• Title/Summary/Keyword: Diagnostic assessment

검색결과 762건 처리시간 0.031초

주의산만과 과잉운동을 주소로 하는 정신과 내원 아동들의 임상 평가 (CLINICAL EVALUATION OF CHILDREN WITH INATTENTION AND HYPERACTIVITY IN A PSYCHIATRIC CLINIC)

  • 권용실
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제13권1호
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    • pp.93-103
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    • 2002
  • 저자는 소아정신과 영역에서 흔하게 관찰되는 주의산만과 과잉운동을 주소로 하는 아동들의 진단특성과 이와 관련된 임상변인들을 알아보기 위하여 본 연구를 시행하였다. 대학병원 소아정신과에 내원한 아동들에서 주의력과 과잉운동 문제를 보이는 5세에서 14세 사이 총 71명(남자 63 명, 여자 8명)을 대상으로 하여, KEDI-WISC, KPI-C, ADS를 시행하였고 진단 분류에 따라 1) ADHD만 있는 군 2) 공존 질환이 있는 ADHD군 3) ADHD 이외의 진단군으로 나누어 비교한 결과 아래와 같은 결과를 얻었다. 1) ADHD 단독 진단군이 17명(23.9%), 공존질환이 ADHD는 26명(38.0%)이었으며 공존질환은 틱장애가 가장 많고 발달성 언어장애, 경계성 지능, 적대적 반항/품행장애, 경계성 지적능력, 학습장애의 순서를 보였으며, ADHD 이외의 진단군 27명(38.0%)은 틱장애, 경계성 지능, 우울/불안장애, 적대적 반항/품행장애의 진단 분포를 나타냈다. 2) 지능검사에서 전체지능, 언어성 지능, 동작성 지능 모두 군별 차이를 보였고 ADHD만 있는 군에서 공존질환 ADHD군보다 전체지능과 언어지능이 유의하게 높은 수치를 나타냈다. KPI-C 임상 척도는 군별 차이를 보이지 않았다. ADS 시각자극 검사에서 누락오류(omission)와 민감도(d')가 세 군 사이에 의미있는 차이를 보였고, 공존질환이 있는 ADHD 군이 ADHD이외의 진단군에 비해 유의하게 누락오류가 많고 민감도는 낮았다. 본 연구 결과를 볼때 아동의 주의산만과 과잉운동 증상은 주 진단인 ADHD 이외에도 다양한 정신과 질환으로 진단될 수 있으므로 이에 대한 감별이 필요하며, 또한 공존질환이 있는 ADHD군이 ADHD만 있는 군이나 기타 질환군보다 주의력에 문제가 많고 지능 수치가 상대적으로 낮아 학습 및 학교 생활 적응에 어려움이 더 많을 것이므로 적극적인 치료개입이 필요할 것으로 생각되었다.

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화병과 주요우울증 환자의 신경인지기능 (Neurocognitive Function in Patients with Hwa-byung and with Major Depressive Disorder)

