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COMORBIDITY AND RISK FACTORS ASSOCIATED WITH CHILDREN WHO HAVE THE SYMPTOMS OF OPPOSITIONAL DEFIANT DISORDER - COMMUNITY BASED STUDY - (반항성 도전 장애 아동과 연관된 공존 증상 및 위험 요인에 관한 연구 - 지역사회 연구 -)

  • Kim Boong-Nyun;Jung Kwang-Mo;Cho Soo Churl;Hong Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.79-89
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    • 2005
  • Objectives : To acquire an improved understanding of oppositional defiant disorder, we evaluated the characteristics of children who have the symptoms of ODD in community sample. Methods : 1200 children from an elementary school in Bucheon (an urban community near Seoul) were recruited by randomized sampling method. By Disruptive Behavior Disorder Scale according to DSM-III-R & DSM-IV, we evaluated the symptoms of ODD and selected subjects with ODD. Psychiatric comorbidity, character trait were compared in subjects with ODD and comparison group. Also we examined the association between prenatal/perinatal risk factors, family functions and the symptoms of ODD. Data were analyzed by appropriate statistical method using SPSS 11.5 window version. Result : Children with oppositional defiant disorder were revealed to have significantly higher rates of psychiatric comorbidity and significantly greater family dysfunction compared to comparison group. Among the prenatal/perinatal risk factors, severe emotional stress during pregnancy, postpartum depression, medication during pregnancy were revealed as risk factors of ODD. In character inventory, ODD group were evaluated to have high score in novelty seeking, harm avoidance, but low in reward dependency. Conclusion : These results support that 1) prenatal/perinatal and psycho-social risk factors could be a important role in the progression of ODD, and 2) children with ODD have diverse comorbid psychiatric symptoms.

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The causative organisms of pediatric empyema in Korea (소아 농흉 원인균에 대한 다기관 연구(1999. 9-2004. 8))

  • Yum, Hye-yung;Kim, Woo Kyung;Kim, Jin Tak;Kim, Hyun Hee;Rha, Yeong Ho;Park, Yong Min;Sohn, Myung Hyun;Ahn, Kang Mo;Lee, Soo Young;Hong, Su Jong;Lee, Hae Ran
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.33-39
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    • 2007
  • Purpose : In spite of medical advances, empyema is a serious complication of pneumonia in children. Vaccination practices and antibiotic prescribing practices promote the change of clinical manifestations of empyema and causative organisms. So we made a nationwide clinical observation of 122 cases of empyema in children from 32 hospitals during the 5 year period from September 1999 to August 2004. Methods : Demographic data, and clinical information on the course and management of empyema patients were collected retrospectively from medical records in secondary and tertiary hospitals in Korea. Results : One hundred twenty two patients were enrolled from 35 hospitals. The most frequent age group was 1-3 years, accounting for 48 percent of all cases. The male to female sex ratio was 1.2:1. The main symptoms were cough, fever, respiratory difficulty, lethargy and chest pain in order of frequency. Hematologic findings on admission revealed decreased hemoglobin levels ($10.4{\pm}1.6g/dL$) and increased leukocyte counts ($16,234.3{\pm}10,601.8/{\mu}L$). Pleural fluid obtained from patients showed high leukocyte counts ($30,365.8{\pm}64,073.0/{\mu}L$), high protein levels ($522.3{\pm}1582.3g/dL$), and low glucose levels ($88.1{\pm}523.5mg/dL$). Findings from pleural fluid cultures were positive in 80 cases(65.6 percent). The most common causative agent was Streptococcus pneumoniae. The majority of patients were treated with antibiotics and closed drainage. Some patients needed open drainage (16.4 percent) or decortication (3.3 percent). The mean duration of hospitalization was $28.6{\pm}15.3days$. Conclusion : We analyzed childhood empyema patients during a period of 5 years in Korean children. The most frequent age group was 1-3 years and the most common causative agent was Streptococcus pneumoniaeiae. The majority of patients were treated with antibiotics and close drainage.

