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CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH PERVASIVE DEVELOPMENTAL DISORDER (입원한 전반적발달장애 소아청소년의 임상특성)

  • Pyo, Kyung-Sik;Bahn, Geon-Ho;Hong, Kang-E;Park, Tae-Won
    • 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.

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Development of dietary behavior items available in Korea National Health and Nutrition Examination Survey (국민건강영양조사에 활용 가능한 식생활 조사항목 개발 및 유용성 검증)

  • Lim, A-Hyun;Choi, Suk-Young;Shim, Jae-Eun;Hwang, Ji-Yun;Moon, Hyun-Kyung;Kim, Kirang
    • Journal of Nutrition and Health
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    • v.48 no.5
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    • pp.407-418
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    • 2015
  • Purpose: Given that the indicators related to chronic diseases are important to evaluating goals of the national health policy, the aim of this study was to develop dietary behavior items available in the Korea National Health and Nutrition Examination Survey. Methods: The dietary behavior items were developed based on the literature reviews, need assessment of the field, expert focus-group interviews, and expert advisory meeting. Questions for each dietary behavior item were developed by reflecting on environmental, personal, and behavior factors of the ecological frame and then revised through expert focus-group interview and expert advisory meeting. The understanding and reliability of the developed questionnaire were assessed by cognitive interview and test-retest reliability. Results: The developed items were sodium and salt intake, added and simple sugar intake, enough time to consume a meal for all ages, caffeine drinks and fresh/healthy food intake for children and adolescents, and limited dietary intake, fresh/healthy food intake for seniors. In most questions except some questions on sodium and salt intake, subjects understood over 70% and consistency of responses based on the kappa values was acceptable. Conclusion: Developed dietary behavior items are expected to be useful for evidence-based nutrition policy, interventions and research targeting dietary patterns through investigating and monitoring dietary behavior patterns.

The Application of Impulse Oscillometry(IOS) in the Detection of Smoking Induced Early Airway Obstruction (Impulse Oscillometry(IOS)를 이용한 흡연자에서의 조기 기도폐쇄의 연구)

  • Kim, Youn-Seup;Kweon, Suk-Hoe;Song, Mi-Young;Yoo, Sun-Mi;Park, Jae-Seuk;Jee, Young-Koo;Lee, Kye-Young;Kim, Keun-Youl
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1030-1039
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    • 1997
  • Background : Impulse Oscillometry is a noninvasive and effort-independent test used to characterize the mechanical impedance of the respiratory system. The clinical potential of the IOS is rapid and demands only passive cooperation which makes it especially appealing for children, for epidemiologic surveys and for conditions in which quiet breathig instead of forced expiratory maneuvers are preferred. However, several studies have shown conflicting results that the role of IOS about detection of smoking induced small airway diseases or early airway obstruction Methods : Study was to evaluate the clinical ability of the IOS to detect about smoking induced early airway obstruction in persons with normal spirometry test. Respiratory asymptomatic study groups were formed that one is non-smoking group, another is smoking group. Results : The parameters of spirometry were not significantly differences between non-smoking group and smoking group. Among the parameters of IOS, total resistance(non-smoking group : smoking group=$2.22{\pm}1.20$ : $2.58{\pm}1.71$), peripheral resistance($1.25{\pm}0.62$ : $1.47{\pm}0.10$), bronchial compliance($0.44{\pm}0.12$ : $0.47{\pm}0.16$) were not statistically significant different (p<0.05), but central resistance and lung compliance were not statistically significant different (unit ; resistance=hPa/l/s, compliance=l/hPa). Resistance(Rrs) was not statistically significant different with changes of frequences(5, 10, 15, 20, 25, 30, 35Hz), but Reactance(Xrs) was statistically significant different with low frequences that X5(non-smoking group : smoking group=$-0.62{\pm}0.28$ : $-0.76{\pm}0.48$, p<0.001) and X10($-0.06{\pm}0.19$ : $-0.15{\pm}0.33$, p<0.013) (unit; hPall/s, $hPa{\cong}cmH_2O$). Conclusion : Impulse oocillometer(IOS) is clinically available method to detect about smoking induced early airway obstruction. And clinically potential parameters of IOS were considers that total resistance, peripheral resistance, bronchial resistance, and reactance of low frequency at 5Hz, 10Hz.