  • 윤영환;이소희;최종혁
    • 생물정신의학
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    • 제12권2호
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    • pp.181-188
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    • 2005
  • Objectives:Hwa-byung has been studied clinically for several years and introduced as Korean Culture- Bound Syndrome. However, the definition and the diagnostic method are not yet clarified, and there has not been any sufficient comparative study on this disease entity. This study was conducted to determine the clinical symptoms and the profile of the neurocognitive functions in Hwa-byung(HB) and Major Depressive Disorder(MDD), and We wish to identify any critical factors that differentiate the disorders. Methods:A total of 102 participants were examined, including 34 participants with MDD, 34 with HB, and 34 healthy controls. The MDD and HB patients were recruited from among inpatients and outpatients at the National Medical Center for the period from May to December of 2004. As a major diagnostic tool of MDD, diagnostic reference of DSM-IV-TR was used and as HB's diagnostic tool, We used computerized neurocognitive function test. Psychiatric symptomatology was evaluated by the Beck Depression Inventory(BDI), and Symptom Checkist-90-Revision(SCL-90-R). Oneway ANOVA, Scheffe post-hoc test and Chi-Squre Tests were used for statistical analysis. Results:The participants in three groups did not differ in terms of age, sex, and education. Assessment of BDI indicated that the MDD group had significantly higher total score than the HB group. MDD and HB groups showed significantly higher total scores on the SCL-90-R in comparison to the controls. The MDD group was found to have significantly more symptoms of depression than the HB group, based on the depression subscale of the SCL-90-R. The computerized neurocognitive function test suggest several results 1) Within the memory domain, it was found that one of the two memory tests in MDD and HB groups were significantly impaired in comparison to the control group. 2) Within the attention domain, it was found that only the MDD group was significantly impaired in comparison to the control group. 3) Within the higher cortical function domain, it was found that significant impairment exist in MDD group and HB group compared to the control group; the severity of impairment was found to be more profound in the MDD group than in the HB group. Conclusion:These results suggest that both HB group and MDD group have significantly decreased neurocognitive function than the control group, and neurocognitive function of the HB group is better than that of the MDD group.

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한국판 Mini International Neuropsychiatric Interview 타당도 연구 (Validity of Korean Version of the Mini-International Neuropsychiatric Interview)

  • 유상우;김영신;노주선;오강섭;김찬형;남궁기;채정호;이기철;전성일;민경준;오동재;주은정;박현주;최영희;김세주
    • 대한불안의학회지
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    • 제2권1호
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    • pp.50-55
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    • 2006
  • Objectives : In the psychiatry, structured interview is very important tool to be used in epidemiological or psychopharmacological studies. However, investigators often find that the administration of comprehensive diagnostic interviews is time-consuming and expensive to be used in clinical or research settings. Considering these points, Sheehan and his colleagues developed MINI (Mini International Neuropsychiatric Interview) to meet the need for a brief, reliable, and valid structured diagnostic interview for psychiatric disorders. The MINI has been translated into many languages and used in many countries. Therefore, we translated the MINI into Korean and determined its validity in this study. Methods : Twohundred seventy patients and normal subjects participated in the validation of the MINI versus an expert's professional opinion. Schizophrenia and other psychotic disorders, mood disorders including major depressive disorder and bipolar disorder, anxiety disorders including panic and other phobic disorders, and alcohol dependence were included in this study. The validity was obtained by examination whether MINI based diagnoses were compatible with diagnoses by expert psychiatrists. Results : The range of Kappa values was 0.22 (somatoform disorder) to 0.93 (bipolar disorder - past). Overall agreement between MINI and expert's diagnoses were good. The Kappa values for anxiety disorders seemed to be higher than those for other disorders. Conclusion : The MINI Korean version has the good validity. It also has potential applications as a diagnostic tool for psychiatric disorders.

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몬테칼로 모의모사를 이용한 유방성형술 환자의 유방선량평가 (Evaluation of Breast Dose in Mammography for Breast Implant Patient using a Monte Carlo Simulation)

  • 김지수;조용인;김정훈
    • 한국방사선학회논문지
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    • 제14권3호
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    • pp.253-259
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    • 2020
  • 유방촬영은 경제적이고 간편하며 미세석회화 검출에 효과적이라는 장점이 있으나, 유방은 감수성이 높은 장기이므로 확률적 영향에 의한 암 발생 위험을 동반한다. 이를 최소화하기 위해 정확한 유방 선량 평가가 필요하나, 현재 유방선량 평가는 일반여성들에게 한정되어 유방성형술 환자에게는 제한적이다. 본 연구는 유방성형환자의 정확한 선량 평가를 위하여 유방 보형물이 삽입된 모의피폭체를 구성하여 관전압에 따른 선량변화를 알아보고자 하였다. 그 결과, 유방 보형물이 있는 경우, 보형물이 없을 때의 선량보다 낮은 결과를 나타내었다. 검사 시 관전압 조건에 따른 선량 분포는 보형물의 유·무와 관계없이 관전압이 높아질수록 선량이 높아지는 양상을 보였다. 추후 본 연구를 통해 유방성형환자의 선량 관리 측면의 진단참고 수준 확립을 위한 기초적인 자료로서 활용 가능할 것으로 사료된다.

