PURPOSE: This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients. METHODS: Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between patients with and without coronary artery lesions (CALs). For evaluation of the relationships across laboratory indices, patients with a fever duration of 5 days or 6 days were used (n=204). RESULTS: The mean fever duration was 6.6±2.3 days, and the proportions of patients with CALs was 19.3% (n=114). C-reactive proteins (CRPs) and neutrophil differential values were highest and hemoglobin, albumin, and lymphocyte differential values were lowest in the 6-day group. Patients with CALs had longer total fever duration, higher CRP and neutrophil differential values and lower hemoglobin and albumin values compared to patients without CALs. CRP, albumin, neutrophil differential, and hemoglobin values at the peak inflammation stage of KD showed positive or negative correlations each other. CONCLUSION: The severity of systemic inflammation in KD was reflected in the laboratory values including CRP, neutrophil differential, albumin, and hemoglobin. Observing changes in these laboratory parameters by repeated examinations prior to the peak of inflammation in acute KD may aid in diagnosis of early-presenting KD patients.
C-Reactive Protein ; Coronary Vessels ; Diagnosis ; Early Diagnosis* ; Fever ; Humans ; Inflammation ; Lymphocytes ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils

Seasonal variation in urinary stone presentation is well described in the literature. However, previous studies have some limitations. To explore overall cumulative exposure-response and the heterogeneity in the relationships between daily meteorological factors and urolithiasis incidence in 6 major Korean cities, we analyzed data on 687,833 urolithiasis patients from 2009 to 2013 for 6 large cities in Korea: Seoul, Incheon, Daejeon, Gwangju, Daegu, and Busan. Using a time-series design and distributing lag nonlinear methods, we estimated the relative risk (RR) of mean daily urolithiasis incidence (MDUI) associated with mean daily meteorological factors, including the cumulative RR for a 20-day period. The estimated location-specific associations were then pooled using multivariate meta-regression models. A positive association was confirmed between MDUI and mean daily temperature (MDT), and a negative association was shown between MDUI and mean daily relative humidity (MDRH) in all cities. The lag effect was within 5 days. The multivariate Cochran Q test for heterogeneity at MDT was 12.35 (P = 0.136), and the related I2 statistic accounted for 35.2% of the variability. Additionally, the Cochran Q test for heterogeneity and I2 statistic at MDHR were 26.73 (P value = 0.148) and 24.7% of variability in the total group. Association was confirmed between daily temperature, relative humidity and urolithiasis incidence, and the differences in urolithiasis incidence might have been partially attributable to the different frequencies and the ranges in temperature and humidity between cities in Korea.
Busan ; Daegu ; Gwangju ; Humans ; Humidity ; Incheon ; Incidence ; Korea* ; Meteorological Concepts ; Population Characteristics ; Seasons ; Seoul ; Urinary Calculi ; Urolithiasis*

OBJECTIVES: The objective of this study was to examine the effects of osmotic-controlled release oral delivery system methylphenidate on changes in regional cerebral blood flow (rCBF) in children with attention-deficit hyperactivity disorder (ADHD) using single photon emission computed tomography (SPECT). METHODS: A total of 26 children with ADHD (21 boys, mean age: 9.2±2.05 years old) were recruited. Each ADHD participant was examined for changes in rCBF using technetium-99m-hexamethylpropylene amine oxime brain SPECT before and after 8 weeks methylphenidate medication. Brain SPECT images of pediatric normal controls were selected retrospectively. SPECT images of ADHD children taken before medication were compared with those of pediatric normal controls and those taken after medication using statistical parametric mapping analysis on a voxel-wise basis. RESULTS: Before methylphenidate medication, significantly decreased rCBF in the cerebellum and increased rCBF in the right precuneus, left anterior cingulate, right postcentral gyrus, right inferior parietal lobule and right precentral gyrus were observed in ADHD children compared to pediatric normal controls (p-value<.0005, uncorrected). After medication, we observed significant hypoperfusion in the left thalamus and left cerebellum compared to pediatric normal controls (p-value<.0005, uncorrected). In the comparison between before medication and after medication, there was significant hyperperfusion in the superior frontal gyrus and middle frontal gyrus and significant hypoperfusion in the right insula, right caudate, right middle frontal gyrus, left subcallosal gyrus, left claustrum, and left superior temporal gyrus after methylphenidate medication (p-value<.0005, uncorrected). CONCLUSION: This study supports dysfunctions of fronto-striatal structures and cerebellum in ADHD. We suggest that methylphenidate may have some effects on the frontal lobe, parietal lobe, and cerebellum in children with ADHD.
Basal Ganglia ; Brain ; Cerebellum ; Child* ; Frontal Lobe ; Humans ; Methylphenidate* ; Parietal Lobe ; Rabeprazole ; Retrospective Studies ; Thalamus ; Tomography, Emission-Computed, Single-Photon

