• Title/Summary/Keyword: 소아와 장애인

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Effects of Myofunctional Appliance in Children with Sleep-Disordered Breathing: Two Case Reports (수면호흡장애 어린이의 근기능 장치 효과 증례 보고)

  • Shim, Hojin;Jeong, Taesung;Kim, Shin;Kim, Jiyeon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.1
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    • pp.119-126
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    • 2019
  • Sleep-disordered breathing (SDB) induces dysfunction of the orofacial muscles, leading to morphologic alteration of the face and dental malalignment. Early diagnosis and treatment of SDB is required in pediatric patients to ensure normal facial growth. Myofunctional therapy (MFT) is a modality for the treatment of SDB and prefabricated appliances can be used. Herein 2 cases of malocclusion with SDB, in which MFT with a prefabricated appliance was used for orthodontic treatment, have been described. SDB was diagnosed based on clinical symptoms taken by interview and home respiratory polygraphy. In both cases, SDB was improved using prefabricated appliance for MFT. However, resolution of crowding depended on the degree of crowding.

BORDERLINE PERSONALITY DISOREDER IN ADOLESCENTS (청소년기의 경계선 인격장애)

  • Jang, Kyung-June;Chung, Jea-Yun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.34-42
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    • 1995
  • Borderline personality disorder in adolescents present with suicide attempts or gestures, and they are characterized by the same patterns of splitting, devaluation, manipulation, need-gratifying object relations, impulsivity, and ego deficits that are finds in borderline adults, Symptomatolgy are depression, anxiety, identity crisis, and occasionally antisocial behavior in borderline personality disorder in adolescents. These findings should be differentiated to normal stormy adolescents. Theses borderline personality disorder in adolescents are known about the instability of object relations, labile affect, splitting, and psychotic episode in severe stress. According to thses finding, schizophrenia, mood disorder, schizoptypal personality disorder, paranoid personality disorder could be differentiated. Etiology is complex including psychodynamic, genetic, familial factor. Treatments are individual psychotherapy, group therapy, and pharmacotherapy. The continuity or discontinuity of borderline states from childhoon to adult life is controversy.

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THE CHARACTERISTICS OF CHILD AND ADOLESCENT INPATIENTS WITH SEVERE OBSESSIVE-COMPULSIVE DISORDER (심각한 소아 ${\cdot}$ 청소년 강박장애로 입원한 환아들의 특징)

  • Hwang, Jun-Won;You, So-Young;Chang, Jun-Hwan;Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;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.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.

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RELATIONSHIP BETWEEN DEPRESSION/ANXIETY AND ATTENTION DEFICIT HYPERACTIVITY DISORDER (주의력결핍 과잉운동장애와 우울, 불안증상과의 상호관계)

  • Cho, Soo-Churl;Chung, In-Kwa;Yoon, Hie-Jin;Nam, Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.2
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    • pp.213-223
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    • 1996
  • This study was performed to assess depression/anxiety of attention deficit hyperactivity disorder(ADHD) in children and adolescents and to use them as basic material for subdivied ADHD on phenomenological aspects. 51 hospitalized ADHD children and adolescents were assessed using the Korean form of the Kovacs' Children's Depression Inventory(CDI), Korean Form of the State-Trait Anxiety Inventory for Children(STAIC). Their data were compared to normal control of 50 mentally healthy children and adolescents in relation with the dermographic characteristic. The mean scores of CDI and STAIC-5(State) of ADHD group were statistically higher than those of the control group(p<0.01 or p<0.05). The mean scores of STAIC-T(Trait) of ADHD group were higher than those of the control group. These results suggest that the authors suggest that ADHD can be subdivide into pure ADHD, depressive ADHD and anxious ADHD by the comorbidity of the depression/anxiety.

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A SURVEY OF GENERAL ANESTHESIA, SEVOFLURANE SEDATION AND INTRAVENOUS SEDATION IN CHUNGNAM DENTAL CLINIC FOR THE DISABLED (충남장애인구강진료센터에서 시행된 전신마취 및 진정법에 관한 실태조사)

  • Kim, Seung-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.1
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    • pp.28-39
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    • 2013
  • General anesthesia or sedation is an essential for a successful dental treatment for the disabled. The aim of this study is to assess the patients who had dental management under general anesthesia or sedation at Chungnam dental clinic for the disabled, who received dental treatment under general anesthesia, sevoflurane sedation and intravenous sedation from January, 2011 to September 2012. Of the 426 patients studied, 389 patients received dental care under general anesthesia, 20 patients received dental care under sevoflurane sedation and 17 patients received dental care under intravenous sedation. The Rate of general anesthesia was higher than that of sevoflurane sedation, intravenous sedation. Sevoflurane sedation is a useful method for short time treatment such as traumatic pediatric patients. Intravenous sedation is an option for patients who had anxiety and fear such as dentally disabled patients. Sevoflurane or intravenous sedation not only gradually reduces the use of general anesthesia but also useful methods themselves for the dentally disabled.

COMORBIDITY OF CHILD AND ADOLESCENT INPATIENTS (소아정신과 입원환자의 공존질병(Comorbidity))

  • Shin, Yun-O;Cho, Soo-Churl;Hong, Kang-E;Kim, Ja-Sung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.91-97
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    • 1993
  • The objective of this paper was to determine the degree of diagnostic overlap. In a pilot study of 56 inpatients(mean age 12) with DSM-III-R axis I and/or II disorders, the degree of psychiatric comorbidity was examined. 64.3% had two or more diagnoses. The samples were divided into the following 9 groups 1) attention deficit hyperactivity disorder 2) conduct disorder 3) oppositional defiant disorder 4) schizophrenia 5) mood disorders 6) tie disorders 7) elimination disorders 8) mental retardation 9) personality disorders Substantial overlap(especially tic disorders, elimination disorders, disruptive behavior disorders) occured among inpatients Patients had about 2 DSM-III-R axis I & II diagnoses. Additional research with increased sample size is necessary to clarify its relationship with other psychiatric diagnoses.

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