• Childhood Kidney Diseases
• /
• v.19 no.1
• /
• pp.1-7
• /
• 2015

Coexisting voiding and bowel dysfunction in children are common in the clinic. The idea that overactive bladder (OAB) and constipation arise from one single pathophysiology has been reinforced in many studies. In Korea, a nationwide multicenter study conducted in 2009 showed that overall prevalence of OAB in children, 5-13 years of age, was 16.59% and this number has increased more recently. The initial step to manage coexisting fecal retention and OAB in children is to characterize their bowel and bladder habits and to treat constipation if present. Although diagnosing constipation in children is difficult, careful history-taking using the Bristol Stool Form Scale, and a scoring system of plain abdominal radiography, can help to estimate fecal retention more easily and promptly. Non-pharmacological approaches to manage functional constipation include increasing fluids, fiber intake, and physical activity. Several osmotic laxatives are also effective in improving OAB symptoms and fecal retention. Additionally, correction and education in relation to toilet training is the most important measure in treating OAB with fecal retention.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.11 no.sup1
• /
• pp.44-54
• /
• 2008

Chronic functional constipation is a common problem in childhood, with soiling a significant issue. It presents a management problem for pediatrician, and parental concern is high. About 5% of pediatric patients is known to have constipation and/or encopresis which is the second most referred disease in pediatric gastroenterology clinic, accounting for up to 25% of all visits. The etiology of constipation was based on initiation factors including vicious cycle concept, genetic factors, psychological factors, dietary influences and histologic abnormalities of colon. Emphasis is placed on the evaluation and management options that are available to the treating pediatrician. Careful history taking is most important to diagnose functional constipation. In addition, diagnostic tests such as plain abdominal radiograph, colonic transit study, anorectal manometry, barium enema were helpful to diagnose the constipation. Childhood constipation can be very delicate to treat. It often requires prolonged supports by physicians and parents, demystification, medical treatment and especially with the child and parent's cooperation.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.21 no.4
• /
• pp.361-364
• /
• 2018

Accessory hepatic lobe is noted as and considered a rare disease in children. It can manifest with various symptoms and complications depending on the location, volume, type and position of the disease as presented on a child. The patient presented as a 14-month-old girl who was seen with a notable hepatosplenomegaly and portal hypertension. A diagnosis was made after taking an extensive medical history, observation and radiological examinations. The formal diagnosis was a prehepatic portal hypertension associated with accessory hepatic lobe.

• Journal of Genetic Medicine
• /
• v.18 no.2
• /
• pp.132-136
• /
• 2021

Maturity-onset diabetes of the young (MODY) is caused by autosomal dominant pathogenic variants in one of 14 currently known monogenic genes. Characteristics of patients with MODY include early-onset clinical disease with a family history of diabetes and negative autoantibodies and may present with heterogeneous phenotypes according to the different subtypes. Here, we report a patient with early-onset diabetes who presented asymptomatic mild fasting hyperglycemia with the absence of autoantibodies. She was diagnosed with glucokinase (GCK)-MODY caused by a GCK variant, c.1289T>C (p.L430P), identified by targeted gene-panel testing, and the affected father had the same variant. We interpreted this rare missense variant as a likely pathogenic variant and then she stopped taking oral medication. This case highlights the usefulness of gene-panel testing for accurate diagnosis and appropriate management of MODY. We also note the importance of familial genetic testing and genetic counseling for the proper interpretation of MODY variants.

