• 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.

• 동의신경정신과학회지
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• 제28권3호
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• pp.263-274
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• 2017

Objectives: To identify the current status of Korean medical practice pattern, diagnosis and treatment of dementia through recognition survey, and to use it as a preliminary data for various dementia research. Methods: Questionnaires were developed through expert meetings. The disease was defined as dementia and mild cognitive impairment, and areas were designated to practice pattern, diagnosis and treatment. From December 18, 2016-January 18, 2017, 221 respondents, including 36 neuropsychiatrists of Korean Medicine and 185 general physicians (including other medical specialists) were included. Results: 1. In both groups, the most commonly used KCD (Korean standard classification of disease and cause of death) were in the order of Unspecified Alzheimer's Dementia (F00.9), Mild Cognitive Impairment (F06.7), and Unspecified Dementia (F03). 2. The most commonly used pattern identification were zang-fu and qi-blood-yin-yang in both groups. 3. Diagnostic evaluation tools were mainly conducted by MMSE, radiologic examination, K-DRS, GDS and CDR in both groups. 4. Both groups reported using acupuncture and herbal medicine mainly. 5. In both groups, the acupuncture method was used extensively in the order of Body, Scalp, and Sa-Am. 6. Neuropsychiatrists used a variety of herbal medicines such as Wonjiseokchangpo-san (Yuanzhushichangpu-san), Yukmijihwang-tang (Liuweidihuang-tang), Palmijihwang-won (Baweidihuang-won), Sunghyangjungki-san (Xingxiang Zhengqi-san) and Ondam-tanggami (Wendan-tangjiawei). General physicians used a variety of herbal medicines such as Ondam-tanggami (Wendan-tangjiawei), Bojungikgi-tang (Buzhongyiqi-tang), Yukmijihwang-tang (Liuweidihuang-tang). 7. Neuropsychiatrists used a variety of Korean herbal preparation products (benefit and non-benefit) such as Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Yukmijihwang-tang (Liuweidihuang-tang), Jodeung-san (houteng-san), Palmijihwang-won (Baweidihuang-won). General physicians used a variety of Korean herbal preparation products such as Bojungikgi-tang (Buzhongyiqi-tang), Banhabaegchulcheonma-tang (banxiabaizhutianma-tang), Yukmijihwang-tang (Liuweidihuang-tang), Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Palmijihwang-won (Baweidihuang-won). Conclusions: By confirming awareness of Korean medical doctors treating dementia in clinical fields and understanding differences between neuropsychiatrists of Korean medicine and general physicians, it can be used to understand guideline users' needs and confirm clinical questions during development of future clinical practice guidelines for dementia.

• 한국융합학회논문지
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• 제5권4호
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• pp.137-146
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• 2014

본 연구는 3단계 지시따르기를 통한 수용언어촉진이 아스퍼거 아동의 반응시간에 미치는 효과에 대하여 알아보고자 실시되었다. 연구대상자는 3세 8개월 남아로, 반응이 느리고 지시따르기에 어려움을 보이는 특성을 보였다. 연구 설계는 행동간 복식기초선 설계법(multiple-baseline across behaviors)이었으며, 종속변인은 지시 후 아동의 반응에 걸리는 시간이었다. 연구결과 행동 1(손들기)의 경우 장면 1(자유놀이)의 기초선 반응시간 3회 평균 3.53초였던 것이 중재이후 평균 0.92초로 짧게 나타났다. 장면 2(생각놀이)의 기초선 반응시간 3회 평균 3.63초가 중재이후 평균 0.66초로 짧아졌다. 행동 2(지시수행하기)의 경우 장면 1(자유놀이) 6회 기초선 평균 3.12초에 나타난 반응이 중재 이후 평균 1.58초로 빠르게 나타났다. 장면 2(생각놀이)의 기초선 6회 평균 4.35초 였던 반응이 중재이후 평균 1.72초로 빠르게 나타났다. 행동 3(대답하기)의 경우 장면 1(자유놀이) 9회 기초선 평균 2.51초에 나타난 반응이 중재이후 평균 1.25초로 빠르게 나타났다. 장면 2(생각놀이)의 기초선 9회 평균 3.04초 였던 반응이 중재이후 평균 0.75초로 빠르게 나타났다. 본 연구를 통해 반응이 느린 아스퍼거 장애 아동의 수용언어 촉진에 3단계 지시따르기가 효과적임을 알 수 있었다.

