Association between Executive Functions and Time Perspectives in Patients with Adults Attention-Deficit/Hyperactivity Disorder / 신경정신의학

OBJECTIVES: This study examined the association between executive functions and time perspectives in patients with adult attention-deficit/hyperactivity disorder (ADHD). The executive function including self-management to time, self-organization/problem solving, self-restraint or inhibition, self-motivation, and self-regulation of emotion was analyzed. In addition, the time perspective, including past-negative, past-positive, present-hedonistic, present-fatalistic, future-negative, and future-positive, were investigated. The correlations between the executive functions and time perspectives were analyzed in an adult ADHD patient group. METHODS: Thirty-six participants were divided into 17 in the ADHD group and 19 in the Control group. The participants conduct psychological tests including Barkley Deficits in Executive Functioning Scale (BDEFS), ADHD Self-Report Scale, and the Swedish Zimbardo Time Perspective Inventory to confirm their executive functions, attention, and time perspectives. The participants were recruited at Samsung Medical Center from April 2017 to November 2018. The collected data was analyzed using a t-test and Pearson correlation analysis. RESULTS: The adult ADHD patients group showed significantly higher scores in the BDEFS and ADHD Self-Report Scale than the control group. In time perspective scores, the adult ADHD patients group was higher in the past-negative, present-hedonistic, present-fatalistic time perspectives than the control group. In addition, the adult ADHD patients group was lower in future-positive than the control group. In the adult ADHD patients group, the future-positive time perspectives were negatively correlated with the executive functions. CONCLUSION: These results suggest that the negative time perspective is related to the executive function deficits in an adult ADHD group, particularly in the self-management of time, self-organization/problem solving, and self-motivation.

Comparison of Confidence in Practice and Satisfaction by Feedback Types Following Objective Structured Clinical Examination(OSCE) among Nursing Students: Focus on Intermittent Gavage Tube Feeding / 기본간호학회지

PURPOSE: The purposes of this study were to compare confidence in practice of intermittent gavage tube feeding and participants' satisfaction by three types of feedback; professor verbal feedback, professor feedback with smartphone video, and peer feedback with smartphone video. In addition, frequently failed items in the intermittent gavage tube feeding procedure were analyzed. METHODS: Data were collected from a convenience sample of 78 nursing college students in November 2014. Students were randomly assigned to the control group, experimental group I (smartphone video with professor feedback) or group II (smartphone video with peer feedback). Data were analyzed using descriptive statistics including chi-square test, ANOVA, and Scheffe test with SPSS 21.0. RESULTS: Confidence in practice of intermittent gavage tube feeding and satisfaction with feedback were highest in experimental group I that had professor feedback with smartphone video. For the procedure, the most frequently failed item was giving an explanation to patients about the purpose and the procedure of tube feeding. CONCLUSION: The results indicate that professor verbal feedback with smartphone video is the most benefit to the nursing students in acquiring core nursing practice skills.

Improvement of Induction Remission Rate by Modifying the Dose of Idarubicin for Relapsed Childhood Acute Lymphoblastic Leukemia

Relapse is the major cause of treatment failure in acute lymphoblastic leukemia (ALL), yet there is no established treatment for relapsed ALL. To improve the induction remission rate, we modified the dose of idarubicin in the original Children's Cancer Group (CCG)-1884 protocol, and retrospectively compared the results. Twenty-eight patients diagnosed with relapsed ALL received induction chemotherapy according to the CCG-1884 protocol. Complete remission (CR) rate in all patients after induction chemotherapy was 57%. The idarubicin 10 mg/m2/week group showed CR rate of 74%, compared with the 22% CR rate of the idarubicin 12.5 mg/m2/week group (p=0.010). Remission failure due to treatment-related mortality (TRM) was 44% and 5.2% in the idarubicin 12.5 mg/m2/week and 10 mg/m2/week groups, respectively (p=0.011). Overall survival (OS) and 4-yr event-free survival (EFS) were 12.8% and 10.3%, respectively. OS and 4-yr EFS were higher in the idarubicin 10 mg/m2/week group (19.3% and 15.6%) than in the 12.5 mg/m2/week group (0% and 0%). In conclusion, a modified dose of idarubicin from 12.5 mg/m2/week to 10 mg/m2/week resulted in an improved CR rate in the treatment of relapsed ALL, which was due to lower TRM. However, despite improved CR rate with modified dose of idarubicin, survival rates were unsatisfactory.