This article provides an overview of the developmental history and rationale of medical ethics to establish the code of ethics and professional conduct of the Korean Academy of Child and Adolescent Psychiatry (KACAP). Most medical professional organizations have their own codes of ethics and conduct because they have continuous responsibility to regulate professional activities and conducts for their members. The Ethics and Award Committee of the KACAP appointed a Task-Force to establish the code of ethics and conduct in 2012. Because bioethics has become global, the Ethics Task Force examined global standards. Global standards in medical ethics and professional conduct adopted by the World Medical Association and the World Psychiatric Association have provided the basic framework for our KACAP's code of ethics and professional conduct. The Code of Ethics of the Americal Academy of Child and Adolescent Psychiatry has provided us additional specific clarifications required for child and adolescent patients. The code of ethics and professional conduct of the KACAP will be helpful to us in ethical clinical practice and will ensure our competence in recognizing ethical violations.
Adolescent ; Adolescent Psychiatry* ; Adolescent* ; Advisory Committees ; Awards and Prizes ; Bioethics ; Child* ; Codes of Ethics ; Ethics ; Ethics, Medical* ; Humans ; Mental Competency ; Societies

OBJECTIVES: This study was conducted in order to describe prescribing practices in treatment of pediatric bipolar disorder in a Korean inpatient sample. METHODS: We performed a retrospective chart review of 66 youths who had been hospitalized and diagnosed with bipolar disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Demographics, clinical characteristics, medications used, doses, and related adverse events were examined. RESULTS: Mood stabilizers and/or atypical antipsychotic medications were the primary treatment. Risperidone, valproate, and lithium were the most commonly used. Thirty seven patients (58.1%) were treated with combination therapy of an atypical antipsychotic and mood stabilizer for improvement of manic/mixed symptoms. CONCLUSION: Combination pharmacotherapy was necessary for most patients in this admission sample group. Conduct of further studies will be needed for evaluation of treatment response according to the clinical characteristics, and the safety and efficacy of treatment for child and adolescent bipolar disorder.
Adolescent ; Bipolar Disorder* ; Child ; Demography ; Diagnostic and Statistical Manual of Mental Disorders ; Drug Therapy ; Humans ; Inpatients* ; Lithium ; Retrospective Studies ; Risperidone ; Valproic Acid

OBJECTIVE: People with attention-deficit/hyperactivity disorder (ADHD) exhibit considerable impairment in social, academic, or occupational functioning. The present study aimed to examine the patterns of associations between ADHD symptoms, depression, and family functioning. METHODS: The sample consisted of 1,022 adults randomly selected from a district in Seoul, South Korea. Several self-assessment scales were utilized to rate ADHD symptoms (both past and current), current symptoms of depression, and level of family functioning. ADHD symptoms in the children of these participants were also assessed. Pearson's correlation and multiple linear regression analyses were performed; structural equation modeling (SEM) was conducted to determine the best fitting model. RESULTS: Adult ADHD symptoms were positively associated with depressive symptoms. Depressive symptoms, in turn, mediated the relationship between adult ADHD symptoms and cohesion among family members. In addition, depressive symptoms mediated the relationship between adult ADHD symptoms and their children's ADHD symptoms. CONCLUSION: The relationship between adult ADHD symptoms and family dysfunction may be influenced by depressive symptoms. When treating ADHD in adults, clinicians should pay attention to the presence or absence of depression.
Adult* ; Child* ; Depression* ; Humans ; Korea ; Linear Models ; Self-Assessment ; Seoul ; Weights and Measures

