This review aimed to assist clinicians in the identification and assessment of adult attention-deficit hyperactivity disorder (ADHD) with an emphasis on diagnostic and rating instruments. Pubmed and RISS were utilized to identify relevant studies and critical reviews on the diagnosis and assessment of adult ADHD, published between 1988 and 2010. The Adult ADHD Self-Report Scale-v1.1, the ADHD Rating Scale-IV, the Conners Adult ADHD Rating Scale, and the Current Symptoms Scale have been utilized for self-reporting of current ADHD symptoms. The Brown ADD Rating Scale, the ADHD Rating Scale-IV, the Current Symptoms Scale, and the Conners Adult ADHD Rating Scale have also been evaluated by an observer. The Childhood Symptom Scale and the Wender-Utah Rating Scale have been used for retrospective assessment of childhood ADHD symptoms and the Adult ADHD Investigator Symptom Rating Scale, the Adult Interview, the Brown ADD Diagnostic Form, the Conners adult ADHD diagnostic interview for DSM-IV, and the Wender-Reimherr Interview have been available as comprehensive diagnostic interviews. There is a wide variety of instruments available with respect to adult ADHD. The choice of appropriate instruments is essential for achieving accurate diagnosis and assessment of this disorder.
Adult ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Research Personnel ; Retrospective Studies ; Weights and Measures

One author's affiliation is misspelled in original article.

OBJECTIVE: CDA (Clinical Document Architecture) is a markup standard for clinical document exchange. In order to increase the semantic interoperability of documents exchange, the clinical statements in the narrative blocks should be encoded with code values. Natural language processing (NLP) is required in order to transform the narrative blocks into the coded elements in the level 3 CDA documents. In this paper, we evaluate the accuracy of text mapping methods which are based on NLP. METHODS: We analyzed about one thousand discharge summaries to know their characteristics and focused the syntactic patterns of the diagnostic sections in the discharge summaries. According to the patterns, different rules were applied for matching code values of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT). RESULTS: The accuracy of matching was evaluated using five-hundred discharge summaries. The precision was as follows: 86.5% for diagnosis, 61.8% for chief complaint, 62.7%, for problem list, and 64.8% for discharge medication. CONCLUSION: The text processing method based on the pattern analysis of a clinical statement can be effectively used for generating CDA entries.
Diagnosis ; Natural Language Processing ; Semantics ; Systematized Nomenclature of Medicine

PURPOSE: We examined the effects of a well-dying program on nursing students in terms of death preparation, death recognition and perception of well-dying perception. METHODS: The design of this study was quasi-experimental and non-synchronized with a non-equivalent control group. The study was conducted with nursing students: 32 in the experimental group and 36 in the control group. The well-dying program was consisted of five sessions: introduction, thinking about meaning of death, organizing things to do before dying, looking back on my life, and leaving a trail of my life. Descriptive analysis, t-test, chi2 test and ANCOVA were used with SPSS 18.0 program to analyze the data. RESULTS: After attending the program, a difference was observed in death preparation of the experimental group (t=2.61, P=0.014). The death recognition (F=154.15, P<0.001) score of the experimental group was significantly higher than the control group. There was no significant difference between the groups in perception of well-dying (F=0.11, P=0.747). CONCLUSIONS: The well-dying program helped nursing students build positive death recognition. Therefore, this study is expected to contribute to development of a death education program for nursing students.
Education ; Humans ; Nursing* ; Students, Nursing* ; Thinking

