PURPOSE: To verify the changes of segmental motion after posterolateral lumbar fusion. MATERIALS AND METHODS: Thirty-eight cases of lumbar posterolateral fusion with good postoperative results and full range of motion, followed up for at least one year were reviewed. We measured the translation and angulation by the Dupuis method on flexion extension radiographs. RESULTS: 1) The motion at adjacent segments was 0.75 mm translation and 6.5 degree angulation at L1-2, 0.75 mm and 8.62 degree at L2-3, 0.95 mm and 9.67 degree at L3-4, 1.17 mm and 10.67 degree at L4-5 and 0.41 mm and 7.41 degree at L5-S1. The motion at L5-S1 was less than that in the control group, but at other levels it was not different. 2) The total range of motion of lumbar spine in the control group was 47.8 degree. In one-segment fusion the range of motion was 31.1 degree(64.9%), in two-segment fusion was 26.8 degree(56.1%) and in three-segment fusion was 14.3 degree(29.8%). The longer the fusion level was, the smaller the total range of motion of lumbar spine was. 3) The percentage of motion at adjacent mobile segments in the fusion group increased more significantly than that in the control group. CONCLUSIONS: Segmental motion at adjacent segment in the fusion group was similar to the motion in the control group. The compensatory increased motion at adjacent mobile segment was not definite, however, the percentage of motion at adjacent segment increased after spinal fusion.
Range of Motion, Articular ; Spinal Fusion ; Spine

Objective: Despite the rapid increase in problematic media device use, relatively little is known about specific characteristics and extent of problematic media device and how they relate to different psychological features. Methods: Data extracted from the Panel Korea Study for the Child Cohort Study were used. At the age of 9 years, media device addiction severity was assessed using the K-scale, and children’s behavioral outcomes were assessed using the Child Behavior Checklist. Among children with problematic media device use (n=339), we performed latent profile analysis using the K-scale to identify subtypes of problematic media device use, and then compared the child behavioral problems and executive function according to the different subtypes of problematic media device use. Results: Children with problematic media device use were divided into class 1 (n=51), class 2 (n=138), and class 3 (n=150). Compared with classes 2 and 3, class 1 had more severe problematic media device use, including daily activity disturbance, withdrawal, and tolerance. Class 1 had the most serious behavioral problems and executive function difficulties among classes. Class 2 had greater daily activity disturbance and tolerance than those of class 3, but executive function showed no significant difference between the two classes. In logistic regression analysis, behavioral problems except for somatization were more common in class 1 than in the control group. Conclusion Results suggest that problematic media device use is associated with significant behavioral problem and executive function difficulties and underscore the need for further clinical and research attention for these specific subgroup members.

Objective: There is clinical concern that the stimulant methylphenidate (MPH) might increase the risk of depression, particularly in children. This study aimed to investigate the association between MPH use and the risk of depression. Methods: A population-based electronic medical records database was used. We obtained claims data for prescription of ADHD medication, diagnosis of depression, and prescription of antidepressant medication between January 2007 and December 2016 for 43,259 individuals aged 6 to 19 who were diagnosed with ADHD between July 1, 2007 and December 31, 2007. The final analysis was based on 2,330 eligible participants. A self-controlled case series design was used to identify risk factors for major depressive disorder (MDD). Results: An elevated MDD risk was found during the 90 days before MPH exposure, with an incidence rate ratio (IRR) of 12.12 (95% confidence interval [95% CI]: 10.06−14.61, p ＜ 0.0001). During methylphenidate treatment, the IRR was 18.06 with a 95% CI of 16.67 to 19.56 (p ＜ 0.0001), but it returned to baseline levels after day 31 of MPH treatment discontinuation. The IRR for patients aged 6 to 9 years was 13.11 (95% CI: 9.58−17.95) during the 90 days before MPH exposure, and 17.7 (95% CI: 15.6−20.08) during MPH treatment, but returned to baseline levels after discontinuation of MPH treatment. Conclusion We confirmed the temporal relationship between depression and methylphenidate use in young people with ADHD. Though the absolute risk is low, the risk of depression should be carefully considered, particularly in the period directly following the start of methylphenidate treatment.