• 한국과학교육학회지
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• 제20권1호
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• pp.101-111
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• 2000

6차 교육과정 개편 이전에 임용된 교사들의 경우 목표 달성을 진단하는 과학 평가에 관한 기본 지식에 대한 이해가 낮은 경향을 보여 주었다. 예를 들면, 관찰하는 방법을 알고 있는 것은 지식이며, 관찰 활동을 실천하는 관찰 능력은 탐구 기능인 것인데 오개념으로 작용하는 경향을 발견할 수 있었다. 현장 수업중에 제시한 학습 목표는 수업 후 목표 달성 여부를 평가하여야 하는데 목표에 부합되지 않은 문항으로 형성 평가를 하는 경향이 나타나고 있었다. 태도 영역 평가의 객관성 확보 방법이 여전히 어려운 과제로 대두되고 있어 이에 관한 개선이 절실함을 알 수 있었다. 6차 또는 7차 교육과정에서 지식, 기능, 태도 3영역의 균형있는 평가를 제시하고 있어 어느 정도 개선되었으나 현장에서는 수행 평가 도입으로 탐구 기능의 평가 비율을 높여 더욱 균형있는 3 영역의 평가가 이루어 질 수 있는 방향으로 개선되고 있는 추세이다.

• 한국한의학연구원논문집
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• 제18권2호
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• pp.139-149
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• 2012

Objectives : This is the study to understand of the pulse wave factor according to BMI and period of sterility on female, and to confirm the relationship of pulse wave factor among left and right inch, bar and cubit. Methods : The Questions and measurement of the pulse wave were operated with subjects(76 sterile females using on public health center). The measurement of the pulse wave was operated in 6 part of left and right inch, bar and cubit. The pulse wave was prior measured in part of left bar (i.e. interior pulsation part of radial process styloides in left hand), and next was measured in part of left inch and bar. And the pulse wave was operated samely in part of right inch, bar and cubit. Results : The results were as follows. The pulse energy of 6 part of left and right inch, bar and cubit was showed statistical significance and decreased in order of left inch, right inch, left cubit, right cubit, left inch, right bar. The left and right inch and cubit were showed numerical value of normal range, but left and right bar were showed lower pulse eneregy than normal range. Also left and right cubit were showed lower than left and right inch, and higher than left and right bar. In BMI, The pulse energy of left and right inch, cubit and the average of right hand was not showed statistical significance in the range of low-weight, normal, over-weight and obesity. But in the left and right bar and the average of left hand, the pulse energy of over-weight and obesity group were showed significantly higher than low-weight group. And the pulse wave factor was divided the pattern of h1 showing high numerical value in inch (Ap, As, Aw) and the pattern of Wm showing high numerical value in bar and cubit (RAI, Ad) Conclusions : The low pulse energy of bar was significant observation on the setting of oriental medical diagnostic index on sterilitas. Also, in the numerical value pattern of diverse pulse wave factor, it was divided the pattern of high numerical value in inch and the pattern of high numerical value in bar and cubit. On this, we think that the studies need in the future.

• 동의생리병리학회지
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• 제18권2호
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• pp.376-380
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• 2004

The purpose of this study is the develop a questionnaire for measuring Yin-Deficiency and examine the reliability and validity for its' value as a barometer for evaluating Yin-Deficiency. Questionnaire was developed according to the symptoms of Yin-Deficiency suggested in the 'Standardization of diagnostic terms and requirements of Korean Medicine', With and as a reference, each symptom has been worked on to be put on the questionnaire. Visual analogue scales(VAS) was used as a barometer for measuring frequency of manifestation of symptoms. A study was performed to measure validity and reliability of the final questionnaire for analysis. reliability of YinDQ was measured by Cronbach's alpha coefficient and test-retest method. This study utilized factor analysis and clinical validity for evaluation of validity. For the purpose of decreasing the amount of data-the number of factors, and at the same time minimize the loss of information factor analysis was performed Component factors were extracted using Principal Component Analysis. This study evaluated the clinical validity for examination of difference between the normal group and the patient group. Evaluation on the's internal consistency showed strong internal consistency with value of 0.8615. reliability from test-rest with three-week interval, followed by comparisons of the correlation coefficient and mean values of each item between the two. The Spearman correlation coefficient was 0.54-0.79. By factor analyse two factors with Eigen value of greater than 2.2 were selected. Factor 1 consists of items of 'irritable fever on the five Hearts', 'flushing of the zygomatic region in the afternoon', 'tidal fever', 'night sweats', and 'dryness on the mouth or the throat'. Factor two consists of items of 'emaciation', 'dizziness', 'insomnia', 'decreased amount of urine with yellowish color', and 'constipation'. The comparison between the patient group and the normal group showed significant differences for every ten questions. The results implies that YinDQ is a barometer with sufficient reliability and validity. The questionnaire for Yin-Deficiency may not be enough to replace the specific differential diagnosis by a doctor of Oriental medicine. Nevertheless, it can be effectively utilized as an assisting method in consultation or a method of measuring the degree of Yin-Deficiency in a group.