OBJECTIVES: This study was conducted to investigate the prevalence of victims of bullying and the demographic characteristics of victims, and their related psychopathology, in a Korean nationwide sample of youths in middle and high school over a one month period. METHODS: During the autumn of 2009, students in the 7th to 12th grades at 23 secondary schools participated in a nationwide, cross-sectional study. The study subjects completed the Adolescent Mental Health and Problem Behavior Screening Questionnaire- II (AMPQ-II) and Symptom Checklist-90-Revision (SCL-90-R). Based on the data acquired, descriptive statistics, correlation coefficients and multiple logistic regression analysis were performed. RESULTS: Among the 3364 participants, 2272 (67.54%) completed the questionnaire. The prevalence of victimization was 28.9%. Male gender was positively associated with victimization, and grade level was negatively related to victimization. The AMPQ-II bullying score (Factor 4) was significantly (p<.001) and positively correlated to the AMPQ-II student total score (r= 0.50), Worry and thought (Factor 1 ; r=0.38), Mood and suicide (Factor 2 ; r=0.31), Academic and Internet-related problems (Factor 3 ; r=0.24), Rule violations (Factor 5 ; r=0.23), and AMPQ-II teacher total score (r=0.11). Somatization (r=0.23), Obsessive-compulsive behavior (r=0.24), Interpersonal sensitivity (r=0.30), Depression (r=0.33), Anxiety (r=0.26), Hostility (r=0.30), Phobic anxiety (r=0.22), Paranoid ideation (r=0.36), and Psychoticism (r=0.31) results from the SCL-90-R were also found to be positively related to the AMPQ-II bullying score, and remained significant after adjusting for age and gender. A total of 26% of the victims reported suicidal ideations as compared to 9% of non-victims over the month prior to the evaluation (chi2=119.595, df=1, p<.001). The multiple logistic regression analysis indicated that the AMPQ-II bullying score significantly increased the risk of suicidal ideation [Exp(b)=1.55, df=1, p<.001] after adjusting for age and gender. CONCLUSION: School bullying was highly prevalent among Korean middle and high school students. This study provided strong evidence that suicidal ideation and psychopathology were serious problems among the victims of bullying.
Adolescent ; Anxiety ; Bullying ; Crime Victims ; Cross-Sectional Studies ; Depression ; Hostility ; Humans ; Logistic Models ; Male ; Mass Screening ; Mental Health ; Prevalence ; Psychopathology ; Suicidal Ideation ; Suicide ; Surveys and Questionnaires

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease with genetic and environmental backgrounds. While the prevalence of AD is increasing, many patients lack accurate information and understanding about AD. OBJECTIVE: This study was performed to investigate the understanding of AD among Korean AD patients. METHODS: We developed a survey instrument to assess patient understanding of AD. Surveys were conducted over a 6-month period (from May 2010 to October 2010) among 415 patients with AD who visited 10 dermatology clinics at a university teaching hospital affiliated with the Korean Atopic Dermatitis Association. RESULTS: We identified points of understanding in Korean AD patients, such as knowledge and attitudes about AD, awareness of AD treatment, reliability of health care providers and information sources, and acting with AD treatment. As the results of this survey, it was confirmed that the patients' understanding of the cause and prognosis of AD was relatively inadequate, and it could be seen that the perception of the negative attitude toward the medical treatment of AD and inconveniences caused by AD was high. However, the results of the survey on the perception about the medical treatment methods of AD showed that they perceived medical doctors' treatment and prescriptions to have the best curative value, and as the criteria for choosing the treatment methods for AD, they chose the curative value rather than safety and cost. With regard to the information source for AD, they evaluated the treatment postscript on the internet sites and reliability of news media more highly than other information sources, and they responded that the main channel through which they obtain information related to AD was the medical doctors' explanations. CONCLUSION: We conducted the first systematic questionnaire survey to assess the understanding of AD among Korean AD patients. The results of this survey indicate that in the education and promotion on AD patients, additional education with regard to the cause and prognosis of AD is needed, and it is considered that efforts should be made to reduce the negative perception of AD through smooth communication with the medical team. In education and promotion related to AD, treatment postscripts on news media and the internet sites should also be addressed. Ultimately, the patients' self-discipline capabilities should be reinforced through proper education and development of programs related to AD.
Dermatitis, Atopic ; Dermatology ; Health Personnel ; Hospitals, Teaching ; Humans ; Internet ; Prescriptions ; Prevalence ; Prognosis ; Skin Diseases ; Surveys and Questionnaires

