• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제7권1호
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• pp.68-76
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• 1996

이 연구에는 틱장애에서 나타나는 공통적 특징을 파악하고 경과 및 예후를 평가하기 위하여 Yale Global Tic Severity Scale(YGTSS)을 이용하여 1984년 1월에서 1994년 8월까지 동산의료원 정신과를 방문한 IS세 이하 틱장애 환자들 중 추적 조사가 가능한 30명을 대상으로 $3.1{\sim}18.1$년 조사하여 다음과 같은 결론을 얻었다. 발병 연령은 $7.5{\pm}2.4$세였으며, 병원을 방문하기까지 틱장애의 지속 기간은 $2.3{\pm}2.2$년이었다. 처음 병원 방문시 증상 부위별 빈도는 눈(66.7%), 음성 틱(43.3%), 입(40%), 머리 (40%), 어깨(20%), 얼굴(20%), 코(20%), 팔(16.7%), 배(13.3%), 다리(13.3%)의 순서였으며, 추적조사시에는 음성틱(40%)과 눈과 머리(각각 20%)에서 많이 나타났다. 처음 발병시 9명 (30%)에서는 유발인자가 있었다. 틱장애와 동반된 다른 질환으로 주의력결핍과잉운동장애가 9명, 수면장애 3명, 상동적운동장애(손톱 물어뜯기), 발달성언어장애, 과잉불안장애, 야뇨증, 정신지체가 각각 2명, 말더듬기 및 강박성장애 1명이 관찰되었다. 대상 환자 30명중 11명 (36.7%)에서 완전호전, 11명(36.7%)이 부분호전되었으며, 나머지 8명(26.7%)은 증상이 지속되거나 악화되었다. 틱 증상 혹은 이차적인 불안이나 우울로 인해서 사회생활을 할 수 없는 경우는 4명 (13.3%)이었다. 증상의 호전과 발병 나이, 처음 방문시의 진단, 추적조사 기간과는 통계적으로 유의한 차이가 없었고 나이의 증가에 따라 증상이 호전되는 경향이 관찰되었다.

• Clinical and Experimental Pediatrics
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• 제51권11호
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• pp.1222-1227
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• 2008

하지 불안증후군은 다리의 감각 둔화와 감각이상을 호소하며, 쉬고 있을 때 악화되고 움직이면 완화되는 특징을 보이는 증후군이다. 정확한 원인은 아직 알려진 바 없으며 아동기 시작되는 하지 불안증후군은 철분 결핍 및 가족력과 연관된 것으로 되어 있다. 또한 하지 불안증후군은 주의력 결핍 과잉행동 장애를 흔히 동반하며, 수면 다원 검사로 확진되는 주기성 사지 운동증과 같은 선상의 질병으로 여겨진다. 저자들은 하지 통증을 호소하는 5세 남아에서 어머니의 가족력을 발견하고 주의력 결핍 장애의 증상을 동반하며 수면 다원 검사로 진단된 경도의 주기성 사지 운동증으로 확진한 하지 불안 증후군을 진단하고 철분제 복용 후 증상 호전을 보인 사례를 경험하였기에 이를 보고하며, 성장통으로 내원하는 아이들에서 하지 불안 증후군을 감별할 것을 제안하는 바이다.

• 대한한의학회지
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• 제34권1호
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• pp.146-159
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• 2013

Objectives: The purpose of this study was to evaluate the effects and develop the role and contents of the atopic dermatitis care program with Korean medicine in a public health center. Methods: The data were collected from 180 parents and 43 kindergarten teachers who participated in a child care program with Korean medicine. The program ran from April to October of 2012. The atopic dermatitis conditions of children were reported by SCORAD index; the questionnaires to measure effect and satisfaction of the program were composed of demographic items, children's life habit change checklist, etc. The questionnaires were executed before and after the program. Results: The SCORAD index total scores decreased (1.3908) after the program, especially itching scores (1.1) and sleep disorder scores (0.5693) significantly. The satisfaction with the program was 88% and 77% of parents and teachers groups, respectively. Making food and treatment were mentioned as the best program. The Children's food preference for junk food, irritability, and anger also decreased after the program. Conclusions: From this study, the atopic dermatitis care program with Korean medicine is worthwhile for treating atopic dermatitis.

• 동의신경정신과학회지
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• 제12궈1호
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• pp.81-95
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• 2001

