• Clinical and Experimental Pediatrics
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• 제53권9호
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• pp.830-833
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• 2010

Crohn's disease is characterized by chronic inflammation involving any portion of the gastrointestinal tract. Treating Crohn's disease is a major challenge for clinicians, as no curative therapy currently exists. Pediatric Crohn's disease is characterized by frequent relapses, a wide extent of disease, a high prevalence of extraintestinal manifestations, and a severe clinical course. The classic therapeutic approach is known as the 'step-up' strategy, and follows a progressive course of treatment intensification as disease severity increases. Although this approach is usually effective for symptom control, many patients become either resistant to or dependent on corticosteroids. The efficacy of infliximab suggests that, rather than a progressive course of treatment, early intense induction may reduce complications associated with conventional treatment and improve quality of life. Intensive early therapy with infliximab is known as the 'top-down' strategy. Such therapy offers the potential for altering the natural history of Crohn's disease, and is changing treatment paradigms. However, the relatively new concept of an early aggressive or 'top-down' treatment approach is not yet widely accepted, especially in pediatric patients. The results of our current study demonstrate that early and intensive treatment of pediatric Crohn's disease patients with infliximab, at initial diagnosis, was more effective for maintaining remission and reducing flares.

• 생물정신의학
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• 제3권1호
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• pp.30-36
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• 1996

Tardive dyskinesia is a syndrome of involuntary hyperkinetic abnormal movements that occurs during or shortly after the cessation of neuroleptic drug treatment. Typically, the movements are choreoatheoid. Other movements such as tics and dystonia may be present. Nonetheless, any dyskinesia seen in a neuroleptic-treated patient is not always neuroleptic-induced tardive dyskinesia. The prevalence of tardive dyskinesia varies widely, which reflects many methodological problems, such as differential diagnosis. symptom fluctuation, masking effect of neuroleptics, validated diagnostic criteria. Of suggested risk factors, only old age has been consistently found to be associated with an increased frequency of tardive dyskinesia. Many hypotheses about the pathophysiolgy of tardive kinesia are proposeed, but time-honored ones are not present. No consistently safe and effective treatments are found. Various treatment modalities signifies the general ineffectiveness of these agents for most patients. In general, reduction or cessation of neuroleptics, if possible, is recommended. Remission or improvemets of tardive dyskinesia after neuroleptics withdrawal usually occurs among most patients within three months.

• 대한간호학회지
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• 제34권4호
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• pp.636-645
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• 2004

Purpose. A natural disaster negatively affects children's emotional and behavioral adjustment. The purpose of this paper was to examine the prevalence, symptoms, and correlates of PTSD after the occurrence of Typhoon Rusa. Method. 261 elementary school children living in Kimcheon, which was a devastated rural area in South Korea by Typhoon Rusa, were selected. Data were collected 4 months after the disaster using the PTSD Reaction Index categories recommended by Frederick, severity of PTSD. Results. 12.3% of the children had either moderate or severe PTSD symptoms; 22.7% reported mild symptoms; and the remaining 65% had sub-clinical symptoms of PTSD. The most frequent symptom was recurrenct fear(67.0%). 13% to 17.2% of children exhibited difficulty in concentration, sleep disturbance, and guilt feeling. The regression model of severity of PTSD was composed of the level of exposure to traumatic experiences, grade in school, gender, negative coping style, and social support, and explained 34.3% for PTSD symptoms. Exposure to traumatic experiences was the strongest factor of all predictors. Conclusion. Emotional support from friends and coping style were correlated with PTSD severity. School-based interventions that emphasizes coping with disaster related problems and problem-solving may prove to be useful, and may aid in building close and supportive ties with teachers, classmates, and friends.

• 동의생리병리학회지
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• 제20권6호
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• pp.1392-1417
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• 2006

‘Cough' can be developed by many causes and the first representative symptom for respiratory diseases which was first referenced in ${\ll}$So Mun${\cdot}$Hae Ron${\gg}$ (素問)${\cdot}$(咳論) and repeated in many medical books to date. Among those medical books, four representative men, Kum Won sa dae ga(金元四大家)- Yoo wan so(劉完素), Jang jong jung(張從政), Lee dong won(李東垣) and Ju jin hyeong(侏震亨), presented new ideas and opinions on rules of occurrence and transformation in disease due to prevalence of wars and febrile communicable diseases during the Kum-Won period(金元時代). I have concluded the following while researching the books of Kum Won sa dae ga(金元四大家).

