• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.619-623
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• 2019

We report the case of a seven-year-old boy with an ingested foreign body, which was retained within the appendix for a known duration of ten months, ultimately requiring appendectomy. The ingested foreign body was incidentally discovered by abdominal x-ray at an emergency room visit for constipation. Despite four bowel cleanouts, subsequent x-rays showed persistence of the foreign body in the right lower quadrant. While the patient did not have signs or symptoms of acute appendicitis, laparoscopic appendectomy was performed due to the risk of this foreign body causing appendicitis in the future. A small metallic object was found within the appendix upon removal. This case highlights the unique challenge presented by foreign body ingestions in non-verbal or developmentally challenged children and the importance of further diagnostic workup when concerns arise for potential retained foreign bodies.

• Mass Spectrometry Letters
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• 제5권2호
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• pp.42-48
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• 2014

A specific and sensitive liquid chromatography-electrospray ionization tandem mass spectrometry method (LC-ESI-MS/MS) was developed and validated for the simultaneous quantification of porphyrins (coproporphyrin, pentacarboxylporphyrin, hexacarboxylporphyrin, heptacarboxylporphyrin, and uroporphyrin) in human plasma and urine. Acidified plasma samples and urine samples were prepared by using liquid-liquid extraction using ethyl acetate and protein precipitation with acetonitrile, respectively. The separation was achieved onto a Synergi Fusion RP column ($150mm{\times}2.0mm$, $4{\mu}m$) with a gradient elution of mobile phase A (0.1% formic acid in 2 mmol/L ammonium acetate, v/v) and mobile phase B (20% methanol in acetonitrile, v/v) at a flow rate of $450{\mu}L$/min. Porphyrins and the internal standard (IS), coproporphyrin I-$^{15}N_4$, were detected by a tandem mass spectrometer equipped with an electrospray ion source operating in positive ion mode. Multiple reaction monitoring (MRM) transitions of the protonated precursor ions and the related product ions were optimized to increase selectivity and sensitivity. The proposed method was validated by assessing selectivity, linearity, limit of quantification (LOQ), precision, accuracy, recovery, and stability. The calibration curves were obtained in the range of 0.1-100 nmol/L and the LOQs were estimated as 0.1 nmol/L for all porphyrins. Results obtained from the validation study of porphyrins showed good accuracy, precision, recovery, and stability. Finally, the proposed method was successfully applied to clinical studies on the autism spectrum disorder (ASD) diagnosis of 203 Korean children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권4호
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• pp.258-267
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• 2023

Objectives: This study aimed to compare the utility of the Psychoeducational Profile-Revised (PEP-R), Korean Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (K-WPPSI-IV), and Vineland Adaptive Behavior Scale, Second Edition (VABS-II) for evaluating developmental disabilities (DD) in preschool children. Additionally, we examined the correlations between the PEP-R, K-WPPSI-IV, and VABS-II. Methods: A total of 164 children aged 37-84 months were assessed. Children's development was evaluated using the PEP-R, K-WPPSI-IV, VABS-II, Preschool Receptive-Expressive Language Scale, and Korean Childhood Autism Rating Scale, Second Edition. Results: Of the 164 children, 103 had typical development (TD) and 61 had DD. The mean of the PEP-R Developmental Quotient (DQ), K-WPPSI-IV Full-Scale Intelligence Quotient (FSIQ), and VABS-II Adaptive Behavior Composite (ABC) scores were significantly higher in the TD group than in the DD group (p<0.001). The estimated area under the curve of the PEP-R DQ, K-WPPSI-IV FSIQ, and VABS-II ABC scores was 0.953 (95% confidence interval [CI]=0.915-0.992), 0.955 (95% CI=0.914-0.996), and 0.961 (95% CI=0.932-0.991), respectively, which did not indicate a statistically significant difference. The PEP-R DQ scores were positively correlated with the K-WPPSI-IV FSIQ (r=0.90, p<0.001) and VABS-II ABC scores (r=0.84, p<0.001). A strong correlation was observed between the K-WPPSI-IV FSIQ and VABS-II ABC scores (r=0.89, p<0.001). Conclusion: This study found that the PEP-R, K-WPPSI-IV, and VABS-II effectively distinguished DD from TD in preschool children, and no significant differences in utility were observed between them.

