다. 5) 결혼 만족도 검사(Marital Satisfaction Inventory ; MSI)의 전반적 고통 척도(Global Distress Scale ; GDS)에 의하면 정신증, 신경증, 자폐증, 정신지체, 틱의 순서로 불만족도를 보였다. 6) 부부 적응도 척도(Dvadic Adjustment Scale ; DAS)에 의하면 정신증, 신경증, 틱, 자폐증, 정신지체의 순서로 부적응도를 보였다. 7) 틱군은 자녀양육 갈등 및 양육태도에 문제점을 시사하였고 부부관계 자체는 유의한 장애를 보이지 않았다. 위의 결과로서 부부의 부적응 및 불만족은 자녀양육 및 자녀문제와 밀접한 연관성이 있음을 시사하며 소아의 정신증과 신경증군의 발병요인은 결혼 불만족과 부적응과 관련이 깊으며 자폐증이나 정신지연군의 발병요인은 결혼 불만족과 부적응과 관련이 깊지 않음을 시사한다.

• 대한한방소아과학회지
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• 제32권4호
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• pp.51-62
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• 2018

Objectives The purpose of this study is to analyze the characteristic of pediatric patients who visited oriental medical hospital for growth treatment. Methods The study was conducted with 130 pediatric patients who visited ${\bigcirc}{\bigcirc}$ Korean medicine hospital from January 2016 to August 2017. The patient's data was classified by sex, age, pattern identification and diseases. The classified data was analyzed to find the correlations and characteristics among variables. Results There were 50.8% of boys and 49.2% of girls. 6.2% of the total patients were in 'early childhood', 50.8% were in 'late childhood' and 43.1% were in 'puberty' stage. In terms of pattern identification, 44.6% of the total patients were 'Spleen-lung Qi Deficiency', 53.8% were 'Lung-kidney Yin Deficiency' and 1.5% were 'Weakness of Heart and gallbladder'. 44.3% of the patients had various diseases including rhinitis (77.6% of 120.7%). Height percentile of the children with using the Growth chart of 2017 was lower than using the Growth chart of 2007. Predicted height based on the child's bone-age were higher than the predicted height based on the parental height, although both of the precited factors were correlated to the current child's height. Conclusions This study showed the characteristic of the pediatric patients who visited oriental medical hospital for growth treatment. It helps to determine prognosis and treatment, and to explain treatment measures.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권2호
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• pp.50-56
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• 2019

Most patients with Tourette's disorder experience an uncomfortable sensory phenomenon called the premonitory urge immediately before experiencing tics. It has been suggested that premonitory urges are associated with comorbidities such as obsessive compulsive disorder, anxiety disorders, and attention-deficit/hyperactivity disorder, although these associations have been inconsistent. Most patients experience tics as a result of the premonitory urges, and after the tics occur, most patients report that the premonitory urges are temporarily relieved. As a consequence, several studies have assessed the premonitory urge and its potential therapeutic utility. Based on the concept that the premonitory urge induces tics, behavioral treatments such as Exposure and Response Prevention and Habit Reversal Therapy have been developed. However, it is still unclear whether habituation, the main mechanism of these therapies, is directly related to their effectiveness. Moreover, the observed effects of pharmacological treatments on premonitory urges have been inconsistent.

• Pediatric Infection and Vaccine
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• 제18권1호
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• pp.97-102
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• 2011

Acinetobactor baumanii 는 기회 감염균으로 carbapenem의 사용이 증가하면서 MDRAB와 같은 내성균으로 출현하고 있다. 저자들은 경희의료원에서 carbapenem을 투약받지 않았더라도 집중치료실에 장기간 입원하여 기관삽관과 인공호흡기 치료를 받거나 침습적인 수술을 받아 도관을 유지하는 환아에서 MDRAB가 동정되었다는 것을 확인하였다. carbapenem을 사용하지 않았더라도 장기간 집중치료실에 입원할 것으로 예상되는 환자들에게 원내전파를 통한 감염을 최소화하기 위하여 원내감염관리에 최선을 다해야 할 것이기에 이상의 증례를 통하여 보고한다.

• Journal of Radiation Protection and Research
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• 제46권3호
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• pp.98-105
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• 2021

Background: In recent events of the coronavirus disease 2019 (COVID-19) pandemic, computed tomography (CT) scans are being globally used as a complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. It will be important to be aware of major organ dose levels, which are more relevant quantity to derive potential long-term adverse effect, for Korean pediatric and adult patients undergoing CT for COVID-19. Materials and Methods: We calculated organ dose conversion coefficients for Korean pediatric and adult CT patients directly from Korean pediatric and adult computational phantoms combined with Monte Carlo radiation transport techniques. We then estimated major organ doses delivered to the Korean child and adult patients undergoing CT for COVID-19 combining the dose conversion coefficients and the international survey data. We also compared our Korean dose conversion coefficients with those from Caucasian reference pediatric and adult phantoms. Results and Discussion: Based on the dose conversion coefficients we established in this study and the international survey data of COVID-19-related CT scans, we found that Korean 7-year-old child and adult males may receive about 4-32 mGy and 3-21 mGy of lung dose, respectively. We learned that the lung dose conversion coefficient for the Korean child phantom was up to 1.5-fold greater than that for the Korean adult phantom. We also found no substantial difference in dose conversion coefficients between Korean and Caucasian phantoms. Conclusion: We estimated radiation dose delivered to the Korean child and adult phantoms undergoing COVID-19-related CT examinations. The dose conversion coefficients derived for different CT scan types can be also used universally for other dosimetry studies concerning Korean CT scans. We also confirmed that the Caucasian-based CT organ dose calculation tools may be used for the Korean population with reasonable accuracy.

• 한국간담췌외과학회지
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• 제28권1호
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• pp.34-41
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• 2024

Backgrounds/Aims: Liver transplantation (LT) provides a favorable outcome for patients with hepatocellular carcinoma (HCC) and was launched in Vietnam in 2004. In this study, we evaluated the short-term and long-term outcomes of LT and its risk factors. Methods: This retrospective study analyzed HCC patients who underwent LT at Viet Duc University hospital, Vietnam, from 01/2012-03/2022. The following data were gathered: demographics, virus infection, tumor characteristics, alpha-fetoprotein (AFP) level, Child-Pugh and MELD scores, selection criteria, type of LT, complications, 30-day mortality, and disease-free and overall survival (DFS and OS). Results: Fifty four patients were included, the mean age was 55.39 ± 8.46 years. Nearly 90% had hepatitis B virus-related HCC. The median (interquartile range) AFP level was 16.2 (88.7) ng/mL. The average MELD score was 10.57 ± 5.95; the rate of Child-Pugh A and B were 70.4% and 18.5%, respectively. Nearly 40% of the patients were within Milan criteria, brain-dead donor was 83.3%. Hepatic and portal vein thrombosis occurred in 0% and 1.9%, respectively; hepatic artery thrombosis 1.9%, biliary leakage 5.6%, and postoperative hemorrhage 3.7%. Ninety-day mortality was 5.6%. Five-year DFS and OS were 79.3% and 81.4%, respectively. MELD score and ChildPugh score were predictive factors for DFS and OS (p < 0.05). In multivariate analysis, Child-Pugh score was the only significant factor (p < 0.05). Conclusions: In Vietnam, LT is an effective therapy for HCC with an acceptable complication rate, mortality rate, and good survival outcomes, and should be further encouraged.