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.

한국국민학교 학생집단에서의 회충감염율 분석

전오배,강신영,심태섭 중앙대학교 의과대학 의과학연구소 1981 中央醫大誌 Vol.6 No.1

The soil-transmitted and contagious helminthes, such as Ascaris lumbricoides, whipworm, hookworm and pinworm are the commonest and the most widespread human parasites in Korea. However, the first intestinal nematode infection has been taken into account as the great endemic parasitic disease in this country. Data cited from KAPE(korean Association for Parasite Eradication) were analyzed on the bases of infection rate, fertilized ova passers/unfertilized ova passers and the evaluation of the effect of mass control on primary school-children during the past 10 years from 1969 to 1978. The results were summarized as follows: 1) The overall prevalence of Ascaris infection was decreased from 57.1% in 1969 to 22.8% in 1978 and the cumulative percent of decrease during that period was 34.3% and the mean annual decrease rate represented as 3.8%. 2) The cumulative rate of decrease in primary school children was in the range of 32.2-36.8% by school year. 3) The prevalence of Ascaris infection of primary school-children in rural area was 60% in 1969, it decreased to 17-30% in 1978, while the rates tangibly dropped to about 10% level in urban primary-school children. 4) The positive rate of A. lumbricoides in 1973 was composed of fertilized and unfertilized ova passers in the ratio of 43.l% :9.2% (F/U=4.68). Five years later in 1978 it changed to 3.22. 5) By applying the present results to the statistical model of Hayashi(1977), the theoretical infection rate per month and cure rate per treatment were computed as 2.54% and 33.3% respectively in primary-school children during the past 10 years. And the observed data were coincide with the theoretical data. From the above statistical analyses, it is distinct that the prevalence and F/U ratio remarkably decreased by efficient mass control on primary school children during the past 10 years from 1969 to 1978.

악관절 강직증의 치험례

현영옥,강창희,노양호,천영두,김신헌,이희원 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.1

Temporomandibular ankylosis is defined as a situation in which the condyle is fused to the fossa by bone or fibrous tissue. Conditons such as trauma, infection, or systemic disease may predispose to various types of ankylosis, bringing about different levels of limitation in mandibular movement. Most patients with temporomandibular ankylosis are associated with limitation of maximal mouth opening, deviation of the chin toward the affected side, impaired occlusion, chronic pain, compromised oral hygiene, severe facial asymmetry & impeded mandibular molar eruption occurring in childhood. Several techniques to release ankylosis have been described in the literature, showing variable and often unsatisfactory results. The most frequently used operations are gap arthroplasty, interpositional arthroplasty, and exicision and joint reconstruction with autogenous or alloplastic materials. We have managed the two patients of TMJ ankylosis. They had previously TMJ surgery and we treated with gap arthroplasty & active physial therapy. We have obtained favorable results and report these cases with literatures review.

식도를 포함한 전위장관을 침범한 전이성 악성 흑색종 1예

최정영,김준기,신성하,고영춘,조상욱,서강석,강명원,임연근,여향순,김경수 全南大醫大 2001 전남의대학술지 Vol.37 No.1

의사국가시험성적과의 상관관계로 살펴본 임상종합평가시험의 가치 : 2002년 연세대 원주의대 졸업생을 대상으로

김명수,김춘배,차병호,박기창,권상옥,신계철,이혜용,강성준,차봉석 한국보건의료인국가시험원 2004 보건의료교육평가 Vol.1 No.1

Korean Medical Licensing Examination(KMLE) 2002 focused on evaluation of the integrative medical knowledge such as primary clinical care or problem-solving competence. We analyzed the correlation among the year-wise student academic scores(grade score), trial examination scores and KMLE score by correlation analysis and multiple regression method. Four times of trial examination were taken in 2001, which were composed according to the principles of KMLE. Trial examination scores were significantly correlated with student grade scores (p(0.05). KMLE score also correlated with student grade score a nd trial examination score. The grade score at senior had higher correlation coefficient than the grade score at junior in correlation analysis. In multiple regressions, grade score at senior and mean score of trial examinatio n score were significant variants affecting KMLE score. Based on this result, regression formula such as [KMLE score] = 110.596+21.449^*[6th grade score of student] + 0.577^*[mean of trial examination score] was established (R2=0.764, p<0.001). Our results show that the trial examination is useful evaluation tool for final assessment of medical achievements. Also a trial examination is used as a reference data for student guidance and control in preparing for KMLE.