• Proceedings of the Korea Information Processing Society Conference
• /
• 2022.11a
• /
• pp.411-413
• /
• 2022

임상 환경에서 진료시간의 대부분은 환자의 증상을 듣고, 추가 증상을 이끌어내는데 사용된다. 이를 병력 청취라고 하며, 진료에 있어서 가장 기본적이고 필수적인 활동이다. 하지만 병력 청취에 대한 연구가 1940 년대부터 계속되고 있음에도 아직까지 표준이 정립되지 않았으며, 다양한 분야에 접목되는 딥러닝 기술 또한 병력 청취와 관련해서는 연구가 부족한 현실이다. 본 논문에서는 Symptom2Vec 을 새롭게 제안하였으며, 이를 활용하여 질병에 따른 증상의 평균 cosine 유사도 점수(0.962)로 병력 청취의 기준을 확립하였다. 또한 most similar word Top5 를 확인하는 것을 통해 환자의 증상에 따른 유사 증상을 묻는 병력 청취가 가능한 것을 확인하였다. 이를 통해 실제 임상 환경에서의 자동화된 병력 청취 시스템을 제안한다.

• Childhood Kidney Diseases
• /
• v.11 no.2
• /
• pp.264-271
• /
• 2007

Purpose : It is important to take a precise history of patients to diagnose enuresis. However, this is difficult to perform in the outpatient department, because the consultation time is limited. So by taking the medical histories with questionnaires, we classified the enuresis patients into monosymptomatic and non-monosymptomatic groups and compared the clinical characteristics between the two groups in order to determine whether this would aid in the diagnosis and treatment of enuresis. Methods : Thirty-four enuresis patients seen in the Department of Pediatrics at Yeungnam University Hospital from 2004 January to 2005 July were enrolled in this study. Two to three weeks before starting medical treatment, questionnaires about the patients' urination habits and past medical history were taken from the Parents with consents. Results : There were 21 patients in the monosymptomatic group and 13 patients in the non-monosymptomatic group. There was no difference in the delivery mode, birth weight, birth order, sleep habit, constipation, and treatment results between the two groups. Urinary infection was more frequently observed in the non-monosymptomatic group. There was a higher incidence of daytime incontinence and a past medical history of allergy in the non-monosymptomatic group. Oriental medicine was the most common treatment of enuresis before visiting the hospital, but the treatment effect was minimal. Conclusion : Comparison between the monosymptomatic and non-monosymptomatic group with the questionnaires was helpful for detailed diagnosis and treatment of enuresis. A more effective education for enuresis patients is needed, since before visiting the hospital many of them wasted their efforts with ineffective oriental medicine treatment. (J Korean Soc Pediatr Nephrol 2007;11:264-271)

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.13 no.2
• /
• pp.120-125
• /
• 2013

Purpose: McCune-Albright syndrome (MAS) is caused by activating mutations in the GNAS gene, resulting in peripheral precocious puberty, caf$\acute{e}$-au-lait spots, and polyostotic fibrous dysplasia (POFD). The aim of the present study was to describe the diverse clinical and endocrine characteristics of patients with MAS. Methods: Seven patients with MAS were included in this study and medical charts were reviewed retrospectively for following parameters: patient's sex and age at diagnosis, POFD, ovarian cysts, and precocious puberty. Results: The mean age at diagnosis was $5.8{\pm}4.2$ years. One patient was male (14%) and the other six patients were female (86%). Peripheral precocious puberty was associated with 6 patients (86%). Five patients manifested premature menarche as early as 2 to 5 years of age. Letrozole was administered to 4 patients, tamoxifen to one patient and GnRH agonist to one patient. Five females developed ovarian cysts. Thyroid function tests were performed in all patients and one patient showed hyperthyroidism (14%) and has been treated with methimazole. One patient presented with pseudohypoparathyroisdism, phosphaturia, calciuria suggesting hypophosphatemic rickets. Six patients (86%) revealed POFD. One patient had symptoms of optic nerve compression and secondary esotropia and 2 patients had bone pain. Conclusion: This study described clinical characteristics and endocrine complications of patients with MAS. Careful physical examinations with history taking and serial endocrine function tests should be needed to detect complications such as endocrinologic hyperfunction and POFD.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.42 no.4
• /
• pp.193-204
• /
• 2016

