• Title/Summary/Keyword: 정상 발달 아동

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18-year Follow-up of Extended Newborn Screening for Metabolic and Endocrine Disorders (대사 및 내분비 질환에 대한 광범위 신생아 선별 검사의 18년 추적 관찰)

  • Song, Wung Joo;Lee, Sunho;Jeon, Young Mi;Kim, Sook Za;Jang, Mea Young
    • 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.

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MUSIC THERAPY FOR ADOLESCENTS WITH CONDUCT DISORDER (품행장애 청소년의 음악치료 사례연구)

  • Jhin, Hea-Kyung;Kwon, Hea-Kyung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.110-123
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    • 2000
  • The short-term music therapy was performed for adolescents with conduct disorder admitted to Seoul National Mental Hospital for 3 months from Jun to September, 1998. This case study focused mainly on two female patients who participated regularly in the group music therapy. The music therapy process was divided into three phases;beginning, opening up, and closing. This music therapy session consisted of three parts;hello song as beginning, various musical activities, and sound & movement activity as closing. Free musical improvisation, song discussion, musical monodrama, and sound & movement were the mainly applied techniques. Free improvisation was used to enhance, motivate, identify and contain the adolescents' feelings and ideas. Song discussion was used to convey their thoughts and to support each other. Musical monodrama was used to make them have insights into interpersonal relationships. Sound & movement was used to enhance spontaneity. It made them explore their body and voice as an expressive medium. Throughout three months period of music therapy, patient A's communication skill, socialization, and behavior areas were assessed with improvement. She could use music as a symbolic form and was able to share her feelings about herself and her family. Patient B's self-expression and cognitive areas were assessed with improvement. She became more spontaneous and could verbalize her emotions during the group session. Music as a non-verbal and therefore often a non-threatening medium wherein so much can be expressed provided two female patients an atmosphere where a sense of trust may be regained.

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Developmental Changes of Static Standing Balance and Sensory Organization in Children (정상아동의 정적 균형과 감각통합의 발달)

  • An, Mi-Hee;Yi, Chung-Hwi
    • Physical Therapy Korea
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    • v.15 no.3
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    • pp.1-7
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    • 2008
  • Multi-sensory systems, including the visual, somatosensory, and vestibular ones, are involved in maintaining standing balance. The organization of these sensory systems is as important as the efficiency of each individual system in maintaining optimal balance. The purpose of the present experiment was to investigate the developmental changes in static standing balance and sensory organization under altered sensory conditions. This study involved 64 children (from 4 to 15 years of age) and 17 young adults. The children were divided into four age groups: 4~6, 7~9, 10~12, and 13~15 years. Static standing balance was assessed with the one-leg standing test under four different sensory conditions: the children stood on a firm surface with (1) eyes open or (2) closed, and they stood on a foam surface with eyes (3) open or (4) closed. In balancing ability, the age groups exhibited significant differences. The function of sensory organization for balance control was poorer for the children than for the young adults. The functional efficiency of the somatosensory system of the children aged 7~9 years was at the young adults' level, and the visual function of the children aged 10~12 years had also reached the young adults' level. However, the functional efficiency of the vestibular system of children was significantly lower than that of the young adults, even at the age of 15 years. This may indicate that sensory organization and standing balance are still developing after the age of 15 years.

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A Pediatric Fall-Risk Assessment Tool for Hospitalized Children (입원 아동의 낙상 위험 예측 도구)

  • Shin, Hyeon Ju;Kim, Young Nam;Kim, Ju Hee;Son, In Sook;Bang, Kyung-Sook
    • Child Health Nursing Research
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    • v.20 no.3
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    • pp.215-224
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    • 2014
  • Purpose: This study was conducted to identify risk factors in hospitalized children, and to develop and validate a fall-risk assessment tool for hospitalized children. Methods: A retrospective chart review was performed at one university children's hospital, and an analysis was done of the characteristics of all patients who fell during a 44-month period (n=48). These patients were compared with another 149 hospitalized children who did not fall. Results: Significant predictors of falls as identified in a multivariate logistic regression analyses were age of less than 3 years old, neurological diagnosis including epilepsy, children's dependency of ADL, physical developmental delay, multiple usage of fall-risk-increasing drugs. The respective odds ratios ranged from 2.4 to 7.1 with 95% confidence interval (p<0.05). Accordingly, defining patients with either 5 risk factors as fall-prone hospitalized children provided a sensitivity of 93.6% and specificity of 16.2%. Conclusion: The results show that this tool has an acceptable level of sensitivity to assess the risk factors of fall in hospitalized children even though the specificity was low, suggesting that this tool may enable nurses to predict the risk level of childhood falls, and develop preventive strategies against pediatric falls in children's units.

