• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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• pp.58-69
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• 2017

Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

• 대한세포병리학회지
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• 제7권2호
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• pp.163-168
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• 1996

Abnormalities of p53 gene are common in lung cancers and are associated with immunologically detectable p53 protein. p53 immunoreactivity is uncommon in normal cells but is frequently seen in neoplasia. Therefore, assessment of p53 expression may assist in the cytological diagnosis of malignancy. The usefulness of p53 immunostaining as a marker of malignancy in the cytological analysis of bronchial brush specimens from the patients with lung cancers was investigated in this study. A total of 71 bronchial brush samples submitted for cytologic diagnosis were immunostained with D07, a monoclonal antibody to recombinant p53 protein. Resultant p53 data were correlated with cytologic diagnosis and clinical information. Of the 17 smears with a benign cytodiagnosis, all were p53 negative. Of the 40 cases with a malignant cytodiagnosis (histologically confirmed), 35 were p53 positive and 5 were negative. Of the 14 cases that were cytologically suspicious but nondiagnostic for malignancy, 11 were p53 positive, 9 of which were subsequently proved to be malignant by histologic examination, and the remaining 2 cases were tuberculosis clinically. Forty four of 51 histologically confirmed lung carcinomas were p53 positive, including 25 of 28 squamous cell carcinomas, 13 of 17 small cell carcinomas, 3 of 3 adenocarcinomas, and 3 of 3 large cell undifferentiated carcinomas. These results suggest that p53 immunostaining could be of value as a marker of malignancy in the cytologic examination of bronchial brush specimens. Furthermore, we have shown the possible clinical utility of p53 immunostaining in cytopathological diagnosis, that is, as a valuable adjunct to morphological assessment in the analysis of cytopathologically suspicious cases.

• 대한방사선기술학회지:방사선기술과학
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• 제26권1호
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• pp.83-89
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• 2003

대퇴골 전염각의 정확한 측정은 정형외과 분야에서 중요한 의미를 가지며, 원위 대퇴골의 양과부를 횡단하는 면에 대하여 대퇴골 경부의 장축이 전방으로 기울어진 축면상의 각도이다. 대퇴골부와 슬개골부를 전산화단층촬영한 영상을 측정하고 있는 기존의 CT 영상의 대퇴골 측정법을 대신하여 다양한 Pulse sequence를 이용한 자기공명영상으로 PACS Image viewer에서 성인 남자 $28{\sim}36$세를 대상으로 대퇴골 전염각을 측정하였다. 오른쪽 대퇴골 전염각의 T2강조영상은 $18.5{\sim}45.4^{\circ}$, T1강조영상 $18.9{\sim}25.6^{\circ}$, 경사에코 $18.7{\sim}26.0^{\circ}$, 지방억제기법 $21.3{\sim}24.9^{\circ}$, 왼쪽 대퇴골 전염각의 T2강조영상은 $19.2{\sim}24.3^{\circ}$, T1강조영상 $18.8{\sim}24.5^{\circ}$, 경사에코 $20.1{\sim}25.6^{\circ}$, 지방억제기법 $20.0{\sim}25.3^{\circ}$로 측정되었고, 오른쪽과 왼쪽 대퇴골 전염각의 이원배치 분산분석에서 모두 유의한 차이가 있었다(p<0.05). 수 작업 방법의 대퇴골 전염각 측정에 비해 Image Viewer 프로그램에서는 마우스를 이용한 측정으로 편리하였고, MR 영상은 CT 영상에 비해 다양한 Pulse sequence를 선택적으로 적절한 촬영기법을 사용하여 대퇴골 전염각 측정에 유용하였다.

• 대한의용생체공학회:의공학회지
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• 제16권3호
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• pp.309-316
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• 1995

