• 제목/요약/키워드: Childhood onset

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주의력결핍.과잉운동장애의한의학적 치료 (1995-2002년까지의 중국논문을 중심으로) (A Review of Attention Deficit Hyperactivity Disorder in Traditional Chinese Medicine)

  • 이태호;장인수;김정연;김락형
    • 동의신경정신과학회지
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    • 제14권1호
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    • pp.161-174
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    • 2003
  • Attention deficit hyperactivity disorder(ADHD) is one of the most common childhood-onset psychiatric disorders. It is distinguished by symptoms of hyperactivity, inattention, and impulsivity. The etiology of ADHD is unknown, and the disorder may several different causes. The pharmacotherapy most widely used for ADHD occasionally gives rise to ill effects. The studys of ADHD were approached from the viewpoint of medicine and pedagogics, but it is rare from the viewpoint of the Korean Medicine. So, we searched for the studies on ADHD of Chinese Traditional Medicine(TCM) in last eight years(1995-2002). In TCM, ADHD was placed under the category of 'wind(風)-one of the five pathogenic factors', 'insomnia(失眠)', 'forgetfulness(健忘)' and 'restlessness(躁動)', etc. Jang and Bu(the internal organs; 臟腑) related with the differentiations of syndrome about ADHD were liver(肝), heart(心), spleen(脾), kidney(腎) and gallbladder(膽). Among them, liver(肝), kidney(腎) and spleen(脾) were important. The herbal medicines used in ADHD had the effects of spirit-calming(安神), orifices-opening(開竅), Eumyang-balance(陰陽平衡). And acupuncture therapy, ear-acupuncture therapy and dietary treatment, etc. were used in the treatment of ADHD. We expect that this review about ADHD in TCM help the clinical study of ADHD in Korean Medicine.

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Diencephalic syndrome: a frequently neglected cause of failure to thrive in infants

  • Kim, Ahlee;Moon, Jin Soo;Yang, Hye Ran;Chang, Ju Young;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • 제58권1호
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    • pp.28-32
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    • 2015
  • Purpose: Diencephalic syndrome is an uncommon cause of failure to thrive in early childhood that is associated with central nervous system neoplasms in the hypothalamic-optic chiasmatic region. It is characterized by complex signs and symptoms related to hypothalamic dysfunction; such nonspecific clinical features may delay diagnosis of the brain tumor. In this study, we analyzed a series of cases in order to define characteristic features of diencephalic syndrome. Methods: We performed a retrospective study of 8 patients with diencephalic syndrome (age, 5-38 months). All cases had presented to Seoul National University Children's Hospital between 1995 and 2013, with the chief complaint of poor weight gain. Results: Diencephalic syndrome with central nervous system (CNS) neoplasm was identified in 8 patients. The mean age at which symptoms were noted was $18{\pm}10.5$ months, and diagnosis after symptom onset was made at the mean age of $11{\pm}9.7$ months. The mean z score was $-3.15{\pm}1.14$ for weight, $-0.12{\pm}1.05$ for height, $1.01{\pm}1.58$ for head circumference, and $-1.76{\pm}1.97$ for weight-for-height. Clinical features included failure to thrive (n=8), hydrocephalus (n=5), recurrent vomiting (n=5), strabismus (n=2), developmental delay (n=2), hyperactivity (n=1), nystagmus (n=1), and diarrhea (n=1). On follow-up evaluation, 3 patients showed improvement and remained in stable remission, 2 patients were still receiving chemotherapy, and 3 patients were discharged for palliative care. Conclusion: Diencephalic syndrome is a rare cause of failure to thrive, and diagnosis is frequently delayed. Thus, it is important to consider the possibility of a CNS neoplasm as a cause of failure to thrive and to ensure early diagnosis.

