노인의 우울증과 인지기능장애

김양래(Yang Rae Kim),정한용(Han Yong Jung) 대한노인정신의학회 2007 노인정신의학 Vol.11 No.1

A number of studies have looked at depression and associated cognitive impairment. The term depressive pseudodementia has proved to be a popular clinical concept. Despite the improvement following treatment of depression, the baseline level of cognitive impairment in older depressive patients remained impaired, mostly. These patients would be likely at high risk of developing progressive dementia. Depressive symptoms and cognitive decline would be different phenotypes result from neurodegeneration of pathophysiology for dementia. Depression in elderly patients, especially late-onset appears to be a strong predictor of dementia. No more concept of pseudodementia, older patients with depressive symptoms combined cognitive impairment should probably have full dementia screenings, comprehensive cognitive testing and ongoing monitoring of their cognitive function.

노년기 양극성장애

김양래(Yang Rae Kim),정한용(Han Yong Jung),이상희(Sang Hee Lee) 대한노인정신의학회 2005 노인정신의학 Vol.9 No.1

Bipolar disorder in old age is a growing public health problem. We reviewed the epidemiology, clinical characteristics, course, cormobidity, and treatment of bipolar disorder in old age with special focus on comparing with younger patients. Most available date is gleaned from retrospective chart reviews and cohort studies. Many of these reviews have been targeted toward the clinician, and they have relied heavily on extrapolating data from other psychiatric disorders in late life or younger people with bipolar disorder. But, at present, there are more gaps in empirical knowledge than there answer, and greater research on bipolar disorder in older people will assist in enhancing services to this group as well as inform research on bipolar disorder across the life span.

노인에서 우울장애와 불안장애 동반질환인가, 증상인가?

김양래(Yang Rae Kim),정한용(Han Yong Jung) 대한노인정신의학회 2006 노인정신의학 Vol.10 No.2

The frequent comorbidity of anxiety and depression, particularly among elderly, is widely recognized by clinicians, but the debate continues as to whether the combined diagnostic designation is merited. There remains a group of patients with depression and anxiety symptoms who are not well classifyed. This article reviews the debate over anxious depression, generalized anxiety disroder in patients with major depressive disorder, mixed anxiety-depressive disorder, and reviews anxiety symptoms in elderly patients with depression. Comorbid anxiety symptoms are associated with a more severe presentation of depressive illness, including greater suicidality. Most antidepressant treatment studies in the elderly have found poorer treatment outcomes in those with comorbid anxiety (including delayed or diminished response and increased likelihood of dropout from treatment). Since comorbid anxiety affect clincal course and prognosis, and may worsen long-term disability in late life depression, considerably more research in this field is needed.

전기화학 이미징 기술의 원리와 현황

김양래 ( Yang-rae Kim ) 한국공업화학회 2022 공업화학전망 Vol.25 No.4

마이크로스케일에 머무는 기존 전기화학 측정법의 분해능 한계를 극복하기 위해 최근 여러 새로운 전기화학 기술이 시도되고 있다. 특히 단일 나노입자의 impact 연구 및 전기화학 이미징 기술의 개발이 활발히 이루어지고 있다. X-ray, 형광, 분광학 등 다른 방식의 도구를 이용하여 전기화학 이미징을 수행하는 간접적인 방식과 패러데이전류 및 전도도 전류를 직접적으로 측정하는 이미징 방식이 모두 연구되고 있다. 특히 이 중에서 나노피펫 기반의 주사 전기화학 프로브 현미경은 상대적으로 높은 분해능 및 다른 도구와의 용이한 결합으로 최근 주목받고 있으며, 이를 이용하여 다양한 전극 물질에 대해 단일 나노구조체 수준에서 전기화학 거동을 관찰할 수 있게 되었다. 본 기고 문에서는 여러 전기화학 이미징 기술의 원리, 현황, 미래에 대해서 소개하고자 한다.

외상성 뇌손상환자에서 Amantadine의 사용

정한용,김양래,Jung, Han Yong,Kim, Yang Rae 대한생물정신의학회 2000 생물정신의학 Vol.7 No.1

Avariety of symptoms can occur following traumatic brain injury(TBI) or other types of acquired brain injury. These symptoms can include problems with short-term memory, attention, planning, problem solving, impulsivity, disinhibition, poor motivation, and other behavioral and cognitive deficit. These symptoms may respond to certain drugs, such as dopaminergic agents. Amantadine may protect patients from secondary neuronal damage after brain injury as a effect of NMDA receptor antagonists and may improve functioning of brain-injured patients as a dopaminergic agonist. Clinically, based on current evidence, amantadine may provide a potentially effective, safe, and inexpensive option for treating the cognitive, mood, and behavioral disorders of individuals with brain injury. The rationales for using amantadine are discussed, and pertinent literatures are reviewed.

