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A CASE OF PERVASIVE DEVELOPMENTAL DISORDER NOS WITH REPETATIVE SELF-INJURIOUS BEHAVIOR (반복적으로 머리를 때리는 전반성발달장애 환아 1례)

  • Kim, Jeong-Lim;Chung, Bo-In;Cho, Soo-Churl;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.244-251
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    • 1999
  • Self-injurious behavior is often showed in mental retardation, especially in autism. Self-injurious behavior has been regarded as a symptom cluster rather than a disease but it is an emergent clinical situation that can directly affect mortality. This case is about a refractory autistic patient who showed a self-injurious behavior of hitting the head repetitively. He was hospitalized and was treated by pharmacotherapy and behavior therapy and for this reason this clinical experience is reported with literature review. The patient is a 7-year old boy who was ward admitted from 1999 April 20 till July 10 into OO hospital OO ward because of self-injurious behavior. During the 12 weeks he had admission treatment. As for the pharmacotherapy, haloperidol was dosed up from 0.5mg to 1.0mg from the 4th week and combination drug therapy was done during the admission with naltrexone 25-50mg. As for the behavioral therapy, Differential Reinforcement of Other behavior was used and regular play therapy was done. To remove the physical restraint, headgear and hard sleeve was used. Currently, OPD follow up treatment is being done and haloperidol 0.5mg and naltrexone 50mg is maintained. The patient’s mother is educated and play therapy is done an hour daily at home. When the patient was released form the hospital, self-injurious behavior was decreased more than the moderate state and remission state is still being maintained at the outpatient clinic.

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A PILOT STUDY FOR STANDARDIZATION OF BERKELEY PUPPET INTERVIEW - SYMPTOMATOLOGY & PARENT-CHILD RELATIONSHIP SCALE (Berkeley Puppet Interview의 표준화를 위한 예비 연구 - 증상 척도와 부모-자녀 관계척도)

  • Shin, Min-Sup;Son, Jung-Woo;Cho, Soo-Churl;Kim, Boong-Nyun;Kim, Soo-Kyoung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.103-111
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    • 2003
  • Objectives:BPI was developed for assessing young children's perceptions. Using an interactive techniques for interviewing children, the BPI blends structured and clinical interviewing technique. Present study was to evaluate the reliability, validity and the clinical utility of Berkeley Puppet Interview(BPI) for young children aged 4 to 7. Methods:Subjects consisted of 37 children(boy20, girl 17) between the age of 4 and 7 who visited the child-psychiatry outpatient division of children's hospital in Seoul and Chungju. The measures used in this study BPI-S(symptomatology) and BPI-PC(parent-child relationship). BPI was translated into Korean by three clinical psychologists. To examine the reliability, Chonbach's alpha were calculated and to examine the validity, correlation coefficients were calculated on BPI-S & K-CBCL. Results:BPI-PC's Cronbach's alpha was 0.86 and BPI-S's Cronbach's alpha was 0.74. Correlation between the internalizing scale of BPI-S and that of K-CBCL was 0.477 and correlation between the internalizing scale of BPI-S and the externalizing scale of K-CBCL was -0.431, suggesting the validity of BPI-S. Conclusion:These results show that BPI-S & BPI-PC may be useful tool for young children's diagnostic interview.

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DENTAL TREATMENT IN A PATIENT WITH METACHROMATIC LEUKODYSTROPHY UNDER GENERAL ANESTHESIA : A CASE REPORT (이염성 백질 이영양증 환아의 치아우식 치료 증례 보고)

