• 한국콘텐츠학회논문지
• /
• 제11권11호
• /
• pp.221-230
• /
• 2011

본 연구는 ADHD 아동의 불안과 어머니 양육스트레스간에 관련이 있는지 알아보기 위해 ADHD로 진단받은 만 7~9세 아동과 M 초등학교에 재학 중인 일반아동과 어머니를 대상으로 불안설문지와 양육스트레스를 실시하였다. 양육스트레스는 한국판 부모 양육스트레스 축약형 검사를 사용하였으며, 불안은 한국형 소아 상태 및 특성 불안척도 를 사용하였다. 총 200부를 방문 및 우편 배부하여, 112부의 자료가 분석에 사용되었다. 연구결과 ADHD 아동은 일반아동에 비해 불안수준과 양육스트레스 점수가 더 높았으며, ADHD 아동은 성별, 연령, 유형에 따른 불안 수준과 양육스트레스에서 유의한 차이가 없었다. 특성불안은 양육스트레스의 하위척도인 부모의 고통(r=.30)과 상관관계를 보였으며, 상태불안은 까다로운 아동(r=.30)과 정적인 상관관계를 보였으나, 양육스트레스가 아동의 불안에 유의한 영향을 미치지는 않았다. 임상현장의 전문가는 ADHD 아동의 불안수준이 일반아동과는 다르다는 것을 인식할 필요가 있으며, ADHD 아동의 불안증상에 대한 개입과 더불어 어머니의 양육스트레스에 대한 상담과 개입이 필요하다.

• Journal of Chest Surgery
• /
• 제22권2호
• /
• pp.308-314
• /
• 1989

Pulmonary sequestration is a congenital malformation characterized by an area of embryonic lung tissue that derives its blood supply from an anomalous systemic artery. Two forms recognized: extralobar and intralobar. Extralobar form is a very rare congenital malformation, usually located in the lower chest, and may be found in newborn infants at the time a congenital diaphragmatic hernia is repaired. Large sequestrated segments may be cause acute respiratory distress in the neonate. The condition is asymptomatic in 15 per cent of patients. This report presents two cases of pulmonary sequestration which misdiagnosed a superior mediastinal tumor and a benign lung tumor. First case was 30-year-old male patient and chief complaints were dyspnea, dry cough and right chest pain. Chest X-ray showed a homogenous increased density of smooth margin at the right superior mediastinal area and suggested a benign mediastinal tumor. And so explothoracotomy was made without other special studies. Second case was 28-year-old male patient. One month ago, he had tracheostomy and right closed thoracostomy due to massive hemoptysis and spontaneous hemothorax. Chest X-ray showed a benign cystic lesion at RLL area. At the time of operation, in first case, a mass of adult fist size was placed medial to the right upper lobe and densely adhesive to trachea, SVC and esophagus. Blood supply of the mass was bronchial arteries of trachea and RUL bronchus and drained to SVC and azygos vein through anomalous systemic veins. There was no bronchial communication on Frozen biopsy. In 2nd case, large cystic lesion contained old blood hematoma was located in RLL and anomalous blood vessel from thoracic aorta was drained to posterior segment of RLL. In operation field, intralobar pulmonary sequestration was diagnosed, and RLL lobectomy was carried out.

• 근관절건강학회지
• /
• 제21권3호
• /
• pp.184-194
• /
• 2014

Purpose: The purpose of this study was to develop and validate a diabetes management self-efficacy scale for older adults (DMSES-O). Methods: A preliminary DMSES-O of 22 items was derived from a literature review and seven domains of self-management behaviors. Content validity was confirmed by experts in diabetes self-management education. To test the reliability and validity of the DMSES-O, data were collected from 150 older adults with type 2 diabetes. The data were analyzed using exploratory factor analysis, and Cronbach's ${\alpha}$ and Pearson's correlation coefficients were calculated. Results: From the exploratory factor analysis, 17 significant items in six subscales were derived. Factors derived were named "problem solving for hypoglycemia and self-monitoring blood glucose," "problem solving for hyperglycemia," "coping with psychological distress and taking medication," "reducing risks of diabetes complications," "appropriate exercise," and "healthy eating." The criterion-related validity of the DMSES-O was established by its correlation with the Summary of Diabetes Self-care Activities Questionnaire. Cronbach's ${\alpha}$, a measure of internal consistency, was .84 for the overall scale and ranged from .54 to .80 for the subscales. Conclusion: The DMSES-O is a reliable and valid instrument to measure selfefficacy for diabetes self-management among older adults.