핵자기공명(Nuclear Magnetic Resonance)에서 신호 획득 시에 가장 중요한 부분중의 하나인 rf-탐침(radio-frequency-probe)은 실험대상이 되는 시료의 기하학적 모양과 획득하고자 하는 정보 등에 따라서 적절히 설계 및 제작되어야 최적의 신호를 얻을 수 있다. 일반적으로, rf-탐침은 시료를 둘러싸는 형태와 시료 표면에 위치하는 형태 등 두 가지로 제작된다. 그러나, 시료나 인체 부위가 관모양을 하고 있으며 관 모양 주위로부터의 신호를 관측하는 경우, 앞에서 기술한 두가지 형태의 탐침을 이용해서는 신호대 잡음비의 저하로 인해 만족할 만한 신호 획득이 어려워진다. 이때, 탐침을 관 모양의 시료 내부에 위치시키고, 관찰하고자 하는 부위에 최대로 가까이하며 탐침의 품격인자를 높이는 것이 최적의 신호획득에 중요한 조건이 되게 된다. 본 논문에서는 탐침을 시료 내부에 넣고 탐침 외부로부터 신호를 얻는 뒤집음-탐침을 역-솔레노이드 saddle 및 이중표면코일 등의 세가지 형태로 제작하고 최적신호의 획득에 대한 시도를 해보았고, 컴퓨터를 이용한 계산을 통하여 기하학적인 모양의 차이에 따른 rf-자기장 발생 상태를 알아보았다. 아울러, 시험시료로부터 발생되는 영상신호를 얻고 영상 영역 내에서 신호대잡음비를 측정하여 탐침들의 성능을 비교 분석했다. 본 연구에서 제작된 뒤집음-탐침의 경우, 어떠한 상품화된 탐침과 비교할 때, 뛰어난 신호대잡음비와 탐침 주위에서 매우 높은 균일성이 유지되었다. 또한, 제작된 형태의 뒤집음-탐침을 이용한 인체 진단에의 응용성은 매우 높을 것으로 예상된다.

• 전자공학회논문지SC
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• 제45권6호
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• pp.117-122
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• 2008

맥진은 한의 진단에 있어 중요한 요소이나 맥진 교육에 있어서 수련자와 교육자 간에 언어적 표현 외에는 적절한 교육 정보 소통의 도구가 없어 정량적이며 과학적 교육이 어려운 실정이다. 이에 본 논문에서는 맥진 시 한의사가 세 손가락을 통해 맥진 부위에 가하는 가압력 프로파일을 정량적으로 측정할 수 있는 하드웨어와 이를 기반으로 맥진 동작을 트레이닝할 수 있는 프로그램을 개발하였다. 가압력 프로파일 측정 하드웨어는 인조 팔 속 맥진 위치에 놓인 3개의 로드셀과 맥진 가압력 신호를 증폭하는 증폭부 및 상용 A/D 변환 모듈인 NI-USB 6009로 구성하였으며, 3채널 가압력 신호는 200Hz로 샘플링하였다. 하드웨어 출력 신호를 질량 값으로 교정할 수 있도록 $50{\sim}500g$ 범위의 8개 추를 인조 팔에 올려놓았을 때의 질량 대비 출력전압 테이블을 작성하였다 또한, 이 시스템을 통해 한방 전문의 3명의 맥진 가압 프로파일을 각 3회씩 측정해 보았으며, 이를 통해 한의사의 맥진은 크게 3개의 구간으로 나눌 수 있고 최대 가압력이 약 $500g{\cdot}f$인 것 등을 알 수 있게 되었다. 맥진 가압트레이닝 프로그램은 LabView를 통해 구현하였으며, 수련자가 미리 저장된 목표 맥진 가압 프로파일과 유사하도록 인조 팔을 맥진할 때의 가압 프로파일이 목표 가압 프로파일과 유사한 정도를 평가하여 일정 범위를 벗어나면 경고하고, 실습이 끝나면 목표 프로파일과 유사도 점수를 화면에 표시하도록 하였다. 더 나아가 유사도 점수의 추이를 통해 숙련 추이를 관찰 할 수 있도록 하였다. 이 시스템을 맥진 교육에 활용한다면 보다 정량적이며 과학적인 교육이 가능해질 뿐만 아니라 교육의 효율도 크게 향상될 것으로 기대된다.

