<SUP>18</SUP>F-FDG PET-CT에서 진단된 갑상선 우연종의 악성종양 발견율 및 특징

이강영,고건<SUP>1<.SUP>,김선국<SUP>1<.SUP>,고진철<SUP>1<.SUP>,김행수,최상용,박신희,박용휘<SUP>2<.SUP>,Kang Young Rhee,Gun Koh,<SUP>1<.SUP>,Sun Kuk Kim,<SUP>1<.SUP>,Jin Chul Koh,<SUP>1<.SUP>,Haeng Soo Kim,Sang Yong Choi,Shin 대한갑상선-내분비외과학회 2008 The Koreran journal of Endocrine Surgery Vol.8 No.1

<B>Purpose: </B>PET-CT is often used to differentiate benign or malignant thyroid incidentalomas. In this retrospective study, we evaluated whether the <SUP>18</SUP>F-FDG uptake pattern and PET-CT findings improved accuracy over the standardized uptake value (SUV). <B>Methods:</B> <SUP>18</SUP>F-FDG PET-CT was performed on 2,178 subjects from August, 2004, to October, 2007, in Sung-ae Hospital. PET-CT was performed on 806 patients (37%) with suspected or known nonthyroidal cancer and 1,372 healthy subjects (63%) without a previous history of cancer. We investigated the clinical characteristics of patients, history, standardized uptake value (SUV), ultrasonography, and hormone levels in blood. Thyroidal cancer was confirmed by ultrasonography-guided fine needle aspiration and pathology after thyroid operation. <B>Results:</B> The prevalence of focal thyroid lesions on PET-CT was 8.8% (191/2178). Thyroid cancer confirmation was 7.9% (15/191). The maximum SUV of malignant thyroid lesions were significantly higher than that of benign lesions (7.00±3.08 vs. 4.49±1.84, P<0.001). <B>Conclusion:</B> PET-CT image interpretation that includes 18F-FDG uptake and SUV is better than PET-CT alone for differentiating benign and malignant lesions. Thyroid cancer risk increases as SUVmax levels increase. <B>(Ko</B><B></B><B>rean J Endocrine Surg 2008;8:38-42)</B>

하회·양동마을에 작용된 환경설계원칙과 文化景觀相

신상섭 한국환경과학회 2003 한국환경과학회지 Vol.12 No.4

The purpose of this research explain the meaning of the environmental design principles and cultural landscape pattern(dualistic space organization) of the Hahoe(河回:winding river village) · the Yangdong(良洞) traditional village. Village's space organizations based on Shamanism, Yin-yang and Five elements principle, Feng-shui idea, social system and Confucian ideas. And it were accomplish the cultural landscape pattern(village:form+object=pattern) through the frame of settlement space. As a central persons of villages(the Hahoe · the Yangdong) construction, Suhae(西厓) experienced through Chunghyodang-Wonjichongsa-Ogyonchongsa-Pyongsansowon channel(忠孝堂-遠志精舍-玉淵精舍-屛山書院) and Kyomam(謙庵) experienced through Yangjindang-Binyeonchongsa-Kyomamchonsa-Hwachonsodang(養眞堂-賓淵精舍-謙庵精舍-花川書堂) channel. Also Woojae(愚齋) experienced through Suhbackdang-Khankachung-Dongkangsowon(書百堂-觀稼亭-東江書院) and Hoejae(晦齋) experienced through Moochumdang-Hyangdan-Oaksansowon(無添堂-香壇-玉山書院). It is space organization of themselves interact contrast and sequence principles with competition in good faith. And ecological art-space, that is, environmental space organizations of traditional village has been reflected harmony between nature and artificiality, spatial rhythm and sequence, spatial hierarchy between upper classes and humble class, permeability space, asymmetrical balance, aesthetic space perception. The humble classes hold a ceremony Hahoe's Pyolsingut-Talnori(maskdance drama), Dangjae(堂齋:religious service) at the Dang(堂:shamanism spot) and Yangdong's Sohraesulnori, Hohminori. And the upper class hold a ceremony Hahoe's Julbulnori and Yangdong's Chungjanori connected with culture of confucianism. Specially, the cultural structure of the village is evidence of a contrast between the upper class and the humble classes, time, method and location of ceremony(performance).