A central challenge in ischemia-induced neuronal death research is understanding the mechanisms by which apoptotic or necrotic cascades are initiated and affected. We tested potential roles for AMPA and NMDA receptor protein levels and activation of calpain, caspase-3 in the hippocampus at times after transient global ischemia when detectable necrotic or apoptotic cell damage was observed by neurofilament 200 (NF200) degradation, TUNEL, and H & E. We determined that the decrease in the AMPA receptor subunit, GluR2, in response to the transient global ischemia plays a major role in triggering the neuronal cell death in hippocampus. We also examined potential roles for calpain and caspase-3 in ischemic cell death and found that (1) calpain is activated at a time following caspase-3 activation and paralleled degradation of NR2A, NR2B, and GluR2 and irreversible necrotic neuronal changes, (2) caspase-3 is has their maximal expression at the time of highest apoptosis, (3) the NF200 degradation, one of the neuronal deathinducing factors was correlated well with the calpain activation and necrotic changes in the hippocampal CA1 neurons. These results suggest that the significant degradation of GluR2 subunits of AMPA receptor and calpain activation are possibly involved in NF 200 degradation-mediated necrotic hippocampal cell death after transient global ischemia.
alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid* ; Animals ; Apoptosis ; Calpain* ; Caspase 3* ; Cell Death* ; Hippocampus* ; In Situ Nick-End Labeling ; Ischemia* ; N-Methylaspartate ; Neurons* ; Rats* ; Receptors, AMPA

The expression of aquaporin-4 (AQP4) protein, bi-directional water channel, in the blood-brain barrier of the hippocampal formation (HF) was studied in the rat to determine the role of AQP4 in the pathophysiology of systemic hyponatremia. Systemic hyponatremia was induced by coadministration of 30 ml (~12% body weight) dextrose solution (140 mM) intraperitoneally and a 3-microg subcutaneous dose of 1-deamino-8-D-arginine vasopressin (dDAVP). Two and six hours after the drug administration, there were significant reductions in the serum osmolarity (252+/-5.1 and 252+/-6.4 mOsm/L) and in Na+/- concentration (117+/-1.7 and 97.2 mM) from the control values (296+/-5.2 mOsm/L, 140+/-4.7 mM). Brain injury in the HF and the expression of AQP4 were determined by using TUNEL, immunohistochemistry and quantitative immunoblotting. TUNEL revealed apoptotic cell death in the dentate gyrus (DG), presumably resulting from brain edema and a subsequent elevation of intracranial pressure after 2 h of systemic hyponatremia. However, AQP4 expression was decreased by 82%+/-6% after 2 h of systemic hyponatremia and then normalized after 6 h (108%+/-9%) compared with that of the control. Therefore, apoptotic cell death in the DG from brain swelling in this systemic hyponatremic model is likely associated with decrease of excessive brain water elimination because reincreased AQP4 expression/function accelerates the elimination of apoptotic cells from the DG.
Animals ; Apoptosis ; Aquaporin 4* ; Blood-Brain Barrier ; Brain ; Brain Edema ; Brain Injuries ; Cell Death ; Deamino Arginine Vasopressin ; Dentate Gyrus ; Glucose ; Hippocampus* ; Hyponatremia* ; Immunoblotting ; Immunohistochemistry ; In Situ Nick-End Labeling ; Intracranial Pressure ; Osmolar Concentration ; Rats