Literature Review on the Research and Developments of Korean Rural Living Science -Food & Nutrition- (한국 농촌 생활과학 연구동향 및 문헌고찰 -식생활 분야-)

  • 강미영
    • Korean Journal of Rural Living Science
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    • v.2
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    • pp.1-23
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    • 1991
  • 농촌주민들의 영양 섭취실태에 대한 동향을 요약해 보면 1. 총 섭취식품중 약 90% 정도를 식물성식품으로써 섭취하고 있으며, 곡류가 차지하는 비율은 점차 감소되는 반면 콩류, 채소류 및 과일류의 섭취 비율은 현저히 증가하고 있다. 2. 총 열량섭취는 감소하는 추세이고 총열량에 대한 탄수화물 :단백질 :지방의 비율이 74 : 12 : 12의 수준이다. 총 단백질 섭취에 대한 동물성 단백질 섭취율은 36%로써 질적으로 바람직하게 변화되고 있다. 칼슘의 섭취수준이 권장량의 90%정도로서 조금 부족한 듯 하지만 철분, 비타민 등 대체로 영양섭취상태는 많이 개선되었음을 알 수 있다. 3. 농촌 영아들의 경우는 모든 영양소가 권장량에 현저히 미달되는 상태이다. 이유식품 개발 및 이유 방법에 대한 상담 지도가 적극 필요한 실정이다. 4. 새마을 유아원의 설치 및 유아급식의 혜택으로 농촌 유아들의 영양 섭취 상태는 두드러지게 개선되었으나 철분섭취 상태는 권장량에 미달되는 실정이다. 취학전 아동의 영양향상을 위해서는 유아 교육시설 확충 및 간식의 중요성에 대한 농촌 주부 대상의 영양 교육 확대 실시가 요청된다. 5. 국민학교 아동들에게서는 빈혈의 발생 빈도가 높게 나타났다. 성장 발육기에 있는 이들의 심신발달에 필요한 영양공급 및 올바른 식습관 형성을 위해서는 학교에서 일정한 지도 목표를 설정하여 계획적으로 실시하는 학교 급식의 필요성이 강조된다 하겠다. 6. 청소년기 및 임신 수유부의 경우도 철분의 섭취상태가 부족하기는 하지만, 철 결핍성 빈혈증상이 나타날 정도는 아니고 영양섭취상태도 대체로 양호하다. 7. 노인들의 식품 영양 섭취실태는 권장량에 크게 미달되는 실정이기는 하지만 혈액검사의 수치들이 대체로 정상인 범위에 있고 건강상태도 양호한 편이다. 식품 개발 및 조리법에 관해서 요약해 보면 1. 식량수급의 안정을 기하고자 다수확 품종인 통일계통 쌀의 취반 및 가공적성에 대한 검토가 진행되었으며, 잡곡류 및 감자류의 효과적인 이용을 위해 복합분의 사용에 의한 식품가공 적성에 대한 연구들이 실시되었다. 2. 콩류에 대한 연구로는, 기름을 추출하고 남은 탈지대두박의 단백질 식품으로의 이용을 위해 추출법의 검토 및 탈지대두박을 이용하는 두부제조법 등 다각적으로 식품에의 적용에 관해 연구가 진행 되었다. 3. 발효식품 중 김치에 대해서는 농촌지역에서 제조되는 김치의 종류와 섭취실태에 관한 연구 및 김치의 저장성을 증진시키기 위한 일련의 검토가 있다. 간장, 고추장, 된장에 대해서는 Koji를 이용한 개량식 제조법 및 팽화시킨 곡분을 사용하는 간편 제조법, 비용 절감을 위한 대체원료 이용에 대한 연구 등이 진행되었다. 4. 이밖에도, 병조림 제조방법, 어린이를 위한 고영양 보충식 개발, 생선의 폐기 부분을 이용하여 칼슘 급원 식품으로서의 유용성에 관한 조리과학적 검토 등이 실시되었다. 식습관 및 식생활 관리 지도에 관한 연구에 의하면, 농촌여성의 농업역할이 가중되면서 자녀들의 식생활을 방임하기 쉬운 실정이므로 유아 교육시설 및 학교 급식 등을 통해서 바람직한 식습관 형성을 위한 프로그램이 개발되어져야 하며, 한편, 식생활 담당자인 농촌주부에 대한 규칙적이고 정확한 영양교육이 이루어져야 하리라 본다.