  • Ryu, Jiyeon;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.2
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    • pp.96-100
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    • 2016
  • Metachromatic leukodystrophy (MLD) is a progressive and degenerative neurological disease caused by a deficiency of the catabolic enzyme arylsulfatase A. Deficiency of arylsulfatase A results in accumulation of sulfatide in the white matter of the peripheral and central nervous system and it occurs demyelination as a result. The patient gradually goes through mental and motor failure. General symptoms of MLD include gait disturbance, mental deterioration, muscle rigidity and impaired swallowing. Inheritance of the disease is autosomal recessive. We report a dental caries treatment of a 3-year old boy with MLD. The patient underwent hematopoietic stem cell transplantation (HSCT) to slow the progression of the disease. He was suffered from difficulties of mastication and swallowing from the degenerative neurological symptom. He was ingesting food by both oral feeding and tubal feeding after he took percutaneous endoscopic gastrostomy (PEG). The cause of multiple caries was mainly presumed as patient's prolonged time of meal. The treatment was performed under general anesthesia considering patient's incompliance. Severely affected lower primary molars were treated with pulp treatment and restored with stainless steel crown. Others were restored with composite resin. There were no postoperative complications. MLD is life threatening progressive disease and also has an impact on unfavorable condition for oral health. Routine home oral care and periodic professional dental care should be emphasized to the caregiver of patient considering the susceptibility of dental caries. Not only the medical care, but periodic dental office visit would benefit the quality of life of the patient.

DENTAL TREATMENT UNDER GENERAL ANESTHESIA IN A PATIENT WITH LOWE SYNDROME : A CASE REPORT (로웨 증후군 환아의 치아우식 치료 증례 보고)

  • Ryu, Jiyeon;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.2
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    • pp.82-86
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    • 2016
  • Lowe syndrome is X-linked gene disorder, characterized by cataracts, renal dysfunction and brain abnormalities. Oral healthcare of young patients with Lowe syndrome could be easily neglected due to the uncooperative behavior or other systemic condition of the child. We are presenting a case of successful treatment under general anesthesia with uncooperative child with Lowe syndrome. A 3-year old boy with Lowe syndrome visited Seoul National University Dental Hospital for multiple caries. He had been suffering from congenital cataract, medullary nephrocalcinosis and hypotonia. Multiple caries were observed from clinical and radiographic examination. Concerning behavior management problem and possibility of aspiration due to hypotonia, dental treatment under general anesthesia was planned. Left upper primary first molar was extracted to prevent further infection. Other teeth were treated with Stainless steel crown or composite resin restoration based upon the extent and the severity of dental caries. Under general anesthesia, dental procedure was carried out successfully and safely. Considering uncooperative behavior and other medical conditions of the patient, general anesthesia could be effective. Home oral care and periodic visit to dental clinic should be emphasized to the caregiver of patient with Lowe syndrome, considering the susceptibility of dental caries and other oral manifestation.

TREATMENT OF HEAVY MANDIBULAR BUCCAL FRENUM USING APICALLY POSITIONED PARTIAL-THICKNESS FLAP IN CHILD (치아 교환기 어린이에서 근단변위부분층 판막술을 이용한 하악 거대 협소대의 처치)

  • Lee, Sung-Ryong;Oh, You-Hyang;Lee, Chang-Seop;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.665-670
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    • 2004
  • The mandibular buccal frenum becomes a problem when its attachment is too close to the marginal gingival. Heavy buccal frenum mucogingivally results in insufficient attached gingiva, inadequate vestibular depth and also difficulty in eruption of mandibular premolar. The aim of this study is to demonstrate the effectiveness of apically positioned partial-thickness flap as adequate method in order to remove heavy buccal frenum and expose impacted teeth. The author presents the case of a 12-year-old boy. He had problems that was prolonged eruption of #34, #35 due to high pull buccal frenum. After space regaining for normal eruption of #34, #35, we performed apically positioned partial-thickness flap on #34, 35 area. As a results, we confirmed that eruption of #34, #35 has been processed normally And vestibular depth, position of buccal frenum and width of attached gingival was within a normal range. Decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth can be expected from this treatment.

