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A Clinical Observation of Children with Urachal Anomalies (요막관 기형의 임상적 고찰)

  • Lee, Sang-Bae;Jung, Chang-Hyun;Kim, Kang-Sung;Ryu, Min-Hyuk;Lee, Dong-Jin
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.213-221
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    • 2005
  • Purpose : Urachal anomalies are rare but are known to develop several complications, especially infection. Moreover, uniform guidelines for management have not been presented because of the variable clinical characteristics of these anomalies. The purpose of this report is to review our experience with urachal anomalies and attempt to determine the optimal management. Methods : We retrospectively reviewed the records of fourteen children with a variety of urachal anomalies who had been treated from January 1996 to June 2005 at Dong Kang General Hospital. Results : The age distribution of the patients(mean age; 3.8 years) was six neonates, one infant, five preschool-age and two school-age children. The male to female ratio was 1:1. Six cases of urachal cyst, four cases of patent urachus, two cases of urachal sinus and two cases of urachal diverticulum were found. Three patients with patent urachus and one with urachal cyst had hydronephrosis. Other associated anomalies included an inguinal hernia in one patient with urachal sinus and a vesicoureteral reflux in one patient with urachal diver ticulum. As a first-line diagnostic tool, high-resolution ultrasound examination was performed in thirteen cases and computed tomography in one case. Surgical excision was performed in nine patients with urachal anomaly. Five cases out of six neonatal cases experienced spontaneous improvement during a three-month follow up period. Due to frequent infection of the umbilicus, surgical excision was performed on one neonate with urachal sinus. Conclusion : All patients with urachal anomalies should undergo investigation for associated anomalies. The neonate with urachal anomalies, especially patent urachus, do not require surgical excision unless the patient has multiple episodes of recurrent infection. (J Korean Soc Pediatr Nephrol 2005;9:213-221)

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A Study of Traffic Incident Flow Characteristics on Korean Highway Using Multi-Regime (Multi-Regime에 의한 돌발상황 시 교통류 분석)

  • Lee Seon-Ha;kang Hee-Chan
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.4 no.1
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    • pp.43-56
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    • 2005
  • This research has examined a time series analysis(TSA) of an every hour traffic information such as occupancy, a traffic flow, and a speed, a statistical model of a surveyed data on the traffic fundamental diagram and an expand aspect of a traffic jam by many Parts of the traffic flow. Based on the detected data from traffic accidents on the Cheonan-Nonsan high way and events when the road volume decreases dramatically like traffic accidents it can be estimated from the change of occupancy right after accidents. When it comes to a traffic jam like events the changing gap of the occupancy and the mean speed is gentle, in addition to a quickness and an accuracy of a detection by the time series analyse of simple traffic index is weak. When it is a stable flow a relationship between the occupancy and a flow is a linear, which explain a very high reliability. In contrast, a platoon form presented by a wide deviation about an ideal speed of drivers is difficult to express by a statical model in a relationship between the speed and occupancy, In this case the speed drops shifty at 6$\~$8$\%$ occupancy. In case of an unstable flow, it is difficult to adopt a statistical model because the formation-clearance Process of a traffic jam is analyzed in each parts. Taken the formation-clearance process of a traffic jam by 2 parts division into consideration the flow having an accident is transferred to a stopped flow and the occupancy increases dramatically. When the flow recovers from a sloped flow to a free flow the occupancy which has increased dramatically decrease gradually and then traffic flow increases according as the result analyzed traffic flow by the multi regime as time series. When it is on the traffic jam the traffic flow transfers from an impeded free flow to a congested flow and then a jammed flow which is complicated more than on the accidents and the gap of traffic volume in each traffic conditions about a same occupancy is generated huge. This research presents a need of a multi-regime division when analyzing a traffic flow and for the future it needs a fixed quantity division and model about each traffic regimes.

