• 제목/요약/키워드: Follow-Up

검색결과 12,374건 처리시간 0.032초

대구 ${\cdot}$ 경북지역 일부 자폐장애 환자의 4 ${\sim}$ 7년후 추적 연구 - 자폐장애의 증상 중심으로 - (A FOUR TO SEVEN YEAR FOLLOW-UP STUDY OF SYMPTOMS OF AUTISTIC CHILDREN IN TAEGU AND KYUNGPOOK PROVINCE)

  • 정철호
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제11권2호
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    • pp.186-197
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    • 2000
  • 연구목적:자폐장애는 예후가 가장 좋지 않은 소아정신장애 중의 하나이나, 최근에는 과거의 연구들보다는 다소 나은 예후가 보고되기도 한다. 본 연구는 자폐장애 환자들의 증상을 중심으로 비교적 단기 경과를 탐색하고자 하였다. 방 법:DSM-III-R 진단기준의 50명 자폐장애 환자들($1{\sim}13$세)을 $4{\sim}7년(6.4{\pm}1.1년)$ 후 추적 평가하여 증상의 변화유무와 사용한 치료방법, 나이, 성별, 지능, 신체증상에 따른 자폐증상의 변화를 분석하였다. DSM-III-R의 진단 기준을 A(Social interaction, A1${\sim}$A5), B(Communication, B1${\sim}$B6), C(Activities and interests, C1${\sim}$C5)로 분류하여 비교하였다. 결 과:추적 평가시가 초기평가시에 비하여 전체적으로 뿐만 아니라, A, B, C 각각의 영역에서도 유의하게 증상의 수가 줄었다. 50% 이상 감소한 증상들로는 A1, A2, A3 증상, B1, B2, B3, B4, B5 증상, C1, C3 증상이었다. 의사소통 영역이 초기 평가시나 추적시에 가장 낮은 빈도를 보였다. 나이가 많은 군과 특수교육군에서 의사소통 능력이 더 나았으나, 성별, 지능, 신체증상에 따른 증상의 변화는 통계적으로 유의하지 않았다. 결 론:자폐장애가 청소년기까지는 시간이 지남에 따라 전반적으로 증상의 호전을 보였다. 향후 성인을 포함한 장기 추적연구가 필요할 것이며, 적극적인 조기 발견과 조기 치료적 중재를 시행하여야 할 것이다.

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수술 후 지속되는 과다비성 환자에서 지속성 기도양압 치료의 장기적 유효성: 증례보고 (Long-term Effectiveness of Post-operative Continuous Positive Airway Pressure (CPAP) Therapy for Treating Hypernasality: Case Report)

  • 권주용;박미경;백롱민
    • Archives of Plastic Surgery
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    • 제38권6호
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    • pp.871-874
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    • 2011
  • Purpose: In some patients with velopharyngeal insufficiency (VPI), Hypernasality can persist after surgical management. Continuous Positive Airway Pressure (CPAP) is applied to these patients for treating hypernasality. The purpose of this study is to report follow-up results of postoperative CPAP therapy. Methods: After performing palatal lengthening, CPAP therapy was applied to three patients for eight weeks from July of 2008 to November of 2009. Perceptual evaluation, nasometry, and nasopharyngeal endoscopy were performed to evaluate hypernasality, nasalance and size of the gap at velopharyngeal port. Each evaluation was made before surgery, right after CPAP therapy and during follow-up of more than a year after CPAP therapy. Results: All of the patients showed improvement in hypernasality right after CPAP therapy according to the auditory perceptual evaluation, nasometry and nasopharyngeal endoscopy. But the improvement in hypernasality in these patients did not last during follow-up. Conclusion: In this study, our results suggest that CPAP therapy is effective in reducing hypernasality for postoperative VPI patients immediately after the therapy, but hypernasality may be worsen in some patients during follow-up. Therefore we recommend follow-ups after CPAP therapy to see if the efficacy of CPAP therapy lasts.

