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Risk factor of influenza virus infection to febrile convulsions and recurrent febrile convulsions in children (인플루엔자 바이러스 감염에서 소아 열성 경련과 열성 경련의 재발에 관한 위험인자)

  • Moon, Jae Won;Kang, Jang Hee;Kim, Hyun Ji;Byun, Soon Ok
    • Clinical and Experimental Pediatrics
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    • v.52 no.7
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    • pp.785-790
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    • 2009
  • Purpose : Febrile convulsions are a common pediatric neurological disease, and it is important to prevent such a disease by controlling the risk factors that may recur. A recent report states that influenza virus infections have a high probability of a relationship with febrile convulsions; therefore, it is necessary to identify the clinical properties of febrile convulsions in relation to domestic influenza virus infections. Methods : Between November 2005 and February 2008, children hospitalized because of febrile convulsions and subsequently confirmed to have influenza infections were enrolled as subjects (patient group, n=11). The control subjects were those admitted with influenza virus infections but no febrile convulsions (control group 1, n=46) and those who developed febrile convulsions without influenza virus infection (control group 2, n=53). Results : The patient group showed a higher maximum body temperature ($39.3{\pm}0.5^{\circ}C$), more histories of past febrile convulsions (72.7%), and a shorter total duration of fever ($2.9{\pm}1.2$ days) than control group 1. When multivariate analysis was performed, the probability of febrile convulsions was found to be as high as 225.9 times in patients who had influenza virus infections with a past history of febrile convulsions (OR=225.9, 95% CI: 1.7-4780.0, P<0.05). When patients with febrile convulsions were compared based on the symptoms of influenza virus infections, the patient group showed a shorter duration of fever ($0.9{\pm}0.7$ days) before convulsion than control group 2; these convulsions were mostly a recurrence of febrile convulsions. When multivariate analysis was performed, the cases with a past history of febrile convulsions showed 5.5 times (OR=5.5, 95% CI: 1.2-25.1, P=0.03) the probability of convulsions when infected with the influenza virus, and this probability decreased by 0.3 times over one-day increments of the febrile period until febrile convulsions (95% CI: 0.1-0.9, P=0.02). Maximum body temperature, total duration of fever, family history of febrile convulsions, and complex febrile convulsions did not show a statistical significance. Conclusion : In cases of pediatric influenza virus infection, the past history of febrile convulsions could be identified within the risk factor of recurrent febrile convulsions. Therefore, influenza vaccination of children having a past history of febrile convulsions will be helpful to avoid the recurrence of these convulsions.

Perfusion MR Imaging of the Brain Tumor: Preliminary Report (뇌종야의 관류 자기공명영상: 예비보고)

  • 김홍대;장기현;성수옥;한문희;한만청
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.119-124
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    • 1997
  • Purpose: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. Materials and Methods: We performed perfusion MR imaing preoperatively in the consecutive IS patients with intracranial masses(3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurocytoma, 1 metastasis, 2 abscesses, 1 radionecrosis). The average age of the patients was 42 years (22yr -68yr), composed of 10 males and S females. All MR images were obtained at l.ST imager(Signa, CE Medical Systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media. (contrast media: IScc of gadopentate dimeglumine, about 2ml/sec by hand, starting at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(CE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE SOms, flip angle $90^{\circ}$, FOV $240{\times}240mm,{\;}matrix{\;}128{\times}128$, slice-thick/gap S/2.S). After data collection, the raw data were transferred to CE workstation and rCBV maps were generated from the numerical integration of ${\Delta}R2^{*} on a voxel by voxel basis, with home made software (${\Delta}R2^{*}=-ln (S/SO)/TE). For easy visual interpretation, relative RCB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Cd-enhanced images with focus on the degree and extent of perfusion and contrast enhancement. Results: Two cases of glioblastoma multiforme with rim enhancement on Cd-enhanced Tl weighted image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin. In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion of moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. Conclusion: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade gliomas. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.

