Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and restricted, repetitive patterns of behavior and interest. Sleep problems are not uncommon in children with autism spectrum disorders. Symptoms of insomnia are the most frequent sleep problems in individuals with ASD. Sleep problems can cause significant difficulties in the daily life of children with ASD and their families. Genetic factor, deregulations of melatonin synthesis, extraneous environmental stimuli and psychiatric and medical conditions may cause sleep problems. The first line treatment of sleep problems in ASD includes managements for potential contributing factors and parent education about sleep hygiene care for child and behavioral therapy. Supplementation with melatonin may be effective before considering other medications, such as risperidone, clonidine, and mirtazapine.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Clonidine ; Education ; Genetics ; Humans ; Hygiene ; Melatonin ; Parents ; Risperidone ; Sleep Initiation and Maintenance Disorders

We assessed about growth hormone binding proteins (GHBP) activity which was measured eluted biotin GH fraction with alkaline phosphatase-streptavidine in children with insulin dependent diabetes mellitus (IDDM), short stature due to growth hormone deficiency (GHD), chronic renal failure, short stature due to nutritional deficiency. hypothyroidism and normal control groups using high pressure liquid chromatography protein pak 300 sw column. The following results are observed: 1) There were 3 types of growth hormone (GH) in serum: first GH binded with type I (minor) GHBP suggesting 200K dalton of molecular weight, second GH binded with type II (major) GHBP suggesting 60~70K dalton of molecular weight, and third GH were free form GH suggesting 20~25K dalton of molecular weight. 2) Type II (major) GHBP showed considerable individual variation in all ages. Neonates had the lowest levels of GHBP activity, but by the puberty the levels had increased & remained stable from adolescent to adult periods. 3) GHBP activity of children with IDDM at diagnosis was low value as compared to the same agenormal control group (p<0.05), and difference of GHBP activity among children with IDDM was related with height velocity (r=+0.92). Follow up GHBP activity during insulin therapy was reverse correlation with HbAlc. 4) GHBP activity of children with GHD at diagnosis was a slightly low compared to aged matched control and follow-up GHBP activity after 1 dose GH therapy showed increasing tendency (r=-0.68). 5) Otherwise, children with chronic renal failure, short stature due to nutritional deficiency, and hypothyroidism were assessed lower value than normal control group. Above results, GHBP activity had the lowest levels at neonatal period and then increasing tendency until puberty period and remained steady level until adult period. Regulation of GHBP may be closely related with metabolic control state by insulin, GH, nutritional status, and thyroid hormone..
Adolescent ; Adult ; Biotin ; Carrier Proteins ; Child ; Chromatography, Liquid ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diagnosis ; Follow-Up Studies ; Growth Hormone ; Humans* ; Hypothyroidism ; Infant, Newborn ; Insulin ; Kidney Failure, Chronic ; Malnutrition ; Molecular Weight ; Nutritional Status ; Puberty ; Thyroid Gland

The secretion of melatonin exhibits a circadian rhythm entrained with the sleep-wake cycle. An alteration of this secretory rhythm has been found in various psychiatric disorders. This review summarizes the regulation of melatonin and its relationship to the circadian rhythm, major depressive disorder, bipolar disorder, seasonal affective disorder, Alzheimer's disease and autism. The review also looks at the effect of melatonin and melatonin agonist on sleep and symptoms of depression, bipolar disorder and seasonal affective disorder. In Alzheimer's disease, the circadian rhythm alterations are associated with the change of melatonin levels and melatonin receptors. It has been reported that melatonin and melatonin synthetic enzyme levels decrease in autism spectrum disorder.
Alzheimer Disease ; Autistic Disorder ; Bipolar Disorder ; Child ; Autism Spectrum Disorder ; Circadian Rhythm ; Depression ; Depressive Disorder, Major ; Melatonin* ; Receptors, Melatonin ; Seasonal Affective Disorder

