• Journal of Korean Philosophical Society
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• v.145
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• pp.167-194
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• 2018

According to the result of 2017 youth statistics, the first rank of the death cause of Korean youth is suicide for nine years. The recent study on factors affecting juvenile suicide presents: family factors; character and psychological factors; mental disease factors; suicide-triggering factors; school factors; and protection factors; and so on. What is required to the youth who are vulnerable to the confusion of identity and the adjustment of emotion or impulse is not only drug treatment or mental therapy but also the support of family or society where adolescents are encouraged to be introspective and form their identity in a healthy approach in the diverse humanistic philosophical dimension. This study is going to pay attention to the aesthetic existence of Kierkegaard who provided the foundation of human existential identity centered on three stages of existence. For this purpose, we attempt to search for the philosophical basis for the understanding of juvenile identity centered on the analysis of Kierkegaard's Either / Or Volume I (Entweder - Oder Teil I). Especially, we are going to attempt the understanding of aesthetics of youth through the analysis of three stages of desire (Begierde) suggested in Chapter 2 of this book. Herewith he suggests aesthetic existence through 'desire', and aesthetic existence as the desire again through three stages of 'dreaming ($tr{\ddot{a}}umend$)' desire, 'searching (suchend)' desire, and 'desiring (begehrend)' desire. Based on this analysis of three stages, we plan to graft the roots of sociological factors presented as the cause of youth's suicide onto the analysis of existential philosophy. Through this, we attempt to grope for the diagnostic and healing discourse which Kierkegaard's existential analysis can present in the formation and recognition of youth identity and disclose a factor of the emotion or the disorder of impulse adjustment as well as depression suggested as the main contributing factor of youth's suicide and search for philosophical discourse for the prevention of juvenile suicide.

• Korean Public Health Research
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• v.44 no.4
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• pp.87-97
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• 2018

Background: Recently, the prevalence of obesity (body mass index [BMI] ${\geq}25kg/m^2$) has been increasing rapidly worldwide over a short period. In Korea, the prevalence of obesity has also increased rapidly due to the rapid socio-economic development and lifestyle changes, with differing patterns according to gender. This study aimed to compare the change in obesity prevalence according to gender among the adult population in Korea using representative data, the National Health Check-up Database (NHCD), to follow-up individuals who had undergone checkups during both years in Korea (2011~2013). Methods: To analyze the changes in obesity prevalence in the recent two years, data regarding men and women who had undergone health check-ups in both two years (2011, 2013) were extracted. The final study population comprised 144,934 persons: 83,604 (58%) males and 61,330 (42%) females. Chi-square test within a univariate analysis, and the level of factor difference was verified with t-test, one-way ANOVA and multiple comparison. Results: In 2011, one out of three participants was obese (BMI ${\geq}25kg/m^2$; male, 37.7%; female, 27.3%) and more than half of the subjects were overweight (BMI ${\geq}23kg/m^2$; male, 65.6%; female, 50.4%) requiring obesity management. For the two years, the BMI of the participants significantly increased (p < .0001) and the prevalence of obesity increased among both males and females. The prevalence of obesity was higher among both genders with a longer duration of smoking, more smoking, family history of hypertension, and family history of diabetes. However, residence, income level, drinking status, psychiatric disorder, disability status and severity of disability were the opposite gender. Conclusion: In the analysis of data, the prevalence of obesity among both men and women was increasing. The degree of change in the prevalence of obesity among men and women was different in each variable. Thus, it will need to consider gender in developing health policies for obesity mediation and to provide integrated healthcare and management for those people.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.2
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• pp.43-49
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• 2018

Maple syrup urine disease (MSUD, OMIM#248600) is a rare and autosomal recessively-inherited metabolic disorder that is caused by mutations in the branched-chain ${\alpha}$-ketoacid dehydrogenase (BCKDH) genes. It prevents the normal breakdown of branched-chain amino acids (BCAAs), such as leucine, isoleucine, and valine, and leads to poor feeding, lethargy, abnormal movements, seizure, and death if untreated. Here, we report the case of a Korean newborn of biochemically- and genetically-confirmed MSUD manifesting lethargy and central apnea, the acute state of which was successfully treated. The molecular genetic investigation revealed two novel heterozygous mutations (p.Ala32Phefs*48 and p.Val 130Phe) in BCKDHB, and both parents were confirmed as carriers. We emphasize the importance of early diagnosis and prompt introduction of specific treatment for MSUD in life saving and prognosis.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.19 no.1
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• pp.1-11
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• 2019

