OBJECTIVES: Identifying children with Attention-Deficit/Hyperactivity Disorder (ADHD) and providing early therapeutic interventions for them are important to prevent secondary problems in academic achievement and emotional disturbances. The aims of the study is to examine the characteristics of K-ARS for parents and teachers, a screening questionnaire to identify children with ADHD, by age and sex of the children, to examine its clinical validity, and to provide norm data of K-ARS for school-aged children which will facilitate the use of K-ARS in clinical practice and research. METHODS: Randomly selected 1st to 6th graders of the two elementary schools (N=1044) in Anyang City participated in this study. Twenty three children diagnosed with ADHD at the child and adolescent clinic at the Hallym University Sacred Heart Hospital were included in this study for the analysis of validity. Parents and teachers completed K-ARS. Descriptive statistics, t-test and analysis of variance were performed. RESULTS: K-ARS scores showed significant difference according to the gender, with boys having higher scores than girls. There was no significant difference of the scores by ages. Validity analysis showed that K-ARS distinguishes children with ADHD from children without ADHD well. The normative data were presented by age and sex. CONCLUSION: K-ARS for parents and teachers has an excellent clinical validity to discriminate children with ADHD from children without ADHD. Different normative data of K-ARS need to be used due to the gender difference. K-ARS is a useful tool for screening and identifying children with ADHD. Future studies are required to include larger samples with adolescents in various geographic areas.
Adolescent ; Affective Symptoms ; Child ; Female ; Gyeonggi-do ; Heart ; Humans ; Mass Screening ; Parents* ; Surveys and Questionnaires

OBJECTIVE: It is important to identify and treat ADHD children early to prevent secondary academial and emotional problem. The Purpose of this study is to investigate the reliability and validity of Korean parent and teacher ADHD Rating Scale. METHOD: First to sixth graders in two elementary schools in Anyang City participated in this study. Teachers and parents completed ADHD Rating Scale. Additionally parents completed K-CBCL and Conners scale. Descriptive statistics, correlation, t-test and analysis of variance were performed. RESULT: A total of 1044 students participated in this study. Correlation of rater reliabilities between parent and teacher was significantly close. And Internal consistency by age was high. As correlations among ARS, K-CBCL, Conners scale were high, the ARS scores can be validated. CONCLUSION: Korean parent and teacher ADHD Rating Scale has high reliability and validity. This scale will be a useful tool for ADHD evaluations and diagnosis. A study of comparing clinical groups is suggested.
Child ; Diagnosis ; Gyeonggi-do ; Humans ; Parents* ; Reproducibility of Results*

OBJECTIVE: School bullying, the most prevalent type of school violence, is known to be related to various behavioral, emotional and social problems both in victims and perpetrators. The purpose of the present study is to investigate the prevalence of school bullying and related psychopathology in a community sample of elementary school students. METHOD: Fourth to 6 th graders of two randomly selected classes in two elementary schools in Anyang City participated in a cross-sectional study. Study subjects completed Korean-Peer Nominating Inventory(K-PNI). Parents completed Korean-Child Behavior Checklist(K-CBCL), ADHD Rating Scale(ARS) and Conners Scales for parents, and teachers completed ARS and Conners Scales for teachers. Descriptive statistics, multiple linear and logistic regression were performed. RESULTS: A Total of 532 students participated in this study. Prevalence of victims, perpetrators, and victim-perpetrators were 48%, 45%, and 30% respectively. Extreme victims and perpetrators of school bullying ranged from 2.1-4.1%. Inattention-passivity in teachers' Conners Scale, social immaturity or aggression in K-CBCL were positively associated with victims and victim-perpetrators, and grade was negatively related to school bullying. Conduct problem in Conners Scale for teachers and emotional instability in K-CBCL, and male gender were positively associated with perpetrators. CONCLUSION: School bullying is very common in Korean children of elementary schools. Those who had experienced school bullying, either as victims or as perpetrators, had signifi-cantly more psychopathology than their counterparts. To clarify a causal relationship between psychopathology and school bullying, a longitudinal follow-up study is suggested.
Aggression ; Bullying* ; Child ; Cross-Sectional Studies ; Gyeonggi-do ; Humans ; Logistic Models ; Male ; Parents ; Prevalence ; Psychopathology* ; Social Problems ; Violence ; Weights and Measures

