Purpose We investigated potentially promising imaging findings and their combinations in the evaluation of cognitive decline. Materials and Methods This retrospective study included 138 patients with subjective cognitive impairments, who underwent brain MRI. We classified the same group of patients into Alzheimer's disease (AD) and non-AD groups, based on the neuropsychiatric evaluation. We analyzed imaging findings, including white matter hyperintensity (WMH) and cerebral microbleeds (CMBs), using the Kruskal-Wallis test for group comparison, and receiver operating characteristic (ROC) curve analysis for assessing the diagnostic performance of imaging findings. Results CMBs in the lobar or deep locations demonstrated higher prevalence in the patients with AD compared to those in the non-AD group. The presence of lobar CMBs combined with periventricular WMH (area under the ROC curve [AUC] = 0.702 [95% confidence interval: 0.599-0.806], p < 0.001) showed the highest performance in differentiation of AD from non-AD group. Conclusion Combinations of imaging findings can serve as useful additive diagnostic tools in the assessment of cognitive decline.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.28
no.2
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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.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.12
no.2
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pp.218-224
/
2001
Although Attention Deficit Hyperactivity Disorder(ADHD) has been considered as the disorder occurring during childhood, the prevalence is increasing among adolescents and adults. The prevalence rate varies from 2.0 to 14.3% due to the difference of diagnostic criteria, different assessment methods, or subjects' age difference. Therefore, it needs to make age specific(i.e., for children, for adolescents, and for adults) assessment tools. Authors translated Conners-Wells Adolescents Self-Report Scales(short form)[CASS(S)] in to Korean to get validity and reliability as a way of development of assessment tool for adolescent with ADHD in Korea. CASS(S) was translated and corrtected by three psychiatrists and one clinical psychologist. To examine the concurrent validity and test-retest validity, CASS(S) was applied with K-YSR on one class of each grade in a middle school in Seoul with two week interval(total 115:male 58, female 57). To test validity, authors analysed and got Cronbach's as internal consistency. Construct validity was done by principal axis factor analysis on 4,354 students. As a result, Cronbach's alpha for internal consistency was .88, Pearson coefficient for test-retest reliability .83, and coefficient for concurrent validity .65. And in the factor analysis to examine construct validity, three factors were revealed as cognition, hyperactivity, and conduct. These results shows that CASS(S) may be useful tool for adolescents with ADHD, although there was a limit not to be done the comparison with clinical groups.
Ah Young Park;Myoungae Kwon;Ok Hee Woo;Kyu Ran Cho;Eun Kyung Park;Sang Hoon Cha;Sung Eun Song;Ju-Han Lee;JaeHyung Cha;Gil Soo Son;Bo Kyoung Seo
Korean Journal of Radiology
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v.20
no.5
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pp.759-772
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2019
Objective: To investigate the value of ultrasound (US) microflow assessment in distinguishing malignant from benign solid breast masses as well as the association between US parameters and histologic microvessel density (MVD). Materials and Methods: Ninety-eight breast masses (57 benign and 41 malignant) were examined using Superb Microvascular Imaging (SMI) and contrast-enhanced US (CEUS) before biopsy. Two radiologists evaluated the quantitative and qualitative vascular parameters on SMI (vascular index, morphology, distribution, and penetration) and CEUS (time-intensity curve analysis and enhancement characteristics). US parameters were compared between benign and malignant masses and the diagnostic performance was compared between SMI and CEUS. Subgroup analysis was performed according to lesion size. The effect of vascular parameters on downgrading Breast Imaging Reporting and Data System (BI-RADS) category 4A masses was evaluated. The association between histologic MVD and US parameters was analyzed. Results: Malignant masses were associated with a higher vascular index (15.1 ± 7.3 vs. 5.9 ± 5.6), complex vessel morphology (82.9% vs. 42.1%), central vascularity (95.1% vs. 59.6%), penetrating vessels (80.5% vs. 31.6%) on SMI (all, p < 0.001), as well as higher peak intensity (37.1 ± 25.7 vs. 17.0 ± 15.8, p < 0.001), slope (10.6 ± 11.2 vs. 3.9 ± 4.2, p = 0.001), area (1035.7 ± 726.9 vs. 458.2 ± 410.2, p < 0.001), hyperenhancement (95.1% vs. 70.2%, p = 0.005), centripetal enhancement (70.7% vs. 45.6%, p = 0.023), penetrating vessels (65.9% vs. 22.8%, p < 0.001), and perfusion defects (31.7% vs. 3.5%, p < 0.001) on CEUS (p ≤ 0.023). The areas under the receiver operating characteristic curve (AUCs) of SMI and CEUS were 0.853 and 0.841, respectively (p = 0.803). In 19 masses measuring < 10 mm, central vascularity on SMI was associated with malignancy (100% vs. 38.5%, p = 0.018). Considering all benign SMI parameters on the BI-RADS assessment, unnecessary biopsies could be avoided in 12 category 4A masses with improved AUCs (0.500 vs. 0.605, p < 0.001). US vascular parameters associated with malignancy showed higher MVD (p ≤ 0.016). MVD was higher in malignant masses than in benign masses, and malignant masses negative for estrogen receptor or positive for Ki67 had higher MVD (p < 0.05). Conclusion: US microflow assessment using SMI and CEUS is valuable in distinguishing malignant from benign solid breast masses, and US vascular parameters are associated with histologic MVD.
