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The Relationship between Coronary Risk Factors and Coronary Calcium Score Detected by Computed Tomography Coronary Angiography in Korean Middle Aged Men (다중절편 방사선단층촬영 결과에 기반한 한국 중년 남성에서의 관상동맥 석회화와 심혈관질환 위험인자와의 연관성)

  • Park, Seung-Hyun;Kim, Young-Wook;Chae, Chang-Ho;Kim, Ja-Hyun;Kang, Yune-Sik;Park, Yong Whi;Jeong, Baek Geun
    • Journal of agricultural medicine and community health
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    • v.39 no.1
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    • pp.25-36
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    • 2014
  • Objectives: The objective of this study was to investigate the relationship between coronary artery calcification and risk factors of cardiovascular disease with multidetector computed tomography. Methods: Data were collected from 5,899 males between 30 and 59 years old by interview, survey, physical examination, blood test, and multidetector computed tomography in the university hospital from January 2010 to December 2011. We confirmed the coronary artery calcium scores of subjects by multidetector computed tomography and identified risk factors of cardiovascular disorders. We investigated the relationship between coronary artery calcification and risk factors of cardiovascular disorders. Results: Mean calcium score of the coronary arteries in 5,899 participants was 8.20, and 773 participants (13.1%) exhibited coronary artery calcification. The presence of coronary artery calcification was correlated to risk factors of cardiovascular disease (age, blood pressure, triglyceride, HDL cholesterol, LDL cholesterol, glucose, Apolipoprotein A-1, Apolipoprotein B, body mass index, waist circumference) and risk assessment tools of cardiovascular disorders. Significant predicted factors of coronary artery calcification had different patterns in each age group (30-39, 40-49, 50-59 years old). Conclusions: We confirmed the relationship between coronary artery calcification and either typical risk factors of cardiovascular disease or risk assessment tools of cardiovascular disease. In addition, we also observed that the pattern of these factors varied according to age. Therefore, age-related variation needs to be considered in management strategies to prevent cardiovascular disease.

The Injury and its Related Factors in the Elderly Using the Data of 2008 Community Health Survey (2008 지역사회 건강조사 자료를 이용한 노인의 손상 관련요인)

  • Kwon, Yu-Jin;Ryu, So-Yeon;Shin, Seung-Ok;Chun, In-Ae;Park, Moon-Sook;Shim, Jae-Soon
    • Journal of agricultural medicine and community health
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    • v.39 no.1
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    • pp.1-13
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    • 2014
  • Objective: The objectives were to estimate the rate of the injury in the elderly over the past year and to identify factors related to injury in the elderly in South Korea. Method: Using data from the 2008 Community Health Survey, 43,049 elderly persons, aged 65 years and older, were selected as study subjects. Their experience of injury during the past year and other variables, including socio-demographic factors, health-related factors, and diagnosed chronic diseases, were used. The chi-squared test and multiple logistic regression analysis with weighted analysis were conducted and statistical significance was set at p<0.05. Result: The rate of injury in the elderly during the past year was 5.1%. The most common types of the injury were falling/slipping down and traffic accidents. Factors related to injury in the elderly were living alone, current drinking, depression, poor self-rated health, stroke, and osteoporosis. Living alone (odds ratio 1.23, 95% CI: 1.05-1.45), current drinkers (OR 1.19, 95% CI: 1.05-1.35), poor self-rated health (OR 1.72, 95% CI: 1.43-2.08), depression (OR 1.23, 95% CI: 1.17-1.68), and history of stroke (OR 1.40, 95% CI: 1.17-1.68), and history of osteoporosis (OR 1.45, 95% CI: 1.26-1.66) were related to an increased risk of injury. Conclusions: Intervention programs that consider the risk factors related to injury should be developed and implemented to decrease and prevent injuries in the elderly.

Discussion by UNCITRAL for Development of International Commercial Conciliation and Arbitration Systems (국제상사조정 및 중재제도 개선에 관한 UNCITRAL 논의동향)