• 재활치료과학
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• 제13권2호
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• pp.9-25
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• 2024

목적 : 자폐 스펙트럼 장애(Autistic Spectrum Disorders: ASD) 아동은 감각 처리, 제한된 흥미, 행동, 인지, 사회성, 구강 운동, 소화 등 복합적인 원인으로 인해 섭식장애가 흔하게 동반된다. 주요한 섭식장애 문제로는 식사 시간 행동 문제, 까다로운 먹기, 선택적 먹기, 새로운 음식 거부, 음식 다양성 저하 등이며 이로 인해 영양 섭취 및 건강 문제, 발달, 사회적 활동 참여 제한, 가족과 보호자 스트레스를 유발하기도 한다. 따라서 ASD 아동의 섭식장애를 조기에 확인하여 적절한 중재 제공과 적합한 평가도구 사용이 필요하다. 본 논문에서는 최신 문헌 고찰을 통해 ASD 아동의 섭식장애 평가도구에 대한 심도 있는 이해를 위한 고찰을 실시하였다. 연구방법 : 본 연구는 ASD, ASD의 섭식문제, ASD의 섭식평가 등의 키워드를 검색하여 최근 약 10년간의 선행연구를 바탕으로 ASD 섭식문제 평가도구를 분석하였다. 결과 : ASD 섭식장애 평가는 직접 평가와 간접 평가로 나뉘는데 그 중, 부모와 보호자가 아동의 전반적인 상황을 척도화 한 질문지나 평가도구로 측정하는 간접 평가가 주로 사용되고 있었다. 평가는 주로 식사 시간 중 아동이 보이는 섭식 행동, 구강 및 미각 관련 감각 처리, 음식 선택 및 선호도를 확인하였으며 보호자의 섭식 태도가 아동의 섭식 행동에 미치는 영향을 평가하기도 하였다. 결론 : ASD 아동의 섭식 장애 평가는 1) 식사 시간 섭식 행동, 2) 감각 처리, 3) 섭취 음식, 4) 기타로 구분되었다. ASD 아동의 주요한 섭식장애 특징은 매우 다양하기 때문에 종합적인 평가가 이루어져야 하지만 아직 제한적이다. 또한 구강 운동 기능, 소화 등 추가적인 영역의 평가도 고려되어야 할 것으로 보인다. 작업치료사 등 연하재활 전문가는 ASD 아동의 섭식 문제, 행동, 감각 등에 대한 기본적인 이해를 바탕으로 한 종합적인 평가도구를 적용해야 할 것이다.

• 대한지역사회작업치료학회지
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• 제1권2호
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• pp.71-79
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• 2011

목적 : 감각통합에 기반을 둔 작업치료의 효과를 연구한 연구들의 체계적인 고찰을 통하여, 임상에서 치료계획 시 도움이 될 수 있는 정보를 제공하고, 앞으로 감각통합에 기반을 둔 작업치료의 연구 방향을 제시하고자 한다. 연구방법 : MEDLINE/PubMed와 AOTAPress에서 제공되는 연구논문들 중에서 1993년부터 2011년까지 발표된 아동과 청소년을 대상으로 감각통합에 기반을 둔 작업치료 효과를 살펴 본 10개의 논문을 분석하였다. 결과 : 연구대상은 감각조절장애와 자폐스펙트럼의 진단군이었으며, 중재 효과를 증명하기 위에 선택한 다른 중재유형은 여전히 과거의 체계적 고찰연구와 유사하였다. 중재기간은 대체로 감각통합에 기반을 둔 작업치료중재를 10주 이상, 20회기 이상, 적어도 주당 2~3회 정도 실시하였다. 감각통합에 기반을 둔 작업치료중재가 대체로 효과적인 편으로 특히 운동수행영역과 행동개선 영역, 학습과 관련한 교육영역이 효과적인 것으로 나타났고, 최근에는 감각처리 영역이나 작업수행영역에 감각통합중재의 효과가 있음을 GAS를 사용하여 규명하고자 하는 연구노력이 있었다. 결론 : 본 연구를 통하여 임상가들에게 감각통합에 기반을 둔 작업치료중재 효과를 증명할 수 있는 연구디자인의 최소 틀을 알고 연구계획을 실시할 수 있는 근거를 갖게 될 것이다.