Experiences of Neuroform Stent Applications for Ruptured Anterior Communicating Artery Aneurysms with Small Parent Vessel

  • Yun, Jung-Ho;Cho, Chun-Sung
    • Journal of Korean Neurosurgical Society
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    • 제48권1호
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    • pp.53-58
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    • 2010
  • Objective : The purpose of this study was to review the safety and durability of aneurysms treated with stent-assisted coiling of ruptured anterior communicating artery aneurysms with small parent vessels (< 2.0 mm). Methods : Retrospective review of all ruptured aneurysm treated with stent assisted endovascular coiling between March 2005 and March 2009 at our institution was conducted. We report 11 cases of the Neuroform stent placement into cerebral vessels measuring less than 2.0 mm in diameter (range, 1.3-1.9 mm) in anterior cerebral artery. Clinical follow-up ranged from 3 to 12 months and imaging follow-up was performed with cerebral angiography at 6 months and 12 months after discharge. Results : Complete occlusion was achieved in 10 patients, and a remnant neck was evident in one. No stent displacement or no dislodgement occurred during stent placement. There was no evidence of thromboembolic complication, arterial dissection and spasm during procedure. We performed follow-up angiography in all patients at 6 months and/or 12 months from the first procedure. The follow-up angiographic data showed successfully results except one in-stent stenosis case. All patients improved clinical performances except one patient with severe vasospasm who showed poor clinical condition initially. Conclusion : We have safely and successfully treated 11 vessels smaller than 2.0 mm in diameter with self-expanding stents with good short and intermediate term results. More clinical data with longer follow-ups are needed to establish the role of stent-assisted coiling in ruptured aneurysms with small parent vessels.

지지 전화를 이용한 자조타이치 프로그램 적용 효과 (Effects of the Self-help Tai Chi Program for Arthritis with Supportive Follow up Phone-Calls)

  • 최정숙;이은희;소애영;이경숙
    • 근관절건강학회지
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    • 제16권2호
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    • pp.174-183
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    • 2009
  • Purpose: The purposes of this study were to develop and examine the self-help and Tai Chi program for arthritis, and to identify the effect when combined with a supportive follow up phone-calls. Method: The design for this study was a 3*2 quasi-experimental design. Sixty-six participants were recruited in W-city, and assigned to Exp 1 group (n=21) or Exp 2 group (n=24) according to supportive follow-up phone call method, or to the control group (n=21). Fifty-two subjects (17 and 20 in Exp 1 and 2, and 15 in the control group) completed pretest and posttest. Both experimental groups participated in the self-help and Tai Chi program for arthritis once a week for 8 weeks. Exp 1 received automated follow up phone-calls made up in KT-SHUT program, and Exp 2 received follow up phone-calls made up by researchers. The control group received no education and no phone call. Measures used to examine the effect self-help and Tai Chi program for arthritis were joint flexibility, hand muscle strength, balance with closed eyes and self-efficacy. The final analysis of the post-test measures was conducted by ANCOVA with age and self efficacy as covariates. Results: Both experimental group had significantly increased right shoulder flexibility (p=.002), left shoulder flexibility (p=.000), right hand grip (p=.024), and self efficacy (p=.008) compared with the control group. But there were no significant differences between two experimental groups in any physical indicators and self efficacy. Conclusion: Automated follow up phone-call would be helpful in managing the self-help and Tai Chi program for arthritis as well as researcher's phone call. The automated follow up phone-call program which was a new method could be recommended for use to encourage home exercise practice and the program participation.

회복기 심초음파 검사상 관상동맥 내경 크기가 정상 범위인 가와사끼병 환자에서 추적관찰 방법에 대한 고찰 (Follow-Up Method in Patients with Kawasaki Disease who had No Coronary Artery Abnormalities in the Convalescent Period)