• 보건교육건강증진학회지
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• 제22권2호
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• pp.19-32
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• 2005

Objectives: The purpose of this study was to examine teachers' safety education activities to determine the significant educational diagnosis variables and to identify their needs of safety education in early-child care centers based on the PRECEDE model. Methods: A total of 304 teachers in early-child care centers participated in this study selected by a multi-stage stratified sampling method considering 11 regions in Seoul, Korea. Self-report type questionnaires were posted to all teachers in 220 early-child care centers by ground mailing service and the 304 teachers completed the questionnaires. The participants' responses were anonymously coded into and analyzed in SPSS program. Results: 'Scratch or bite' was the most frequent accident type(78.3%) and the frequent accident places were 'classroom(88.8%)' and 'playground(67.8%)'. The most frequently conducted safety education activities were 'reminding children their safe behaviors at the beginning and the end of daily class' and the next was 'saving a special time for safety education.' For educational diagnosis factors, related to safety education activities, teachers' safety education activity was more frequent when teachers' safety knowledge was high(p<.001), when teachers had good application skills of their knowledge to their teaching activities(p<.001), when they had strong needs on safety training opportunities(p<.05), and their interests on safety education(p<.001). For enabling factors, class preparation by safety education guide-book review(p<.001), by development of educational materials(p<.001), and by search for the related reference (p<.001), and by participation to safety education training programs for teachers(p<.01) were the significant enabling factors on teachers' safety class activities. For the reinforcing factors, the center-wide support of safety education brochures to children (p<.001), the concerns of centers utilizing safety education specialists(p<.001), and the concerns about safety information collection out of centers(p<.001) were significant factors related with teachers' safety education activities. Conclusions: The significant educational and institutional factors on teachers' safety education activities were teachers' concerns on safety education, their interests on safety knowledge, and the strong concerns on child safety education from the centers.

• Annals of Clinical Neurophysiology
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• 제4권2호
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• pp.114-118
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• 2002

Backgrounds : Carpal tunnel syndrome (CTS) is a common condition that is usually diagnosed by electrophysiologic studies. However, CTS provide limited information to determine the causes of CTS and to choose the treatment method. We evaluated diagnostic sensitivity of MR imaging and treatment decisions by MR imaging in electrodiagnosed CTS. Methods : 14 patients (26 wrists) with electrodiagnosed CTS were studied using MR imaging. In 26 wrists for which axial T1 & T2 weighted images were obtained at 1.5T with a decided wrist coil. Previously described MR imaging of CTS such as increased median nerve signal, flattening of median nerve, reticular bowing, tenosynovitis and space occupying lesions were retrospectively evaluated. Degree of improvement was evaluated by global symptom score (GSS). The GSS rated symptoms from 0 (no symptoms) to 10 (severe) in each of five categories: pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening. Subjects' GSS was recorded at baseline, 2 weeks, 1 month, 6 months after treatment. We decided to medical treatment that showed mainly inflammatory sign such as increased median nerve signal, tenosinovitis and to surgical treatment such as space occupying lesion, high canal pressure sign. Results : MR imaging showed that increased median nerve signal were in 20 wrists (77%), flattening of median nerve were in 6 wrists (23%), reticular bowing were in 3 wrists (12%), tenosynovitis were in 8 wrists (32%), decreased canal size in 2 wrists (7.6%), space occupying lesion were in 1 wrist (4%). A good outcome was revealed in 21 wrists by medical treatment that showed mainly increased median nerve signal, tenosynovitis. The mean GSS were 27.7 at baseline, 11.2 at 2 weeks, 11.0 at 6 months in medical treatment group. Another 5 wrist had surgical treatment shown by ganglion and high canal pressure sign such as median nerve flattening, reticular bowing, decreased canal size: 3 wrists had good prognosis, but 2 wrists (one patient) had no significant improvement due to small carpal tunnel size. Conclusions : Our results are in agreement with most previously described MR imaging signs of CTS. MR imaging plays an important role in several cases and especially in the assessment of failure of surgical treatment. Knowledge of MR findings may permit more rational choice of treatment.

• Pediatric Infection and Vaccine
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• 제19권1호
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• pp.28-36
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• 2012

목 적 : 이 연구는 경기서부지역의 감염성 설사의 원인 바이러스의 역학 및 지역적 유병율에 대한 정보 제공을 위해 실시되었다. 방 법 : 2009년 1월부터 12월까지 가톨릭대학교 부천성모병원에 급성 설사로 입원한 10세 미만 환아를 대상으로 흔한 세균성 병원체가 없는 310개의 대변 검체에서 rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, norovirus의 유무를 PCR과 RT-PCR을 이용하여 확인하였다. 결 과 : parechovirus (16%)가 가장 흔한 것으로 나타났으며, adenovirus (15%), astrovirus (14%), rotavirus (13%), enterovirus (5%)의 순으로 검출되었다. 단일 감염은 55.8%에서, 중복 감염은 3.2%에서 나타났다. 바이러스성 장염은 전체적으로 두 차례의 유행 시기를 보였으며, 84.6%는 2세 이하에서 발생하였다. 결 론 : parechovirus, adenovirus, astrovirus, enterovirus는 기존에 시행 중인 진단방법으로는 과소평가되어 있으나 소아 설사의 중요한 원인이다.