골결손부 치유과정에서 cone beam형 전산화단층영상의 정확도 (The accuracy of the imaging reformation of cone beam computed tomography for the assessment of bone defect healing)

  • 강호덕;김규태;최용석;황의한
    • Imaging Science in Dentistry
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    • 제37권2호
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    • pp.69-77
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    • 2007
  • Purpose: To evaluate the accuracy of the imaging reformation of cone beam computed tomography for the assessment of bone defect healing in rat model. Materials and Methods: Sprague-Dawley strain rats weighing about 350 gms were selected. Then critical size bone defects were done at parietal bone with implantation of collagen sponge. The rats were divided into seven groups of 3 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 6 weeks, and 8 weeks. The healing of surgical defect was assessed by multi planar reconstruction (MPR) images and three-dimensional (3-D) images of cone beam computed tomography, compared with soft X-ray radiograph and histopathologic examination. Results: MPR images and 3-D images showed similar reformation of the healing amount at 3 days, 1 week, 2 weeks, and 8 weeks, however, lower reformation at 3 weeks, 4 weeks, and 6 weeks. According to imaging-based methodologies, MPR image revealed similar reformation of the healing amount than 3-D images compare with soft X-ray image. Among the four threshold values for 3-D images, 400-500 HU revealed similar reformation of the healing amount. Histopathologic examination confirmed the newly formed trabeculation correspond with imaging-based methologies. Conclusion: MPR images revealed higher accuracy of the imaging reformation of cone beam computed tomography and cone beam computed tomography is a clinically useful diagnostic tool for the assessment of bone defect healing.

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u-헬스케어시스템의 정보보안 체계 확보를 위한 5단계 보안위험도 평가모델 설계 (A Study on Five Levels of Security Risk Assessment Model Design for Ensuring the u-Healthcare Information System)

  • 노시춘
    • 융합보안논문지
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    • 제13권4호
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    • pp.11-17
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    • 2013
  • 모든 u-헬스케어 시스템은 보안 취약점을 가지고 있다. 이 취약점은 로컬(local) 또는 네트워크(network) 상에서 잠재적인 위험이 된다. 의료정보 기술의 Smart 환경, Ad-hoc networking, 무선통신 환경은, u-헬스케어 보안 취약성을 증가시키는 주요 요인이다. u-헬스케어 의료정보시스템 도메인은 사용자단말 구간, 공중통신망 인프라구간, 네트워킹구간, 인트라넷구간으로 구분된다. 의료정보시스템 도메인별을 구분하여 취약점을 평가하는 이유는 도메인별로 취약점에 대한 대처방법이 다르기 때문이다. u-헬스케어시스템 5단계의 보안위험도 평가체계는 도메인별 보안취약성 진단체계를 설계하여 보안대책을 강구하기 위해 필요하다. 제안하는 모델을 사용할 경우 현재까지 막연하게 진행 되어온 USN 기반 의료정보네트워크 보안취약성 진단대책을 좀 더 체계적으로 수행할 수 있는 모형을 제공한다.

Matrix Metalloproteinase-13 - A Potential Biomarker for Detection and Prognostic Assessment of Patients with Esophageal Squamous Cell Carcinoma