급성 뇨 폐색을 동반한 처녀막 폐쇄증 1례 (A Case of Imperforate Hymen with Acute Urinary Retention)

  • 최림;조세은;임형은;유기환;홍영숙;이주원
    • Childhood Kidney Diseases
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    • 제15권1호
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    • pp.86-89
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    • 2011
  • 처녀막 폐쇄증은 0.1%의 빈도를 가지는 드문 여성질환으로 초경이 시작된 후 처녀막 폐쇄로 생리혈이 저류되면서 하복부 통증, 변비, 1차성 무월경, 드물게 배뇨곤란, 무뇨증의 증상을 보인다. 일반적으로 요 체류(urinary retention) 증상은 대개 정신적 원인, 약물에 의한 원인, 감염이나 선천성 기형 등에 의한 급성 요 폐색이 주된 원인이며 본 증례와 같이 처녀막 폐쇄로 요 폐색이 생기는 경우는 드물다. 저자들은 급성 요 체류 증상으로 내원하여 당시 급성 요폐색이 의심되었으나 처녀막 폐쇄증으로 진단되었던 증례를 경험하였다. 자세한 병력 청취 및 외부 성기의 진찰이 오진과 치료의 지연을 막을 수 있다는 것을 다시 확인할 수 있었다.

Cytomegalovirus Infection in Pediatric Renal Transplant Recipients: A Single Center Experience

  • Kim, Mi Jin;You, Ji Hye;Yeh, Hye Ryun;Lee, Jin A;Lee, Joo Hoon;Park, Young Seo
    • Childhood Kidney Diseases
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    • 제21권2호
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    • pp.75-80
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    • 2017
  • Purpose: To investigate the frequency, presentation, management, and outcome of cytomegalovirus (CMV) infection in pediatric patients who underwent renal transplantation. Methods: We performed a retrospective chart review of 70 patients under the age of 18, who underwent renal transplantation between January 1990 and November 2014. A diagnosis of CMV infection was based on serology, molecular assays, antigenemia assays, and culture. CMV infection was defined as detection of virus and CMV disease was diagnosed when clinical signs and symptoms were present. Results: The number of patients with CMV infection was 18 (25.7% of renal transplant recipients). Twelve were male (66.7%), and the $mean{\pm}standard$ deviation (SD) age at infection was $13.3{\pm}3.9$ years. Median time of infection after renal transplantation was 4 months (range 1.0-31.0 months). Pretransplantation CMV status in the infected group was as follows: donor (D)+/recipient (R)+, 11 (61.1%); D+/R-, 7 (38.9%); D-/R+, 0; and D-/R- 0. Nine patients had CMV disease with fever, leukopenia, thrombocytopenia, or organ involvement such as enteritis, hepatitis, and pneumonitis. The age of disease occurrence was $13.1{\pm}3.9$ years and the median time to disease onset after renal transplantation was 8 months (range 1.0-31.0). Immunosuppressive agents were reduced or discontinued in 14 patients (77.8%), antiviral agents were used in 11 patients (61.1%), and all patients with CMV infection were controlled. Conclusions: A quarter of the patients had CMV infection about 4 months after renal transplantation. CMV infection was successfully treated with reduction of immunosuppressants or with antiviral agents.

유전질환 신경 세로이드 리포푸신증들에 대한 고찰 (Genetic and Molecular Mechanisms in the Neuronal Ceroid-Lipofuscinoses)

  • 이민영;김동현;윤동호;김한복;박주훈;이환명;김성훈;김성조
    • 한국발생생물학회지:발생과생식
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    • 제13권2호
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    • pp.63-77
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    • 2009
  • 신경리포푸신증(NCLs)은 신경퇴행 축적 질환으로 뇌에 자기형광물질을 포함한 다양한 물질의 축적이 야기되어 발생하며, 노던에필렙시를 제외한 모든 신경포푸신증은 리소즘 축적 질환으로 분류된다. 이러한 신경리포푸신증은 전세계적으로 12,500명 중 1명에게 발생되는 높은 발병 빈도를 나타내며, 그 발병 시기에 따라 영아형, 영유아형, 유년형, 그리고 성인형과 같이 분류된다. 신경리포푸신증이 유발하는 의학적 증상로는 시각 손실, 발작, 간질, 진행성 정신지체등을 야기하여 소아성 치매라는 이야기를 들으며, 증상이 심할 경우 환자가 사망에 이르게 된다. 신경퇴행성 리포푸신증의 원인은 유전자의 돌연변이 때문이라고 알려져 있으며, 일부의 연구를 통해 태아의 발생과정 상 문제를 통해 질병이 야기되는 경우도 관찰이 되고 있으나, 아직 그 분자 발생학적 기전이 명확하게 규명되어 있지 않은 현실이다. 현재 전 세계적으로 많은 연구가 수행되고 있어 그 결과가 주목되는 바이다.

