• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.6 no.1
• /
• pp.74-89
• /
• 1995

Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.10
• /
• pp.480-489
• /
• 2017

Blood flow restriction(BFR) exercise is defined as low intensity and short term exercise using pneumatic pressure belts at the top of limbs, which affects the physiological functions of the body. The purpose of this study was to investigate the effects of walking exercise with BFR on inflammatory index, isokinetic muscle function, and thigh circumference in obese women. Eleven obese women(> BMI $25kg/m^2$ & > body fat 30%) wore pneumatic pressure belts on both femurs and performed walking exercise twice per day, 3 days/wk for 4 weeks (walking 2 min; resting 1 min). Data analysis was carried out using paired t-test. Body weight, BMI, and body fat significantly decreased after exercise(p<.05), and right thigh circumference significantly decreased(p<.05). The concentration of plasma IL-6 significantly increased(p<.05) after exercise. TNF-${\alpha}$ level was not statistically different but tended to slightly increase. CRP slightly decreased, although it did not reach statistical significance after exercise. Muscle strength significantly increased in the $60^{\circ}/sec$ of right/left side extension, left side flexion, and $180^{\circ}/sec$ of left side extension after training(p<.05). These results suggest that 4 weeks of blood flow restriction walking exercise has positive effects on inflammatory index and isokinetic muscle function. Therefore, we consider that blood flow restriction exercise can be used for treatment of obesity, related chronic diseases, and metabolic syndrome. Further, blood flow restriction exercise for a short time has similar effects as a high intensity resistance program.

• Clinical and Experimental Pediatrics
• /
• v.45 no.10
• /
• pp.1219-1226
• /
• 2002

Purpose : To assess the clinical characteristics of the 2000-2001 measles outbreak in the Seoul metropolitan area, Korea, the clinical data of measles inpatients were analyzed. Methods : Three hundred and five children diagnosed with measles by clinical manifestation from July, 2000 to February, 2001, in Seoul, Ilsan and Ansan City were grouped according to their age and investigated for clinical manifestations, vaccination history and measles-specific IgM/IgG antibody positivity. Results : Thirty eight point seven percent of the subjects were less than 12 months of age, 27.5 % were 12-47 months of age and 33.8% were 48 months of age or older. There was no significant sexual difference(male : female=1.2 : 1). This epidemic started in June, 2000 and the number of patients increased abruptly in October, peaked in December and finally decreased after February, 2001. It started from the older age group and moved to the younger. Sixty five point two percent had a history of more than 1-dose vaccination and 13.6% of the patients equal or more than 48 months of age had a history of 2-dose vaccination. Primary vaccine failure rate was 59.4%(107/180) and secondary vaccine failure rate was 3.9%(7/180) in 1 dose vaccinees. Sixty one point six percent showed more than one complication and 38.4% had no complication. The most common complication was pneumonia(31.8 %), followed by bronchitis(11.5%) and acute otitis media(4.6%). Vaccination and dose were not related significantly with the occurrence of complications. Conclusion : Compared with previous outbreaks in Korea, clinical features showed no specific change in the 2000-2001 measles epidemic. However, primary vaccine failure rate was so high that the second vaccination at four to six years of age must be emphasized in Korea.

• Clinical and Experimental Pediatrics
• /
• v.48 no.3
• /
• pp.292-297
• /
• 2005

Purpose : It is known that 3-50 percent of type 1 diabetes mellitus(T1DM) patients develop autoimmune thyroid disease. We analyzed the clinical characteristics of autoimmune thyroid disease(AITD) developed in patients with T1DM in Korean. Methods : The medical records of 139 patients, who were followed up in Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1981 to Jul. 2004, were analyzed retrospectively. Results : Forty-four males and 95 females were enrolled. At least one of the autoantibodies for thyroid was positive in 54 cases. The detection rate for AITD was not correlated with sex ratio, control of T1DM, body mass index, age at diagnosis of T1DM, and familial history of thyroid disease, between two groups. In the male group, AITD was more frequently found at a younger age than in the female group. The frequency of AITD was significantly higher in the goiter group without sex differences. In the thyroid disease group, 40 patients(74.0 percent) were euthyroid, seven patients(12.9 percent) were hypothyroid, and seven patients(12.9 percent) were hyperthyroid. Conclusion : We should monitor thyroid function and autoantibodies routinely in T1DM patients who develop goiters, or young boys with T1DM.