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Differentiation of Recurrent Rectal Cancer and Postoperative Fibrosis: Preliminary Report by Proton MR Spectroscopy (재발성 직장암과 수술 후 섬유화의 감별 진단: 수소 MRS에 의한 예비보고)

  • Jeon Yong Sun;Cho Soon Gu;Choi Sun Keun;Kim Won Hong;Kim Mi Young;Suh Chang Hae
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.1
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    • pp.24-31
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    • 2004
  • Purpose : To know the differences of proton MR spectroscopic features between recurrent rectal cancer and fibrosis in post-operative period, and to evaluate the possibility to discriminate recurrent rectal cancer from post-operative fibrosis by analysis of proton MR spectra. Materials and Methods : We evaluated the proton MR spectra from 25 soft tissue masses in perirectal area that developed in post-operative period after operation for the resection of rectal cancer. Our series included 11 cases of recurrent rectal cancer and 14 of fibrotic mass. All cases of recurrent rectal cancer and post-operative fibrosis were confirmed by biopsy. We evaluated the spectra with an attention to the differences of pattern of the curves between recurrent rectal cancer and post-operative fibrosis. The ratio of peak area of all peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P (1.6-4.1ppm/P (0.9-1.6ppm)] was calculated in recurrent rectal cancer and post-operative fibrosis groups, and compared the results between these groups. We also evaluated the sensitivity and specificity for discriminating recurrent rectal cancer from post-operative fibrosis by analysis of $^1H-MRS$. Results : Proton MR spectra of post-operative fibrosis showed significantly diminished amount of lipids compared with that of recurrent rectal cancer. The ratio of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis was much higher than that of recurrent rectal cancer with statistical significance (p < .05) due to decreased peak area of lipids. Mean (standard deviations of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis and recurrent rectal cancer group were $2.71{\pm}1.48\;and\;0.29{\pm}0.11$, respectively. With a cut-off value of 0.6 for discriminating recurrent rectal cancer from post-operative fibrosis, both the sensitivity and specificity were $100\%$ (11/11, and 14/14). Conclusion : Recurrent rectal cancer and post-operative fibrosis can be distinguished from each other by analysis of proton MR spectroscopic features, and $^1H-MRS$ can be a new method for differential diagnosis between recurrent rectal cancer and post-operative fibrosis.

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A Study on Implementation of Primary Health Care Delivery System meet to Rural Area in Korea -Village Health Voluntary Worker Development- (우리 나라 농촌지역(農村地域)에 부합하는 1차(次) 보건의료전달체계(保健醫療傳達體系) 정착구현(定着具現)에 관한 연구(硏究) -마을 보건임원(保健任員) 개발(開發)-)