OBJECTIVES: The slow cortical potential (SCP) training is one of the methods of neurofeedback which is considered as an adjunctive treatment for attention deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate the effect of the SCP training in children with ADHD. METHODS: Subjects were consisted of 12 children aged between 7 and 13 years and all of the subjects have completed neuropsychological tests to assess their cognitive and executive functioning, before and after their neurofeedback training. Their parents have completed the Korean-ADHD Rating Scale (ARS). Each subject was given 30 sessions of SCP training. RESULTS: The inattention scores and total ARS scores of the subjects have decreased (Z=-2.54, p<0.05, Z=-2.26, p<0.05, respectively) after training, but the hyperactivity/impulsivity scores did not show significant improvement. The commission error scores for both the visual and auditory ADHD diagnostic system (ADS) showed a trend toward improvement after training (p=0.053, p=0.092, respectively). The larger improvement of positive task of feedback trial, which is one of the methods of SCP training, was associated with the larger reduction of ARS total scores (p<0.05) and the larger improvement of negative task of transfer trial was associated with a larger reduction of omission error scores of auditory ADS (p<0.05). CONCLUSION: This study suggests that the SCP neurofeedback program may improve ADHD symptoms and assumes that SCP training is a viable treatment option for ADHD treatment.
Aged ; Attention Deficit Disorder with Hyperactivity ; Child ; Humans ; Neurofeedback ; Neuropsychological Tests ; Parents

OBJECTIVES: The current study was conducted in order to investigate teachers'recognition of school bullying using a nationwide database of adolescents in middle and high school in Korea. METHODS: Students in the 7th to 12th grades at 23 secondary schools participated in the current study during the fall of 2009. Subjects completed the self-report form of the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II (AMPQ-II) and Symptom Checklist-90 Revised (SCL-90-R). In addition, relevant teachers used the teachers' rating scale of the AMPQ-II to report their students' status. Differences in the number of bullied students between teachers' recognition and students' report were explored. RESULTS: A total of 2270 subjects provided relevant responses to the questionnaire. While the one-month prevalence of victimization according to students' self-reports was 28.9%, the recognized prevalence by teachers was only 10.6%. For prediction of the presence of school bullying according to students' self reports on the AMPQ-II, item 7 of the teachers' report on the AMPQ-II showed a sensitivity of 16%, a specificity of 92%, a positive predictability of 44%, a negative predictability of 72%, a false positive rate of 8%, a false negative rate of 84%, and an accuracy of 69%, respectively. No significant differences in subscores of students' self reports of the AMPQ-II and SCL-90-R were observed between bullied students who were recognized by teachers and those who were not recognized. In stepwise discriminant analysis, classification of teachers' item 2 and item 7 on the AMPQ-II with respect to school bullying according to students' reports showed an accuracy of 63.4%. Using this model, 75.2% of non-victimized subjects were classified correctly, while only 35.2% of victimized subjects were classified correctly. CONCLUSION: Despite the high prevalence in Korea, teachers' recognition of school violence among their students remains low. Pre-professional and continuing education to improve teachers' understanding of school bullying and knowledge of effective classroom-based prevention activities should be encouraged.
Adolescent ; Bullying ; Crime Victims ; Education, Continuing ; Humans ; Korea ; Mass Screening ; Mental Health ; Prevalence ; Self Report ; Sensitivity and Specificity ; Violence ; Surveys and Questionnaires