외상성 뇌손상 환자에서 Amantadine의 치료적 효과 : 2증례 및 고찰

정한용,이소영,김양래,Jung, Han Yong,Lee, Soyoung Irene,Kim, Yang Rae 대한생물정신의학회 2001 생물정신의학 Vol.8 No.1

We reported two cases of amantadine treatment in traumatic brain injury patients and reviewed the literature of amantadine treatment of those patients. Problems with short-term memory, attention, planning, problem solving, impulsivity, disinhibition, poor motivation, and other behavioral and cognitive deficit could occur following traumatic brain injury or other types of acquired brain injury. This report described results of amantadine using in two patients with this type of symptom profile. Patients received neuropsychiatric examination as well as BPRS and Barthel index. These patients were improved, respectively from 57 point to 82 point(case 1), from 85 to 94(case 2) in Barthel index, and from 66 point to 35 point(case 1), from 55 to 32 point(case 2) in BPRS. These two patients did not reveal any other adverse effect. The rationale for using amantadine were discussed. 두부 외상을 받은 환자는 여러 가지 다양한 병태생리학적인 과정을 통해 뇌손상을 받으며 이로 인해 다양한 신경정신과적인 장애를 나타낸다. 두부외상을 받은 두 명의 환자에서 이에 대한 약물학적인 접근으로 amantadine을 사용하였고 증세의 호전을 경험하였다. 이에 대한 이론적인 근거로는 amantadine은 전연접(presynaptic)과 후연접(postsynaptic)에서 도파민 신경전달(dopamine neurotransmission)을 증진시켜 인지기능과 전두엽 기능장애에서 발생되는 특징적인 정신 행동학적인 증상을 호전시키고, NMDA 수용체 길항제(NMDA receptor antagonist)로 작용하여 흥분성 독성물질(excitotoxic substrate)에 의한 이차적인 신경손상을 차단하는 신경보호제(neuroprotective agent)로 작용한다. 이와 같이 amantadine은 급성과 만성 외상성 뇌손상 환자 모두에서 나타나는 인지, 기분과 행동장애의 치료에 효과적이고 안전하며 비싸지 않은 가격으로 사용될 수 있을 것으로 사료된다. 또한 이 영역에서 더욱 많은 대조군 연구가 필요하고, 나아가서 외상성 뇌손상 환자의 인지기능 호전을 위한 약물학적인 개입에 관한 연구가 필요할 것으로 사료된다.

주관적 기억감퇴를 가진 노인에서 백질 변화와 인지기능 장애의 관련성

신은영,정한용,김양래,이소영,김신겸,Shin, Eun-Young,Jung, Han-Yong,Kim, Yang-Rae,Lee, So-Young-Irene,Kim, Shin-Gyeom 대한생물정신의학회 2011 생물정신의학 Vol.18 No.3

Objectives The purpose of this study is to evaluate the relationship between the severity of white matter changes (WMC), risk factors and cognitive domains, including executive function profiles. Method Forty nine subjects over 55 years with subjective memory complaints were assessed with MRI and neuropsychological tests. The WMC were assessed by MRI T2-FLAIR images and divided into 3 groups of mild vs. moderate vs. severe and 2 groups of mild-moderate vs. severe by using Mantyla's criteria and Fazeka's criteria. The risk factors were examined in hypertension, heart disease history and chemistry Lab. Medical conditions which affect to cognitive dysfunction and definite dementia were also excluded. Results Comparing 3 groups, hypertension was identified as a risk factor of the WMC. Comparing 2 groups, total cholesterol and LDL were identified for as the risk factor of WMC. The severity of WMC was significantly associated with cognitive disturbances and their main effect on cognition was working memory and inhibition. Conclusion The risk factors of the WMC in the elderly were hypertension, hyperlipidemia. The severity of WMC appears to be associated with executive dysfunction in the elderly.

연안 해역 소형 함정 소요 최적화 모델링 연구

홍윤기,김영인,김양래,이정우,장동학,Hong, Yoon-Gee,Kim, Young-In,Kim, Yang-Rae,Lee, Jung-Woo,Jang, Dong-Hak 한국국방경영분석학회 2010 한국국방경영분석학회지 Vol.36 No.2