Standardization of Korean Version of Daily Stress Inventory(K-DSI) (한국어판 일상 생활 스트레스 척도(K-DSI)의 표준화 연구)

  • Joe, Sook-Haeng;Lee, Hyeon-Soo;Song, Hyun-Cheol;Kim, Seung-Hyun;Sub, Kwang-Yun;Sin, Dong-Kyun;Ko, Seung-Duk
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.72-87
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    • 2000
  • Objectives : This study was to provide normative data of Korean version of DSI(K-DSI), a sensitive measure of relatively minor stressors that could be administered daily. Methods : K-DSI was administered in 524 adults, age of 19 or over, daily for 1 week. On the seventh day, Becks Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), and Social Readjustment Rating Scale(SRRS) were also given to test the convergent validity. Analyses(ANOVA or t-test) were conducted to examine the potential effects of demographic variables on K-DSI score. Internal consistency for reliability and Pearson's corelation coefficient with BDI, STAI, SRRS for convergent validity were computed. Percentile scores were calculated for daily and weekly K-DSI Event, Impact and I/E Ratio scores. Results : K-DSI scores in women were higher than those in men. According to age and educational level, the younger and the higher educational level the normative groups were, the higher were K-DSI scores. Among the 5 categories of the inventory, the category of cognitive stressors was highest. Internal consistency of K-DSI(Cronbach's $\alpha$) was .99. Daily and Weekly events and impacts scores were significantly correlated with the scores of State-Trait Anxiety Inventory, Social Readjustment Rating Scale, and Beck Depression Inventory. 75 percentile scores of the daily/weekly Events, Impacts, and I/E ratio were 17/118 - 124, 57/368 - 389 and 3.48 - 3.49/3.47 - 3.48 respectively. And 95 percentile scores of daily/weekly Events, Impacts, and I/E ratio were 57/151- 161, 405/1038 - 1122, and 4.72 - 4.86/4.46 - 4.56 respectively. Conclusion : Reliability and validity of K-DSI were tested satisfactorily. Authors presented the normative data of K-DSI for Koreans. K-DSI could be a useful measure in clinical settings or researches to assess the minor stressors frequently experienced in everyday life.

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Comparison of a whole blood Interferon-γ assay and A tuberculin skin test for detecting latent tuberculosis infection in children (소아 잠복 결핵 감염 진단에 있어서 투베르쿨린 피부반응 검사와 결핵 특이항원 자극 Interferon-γ 분비능 측정의 비교)

  • Chun, Jin-Kyong;Kim, Chang Ki;Kim, Hyun Sook;Jung, Ghee Young;Linton, John A.;Kim, Ki Hwan;Lee, Taek Jin;Jeon, Ji Hyun;Kim, Dong Soo
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.971-976
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    • 2008
  • Purpose : Surveillance for detecting and managing latent tuberculosis infection (LTBI) is a key component of tuberculosis control. The classic surveillance tool, the tuberculin skin test (TST), may have some limitations when used in the Bacillus Calmette-$Gu{\acute{e}}rin$ (BCG)-vaccinated population. The object was to perform a blood test $QuantiFERON^{(R)}$-TB Gold In Tube (QFT-G IT) based on the detection of interferon-$\gamma$ ($IFN-{\gamma}$) released by T cells in response to Mycobacterium tuberculosis-specific antigens, and to compare the efficacy of this new diagnostic tool for LTBI with that of TST. Methods : For six months, between October 1, 2006 and April 30, 2007, data were collected from 111 patients under 15 years of age at Severance Children's Hospital. TST and QFT-G IT tests were performed with children with or without contact histories of tuberculosis. In addition to these tests, we examined comparative data from 29 adults who had tuberculosis, to detect false negative rates in the QFT-G IT method. Results : Thirty-three children had household contact histories. In this group, 15% and 42% of cases were found to be positive using the QFT-G IT assay and TST, respectively. Agreement was low between these two tests (${\kappa}=0.39$). In the adult active tuberculosis group, the QFT-G IT false negative rate defined as a positive culture and a negative QFT-G IT result was 12.5%. Conclusion : In diagnosing LTBI in children, the usefulness of a whole-blood $IFN-{\gamma}$ assay employing TB-specific antigens will be revealed only by examining additional longitudinal clinical data; this study serves as a starting point in that process.