• 대한수의학회지
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• 제42권3호
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• pp.363-370
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• 2002

For the development of diagnostic polymerase chain reaction (PCR) to fungal infection by dermatophytes Trichophyton and Microsporum, detection of the fungal DNA by PCR and analysis of the DNA pattern were undertaken in the present study. A total of 15 strains were tested and those consisted of 3 reference strains and 12 isolates such as: reference strains of T mentagrophytes (downy type, ATCC 9533), T rubrum (IFO 6204) and M gypseum (ATCC 9083), and each isolate of T mentogrophytes (powdery type), T mentagrophytes (granular type), T mentogrophytes (purple-red type), T rubrum, T raubitschekii, T tonsurans, T equinum, T ajelloi, T verrucosum, M cookei, M nanum and M gypseum. The DNA were purely isolated from all strains of Trichophyton spp. and Microsporum spp. by a simple method partly consisted of disruption of fungal cells by lyophilization and grinding and extraction of fungal DNA without phenol treatment which is a routine procedure in DNA isolation. For the detection of fungal DNAs, optimal condition of PCR was determined as preheating once at $94^{\circ}C$ for 5 min, 35 cycles of denaturation at $94^{\circ}C$ for 1 min, annealing at $38^{\circ}C$ for 1 min and polymerization at $72^{\circ}C$ for 2 min, and 1 cycle of final extension at $72^{\circ}C$ for 5 min. In PCR using arbitrary primers AP-1 (5' ACCCGACCTG3') and AP-2 (5' ACGGGCCAGT3'), DNAs in various numbers and sizes were detected from different species of Trichophyton and Microsporum, while DNAs in similar size were also detected in all strains of Trichophyton spp. and Microsporum spp. There were unique DNAs observed from certain dermatophytes by AP-1 such as 1,900 bases in T rubrum, 950 and 1,100 bases in T raubitscheldi, 2,100 bases in T equinum, 400 bases in T verrucosum and 1,150 bases in M gypseum. The unique DNAs were also observed by AP-2 such as 1,200 bases in T ajelloi, 250 bases in T verrucosum, 1,150 bases in M cookei and 2,000 bases in M nanum. The results indicated that PCR can detect a specific DNA from certain Trychophyton and Microsporum spp, which can be the information for further development of diagoomc PCR to dennatophytes.

• 대한골관절종양학회지
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• 제2권1호
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• pp.1-7
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• 1996

PURPOSE : The purpose of this study is to know the ability of detecting malignant tumor tissue by Tl-201 scan, and to compare with that of Tc-99m-MIBI and Tc-99m-MDP scan. MATERIAL AND METHODS : Between February 1994 and December 1995,38 unselected patients with various bone pathologies were studied prospectively. Eighteen had malignant bone and soft tissue pathologies, while twenty had benign. All patients were studied with Tl-201, Tc-99mMIBI and Tc-99m-MDP scan prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator was used for scanning. To avoid the interaction of isotope, the early(30min.) and delayed phase(3hrs.) of Tl-20l scan was performed first and Tc-99m-MIBI scan was performed after 30 minutes, and then Tc-99m-MDP scan 48 hours later. The scan images were visually evaluated by a blinded nuclear medicine physician. We could find true positive, true negative, false positive and false negative by the comparison of results with those of biopsy. We calculated positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%) of each scan. RESULT : The results of each scan were 85.7, 100, 100, 85, 92.1% in Tl-201, 81, 94.1, 94.4, 80, 86.8% in Tc-99m-MIBI and 50, 66.7, 88.9, 20, 52.6% in Tc-99m-MDP scan. As a conclusion, Tl-201 scan was the most specific and accurate method for detecting malignant tumor tissue. Tc-99m-MIBI scan was also good for malignant tumor searching. CONCLUSION : With our results, we can use Tl-201 scan to differentiate benign from malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.