• Clinical and Experimental Pediatrics
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• 제57권8호
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• pp.363-369
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• 2014

Purpose: This study examines changes in developmental profiles of children with language delay over time and the clinical significance of assessment conducted at age 2-3 years. Methods: We retrospectively reviewed the medical records of 70 children (62 male, 8 female), who had visited the hospital because of delayed language development at 2-3 years, and were reassessed at ages 5-6. Language and cognitive abilities were assessed using multiple scales at the initial and follow-up visits. Results: At the initial test, 62 of the 70 children had mental development index (MDI) below 70 of Bayley Scales of Infant Development Test II. Of the 62 children in the follow-up assessment, 30 children (48.4%) remained within the same cognitive range (full-scale intelligence quotient, FSIQ<70 of Wechsler preschool and primary scale of intelligence), 12 had borderline intellectual functioning (FSIQ, 70-85), 6 improved to average intellectual functioning (FSIQ>85), and 5 had specific language impairment, 9 had autism spectrum disorders. At the initial test, 38 of the 70 children had cognitive developmental quotients (C-DQ) below 70. Of the 38 children in the follow-up assessment, 23 children (60.5%) remained within the same cognitive range (FSIQ<70). The correlation coefficient for MDI and FSIQ was 0.530 (P<0.0001) and that for C-DQ and FSIQ was 0.727 (P<0.0001). There was a strong correlation between C-DQ and FSIQ, and a moderate correlation between MDI and FSIQ. Conclusion: Low MDI scores reflect a specific delay in cognitive abilities, communication skills, or both. The C-DQ, receptive language development quotient, and social maturity quotient also help to distinguish between children with isolated language delay and children with cooccurring cognitive impairment. Moreover, changes in the developmental profile during preschool years are not unusual in children with language delay. Follow-up reassessments prior to the start of school are required for a more accurate diagnosis and intervention.

• Clinical and Experimental Pediatrics
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• 제62권10호
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• pp.374-379
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• 2019

Background: Attention deficit hyperactivity disorder (ADHD) symptoms have a major impact on individuals, families, and society. Therefore identification risk factors of ADHD are a public health priority. Purpose: This is meta-analysis evaluated the association between maternal prepregnancy body mass index and the risk of ADHD among the resulting offspring. Methods: The search identified studies published through December 2018 in the PubMed, Web of Science, and Scopus databases. The odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CI) extracted from eligible studies were used as the common measure of association among studies. Results: A significant association was found between overweight women and the risk of ADHD among children with the pooled HR and OR estimates (HR, 1.27 and 95% CI, 1.17-1.37; OR, 1.28 and 95% CI, 1.15-1.40, respectively). This association was significant between obese women and the risk of ADHD among children and adolescents with the pooled estimates of HR and OR (HR, 1.65 and 95% CI, 1.55-1.76; OR, 1.42 and 95% CI, 1.23-1.61). Conclusion: The current epidemiological studies present sufficient evidence that prepregnancy overweight and obesity are significantly associated with an increased risk of ADHD among children and adolescents. These findings provide a new approach to preventing ADHD by controlling weight gain in the prenatal period, which should be considered by policymakers.

• 말소리와 음성과학
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• 제10권3호
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• pp.1-8
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• 2018