  • Koo, Y.C.;Wie, J.H.;Hwang, S.J.;Choi, S.S.
    • Journal of Preventive Medicine and Public Health
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    • v.12 no.1
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    • pp.13-23
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    • 1979
  • A study was carried out from October 1977 to September 1978 in order to develope health care delively system which will meet to rural area in Korea. For the study objective a model of health care delivery system of Myun (township) area was developed which is adopted the net-work of village health voluntary worker who will play the role of bridge for communication related with health and illness between families or village people and health subcenter, and :he model health care delivery system net-work was set in the area of Soodong Myun, Yangju Gun. which is the rural health demonstration area of Ewha Womans University since 1972. The activities and attitude of 22 village health voluntary workers were observed and analized. during the study period. The results are as follows; 1. For the field activities of village health voluntary workers. a guide line which is described with specific behavioral objectives was developed and used for not only training of the workers but also evaluation of their field activities. 2. During the study period, the number of 971 village people were served primary health care service by village health voluntary worker and the service was classified largely into symptomatic medications (92%) and preventive measures (8%). 3. Comparative percentage of the number of 894 symptomatic cases cared by village health voluntary workers to 5,695 cases of patient treated by Soodong Health Subcenter during the same period was 15.7%. 4. Annual utility rate of village health voluntary worker by Myun total people was 16.1% but utility rate by Rie was varied from 38.2% to 2.8% which shown there were considerable differences in each Rie. In order to settle the village health care service, the obstructive factors of utility should be detected and their counter measure must be taken. 5. As the health need of village people increases, it is expected that the supplement of drug excluding present sit basic drugs is inevitable, but considering the ability of village health voluntary worker, the selection of additional drugs and education, plan should be carefully studied. 6. It is desirable that a financial resource for supplementary purchase of first aid kit, drugs and materials whould be alloted from village public fund like Saemaeul Women's Club fund, which has already practiced in a few villages in the study area. 7. As pointed out by village health voluntary workers, in order to improve the village health, village leaders should be in the center of it and the cooperation of whole village people is a core of healthful village development, and it is reasonable that the health subcenter backs up these voluntary health activities by village people in techniques. 8. It seems effective that a supplementary education for village health voluntary worker be accomplished by a planned education through regular meetings like worker's monthly meeting and irregular post guide when Myun Health Workers can handle the problems found during the round trip of villages. 9. It is desirable that village health voluntary workers, who are recommended by a civil voluntary organization like Saemael Woman's Club, are charged by natural villagc unit, are given a function of village health care service and used through basic education at health subcenter. 10. It is advisable that the village health voluntary worker's service is compensated not by a form of money, but by other way such as an exemption of medical fee of worker herself or her families in health subcenter can be one method. 11. Daily health activities of each village health voluntary worker should be reported to health subcenter by biweekly or monthly in order to get not only for basic data of the program but also for evaluation the program. It is recomandable that the report form should be simple and clear enough for village health voluntary worker to fill it effectively. 12. Village health care service should be developed into a Saemaeul Movement in which village people actively participate. For this, the appointed function of village health voluntary worker should be absorbed into those of living Environment Betterment Section or Family Planning Section of Saemaeul Women's Club or it is desirable that establish a new section, Village Health Promoting Section and make it involve the appointed functions of those sections mentioned above.

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Airway Expandible Metallic Stent Implantation in Children with Tracheal or Bronchial Stenosis (기관 또는 기관지 협착을 가진 소아에서의 스텐트 적용)

  • Jang, Ju Young;Kim, Hyo-Bin;Lee, So Yeon;Kim, Ja Hyung;Park, Seong Jong;Shin, Ji Hoon;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.512-517
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    • 2005
  • Purpose : In adults, endoscopic tracheobronchial balloon dilatation and stenting have become valuable methods to establish and maintain an adequate airway lumen when tracheomalacia or neoplastic growth compromise the airways. But in children, only a few cases were reported due to technical problems. We report six children who were treated with stent implantation and describe the use and safety of airway stents. Methods : Six patients with severe airway obstruction were treated. We investigated the underlying medical problems, stenotic site, symptomatic improvement and complications, and the size and location of stent. Results : The median age of the six patients was 21 months. Three of them were mechanically ventilated and one had an endotracheal tube to maintain the patency of airway. Diagnoses were : congenital tracheal stenosis with or without bronchomalacia, granulation tissue formation after right upper lobectomy by bronchial carcinoid or after prolonged intubation, endobronchial tuberculosis, and airway compression by mediastinal undifferentiated sarcoma. Nitinol stents were implanted in the airway guided by bronchoscopy and fluoroscopy simultaneously. Three cases were placed in trachea, the others were in the bronchus. After stent implantation, all patients showed marked improvements of their airway obstructive symptoms. Four patients are doing well, although two expired due to underlying diseases. Four patients had granulation tissue formation around stents, but that was tolerable after removing the stent. Conclusion : We suggest that the use of expandible metallic stent implantation can offer safe therapeutic option even in extremely severe, life threatening and inoperable airway stenosis in children.