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Clinical and Epidemiological Study of 1,165 Hospitalized Cases of Rotaviral Gastroenteritis Before and After the Introduction of Rotavirus Vaccine, 2006-2013 (로타바이러스 백신 도입 전후 입원한 로타바이러스 위장관염 1,165례의 역학 및 임상적 연구, 2006-2013년)

  • Sohn, Tae-Young;Lee, Chan-Jae;Kim, Yoon-Joo;Kang, Min-Jae;Kim, Sung-Hye;Lee, So-Yeon;Lee, Dae-Hyoung;Lee, Hae-Ran;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.174-180
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    • 2014
  • Purpose: This study was performed to assess the clinical and epidemiological changes after the introduction of the rotavirus vaccine in Korea, as well as to determine the efficacy of the rotavirus vaccine among hospitalized rotaviral gastroenteritis patients over the past two years. Methods: We analyzed yearly and seasonal patterns of 1,165 inpatients who were hospitalized for rotaviral gastroenteritis under the age of 5 years between 2006 and 2013. We also conducted a survey among 460 gastroenteritis patients who were hospitalized between 2012 and 2013 regarding the rotavirus vaccination and the symptoms of gastroenteritis. Among those individuals surveyed, clinical indices were analyzed for 124 patients who were tested positive for the rotavirus antigen. Results: The incidence of Rotaviral gastroenteritis have decreased significantly by year 2010. After the introduction and widespread dissemination of the rotavirus vaccine, the onset of the disease and the seasonal peak have been delayed. Overall, the vaccinated group showed a lower rate of positivity than the unvaccinated group. Among the hospitalized rotaviral gastroenteritis patients, the vaccinated group had a shorter hospitalization period, less severe clinical symptoms of gastroenteritis, and better laboratory test results. Conclusions: After introduction of the rotavirus vaccine in Korea, there were two main trends observed: 1) the overall level of disease incidence was reduced; 2) the severity of rotaviral gastroenteritis cases also decreased. Based on this data, more children should receive vaccination in order to prevent the rotavirus infection and decrease the severity of rotaviral gastroenteritis.

The effects of high-dose intravenous immunoglobulin on plasma protein and lipid levels in the patients with Kawasaki disease (가와사끼병에서 고용량 정맥용 면역글로불린이 혈장 단백 및 지질에 미치는 영향(면역글로불린 투여 후 단백질 농도 변화))

  • Lee, Keun Young;Kim, Dong-Un;Lee, Hyun Seung;Jang, Pil Sang;Kim, Young-Hoon;Kim, Jin Tack;Kim, Hyun Hee;Lee, Kyung-Yil;Lee, Joon-Sung
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1348-1353
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    • 2006
  • Purpose : The reticuloendothelial system is composed of sinusoidal capillaries, through which even large protein molecules are freely movable between plasma and interstitial space, including the lymphatic system. Therefore, high-dose intravenous immunoglobulin (IVIG) would cause a redistribution of proteins between two compartments. To investigate this hypothesis, we measured plasma protein and lipid levels in patients with Kawasaki disease before and after high-dose IVIG treatment. Methods : Thirty four children with Kawasaki disease who had complete responses to high-dose IVIG treatment (1 g/kg/day for two consecutive days), were analyzed. Before and after the administration of IVIG, serum analyses were performed for such parameters as total protein, albumin, ${\gamma}$-globulins (IgG, IgM, IgA), ${\alpha}1-$, ${\alpha}2-$, and ${\beta}-$ globulin fractions, and lipid profiles (total cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride). Results : The levels of ${\gamma}$-globulins including IgG, IgM, IgA were significantly increased, and IgG was increased by $1,779{\pm}304mg/dL$ after two-dose of IVIG infusion. The levels of albumin, ${\alpha}1-$, ${\alpha}2-$, and ${\beta}$ globulin fractions were significantly decreased by 18 percent, 24 percent, 19 percent and 12 percent, respectively. HDL-cholesterol level was significantly decreased by 20 percent, while LDL-cholesterol and triglyceride levels were significantly increased by 21 percent and 50 percent, respectively. The total cholesterol level was not changed. Conclusion : High-dose IVIG treatment decreased the levels of a variety of proteins except immunoglobulins, and the increase of IgG after IVIG treatment was lower than expected. Our results suggest that a part of infused IVIG and plasma proteins, including etiologic proteins for Kawasaki disease, may be distributed to the extravascular compartments. The rapid improvement of symptoms induced by IVIG in Kawasaki disease might be explained by this mode of action of IVIG.

