지역사회 거주 노인에서 장애 변화의 예측인자

신희영,신일선,김재민,김성완,양수진,윤진상 대한신경정신의학회 2008 신경정신의학 Vol.47 No.2

Objectives : This study aimed to identify the predictors for change in disability measured by the Korean version of World Health Organization Disability Assessment Schedule II (WHODAS II-K) m community-dwelling elderly population. Methods : Of 1204 community participants aged 65 years or over, 717 were reevaluated by WHODAS II-K 2 years later. At baseline, information on demographic characteristics (age, gender, living area, marital status, and religion), socioeconomic status (education, type of accommodation, number of rooms, previous occupation, current employment, and social network), and clinical characteristics (number of physical illness, depression by the Korean version of Geriatric Mental State Schedule B3, and cognitive impairment by Korean version of Mini-Mental State Examination) were collected. Results : Scores on the WHODAS II-K increased by 17.5 in 2 years. Age (B coefficient 0.52, 95% CI : 0.21~0.84), number of rooms (B coefficient -1.92, 95% CI : -3.53~-0.30), and depression (B coefficient 1.84, 95% CI : 0.43~3.25) were independently significant predictors for change in disability. Conclusion : Change in the level of disability measured by the WHODAS II-K was mainly affected by age, number of rooms, and depression. These results can be useful for the development of community-based health promotion program for the elderly.

지역사회 거주 저소득층 노인의 우울증상 유병률과 관련인자

신희영,이훈,신일선,김재민,김성완,양수진,윤진상 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.5

Objectives : This study aimed to investigate the prevalence and correlates of depressive symptoms in community-dwelling low income elderly. Methods : A community survey of 1,351 low income residents aged 65 or over was conducted in Buk district of Gwangju, Korea. Depressive symptom was evaluated by the Korean Form of the Geriatric Depression Scale (KGDS). Their Sociodemographic factors, the precence of chronic physical illness, and cognitive functions were investigated. Results : The prevalence rate of depressive symptoms was 69.8%. In multiple logistic regression, chronic physical illness (Odds Ratio : 2.68, 95% Confidence Interval : 1.98-3.63), low education (Odds Ratio : 1.84, 95% Confidence Interval : 1.39-2.43), and cognitive impairment (Odds Ratio : 1.61, 95% Confidence Interval : 1.20-2.16) were independently associated with depressive symptoms. Conclusion : Depressive symptoms in community-dwelling low income elderly were very common, particularly related to current chronic physical illnesses. The results of this study can be useful for the development of community-based prevention and management programs for depression. Of elderleg.

정신병적 증상을 동반한 기면병 1례

신일선,양종철,윤진상 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.4

저자들은 정신병적 증상이 동반된 기면병 환자를 경험하였다. 본 증례에서 정신병적 증상은 methyl-phenidate에 의해 유발 및 악화되었지만, 또한 기면병과는 별개로 서서히 진행되어온 정신분열병의 증상이기도 하였다. 진단 및 치료 특히 약물치료와 관련된 어려움을 외국문헌의 고찰과 함께 보고한다. The case of a 19-year-old man with coexistent narcolepsy and psychotic symptoms was presented. The psychotic symptoms were induced and / or exacerbated by methylphenidate. In addition, they were considered as symptoms of schizophrenia which had been developed regardless of the use of methylphenidate. The case illustrates the difficulties in diagnosing and treating, in particular, pharmacotherapy.

광주광역시 치매의 유병률과 위험인자의 도시-농촌 지역 비교

신일선,김재민,윤진상,김석재,양수진,김웅장,이승현,강순아,곽지영,이형영 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.6