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소아청소년 틱장애 환자의 B림프구에서 D8/17의 발현 (D8/17 Expression on B Lymphocytes of Children and Adolescents with Tic Disorder)

  • 오영근;박태원;정용우;정상근;정영철;양종철
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제24권3호
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    • pp.151-156
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    • 2013
  • Objectives : It has been reported that higher percentage of B cells react with monoclonal D8/17 antibody in patients with rheumatic fever, childhood onset obsessive-compulsive disorder, Tourette's disorder, or prepubertal anorexia nervosa. The purpose of this study is to replicate the previous studies in a Korean young population with tic disorder and to identify any relationship between D8/17 and clinical symptoms. Methods : The binding of D8/17 to B cells was determined in patients with tic disorder (N=21) and healthy controls (N=9) by Fluorescence-Activated Cell Sorter analysis. Results : In the sample examined by this study, the average percentage of B cells expressing D8/17 in tic disorder was 2.05%; healthy controls was 3.15%. No statistically significant differences were found in the mean percentages of D8/17 between the two groups. Conclusion : The expression of D8/17 in B cells was very low in this study. No subjects with tic disorder or healthy controls was above 12% in D8/17 positive proportion. Further studies, including higher number of patients and control group members, should be performed.

급성 신손상을 가진 소아의 지속적 신대체 요법 (Overview of Pediatric Continuous Renal Replacement Therapy in Acute Kidney Injury)

  • 박세진;신재일
    • Childhood Kidney Diseases
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    • 제15권2호
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    • pp.107-115
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    • 2011
  • 소아에서 급성 신손상의 흔한 원인들로는 신허혈, 신독성 약물들, 그리고 패혈증 등이 있으며, 신대체요법 시작시의 저혈압, 신대체 요법 동안 승압제의 사용, 그리고 신대체 요법 시작시의 수액 과부하 정도가 환자의 생존(소아 중환자실 퇴원)에 영향을 미치는 요인들로 알려져 있다. 지속적 신대체 요법의 빠른 시작은 급성 신손상을 가진 환자들에게서 사망률과 예후에 나쁜 영향을 미치는 수액 과부하를 감소시키는 것으로 보고되었다. 이에 저자들은 소아 환자에게서 지속적 신대체 요법의 실제 처방과 급성 신손상, 수액 과부하, 그리고 지속적 신대체 요법간의 연관성 및 치료결과를 살펴보고자 한다. 결론적으로, 급성 신손상을 가진 소아의 치료에 있어서 과도한 수액 과부하가 발생하기 전에 빠른 지속적 신대체 요법의 시작이 필요하다고 제시하는 바이다.

A late onset solitary mediastinal cystic lymphangioma in a 66-year-old woman who underwent kidney transplantation

  • Lee, Jung Mo;Lee, Sang Hoon;Park, Youngmok;Kim, Chi Young;Goag, Eun Kyoung;Lee, Eun Hye;Park, Ji Eun;Lee, Chang Young;Kim, Se Kyu
    • Journal of Yeungnam Medical Science
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    • 제32권2호
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    • pp.155-158
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    • 2015
  • Lymphangioma is a congenital abnormality of the lymphatic system detected primarily in early childhood. There are rare reports of mediastinal lymphangioma in older adults. We hereby report on a 66-year-old female patient who underwent kidney transplantation 20 years previously and who developed pathologically confirmed solitary mediastinal lymphangioma 1 year ago. Chest radiography showed a mediastinal nodule, which was not observed 2 year previously, therefore she was referred to the pulmonary division. She had no symptoms, and chest computed tomography demonstrated a 25-mm, well-defined, low-density nodule located at the anterior mediastinum. The size of the nodule had increased from 25 mm to 34 mm 1 year later, and it was completely resected via video-assisted thoracic surgery. The histological diagnosis was cystic lymphangioma. Therefore, we recommend that clinicians consider cystic lymphangioma as a possible diagnosis even in older patients with a mediastinal cystic mass that shows progressive enlargement.