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Glycogen Storage Disease Type III Confirmed by AGL Gene Analysis (AGL 유전자 검사로 확진된 제 3a형 당원병 1례)

  • Suh, Junghwan;Koo, Kyo Yeon;Kim, Kyu Yeun;Lee, Chul Ho;Yang, Jeong Yoon;Lee, Jin-Sung
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.12 no.2
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    • pp.108-112
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    • 2012
  • Glycogen storage disease type III (GSD type III, OMIM #232400) is a rare autosomal recessive disease caused by a deficiency of the glycogen-debranching enzyme (GDE) with a mutation in the AGL gene (OMIM *610860). It is known to be bifunctional enzyme, that is, having two independent catalytic activities; 1,4-${\alpha}$-D-glucan 4-${\alpha}$-D-glycosyltransferase (EC 2.4.1.25) and amylo-1,6-glucosidase (EC 3.2.1.33) that occur at separate active sites on a single polypeptide chain. Most patients with GSD type III usually have symptoms related to decreased glycogenolysis in liver and muscles, such as hepatomegaly, hypoglycemia, failure to thrive, hyperlipidemia, muscle weakness and cardiomyopathy (type IIIa), however some patients show symptoms restricted to liver (type IIIb). GSD type III is diagnosed by enzyme test through liver or muscle biopsy or mutation analysis of the AGL gene. We report the case of GSD type III proven by gene study after liver biopsy, which revealed c.476delA, c.3444_3445insA in exon 6, 27 of AGL gene in Korean patient.

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Infant Parents' Marital Satisfaction and Their Family Environment Focused on Employment Status (영아기 자녀를 둔 부모의 결혼만족도 및 가정환경 탐색 - 취업여부를 중심으로)

  • Kim, Jin Kyung
    • Korean Journal of Childcare and Education
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    • v.11 no.4
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    • pp.63-79
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    • 2015
  • This study explored the effect of mother's employment status on family environment and physical environment and psychological environment, the main concern of this which factors have effects on marital satisfactions of either employed or non-employed mothers. First, the result of analysis on family environment according to mothers' employment status shows non-employed mother's parental stress is higher than employed mother's. Besides, non-employed mother's self-esteem is lower than employed mother's, and non-employed mother's depression is significantly high. Concerning fathers' factors, the level of conflict between husband and wife is higher among husbands when their wives are employed. In the light of childrens' factors, non-employed mothers consider that their children display more negative emotion and more picky. Children's development of employed mothers is included in normal development range more than that of non-employed mothers. Second, conflict between husbands and wives have an significantly negative effect on marital satisfaction regardless wife's employment status. Husbands' cooperation in child-rearing and marital satisfaction have a positive effect on wives' marital satisfaction. The significant factor which influences on employed mother's marital satisfaction is education level of wives. This study would be meaningful in that infancy home environment was compared focusing on the mothers' employment status, and some factors which factors(variables) have impacts on marital satisfaction of infancy mothers were examined.

Analysis of Working Memory for Attention Deficit Hyperactivity Disorder (ADHD) Children using fMRI (주의력결핍 과잉행동성장애(ADHD) 아동의 작업기억 과제 수행 시 fMRI 분석)

  • Lee, Yong-Ki;Ahn, Sung-Min
    • The Journal of the Korea Contents Association
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    • v.14 no.12
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    • pp.854-862
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    • 2014
  • Attention deficit hyperactivity disorder (ADHD) students' intellctual defects, learning problems, and poor academic achievements seem to be due to significantly lower intelligence compared to the normal students, but rather the characteristic of inability to pay attention at a given time can be seen as the more attributing reason. In this study, a comparison between the ADHD students and the normal students will be performed using a fMRI analysis in order to differentiate the brain function between the two groups during a working memory task performance and to assess the difference in the activated regions of the brain. Clinical survey examinations and fMRI measurements were performed for a group of 26 elementary students from the Incheon area. The stimulus of fMRI was a working memory. Cartography statistically analyzed parameters and the Statistical Package of Social Sciences using single-sample t-test, two-sample t-test, were analyzed by multiple regression analysis, the statistical significance level was p<0.05 in, respectively. The disproportionate developments could be seen in the ADHD students group such as the frontal cortex, parietal cortex, thalamus, and caudate nucleus, among others. In addition, as some students felt the increase in the difficulty of working memory task performance, the orbitofrontal cortex and the hippocampus were activated, which seems to be the result of an effort for looking for an answer. More types of ADHD students needs to be secured as research subjects, and more stimulations for fMRI experiments should be considered as it would be useful in the overall evaluation of brain function.