Unrelated Bone Marrow Transplantation with a Reduced Toxicity Myeloablative Conditioning Regimen in Wiskott-Aldrich Syndrome

Wiskott-Aldrich syndrome (WAS) is an X-linked congenital immune-deficiency syndrome, and bone marrow transplantation (BMT) has become a curative modality. However, the transplant with the alternative donor needed more intensive conditioning with increased treatment-related toxicities. Recently, fludarabine-based reduced toxicity myeloablative conditioning regimens have been developed for adult myeloid malignancies with promising results of good engraftment and low treatment-related toxicities. To increase the engraftment potential without serious complications, a boy with WAS received successful unrelated BMT with a reduced toxicity myeloablative conditioning regimen composed of fludarabine (40 mg/m(2) on days -8, -7, -6, -5, -4, -3), busulfan (0.8 mg/kg i. v. q 6 hr on days -6, -5, -4, -3), and thymoglobulin (2.5 mg/kg on days -4, -3, -2). This novel conditioning regimen could improve the outcome of allogeneic transplantation for other non-malignant diseases such as congenital immune-deficiency syndromes or metabolic storage diseases.

Effect of Treatment Modification by the Initial Response in Patients with High-Risk Childhood Acute Lymphoblastic Leukemia

BACKGROUND: The bone marrow (BM) findingd on day 7 of induction chemotherapy is one of major prognostic factors for patients with acute lymphoblastic leukemia (ALL). M3 marrow (blast >25% on BM examination) on day 7 is associated with lower survival rates, compared with the M1 (blast <5%) or M2 (blast 5~25%) marrow. Herein, we analyzed the effect of augmented post-induction chemotherapy in patients who have high-risk ALL with M3 marrow on the day 7 BM examination. METHODS: We analyzed the patients who were diagnosed with high-risk ALL and they received modified Children's Cancer Group (CCG)-1882 induction chemotherapy between January 1996 and October 2005 at Seoul National University Children's Hospital. The patients with M1 or M2 marrow on day 7 were treated with modified CCG-1882A/B chemotherapy from consolidation, and the patients with M3 marrow were treated with modified CCG-1882C chemotherapy. RESULTS: A total of 44 patients (29 with modified CCG-1882A/B and 15 with modified CCG-1882C) were analyzed. The overall survival (OS) and 5-year event-free survival (EFS) were 86.2% and 81.9%, respectively. The OS of the patients who were treated with the modified CCG-1882A/B protocol (88.9%) was not different from that of the patients who were treated with the modified CCG-1882C protocol (80.0%) (P=0.3256). Also, there was no statistical difference in the 5-year EFS of both groups (85.4% vs 72.7%, respectively, P=0.2117). CONCLUSIONS: There was no difference of survival between the patients with M1/M2 marrow on the day 7 BM examination and those with M3 marrow after augmented post-induction chemotherapy for the patient with high-risk ALL. We suggest that the poor prognosis of high-risk ALL patients with a poor initial response could be overcome by augmented post-induction chemotherapy.

Retrospective Analysis of Peripheral Blood Stem Cell Transplantation for the Treatment of High-Risk Neuroblastoma

Disease relapse after autologous peripheral blood stem cell transplantation (APBSCT) is the main cause of treatment failure in high-risk neuroblastoma (NBL). To reduce relapse, various efforts have been made such as CD34+ selection and double APBSCT. Here the authors reviewed the clinical features and outcomes of highrisk NBL patients and analyzed their survival. The medical records of 36 patients with stage III or IV NBL who underwent APBSCT at Seoul National University Children's Hospital between May 1996 and May 2004 were reviewed. Total 46 APBSCTs were performed in 36 patients. Disease free survival (DFS) and overall survival of all patients were 47.7% and 68.8%, respectively. The patients were allocated to three groups according to the APBSCT type. The DFS of CD34+ non-selected single APBSCT patients (N=13), CD34+ selected single APBSCT patients (N=14), and CD34+ selected double APBSCT patients (N=9) were 55.6%, 40.6%, and 50.0%, respectively, which were not significantly different. Thus the survival was not found to be affected by CD34+ selection or transplantation number. To improve long-term survival, various efforts should be made such as chemotherapy dose intensification, more effective tumor purging, and control of minimal residual disease via the use of differentiating and immune-modulating agents.