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BILATERALLY PRIMARY FIRST MOLARS WITH SINGLE ROOT (단일 치근을 가진 하악 제1유구치)

  • Yoon, Sang-Il;Kim, Sung-Oh;Lee, Jae-Ho;Son, Heung-Kyu;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.701-704
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    • 2004
  • In this case, we would like to discuss about the single rooted deciduous mandibular first molar. The deciduous mandibular molar of a five years old boy was shown to have a single root, bilaterally. Ordinarily, the maxilary molars have three roots and the mandibular molars have two roots. However, when the hertwig's epithelial root sheath do not invaginate properly during tooth development, root fusion can occur from the absence of root separation. Molars with fused roots not only have unfavorable crown to root ratio, but also according to many reports, have higher probability of having multiple congenitally missing teeth or dens invaginatus in the maxillary incisors, consequently requiring preventive dental treatment In addition, disorders such as ectodermal dysplasia, syndactyly, clinodactyly, bluish sclera can also be related to this condition. Root fusion is known to be of autosomal recessive inheritance. Up to date, single rooted molars have been reported several times in permanent dentitions but hardly in deciduous dentition, which is the motive for this paper.

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ERUPTION DISTURBANCE OF THE LOWER LEFT FIRST PERMANENT MOLAR CAUSED BY AMELOBLASTIC FIBROMA (법랑모세포섬유종에 의한 하악 제1대구치의 맹출 장애)

  • Kim, Seung-Hye;Song, Je-Seon;Son, Heung-Kyu;Choi, Hyung-Jun;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.102-108
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    • 2010
  • Impaction is the cessation of eruption process caused by physical obstacles on the eruption pathway, abnormal tooth position, or lack or space. It often occurs in association with supernumerary teeth, odontogenic tumor, or cystic lesions, and ameloblastic fibroma is one of the odontogenic tumors that can cause impaction of teeth. In many cases, ameloblastic fibroma occurs in association with one or more unerupted teeth. The proper management of ameloblastic fibroma is determined between conservative resection or more aggressive block resection, based size and morphologic features of the lesion and age of the patient. This is a case of a 8 year and 6 month old boy whose lower left permanent molar showed eruption disturbance. The impacted tooth was successfully repositioned favorably through surgical exposure and orthodontic traction using a modified halterman appliance. Long term follow-up, longer than 10 years, is planned considering relatively high recurrence rate and possibility of malignant transformation of ameloblastic fibroma, which cause impaction of the lower left permanent molar in this case.

ORAL FINDINGS AND TREATMENT OF A PATIENT WITH CYCLIC NEUTROPENIA (주기성 호중구 감소증 환자의 구강 내 소견과 치료에 대한 증례 보고)

  • Kang, Eun-Joo;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.2
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    • pp.133-140
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    • 2013
  • Cyclic neutropenia is a hematologic disorder characterized by a marked decrease in the number of circulating neutrophils occurring at regular intervals and after this period, the level of neutrophils usually recovers to a normal range. The clinical symptoms of cyclic neutropenia include fever, malaise, headaches and oral findings associated with painful soft tissue ulceration where lips, tongue and gingiva are typically involved. A 4 year 1 month old boy was presented to the hospital. His chief complaint was mobility of his teeth and swollen gums. The patient had suffered from cyclic neutropenia. Clinical examination revealed evident decay on all primary teeth except for the mandibular anterior teeth and localized alveolar bone loss around mandibullar right and left first primary molars which have mobility was notable. The patient was diagnosed with multiple dental caries, gingivitis and localized periodontitis associated with cyclic neutropenia and treated based on it. The dental treatment, including regular tooth care and appropriate treatment of dental caries or gingivitis, is essential for patients suffering cyclic neutropenia. Especially, proper care at an early stage is needed for young patients to minimize the unwanted consequences for permanent teeth development.

