Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.5
no.1
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pp.3-11
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1994
Childhood depression was not officially accepted as a separate diagnosis until 20-25years ago. Although DSM-III R criteria gave us a starting point and are gaining acceptances as a useful tool for diagnosing childhood depression recently, many professionals feel that additional modifications are needed to better reflect the developmental aspects of children. And because children are relatively poor in expressing their moods or feelings due to weak reality sence and/or cognitive and linguistic limitations, the author too carefully suggest that developmental perspectives of children should be considered in diagnosing childhood depression. Little is known about the extent to which childhood depression precedes adult depression and persists into adult life and about the impact of it on the personality formation. Some evidences that childhood depressive symtoms can be quite enduring make it important to make an early diagnosis and treatment.
Purpose: The aim of this study was to analyze the effects of neurofeedback training for reducing stress and enhancing self-regulation in late adolescence to identify the possibility of use for nursing intervention. Methods: A nonequivalent control group pre-post quasi-experimental design was used. Participants were 78 late adolescents assigned to the experimental group (n=39) that received the neurofeedback training and the control group (n=39). Data were collected on heart rate variability (HRV) and skin conductance level (SCL) to assess stress-biomarker response. The questionnaire contained 164 items from: Positive and Negative Affect Schedule (PANAS), Symptom Checklist-90-Revised (SCL-90-R) and Self-regulatory Ability scale. The neurofeedback training was based on the general adaptation syndrome and body-mind medicine. The intervention was conducted in a total of 10 sessions for 30 minutes per session with high-beta, theta and sensory motor rhythm training on scalp at central zero. Results: There were significant difference in standard deviation of normal to normal interval (p=.036) in HRV and SCL (p=.029) of stress-biomarker response between the two groups. Negative affect (p=.036) in PANAS and obsessive compulsive (p=.023) and depression (p<.001) in SCL-90-R were statistically significant. Self-regulation mode (p=.004) in self-regulation ability scale showed a significant difference between the two groups. Conclusion: The results indicated that the neurofeedback training is effective in stress-biomarkers, psychoemotional stress response and self-regulation. Therefore, neurofeedback training using neuroscientific approach based on brain-mind-body model can be used as an effective nursing intervention for late adolescents in clinics and communities for effective stress responses.
Purpose : To identify the short-term clinical outcomes of late preterm infants and to test the hypothesis that late preterm infants have more clinical problems during the early postnatal period than term infants. Methods : One hundred late preterm infants [gestational age (GA) $34^{+0}$-$36^{+6}$ weeks] and the same number of term infants (GA $37^{+0}$-$41^{+6}$ weeks) were randomly selected from 289 late preterm infants and 825 term infants born in the Seoul National University Bundang Hospital between January 2007 and December 2007, and their electronic medical records were reviewed and analyzed. Results : Compared to term infants, late preterm infants had significantly more medical problems such as temperature instability (odds ratio [OR] 8.7), hypoglycemia (OR 17.5), intravenous fluid infusion (OR 10.2), evaluation for sepsis (OR 9.4), respiratory problems (OR 7.5), apnea and bradycardia (OR 8.6), phototherapy for jaundice (OR 3.6), and feeding intolerance (OR 10.0). Hospital stay was also significantly longer in late preterm infants. Conclusion : Late preterm infants had significantly more medical problems and increased length of hospital stay compared to term infants. More attention should be given to caring for these late preterm infants in newborn nursery during the early postnatal period.
Purpose : A quantitative and easily measured Doppler index of combined systolic and diastolic ventricular myocardial performance (Tei index) was recently proposed as a potentially useful predictor of global myocardial performance. However, presence of heart rate fluctuation makes it unreliable. Therefore, the modified Tei index was introduced by using tissue Doppler imaging (TDI) which enables measuring contraction and relaxation velocities from myocardium simultaneously. The purpose of this study was to investigate the effectiveness of the modified Tei index in the evaluation of global cardiac function. Methods : Forty eight patients in the acute phase of Kawasaki disease (KD) were studied. These patients were divided into two groups according to the modified Tei index. TDI and conventional echocardiography were performed. Systolic velocity, systolic displacement, E' velocity, E' displacement, A' velocity and A' displacement were measured at the base, mid-septum and the apex of the interventricular septum. Ejection fraction (EF), Tei index and modified Tei index were estimated. Results : Modified Tei index correlated negatively with systolic displacement, E' displacement and A' displacement at the base. Modified Tei index correlated positively with ESR and CRP. EF and Tei index were normal in KD patients. Conclusion : Modified Tei index is a safe, feasible and sensitive index for evaluating global ventricular functions in spite of normal EF and Tei index in KD.
