• 제목/요약/키워드: Juvenile Idiopathic

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소아 특발성 관절염의 한약치료에 대한 문헌 고찰 (Literature Review of Clinical Studies for Herbal Medicine Treatment on Juvenile Idiopathic Arthritis (JIA))

  • 김미연;정민정
    • 대한한방소아과학회지
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    • 제32권4호
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    • pp.24-41
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    • 2018
  • Objectives The purpose of this study is to investigate the clinical studies on the effect of herbal medicine in JIA and to seek better approach of herbal medicine to treat JIA. Methods This study researched randomized controlled trials through various databases in the world about herbal medicine treatments in JIA. Results 11 out of 414 studies were selected and analyzed. All studies were conducted in China. Most of the studies were using herbal medicines, as an adjunctive treatment to the main regimen, and the total effective rate was higher in the treatment group than in the control group. One study was comparing the herbal oriental medicine treatment to the western medicine treatment, and it showed that treatment group was more effective than control group. 5 out of 11 studies reported treatment cases from a single herbal medicine; most of them used Total glucosides of Paeonia (TGP). Clematidis Radix et Rhizoma (威靈仙) were also commonly used, as well as medicinal herbs belong to Eliminating wind-dampness medicine (祛風濕藥) and Activating blood resolving stasis medicine (活血祛瘀藥). Conclusions Based on this study, herbal medicines for JIA treatment will be effective even if used alone or in conjunction with other medicines. To apply clinically, further studies are needed.

Can Breast Asymmetry Following the Treatment of Juvenile Idiopathic Scoliosis with Growing Rod Be Prevented? : A Preliminary Analysis

  • Atici, Yunus;Polat, Baris;Erdogan, Sinan;Gurpinar, Tahsin;Demiroz, Serdar
    • Journal of Korean Neurosurgical Society
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    • 제63권2호
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    • pp.228-236
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    • 2020
  • Objective : It can be assumed that the progression of scoliosis in the juvenile period will increase the asymmetry in the rib cage, and thus will contribute to an increase in the breast asymmetry (BA) in the future. We are looking for answers to the questions; "How will the breasts look with respect to each other and what is the possibility of developing BA in the early follow-up period following the early surgical treatment and final fusion surgery of juvenile idiopathic scoliosis (JIS)?" For this reason, in this study, we aimed to evaluate the breast asymmetries of patients in the period after the final fusion. Methods : Following growing rod treatment, final fusion was achieved in 12 females with JIS. We used the anthropomorphic measurement of the modified BREAST-V formula to assess whether there was an asymmetry between the breasts after an average of 4.8 years (2-11) following final fusion. Results : In comparison, the mean volume of the left breast (222.4 mL [range, 104.1-330.2]) was larger than the mean volume of the right breast volume (214.5 mL [range, 95.2-326.7]) (p=0.034). The left breast was larger in 75% of the patients. BA was observed in 50% of the patients. No correlation was detected between the Cobb angle of the patient after final fusion and BA (p=0.688). Conclusion : In the late follow-up period, BA was detected in 50% of the patients with JIS who achieved final fusion after treatment with growing rod. In majority of the patients, left breast was larger. The patients with JIS and their families can be informed prior to the operation about the probability of BA seen in the follow-up period after fusion.

Diagnosis and Management of Suspected Case of Early Rheumatoid Arthritis in the Temporomandibular Joint: A Case Report