  • 주희정;송민섭;김철호
    • Clinical and Experimental Pediatrics
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    • 제48권2호
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    • pp.165-173
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    • 2005
  • 목 적 : 가와사끼병의 치료에 면역 글로불린이 도입된 이후 환자의 대부분이 회복기 심초음파 검사에서 정상 관상동맥 소견을 보이게 되었으나 그 장기 예후는 아직 불분명하며 추적관찰 방법도 아직 표준화되지 못한 상태이다. AHA에서는 이 환자군을 위험도 1 또는 2로 분류하고 발병 6-12개월경의 추적 심초음파 검사와 발병 1년까지 외래 추적관찰을 권하고 있다. 본 연구는 이 추적 심초음파 검사의 유용성 정도를 알아보고자 하였으며, 실제 임상에서는 이들 환자가 어떻게 추적관찰되고 있는지 조사하여 그 결과를 비교하였다. 방 법 : 2000년 1월부터 2003년 10월까지 인제대학교 부속 부산백병원 소아과에 가와사끼병으로 내원하였던 환아 147명 중 급성기와 회복기 심초음파 검사결과 AHA위험도 1, 2에 해당되며 발병 후 최소 6개월 이상의 경과를 가진 환아 중에서 심초음파 및 심전도 검사를 시행할 수 있었던 45례를 대상으로 하여 의무기록과 심초음파 검사 결과를 분석하였다. 아울러 국내 소아 심장전문의들에게 관상동맥 병변의 진단 기준 및 AHA 위험도 1, 2군에 속하는 환자들의 추적관찰 방법에 대한 설문조사를 실시하였다. 결 과 : 1) 45례의 대상 환아들의 발병 당시 연령은 5개월에서 7세(평균 29.7개월), 남녀비는 1.4 : 1이었고 평균 발열 기간은 7.3일이었다. 이 중 AHA 위험도 1군은 37례(82.2%), AHA 위험도 2군은 8례(17.8%)이었다. 2) 급성기 심초음파 검사는 평균 발열 후 11.2일에 시행되었다. 24례(53.3%)에서 경한 판막 역류나 소량의 심막액 저류를 보였고 관상동맥 확장은 8례(17.8%)에서 나타났다. 회복기 검사는 평균 발열 8.8주에 시행되었고 모두 심초음파 검사상 정상 관상동맥 소견을 보였으며 경도의 판막 역류가 3례(6.7%)에서 관찰되었다. 추적 검사는 발병 후 평균 22.2개월에 시행되었고 관상동맥 소견은 모두 정상이었다. 5례(11.1%)에서 심낭 삼출 및 판막의 역류가 미량 관찰되었고 1례에서는 심전도에서 이속성 각차단이 나타났으나 심근 경색, 허혈의 소견이나 심기능의 저하는 없었다. 5세 미만과 5세 이상에서 각각 급성기, 회복기, 추적관찰기간의 좌, 우 관상동맥의 평균 내경을 비교하였으나 통계적으로 유의한 변화는 없었다(Table 2, 3). 3) 설문조사의 응답자는 27명이었으며 AHA 위험도 1군에게는 회복기 심초음파 검사까지만 실시한다는 응답이 가장 많았고(48.2%) 외래 추적관찰은 회복기 이후 중단하거나(37.0%), 발병 1년까지만 하는 경우(33.3%)가 대부분이었다. 평균 심초음파 검사 횟수는 2.3회였다. AHA 위험도 2군에게는 회복기 이후 발병 6개월에서 12개월 사이에 1회(37.0%) 또는 2회(51.9%)의 추가 검사를 실시하는 것으로 나타났다. 외래 추적관찰은 1년까지만 하는 경우(33.3%)가 가장 많았으나 다양한 답변이 있었다(Table4). 평균 심초음파 검사 횟수는 3.4회였다. 관상동맥 이상의 판단은 5세 미만 내경 3 mm 이상, 5세 이상에서 내경 4 mm 이상을 병변으로 판단한다는 답변이 가장 많았다(77.8%). 그러나 개인의 선호도에 따라 응답에 차이가 있었다. 결 론 : 본 연구에서 회복기 심초음파 검사상 정상 관상동맥 내경을 보였던 환자들은 발병 6개월 이후 실시한 추적 검사에서도 관상동맥 내경의 변화는 없는 것으로 나타나 AHA에서 권고하는 발병 6-12개월 사이의 추적 심초음파 검사는 유용성이 떨어지는 것으로 판단된다. 임상의들을 대상으로 한 설문조사에서는 AHA 위험도 1군에서는 회복기 이후에 심초음파 추적검사를 하지 않는 병원이 많은 것으로 나타났으나 AHA 위험도 2군에서는 발병 1년까지 추적 심초음파 검사를 하는 병원이 더 많은 것으로 나타났다. 앞으로 초기 심초음파 검사상 정상이었던 가와사끼병 환자군의 장기예후와 추적관찰 방법에 대해 더 많은 수의 증례를 대상으로 한 다기관 조사를 통해 관상동맥 이상의 진단 기준의 표준화 및 적절한 추적관찰 지침을 제정할 필요가 있는 것으로 사료된다.

