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Childhood Cancer Incidence and Survival 1985-2009, Khon Kaen, Thailand

  • Wiangnon, Surapon;Jetsrisuparb, Arunee;Komvilaisak, Patcharee;Suwanrungruang, Krittika
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7989-7993
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    • 2014
  • Background: The Khon Kaen Cancer Registry (KKCR) was established in 1984. Previous population-based incidences and survivals of childhood cancer in Thailand were determined using a short cancer registration period. Materials and Methods: Data were retrieved of all children residing in Khon Kaen, between 0-15 years, diagnosed as having cancer and registered in the KKCR (1985-2009). The follow-up censored date was December 31, 2012. The childhood cancers were classified into 12 diagnostic groups, according to the International Classification of Childhood Cancer. The incidence was calculated by the standard method. Survival of childhood cancer was investigated using the KKCR population-based registration data and overall survival calculated using the Kaplan Meier method. Results: In the study period, 912 newly diagnosed cases of childhood cancer were registered. The respective mean and median age was 6.4 (SD=4.6) and 6 (0-14) years. The age-peak for incidence was 0-4 years. The age-standardized rate (ASR) was 83 per million. Leukemia was the most common cancer (N=360, ASR 33.8) followed by neoplasms of the central nervous system (CNS, N=150, ASR 12.8) and lymphoma (N=79, ASR 7.0). The follow-up duration totaled 101,250 months. The death rate was 1.11 per 100 person-months (95%CI: 1.02 -1.20). The 5-year overall survival was 52% (95%CI: 53-56.9) for all cancers. The respective 5-year overall survival for (1) acute lymphoblastic leukemia (ALL), (2) acute non-lymphoblastic leukemia (ANLL), (3) lymphoma, (4) germ cell tumors, (5) renal tumors, (6) retinoblastoma, (7) soft tissue tumors, (8) CNS tumors, (9) bone tumors, (10) liver tumors, and (11) neuroblastoma was (1) 51%, (2) 37%, (3) 63%, (4) 74%, (5) 67%, (6) 55%, (7) 46%, (8) 44%, (9) 36%, (10) 34%, and (11) 25%. Conclusions: The incidence of childhood cancer is lower than those of western countries. Respective overall survival for ALL, lymphoma, renal tumors, liver tumors, retinoblastoma, soft tissue tumors is lower than that reported in developed countries while survival for CNS tumors, neuroblastoma and germ cell tumors is comparable.

Epidemiology of Pesticide Poisoning in Kyungpook (경북지방(慶北地方)의 농약중독(農藥中毒)에 대한 역학적(疫學的) 조사(調査))

  • Chung, Jong-Hak;Cho, Jae-Yeun
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.28-34
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    • 1983
  • In spite of the world-wide increase of incidence of pesticide poisoning due to greater use of pesticides, the epidemiological study of pesticide poisoning in Korea has been grossly neglected. The author gained access to the medical records for two year period (1981 through 1982) from local clinics, hospitals and health centers of Kyungpook area to investigate the status of the pesticide poisoning. During these two years, there were 1,618 cases of documented pesticide poisoning, of which in 1981 were 765 and in 1982 were 853. Those in the twenties decade of age was the most frequent and the male(70%) was more liable than the female (30%). In view of manner of poisoning, occupational poisoning was 27.8%, accidental 5.6%, and suicidal 66.6%. There are three distinct groups which make up the large majority of both fatal and nonfatal cases; young children who accidentally ingest pesticides, young to middle age adult who are occupationally poisoned, and middle age to older adults who suicidally ingest pesticides. The seasonal distribution of these poisonings disclosed the peak month to be July, with August next, followed by June and September. Only 11% of cases occurred during the three-month winter season of December to February. Thus pesticide caused poison- ing was primarily a summer and early fall occurrence. During these two years, average of 67 cases of poisoning was observed monthly. Of the pesticide poisoning documented, 49% were treated with poisoning patients from local clinic and 43% from hospital. The case fatality rate of occupational poisoning was 0.9%, accidental 5.6% and suicidal 20.3%. The mean overall case fatality rate was 14.1%. Annual incidence of pesticide poisoning was 25.4 per 100,000 population in the study area. There is a nationwide need for more reliable date on pesticide poisoning. This need can only grow more acute with the passage of time because of the increasing importance of pesticides as a cause of morbidity and mortality.