  • Tae-Seok Kim;Yeon-Hee Lee
    • Journal of Oral Medicine and Pain
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    • 제48권1호
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    • pp.31-36
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    • 2023
  • This report presents the case of a 14-year-old male with rheumatoid arthritis (RA) in both temporomandibular joints (TMJs), in whom a bone scan and laboratory tests were used to confirm the diagnosis. The patient visited the Department of Orofacial Pain and Oral Medicine at the affiliation hospital with a complaint of a 1-year history of bilateral TMJ pain and sound. Clinical examination revealed bilateral TMJ and masseter muscle pain during mouth opening and palpation. Radiological examination revealed no significant morphological changes in either TMJ. The patient was prescribed medications at the first visit to address the pain, inflammation, and stiffness. A bone scan and laboratory tests were planned/scheduled for differential diagnosis between simple arthralgia and osteoarthritis. The bone scan revealed increased radiotracer uptake in both TMJs. The laboratory tests revealed a RA factor of 82.4 IU/mL, which is more than four times the normal range. The final diagnoses were bilateral TMJ early rheumatoid arthritis (ERA) and juvenile idiopathic arthritis. We created a stabilization splint and referred the patient to the Department of Rheumatology for further evaluation of the ERA. After fitting of the stabilization splint and giving instructions regarding its use, the patient has been receiving monthly follow-up checks for symptoms and undergoes follow-up blood tests every 3 months. About 14 months after the initial visit, the pain had significantly decreased from a Visual Analog Scale score of 5 to 1, and the RA factor decreased to 66.6 IU/mL. A regular follow-up check will continue until the end of growth.

방사선 간접검사를 이용한 청소년의 척추 측만증에 관한 연구 (A Survey Study of the Juvenile Idiopathic Scoliosis Using Radiation Indirect Examination)

  • 김기복;정홍량
    • 대한방사선기술학회지:방사선기술과학
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    • 제28권4호
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    • pp.327-332
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    • 2005
  • 본 연구는 초등학생, 중학생, 고등학생 및 대학생 등 청소년 2,787명을 대상으로 100 mm Mirror Camera을 이용하여 Cobb's Angle이 $10^{\circ}$이상인 특발성 척추 측만증 이상자의 유병율을 성별과 연령별로 분석하였다. 연구 결과 Cobb's Angle이 $10^{\circ}$이상으로 특발성 척추 측만증인 자는 전체 2.787명 중 257명(9.2%)이었으며, 13세 이하(초등학생)가 132명, 16세 이하(중학생)가 52명, 18세 이하(고등학생)가 35명, 19세 이상(대학생)이 38명이었고, 연령 따른 1차 검사에서의 $x^2-test$ 분석결과 유의성이 없는 것으로 나타났으며, Cobb's Angle이 $10^{\circ}$이상인 대상자들의 측만발생 부위는 흉-요추부 147명(57.2%), 흉추부 81명(31.5%), 경-흉추부위 20명(7.8%), 요추부위 7명(2.7%), 경추부위 2명(0.8%)으로 흉-요추부위에서 가장 많은 빈도를 보였으며, 측만방향으로는 우측 183명(71.2%)으로 좌측 74명(28.8%)보다 높게 나타났다. 척추 측만증이 $10^{\circ}$이상인 대상자 중에서 주요 호소 부위는 느끼지 못함이 219명이었으며, 요추부위 18명, 경추부위 9명, 흉추부위 7명, 견부부위 2명, 골반부위와 온몸이 다 아프다고 한 대상자는 각각 1명으로 총 257명이었고, 척추 측만증이 있는 자와 대상자의 주요 호소증상간의 분산분석의 결과는 유의성이 있는 것으로 나타났다.

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소아기 특발성 관절염 환자에서 관절 내 종양형태로 나타난 쌀소체: 증례 보고 (Rice Bodies Presenting as Intra-Articular Masses in Pediatric Idiopathic Arthritis: A Case Report)

  • 김동현;이지혜;정명자;김성희;김지영;김수현;강미진
    • 대한영상의학회지
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    • 제84권3호
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    • pp.731-735
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    • 2023
  • 쌀소체는 성인 류마티스 관절염 환자에서 종종 발생하나 소아의 경우에는 성인에 비해 드물게 발생한다. 저자들은 무릎 통증으로 내원한 11세 여자 환자의 무릎 자기공명영상에서 관절강 내 종괴를 발견하였고 관절경 검사에서 뭉쳐진 쌀소체들을 확인하였다. 소아에서 관절강 내 종괴 형태로 나타난 쌀소체의 자기공명영상 소견을 보고하고자 한다.