본 연구는 한반도 연안 해역에서 발생할 수 있는 다양한 작전유형을 바탕으로 소형 고속 함정의 적정 소요를 산출하기 위한 방법론적 접근이다. 이 연구방법은 운용 해역을 단위 경비구역으로 구분하고 구역할당 모형과 군집화 모형 등을 활용하였다. 이는 지금까지 작전 운용 장비의 적정 소요 산정시 선형기법등을 여러 가지 다양한 방법을 통해 검증해온 방법과는 달리, 최적화 기법을 활용한 작전 함정의 소요를 모델링하는 방법을 채택하였다. 이러한 경비구역에서 임무수행이 가능한 소형 고속 함정의 적정 소요는 "소요 최적화 프로세스"를 거쳐 소위 "하이브리드 적정 소요 모형"에 의하여 적정성을 산출, 검증하는 모델링 방법으로 제시하고자 한다. This paper deals with achieving the optimal quantity of required PKMs to cover the coastal areas divided into the proper size of sectors, and then using Set Cover Model, Clustered Model, etc. It is optimized via "Requirement Optimization Process" to allocate PKMs reasonably which is considered as conducting mission deployment sectors. This "Hybrid Proper Requirement Model" accommodating the optimization process is introduced and testified by examining a requirement problem.

물리치료사의 직무스트레스와 이직의도의 관련성 분석

왕중산(Wang, Joong-San),김양래(Kim, Yang-Rae) 한국산학기술학회 2015 한국산학기술학회논문지 Vol.16 No.9

이 연구는 물리치료사의 직무스트레스와 이직의도를 확인하고 둘 사이의 관련성을 파악하기 위해 실시되었다. 연구 대상자는 경기·인천지역에 근무하는 물리치료사 309명이었다. 자료 수집은 2015년 6월 1일부터 동년 6월 25일까지 구조화된 자기-기입방식 설문조사를 사용하였다. 연구결과, 직무스트레스는 직무자율에서 가장 높았고, 관계갈등에서 가장 낮게 나타 났으며, 이직의도는 2.80±.70점이었다. 물리치료사는 나이와 총근무년수가 증가할수록 직무스트레스와 이직의도가 높아지는 유의한 양의 상관관계를 보였다(p<.05). 이직의사는 모든 직무스트레스 요인들과 유의한 양의 상관관계가 있었고, 의욕저하 또한 직무불안정을 제외한 직무스트레스의 모든 요인들과 유의한 양의 상관관계를 보였다(p<.05). 또한 직무스트레스 요인 중 직무자율, 직무체계, 보상, 직장문화가 이직의도에 영향을 미치는 요인으로 나타났다. 본 연구를 통해 물리치료사의 직무 스트레스의 증가는 이직의도를 높이는 위험요인인 것을 알 수 있었고, 직무스트레스와 이직의도를 감소시키기 위한 노력이 필요할 것으로 사료된다. This study attempted to examine the job stress and turnover intentions of physical therapists and to investigate the relationship between these two factors. A total of 309 physical therapists currently working in Gyeonggi-do and Incheon in South Korea were selected as research subjects. The data were collected by a survey using self-administered questionnaires structured from June 10 to June 25, 2015. According to the study results, job stress was highest in job autonomy and lowest in relationship conflict, while the turnover intention score was 2.80±0.70. The physical therapists showed higher job stress and turnover intention level with increasing age and working experience, showing a significant positive correlation(p<.05). The turnover intention showed a significant positive correlation with all of the job stress factors. Decreased work motivation showed a significant positive correlation with all of the job stress factors except for job instability(p<.05). In addition, among the factors for the job stress, Job autonomy, Structure and organization, Inappropriate compensation, and Workplace culture turned out to be those affecting their turnover intention. This study confirmed that an increase of job stress among physical therapists can be a risk factor of higher turnover intention, implying a necessity to try to reduce their job stress and turnover intention.

내․외과계열에서 나타나는 자아방어기제의 특성에 대한 연구: 전문의를 대상으로

정한용(Han Yong Jung),김양래(Yang Rae Kim) 한국의학교육학회 2001 Korean journal of medical education Vol.13 No.2

The purpose of this study was to explore the differentiation of common personality profiles and defense mechanisms between medicine and surgery specialist groups. The authors evaluated the defense mechanisms of the specialist by using Ewha Defense Mechanisms Test. The authors compared the defense mechanisms between two groups (medicine and surgery specialist groups) who are employed Soonchunhyang university hospital at 2000. First, There were significant differences in mean scores of the defense mechanisms ratings. For the surgery groups, projection and show-off were significantly higher than in the medicine group, and for the medicine groups, altruism was significantly higher than surgery groups. Second, Compared of maturity level between two groups, the medicine group used mature defense significantly. Third, We compared of major defense mechanisms between two groups. Surgery groups used show-off as a major defense mechanisms in significantly higher frequency than the medicine groups. This results were reflect that surgery group have property of apprentice system and dramatical therapeutic approach. The results seem to be useful in understanding specialist s optimal character for specific specialities that were selected by evaluating the differences of the common characteristics and coping mechanisms of each specialty group.