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COMPARATIVE STUDY OF RORSCHACH RESPONSE CHARACTERISTICS BETWEEN ADHD WITHOUT DEPRESSION AND ADHD WITH DEPRESSION (우울 동반 여부에 따른 ADHD의 Rorschach 반응 특성 비교)

  • Lee, Sun-Mi;Lee, Moon-Suk;Cho, Eun-Cheong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.2
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    • pp.174-182
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    • 2003
  • Objective:Present study compared the Rorschach responses characteristics between ADHD without depression and ADHD with depression. Method:60 children diagnosed ADHD(30 ADHD without depression and 30 ADHD with depression) were assessed with The Rorschach. Responses characteristics between two groups were compared by t test and ${\chi}^2$ test. Results:ADHD without depression had more Rorschach response ration and frequency, with statical significance, in m, M-, DV, (3r+(2)/R>.44 and Fr+rF=0, OR(3r+(2)/R>.33)=YES, pure H<2=YES, H+(H)+Hd+(Hd), FQ none, Sc than ADHD with depression. ADHD with depression had more Rorschach response ration and frequency, with statical significance, in p, H+(H)+Hd+(Hd), (Hd), M than ADHD without depression. Conclusion:This results suggest that we had better consider the impulsivity of idation and cognition for ADHD without depression, preferred introversive coping style for ADHD with depression in diagnosing and intervening.

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A Diagnostic Algorithm after Newborn Screening for Hypermethioninemia (고메티오닌혈증의 신생아 선별 검사 후 진단 알고리즘)

  • Kim, Yoo-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.1-9
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    • 2016
  • Newborn screening (NBS) is important if early intervention is effective in a disorder and if there are sensitive and specific biochemical markers to detect disorder. Methionine is a useful marker to detect abnormal methionine-homocysteine metabolism, especially homocystinuria which needs urgent medical intervention. However, hypermethioninemia could occur in other metabolic disorder including liver disease, tyrosinemia type I, methionine adenosyltransferase (MAT) I/III deficiency, glycine N-methyltransferase (GNMT) deficiency, or adenosylhomocysteine hydrolase deficiency. However, experience with NBS for homocystinurias and methylation disorders is limited. Especially, MAT I/III deficiency which is the most common cause of persistent hypermethioninemia have two inheritance, autosomal recessive (AR) and autosomal dominant (AD), and their clinical manifestation is different between AR and AD. Here, author reviewed recent articles of guideline and proposed guideline for homocystinuria and methylation disorder.

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Tentative Proposal of Optimal Timing of Kasai Operation for Biliary Atresia Based on Fibroscan Results (간섬유화스캔을 이용한 선천성 담도 폐쇄증의 최적 수술시기 시험적 제안)

  • Lee, Hwa-Young;Park, Young-A;Han, Seok-Joo;Koh, Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.1
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    • pp.74-80
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    • 2011
  • Purpose: Based on previous research findings, it is well-known that the timing of surgery is generally considered the most important prognostic factor for a Kasai portoenterostomy, the primary treatment for biliary atresia. This research aimed to identify the optimal timing of a Kasai portoenterostomy and to verify if the proposed optimal timing corresponds to previous studies. All patients were classified by the timing of surgery, and pre- and post-operative fibrotic changes of the liver were measured with the elasticity value from fibroscans. Methods: The stiffness scores of the pre- and post-operative fibroscans in 34 patients who were treated by Kasai portoenterostomy from October 2007 to September 2010 in Severance children's hospital were reviewed. Results: The earlier the patients were treated by Kasai portoenterostomy, the lower the fibroscan scores. When the patients were treated prior to the 8th week, the post-operative scores of the fibroscans were significantly better than those patients who were treated after the 8th week, and some even recovered partially. Moreover, when operated before the 8th week, the differences between each pre- and postoperative fibroscan score also showed statistical relevance (p=0.0002). Conclusion: The earlier the patient was treated by Kasai portoenterostomy, the less liver fibrosis that developed, the lower the level of post-operative fibrosis, and the less the degree of fibrotic progress before and after the operation. Thus, this research proposal reconfirms once more that the 8th week is the optimal timing for a Kasai portoenterostomy.

