중·고등학교 청소년의 자살사고 및 자살시도의 유병률과 자살시도의 위험요인에 관한 연구

조성진,전홍진,김장규,서동우,김선욱,함봉진,서동혁,정선주,조맹제 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.6

연구목적 : 지역사회에 거주하고 있는 중·고등학교 청소년들을 대상으로 자살 사고 및 자살시도의 빈도, 성별과 연령(13∼15세 vs 16∼18세)에 따른 자살사고 및 시도의 빈도에 차이가 있는지 여부, 자살사고 및 자살시도가 있는 청소년의 특징, 그리고 자살시도의 위험요인을 알아보고자 하였다. 방 법 : 부천시에 소재하고 있는 중학교 24개교 및 고등학교 20개교의 청소년 71,102명중에서 무작위 집락 표본 추출범으로 청소년 2,203명(남자 1,105명, 여자 1,098명)을 조사대상으로 선정하였다. 자살시도 및 자살사고의 정의에 관한 항목은 Moscicki가 사용한 자살행동에 관한 4항목 중 2항목을 사용하였다. 우울증에 대한 조사도구는 the Center for Epidemiologic Studies Depression Scale, 알코올 의존에 대한 조사도구는 Composite International Diagnostic Interview의 알코올 의존 관련 항목을 사용하였다. 조사자료 통계는 빈도, 백분율, chi-square test, 단변인 및 다변인 로지스틱 회귀분석을 사용하였다. 결 과 : 본 조사연구의 분석결과를 통계적으로 유의한 차이를 보인 항목으로 살펴보면 다음과 같다. 1) 전체 대상자의 자살 사고률은 30.7%, 자살 시도률은 5.3%인 것으로 조사되었다. 남자 대상자의 자살 사고률과 시도률은 26.9%, 3.4%이었고, 여자 대상자의 자살 사고률과 시도률은 34.9%, 7.3%인 것으로 조사되었다. 성별에 따라 자살 사고률과 시도률에 통계적으로 유의한 차이가 있었다. 2) 연령(학년)을 13∼15세(중학교)와 16∼18세(고등학교)의 두 연령층으로 조사하였을 때, 중학생의 자살 사고률과 시도률은 30.1%, 4.3%이었고, 고등학생의 자살 사고률과 시도률은 31.6%, 6.4%인 것으로 조사되었다. 연령에 따른 자살 사고률에는 통계적으로 유의한 차이가 없으나 자살 시도률에는 유의한 차이가 있었다. 3) 전체 조사 대상자를 대상으로 시행한 다변인 로지스틱 회귀 분석 결과에 의하면, 자살 시도의 위험요인이 여자, 알코올 의존, 중등도 및 중증 우울 증상인 것으로 조사되었다. 남녀별로 시행한 단변인 로지스틱 회귀 분석 결과에 의하면, 남자는 알코올 의존이 있을 때, 여자는 알코올 의존, 중등도 및 중증의 우울 증상이 있을 때 자살시도의 위험성이 높았다. 결 론 : 본 연구에서 자살 사고률 및 자살 시도률이 각각 29.6%(남자 25.6%, 여자 33.7%)와 5.31%(남자 3.3%, 여자 7.3%)인 점과 자살시도의 위험요인이 우울 증상의 정도, 알코올 의존인 점을 고려할 때 알코올 의존 및 우울 증상의 조기발견과 치료, 그리고 자살 사고자 및 자살 시도자에 대한 정신의학적 접근과 추적관찰에 대한 방안이 강구되어야 할 것으로 생각된다. Objectives : Aims of this study were 1) to estimate prevalence rates of suicidal ideation and suicide attempt, 2) to find out whether the gender difference and age difference(13-15 years vs 16-18 years) for suicide behaviors exist, 3) to analyse correlates of suicide attempts among junior and high school adolescents aged 13-18 years old. Methods : A self-administered questionnaire was used in a cluster random sample of 2,203 school adolescents(male 1,105, female 1,098). Data were obtained on a wide range of constructs including suicidal ideation and attempts during past 2 weeks, depressive symptoms, symptoms of DSM-IV alcohol dependence, family structure, socioeconomic status, smoking, satisfaction with school achievements, and subjective health status. Chi-square test were done for analysing gender difference and age difference of suicide behaviors. Statistical analyses including uni-variate and multi-variate logistic regression analysis were done for each sex, respectively. Results : 1) The prevalence of suicide ideation during past 2 week was 30.7% in the total sample. The prevalence rates of male and female ideators were 26.9% and 34.9% respectively. The prevalence of suicide attempt during past 2 week was 5.3% in the total sample. The prevalence of suicide attempt in males was 3.4% and 7.3% in females. 2) Gender difference was significant. That is, female respondents showed higher rate of suicidal ideation and suicide attempt. In our study age difference was found only at the rate of suicide attempt. That is, older adolescents(16-18 years) showed only statistically significant higher rate of suicide attempt than younger adolescents(13-15 years). 3) Multi-variate logistic regression analysis revealed that the correlates for suicide attempt were female, moderate to severe depressive symptoms, alcohol dependence in the total sample. In males the correlate for suicide attempt was alcohol dependence. In females, were moderate to severe depressive symptoms, and alcohol dependence. Conclusion : Depressive symptoms, alcohol dependence, presence of suicidal ideation were strong predictors for suicide attempts. This suggest that early detection of treatment of depression and alcohol dependence is important and psychiatric approach and follow-up be needed for the prevention of suicide.