• 대한화장품학회지
• /
• 제24권3호
• /
• pp.134-145
• /
• 1998

Facial hyperpigmentation in women, which is considered to be a serious cosmetic disability and a cause of mental distress, requires proper management. Melanocyte dendricity is a crucial factor affecting epidermal pigmentation. We found that BQ-788, the endothelin-B (ETB) receptor antagonist, blocks the formation of multi-dendricity which is induced by cocultured keratinocytes. Melanocytes in vivo show numerous dendrites which are in close contact with multiple keratinocytes, forming the epidermal-melanin unit. While melanocytes transfer their melanosomes into the neighboring keratinocytes via dendrites, keratinocytes secrete many growth factors and cytokines that influence viability, morphology, and melanin formation of melanocytes. Endothelin-1 (ET-1), prostaglandin E2(PGE2), and leukotriene-C4 (LT-C4) have been suggested as the candidates for increasing dendricity. Other reports suggested that ET-1 has stimulatory effects on proliferation and melanin formation of melanocytes in vitro. In the present study, using type-specific ET receptor antagonists, we observed how the morphology of melanocytes could be modulated in a coculture system. In addition, the roles of ET-1 for morphology and proliferation on melanocytes were evaluated in different culture media. We suggest that ET-1 increases dendricity and proliferation of melanocytes, and that its dendrite-inducing effect and mitogenic effect are regulated independently.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제26권1호
• /
• pp.38-44
• /
• 2015

Objectives : The purpose of this study is to examine the effects of the characteristics of victim and sexual abuse on posttraumatic psychiatric symptoms in children and adolescents with a history of sexual abuse. Methods : A total of 137 children and adolescents were recruited from the Seoul Sunflower Children Center, a nation-funded sexual violence victim protection center, from January 2009 to December 2013. We collected the demographic data of the victims and the Trauma Symptom Checklist for Children (TSCC) from victims. We hypothesized victims' age, sex, and intelligence quotient, and the characteristics of sexual abuse as the affecting factors of posttraumatic psychiatric symptoms. Descriptive analysis and hierarchical regression analysis were performed for analysis of demographic data, TSCC scores, and psychiatric symptoms. Results : The victims' age and the characteristics of sexual abuse were significantly related to the traumatic distress of sexual abuse. R-square was 23% for anxiety, 39% for depression, 21% for posttraumatic stress, and 37% for dissociation on TSCC. Conclusion : This study suggests that victims' age, type, frequency and duration of exposure, and disclosure of sexual abuse are significant affecting factors on posttraumatic psychiatric symptoms in children and adolescents. Exploration of psychiatric symptoms other than posttraumatic symptoms, and relations between pretraumatic and posttraumatic psychiatric symptoms is needed through collection of larger samples.

• Tuberculosis and Respiratory Diseases
• /
• 제45권5호
• /
• pp.1094-1097
• /
• 1998

만성적인 경부 동통을 호소하던 57세 남자가 호흡곤란을 호소하여 경추부 단순 촬영 및 경부 전산화 단층 촬영을 시행한 결과 경추 전방부의 과골화를 포함한 Forestier병의 소견을 보였으며, 기관지 내시경상 경추부 과골화로 인한 기도 협착 및 성문 하부의 부종이 관찰되어 스테로이드로 치료하여 호전되었기에 문헌 고찰과 함께 보고하는 바이다.

• 대한의용생체공학회:의공학회지
• /
• 제27권4호
• /
• pp.143-153
• /
• 2006

The purpose of this work was to assess and quantify the beneficial effects of gas exchange, while testingto the various frequencies of the sinusoidal wave that was excited by the PZT actuator, for patients suffering from acute respiratory distress syndrome (ARDS) or chronic respiratory problems. Also, this paper considered a simulator to design a hollow type artificial lung, and a mathematical model was used to predict a behavior of blood. This simulation was carried out according to the Montecarno's simulation method, anda fourth order Runge-Kutta method was used to solve the equation. The experimental design and procedure are then applied to the construction of a new device to assess the effectiveness of the membrane vibrations. As a result, the vibration method is very effective in the increase of gas transport. The gas exchange efficiency for the vibrating intravascular lung assist device can be increased by emphasizing the following design features: consistent and reproducible fiber geometry, and most importantly, an active means of enhancing convective mixing of water around the hollow fiber membranes. The experimental results showed the effective performance of the vibrating intravascular lung assist device. Also, we concluded that important design parameters were blood flow rates, fiber outer diameter and oxygen pressure drop. Based on the present results, it was believed that the optimal level of blood flow rates was 200$cm^3$/min.

