Journal of the Korean Academy of Child and Adolescent Psychiatry
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제27권1호
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pp.48-55
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2016
Objectives: Children with attention-deficit hyperactivity disorder (ADHD) may have deficits in time perception, as assessed by the time estimation task and the time reproduction task, however its age-related trajectory is not yet determined. Therefore we examined the correlation between accuracy of time perception tasks and age, and the association between accuracy of estimation tasks and reproduction tasks. Methods: Sixty-three patients with ADHD, aged 8 to 18 years tested the tasks for five time durations (2, 4, 12, 45, and 60 seconds). Accuracy of tasks was assumed differences (absolute values) between raw results of tasks and original time durations. Spearman's correlation analysis was performed to determine correlation between accuracy of time perception tasks and age. Multivariate regression was used to determine the association of accuracy of estimation tasks with accuracy of reproduction tasks. Results: Age showed correlation with accuracy of estimation tasks, but not with that of reproduction tasks. We observed that the higher the accuracy in 12, 45, and 60 seconds duration time reproduction, the higher the accuracy in longer seconds duration time estimation. Conclusion: Age was correlated with time estimation accuracy whereas there was no impact on time reproduction accuracy. Association of each of the two time perception tasks, particularly in longer time duration, suggested specific impairments in time perception.
Introduction: Febrile neutropenia is a relatively frequent event in cancer patients treated with chemotherapy and improvement in absolute neutrophil count (ANC) has been linked directly to improved outcome. Evaluation of granulocyte colony stimulating factors (GCSFs) for treatment has shown reduced incidences of episodes of prolonged neutropenia and protracted hospitalization. To determine absolute neutrophil counts with GCSF in febrile neutropenic cancer patients admitted to a tertiary care centre and to co-relate the improvement in ANC with mortality and hospital discharge. Methods: A prospective cross sectional study was carried at an oncology ward at Aga Khan University hospital from January 2010 to June 2011. All adult patients who were admitted and treated with GCSF for chemotherapy induced febrile neutropenia were included. Multivariable regression was conducted to identify the factors related with poor outcomes. Results: A total of 131 patients with febrile neutropenia were identified with mean age of 43.2 (18-85) years, 79 (60%) being ${\leq}50$. Seventy-five (57%) had solid tumors and 56 (43%) hematological malignancies, including lymphoma. Fifty seven (43.5%) had an ANC less 100 cells/$mm^3$, 34 (26%) one between 100-300 cells/$mm^3$ and 40 (31%) an ANC greater than 300 cells/$mm^3$. Thirty (23%) patients showed ANC recovery in 1-3 days, and 74(56%) within 4-7 days. Thirteen (10%) patients showed no recovery. The overall mortality was 18 (13.7%) patients. The mean time for ANC recovery seen in hematological malignancies was 6.34 days whereas for solid tumors it was 4.88 days. Patients with ANC <100 cells/$mm^3$ were more likely to die than patients with ANC >300 cells/$mm^3$ by a factor of 4.3. Similarly patients >50 years of age were 2.7 times more likely to die than younger patients. Conclusion: Our study demonstrated that use of GCSF, in addition to intravenous antibiotics, in treatment of patients with chemotherapy induced febrile neutropenia accelerates neutrophil recovery, and shortens antibiotic therapy and hospitalization. We propose to risk classify the patients at the time of admission to evaluate the cost effectiveness of this approach in a resource constrained setup.
