OBJECTIVE: We attempted to confirm the effects of the combined treatment of medication and parent training on the behavioral problems of referred ADHD children, the maternal behavior, and the parenting stress of their mothers. METHODS: Twenty-four children between the ages of 5 to 11 and their mothers were selected as subjects from Child Psychiatric Clinics of Hanyang University Hospital. Three groups were organized : combined treatment group of medication and parent training(N=6) ; wating list group(N=6) ; and medication only group(N=6). Methylphenidate(0.5-0.7 mg/kg/day) was prescribed for children. Mothers of the combined treatment group of medication and parent training and the wating list group attended the parent training once a week for nine weeks and a booster session 4 weeks later. Treatment outcomes were evaluated by comparing both treatment groups at pre- and post-treatment using the various rating scales. Especially the combined treatment group was followed up after 6 months to evaluate the stability of treatment effects. RESULTS: This study showed greater effectiveness of the combined treatment of medication and parent training relative to the medication only in decreasing the overall behavioral problems of ADHD children and the parenting stress of mothers as well as in increasing the desirable maternal behavior. In addition, these improvements were maintained at 6 month follow-up. CONCLUSION: The combined treatment of medication and parent training facilitated the behavioral improvement of referred ADHD children in several aspects.
Child* ; Drug Therapy ; Follow-Up Studies ; Humans ; Maternal Behavior ; Mothers ; Parenting ; Parents* ; Weights and Measures

The aims of this paper are to identify where the quality research activity has been and is carried out in Korea, and to examine weather the Korean plastic surgeons have sufficient capacity to place their official journal "The Journal of Korean Society of Plastic and Reconstructive Surgeons(KPRS)" to international databases. We investigated the publication productivity of all departments of plastic surgery in Korean medical colleges, hospitals, and clinics as measured by the number of papers in journals indexed in SCI(Science citation index). The 27 year period from 1974 to 2000 is covered. A total of 195 papers is published in SCI journals by the plastic surgeons in Korea. The first SCI paper was published in 1985; the number of publication has gradually increased. Since 1998, over 30 papers are annually published in SCI journals by Korean plastic surgeons. The production of SCI papers are concentrated in a few universities. About seventy percent of SCI journal papers is published by top seven medical schools; 25.6% by Yonsei university. In 1985, only one medical school was involved in the production of SCI journal papers. After 1997, however, more than 10 medical school and some surgeons in local clinics published SCI journal papers. The percent of SCI journal papers among all papers written by the Korean plastic surgeons increased recently: About 15% are published in SCI journals in 1999 and 2000 respectively. These data suggest that Korean plastic surgeons have enough capacity to place their official journal KPRS into international data bases.
Efficiency* ; Korea ; Publications* ; Schools, Medical ; Surgery, Plastic ; Weather

This study examined the reproducibility of nutrient intakes estimated by the 24-hour recall method in a prospective cohort study (Longitudinal study of aging and health monitoring of Korean elderly) of middle-aged volunteer subjects (42 males and 49 females) in the Seoul area. The three-day 24-hour recall was administered twice at an interval of approximately 6 months. The first data were collected and a corrective procedure was performed by interviewing of the subjects and a trained dietitian. The second data were collected by mail from the subjects without the performance of any corrective procedure. The mean age of the subjects was 53.5+/-9.6 for the males and 52.2+/-8.9 for the females. The subjects who had above college education were 95% in the case of the males and 60% in the case of the females. The characteristics of the male subjects in this study were that they were highly educated and held professional jobs and were from the middle or upper class. Comparing the first and second 24-hour recall data, the second data showed relatively lower intakes of all nutrients, except vitamin A, vitamin Bi and cholesterol. There was no difference in the nutrients of the first and the second data with respect to vitamin A, vitamin B1 and cholesterol in the males and calcium, iron, sodium, vitamin A, vitamin B1, vitamin B2 and cholesterol in the females. This data may indicate that the 24 hour retail method without a dietitian's help may result in lower reporting of the subject's intakes. The men had a tendency to remember less than the women. Pearson's correlation coefficients with unadjusted nutrient intakes values were ranged from 0.24 to 0.66. When energy intake was adjusted, there was a slight increase (from 0.26 to 0.71). Intra-class correlation coefficients with nutrient-unadjusted values ranged from 0.22 to 0.66, and the energy-adjusted values were ranged from 0.23 to 0.69. The weighted Kappa statistical values ranged from 0.10 to 0.40. On the average,46.3% of the subjects who were found in the lowest quartile of the nutrient intake levels based on the first 24-hour recall, were in the lowest quartile based on the second 24-hour recall. Therefore, there was a low reproducibility between the first and the second 24-hour recall. We should examine the factors influencing low reproducibility. Also, strategies should be developed to maximize the reliability of the assessment, with regard to portion-size training and telephone validation.
Aging ; Calcium ; Cholesterol ; Cohort Studies ; Education ; Energy Intake ; Female ; Humans ; Iron ; Male ; Nutritionists ; Postal Service ; Prospective Studies ; Riboflavin ; Seoul ; Sodium ; Telephone ; Thiamine ; Vitamin A ; Vitamins ; Volunteers

