No abstract available.
Phenylketonurias*

Objectives: This study aimed to examine the trend in diagnostic prevalence of psychiatric disorders in children and adolescents. Methods: Individuals aged 0–18 years were included in the study based on the National Health Insurance Claims Data. To investigate the trends in diagnosis and diagnostic prevalence of psychiatric disorders reflecting the decrease in the birth rate, data were analyzed from 2010 as a reference year to 2015. Results: The number of patients diagnosed with psychiatric disorder decreased annually, from 23,412 on 2010 to 18,821 on 2015. The most common disorder was hyperkinetic disorder in male and depressive episode in female. Although there was no significant change in overall diagnostic prevalence rate of psychiatric disorders, age groups <10 years and some disorders had significant changes in prevalence rate. This study classified the diagnostic prevalence by age into two unique patterns: group in which the diagnosis rate increases with age and group in which the diagnosis rate peaks at a certain age and then decreases. Conclusion Diagnostic prevalence of psychiatric disorders was different according to age and sex. These patterns should be reflected in the formulation of policies related to mental health and in medical practice for pediatric patients. It is urgent to identify how these patterns change in young adults.

In studying child and adolescent psychiatry (CAP), animal models are extremely useful to explore the pathogenesis of disorders or to experiment drugs as substitutes for the human body. Particularly in young children, the accuracy of their expression can be low and there are many restrictions in experiments directly upon the patients including difficulties in medication and tests. However, it is not easy to develop animal models because standards for diagnosis are phenomenological and based on behavioral descriptions. The biggest problem in research using animal models in CAP is that it is difficult to make representative models specific to each disorder. The present study reviewed articles about research with animal models in connection to disorders common in CAP such as autism , Tourette syndrome (TS), attention deficit/hyperactivity disorder (ADHD) and mental retardation (MR). Recent researches through animal models are mainly focused on anatomical studies on sites related to disorders and genetic studies. Although there have been many researches for autism, they still seem to be away from establishing representative models. For TS, it is not easy to make specific animal models because of the complexity of the syndrome, but animal models have been greatly helpful to find pathogenesis and develop remedies for TS. In ADHD, Spontaneously Hypertensive Rats (SHR) model is recognized as a fine model. With regard to MR, a majority of studies are gene researches related to known abnormal chromosomes. Throughout this review, authors recognized that only few articles have been published using animal models for CAP in Korea. We hope that research using animal models will be more activated in Korea.
Adolescent ; Adolescent Psychiatry* ; Adolescent* ; Animals* ; Autistic Disorder ; Child* ; Diagnosis ; Hope ; Human Body ; Humans ; Intellectual Disability ; Korea ; Models, Animal* ; Rats, Inbred SHR ; Tourette Syndrome

Phenomenology has been developed by philosophers like Kant and Husserl since the late 18th century. Jaspers, a German psychiatrist, adopted it into psychopathology studies and accumulated data by closely observing and recording the patients' symptoms and signs. Among descriptions done even before the psychopathology or diagnostic criteria of disorders in the field of child psychiatry was established, we can find exact and valuable descriptions matching the autism spectrum disorder or attention deficit/ hyperactivity disorder. The diagnostic criteria of modern childhood psychiatric disorders were established based on these grounds. Phenomenological/descriptive methods in various psychiatric fields lead to medical study methods for social phenomenon such as oiettolie, hikikomori, and internet game addiction. Since Romanian orphans were adopted to the western world, descriptive studies along with neurobiological studies on the influence of stimulus deprivation on emotional and physical development are being conducted. While phenomenology, which was adopted by Jaspers to verify psychopathology, was developed mainly by observation and description, recent studies are explaining such descriptive phenomena even at the synapse level due to advances in neurobiology. Although phenomenological/descriptive psychiatry, describing precise and detailed experiences of patients, is less applied nowadays among modern study methods, we must remember that such descriptions may lead to biological studies and provide evidence to improve the accuracy of choosing and applying treatment methods.
Autistic Disorder ; Child ; Autism Spectrum Disorder ; Child Psychiatry* ; Child, Orphaned ; Humans ; Internet ; Neurobiology ; Psychiatry ; Psychopathology ; Romania ; Synapses ; Western World

