피부 백혈병을 동반한 선천성 급성 골수성 백혈병 1례

홍유라,김미향 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Congenital leukemia is a rare disease developing within the first 4 to 6 weeks of life. Specific cutaneous leukemic infiltrates occur in 25% to 30% of infants with congenital leukemia and usually appear as firm blue, red, or purple nodules in a generalized distribution. We report a male term leukemic patient who presented with multiple skin nodules of reddish to purple color on the trunk and extremities. Skin biopsy revealed hematopoietic cells and acute monoblastic leukemia(M5 in FAB) was diagnosed by subsequent bone marrow aspiration. The skin lesion was completely disappeared after one cycle of chemotherapy with cytarabine, daunorubicin, etoposide, and dexamethasone, while the fraction of blasts remain unchanged.

초극소 저체중 출생아에서 회음부 궤양을 동반한 혈관종 치료경험 1례

홍유라 고신대학교 의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Hemangiomas represent the most common benign tumor of infancy, with ulceration its most frequent complication. I experienced a case who was extremely very low birth weight infant(born at 25 weeks gestation, 670 g) and had a ulcerated perineal hemangioma. Ulcerated hemangiomas in the perineal area are usually very painful and distressing for the infant and secondary infection is common. But no one uniformly effective treatment modality was found and their potential side effects in infant are not known. Without specific therapeutic modalities(corticosteroids, interferon alfa-2a and flashlamp pulsed-dye laser), I treated with local wound care(occlusive dressings) and management of infection. After 8 weeks of treatment, the ulcer was healed.