학교폭력 피해자의 정신병 실태 조사

신성웅,권석우,신민섭,조수철 대한소아청소년정신의학회 2000 소아청소년정신의학 Vol.11 No.1

요 약 : 본 연구는 학교폭력의 피해자를 대상으로 정신병리에 대한 특성을 알아내고, 조기 정신병과의 관계를 규명함을 기본 목적으로 시행되었다. 더 나아가서는 조기정신병의 발견과 아울러, 조기 치료를 시행함으로써 심각한 정신병의 예방을 도모하고자 하였다. 서울시 전 구역 중 16개 중학교를 선정하여 중학교 1, 2학년 남 · 녀 학생에게 간이정신진단검사 피어스-해리스 자아상 검사의 인기도와 학교 적응 소척도, 저자들이 개발한 따돌림 척도를 배포하여 따돌림을 당하는 정도의 점수가 평균보다 통계적으로 유의하게 차이가 나는 대상을 선정하고, 이들 중에서 스스로 인기가 없다고 여기면서 정신병적 증상이 유의하게 높게 보고된 대상을 선정하여 '정신병의 전구기에 있는 군'으로 판정하여, 이들의 대상의 수를 계산하여 위험도를 산출하고, 정신병 전구기에 있다고 판단되는 대상의 임상적 특성을 상관 분석 및 회귀 분석을 통해 정신병적 증상과 관련된 임상적 척도들을 파악하였다. 결과는 다음과 같다. 1) 따돌림 척도에서 통계적으로 유의하게 높은 점수를 받은 군은 총 157명(5.3%)이었고, 그 중에서 47명(29.9%)이 간이정신진단검사의 정신병적 증상 수치가 유의하게 높았다. 따돌림 척도에서 높지 않은 점수를 보인 2,135명 중 정신병적 증상이 높은 군은 50명이어서,따돌림 척도에서 높게 나온 군의 정신병적 증상이 높게 나올 위험도(odds ratio)는 17.8이었다 이는 통계적으로 유의한 수치였다(X2=274.8, df=1 p<0.05). 즉 따돌림을 당한다고 호소한 집단은 정신병적 증상이 유의하게 높았고, 이를 통해 왕따 피해자는 정신병 발병 위험이 통계적으로 유의하게 높다고 할 수 있었다. 2) 자신은 남들에겐 인기도 없고, 따돌림을 당한다고 여기며 정신병적 증상을 가진 군(47명, 남자31명, 여자 16명)은 단순히 정신병적 증상이 높은 군에 비해 불안 척도,우울증 척도, 공격성, 대인 민감성 학교 및 사회 적응 척도, 강박증상 척도, 공포불안 척도, 정신병적 증상 신체적 증상 호소 등에서는 차이를 보이지 않았으나 자신이 따돌림을 받는다는 호소와 편집증은 더 높게 측정되었다. 그리고, 학교폭력 피해자 중에서 정신병적 증상이 유의하게 높게 측정되었고, 스스로 인기가 없다고 생각하는 대상들에서는, 불안 증상, 우울증, 공격성, 대인 예민성, 강박증상, 편집증, 신체 증상 호소 등이 정신병적 증상을 잘 설명해주었다(r2=0.93). 즉, 따돌림을 당한다고 호소한 집단은 정신병적 증상이 유의하게 높았고, 이를 통해 왕따 피해자는 정신병 발병 위험이 통계적으로 유의하게 높다고 할 수 있었다. 이를 통해서 따돌림과 같은 학교폭력 피해자가 불안 증상, 우울증, 공격성, 대인 예민성, 강박증상, 편집증, 신체 증상 호소와 같은 문제를 보였을 경우에는 정신병적 증상 유무와 학교 적응, 집중력 장애, 사고개념 형성 장애 등을 확인하여 정신병의 진단을 고려해야 한다고 할 수 있다. Objectives : The primary purpose of this study is to understand the psychopathology of the victims of school violence in terms of early psychosis. By doing this, the early detection of psychosis among the victims is possible, and early detection may lead to early intervention. Methods : Two-thousand and nine-hundred seventy two students from 16 middle schools in Seoul were asked to fill out questionnaire comprised of popularity and intellectual and school status of Piers-Harris Children's Self Concept Inventory, Symptom Check List-90-Revised, and Ostracism Scale. The subjects whose scores upon Ostracism Scale were higher than average by two standard deviation were labeled as 'Repelled and Isolated group', and subjects whose scores on popularity were significantly lower than average and whose scores on psychoticism of SCL-90-R were higher than average were defined as 'tentative early psychosis group'. Odds ratios were calculated from the numbers of subjects with and without high psychoticism scores and high ostracism scores. On the subjects of 'tentative early psychotic group', we examined every clinical characteristic and conducted correlation analysis and regression analysis in order to find out the risk factors and to construct theoretical model that explains the psychoticism scores. Results : The results were a follows : 1)Total 157(5.3%) subjects were rated significatntly higher on ostracism scale, and among them, 47 subjects(29.9%) were rated significantly higher than average on psychoticism scale, while only 50 subjects among 2,135 students who were rated within normal range showed significantly higher score on psychoticism scale. Odds ratio for psychotic group of isolated group were 17.82 and it was statistically significant. 2)Forty-seven subjects(31 boys, 16 girls) who were rated as they were unpopular and rejected from peers had significantly higher psychoticism scores. They were not significantly different from simply high psychoticism subjects in anxiety, social anhedonia scale, magical thinking, obsessive-compulsive symptoms, phobic anxiety, psychoticism, somatization, but showed higher ostracism scores and paranoid tendencies. Among school violence victims, who rated themselves unpopular and showed higher psychoticism scores, the psychoticism scores were mainly explained by anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization scales(r2=0.93). Conclusion : Thus, it can be concluded that the subjects with higher ostracism score have the substantially high risk for psychosis development. By these results, we propose that school violence victims with anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization should be tested individually considering school adjustment, attentional deficit, concept formation problems. KEY WORDS : School violence·Ostracism·Psychosis.

