• Title/Summary/Keyword: 발달장애 청소년

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COMPLIANCE STUDY OF METHYLPHENIDATE IR IN THE TREATMENT OF ADHD (주의력결핍과잉행동장애 치료 약물 Methylphenidate IR의 순응도 연구)

  • Hwang, Jun-Wan;Cho, Soo-Churl;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.160-167
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    • 2004
  • Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

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Investigation of Automated Neonatal Hearing Screening for Early Detection of Childhood Hearing Impairment (소아 난청의 조기진단을 위한 신생아 청력 선별검사에 대한 평가)

  • Seo, Jeong Il;Yoo, Si Uk;Gong, Sung Hyeon;Hwang, Gwang Su;Lee, Hyeon Jung;Kim, Joong Pyo;Choi, Hyeon;Lee, Bo Young;Mok, Ji Sun
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.706-710
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    • 2005
  • Purpose : Early diagnosis of congenital hearing loss through the neonatal hearing screening test minimizes language defect. This research intends to identify frequency of congenital hearing loss in infants through neonatal hearing screening test with the aim of communicating the importance of hearing test for infants. Methods : From May 20, 2003 to May 19, 2004, infants were subjected to Automated Auditory Brainstem Response test during one month of birth to conduct the test with 35 dB sound. Infants who passed the 1st round of hearing test, were classified into 'pass' group whereas those who did not were classified into 'refer' group. Infants who did not 'pass' in the hearing test conducted within one month of birth were subjected to re-test one month later, and if classified as 'refer' during the re-test, they were subjected to the diagnosis for validation of hearing loss by requesting test to the hearing loss clinic. Results : There was no difference among the 'pass' and 'refer' group in terms of form of childbirth, weight at birth and gestational age. In the 1st test, total of 45 infants were classified into 'refer' group. Six among 35 who were subjected to re-test(17%) did not pass the re-test, and all were diagnosed with congenital hearing loss. This corresponds to 0.35%(3.5 per 1,000) among total number of 1,718 subjects. Conclusion : In our study the congenital hearing loss tends to be considerably more frequently than congenital metabolic disorder. Accordingly, newly born infants are strongly recommended to undergo neonatal hearing screening test.

A CASE OF TREATMENT-RESISTANT CHILDHOOD-ONSET SCHIZOPHRENIA WITH LONG-TERM TRIAL OF CLOZAPINE (치료저항성 소아기 발병 정신분열증의 Clozapine 장기치험 1례)

  • Jang, Soon-Ah;Kim, Kyung-Hee;Lee, Hong-Shick;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.98-104
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    • 1998
  • A 12-year-old girl with a 6 year history of childhood-onset schizophrenia required 2 hospitalizations and long-term clozapine trial due to inadequate responses to combinations of typical neuroleptics and traditional treatments of schizophrenic disorder. On admission, she had continuous auditory and visual hallucinations, persecutory delusion, emotional instability, regression of behaviors including temper tantrums as well as specific developmental delays in learning, language, and motor coordination. The clozapine trial significantly reduced most of the positive symptoms, and facilitated in successful discharge from the hospital. During the 4 year clozapine treatment, no significant adverse reactions were noted, and she returned to a structured school setting with minimal degrees of schizophrenic symptoms. From this clinical experience, we suggest that clozapine might be safe and effective in treating treatment-refractory schizophrenic children.

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STRUCTURAL MODEL OF CAUSES OF CONDUCT PROBLEM - RELATIONSHIP AMONG CONDUCT PROBLEMS, DEPRESSION, ANXIETY, FAMILY ENVIRONMENT, SELF-CONCEPT, AND TODDLER TEMPERAMENT - (행동문제 원인의 구조적 모델에 관한 연구 - 행동문제, 우울, 불안, 가정환경, 자기개념, 걸음마기 기질의 관계 -)