연구목적 : 본 연구의 목적은 광주광역시의 도시 및 농촌 지역에 거주하는 노인에서 치매의 유병률과 위험인자를 조사하고자 하였다. 부가적으로 이 두 지역간에 치매의 유병률과 위험인자를 비교하고자 하였다. 방 법 : 광주광역시의 전형적인 도시와 농촌지역의 65세 이상의 노인(N=1,598)을 대상으로, 2단계의 역학연구를 수행하였다. 1차 선별 단계에서는 38명의 훈련된 연구보조원이 대상노인을 면담하여, 사회인구학적 특징을 조사하고 한국판 간이정신상태검사(Korean version of Mini-Mental State Examination ; MMSE-K)로 평가하였다. 2차 임상 진단 단계에서는 1차 단계에서 MMSE-K 점수가 24점 이하인 노인(N=431)을 대상으로, 전문연구팀의 임상적 평가를 통해 치매를 진단하고 원인질환별로 알쯔하이머병(Alzheimer's disease ; AD), 혈관성 치매(vascular dementia ; VaD) 및 기타 치매로 분류하였다. 대상노인에서 치매의 유병률을 측정한 후, 광주광역시 전체 노인의 연령보정 유병률을 산출하였다. 전체 대상에서 AD의 위험인자를 조사한 후, 도시와 농촌군으로 나누어 분석을 다시 시행하였다. 결 과 : 1차 및 2차 단계의 참가율은 각각 71.0%(N=1,134) 및 83.2%(N=410) 였다. 연구 참여 노인(N=1,134)에서 전체 치매, AD 및 VaD의 유병률은 최소 각각 9.7%, 5.2%, 1.8%였다. 광주광역시 전체 노인의 연령 보정 유병률은 각각 10.7%, 5.7%, 1.9%인 것으로 산출되었다. AD의 독립 위험인자는 고령, 여성, 무학이었다. 도시와 농촌에 따른 유병률의 차이는 파악되지 않았다. 그러나 AD의 위험인자는 지역에 따라 차이가 있었다. 도시 노인에게는 무학만이, 농촌 노인에게는 고령과 여성인 경우가 독립 위험인자였다. 결 론 : 광주광역시 노인에서 치매의 유병률은 높았고, 이는 국내 다른 지역에서 수행된 선행연구 결과와 유사하였다. 알쯔하이머형 치매의 위험인자는 도시와 농촌에 따라 다른 결과를 보였다. 본 연구 결과는 한국에서의 치매의 실태를 반영하며, 치매의 적절한 관리와 예방을 위해서는 지역성 특성이 고려되어야 함을 시사한다. Objectives : The purpose of this study was to investigate the prevalence rate and risk factors of dementia in an urban and a rural sample of older persons in the metropolitan Kwangju area, Republic of Korea. In addition, the prevalence rate and risk factors of dementia between the two samples were compared. Methods : A two-phase epidemiological study of residents aged 65 or over(N=1,598) was conducted in a highly developed, urban and a non-contiguous, poorly developed, rural area of metropolitan Kwangju. In the first(screening) phase, 38 trained research assistants collectively peformed in-home interviews for all participants. Detailed sociodemographic characteristics were gathered and the Korean version of Mini-Mental State Examination (MMSE-K) was administered. In the second (diagnosing) phase, diagnosis of dementia was established for those scoring 24 or less on the MMSE-K in the screening phase(N=431), and etiological types of dementia were classified to Alzheimer's disease(AD), vascular dementia(VaD) or miscellanous type by two teams of experts. Prevalence rate of dementia was determined in the participants, and age-standardized prevalence rate adjusted by age distribution in metropolitan Kwangju was estimated. For AD, the risk factors were investigated in all participants, and analyses were repeated for the urban and rural samples separately. Results : The participating rates in the first and second phases were 71.0%(N=1,134) and 83.2%(N=410), respectively. In the participants, the prevalence rates of dementia(all types), AD and VaD were 9.7%, 5.2% and 1.8%, respectively. The age-standardized prevalence rates were 10.7%, 5.7% and 1.9%, respectively. Aging, female gender and no education(complete lack of formal education) were identified as independent risk factors for AD. No difference between the urban and rural samples was observed in the prevalence rates of dementia(all types), AD and YaD. However, risk factors for AD differed between these areas. In the urban sample, no education was the only significant factor ; whereas, aging and female gender were identified as risk factors in the rural sample. Conclusion : A high prevalence rate of dementia was observed among old persons in metropolitan Kwangju, consistent with previous studies conducted in other Korean areas. The risk factor profi1es for AD differed between urban and rural settings. The results of this study reflect the current status of dementia in Korea and suggests that appropriate management and prevention strategies for dementia should be tailored toward the geographic settings.

지역사회거주 노인에서 한국어판 세계보건기구 장애평가조사표의 개발

윤진상,김재민,신일선,양수진,정태길,이형영 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.1

Objectives : This study aimed to develop the Korean version of World Health Organization Disability Assessment Schedule II (WHODAS II-K) with community dwelling elderly population. Methods : The WHODAS II-K was administered to 1204 community residents aged 65 or over in two areas of Kwangju, South Korea, in 2001. For assessing 'health condition', data on physical illness, depression (Korean version of Geriatric Mental State Schedule B3), and cognitive dysfunction (Korean version of Mini-Mental State Examination) were collected. For evaluating 'contextual factors', informations on demographic charactehstics (age, gender, living area, marital state, and religiou), socio-economic status (education, type of accommodation, number of room, previous occupation, and current employment), and social network were obtained. Results : WHODAS II-K showed high levels of internal consistency, split-half reliability, and inter-rater and test-retest reliabilities. In the correlation analyses, scores on the WHODAS II-K were significantly correlated with the unfavorable conditions in the all variables on health condition and contextual factors. Partial correlations of scores on the WHODAS II-K with health condition were significant even after controlling for contextual factors. Conclusion : The WHODAS II-K is a reliable and valid instrument for assessing disability in elderly population since it reflects physical illness, depression, and cognitive impairment, which are common in elderly.