주의력결핍/과잉운동장애, 주 부주의형과 혼합형간의 지속적 주의력 및 과잉운동의 비교

정선주,서동혁,홍강의 가천의과대학 2000 가천의학 Vol.2 No.1

한국판 아동용 예일-브라운 강박 척도:신뢰도와 타당도 연구

정선주,이정섭,강윤형,조성진,서동혁,홍강의 대한소아청소년정신의학회 2000 소아청소년정신의학 Vol.11 No.1

목적 : 본 연구는 소아, 청소년의 강박 증상을 평가하기 위한 도구인 아동용 예일-브라운 강박척도(Childen's Yale-Brown Obsessive Compulsive Scale : Y-BOCS)의 한국판을 제작하여 그 신뢰도와 타당도를 검증하고자 시행되었다. 방법 : 강박장애로 진단된 42명의 아동과 청소년들을 대상으로 CY-BOCS를 시행하였다. 평가자간 신뢰도를 측정하기 위하여 20명의 환자를 2명의 평가자가 동시에 면담하였다. 수렴타당도와 변별타당도의 검증을 위해 총괄적인 임상 인상척도-강박장애(Clinical Global Impression-Obsessive Com-pulsive Disorder : CGI-OCD). 아동용 Leyton 강박 척도(Lryton Obsessional Inventory-Child Version : LOI-CV), 소아우울척도(Child Depression Inventory : CDI), 소아 상태-특성 불안척도(State-Trait Anxiety Inventory for Children : STAI-C)를 시행한다. 결과 : Cronbach's α값으로 평가한 내적 일치도는 0.86으로 높게 나타났다. CY-BOCS 전체 점수 강박사고, 강박행동 소척도 점수에 대한 군내 내적일치도는 각각 0.94. 0.94. 0.84로 우수한 평가자간 일치도를 보였다. CY-BOCS 전체 점수와 CGI-OCD 점수간의 상관관계는 매우 높게 나타났고(r-0.88), LOI-CY 총점과도 통계적으로 유의한 상관관계(r=0.51)가 관찰되었다. CY-BOCS 전체 점수와 STA-I-C의 상태불안 점수간에는 상관관계가 나타나지 않았고(r=0.25), 특성불안 점수(r=0.43) 및 CDI 점수(r=0.49)와는 유의한 상관관계를 나타냈다. 결론 : 본 연구결과, 한국판 CY-BOCS의 높은 타당도 및 신뢰도가 입증되었으며, 향후 강박 증상의 객관적인 평가 및 정량화를 위해 유용하게 사용될 수 있을 것이다. Objective : This study was carried out to evaluate the reliability and validity of the Korean form of the Children's Yale-Brown Obsessive Compulsive Scale(CY-BOCS). Method : Forty-two children with obsessive-compulsive disorder(OCD)(31 boys and 11 girls, aged 7 to 18 years) were assessed with CY-BOCS. Interrater agreement was assessed by two raters in subsample(n=20). discriminant and convergent validity were assessed by comparing CY-BOCS scores to Clinical Global Impression-OCD(CGI-OCD), Leyton Obsessional Inven-tory-Child Version(LOI-CV), State-Trait Anxiety Inventory for Children(STAI-C), and Child Depression Inventory( CDI ). Results : Internal consistency was high, measuring 0.86 for the 10 items and total score. The intraclass correlations for the CY-BOCS total, obsession, and compulsion scores were 0.94, 0.94, 0.84, suggesting excellent interrater agreement for subscale and total scores. The CY-BOCS total score showed highest correlation with CGI-OCD(r=0.88), and significant correlation with LOI-CV(r=0.51), Trait Anxiety score(r=0.43), and CDI scores(r=0.49), but it was not correlated with State-Anxiety score(r=0.25). Conclusion : The results of this study indicate that the Korean form of CY-BOCS is a reliable and valid scale for rating obsessive-compulsive symptom severity. KEY WORDS : Development · Rating scale · Obsessive-compulsive disorder · Reliability Validity.

