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Predictive indicators of coronary artery complications in Kawasaki disease (가와사키 병 환아에서 관상동맥 합병증의 예측인자)

  • Park, Min Jee;Jeon, In-sang;Tchah, Hann;Choi, Kang Ho;Jung, Mi-Jin;Choi, Deok Young
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1161-1166
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    • 2009
  • Purpose : Kawasaki disease—the most common cause of acquired heart disease in children—incidence is increasing yearly. Therefore, we evaluated the predictive indicators of coronary complications of Kawasaki disease based on clinical and laboratory data. Methods : Between January 2005 and March 2008, of the 201 children with Kawasaki disease treated at the Gil Hospital of Gachon University of Medicine and Science, 51 had coronary artery lesions (Group II) and 150 had no lesions (Group I). The reasons for coronary artery lesions were deduced from the clinical and laboratory data. Results : Analysis of the 2 groups revealed that fever duration and days of fever after and before initial intravenous gammaglobulin (IVIG) treatment were significantly longer in Group 2 than in Group I. IVIG infusions were statistically higher in Group II than in Group I. As per the laboratory data, C-reactive protein (CRP) value was significantly higher in Group II. Collectively, >10 days of fever duration, >48 h of fever duration after, and >10 days of fever before IVIG treatment increased the risk of coronary artery lesions 6-, 5-, and 3.5-fold, respectively. Furthermore, additional IVIG courses and higher CRP level increased the risk of coronary artery lesions 4-fold and 2-3-fold, respectively. Conclusion : The following 3 factors were responsible for increased risk of coronary artery lesions in children with Kawasaki disease: fever duration and days of fever after and before IVIG treatment. To identifythe predictive indicators of coronary complications, it is necessary to further elucidate the relationship between well-known forecasting factors.

A STUDY ON COMORBID DISORDERS AND ASSOCIATED SYMPTOMS OF PERVASIVE DEVELOPMENTAL DISORDER CHILDREN (전반적 발달장애 아동들의 공존질환 및 동반증상에 대한 연구)

  • Kwak, Young-Sook;Kang, Kyung-Mee;Cho, Seong-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.64-75
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    • 1999
  • Objective:The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method:The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result:The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion:These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.

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RELATIONSHIP BETWEEN DENTOCULT-SM TEST, MICROBIAL ANALYSIS AND DENTAL CARIES IN THE PRE-SCHOOL CHILDREN (미취학아동들의 유치우식경험도와 개량형 Dentocult-SM 검사 및 치면세균막 세균활성과의 관련성)

  • Shin, Doo-Kyo;Kim, Ji-Young;Song, Keun-Bae;Nam, Soon-Heyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.2
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    • pp.254-262
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    • 2003
  • Dental caries has a multifactorial aetiology in which there is an interplay of three principal factors: the host(saliva and teeth), the microflora(dental plaque) and the substrate(diet), and a fourth factor time. There is no single test that takes into consideration all these factors and can accurately predict an individual's susceptibility to dental caries. The risk of dental caries can be evaluated by analysing and integrating several causative factors. The objective of the study was to clarify the relationship between caries activity and the status of caries of primary teeth and the relationship between the quantity of S. mutans in the dental plaque and the status of dental caries. Forty nine children ages 5 were examined with caries indices, Dentocult-SM and quantity of S. mutans. The results were as follows: All the survey results were similar with national means of 5-6 years Korean preschool children. The deft index of subjects was 5.46 and defs index was 9.81. There was 8.6% of negative, 10.9% of mild, 28.1% of moderate and 52.3% of active results at screening strip test. 8.6% was negative, 17.2% was mild, 33.6% was moderate and 40.6% was active in site strip test. The Spearman correlation coefficient was 0.775, and overall kappa index was 0.496 between screening strip test and site strip test. There also was a high correlation between caries incidence, Dentocult-SM test, and quantity of S. mutans. Dentocult-SM test as a caries activity test is a reliable method for measuring the status of dental caries in primary teeth.

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Current Status and Actual Conditions of the Use of Occupational Therapy Evaluation Tools in Relation to the Type of Therapy Institution (국내 아동작업치료 기관별 평가도구 사용 현황 및 실태에 관한 연구)

