• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.3
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• pp.157-163
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• 2013

Objectives : Previous studies reported that attention-deficit hyperactivity disorder (ADHD) resulted from a deficit of selective attention and sustained attention. In this study, we assessed the result of methylphenidate-induced changes of the cerebral frontal executive functions in patients with ADHD. Methods : The subjects in this study consisted of 16 ADHD patients whose age ranged from 7 to 12. We used ADHD Diagnostic System (ADS) for the attention improvement, and the Stroop Test for the executive function response to pharmacotherapy with MPH. Results : After pharmacotherapy with methylphenidate for 12 weeks, the study group showed improvement in the clinical aspects through Clinical Global Impression-Severity, ADHD-rating scale and Inattention/Overactivity With Aggression Conner's Parents Rating Scale. In the ADS test, only in auditory task there was a decrease of both the response time and the standard deviation of the response time significantly. In the Stroop Test, there was a decrease in the word task, color task and color-word task significantly. Conclusion : Our results show that psychostimulant medication improves neuropsychological function, including the cerebral frontal executive function. This study implies that we have to consider the improvement of executive function, as well as attention when evaluating the efficacy of treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4445-4450
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• 2016

Background: This study explored perspectives of health-care providers on childhood cancer treatment in Kenya. Materials and Methods: A self-administered questionnaire was completed by 104 health-care providers in January and February 2013. Results: Seventy six percent of the health-care providers believed cancer to be curable. More doctors than other health-care providers had this positive opinion (p=0.037). The majority of health-care providers (92%) believed that most children with cancer will not be able to finish their treatment due to financial difficulties. They considered that prosperous highly-educated parents adhere better with treatment (88%) and that doctors adhere better with treatment for prosperous highly-educated parents (79%). According to 74% of health-care providers, quality of care is better for prosperous highly-educated parents (74%). Most health-care providers reported giving more explanation (71%), work with greater accuracy (70%) and use less difficult vocabulary (55%) to prosperous more educated families. Only 34% of health-care providers reported they feel more empathy towards patients from prosperous families. Reasons for non-adherence with the protocol according to health-care providers are: family refuses drugs (85%), inadequate supply of drugs at pharmacy (79%), child looks ill (75%), and financial difficulties of parents (69%). Conclusions: Health-care providers' health beliefs and attitudes differ for patients with families having high versus low socio-economic backgrounds.

• Journal of Preventive Medicine and Public Health
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• v.41 no.3
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• pp.153-158
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• 2008

Objectives : This study describes a plan that was designed to prevent a measles outbreak that showed a changed outbreak pattern. This study is based on the epidemiological investigation of a measles outbreak in a preschool in Incheon, Korea, 2006. Methods : The subjects were 152 students at a preschool where a measles outbreak occurred. A questionnaire survey was conducted and serological testing for measles-specific IgM was preformed. Results : Of the fifteen confirmed, identified cases, eleven patients had been vaccinated with one dose, one patient had received two doses and three patients were unvaccinated. The three unvaccinated cases consisted of one 5-year-old child, one 3-year-old child and one 16-month-old infant. For the cases with one dose of the vaccination, there were 11 cases, which consisted of six 5-year-old children, two 4-year-old children, two 3-year-old children and one 2-year-old child. The case with two doses of the vaccination was one 4-year-old child. The attack rate of measles was 100% in the 0-dose group, 11.2% in the 1-dose group and 2.0% in the 2-dose group. The vaccine's efficacy was 88.8% in the 1-dose group and 98.0% in the 2-dose group. The vaccine effectiveness for the 2-dose group was higher than that of the 1-dose group. Conclusions : High coverage with a 2-dose vaccination should be maintained, and the vaccination should be given at the suitable time to prevent a measles outbreak with a changed outbreak pattern.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.1
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• pp.1-11
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• 2015