지역사회거주 노인에서 한국어판 세계보건기구 장애평가조사표의 개반

윤진상,김재민,신일선,양수진,정태길,이형영 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.1

열파이프의 위크현상에 따른 전열특성

김성원,이진호,강신형 연세대학교 산업기술연구소 1990 논문집 Vol.22 No.2

Experimental investigation is made to study the dependence of performance characteristics of heat pipe on the types of wick shapes. Types of wick shapes adoped are open groove wick, screen wick, closed groove wick and no wick.(thermo-syphone). The dependence of heat pipe performance on the wick shape is turned out to be in the following order ; open groove wick, closed groove wick, screen wick and no wick. This shows that the heat transfer efficiency of heat pipe depends more upon the returning capacity of liquid from condenser to evaporator, implying that the wick which has low capillary pressure but good permeability is better than those which has higher capillary pressure.

간호사들에서 월경전불쾌기분장애와 삶의 질, 사회직업기능 및 장애 간의 연관성

김선영,김재민,김웅장,양수진,김성완,신일선,윤진상 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.1

Objectives : This study aimed to investigate the prospective associations of premenstrual dysphoric disorder (PMDD) with quality of life, socio-occupational function and disability. Methods : 170 nurses were recruited 6om two general hospitals. Interviews were made at baseline and at four follow-up points (two mid follicular phases and two late luteal phases ofthe two consecutive menstrual cycles). The baseline evaluation Consis-ted of sociodemographic characteristics and menstmal history. PMDD was diagnosed by DSM-IV criteria after observation of the two menstrual cycles. The follow-up evaluations were consisted ofthe World Health Organization Quality of Life-Brief form, the Social and Occupational Functioning Assessment Scale, and the World Health Organization Disability Assessment Scale-II. Results : PMDD was detected 15 (8.8%) of 170 participants. The PMDD group showed significantly worse quality of life and socio-occupational functioning than the none-PMDD group particularly at the late luteal phases. No significant differences were found in sociodemographic characteristics and menstrual history between those with and without PMDD. Conclusion : PMDD was prospectively associated with worse quality of life and socio-occupational functioning in this study group.

"한국판 학령전기 기질성격검사[K-psTCI]" 의 신뢰도 및 타당도 검사

박진균,김지웅,기선완,신의진 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : The purpose of this study was to evaluate the reliability and validity of the Korean version of Preschool Temperament and Character Inventory (K-psTCI), a questionnaire based on Cloninger's seven-factor model of personality. Methods : The psTCI was translated into Korean and administered to 266 children aged 2-6 years. α test-retest study of the K-psTCI was conducted across a 4-month interval, Internal consistency was calculated by Cronbach a. Test-retest and reliability was analyzed by Pearson correlation analysis. Factor analyses for the temperament and character dimensions were performed using principal component analysis, rotating factors by varimax. The psTCI scores of Korean and United States preschoolers were compared Results : Cronbach α values for the K-psTCI scales ranged from .62 to .78 for each dimensions. Test-retest correlations (r) ranged from .50 to .77 for each dimensions. Explorative factor analysis with the condition of eigenvalue greater than 2 produced four factors for the temperament items and three factors for the character items like the US original version of psTCI. Through factor analyses, five items in the K-psTCI were categorized differently from the US version of psTCI. Korean preschoolers had higher mean scores on Cooperativeness (CO) in males as compared to a sample of US preschoolers. Conclusion : The results of this study suggests that the Korean preschool TCI is satisfactory in reliability and validity.

만성 C형 간염 환자에서 알파 인터페론 치료 중발생한 후천성 반응성 천공성 교원증

최연진 ( Yeon Jin Choi ),신미선 ( Mi Seon Shin ),안지영 ( Ji Young Ahn ),박미연 ( Mi Youn Park ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.6

Reactive Perforating Collagenosis (RPC) is a kind of perforating dermatosis, which shows transepidermal elimination of altered collagens. Acquired form is developed in an adult without family history, is favorably developed in scratched region due to pruritic sense. Acquired RPC has been reported to be associated with various systemic disorders, such as diabetes mellitus, liver disease, chronic renal failure, lymphoma, AIDS, hypothyroidism, hyperparathyroidism, and neurodermatitis, accompanied by itching & scratching. We report a case of acquired RPC in a patient with HCV hepatitis who was treated with interferon alpha. Skin lesions showed multiple erythematous centrally umbilicated, crusted papules of variable sizes on the extensor surfaces of both shins. (Korean J Dermatol 2008;46(6):788∼791)