급성 림프구성 백혈병 환자에서 발생한 침습성 국균 심내막염 2예

신성철,백경란,정재홍,송봉근,김동희,전경만,채제욱,손준성,정숙인,오원섭,송재훈 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

국균은 호흡기를 통해 유입되며 심한 면역기능저하 환자에서 기회감염을 일으키는 진균이며 주로 혈관을 따라 폐를 침범하고 심장과 골침범은 매우 드문 것으로 알려져 있다. 저자들은 급성 림프구성 백혈병 환자에서 발생한 침습성 국균 심내막염을 2예을 경험하였다. 19세 남자환자로 동종 조혈모세포이식 후 발생한 고열과 요통의 원인으로 감염성 심내막염 진단하에 수술결과 국균에 의한 감염으로 확증되어 수술적 절제술과 liposomal amphotericin B로 치료하였으나 국균 심내막염의 재발과 국균 척추염의 악화, 뇌 출혈로 사망하였다. 23세 남자환자로 관해요법 후 발생한 고열과 요통의 원인으로 국균 심내막염과 국균 척추염 진단하에 수술적 절제술과 amphotericin B로 치료하여 1년 2개월 동안 국균 심내막염의 재발은 없었으나 지속적인 백혈병의 재발과 국균 척추염의 악화, 침습성 폐 국균증으로 사망하였다. Although Aspergillus endocarditis has rarely been reported, it can cause fatal complications in hematologic malignancy patients and allogeneic stem cell transplant recipients. We experienced two cases of aspergillus endocarditis developed in acute lymphoblastic leukemia patients. Case; A 19-year-old patient developed Aspergillus endocarditis after allogenic hemopoietic stem cell transplantation. He was treated with surgical intervention and liposomal amphotericin B. He died of recurred Aspergillus endocarditis and cerebral hemorrhage probably related with aspergillosis of central nervous system. Case 2; A 23-year-old patient developed invasive Aspergillus endocarditis after induction chemotherapy. Aspergillus endocarditis was successfully treated by surgical intervention and amphotericin B. He died of refractory neutropenic fever and sepsis after the third relapse of leukemia and repetitive chemotherapy. He probably had invasive pulmonary aspergillosis without evidence of endocarditis recurrence. Because the mortality of Aspergillus endocarditis is very high, early diagnosis and surgical intervention are very important for better outcome.

