• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.85-95
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• 1996

Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

• Journal of dental hygiene science
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• v.16 no.2
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• pp.111-117
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• 2016

The purpose of this study was to assess the relationship that adolescent stress perception level has with dietary habits and oral health behaviors in high school students. A survey of high school students in some areas of the Jeollabuk-do province of South Korea was conducted. Five hundred fourteen survey responses were used in the final analysis. As a result of the questionnaire survey, the following conclusions were obtained. The highest stress type was indicated to be academic stress (mean${\pm}$standard deviation [SD], $3.09{\pm}0.89$). The next was shown to be home (family) stress (mean${\pm}$SD, $2.85{\pm}0.84$). The possibility of using a dental clinic was indicated to be less in girls than boys (p<0.001). Regarding subjective oral health behavior, the possibility of visiting a dental clinic was low in those who thought that their own oral health condition was not good or moderate (p<0.05). Also, it was shown that the higher stress led to the higher possibility of visiting a dental clinic (p<0.01). Students with higher grades had a in the upper ranks were indicated to have high possibility of having a regular meal (p<0.01). Higher stress led to the significantly higher possibility of eating cariogenic food (p<0.01). Students with median grades had a high possibility of eating cariogenic food (p<0.01), while students with higher grades had a low possibility of eating cariogenic food (p<0.05). These resultss show that stress perception level influences dietary habits and oral health behaviors. Thus, there is a need to develop a program in high scholls to promote the physical and mental health of students to relieve stress. Substantial and systematic oral health education is thought to be likely needed to develop desirable dietary habits.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.300-306
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• 2010

Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors—or example, good mental health, balanced nutrition, and more exercise.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.108-117
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• 1994

Twenty nine children with autism and thirty children with mental retardation were examined for association between autism and chromosomal disorders including fragile X. The peripheral blood was cultured in Medium 199 with methotrexate and without methorexate for 70 hours. Thirty metaphase cells in each case were karyotyped in all samples. Chromosomal abnormalities were found in 11 cases(37.9%) of autistic disorder and 10 cases (33.3%) of mental retardation, but in none of fragile(X)(q27.3) from all cases. Chromosomal abnormalities were present on group A, C, D and X in autistic disorder and on group A, B, C, D, E and X in mental retardation. No specific chromosomal region was found in both autistic disorder and mental retardation. Types of chromosomal disorders were only fragile and/or gap but no numerical abnormality was present in all cases. Number of cells which revealed fragile sites were 31 cells(3.6%) out of 870 cells in autistic disorder and 29 cells(3.2%) out of 900 cells in mental retardation Number of cells which revealed gaps were 43 cells(4.9%) out of 870 cells in autistic disorder and 35 cells(3.9%) out of 900 cells in mental retardation. Autistic disorder may not be directly correlated with fragile X but with nonspecific chromosomal breakages from these data.

• Journal of Korean Home Economics Education Association
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• v.19 no.4
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• pp.57-74
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• 2007

The purpose of this study was to investigate differences in adolescent's academic motivation, which is composed of intrinsic learning motivation and extrinsic learning motivation, by family strengths and parent's expectation styles. The subject of this study were 508 students who were selected at random from second, and third grade of middle school in Daegu. Factor analysis and MANOVA were employed for data analysis and Scheff test for post - hoc analysis. The main findings of this study were as follows: First, there were significant differences in learning motivation of adolescents according to the degree of family strengths. More specifically, adolescents who perceived their family strengths to be high had higher intrinsic learning motivation than adolescents who perceived their family strengths to be middle and low. Second, there were significant differences in intrinsic learning motivation of adolescents according to the parent's academic expectation styles. Adolescents who perceived their parent's academic expectation styles paternal support-maternal support, paternal pressure-maternal support, and paternal support-maternal pressure showed higher intrinsic learning motivation than adolescents who perceived their parent's academic expectation styles paternal pressure-maternal pressure. Third, there were significant differences in intrinsic learning motivation of adolescents according to the parent's academic expectation styles and the degree of family strengths. In adolescents group who perceived their family strengths to be low, adolescents who perceived their the parent's academic expectation styles to be paternal support-maternal support, paternal pressure-maternal support and paternal support-maternal pressure had higher intrinsic learning motivation than adolescents who perceived their the parent's academic expectation styles to be paternal pressure-maternal pressure.

