• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.2
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• pp.153-159
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• 2005

Autistic disorder and other PDD are currently viewed as a largely genetically determined neurodevelopmental disorder, although its underlying biological causes remain to be established. In this review, we examine the available neurodevelopmental literature on autistic disorder and discuss the findings that have emerged. Typical neuropathological observations are rather consistent with respect to the limbic system (increased cell packing density and smaller neuronal size), the cerebellum (decreased number of Purkinje cells) and the cerebral cortex ($>50\%$ of the cases showed features of cortical dysgenesis). However, most of the reported studies had to contend with the problem of small sample sizes, the use of quantification techniques, not free of bias and assumptions, and high percentages of autistic subjects with comorbid mental retardation or epilepsy. Furthermore, data from the limbic system and on age-related changes lack replication by independent groups. It is anticipated that future neuropathological studies held great promise, especially as new techniques such as design-based stereology and gene expression are increasingly implemented and combined, larger samples are analysed, and younger subjects free of comorbidities are investigated.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.1
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• pp.26-32
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• 2005

Neuroimaging in neurodevelopment is a fast growing area and new imaging techniques are rapidly developed every year. In the neurodevelopmental viewpoint, the definitive psychopathology in child and adolescent psychiatric disorders are not yet known. But many consistent findings in neuroimaging studies are being published recently. This review describes the past, present, future and limitation of neuroimaging study in neurodevelopmental perspectives.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.3-14
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• 2002

Childhood psychic trauma appears to be a crucial factor in the development of serious disorders both in childhood and in adulthood. Traumatized children show strong tendency to revisualize or re-feel a traumatic events. Play and behavioral reenactments are frequent manifestations of both the single blow and the long-standing traumas in childhood. Those children who suffer the results of single, intense terror appear to exhibit detailed memory, retrospective reworkings and misperceptions. In long-standing or repetitive trauma, children would show psychic numbing, self-hypnosis, dissociation and rage. Child's brain is undergoing critical and sensitive periods of differentiation. During this time, developing central nervous system is exquisitely sensitive to stress. Stressor-activated neurotransmitters and hormones can play major roles in neurogenesis, migration, synaptogenesis, and neurochemical differentiation. Internal opiate system operates in some trauma and causes the victim to fail to respond, to avoid, to shut off feelings. Evidence is also accumulating in traumatology that dysfuntion of locus coeruleus and ventral tegmental neucleus system leads to catecholamine receptors hypersensitivity. This change result in hypervigilance, increased startle, affective lability, and increased autonomic nervous system hyperreactivity. Another site of action of trauma on the brain is hypothalamic-pituitary-adrenal axis. Individuals with PTSD do not have enough cortisol to halt the alarm reaction. When children are exposed to long-standing extreme events, massive attempts to protect the psyche and to preserve the self are put into gear. These developmental traumas mobilize various kinds of defense mechanisms. Massive denial, dissociation, self anesthesia, identification with aggressor and aggression turned against the self often lead to profound character changes in the youngsters.

• Korean Journal of Biological Psychiatry
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• v.9 no.1
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• pp.50-61
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• 2002

Objectives:High nailfold plexus visibility can reflect central nervous system defects as an etiologic factor of schizophrenia indirectly. Previous studies suggest that this visibility is particularly related to the negative symptoms of schizophrenia and frontal lobe deficiency. In this study, we examined the relationships between nailfold plexus visibility, and various clinical variables and neuropsychological functions in schizo-phrenic patients. Methods:Forty patients(21males, 19 females) satisfying the DSM-IV criteria for schizophrenia and thirty eight normal controls(20 males, 18 females) were measured for Plexus Visualization Score(PVS) by using the capillary microscopic examination. For the assessment of psychopathology, process-reactivity, premorbid adjustment, and neuropsychological functions, we used Positive and Negative Syndrome Scale(PANSS), Ullmann-Giovannoni Process-Reactive Questionnaire(PRQ), Phillips Premorbid Adjustment Scale(PAS), Korean Wechsler Adult Intelligence Scale(KWIS), Continuous Performance Test(CPT), Wisconsin Card Sort Test (WCST), and Word Fluency Test. We also collected data about clinical variables. Results:PVS was correlated with PANSS positive symptom score and composite score negatively. There were no correlations between PVS and PRQ score, PAS score and neuropsychological variables respectively. Conclusions:This study showed that nailfold plexus visibility was a characteristic feature in some schizophrenic patients, and that higher plexus visibility was associated with the negative symptoms of schizophrenia. There was no association between plexus visibility and neuropsychological functions.