• 대한두경부종양학회지
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• 제32권2호
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• pp.35-39
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• 2016

Castleman's disease (CD) is an uncommon lymphoproliferative disorder. The disease entity is classified into 2 clinical subtypes, unicentric and multicentric type. Prevalence of lymphoid malignancy in multicentric CD (MCD) is very low. In this case, we report a case of 77 years old woman who developed high fever and swelling in both side of her neck. Neck lymph node biopsy revealed plasma cell hyperplasia. Patient's symptom was subsided after treatment with Dexamethasone. Three months later, multiple lymph node enlargement was developed in abdomen and neck area again. Repeated neck lymph node biopsy confirmed diffuse large B cell lymphoma. The patient started chemotherapy.

• Safety and Health at Work
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• 제12권2호
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• pp.174-183
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• 2021

Background: Toluene diisocyanate (TDI) is a highly reactive chemical that causes sensitization and has also been associated with increased lung cancer. A risk assessment was conducted based on occupational epidemiologic estimates for several health outcomes. Methods: Exposure and outcome details were extracted from published studies and a NIOSH Health Hazard Evaluation for new onset asthma, pulmonary function measurements, symptom prevalence, and mortality from lung cancer and respiratory disease. Summary exposure-response estimates were calculated taking into account relative precision and possible survivor selection effects. Attributable incidence of sensitization was estimated as were annual proportional losses of pulmonary function. Excess lifetime risks and benchmark doses were calculated. Results: Respiratory outcomes exhibited strong survivor bias. Asthma/sensitization exposure response decreased with increasing facility-average TDI air concentration as did TDI-associated pulmonary impairment. In a mortality cohort where mean employment duration was less than 1 year, survivor bias pre-empted estimation of lung cancer and respiratory disease exposure response. Conclusion: Controlling for survivor bias and assuming a linear dose-response with facility-average TDI concentrations, excess lifetime risks exceeding one per thousand occurred at about 2 ppt TDI for sensitization and respiratory impairment. Under alternate assumptions regarding stationary and cumulative effects, one per thousand excess risks were estimated at TDI concentrations of 10 - 30 ppt. The unexplained reported excess mortality from lung cancer and other lung diseases, if attributable to TDI or associated emissions, could represent a lifetime risk comparable to that of sensitization.

• 대한두개안면성형외과학회지
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• 제23권3호
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• pp.125-129
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• 2022

Most malignant lymphomas of the head and neck region are non-Hodgkin lymphomas (NHL), and diffuse large B-cell lymphoma is the most common subtype. The prevalence of malignant lymphoma among parotid tumors is low, approximately 1% to 4%. The most common symptom of parotid lymphoma is a unilateral, non-tender, firm mass that slowly grows in size over time. As its clinical manifestations are nonspecific, a comprehensive assessment is required for an accurate diagnosis. The initial work-up includes imaging tools, such as computed tomography and magnetic resonance imaging. However, NHL of the parotid gland is difficult to distinguish from other types of benign tumors prior to biopsy; histopathological evaluation and subsequent immunohistochemical staining are needed for the final diagnosis. Once a definitive diagnosis is established, patients should be referred to an oncologist for staging. Treatment is mainly based on systemic chemotherapy, whereas radiotherapy is indicated for certain cases. Here, we report the case of a 53-year-old man who presented with a progressively enlarging mass in the right parotid area, which was later diagnosed as malignant lymphoma of the parotid gland after superficial parotidectomy.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.204-210
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• 2023

Lesch-Nyhan syndrome is a rare X-linked recessive disorder characterized by a deficiency of the enzyme hypoxanthine-guanine phosphoribosyl transferase, which is important in the metabolism of purines. Prevalence of Lesch-Nyhan syndrome is 1:100,000 to 1:380,000 live births, and Lesch-Nyhan syndrome mainly affects males. It is characterized by neurologic dysfunction, uric acid overproduction, and cognitive and behavioral disturbances. The self-mutilation is the most distinctive symptom in Lesch-Nyhan syndrome, appearing about 1 year of age. It is expressed as persistent bites in the oral mucosa, tongue, lips, and fingers, which leads to the total or partial destruction of the affected tissues. Several medical and dental management methods might be performed in Lesch-Nyhan syndrome patients. Dental approaches to prevent injuries caused by self-mutilation include treatments with oral appliances such as mouth guards or lip bumpers, extraction, and orthognathic surgery. This report described two brothers with Lesch-Nyhan syndrome, who injured themselves on oral tissues. The methods of tooth reduction and extraction were performed to prevent injuries caused by self-mutilation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제10권1호
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• pp.64-75
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• 1999