  • Gil, Young-Suk;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.1
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    • pp.47-58
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    • 2023
  • Objective : This study aimed to investigate the current status and actual use of assessment tools by institutions in the field of occupational therapy with children in Korea. Methods : The study was conducted with 67 occupational therapists working with children in Korea. To investigate the use of evaluation tools by area, knowledge of the evaluation tools, and desire to participate in further education, the questionnaires used in studies by Lee, Hong, and Park (2018) and Kim (2015) were modified and supplemented according to the child evaluation tools currently in usein institutions in Korea. For data collection, we distributed Google questionnaires to child occupational therapists for 3 weeks using convenience sampling. Excel was used to analyze the use of the evaluation tools according to institution. Technical statistics and frequency analyses were used to verify the general characteristics, evaluation-related information, status of evaluation tool use, knowledge levels relating to evaluation tools, and desire to participate in education. A t-test was used for the evaluation tool status. Results : Welfare centers used the most evaluation tools, with an average of 11.1, followed by university hospitals, rehabilitation hospitals, clinics, and daycare centers. There were differences in the choice of tools used, hospital with the Jebsen-Taylor hand function test and the Wee-FIM (Functional Independence Measure) being the most frequently applied. Centers, daycare centers, and welfare center the Sensory Profile test and clinical observation were also used often. Regarding the level of knowledge of evaluation tools and the desire to participate further in education, 30 (44.8%) of the respondents had not completed their education, and 42 (62.7%) rated their knowledge level as generally low. When asked about the importance of using a manual to guide them in their use of evaluation tools, 66 (98.6%) answered positively, and 66 (98.6%) answered that they needed specialized training in the use of evaluation tools. Conclusion : This study makes it possible to understand the use and status of evaluation tools as used by different institutions in Korea in the field of child occupational therapy It is anticipated that it will provide the basis for introducing existing evaluation tools and preparing new evaluation tools to be used in this field in Korea.

THE EFFECTS OF HORIZONTAL ORTHODONTIC TOOTH MOVEMENT ON THE PERIODONTALLY DISEASED TISSUE IN DOGS (성견 치주질환 이환치아의 수평이동이 치주조직에 미치는 영향)

  • Kim, Kyung-Ho;Ryu, Young-Kyu
    • The korean journal of orthodontics
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    • v.24 no.3 s.46
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    • pp.673-693
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    • 1994
  • Most adults, unlike growing children, have some periodontal problems which can influence the outcome of the orthodontic treatment. In cases where periodontal disease progression resulted in marked reduction of periodontium, orthodontic treatment could result in the worsening of the periodontal conditions, and therefore orthodontic treatment planning in such adult patients requires special considerations for the periodontal problems. This study investigates the effects of horizontal orthodontic tooth movement on the changes in the mesial, distal and furcation areas of the disease affected periodontium of adult dogs with advanced bone loss. Six adult dogs with healthy periodontium were selected, and mandibular 2nd premolars were extracted. In the mandibular 3rd premolars, angular bony defects in the mesial and distal sides, and horizontal bony defects in the furcation areas were created. Those that received the flap operation and plaque control were designated as the control, those that had horizontal tooth movement without plaque control after the flap operation as Experimental group I, those that had horizontal tooth movement under plaque control without the flap operation as Experimental group II, and those that had horizontal tooth movement under plaque control after the flap operation as Experimental group III. The control group was sacrificed 2 months postoperatively, and the experimental groups were sacrificed 5 months after the initiation of tooth movement. Specimens were histologically analyzed under light microscope. The results were as follows; 1. After the horizontal tooth movements, Experimental group I and II showed angular bony defects in the mesial sides of the roots and the distal side of the furcation areas, which correspond to the pressure sides. 2. After the horizontal tooth movements, Experimental group I and II showed decreased level of alveolar bone crest in the distal sides of the roots, which correspond to the tension sides. 3. Long junctional epithelium in the control group has not been replaced by periodontal connective tissue after the horizontal tooth movements. 4. Limited formation of new bone was observed in the angular bony defects in the mesial and distal aspects of the roots in the control group. 5. Inflammatory cell infiltration in the connective tissue was most severe in the Experimental group I, followed by Experimental group II, III, and the control group in that order. These results seem to indicate that plaque control was the most influencing factor in the alteration of the periodontal tissue after the horizontal tooth movements in the periodontal tissue with alveolar bone defects.

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The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(II) - 진단 및 평가 -)

  • Lee, Moon-Soo;Park, Su-Bin;Kim, Gyung-Mee;Kim, Hyun-Jin;Park, Sangwon;Kim, Yunsin;Lee, Young Sik;Kweon, Yong-sil;Shin, Dongwon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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    • pp.58-69
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

Findings of Core Elements for Library Outreach Model of Social Workers in the Library (사회복지 전문가 참여형 도서관 아웃리치 모델 개발을 위한 핵심 요소 도출)

  • Lee, Hyewon
    • Journal of the Korean Society for Library and Information Science
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    • v.52 no.3
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    • pp.363-390
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    • 2018
  • The libraries and social welfare centers carry out various programs for the information poor. The libraries have focused on accessing and utilizing information, while social welfare centers have centered on improving the quality of life. This study have investigated as follows. Firstly, this study examined the cooperation model between libraries and social welfare centers or librarians and social workers in public libraries in Korea and California, USA, and analyzed the international library policies and guidelines in literature review. Through the definition of terms and related concepts, we confirmed the range of the information poor in this study. Secondly, this study executed to interview librarians and social workers in Korea and USA about the way of cooperation for the information poor. These interviews have been understood the public library outreach programs in California and the program of the National Library for Children and Young Adults' Out of School Youth Reading Program (2018). Finally, this study suggested the core elements to be considered in developing a library outreach model for the information poor based on the implications derived from literature review and interviews.