Excimer-Based White Phosphorescent OLEDs with High Efficiency

  • Yang, Xiaohui;Wang, Zixing;Madakuni, Sijesh;Li, Jian;Jabbour, Ghassan E.
    • 한국정보디스플레이학회:학술대회논문집
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    • 2008.10a
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    • pp.1520-1521
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    • 2008
  • There are several ways to demonstrate white organic light emitting diodes (OLEDs) for displays and solid state lighting applications. Among these approaches are the stacked three primary or two complementary colors light-emitting layers, multiple-doped emissive layer, and excimer and exciplex emission [1-10]. We report on white phosphorescent excimer devices by using two light emitting materials based on platinum complexes. These devices showed a peak EQE of 15.7%, with an EQE of 14.5% (17 lm/W) at $500\;cd/m^2$, and a noticeable improvement in both the CIE coordinates (0.381, 0.401) and CRI (81). Devices with the structure ITO/PEDOT:PSS/TCTA (30 nm)/26 mCPy: 12% FPt (10 nm) /26 mCPy: 2% Pt-4 (15 nm)/BCP (40 nm)/CsF/Al [device 1], ITO/PEDOT:PSS/TCTA (30 nm)/26 mCPy: 2% Pt-4 (15 nm)/26 mCPy: 12% FPt (10 nm)/BCP (40 nm)/CsF/Al [device 2], and ITO/PEDOT:PSS/TCTA (30 nm)/26 mCPy: 2% Pt-4: 12% FPt (25 nm)/BCP (40 nm)/CsF/Al [device 3] were fabricated. In these cases, the emissive layer was either the double-layer of 26 mCPy:12% FPt and 15 nm 26 mCPy: 2% Pt-4, or the single layer of 26mCPy with simultaneous doping of Pt-4 and FPt. Device characterization indicates that the CIE coordinates/CRI of device 2 were (0.341, 0.394)/75, (0.295, 0.365)/70 at 5 V and 7 V, respectively. Significant change in EL spectra with the drive voltage was observed for device 2 indicating a shift in the carrier recombination zone, while relatively stable EL spectra was observed for device 1. This indicates a better charge trapping in Pt-4 doped layers [10]. On the other hand, device 3 having a single light-emitting layer (doped simultaneously) emitted a board spectrum combining emission from the Pt-4 monomer and FPt excimer. Moreover, excellent color stability independent of the drive voltage was observed in this case. The CIE coordinates/CRI at 4 V ($40\;cd/m^2$) and 7 V ($7100\;cd/m^2$) were (0.441, 0.421)/83 and (0.440, 0.427)/81, respectively. A balance in the EL spectra can be further obtained by lowering the doping ratio of FPt. In this regard, devices with FPt concentration of 8% (denoted as device 4) were fabricated and characterized. A shift in the CIE coordinates of device 4 from (0.441, 0.421) to (0.382, 0.401) was observed due to an increase in the emission intensity ratio of Pt-4 monomer to FPt excimer. It is worth noting that the CRI values remained above 80 for such device structure. Moreover, a noticeable stability in the EL spectra with respect to changing bias voltage was measured indicating a uniform region for exciton formation. A summary of device characteristics for all cases discussed above is shown in table 1. The forward light output in each case is approximately $500\;cd/m^2$. Other parameters listed are driving voltage (Bias), current density (J), external quantum efficiency (EQE), power efficiency (P.E.), luminous efficiency (cd/A), and CIE coordinates. To conclude, a highly efficient white phosphorescent excimer-based OLEDs made with two light-emitting platinum complexes and having a simple structure showed improved EL characteristics and color properties. The EQE of these devices at $500\;cd/m^2$ is 14.5% with a corresponding power efficiency of 17 lm/W, CIE coordinates of (0.382, 0.401), and CRI of 81.