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The Study on Evaluating the Policy Value of Public Projects for Housing Welfare - Focused on the Remodeling Projects for Long Term Rental Housing - (장기공공임대주택의 리모델링을 통한 주거복지 정책사업의 가치평가에 관한 연구)

  • Cho, Yongkyung;Lee, Sangyoub
    • Korean Journal of Construction Engineering and Management
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    • v.15 no.5
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    • pp.82-93
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    • 2014
  • Long Term rental housing, which is supplied for performing housing welfare, has been aging from permanent rental housing. Therefore, variety housing welfare projects are planing and performing for improving aged facilities. However, although every welfare policy are necessary, we have to efficiently allocate and commit the funds, because the fund and resources is limited. And there is required the feasibility study before performing public project for housing welfare, because it needs large amount of financial supports by government. Meanwhile, because most of existed studies are focused on guide development, it has limitation to apply the result of existed studies in this study, which considers public remodeling project for housing welfare. But in reality, public project is been decided by willing of policy decision-maker. Therefore, in this study, we suggest the evaluation method of policy value for two alternatives(remodeling and maintain) of a aged long term rental housing. To extract the attributes of policy value, we considered categorized items of preliminary feasibility study. Through extracting attribute factors of policy value for aged long term rental housing, we can calculate the policy value of remodeling and maintain alternatives by using MAUT. As a result of analysis, we can find that the utility value of remodeling is 0.6161 and the utility value of maintain is 0.2461 and also the utility of remodeling is higher than utility of maintain. Therefore, when we plan the public projects for performing housing welfare, we can choose remodeling alternative rather than maintain alternative using quantitive data.

A Study on the Evaluation Criteria for Reconstruction Charge Allocation (재건축부담금 배분을 위한 지자체 평가기준 연구)

  • Kim, Joo-Jin;Song, Young-Hyun
    • LHI Journal of Land, Housing, and Urban Affairs
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    • v.2 no.1
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    • pp.35-46
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    • 2011
  • This paper aims at examining the indices and their weights for the evaluation of local government to allocate reconstruction charge and reviewing the availability of them simulating local governments' evaluation. There has been no specific evaluation criteria existed, while central government has to allocate the reconstruction charge to local governments by the provision 3 of Restitution of Housing Reconstruction Gains Act. The results as follows : According to a survey on evaluation indices weight and AHP analysis, the weight of 'the housing welfare improve effort' is the highest with 25.1% among 5 upper-classification indices. Following this, each weight of 'housing welfare conditions(22.7%)', 'housing SOC establishment(22.5%)', 'the achievement and planning on reconstruction charge use(15.8%)', and 'housing sector achievement such as Bogeumjari(13.9%)' are ranked. Meanwhile, Among 16 lower-classification indices, 'the rate of minimum housing standard households(11.5%)', 'public rental housing supply(8.9%)', 'reconstruction charge use achievement(8.3%)', 'reconstruction charge use planning submit(7.5%)', and 'rate of water and sewage(6.3%)' hold high rank. The analysis results show the weight of 'housing sector achievement such as Bogeumjari' on the existing provisions should be decreased(30%${\rightarrow}$13.9%) as others' weight has to be slightly increased. According to the result of the simulation, Jeonbuk, Gyeongbuk, Jeonnam, Jeju, Gyeonggi received higher scores in the comprehensive evaluation, while Daejeon, Seoul, Incheon, Daegu and Gwangju, where the housing conditions are relatively good, received lower scores. These results of the analysis correspond with the direction of reconstruction charges allocation and indicate that the evaluation criteria used in this simulation is acceptable.

Therapeutic Effect of Nocturnal Water Restriction in Children with Primary Nocturnal Enuresis (일차성 야뇨증 아동에서 야간 수분 제한의 치료 효과)

  • Lee Soo Jin;Yang Jae Young;Kim Hae Soon;Lee Seung Joo
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.51-58
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    • 2001
  • Purpose : Treatment of primary nocturnal enuresis (PNE) includs folk remedies and various treatments based on pathogenesis. We assessed the therapeutic effect of nocturnal water restrict ion as the primary treatment of PNE. Materials and methods : From October 1998 to June 1999, 41 children with PNE (>3 wet nights per week) who visited Ewha Womans University Mokdong hospital and who had good compliances to nocturnal water restriction for 2 months were included. Before and during nocturnal water restriction, daily fluid intake and urine volume were recorded for 2 days every 2 weeks. Responses to nocturnal water restriction were classified according to the decrease of wet nights as complete (>90$\%$), partial (50-90$\%$) and no (<50$\%$) response. Predictors such as age, sex, daytime voiding dysfunction, fluid intake, urine volume, maximum urine volume per void and fasting urine osmolality were evaluated. Results . The response rate to nocturnal water restriction fir 2 month was 82.9$\%$(34/41) [complete response 39.0$\%$(16/41), partial response : 43.9$\%$(18/41)]. The response rate to nocturnal water restriction was significantly higher in monosymptomatic PNE than polysymptomatic PNE and more effective in PNE with or nocturnal fluid intake, nocturnal urine volume, and maximum urine volume than lower nocturnal fluid intake, nocturnal urine volume and maximum urine volume per void (P<0.05). Nocturnal urine volume, maximum urine volume per void and luting urine osmolality after nocturnal water restriction has significantly increased higher in complete response and partial response group than in no response group (P<0.05). Conclusion : The nocturnal water restriction was effective in monosymptomatic PNE with nocturnal polydypsia, nocturnal polyuria and high bladder capacity. (J, Korean Soc Pediatr Nephrol 5 : 51- 8, 2001)