• Journal of the Korean Association of Geographic Information Studies
• /
• v.19 no.4
• /
• pp.186-198
• /
• 2016

HPAI(Highly Pathogenic Avian Influenza) is a contagious animal disease that spreads rapidly by diffusion after the first occurrence. The disease has brought tremendous social costs and economic losses. KAHIS (Korea Animal Health Information System) is the integrated system for supporting the task of preventing epidemics. They provide decision-support information, recording vehicle visiting times and facility location, etc., which is possible by enforcing registration of all livestock related facilities and vehicles. KAHIS has accumulated spatial and temporal information that enables effective tracing of potential disease trajectories and diffusion through vehicle movements. The contact network is created utilizing spatial and temporal information in KAHIS to inform facility connection via vehicle visitation. Based on the contact network, it is possible to infer spatial and temporal mechanism of disease spread and diffusion. The study objective is to empirically demonstrate how to utilize primary spatial and temporal information in KAHIS in the form of the contact network. Based on the contact network, facilities with the possibility of infection can be pinpointed within the potential spatial and temporal extent where the disease has spread and diffused. This aids the decision-making process in the task of preventing epidemics. By interpreting our demonstration results, policy implications were presented. Finally, some suggestions were made to comprehensively utilize the contact network to draw enhanced decision-support information.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.16 no.1
• /
• pp.47-53
• /
• 2005

Objectives : Few studies have examined the relation between the attachment styles of the primary caregivers and the behavioral problems of their children. This study was performed to identify the impact of the insecure parental attachment patterns on the development of their higher grades elementary school children's psychiatric manifestations and disorders. Methods : 504 higher elementary pupils and their primary caretakers were included in our study. Relationship Questionnaire, Kovacs Children's Depression Inventory, Spielberger's State-Trait Anxiety Inventory for children, and Korean Child Behavior Checklist were applied to them. Results : The grade-school children of the parents who belonged to preoccupied attachment type revealed higher Withdrawn, Anxious/depressed, Social Problems, Attention Problems, Delinquent Problems, Aggressive Problems, Internalizing Problems, Externalizing Problems, Total Behavioral Problems scores than ones of securely attached parents (p<0.01). Internalizing Problems score of preoccupied parents' children was highest, and one of avoidant and secure typed parents' kids followed in order (p=0.004) . More youngsters revealed Total Behavior Problem score high enough to clinically meaningful level in insecure parental attachment style than in secure one (p=0.038). Higher CDI score in insecure parental group was reported than in secure one (p=0.040). Conclusion : Parental insecure attachment can be associated with the development of the behavioral problems and psychiatric illness of their children.

• Journal of Acupuncture Research
• /
• v.26 no.4
• /
• pp.1-9
• /
• 2009

목적 : 한양방 협진을 통한 보존적 입원 치료를 받은 급성 흉요추 압박골절 환자군에서의 압박골절 compression ratio의 급성기 내의 변화를 기록 분석하여 차후 환자군의 예후를 예측하고자 하였다. 방법 : 한양방 협진병원 척추센터에 입원하여 보존치료를 시행한 발병 2주 내의 압박골절 환자 중 2회 이상의 시점에서 압박골절 부위의 측면 X-ray 영상이 있는 환자 16명의 기록을 수집하였다. X-ray상 급성 압박골절이 발생한 추체(n=19)의 anterior wall과 posterior wall의 높이를 입원 1주차, 입원 2주차, 입원 3주차와 최종 영상 확보 시점의 X-ray에서 측정해 wedge fracture에 해당하는 anterior column fracture가 있는 추체(n=14)에 한해 anterior height/posterior height의 공식을 통해 compression ratio를 산출하였다. 2차적 지표로 입원 1주차에서 입원 3주차까지 환자의 VAS(visual analog scale) 통증 척도 점수를 분석하였다. 그 외 연령, 성별, 입원 기간, 총 치료기간, 당뇨, 골다공증, 골밀도, 압박골절 기왕력, 압박골절의 형태의 빈도와 비율을 분석하였다. 결과 : 1. 전방 골주 단독 골절에서의 compression ratio는 입원 1주차에서 3주차, 그리고 최종 영상 확보시점까지 각각 20.92${\pm}$10.42, 25.22${\pm}$10.90, 25.57${\pm}$11.04, 25.07${\pm}$11.94로 기록되었다. 시점간에는 통계적으로 유의한 compression ratio의 차이가 나타나지 않았다. 2. 통증 VAS 점수 평균은 입원 1주차부터 3주차까지 각각 7.44${\pm}$2.07, 4.67${\pm}$1.63, 3.00${\pm}$1.80으로 기록되었다. 시점간 모두 통계적으로 유의한 감소가 있었다(1주차-2주차 p=.003, 1주차-3주차 p<.000 2주차-3주차 p=0.021). 결론 : 본 연구의 협진 입원치료 압박골절의 compression ratio는 입원 1주차 시점에서 최종 follow-up 시점까지 유의한 차이를 보일 만큼의 추가적인 추체 높이 감소를 보이지 않아 향후 좋은 예후를 예상할 수 있다. 통증 VAS 점수는 모든 주별 시점간에서 유의하게 감소되었다.