Intracranial Atypical Teratoid/Rhabdoid Tumor: Retrospective Analysis in a Single Institution / 대한소아혈액종양학회지

PURPOSE: Intracranial atypical teratoid/rhabdoid tumor (ATRT) is an extremely rare and aggressive tumor of early childhood. In this study, we evaluated the clinical characteristics, therapeutic approaches and outcomes of children who were treated at Seoul National University Children's Hospital (SNUCH). METHODS: We reviewed the clinical records of seven patients who were diagnosed as ATRT at SNUCH between January 2000 and July 2005. RESULTS: Of the seven patients, three patients were male and four were female. Median age at diagnosis was 13 months ranging from 3 months to 67 months. The tumors occurred in the infratentorial area in six and at multiple sites in one patient. Metastatic disease at diagnosis was present in two patients. One showed cerebrospinal fluid (CSF) dissemination and the other showed bony metastasis. Tumor excision was performed in all patients, and with the exception of two cases that refused further treatment, five patients received postoperative chemotherpay. One patient with CSF dissemination received radiotherapy and intrathecal chemotherapy as well. Of all the patients who received chemotherapy, two patients died during treatment because of tumor progression. The chemotherapy regimen was changed in three patients during treatment because the tumor showed poor response to chemotherapy. The median length of follow-up for five patients receiving chemotherapy was 6 months and the overall survival (OS) and event free survival (EFS) were 33.3% and 0%, respectively. CONCLUSION: Though various therapeutic approaches have led to improved survival in ATRT, the prognosis of ATRT is dismal compared with other brain tumors. A precise pathologic diagnosis is crucial and intensified treatment modalities should be considered according to the extent of tumor. To establish optimal treatment guidelines, a cooperative prospective study is needed and the efficacy of individual regimens should be analyzed.

Polymorphism of Matrix Metalloproteinase-3 Promoter Gene as a Risk Factor for Coronary Artery Lesions in Kawasaki Disease

Kawasaki disease (KD) is a major cause of acquired coronary artery diseases in childhood. The serum levels of matrix metalloproteinase (MMP)-3 and MMP-9 in KD have been reported to be significantly higher than other diseases. Several studies have demonstrated that MMP-3 5A/6A polymorphism and MMP-9 C-1562T polymorphism modify each transcriptional activity in allele specific manner. We hypothesized that these polymorphisms may play a role as a risk factor for development of coronary artery lesions (CAL) in KD. Eighty-three patients, diagnosed with KD in Cheju National University Hospital from January 2000 to February 2004, were divided into two groups according to the presence of CAL. Genotyping of MMP-3 and MMP-9 gene polymorphisms were determined by restriction fragment length polymorphism. With regard to MMP-3 gene polymorphism, the KD with CAL group had a higher frequency of 6A/6A genotype than control group (p=0.0127) and the KD without CAL group (p=0.0036). However, no significant differences in the allele and genotype distributions of the MMP-9 polymorphism were observed. These findings suggest that MMP-3 6A/6A genotype may be an independent risk factor for CAL formation in KD.

Establishment of Human Bone Marrow-Derived Mesenchymal Stem Cell Lines with SV40 Large T Antigen and Their Differentiation to Chondrocytes / 대한소아혈액종양학회지

PURPOSE: Mesenchymal stem cells (MSC) can be isolated from bone marrow (BM) and when systemically administrated to different species, they undergo site-specific differentiation. In this study, we isolated MSC from human BM and generated a continuously growing colony of cell lines (SNU-hMSC) with SV40 large T antigen. The purposes of this study are to identify whether SNU-hMSC have the characteristics of MSC and their possibility of chondrogenic differentiation. METHODS: MSC were mobilized from BM and cultured in DMEM-LG media for 2 weeks. We obtained SNU-hMSC, by introducing a viral vector of SV40 large T antigen and culturing it in the selected media for 6 months. We identified specific cell markers of MSC via FACS analysis and analyzed expression of cytokines, chemokines and receptors by RT-PCR. To stimulate the proliferation of the cells, we processed the media with FGF, BMP-2 and IL-6. The each medium's cell counts were counted in day 7 and day 14. To differentiate SNU-hMSC, they were cultured in chondrogenic media. After 2 weeks, chondrogenic differentiation was evaluated with safranin-O staining and the expression of COMP, aggrecan and SOX-9. RESULTS: SNU-hMSC exhibited MSC markers. When the IL-6, BMP-2 and FGF were added to each medium, the cell numbers were significantly increased as compared with control. In the study of differentiation, SNU-hMSC exhibited strong safranin-O staining, and chondrogenic gene expression was observed. CONCLUSION: SNU-hMSC expressed markers and cytokines identical with MSC. SNU-hMSC maintained multipotency of differentiation.