A Study on the Variation of Daily Urban Water Demand Based on the Weather Condition (기후조건에 의한 상수도 일일 급수량의 변화에 관한 연구)

  • Lee, Gyeong-Hun;Mun, Byeong-Seok;Eom, Dong-Jo
    • Water for future
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    • v.28 no.6
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    • pp.147-158
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    • 1995
  • The purpose of this study is to establish a method of estimating the daily urban water demand using statistical model. This method will be used for the development of the efficient management and operation of the water supply facilities. The data used were the daily urban water use, the population, the year lapse and the weather conditions such as temperature, precipitation, relative humidity, etc. Kwangju city was selected for the case study area. The raw data used in this study were rearranged either by month or by season for the purpose of analysis, and the statistical analysis was applied to the data to obtain the regression model. As a result, the multiple linear regression model was developed to estimate the daily urban water use based on the seather condition. The regression constant and the model coefficients were determined for each month of a year. The accuracy of the model was within 3% of average error and within 10% of maximum error. The developed model was found to be useful to the practical operation and management of the water supply facilities.

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The Usefulness of the Abdominal Computerized Tomography for the Diagnosis of Childhood Obesity and Its Correlation with Various Parameters of Obesity (소아 복부비만 진단을 위한 복부 전산화 단층 촬영의 유용성과 여러 지표와의 상관성 연구)

  • Shim, Yoon Hee;Cho, Su Jin;Rhyu, Jung Hyun;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1082-1089
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    • 2005
  • Purpose : Abdominal obesity is encountered as a risk factor for cardiovascular diseases. However, the anthropometric cut-off value to estimate the cardiovascular risk, has not been suggested. This study was designed to find the relationship between the abdominal fat and various parameters of obesity to find the cardiovascular risk factors related to abdominal obesity and to establish practical methods to measure them. Methods : Twenty seven obese Korean adolescents of moderate to severe degree and 22 healthy adolescents were enrolled. The body mass index(BMI), arm circumference and skinfold thickness were measured. Furthermore, blood lipid, sugar, insulin and four different cytokines' levels were checked and the distribution of body composition was measured by bioelectrical impedance analysis. The subcutaneous and intra-abdominal fat thickness by abdominal ultrasonography(US) and the total and intra-abdominal fat area by abdominal computerized tomography(CT) were measured in the obese group. Results : The most accurate method to measure abdominal fat in children is abdominal CT and the fat mass measured by bioelectrical impedance was strongly correlated with it(r=0.954). It was also correlated with arm circumference, fat thickness measured by abdominal US, BMI, aspartate aminotransferase(AST), alanine aminotransferase(ALT) and triglyceride level. Conclusion : Abdominal CT is the most accurate method to measure intra-abdominal fat, and it can be replaced by abdominal US for cost effectiveness. The screening methods that can be used at school or in outpatient basis include bioelectrical impedance, waist/hip ratio, and arm circumference. The cardiovascular risk factors include leptin, triglyceride and insulin level.

A CASE OF TREATMENT-RESISTANT CHILDHOOD-ONSET SCHIZOPHRENIA WITH LONG-TERM TRIAL OF CLOZAPINE (치료저항성 소아기 발병 정신분열증의 Clozapine 장기치험 1례)

  • Jang, Soon-Ah;Kim, Kyung-Hee;Lee, Hong-Shick;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.98-104
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    • 1998
  • A 12-year-old girl with a 6 year history of childhood-onset schizophrenia required 2 hospitalizations and long-term clozapine trial due to inadequate responses to combinations of typical neuroleptics and traditional treatments of schizophrenic disorder. On admission, she had continuous auditory and visual hallucinations, persecutory delusion, emotional instability, regression of behaviors including temper tantrums as well as specific developmental delays in learning, language, and motor coordination. The clozapine trial significantly reduced most of the positive symptoms, and facilitated in successful discharge from the hospital. During the 4 year clozapine treatment, no significant adverse reactions were noted, and she returned to a structured school setting with minimal degrees of schizophrenic symptoms. From this clinical experience, we suggest that clozapine might be safe and effective in treating treatment-refractory schizophrenic children.