Objective: Despite the rapid increase in problematic media device use, relatively little is known about specific characteristics and extent of problematic media device and how they relate to different psychological features. Methods: Data extracted from the Panel Korea Study for the Child Cohort Study were used. At the age of 9 years, media device addiction severity was assessed using the K-scale, and children’s behavioral outcomes were assessed using the Child Behavior Checklist. Among children with problematic media device use (n=339), we performed latent profile analysis using the K-scale to identify subtypes of problematic media device use, and then compared the child behavioral problems and executive function according to the different subtypes of problematic media device use. Results: Children with problematic media device use were divided into class 1 (n=51), class 2 (n=138), and class 3 (n=150). Compared with classes 2 and 3, class 1 had more severe problematic media device use, including daily activity disturbance, withdrawal, and tolerance. Class 1 had the most serious behavioral problems and executive function difficulties among classes. Class 2 had greater daily activity disturbance and tolerance than those of class 3, but executive function showed no significant difference between the two classes. In logistic regression analysis, behavioral problems except for somatization were more common in class 1 than in the control group. Conclusion Results suggest that problematic media device use is associated with significant behavioral problem and executive function difficulties and underscore the need for further clinical and research attention for these specific subgroup members.

Objective: Adolescent gambling is rapidly increasing recently. However, little is known about the core feature of adolescent gambling that should be the treatment target for adolescents. Thus, the objective of this study was to determine the core symptom of adolescent gambling using network analysis with large-scale data targeting community indwelling adolescents. Methods: We used dataset of the 2018 national survey on youth gambling problems collected by the Korea Center on Gambling Problems to explore symptom networks of gambling in adolescents. Of 17,520 respondents in the dataset of the 2018 national survey on youth gambling problems collected by the Korea Center on Gambling Problems, 5,619 adolescents with experience of gambling were included in the analysis. We computed an association network, a graphical least absolute shrinkage and selection operator, and a directed acyclic graph to model symptom interactions. Results: In each network of online, offline, and all gambling, stealing money or other valuable things in order to gamble or pay off gambling debts was the most centrally situated and skipping practice followed by dropping out of activities. Especially strong connections emerged between stealing money or other valuable things in order to gamble or pay off gambling debts and academic performance degradation due to gambling. Feeling bad due to gamble and skipping hanging out with friends who do not gamble emerged as a highly central node that might be distinctive to adolescents with online gambling. Conclusion These findings demonstrate central features of adolescent gambling. Different associations among specific network nodes suggest the existence of distinctive psychopathological constructs between online and offline gambling.

Background: Excessive media use is known to be associated with executive dysfunction in children, but it’s unclear whether this exposure can lead to long-term changes of executive function. This study aimed to investigate the association between media exposure and longitudinal changes in executive function within a population-based study, while considering the potential influence of intelligence. Methods: This study used data from 1,209 participants in the Panel Korea Study for Children.The children’s media exposure was measured at ages 7 and 8, and executive function was evaluated annually from ages 7 to 10 using the Executive Function Difficulty Screening Questionnaire. Participants were grouped by media exposure level (low, medium, or high), and longitudinal changes in executive function were analyzed using linear mixed effects models. Subgroup analysis was conducted to investigate how executive function changes varied based on intelligence within each media exposure group. Results: Children with high media exposure (n = 97) had severer executive function difficulties than those with low (n = 141) or medium (n = 971) exposure in all waves. The high exposure group demonstrated persistent higher executive function difficulties up to age 10 after controlling for child gender, intelligence, parental education level and maternal depression. Children with intelligence quotient (IQ) ≤ 100 in the medium to high media exposure group had significantly more severe executive function difficulties than those with IQ > 100. Conclusion This study provided evidence of a longitudinal negative association between media exposure and executive function. The findings suggest that excessive media exposure may lead to long-term changes in executive function in children and highlight the importance of implementing targeted interventions and educational strategies to mitigate the potential negative effects of excessive media use, particularly for children with lower cognitive abilities.

This study's aim was to investigate whether the incidence of neutropenia was higher in subjects who received a combination pharmacotherapy with valproate (VPA), antipsychotics (APs), and attention deficit hyperactivity disorder (ADHD) medication than in those administered only VPA and APs combination pharmacotherapy. We conducted this study through retrospective review of medical records. We collected the records of 231 children admitted to the National Center for Mental Health. The incidence of neutropenia was significantly higher in the VPA–APs–ADHD combination group than in the other groups (55.2% vs. 25% vs. 12%, VPA + AP + ADHD vs. VPA + AP vs. AP). The presence of the combination of VPA, APs, and ADHD medication was a powerful predictor of neutropenia occurrence after adjusting for age, gender, and body mass index (odds ratio, 6.43; 95% confidence interval, 2.26–18.26; P < 0.001) The combination of VPA, APs, and ADHD medication in children with psychiatric disease appears to increase the incidence of drug-induced neutropenia.