골수이식 후 발생한 출혈성 방광염 환자에서 Polyomavirus의 검출 양상

박민정,강희정,신동훈,이규만,이동건,최정현,김춘추 대한임상병리학회 2000 대한임상병리학회지 Vol.20 No.6

도시고형폐기물의 성분분석에 관한 연구

선정화,김희택,배성렬,강신춘 한양대학교 에너지·환경기술연구소 1994 에너지·環境技術論文集 Vol.1 No.-

도시지역에서 배출되는 일반폐기물에 대한 성분분석결과 밀도는 250∼300㎏/㎥, 수분함량은 중량비로 평균 51.83%, 가연성분 42.09%, 회분 6.08%로 각각 측정되었다. 한편, 저위발열량은 주거지역이 700∼1,700㎉/㎏, 상업지역이 2,000㎉/㎏이상으로 측정되어 상업지역이 주거 지역보다 발열량이 높은 폐기물이 배출됨을 알 수 있었는데 이는 수분함량이 높은 주개류의 배출이 상업지역이 주거지역보다 적으며 소비자 포장지로서 종이, 비닐, 플라스틱류 등의 사용이 많은데 기인하는 것으로 생각되어 진다. 한편, 분리수거, 유가품에 대한 자원 재활용, 연탄재 배출의 감소추세 등의 효과로 폐기물 중 불연성 함량은 줄어들고 반면 종이, 비닐, 플라스틱류 등의 가연성 폐기물의 함량은 크게 늘어 전체적으로 폐기물의 질이 향상되고 있음을 알 수 있다. The analysis results of components of municipal solid wastes are as follows : ① Density ranged from 250㎏/㎥ to 300㎏/㎥. ② Water content, combustible content and ash content measured 51.83%, 42.09%, 6.08% respectively. ③ Low calorific value was ranged from 700 to 1,700㎉/㎏ in residential area and measured 2,000㎉/㎏ in commercial one. Therefore, it was known that calorific value of wastes in residential area is smaller than that in commercial area. Also, the quality of wastes was improved by increase of combustible content which results from vitality of valuable recycling, reduction trend of briquette ash generation rate and increase of paper, plastic consumption as wrapping materials.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

Analysis of spatial relationship of the superciliary arch and the eyeball in Korean young adults using 3 dimensional reconstruction

Kang-Jae Shin,Young-Chun Gil,Ju-Young Lee,Shin-Hyo Lee,Wu-Chul Song,Ki-Seok Koh 대한체질인류학회 2014 대한체질인류학회 학술대회 연제 초록 Vol.57 No.-

Positional Relationship of Ethmoidal Foramens With Reference to the Nasion and Its Significance in Orbital Surgery

Shin, Kang-Jae,Gil, Young-Chun,Lee, Shin-Hyo,Song, Wu-Chul,Koh, Ki-Seok,Shin, Hyun Jin by Mutaz B. Habal, MD. 2016 JOURNAL OF CRANIOFACIAL SURGERY - Vol.27 No.7

<P>Purpose:The aim of the study was to elucidate the positional relationship of the ethmoidal foramens (EFs) with reference to the nasion to facilitate prediction of the exact location of EFs, the optic canal (OC), and the frontoethmoidal suture (FS), and thereby avoid complications during complex surgery involving the medial wall of the orbit.Materials and Methods:One hundred two intact orbits of 57 embalmed cadavers were dissected in this observational anatomic study. Nasion' (N') was defined as the intersection point of the medial orbit margin with the horizontal line through the nasion, and this was used as a reference point. N'-OC was defined as the straight line joining N' and OC. The locations of the anterior ethmoidal foramen (AEF), posterior ethmoidal foramen (PEF), and OC were determined with reference to N'. The vertical distances from N'-OC to EFs and to FS were also determined.Results:The N'-AEF, AEF-PEF, and PEF-OC distances were 18.4, 15.3, and 8.3mm, respectively. Vertically, AEF and PEF were situated at 0.2mm below and 0.4mm above N'-OC, respectively. At the same reference points, N'-OC was situated at 0.4 and 0.6mm above FS, respectively.Conclusions:N', AEF, PEF, and OC were considered to be situated on the same straight line, and N'-OC could be regarded as coinciding with FS. This means that N' is an easily identifiable and reliable landmark for identifying EFs, OC, and FS. Our navigational parameters with reference to N' will help surgeons to enhance the safety of orbital surgery.</P>