A Study on the Triage and Statitical Data of Patients in the Emergency Room, PNU (일 종합병원 응급실 이용환자의 중증도 분류)

  • 김영혜;이화자;조석주
    • Journal of Korean Academy of Nursing
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    • v.31 no.1
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    • pp.68-80
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    • 2001
  • The purpose of this study is to analyze ER patient's Triage and other statistical data. The subjects were 12,618 patients who visited the ER during the year 1998. The study showed the following results; 1. The male vs female ratio was 1.3 : 1.0, the male were in the majority (56.6%), and the age range of 20-29 old was the majority (15.3). The patients who visited ER at 8-10 pm were the majority (11.5%). On Sunday the number of patients who visited the ER were 2,189, and the majority were 17.4%. On Saturday the number of patients was visited the ER were 1,944 patients the second majority (15.4%). Their traffic means : the general passenger cars (75.5%), 119 or hospital ambulance (11.3%). 2.The reasons of visiting ER were : diseases (59.2%), injuries (23.7%). The disease vs injury ratio was 100 : 69. 3. Triage : urgent 40.7%, non-urgent 38.2%, acute 17.8%, and critical 3.2%. 4. The time of waiting and staying in the ER by the Triaget: the average time was 572 minutes (9.53 hrs.). The majority of critical patients (20.5%), acute patients (24.7%) and urgent patients (21.2%) stayed 12-24 hrs., but the majority of non-emergent (27.8%) stayed not longer than one hour. 5. Treatments by the Triage : the 42.9% of critical patients, and 61.3% of acute patients, 57.5% of urgent patients were admitted. But 91.8% of the non-emergents were discharged and 4.7% was admitted. Mortality of total ER visiter were 1.7%. DAA portion was 0.86%. 26.6% of the critical patients were DAA. DAA vs DOA ratio was 1.3 : 1.0. 6. Visiting time, monthly and seasonal distribution by the Triage : the majority of critical patients (12.2%), visited 10-12 am. The majority of acute (12.9%) and urgent (11.7%) visited 4-6 pm, but the majority of non-emergents (15.1%) visited during 8-10 pm. Autumn visiter were the majority (27.6%). The percentage of non-emergent visited in Spring was 41.4% and Autumn was 41.3%. The percentage of urgents who visited in the Summer was 45.3% and the Winter was 40.4%. By clinical departments: the 48.0% of critical patients was NS. The 45.5% of acute and the 33.6% of urgent patients were IM. But the majority of non-emergent patients was PS (21.2%), and the second majority of non-emergent patients was oral Surgery (12.8%).

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Analysis of Dietary and Health Characteristics and Disease Correlation of Adult Men Aged 40 in Areas with High Levels of Fine Dust Pollution based on the 2013-2017 Korea National Health and Nutrition Examination Survey Data (2013-2017 국민건강영양조사 자료에 근거한 미세먼지 오염도가 높은 지역의 40세 이상 성인남성의 식생활과 건강관련 특성 및 질환 상관성 분석)

  • Yu, Da-Som;Kang, Nam E;Lim, Hee-Jung;Jang, Se-Eun;Oh, Yoon Sin
    • Journal of the Korean Society of Food Culture
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    • v.35 no.4
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    • pp.363-370
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    • 2020
  • This study analyzed the health characteristics and comorbidity of adult men aged 40 years by dividing them into a control group of those without any disease related to fine dust and a patient group with one or more diseases related to fine dust in areas with high levels of fine dust pollution using the sixth and seventh Korea National Health and Nutrition Examination Survey (2013-2017). Among the general characteristics, the mean age of the patient group was significantly older than that of the control group (p<0.001), and in terms of the health-related characteristics, the frequency of breakfast consumption in the patient group was higher than in the control group (p<0.043). The body measurements were similar in the patient and control groups. Regarding the prevalence of comorbidity, the patient group showed a higher prevalence of hypertension, dyslipidemia, stroke, myocardial infarction, heart failure, and diabetes than the control group, but the differences were not statistically significant. On the other hand, the prevalence of other cancers (except stomach cancer, liver cancer, colorectal cancer, breast cancer, and cervical cancer) in the patient group was higher than in the control group (p<0.05). In terms of the clinical characteristics, the glycated hemoglobin levels in the patient group were significantly higher than in the control group (p<0.048). Information on nutrition and health in areas with frequent occurrences of fine dust was obtained through the study results, which can be used as basic data for measures of health and diet management against diseases that will increase in relation to fine dust.