본 연구에서는 전반적 발달장애 pervasive developmental disorder(이하 PDD)의 공존질환과 동반증상의 현황을 파악하고자 전반적 발달장애 아동에서의 동반증상과 공존질환의 빈도 및 특성을 알아보고 발달성 언어장애 developmental language disorder(이하 DLD)와의 차이를 비교해 보았다. 연구대상은 1996년 1월부터 1999년 3월까지 국립서울정신병원 소아정신과 외래에서 통원치료를 받았거나 발달장애 주간치료프로그램에 참가했던, DSM-IV를 기준으로 소아정신과 전문의에 의해 진단된, 만 1세에서 11세 아동 352명 이었으며 이중 PDD는 209명(남179, 여30), DLD는 143명(남119, 여24)이었다. 진단적 평가에는 병록지, 언어평가, 작업평가, 가정방문보고서, 부모양육보고서, SMS, CARS, PEP 결과 등을 참조하였다. 진단군에 따른 각각에서의 공존질환과 동반증상의 빈도와 특징을 비교분석하였고, PDD아동 64명을 CARS에 따라 3군으로 나누어 동반증상의 양상을 비교하였으며, 106명을 대상으로 각 동반증상과 교육진단검사 소항목과의 관계를 검증하였다. 연구결과 PDD와 DLD 양군에서 공존질환의 비율은 각각 19.6%, 41.2%이었고, 동반증상 13개 항목의 평균 동반비율은 31.47%, 22.13%이었다. 비정상적 집착, 강박증, 자해행동, 상동증, 수면문제, 기묘한 반응 등은 PDD에서 유의하게 높은 빈도를 보였다. 동반비율에서 PDD에서는 비정상적 집착, 상동증, 주의집중 부족, 부적절한 정서 등의 순서를 보인 반면, DLD에서는 주의집중 부족, 공격성, 부적절한 정서, 행동과다, 비정상적 집착 등의 순서를 보였다. 각 동반증상의 유무에 따른 교육진단검사 소항목 들의 양상을 분석해본 결과, 전체군에서는 비정상적 집착, 자기자극행동, 상동증, 부적절한 정서, 수면문제, 기묘한 반응 등의 유무에 따라 유의한 차이를 보였고, 진단별에 따라서는 두 군 모두 차이를 나타낸 항목이 없었다. 한편 CARS에 따라 유의한 차이를 보인 동반증상은 상동증, 불안, 수면문제 등이었다. 이와 같은 결과는 전반적 발달장애에서의 공존질환 및 동반증상의 임상적 중요성을 나타내며, 추후 공존질환과 동반증상의 빈도 및 특성에 따라 세부적인 진단과 이에 따른 현실적인 치료적 접근이 필요함을 시사한다.

• 대한핵의학회지
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• 제29권4호
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• pp.504-510
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• 1995

목적 : 신장 이식후 발생한 무혈관성 골괴사의 빈도를 알아보고, 골스캔과 SPECT, MRI의 역할을 비교해 보고자 하였다. 대상 및 방법 : 1989년 6월부터 1995년 9원까지 본원에서 신장 이식을 받은 301명중 임상적으로 무혈관성 골괴사를 진단받은 환자의 발생빈도 및 침범 부위를 알아보고, 무혈성 골괴사 환자에서 시행한 골스캔과 SPECT, MRI 소견을 비교하여 보았다. 결과 : 무혈관성 골괴사의 발생빈도는 3.3%(10/301)였고, 침범 부위는 대퇴골두 16병변과 종골 융기 2병변이었다. 또한 전신 골스캔상 천골의 불충분 골절을 보인 경우가 1례 있었다. 골스캔 소견은 열소에 둘러싸인 냉소 13병변, 열소 3병변, 냉소 1병변, 정상 1병변의 소견을 보였고 열소만을 보인 경우는 SPECT에서는 작은 냉소를 둘러싸는 열소로, 냉소나 정상으로 보인 경우는 SPECT상 반응성 열소 없는 냉소로 나타났다. SPECT와 MRI를 같이 시행한 6례중 모두양성인 경우가 5례였고, 증상이 있었던 1례에서 SPECT상 냉소로 보였으나 MRI에서는 정상소견을 보였다. 결론 : 신장 이식후 발생한 무혈관성 골괴사의 발생빈도는 3.3%였고, 전신골스캔으로 골괴사외의 전신골 병변을 관찰할 수 있었으며 증상은 있으나 골스캔상에서 병변이 뚜렷하지 않거나 MRI에서 음성인 경우 등에 SPECT가 진단에 도움이 되었다. 그러므로 증상은 있으나 MRI에서 음성인 경우 SPECT를 시행하는 것이 신장 이식후의 환자에서 발생하는 무혈관성 골괴사의 진단에 유용하리라고 생각된다.