PURPOSE: It was suggested that immunogenic region of E7 proteins of human papillo- mavirus (HPV) type 16 encompass casein kinase (CK) II phosphorylation site and the resulting negative charge may affect the various biologic function of E7 protein. This study was undertaken to analyze the change of antigenic characteristics of HPV type 16, E7 oncoprotein according to phosphorylation. MATERIALS AND METHODS: We produced two monoclonal antibodies (VD6 and IB10) which showed different reactivities to E7 proteins expressed from bacteria or extracted from CaSki cell. These reaction were analyzed by Western blotting. Also the antigenic sites estimation of these antibodies using nested deletion sets was done. On the basis of above experiments, we performed in vitro phosphorylation assay using CK II and its specific inhibitor, DRB (5, 6-dichloro-l-beta-D-ribofuranosylbenzimidazole), to analyze the IB10 reactivity to E7 oncoproteins according to phosphorylation. RESULTS: In Westem blot analysis, VD6 and IB10 antibodies reacted strongly to bacterially expressed E7 protein. But using E7 extracted from CaSki cell, VD6 reacted to 2.0 kDa E7 protein whereas IB10 showed weak reactivity. The antigenic sites estimation of these antibodies showed that antigenic site of VD6 was located in amino terminal region and that of IB10 in the middle portion in the range of approximate amino acid 25-45. The antigenic site of IB10 might contain the possible phosphorylation sites (Ser-31, 32) in E7. Considering this, the different reactivities of IB10 to E7 proteins expressed in bacteria and extracted from CaSki cell might be due to phosphorylation. In in vitro phosphorylation assay using CK II, the phosphorylation of E7 increased according to reaction time. And this phosphorylation reduced the reactivity of IB10 to E7 protein whereas the reactivity of VD6 did not change. Also the reactivity of IB10 to E7 protein increased in a dose dependent manner with CK II specific inhibitor, DRB treated CaSki cell extracts. CONCLUSION: These result showed the antigenecity is affected by the degree of phosphorylation of E7 protein.
Antibodies ; Antibodies, Monoclonal ; Bacteria ; Blotting, Western ; Casein Kinases ; Cell Extracts ; Dichlororibofuranosylbenzimidazole ; Human papillomavirus 16 ; Humans* ; Oncogene Proteins ; Phosphorylation* ; Reaction Time

A 43-year-old woman presented with dizziness, ataxia and right hearing difficulty. Her magnetic resonance images demonstrated an inhomogeneously contrast-enhanced large tumor growing into right cavernous sinus and Meckel's cave located totally within intradural retroclival region. She underwent retromastoid suboccipital craniotomy to resect the tumor mass and adjuvant gamma knife radiosurgery for remnant tumor at 1 month after operation. Adjuvant radiosurgery after surgical excision seems to be effective for the treatment of intradural extraosseous chordomas.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; Ataxia ; Cavernous Sinus ; Chordoma ; Craniotomy ; Cyclophosphamide ; Dizziness ; Doxorubicin ; Female ; Hearing ; Humans ; Magnetic Resonance Spectroscopy ; Podophyllotoxin ; Radiosurgery ; Vincristine