구속된 비행 청소년들의 특성 및 석방 후 6개월간 재범여부와 관련된 변인

정선주,김원식,고승희,구영진,김홍창,서동혁 대한소아ㆍ청소년정신의학회 1999 소아청소년정신의학 Vol.10 No.2

Morphometric analysis of dermal microstructure using cadaver from photomicrographic images

( Ji Hyuck Hong ),( Min Seok Ham ),( Dae Yeon Kim ),( Dong Won Lee ),( Young Chul Kye ),( Soo Hong Seo ),( Hyo Hyun Ahn ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: For many dermatologists and researchers, the proper evaluation of dermal main constituents such as collagen fibers is one of the most important concerns. Objectives: We designed this pre-study to evaluate the collagen fibers of the human skin as main light scatterer, which would have an effect on the gross image of skin. Methods: We obtained normal skin specimens from cadavers. These specimens were processed with MT stain, which is an effective method that can stain collagen fibers in blue with aniline dye. This blue color were measured and used for segmentation of collagen fibers in the image processing and analysis software, ImageJ. Results: Color thresholding, a histogram-based method, is a function of ImageJ that can be used for image segmentation with several thresholding methods. Color moments, a feature of color, can be used to differentiate the images as a color similarity variable. As a descriptor, it contains local photometrical and spatial information of color. Using color thresholding and color moments, the blue channel of RGB images of MT stained pathologic slide was set to include the majority of blue colors, while preventing too much sensitivity to background blue hue by increasing the low cut-off value. And, we selected the quantitative area highlighted and occupied by the specific blue color, which represented the quantity of collagen fibers. Conclusion: Herein, we report a simple method to analyze the dermal constituents quantitatively in MT stained slides.

The effect of histologic parameters on skin lightness: the analysis using crossed polarized light on fresh cadaver

( Ji Hyuck Hong ),( Min Seok Ham ),( Dae Yeon Kim ),( Dong Won Lee ),( Young Chul Kye ),( Soo Hong Seo ),( Hyo Hyun Ahn ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Many dermatologists have investigated the skin brightness. It is known that the subsurface composed of dermal microstructures affects the skin brightness. Objectives: The aim of study was to investigate which histological characteristics of each skin are related with the skin brightness. Methods: Total 10 cadavers were used. Each cadaver provides 5 parts of skin specimens : forehead, cheek, forearm, abdomen, lower leg. These specimens were processed with Masson trichrome stain and hematoxylin and eosin stain and measured their histological features such as density and diameter of collagen fiber using anlaysis software, ImageJ. We obtained the gross photos of each sites using green light crossed-polarized ligh(CPL) to esitmate subsurface reflection and using macro lens with bulit-in white light emitting diode lamps to analyze skin color coordiates. The CIELAB values of each images were measured. Results: In correlation analysis, L^* of lesions for green light which represents subsurface brightness had a positive correlation with density of collagen fiber in dermis, diameter of collagen fiber in reticular dermis, thickness of dermis. And it showed a negative correlation with depth of dermo-epidermal junction, thickness of epidermis Conclusion: According to the results of our study, the subsurface skin brightness is related with dermal microstructure, especially collagen fiber. With further research, we could enhance the skin brightness by modifying dermal microstructure.

Chondroid syringoma (mixed tumor) with calcification on hand

( Ji Hyuck Hong ),( Min Seok Ham ),( Dae Yeon Kim ),( Dong Won Lee ),( Hyo Hyun Ahn ),( Young Chul Kye ),( Soo Hong Seo ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Chondroid syringoma (mixed tumor of the skin) is a rare, benign neoplasm composed of epithelium and mesenchyme.1 It usually presents with slowly growing, asymptomatic firm nodule on the head and neck area. Microscopically, it shows epithelial ducts and tubules in a myxoid-cartilaginous stroma. There are two types according to the origin: apocrine type and eccrine type. The former type usually shows branching lumina and the latter type shows small tubular lumina.2 A 66-year-old male presented with an asymptomatic 1.5 x 1.5 sized firm nodule on right finger of 5 years’ of duration. His clinical history did not show significant information. Excisional biopsy was done with an impression of epidermal cyst. Histopathology of the specimen showed dilated tubules embedded in the myxoid-cartilaginous stroma. The dilated tubules were lined by single inner cuboidal cells and this point explained that the lesion was originated from the eccrine gland. Also, tubules showed cystic change and were filled with calcification, which was atypical feature of this lesion. According to the literature, calcifications are more commonly present in eccrine type chondroid syringoma than apocrine type.3 Additional treatment was not needed. Herein, we report a rare case of chondroid syringoma with calcification developed on hand, which is the uncommon site of the tumor.