• Journal of Acupuncture Research
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• 제29권5호
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• pp.61-74
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• 2012

Objectives : This study is perfomed for preparation of oriental medicine clinical guidelines for drawing up the standards of oriental medicine demonstration and diagnosis classification about the knee pain. Methods : Statistical analysis about Crane's-knee wind(鶴膝風), arthralgia syndrome(痺症), knee injury(膝傷), gout arthritis(痛風), Youk jeol poung(歷節風) classified experts' opinions about knee pain patients by Delphi method is conducted by using oriental medicine diagnosis questionnaire. The result was classified by using linear discriminant analysis(LDA), diagonal linear discriminant analysis(DLDA), diagonal quadratic discriminant analysis(DQDA), K-nearest neighbor classification(KNN), classification and regression trees(CART), support vector machines(SVM). Results : The results are summarized as follows. 1. The result analyzed by using LDA has a hit rate of 81.65% in comparison with the original diagnosis. 2. The result analyzed by using DLDA has a hit rate of 63.3% in comparison with the original diagnosis. 3. The result analyzed by using DQDA has a hit rate of 65.14% in comparison with the original diagnosis. 4. The result analyzed by using KNN has a hit rate of 74.31% in comparison with the original diagnosis. 5. The result analyzed by using CART has a hit rate of 75.23% in comparison with the original diagnosis when the test of selected 13 significant questions based on analysis of variance was performed. 6. The result analyzed by using SVM has a hit rate of 87.16% in comparison with the original diagnosis. Conclusions : Statistical analysis using oriental medicine diagnosis questionnaire on knee pain generally turned out to have a significant result.

• Tuberculosis and Respiratory Diseases
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• 제55권2호
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• pp.165-174
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• 2003

연구배경 : 천식은 우리나라에서 유병률이 높은 질병 중에 하나이다. 국내에서도 천식 진료 지침이 발표되었지만 일차 진료에서 천식 진료의 실제 양상에 대해서는 연구된 바가 없다. 본 연구를 통해서 일차 진료에서 천식 진료의 실제 양상을 규명하는데 도움을 얻고자 하였다. 방 법 : 2002년 11월 서울 지역 내과 개원의 710명을 대상으로 경증 및 중증 천식 시나리오를 제시하고 천식 진료의 실제 양상에 대해서 설문 조사하였다. 1차에서는 우편조사를, 2차에서는 방문 수거조사를 실시하였으며 325명이 응답하였다 (응답률 46%). 결 과 : 응답자 중 경증 및 중증 천식시나리오에 대하여 경구 테오필린(theophylline)제를 처방하겠다고 답한 경우는 각각 71%, 81%으로 제일 많았다. 그 다음으로 많이 처방하겠다고 답한 것은 거담제(mucolytics), 경구 베타$_2$-항진제 순이었다. 하지만, 흡입 스테로이드를 처방하겠다고 답한 경우는 경증 및 중증 천식에 각각에 대하여 36%, 56%이었다. 진단적 검사로 폐기능 검사를 하겠다고 답한 경우보다 흉부 방사선 검사를 하겠다고 답한 경우가 더 많았다. 결 론 : 서울 지역 내과 개원의들은 천식 환자 치료에 흡입 스테로이드보다 경구 기관지확장제를 더 선호하였다. 일차 진료에서 천식 진료의 실제 양상과 천식 지침 사이의 차이를 줄이는데 노력을 경주해야 하겠다.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.111-120
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• 2016

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

• 식물분류학회지
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• 제48권1호
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• pp.9-23
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• 2018

Orbicule(소구상체)의 분포를 확인하기 위하여 꿀풀과에 속하는 6속 11분류군과 마편초과 3속 4분류군의 약벽을 주사전자현미경(scanning electron microscope)을 이용하여 관찰하였으며, 문헌조사를 통해 현화식물 내 소구상체의 분포가 갖는 계통분류학적 유용성 및 융단조직 유형과의 관련성에 대해 검토하였다. 그 결과 꿀풀과 분류군들에서는 모두 소구상체가 관찰되지 않았고, 마편초과 분류군들에서는 평균 $1{\mu}m$ 이하, 구형의 소구상체들이 조밀하게 분포하는 것을 살펴볼 수 있었다. 이와 같은 과 수준에서 일관성 있는 소구상체의 분포 특징은 현화식물 전체 orbicules에 대해 조사된 150과 중 123과와 일치하는 것으로 소구상체의 분포 유형 자체가 분류학적 예견적 가치를 지니는 것으로 나타났다. 또한, 융단조직 유형이 확인된 분류군들 중 분비형 융단조직을 갖는 분류군의 약 84%에서 소구상체가 나타나고, 아메바형 융단조직을 갖는 분류군의 약 80%은 소구상체가 나타나지 않는 것으로 조사되어 소구상체의 발달이 융단조직 유형과 밀접한 관련이 있는 것으로 조사되었다. 하지만, 현재까지 수행된 소구상체 연구는 현화식물 전체 416과들 중 150과에 제한되어 있고, 이들 분류군들 중 융단조직 유형은 92과에서만 알려져 있어 소구상체의 기능 및 융단조직 유형과의 유연관계를 규명하기 위해서는 보다 광범위한 분류군을 대상으로 한 연구가 필요한 것으로 나타났다.