• 제목/요약/키워드: School-age follow-up

검색결과 854건 처리시간 0.031초

Sex-specific differences in the association of a common aldehyde dehydrogenase 2 gene polymorphism and alcohol consumption with stroke risk in a Korean population: a prospective cohort study

  • Shin, Chol;Kwack, KyuBum;Cho, Nam H.;Kim, Seong Hwan;Baik, Inkyung
    • Nutrition Research and Practice
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    • 제9권1호
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    • pp.79-86
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    • 2015
  • BACKGROUND/OBJECTIVES: It is well-known that alcohol consumption is associated with stroke risk as well as with aldehyde dehydrogenase 2 gene (ALDH2) polymorphisms. However, it is unclear whether ALDH2 polymorphisms are associated with stroke risk independent of alcohol consumption and whether such association is modified by sex. We evaluated sex-specific associations of a common ALDH2 polymorphism and alcohol consumption with stroke risk in a Korean population. SUBJECTS/METHODS: We conducted a prospective cohort study involving 8,465 men and women, aged 40-69 years and free of stroke between June, 2001 and January, 2003, and followed for the development of stroke. We identified new cases of stroke, which were self-reported or ascertained from vital registration data. Based on genome-wide association data, we selected a single-nucleotide polymorphism (rs2074356), which shows high linkage disequilibrium with the functional polymorphism of ALDH2. We conducted Cox proportional hazards regression analysis considering potential risk factors collected from a baseline questionnaire. RESULTS: Over the median follow-up of 8 years, 121 cases of stroke were identified. Carrying the wild-type allele of the ALDH2 polymorphism increased stroke risk among men. The multivariate hazard ratio [95% confidence interval] of stroke was 2.02 [1.03-3.99] for the wild-type allele compared with the mutant alleles, but the association was attenuated after controlling for alcohol consumption. Combinations of the wild-type allele and other risk factors of stroke, such as old age, diabetes mellitus, and habitual snoring, synergistically increased the risk among men. Among women, however, the ALDH2 polymorphism was not associated with stroke risk. CONCLUSIONS: The prospective cohort study showed a significant association between a common ALDH2 polymorphism and stroke risk in Korean men, but not in Korean women, and also demonstrated that men with genetic disadvantages gain more risk when having risk factors of stroke. Thus, these men may need to make more concerted efforts to control modifiable risk factors of stroke.

Efficacy of Antiepileptic Drug on the Benign Childhood Epilepsy with Centro-Temporal Spikes (중심-측두엽 극파를 보이는 양성 소아 간질 환자에서 항경련제 투여의 유효성)

  • Oh, Mee Hye;Kim, Soo Young;Seo, Won Hee;Pee, Dae Hun;Choi, Byung Min;Eun, Baik-Lin
    • Clinical and Experimental Pediatrics
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    • 제46권9호
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    • pp.893-897
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    • 2003
  • Purpose : Benign childhood epilepsy with centrotemporal spikes(BECT) is characterized by an excellent prognosis. Therefore, the necessity for the use of antiepileptic drugs is controversial. The object of this study is to know about the long-term follow-up of BECT, comparing daily treatment with antiepileptic drug(AED) versus no medication. Methods : We retrospectively studied 56 cases of BECTs, examined at Pediatric Neurology Clinic, Korea University Medical Center as reference study time, August 2002. Thirty-eight patients didn't have mediation(group I), while eighteen patients received one or two AED(group II). We evaluated demographics, clinical manifestations at diagnosis, EEG findings and clinical courses in groups I & II. Results : There was no significant differences of sex, age, seizure frequency, seizure type, seizure onset time, family history and EEG findings between group I & II. The reasons to start AED were : parents' anxiety(three cases), frequent seizure(12 cases) and daytime seizure(three cases). There was no evolution of status epilepticus and no difficulty in school performance. Conclusion : AED treatment was of no advantage and long-term prognosis was good regardless of treatment strategy. So it is advisable not to choose AED as the first line of therapy, provided that the patient himself/herself or the family understands the benign nature of BECT.