Epidemiological Aspects of Osteosarcoma, Giant Cell Tumor and Chondrosarcoma Musculoskeletal Tumors - Experience of the National Rehabilitation Institute, Mexico City

  • DelaGarza-Montano, P;Estrada-Villasenor, E;Dominguez Rubio, R;Martinez-Lopez, V;Avila-Luna, A;Alfaro-Rodriguez, A;Garciadiego-Cazares, D;Carlos, A;Hernandez-Perez, AD;Bandala, C
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6451-6455
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    • 2015
  • Background: Primary bone neoplasms are rare, contributing only 0.2% of the global burden of all human malignancies. Osteosarcoma (OS) and chondrosarcoma (CS) are the most common malignancies of bone. The giant cell tumor of bone (GCTb) is a benign tumor with behavior characterized by osteolytic bone destruction. The OS, CS and GCTb affect both sexes, all races and generally have incidence peaks regarding the age of the patient which vary according to the tumor type. We analyzed the incidences of OS, CS and GCTb and their relations with gender and age in patients treated in the National Rehabilitation Institute (INR, for its acronym in Spanish) over a period of nine years. Materials and Methods: In the study period, clinic pathological data for 384 patients were obtained with clinical, radiological and histopathological diagnosis for OS, GCTb and CS. Data analysis was performed using the chi-square and Fisher's exact tests. Results: From 2006 to 2014 were recorded 384 cases of bone malignancies in the database of INR. The GCTb had the highest incidence (53.1%), followed by OS (31.3%) and finally the CS (15.6%). The overall average age was $33.6{\pm}15.8$ years and the overall frequency of gender had a ratio of 1/1.03 male/female. The states with the highest incidence were Distrito Federal and Estado de Mexico with 29.2% and 25.3% respectively. Malignant neoplasms of bone assessed in the course of nine years show three significant increases in 2008, 2011 and 2014 (p=0.14). We found association between sex and tumor type (p=0.03), GCTb and CS predominated in females (54.9% and 56.6% respectively), while for the OS males were most affected (59.1%). Age was different in relation with tumor type (p=0.0001), average age was $24.3{\pm}11.2$ years for OS, $34.5{\pm}13$ years for GCTb and $49.2{\pm}18.5$ years for CS. Furthermore, associations of tumor type with topographic location of the primary tumor (P=0.0001) were found. Conclusions: In this study we can see that incidence of musculoskeletal tumor in our population is continuously increasing and in nine years an approximately 200% increase of musculoskeletal tumor cases was observed.

Patterns of Esophageal Cancer in the National Cancer Institute at the University of Gezira, in Gezira State, Sudan, in 1999-2012

  • Gasmelseed, Nagla;Abudris, Daffalla;Elhaj, Ahmed;Eltayeb, Elgaylani A;Elmadani, Ahmed;Elhassan, Moawia M;Mohammed, Khadiga;Elgaili, Elgaili M;Elbalal, Moawia;Schuz, Joachim;Leon, Maria E
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6481-6490
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    • 2015
  • Background: Esophageal cancer (EC) is among the most common malignancies in Eastern Africa, but the occurrence of EC in Sudan has rarely been described in the scientific literature. This paper reports the results of a consecutive case series of all EC patients who visited one of the two public cancer treatment centers in the country in 1999-2012, providing a first description of this disease in a treatment center located in central Sudan. Materials and Methods: Clinical and demographic data for all EC patients who visited the Department of Oncology of the National Cancer Institute at the University of Gezira (NCI-UG) from 1999 to the end of 2012 were abstracted and tabulated by sex, tumor type and other characteristics. Results: A total of 448 EC patients visited NCI-UG in 1999-2012, and the annual number of EC cases increased steadily from 1999. Squamous cell carcinoma (SCC) was the predominant EC tumor type (90%), and adenocarcinoma (ADC) was reported in 9.4% of the EC cases. The overall male-to-female ratio for EC was 1:1.8, but the ratio was tumor type-dependent, being 1:2 for SCC and 2:1 for ADC. Only 20% of EC patients reported having ever used tobacco and/or alcohol, and the vast majority of these patients were male. At the time of EC diagnosis, 47.3% of the patients resided in Gezira State. Some EC patients from Gezira State seek out-of-state treatment in the national capital of Khartoum instead of visiting NCI-UG. Conclusions: The annual number of EC patients visiting NCI-UG has increased in recent years, approximately half of these patients being from Gezira State. Although this consecutive series of EC patients who visited NCI-UG was complete, it did not capture all EC patients from the state. A populationbased cancer registry would provide more complete data required to better understand EC patterns and risk factors.

