• Mood & Emotion
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• v.10 no.1
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• pp.13-21
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• 2012

Suicide is a complex behavior associated with various neurobiological and psychosocial factors. It is considered that genetic polymorphism combined with environmental stress such as child-adolescent trauma make differences in neurobiological systems, which cause psychiatric disorders or pessimistic personality, impulse-aggressive behaviors, lack of judgment, and finally result in suicidal behavior. Much progress in the neurobiology of suicide has been made over the several decades. There seems to be a hereditary disposition to suicide independent of psychiatric disorder. The changes in neurotransmitters, neurohormones, neurotrophic factors, cytokines, lipid metabolisms related with their genetic polymorphism can contribute to disturbance of signal transductions and neuronal circuits vulnerable to suicide. It is likely that the main factors are dysfunctions of serotonin (5-HT) and hypothalamus-pituitary-adrenal (HPA) axis. Our understanding about the neurobiology of suicide is still limited. However, clinical practice could be assisted by neurobiological findings capable of making the detection of risk populations with higher sensitivity and the development of new treatment interventions. The settlement of biological markers in suicidal behaviors and their relationships is required.

• Childhood Kidney Diseases
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• v.27 no.2
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• pp.97-104
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• 2023

Purpose: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) are frequently employed to counteract the detrimental effects of proteinuria on glomerular diseases. However, the effects of ARBs remain poorly examined in pediatric patients with immunoglobulin A (IgA) nephropathy. Herein, we evaluated the efficacy and safety of losartan, an ARB, in pediatric IgA nephropathy with proteinuria. Methods: This prospective, single-arm, multicenter study included children with IgA nephropathy exhibiting proteinuria. Changes in proteinuria, blood pressure, and kidney function were prospectively evaluated before and 4 and 24 weeks after losartan administration. The primary endpoint was the difference in proteinuria between baseline and 24 weeks. Results: In total, 29 patients were enrolled and received losartan treatment. The full analysis set included 28 patients who received losartan at least once and had pre- and post-urinary protein to creatinine ratio measurements (n=28). The per-protocol analysis group included 22 patients who completed all scheduled visits without any serious violations during the study period. In both groups, the mean log (urine protein to creatinine ratio) value decreased significantly at 6 months. After 24 weeks, the urinary protein to creatinine ratio decreased by more than 50% in approximately 40% of the patients. The glomerular filtration rate was not significantly altered during the observation period. Conclusions: Losartan decreased proteinuria without decreasing kidney function in patients with IgA nephropathy over 24 weeks. Losartan could be safely employed to reduce proteinuria in this patient population. ClinicalTrials.gov trial registration (NCT0223277)

• Korean Journal of Culture and Social Issue
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• v.10 no.spc
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• pp.177-209
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• 2004

This paper provides a theoretical and conceptual framework for understanding adolescent culture and educational achievement in Korea. In the first part of the paper, the authors outline a research paradigm in cultural psychology and adolescent culture. In the second section, the traditional family structure, the role of parents, and how they have been changed by modernization are outlined. In the third section, socialization practices and parent-child relationship are reviewed. In the fourth section, Western theories that have been developed to explain educational achievement and their limitations are examined. In the fifth section, factors that contribute to educational success of Korean students are presented. In the final section, the impact of centralized, standardized, and rigid educational system that is imposed on adolescents is discussed. The highly regulated and centralized bureaucracy restricts educational and career opportunities for adolescents and it is responsible for the high rate of violence, delinquency, and bullying in Korea. The need for encouraging civil society that allows for diversity of ideas and skills and at the same time maintaining strong relational bonds are discussed.

• Korean Journal of Culture and Social Issue
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• v.9 no.2
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• pp.127-164
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• 2003

This study investigates how Korean children and adolescents perceive their parents using the indigenous psychological approach. An open-ended questionnaire was developed by the first two authors to investigate reasons why children and adolescents feel grateful, respect, indebted, close, conflict, and distance with their parents. A total of 763 participants (212 grade three students, 267 grade eight students, and 284 grade eleven students) completed the questionnaire. The results can be summarized into three main points. First, the vast majority of children and adolescents feel grateful, respect, and indebted to their parents. They feel grateful, respect and indebted for the sacrifice and suffering they experience looking after the family. Moreover, they respects their parents because of their sincerity, blood relationship, benevolence, guidance and educational support. They feel indebted since they did not obey them, were not able to meet their expectations, and were not diligent in their schoolwork. They felt especially close to their mother. The conflict they felt was due to generational gap and in their academic performance. Second, age affects how they perceive their parents. The parent-child conflict increases with age. The feeling of indebtedness also increase with age. However, the feeling of gratefulness and respects decreases with age. The feeling of closeness with father also decreases with age. Third, socio-economic status and educational achievement of children and adolescent affect the perception of their parents. Those with higher academic grade and socio-economic status are more likely to feel respect and indebtedness and less likely to feel conflict and distance.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.1
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• pp.26-36
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• 2024