Purpose: Congenital hypothyroidism (CH) is the most common congenital endocrine disorder. The purpose of the present study was to determine the incidence of CH in South Korea during the period from January 1991 to March 2004. Methods: Central data from each city branch of SCL (Seoul Clinical Reference Laboratories) in Yongin, South Korea, was gathered and collectively analyzed. Newborn screening (NBS) for CH was based on measuring the levels of neonatal thyroid stimulating hormone (TSH) and free T4 (a cut-off of 20 mIU/L and less than 0.8 ng/dL, respectively). Results: During the study period, 671,805 live births were screened for CH based on TSH and free T4 ELISA assays. A total of 159 newborns were deemed positive for CH out of 671,805, with a corresponding incidence of 1 in 4,225. When a cut-off of 20 mIU/L was used in TSH assays, the associated sensitivity, specificity, and positive predictive values (PPV) were 100.0%, 99.7%, and 10.8%, respectively. When a cut-off of 0.8 ng/dL in free T4 assays was used, the associated sensitivity, specificity, and PPV were 100.0%, 98.5%, and 3.9%, respectively. Conclusion: CH incidence in South Korea as evidenced by the results of NBS was compared with its incidence and comparable to the other countries prior to 2004.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.2
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• pp.35-42
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• 2018

Purpose: To follow up Korean patients with metabolic and endocrine disorders ascertained by Korea Genetics Research Center, and assess the long-term effectiveness of extended newborn screening program in Korea. Methods: From January 2000 to December 2017, tandem mass spectrometry and fluoroimmunoassay were employed in extended newborn screening (NBS). The NBS program obtained dried blood spots from 283,626 babies, 48 hours after birth, and screened for galactosemia, congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH), and 50 preventable inborn errors of amino acid, fatty acid, and organic acid metabolism. Results: 28 cases of amino acid disorders, 75 cases of organic acid disorders, 27 cases of fatty acid disorders, 51 cases of urea cycle disorders, 127 cases of CH, 14 cases of CAH, and 15 cases of galactosemia were ascertained through NBS and subsequent confirmatory laboratory tests. Patients with amino acid metabolic disorders, galactosemia, CH, or CAH were more likely to have a better long-term outcome if detected early. Early management of MSUD led to much better outcome in over 90%. Despite early intervention, 32% of other organic acidemia cases still resulted in developmental delay and neurological problems. Fatty acid disorders showed varied results; those with EMA and MCAD had a good outcome, but those with VLCAD had serious neurological problems and considerably higher mortality. 75% with UCD experienced serious neurological complications and higher mortality. Conclusion: The nation-wide NBS program must be accompanied by comprehensive long-term management and physician and family education of inborn errors of metabolism for a better outcome.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.19 no.1
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• pp.12-19
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• 2019

Purpose: Isolated methylmalonic acidemia (MMA) is an autosomal recessive inherited disorder of propionate metabolism. There are two subtypes of MMUT gene defects. $Mut^0$ represents complete loss of methylmalonyl-CoA mutase (MCM) activity while mut- is associated with residual MCM activity, which can be stimulated by hydroxocobalamin (OHCbl) supplementation. The objective of this study is to investigate cobalamin responsiveness and mutations present in Korean MMA population. Methods: We evaluated 10 MMA patients using somatic cell complementation analysis on their fibroblasts to measure MCM activity and vitamin B12 responsiveness for the optimal treatment. MMUT gene was sequenced to identify the MMA mutations. Results: For all patients, the incorporation of $[^{14}C]-propionate$ was low, and there was no response to OHCbl. The incorporation of $[^{14}C]-methyltetrahydrofolate$ and $[^{57}Co]-CNCbl$ fell within the normal range. There was adequate synthesis of methylcobalamin while the synthesis of adenosylcobalamin was low. The complementation analysis showed all patients were $mut^0$. The sequence analysis identified 12 different MMUT mutations, including 2 novel mutations, p.Gln267Ter and p.Ile697Phe, were identified. All the patients in this study had neonatal onset of symptoms, belonged to $mut^0$ complementation class, and as a result, showed no cobalamin responsiveness. Conclusion: No Korean MMA patient showed cobalamin responsiveness.

• The Journal of Korean Academy of Sensory Integration
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• v.16 no.2
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• pp.1-14
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• 2018

Objective : The present study investigated the effects of group play activities based on Ayres Sensory $Integration^{(R)}$ (ASI) on sensory processing ability, social skill ability and self-esteem of low-income children with attention deficit hyperactivity disorder (ADHD). Methods : A total of 20 low-income participants with children with ADHD were recruited and divided into an experimental group (n=10) and a control group (n=10). Sensory processing ability was measured via the Short Sensory Profile (SSP). Social skill ability was measured via the Social Skills Rating System (SSRS). To measure self-esteem, the Rosenberg's self- esteem scale was used. The experimental group received the $ASI^{(R)}$ group play activities for 50 minutes, twice per week for six weeks, while the control group did not receive an intervention. Level of significance of all statistical analyses was .05. Results : Social skill ability (F=4.443, p=.05), cooperation (F=5.328, p=.035) and self-esteem (F=5.358, p=.033) differed significantly between groups after the intervention. Conclusion : Our findings indicate that the group play activities based on $ASI^{(R)}$ are effective in improving social skill ability and self-esteem. This study provided a theoretical basis for the claim that sensory integration therapy should be applied in general elementary schools.

