• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.1
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• pp.3-15
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• 2000

Objectives：There has been a rapid expansion of studies aimed at elucidating the genetic basis of autistic disorder, especially it’ relationship to fragile-X syndrome. The detection of fragile X chromosome(Xq27.3) by cytogenetic analysis has revealed many difficulties in testing. Therefore, to explore the relationship between autistic disorder and fragile X syndrome, this study administered molecular biologic methods which examined an unstable CGG repeat within the fragile X mental retardation-1(FMR-1) gene. Methods：Ninety nine autistic children and eight normal control children were tested. The number of CGG repeats within FMR-1 gene was measured after amplification by PCR, and cytogenetic analysis was also carried out to detect fragile site Xq27.3. Southern blot hybridization, using StB12.3 and/or Pfxa3 probe, was done for the patients showing expansion of more than 50 CGG repeats (premutation). Results：All but two autistic patients had no expansion in CGG repeats by PCR and there was no significant statistical difference in number of CGG repeat in comparison with normal control. Two autistic patients, considered as premutation by PCR analysis, had no full mutation or premutation by Southern blot hybridization. All autistic children tested did not have any abnormal karyotype or fragile site Xq27.3. Conclusions：These results suggest that autistic patients may not have abnormality in FMR-1 gene or abnormal expansion in CGG repeat. In conclusion, fragile X syndrome may not be antecedent of autistic disorder.

• Journal of agricultural medicine and community health
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• v.34 no.1
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• pp.24-33
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• 2009

Objectives: In September 2008, an outbreak of diarrhea occurred among students attending Y school in Yeongcheon-si. Shigella sonnei was cultured from some of the rectal swabs. An epidemiological investigation was carried out to determine the source of the infection and the mode of transmission of the shigellosis outbreak. Methods: The index case lived in the D rehabilitation facility in Gyeongsan-si and an additional epidemiological investigation was carried out there. The cases could not be questioned due to their mental handicaps. The teachers were interviewed instead. A patient case was defined as a resident with diarrhea more than one time a day from September 18 to September 26, 2008 or a resident with confirmed Shigella sonnei at the Y school or the D rehabilitation facility. Results: The attack rate was 1.2% (8 persons) among 659 persons in the Y school and D rehabilitation facility. Five persons were microbiologically confirmed to have the infection and three persons were diagnosed on the basis of symptoms. Shigella sonnei was cultured from five of the 659 rectal swabs. However, 80 environmental specimens including drinking water, preserved foods, and cooking utensils were negative. All eight patients were Y school students and had been living in group boarding and lodging. Six of them lived in the D rehabilitation facility and two lived in the dormitory at the Y school. Five cases showed pulsed-field gel electrophoresis patterns that were identical for Shigella sonnei. Conclusions: The results of this study showed that the infection source of the shigellosis outbreak, in the two places, were identical. It is likely that the infections initially spread from a teacher or volunteer and then among the students.

• The Korean Journal of Rehabilitation Nursing
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• v.4 no.2
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• pp.240-247
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• 2001