Ha Kyung Jung;Jin Young Kim;Mu Sook Lee;Ji Yeon Lee;Jae Seok Park;Miri Hyun;Hyun Ah Kim;Yong Shik Kwon;Sang-Woong Choi;Sung Min Moon;Young Joo Suh
Korean Journal of Radiology
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제21권11호
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pp.1265-1272
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2020
Objective: We investigated the prevalence of pneumonia in novel coronavirus disease 2019 (COVID-19) patients using chest radiographs to identify the characteristics of those with initially negative chest radiographs, who were positive for pneumonia on follow-up. Materials and Methods: Retrospective cohort data of 236 COVID-19 patients were reviewed. Chest radiography was performed on admission, with serial radiographs obtained until discharge. The 'positive conversion group' was defined as patients whose initial chest radiographs were negative but were positive for pneumonia during follow-up. Patients with initially positive chest radiographs were defined as the 'initial pneumonia group.' Patients with negative initial and follow-up chest radiographs were defined as the 'non-pneumonia group.' Clinical and laboratory findings were compared between groups, and predictors of positive conversion were investigated. Results: Among 236 patients, 108 (45.8%) were in the non-pneumonia group, 69 (29.2%) were in the initial pneumonia group, and 59 (25%) were in the positive conversion group. The patients in the 'initial pneumonia group' and 'positive conversion group' were older, had higher C-reactive protein (CRP) and lactate dehydrogenase levels, and lower absolute lymphocyte counts than those in the 'non-pneumonia group' (all p < 0.001). Among patients with negative initial chest radiographs, age ≥ 45 years (odds ratio [OR]: 3.93, 95% confidence interval [CI]: 1.76-8.75, p = 0.001), absolute lymphocyte count < 1500 cells/μL (OR: 2.25, 95% CI: 1.03-4.89, p = 0.041), and CRP > 0.5 mg/dL (OR: 3.91, 95% CI: 1.54-9.91, p = 0.004) were independent predictors for future development of pneumonia. Conclusion: More than a half of COVID-19 patients initially had normal chest radiographs; however, elderly patients (≥ 45 years of age) with abnormal laboratory findings (elevated CRP and low absolute lymphocyte counts) developed pneumonia on follow-up radiographs.
Objective: To develop a deep-learning-based bone age prediction model optimized for Korean children and adolescents and evaluate its feasibility by comparing it with a Greulich-Pyle-based deep-learning model. Materials and Methods: A convolutional neural network was trained to predict age according to the bone development shown on a hand radiograph (bone age) using 21036 hand radiographs of Korean children and adolescents without known bone development-affecting diseases/conditions obtained between 1998 and 2019 (median age [interquartile range {IQR}], 9 [7-12] years; male:female, 11794:9242) and their chronological ages as labels (Korean model). We constructed 2 separate external datasets consisting of Korean children and adolescents with healthy bone development (Institution 1: n = 343; median age [IQR], 10 [4-15] years; male: female, 183:160; Institution 2: n = 321; median age [IQR], 9 [5-14] years; male: female, 164:157) to test the model performance. The mean absolute error (MAE), root mean square error (RMSE), and proportions of bone age predictions within 6, 12, 18, and 24 months of the reference age (chronological age) were compared between the Korean model and a commercial model (VUNO Med-BoneAge version 1.1; VUNO) trained with Greulich-Pyle-based age as the label (GP-based model). Results: Compared with the GP-based model, the Korean model showed a lower RMSE (11.2 vs. 13.8 months; P = 0.004) and MAE (8.2 vs. 10.5 months; P = 0.002), a higher proportion of bone age predictions within 18 months of chronological age (88.3% vs. 82.2%; P = 0.031) for Institution 1, and a lower MAE (9.5 vs. 11.0 months; P = 0.022) and higher proportion of bone age predictions within 6 months (44.5% vs. 36.4%; P = 0.044) for Institution 2. Conclusion: The Korean model trained using the chronological ages of Korean children and adolescents without known bone development-affecting diseases/conditions as labels performed better in bone age assessment than the GP-based model in the Korean pediatric population. Further validation is required to confirm its accuracy.
Purpose: We used technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy to identify factors predictive of renal cortical defects in infants <3 months of age with urinary tract infections (UTIs). Methods: We retrospectively reviewed data on infants <3 months of age with culture-proven UTIs treated at a single center from March 2010 to February 2016. Blood samples were obtained for laboratory evaluation prior to commencement of antibiotic therapy. The therapeutic delay time (TDT) and therapeutic response time (TRT) were recorded. All patients were divided into two groups depending on features of their DMSA scans. We compared the demographic, clinical, and laboratory characteristics of the two groups. Results: A total of 119 infants (94 males and 25 females; mean age, $56.9{\pm}21.3days$) were included. Cortical defects were evident in the DMSA scans of 47 cases (39.5%). In infants with such defects, the peak temperatures ($38.9{\pm}0.57^{\circ}C$ vs. $38.4{\pm}0.81^{\circ}C$, P=0.001), the absolute neutrophil counts ($8,920{\pm}4,460/mm$ vs. $7,290{\pm}4,090/mm$, P=0.043), and the C-reactive protein (CRP) levels ($6.49{\pm}4.33mg/dL$ vs. $3.21{\pm}2.81mg/dL$, P=0.001) were significantly higher than those in infants without cortical defects. The TDT was also longer in those with cortical defects (P=0.037). Conclusion: We found that a TDT ${\geq}8.5hr$ (odds ratio [OR] 5.81), a peak temperature ${\geq}38.3^{\circ}C$ (OR 6.19), and a CRP level ${\geq}4.96mg/dL$ (OR 7.26) predicted abnormal DMSA scan results in infants <3 months of age with UTIs.
