• Title/Summary/Keyword: Response Criteria

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A STUDY ON COMORBID DISORDERS AND ASSOCIATED SYMPTOMS OF PERVASIVE DEVELOPMENTAL DISORDER CHILDREN (전반적 발달장애 아동들의 공존질환 및 동반증상에 대한 연구)

  • Kwak, Young-Sook;Kang, Kyung-Mee;Cho, Seong-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.64-75
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    • 1999
  • Objective:The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method:The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result:The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion:These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.

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The Basic Data Analysis of Lupus Nephritis in Children (소아 루프스 신염에 대한 기초 조사)

  • Min Jae Hong;Paek Kyung Hoon;Park Kyung Mi;Kim Jung Sue;Ha Il Soo;Cheong Hae Il;Kim Joong Gon;Choi Yong
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.80-87
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    • 1999
  • Purposes : Renal involvement is a potentially serious complication of systemic lupus erythematosus (SLE). There have been only few studies of lupus nephritis in pediatric age. In this study, the clinical manifestations, pathologic findings, response to treatment, and clinical course of lupus nephritis in children were analyzed. And the results will provide basic data for future nation-wide prospective multi-center study. Methods . The medical records of 46 children clinically and pathologically diagnosed to have lupus nephritis at Seoul National University Children's Hospital during 1986 to 1997 were analyzed retrospectively. Results : 1) The median age of diagnosis of lupus nephritis was 12.8 years ($2\;years\~\;15year$ 8months), and the sex ratio was 1:2.5. 2) FANA($85.7\%$), anti-ds-DNA antibody ($78.0\%$), and malar rash ($60.8\%$) were the most common findings among the classification criteria by ARA Decreased C3 was detected in $88.9\%$ of patients. 3) Hematuria ($87.0\%$) was the most common renal symptom, and WHO class IV lupus nephritis was identified in 41 cases by renal biopsy. 4) In most of patients, the disease activity was controlled relatively well with a single or combined therapy of prednisolone, azathioprine, or cyclophosphamide. The response revealed no difference according to the mode of treatment. 5) Infection, especially of Varicella-Zoster virus and candida, was the most common complication during the disease course. Conclusion : The renal involvement was noted in $87.0\%$ of childhood SLE, and $89.1\%$ of renal lesions was WHO class IV lupus nephritis known to associated with poor long-term prognosis. So, aggressive treatment using immunosuppressants in the early disease course may be helpful to increase long-term prognosis of lupus nephritis. A prospective multi-center study is necessary to analyze the therapeutic efficacy of various treatment modalities.

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The Short Term Efficacy of Entecavir Therapy in Chronic Hepatitis B (만성 B형 간염 환자에서 엔테카비어의 단기 치료 효과)

  • Kim, Hyun;Chae, Hee-Bok;Jeon, Won-Joong;Park, Seon-Mee;Youn, Sei-Jin;Eun, Jong-Ryul;Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.31-40
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    • 2008
  • Background/Aims : Entecavir is a synthetic nucleoside analogue, cyclopentyl guanine nucleoside, which has a potent antiviral effect and the least viral breakthrough in hepatitis B virus (HBV) replication. Entecavir has been available in Korea since 2007 but there are few reports on its effects. The aim of this study was to evaluate the virological response (VR) and biochemical response (BR) to entecavir in HBV patients at 3, 6 and 9 months after treatment with entecavir. Materials and Methods : Thirty-three chronic hepatitis B patients who took entecavir for at least 9 months were enrolled. We investigated VR and BR by retrospectively reviewing medical records. Patients who satisfied the following criteria were chosen: 1) initial alanine aminotransferase (ALT) levels = 1.5upper limit of normal (ULN) and 2) initial HBV DNA levels = $5\;log_{10}\;copies/ml$. We measured ALT levels every 3 months until month 9. HBV DNA was measured every 2 or 3 months by polymerase chain reaction (PCR) method. Results : Most patients taking entecavir showed good BR (ALT < 40 IU/L). The BR rates were 61%, 73% and 67% at months 3, 6 and 9, respectively. VR (HBV DNA < $5\;log_{10}\;copies/ml$ or 2 log lower than initial HBV DNA) rates were 82%, 91% and 91% at months 3, 6 and 9, respectively. Undetectable HBV DNA (HBV DNA < 4 log10 copies/ml) rates were 49%, 73% and 85% at months 3, 6 and 9, respectively. Two patients presented with virological breakthrough without adverse effects until month 9. Conclusions : Entecavir showed good BR and VR from month 3 and these effects continued through the 9-month observation period. This suggests that entecavir is also a good choice for the first line treatment of chronic hepatitis B (CHB). Further studies are needed to determine the long-term efficacy and drug resistance of entecavir in Korean CHB patients.