This study investigated the effect of parents' marital conflict and parent-adolescent communication on the psycho-social adjustment of college students. The subjects were 287 college students(107 boys and 180 girls) in Daegu and Kyoungbuk Province. Questionnaires were used to investigate the college students' depression, anxiety and school adjustment and parents' marital conflict and parent-adolescent communication perceived by college students. Data were analyzed by SPSS-WIN program, including median, mean, standard deviation, correlational analysis, and regression. Results were as follows. (1) The college students who perceived their parents' marital conflict as lower and parent-adolescent communication as positive were less depressive and less anxious and were good at school than those who perceived them as higher and negative. (2) The college students of the family with negative parent-adolescent communication and high parents' marital conflict were more negative in psycho-social adjustment than those of the family with positive parent-adolescent communication or low parents' marital conflict. (3) The regression analysis showed that college students' perception of positive parent-adolescent communication was more influential on college students' psycho-social adjustment than the parents' marital conflict perceived by college students.
Longitudinal studies have shown mixed findings on the association between body image dissatisfaction and self-esteem among adolescents. This study examined the longitudinal, reciprocal influences between body image dissatisfaction and self-esteem among Korean pre- and early adolescents by using nationally representative longitudinal panel data from the Korean Youth Panel Study (KYPS). Analyses based on 2,230 participants indicated that girls' body image dissatisfaction was significantly higher than boys'. The trajectory of body image dissatisfaction increased sharply during pre- and early adolescence, but stabilized afterwards for both boys and girls. Self-esteem deteriorated rapidly initially, but began to recover as adolescent girls and boys matured. Structural equation modeling showed that reciprocal influences between body image dissatisfaction and self-esteem were detected for boys. Body image dissatisfaction among girls predicted self-esteem during the entire period, while the opposite direction from self-esteem to body image dissatisfaction emerged two years later. The present study found that, during pre- and early adolescence, body image dissatisfaction and self-esteem develop in a circular fashion by forming a vicious cycle. Implications for the development of intervention and prevention programs are discussed in consideration of age and gender.
The purpose of this study was to identify intrapsychic processes of self socialization in sex role development during late childhood and adolescence. For this purpose I investigated the sex-role stereotypes, sex-role ideology, sex-role identity, and self-esteem of 6th, 8th, and 10th graders and examined the causal relationships among these sex-role variables. Data were gathered through questionnaires administered twice with an interval of three months. The methods of analysis were one-way ANOVA, $x^2$, and multiple regression. The results showed, (1) Adolescents' sex-role stereotypes had significant relationships with sex typing. Subjects with low scores on sex-role stereotypes were more likely to show opposite sex typing. (2) Sex-role ideologies had significant relationships with sex typing. As Subjects agreed more with egalitarianism, they were more likely to exhibit opposite sex typing. (3) Adolescents' sex typing had significant relationships with their self-esteem. The androgynous group exhibited the highest scores on self-esteem. (4) Path analysis from the multiple regression analysis indicated different processes between sexes in sex-role development. In the boys' sex-role development, it was found that only masculinity contributed to self -esteem. Girls' masculinity also contributed most to self -esteem, but other sex -role variables such as femininity and sex-role stereotypes made some contributions to girls' self-esteem.