  • Lee, Kang Bin
    • Journal of Arbitration Studies
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    • v.10 no.1
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    • pp.3-25
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    • 2000
  • At its thirty-second session in 1999, the UNCITRAL had before it the requested note entitled "Possible future work in the area of international commercial arbitration." After concluding the discussion on its future work in the area of international commercial arbitration, it was agreed that the priority items for the working group should be conciliation, requirement of written form for the arbitration and enforceability of interim measures of protection. the Commission entrusted the work to the Working Group on Arbitration which held its thirty-second session at Vienna from 20 to 31 March 2000. The Working Group discussed agenda item 3 on the basis of the report of Secretary General entitled "Possible uniform rules on certain issues concerning settlement of commercial disputes : conciliation, interim measures of protection, written form for arbitration agreement." At its thirty-three session in 2000, the UNCITRAL had before it the report of Secretary General on agenda item 3 discussed by the Working Group. The Working Group discussed the issues relating to certain aspects of conciliation proceedings ; (1) Admissibility of certain evidence in subsequent judicial or arbitral proceedings ; (2) Role of conciliatior in arbitration or court proceedings ; (3) Enforceability of settlement agreements reached in conciliation proceedings ; (4) Other possible items for harmonized treatment : a) Admissibility or desirability of conciliation by arbitrators b) Effect of an agreement to conciliate on judicial or arbitral proceedings c) Effect of conciliation on the running of limitation period d) Communication between the conciliator and parties ; disclosure of information e) Role of conciliator. It was generally considered that decisions as to the form of the text to be prepared should be made at a later stage when the substance of prepared solutions would become clearer. However, it was noted that model legislative provisions seemed to be appropriate form for a number of matters proposed to be discussed in the area conciliation. There was general support in the Working Group for the proposition to perpare a legislative regime governing the enforcement of interim measures of protection ordered by arbitral tribunals. It was generally considered that legislative regime should apply to enforcement of interim measures issued in arbitration taking place in State where enforcement was sought as well as outside that State. It was generally observed that there was a need for provisions which conformed to current practice in international trade with regard to requirements of written form for arbitration agreement. The view was adopted by the Working Group that the objective of ensuring a uniform interpretation of the form requirement that responded to the needs of international trade could be achieved by : preparing a model legislative provision clarifying, for avoidance of doubt, the scope of article 7(2) of the UNCITRAL Model Law on International Commercial Arbitration : and adopting a declaration, resolution or statement addressing the interpretation of the New York Convention that would reflect a broad understanding of the form requirement. There was general agreement in the Working Group that, in order to promote the use of electronic commerce for international trade and leave the parties free to agree to the use of arbitration in the electronic commerce sphere, article II(2) of the New York Convention should be interpreted to cover the use of electronic means of communication as defined un article 2 of the Model Law on Electronic Commerce and that it required no amendment to do that. The UNCITRAL may wish to consider to the desirability of preparing uniform provisions on any of those issues concerning conciliation and arbitration proceedings, possibly indicating whether future work should be towards a legislative text or non-legislative text.

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THE PRELIMINARY STUDY OF THE QUANTITATIVE MORPHOLOGIC ANALYSIS USING MRI OF THE LATERAL VENTRICLE IN EARLY-ONSET PSYCHOTIC DISORDER (조기 발병한 정신증적 장애에서 자기공명영상을 이용한 측뇌실에 대한 구조적인 예비연구)

  • Lee, Youn-Hee;Kang, Min-Hee;Kim, Chul-Eung;Bae, Jae-Nam;Hong, Kang-E;Lee, Jeong-Seop
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.256-262
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    • 2001
  • Objective:The enlargement of the lateral ventricle is well established finding in adult-onset schizophrenia, but in the patients with early-onset psychotic disorder(EOPD) is still controversal. To identify structural abnormalities of the lateral ventricle in patients with EOPD and difference of the brain developmental course in EOPD group, planimetrical assessment of the lateral ventricle was conducted by means of retrospective quantitative neuroimaging. Methods:The brain MR images of 14 patients with EOPD(mean age $14.0{\pm}2.1$ years) who met the DSM-III-R diagnostic criteria for schizophrenia and bipolar disorder and 24 control subjects with simple headache(mean age $10.0{\pm}2.1$ years) were collected. Single best view for the lateral ventricle, one axial slice was selected for analysis. MR images were redigitalized with flatbed scanner and data were analyzed with NIH IMAGE software. Results:In the patients with EOPD, there were significant correlations between aging and lateral ventricular sizes and between aging and ventricular brain ratio(VBR). The statistical significance of normal asymmetry of the lateral ventricle was not observed for the EOPD group. The EOPD group had larger lateral ventricular sizes and VBR than control group, but these results were not statistically significant. Conclusion:These findings suggest that the brain abnormalities in patients with EOPD progress from the earlier course of the disorders and the course of brain development in EOPD group is different from control group.