• Korean Journal of Head & Neck Oncology
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• v.10 no.1
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• pp.38-45
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• 1994

부인두강(Parapharyngeal space)는 비인두강과 구인두강에 인접하여 위로는 두개저, 아래로는 설골사이에 위치하는 해부학적 잠재공간으로 이곳에 발생하는 종양은 매우 드무나 다양한 병리조직학적 소견을 보이며 인접한 중요장기들로 인한 수술적 어려움으로 두경부 외과의사의 관심이 되어 왔다. 최근 CT나 MRI의 도입으로 이학적 검사가 어려웠던 이부위의 진단에 많은 도움을 얻게 되었고, 발달된 수술방법의 사용으로 크기가 매우 큰 종양도 절제가 가능하게 되었다. 저자들은 1990년 9월부터 1993년 8월까지 한림대학교 이비인후과학교실에서 술전 CT나 MRI를 시행한 후 조직검사로 확진된 부인두강 종물 22례의 후향적 임상분석을 시행하여 다음의 결과를 얻었다. 1) 양성종양이 11례(30.0%), 악성종양이 11례(50.0%)로 빈도에 차이는 없었다. 2) 종양의 조직학적 기원은 타액선종양이 10례(45.5%)로 가장 많았으며 신경종양이 4례(18.2%)였고 기타 종양이 8례(36.4%)로 다양하였다. 3) 방사선학적 진단방법으로는 18례(81.8%)에서 CT를 시행하였고 필요한 경우에 MRI를 5례(22.7%), 혈관조영술을 3례(13.6%)에서 시행하였다. 4) 치료방법으로는 악성종양은 수술 및 방사선치료 또는 항암약물요법을 병리조직검사 결과에 따라 단독 또는 병합하여 시행하였고, 양성종양의 경우에는 모두 수술을 시행하였는데 수술방법은 경이하선 접근법이 가장 많이 사용되었다. 5) 추적조사는 평균 20개월로 양성종양의 경우는 모두 종양의 재발이 없이 치료되었으나 악성종양 중 전이암 1례와 악성 임파종 1례가 사망하였다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.237-246
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• 1998

Objectives and Methods：This study investigated clinical characteristics, treatment modality, outcome of 57 children and adolescent inpatients(male 53, female 4) who were diagnosed as pervasive developmental disorder(PDD) by DSM-Ⅳ criteria recent five years. Results：1) The mean age at admission was $96{\pm}28.2$ months, and the mean age at which they first visited treatment facility was $52{\pm}26.6$ months. The mean hospitalization period was $43.7{\pm}31.3$ days. 2) Diagnosis：Twenty-seven(47.4%) of subjects met DSM-Ⅳ criteria for PDD NOS. Fifteen (26.3%) met for autistic disorder, nine(15.8%) met for Asperger's syndrome, and two(3.5%) met for childhood disintegrative disorder. 3) Comorbid diagnosis：The most common comorbid dignosis was attention deficit hyperactivity disorder(23.8%). 4) IQ test：IQ test for twenty-eight subjects was possible. The Average of the subjects was $70{\pm}27.5$. Fifteen(53.6%) of the subjects were approximate or under 70. 5) Neurology Abnormality：EEG findings of eleven(21.2%) subjects were abnormal, brain CT or MRI findings of eight subjects(21.6%) were abnormal. 6) Family Hx：Depressive disorder were found in Eight mothers(14%). Familial loading was found in twenty families(35.1%), and familial loading of PDD was found in three(5.3%). Conclusion：The most important thing for the management of PDD is early detection and early treatment. To do so, multidisciplinary team approach should be emphasized.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.2
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• pp.209-220
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• 2000

The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.