Though, these days there are increasing many patient of insomnia, there was not considered literatual study on insomnia. So, the result of consideration about cause and process of insomnia from thirty kinds of literatures, are as follows. 1. Early literature like Huangjaenankyung(黃帝內經), Sanghanron(傷寒論) reffered to insomnia as accompanying symptom. on the other hand, Myung(明), Chung(淸)'s literatures reffered to that as chief symptom or distinguished chief symptom from accompanying symptom. 2. There were tendency of deductive expanding of various masters and tendency of induction of simple theory that was based on Huangjaenankyung(黃帝內經). 3. Huangjaenankyung(黃帝內經) showed basic process of the sleep disorder that 'exhausting of Yin and excess of Yang (陰盡陽盛)', protecting energy does not invade Yin portion(陽氣不入於陰). And Huangjaenankyung(黃帝內經) showed cause of insomnia that deficiency of vital energy and blood, imbalanced of spleen and stomach, a fever as a invasion in the outside, lung system's disease. This became a basic cause and process of the sleep disorder in ancient period. 4. Sanghanron(傷寒論) occurred to insomnia as accompanying symptom in progress, remedy of a fever invaded outside, Kumkyeyoriak showed as origination in weakness, fatique, various diseases. Out of that, there is a significance in description of insomnia from some disease like histery or neurosis. 5. Jaebyungwonhuron(諸病源候論), Chunkumbang(千金方), Kukbangseo(局方書.) occured to a fire of heart(心慤) and a deficiency of heart and gall bladder(心膽虛) in defails. Insomnia is caused by agony of seven emotion, delivering of a child, are similar to insomnia is caused by psychologic disorders. Injaesanghanyusu(仁劑傷寒類書) occured to exhausting of Yin and excess of Yang (陰盡陽盛), imbalanced of stomach(胃不和) invasion of coldness(傷寒) are brought a conclusion of assumption of sap(津液耗損) brought about unreturn of yin energy. 6. Manbyunghuechum(萬病回春) in Myung period (明代) made much of portion of phlegm's influence about spiritual function. Kyungakjunsu(景岳全書) valued much of treatment divided according to excess and deficiency. Junginmaekchi(證因脈治) occurred to concept of pyorihesil(表裏虛實), Dongyibokam(東醫寶鑑) synthesised various theories. 7. Hyuljungron(血證論), Byunjungkimun(辨證奇聞), Suksilbirok(石室秘錄) made much of surprisemeni(驚恐) Consideration(思慮), liver's dryness(肝燥) is caused by liver's weakness(肝虛), imbalance of haert -kidney(心腎不交), seven emotion(七情). Especially, ftyujungchijae(類證治載) said that heart, liver, gall-bladder, kidney, surprisment, consideration baought to a conclusion of inbalance of Yang and Yin (陽不交陰). There is a tendency in literature mostly that literature showed separation of insomnia as a chief symptom. 8. These days there are increasing many patient of insomnia. So, it is needed to study about insomnia as a psychologic disease. Saying in conclusion, it is needed that we have to recognize in modern style based on ancient style of cause and process of insomnia. It is regarded to study about insomnia definitely and experimently.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제21권3호
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• pp.153-160
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• 2010

Objectives: The purpose of this study was to evaluate the prenatal, perinatal, and infancy history of children with autism spectrum disorder (ASD) as compared to unaffected siblings (SIB) and typically developing children (TC). Methods: Subjects with ASD, their SIB, and TC were recruited. All subjects were assessed using both the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R) and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS) and were subsequently identified as affected or unaffected. Prenatal, perinatal, and infancy history was obtained from the primary caregivers and each facet was compared in those with ASD, the SIB, and the TC groups using SPSS ver. 17.0 (p<.05). Results: 70 individuals with ASD (63 males, 87.94${\pm}$37.8months), 53 SIB (27 males, 85.4087.94${\pm}$48.06 months), and 32 TC (19 males, 104.1987.94${\pm}$23.409 months) were analyzed. The ASD group showed significantly higher rates of insufficient vaccination as they aged age ($x^2$=15.54, p=.000). Among the scheduled vaccinations, the DPT vaccination ($x^2$=10.08, p=.006) was insufficient in ASD groups. The ASD group also showed higher rates of sleep disturbances from infancy. Differences in maternal/paternal age at conception, gestational age, and growth parameters at birth were not significantly difference among the three groups. Conclusion: These results do not support the previous controversies regarding the relationship between prenatal/perinatal complications and ASD. However, these results indicate that perinatal and prenatal factors may contribute to the development of ASD.

• 대한간호학회지
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• 제24권3호
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• pp.448-460
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• 1994

This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.

• Clinical and Experimental Pediatrics
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• 제55권10호
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• pp.383-387
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• 2012

Purpose: Although benign rolandic epilepsy (BRE) is a benign condition, it may be associated with a spectrum of behavioral, psychiatric, and cognitive disorders. This study aimed to assess the cognitive and other neuropsychological profiles of children with BRE. Methods: In total, 23 children with BRE were consecutively recruited. All children underwent sleep electroencephalography (EEG) and were assessed on a battery of comprehensive neuropsychological tests including the Korean versions of the Wechsler intelligence scale for children III, frontal executive neuropsychological test, rey complex figure test, Wisconsin card sorting test, attention deficit diagnostic scale, and child behavior checklist scale. Results: The study subjects included 13 boys and 10 girls aged $9.0{\pm}1.6$ years. Our subjects showed an average monthly seizure frequency of $0.9{\pm}0.7$, and a majority of them had focal seizures (70%). The spike index (frequency/min) was $4.1{\pm}5.3$ (right) and $13.1{\pm}15.9$ (left). Of the 23 subjects, 9 showed frequent spikes (>10/min) on the EEG. The subjects had normal cognitive and frontal executive functions, memory, and other neuropsychological sub-domain scores, even though 8 children (35%) showed some evidence of learning difficulties, attention deficits, and aggressive behavior. Conclusion: Our data have limited predictive value; however, these data demonstrate that although BRE appears to be benign at the onset, children with BRE might develop cognitive, behavioral, and other psychiatric disorders during the active phase of epilepsy, and these problems may even outlast the BRE. Therefore, we recommend scrupulous follow-up for children with BRE.