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Pericentric Inversion of the X Chromosome in a Male with Azoospermia and in the Family of a Pregnant Female Carrier (무정자증을 보이는 남성과 정상 생식력을 가진 여성의 가계에서 관찰된 X 염색체의 Pericentric Inversion)

  • Lee, Bom-Yi;Ryu, Hyun-Mee;Lee, Moon-Hee;Park, Ju-Yeon;Kim, Jin-Woo;Lee, Joong-Shik;Kim, Hye-Ok;Kim, Min-Hyung;Park, So-Yeon
    • Journal of Genetic Medicine
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    • v.5 no.2
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    • pp.139-144
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    • 2008
  • We report on two cases of pericentric inversion of X chromosome. The cases were found in a 40-year-old man with azoospermia and in a family of a 38-year-old pregnant woman. The first case with 46,Y,inv(X)(p22.1q27) had concentrations of LH, prolactin, estradiol, and testosterone that were within normal ranges; however, FSH levels were elevated. Testis biopsy revealed maturation arrest at the primary and secondary spermatocytes without spermatozoa. There were no microdeletions in the 6 loci of chromosome Y. For the second case, the cytogenetic study of thepregnant woman referring for advanced maternal age and a family history of inversion X chromosome was 46,X,inv(X)(p22.11q27.2). The karyotype of her fetus was 46,X,inv(X)(p22.1q27). Among other family members, the karyotypes of an older sister in pregnancy and her fetus were 46,X,inv(X)(p22.11q27.2), and 46,Y,?inv(X), respectively. The proband's father was 46,Y,inv(X)(p22.11q27.2). All carriers in the family discussed above were fertile and phenotypically normal. In addition, the ratio of inactivation of inv(X) by RBG-banding was discordant between the two sisters, with the older sister having only 4.1% of cells carrying inactivated inv(X) while the proband had a 69.5% incidence of late replicating inv(X). Therefore, we suggest that the cause of azoospermia in the first case might be related to inversion X chromosome with positional effect. Also, the family of the second case showing normal phenotype of the balanced inv(X) might be not affected any positional effect of genes.

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A Knowledge-based Approach for the Estimation of Effective Sampling Station Frequencies in Benthic Ecological Assessments (지식기반적 방법을 활용한 저서생태계 평가의 유효 조사정점 개수 산정)

  • Yoo, Jae-Won;Kim, Chang-Soo;Jung, Hoe-In;Lee, Yong-Woo;Lee, Man-Woo;Lee, Chang-Gun;Jin, Sung-Ju;Maeng, Jun-Ho;Hong, Jae-Sang
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.16 no.3
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    • pp.147-154
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    • 2011
  • Decision making in Environmental Impact Assessment (EIA) and Consultation on the Coastal Area Utilization (CCAU) is footing on the survey reports, thus requires concrete and accurate information on the natural habitats. In spite of the importance of reporting the ecological quality and status of habitats, the accumulated knowledge and recent techniques in ecology such as the use of investigated cases and indicators/indices have not been utilized in evaluation processes. Even the EIA report does not contain sufficient information required in a decision making process for conservation and development. In addition, for CCAU, sampling efforts were so limited that only two or a few stations were set in most study cases. This hampers transferring key ecological information to both specialist review and decision making processes. Hence, setting the effective number of sampling stations can be said as a prior step for better assessment. We introduced a few statistical techniques to determine the number of sampling stations in macrobenthos surveys. However, the application of the techniques requires a preliminary study that cannot be performed under the current assessment frame. An analysis of the spatial configuration of sampling stations from 19 previous studies was carried out as an alternative approach, based on the assumption that those configurations reported in scientific journal contribute to successful understanding of the ecological phenomena. The distance between stations and number of sampling stations in a $4{\times}4$ km unit area were calculated, and the medians of each parameter were 2.3 km, and 3, respectively. For each study, approximated survey area (ASA, $km^2$) was obtained by using the number of sampling stations in a unit area (NSSU) and total number of sampling stations (TNSS). To predict either appropriate ASA or NSSU/TNSS, we found and suggested statistically significant functional relationship among ASA, survey purpose and NSSU. This empirical approach will contribute to increasing sampling effort in a field survey and communicating with reasonable data and information in EIA and CCAU.