부모 기록용 아동 행동 조사표에 의한 초등학교 어린이들의 정서와 행동문제 연구

여순,홍유라,박재선,이용환,김민향 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

목적: 외견상 정상으로 간주되는 일정 지역사회 어린이들을 대상으로 문제성 정서․행동의 빈도를 알아보고, 이들 정서․행동 문제의 빈도와 사회경제적 요인들과의 관계를 알아보고자 하였다. 방법: 부산광역시의 일개 초등학교 1, 3, 5학년 어린이 700명을 대상으로 아동 행동 증상 목록표(Pediatric Symptom Checklist, PSC)로 된 설문지를 배부하였다. 설문지에는 50 항목의 행동 증상을 짧게 적고 부모가 각각의 행동 빈도에 “전혀 아님”, “가끔”및 “자주” 중 하나를 표시하도록 하였고, 아동의 건강상태, 부모 자녀간의 대화방식, 부모의 수입과 교육수준도 함께 조사하였다. 또한 일부 항목에 대해 원하는 경우, 담임선생님에 의해 이중으로 기록하게 하였다. 회수된 설문지 609매를 대상으로 빈도가 “전혀 아님”은 0, “가끔”은 1점, “자주”는 2점을 부과해 합산한 뒤 분석하였다. 결과: 피검아동 609명이 50개 문항의 행동들에서 “가끔” 또는 “자주”에 응답한 예의 빈도는 0.9-65.3%의 분포를 보였으며, 응답률에서 5%미만이 4개, 5-20%가 15개, 21-50%가 27개, 51%이상이 4개 문항이었고, 문제행동 총점들의 평균은 14.03(범위 0-43, 표준편차 8.96)점이었다. 빈도가 50%이상이었던 행동들은 “잘 울고 화내고 짜는 소리하기(총 65.2%, 남 62.75%, 여 67.9%)”, “부끄럼을 타고 남 앞에 나서기 두려움(총 60.9%, 남60.0%, 여 61.8%)”, “머리, 배, 다리가 자주 아프다(총55.8%, 남 53.1%, 여 58.8%)”, “집중하기 힘들다(총53.0% 남 55.5%, 여 50.4%)”의 4문항이었다. 성별 비교에서, 여아는 “새롭고 낯선 환경에서 겁이 많고 적응하기 힘들다”, “아무도 자신을 좋아하지 않아 희망이 없다고 느낀다”라는 두 문항에서만 남아에 비해 빈도가 높았으며(P<0.05), 문제 행동 유형별 비교시 주의산만 유 형, 공격성 유형은 남아에서, 불안은 여아에서 유의하게 높았다. 그러나 문제 행동 총점의 평균은 남녀 각각 14.44, 13.60로 유의한 차이가 없었다. 건강한 피검자 군의 총점 평균은 13.64로 이상이 있는 군의 17.29와 유의한 차이를 보였다(P=0.007). 건강한 친부모와 생활하는 피검자 군에서의 총점 평균은 13.68로 그 외 군에서의 15.92와 유의한 차이를 보였다(P=0.025). 부모자녀간의 대화방식에서 비효율적인 방법을 많이 사용하는 경우(4점이상군), 문제 행동의 총점이 16.77로서 3점 이하군의 9.48과 현저한 차이를 보였다(P<0.001). 결론: 조사 대상 어린이들의 과반수 이상은 잘 울고, 부끄러워 남앞에 나서길 두려워하며, 신체 통증을 자주 호소하고, 주의산만하다는 정서․행동의 특성을 가지고 있었다. 전체 문제 행동들의 빈도에 영향을 주는 인자로는 어린이의 외관상 건강상태, 가족 구성원의 구조, 부모의 대화습관이었고 부모의 경제력이나 학력과는 유의한 상관관계가 없었다. 문제성 정서․행동의 빈도에 가장 강력한 변인은 부모의 효율적 대화능력으로 생각되었다. Background : This study was conducted to identify the types and prevalence of emotional and behavioral problems in primary school children based on a Pediatric Symptom Checklist (PSC) which was filled out by parents. Methods : The subjects were 609 children between the age of 7 to 11 in one primary school in Busan, Korea. The PSC containing 50 behavior items were initially rated by parents and checked again by teachers in 17 items for the children whose parent consented to review. The PSC is scored by assigning 0 for never, 1 point for sometimes, and 2 point for often, and then adds the points for overall score. Parental attitudes of communication with their children were also assessed by scoring of parental responses to the questionnaire. Comparison of total behavior scores and other factors including parental competency scores were also made. Results : In each items of 50 behavioral problems, the frequency which is comprised of often true and sometimes true were widely distributed from 0.9% to 65.3%. The most common problem behavior was "crying easily and become angry"(often+sometimes: 65.2%) The next common problem behaviors were "shyness and being afraid of strange people"(60.9%), "complains of bodily aches or pains"(55.8%), "has trouble in concentrating"(53.0%), "be afraid of new situation with uneasiness"(44.5%), and "prefers to spends more time alone indoors"(43.3%) in descending order of frequency. In sexual comparison of frequency of problem behaviors, girls had significantly high frequency in two items-"be afraid of new situation with uneasiness"(P=0.018) and "no one likes him or her and has no hope" (P=0.029). On classifying 50 items into 8 behavior patterns, boys revealed higher frequencies in the behavior of inattention, impulsivity, hyperactivity and anger, aggression, antisocial activity, while girls revealed higher frequencies in the behavior of anxiety. The mean total problem scores were significantly lower in the children of healthy group (healthy 13.64 vs unhealthy 17.29, P=0.007), living with healthy biological parents (biological 13.68 vs others 15.92, P=0.025) and parents who were using less destructive communication (barrier score≤3 9.48 vs barrier score≥4 16.77, P<0.001). There was no significant correlation between the mean total problem scores and variables such as sex, grade, incomes, and educational career of mother. Conclusions : Crying easily, shyness, bodily aches, difficulty in concentrating, being afraid of new situation with uneasiness, and loneliness were commonly prevalent behaviors in the children of the primary school studied. Total problem scores were significantly higher in children with physical handicaps, children living without both biological parents, and most remarkably in children who were cared by parents with poor communication skills

단일 기관에서 극소 저출생 체중아의 11년 치료 성적

이대성,홍유라 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Background : The Outcome of Infants weighing less than 1,500 g(very low birth weight infants : VLBWI) reflect recent progress in neonatal intensive care. In this study, we evaluated mortality and morbidity of very low birth weight (VLBW) infants during the past eleven years. Methods : A retrospective review of medical record was analyzed for VLBWIs admitted to the neonatal intensive care unit of Kosin University Gospel hospital between January 1, 1996 and March 31 2007. Results : The incidence of VLBWI was 3.6%. Overall survival rate of VLBWI was 65.9%. The survival rate increased significantly over time(period Ⅰ: 49.4%, period Ⅱ : 82.4%, P<0.05). The survival rate increased as birth weight increased. The incidence of respiratory distress syndrome was 70.3%(102/171), bronchopulmonary dysplasia 32.1% (36/171), intraventricular hemorrhage 19.4%(33/171), sepsis 24.4%(41/171). The main causes of death were respiratory distress syndrome and sepsis. Conclusion : The survival rate of VLBWI during recent 11 years was 65.9%. Survival rate increased as birth weight and gestational age increased. More efforts are needed to improve the long term outcome by reducing common morbidities.