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A STUDY ON THE PERSONALITY TRAIT OF BULLYING & VICTIMIZED SCHOOL CHILDRENS (학령기 집단따돌림 피해 및 가해아동의 인격성향에 관한 연구 - 한국아동인성검사를 이용하여 -)

  • Jhin, Hea-Kyung;Kim, Jong-Won;Choi, Yun-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.94-102
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    • 2001
  • Bullying has recently become a serious social problem in Korean society. Bullying, which is defined as a phenomenon that one particular student is intensively and continuously harassed or ostracized by a group of students, is apt to produce harmful effects on bullies as well as victims. Bullying has many causes including those originated from the personality of victims and bullies. This study is designed to investigate the difference in personality trait between victims, bullies, victims/bullies, and neither. The subjects of this study were 215(115 male and 100 female) 6th-grade students in the primary school in Seoul. Questionnares were distributed to the students and their carers. The student carers were also asked to answer the questions for a survey called the Korean Personality Invertory for Children(KPI-C). SPSS was used for the statistical analysis of the collected test information;ANOVA, post hoc scheffe test, and T-test were used to analyze the differences between the tested groups. The result of the study is as follows. 1) The victims, bullies, victims/bullies and neither totaled respectively 11(5.1%), 56(26.0%), 11(5.1%) and 137(63.7%). 115 were male and 100 were female. 2) The frequency of victimized is as follows:1 time is 15(7.0%), 2 times is 4(1.9%) and more than 3 times is 3(1.4%). The frequency of bullying is as follows;1 time is 40(18.6%), 2 times is 17 (7.9%) and more than 3 times is 10(4.7%). 3) The differences between froups in KPI-C test is as follows. (1) The ESR(p=.00) scale was significantly lower in the victims group than in the neither group and the HPR(p=.00) scale and PSY(p<.01) scale were significantly higher in the former than in the latter. (2) The ESR(p=.00) scale was significantly lower in the victims/bullies group than in the neither group and the SOM(p=.00) scale and HPR(p=.00) scale were significantly higher in the formaer than in the latter. (3) The SOC(p=.00) scale, PSY(p<.01) scale and AUT(p=.00) scale were significantly higher in the victims group than in the bullies group. (4) There is statistically no difference between the bullies group and the neither group. To conclusion, Victims need to learn how to cope with harsh situations, or they will have to face difficulties in relationships. Even after they experience bullying, they may not realize why they have been bullied, or speak out for themselves.

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A Comparative Analysis of the Clinical and Pathological features of IgA Nephropathy and Thin Glomerular Basement Membrane Disease (IgA 신병증과 비박형 기저막 신증의 임상 및 병리학적 비교 분석 - 사구체 기저막의 비박화를 중심으로 -)