• Journal of Genetic Medicine
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• 제19권1호
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• pp.32-37
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• 2022

Mucopolysaccharidosis type VI (MPS VI) is an autosomal recessive lysosomal disorder caused by the deficiency of arylsulfatase B due to mutations in the ARSB gene. Here, we report the case of a Korean female with a novel variant of MPS VI. A Korean female aged 5 years and 8 months, who is the only child of a healthy non-consanguineous Korean couple, presented at our hospital for severe short stature. She had a medical history of umbilical hernia and recurrent otitis media. Her symptoms included snoring and mouth breathing. Subtle dysmorphic features, including mild coarse face, joint contracture, hepatomegaly, and limited range of joint motion, were identified. Radiography revealed deformities, suggesting skeletal dysplasia. Growth hormone (GH) provocation tests revealed complete GH deficiency. Targeted exome sequencing revealed compound heterozygous mutations in the ARSB genes c.512G>A (p.Gly171Asp; a pathogenic variant inherited from her father) and c.1157C>T (p.Ser386Phe; a novel variant inherited from her mother in familial genetic testing). Quantitative tests revealed increased urine glycosaminoglycan (GAG) levels and decreased enzyme activity of arylsulfatase B. While on enzyme replacement therapy and GH therapy, her height increased drastically; her coarse face, joint contracture, snoring, and obstructive sleep apnea improved; urine GAG decreased; and left ventricular mass index was remarkably decreased. We report a novel variant-c.1157C>T (p.Ser386Phe)-of the ARSB gene in a patient with MPS VI; these findings will expand our knowledge of its clinical spectrum and molecular mechanisms.

• 한국학교보건학회지
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• 제36권3호
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• pp.113-125
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• 2023

Purpose: The purpose of this study is to develop a model for predicting mental health risk among adolescents based on health behavior information by employing a hybrid machine learning method. Methods: The study analyzed data of 51,850 domestic middle and high school students from 2022 Youth Health Behavior Survey conducted by the Korea Disease Control and Prevention Agency. Firstly, mental health risk levels (stress perception, suicidal thoughts, suicide attempts, suicide plans, experiences of sadness and despair, loneliness, and generalized anxiety disorder) were classified using the k-mean unsupervised learning technique. Secondly, demographic factors (family economic status, gender, age), academic performance, physical health (body mass index, moderate-intensity exercise, subjective health perception, oral health perception), daily life habits (sleep time, wake-up time, smartphone use time, difficulty recovering from fatigue), eating habits (consumption of high-caffeine drinks, sweet drinks, late-night snacks), violence victimization, and deviance (drinking, smoking experience) data were input to develop a random forest model predicting mental health risk, using logistic and XGBoosting. The model and its prediction performance were compared. Results: First, the subjects were classified into two mental health groups using k-mean unsupervised learning, with the high mental health risk group constituting 26.45% of the total sample (13,712 adolescents). This mental health risk group included most of the adolescents who had made suicide plans (95.1%) or attempted suicide (96.7%). Second, the predictive performance of the random forest model for classifying mental health risk groups significantly outperformed that of the reference model (AUC=.94). Predictors of high importance were 'difficulty recovering from daytime fatigue' and 'subjective health perception'. Conclusion: Based on an understanding of adolescent health behavior information, it is possible to predict the mental health risk levels of adolescents and make interventions in advance.

• 정신신체의학
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• 제28권2호
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• pp.99-107
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• 2020

섬유근통은 피로, 수면장애, 기분변화, 인지장애 및 만성 전신통증을 핵심 증상으로 하는 질환이다. 섬유근통은 유전적 취약성, 통증 처리과정 및 스트레스 반응 체계의 변화 등을 포함하는 생물학적 요인과 불안, 우울, 분노, 스트레스 등의 심리적 요인, 그리고 감염, 발열 질환, 외상 등의 환경적 요인이 함께 작용하여 발생하는 것으로 알려져 있으며, 핵심 병인으로 감각 자극이 인식되는 과정에서 증폭되어 통증이 증진되는 중추성 감작의 역할이 강조되고 있다. 가이드라인들은 개별 환자의 필요에 따라 선택된 다원적 접근을 권고하며, 임상의는 충분한 교육을 통해 지적 이해의 틀을 제공하고 자기 관리의 중요성을 강조해야 한다. 섬유근통에서 정신건강 문제의 유병률은 일반인구집단의 7~9배로 유의하게 높으며, 특정 정신병리 및 수면장애와의 관련성도 제기되고 있다. 정신과적 상태는 섬유근통과 양방향성 상호작용을 하며 경과에 영향을 주고, 취약성을 공유하며 서로의 위험 요인으로 작용할 수 있으므로, 동반질환을 면밀히 평가하여 보다 통합적인 관리가 필요할 것이다.