Objectives: This study examined the statistical relevance of whether the systemic predisposing factors affect the prognosis of surgical treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). All cases had undergone bone biopsies to determine the characteristics of the mechanisms of BRONJ by optical microscopy. Materials and Methods: The data included 54 BRONJ cases who underwent surgery and in whom bone biopsies were performed. The results of surgery were evaluated and the results were classified into 3 categories: normal recovery, delayed recovery, and recurrence after surgery. The medical history, such as diabetes mellitus, medication of steroids, malignancies on other sites was investigated for an evaluation of the systemic predisposing factors in relation to the prognosis. The three factors involved with the medication of bisphosphonate (BP) were the medication route, medication period, and drug holiday of BP before surgery. The serum C-terminal cross-linking telopeptide (CTX) value and presence of microorganism colony in bone biopsy specimens were also checked. Statistical analysis was then carried out to determine the relationship between these factors and the results of surgery. Results: The group of patients suffering from diabetes and on steroids tended to show poorer results after surgery. Parenteral medication of BP made the patients have a poorer prognosis after surgery than oral medication. In contrast, the medication period and drug holiday of BP before surgery did not have significance with the results of surgery nor did the serum CTX value and presence of microorganism colony. Necrotic bone specimens in this study typically showed disappearing new bone formation around the osteocytic lacunae and destroyed Howship's lacunae. Conclusion: Although many variables exist, this study could in part, predict the prognosis of surgical treatment of BRONJ by taking the patient's medical history.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.8
• /
• pp.3635-3640
• /
• 2014

Aim: To determine whether induced abortion (IA) increases breast cancer (BC) risk. Materials and Methods: A population-based case-control study was performed from Dec, 2000 to November, 2004 in Shanghai, China, where IA could be verified through the family planning network and client medical records. Structured questionnaires were completed by 1,517 cases with primary invasive epithelial breast cancer and 1,573 controls frequency-matched to cases for age group. The information was supplemented and verified by the family planning records. Statistical analysis was conducted with SAS 9.0. Results: After adjusting for potential confounders, induced abortions were not found to be associated with breast cancer with OR=0.94 (95%CI= 0.79-1.11). Compared to parous women without induced abortion, parous women with 3 or more times induced abortion (OR=0.66, 95%CI=0.46 to 0.95) and women with 3 or more times induced abortion after the first live birth (OR=0.66, 95%CI =0.45 to 0.97) showed a lower risk of breast cancer, after adjustment for age, level of education, annual income per capita, age at menarche, menopause, parity times, spontaneous abortion, age at first live birth, breast-feeding, oral contraceptives, hormones drug, breast disease, BMI, drinking alcohol, drinking tea, taking vitamin/calcium tablet, physical activity, vocation, history of breast cancer, eating the bean. Conclusions: The results suggest that a history of induced abortions may not increase the risk of breast cancer.

• Korean Journal of Acupuncture
• /
• v.32 no.2
• /
• pp.41-50
• /
• 2015

Objectives : In this study we investigated characteristics of eight extra meridians based on the chapter of Pyoung Gi Kyoung Pal Maek Byoung(PGKPMB) of the Pulse Classic(Maijing; PC) and the 27, 28, and $29^{th}$ question of the Classic of Difficult Issues(Nanjing; CDI). Methods : We searched out the contents of eight extra meridians in historical background, the principal and circulation of eight extra meridians, and the symptoms and pulse diagnosis of eight extra meridians on the PGKPMB of the PC and the 27, 28, and $29^{th}$ question of the CDI. Results and Conclusions : About development of eight extra meridians, content which was scattered in the CDI was supplemented and developed in the CDI. Also taking over the content in the CDI, the meaning of the eight extra meridians was expanded and supplemented in the PC. In the PC, the mechanism about symptom of eight extra meridians especially has been described. Also materialization of symptom which linked to pathogenic pulse of eight extra meridians had a great impact on future generation.