The Effect of Safety Education on Accident Proneness Prospect in Preschooler (안전교육이 학령전기 아동의 사고경향 예측에 미치는 효과)

  • Kim Shin Jeong;Lee Jung Eun
    • Child Health Nursing Research
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    • v.6 no.3
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    • pp.372-386
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    • 2000
  • The purpose of this study was to provide basic data on preschool children for accident prevention and improve their health through sound, safe living environment with safety education established through more systematic method. Data were collected from 300 preschoolers(150 preschooler are assigned to experimental group and 150 preschoolers are assigned to control group) from 4 to 6 years old using APP paper test which consists of questions and drawings. To experimental group, safety education were done 4 times within the time of 30 minutes per 1 time using education books, video, OHP, slide. The findings of this study are as follows: 1. There were significant difference in behavioral character between experimental group and control group(χ2=11.690, p= 0.003). So, safety education have effect on the behavioral character of preschooler. 2. In the accident proneness on preschooler between experimental group and control group according to general characteristics, it proved significant difference in the case of accident prevention education were done, movement stability(χ2=8.844, p=0.012) and behavioral character(χ2=6.699, p=0.035), in the case of housing pattern is mixed-type, behavioral character(χ2=10.37, p=0.006), in the case of subjects' age is 4 years old, watchfulness(χ2=9.525, p=0.009), in the case of subjects' age is 5 years old, behavioral character(χ2=7.324, p=0.026), in the case of children's order is second, behavioral character(χ2=14.31, p=0.001), in the case of children's sex is boy, living safety(χ2=7.981, p=0.018), movement speed (χ2=6.661, p=0.036), bihavioral character(χ2=8.837, p=0.012), in the case of children's sex is girl, reasoning power(χ2 =9.78, p=0.008), in the case of childrens have no past accidental experience, behavioral character(χ2=9.862, p=0.007), in the case of nuclear family, movement speed(χ2=6.341, p=0.042) and behavioral character(χ2=9.326, p=0.009), in the case of mothers' age is under thirty behavioral character(χ2=16.40, p=0.000), in the case of mothers' school career is under high school graduate, behavioral character(χ2 =8.375, p=0.015), in the case of mothers' school career is beyond college graduate, reasoning power(χ2=9.803, p=0.007) and behavioral character(χ2=6.205, p=0.045), in the case of mothers' job is part time, movement speed(χ2=10.99, p=0.004), in the case of mothers have no job, movement stability(χ2=8.490, p=0.014) and behavioral character(χ2=10.11, p=0.006). The difference of accident proneness between experimental group and control group according to general characteristics, it also showed that there were significant difference in behavioral character compared to other area.. From this findings, we can guess that safety education change and guide preschoolers' behavioral character to desirable direction.

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Establishment of Teaching Strategy Through Investigating Scientific Attitude, Learning Style, Student'S Preferences of Teaching Style and Learning Environments of Korea Science Academy Students (한국과학영재학교 학생들의 과학적 태도, 학습양식, 선호하는 수업형태와 수업환경 조사를 통한 수업전략의 수립)

  • Lee, Jeong-Cheol;Kang, Soon-Min;Huh, Hong-Wook
    • Journal of Gifted/Talented Education
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    • v.19 no.1
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    • pp.141-162
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    • 2009
  • The purpose of this study was to find out the learner's characteristics of students of Korea Science Academy by comparing general high school students and science high school students to Korea Science Academy students in terms of scientific attitude, learning styles, preferred teaching style, and learning environment, and to find out the differences of the learner's characteristics by gnender and school number, and to establish teaching strategies based on the findings. First, scientific attitude level of Korea Science Academy students was similar with science high school students and was high level comparing with general high students. Second, for learning style, the students of Korea Science Academy had many independent, collaborative and participatory types, Third, for the prefered science teaching style, the students of Korea Science Academy had high demands for diversification and thinking at higher levels girl students had open-mindedness and cooperation and voluntariness of higher level in scientific attitude, had more independent types in leraning style, and had higher preference of teacher's support, subject convergence and permissive atmosphere than boy students. there were no difference of student's characteristics and preferences by school number. Based on the findings, we proposed 4 teaching strategies.