인공 판막 환자에서 발생한 Listeria monocytogenes 심내막염 1예

신상엽,손준성,김형훈,민태훈,윤종욱,장현하,정숙인,오원섭,김성민,백경란,송재훈 대한감염학회 2002 감염 Vol.34 No.5

우리나라 傳統住宅 外部空間의 特徵에 關한 硏究 : 密陽 校洞마을을 中心으로 Case Study of Gyo-Dong villages in Mil-Yang City

申相燮 又石大學校 1990 論文集 Vol.12 No.-

This study is about characteristics of Exterior-space in Gyo-Dong villages, expecially traditional dwelling. The results were as follow: 1. Location of a village introduced overall land use concept about ervironment factor, adapted Pung-Su theory and natural features. 2. Plan space form of residence was similor to "□"shape and proportional relation of a nutual space side analyzed into Golden section. 3. the men's part of a house be formulated profitable form by height mediation of struc ture and wall, be emphasized openness of house structure, location condtion, penetration system. 4. The wall be considerably constructed of topography condition, structual security, high house decorated. 5.Garden tree introduced much rate of an evergeen, a fruit tree, lay out of vegetable garden was emphasize, in case of tree of yard very restrieted.

도시지역 소외계층 교육복지 문제점과 발전과제

신상명,신윤섭 경북대학교 사범대학부속 중등교육연구소 2003 중등교육연구 Vol.51 No.2

This paper purposes to study the presentation of education welfare and development tasks for a class of alienation in urban area. Education is essential of human life and a nation is in charge of that. So, the commitment for the class of alienation is inevitable duty of welfare states. Our nation`s educational welfare policy staying passive welfare like supplying school expenses or school free meals. Through the passive welfare policy, a nation can`t accomplish nation's development of human resource illumination and integration of society. Now a nation needs positive educational welfare policy for the class of alienation in urban area. The ultimate goal of positive educational welfare prepose of student's whole man development. The whole man development of student is accomplished by academic achievement, physical development, characteristic development. First, basic learning capacity development, expansion of scholarship and learning condition are to be equipped for security of academic achievements. Second, school execute medical benefits and expand school free meals for the physical development. Third, the nation must develop family faculty supporting programs and serve diverse cultural experiences for the characteristic development.