PURPOSE: This study was designed to evaluate the prognostic factors, survival rate and local recurrence rate of the patients with rectal cancer who received postoperative radiation therapy. METHODS & MATERIALS: Seventy patients with rectal cancer received postoperative radiation therapy after curative surgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medial College between May 1984 and April 1993. Of the seventy patients, sixty-four evaluable patients were analysed retrospectively. There were 34 men and 28 women. Age at diagnosis ranged from 23 to 74 years. The distribution of stage according to the modified Astler-Coller (MAC) system was as follow: 12 in B2+3, 2 in C1, and 50 in C2+3. Postoperative adjuvant therapy included pelvic radiotherapy in all cases and chemotherapy in addition in 55 cases. A total dose of 45 to 60 Gy (median dose: 55.8Gy) was delivered in a period of 5 to 6 weeks and the follow-up period ranged from 26 to 133 months with a median of 55 months. RESULTS: Overall two-year and five-year actuarial survival rate were 70.3% and 51.4%, 90.9% and 90.9% in stage B2+3, and 68.2% and 53.6% in stage C. Local failure occurred in 13 (20.3%) of the 64 patients and distant failure rate was 18.8% (12/64). Severe late complication was small bowel obstruction in 4 patients and surgery was required in 3 patients (5%). The significant prognostic factors were stage (p=0.0019) and histologic differentiation (p=0.0046). CONCLUSION: This study suggested a potential adjuvant role for radiation. However, the possible reduction in local failure rates in this study compared with historic control groups must be verified in randomized trial.
Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Radiation Oncology ; Radiotherapy ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies ; Survival Rate

BACKGROUND: Langerhans cell histiocytosis (LCH) is a rare disease that involves a clonal proliferation of Langerhans cells. LCH has a predilection for hypothalamo-pituitary axis (HPA) dysfunction, and this leads to diabetes insipidus (DI) and/or anterior pituitary dysfunction. Here, we describe the endocrine dysfunction and clinical characteristics of adult patients with LCH and we analyzed the differences between an adult-onset type and a childhood-onset type. METHODS: The data was obtained from a retrospective chart review of the patients with LCH that involved the HPA and who attended Seoul National University Hospital. The patients were classified into the adult-onset type (age at the time of diagnosis > or = 16) and the childhood-onset type (age at the time of diagnosis < or = 15). RESULTS: Ten patients (9 males and 1 female) were diagnosed with LCH involving the HPA. Five patients were classified as an adultonset type and the other five patients were classified as a childhood-onset type. The median follow-up duration was 6 (3-12) years for the adult-onset type and 16 (15-22) years for the childhood-onset type. All the patients presented with DI as the initial manifestation of HPA involvement. Four adult-onset patients and three childhood-onset patients had a multi-system disease. Panhypopituitarism developed in three adult-onset patients and in one childhood-onset patient. The pituitary lesion of the three adult-onset patients had spread to the brain during the follow-up duration. In contrast, the pituitary lesion of the other two adult-onset patients without panhypopituitarism and all the childhood-onset patients had not changed. CONCLUSION: DI was the initial presentation symptom of HPA involvement. Anterior pituitary hormone deficiency followed in some patients. Compared with the childhood-onset patients, the adult-onset patients were more likely to have panhypopituitarism and a poor prognosis.
Adult ; Brain ; Diabetes Insipidus ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans ; Hypopituitarism ; Langerhans Cells ; Male ; Prognosis ; Rare Diseases ; Retrospective Studies ; Axis, Cervical Vertebra