초등교사의 ADHD 관련 지식, 태도, 스트레스 수준 및 통합교육의지에 대한 인식 (Assessment of Elementary Teachers' Knowledge about ADHD, Attitude, Stress Level and Intention for Inclusion Education)

  • 최연숙
    • 디지털융복합연구
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    • 제15권5호
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    • pp.363-372
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    • 2017
  • 주의력결핍 과잉행동장애(ADHD)는 소아청소년기에 흔히 나타나는 장애질환으로 초등학교 아동들의 교육적, 사회적 적응에 어려움을 불러일으키는 요인 중의 하나이다. ADHD 증상아동들은 다른 학생들과 함께 가르치는 교사들의 태도와 행동을 결정하는 요인에 대한 분석은 효율적인 통합교육을 위한 교육방법의 개선과 교사 교육을 위해 필요한 과정이다. 본 연구에서는 ADHD 아동을 경험한 적이 있는 227명의 초등교사 설문조사를 바탕으로 나이, 성별, 교직경력, 연수시간 등이 지식, 태도, 스트레스 및 교실에서의 통합교육 의지에 미치는 영향 정도를 살펴보고자 하였다. 회귀분석 결과, 5% 유의수준에서 성별은 스트레스에, 연수시간은 ADHD 관련지식수준에 영향을 미치는 것으로 나타났다. 그렇지만 ADHD 학생의 지도경험, 나이, 성별, 교직경력, 연수시간 등의 요인은 통합교육 의지에 별다른 영향을 미치는 않는 것으로 분석되었다. 결론으로 교사들의 정책적 지원요구사항도 간략히 요약하여 제시하였다.

Korean speech sound development in children from bilingual Japanese-Korean environments

  • Kim, Jeoung-Suk;Lee, Jun-Ho;Choi, Yoon-Mi;Kim, Hyun-Gi;Kim, Sung-Hwan;Lee, Min-Kyung;Kim, Sun-Jun
    • Clinical and Experimental Pediatrics
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    • 제53권9호
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    • pp.834-839
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    • 2010
  • Purpose: This study investigates Korean speech sound development, including articulatory error patterns, among the Japanese-Korean children whose mothers are Japanese immigrants to Korea. Methods: The subjects were 28 Japanese-Korean children with normal development born to Japanese women immigrants who lived in Jeonbuk province, Korea. They were assessed through Computerized Speech Lab 4500. The control group consisted of 15 Korean children who lived in the same area. Results: The values of the voice onset time of consonants /$p^h$/, /t/, /$t^h$/, and/$k^*$/ among the children were prolonged. The children replaced the lenis sounds with aspirated or fortis sounds rather than replacing the fortis sounds with lenis or aspirated sounds, which are typical among Japanese immigrants. The children showed numerous articulatory errors for /c/ and /I/ sounds (similar to Koreans) rather than errors on /p/ sounds, which are more frequent among Japanese immigrants. The vowel formants of the children showed a significantly prolonged vowel /o/ as compared to that of Korean children ($P$<0.05). The Japanese immigrants and their children showed a similar substitution /n/ for /ɧ/ [Japanese immigrants (62.5%) vs Japanese-Korean children (14.3%)], which is rarely seen among Koreans. Conclusion: The findings suggest that Korean speech sound development among Japanese-Korean children is influenced not only by the Korean language environment but also by their maternal language. Therefore, appropriate language education programs may be warranted not only or immigrant women but also for their children.