  • Cho, Soo-Churl;Shin, Min-Sup;Roh, Myoung-Sun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.3-14
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    • 1999
  • Objective:This study was designed to investigate the difference between executive function of Attention Deficit/Hyperactivity Disorder(ADHD) group and that of neurotics, and to investigate the developmental aspects of ADHD group's executive function. Method:Executive function between ADHD(N=87) and Neurotics(N=19) was evaluated through their performance on the Wisconsin Card Sorting Test. The results were analyzed by 2-way ANOVA and t-test. Results:The results revealed group difference between ADHD and neurotics in total correct reponses, total error responses, nonperseverative errors, number of categories completed, conceptual level responses. There was no significant difference between the performance of 8-12 aged group and 13-15 aged group. But 7-8 aged group showed significantly poor performance than 8-12 aged in total responses, total error responses, perseverative responses, perseverative error responses, nonperseverative error responses. Conclusions:In comparison to the neurotics group, the children of ADHD group are suggested to be lacking the ability to correct their responses according to the external feedback and they probably respond randomly without self-control. However, as there is no difference between perseverative errors and perseverative responses, the interpretation of this finding warrants caution. It also suggests that the developmental aspects should be considered in the studies of executive functions because there are differences in the performance of executive functions by ages.

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Clinical and Cytogenetic Analysis of Children with Maternal Chromosomal Balanced Translocation (모체의 염색체 균형전좌를 가진 환아들의 임상적 세포 유전학적 관찰)

  • Lim, Han Hyuk;Jeong, Hee Jeong;Park, Kyung Duk;Kim, Sook Ja
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.701-705
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    • 2005
  • Purpose : Parents' genetic information plays an important role in their children's genetic expression. Human chromosome has 23-paternal chromosomes and 23-maternal chromosomes. Parental chromosomal translocation can induce clinical problems in their children because of imbalance in genetic information. We intent to analyze the cytogenentic and clinical features about children with maternal balanced translocation between chromosome 15 and 18. Methods : We detected by one family's FISH study of chromosome 15. We have evaluated children born to clinically normal parents about peripheral bood analysis, endocrine, metabolic, radiologic study, electroencephalogram and social & intelligence scale. and We analysis their clinical manifestation by hospital records. Results : Patient's father and elder sister are normal clinically and genetically. Her mother's chromosome show balanced translocation, 46, XX, t(15;18)(p11.2;p11.3). One child has 46, XX, der(18) t(15;18)(p11.2;p11.3), mental retardation, growth retardation, speech & social developmental delay, recurrent infection and mild mitochondria dysfunction. Her young brother has 46, XY, der(15) t(15;18) (p11.2;p11.3), mental retardation, aggressive behavior, obesity and speech developmental delay. Conclusion : In this study we observed the children with developmental delay, dysmorphic facial features, mental retardation, growth retardation associated with growth hormone deficiency and aggressive behavior due to unbalanced translocation between chromosome 15 and 18.

Two cases of congenital atretic encephalocele misdiagnosed as dermoid cyst (유피낭종으로 오인된 atretic encephalocele 2례)

  • Kim, Jae-Hui;Cho, Jae-Min;Jung, Jin-Myung;Park, Eun-Sil;Seo, Ji-Hyun;Lim, Jae-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.1000-1004
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    • 2006
  • Atretic cephalocele is a degenerative form of encephalocele, which is detected as a cystic mass in the head, primarily in infants. Its presentation and prognosis vary and depend on various factors, including the nature of the tissues within the cyst, other concomitant anomalies, the site of development, and the presence or absence of an embryonic straight sinus. We here report 2 cases of atretic encephalocele, that were transferred to our hospital because round tumors, misdiagnosed as dermoid cysts, were detected in their parietal lobes immediately after birth. On diagnostic and differential MRI, an embryonic straight sinus was detected while histochemical results indicated that the lesions contained cerebral tissues. Despite these structural anomalies, the two patients developed normally neurologically and no other anomalies were detected. We here discuss these two cases and present a review of the relevant literature.

A Case of Lesch-Nyhan Syndrome (Lesch-Nyhan 증후군 1례)

  • Kim, Joon-Sung;Lee, Jae-Seung;Noh, Ha-Young;Kim, Byung-Ju;Woo, Young-Jong;Park, Jee-Min;Kim, Myung-Gwan;Kim, Gu-Hwan;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.505-509
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    • 2003
  • Lesch-Nyhan syndrome is an X-linked recessive disorder characterized by hyperuricemia, choreoathetosis, spasticity, mental retardation, and compulsive, self-injurious behavior. This disorder results from a complete deficiency of the purine salvage enzyme, hypoxanthine-guanine phosphoribosyl transferase(HPRT). We report here on a case of Lesch-Nyhan syndrome in a 1-year, 7-month-old male who presented with frequent vomiting, failure to thrive, and developmental delay. The diagnostic work-up revealed hyperuricemia, hyperuricosuria, and medullary nephrolithiasis. The HPRT activity in the erythrocytes was undetectable with a biochemical assay. We also identified de novo mutation which was a deletion of the 649th base, adenosine, in HPRT gene(649delA) by analysis of cDNA using RT-PCR technique coupled with direct sequencing.