Purpose: We investigated the role of CD8⁺T cells as host immune factors in pediatric patients with Helicobacter pylori gastritis. Methods: Gastric mucosal tissue and blood samples were collected from 39 children, including 11 children with H. pylori infection and 28 children as controls. Anti-CD8 and anti-T-bet antibodies were used for immunohistochemistry of the gastric mucosa. For the cell surface and intracellular staining, peripheral blood mononuclear cells were stained with anti-IL7Rα, anti-CX3CR1, anti-CD8, anti-T-bet, and anti-IFN-γ antibodies. Cytokines of sera such as tumor necrosis factor alpha (TNF-α) and CX3CL1 were analyzed using enzyme- linked immunosorbent assay (ELISA). Results: In the immunohistochemistry of gastric mucosa, the frequency of CD8⁺ and T-bet⁺ T cells cells was higher in the H. pylori-positive group than in the control group (26.9± 7.8% vs. 16.9±3.3%, p<0.001; 5.0±2.5% vs. 2.2±0.7%, p=0.001). Between the control and H. pylori-positive groups, the frequency of IL-7Rα^lowCX3CR1⁺ CD8⁺ and T-bet⁺ INF-γ⁺ CD8⁺ T cells were not significantly different between surface and intracellular staining, respectively (40.4±24.0% vs. 38.2±17.8%, p=0.914; 40.4±24.0% vs. 38.2±17.8%, p=0.914). In the ELISA, no significant differences in TNF-α and CX3CL1 concentrations were observed between the control and H. pylori-positive groups (34.3±12.1 pg/mL vs. 47.0±22.6 pg/mL, p=0.114/0.5± 0.1 pg/mL vs. 0.5±0.1 pg/mL, p=0.188). Conclusion: CD8⁺ T and Th1 cells, which secrete IFN-γ, might play important roles in the mucosal immunity of the stomach in children with H. pylori infection.

• The Journal of Korean Academy of Sensory Integration
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• v.21 no.3
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• pp.1-12
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• 2023

Objective : The purpose of this study was to compare the effects of the sensory processing characteristics of parents of developmentally delayed children and parents of typically developed children on parenting stress. Methods : From July to August 2022, 61 parents of children with developmental delays and 64 parents of children with typical development who used occupational therapy services at pediatric clinics and child development centers were evaluated for parenting stress and sensory profiles. Results : In a multiple regression analysis on the effect of sensory processing characteristics on the total score of parenting stress, tactile processing (β = 0.353, p = 0.001), gender (β = 0.438, p = 0.000), and monthly income (β = -0.261, p = 0.014) significantly affected the parenting stress of the parents of children with developmental delay. In parents of typically developing children, tactile processing (β = 0.376, p = 0.002) and gender (β = -0.264, p = 0.024) were found to have a significant effect on parenting stress. Conclusion : Parental gender and tactile processing characteristics of developmentally delayed and typically developing children are significant influencing factors for parenting stress.

• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.1081-1089
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• 2022

Purpose To compare the computerized Greulich-Pyle based bone age with elbow bone age. Materials and Methods A total of 2126 patients (1525 girls; 601 boys) whose elbow bone age was within the evaluable range by the Sauvegrain method, and who simultaneously underwent hand radiography, were enrolled in the study. The 1st-bone age and VUNO score of the hand were evaluated using VUNOMed-BoneAge software. The correlation between the hand and elbow bone age was analyzed according to the child's gender and the probability of 1st-bone age. Results The correlation between VUNO score and elbow bone age (r = 0.898) was higher than the correlation between 1st-bone age and elbow bone age (r = 0.879). Moreover, the VUNO score showed a better correlation with the elbow bone age in patients with a 1st-bone age probability of less than 70%, or in girls. Elbow bone age was more advanced compared to hand bone age, and this difference increased until the middle of puberty and gradually decreased in the latter half. Conclusion The computerized Greulich-Pyle based hand bone age showed a significant correlation with the elbow bone age at puberty. However, since the elbow bone age tends to advance faster than the hand bone age, caution is required while judging the bone age during puberty.