Differences of EEG and Sleep Structure in Pediatric Sleep Apnea and Controls (소아 수면무호흡증 환아와 정상 소아에서 수면구조와 뇌파 양상 차이)

  • Ahn, Young-Min;Shin, Hong-Beom;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.15 no.2
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    • pp.71-76
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    • 2008
  • Introduction: In this study, we compared sleep structure, EEG characteristic of pediatric obstructive sleep apnea (OSA) and normal controls which were matched in sex and age. Methods: Fifteen children (male:female=4:11) who complained snoring and were suspected to have sleep apnea and their age and sex matched normal controls (male:female=5:10) have been done nocturnal polysomnography (NPSG). Sleep parameters, sleep apnea variables and relative spectral components of EEG from NPSG have been compared between both groups. Results: Pediatric OSA group were distinguished from normal controls in terms of apnea index, respiratory disturbance index and nadir of oxyhemoglobulin desaturation. Pediatric OSA group showed increased percent of sleep stage 1, decreased rapid eye movement sleep percent and increased delta power in O1 EEG channel. However other sleep parameters and spectral powers were not different between two groups. Conclusion: In pediatric OSA group, sleep structure parameter disruption may be not prominent as the previous studies for adult OSA group because of including mild OSA data in diagnostic criteria. In addition, EEG changes might not be distinct due to low arousal index compared to adult OSA patients. We can observe general characteristics and particularity of pediatric OSA through this study.

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Structural Correlations of Psychological Anxiety, Appearance-oriented Attitude, Self-esteem and Behavioral Problems: Multi-group Analysis in Gender and Grade Level (청소년의 심리적 불안감, 외모지향태도, 자아존중감과 문제행동의 구조관계: 성별 및 학교급별의 다집단분석)

  • Park, Seon-Tae;Lim, Sung-Ok
    • The Journal of the Korea Contents Association
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    • v.17 no.2
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    • pp.449-466
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    • 2017
  • This research is to find structural relationships among psychological anxiety, appearance-oriented attitude, and self-esteem of youth and investigates how the structural relationships show by genders and different school classes. For the investigation, a collected data for the research of 'adolescent's misbehaviors and tendency of their young average age and political subject' were used from SPSS 22.0 program and AMOS 22 statistical program provided by Korea youth and children's data archive. First of all, the research determines as the psychological anxiety gets higher, youth have lower self-esteem level and more behavior problems. In addition, when adolescents show stronger appearance-oriented attitude they have higher self-esteem level and more behavior problem. The study also indicates that as youths have higher self-esteem their behavior problem levels are reduced. Secondly, by examining the relationships of youth's psychological anxiety and appearance-oriented attitude based on their self-esteem, the self-esteem gives a positive mediated effect on psychological anxiety and behavior problem whereas the self-esteem affects as negative mediated effect on the appearance-oriented attitude and behavior problem. Lastly, the study indicates there is a causal interaction between youth's appearance-oriented attitude and behavior problem which differs by genders and different school classes. Based on the results of the research, the theoretical and practical applications were suggested to prevent and relax the adolescent's behavior problems.

Studies on Intake and Serum Concentrations of Fatty Acids in Korean Adolescents

  • Chung, Eun-Jung;Kim, Soo-Jung;Um, Young-Sook;Ahn, Hong-Seok;Lee, Dong-Hwan;Lee, Yang-Cha-Kim
    • Nutritional Sciences
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    • v.1 no.1
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    • pp.42-50
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    • 1998
  • In this study, we evaluated the dietary fatty-acid pattern and serum fatty-acid composition of middle school students (total, 355 ; male, 182 ; female, 173), who are vulnerable to excessive and unbalanced food intakes such as fatty acids and energy. In serum lipid levels, total Chol (p<0.05) and HDL-Chol (p<0.001) levels of female students were significantly higher than those of mal, students. The average fat intake was 23-26 energy % which falls in with the current recommendation level (15-25%) for adults. Although the average P/M/S ratio of dietary fat was 1.1/1.2/1.0 which approaches the recommended ratio, the average range of $\omega$6/$\omega$3 fatty acid ratio of dietary fat was found to be 12.0-16.5, which is higher than the presently recommended range of 4 -10. Some of the very high values found in this study were partly explained by the fact that the range of individual variation of $\omega$6/$\omega$3 ratios was very large. Mean daily intake of Chol was 357-361 mg. The n3 fatty acid intake of middle school students was higher in the LFHM (high fish low meat) group than in the LFHM (low fish high meat) group. EPA and DHA intakes appeared to be significantly higher (p<0.01) in the HFLM group than in the LFHM group as expected. Dietary total $\omega$3 fatty acids (p<0.05) and EPA (p<0.01) were also negatively associated with serum AA($\omega$6) levels. Interestingly, energy intakes and dietary SEAs such as 12 : 0 (p<0.05), 14 : 0 (p<0.01) and 16 : 0 (p<0.05) were negatively associated with serum AA ($\omega$6) levels. To lower the $\omega$6/$\omega$3 ratio of dietary fatty acids for children, frequent consumption of $\omega$3 series fatty-acid rich foods such as soy bean, bean products and fish is recommended. Detailed guidelines should be developed in recommending balanced food intake and qualitative fat intake for Korean adolescents taking heterogeneous groups into consideration. In accurately evaluating fatty acid intake, it is also necessary to have the fatty acid composition data of all foods consumed in each country.

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