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COMPARISON BETWEEN ATTENTION DEFICIT HYPERACTIVITY DISORDER AND MANIA IN CHILDREN AND ADOLESCENTS (주의력결핍과잉행동장애와 소아, 청소년기 조증의 비교 연구)

  • Sung, Yang-Sook;Hong, Kang-E;Cho, Soo-Churl;Nam, Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.91-99
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    • 1999
  • Objects:It is difficult to differentiate between attention deficit hyperactivity disorder(ADHD) and mania because of similar symptoms and atypical symptoms of mania in children and adolescents. The purpose of this study is to identify the characteristics and to clarify the relationship by comparing the clinical features and comorbidities of ADHD and manic patients. Methods:The subjects consisted of 35 patients with ADHD and 19 manic patients. To Compare the characteristic symptoms between the two disorders, we selected 29 patients with ADHD and 14 patients with manic disorders. 6 ADHD patients who had manic disorders as comorbid disorder, and 5 manic patients who had ADHD as comorbid disorders were manic disorders were excluded. Results:1) There were significant differences in ages of onset and state anxiety scale scores, birth weights, numbers of perinatal problem, gestational ages, school behavioral problems between ADHD patients and manic patients(p<0.01). 2) There were significant differences in loses things(p<0.05) of ADHD-symptoms and grandiosity(p<0.01), decrease in sleep(p<0.05), delusions(p<0.01), hallucinations(p<0.05) of mania-symptoms between ADHD patients and manic patients. 3) The comorbid disorders of ADHD patients are significantly high(p<.05) than that of manic patients in major depression. 4) The familial loading of manic patients are significantly high(p<.05) than that of ADHD patients in mood disorder. Conclusions:The above results suggest that ADHD and mania are different disorders, considering the significant differences of clinical features and characteristics, familial loadings of the two disorders.

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A STUDY ON THE STRUCTURAL RELATIONSHIP AMONG TEST ANXIETY, PSYCHOPATHOLOGY, TEMPERAMENT & FAMILY ENVIRONMENT (시험불안과 정신병리, 기질 그리고 가정환경 간의 구조적 관계에 관한 연구 - 시험불안-우울-불안-자기개념-가정환경간의 인과적 관계분석 -)

  • Cho, Soo-Churl;Yoo, Tae-Ik;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.50-63
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    • 1999
  • Introduction:Test anxiety is a pervasive problem among high school students in Korea. While anxiety in test situations may actually facilitate the performance of some students, more often it is disruptive and leads to performance decrements. Over the past years, many child psychiatrists have become concerned with understanding the nature of test anxiety, but it is not clearly understood yet. In order to understand the nature of test anxiety, the relationship between test anxiety and depression, state anxiety, trait anxiety, temperament and family environment were examined. Methods:The Test Anxiety Inventory, Chidlren's Depression Inventory, State-Trait Anxiety Inventory, Temperamnet and Family Environment Scale Scale were administered to 576 high school students in Seoul. The relationships between test anxiety and other measures were tested using Pearson correlation coefficients and to test the causal relationship among the variables, regression analysis was performed. Results:The correlation coefficients between test anxiety and depression, state anxiety, trait anxiety, temperament and family environment scale were 0.42(p<0.01), 0.34(p<0.05), 0.38(p<0.05), 0.36(p<0.05) and -0.23(p<0.01), respectively. Regression analysis showed that only state and trait anxiety had direct causal relationship with test anxiety. Depression, temperament and family environment were indirecly related with test anxiety. Conclusions:This study indicates that the level of state and trait anxiety are directly related with test anxiety, and other variables such as temperament, family environment and depression are indirectly related with test anxiety. Thus, in order to develop the effective methods for treatment, these psychopathological characteristics should be kept in mind and the most important factors are the levels of state and trait anxiety.

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A STUDY ON COMORBID DISORDERS AND ASSOCIATED SYMPTOMS OF PERVASIVE DEVELOPMENTAL DISORDER CHILDREN (전반적 발달장애 아동들의 공존질환 및 동반증상에 대한 연구)

  • Kwak, Young-Sook;Kang, Kyung-Mee;Cho, Seong-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.64-75
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    • 1999
  • Objective:The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method:The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result:The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion:These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.