Repeat Stereotactic Radiosurgery for Recurred Metastatic Brain Tumors

  • Kim, In-Young;Jung, Shin;Jung, Tae-Young;Moon, Kyung-Sub;Jang, Woo-Youl;Park, Jae-Young;Song, Tae-Wook;Lim, Sa-Hoe
    • Journal of Korean Neurosurgical Society
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    • 제61권5호
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    • pp.633-639
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    • 2018
  • Objective : We investigated the outcomes of repeat stereotactic radiosurgery (SRS) for metastatic brain tumors that locally recurred despite previous SRS, focusing on the tumor control. Methods : A total of 114 patients with 176 locally recurring metastatic brain tumors underwent repeat SRS after previous SRS. The mean age was 59.4 years (range, 33 to 85), and there were 68 male and 46 female patients. The primary cancer types were non-small cell lung cancer (n=67), small cell lung cancer (n=12), gastrointestinal tract cancer (n=15), breast cancer (n=10), and others (n=10). The number of patients with a single recurring metastasis was 95 (79.8%), and another 19 had multiple recurrences. At the time of the repeat SRS, the mean volume of the locally recurring tumors was 5.94 mL (range, 0.42 to 29.94). We prescribed a mean margin dose of 17.04 Gy (range, 12 to 24) to the isodose line at the tumor border primarily using a 50% isodose line. Results : After the repeat SRS, we obtained clinical and magnetic resonance imaging follow-up data for 84 patients (73.7%) with a total of 108 tumors. The tumor control rate was 53.5% (58 of the 108), and the median and mean progression-free survival (PFS) periods were 246 and 383 days, respectively. The prognostic factors that were significantly related to better tumor control were prescription radiation dose of 16 Gy (p=0.000) and tumor volume less than both 4 mL (p=0.001) and 10 mL at the repeat SRS (p=0.008). The overall survival (OS) periods for all 114 patients after repeat SRS varied from 1 to 56 months, and median and mean OS periods were 229 and 404 days after the repeat SRS, respectively. The main cause of death was systemic problems including pulmonary dysfunction (n=58, 51%), and the identified direct or suspected brain-related death rate was around 20%. Conclusion : The tumor control following repeat SRS for locally recurring metastatic brain tumors after a previous SRS is relatively lower than that for primary SRS. However, both low tumor volume and high prescription radiation dose were significantly related to the tumor control following repeat SRS for these tumors after previous SRS, which is a general understanding of primary SRS for metastatic brain tumors.

Spirituality and Stress in Mental Health Social Workers (정신보건사회복지사의 영성과 스트레스)

  • Kim, Chang-Gon
    • Journal of Hospice and Palliative Care
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    • 제16권4호
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    • pp.253-263
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    • 2013
  • Purpose: This study was conducted to analyze the association between spirituality and stress of mental health social workers, which could be used in development of a program to help them manage stress and offer spiritual support. Methods: Participants were 154 mental health social workers in Korea. Data were collected from November 1 through November 30, 2011. The study employed the Korean version of the Spirituality Scale and Psychosocial Well-being Index-Short Form (PWI-SF). Data were analyzed using SPSS/Windows 17.0. Results: The mean score for the Spirituality Scale was 3.63 and for PWI-SF 18.78. Spirituality scores showed a significant difference among participants by age, education, religion and marital status. Psychosocial stress scores also significantly differed by marital status. Spirituality scores were negatively correlated with psychosocial stress scores (r=-0.548, P<0.001). Conclusion: In this study, a significant negative association was found between spirituality and stress in mental health social workers in Korea. A follow-up study with a larger sample of participants is needed to confirm these findings.