• 정신신체의학
• /
• 제27권1호
• /
• pp.50-59
• /
• 2019

연구목적 2형 당뇨병을 지닌 환자의 다수에서 수면문제가 동반되며, 이들에서 불면증의 비율은 일반 인구에 비해서 높다고 알려져 있다. 본 연구의 목적은 2형 당뇨병 환자에서 불면증의 발생빈도, 불면증의 임상적 특징 및 이에 연관되는 변인을 알아보기 위함이다. 방 법 2형 당뇨병으로 진단받은 18세에서 80세 이하의 99명(남자 65명, 여자 34명)을 대상으로 연구자 1인(제1저자)가 면담을 시행하였다. 면담으로 수면 잠복기, 총 수면시간을 조사하였고, 한국판 불면증 심각도 지수(Korean Version of Insomnia Severity Index, ISI-K) 평가하고, 우울증상의 심각도는 한국판 Hamilton 우울증 평가 척도(Korean Version of the Hamilton Depression Rating Scale, K-HDRS)로 평가하였다. ISI-K의 절취점 15.5점을 기준으로 불면증 있는 군(N=34명)과 불면증 없는 군(N=65)으로 양분하여 불면증군과 대조군의 여러 변인과의 연관성을 상관분석하고 다중 로지스틱 회귀분석을 사용하여 검토하여 다음의 결과를 얻었다. 결 과 2형 당뇨병 환자의 34.34%(N=34)에서 불면증이 있었다. 불면증이 있는 2형 당뇨병 환자군은 불면증이 없는 2형 당뇨병 환자군보다 유의하게 미혼(11.8%)이나 이혼(11.8%)이많았고(p<0.05), K-HDRS 총점($11.76{\pm}5.52$점)이 높았으며(p<0.001), 총수면시간($5.35{\pm}2.00$시간)이 짧았고(p<0.001), 수면잠복기($50.29{\pm}33.80$분)가 길었다(p<0.001). 불면증이 있는 2형 당뇨병 환자군은 불면증이 없는 2형 당뇨병 환자군보다 ISI-K 검사상 합계($18.38{\pm}2.69$점), A1 (입면)($2.97{\pm}0.76$점), A2 (수면유지)($3.06{\pm}0.69$점), A3 (일찍 깸)($2.76{\pm}0.61$점), B (수면만족도)($3.18{\pm}0.72$점), C (수면장애로 인한 기능방해)($2.09{\pm}0.97$점), D (남이 알아차림)($2.12{\pm}1.09$점), E (수면장애에 대한 걱정)($2.21{\pm}0.81$점) 등 모든 항목의 점수가 유의하게 높았다(각각 p<0.001). 2형 당뇨병 환자에서 불면증에 영향을 미치는 요인들은 다음과 같다. 나이는 ISI-K A3 항목과 유의한 역상관관계가 있었고 (${\beta}=-0.241$, p<0.05), K-HDRS 총점은 ISI-K 모든 항목과 유의한 순상관관계가 있었으며(각각 p<0.05), 총 수면시간은 ISI-K 모든 항목과 유의한 역상관관계가 있었다(각각 p<0.05). 수면잠복기는 ISI-K 합계, A1, B, E 항목과 유의한 순상관관계가 있었다(각각 p<0.05). 결 론 2형 당뇨병 환자의 약 1/3에서 불면증이 존재하며, 불면증이 없는 2형 당뇨병 환자군과 수면의 양적 및 질적 차이가 있음을 시사한다. 우울증상의 심각도는 2형 당뇨병 환자의 불면증과 상관관계가 있으므로 우울증의 조기 발견과 치료가 요구된다.

• 재활치료과학
• /
• 제7권4호
• /
• pp.19-30
• /
• 2018

목적 : 본 연구의 목적은 지역사회 거주 척수장애인의 참여 제약과 관련이 있는 요인간의 상관관계 및 그 영향을 종합적으로 분석하는 것이다. 연구방법 : 연구 대상은 지역사회에 거주하는 미국 척수 손상 협회(American Spinal Injury Assocation; ASIA) 분류법 상 손상정도(Frankel type)가 A,B,C에 해당하는 만 18세 이상 성인 척수장애인 82명이었다. 대상자들을 통하여 참여, 환경적 요인, 기능적 요인, 손상관련 요인, 심리사회적 요인, 인구사회학적 요인을 조사하였다. 참여 수준은 한국형 단축형 크레이그 핸디캡 평가(CHART-K-SF)로, 환경적 요인은 CHIEF-25 한국형으로, 기능적 요인은 척수손상환자 독립성 지수SCIM-III을 사용하였다. 손상관련 요인의 통증 및 통증관련 심리적 고통은 Pain and Distress Scale (PAD)로, 심리사회적 요인 중 자존감은 로젠버그 자아존중감 척도(RSES), 자기효능감은 일반적 자기효능감 척도(GSS)로 평가하였다. 수집된 정보는 SPSS Version 21.0을 통하여 상관관계분석, 로지스틱 회귀분석, 다중회귀분석에 사용되었다. 결과 : 참여 제약의 위험요인은 환경적 요인과 기능적 요인이었으며, 본 회귀모형의 설명력은 약 73.7%였다(R2N=.737). 환경적 장벽이 있는 것이 없는 것에 비해 약 40배 정도 참여 제약을 겪을 위험도가 높았으며, 기능적 수준이 4사분위수(상위 25%)인 것에 비해, 2사분위수일 경우 약 21배, 1사분위수(하위25%)일 경우 약 236배 정도 참여 제약을 겪을 위험도가 높아졌다. 결론 : 본 연구는 지역사회 거주 척수장애인의 참여 제약의 예측요인을 다각적인 측면으로 확인한 것에 의의가 있으며, 이를 통하여 지역사회에서 척수장애인에 대한 작업치료사의 역할을 규명한 것에 중요한 의미를 갖는다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제18권1호
• /
• pp.10-15
• /
• 2007

Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview 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 objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet 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, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.