저긴장증과 잠복고환을 주소로 신생아기에 진단된 Prader-Willi 증후군 1례

여순,이정현,홍유라 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Prader-Willi syndrome(PWS) was first described by Prader et al in 1956. This syndrome is characterized by diminished fetal activity, fetal distress, low birth weight, infantile hypotonia with feeding problem, onset of obesity in early childhood, short stature, hypogonadism, mental retardation, and small hands and feet. The cause of this syndrome is unknown, but a disturbance in the hypothalamus has been postulated because of the various manifestation of the syndrome. Recently, this syndrome is easily diagnosed by DNA polymorphism analysis, DNA methylation analysis, and fluorescence in situ hybridization technique (FISH). We report a Prader-Willi syndrome confirmed by FISH in a neonate that had diminished fetal activity, fetal distress, hypotonia, and bilateral cryptorchidism and recommend molecular genetic studies in floppy infants who have feeding disturbance and hypotonia during the neonate stage and infacny because invasive study such as muscular biopy is avoided.

Machine Learning Algorithms for the Prediction of Locomotor Activity by an Infrared Motion Detector on the Sleep-wake States in Mice

Yoo Rha Hong(Yoo Rha Hong),Kyungwon Kim(Kyungwon Kim),Eunsoo Moon(Eunsoo Moon),Jeonghyun Park(Jeonghyun Park),Chi Eun Oh(Chi Eun Oh),Jung Hyun Lee(Jung Hyun Lee),Min Yoon(Min Yoon) 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.2

Objective: Even though studies using machine learning on sleep-wake states have been performed, studies in various conditions are still necessary. This study aimed to examine the performance of the prediction model of locomotor activities on sleep-wake states using machine learning algorithms. Methods: The processed data using moving average of locomotor activities were used as predicting features. The sleep-wake states were used as true labels. The prediction models were established by machine learning classifiers such as support vector machine with radial basis function (SVM-RBF), linear discriminant analysis (LDA), naïve Bayes, and random forest (RF). The prediction model was evaluated by a six-fold cross validation. Results: The SVM-RBF and RF showed acceptable performance within a window of moving average from 480 to 1,200 seconds. The highest accuracy (0.869) was shown by the RF at the interval of 480 seconds. Meanwhile, the highest area under the curve (0.939) was shown by LDA at the interval of 870 seconds. Conclusion: This study suggested that the prediction model on sleep-wake state using machine learning could show an improvement of the model performance when using moving average with raw data. The prediction model using locomotor activity can be useful in research on sleep-wake state.

Impact of attachment, temperament and parenting on human development

Hong, Yoo Rha,Park, Jae Sun The Korean Pediatric Society 2012 Clinical and Experimental Pediatrics (CEP) Vol.55 No.12

The purpose of this review is to present the basic concepts of attachment theory and temperament traits and to discuss the integration of these concepts into parenting practices. Attachment is a basic human need for a close and intimate relationship between infants and their caregivers. Responsive and contingent parenting produces securely attached children who show more curiosity, self-reliance, and independence. Securely attached children also tend to become more resilient and competent adults. In contrast, those who do not experience a secure attachment with their caregivers may have difficulty getting along with others and be unable to develop a sense of confidence or trust in others. Children who are slow to adjust or are shy or irritable are likely to experience conflict with their parents and are likely to receive less parental acceptance or encouragement, which can make the children feel inadequate or unworthy. However, the influence of children's temperament or other attributes may be mitigated if parents adjust their caregiving behaviors to better fit the needs of the particular child. Reflecting on these arguments and our childhood relationships with our own parents can help us develop the skills needed to provide effective guidance and nurturance.

Reliability and validity of free software for the analysis of locomotor activity in mice

( Yoo Rha Hong ),( Eunsoo Moon ) 영남대학교 의과대학 2018 Yeungnam University Journal of Medicine Vol.35 No.1

Background: Kinovea software that tracking semi-automatically the motion in video screen has been used to study motion-related tasks in several studies. However, the validation of this software in open field test to assess locomotor activity have not been studied yet. Therefore, this study aimed to examine the reliability and validity of this software in analyzing locomotor activities. Methods: Thirty male Institute Cancer Research mice were subjected in this study. The results examined by this software and the classical method were compared. Test-retest reliability and inter-rater reliability were analyzed with Pearson's correlation coefficient and intraclass correlation coefficient (ICC). The validity of this software was analyzed with Pearson's correlation coefficient. Results: This software showed good test-retest reliability (ICC=0.997, 95% confidence interval [CI]=0.975- 0.994, p<0.001). This software also showed good inter-rater reliability (ICC=0.987, 95% CI=0.973-0.994, p<0.001). Furthermore, in three analyses for the validity of this software, there were significant correlations between two methods (Pearson's correlation coefficient=0.928-0.972, p<0.001). In addition, this software showed good reliability and validity in the analysis locomotor activity according to time interval. Conclusion: This study showed that this software in analyzing drug-induced locomotor activity has good reliability and validity. This software can be effectively used in animal study using the analysis of locomotor activity.

