• Journal of Chest Surgery
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• v.39 no.7 s.264
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• pp.556-560
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• 2006

A 42-year-old female was admitted to our hospital complaining of a dyspnea. Chest X-ray showed left atelectasis. A mass was detected in left main bronchus by computed tomography and bronchoscopy. The mass was diagnosed as a endobronchial leiomyoma by biopsy exam. After open thoracotomy and bronchotomy, mass removal was done and middle lobe was ventilated normally. Aberrant arterial supply from descending aorta to left lower lobe of the lung was detected and left lower lobectomy was done. The lower lobe of the left lung was pathologically diagnosed as intralobar pulmonary sequestration. Herein we report a rare coexistent case of endobronchial leiomyoma and intralobar pulmonary sequestration.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.18-33
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• 1995

The Purpose of this article is to identify the specific characteristics of borderline disorder in adolescence to conceptualize the borderline state as an adolescent process different from borderline personality disorder in adult, and to classify them according to it's unique clinical feature, porcess and outcome. The development of borderline disorder in adolescent, epidemiology, comorbid disorders and differential diagnosis, pre-existing sub-classification systems, and etiology in theories of psychodynamics, biological theories, experimental studies, and follow-up studies are reviewed. The authors conceptualize the adolescent borderline state include all clinical states generated by re-emergence of unresolved rapproachement conflicts in adolescent, and propose that there are four subgroups in adolescent borderline state. (1) Borderline state as an adolescent process. (2) Borderline state associated with psychotic disorders (3) Borderline state as an initial stnge of typical borderline personality disorder (4) Borderline state associated with organic problems. Conceptually, borderline state in adolescence is not a simple continuation of primary failure of separation-individuation but a struggle for mastering unresolved separation-individuation conflicts in adolesance i.e., the second separation-individuation state, and if it fails this time, the struggle might continue into adult life as borderline personality disorder.

• Mood & Emotion
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• v.16 no.3
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• pp.129-133
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• 2018

Objectives : The fourth revision of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was performed in 2018, to provide newer guidelines for clinicians. In this section, we examined expert opinions to facilitate clinical decisions relative to treating bipolar disorder with medical comorbidity. Methods : The survey was completed by the review committee, consisting of 61 experienced psychiatrists. This part of the survey constitutes treatment strategies, under major medical comorbidities. The executive committee analyzed results, and discussed the final production of algorithm. Results : Aripiprazole was the first-line medication for bipolar patients with metabolic syndrome, cardiovascular, hepatic, renal, and cerebrovascular comorbidities. Ziprasidone also was recommended as the first-line medication in case of metabolic syndrome. Lithium also was regarded as the first-line medication, in case of hepatic problems. Valproate also was considered as the first-line medication, in case of cerebrovascular problems. Conclusion : This study provided the most recent consensus among experts, for treatment of bipolar disorder with physical problems.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.143-151
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• 2004

Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.81-94
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• 2003

Objectives：Developmental reading disorder is a condition which manifests significant developmenttal delay in reading ability or persistent errors. About 3-7% of school-age children have this condition. The purpose of the present study was to validate the diagnostic values of Word/Nonword Reading Test and Letter-Symbol Discrimination Task for the purpose of overcoming the caveats of Basic Learning Skills Test. Methods：Sixty-three reading-disordered patients(mean age 10.48 years old) and sex, age-matched 77 normal children(mean age 10.33 years old) were selected by clinical evaluation and DSM-IV criteria. Reading I and II of Basic Learning Skills Test, Word/Nonword Reading Test, and Letter-Symbol Discrimination Task were carried out to them. Word/Nonword Reading Test：One hundred usual highfrequency words and one hundred meaningless nonwords were presented to the subjects within 1.2 and 2.4 seconds, respectively. Through these results, automatized phonological processing ability and conscious letter-sound matching ability were estimated. Letter-Symbol Discrimination Task：mirror image letters which reading-disordered patients are apt to confuse were used. Reliability, concurrent validity, construct validity, and discriminant validity tests were conducted. Results：Word/Nonword Reading Test：the reliability(alpha) was 0.96, and concurrent validity with Basic Learning Skills test was 0.94. The patients with developmental reading disorders differed significantly from normal children in Word/Nonword Reading Test performances. Through discriminant analysis, 83.0% of original cases were correctly classified by this test. Letter-Symbol Discrimination Task：the reliability(alpha) was 0.86, and concurrent validity with Basic Learning Skills test was 0.86. There were significant differences in scores between the patients and normal children. Factor analysis revealed that this test were composed of saccadic mirror image processing, global accuracy, mirror image processing deficit, static image processing, global vigilance deficit, and inattention-impulsivity factors. By discriminant analysis, 87.3% of the patients and normal children were correctly classified. Conclusion：The patients with developmental reading disorders had deficits in automatized visuallexical route, morpheme-phoneme conversion mechanism, and visual information processing. These deficits were reliably and validly evaluated by Word/Nonword Reading Test and Letter-Symbol Discrimination Task.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.123-136
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• 1997

