• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권2호
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• pp.142-151
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• 2019

Purpose: The aim of the study was to identify factors related to the recurrence of intussusception in pediatric patients. Methods: The medical charts of patients diagnosed with intussusception and treated at Dongsan Medical Center, between March 2015 to June 2017, were retrospectively reviewed. Univariate and multivariate analyses were performed. Results: Among 137 patients, 23 patients (16.8%) had a recurrent intussusception and 8 of these patients (6%) had more than 2 episodes of recurrence. The age at diagnosis was significantly different between the non-recurrence and recurrence group (p=0.026), with age >1 year at the time of diagnosis associated with a greater rate of recurrence (p=0.002). The time interval from symptom onset to the initial reduction (<48 vs. ${\geq}48$ hours) was significantly longer in the recurrence group (p=0.034) and patients in the recurrence group had higher levels of C-reactive protein (CRP) (p=0.024). Bloody stools and a history of infection were significantly more frequent in the non-recurrence group (p=0.001 and p<0.001, respectively). On stepwise regression analysis, age >1 year at the time of presentation (odds ratio [OR], 4.79; 95% confidence interval [CI], 1.56-14.06; p=0.016) and no history of infection (OR, 0.18; 95% CI, 0.06-0.58; p=0.004) were retained as predictors of recurrence. Conclusion: Patients with intussusception who are older than 1 year at diagnosis, have an elevated CRP level, a delay of ${\geq}48$ hours between symptom onset and the initial reduction, an absence of bloody stools, and no history of infection should be closely monitoring for symptoms and signs of a possible recurrence.

• 스마트미디어저널
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• 제11권5호
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• pp.26-37
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• 2022

본 논문에서는 시설재배 작물 중 딸기의 초기 병해를 방제하고자 이미지를 자동으로 취득하고, EfficientNet 모델을 활용해 병해를 분석하여 농민에게 병해 여부를 알려주고, 전문가를 통한 병해 진단 서비스를 제안한다. 딸기 생육단계의 이미지를 취득하고, 학습된 EfficientNet 모델을 활용해 병해 진단 분석결과를 농민의 애플리케이션으로 전송 후 전문가의 피드백을 신속하게 받을 수 있다. 데이터 세트로는 실제 시설재배를 운영하는 농민을 섭외하여 시스템을 이용해 이미지를 취득하였고, 핸드폰으로 촬영한 이미지의 초안을 활용하여 데이터가 부족한 문제를 해결했다. 실험 결과 EfficientNet B0부터 B7까지의 정확도는 유사하여 추론 속도가 가장 빠른 B0를 채택했다. 성능향상을 위해 ImageNet으로 사전학습 된 모델을 사용해 Fine-tuning 했고, 100 Epoch부터 급격한 성능향상을 확인했다. 제안하는 서비스는 초기 병해를 빠르게 탐지하여 생산량을 증대시킬 것으로 기대한다.

• Journal of Oral Medicine and Pain
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• 제20권1호
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• pp.195-204
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• 1995

The purpose of this study was to evaluate effect of head posture change on initial occlusal contacts through measuring the distances between initial occlusal contacts and maximum intercuspal position at different head posture. Two special devices were designed and constructed. Mandibular movement replicator was used to assess reliability of the K6 diagnostic system(MKG; Myo-tronic Inc, Seatle, USA) and head posture calibrator was used to maintain the constant head posture during experiment. We measured difference of distance between initial occlusal contact and maximum intercuspal position with MKG in upright, supine, 45 degrees extension, 30 degrees flexion, 30 degrees right and left bending postion of the head. The Frankfurt horizontal plane was used as a reference plane. 21 adults aged from 23 to 25 were selected, who have normal or class I molar relationship, and have no symptoms on TMJ and masticatory muscles, and have restorations less than 3 surfaces on each tooth, and have no other prosthetic restoration. The obtained results were as follows : The mean absolute distances between initial occlusal contact and maximum intercuspal postion were 0.39(0.18mm in the upright position, 0.65(0.37mm in the supine position, 0.59(0.33mm in the 45 degree extension, 0.70(0.53mm in the 30 degrees flexion, 1.12(1.10mm in the 30 degrees right bending and 1.94(0.67mm in the 30 degrees left bending of the head. The positions of the initial occlusal contacts have a tendency to locate anterior, left and inferior to maximal intercuspal position in upright position, posterior and inferior in supine position and 45 degrees extension, anterior and inferior in 30 degrees flexion, right and inferior in 30 degrees right bending, and left and inferior in 30 degrees left bending of the head. There were significant differences among the initial occlusal contacts in each head postures(P<0.0001). Therefore, we need to check initial occlusal contacts in the altered head posture during occlusal analysis and adjustment of occlusal appliance and dental occlusion for diagnosis and treatment of temporomandibular disorder.