Phenomenology has been developed by philosophers like Kant and Husserl since the late 18th century. Jaspers, a German psychiatrist, adopted it into psychopathology studies and accumulated data by closely observing and recording the patients' symptoms and signs. Among descriptions done even before the psychopathology or diagnostic criteria of disorders in the field of child psychiatry was established, we can find exact and valuable descriptions matching the autism spectrum disorder or attention deficit/hyperactivity disorder. The diagnostic criteria of modern childhood psychiatric disorders were established based on these grounds. Phenomenological/descriptive methods in various psychiatric fields lead to medical study methods for social phenomenon such as oiettolie, hikikomori, and internet game addiction. Since Romanian orphans were adopted to the western world, descriptive studies along with neurobiological studies on the influence of stimulus deprivation on emotional and physical development are being conducted. While phenomenology, which was adopted by Jaspers to verify psychopathology, was developed mainly by observation and description, recent studies are explaining such descriptive phenomena even at the synapse level due to advances in neurobiology. Although phenomenological/descriptive psychiatry, describing precise and detailed experiences of patients, is less applied nowadays among modern study methods, we must remember that such descriptions may lead to biological studies and provide evidence to improve the accuracy of choosing and applying treatment methods.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.1 no.1
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• pp.117-129
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• 1990

35 children(17 boys, 18 girls) with Recurrent Abdominal pain(RAP) without apparent organic causes, referrd from pediatric department of Seoul National University Children's Hospital were studied during 1988. 7. 1 ${\sim}$ 1989. 2. 28. The aims of this study are to examine clinical characteristics of the patients with RAP, to find possible factors influencing the onset and the course of the disorder, to evaluate the psychological status and the relationship with psychiatric diagnoses. The study subjects were compared with the age and sex matched control subjects on measures of social and school functioning, family-environment, behavior traits by CBCL and parent-environment rating scale. All patients and their mothers were interviewed by a child psychiatrist. The results were as follows ; 1) Abdominal pain was found to be more frequent when with a care taker, and related with traumatic life stresses such as separation from parents, death of family members. 2) Family members of the patients with RAP also had a high rate of a history of gastrointestinal dysfunctions with could not be attributed to organic etiologies. 3) Among 35 patients with RAP, 16 were diagnosed as psychiatric disorders. They were adjustment disorders (4), overanxious disorders (4), depression (2), tic disorders (2), attention deficit disorders (2), separation anxiety disorders (1), enuresis (1). 4) On CBCL, the patients with RAP were more internalized, socially less competent and less active compared with the control subjects. 5) According to the parent-environment rating scale, the patients with RAP had more conflicts with their parents about control issues. Family members of the patients with RAP were socially less competent and less abjustable. The parents of the patients with RAP were more affectionate and spent more time with their children but they were unfair and vague on instruction and discipline.

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.436-442
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• 2007

Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.3
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• pp.101-113
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• 2018

Objectives: The purpose of this study was to investigate whether the neural activity of autism spectrum disorder (ASD) patients is different from that of normal individuals when performing aesthetic judgments. Methods: We recruited typical ASD patients without savant skills (ASD group, n=17) and healthy controls (HC group, n=19) for an functional magnetic resonance imaging study. All subjects were scanned while performing aesthetic judgment tasks on two kinds of artwork (magnificent landscape images and fractal images). Differences in brain activation between the two groups were assessed by contrasting neural activity during the tasks. Results: The aesthetic judgment score for all images was significantly lower in the ASD group than in the HC group. During the aesthetic judgment tasks, the ASD group showed less activation than the HC group in the anterior region of the superior frontal gyrus, and more activation in the temporoparietal area and insula, regardless of the type of images being judged. In addition, during the aesthetic judgment task for the fractal images, the ASD group exhibited greater neural activity in the amygdala and the posterior region of the middle/inferior temporal gyrus (Brodmann area 37) than the HC group. Conclusion: The results of this study suggest that the brain activation patterns associated with aesthetic experiences in ASD patients may differ from those of normal individuals.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.25-50
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• 2001