The history of rehabilitation of disabilities in Korea began with the foreigners and missionaries who were interested in it after Korean War. In 1981, Disabled Persons Welfare Act was enacted and the 88 Paralympics brought the nations attention to the welfare and rehabilitation of persons with disabilities. Since then, the facilities and the services for the disabled persons have expanded rapidly and the rehabilitation treatment and nursing intervention are drawing more attention. Against this background, the survey on the current status of disabilities, welfare service, facilities, and rehabilitation nursing was conducted. The results of this survey are as follows. 1. According to the 2000 census of disabilities, the number of persons with disabilities in Korea is estimated at 1,449,500, or 3.09% of the entire Korean population, 0.74% up from 2.35% in 1995. 2. Disability Types in 2000 The 2000 census showed that the persons with disabilities numbered 1,449,496 out of the total population and 1,024,371 persons are registered for disability, making up 70.7% of the estimated disabled population. Among them, physically disabled persons accounted for the largest 41.7% (605,127) and mentally retarded persons stood at the smallest 9% (13,481). 3. Percentage of Disability Presence The survey showed that more than 90% of disability were acquired. However, 44.8% of mental disability and 61.4% of hearing/speaking disability were not acquired after birth. This means that these disabilities happened by congenital cause or birth accident. 4. Yearly Figure of Registered Disabled Persons In 1989, 218,601 persons registered for disability and, in 2000, the number increased by 4.7 times to 1,024,371. These figures are different from the actual number of disabled persons. According to the 1995 census, 1,053,486 were disabled persons but only 378,323registered for disability. And, in the 2000 census, 1,024,371 out of the 1,449,496 of disabled persons registered for disability. 5. Welfare Service for Persons with Disability 62.6% of the total disabled people are registered and physically disabled persons accounted for the highest percentage of 96.7%. 26.5% of non-registered disabled people said that they didnt know the registration procedure. The rest of them replied that they didnt think they were disabled or that registration didnt seem to give any benefits. 6. Welfare Policies for Disabled Persons The welfare benefits given to the disabled are as follows: Issuance of disabled sign for car drivers, Permission to use LPG fuel, Communication fee reduction, Tax exemption related to cars, Reduction of public facility fees, Household allowance, Tax reduction or exemption, Medical allowance and education subsidy for children, and Housing. 7. Current Condition of Welfare Facilities by Disability Type The welfare institutions for disabilities numbered 188 in total and they can accommodate 16,823 persons. Categories of these institutions are physical disability(37), visual disability(10), hearing/speaking disability(14), mental retardation(59), and sanatoriums(68). 8. Human Resource of Rehabilitation of Disabilities Advanced education programs include rehabilitation nursing in its curriculum and this was selected as the program of Korean Academic Society of Nursing in 1990. In November 1997, Korean Academic Society of Rehabilitation Nursing was launched and many academic meeting and seminars were held. This organization is also making efforts to develop the education program for qualified rehabilitation nursing professionals and to develop the standards of rehabilitation nursing practice. In the professionals of the rehabilitation, there are rehabilitation specialist, physical therapist, speech therapist, occupational therapist. It is needed to come up with the measures to supply stable human resources following the demand of disabled persons and to recognize the private certificates for rehabilitation professionals as official ones after reviewing the education and training programs of private institutions. 9. Rehabilitation Nursing 1) Rehabilitation nursing was taught as an independent subject in 11 undergraduate programs and 9 graduate programs. 2) Research on rehabilitation nursing in Korea were 24 experimental research and 11 non-experimental research. The intervention of experimental research were mostly education and exercise rehabilitation programs. 3) In the three rehabilitation hospitals, nursing is divided into two categories, direct nursing and education & counseling. Direct nursing includes tracheostomy or nasogastric tube care, urination and defication, skin care, pain control, complication prevention and care, prevention of injury from a fall, etc.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.103-111
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• 1985

Childhood epilepsy which has high prevalence rate and inception rate is one of the commonest problem encountered in pediatrician. In contrast with epilepsy of adult, in childhood epilepsy, more variable and varying manifestations are found because the factors of age, growth and development exert their influences in the manifestations and the courses of childhood epilepsy. Moreover epileptic children have associated problems such as physical and mental handicaps, psychologicaldisorders and learning disability. For these reasons pediatrician who deals with epileptic children experiences difficulties in making diagnosis and managing them. In order to improve understanding and management of childhood epilepsy, authors reviewed 103 cases of epileptic patients seen at pediatric department of Yeungnam University Hospital retrospectively. The patients were classified according to the type of epileptic seizure. Suspected causes of epilepsy, associated conditions of epileptic patients, age incidence and the findings of brain CT were reviewed. Large numbers of epileptic patients (61.2%) developed their first seizures under the age of 5. The most frequent type of epileptic seizure was generalized ionic-clonic, tonic, clonic seizure (49.5%), followed by simple partial seizure with secondary generalization (17.5%), simple partial seizure (7.8%), a typical absence (5.8%) and unclassified seizure (5.8%). In 83.5% of patients, we could not find specific cause of it, but in 16.5% of cases, history of neonatal hypoxia (4.9%), meningitis (3.9%), prematurity (1.9%), small for gestational age (1.0%), CO poisoning (1.0%), encephalopathy (1.0%), DPT vaccination (1.0%), cerebrovascular accident (1.0%) and neonatal jaundice (1.0%) were found, 30 cases of patients had associated diseases such as mental retardation, hyperactivity, delayed motor milestones or their combinations. The major abnormal findings of brain CT performed in 42 cases were cortical atrophy, cerebral infarction, hydrocephalus and brain swelling. This review stressed better designed classification of epilepsy is needed and with promotion of medical care, prevention of epilepsy is possible in some cases. Also it is stressed that childhood epilepsy requires multidisplinary therapy and brain CT is helpful in the evaluation of epilepsy with limitation in therapeutic aspects.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.67-77
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• 1990