No abstract available.
Radiation Oncology*

PURPOSE: To evaluate the accuracy of ultrasonography(USG) and abdominal computerized tomography(CT) and the possibility of reducing unnecessary appendectomy rate with improvement of diagnostic accuracy using optional CT with USG. METHODS: From January 1999 to May 2003, 496 patients younger than 14 years received surgical intervention with preoperative impression of acute appendicitis. They were devided into three groups no preoperative imaging study; preoperative abdominal USG only; and USG with optional abdominal CT. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated in each group, and percentage of unnecessary appendectomy was also obtained. RESULTS: Sensitivity and unnecessary appendectomy rate of group was 78.4% and 21% respectively. Sensitivity, specificity, positive predictive value, negative predictive value and unnecessary appendectomy rates of group were 96.5%, 42.8%, 85.4%, 78% and 12.2%. Sensitivity and positive predictive value of group was 100% and 98%, and no unnecessary appendectomy was performed in this group. CONCLUSION: With consideration of radiation exposure, cost, and in-hospital delay time, using optional CT with USG under optimal indication can decrease the frequency of complications and unnecessary appendectomy rates.
Appendectomy ; Appendicitis* ; Diagnosis* ; Diagnostic Errors ; Humans ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonography

INTRODUCTION: Although it is well known that medical students are not getting an adequate amount of sleep, there have been only a few studies on the sleep patterns of medical students and the related factors. Therefore, the present study aimed to investigate the medical students' sleep patterns and the related factors. METHODS: A questionnaire package was administered to the 1st to 4th year medical students at one medical school. It consisted of questions asking about their lifestyles as well as Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), global assessment of recent stress scale (GASS), the center for epidemiologic studies-depression scale (CES-D), and Moudsley obsessive-compulsive inventory (MOCI). A total of 352 students (206 males and 146 females) responded to the survey and the result was analyzed using the independent t-test, the chi-square test, the paired t-test, Pearson's correlation and ANOVA. p-values of less than 0.05 were considered statistically significant in analyses. RESULTS: The weekend bedtime was significantly delayed (0 : 49 on weekday ; 1 : 34 on weekend ; t=-5.23, p<0.001), the weekend rise time was delayed (6 : 58 on weekday ; 9 : 30 on weekend ; t=-24.48, p<0.001) and the total sleep time was increased on weekends (5 : 36 on weekday ; 7 : 39 on weekend ; t=15.94, p<0.001). The PSQI score of all subjects was 6.43+/-2.64. PSQI was positively correlated with ESS (r=0.383, p<0.001), GASS (r=0.326, p<0.001), CES-D (r=0.393, p<0.001), and MOCI (r=0.247, p<0.001), but not with GPA (r=0.072, p=0.228. The more senior students had lower PSQI, GASS, CES-D, and MOCI score (p<0.05). CONCLUSION: Medical students were experiencing a lack of sleep during weekdays as they have a later bedtime and earlier rise time, and consequently had more hours of sleep on weekends. Overall, the medical students were experiencing poor sleep quality and sleep deprivation. Poor sleep quality is associated with psychological problems (daytime sleepiness, stress, depression, and obsessive tendency).
Depression ; Humans ; Life Style ; Male ; Surveys and Questionnaires ; Schools, Medical ; Sleep Deprivation ; Students, Medical*

PURPOSE: The aim of this study is that the prevalence of rotavirus infection was evaluated by each group and clinical features of group A, B and C rotaviruses infections were described respectively to compare one with another. METHODS: Between January 2010 and December 2010, we enrolled a group of children below 10 years of age admitted for management of acute diarrhea at the Catholic University of Korea Bucheon St. Mary's Hospital. A total of 310 stool samples documented to be free of common bacterial pathogens were collected from children with diarrhea. The presence of group A, B or C rotavirus is indicated by amplification of DNA segments of the expected lengths after the first and second PCRs. RESULTS: In a total of 310 stool specimens, 40 (12.9%) specimens were positive for rotaviruses. These included 23 (7.4%) positive for group A, 5 (1.6%) for group B and 12 (3.9%) for group C rotaviruses. Group B rotavirus infected patients had significantly less diarrheas per day (group A: P=0.01, group C: P=0.01) and shorter duration of vomiting days (group A: P=0.03, group C: P=0.03) than those with group A and C rotaviruses infection respectively. All the group B rotaviruses had been isolated in March and October. Group C rotavirus infections were prevalent during late summer and early winter and peaked in October. CONCLUSION: These findings indicate that group B and C rotaviruses are notable causes or the contributing causes of diarrhea among infants and children in Korea.
Child* ; Diarrhea ; DNA ; Gastroenteritis* ; Gyeonggi-do ; Humans ; Infant ; Korea ; Polymerase Chain Reaction ; Prevalence* ; Rotavirus ; Rotavirus Infections ; Vomiting