  • Chi, Geun-Ha;Ha, Chang-Woo;Kim, Young-Ju;Yoon, Hye-Kyung;Chung, Woo-Yeong
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.147-155
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    • 2001
  • Purpose : IgA nephropathy(IgAN) and thin glomerular basement membrane disease(TGBMD) are common glomerular diseases that cause hematuria in childhood. IgAN has characteristics of IgA deposit as the sole or predominantly localized to the mesangium Recently, it has been reported that thinning of glomerular basement membrane(GBM) is commonly accompanied with precipitation of electron dense deposits in IgAN. We performed this study to examine the frequency of thinning of GBM among children with IgAN and to analysis tile correlation between urinary abnormalities and GBM thickness and furthermore to conduct comparative analysis of the clinical and pathological features of IgAN and TGBMD. Methods : This study summarizes data collected from Department of Pediatrics, Busan Paik Hospital, Inje Medical College. Data include 51 cases who were diagnosed as IgAN from 1995 to 2000, and 26 cases who were diagnosed as TGBMD from 1990 to 2000 by percutaneous renal biopsy. Results : Males accounted for 29/51($56.9\%$) patients with IgAN and 8/26($30.8\%$) of those with TGBMD. The clinical and laboratory features between IgAN and TGBMD were significantly different regarding the incidence of proteinuria(IgAN vs TGBMD: $43.1\%\;vs\;3.8\%$, p=0.001), the incidence of co-appearance of proteinuria with hematuria ($41.2\%\;vs\;3.8\%$, p=0.001), total amount of protein in 24 hours collected urine ($808{\pm}\;mg\;vs\;251{\pm}200.7\;mg$, p=0.001) and the incidence of proteinuria more than 1 gm in 24 hours collected urine ($23.5\%\;vs\;3.8\%$, p=0.01). On the contrary, there were no significant differences in the levels of serum albumin, creatinine, BUN, and Ccr between two groups. The mean thickness of GBM in patients with IgAN was $293.0{\pm}79.2\;nm$(139.7-461.9 nm) and $180.9{\pm}35.8\;nm$(110.5-229.5 nm) in patients with TGBMD. The mean GBM thickness revealed significantly thinner in TGBMD compared than those with IgAN (P=0.0001). The frequency of thickness being less than 250 nm was $37.4{\pm}34.4\%$ in IgAN and $93.0{\pm}7.0\%$ in TGBMD (P=0.0001). But there were no correlations between urinary abnormalities and GBM thickness in patients with IgAN. Conclusion : The thinning of GBM would be one of the common pathological findings in IgAN Moreover, there is no significant correlations between urinary abnormalities and GBM thickness in patients with IgAN, However, patients with IgAN tend to have significantly higher possibilities of proteinuria, co-appearance of proteinuria with hematuria and higher total amount of protein in 24 hours collected urine compared those with TGBMD. These differences might be play all important role as progressive prognostic indicators in patients with IgAN. (J Korean Soc Pediatr Nephrol 2001;5 : 136-46)

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The Effects of Intravenous Methylprednisolone Pulse Therapy by Mendoza Protocol in Primary and Secondary Nephrotic Syndrome (일차성 및 이차성 신증후군에서 Mendoza Protocol에 의한 Intravenous Methylprednisolone Pulse Therapy의 효과)

  • Lee Kyoung-Jae;Han Jae-Hyuk;Lee Young-Mock;Kim Ji-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.117-124
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    • 2001
  • Purpose : Since Mendoza(1990)'s report that long term methylprednisolone pulse therapy by Mendoza protocol (MP therapy) is a good treatment option in focal segmental glomerulosclerosis(FSGS), there have been reports of the effects of this therapy in steroid-resistant nephrotic syndrome. However, no studies have been performed on the effects of MP therapy in steroid- dependent nephrotic syndrome and secondary nephrotic syndrome. In this study, we investigated the effects of long term MP therapy in primary and secondary nephrotic syndrome in which previous treatment options were not effective. Methods : We chose 10 children who were diagnosed with steroid-dependent minimal change nephrotic syndrome(SD-MCNS), who had shown frequent relapse during the immunocompromised or cytotoxic therapy Period, and 6 children with FSGS and 5 children with secondary nephrotic syndrome children, who had shown no response during the previous therapy period. We treated these patients according to Mendoza protocol involving infusions of high doses of methylprednisolone, often in combination with oral cyclophosphamide for 82 weeks. Results : In all the 10 children with SD-MCNS, complete remission was visible on average of $18{\pm}9$ days after MP therapy was started. However, all these children relapsed during or after MP therapy. In these children, the mean relapse rate prior to MP therapy was $2.1{\pm}1.0$ relpases/year, which was reduced to $1.4{\pm}0.9$ relapses/year during MP therapy(P>0.05) and rose to $2.7{\pm}1.0$ relapse/year after MP therapy. Of the 6 children with FSGS, 4 children($67\%$) showed complete remission, of whom 3 children($50\%$) remained in the remission status during the follow up period, $1.2{\pm}0.7$ years, after the end of MP therapy. 2 children($33\%$) showed no response. All of the 5 children with secondary nephrotic syndrome showed remission and remained in the remissiom status during the follow up period, $1.7{\pm}0.6$ years The only side effect of MP therapy was transient hypertension in 10 children of ail subjects during the intravenous infusion of methylprednisolone. Conclusion : We conclude that although long term MP therapy is not effective in the treatment of SD-MCNS, it is an effective therapy against intractable FSGS and secondary nephrotic syndrome. (J Korean Soc Pediatr Nephrol 2001 ; 5 : 117-24)