• The Korean Journal of Vision Science
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• v.20 no.4
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• pp.497-504
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• 2018

Purpose : The purpose of this study was to investigate the temperature changes of the ocular surface before and after cataract surgery using thermography of a thermal imaging camera. Methods : The study included 75 patients (75 eyes) aged from 50 to 79 years who underwent cataract surgery. In the past, those who underwent corneal-related surgery, wearing contact lens, disorder of tear secretion and taking medication for systemic disease were excluded from this study. The temperature changes of the eyeball surface were measured using a thermal imager (Cox CX series, Answer, Korea) following Tear Break Up Time (TBUT) test, Mcmonnies questionnaire and Schirmer's Test in real time, Results : While the temperature of preoperative ocular surface was $35.20{\pm}0.54^{\circ}C$ and that of postoperative temperature was $35.30{\pm}0.53^{\circ}C$, the difference was not significant. The temperature changes in the ocular surface were statistically significant at $-0.12{\pm}0.08{\Delta}$ ($^{\circ}C/sec$) before the surgery and $-0.18{\pm}0.07{\Delta}$ ($^{\circ}C/sec$) after the surgery. In comparison of the age groups, it was shown that the changes in the surface temperature before the surgery were from $-0.19{\pm}0.05{\Delta}$ ($^{\circ}C/sec$) to $-0.14{\pm}0.09{\Delta}$ ($^{\circ}C/sec$) in the 50s group, and from $-0.12{\pm}0.08{\Delta}$ ($^{\circ}C/sec$) to $-0.15{\pm}0.07{\Delta}$ ($^{\circ}C/sec$) in 60s group, and $-0.18{\pm}0.07{\Delta}$ ($^{\circ}C$) to $-0.12{\pm}0.08{\Delta}/sec$) in the 70s group, showing significant changes in the ocular surface temperature at all ages. Conclusion : Following the cataract surgery, all the indicators of dry eye syndrome were decreased, and eye surface temperature changes were significant. The thermography technique of the ocular surface would be expected to be useful for the evaluation of various dry eye syndromes because it is easy to evaluate dry eye syndrome noninvasively and can be quantified.

• Sleep Medicine and Psychophysiology
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• v.25 no.2
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• pp.51-57
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• 2018

Objectives: Previous studies have shown that periodic limb movements in sleep (PLMS) could be one of risk factors for cardiovascular morbidity. The purpose of this study was to investigate the association between PLMS and blood pressure changes during sleep. Methods: We analyzed data from 358 adults (176 men and 182 women) aged 18 years and older who were free from sleep apnea syndrome (Respiratory Disturbance Index < 5) and sleep disorders such as REM sleep behavior disorder or narcolepsy. Demographic characteristics, polysomnography records, and clinical variable data including blood pressure, body mass index, alcohol, smoking, and current medications were collected. In addition, self-report questionnaires including the Beck Depression Index, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were completed. Blood pressure change from bedtime to awakening was compared between the two periodic limb movement index (PLMI) groups [low PLMI ($PLMI{\leq}15$) and high PLMI (PLMI > 15)]. Blood pressure change patterns were compared using repeated measures analysis of variance. Results: Systolic blood pressure in the high PLMI group was lower than that in the low PLMI group (p = 0.036). These results were also significant when adjusted for gender and age, but were not statistically significant when adjusted for BMI, alcohol, smoking, anti-hypertension medication use and sleep efficiency (p = 0.098). Systolic blood pressure dropped by 9.7 mm Hg in the low PLMI group, and systolic blood pressure in the high PLMI group dropped by 2.9 mm Hg. There was a significant difference in delta systolic blood pressure after sleep between the two groups in women when adjusted for age, BMI, alcohol, smoking, antihypertensive medication use and sleep efficiency (p = 0.023). Conclusion: PLMS was significantly associated with a decreasing pattern in nocturnal BP during sleep, and this association remained significant in women when adjusted for age, BMI, alcohol, smoking, antihypertension medication use and sleep efficiency related to blood pressure. We suggest that PLMS may be associated with cardiovascular morbidity.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.102-111
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• 2018

Objectives : This study aimed to investigate the relationship between personality characteristics of medical students at their admission and the level of depression, anxiety, and resilience at their third year. Methods : Self-reported questionnaires were conducted to the students at the beginning of the first year and the third year. When the students in their first year, they performed the personality assessment inventory, the Beck depression inventory, and the Beck anxiety inventory. When they were in the third year, the students answered the composite Scale of morningness and Conner-Davidson resilience scale-10 in addition to the BDI and BAI. Multiple linear regression analyses were performed to identify predictors of the level of depression, anxiety, and resilience. Results : Of the subscales of depression in the PAI, the physiological depression (${\beta}=-0.285$, p=0.049) associated with increase in the depression from the first to the third year. Among the anxiety-related disorder subscale in the PAI phobia (${\beta}=0.119$, p=0.022) and traumatic stress (${\beta}=0.375$, p=0.007) associated with the level of depression at third grade. Somatization (${\beta}=0.631$, p<0.001) in the PAI associated with the level of anxiety at third year. The anxiety (${\beta}=-0.531$, p<0.001) in the PAI was positive associated with the resilience at third grade. Conclusions : This study showed that certain personality characteristics at admission had significant relationships with the level of depression, anxiety, and resilience at the third grade medical students.