SEMI-LONGITUDINAL STUDY ON GROWTH AND DEVELOPMENT OF CHILDREN AGED 6 TO 17 Part II : GROWTH CHANGE OF CRANIOFACIAL SOFT TISSUE (한국인 6-17세 아동의 성장과 발육에 관한 준종단적 연구 제 2 세부과제 : 두개 및 안면 연조직의 성장변화)

  • Park, Young-Chel;Lee, Kee-Joon;Han, Hee-Kyoung;Lee, Jang-Yeol
    • The korean journal of orthodontics
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    • v.26 no.4
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    • pp.325-340
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    • 1996
  • Along with traditional goal of 'straightening teeth', today's orthodontics put more and more emphasis on facial esthetics. Naturally, the importance of soft tissue, which dictates one's facial form, is noticed. There have been many cephalometric studies on growth of hard tissue ; however, only a few on that of soft tissue. In Korea, various methods of sampling, measuring and analysing were used to study soft tissue changes, and yet, soft tissue changes along with process of normal growth have not been studied. The author carried out this study as a part of semi-longitudinal study on craniofacial growth and development of Korean children from ages of six to seventeen. 409 boys and 436 girls who'd had no systemic disease for the last three years and shown normal developmental and occlusal status were chosen as subjects. Cephalometric X-rays were taken of each subject, and facial form, lip position & form, nose form, and lip thickness were measured. Mean values and standard deviations were calculated according to age and gender, and figures and tables were drawn accordingly. The following results were obtained: 1. In respect to facial form, boys showed growth for longer period compared to girls. Also, lower face showed higher growth rate than upper face. 2. There was not much change in thickness of upper and lower lips with age; however, they appeared more prominent compared to caucasian children. 3. Nose grew horizontally with age. 4. Horizontal thickness of lower face increased with age, and upper lip thickness at nose base[A-Sn(FH)] showed more growth than anywhere else.

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A Study on Life Styles, Dietary Attitudes and Dietary Behaviors According to Extracurricular Activities of Elementary Students in Sejong (세종시 일부 초등학생의 과외수강에 따른 생활습관, 식태도 및 식행동에 대한 연구)

  • Oh, Keun-Jeong;Kim, Mi-Hyun;Kim, Myung-Hee;Choi, Mi-Kyeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.8
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    • pp.1335-1343
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    • 2013
  • Parents in South Korea are known for their high level of educational zeal for their children. As a result, their children usually take extra classes in institutions as well as participate in other extracurricular activities such as sports and music. The purpose of this study was to examine the lifestyle and dietary behaviors of Korean elementary students involved in such activities. The total number of subjects was 550 fourth to sixth graders in elementary schools in Sejong, Korea. Of the total subjects, 88.0% were involved in extracurricular classes or other activities for an average of 7.34 hours/week. The subjects were assigned to one of four groups based on the degree of extracurricular activities: No extra-class (n=66), Low extra-class (1${\leq}$taking time<5 hours/week, n=118), Medium extra-class (5${\leq}$taking time<10 hours/week, n=184), and High extra-class (taking time${\geq}$10 hours/week, n=182). More subjects in the High extra-class group went to bed late (P<0.01), were under stress (P<0.01), and skipped breakfast, compared with those in the other groups. The ratio of students who answered 'I go to an institute without a meal' (P<0.01), 'I prepare a meal for myself' (P=0.053), or 'I eat out before going to an institute' (P<0.01) was higher in the High extra-class group than in the Low extra-class group. The frequency of eating fast food was higher in the High extra-class group, compared with the other groups. These results indicate that a high amount of extracurricular studies may have a negative effect on the children's lifestyles and dietary behaviors. Therefore, this study alerts parents to the potential harm of excessive extracurricular activities to their children's health.