Age, sex and the amount of activity determine recommended dietary allowances. So the method of developing RDA and their levels have been revised according as the physical condition of a nation improves and the amount of activity changes along with the variety of social situations. It can be seen from records that in Korea the absolute nutrient requirements for the people in Chosun Dynasty were first published in 1922. After that, in 1941 Gui Dong Han expressed his view that the standard health diets for the Japanese would be suitable for the people in Chosun Dynasty. In 1960, the temporary nutrition standards for the Koreans were established by the Ministry of the Health and Social Affairs. For these standards, males and females were respectively divided into three groups by age and nine nutrients were recommended for each group. In 1962, The Korean Association to FAO published the RDA for the Koreans. Since then, regular researches have been done. For these allowances, there were 16 age groups of men and women and ten nutrients recommended for each group. On the first revision in 1967, the fat allowance was presented at the ratio (12%) of fat calorie to total calories with no change in the number of age catagories and in the kinds of nutrients. And the basis of the riboflavin allowance was changed from the level of protein intake to that of energy intake. On the socond revision in 1975, there was brought 19 are catagories and ten nutrients recommended. On the third revision in 1980, age catagories increased to 22, and ten nutrients were recommended. On the fourth revision in 1985, there remained 21 groups by uniting the early and later periods of pregency. On the first revision in 1967, the recommended energy allowance was 3000 kcal, the highest level. Since then it has gradually been reduced. And it can be noticed that the protein allowance was high when food was difficult to obtain.
The Gwan ceremony (冠禮) is a coming-of-age ceremony that takes place through traditional Gwan (冠: the hat) and clothes in the traditional era. The rite is performed by wearing hats and clothes three consecutive times (三加禮). It was an important rite which meant that underage children were formally recognized as members of society. This study examined costumes of people who participated in various coming-of-age ceremony rites in the Ming dynasty imperial court of China. For the research data, this study mainly used authentic chronicles (正史), codes of law and books on Ming dynasty rituals. This study examined the costumes used in the coming-of-age ceremony for the emperor, Prince Imperial, Emperor's eldest grandson, and emperor's sons. The results of this study were divided into an analysis of the document structure, institutional changes by time, characteristics of costumes, and characteristics of the rite. Of particular note in their ceremony, the emperor is presupposed to be a 'human already full-equipped with virtue', which means that the costume is worn only once. It is a case in which the emperor's absolute identity is revealed through the rite and costume.
It has been well known that the splanchnic nerve block is effective for patients who suffer from intractable upper abdominal pain. However, it is unclear whether the effect of the splanchnic nerve block depends on varied alcoholic concentration. In this study, an attempt was made to use absolute ethanol on patients who recieved a splanchnic nerve block at Severance Hospital during the period from September l990 to April l991. The results are as follows; 1) Among the 33 patients, including 22 males and 1l females, the fifties and sixties were the major age groups. 2) Stomach cancer was the most common underlying disease(13 cases), with pancreatic can- cer next(9 cases). 3) The main locations of pain were the upper abdomen, epigastrium, and entire abdomen in decreasing order. 4) There were 17 cases who had had chemotherapy, and 1l cases of whom had had surgery before the splanchnic nerve block. 5) The volume of alcohol used was 12 ml bilaterally. 6) Among the 33 patients, 15.2% required a second block within two weeks of the first block. One case required a third block. 7) The most common complications of splanchnic nerve block were hypotension(33.3%), occasional transient sharp burning pain, flushing of face, pain on injection site, nausea, vomiting, dyspnea, chest discomfort and diarrhea. 8) The supplemental block most commonly used was a continuous epidural block. It was used both as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 9) The interval between the receiving the absolute ethanol block and discharge was within 2 weeks in l5 cases. But, in the patients with poor general health, the interval between the splanchnic nerve block and discharge prolonged. The above results suggest that bilateral splanchnic nerve block done with absolute ethanol after an effective test block with 1% lidocaine under C-arm fluroscopic control is satisfactory and reliable. Still, 26.6% of the patients received a repeat block within 2 weeks. Insufficient spread of ethanol due to its small volume seems to be a major factor in the repeat block. Minimizing the incidence of repeat block remains a problem to be solved.