• 대한불안의학회지
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• 제2권2호
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• pp.108-114
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• 2006

Objectives : Only a few prospective studies of panic disorder are available. This study investigated naturalistic outcome of panic disorder patients at twelve months after the initial diagnosis. Methods : A total of 84 subjects were diagnosed with panic disorder by diagnostic interview, Structured Clinical Interview for DSM-IV (SCID-IV) and Anxiety Disorder Interview Schedule for DSM-IV (ADISIV). Among them, 80 subjects could be evaluated by means of Panic Disorder Severity Scale (PDSS) at follow-up interview after twelve months. Treatment continuation was also examined at follow-up interview. Results : At initial intake, 80 patients were classified into 22% with mild, 33% with moderate-to-marked, and 45% with severe symptoms on the basis of their PDSS total score. At twelve months, 20% of patients reached remission, 65% had mild and 15% had moderate-to-marked symptoms. Initial panic symptom severity, presence of agoraphobia, panic symptom duration before diagnosis, number of comorbid Axis I disorders were associated with significantly higher PDSS total score at twelve months. Forty six percent of total patients continued medication and 23% have stopped treatment by clinician's recommendation and 31% have selfdiscontinued their medication. At twelve months, all three groups were improved but self-discontinuation group had significantly higher PDSS total score. Conclusion : In the one-year naturalistic outcome study of panic disorder patients, high percentage of patients achieved remission or had mild symptoms.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1101-1106
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• 2013

Background: Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Carboplatin, a platinum-derived agent, is used as neoadjuvant chemotherapy for pediatric osteosarcoma because of its anti-tumor activity and had low toxicity as compared to cisplatin. Objective: To determine demographic data, prognostic factors and outcome of childhood osteosarcoma treated with a carboplatin-based chemotherapeutic protocol at Chiang Mai University. Method: A retrospective analysis was conducted on 34 osteosarcoma patients aged less than 18 years and treated between 2003 and 2011. Results: Overall limb-salvage and amputation rates were 23.5% and 70.6%, respectively. With the mean follow-up time of 29.5 months (1.5-108.9), the Kaplan-Meier analysis for 3-year disease-free survival (DFS) and 3-year overall survival (OS) were $20.2{\pm}7.7%$ and $47.1{\pm}9.5%$ respectively. Patients who had initial pulmonary metastasis were at significantly greater risk for developing recurrence (p=0.02, OR=7; 1.2-40.1) and had a tendency to have lower 3-year OS compared to those without initial pulmonary metastasis ($28.1{\pm}13%$, $63.1{\pm}12.3%$, respectively, p=0.202). On univariate analysis, age at diagnosis >14 years and patients who were declined surgery were significantly associated with lower 3-year OS (p=0.008 and <0.05, respectively). However, age at diagnosis, sex, tumor size and histological subtypes were not found to significantly affect recurrence or survival. Conclusions: In our study, the survival rate was far lower than those reported from developed countries. These might indicate the ineffectiveness of carboplatin in combination with doxorubicin as frontline treatment of pediatric osteosarcoma, especially in those with initial pulmonary metastasis. Refinement in risk and treatment stratification and dose intensification for pediatric osteosarcoma constitutes a future challenge to improve outcomes, especially in metastatic patients who may need a more intensive regimen.

• Journal of Korean Neurosurgical Society
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• 제64권3호
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• pp.460-468
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• 2021

Objective : Extremely low alanine transaminase (ALT) levels are associated with all-cause mortality in frail elderly individuals; the clinical significance of ALT as a reliable biomarker is now being considered. Predicting mortality with routine tests at the time of diagnosis is important for managing patients after intracranial hemorrhage. We aimed to investigate whether an extremely low ALT level is associated with mortality in the elderly after intracranial hemorrhage. Methods : A retrospective review was performed on 455 patients with intracranial hemorrhage admitted to a university-affiliated tertiary care hospital from February 2014 to May 2019. Multivariate Cox regression analysis was performed for all ages and for each age group to determine whether an extremely low ALT level is an independent predictor of mortality only in the elderly. Results : Overall, 294 patients were enrolled, and the mean age of the subjects was 59.1 years, with 99 (33.8%) aged ≥65 years. The variables associated with all-cause mortality in all subjects were age, C-reactive protein (CRP) levels, hemoglobin (Hb) levels (<11 g/dL), and initial Glasgow coma scale (GCS) scores. In young patients, CRP, low Hb levels, and initial GCS scores were significantly associated with all-cause mortality. However, in the elderly (≥65 years), the variables significantly associated with all-cause mortality were extremely low levels of ALT (<10 U/L) (adjusted hazard ratio, 3.313; 95% confidence interval, 1.232-8.909; p=0.018) and initial GCS scores. Conclusion : Extremely low ALT level (<10 U/L) at the time of diagnosis is a significant risk factor for all-cause mortality in the elderly after intracranial hemorrhage.