It has been known that granule neurons of the dentate gyrus (DG) are born in adulthood as well as during development. Apoptotic cell death also occurs normally throughout the life of the rat brain. The present study was designed to determine the effect of transient global ischemia on the apoptosis and/or neurogenesis of granule cells in the dentate gyrus. TUNEL study revealed that the ischemia produced an significant increase in apoptosis mainly in the granular zone (GZ) of the DG. The percentage of TUNEL-positive cells in the DG was maximal (37.3+/-2.5%) 8 hr after ischemia and declined thereafter. However, immunocytochemical studies showed that there was an increase in neurogenesis mainly in the subgranular zone (SGZ) although the induction of neurogenesis took longer than the apoptosis. As a neurogenesis marker, proliferating cell nuclear antigen (PCNA)-positive cells, possibly progenitor cells, were significantly increased by 34.1+/-2.2%(n=3, p<0.05) mainly in the dentate SGZ 4 days after ischemia. In addition, the gradual increase in Bcl-2 expression was only paralleled with the neurogenesis in the SGZ, but not with the apoptosis in the GZ of the DG. The expression level of Bcl-2 in the SGZ was increased significantly (optical density 43.7+/-3.4; n = 3, p<0.05) 4 days after the ischemic insult. Furthermore, the ischemia-induced neurogenesis in the SGZ was also indirectly supported by the observation that the expression of synapsin-alpha was significantly increased (176%; n=3 p<0.05) in the CA3 region 4 days after the ischemia. Taken together, these results strongly suggest that the transient global ischemia induces the apoptosis in the GZ, whereas the cell proliferation in the SCZ of the DG. In situ hybridization using the antisense probes to the NR2A and NR2B subunits of NMDA receptors revealed that the ischemia produced a more profound effect on the mRNA expression of NR2A (61.9% reduction) than NR2B (20.5% reduction). Thus, we also suggest a possibility that ischemia could induce the neurogenesis in the SGZ of the DG through downregulation of the number of functional NMDA receptors.
Animals ; Antisense Elements (Genetics) ; Apoptosis* ; Brain ; Cell Death ; Cell Proliferation ; Dentate Gyrus* ; Down-Regulation ; In Situ Hybridization ; In Situ Nick-End Labeling ; Ischemia* ; Neurogenesis* ; Neurons ; Proliferating Cell Nuclear Antigen ; Rats* ; Receptors, N-Methyl-D-Aspartate ; RNA, Messenger ; Stem Cells

The organization of the striatal projection fibers from the hippocampal formation (HF) was studied in the monkey with particular emphasis on specific projections of the ventral striatum. Retrograde tracers were injected into the five different regions of the ventral striatum such as the ventromedial caudate nucleus, ventral shell, central shell, and dorsal core of the nucleus accumbens (NA), and ventrolateral putamen. The ventromedial caudate nucleus and the shell of the NA received dense projections from the HF. Although the ventromedial caudate nucleus and the shell of the NA are both innervated by the HF, the shell receives the larger of these projections. This suggests that the HF is more strongly connected with the shell of the NA than with the ventromedial caudate nucleus. There are no differences between the ventral shell and central shell of the NA. Labeled neurons were mainly observed in the rostral parts of the dorsomedial CA1 and adjacent subicular complex (prosubiculum, subiculum, presubiculum, and parasubiculum) of the HF. These results suggest that the shell of the NA is the main converging site receiving hippocampal projections primarily related to integrating visuospatial and limbic information.
Basal Ganglia* ; Caudate Nucleus ; Haplorhini ; Hippocampus ; Neurons ; Nucleus Accumbens ; Primates* ; Putamen

OBJECT: To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. METHODS: This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. RESULTS: We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. CONCLUSION: Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.
Antipsychotic Agents ; Follow-Up Studies ; Humans ; Inpatients ; Male ; Outpatients ; Rehabilitation ; Retrospective Studies ; Schizophrenia*

Purpose: : This Study is designed to identify factors related to ethical values that can help medical students preparing to become healthcare professionals make better ethical judgments in the face of conflicting opinions. Methods : This study is based on 114 Nursing students in University, preparing and studying to become healthcare professionals. The Data obtained from questionnaires to research perceptions of physical restraints use and attitudes regarding use of restraints, nursing professional values, and scale affect ethical values were analyzed using the SPSS/WIN 21.0. Results: : To research the effects of perceptions of physical restraints use, attitudes regarding use of physical restraints and nursing professional values on ethical values, a hierarchical regression analysis is conducted with three models. In Model 3, as the last step, the perceptions of physical restraints is not a significant predictor of ethical values. However, the attitudes regarding use of restraints and the nursing professional values are related to ethical values. Conclusion : The formation of deontological ethics, which begins with the proposition that life is important, can be approached through education related to nursing professional values and education related to physical restraints.