ISO 9000 품질경영시스템 규격변화에 따른 조선업 협력업체의 사후관리심사에 관한 연구 (The Study of Follow-up Audit Compliance for Quality Management System in Subcontractors of Shipbuilding Industry Based on ISO 9000 Requirements Changes)

  • 박동준;강인선
    • 대한안전경영과학회지
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    • 제13권4호
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    • pp.161-169
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    • 2011
  • International Organization for Standardization has recently published ISO 9001:2008 which is the basic requirements for a quality management system that an organization must fulfil to demonstrate its ability to consistently provide products that enhance customer satisfaction and meet applicable statutory and regulatory requirements. Not many empirical researches based on ISO 9001:2008 have been done up until now. In this article we outline transitional features for ISO 9000 quality management system (QMS) since its first publication in 1987. In order to effectively maintain ISO 9001:2008 QMS certification and continuously enhance quality management activities, we perform statistical analysis for the minor nonconformity data generated from follow-up audits for subcontractors of shipbuilding industry based on ISO 9001:2008 requirements. A Kruskal-Wallis test is used to show relationships between the minor nonconformity data and three classification criteria: the type of business, the size of business, and the number of follow-up audits.

Incidence of Infection among Subjects with Helicobacter pylori Seroconversion

  • Young Jung Kim;Sun-Young Lee;Jeong Hwan Kim;In-Kyung Sung;Hyung Seok Park
    • Clinical Endoscopy
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    • 제55권1호
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    • pp.67-76
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    • 2022
  • Background/Aims: Helicobacter pylori (H. pylori) seroconversion may occur during screening for gastric cancer. Our study aimed to assess the number of seroconverted subjects with H. pylori and their results in follow-up tests. Methods: Data were consecutively collected on subjects who were H. pylori-seronegative and presented for gastric cancer screening. Subjects who were followed up using the same serology test and pepsinogen (PG) assays on the day of endoscopy were included in the study. Results: During the follow-up of 57.7±21.4 months, 61 (15.0%) of 407 seronegative subjects showed seroconversion. H. pylori infection was detected in six (9.8%) of 61 seroconverted subjects. A diffuse red fundal appearance, with a significant increase in the Kyoto classification scores for gastritis, was observed in the infected subjects (p<0.001). Compared to the false-seropositive subjects, infected subjects showed higher serology titers (p<0.001) and PG II levels (p<0.001) and lower PG I/II ratios (p=0.002), in the follow-up tests. Conclusions: Seroconversion occurred in 3.3% of seronegative subjects per year; however, only 9.8% had H. pylori infection. The majority (90.2%) of the seroconverted subjects showed false seropositivity without significant changes in the follow-up test results. The diffuse red fundal appearance could be an indicator of H. pylori infection.

Partially Parametric Estimation of Lifetime Distribution from a Record of Failures and Follow-Ups

  • Yoon, Byoung Chang
    • 품질경영학회지
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    • 제22권4호
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    • pp.59-78
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    • 1994
  • In some observational studies, we have often random censoring model. However, the data available may be partially observable censored data consisting of the observed failure times and only those nonfailure times which are subject to follow up. In this paper, we present an extension of the problem of partially parametric estimation of the survival function to such partially observable censored data. The proposed estimator treats the observed failure times nonparametrically and uses a parametric model only for those nonfailure times which are subject to follow-up. We discuss the motivation and construction of the proposed estimator and investigate the limiting properties of the proposed estimator such as asymptotic normality. Also, when the assumed parametric model is exponential, the asymptotic variance of the estimator is obtained. Furthermore, an example is given to compare the proposed estimator with the modified Kaplan Meier(MKM) estimator. From the results, it is shown that the relative efficiency of the proposed estimator is higher than that of the MKM estimator in the follow-up study with increasing time.