• The Journal of Korean Physical Therapy
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• 제13권1호
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• pp.33-40
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• 2001

Objectives: This study was to identify the effect of physical therapy and related factors on depression in stroke patients. Methods: Questionnaires were completed by 46 stroke patients at physical therapy room in Busan Dongeui Medical Center from September 1999 to April 2001. The self·rating depression scale(SDS)was used to assess the differences for depression score in patients who had suffered a stroke. The design of this study was follow-up study between initial physical therapy and one month after initial. Results: A little decreased score(-0.17) was seen in patients treated with physical therapy in difference of depress between initial physical therapy and one month after initial, but there was no significant difference. In gender, male had -0.42 decreased score, female. on the contrary, had +0.09 increased score. Depress score for 50 years group was decreased(-2.08), but below 50 years and above 60 were increased in age (+1.25 and +0.27, respectively). There were no significant difference in weight, educational level, religion, side of paresis, and diabetes. Significant variables related to difference of depress in multiple regression analysis were weight(p=0.0082)and diagnosis(cerebral infarction, hemorrhage)(p=0.0473, R2=0.4241). Conclusions: This study was indicated that the more weight was a higher, the higher difference of depress score was. Difference of hemorrhage patients was smaller than that of infarction patients.

• 치과방사선
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• 제15권1호
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• pp.41-49
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• 1985

The purpose of this study was to evaluate the initial and postoperative radiographic features of the endodontic treated teeth. The author examined the radiographs which comprise 114 teeth with 155 canals of 64 persons. The following factors were considered; Age, sex, tooth location, number of root canals, postoperative periods, initial diagnosis, and radiographic findings, postoperative radiographic findings. The apical levels of the root fillings were 76.8% to apex, 19.0% underfilling, 3.9% overfilling. The following results were obtained. 1. Of the 93 teeth which revealed initial periapical rarefaction, 66 teeth (71.0%) had showed complete bone healing, 19 teeth (20.4%) decreased rarefaction, 6 teeth (6.5%) no change, 2 teeth (2.2%) increased rarefaction after 20.0 months mean healing time. 2. 21 teeth which had no initial periapical rarefaction showed no occurrence of new periapical rarefaction. 3. Of the 66 teeth completely healed, 53 teeth (80.3%) had showed reappearance of lamina dura, 64 teeth (97.0%) reappearance of periodontal ligament space after 23.4 months mean healing time.

• 대한두경부종양학회지
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• 제18권2호
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• pp.168-172
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• 2002

Objectives: This study was done to determine the diagnostic efficacy of fine needle aspiration cytology (FNA), frozen section biopsy (FSx) and ultrasonography in a palpable thyroid mass. Materials and Methods: During the period from July 1999 to March 2002, the medical records of 98 patients who underwent a thyroidectomy for thyroid mass, at the Department of Surgery, Chonbuk National University Hospital, were reviewed retrospectively. Ninety eight cases were classified according to whether the FNA cytological diagnosis inadequate, benign, suspicious, or malignant and the FSx diagnosis benign or malignant and the ultrasonographic examination was benign, suspicious, or malignant. The diagnostic correlations of ultrasonography, FNA cytology, frozen section, and both FNA cytology and frozen section with definite histologic diagnosis were evaluated. Results: According to the FNA cytological interpretation, 76 cases were diagnosed as benign, 6 cases suspicious, 13 cases malignant, and 3 cases inadequate. The sensitivity and specificity for FNA were 86.3% and 95.9% and for FSx 95.5% and 100% respectively. The diagnostic accuracy of FNA and FSx were 93.5% and 98.9% respectively. Based on a definite histologic diagnosis, the ultrasonographic examination had a sensitivity and a specificity of 77.2% and 78.9%. Conclusion: The results confirm that FNA cytology is a reliable and useful tool in the initial evaluation of a palpable thyroid mass compared to the ultrasonographic examination. Intraoperative FSx is a valuable diagnostic procedure to confirm the cytological diagnosis with undetermined or unsatisfactory cytological diagnosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권3호
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• pp.178-184
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• 2013

Purpose: The clinical presentations of inflammatory bowel disease (IBD) prior to diagnosis are so diverse or vague that many of them waste time before final diagnosis. This study was undertaken to know the medical history of the pediatric patients until the final diagnosis could be reached. Methods: The medical records of all pediatric patients who were diagnosed with IBD (Crohn's disease [CD] in 14 children, ulcerative colitis [UC] in 17) during the last 13 years were reviewed. We investigated the length of the diagnostic time lag, chief clinical presentation, and any useful laboratory predictor among the routinely performed examinations. Indeterminate colitis was not included. Results: The mean ages of children at the final diagnosis was similar in both diseases. As for the pre-clinical past history of bowel symptoms in CD patients, 5 were previously healthy, 9 had had 1-3 gastrointestinal (GI) symptoms, weight loss, bloody stool, anemia and rectal prolapse. With UC, 9 were previously healthy, 8 had had 1-3 GI symptoms, bloody stool, anorexia. The average diagnostic time lag with CD was 3.36 months, and with UC 2.2 months. Body mass index (BMI) and the initial basic laboratory data (white blood cell, hemoglobin, mean corpuscular volume, serum albumin, and serum total protein) were lower in CD, statistically significant only in BMI. Conclusion: IBD shows diverse clinical symptoms before its classical features, making the patients waste time until diagnosis. It is important to concern possibility of IBD even in the mildly sick children who do not show the characteristic symptoms of IBD.