Reliability and validity of free software for the analysis of locomotor activity in mice

Hong, Yoo Rha,Moon, Eunsoo Yeungnam University College of Medicine 2018 Yeungnam University Journal of Medicine Vol.35 No.1

Background: Kinovea software that tracking semi-automatically the motion in video screen has been used to study motion-related tasks in several studies. However, the validation of this software in open field test to assess locomotor activity have not been studied yet. Therefore, this study aimed to examine the reliability and validity of this software in analyzing locomotor activities. Methods: Thirty male Institute Cancer Research mice were subjected in this study. The results examined by this software and the classical method were compared. Test-retest reliability and inter-rater reliability were analyzed with Pearson's correlation coefficient and intraclass correlation coefficient (ICC). The validity of this software was analyzed with Pearson's correlation coefficient. Results: This software showed good test-retest reliability (ICC=0.997, 95% confidence interval [CI]=0.975-0.994, p<0.001). This software also showed good inter-rater reliability (ICC=0.987, 95% CI=0.973-0.994, p<0.001). Furthermore, in three analyses for the validity of this software, there were significant correlations between two methods (Pearson's correlation coefficient=0.928-0.972, p<0.001). In addition, this software showed good reliability and validity in the analysis locomotor activity according to time interval. Conclusion: This study showed that this software in analyzing drug-induced locomotor activity has good reliability and validity. This software can be effectively used in animal study using the analysis of locomotor activity.

고용량 Ara-C를 기조로 한 소아 급성골수성백혈병 환아의 치료

홍유라,이보영,이정현,강지혜,박재선,김미향 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

목적: 급성골수성백혈병 환아들에 대한 치료성적을 향상시키기 위화여 단일기관에서 진료한 환아들의 임상적 특징, 치료 성적을 분석하였다. 방법 : 1991년 8월부터 2001년 9월까지 고신대학교 복음병원에서 치료받은 급성골수성백혈병 환아 16례의 말초혈액소견, 골수검사소견, 치료, 사인, 관해율과 생존율을 후향적으로 분석하였다. 결과 : 1. 급성골수성백혈병 소아 12례 중 8례에서 변형 Capizzi-Denver 항암요법(고용량 Ara-C, Adriamycin, L-asparaginase, Etoposide, Thioguanine, Dexamethasone)을, 4명에서는 "DCTER 항암요법" (Dexamethasone, Cytarabine, Thioguanine, Etoposide, Rubdomycin)으로 치료하였다. 2. 치료를 받았던 환아 12명 중 9명에서 관해되어 관해율은 75%(9/12)였으며 6년 무사고 생존율은 19%(3/16)이나 일단 관해된 환자에서 6년 이상 재발없이 관해를 유지했던 환자의 비율은 25%(n=12. 3 in CCR) 였다. 3. 변형 Cappizzi요법을 받았던 8명의 환아만을 대상으로 보면 관해율은 100%였으며 6년 무재발 생존율은 37.5%(3/8)였다. 4. 사망한 13례의 주된 사인은 치료 전 진행된 암에 의한 DIC 1례, 치료 전 뇌출혈 1례, 진단 즉시 치료거부 2명, 치료 중 종양용해증후군 1례, 카테타 심장삽관 중 심정지 1례, 치료 중 자의 중단 1례, 관해 후 재발 2례, 관해 후 패혈증 2례, 말초자가 조혈모세포이식 과정에서 수혈 후 폐부종 1례, 장염 1례였다. 결론 : 치료 초기부터 고용량 Ara-C를 사용하는 "변형 Capizzi-Denver요법"의 관해율, 치료독성은 기존 치료법들과 비슷한 수준이며, 생존 환자가 적어 치료 성적의 비교가 곤란하나 향후 더 많은 환자를 대상으로 한 연구가 요망된다. Purpose: To improve the survival of children with acute myelocytic leukemia(AML), retrospective evaluation of treatment results was made in a single institution. Methods: From August 1991 to September 2001, 16 children with AML diagnosed at Kosin University Collage of Medicine were analysed in terms of remission, survival and cause of death. Twelve of the 16 patients were applicable to an induction and postremission chemotherapy with "modified Capizzi-Denver regimen" (Cytarabine, Adriamycin, Dexamethasone, L-asparaginase, Etoposide, Thioguanine) or "DCTER regimen" (Dexamethasone. Cytarabine, Thioguanine, Etoposide, Rubdomyein) Results: 6-year event free survival by Kaplan Meier estimation was 19%. 9 of 12 treated patients responded to the induction therapy and the probability of remaining in first remission was 33%. All patients in "modified Capizzi-Denver regimen" remitted (8/8) and 3 of them have been survived more than 6 years. Conclusion: Although the number of patients was small, some of the patients with AML achieved long term survival with "modified Capizzi-Denver regimen without severe toxicity and need study with more patients.