Along with language, socialization is a unique feature of the human being. There is a continuous debate regarding whether the development of socialization is innate, and conducted by the environment in the growing process, or the result of the interaction of both aspects. If socialization is the result of the interaction with the environment or is an acquired developmental process, the following question rises. "Is there a 'critical period' for the development of socialization?" Although there are a huge number of studies seeking for treatment and solutions for developmental delay or deficits of socialization, it is very complicated question to answer. Historical figures such as 'Hugh Blair' of Borgue in England, and 'the wild boy of Aveyron' in France, seem to have innate socialization deficits. Nowadays patients with non-verbal learning disorder, social communication disorder, or autism spectrum disorder seem to have genetic defects. On the other hand, Harry Harlow's monkey experiments, hikikomori of Japan, Romanian orphans and patients with reactive attachment disorder seem to display social deficits due to environmental factors. However, it is not easy to clearly draw a line between innate or acquired factors. Therefore, rather than subdividing the diseases for etiological and pathophysiological approach to heterogenous groups with the common denominator of social deficit, and for the research of pathophysiology and treatment development, the authors suggest a comprehensive concept of "social dysfunction spectrum."
Autistic Disorder ; Child ; Autism Spectrum Disorder ; Child, Orphaned ; Communication Disorders ; England ; France ; Hand ; Haplorhini ; Humans ; Japan ; Learning Disorders ; Male ; Reactive Attachment Disorder ; Socialization

Objective: The shortage of clinical data regarding adult patients with often results in adults with ADHD being stigmatized and being inadequately treated. In this paper, famous people who potentially have ADHD were analyzed to understand better, the life-long progression of ADHD. Methods: 131 people were analyzed as potential candidates for ADHD. A grading system for the candidates was developed: class 1, compatible with ADHD; class 2, likely; class 3, less likely; class 4, uncertain with a shortage of data; and class 5, not compatible. Initially, 39 subjects in class 4 and 12 in class 5 were excluded from the analysis. Finally, 80 subjects (30 in class 1, 33 in class 2, and 17 in class 3) were analyzed for sociodemographic data and psychiatric comorbidities. Results: 88.8% were men and 47.5% of the subjects were married once. In terms of occupation, 45.0% of the subjects were cultural professionals and 25.0% were chief executives. Narcissistic personality disorder was the most frequently noted comorbidity, followed by substance-related and addictive disorder. Conclusion Famous people with ADHD in this study revealed high skill levels in occupation, offering positive aspects of ADHD in adults.

The iron uptake and utilization pathways play a critical role in allowing human pathogens, including Cryptococcus neoformans, the causative agent of fatal meningoencephalitis, to survive within the mammalian body by competing with the host for iron. Here we show that the iron regulon is also required for diverse environmental stress responses and that in C. neoformans, it is regulated by the high-osmolarity glycerol response (HOG) pathway. Between CFO1 and CFO2, two ferroxidase genes in the iron regulon, CFO1 but not CFO2 was induced during oxidative and osmotic stress. Interestingly, we found that the HOG pathway repressed basal expression of both CFO1 and CFO2. Furthermore, when the HOG pathway was blocked, CFO2 also responded to oxidative and osmotic stress and the response of CFO1 was increased. We also established that CFO1 plays a major role in responding and adapting to diverse environmental stresses, including oxidative and genotoxic damage, osmotic fluctuations, heavy metal stress, and stress induced by cell membrane destabilizers. Therefore, our findings indicate that in C. neoformans, the iron uptake and utilization pathways are not only required for iron acquisition and survival, but also play a significant role in the environmental stress response through crosstalk with the HOG pathway.
Cell Membrane ; Ceruloplasmin* ; Cryptococcus neoformans* ; Glycerol ; Humans ; Iron ; Meningoencephalitis ; Osmotic Pressure ; Regulon