PURPOSE: It has been stressed that age itself as well as multiple organ failure are important prognostic factors in acute renal failure (ARF) in children. This study was performed to find out the significance of age factor and underlying disease of ARF in children. METHODS: We tried to review 58 pediatric ARF cases, retrospectively, in the pediatric intensive care unit (excluding the neonatal and surgical intensive care unit cases) of the Samsung Seoul Hospital of Sung Kyun Kwan University from Sept., 1994. to Dec., 1996. RESULTS: We classified the enrolled 58 cases into 5 age groups and more than half were younger than 1 year old. As underlying causes, heart and gastrointestinal disease were predominant in less than 1 month of age group. After 1 year of age, intrinsic renal disease was the most common cause (43-50%). Among the renal disease, systemic lupus erythematosus (10-15 year group), hemolytic uremic syndrome (1-10 year group), and obstructive uropathy (less than 1 year age group) were common etiologies. The mortality was the highest (46.7%) in less than 1 year group and lowest (21.4%) in 10-15 year age group. CONCLUSION: The underlying disorders of ARF in children were different among the age group. Among intrinsic renal diseases, hemolytic uremic syndrome was the most common cause. The difference in the mortality was dependent on age and underlying disease.
Acute Kidney Injury* ; Age Factors ; Child* ; Gastrointestinal Diseases ; Heart ; Hemolytic-Uremic Syndrome ; Humans ; Critical Care ; Intensive Care Units ; Lupus Erythematosus, Systemic ; Mortality ; Multiple Organ Failure ; Retrospective Studies ; Seoul

OBJECTIVES: Attention deficit hyperactivity disorder (ADHD) is a disease of high heritability. Parents of children with ADHD have high parenting stress and low parenting efficacy. In this study, we assessed parents' characteristics including inattention, hyperactivity, impulsivity, executive function, anxiety/depression severity level, child's ADHD symptom severity, and parents' emotional distress level. The relationships between severity of ADHD symptoms in children, cognitive and emotional characteristics in parents, as well as parenting stress and parenting efficacy were evaluated. METHODS: 96 parents participated in the study. Each parent assessed their child's ADHD symptom severity, their own ADHD symptom severity, as well as executive function, depression, anxiety, parenting stress and parenting efficacy. Collected data was analyzed using multiple regression analysis. RESULTS: The mean ADHD Rating Scale score of 53 children was 22.91 (±9.63). Of these, 26 (49.0%) were taking medication. Eight (8.3%) of the 96 parents had psychiatric illnesses and 12 (12.5%) had the possibility of ADHD. Mothers showed significantly higher levels of parenting stress (p < 0.001), depression (p=0.006), and parenting efficacy (p < 0.001) compared with fathers. The children's ADHD symptoms, severity, and parental depression were related to high parenting stress. The ADHD symptoms of parents were associated with high parenting stress (p=0.032). Parental executive function was significantly associated with low parenting efficacy (p=0.015). CONCLUSION: Children's ADHD symptoms severity, parental depression and ADHD symptom severity were significantly associated with high parenting stress. Parental executive function was significantly associated with low parenting efficacy. In addition to treating the children with ADHD, evaluation and treatment of parents' symptoms is needed in order to reduce parenting stress and provide a stable parenting environment.
Anxiety ; Attention Deficit Disorder with Hyperactivity* ; Child ; Depression ; Executive Function* ; Fathers ; Humans ; Impulsive Behavior ; Mothers ; Parenting ; Parents*

PURPOSE: Helicobacter pylori infection is thought to be correlated with iron-deficiency anemia (IDA) at puberty. The H. pylori feoB gene, a high-affinity ferrous iron transporter, plays a central role in iron acquisition. This study aims to analyze the H. pylori feoB status according to the presence of antral gastritis with or without IDA. METHODS: Fourteen H. pylori-positive patients aged from 10~18 years were categorized into subgroups based on the presence or absence of IDA. Eight patients had IDA, and the other six showed normal hematological findings. Genomic DNA was isolated from cultured H. pylori. Five sets of primers were used for PCR amplification of the feoB gene. The feoB region, 1.93 kb, was generated by linking of the PCR products and sequenced. The feoB gene sequences of H. pylori J99 and 26695 were used to compare with the clinical strains. Sequence comparisons of the feoB regions between the IDA (+) and (-) groups were performed. RESULTS: Sequence analysis of the complete coding region of the feoB revealed 16 sites of polymorphism. Among these, 3 polymorphisms-Glu/Thr254Ala, Ile263Val, and Lys511Gln - were indigenous to Korean strains. Although statistically significant differences appear in 4 sites between IDA (+) and (-), the number of specimens are too low to assess the real differences. CONCLUSION: The 4 polymorphisms in the feoB gene seem to be related with IDA, but it is unclear yet because of small number of study strains. Further studies are required to prove the correlation of IDA and H. pylori infection.
Adolescent ; Anemia, Iron-Deficiency* ; Clinical Coding ; DNA ; Gastritis ; Genes, vif ; Helicobacter pylori* ; Helicobacter* ; Humans ; Iron ; Korea* ; Polymerase Chain Reaction ; Puberty ; Sequence Analysis