Climate vulnerability index is usually defined as a function of the climate exposure, sensitivity, and adaptive capacity, which requires adequate selection of proxy variables of each variable. We selected and used 9 proxy variables related to climate exposure in the literature, and diagnosed the adequacy of them for application in Korean peninsula. The selected proxy variables are: four variables from temperature, three from precipitation, one from wind speed, and one from relative humidity. We collected climate data over both previous year (1981~2010) and future climate scenario (A1B scenario of IPCC SERES) for 2020, 2050, and 2100. We introduced the spatial and temporal diagnostic statistical parameters, and evaluated both spatial and time variabilities in the relative scale. Of 9 proxy variables, effective humidity indicated the most sensitive to climate change temporally with the biggest spatial variability, implying a good proxy variable in diagnostics of climate change vulnerability in Korea. The second most sensitive variable is the frequency of strong wind speed with a decreasing trend, suggesting that it should be used carefully or may not be of broad utility as a proxy variable in Korea. The A1B scenario of future climate in 2020, 2050 and 2100 matches well with the extension of linear trend of observed variables during 1981~2010, indicating that, except for strong wind speed, the selected proxy variables can be effectively used in calculating the vulnerability index for both past and future climate over Korea. Other local variabilities for the past and future climate in association with climate exposure variables are also discussed here.
Now, most of programs developed were presented as form of item pool by dividing problems by section and level for the level differentiated course, so the utilization is decreasing at the field caused by unconsidered school underachievement elements by achievement. Especially, the study on teaching materials and effective measures map for mid-low level students with low utilization is more urgent. Therefore, in this study we will promote teaching method for improving learning achievement at high school. The development teaching materials(the performance evaluation and diagnostic assessment, reconstruction of textbooks) will be applied to classes for the underachieving students directly, and the achievement in the experimental class was significantly improved compared to the comparative class and the meaningful conclusions could be drawn as results of conducting same assessment based on the experimental class and the comparative class.
Purpose: This study investigated the association between the objective indicator of masticatory function assessment and the masseter muscle thickness (MMT) using ultrasound imaging. Methods: A total of 99 subjects (males: 24, females: 75, mean age: 76) were analyzed. The maximum bite force (MBF) was measured with a pressure-sensitive sheet and an image scanner. The mixing ability index (MAI) was calculated by image analysis after asking the subjects to chew a wax specimen. The MMT during rest and clenching were obtained with a diagnostic ultrasound system, and the difference in MMT during rest and MMT during clenching was defined as the difference in masseter muscle thickness (DMMT). Multiple regression analysis was performed to determine the independent variables affecting MBF and MAI. Results: The MBF showed correlation with the number of remaining teeth (β=0.346, p=0.002) and DMMT (β=0.251, p=0.011). The MAI correlated with only the number of remaining teeth (β=0.476, p<0.001). Conclusions: The DMMT reflects the state of masseter muscle contraction, and can be used as a predictor as well as the number of teeth when assessing masticatory function.