The purpose of this study was to examine the reliability and validity of a Korean form of Childhood Attention Problem(CAP) scale. CAP were administered to 98 normal elementary school students as control group and 98 attention deficit hyperactivity disorder patients. Male students showed high scores than female students in both subscale and total scores, but not statistically significant. There were no significant difference in CAP scale between male students and female students in attention deficit hyperactivity disorder patients. In the reliability test, the test-retest reliability coefficient was highly satisfactory and that of inattention subscale was 0.83, impulsivity subscale was 0.70 and total score was 0.82. In the reliability test by internal consistency, the Cronbach $\alpha$ coefficient was highly satisfactory and that of inattention subscale was 0.91, overactivity subscale was 0.89(p<0.05). The concurrent validity between CAP scale and ADDES-BV scale was 0.85 in attention deficit hyperactivity disorder patient group and 0.73 in normal control group(p<0.05). In discriminant validity test between attention deficit hyperactivity disorder patient group and normal control group, the patient group showed higher score(p<0.05). The total discriminant capacity of the patient group in CAP was 93.4%. In this point of view, CAP scale showed high reliability and validity in applying to Korean subjects and was proved to be the good and simple screening test tool for attention deficit hyperactivity disorder research and can help many young patient to treat early.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.2
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• pp.219-230
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• 2005

Objectives : This study was designed to compare the demographic data, clinical characteristics, developmental delay, and psychological tests between childhood-onset and adolescent-onset schizophrenic in-patients. Methods Medical records of the 17 childhood-onset (very early onset) Schizophrenia and 16 adolescent-onset (early onset) Schizophrenia in-patients were reviewed. Sex, age, psychiatric past history, prodromal symptoms and period, subtype, co-morbid disease, developmental delay, prescribed drug and dosage, treatment response, intelligence quotient (IQ), and Rorschach test were evaluated. Results : The mean admission age of childhood-onset (very early onset) group and adolescent-onset (early onset) group were 12.69$({\pm}2.34)$ and 15.13$({\pm}1.04)$ years. The mean onset age of childhood-onset(very early onset) group and adolescent-onset (early onset) group were 10.79$({\pm}1.95)$ and 14.46$({\pm}0.82)$ years. The mean prodromal period of childhood-onset (very early onset) group and adolescent-onset (early onset) group were 15.94$({\pm}12.33)$ and 8.06$({\pm}6.10)$ month. The time to remission period of childhood-onset (very early onset) group and adolescent-onset (early onset) group were 50.58$({\pm}24.67)$ and 30.06$({\pm}18.04)$ days. Longer time to remission period in childhood-osnet (very early onset) group was associated with earlier age of onset. The mean of total IQ, performance IQ, verbal IQ were at an average level. Discussion : Childhood-onset (very early onset) group and adolescent-onset (early onset) group Schizophrenia had different clinical and psychological features including prodromal period, and IQ subtests.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.136-144
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• 2017

Objectives : Cognitive complaints are reported frequently after breast cancer treatments. The causes of cognitive decline are multifactorial, a result of the effect of cancer itself, chemotherapy, and psychological factors such as depression and anxiety. However, cognitive decline does not always correlate with neuropsychological test performance. The purpose of this study was to examine the relationship of subjective cognitive decline with objective measurement and to explore associated factors of cognitive function in breast cancer survivors. Methods : We included 29 breast cancer survivors who complain cognitive decline at least 6 months after treatment and 20 age-matched healthy controls. Neuropsychological tests were performed in all participants. Multivariable regression analysis evaluated associations between neuropsychological test scores and psychological distress including depression and anxiety, also considering age, education, and comorbidity. Results : There were no statistically significant differences in neuropsychological test performances. However, the breast cancer survivors showed a significantly higher depression(p=0.002) and anxiety(p<0.001) than the healthy controls did. Among the cancer survivors, poorer executive function was strongly associated with higher depression(${\beta}=-0.336$, p=0.001) and anxiety(${\beta}=-0.273$, p=0.009), after controlling for age, education, and comorbidity. In addition, poorer attention was also significantly related with depression(${\beta}=-0.375$, p=0.023) and anxiety (${\beta}=-0.404$, p=0.013). Conclusions : The results of this study showed the discrepancies between subjective complaints and objective measures of cognitive function in breast cancer survivors. It suggests that subjective cognitive decline could be indicators of psychological distress such as depression and anxiety.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.178-184
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• 2004

Objectives : This study was conducted to investigate the association of the COMT polymorphism with the TD in Korean sample of families with TD probands. The relationship between risk alleles and specific clinical features (tic severity, comorbidity, drug response) was also explored. Method : Patients were recruited from the Tic Disorder clinic at the Child & Adolescent Psychiatric Division of Seoul National University Hospital and assessed through 2 stage evaluation. Firstly, all the patients and parents received semistructured interview using Korean version of K-SADS-PL. Secondly all the patients received clinical interview and tic severity assessment with Korean version of YGTSS. The subjects in control group were recruited from the health promotion center in out hospital and were evaluated by SCL-90 and SCID-IV. Through these process, total of 42 children and adolescents with TD, their 84 parents and 86 control subjects were finally recruited. Genotyping for The Val158Met polymorphism of the COMT gene was done by standardized method. After collection of genetic data of all the patients, parents and control subjects, case-control comparison and tranmission dysequilibrium test was executed by SPSS version 11. Result : From the case-control comparison, the frequency of L-allele and LL genotype was significantly higher in TD group. However, no differences were found from the TDT. No significant differences were found in in family history of tic, ADHD, OCD, drug response and comorbid conditions among the three different genotypes in patients with TD. Conclusion : Though this study results should be interpreted cautiously due to small sample size and negative finding in TDT test, this study is the first report that there is positive association between the functional polymorphism of COMT gene the TD.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1058-1066
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• 1998

Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.