A Case of Opsoclonus-Myoclonus-Ataxia Syndrome in Ganglioneuroblastoma / 대한소아혈액종양학회지

The presence of rare paraneoplastic syndrome, the opsoclonus-myoclonus-ataxia syndrome (OMA), may strongly signal the presence of neuroblastoma. We report a case of ganglioneuroblastoma presented with OMA. A 26 month-old girl was admitted due to progressive ataxic gait and myoclonic jerking of the limbs. Brain and spine MRI scans were normal and cerebrospinal fluid analysis showed no specific abnormal finding. Abdominal computed tomography (CT) demonstrated about 3x1.5 cm sized well enhancing solid mass originated from the right adrenal gland. Urinary vanillyl mandelic acid (VMA) was mildly elevated and urinary homovanillic acid (HVA) was normal. After complete resection of the tumor, she was diagnosed with ganglioneuroblastoma and her symptomatology had disappeared.

A Study on Elementary School Dietitian's Status and Recognition of Nutrition Education in Incheon / 대한지역사회영양학회지

The purpose of this study was to investigate the elementary school dietitian's status and recognition of nutrition education (NE) in Incheon. A cross-sectional study was carried out using a self-administered questionnaire and subjects were 100 elementary school dietitians. The results are as follows As for training in NE, 61.2% of the dietitians attended training in NE. After training in NE, 86.5% of the dietitians who attended training in NE were more concerned about NE. Also 59.5% of the dietitians gave students NE and most of them did as a weekly printout 2-4 times per month. There was a significant difference in experience of NE for teachers between subgroups by experience of training in NE; while 48.1% of the dietitians with training in NE gave teachers NE, 20.0% of the dietitians without training in NE gave teachers NE. The main reason for not giving NE was too much work load and low concern of school administration. Also 96.4% of the dietitians answered that NE is necessary in elementary school and the main reason for being necessary was correction of unbalanced diet and good table manner, As for proper time to start NE for children, 51.8% of dietitians answered 'kindergarten' and 45.8% of them answered 'lower grade of elementary school'. As for effective type for NE, 59.5% of the dietitians answered 'NE as a part of other subject' and 23.8% of them answered 'NE as a separate subject'. Also 79.5% of the dietitians answered 'teacher' as the suitable person for NE. Most of the dietitians recognized menu formation as the ideal major work load and office work as the most time-consuming work load. As to job satisfaction, most of them were dissatisfied with office work and NE. Therefore, it is nationally supported for elementary school students' health and well-being that school dietitians as NE specialists give NE with minimizing their office work and developing a standardized NE program.

A Study on Elementary School Teacher's Status and Recognition of Nutrition Education in Incheon

The purpose of this study was to investigate the elementary school teacher's status and recognition of nutrition education (NE) in Incheon. A cross-sectional study was carried out using a self-administered questionnaire and subjects were 147 elementary school teachers. The results are as follows. Only 9.5% of the teachers had training in NE and 71.4% of the teachers with training increased concern about NE after training. As for experience of NE, 61.6% of the teachers experienced NE and more than half of them gave NE less than twice per month. There was a significant difference in reason for not giving NE between subgroups by teaching career; 57.7% of the teachers with career more than 10 years did not give NE due to too much other work. As for existence of nutrition educator in school, 48.9% of the teachers recognized its existence and 91.3% of them answered that dietitians have done NE. For correction of unbalanced diet, good table manner, and nutrition and growth, 97.9% of the teachers answered that NE is necessary in elementary school. As for proper time to start NE, 57.5% of the teachers answered kindergarten and 39,7% answered lower grade of elementary school. As for effective type for NE, 47.3% of the teachers answered NE as a part of other subject and 28.1% answered NE as a separate subject. Also 69.8% of the teachers answered dietitian as suitable person for NE. As for newly establishing a NE subject, 37.9% of the teachers disagreed and as for most effective method for NE, 73.3% answered NE linked with school lunch program. Most of teachers recognized elementary school students'eating habit problem severe and change of their eating habit such as various food choice, no plate waste and good table manner after school lunch program. Therefore, it should be nationally supported that a standardized NE program is developed and coordinated among teachers, school lunch dietitian as NE specialist, family and community for elementary students' health and well-being.

Arthrogryposis Multiplex Congenita in Siblings

No abstract available.