복잡한 사고에 의해 유발되는 간질발작 2예 (Two Patients with Epilepsy Induced by Complex Thinking)

  • 김재문;이경목;손은희;정기영
    • Annals of Clinical Neurophysiology
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    • 제2권1호
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    • pp.27-30
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    • 2000
  • Reflex epilepsies are distinct but not clearly understood clinical entity. Various cerebral activities induced by simple stimulation including visual, auditory, somatosensory stimulation, as well as diverse functional tasks such as reading, calculation, complex thinking are believed to be seizure-inducing factors. We experienced two patients whose seizures were readily precipitated by complex, strenuous thinking. Both patients was teen-aged boy at the onset of seizure(13, and 15 years of age each) with normal physical and mental growth. Although first seizure was precipitated by watching TV and playing puzzles in each patient, initial diagnosis was idiopathic generalized epilepsy, possibly juvenile myoclonic epilepsy( JME). For the first few years, seizures were infrequent but mostly precipitated by the tasks needs concentration such as playing computer games, decision-making, mathematics, reading, or during the examination. EEG revealed various thinking process including reading hard books, drawing complex figure, complex calculation induced epileptic discharges even if it usually needs certain period of concentration. Phenytoin, valproic acid, clonazepam, vigabatrin, and lamotrigine sometimes abated their seizures but none of these made them seizure-free. Complex reflex epilepsy induced by thinking was proposed to be a separate type of epilepsy or a variant of JME. Age, sex, stereotypic seizure-inducing factors, clinical course, and refractory epilepsies in these patients highly suggested this type of epilepsy as a variant of JME but its refractoriness and unique provocation still needs more speculation.

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한방소아과학회지에 출판된 임상연구논문에 대한 분석 (Trend Analysis of Clinical Studies Published in the Journal of Pediatrics of Korean Medicine)

  • 양두화;박장경;성현경;성수현
    • 대한한방소아과학회지
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    • 제32권4호
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    • pp.141-162
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    • 2018
  • Objectives The purpose of this study is to provide evidence of traditional Korean medicine treatment in children and adolescents by reviewing previous studies published in the journal of pediatrics of Korean medicine. Methods We have reviewed clinical studies of children and adolescents in the journal of pediatrics of Korean medicine from 2008 to 2017. Results Eighty-seven clinical studies of children and adolescents were reviewed. Total number of patients were 1644 in the studies. Among these, top 5 most commonly reported diseases in children and adolescents were atopic dermatitis, growth, autism, juvenile idiopathic arthritis and obesity. The most common intervention to treat those was taking herbal medicine. Most of the clinical studies showed effectiveness of this approach in treating children and adolescents. Conclusions More double-blinded randomized controlled clinical trials of Korean medicine interventions treating children and adolescents are needed to establish evidence-based treatment.

소아 근골격계 감염성 질환 및 염증성 질환의 영상 소견 (Imaging Findings in Pediatric Musculoskeletal Infection and Inflammation)

  • 김지영
    • 대한영상의학회지
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    • 제85권3호
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    • pp.520-530
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    • 2024
  • 소아 환자의 아직 미성숙한 근골격계 감염 및 염증성 질환은 뼈 뿐만 아니라 인접한 근육을 포함한 연조직 및 관절에 영향을 미친다. 빠른 진단을 통한 적절한 치료가 후유증 발생 여부나 질환에 의한 이환율 및 사망률에 큰 영향을 끼칠 수 있다. 소아 환자의 근골격계 감염 및 염증성 질환의 영상 소견에 익숙해진다면, 보다 빠른 진단을 가능하게 할 뿐 아니라 및 치료의 적절성 평가에도 도움을 줄 수 있을 것이다. 이 논문에서는 소아의 미성숙한 근골격계의 해부학적 특징을 포함한 병리 생리학적 특징을 설명하고, 이를 바탕으로 하여 골수염, 연조직 감염 및 비감염성 염증성 관절 질환의 영상 소견을 소개하고자 한다.