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Analysis of Childhood Rapidly Progressive Glomerulonephritis (소아 급속 진행성 사구체신염의 임상적 고찰)

  • Uhm Ji Hyun;Kim Mi Jin;Lee Young-Mock;Kim Ji Hong;Lee Jae Seung;Kim Pyung-Kil;Hong Soon Won;Jeung Hyeun Joo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.78-86
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    • 2001
  • Purpose: Rapidly progressive glomerulonephritis (RPGN) is characterized by the rapid increase in serum creatitnin and crescents formation involving more than $50\%$ of glomeruli. 10 patients who had been treated for RPGN were studied retrospectively for thier underlying diseases and clinical features Method: Cilinical review was performed on 10 children who were diagnosed with RPGN by clinical features and renal biopsy and followed up at department of pediatrics during tile last 10 years, from May 1990 to May 2000. Result: There were 6 males and 4 females between the ages of 2.1 and 14.3 years (mean $10.9{\pm}3.8$). 3 had Henoch-$Sch{\ddot{o}}nlein$ purpura nephritis; 2, idiopathic rapidly progressive glomerulonephritis; 2, lupus nephritis; 1, hemolytic uremic syndrome; 1, membranous glomerulonephritis and 1, microscopic polyangiitis. The most common chief complaints were gross hematuria and oliguria. Initial clinical features included proteinuria, edema, hypertension, nausea and arthralgia. Mean serum BUN was $74.2{\pm}39.1\;mg/dL$ mean serum creatinin, $3.2{\pm}1.8\;mg/dL$ and mean creatinin clearance, $26.5{\pm}13.2\;mL/min/1.73m^2$. Antineutrophil cytoplasmic antibody was positive only in microscopic polyangiitis. ANA and Anti-DNA antibody were positive in two lupus nephritis patients. Serum complements were decreased in 4 patients. All patients except Hemolytic uremic syndrome received steroid pulse therapy and immunosupressive agents. 3 patients were performed acute peritoneal dialysis and 2 patients were given plasmapheresis. At the last follow up, 1 patient was dead, 4 patients had elevated serum creatinin, 2 of these 4 patients were on chronic ambulatory peritoneal dialysis and 6 patients had normal renal function. Conclusion: Rapidly progressive glomerulonephritis is a medical emergency that requires very rapid diagnosis, classification, and therapy. Appropriate therapy selected on the basis of underlying disease mechanism can substantially improve renal survival. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 78-86)

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Risk Factor's Affecting long-term Outcome of Alport syndrome (Alport 증후군의 예후와 관련된 위험요인 분석)

  • Byun Ji-Yoon;Baek Seoung-Yon;Lee Young-Mock;Kim Ji-Hong;Lee Jae Seung;Kim Pyung-Kil;Hong Soon-Won;Jeong Hyeon-Joo;Kim Soon-Il;Kim Yu-Seun;Park Ki-Il
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.164-175
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    • 2001
  • Purpose : Alport syndrome is a hereditary nephrotic disease characterized by progressive nephrotic symptom, sensorineural hearing loss, ophthalmic abnormality, typical microscopic findings, and familial occurrence. In this study, we tried to find the risk factors related with its prognosis by taking a close observation on clinical symptoms of children with Alport syndrome reviewing retrospectively. Materials & methods : We chose children diagnosed as Alport syndrome in renal biopsy during 20 years(from 1980, Jan. until 1999, Dec.) who could receive follow up studies in tile department of pediatrics. They were divided into two groups by comparing renal function at the time of diagnosis and at current status. We compared several clinical aspects in them, and applied nonparametric test for statistical analysis. Results : The sex ratio(male:female) of 24 children was 3:1. The most common clinical symptom presented at their first visit was gross hematuria. Among those 24 children, 11 cases($46\%$) of progressing into chronic renal failure(Group II) were observed. Hypertension, proteinuria and edema were seen much frequently in group II. The level of serum protein, albumin, and creatinine clearance were decreased while BUN, creatinine were relatively increased. All the results were statistically significant. Conclusion Clinically significant risk factors related to prognosis in Alport syndrome were the presence of hypertension, edema, and proteinuria at the time of diagnosis. Also, the level of serum protein, albumin, BUN, creatinine, and glomerular filtration rate were proved to be important factors in predicting prognosis. We believe that studies on these possible risk factors would be of great help in treating and predicting prognosis of children suffering with Alport syndrome. (J Korean Soc Pediatr Nephrol 2001;5 : 164-75)

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