  • Sedighi, Maryam;Aledavood, Seyed Amir;Abbaszadegan, MR;Memar, Bahram;Montazer, Mehdi;Rajabian, Majid;Gholamin, Mehran
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2781-2785
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    • 2016
  • Background: Matric metalloproteinase (MMP) 13 gene expression is increased in esophageal squamous cell carcinomas (ESCCs) and associated with increasing tumor invasion, lymph node involvement and decreased survival rates. Levels of the circulating enzyme may be elevated and used as a marker of tumor progression. In this study, clinical application of MMP-13 serum levels was evaluated for early detection, prediction of prognosis and survival time of ESCC patients. Materials and Methods: Serum levels of MMP13 were determined by ELISA in 66 ESCC patients prior of any treatment and 54 healthy controls for comparison with clinicopathological data through statistical analysis with Man Whitney U and Log-Rank tests. In addition, clinical value of MMP13 levels for diagnosis was evaluated by receiver operating characteristic (ROC) test. Results: The serum level of MMP-13 in patients (>250 pg/ml) was significantly higher than in the control group (<100 pg/ml) (p value=0.004). Also the results showed a significant correlation between MMP-13 serum levels with tumor stage (p value = 0.003), depth of tumor invasion (p value=0.008), involvement of lymph nodes (p value = 0.011), tumor size (p value = 0.018) and survival time. While there were no significant correlation with grade and location of tumors. ROC analysis showed that MMP-13 level is an accurate diagnostic marker especially to differentiate pre-invasive/ invasive lesions from normal controls (sensitivity and specificity: 100%). Conclusions: These findings indicate a potential clinical significance of serum MMP13 measurement for early detection and prognostic assessment in ESCC patients.

아동학대, 찾아낼 수 있는가 - 소아청소년과 의사의 역할 (Child abuse, can we find child abuse? - Role of the pediatrician)

  • 민기식
    • Clinical and Experimental Pediatrics
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    • 제52권11호
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    • pp.1194-1199
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    • 2009
  • Child abuse is defined by a recent act or failure to act that results in death, serious physical or emotional harm, sexual abuse or exploitation, or imminent risk of serious harm; involved a child; and is carried out by a parent or caregiver. This report provides guidance in the clinical approach to the evaluation of suspected physical abuse in children, and role of pediatrician. The medical assessment is outlined with obtaining a medical history, physical examination, and diagnostic testing. A minor form of child abuse which only involves skin injury is most frequently seen by a pediatrician. This kind of child abuse can be followed by more severe forms of child abuse, which have high mortality rates and cause serious physical and mental sequelae to the survivor. Therefore, a pediatrician's role in an early detection and prevention of child abuse is very important.

흉부의 자기공명영상 (Magnetic Resonance Imaging in Thorax)

  • 최병욱
    • Tuberculosis and Respiratory Diseases
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    • 제56권6호
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    • pp.571-584
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    • 2004
  • Magnetic Resonance Imaging (MRI) is one of the most advanced imaging techniques in clinical and research medicine. However, clinical application of MRI to the lung or thorax has been limited due to various drawbacks. Low signal intensity of the lung and cardiac and respiratory movements are the most serious problems with MRI in thorax. Nevertheless, MRI is superior to CT in some selected patients with thoracic diseases. The role of clinical MRI in thoracic disease has been widened with improvement of MR equipments and development of new pulse sequences. Otherwise, functional assessment of lung by MRI has been studied for the last decade. These include perfusion MRI with or without contrast enhancement and ventilation MRI with oxygen-enhancement or hyperpolarized noble gas, $^3He$ and $^{129}Xe$.

Physical Therapy Strategies for the Patient With Hysterical Motor Paralysis Disorder : A Case Report and Literature Review

  • Oh, Duck-Won;Yoo, Eun-Young
    • 한국전문물리치료학회지
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    • 제11권4호
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    • pp.43-49
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    • 2004
  • It is not common in rehabilitation situation to encounter patients exhibiting paralysis or other disabilities which have no apparent organic basis. Even without organic causes for their signs and symptoms these patients often require comprehensive treatment and management. Patients with conversion disorder often pose particular difficulties because of diagnostic confusion and the lack of therapeutic strategies for rehabilitation management. We feel that systematic functional rehabilitation is helpful in resolving symptom and recovering normal function in the patient suffering from conversion disorder since it provides motivation and reduces reinforcements which contribute to sustained disabled state. This report describes the patient with hysterical motor paralysis who is successfully treated with structured physical therapy. The objectives of this report are to provide therapeutic guidelines for physical therapy and to emphasize the role of physical therapist in the assessment and treatment of hysterical paralysis.

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