Protocol of a Nationwide Observational Study among Patients with Nontuberculous Mycobacterium Pulmonary Disease in South Korea (NTM-KOREA)

  • Kwak, Nakwon;Choi, Hongjo;Jeon, Doosoo;Jhun, Byung Woo;Jo, Kyung-Wook;Kang, Young Ae;Kwon, Yong-Soo;Lee, Myungsun;Mok, Jeongha;Shim, Tae-Sun;Shin, Hong-Joon;Whang, Jake;Yim, Jae-Joon
    • Tuberculosis and Respiratory Diseases
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    • 제83권2호
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    • pp.141-146
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    • 2020
  • Background: The burden of nontuberculous mycobacterial (NTM) pulmonary disease (PD) is increasing globally. To understand the treatment outcomes and prognosis of NTM-PD, a unified registry is needed. In this project, we aim to construct a multicenter prospective observational cohort with NTM-PD in South Korea (NTM-KOREA). Methods: The primary objective of this study is to analyze treatment outcomes according to the species. In addition, recurrence rate, adverse events, the impact of each drug on treatment outcomes as well as the impact of characteristics of mycobacteriology will be analyzed. The inclusion criteria for the study are as follows: fulfilling the criteria for NTM-PD having one of the following etiologic organisms: Mycobacterium avium complex, M. abscessus subspecies abscessus, M. abscessus subspecies massiliense, or M. kansasii; receiving the first treatment for NTM-PD after enrollment; age >20 years; and consenting to participate in the study. Seven institutions will participate in patient enrollment and about 500 patients are expected to be enrolled. Participants will be recruited from 1 March 2020 until 19 March 2024 and will be observed through 19 March 2029. During the follow-up period, participants' clinical course will be tracked and their clinical data as well as NTM isolates will be collected. Conclusion: NTM-KOREA will be the first nationwide observational cohort for NTM-PD in South Korea. It will provide the information to optimize treatment modalities and will contribute to deeper understanding of the treatment outcomes and long-term prognosis of patients with NTM-PD in South Korea.

A Study on the Reduction of Patient's Exposure Dose according to the Arrival Time of Contrast Media in Abdominal CT Scan using Bolus Tracking Technique (Bolus tracking 기법을 이용한 복부 CT 검사 시 조영제 도달시간에 따른 환자 피폭선량 감소에 관한 연구)

  • Lee, Seung yong;Han, Dong kyoon
    • Journal of the Korean Society of Radiology
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    • 제15권2호
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    • pp.93-100
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    • 2021
  • The purpose of this study is to find out the factors that affect the patient's exposure dose during the abdominal CT scan using the bolus tracking technique, and reducing the radiation exposure to the patient during the abdominal CT scan using the bolus tracking technique by adjusting the delay time according to the corresponding factor. The experiment was divided into two parts, and the first experiment was conducted with 300 patients There were 188 males and 112 females, and their average age was 58±12.18(19~85). In the second experiment, 150 subjects (100 males and 50 females) who were undergoing their follow-up examination among the first experiment subjects, and the difference in dose before and after was compared by applying the delay time according to the influencing factor. As a result of the first experiment, there was a relationship between the arrival time of the contrast media and the heart rate, and it was found that the arrival time decreased as the heart rate increased for both men and women. As a result of the second experiment, the average dose of CTDIvol and DLP before/after applying the delay time according to the heart rate decreased 4.98 mGy and 5.33 mGy·cm in the male group, and 3.54 mGy and 3.88 mGy·cm in the female group. By applying proper delay time according to the patient's heart rate during abdominal CT scan with the bolus tracking technique, the radiation exposure dose of the patient can be reduced.