This study was intended to analyse the relation between the psychic traumatic experience and the psychological health of the aged. The authors carried out this study by means of the combined anxiety-depression scale(CADS) and the preadolescence traumatic experience scale(PTES) with 278 aged men and women residing in Taegu from September to October 1988. The results were as follows : 1. Based on the scores avaluated by CADS, the scores of the both groups showed that comparative group was accounted for $40.15{\pm}6.19$, while the experimental group for $57.75{\pm}6.37$, which showed significantly higher score in the experimental group(p<0.001). 2. The experimental group showed significantly higher early experience score than the comparative group in the dietary difficulty, alcoholism among family members, disunion between husband and wife, trouble between mother and children, early mother loss, parent's indifference and unwanted birth(p<0.001). 3. The experimental group showed higher early experience score than the comparative group by sex, age, marital status and grown location(p<0.001). 4. When the subjects were included in the unemployed and in the middle or low classes and their parents were engaged in agriculture and commercial business and believing in buddhism or non-religion, showed higher experience score (p<0.001).

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.43-46
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• 2007

Purpose : Neonatal bacterial meningitis has been known that its mortality and morbidity is high and its neurologic complications are common. This study was performed to review of the etiology of neonatal bacterial meningitis in Busan, Korea. Methods : We retrospectively analyzed 21 medical records of patients who were diagnosed neonatal bacterial meningitis in four university hospitals in Busan from January 1997 to December 2005. We analyzed age at onset of symptoms, symptoms at admission, causative organisms, and complications. Results : There were 11 male patients and 10 female patients. One premature neonate was included. 7 patients had symptoms at 2-3 weeks after birth and 6 patients at 1-2 weeks after birth. 18 cases had fever, 8 cases had seizure and some had poor feeding, lethargy and irritability. The most common organism causing neonatal bacterial meningitis was Group B streptococcus (GBS). 11 cases were due to GBS, 3 cases due to E. coli, 3 cases were due to Klebsiella pneumoniae, and 2 cases due to Streptococcus pneumoniae. one Listeria monocytogenes and one Enterobacter cloacae were included. 18 patients were alive and 3 patients died. Mental retardation, developmental delay and epilepsy occurred in a living patient. Conclusions : Although this was a retrospective study, we found that Group B streptococcus (GBS) was the most common organism causing neonatal bacterial meningitis and this data is nearly same as others in the world.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.2
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• pp.239-250
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• 2005

Objective : The purpose of this study was obtaining data on the efficacy and safety of risperidone in child and adolescent psychiatric patients. Method : Thirty one children and adolescents (males n=18, females n=13, age ranged from 5.4 to 17.3 years) treated with risperidone were selected among child and adolescent psychiatric inpatients of Seoul National University Hospital from January, 2001 to June, 2002, and charts for them were reviewed retrospectively. Results : The primary psychiatric disorders treated with risperidone were schizophrenia and other psychosis, bipolar I disorder with psychotic features, Tourette's disorder, autism spectrum disorders, mixed receptive and expressive language disorder, attention deficit-hyperactivity disorder, conduct disorder and obsessive-compulsive disorder. twelve of these had comorbid mental retardation. Primary target symptoms of risperidone were psychotic symptoms (n=13 or $41.9\%$), behavioral symptoms (n=10 or $32.3\%$) including aggression, impulsivity, hyperactivity, stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics (n=8, $25.8\%$). The efficacy of risperidone was measured by clinical global improvement (CGI) for target symptoms, $67.7\%$ of subjects showed moderate or marked improvements and its therapeutic effect appeared to be maintained during at least 7.5 months. Mean daily dosage of risperidone was $0.05{\pm}0.01mg/kg$, the group with psychotic symptoms had significantly higher mean daily dosage (0.07mg/kg) compared with other two groups (0.04mg/kg) with behavioral symptoms or tics. A variety of adverse events were reported in this study : weight gain (n=23) most commonly reported, extrapyramidal symptoms (n=15), autonomic symptoms (n=6), sedation (n=5) and symptoms related to hyperprolactinemia (n=2) etc. Although there was no drug change related to the adverse events of risperidone, and $90\%$ of subjects at their last visits were maintained on it, thus its tolerability appeared good. Conclusions Results suggest that risperidone may be relatively safe and effective drug in managing a wide variety of child and adolescent psychopathologies such as psychotic symptoms, behavioral symptoms including aggression, impulsivity, hyperactivity and stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics. Controlled and long-term studies of efficacy and safety of risperidone treatment for children and adolescents are recommended in the future.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.67-75
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• 2002