경주시 황룡동 일대에 분포하는 제3기 추령각력암과 주변 화산암류에 대한 암상분포, 암석기재, 접촉 및 선후관계 그리고 각종 지질구조 요소들의 특성을 파악하고 기존 지화학 및 절대연령 자료들을 종합적으로 분석하여 다음과 같은 결론을 도출하였다. (1) 연구지역의 제3기 암석은 하위로부터 데사이트질 응회암, 이를 부정합으로 피복하는 추령각력암, 그리고 이들을 다시 관입 및 피복한 안산암질 화산암류로 구분된다. (2) 데사이트질 응회암은 고제3기 팔레오세${\sim}$에오세 동안에 발생한 산성 화산활동의 산물인 왕산층에 대비되며, 추령각력암과 안산암질 화산암류는 신제3기 전기 마이오세 초의 범곡리층군 안동리층과 용동리응회암에 각각 대비된다. (3) 추령각력암은 동해가 활발히 확장하던 시기에 한반도 동남부에서 발생한 북서-남동방향의 지각신장 과정에서 만들어진 약 1.5 km 폭의 북동방향 지구대로 빠르게 유입된 각형의 주변 기반암편들이 퇴적된 결과이다. (4) 전기 마이오세 초에는 한반도 동남부에 데사이트${\sim}$안산암질 화산활동과 함께 활발한 지각신장이 발생하였으며, 특히 추령각력암이 퇴적되는 시기에는 화산활동이 잠시 중단되었으나 활발한 정단층운동이 발생하여 곳곳에 소규모 지구대가 형성되었다.
During the previous several decades the osseointegrated implants have been considered as the most ideal therapy for the fully edentulous or partially edentulous patients. Although the research on the biocompatibility of osseointegration, the oral tactile function, and the histo-neurologic study had been performed, the change of the oral tactile sensibility and maximal occlusal force according to the postinsertion time of implant prostheses has not been studied. The purpose of this study was to compare the oral tactile sensibility and maximal occlusal force of implant pros-theses to natural teeth according to the specific postinsertion time intervals. The fifty seven patients treated with $Br{\aa}nemark$ implants during the recent seven years were involved in this study. The oral tactile sensibility and maximal occlusal force were measured according to the postinsertion time (${\leqq}6\;months,\;{\leqq}12\;{\leqq}\;18\;months\;{\leqq}\;24\;months,\;and\;{\geqq}20\;months$) 1. The passive tactile threshold of implants was higher than 6-7 times when comparing to natural teeth(P<0.05) 2. The absolute pressure threshold in horizontal and vertical direction for the passive tactile sensibility had decreased significantly in the post insertion time 13-18 months group and had increased significantly in the post insertion time over 25 months group (P<0.05) 3. 50% limit thickness and 100% absolute thickness for the active tactile sensibility had decreased significantly in the postinsertion time 7-12 months group ($AT_{50}:P<0.005,\;AT_{100}:P<0.05$) 4. The maximal occlusal force of the implants prostheses had decreased when comparing with natural teeth in the postinsertion time 1-6 months group(P<0.05) and after that there was no significant difference between the implant prostheses and natural teeth(P<0.05) 5. Maximal occlusal force according to the postinsertion time had increased significantly in the 13-18 months group (P<0.05) after that there was no significant difference. 6. There was positive correlation between age and oral tactile sensibility tested in horizontal and vertical direction ($P_{H:r}=0.39,\;P_{v:r}=0.41$) and there was no correlation between age and maximal occlusal force, age and active tactile sensibility 7. According to the results or the questionnaire, 76.6% of the patients were satisfied with the function and 96.7% of the patients were satisfied with the sensibility. In conclusion oral tactile sensibility and maximal occlusal force of implants have changed with the postinsertion time. Oral tactile function of implants was lower than that of the natural teeth, but for the maximal occlusal force there was no difference between implants and natural teeth.
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