• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제11권2호
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• pp.290-296
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• 2000

본 연구에서는 주의산만을 주소로 내원하는 아동을 진단 준거에 따라 분류하고 각 진단 집단을 설명할 수 있는 인지적 특성을 T.O.V.A. 양상을 중심으로 설명하였다. 소아정신과를 방문한 65명의 아동을 각각 주의력결핍 과잉행동장애(38명), 틱장애(17명), 그리고 기타 정서장애(10명) 집단으로 분류한 후 주의산만의 정도에 영향을 미칠 수 있는 집단의 연령 및 지능(전체 지능, 동작성 지능, 언어성 지능)을 먼저 파악한 후 T.O.V.A.의 중다구인(누락오류, 오경보오류, 정반응시간, 반응시간 표준편차, 예기반응, 다중반응)을 통해 주의산만의 양상을 살펴보았다. 세 집단 간에 연령에서 집단 간에 유의미한 차이가 나타나 연령 수준의 차이에서 기인한 효과를 배제한 결과, 언어성 지능에서 세 집단 간에 유의미한 차이가 나타났다. 또한, T.O.V.A.의 정반응 시간(전반부, 후반부, 전체)에서 세 집단간에 유의미한 차이가 있는 것으로 나타났다. 주의력결핍 과잉행동장애 집단은 틱장애 및 기타 정서장애 집단보다 T.O.V.A.의 정반응 시간이 길어 정보처리의 지연을 시사해 주었다. 한편 주의산만을 주소로 내원하는 아동의 경우 T.O.V.A. 양상과 더불어 연령과 지능의 효과에 대해 신중히 고려해야 할 필요가 있겠다.

• Tuberculosis and Respiratory Diseases
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• 제75권6호
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• pp.238-243
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• 2013

Background: The aim of our study was to evaluate the "diagnosis changed" rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: "diagnosis maintained", "diagnosis changed" (initially notified as TB, but ultimately diagnosed as non-TB), and "administrative error" (notified as TB due to administrative errors). Results: Excluding 17 patients in the "administrative error" group, the "diagnosis maintained" and "diagnosis changed" groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of "diagnosis changed" were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn's disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a "diagnosis changed" result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high "diagnosis changed" rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the "diagnosis changed" rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of "diagnosis changed" cases is desirable.

• 말소리와 음성과학
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• 제13권2호
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• pp.77-90
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• 2021

본 연구는 국외에서 개발된 비단어 중재접근법을 수정 및 보완하여 한국어 비단어 중재접근법을 확립하고, 아동기 말실행증 아동에게 직접 적용하여 그 효과를 확인하기 위해 실시되었다. 궁극적인 목적은 비단어를 이용한 중재가 아동기 말실행증의 말운동프로그래밍 능력을 개선시켜 비단어 산출 및 단어로의 일반화에 효과적인지 알아보기 위함에 있다. 중재는 아동기 말실행증의 진단 특성을 보이는 5세 6개월의 남아를 대상으로, ABA설계를 사용한 단일대상연구를 실시하였다. 중재에 사용된 비단어는 아동 맞춤형으로 제작하였으며, 한 회기당 60분씩 주 2회로, 총 12회기를 실시하였다. 그 결과 중재한 3음절 비단어의 모든 지표가 향상되었으며, 중재하지 않은 3음절, 4음절 비단어 및 단어로의 일반화를 확인하였다. 단, 단어로의 일반화 효과는 비단어로의 일반화 효과에 비해 미비하였다. 비단어 중재는 대상 아동의 말운동프로그래밍 능력을 개선시키는데 효과적이었다. 그 결과 운동프로그래밍 손상에 기인한 전환 오류가 크게 감소하였고, 중재하지 않은 비단어의 산출 능력이 큰 폭으로 증가하였다. 그러나 강력하게 습관화된 단어 오류를 완전히 개선시키는 데에는 한계가 있었으며, 이는 보다 집중적이고 반복적인 중재 일정을 제공했을 때 기대할 수 있는 결과일 것이다.