An Epidemiologic Investigation of Aseptic Meningitis Occurred in Pohang City : 1997~2002 (포항지역에서 발생한 무균성 뇌막염 환아의 역학적 양상 연구 : 1997~2002)

  • Kim, Seog Heon;Cheong, Hae-Kwan;Jung, Cheoll;Lee, Seonju;Ko, Joon Tae;Kim, Moon Kyu;Jeoung, Eun Young;Bae, Sun Ho
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.193-199
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    • 2003
  • Purpose : This study was performed to investigate the epidemiologic feature of aseptic meningitis in Pohang city for 6 years from 1997 to 2002. Methods : We reviewed the clinical records of 1,839(1,138 male and 701 female) aseptic meningitis patients who had been admitted to 3 general hospitals in Pohang city from 1997 to 2002. Results : 1,750 cases(1,078 male and 672 female) were selected as aseptic meningitis by reviewing clinical records. The ratio of male to female was 1.6 : 1. Aseptic meningitis occured in children of all age groups, and the prevalent age group was different by year. The most common developed month was June(31.3%), and 84.2% of cases were focused from May to August. The time from the initial manifestation to hospital admission was $4.19{\pm}2.96$ (median 3 days). Conclusion : We were performed to investigate the epidemiologic feature of clinical records of Aseptic meningitis pediatric patients who had been admitted and treated to 3 General hospitals in Pohang city from 1997 to 2002. We have to keep up Our study for consideration of the basic of Aseptic meningitis epidemiology and long term control is necessary to prevention the impact of Aseptic meningitis because Aseptic meningitis pediatric patients were continuously recorded by Epidemiological annual report in Pohang city.

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Clinical Study on Primary Mediastinal Tumors and Cysts -Report of 344 Cases- (원발성 종격동 종양 및 낭종에 대한 임상적 고찰 -344예에 대한 보고-)

  • Lee, Hong-Lyeol;Kim, Se-Kyu;Kim, Hae-Kyun;Chung, Kyung-Young;Lee, Doo-Yun;Kim, Sung-Eun;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.575-583
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    • 1993
  • Background: Mediastinal masses are not uncommon, and an overall incidence of one case per 100,000 population per year in individuals of all ages and with no difference in sex incidence may be a reasonable estimation. At least half of all mediastinal masses are asymptomatic and this proportion has increased in recent decades with wider use of screening chest roentgenography. Symptoms in patients with mediastinal mass lesions are usually due to compression or invasion of nearby intrathoracic structures. Most mediastinal mass lesions have characteristic predilectional locations. The basic focus of diagnostic evaluation is an orderly preparation for obtaining a tissue diagnosis but even lesions discovered to be benign must generally be removed. Seldom is this status known for certain preoperatively. In additaion, benign tumors may continue to enlarge, thus compromising vital organs; they may rupture, hemorrhage, become infected or have the possibility of various malignant degeneration. Therefore, all mediastinal masses must be surgically removed whether they are malignant or benign. Methods: We reviewed the medical records of 344 cases previously confirmed as mediastinal tumors or cysts from January, 1960 to August, 1992 and investigated the clinical findings. Results: Neurogenic tumors were the most common(24.7%) and thymomas were distinctively increased recently. Overall ratio between males and females was 1.1:1 and age distribution was relatively even among all age groups. Predilectional sites were posterior for neurogenic tumors, and anterior for teratodermoid tumors, thymomas and lymphomas. Dyspnea was the most common symptom in the patients of the mediastinal tumors and asymptomatic patients were 19.5%, Benign mediastinal mass lesions were 66.0% and malignant, 34.0%, Complete or partial resection was done in 42.4%. Conclusion: We could find the increasing incidence and the tendency of aggressive resection as possible in the mediastinal tumors. We expect the discovery of more mediastinal tumors with wider use of regular check-up and development of diagnostic methods.

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