PURPOSE: To assess the clinical characteristics of central serous chorioretinopathy in patients over 50 and be of help to diagnose it. METHODS: The medical records of 30 eyes of 24 patients diagnosed as central serous chorioretinopathy were reviewed retrospectively. We analyzed age, sex, visual acuity, and evaluated clinical features of fundus, characteristics of fluorescein angiography, indocyanine green angiography (ICGA), optical coherence tomography (OCT). RESULTS: The mean age was 55.4 years (50-69 years). 18 were male and 6 were female. Of the 30 eyes, 8 eyes were identified as classic central serous chorioretinopathy and 22 eyes were identified as chronic. On ICGA, 16 patients (76.2%) showed transient multifocal choroidal hyperpermeability bilaterally and 19 patients (90.5%) showed dilated choroidal vasculature bilaterally. Late hypofluorescence due to severe atrophy, hypertrophy, pigmentation, or small detachment of retinal pigment epithelium was noted in 22 eyes. On fellow eyes, retinal pigment epithelial degeneration was found in 15 eyes (79%). On OCT, serous retinal pigment epithelial detachment was noted in 10 eyes, serous retinal detachment in 25 eyes, and foveal thickening in 19 eyes. CONCLUSIONS: Central serous chorioretinopathy in patients over 50 was often associated with more degeneration of retinal pigment epithelium. ICGA and OCT are useful in diagnosing central serous chorioretinopathy in old ages.
Angiography ; Atrophy ; Central Serous Chorioretinopathy* ; Choroid ; Female ; Fluorescein Angiography ; Humans ; Hypertrophy ; Indocyanine Green ; Male ; Medical Records ; Pigmentation ; Retinal Detachment ; Retinal Pigment Epithelium ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: To evaluate the CT findings of histopathologically proven pulmonary hamartoma MATERIALS AND METHODS: CT findings of 16 patients with pulmonary hamartoma, histopatologically proven between 1990 and 1996, wereretrospectively reviewed. Diagnosis was based on thoracotomy9n=11) or fine-needle aspiration biopsy(n=5). Weanalyzed the location, margin discreteness, shape, and size of the mass, and the presence of calcification or fatdensity, as seen on CT scan. RESULTS: All 16 tumors showed a discrete and smooth margin and there was nopredilection for any specific site. They were lobulated(11/16, 69%), round(4/16, 25%) or oval(1/16, 6%) and wereless than 1cm(2/16), 1~ < 2cm(4/16), 2~ < 3cm(5/16), 3~ < 4cm(3/16) or 4~5cm(2/16) in size. Nine of 16 cases(56%)showed calcification;this was either popcorn-type(n=3), stippled(n=3), eccentric(n=2), or diffuse(n=1). Five of 16cases(31%) showed fat attenuation. CONCLUSION: On CT, pulmonary hamartomas showed a discrete margin, werelobulated (rather than round or oval) and varied in size. calcification was more common than fat density. These CTfindings may be useful for the differential diagnosis of pulmonary hamartoma.
Biopsy, Fine-Needle ; Diagnosis ; Diagnosis, Differential ; Hamartoma* ; Humans ; Tomography, X-Ray Computed

Background/Aims: This study was conducted to investigate the inhibitory effect of irsogladine maleate (IM) on gastric ulcers induced by ethanol and hydrochloric acid (HCl). Methods: Mice were pretreated with IM for 1 hours before ulcer induction. Gastric ulcers were induced by oral administration of an ethanol/HCl mixture. To clarify the action mechanism of IM, the roles of 3ʹ5ʹ-cyclic adenosine monophosphate (cAMP), nitric oxide (NO), adenosine triphosphate-sensitive potassium (KATP ) channels, prostaglandins and transient receptor potential cation channel subfamily V member 1 (TRPV1) were investigated, and lipid peroxidation in the stomach of IM-treated and -untreated animals was also measured. Results: IM significantly reduced the extent of ethanol/HCl mixture-induced gastric ulceration. It exhibited dose-related gastroprotection against the ethanol/ HCl-induced lesions, while pretreatment with glibenclamide but not N(ω)-nitro-L-arginine methyl ester, reversed this action. While pretreatment with the TRPV1 antagonist capsazepine failed to effectively block the gastroprotective effect of IM, the non-selective cyclooxygenase inhibitor indomethacin almost abolished it. IM also decreased the level of thiobarbituric acid reactive substances. Conclusions We concluded that IM exhibited significant gastroprotective effects in an ethanol/HCl-induced ulcer model, which appear to be mediated, at least in part, by NO, cAMP, endogenous prostaglandins, KATP channel opening, activation of TRPV1 channels, and antioxidant properties.