OBJECTIVES: To investigate if vitamin D receptor (VDR) gene polymorphisms and circulating vitamin D levels are associated with pelvic floor disorders (PFDs). METHODS: In this case-control study, 25-hydroxy-vitamin D (25[OH]D) serum levels were analyzed in 47 females with PFDs and 87 healthy females (controls), respectively. The VDR gene polymorphisms were determined by using polymerase chain reaction and performing digestions with 4 restriction enzymes i.e., ApaI, TaqI, FokI, and BsmI. Vitamin D levels of patients were divided into <20 ng/mL, 20 to 30 ng/mL, and ≥30 ng/mL categories. RESULTS: Our correlative analysis of VDR polymorphisms as a function of the presence of PFD showed that ApaI and BsmI polymorphisms were significantly associated with PFD in vitamin-D-deficiency and insufficiency groups (P < 0.05). Mean vitamin D levels did not differ between the PFD case (13.01 ± 0.84 ng/mL) and control (15.11 ± 1.04 ng/mL) groups (P > 0.05). However, there was a significant difference in the distribution of vitamin D levels between study group and controls using Pearson's χ2 test (<20 ng/mL, 20–30 ng/mL, and >30 ng/mL: 87.2%, 12.8%, and 0% in the study group and 75.9%, 16.1%, and 8.0% in controls, respectively, P < 0.05). Taken together, our observations suggest that vitamin D levels could be associated with PFDs and that 2 polymorphisms (i.e., ApaI and BsmI) in the VDR gene may contribute to an increased prevalence of PFDs in women with insufficient levels of vitamin D. CONCLUSIONS: Examining vitamin D levels and performing a VDR genotype analysis may be helpful for assessing PFD risk.
Case-Control Studies ; Female ; Genotype ; Humans ; Pelvic Floor Disorders ; Pelvic Floor ; Polymerase Chain Reaction ; Prevalence ; Receptors, Calcitriol ; Vitamin D Deficiency ; Vitamin D ; Vitamins

Colon capsule endoscopy (CCE) is a relatively new diagnostic procedure for patients with suspected colonic diseases. This convenient, noninvasive method enables the physician to explore the entire colon without significant discomfort to the patient. However, while CCE can be performed painlessly without bowel air insufflation, the need for vigorous bowel preparation and other technical limitations exist. Due to such limitations, CCE has not replaced conventional colonoscopy. In this review, we discuss historical and recent advances in CCE including technical issues, ideal bowel preparation, indications and contraindications and highlight further technical advancements and clinical studies which are needed to develop CCE as a potential diagnostic tool.
Capsule Endoscopy* ; Colon* ; Colonic Diseases ; Colonoscopy ; Humans ; Insufflation ; Methods

BACKGROUND/AIMS: Dominant genotype of hepatitis A virus (HAV) in Korea had been known to be genotype 1A in 1990s. Recently, the epidemiologic change of HAV genotype was reported with an upsurge of acute hepatitis A in Korea. The aim of this study was to investigate the change of HAV genotypes and clinical characteristics in Gwangju and Jeonnam province. METHODS: From November 2008 to October 2009, a total of 82 patients with acute hepatitis A were enrolled prospectively. HAV genotype was determined using reverse transcriptase polymerase chain reaction and sequencing of the PCR products of VP1/2A region of HAV. RESULTS: HAV RNA was detected in 82% (67/82). The genotype IIIA (88%, 59 cases) was significantly more frequent than genotype IA (12%, 8 cases) (p< or =0.01). The subtypes of genotype IIIA were AJ299467 Norway (49%), HA-JNG04-09 Japan (27%), HS-14-12-00 Spain (22%) and H-122 Sweden (2%). The subtypes of IA were FH1 Japan (50%) and HA J04-3 Japan (50%). The substitutions of amino acid were more frequent in genotype IIIA than IA (p< or =0.01). There was no difference in the clinical characteristics between the patients with genotype IIIA and IA. CONCLUSIONS: Genotype IIIA was a dominant genotype of recent HAV infection in Gwangju and Jeonnam province. This study provides valuable epidemiologic information of genetic distributions of HAV in Korea.

