• Title/Summary/Keyword: 소아와 장애인

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Sleep-Disordered Breathing in Children (소아에서의 수면호흡장애)

  • Shin, Chol
    • Sleep Medicine and Psychophysiology
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    • v.10 no.2
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    • pp.88-92
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    • 2003
  • Sleep-disordered breathing (SDB), including snoring, sleep apnea and upper airway resistance syndrome are common problems in children. The pathophysiological mechanism of SDB in children is unclear but may include hypoxemia and changes in sleep architecture. Children with SDB show reduced neurocognitive function, and memory and attentional capacity. Furthermore, these children show increased problematic behaviour and reduced school performance. Whether early recognition and treatment of SDB in children may improve neurocognitive function and school performance remains to be fully evaluated in the future.

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The Distribution and Treatment of Outpatients with General Anesthesia in Chonbuk National University Dental Hospital for 9 Years (최근 9년간 전북대학교 치과 병원 외래 전신마취 환자 분포 및 치료)

  • Moon, Yujin;Lee, Daewoo;Kim, Jaegon;Baik, Byeongju;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.158-163
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    • 2015
  • General anesthesia (GA) for dental care in handicapped patients is necessary to facilitate the provision of safe, efficient, and effective quality treatment. The aims of this study were to determine the anesthetic characteristics of handicapped patients in need of dental treatment in these day care units, and to establish for plan to provide better services. 325 patients who had outpatient general anesthesia from January 2005 to March 2014 were assessed for this study. Patients' distribution and treatment patterns were examined. The proportion of male patients (202, 62.2%) was higher than female patients (123, 37.8%) and the largest group of patients were 5 to 10 years old (85, 26.2%). The reasons for general anesthesia included mental and physical disabilities (207, 63.7%), behavior management (84, 25.8%), parent needs (14, 4.3%), and so on. Restorative treatment was the most common procedure with the average of 4.2 teeth treated per one patient and 43 (13.2%) patients underwent general anesthesia for dental treatment more than once. To expand and improve access to the dental care of the disabled, improvement of the health care system, enhancement of their training for dental care by professionals, and enlarging caregivers'understanding of the importance of oral care in the early stages are required.

Relationship between Upper Airway and Sleep-Disordered Breathing in Children with Mouth Breathing (구호흡 어린이에서 수면호흡장애와 상기도와의 관계)

  • Kim, Doyoung;Lee, Daewoo;Kim, Jaegon;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.1
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    • pp.38-47
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    • 2019
  • The most common cause of mouth breathing is obstacles caused by mechanical factors in upper airway. Mouth breathing could be consequently pathological cause of sleep-disordered breathing. Sleep-disordered breathing in children can cause growth disorders and behavioral disorders. The purpose of this study was to investigate relationship between upper airway and sleep-disordered breathing in children with mouth breathing. Twenty boys between 7 - 9 years old who reported to have mouth breathing in questionnaire were evaluated with clinical examination, questionnaires, lateral cephalometric radiographs, and portable sleep testing. This study assessed apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) for the evaluation of sleep-disordered breathing and was done to investigate the correlation between these values and the upper airway width measured by lateral cephalometric radiographs. There was no significant correlation with the size of the tonsils (p = 0.921), but the adenoid hypertrophy was higher in the abnormal group than in the normal group (p = 0.008). In the classification according to AHI and ODI, retropalatal and retroglossal distance showed a statistically significant decrease in the abnormal group compared to the normal group (p = 0.002, p = 0.001). As AHI and ODI increased, upper airway width tended to be narrower. This indicates that mouth breathing could affect the upper airway, which is related to sleep quality.

RELATIONSHIP BETWEEN DEPRESSION/ANXIETY AND PARENTAL REARING PATTERNS IN ADOLESCENTS WITH CONDUCT DISORDER (품행장애 청소년에서의 우울, 불안 증상과 부모양육특성)