Objectives：This study was conducted to investigate the degree of psychopathologies of the family members of children with chronic convulsive disorder and evaluate the structures and dynamics of those families. Methods：The participant patients and family members were recruited from the population attending the outpatient clinic of department of pediatric neurology in Seoul National University Hospital in Korea. All the patients had idiopathic chronic convulsive disorder. Any patient with mental retardation, pervasive developmental disorder and gross brain pathology was excluded. As controls, normal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The author interviewed the children and their family members twice and obtained informations about patient-parent relationship, patient-sibling relationship and others. For in-depth evaluation, we used family environment scales(FES), symptom Checklist-90-revised(SCL-90-R), self administered dependency questionnaire for mother(SADQ). Results：After interviewing with the parents of epileptic children, overprotection of parents, hostile feeling of siblings toward index children were higher than controls. The parental conflict was also more expressed than control families. According to results from FES, the scores of the subscales of expression, achievement-orientation, intelligence-orientation and active recreation were significantly lower than control group. The epileptic children showed higher dependency to parents especially in affection, communication and traveling areas of SADQ than control group. Maternal psychopathologies evaluated by SCL-90-R were much higher than the mothers of controls. According to T scores of SCL-90-R, about 40% of mothers with epileptic children had the risk of clinically significant depressive or anxiety disorders. Conclusion：These results suggested that the family members of epileptic children had more relationship problems and psychopathologies than control group and some mothers might have clinically significant depressive or anxiety disorders. so, effective psychiatric family interventions are needed for resolution of conflict and psychopathologies of family members.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.117-128
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• 2002

Objectives：For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods：Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results：(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions：Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.2
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• pp.270-278
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• 2005

Objectives : This study is to understand the clinical characteristics and course of inpatient severe ADHD. Methods : This study retrospectively investigated the chief complaints, history, demographics, neuropsychologic test, psychosocial status of 63 (male 58, female 5) inpatients from a single center with severe attention deficit/hyperactivity disorder(ADHD) during January 1, 1996 to October 31, 2002. Results : The patients with inpatient severe ADHD revealed a male to female ratio of 11.6 : 1 and the average age of onset was 5.3 years(63.6 months, SD 24.3 months) . Comorbidities were noted in 56/63 $(88.9\%)$ patients with the following frequencies : comorbid conduct disorder, 35$(55.6\%)$, mental retardation (MR), 24$(38.1\%)$, mood disorder, 5$(7.9\%)$, tic and Tourette's disorder, 4$(6.4\%)$, oppositional defiant disorder, 4$(5.0\%)$. Chief complaints for admission related to ADHD in 23$(36.5\%)$ patients while 37$(58.7\%)$ patients admitted due to symptoms associated to conduct disorder (CD). The mean onset age of comorbid delinquency was 9.0 years (108.2 months, SD28.8 months), and the average interval between onsets of ADHD and delinquency was 3.6 years (42.9 months, SD32.0 months). Patients who showed early delinquency tended to have an earlier onset of ADHD (p<0.05). Conclusion : The demographics, natural course, and psychosocial factors of hospitalized ADHD patients were similar to prior studies of ADHD in the general population. The onset of age was 5.3 years, and the onset of comorbid delinquency was 9.0 years. The earlier symptoms of ADHD manifested, the earlier delinquency appeared. Most patients were admitted due to chief complaints related to CD. Comorbidities, most of which were CD, were seen in $88.9\%$ of the patients.