• The Korean Journal of Community Living Science
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• v.16 no.4
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• pp.83-93
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• 2005

This study was conducted to provide information about the behavioral intentions to diet in adolescent females. To explain the behavior intention to diet, a conceptual framework based on the ' Social Support, Control and the Stress Process Model ' and the ' Theory of Reasoned Actio ' was used. The survey was carried out by self-questionnaires with 463 female high school and college students in Daegu. Analysis of data was done by using mean, correlation and multiple regression analysis with the SAS computer program. Subjects were divided into 3 groups-underweight, normal weight, and overweight-according to their current body size. The most powerful influencing factor related to perceived stress -that is dissatisfaction with body image- was the current figure, regardless of current body size. The fatter the current body size, the higher the score for the behavioral intention to diet. In attitude toward the behavior of dieting, the fatter the current figure, the higher the attitude score, and the belief of behavioral outcome was the main decision variable. For the score of the subjective norm, the overweight group was significantly higher than other groups. The influencing factors for the behavioral intention to diet were perceived stress and attitude toward dieting behavior, especially beliefs of behavioral outcome.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.2
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• pp.212-219
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• 1999

Objective：This study is designed to get clinical guidelines for management of children with TBI by examining neuropsychiatric sequelae of TBI, determining whether the severity of TBI, type of treatment, and enviornmental factors are related to those sequelae, and defining the adequacy of public psychological tests as evaluating tools for them. Method：This is chart review of 47 children, aged 5 to 14 years, referred to a psychiatric outpatient clinic for neuropsychiatric evaluation at least 6 months after TBI. Data on the initial GCS score, associated injury, treatment type, and duration of hospital stay are obtained from medical records. EEG, MRI, intelligent test, and several psychological tests are administrated at the point of assessment. Results：1) Cognitive symptoms outnumber externalizing behavioral, emotional, and somatic symptoms, with no significant differences of frequencies of those 4 categorical symptoms between mild injury group and moderate to severe group. 2) Children treated with non-surgical method(p<0.01) complain more cognitive symptoms than the others. 3) Behavioral symptoms are related to younger age(p<0.05), and to anticonvulsant medication(p<0.05). 4) Children with associated injury complain emotional symptoms more frequently(p<0.05). 5) More somatic symptoms are presented by children with no medication(p<0.05), and with higher I.Q(p<0.05). 6) Low I.Q is correlated to low GCS score (p<0.05). Cognitive impairment is confirmed in 25 in 42 children complaining cognitive symptoms though I.Q test and BGT, whose hospital stay is longer than the others(p<0.05). 7) emotional disturbance is confirmed in 22 in 25 children showing emotional problems through psychological tests, who complain cognitive symptoms more frequently(p<0.05). Conclusion：This findings suggest that even mild TBI children need to be followed-up and treated as complaining neuropsychiatric symptoms over 6 months after injury, and shorter hospital stay is recommended for cognitive and emotional status of children, and for better evaluation of neuropsychiatric sequelae of TBI, more specific tests should be included in neuropsychological test tools.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.197-208
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• 2015