  • Han, Sung-Hee;Choe, Kyoung-Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.83-91
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    • 1997
  • Objects:This study investigated whether depression, anxiety and perceived parental rearing patterns of the conduct disorder patients are different from those of the normal control group. The correlations were also assessed between perceived parenting style and depression, anxiety, severity of conduct problems and age at onset of conduct disorder in adolescents with conduct disorder. Methods:Thirty hospitalzed patients who met the DSM-Ⅳ criteria of conduct disorder, and 30 normal control subjects completed self-report questionnaires containing the Children’s Depression Inventory(CDI), the State-Trait Anxiety Inventory for Children(STAIC) and the Parental Bonding Instrument(PBI). Results:In the conduct disorder group, the results were as follows:1) The mean scores of CDI and STAIC-T(Trait) were not significantly different from those of the control group, but STAIC-S (State) showed significantly higher scores. 2) Parenting style was perceved to be less caring and more overprotective than in the control subjects. 3) There were negative correlations between maternal care and CDI and between maternal care and severity of conduct problems. 4) There were positive correlations between maternal overprotection and STAIC-T(Trait). 5) There were no correlations between paternal rearing patterns and depression, anxiety, severity of conduct problems, or age at onset of conduct disorder. Conclusion:We failed to identify depression and anxiety as common comorbid disorders in conduct disorder. Parental rearing patterns are thought to be significantly negativistic in conduct disorder group. It is guessed that less caring and more overprotective rearing style of parents, especially of mothers, could have much influence on depression and anxiety, more severe conduct problems and earlier age at onset of conduct disorder in the adolescents with conduct disorder.

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The Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Treatment-Resistant Tourette's Syndrome among Children and Adolescents : An Open-Label Study (치료저항성 뚜렛장애를 가진 소아청소년에서 저빈도 반복적 경두개자기자극술의 효과 : 오픈 라벨 연구)

  • Lee, Young-Ji;Chae, Jin Hyuk;Seo, Wan Seok
    • Journal of the Korean society of biological therapies in psychiatry
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    • v.24 no.3
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    • pp.239-246
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    • 2018
  • 목 적 : 본 연구의 목적은 치료저항성 뚜렛장애를 가진 소아 청소년들에 대해서 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술의 효과를 평가하는 것이다. 방 법 : 이 연구는 미국정신의학회 진단기준 및 통계편람, 제 4판을 기준으로 뚜렛장애로 진단받은 10명의 소아 청소년(평균연령 $12.56{\pm}1.04$세)을 대상으로 하였다. 모든 참가자들은 1년 이상 지속적으로 충분한 용량의 약물치료를 받았음에도 불구하고 한국판 예일 틱 증상 평가척도(YGTSS) 20점 이상, 임상인상척도(CGI-TS) 4점 이상을 받았다. 참가자들은 보조운동영역을 표적으로 1 Hz 반복적 경두개자기자극 치료를 매일 20분간 받았으며, 총 20회 치료를 받았다. YGTSS, CGI-TS 및 이상반응 체크리스트는 연구 시작 전과 연구 시작 후 4, 8, 12주에 시행되었다. 결 과 : 틱 증상은 연구 12주차까지 호전된 상태로 지속되었으며, YGTSS와 CGI-TS가 통계적으로 유의하게 감소하였다. 특히 음성 틱 점수의 감소가 운동 틱 점수의 변화보다 전체 YGTSS 점수의 감소에 큰 역할을 한 것으로 나타났다. 그리고 전체 10명의 참가자 중 9명이 심각한 부작용 없이 연구를 끝까지 완료하였다. 결 론 : 본 연구는 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술이 치료 저항성 뚜렛장애를 가진 소아 청소년들에게 효과적이고 안전한 치료도구가 될 수 있음을 시사한다. 이러한 반복적 경두개자기자극술의 치료효과를 확정하기 위해서는 보다 많은 환자를 대상으로 한 잘 통제된 연구가 필요할 것이다.

NEW DRUG THERAPY IN CHILD AND ADOLESCENT PSYCHIATRY-NEW LONG-ACTING PSYCHOSTIMULANTS (소아청소년 정신과 영역에서의 새로운 약물치료:새로운 장기작용형 중추신경자극제)

  • Choi, Sung-Ku
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.3-11
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    • 2003
  • Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations:the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

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Cantilever-Type Traction Appliance for Mandibular First Permanent Molars with Eruption Disturbances (하악 제1대구치 맹출 장애에서 Cantilever-Type의 견인 장치를 활용한 맹출 유도)

  • Lim, Heejung;Lee, Eungyung;Jeong, Taesung;Shin, Jonghyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.2
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    • pp.229-236
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    • 2021
  • Eruption disturbances of the mandibular first molars can cause multiple problems in occlusal development although they are extremely rare. Early diagnosis and treatment are very important to prevent complications associated with eruption disturbances. The present case report describes the treatment of two cases of eruption disturbances of the mandibular first permanent molar. A fixed appliance composed of a cantilever spring with mandibular second deciduous molar as an anchor tooth was used to tract the impacted mandibular first permanent molar. The success of both cases shows that this novel traction appliance can be used to induce the eruption of an impacted mandibular first permanent molar within a short time in patients with intact mandibular second deciduous molar as an anchor tooth.