전산화된 주의력장애 진단시스템의 개발 및 표준화 연구

신민섭,조성준,전선영,홍강의 대한소아청소년정신의학회 2000 소아청소년정신의학 Vol.11 No.1

목적 : 주의력결핍 과잉운동 장애의 진단과 치료 효과를 평가하기 위해 전산화된 한국판 주의력 장애 진단 시스템(ADHD Diagnostic System : ADS)을 개발한 후, 연령별 규준을 산출하였다. 방법 : 서울, 경기도, 강원도 지역의 유치원, 초등학교, 중학교에 재학중인 5세에서 15세 연령범위의 ADS의 신뢰도와 변별 타당도를 검증하기 위해 서울대학병원 소아정신과에서 DSM-IY 기준에 ADHD로 진단 받은 아동 30명이 본 연구에 포함되었다. 정상 집단의 아동들에게는 그들이 다니는 학교의 컴퓨터실에서 ADS를 실시하였고, ADHD 아동들에게는 소아정신과 외래 임상심리실에서 ADS를 실시한 후, 정상 아동의 자료에 입각해서 연령별 규준을 산출하였고, 신뢰도와 타당도 분석을 하였다. 결과 : ADS의 내적 일치도 계수(Cronbach's α)응 .85이었다. 정상 집단간에 오경보 오류를 제외한 모든 측정치에서 유의미한 차이가 있었다. 오인분석 결과, ADS 시각, 청각 검사에서 모두 3개의 요인이 산출되었다. 요인 1은 "주의력 요인"으로 누락오류, 오경보 오류, 민감도(d ')가 포함되었고, 요인 2는 "정보처리 속도 요인"으로 정반응시간, 정반응시간의 표준편차가 여기에 해당되며, 요인 3은 "충동성 요인"으로 반응기준(β)이 포함되었다. 요인 1, 2, 3은 ADHD의 핵심적 증상과 정확하게 일치하므로, 이상과 같은 요인분석, 결과는 ADS가 주의집중력 장애를 도구로써 구성 타당도가 있음을 입증해주었다. 판별분석 결과, 시각, 청각 ADS가 정상 아동과 ADHD 아동의 96.7%를 정확하게 변별해 주는 것으로 나타났다. 논의 : ADS가 주의력-과잉 운동 장애를 일관성이 있게 평가하는 신뢰롭고, 타당한 검사로 입증되었고, ADS를 통해 정상 집단과 ADHD 집단을 정확하게 분류할 수 있음이 시사되었다. Objectives : Present study developed the computerized ADHD Diagnostic System(ADS) in order to diagnose ADHD and evaluate treatment effect of it, and conducted a standardization study for ADS. Methods : The normative group was composed of 847 children and adolescents between the age of 5 and 15(boy 429, girl 418) living in the areas of Seoul, Kyunggi-do, and Kangwon-do. 30 ADHD children with age ranged 7 to 9 years were participated present study to evaluate the validity of ADS. To establish the norms for diagnosing ADHD, the means and standard deviations of normative group were used to calculate T-scores for each age group. Results : The reliability coefficient of ADS(Cronbach's α) was .85. There were significant differences in the measures of ADS except commission error between the normal and the ADHD groups. Three factors were extracted through factor analysis of ADS, which were labelled "inattention", "slow information processing" and "impulsivity". Discriminant analysis showed that ADS significantly discriminate the normal and the ADHD groups. Percentage of correct classification by ADS variables was 96.7%. Conclusion : These results put together strongly support the reliability and validity of ADS as a diagnostic instrument for ADHD. KEY WORDS : ADHD · ADS · Standardization study.

文化認識으로 본 現代 韓國造景의 作品 및 設計傾向에 관한 연구

申相燮 又石大學校 1997 論文集 Vol.19 No.-

This study is about the work tendency of contemporary Korea landscape architecture space. The theme of this study is a part of researches on the design trends and tasks take a side view of culture recognition in the contemporary Korean landscape architecture works. The landscape architecture professional works were cited to reinforce the outlined "-ism" or "tendency" of the contemporary design phenomena. Results of this study can be summaries as follows: a tendency to amateurish, a tendency to the mixing-ism of unknown nationality international style, a tendency to architecture inter relationship-ism.

주택단지 조경식재설계에 관한 기초연구

신상섭 韓國植物ㆍ人間ㆍ環境學會 1999 인간식물환경학회지 Vol.2 No.1

The purpose of this study was an alternative suggest landscape planting design approach in community of residential site. The results were summarized as follows; Firstly, character of landscape planting space must have been designed after due consideration of planting position and visual angle, functional structure and landscape value, planting for energy preservation etc. Secondly, planting space in residential environment must have been great emphasis of various planting pattern, selection of main species of tree and stock planting design etc. Thirdly, landscape planting design make efficient use of ground cover planting and vine trees, native plants, moreover must be grope for harmony of natural landscape and relief of native beauty. Fourthly, preservation feasible excellent trees and green area must have been consideration from site planning process and encourage compensation system. Fifthly, planting design of residential outdoor space must have been induce fruit trees, fragrance trees, aquatic trees, moreover secure of species variety and lure wildlife out, induction of self perpetuating environment.