[P033] A case of neurothekeoma developed on unusual site

( Ji Hyuck Hong ),( Dae Yeon Kim ),( Dong Won Lee ),( Tae Hyung Ryu ),( Jae Eun Choi ),( Soo Hong Seo ),( Young Chul Kye ),( Hyo Hyun Ahn ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Neurothekeomas (nerve sheath myxoma) are rare benign tumors consist of Schwann cells and perineural cells. These tumors are divided into three groups according to histologic feature: classical, cellular, mixed. Classical types show well-circumscribed masses with usually positive for S-100 and negative for EMA. Cellular types are not encapsulated and have a lobular growth pattern with negative for S-100 and reactive with CD57. Neurothekeomas develop on the head, neck, shoulder, or arm as asymptomatic papules or nodules. The most common site of tumors are the upper extremities (33.6%). Several literatures have reported neurothekeomas appeared on uncommon sites such as scalp. A 48-year-old female presented with brownish scaly mass on dorsum area of left foot. She had have a breast cancer 5 years ago before the visit and had any other familial history. Skin excisional biopsy was done. Histopathology of the specimen showed a lobule composed of spindle and stellate shaped cells on the mucinous stroma which is the typical feature of dermal nerve sheath myxoma and additional S-100 immunostaining was done to know whether this tumor came from Schwann cells. The result of S-100 staining was positive. It represented that the tumor is classical type of neurothekeoma. Additional treatment was not needed. Herein, we report the classical type neurothekeoma developed in left foot which is uncommon site for this tumor.

[P031] A case of neurothekeoma mimicking a hemangioma clinically

( Ji Hyuck Hong ),( Dae Yeon Kim ),( Dong Won Lee ),( Tae Hyung Ryu ),( Jae Eun Choi ),( Hyo Hyun Ahn ),( Young Chul Kye ),( Soo Hong Seo ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Neurothekeomas are uncommon benign neoplasm of presumed nerve sheath origin. Grossly, the neurothekoemas are asymptomatic, solitary, flesh-colored, soft dermal nodules. They show certain microscopic features: lobulated, spindled cells embedded within a myxoid stroma. According to the amount of myxoid stroma, it is categorized into three types: myxoid, cellular, and mixed. Immunhistochemically, myxoid types show S-100 positive and rarely negative. Cellular types are generally not stained with S-100, but positively stained with CD68. Mixed-type show overlapping features of both variants. A 45-year-old male presented with erythematous protruding nodule on back. He had a history of hypertension. Excisional biopsy was donewith an impression of the pyogenic granuloma which is a common, solitary and pedunculated vascular-proliferating lesion. Histopathology of the specimen showed lobular dermal tumor nodules composed of spindle-shaped and stellate cells with myxoid stroma. Some nodules are composed of fascicles of epithelioid tumor cells with sparse mucinous matrix. Numerous mitotic figures are observed and S-100 staning was negative, but CD68 and vimentin staining showed positivity. Interestingly, ectatic vessels on papillary dermis were observed and considered as contributing to clinical feature appearing like hemangioma. Herein, we report an interesting case of mixed-type neurothekeoma which clinically appeared as a pyogenic granuloma.

Syringocystadenoma papilliferum on the external auditory meatus

( Ji Hyuck Hong ),( Min Seok Ham ),( Dae Yeon Kim ),( Dong Won Lee ),( Young Chul Kye ),( Hyo Hyun Ahn ),( Soo Hong Seo ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Syringocystadenoma papilliferum is a rare, benign adnexal neoplasm originated from apocrine or eccrine glands.1 It usually develops on head and neck area, most commonly on scalp, in young adults presented with an asymptomatic solitary pink papule.2 The external auditory canal is uncommon site of syringocystadenoma papilliferum. The lesion can become papillated or hyperkeratotic. Histopathologically, it shows papillomatous epidermal invaginations lined with basilar cuboidal cells and columnar secretory cells. Diagnosis is determined by confirming the characteristic histologic feature. A 18-year-old female presented with an asymptomatic flesh colored papule in right external auditory meatus. She had a history of asthma. The lesion had been treated with laser in other dermatologic clinic 2 years ago and was recurred. The sign of inflammation was not seen. Excisional biopsy was done with an impression of nevus sebaceous. Histopathology of the specimen showed papillomatous glandular invaginated epithelium lined with dual cell population: inner cuboidal and outer columnar cells. These inner columnar cells showed a decapitation secretion, which is characteristic feature of apocrine gland. Also, the characteristic plasma cell-rich stroma was seen. The lesion was excised completely and additional treatment was not needed. Herein, we report a rare case of syringocystadenoma papilliferum on atypical site, the external auditory meatus.