Objectives : The purposes of this study were to examine the reliability and validity of the Korean version of Social Communication Questionnaire (K-SCQ) and to determine cut-off scores for diagnosis of autism spectrum disorder (ASD). Methods : A total of 166 subjects with ASD and their 186 unaffected siblings were recruited through child psychiatry clinics of university hospitals. Board certified child psychiatrists screened all probands suspected to have ASD based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. To confirm the diagnoses, the Korean versions of the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised (K-ADI-R) were administered to all the subjects. All parents completed the K-SCQ and Social Responsiveness Scale (SRS). The non-ASD siblings were evaluated with the same instruments as the probands with ASD. We performed a factor analysis to examine the structure of K-SCQ. For testing the validity of K-SCQ, we compared the difference in Lifetime and Current scores of probands with ASD and their non-ASD siblings using t-test and analysis of covariance. Correlations between the K-SCQ and other measurements of ASD symptomatology, including K-ADI-R totals and domain scores and SRS, were examined. Receiver operation characteristic curve analysis was performed to extract cutoff scores discriminating affection status. Results : Four factors were extracted through factor analysis of K-SCQ ; 1) social relation and play, 2) stereotyped behavior, 3) social behavior, and 4) abnormal language. Cronbach's internal consistency was .95 in K-SCQ Lifetime, and .93 in K-SCQ Current. There were significant differences in total score of K-SCQ, both in Lifetime and Current between the ASD group and non-ASD siblings group (p<.05). K-SCQ scores were significantly correlated with K-ADI-R subdomain scores and SRS total scores (p<.05). The best-estimate cut-off scores of K-SCQ for diagnosis of ASD were 12 for 48 months and over, and 10 for below 47 months. Conclusion : Our findings suggest that the K-SCQ is a reliable and valid instrument for screening autistic symptoms in the Korean population. Lower cut-off scores than the original English version might be considered when using it as a screening instrument of ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.2
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• pp.63-71
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• 2010

Objectives : The aim of this study was to investigate the effect of the clinical and demographic variables such as body weight, dosage, family history of attention-deficit hyperactivity disorder (ADHD), and psychiatric co-morbidity on the side-effects of OROS-Methylphenidate (OROS-MPH), and to evaluate the relationship between drug response and side effect severity. Methods : A total of 144 children (ages 6-18) with diagnosed ADHD were treated with OROS-MPH. Children were examined at baseline and after 1, 3, 6, 9, and 12 weeks of each treatment condition. The stimulant drug side effect rating scale (SERS), pulse rate, systolic blood pressure, diastolic blood pressure, and electrocardiogram (ECG) were evaluated to assess side effect profiles. Changes in these parameters from baseline were examined and analyzed. Results : Anorexia (30.95%) and insomnia (13.10%) were the most commonly reported side effects during this study. Insomnia and loss of appetite score increased at one week follow-up, but was sustained or decreased as treatment progressed. Small but significant increases in pulse rate and diastolic blood pressure were observed during treatment ; however, no clinically meaningful changes in ECG parameters were noted during the study. Low body weight, high dosage of OROS-MPH, and family history of ADHD were associated with cardiovascular side effect. In contrast, there was no significant relationship between OROS-MPH treatment response and the severity of side effect and no difference resulted between the responder and non-responder groups with respect to OROS-MPH dosage in the 12 weeks of follow-up. Conclusion : To the best of our knowledge, this study is the first Korean study to investigate comprehensive side effect profiles and their correlates in OROS-MPH treatment for ADHD children. OROS-MPH was well tolerated with no clinically significant side effects during the treatment period. In conclusion, low body weight, high dosage of OROSMPH, and family history of ADHD could be used as predictive factors in increasing pulse rate and blood pressure.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.5
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• pp.2713-2723
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• 2014

This study adopts an ecological perspective to empirically navigate the issues surrounding the impact of parental abuse on the emotional development of adolescents. The data is used from the Korean Children and Youth Panel Survey 2011 (KCYPS 2011), which was conducted by the National Youth Policy Institute (n=2,270). Path models were constructed in which adolescents' environmental mediators (i.e., the relationship with parents, friends, and teachers; and school life) control their negative emotions (i.e., aggressiveness, negative physical symptoms, social weakness and depression); in turn to compare the difference between two groups based on parental abuse by using Structural Equation Modeling (SEM). As with the non-abused group (n=1,644), all the environmental mediators remained significant to control their negative emotion; whereas, the abused group (n=626) showed no significant pathway from their relationship with teachers and school life to negative emotion. This indicates that the abused group have limited number of the mediators to control their negative emotion than those of the non-abused group. For the non-abused group, the mediator with the highest total effect to control their negative emotion was the relationship with their friends; on the other hand, the abused group's mediator that showed the highest total effect to control their negative emotion was the relationship with their parents. Although the relationship with teachers remained significant as a mediator to affect school life for the both groups, teachers were not significant to control the negative emotion of the abused group. These findings suggest that the negative relationship with teachers in the abused group is a factor to threat the school adaptation of adolescents, which also leads to problems that are related to the emotional development of adolescents.