• 한국방사선학회논문지
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• 제15권4호
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• pp.473-479
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• 2021

미만성 갑상샘질환은 그 진단 기준이 모호하고 숙련자의 주관적인 진단에 따라 오류가 많이 발생한다. 또한 갑상샘 결절의 초음파 영상에 관한 연구는 활발히 이루어졌지만 미만성 갑상샘질환에 관한 연구 사례는 미흡한 실정이다. 본 연구에서는 정상과 미만성 갑상샘질환의 영상에 GLCM 알고리즘을 적용하여 영상의 특징을 추출하고 추출된 특징값을 파라미터를 이용하여 정량적인 분석을 하였다. W 병원에서 진단한 환자의 갑상샘 초음파 영상을 대상으로 GLCM 알고리즘을 이용하여 정상 199증례, 경도 132증례, 중등도 99증례 총 영상 430증례에 관심영역(50×50 pixel)을 설정하고, 각 영상에서 Autocorrelation, Sum of squares, Sum average, Sum variance, Cluster prominence, Energy 6가지 파라미터를 이용하여 분석하였다. Autocorrelation, Sum of squares, Sum average, Sum variance 4가지 파라미터에서 Normal, Mild, Moderate를 구분하는데 90%이상의 높은 인식률을 보였다. 미만성 갑상샙질환의 초음파영상에서 GLCM 알고리즘을 이용하여 미만성 갑상샘질환의 심각도 정도를 분류하는 기준으로서 가치가 있다. 이러한 파라미터를 적용하여 갑상샘질환의 진단에 있어 육안 판독에 따른 오류를 감소시키고 미만성 갑상샘질환 진단의 2차적인 수단으로 활용 가능할 것으로 기대된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권9호
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• pp.4109-4115
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• 2014

Background: Accurate assessment of disease progression requires proper understanding of natural disease process which is often hidden and unobservable. For this purpose, disease status should be clearly detected. But in most diseases it is not possible to detect such status. This study, therefore, aims to present a model which both investigates the unobservable disease process and considers the error probability in diagnosis of disease states. Materials and Methods: Data from 330 patients with gastric cancer undergoing surgery at the Iran Cancer Institute from 1995 to 1999 were analyzed. Moreover, to estimate and assess the effect of demographic, diagnostic and clinical factors as well as medical and post-surgical variables on transition rates and the probability of misdiagnosis of relapse, a hidden Markov multi-state model was employed. Results: Classification errors of patients in alive state without a relapse ($e_{21}$) and with a relapse ($e_{12}$) were 0.22 (95% CI: 0.04-0.63) and 0.02 (95% CI: 0.00-0.09), respectively. Only variables of age and number of renewed treatments affected misdiagnosis of relapse. In addition, patient age and distant metastasis were among factors affecting the occurrence of relapse (state1${\rightarrow}$state2) while the number of renewed treatments and the type and extent of surgery had a significant effect on death hazard without relapse (state2${\rightarrow}$state3)and death hazard with relapse (state2${\rightarrow}$state3). Conclusions: A hidden Markov multi-state model provides the possibility of estimating classification error between different states of disease. Moreover, based on this model, factors affecting the probability of this error can be identified and researchers can be helped with understanding the mechanisms of classification error.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권1호
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• pp.17-22
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• 2009

Objectives : A higher level of aggression has been reported for children with attention-deficit/hyperactivity disorder (ADHD) than for non-ADHD children. Aggression was shown to have a negative effect on the social functioning of children with ADHD. The ability to recognize facial emotion expression has also been related to aggression. In this study, we examined whether impulsivity and dysfunctional recognition of facial emotion expression could explain the aggressiveness of children with ADHD. Methods : 67 children with ADHD participated in this study. We measured the ability to recognize facial emotion expression by using the Emotion Recognition Test (ERT) and we measured aggression by the T score of the aggression subscale of the Child Behavior Checklist (CBCL). Impulsivity was measured by the ADHD diagnostic system (ADS). Results : The teacher rated level of aggression was related to the score of recognizing negative affect. After controlling for the effect of impulsivity, this relationship is not significant. Only the score of the visual commission errors ex plained the level of aggression of children with ADHD. Conclusion : Impulsivity seems to have a major role in explaining the aggression of children with ADHD. The clinical implication of this study is that effective intervention for controlling impulsivity may be expected to reduce the aggression of children with ADHD.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2003년도 제27회 추계학술대회
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• pp.69-69
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• 2003