Development and Validation of MRI-Based Radiomics Models for Diagnosing Juvenile Myoclonic Epilepsy

  • Kyung Min Kim;Heewon Hwang;Beomseok Sohn;Kisung Park;Kyunghwa Han;Sung Soo Ahn;Wonwoo Lee;Min Kyung Chu;Kyoung Heo;Seung-Koo Lee
    • Korean Journal of Radiology
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    • 제23권12호
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    • pp.1281-1289
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    • 2022
  • Objective: Radiomic modeling using multiple regions of interest in MRI of the brain to diagnose juvenile myoclonic epilepsy (JME) has not yet been investigated. This study aimed to develop and validate radiomics prediction models to distinguish patients with JME from healthy controls (HCs), and to evaluate the feasibility of a radiomics approach using MRI for diagnosing JME. Materials and Methods: A total of 97 JME patients (25.6 ± 8.5 years; female, 45.5%) and 32 HCs (28.9 ± 11.4 years; female, 50.0%) were randomly split (7:3 ratio) into a training (n = 90) and a test set (n = 39) group. Radiomic features were extracted from 22 regions of interest in the brain using the T1-weighted MRI based on clinical evidence. Predictive models were trained using seven modeling methods, including a light gradient boosting machine, support vector classifier, random forest, logistic regression, extreme gradient boosting, gradient boosting machine, and decision tree, with radiomics features in the training set. The performance of the models was validated and compared to the test set. The model with the highest area under the receiver operating curve (AUROC) was chosen, and important features in the model were identified. Results: The seven tested radiomics models, including light gradient boosting machine, support vector classifier, random forest, logistic regression, extreme gradient boosting, gradient boosting machine, and decision tree, showed AUROC values of 0.817, 0.807, 0.783, 0.779, 0.767, 0.762, and 0.672, respectively. The light gradient boosting machine with the highest AUROC, albeit without statistically significant differences from the other models in pairwise comparisons, had accuracy, precision, recall, and F1 scores of 0.795, 0.818, 0.931, and 0.871, respectively. Radiomic features, including the putamen and ventral diencephalon, were ranked as the most important for suggesting JME. Conclusion: Radiomic models using MRI were able to differentiate JME from HCs.

KiSS-1 : 포유동물 생식계에서의 새로운 신경펩타이드 (KiSS-1 : A Novel Neuropeptide in Mammalian Reproductive System)

  • 이성호;최돈찬
    • 한국발생생물학회지:발생과생식
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    • 제9권1호
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    • pp.1-5
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    • 2005
  • 시상하부-뇌하수체-생식소(HPG) 호르몬 축은 유아기와 아동기에는 작동하지 않다가 사춘기 개시 직전에 활성화되는 흥분성 및 억제성 신호들의 복잡한 중추성 조절 네트워크에 의해 조절된다. 최근 주목받고 있는 kisspeptin은 KiSS-1 유전자의 펩타이드 산물로, 최초 orphan receptor로 클로닝된 G protein-coupled receptor 54(GPR54)의 내인성 리간드이다. KiSS-l은 본래 종양전이억제 유전자로 알려졌으나, 최근의 연구들은 KiSS-1/GPR54 시스템이 생식계의 주요한 조절자임을 시사하고 있다. 비록 생식 관련 호르몬 분비의 신경내분비적 조절에서 KiSS-1/GPR54 시스템의 정확한 역할은 아직 자세히 모르지만, 이 시스템은 생식호르몬 축에서의 일차적인 연결 고리일 수 있다. 중추적(icv) 또는 말초적(sc 또는 ip)으로 kisspeptin을 주사할 경우 시상하부-뇌하수체-생식소 축이 자극되어 혈중 LH 수준이 증가함이 설치류, 양, 원숭이 그리고 인간을 대상으로 한 실험들에서 관찰되었다. 이러한 kisspeptin의 효과는 시상하부 GnRH 신경계를 경유하여 나타나는 것으로 보이지만, 뇌하수체 전엽에 직접 작용할 수도 있다. GPR54 녹아웃 생쥐에서는 사춘기 개시의 소실과 생식소자극호르몬 저하성 생식소 기능저하증(hypogonadotropic hypogonadism, HH)이 나타났다. 따라서 kisspeptin 주사는 인간의 생식계 이상을 치료하기 위한 HPG 축을 활성화시키는 치료에 응용할 수 있을 것이다.

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