Loss of p15INK4b Expression in Colorectal Cancer is Linked to Ethnic Origin

  • Abdel-Rahman, Wael Mohamed;Nieminen, Taina Tuulikki;Shoman, Soheir;Eissa, Saad;Peltomaki, Paivi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2083-2087
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    • 2014
  • Colorectal cancers remain to be a common cause of cancer-related death. Early-onset cases as well as those of various ethnic origins have aggressive clinical features, the basis of which requires further exploration. The aim of this work was to examine the expression patterns of $p15^{INK4b}$ and SMAD4 in colorectal carcinoma of different ethnic origins. Fifty-five sporadic colorectal carcinoma of Egyptian origin, 25 of which were early onset, and 54 cancers of Finnish origin were immunohistochemically stained with antibodies against $p15^{INK4b}$ and SMAD4 proteins. Data were compared to the methylation status of the $p15^{INK4b}$ gene promotor. $p15^{INK4b}$ was totally lost or deficient (lost in ${\geq}50%$ of tumor cell) in 47/55 (85%) tumors of Egyptian origin as compared to 6/50 (12%) tumors of Finnish origin (p=7e-15). In the Egyptian cases with $p15^{INK4b}$ loss and available $p15^{INK4b}$ promotor methylation status, 89% of cases which lost $p15^{INK4b}$ expression were associated with $p15^{INK4b}$ gene promotor hypermethylation. SMAD4 was lost or deficient in 25/54 (46%) tumors of Egyptian origin and 28/48 (58%) tumors of Finnish origin. 22/54 (41%) Egyptian tumors showed combined loss/deficiency of both $p15^{INK4b}$ and SMAD4, while $p15^{INK4b}$ was selectively lost/deficient with positive SMAD4 expression in 24/54 (44%) tumors. Loss of $p15^{INK4b}$ was associated with older age at presentation (>50 years) in the Egyptian tumors (p=0.04). These data show for the first time that $p15^{INK4b}$ loss of expression marks a subset of colorectal cancers and ethnic origin may play a role in this selection. In a substantial number of cases, the loss was independent of SMAD4 but rather associated with $p15^{INK4b}$ gene promotor hypermethylation and old age which could be related to different environmental exposures.

Nonlinear Dynamic Analysis of EEG in Patients with Positive and Negative Schizophrenia (양성 및 음성 정신분열증 환자 뇌파의 비선형 역동 분석)

  • Chae, Jeong-Ho;Pak, E-Jin;Kim, Dai-Jin;Jeong, Jae-Seung;Kim, Soo-Yong;Kim, Kwang-Soo
    • Sleep Medicine and Psychophysiology
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    • v.5 no.2
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    • pp.185-193
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    • 1998
  • Objectives : The hypothesis that the brain is a nonlinear dynamical system exhibiting deterministic chaos has offered new perspectives to the investigation of information processing in the brain of schizophrenic patients. It seemed worthwhile to estimate nonlinear measures of the electroencephalogram (EEG) in positive and negative schizophrenics, because nonlinear measures might serve as indicators of the specific brain function in schizophrenia according to specific psychopathologies. Method : Previous studies which estimated the chaoticity in the brain of schizophrenia with nonlinear methods recorded the EEGs at limited electrodes, so we tried to record EEGs from 16 channels for nonlinear analysis in 8 positive and 9 negative schizophrenics and 8 healthy control subjects. We employed a new method to calculate the nonlinear invariant measures. For limited noisy data, this algorithm was strikingly faster and more accurate than previous ones. Results : Our results showed that the patients with negative schizophrenia had lower the first positive Lyapunov exponents ($L_1$) than the positive schizophrnics and control subjects at $T_3$ lead. Positive symptoms were positively correlated with $L_1$ in $C_3,\;O_1$ leads, and negatively correlated with $C_4$ lead. Conclusion : These results suggest that if clinical variables such as psychopathology or neuroleptic medications would be well controlled, the nonlinear analysis of the EEGs in patients with schizophrenia seems to be a useful tool in analyzing EEG data to explore the neurodynamics.

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