The vowel /o/ in Seoul Korean has been undergoing a sound change by altering the acoustic weighting of F2 and F1. Studies documented that this on-going change redefined the nature of a /o/-/u/ contrast as F2 differences rather than as F1 differences. The current study examined two cognitive factors namely executive function capacity (EF) and autistic traits, in terms of their roles in explaining who in speech community would adapt new acoustic forms of the target vowels, and who would retain the old forms. The participants, 55 college students speaking Seoul Korean, produced /o/ and /u/ vowels in isolated words; and completed three EF tasks (Digit N-Back, Stroop, and Trail-Making Task), and an Autism screening questionnaire. The relationships between speakers' cognitive task scores and their utilizations of F1 and F2 were analyzed using a series of correlation tests. Results yielded a meaningful relationship in participants' EF scores interacting with gender. Among the females, speakers with higher EF scores were better at retaining F1, which is a less informative cue for females since they utilized F2 more than they did F1 in realizing /o/ and /u/. In contrast, better EF control among male speakers was associated with more use of the new cue (F2) where males still utilized F1 as much as F2 in the production of /o/ and /u/ vowels. Taken together, individual differences in acoustic realization can be explained by individuals' cognitive abilities, and their progress in the sound change further predicts that cognitive ability influences the utilization of acoustic information which is non-primary to the speaker.

• Neonatal Medicine
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• 제25권1호
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• pp.7-15
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• 2018

We need to understand the outcomes into adulthood for survivors born either extremely low birthweight (ELBW; <1,000 g) or extremely preterm (EP; <28 weeks' gestational age), particularly their blood pressure and cardiovascular metabolic status,respiratory function, growth, psychological and mental health performance, and functional outcomes. Blood pressure is higher in late adolescence and early adulthood in ELBW/EP survivors compared with controls. In some studies, expreterm survivors have higher insulin and blood lipid concentrations than controls, which may also increase their risk for later cardiovascular disease. ELBW/EP survivors have more expiratory airflow obstruction than do controls. Those who had bronchopulmonary dysplasia (BPD) in the newborn period have even worse lung function than those who did not have BPD. As a group, they are unlikely to achieve their full lung growth potential, which means that more of them are likely to develop chronic obstructive airway disease in later life. Although they are smaller than term born controls, their weight gradually rises and ultimately reaches a mean z-score close to zero in late adolescence, and they ultimately attain a height z-score close to their mid-parental height z-score. On average, ex-preterm survivors have intelligence quotient (IQ) scores and performance on tests of academic achievement approximately 2/3 SD lower than do controls, and they also perform less well on tests of attention and executive function. They have similar high rates of anxiety and depression symptoms in late adolescence as do controls. They are, however, over-represented in population registries for rarer disorders such as schizophrenia and Autism Spectrum Disorder. In cohort studies, ex-preterm survivors mostly report good quality of life and participation in daily activities, and they report good levels of self-esteem. In population studies, they require higher levels of economic assistance, such as disability pensions, they do not achieve education levels as high as controls, fewer are married, and their rates of reproduction are lower, at least in early adulthood. Survivors born ELBW/EP will present more and more to health carers in adulthood, as they survive in larger numbers.

• The Korean Journal of Physiology and Pharmacology
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• 제22권6호
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• pp.679-688
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• 2018

Autism spectrum disorders (ASDs) are neurodevelopmental disorders that share behavioral features, the results of numerous studies have suggested that the underlying causes of ASDs are multifactorial. Behavioral and/or neurobiological analyses of ASDs have been performed extensively using a valid model of prenatal exposure to valproic acid (VPA). Abnormal synapse formation resulting from altered neurite outgrowth in neural progenitor cells (NPCs) during embryonic brain development has been observed in both the VPA model and ASD subjects. Although several mechanisms have been suggested, the actual mechanism underlying enhanced neurite outgrowth remains unclear. In this study, we found that VPA enhanced the expression of brain-derived neurotrophic factor (BDNF), particularly mature BDNF (mBDNF), through dual mechanisms. VPA increased the mRNA and protein expression of BDNF by suppressing the nuclear expression of methyl-CpG-binding protein 2 (MeCP2), which is a transcriptional repressor of BDNF. In addition, VPA promoted the expression and activity of the tissue plasminogen activator (tPA), which induces BDNF maturation through proteolytic cleavage. Trichostatin A and sodium butyrate also enhanced tPA activity, but tPA activity was not induced by valpromide, which is a VPA analog that does not induce histone acetylation, indicating that histone acetylation activity was required for tPA regulation. VPA-mediated regulation of BDNF, MeCP2, and tPA was not observed in astrocytes or neurons. Therefore, these results suggested that VPA-induced mBDNF upregulation was associated with the dysregulation of MeCP2 and tPA in developing cortical NPCs.