Epidemiologic and Clinical Comparisons of Three Measles Outbreaks in Korea(1989~2001) (국내에서 1989년부터 2001년 사이에 세 번 돌발 유행한 홍역의 역학 및 임상적 비교)

  • Yoon, Ju-Yun;Lee, Kyung-Yil;Kang, Jin-Han
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.223-228
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    • 2003
  • Purpose : We evaluated and compared clinical and laboratory characteristics of patients with measles in three epidemics(1989~90, 1993~94, and 2000~01) in Daejeon, Korea. Methods : Retrospective analyses were performed using medical records of 520 patients with measles at the Catholic University of Korea, Daejeon St. Mary's Hospital during three epidemics. We divided the subjects into three groups, i.e., those who admitted during 1989~1990(group I, 116 patients), those during 1993~1994(group II, 127 patients), and those during 2000~2001(group III, 277 patients). We compared clinical, demographic and laboratory characteristics among these 3 groups. Results : In age distribution, ratios of under 2 years of age in three groups were 61%, 58% and 57%, respectively with no statistical differences. However there are differences in age distribution above 2 years of age, as 21% in 2~5 years of group I, 28% in 6~9 years of group II, and 21% above 10 years of group III. No statistical differences were present between 3 groups in the male to female ratio, MMR vaccination rate in above 2 years of age, duration of fever, incidence of hepatitis. Hospitalization days(P=0.019) and rate of complications(P=0.012) were longer and higher in group I than in group III. Conclusion : In three epidemics, the second peak age group(except 0~1 year) of children above 2 years of age who had mostly received MMR vaccination showed a trend for increased age with increasing time(statistical difference). This result suggest that secondary vaccine failure may have a role in each epidemics. So, if measles outbreaks is happened in the future, we will have consideration in this aspect.

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DENTAL TREATMENT FOR A PATIENT WITH NOONAN SYNDROME UNDER GENERAL ANESTHESIA: CASE REPORT (누난 증후군(Noonan syndrome) 환자의 전신마취 하 치과치료 : 증례보고)

  • Seo, Meekyung;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.37-42
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    • 2017
  • Noonan syndrome is a relatively common genetic disorder which is autosomal dominant. Prevalence of Noonan syndrome is varying from 0.04% to 0.1%. It is characterized by distinctive facial features, chest deformity, short stature and congenital heart disease. Oral findings in patient with Noonan syndrome include high arched palate, dental malocclusion, articulation difficulties, and micrognathia. The purpose of this case report is to describe dental treatment of a children with Noonan syndrome. 5 year old boy with Noonan syndrome visited to the Seoul National University Dental Hospital for dental treatment. Due to need for close monitoring, concern about seizure and poor cooperation, we planned to perform the dental treatment under general anesthesia. Under general anesthesia, caries treatment was successfully performed and there was no postoperative complications related to general anesthesia. High arched palate was observed which is characteristic in Noonan syndrome.

Surgical indication analysis according to bony defect size in pediatric orbital wall fractures