PURPOSE: Paroxysmal nocturnal hemoglobinuria (PNH) has been known to be a late clonal complication of aplastic anemia (AA). Flow cytometric analysis using CD55 and CD59 antibodies became the gold standard of diagnosing PNH, replacing a traditional, less sensitive Ham's test, as the pathophysiologic mechanism was identified as the deficiency of glycophosphatidyl-inositol anchored protein. Although the incidence of AA seems to be higher in Korea than that of other Western countries, the study of PNH in Korean pediatric AA has never been accomplished. We studied the frequency of PNH in AA, and tried to compare the characteristics of them with those from other countries. METHODS: Twenty-two pediatric AA patients were enrolled for the study. As a control, 5 patients with inherited bone marrow failure syndromes (Fanconi anemia, 1; Diamond-Blackfan anemia, 3; dyskeratosis congenita, 1) and 11 normal children were pooled. For the flow cytometry, 10muL each of CD55-PE and CD59-FITC was mixed with 50muL of whole blood and incubated for 15 min. Red cells were lysed with Q-prep apparatus (Coulter, Fullerton, USA). Beckman Coulter XL flow cytometer was used for the analyses. RESULTS: The median age for the patients was 14 years (range, 2~21). CD55- and CD59-negative cells from controls were 0.13+/-0.18%. Cut-off value for the diagnosis for PNH was designated as > 0.49%, which was mean +2 S.D. of controls. All the patients showed CD55- and CD59-negative PNH cell proportions within the normal ranges, except for a 19-year-old boy who was still cyclosporine-dependent after initial response to immunosuppressive therapy 4 years before. He had 4.79% of CD55- and CD59-negative PNH population. CONCLUSION: The frequency of PNH clones in Korean children with AA was low (1/22=4.5%). This might reflect the relatively low association of PNH in childhood AA, the limitation caused by small numbers of the study population, or true ethnic differences. A further study incorporating more patients seems to be warranted.
Anemia ; Anemia, Aplastic* ; Anemia, Diamond-Blackfan ; Antibodies ; Bone Marrow ; Child ; Clone Cells ; Diagnosis ; Dyskeratosis Congenita ; Flow Cytometry* ; Hemoglobinuria, Paroxysmal* ; Humans ; Incidence ; Korea ; Male ; Reference Values ; Young Adult

OBJECTIVE: To evaluate the accuracy of a smartphone application measuring heart rates (HRs), during an exercise and discussed clinical potential of the smartphone application for cardiac rehabilitation exercise programs. METHODS: Patients with heart disease (14 with myocardial infarction, 2 with angina pectoris) were recruited. Exercise protocol was comprised of a resting stage, Bruce stage II, Bruce stage III, and a recovery stage. To measure HR, subjects held smartphone in their hands and put the tip of their index finger on the built-in camera for 1 minute at each exercise stage such as resting stage, Bruce stage II, Bruce stage III, and recovery stage. The smartphones recorded photoplethysmography signal and HR was calculated every heart beat. HR data obtained from the smartphone during the exercise protocol was compared with the HR data obtained from a Holter electrocardiography monitor (control). RESULTS: In each exercise protocol stage (resting stage, Bruce stage II, Bruce stage III, and the recovery stage), the HR averages obtained from a Holter monitor were 76.40±12.73, 113.09±14.52, 115.64±15.15, and 81.53±13.08 bpm, respectively. The simultaneously measured HR averages obtained from a smartphone were 76.41±12.82, 112.38±15.06, 115.83±15.36, and 81.53±13 bpm, respectively. The intraclass correlation coefficient (95% confidence interval) was 1.00 (1.00–1.00), 0.99 (0.98–0.99), 0.94 (0.83–0.98), and 1.00 (0.99–1.00) in resting stage, Bruce stage II, Bruce stage III, and recovery stage, respectively. There was no statistically significant difference between the HRs measured by either device at each stage (p>0.05). CONCLUSION: The accuracy of measured HR from a smartphone was almost overlapped with the measurement from the Holter monitor in resting stage and recovery stage. However, we observed that the measurement error increased as the exercise intensity increased.
Electrocardiography, Ambulatory ; Fingers ; Hand ; Heart Diseases ; Heart Rate* ; Heart* ; Humans ; Male* ; Myocardial Infarction ; Myocardial Ischemia* ; Photoplethysmography ; Rehabilitation ; Smartphone*