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The Quality of Teacher-child Interactions by Teachers' Perception of Professionalism and Teaching Intentions (교사의 전문성 인식, 교수 의도 행동에 따른 교사-영유아 상호작용)

  • Ju, Hyun Jeong;Shin, Hye Won
    • Korean Journal of Child Education & Care
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    • v.18 no.2
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    • pp.1-15
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    • 2018
  • The purpose of this study was to determine if teachers' perception of professionalism, teaching intentions, and the quality of teacher-child interactions differed by teachers' education and career and how those variables were associated with one another. It was conducted in 50 teachers who were in charge of two- to five-year-olds at 22 national/public, private, and employer-supported childcare centers in Seoul and Gyeonggi Province. Arnett's (1989) Caregiver Interaction Scale (CIS) translated by Choi and Shin (2015) was used to measure the quality of teacher-child interactions, and the Current Status and Self-Desire for Professional Competence scale developed by Wang (2005) and translated and revised by Jeong (2016) was used to measure a teacher's perception of professionalism. The Teaching Intention Scale (TIS) developed by Wilcox-Herzog and Ward (2004) and translated and revised by the researcher was used to measure teaching intentions. The researcher and the research assistant personally visited the centers to observe the teachers for the quality of teacher-child interactions and a questionnaire for teachers was used to determine a teacher's perception of professionalism and teaching intentions. For data analysis, t-test and Pearson's product-moment correlation analysis were performed on the basis of the questions. The results of this study can be summarized as follows: First, the quality of teacher-child interactions differed insignificantly by education or career. Second, teacher's perception of professionalism differed significantly by teachers' career but differed insignificantly by education: the longer career, the better perception of professionalism. Third, teaching intentions differed insignificantly by education or career. Fourth, teachers with better perception of professionalism showed higher quality of teacher-child interaction. Fifth, The higher level of teaching intentions teachers showed the more sensitive interactions they made with children.

Relation between Helicobacter pylori Infection and Socioeconomic Status in Korean Adolescents (Helicobacter pylori 감염과 사회경제적 요인에 대한 연구)

  • Jung, Min-Kyong;Kwon, Young-Se;Choe, Hyon;Choe, Yon-Ho;Hong, Yun-Chul
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.17-22
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    • 2000
  • Purpose: This study was conducted to evaluate the association between H. pylori infection and socioeconomic status and to determine the current prevalence of H. pylori infection in Korean adolescents. Methods: A structured questionnaire was sent to the children's parents to obtain demographic information on the parents and environmental information. Of the 532 questionnaires sent out, 375 (70.5%; 170 girls and 205 boys) were returned. Their ages ranged from 10 to 15 years (mean, 12.9 years). After collecting blood samples, we measured serum IgG antibody to H. pylori using ELISA method. The association of risk factors such as age, sex, socioeconomic class, type of house, and crowding index with H. pylori infection were analyzed by multiple regression analysis. Socioeconomic status was estimated from the parents' education and occupation using a modified Hollingshead index. Results: The prevalence rate of H. pylori infection was 16.8% (63/375). It increased with age (10.3% at 10~11 years, 15.9% at 12~13 years, and 20.7% at 14~15 years). The H. pylori infection was inversely related to the socioeconomic class (6.3% for the upper class, 16.0% for the middle class, and 20.0% for the lower calss). Crowding condition and type of house did not affect significantly on seroprevalence of H. pylori infection. After logistic regression, we found that the odds ratio for age was 2.2 (95% confidence interval 0.9~5.4), and for socioeconomic status, 3.6 (95% confidence interval 0.5~28.9). Conclusion: The prevalence of H. pylori infection in Korean adolescents was 16.8%. It related inversely to socioeconomic status but was not statistically significant. Socioeconomic status based on parents' education and occupation seemed to affect more on H. pylori seroprevalence than crowding or type of house did.

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