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Combined Transcatheter Arterial Chemoembolization and Local Radiotherapy for Unresectable Hepatocellular Carcinoma (절제불가능 원발성 간암에서 경간동맥 항암 색전술과 국소 방사선의 병용요법)

  • Seong Jinsil;Keum Ki Chang;Han Kwang Hyub;Lee Do Yun;Lee Jong Tae;Chon Chae Yoon;Moon Young Myoung;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.159-165
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    • 1998
  • Purpose : The best prognosis for hepatocellular carcinoma can be achieved with surgical resection. However, the number of resected cases is limited due to the advanced lesion or associated liver disease. A trial of combined transcatheter arterial chemoembolization(TACE) and local radiotherapy(RT) for unresectable hepatocellular carcinoma(HCC) was prospectively conducted and its efficacy and toxicity were investigated. Materials and Methods : From 1992 to 1994, 30 Patients with unresectable HCC due either to advanced lesion or to associated cirrhosis were entered in the study Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child's class C, tumors occupying more than two-thirds of the whole liver, and an ECOG scale of more than 3. Patient cHaracteristics were : mean tumor size $8.95\pm3.4cm$, serum AFP+ in all patients, portal vein thrombosis in all patients, liver cirrhosis in 22 patients, and UICC stage III and IVA in 10 and 20 patients, respectively. TACE was performed with the mixture of Lipiodol(5ml) and Adriamycin(50mg) and Gelfoam embolizatin. RT(mean dose $44.0\pm9.3Gy$) 10 days with conventional fractionation. Results : An objective response was observed in 19 patients($63.3\%$). Survival rates at 1 2, and 3 years were $67\%,\;33.3\%$ and $22.2\%$, respectively. Median survival was 17 months. There were 6 patients surviving more than 3 years. Distant metastasis occurred in 10 patients, with 8 in the lung only and 2 in both lung and bone, Toxicity included transient elevation of liver function test in all patients, fever in 20, thrombocytopenia in 4, and nausea and vomiting in 1. There was no treatment-related death. Conclusion : Combined TACE and RT appear to produce a favorable response and survival results with minimal toxicity.

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Efficacy of the Antibiotics Chosen by ATS Guideline in the Treatment of Korean Patients with Community-acquired Pneumonia Admitted to a Tertiary Hospital (3차 병원에 입원한 한국 지역사회획득 폐렴 환자에서 미국흉부학회 추천 항생제의 유용성)

  • Oh, Sung-Yong;Park, Sang-Joon;Kang, Kyeong-Woo;Koh, Young-Min;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Choi, Dong-Chull;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.460-470
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    • 1999
  • Background : In 1993, American Thoracic Society (ATS) recommended a guideline for the initial management of adults with community-acquired pneumonia(CAP). However, etiologic organisms and medical system in Korea seem to be different from those in Western countries. Retrospective analysis was done to evaluate the efficacy of antibiotics chosen by ATS guideline in the treatment of Korean patients with CAP admitted to a tertiary university medical center. Methods : Hospitalized patients with CAP at Samsung Medical Center from April 1997 through March 1998 were retrospectively reviewed. Patients who fulfilled all of the following criteria were included in this study : (1) fever ${\geq}38^{\circ}C$ (2) purulent sputum (3) pulmonary infiltrates on chest X-ray. Patients were classified as : 1) ATS group ; patients whose initial antibiotics were chosen by ATS guideline 2) Non-ATS overuse group ; additional antibiotics administered more than those of ATS guideline, and 3) Non-ATS underuse group ; initial antibiotics were insufficient to ATS guideline. Response of empirical antibiotics and etiologic organisms of 3 groups were identified. Results : Sixty-four patients were enrolled. Thirty-six patients were classified into ATS group, 10 patients Non-ATS overuse group, and 18 patients Non-ATS underuse group. Thirty-three patients of 36 ATS group, 9 patients of 10 Non-ATS overuse group, and 14 patients of 18 Non-ATS underuse group showed improvement by initial empirical antibiotics. There was no statistical difference in antibiotic response between 3 groups (p>0.05). S. pneumoniae (12.5%), K. pneumoniae (9.4%), and P. aeruginosa (4.7%), Mycoplasma (3.1%) were the most commonly isolated organisms. In 18 patients with severe CAP, P. aeruginosa was isolated only in 1 patient and Legionella organism not isolated. Conclusion : Initial empirical antibiotics chosen by ATS guideline were effective in the management of Korean patients with CAP admitted to a tertiary hospital. However, well-designed large-scale prospective study is needed to identify etiologic organisms and choose an adequate initial empirical antibiotics in Korean adults patient with severe CAP.