Relationships Between Premonitory Urge, Tics and Comorbidities in Children and Adolescents With Chronic Tics (만성 틱장애 소아청소년의 전조충동, 틱증상 심각도, 동반질환 간의 관련성)

  • Joo-Han Kwon;Sang-Keun Chung;Jong-Chul Yang;Jong-Il Park;Ha-Min Kim;Tae Won Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.142-148
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    • 2023
  • Objectives : The purpose of this study is to investigate the relationships between premonitory urge, tic severity, and comorbidities in children and adolescents with chronic tic disorders. Methods : In this study, scales for tic symptoms, premonitory urge, obsessive-compulsive symptoms, and ADHD symptoms were repeatedly measured twice in 26 children and adolescents aged 10 to 18 years with chronic tic disorders. Correlations between scales were confirmed through repeated measures correlation analysis, and causal relationships between scales were confirmed through regression analysis using a linear mixed model. Results : The degree of premonitory urges showed a significant positive correlation with the severity of tic symptoms, the severity of obsessive-compulsive symptoms, and the severity of ADHD symptoms. The ADHD symptoms showed a significant positive correlation with the severity of tic symptoms. These results were the same even in children and adolescents with tic disorders who were not diagnosed with obsessive-compulsive disorder. Additionally, premonitory urges were found to have a significant positive effect on the severity of tic symptoms. Conclusions : These results may be helpful in treating tic disorders and can be used in future tic disorder research considering developmental trajectory.

PHARMACOLOGICAL TREATMENT IN PERVASIVE DEVELOPMENTAL DISORDERS (전반적발달장애의 약물치료)

  • Choi, Jin-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.27-38
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    • 1993
  • Pervasive developmental disorder is one of the most severe clinical disorder in child psychiatry and is associated with deviancies in multiple areas of development. Medication does not cure pervasive developmental disorder and its effectiveness is generally nonspecific. But psychopharmacological treatment can be important for some children with pervasive developmental disorder and can make many young autistics more amenable to behavior modification and education. Haloperidol, the most widely studied antipsychotics, was statistically and clinically superior to placebo, and furthermore, was known to facilitate the positive functioning such as, discrimination learning and imitative communication, without side effects. However, administration of haloperidol is associated with drug related dyskinesia, and it warrants the introduction and use of the other novel drugs. Several biochemical studies suggest that subgroups of children with pervasive developmental disorder show hyperserotonemia and increased endogenous opioid level as compared with controls. Psychopharmacological trials were conducted according to these findings(ex : fenfluramine, naltrexone), with mixed results till now. These and another drugs that have been used in children with pervasive developmental disorder and their effectiveness are reviewed.

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NURSING PROBLEMS OF THE INPATIENTS WITH CONDUCT DISORDER (행동장애 입원환아의 간호문제)

  • Im, Sook-Bin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.116-124
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    • 1991
  • Nursing problems of 48 hospitalized patients with Conduct Disorder at a Child-Adolescent psychiatry inpatient were analyzed by reviewing nursing records. The results showed that the problems such as ineffective individual coping, impaired social interaction, disturbance in self-concept, potential for violence, alteration in parenting, altered growth and development were continued from early to later phase of the hospitalization and the other problems such as self-care deficit, anxiety, sleep disturbance, altered nutrition, hyperthermia were temporary. The etiologic factors related to these problems were underdeveloped ego, low self-esteem, dysfunctional parent-child relationship, some situational crises in family and handicap like mental retardation or epilepsy. Therefore nursing approach for the patients with Conduct Disorder should focus on ego growth and improvement of interpersonal relationship through systematic and long-term nursing plans and interventions for these patients and their family.

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