Flat panel based digital radiography (DR) systems have recently become useful and important in the field of diagnostic radiology. For DRs with amorphous silicon photosensors, CsI(TI) is normally used as the scintillator, which produces visible light corresponding to the absorbed energy. The visible light photons are converted into an electric signal in the amorphous silicon photodiode. In order to produce good quality images, we need to understand the detailed behavior of DR detectors in radiation. We, therefore, investigated the relationship between DR outputs and X -ray in terms of absorbed energy, using the SPEC-78, X-ray energy spectrum model. We calculated the total filtration of X-ray equipment measuring air exposure and this value was used in the calculation of absorbed energy. The relationship between DR output and the absorbed energy of the X-ray was obtained by matching the absorbed energy with pixel values of real images under various conditions. It was found that the relationship between these two values was almost linear. The results were verified using phantoms made of water and aluminium. The pixel value of the phantom image was estimated and compared with previous results under various conditions. The estimated pixel value coincided with the results, although the effect of scattered photons introduced some errors.

• 대한의용생체공학회:의공학회지
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• 제36권5호
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• pp.183-190
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• 2015

Invasive blood pressure (IBP) is measured for the patient's real time arterial pressure (ABP) to monitor the critical abrupt disorders of the cardiovascular system. It can be used for the estimation of cardiac output and the opening and closing time detection of the aortic valve. Although the unexplained inflections on ABP make it difficult to find the mathematical relations with other cardiovascular parameters, the estimations based on ABP for other data have been accepted as useful methods as they had been verified with the statistical results among vast patient data. Previous windkessel models were composed with systemic resistance and vascular compliance and they were successful at explaining the average systolic and diastolic values of ABP simply. Although it is well-known that the blood pressure reflection from peripheral arteries causes complex inflection on ABP, previous models do not contain any elements of the reflections because of the complexity of peripheral arteries' shapes. In this study, to simulate a reflection wave of blood pressure, a new mathematical model was designed with four elements that were the impedance of aorta, the compliance of aortic arch, the peripheral resistance, and the compliance of peripheral arteries. The parameters of the new model were adjusted to have three types of arterial blood pressure waveform that were measured from a patient. It was used to find the relations between the inflections and other cardiovascular parameters such as the opening-closing time of aortic valve and the cardiac output. It showed that the blood pressure reflection can bring wide range errors to the closing time of aortic valve and cardiac output with the conventional estimation based on ABP and that the changes of one-stroke volumes can be easily detected with previous estimation while the changes of heart rate can bring some error caused by unexpected reflections.

• 생물정신의학
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• 제22권4호
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• pp.173-178
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• 2015

Objectives Previous genome-wide association studies have indicated the association between ankyrin 3 (ANK3) and the vulnerability of schizophrenia. We investigated the association between single nucleotide polymorphisms (SNPs) covering the whole ANK3 locus and schizophrenia in the Korean population. Methods The study subjects were 582 patients with schizophrenia and 502 healthy controls. Thirty-eight tag SNPs on ANK3 and five additional SNPs showing significant association with schizophrenia in previous studies were genotyped. Results Three (rs10994181, rs16914791, rs1938526) of 43 SNPs showed a nominally significant association (p < 0.05) with at least one genotype model. But none of these associations remained significant after adjusting for multiple testing errors with Bonferroni's correction. Conclusions We could not identify a significant association between ANK3 and schizophrenia in the Korean population. However, three SNPs showing an association signal with nominal significance need to be investigated in future studies with higher statistical power and more specific phenotype crossing the current diagnostic categories.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제19권2호
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• pp.112-119
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• 2008

Objectives : This study was conducted to examine whether there are qualitative differences in attention problem among children with various psychiatric disorders, including attention-deficit hyperactivity disorder (ADHD), depressive disorder, anxiety disorder, and tic disorder using clinical ADHD diagnostic system (ADS) T-scores. Methods : The subjects were 794 outpatient children aged from 5 to 15 years, including 540 children with ADHD, 95 children with depressive disorder, 86 children with anxiety disorder, and 73 children with tic disorder. Clinical T-scores on the ADS were calculated using the mean and standard deviations of four ADS variables for the ADHD group. Results : All four groups had T-scores on the ADS in the abnormal range. However, when comparing the clinical T-scores, the children with depressive and anxiety disorders performed better than the children with ADHD. We also found that although the four groups seemed to be similar in terms of clinical T-scores for omission and commission errors, there were significant differences in clinical T-scores for reaction time and the standard deviation of response time (RT) between the ADHD and other groups. Conclusions : We concluded that inattention and impulsivity might not be specific only to ADHD and that the clinical T-scores of RT and standard deviation of RT on the ADS could be used to discriminate between ADHD and other clinical groups.