Cytogenetic evaluation of a patient with ring chromosome 9 presenting failure to thrive and developmental delay (성장부진과 발달지연을 보인 환아에서 확인된 환상 9번 염색체 1례의 세포유전학적인 연구)

  • Park, Yun Mi;Nho, Han Nae;Kim, Sook Za;Ahn, Young Min
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.426-430
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    • 2008
  • We report clinical, cytogenetic, and fluorescence in situ hybridization (FISH) studies of a patient with ring chromosome 9. She presented with failure to thrive, facial dysmorphysm and mild psychomotor development delay in the absence of major malformations. Peripheral blood karyotype of the patient was 46,XX,r(9)(p24q34). G-band analysis suggested no loss of material in the ring chromosomes. FISH analysis using the subtelomere-specific sequences on chromosome 9p and 9q, revealed 46,XX,r(9)(p24q34),ish r(9)(D9S913-,D9S325+). Failure to detect any hybridization of a probe for the subtelomeric sequences in the ring 9p terminal suggested that this ring arose from breakage in the distal short arm. The cytogenetic and FISH data in our case provided further evidence for the existence of a "complete ring" phenotype with incomplete subtelomeric sequences.

A Study on Elementary School Students' Current State on Harmful Information on the Internet and Educational Plan (인터넷 유해정보에 대한 초등학생 실태 및 교육적 보호방안 연구)

  • Lee, Jae-Woon;Kim, Seong-Sik
    • Journal of The Korean Association of Information Education
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    • v.11 no.3
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    • pp.329-337
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    • 2007
  • The rapid growth in areas related to IT is bringing about benefits and dysfunctions of informatization and harmful information on the Internet. It exerts evil effects on adolescents' mind and hampers their development of personality. The present study purposed to analyze the state on harmful information on the Internet, and to propose various educational plans for elementary school students. For these purposes, we analyzed the current state of harmful information by reviewing various literatures and previous researches, suggested the definition and types of harmful information based on previous researches in this study. In addition, we analyzed the state on harmful information of elementary school students by making a comparative analysis various researches about the state of harmful information; and based on this, various educational protective plans were suggested for elementary school students, teachers and parents. The proposed educational plan can be used for organizing education curricula of IT ethics, education programs for teachers and parents.

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A Study of Functional Disability in a Rural, Community-Dwelling Elderly Population (농촌 지역사회 거주 노인의 기능장애에 관한 연구)

  • Park, Sol-Bi;Park, Kyoung-Young;Kim, Hyeon-June
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.4
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    • pp.1-9
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    • 2021
  • Purpose : The purpose of this study was to investigate functional disability for the elderly in rural Korea and to identify influencing factors of functional disability. Methods : The data were collected for 76 community-dwelling elderly in rural area and above 65 years. We assessed cognitive function, functional disability, depression using LACLS, WHODAS 2.0, SGDS-K. Data were analyzed using descriptive statistics for general characteristics of subjects, Spearman's correlation among LACLS, SGDS-K, WHODAS 2.0, age, educational levels. And multiple regression was used to find influencing factors of functional disability. Results : As a result of this study, we identified that WHODAS 2.0 total score was 50.59, summary score was 9.94 and functional disability of the elderly in rural area is in the 70th percentile. The highest level of disability occurred in areas related to 'life activities (household)', 'participation in society' and the lowest level of disability occured in areas of 'self-care', 'getting along with people'. Functional disability was significantly correlated with age (r=.398), cognitive function (r=-.547), depression (r=-.563) but not educational levels (r=-.215). Finally, we confirmed that depression (𝛽=.371), cognitive function (𝛽=-.263), widowed status (𝛽=.303), age (𝛽=.272), non-participation of community program (𝛽=.165) was significantly influencing factors of functional disability and the explanatory power of these factors was 52.80 %. Conclusion : This study revealed important factors of functional disability. Therefore, we need to consider these factors when we developed program related to health for the elderly (aged > 65 years) in rural Korea. Further, we need to standardize WHODAS 2.0 in order to enhance its applicability in clinical practices.