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A Study of Optical Follow-up Pipeline for Gravitational-Wave transients using QUEST data

  • 김용범;이형목
    • 천문학회보
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    • 제38권1호
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    • pp.69.2-69.2
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    • 2013
  • The direct detection of gravitational wave has a very important meaning as a basis for verification of the theory of relativity. Several laser interferometer detectors have attempted to detect GW directly (e.g. LIGO, VIRGO), but positional accuracy of GW detector is too wide (about 10~100sq deg) to find which objects emit GW. One of the main sources of GW is gamma-ray burst which can be detected even in electromagnetic wave. Then to verify Gamma-ray burst object as a GW source, we proceed EM follow-up observation with wide field of view. A first program initiating EM follow-ups to possible transients GW events has been developed and exercised by LIGO and VIRGO community in association with several partners. Using QUEST optical data, we tested the method of cross-convolution recommended by EM follow-up community. We will describe the results of that test.

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The Efficacy of Aspirin in Preventing the Recurrence of Colorectal Adenoma: a Renewed Meta-Analysis of Randomized Trials

  • Zhao, Tai-Yun;Tu, Jing;Wang, Yin;Cheng, Da-Wei;Gao, Xian-Kui;Luo, Hao;Yan, Bi-Chun;Xu, Xiao-Li;Zhang, Hong-Ling;Lu, Xing-Jun;Wang, Yao-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권5호
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    • pp.2711-2717
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    • 2016
  • Background: Through search the possible randomized control trials, we make a renewed meta-analysis in order to assess the impact of aspirin in preventing the recurrence of colorectal adenoma. Materials and Methods: The Medicine/PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Chinese biomedical literature service system (SinoMed) databases were searched for the related randomized controlled trials until to the April 2016. Three different authors respectively evaluated the quality of studies and extracted data, and we used the STATA software to analyze, investigate heterogeneity between the data, using the fixed-effects model to calculate and merge data. Results: 7 papers were included the renewed meta-analysis, among these studies, two pairs were identified as representing the same study population, with the only difference being the duration of follow-up. Thus there were only five papers included our meta-analysis, and one Chinese paper were also included the work. Results were categorized by the length of follow-up, different kinds of people, varied dose of oral aspirin. The relative of adenoma in patients taking aspirin vs placebo were 0.73 (95% CI 0.55-0.98, P=0.039) with 1 year follow up; 0.84 (95% CI 0.72-0.98, P=0.484) with greater than 1 year follow up; for the advanced adenoma, the RR 0.68 (95% CI 0.49-0.94, P=0.582),for one year; RR=0.75 (95% CI 0.52-1.07, P=0.552) for greater one year. Furthermore the white population could divided into two subgroups according to the different length of follow-up time. When the length of follow-up time less than 3-year, The RR of two subgroups respective were RR=0.86 (95% CI 0.76-0.98, P=0.332), $I^2=0%$, RR=0.68 (95% CI 0.47-0.98, P=0.552), $I^2=64.6%$, But with the extension of follow-up time greater than 2-year, with the white, oral aspirin without considering dose had no efficacy on preventing the recurrence of any adenoma, the RR was 0.86 (95% CI 0.71-1.05, P=0.302), $I^2=16.4%$. Conclusions: This meta-analysis indicated that oral aspirin is associated with a remarkable decrease in the recurrence of any adenoma and advanced adenomas in patients follow-up for 1 year without concerning the dose of aspirin, but with the extension of follow-up time for greater than 1 year, oral aspirin can be effective on preventing the recurrence of any adenoma, but for the advanced adenoma, the result indicated that oral aspirin had no efficacy, According to the inclusion of ethnic groups, we also divided relevant papers into two subgroups as the yellow and white group. Then the follow-up time was less than 3 years, oral aspirin without considering the dose, had an significant efficacy on preventing the recurrence of any adenoma. But with the follow-up greater than 2 years, oral aspirin had no effect in the white.