School Bullying and Related Psychopathology in Elementary School Students / 신경정신의학

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.

Changes in Plasma Dehydroepiandrosterone-Sulfate ( DHEA-S ) Level & DHEA-S / cortisol Ratio by Age in Healthy Korean / 대한내분비학회지

BACKGROUND: DHEA-S is the most abundant steroid hormone in circulation, and primarily secreted from the adrenal cortex, but its physiological role is little known. One of the characteristic features of DHEA-S is progressive decrement of plasma DHEA-S level with advancing age, in contrast, plasma levels of other adrenal hormones are not chaging or littie decreasing. To grasp the trends of plasma DHEA-S level and DHEA-S/cortisol ratio by age in healthy Korean, we measured the plasma DHEA-S levels and DHEA-S/cortisol ratios in healthy Korean. METHODS: Healthy Korean (men: 99, women: 102, age range: 15-97 year old)were studied. Subjects were not taking drugs (such as glucocorticoid or androgenic medication) or cigarettes known to modify the plasma level of DHEA-S and cortisol, and had no evidence of hepatic, renal disease or hyperlipidemia as determined by serum lipid, bilirubin, SGOT, SGPT, BUN, creatinine. Data were analyzed by 10-year age group for men and women: i.e, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89 and 90 year or more. Plasma DHEA-S levels were measured by using a commercially available RIA kit with 125I labeled-DHEA-SO4 (Coat-A Count DHEA-SO4), and for the measurement of plasma cortisol levels, commercial Gamma Coat TM[125I] Cortisol Radioimmunassay Kit was used. RESULTS:. 1) In both men and women, plasma DHEA-S level showed high interindividual variation within the same age group. 2) There were individual sex differences in plasma levels of DHEA-S, in all age groups, plasma DHEA-S levels were significantly higher values for men than for women. 3) Maximum plasma DHEA-S levels (men; 237+-3.35 ug/dL, women; 108+-17.5 ug/dL) were at third decade in both men and women. 4) Both men and women showed the continuous decline in plasma DHEA-S level with age. These age-related decline was more prominent in men than in women (men; y=-3.152 * +292.6, r2= 0.8459, P<0.05, women; y= -1.417 * +143.3, r2 = 0.7278, P< 0.05). 5) As an index of aging, there was no stastical difference between DHEA-S and DHEA-S/cortisol ratio. CONCLUSION: In healthy Korean, there were high interindividual variation of plasrna DHEA-S levels. In both men and women plasma DHEA-S level was peak at third decade, and from when it declined progressively with age. These results suggest that although the reliability of single plasma DHEA-S measurement are limited, the decline of DHEA-S with advancing age might be a specific marker of endocrinologic hormonal milieu (aging index). Also, concerning to individual adrenal secreting capacity, we measured DHEA-S/cortisol ratio. But we did not found that plasma DHEA-S/cortisol ratio is superior to the plasma DHEA-S level as an aging index.

Correlation of Urine Ammonium with Urine Osmolal Gap in High Anion Gap Matabolic Acidosis: Comparison to Urine Anion Gap / 대한내과학회지

OBJECTIVES: Urine anion gap(UAG) and urine osmolal gap(UOG) were proposed as indirect measures of urine ammonium(NF4+). While the former is known to have its usefulness limited to hyperchloremic metabolic acidosis, the latter is reported to have its correlation with urine NE4+ in ketoacidosis. This study was undertaken to evaluate the correlation of urine NH with IJOG in high anion gap metabolic acidosis(AGMA) and to compare it with UAG. METHODS: We measured urine NH' by enzymatic determination, UOG(=0.5 X [urine osmolality-{2 X (Na++K+)+urea+glucose)]), and UAG(=Na++K+-Cl-) in 18 patients(serum AG=24.4+/-1.6mmol/L ) with AGMA. RESULTS: When they were grouped into those with acute disorders(n=11) and those with chronic disorder(n=7), urine Nk4+ concentration was higher (p40mmol/d) had the UOG>40mmol/L. CONCLUSION: In contrast to the UAG, the UOG has a significant correlation with urine NH4+ in AGMA.

A Case of Calciphylaxis in a Patient with Diabetic End Stage Renal Disease / 대한신장학회잡지

Calciphylaxis is a rare but life-threatening complication in patients with end stage renal disease (ESRD). Clinical presentation consists of violaceous skin lesions that progress to nonhealing ulcers and gangrene. Secondary infection of skin lesions is common, often leading to sepsis and death. We report a case presenting in 15months after maintenance hemodialysis for diabetic ESRD with painful violaceous skin discoloration on distal fingers of both hands and toes of left foot. X-ray of both hands and left foot showed vascular calcification along the course of the arteries. Despite symptomatic treatement, skin lesions progressed to nonhealing ulcers and became necrotic, and amputation of the second and fifth fingers of right hand was required. The surgical biopsy specimen revealed circumferential calcium deposition in the intima and media of the arteries by von Kossa stain. Two months after the operation, the patient died of cachexia.

Drug Compliance and Occurrence of Adverse Drug Reactions According to Activities of Daily Living(ADL) Function of Elderly Diabetic Patients

BACKGROUND: To investigate the effect of ADL on the drug compliance and the occurrence of drug side reactions in elderly diabetic out-patients, we performed a study concerning prescriptions. METHODS: Eighty six elderly diabetic out-patients(65~92 year-old)were divided into two groups by the function of ADL(normal ADL group> or =5 score, impaired ADL group< or = 4 score). Four weeks after prescription we examined the account of remaining medicines and the occurrence of adverse drug reactions. Patient compliance with drug therapy was assessed by counting the remained drugs at 4 week according to the following criteria: 2 or 3 days of prescribed drugs, 95% compliance; 1 week, 75%; 2 weeks, 50%; and 3 weeks or more, 25%. The frequency of drug adverse reaction is expressed as the percentage of the number of patients experienced side effect(s) over the total number of patients in each group during 4-weeks. RESULTS: Drug compliance was significantly higher in normal ADL group than in impaired Group(normal 87+/-15.6%, impaired 66+/-14.1%, p<0.01). Drug side effects were more in impaired ADL group than in normal group(impaired ADL group 26.3%, normal group 10.4%). Five normal ADL patients and 10 impaired ones had a total of 20 adverse events. CONCLUSIONS: ADL performance influenced the drug intake compliance and the frequency of drug side effects in elderly diabetic out-patients.

Tourett's disorder and histocompatibility antigen / 신경정신의학

No abstract available.

Tourette disorder and HLA typing

HLA A, B, C and DR were typed in 73 Korean patients with Tourette disorder meeting the diagnostic criteria of DSM III-R and compared with 291 normal subjects. Relatively higher frequencies were found in HLA A11 and A26(10) with lower incidences in HLA A24(9) and B13. A family history of tic disorders was associated with a lower frequency of HLA A24(9).