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MENTAL REPRESENTATION OF PRESCHOOL CHILDREN:ASSOCIATION WITH PARENTAL MENTAL REPRESENTATION (학령전기 아동의 심적 표상 : 부모에 대한 심적 표상과의 관계를 중심으로)

  • Lee, Kyung-Sook;Lee, Hae-Ran;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.21-33
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    • 1999
  • The clinical assessment for preschool children who are known to have problems in selfreporting tends to be dependent on outsiders' reporting. Thus, the direct assessment of children's inner experience, thoughts and feelings is difficult. MacArthur Story-Stem Battery(MSSB) developed to learn more about preschool children's mental representation in play is used in this study to help assess clinical preschool children through developmental study of normal children's mental representation. Fifty five children(32boys and 23girls) who performed MSSB, IQ Test, Peabody Picture Vocabulary Test-Revised(PPVT) were videotaped and were analyzed. The results of this study were as follows:1) Children frequently displayed negative mental representation such as atypical negative response, reparation/guilt, punishment, personal injury and so on during emotionally laden play situation. 2) Mental representation of parent appeared positive, disciplinary, and negative in respective. 3) As a result of factor analysis of MSSB content themes, aggressive, prosocial, and oppositional content theme composites were generated. Aggressive content included atypical negative response, aggression, personal injury, and exclusion. Prosocial content included affection, affiliation, and reparation/guilt. Oppositional content included punishment and non-compliance. 4) Mental representation of parent and content themes showed significant correlation. Positive, negative, and disciplinary representation were significantly correlated for prosocial(r=0.40), aggressive (r=0.52), and oppositional(r=0.75) content theme respectively. 5) Among the correlations between parental mental representations and emotional responses, positive parental representation and anxiety showed significant negative correlation(r=-0.43). 6) Among the correlations between content themes and emotional responses, there were significant positive correlations between aggressive(r=0.28) and oppositional content themes(r=0.29) and distress, and were significant negative correlations between prosocial content theme and concern(r=-0.29) and anxiety(r=-0.43). According to the above results, preschool children frequently displayed negative mental representation in emotionally conflictual play situation. Children with more prosocial themes in their stories exhibit more positive parental mental representation. Also, children with more aggressive themes tend to display more negative parental representation and negative emotional responses.

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A Preliminary Study on the Development of Korean Medication Algorithm for Attention-Deficit Hyperactivity Disorder (한국형 주의력결핍 과잉행동장애 약물치료 알고리듬 개발을 위한 예비연구)

  • Park, Jae-Hong;Kim, Bung-Nyun;Kim, Jae-Won;Kim, Ji-Hoon;Son, Jung-Woo;Shin, Dong-Won;Shin, Yun-Mi;Yang, Su-Jin;Yoo, Hanik-K.;Yoo, Hee-Jeong;Lee, Soyoung Irene;Cheon, Keun-Ah;Hong, Hyun-Ju;Hwang, Jun-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.1
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    • pp.25-37
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    • 2011
  • Objectives:This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). Methods:Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, aver-age dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, vol untarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. Results:Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). Conclusion:We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.

Analysis of the Present Condition and Demand for the Assistant Workforce in Korean Childcare Center (어린이집 보조인력의 노동실태 및 요구분석: 보조교사, 대체교사, 부담임 교사를 중심으로)

  • Park, Chang Hyun;Kim, Sang Lim
    • Korean Journal of Child Education & Care
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    • v.18 no.2
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    • pp.85-102
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    • 2018
  • The purpose of this study is to determine the working conditions and demands of the assistant workforce at childcare centers, and to provide suggestions on policies for childcare teachers. To achieve the purpose of the study, a total of 190 assistant teachers, nursing helpers, alternative teachers and others were surveyed online during the month of August 2017. The survey examined the employment route and working motives, working conditions and environment, job and educational difficulties for analyzing the work conditions and demands of ancillary staff. For the analysis method, SPSS 12.0 was used to analyze frequency and difference. The main findings are as follows. First, childcare center assistants were able to work at their respective times, making it mandatory for them to enter the workforce, and making job openings for ancillary teachers. Second, 73.7% said the daily working hours were '4 hours to 8 hours' under the conditions and 57.9% said 'More than 510,000 won to less than 1 million won.' Average amount of rest time per day was about 30 minutes, and 17% had no rest periods. Third, based on the job and education status, ancillary personnel performed "infant and child guidance and interaction", "Cleaning and cleanliness related tasks" most actively, and "care for cleaning and cleanliness" and "care for morning and night care". Fourth, in the job trouble and difficulty, ancillary staff found it difficult to satisfy with wage related complaints and job insecurity, and the reason for agreeing to the non-regular workforce becoming a regular worker was found to be due to the stability of employment. Lastly, the most urgent tasks to solve the problem of non-regular workers were to fill the wage gap between regular and irregular workers, shorten the working hours and improve the working conditions. The policy implications are presented based on the above findings.