BACKGROUND: Intraoperative alfentanil is known to increase the epileptic discharge in the adult seizure patients. This study hypothesized that alfentanil might localize an epileptogenic focus in pediatric seizure patients. METHODS: This study was performed in the pediatric seizure patients who undergo second-staged operation. Thirteen pediatric patients were enrolled and their epileptic foci were already suspected from first operation. After anesthetic induction, sevoflurane was maintained at 0.6% end-tidal concentration for study period. Electrocorticography (ECoG) was recorded for 5 minutes before and 5 minutes after alfentanil 20microgram/kg IV. During the ECoG recordings, the mean arterial pressure (MAP) and heart rate (HR) were continuously monitored. After the surgery, a pediatric neurologist analyzed the changes of spike frequencies of suspected ictal zone. The spike frequencies of suspected non-ictal zone were also calculated in five patients. The suspected ictal zone was defined as the most abundant spontaneous spiking area observed after first staged grid insertion. RESULTS: Alfentanil induced a significant increase in spike activity of suspected ictal zone in 12 out of 13 patients (median of 20 [ranged 10 to 100] vs 38 [ranged 20 to 100], P< 0.05). Alfentanil-induced increase of spike activity was prominent in the suspected ictal zone rather than non-ictal zone. There were no significant changes in the MAP and HR after administration of alfentanil. CONCLUSIONS: Alfentanil activates epileptiform activity of suspected ictal zone in pediatric patients with seizure disorder and can be used to assist in the localization of the epileptogenic focus during seizure surgery.
Adult ; Alfentanil* ; Arterial Pressure ; Epilepsy* ; Heart Rate ; Humans ; Seizures*

BACKGROUND: Exercise can aggravate asthmatic symptoms in many patients with bronchial asthma. It is caused by that inhaled air bypasses nasal cavity and goes directly to the lower airways through open mouth dring exercise. Although the pathogenetic mechanisms of exercise-induced asthma(EIA) have not been clarified yet, there is evidence that chemical mediators, released from the inflammatory cells triggered by airway cooling or drying, might be responsible for induction of bronchoconstriction. However, it has been controversial which chemical mediators or cells are involved in such process. Objectiye . The aim of this study was to evaluate the role of activated mast cells in the pathogenesis of EIA and find out whether or not sulfidopeptide leukotrienes (LTC4/d4/E4) are involved in the exercise-induced bronchoconstriction. MATERIAL AND METHOD: Eleven asthmatics with documented exercise-induced bronchoconstriction and 10 control subjects were studied. Before and 6 hours after free running for 6 minutes, forced expiratory volume in 1 second (FEV,) and the concentrations of N- methylhistamine, LTE4, and creatinine in unine collected for 6 hours after exercise were determined. RESULT: Urinary concentrations of N-methylhistamine(mean+SE, ng/mg creatinine) of EIA patients before and after exercise were 159+40 and 450+75, respectively. Those of control subjects were 208+ 54 and 275+ 62, respectively. Uninary N-methylhistamine levels of EIA group increased significantly after exercise, while those of control group did not change. Urinary concentrations of LTE,(mean+SE, pg/mg creatinine) of EIA patients before and after exercise were 15.6 k2.6 and 22.2+5.8, respectively. Those of control subjects were 10.4+ 4.0, 18.2 +7.0, respectively. The concentrations of LTE4 in the urine samples collected before exerise revealed no difference between EIA and control subjects (p=0.07). There was no change after exercise in both groups. Percent fall of FEV, was 29.1+8.0% (mean+SD) in EIA group and 3.4 + 4.0% in control group, respectively. There was no correlation between reduction of FEV, and change in urinary concentrations of N-methyl-histmine after exercise. CONCLUSTION: Chemical mediators of activated mast cells may be involved in exercise-induced bronchoconstriction, but there is little evidence for enhanced sulfidopeptide leukotriene generation as assessed by urinary LTE4.
Asthma ; Asthma, Exercise-Induced* ; Bronchoconstriction ; Creatinine ; Forced Expiratory Volume ; Humans ; Leukotriene E4 ; Leukotrienes ; Mast Cells ; Mouth ; Nasal Cavity ; Running