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The Relation of Bipolar Tendency with Type A Behavior Pattern, Perceived Stress, and Lifestyle:Comparison between Mood Disorder Questionnaire Positive and Negative Respondents (양극성 경향과 스트레스 취약성:기분장애설문지 양성 반응군과 음성 반응군에서 지각된 스트레스, A형 행동, 그리고 생활습관의 비교)

  • Kim, Byung-Su;Kim, Seong-Yoon;Choe, Jae-Won;Joo, Yeon-Ho;Yoon, Dae-Hyun;Han, Nae-Jin;Kim, Yoo-Shin;Kim, Seon-Ok
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.1
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    • pp.19-29
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    • 2010
  • Objectives:Authors hypothesized that bipolar tendency of non-psychiatric person would be associated with stress vulnerability. To test the hypothesis, we compared perceived stress level, Type A Behavioral Pattern (TABP) and unhealthy lifestyle between person with and without bipolar tendency. Methods:The study cohort consisted of 1987 subjects without past and current psychiatric history. In this study, bipolar tendency was determined by MDQ response which requires endorsement of at least 7 of the 13 "yes or no" questions. We compared the scores of Perceived Stress Scale, A/B lifestyle questionnaire, and unhealthy lifestyle(alcohol, smoking, lack of exercise, irregular meal) between MDQ positive and negative respondents. Results:We identified the bipolar tendency group determined by the MDQ positive response were 329 subjects(16.6%). The overall score of the bipolar tendency group was significantly high on the A/B lifestyle questionnaire compared to the non-bipolar tendency group(125.4 vs. 115.9, p<0.001), and the rate of the subjects defined as TABP was also significantly high(41.3% vs. 30.1%, p<0.001). In comparison of subjectively perceived stress level, the bipolar tendency group was observed to be significantly higher than the non-bipolar tendency group (18.5% vs. 16.5%, p<0.001). The bipolar tendency group was significantly higher than the non-bipolar tendency group on the rate of answering:'irregular eating habit' (20.1% vs. 14.3%, p=0.002), '4-or-more-times alcohol intake per week' (29.8% vs. 16.5%, p<0.001), 'currently smoking' (41.9% vs. 23.0%, p<0.001), '2-or-less-times physical exercises per week' (63.2% vs. 55.1%, p=0.007). Conclusion:By clinical diagnosis, even a person who does not meet the criteria of bipolar disorder has a high risk of stress-related behavioral pattern, and perceived stress when possessing bipolar tendencies such as the (hypo) maniac tendency or affective instability. Such individual has significantly higher risk of having unhealthy life-style such as smoking, drinking, irregular eating habit and lack of exercise compared to non-bipolar tendency group. Since these risk factors lead to increase the risk of obesity, metabolic syndrome, diabetes, and cardiovascular diseases, the individual with the bipolar tendency requires a more effort to manage stress and to maintain healthy lifestyle.