A Study on the Application of Visual Special Effects to TV Dramas; Focus on , (시각특수효과의 드라마 적용사례에 관한 연구 -<태양의 후예>,<미스터션샤인>을 중심으로-)

  • Chung, Tae-Sub
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제20권3호
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    • pp.400-406
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    • 2019
  • This study will explore the reenactment of visual special effects used in TV dramas. The subjects of the study are images that are reproduced in visual special effects through and . Accordingly, we looked at the changes in the way TV dramas were produced according to the times, and looked at the changes in the market. Also, we looked at cases of visual special effects of Korean dramas, and looked at expressions according to the degree of completion of visual special effects. For the purpose of the analysis of the research targets, the images of reproducibility and the flow through reality were analyzed. In the case of , the period setting is realistic, but visual special effects were used to maximize the actor's safety and expression, and in the case of , the visual effects were used to maximize the aesthetic of the period background. In addition, it can be seen that the visual special effects were used for the effect of PPL on the export of images. This shows that the emphasis of reality and image montage techniques are being used to pursue hyperrealism. It is now possible to actively express and use the beauty of TV dramas rather than technical limitations. In addition, the pursuit of realism can actively express the changing times of digital age. This is an active representation of the camera's angle, lighting, and perspective that coincides with the background. The environment of video production is crucial for realistic expressions. The study examined various visual directions and applications. In TV images, we looked at reproduction, which can make a natural period of time by combining. As a follow-up study, we are going to study the changes in the new quadratic image based on the present image representation.

Clinicopathological Features of Primary Solitary Spinal Cord Tumors in Pediatric Patients : A 32-Year Single Institution Experience

  • Choi, Ho Yong;Kim, Kyung Hyun;Cho, Byung-Kyu;Wang, Kyu-Chang;Phi, Ji Hoon;Lee, Ji Yeoun;Park, Sung-Hye;Kim, Seung-Ki
    • Journal of Korean Neurosurgical Society
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    • 제64권4호
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    • pp.592-607
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    • 2021
  • Objective : Few studies exist on primary spinal cord tumors (PSCTs) in pediatric patients. The purpose of this study was to perform descriptive analysis and detailed survival analysis for PSCTs. Methods : Between 1985 and 2017, 126 pediatric patients (male : female, 56 : 70) with PSCTs underwent surgery in a single institution. We retrospectively analyzed data regarding demographics, tumor characteristics, outcomes, and survival statistics. Subgroup analysis was performed for the intramedullary (IM) tumors and extradural (ED) tumors separately. Results : The mean age of the participants was 6.4±5.04 years, and the mean follow-up time was 69.5±46.30 months. The most common compartment was the ED compartment (n=57, 45.2%), followed by the IM (n=43, 34.1%) and intradural extramedullary (IDEM; n=16, 12.7%) compartments. Approximately half of PSCTs were malignant (n=69, 54.8%). The most common pathologies were schwannomas (n=14) and neuroblastomas (n=14). Twenty-two patients (17.5%) died from the disease, with a mean disease duration of 15.8±15.85 months. Thirty-six patients (28.6%) suffered from progression, with a mean period of 22.6±30.81 months. The 10-year overall survival (OS) rates and progression-free survival (PFS) rates were 81% and 66%, respectively. Regarding IM tumors, the 10-year OS rates and PFS rates were 79% and 57%, respectively. In ED tumors, the 10-year OS rates and PFS rates were 80% and 81%, respectively. Pathology and the extent of resection showed beneficial effects on OS for total PSCTs, IM tumors, and ED tumors. PFS was affected by both the extent of removal and pathology in total PSCTs and ED tumors; however, pathology was a main determinant of PFS rather than the extent of removal in IM tumors. The degree of improvement in the modified McCormick scale showed a trend towards improvement in patients with IM tumors who achieved gross total removal (p=0.447). Conclusion : Approximately half of PSCTs were malignant, and ED tumors were most common. The most common pathologies were schwannomas and neuroblastomas. Both the pathology and extent of resection had a decisive effect on OS. For IM tumors, pathology was a main determinant of PFS rather than the extent of removal. Radical excision of IM tumors could be a viable option for better survival without an increased risk of worse functional outcomes.