  • Kim, Seung Hyun;Choi, Jun Ho;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.276-282
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    • 2020
  • Background: Orbital fractures are the most common pediatric facial fractures. Treatment is conservative due to the anatomical differences that make children more resilient to severe displacement or orbital volume change than adults. Although rarely, extensive fractures may result in enophthalmos, causing cosmetic problems. We aimed to establish criteria for extensive fractures that may result in enophthalmos. Methods: We retrospectively reviewed the charts of patients aged 0-15 years diagnosed with orbital fractures in our hospital from January 2010 to February 2019. Computed tomography images were used to classify the fractures into linear, trapdoor, and open-door types, and to estimate the defect size. Data on enophthalmos severity (Hertel exophthalmometry results) and fracture pattern and size at the time of injury were obtained from patients who did not undergo surgery during the follow-up and were used to identify the surgical indications for pediatric orbital fractures. Results: A total of 305 pediatric patients with pure orbital fractures were included-257 males (84.3%), 48 females (15.7%); mean age, 12.01±2.99 years. The defect size (p=0.002) and fracture type (p=0.017) were identified as the variables affecting the enophthalmometric difference between the eyes of non-operated patients. In the linear regression analysis, the variable affecting the fracture size was open-door type fracture (p<0.001). Pearson's correlation analysis demonstrated a positive correlation between the enophthalmometric difference and the bony defect size (p=0.003). Using receiver operating characteristic curve analysis, a cutoff value of 1.81 ㎠ was obtained (sensitivity, 0.543; specificity, 0.724; p=0.002). Conclusion: The incidence of enophthalmos in pediatric pure orbital fractures was found to increase with fracture size, with an even higher incidence when open-door type fracture was a cofactor. In clinical settings, pediatric orbital fractures larger than 1.81 ㎠ may be considered as extensive fractures that can result in enophthalmos and consequent cosmetic problems.

A CLINICAL STUDY ON THE CONGENITALLY MISSING TEETH IN MESIODENS CASES (상악 정중 과잉치 증례 중 선천 결손치 발생에 관한 임상적 고찰)

  • Kwon, Min-Seok;Jung, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.574-578
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    • 2002
  • Mesiodens is developmental tooth anomaly which is commonly found in clinical pediatric dentistry. however, it may cause many partial problem in tooth alignment when congenitally missing teeth was accompanied by mesiodens. The terms, concomitant hypodontia and hyperdontia' and oligo-pleiodontia' have been used to describe the condition in witch developmental absence of teeth and supernumerary teeth are present in the same individual. Only a few case reports of this rare condition which is opposite developmental phenomena exist in the literature. The purpose of this study is survey of congenitally missing teeth in mesiodens case and to compare previous literature of congenitally missing teeth in normal. The subjects were 310 children(247 male and 63 female) at the age from 5 to 12 years visiting the Department of Pediatric Dentistry, Pusan National University Hospital with mesiodens for last 3 years. With their pantomograms we studied congenitally missing teeth except permanent 3rd molar. 1. The preference of congenitally missing teeth in mesiodens cases was revealed to be 17.1%(53 out of 310 in total), and there was a higher prevalence in females(22.2%) than in males(15.8%). 2. The most frequently missing teeth were maxillary lateral incisors(22.7%) and mandibular second premolars(22.7%), followed by maxillary second premolar(17.3%), and mandibular lateral incisors(16.0%). There was no significant differences between maxilla(49.3%) and mandible(50.7%). 3. In number of congenitally missing teeth per person, 69.9% had one missing tooth, 22.7% had two missing teeth and 9.4% had three missing teeth.

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SUPERNUMERARY TEETH IN MANDIBULAR INCISOR REGION (하악 절치부에 발생한 과잉치)

  • Mah, Yon-Joo;Lee, Jae-Ho;Song, Je-Seon;Choi, Byung-Jai;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.580-585
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    • 2009
  • Pediatric dentists often meet children with abnormal in number of tooth. Presence of supernumerary teeth is frequent cause of malocclusion. Etiology for supernumerary teeth is not yet clearly defined, but it is thought to be caused by excessive proliferation of dental lamina by hereditary and environmental factors. Supernumerary teeth occur in the maxilla nine times more frequently than in the mandible. Most common supernumerary tooth is the mesiodens in the maxilla, and some are observed in the maxillary molar and mandibular premolar. It occurs rarely in the mandibular incisor region with the incidence of 1-2% among all supernumerary teeth. A six-year old boy visited the department of the pediatric dentistry, Yonsei University Dental Hospital, with the chief complaint of crowded supernumerary teeth on the mandibular incisor region. Clinical and radiographic examinations revealed six permanent mandibular incisors similar in size, shape, and length. Further investigation using computed tomography(CT) was proceeded on the mandible to measure and compare morphologic features and positions of the six incisors. Then, we decided to remove two incisors which were already erupted. Periodic check-up was followed to monitor the dental development and spontaneous positional enhancement of the remaining four incisors in the mandible.

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