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A Study on Institutional Reliability of Open Record Information in the Information Disclosure System (정보공개제도에서 공개 기록정보의 제도적 신뢰성에 관한 연구)

  • Lee, Bo-ram;Lee, Young-hak
    • The Korean Journal of Archival Studies
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    • no.35
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    • pp.41-91
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    • 2013
  • There have been numerous steps of growth in policy system since the legal systemization through the enactment of Information Disclosure of public institution Act in 1996 and Records Management of public institution Act in 1999 as well as infrastructure advancement led by government bodies, but it still shows insufficiency in some aspects of information disclosure system and records management. In particular, the issue of reliability on record information disclosed through information disclosure system is raised, and institutional base through the legal and technical devices to ensure the reliability are not well prepared. Government has attempted to enact laws and regulations to guarantee the public right to know through information disclosure and records management at government level, and establish the national system in a way that advances the infrastructure for encouraging the participation in state affairs and utilization of national record information resources. There are limitations that it lacks internal stability and overlooks the impact and significance of record information itself by focusing upon system expansion and disclosing information quantatively. Numerous record information disclosed tends to be falsified, forged, extracted or manufactured by information disclosure staffs, or provided in a form other than official document or draft. In addition, the disclosure or non-disclosure decisions without consistency and criteria due to lack of information disclosure staff or titular supervising authority, which is likely to lead to societal confusion. There are also frequent cases where the reliability is damaged due to voluntary decision, false response or non response depending upon request agents for information disclosure. In other cases, vague request by information disclosure applicant or civil complaint form request are likely to hinder the reliability of record information. Thus it is essential to ensure the reliability of record information by establishing and amending relevant laws and regulations, systemic improvement through organizational and staff expertise advancement, supplementing the information disclosure system and process, and changing the social perception on information disclosure. That is, reliable record information is expected to contribute to genuine governance form administration as well as accountability of government bodies and public organizations. In conclusion, there are needed numerous attempts to ensure the reliability of record information to be disclosure in the future beyond previous trials of perceiving record information as records systematically and focusing upon disclosing more information and external development of system.

Setting Criteria of Suitable Site for Southern-type Garlic Using Non-linear Regression Model (비선형회귀 분석을 통한 난지형 마늘의 적지기준 설정연구)

  • Choi, Won Jun;Kim, Yong Seok;Shim, Kyo Moon;Hur, Jina;Jo, Sera;Kang, Mingu
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.23 no.4
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    • pp.366-373
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    • 2021
  • This study attempted to establish a field data-based write analysis standard by analyzing field observation data, which is non-linear data of southern garlic. Five regions, including Goheung, Namhae, Sinan, Changnyeong, and Haenam, were selected for analysis. Observation values for each observation station were extracted from the temperature data of farmland in the region through inverse distance weighted. Southern-type garlic production and temperature data were collected for 10 years, from 2010 to 2019. Local regression analysis (Kernel) of the obtained data was performed, and growth temperatures were analyzed, such as 0.8 (18.781℃), 0.9 (18.930℃), 1.0 (19.542℃), 1.1 (20.165℃), and 1.2 (21.042℃) depending on the bandwidth. The analyzed optimum temperature and the grown temperature (4℃/25℃) were applied to extract the growth temperature for each temperature by using the temperature response model analysis. Regression analysis and correlation analysis were performed between the analyzed growth temperature and production data. The coefficient of determination(R2) was analyzed as 0.325 to 0.438, and in the correlation analysis, the correlation coefficient of 0.57 to 0.66 was analyzed at the significance probability 0.001 level. Overall, as the bandwidth increased, the coefficient of determination was higher. However, in all analyses except bandwidth 1.0, it was analyzed that all variables were not used due to bias. The purpose of this study is to accommodate all data through non-linear data. It was analyzed that bandwidth 1.0 with a high coefficient of determination while accepting modeling as a whole is the most suitable.