• Childhood Kidney Diseases
• /
• v.8 no.2
• /
• pp.159-165
• /
• 2004

Purpose: This study aimed to compare the clinical outcome of acute poststreptocaccal glomerulonephritis (APSGN) between patients who had presented with gross hematuria and those with microscopic hematuria. Methods: Thirty-nine patients with acute poststreptococcal glomerulonephritis, who were diagnosed from January 2000 to April 2003 were enrolled. Results: The mean age was 8.85 years and the male to female ratio was 1.1:1 Seventeen patients presented with gross hematuria at diagnosis(group A) and twenty-two patients had microscopic hematuria only(group B). There were no significant differences between the two groups in the incidence of edema, fever or history of respiratory infection and oliguria. But hypertension was more frequent in group B. Laboratory data showed decreased C3 and C4 level in group B. Spot urine protein/creatinine ratio and 24hr urine protein showed higher levels in group A. Conclusion; Patients with gross hematuria at diagnosis had lower incidence of hypertension and a higher rate of nephrotic range of proteinuna than patients with microscopic hematuria. However, no difference in the duration of admission or complication rate was observed. All patients had clinical improvement during follow-up. We conclude that gross hematuria is not a significant prognostic factor for poststreptococcal glomerulonephritis.

• The Korean Journal of Applied Statistics
• /
• v.21 no.1
• /
• pp.81-94
• /
• 2008

Family-based tests such as the transmission and disequilibrium tests(TDT) have proved to be powerful tools in the search for disease genes. Unlike case-control studies, the tests are not affected by population admixture, which can lead to spurious association of multiple highly linked makers with disease-susceptible genes. Those tests have largely required knowledge of parental marker genotypes. However, parental data are often not available for late-onset diseases. In this article we propose sib-TDTs that overcome this problem by use of marker data from unaffected sib(s) instead of parents. To do this end, we fist defined a Mantel-Haenszel-type statistic for each haplotype and then proposed two tests based on this statistic. Simulation studies suggest that the proposed tests are robust to population admixture and are monotone increasing as a relative risk increases irrespective of mode of inheritance. We also illustrated the proposed tests with data adopted from Yonsei Cardiovascular Genome Center.

• Korean Journal of Clinical Laboratory Science
• /
• v.48 no.4
• /
• pp.388-393
• /
• 2016

Epilepsy, characterized by enduring the predisposition to generate epileptic seizures, was conceptually defined in 2005 as a disorder of the brain. According to the international league against epilepsy in 2014 that there is a high risk of recurrence within 10 years. The existence of interictal epileptiform discharges (IEDs) at the Electroencephalography (EEG) is an important risk factor for a possible recurrence of seizures, disproving that the seizures may increase. The purpose of this study was to analyze the correlation between recurrent seizures and epilepsy EEG findings in patients with IEDs, which was carried out to serve as the basis for the EEG to predict the prognosis of patients with epilepsy. This study included 432 adults older than 20 years of age who care for patients with epilepsy at Seoul National University Hospital, between June 2007 and December 2010. The results showed no difference between men and women in the EEG epilepsy disease, but there was a difference between various age groups. Correlation analysis showed a negative correlation between recurrence of seizures and age; it showed a positive correlation between recurrence and IEDs. In addition, age was associated with a predictive power of 10.9% and IEDs showed a predictive power of 15% on recurrent seizures. Therefore, EEG is considered as a very important test in epilepsy diagnosis. Therefore, further studies are necessary on the relationship between seizure recurrence and EEG.