Using Fourier transformation and wavelet analysis, we compared the auditory event-related potentials of the patients with attention deficit-hyperactivity disorders(abbr. ADHD, 13 boys) and normal control children(8 boys). Amplitudes of the event-related potentials which were calculated via Fourier transformation were compared between the groups and between conditions(non-target versus target) in each group. To the non-target stimuli, the patients with ADHD showed significantly greater amplitudes across almost all of the electrode sites and frequencies. To the target stimuli, the incidents which ADHD patients showed much higher amplitudes than normal controls significantly decreased, while those of the reverse results increased significantly. These results were consistent with the comparison results about negative difference wave(abbr. Nd wave) using Fourier transformation. In summary, it was proved that non-target stimulus which should be ignored elicited more robust electrical response from the patients with ADHD than normal children, but the target stimulus which reguired active processing did much less electrical activity in the patients. For the patients, they showed much inhibited electrical response to the target stimuli in some electrodes and frequency ranges. Normal children were more strongly stimulated by the target stimuli in almost all electrodes and frequency ranges than the patients, but less in prefrontal leads and frontal leads. Wavelet analysis results proved that early responses(0-300msec) to the nontarget stimuli of the patients were significantly greater than the normal controls in prefrontal, anterior frontal, some parts of temporal, and occipital lobes and that late response(300-370msec) were significantly lesser than normal children in parietal and central electrodes. Target stimuli elicited significantly higher electrical activity in both group than non-target stimuli did. Prefrontal and frontal lobes showed stronger responses in the patients than normal children irrespective of stimulus condition, but parietal and temporal lobes did higher activities in normal children than the patients only to the target stimuli. In conclusion, the patients with ADHD showed much greater responses to the stimuli which should be ignored, but failed to activated the necessary processes to the target stimuli. Also, we found that the frequency-dimension analysis and wavelet analysis were useful for the signal processing such as event related potentials.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.81-94
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• 2003

Objectives：Developmental reading disorder is a condition which manifests significant developmenttal delay in reading ability or persistent errors. About 3-7% of school-age children have this condition. The purpose of the present study was to validate the diagnostic values of Word/Nonword Reading Test and Letter-Symbol Discrimination Task for the purpose of overcoming the caveats of Basic Learning Skills Test. Methods：Sixty-three reading-disordered patients(mean age 10.48 years old) and sex, age-matched 77 normal children(mean age 10.33 years old) were selected by clinical evaluation and DSM-IV criteria. Reading I and II of Basic Learning Skills Test, Word/Nonword Reading Test, and Letter-Symbol Discrimination Task were carried out to them. Word/Nonword Reading Test：One hundred usual highfrequency words and one hundred meaningless nonwords were presented to the subjects within 1.2 and 2.4 seconds, respectively. Through these results, automatized phonological processing ability and conscious letter-sound matching ability were estimated. Letter-Symbol Discrimination Task：mirror image letters which reading-disordered patients are apt to confuse were used. Reliability, concurrent validity, construct validity, and discriminant validity tests were conducted. Results：Word/Nonword Reading Test：the reliability(alpha) was 0.96, and concurrent validity with Basic Learning Skills test was 0.94. The patients with developmental reading disorders differed significantly from normal children in Word/Nonword Reading Test performances. Through discriminant analysis, 83.0% of original cases were correctly classified by this test. Letter-Symbol Discrimination Task：the reliability(alpha) was 0.86, and concurrent validity with Basic Learning Skills test was 0.86. There were significant differences in scores between the patients and normal children. Factor analysis revealed that this test were composed of saccadic mirror image processing, global accuracy, mirror image processing deficit, static image processing, global vigilance deficit, and inattention-impulsivity factors. By discriminant analysis, 87.3% of the patients and normal children were correctly classified. Conclusion：The patients with developmental reading disorders had deficits in automatized visuallexical route, morpheme-phoneme conversion mechanism, and visual information processing. These deficits were reliably and validly evaluated by Word/Nonword Reading Test and Letter-Symbol Discrimination Task.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.1
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• pp.14-22
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• 1996

This study aims to look at main problems of visiting the clinic, diagnoses and other related factors of outpatients in a private psychiatric clinic f3r children and adolescents located in Seoul. The analyses were based on the reports of 2,785 patients who were 18 years old and less, and visited the clinic during last 4 years. The results showed that the ratio of boys to girls was 2.7 to 1, and about 64% of the whole sample were 6 years old and less. Especially the percentage of patients aged 3 and less was the highest and that of schoolage and more was gradually reduced. The average number of siblings was 195 and the percentage of the first child in a family was the highest. Particularly, there were more boys in rase of one child families and more girls in case of families with 3 children and more. The chief problems were mainly language-deficit, hyperactivity, autistic behaviour, tic, aggressive behavior and academic problem. The higher frequency of diagnoses was in the order of parent-child problem, mental retardation, developmental language disorder, reactive attachment disorder, other emotional disorder, and pervasive developmental disorder. The more frequently used method fir treatments was in the sequence of psychotherapy, play therapy, parental counseling, occupational therapy and speech therapy. The results from this study were compared with those from other studies and discussed.