An Analytical Study on the Seismic Behavior and Safety of Vertical Hydrogen Storage Vessels Under the Earthquakes (지진 시 수직형 수소 저장용기의 거동 특성 분석 및 안전성에 관한 해석적 연구)

  • Sang-Moon Lee;Young-Jun Bae;Woo-Young Jung
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.27 no.6
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    • pp.152-161
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    • 2023
  • In general, large-capacity hydrogen storage vessels, typically in the form of vertical cylindrical vessels, are constructed using steel materials. These vessels are anchored to foundation slabs that are specially designed to suit the environmental conditions. This anchoring method involves pre-installed anchors on top of the concrete foundation slab. However, it's important to note that such a design can result in concentrated stresses at the anchoring points when external forces, such as seismic events, are at play. This may lead to potential structural damage due to anchor and concrete damage. For this reason, in this study, it selected an vertical hydrogen storage vessel based on site observations and created a 3D finite element model. Artificial seismic motions made following the procedures specified in ICC-ES AC 156, as well as domestic recorded earthquakes with a magnitude greater than 5.0, were applied to analyze the structural behavior and performance of the target structures. Conducting experiments on a structure built to actual scale would be ideal, but due to practical constraints, it proved challenging to execute. Therefore, it opted for an analytical approach to assess the safety of the target structure. Regarding the structural response characteristics, the acceleration induced by seismic motion was observed to amplify by approximately ten times compared to the input seismic motions. Additionally, there was a tendency for a decrease in amplification as the response acceleration was transmitted to the point where the centre of gravity is located. For the vulnerable components, specifically the sub-system (support columns and anchorages), the stress levels were found to satisfy the allowable stress criteria. However, the concrete's tensile strength exhibited only about a 5% margin of safety compared to the allowable stress. This indicates the need for mitigation strategies in addressing these concerns. Based on the research findings presented in this paper, it is anticipated that predictable load information for the design of storage vessels required for future shaking table tests will be provided.

Combined Chemotherapy and Radiation Therapy in Limited Disease Small-Cell Lung Cancer (국한성 소세포 폐암에서 항암 화학 및 흉부 방사선치료의 병합요법 적응)

  • Kim Moon Kyung;Ahn Yong Chan;Park Keunchil;Lim Do Hoon;Huh Seung Jae;Kim Dae Yong;Shin Kyung Hwan;Lee Kyu Chan;Kwon O Jung
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.9-15
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    • 1999
  • Purpose : This is a retrospective study to evaluate the response rate, acute toxicity, and survival rate of a combined chemotherapy and radiation therapy in limited disease small cell lung cancer, Materials and Methods : Firty-six patients with limited disease small-cell lung cancer who underwent combined chemotherapy and radiation therapy between October 1994 and April 1998 were evaluated. Six cycles of chemotherapy were planned either using a VIP regimen etoposide, ifosfamide, and cis-platin) or a EP regimen (etoposide and cis-platin). Thoracic radiation therapy was planned to deli- ver 44 Gy using 1 OMV X-ray, starting concurrently with chemotherapy. Response was evaluated 4 weeks after the completion of the planned chemotherapy and radiation therapy, and the prophylaetic cranial irradiation was planned only for the patients with complete responses. Acute toxicity was evaluated using the SWOG toxicity criteria, and the overall survival and disease-free survival were calculated using the Kaplan-Meier Method. Results : The median follow-up period was 16 months (range:2 to 41 months). Complete response was achieved En 30 (65$\%$) patients, of which 22 patients received prophylactic cranial irradiations. Acute toxicities over grade III were granulocytopenia in 23 (50$\%$), anemia in 17 (37$\%$), thrombo- cytopenia in nine (20$\%$), alopecia in nine (20$\%$), nausea/vomiting in five (11$\%$), and peripheral neuropathy in one (2$\%$). Chemotherapy was delayed in one patient, and the chemotherapy doses were reduced in 58 (24$\%$) out of the total 246 cycles. No radiation esophagitis over grade 111 was observed, while interruption during radiation therapy for a mean of 8.3 days occurred in 21 patients. The local recurrences were observed in 8 patients and local progressions were in 6 patients, and the distant metastases in 17 patients. Among these, four patients had both the local relapse and the distant metastasis. Brain was the most common metastatic site (10 patients), followed by the liver as the next common site (4 patients). The overall and progression-free survival rates were 79$\%$ and 55$\%$ in 1 year, and 45'/) and 32% in 2 years, respectively, and the median survival was 23 months. Conclusion : Relatively satisfactory local control and suwival rates were achieved after the combined chemotherapy and radiation therapy with mild to moderate acute morbidities in limited disease small cell lung cancer.

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