Aim: To compare the agreement of screening breast mammography plus ultrasound and reviewed mammography alone in asymptomatic women. Materials and Methods: All breast imaging data were obtained for women who presented for routine medical checkup at National Cancer Institute (NCI), Thailand from January 2010 to June 2013. A radiologist performed masked interpretations of selected mammographic images retrieved from the computer imaging database. Previous mammography, ultrasound reports and clinical data were blinded before film re-interpretation. Kappa values were calculated to assess the agreement between BIRADS assessment category and BIRADS classification of density obtained from the mammography with ultrasound in imaging database and reviewed mammography alone. Results: Regarding BIRADS assessment category, concordance between the two interpretations were good. Observed agreement was 96.1%. There was moderate agreement in which the Kappa value was 0.58% (95%CI; 0.45, 0.87). The agreement of BI-RADS classification of density was substantial, with a Kappa value of 0.60 (95%CI; 0.54, 0.66). Different results were obtained when a subgroup of patients aged ${\geq}60$ years were analyzed. In women in this group, observed agreement was 97.6%. There was also substantial agreement in which the Kappa value was 0.74% (95%CI; 0.49, 0.98). Conclusions: The present study revealed that concordance between mammography plus ultrasound and reviewed mammography alone in asymptomatic women is good. However, there is just moderate agreement which can be enhanced if age-targeted breast imaging is performed. Substantial agreement can be achieved in women aged ${\geq}60$. Adjunctive breast ultrasound is less important in women in this group.
Malnutrition is common and the major risk factor of mortality of end stage renal disease (ESRD) patients. The aim of this study is to assess nutritional status of malnutrition patients on dialysis by various methods and compare nutritional parameters of continuous ambulatory peritoneal dialysis (CAPD) patients with hemodialysis patients. 137 patients on dialysis from April 2009 to July 2013 were enrolled. Nutritional parameters of 66 CAPD and 71 hemodialysis patients were investigated by anthropometry, biochemical study, diet analysis and questionnaires. Malnutrition patients were selected by body mass index (BMI), serum albumin and pre-albumin based on International Society of Renal Nutrition and Metabolism (ISRNM) diagnostic criteria for protein-energy wasting and compared with non-malnutrition patients. In comparison of CAPD and hemodialysis patients, most anthropometric values showed no significant difference except total body water (TBW). TBW was lower in CAPD patients (P=0.024). Although serum albumin was slightly higher in hemodialysis patients (P=0.047), pre-albumin were significantly higher in CAPD patients (P=0.000). Serum blood urea nitrogen (BUN) was higher in hemodialysis patients (P=0.000). In diet analysis, Total calorie (P=0.000) and total cholesterol (P=0.012) intakes were higher in CAPD patients. Mean subjective global assessment (SGA) grade was higher in CAPD patients (P=0.003). Several nutritional parameters of CAPD patients were better than hemodialysis patients implying more intensive therapeutic approach may be needed for hemodialysis patients. We have to understand multiple factors contributing malnutrition of ESRD patients and individualized therapeutic approach is needed.
Purpose: The primary aims of this retrospective study were to compare subjective bone quality and bone quality based on the Hounsfield scale in different segments of the edentulous jaw, and to establish quantitative and objective assessment of the bone quality. Materials and Methods: Twenty eight randomly selected cone-beam computed tomographic (CBCT) scans were analyzed. For evaluation one hundred and twelve edentulous areas were selected. Implant recipient sites were evaluated visually for Lekholm and Zarb classification. The same sites were subsequently evaluated digitally using the Hounsfield scale with Vimplant$2.0^{TM}$, and the results were correlated with visual classification. Data was subject for statistical analysis in order to determine correlation between recorded HU and the regions of the mouth with the Kruskal-Wallis test. Results: The highest unit/mean density value (311 HU) was found in the anterior mandible, followed by 259 HU for the posterior mandible, 216 HU for the anterior maxilla, and 127 HU for the posterior maxilla. These results demonstrate a strong correlation for HU depending on the region of the mouth (p<0.001). The relationship between HU and type 4 bone was found to be significant (r=0.74). Conclusion: Knowledge of the Hounsfield value as a quantitative measurement of bone density can be helpful as a diagnostic tool by using $CBMercuRa6^{TM}$ with $Vimplant^{TM}$ software.
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