Kim, Hyun-Jung;Bae, Eun-Jung;Noh, Jung-Il;Choi, Jung-Yun;Yun, Yong-Su;Kim, Wong-Hwan;Lee, Jung-Yeul;Kim, Yong-Jin
Clinical and Experimental Pediatrics
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v.50
no.1
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pp.40-46
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2007
Purpose : This study assessed the long term survival rate and long term complications of patients who had a modified Fontan operation for functionally univentricular cardiac anomaly. Methods : Between June 1986 and December 2000, 302 patients with a functional single ventricle underwent surgical interventions and were followed up until February 2006. The mean follow-up period was $8.3{\pm}5.3years$ (range 3.5-18 years). Their median age was 2.4 years at the Fontan operation. The survival rate, the incidence and the risk factor of late complications were evaluated retrospectively. Results : The verall survival rate was 91 percent at 5 years and 87 percent at 10 years. In multivariate analysis, early calendar year of operation and significant regurgitation were risk factors of death. The surviving patients showed NYHA functional class I in 82 percent, class II in 15 percent, and class III in 3 percent. Redo Fontan operations were necessary in 8.8 percent of patients at average $12.8{\pm}3.6years$ after initial Fontan operation. The most common cause of Fontan conversion was atrial arrhythmia. The incidence of thromboembolic events was 9.3% and these complications were associated with the occurrence of atrial tachyarrhythmia. Supraventricular tachycardia including atrial flutter or fibrillation were reported on the follow-up examination by 11.2 percent of survivors after $8.4{\pm}5.6years$. Atriopulmonary connection showed higher rates of late tachycardia than lateral tunnel operation. Conclusions : This study revealed that the recent survival rate of Fontan type operation was satisfactory, but the occurrence of late complications after a Fontan type operation increased with the longer survival. There is a need for strict follow up and early treatment of late complications in patients who had a Fontan operation.
Purpose : The hematologic change during the treatment of acute lymphoblastic leukemia(ALL) is critical as a prognostic determinant and a variable to determine the dose of chemotherapeutic agents. It is known that the dose of vincristine used in the maintenance phase of ALL is small enough to increase the count of platelet. To investigate the change of platelet count according to the vincristine administration in maintenance phase of ALL chemotherapy, we performed this study. Methods : Eleven patients eligible under the criteria of Children's Cancer Study Group(CCG)-1882 and who had completed chemotherapy were enrolled in this study. The count of platelets before vincristine administration was compared with those of vincristine administration 1, 2 and 3 weeks after the early and last periods of maintenance phases. The platelet count before vincristine administration was defined as 100 percent and that after vincristine were compared. In addition, we tentatively defined an enhancing effect of vincristine as positive when the relative count was more than 120 percent. Results : Platelet count did not differ according to the early and last periods of maintenance phase. Platelet count at first week after vincristine administration increased more significantly than that before vincristine in early and last periods. There was an enhancing effect in 10(90.9 percent) of 11 patients after 1 week vincristine administration both in the early and last periods of the maintenance phase. Conclusion : Vincristine, used in ALL maintenance phases as a low dose, increased platelet count 1 week after administration. The increased platelet count resumed to the previous level 2-3 weeks later. However, the thrombocytosis observed in the maintenance phase by vincristine was not high enough to induce thrombosis. In addition, vincristine is known to reduce the activity of platelets. Therefore, the risk of thrombosis in the maintenance phase of ALL chemotherapy would be low.
Kim Young-Kyu;Sabick Michelle B.;Torry Michael R.;Hawkins Richard J.
Journal of Korean Orthopaedic Sports Medicine
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v.2
no.1
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pp.62-70
/
2003
Purpose: We examined the kinematics and kinetics of the shoulder in youth baseball pitchers in light of the mechanisms of development of little league shoulder and humeral retrotorsion. Materials and Methods: The joint kinematics and the net force and torque acting on the humerus were calculated in fourteen youth pitchers throwing in a simulated game. Results: The major force component acting on the humerus was a tensile force of 378$\pm$81 N that peaked just after ball release. The predominant torque on the humerus was an external rotation torque about the long axis of the humerus. This torque reached a peak value of 35.3$\pm$6.7 Nm about 73$\%$through the pitching motion. This torque is approximately 66$\%$ of the torque required to fracture of the adult humerus. Conclusions: The direction of the humeral torque was consistent with the development of increased humeral retrotorsion in the throwing arm. Shear stress arising from the high torque during the late cocking phase likely leads to deformation the relatively weak proximal humeral epiphysis. The external rotation torque applied to the humerus during the pitch also agrees with the proposed mechanism for development little league shoulder, which has been hypothesized to be due to rotational stresses acting on the epiphysis during the throwing motion.
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