The Prognostic Value of 18F-Fluorodeoxyglucose PET/CT in the Initial Assessment of Primary Tracheal Malignant Tumor: A Retrospective Study

  • Dan Shao;Qiang Gao;You Cheng;Dong-Yang Du;Si-Yun Wang;Shu-Xia Wang
    • Korean Journal of Radiology
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    • 제22권3호
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    • pp.425-434
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    • 2021
  • Objective: To investigate the potential value of 18F-fluorodeoxyglucose (FDG) PET/CT in predicting the survival of patients with primary tracheal malignant tumors. Materials and Methods: An analysis of FDG PET/CT findings in 37 primary tracheal malignant tumor patients with a median follow-up period of 43.2 months (range, 10.8-143.2 months) was performed. Cox proportional hazards regression analyses were used to assess the associations between quantitative 18F-FDG PET/CT parameters, other clinic-pathological factors, and overall survival (OS). A risk prognosis model was established according to the independent prognostic factors identified on multivariate analysis. A survival curve determined by the Kaplan-Meier method was used to assess whether the prognosis prediction model could effectively stratify patients with different risks factors. Results: The median survival time of the 37 patients with tracheal tumors was 38.0 months, with a 95% confidence interval of 10.8 to 65.2 months. The 3-year, 5-year and 10-year survival rate were 54.1%, 43.2%, and 16.2%, respectively. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), maximum standardized uptake value, age, pathological type, extension categories, and lymph node stage were included in multivariate analyses. Multivariate analysis showed MTV (p = 0.011), TLG (p = 0.020), pathological type (p = 0.037), and extension categories (p = 0.038) were independent prognostic factors for OS. Additionally, assessment of the survival curve using the Kaplan-Meier method showed that our prognosis prediction model can effectively stratify patients with different risks factors (p < 0.001). Conclusion: This study shows that 18F-FDG PET/CT can predict the survival of patients with primary tracheal malignant tumors. Patients with an MTV > 5.19, a TLG > 16.94 on PET/CT scans, squamous cell carcinoma, and non-E1 were more likely to have a reduced OS.

The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography

  • Younjung Choi;Sun Mi Kim;Mijung Jang;Bo La Yun;Eunyoung Kang;Eun-Kyu Kim;So Yeon Park;Bohyoung Kim;Nariya Cho;Woo Kyung Moon
    • Korean Journal of Radiology
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    • 제23권9호
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    • pp.866-877
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    • 2022
  • Objective: The optimal imaging approach for evaluating pathological nipple discharge remains unclear. We investigated the value of adding ductography to ultrasound (US) for evaluating pathologic nipple discharge in patients with negative mammography findings. Materials and Methods: From July 2003 to December 2018, 101 women (mean age, 46.3 ± 12.2 years; range, 23-75 years) with pathologic nipple discharge were evaluated using pre-ductography (initial) US, ductography, and post-ductography US. The imaging findings were reviewed retrospectively. The standard reference was surgery (70 patients) or > 2 years of follow-up with US (31 patients). The diagnostic performances of initial US, ductography, and post-ductography US for detecting malignancy were compared using the McNemar's test or a generalized estimating equation. Results: In total, 47 papillomas, 30 other benign lesions, seven high-risk lesions, and 17 malignant lesions were identified as underlying causes of pathologic nipple discharge. Only eight of the 17 malignancies were detected on the initial US, while the remaining nine malignancies were detected by ductography. Among the nine malignancies detected by ductography, eight were detected on post-ductography US and could be localized for US-guided intervention. The sensitivities of ductography (94.1% [16/17]) and post-ductography US (94.1% [16/17]) were significantly higher than those of initial US (47.1% [8/17]; p = 0.027 and 0.013, respectively). The negative predictive value of post-ductography US (96.9% [31/32]) was significantly higher than that of the initial US (83.3% [45/54]; p = 0.006). Specificity was significantly higher for initial US than for ductography and post-ductography US (p = 0.001 for all). Conclusion: The combined use of ductography and US has a high sensitivity for detecting malignancy in patients with pathologic nipple discharge and negative mammography. Ductography findings enable lesion localization on second-look post-ductography US, thus facilitating the selection of optimal treatment plans.