• Pediatric Infection and Vaccine
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• v.21 no.1
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• pp.9-21
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• 2014

Purpose: To determine the clinical significance of voriconazole therapeutic drug monitoring (TDM) in the pediatric population. Methods: Twenty-eight patients with invasive fungal infections administered with voriconazole from July 2010 to June 2012 were investigated retrospectively. Fourteen received TDM, and 143 trough concentrations were analyzed. All 28 patients were assessed for adverse events and treatment response six weeks into treatment, and at the end. Results: Out of 143 samples, 53.1% were within therapeutic range (1.0-5.5 mg/L). Patients administered with the same loading (6 mg/kg/dose) and maintenance (4 mg/kg/dose) dosages prior to initial TDM showed highly variable drug levels. Adverse events occurred in 9 of 14 patients (64.3%) in both the TDM and non-TDM group. In the TDM group, voriconazole-related encephalopathy (n=2, 14.3%) and aspartate aminotransferase (AST) or alanine aminotransferase (ALT) elevation (n=8, 57.1 %) occurred with serum levels in the toxic range (>5.5 mg/L), whereas blurred-vision (n=2, 14.3%) occurred within the therapeutic range (1.18 mg/L and 3.9 mg/L). The frequency of voriconazole discontinuation due to adverse events was lower in the TDM group (0.0% vs. 18.2%, P =0.481). Overall, 57.2% of the patients in the TDM group versus 14.3% in the non-TDM group showed clinical response after 6 weeks (P =0.055), whereas 21.4% in the TDM group versus 14.3% in the non-TDM group showed response at final outcome (P =0.664). In the TDM group, >67.0% of the serum levels were within therapeutic range for the first 6 weeks; however 45.5% were within therapeutic range for the entire duration. Conclusion: Routine TDM is recommended for optimizing the therapeutic effects of voriconazole.

• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.227-233
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• 2009

Purpose : Growth hormone (GH) replacement after retesting is necessary because impairment of body composition and cardiovascular health has been more severe in adult patients with persistent GH deficiency (GHD) from childhood to adulthood. This study aimed to investigate the factors for persistent GHD and define a highly probable group of persistent GHD in young adults with childhood-onset GHD. Methods : GHD was reassessed by insulin tolerance test (ITT) in 55 adult patients (39 males, 16 females) with childhood-onset GHD. Twelve patients presented with idiopathic GHD and 43 patients presented with organic GHD caused by tumors involving the hypothalamus-pituitary (H-P) region (n=33), other brain tumors (n=3), meningitis (n=3), leukemia (n=2) and others (n=2). Results : Forty-nine (89.1%) of 55 patients had persistent GHD. IGF-I was positively correlated with log of peak GH (r=0.57, P<0.001). There was no difference in the proportion of persistent GHD between idiopathic and organic GHD. The percentage of patients with persistent GHD was 40%, 80%, and 95.6% for patients with zero, one, two or more additional pituitary hormone deficiencies (PHDs), respectively (P=0.002). The probability of persistent GHD was higher in patients with diseases involving the H-P region (P=0.003). GHD persisted in 15 of 18 patients treated with cranial irradiation. Conclusion : We suggest that the probability of persistent GHD in adulthood was high in patients with 2 or more additional PHDs, and diseases involving the H-P region.

• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.998-1006
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• 2008

Purpose : Hypertension is defined as average systolic blood pressure and/or diastolic blood pressure that is ${\geq}95^{th}$ percentile for gender, age, and height on ${\geq}three$ occasions. Knowing that blood pressure values increase in children as they grow older, the purposes of this study were to measure blood pressure by an oscillometric device and to determine normal values and percentile curves for children. Methods : Systolic and diastolic blood pressures were measured twice with an oscillometric device in 3,545 boys and 3,145 girls under six years of age, in Seoul. Using this data, we determined average blood pressure values and percentile curves based on gender and age; we subdivided these values into blood pressures of $50^{th}$, $90^{th}$, $95^{th}$, and $99^{th}$ percentiles, by percentile of height. The regression coefficients and standard deviations of the systolic and diastolic blood pressure values were obtained from linear regression models. Results : Older boys and girls had higher systolic and diastolic blood pressure values. Older boys and girls in the same percentile of height for age had higher systolic and diastolic blood pressure values. Taller boys and girls within the same age group had higher systolic and diastolic blood pressure values. Conclusion : Blood pressure standards based on gender, age, and height were obtained via an oscillometric method. Llimitation of this study is that the study population was not from the whole country, but exclusively from Seoul. Nonetheless, the data from this study will be helpful in diagnosing and managing hypertension in Korean children.