회원작품 - 남해 프라임하우스

송인욱,Song, In-Uk 대한건축사협회 2016 建築士 Vol.2016 No.5

치매 심각도에 따른 알츠하이머형 치매의 기억 책략 변화

박종식(JongSik Park),송인욱(In-Uk Song),강연욱(Yeonwook Kang) 대한임상노인의학회 2020 대한임상노인의학회지 Vol.21 No.2

Background: In recent years, an increasing attention has been paid to the investigation of cognitive impairment in dementia of the Alzheimer s type (DAT). In particular, studies have shown that memory impairment is a useful indicator for diagnosis of DAT. However, little research has been conducted on memory strategies in patients with DAT. Thus, this study was conducted to examine changes in memory strategies according to the severity of dementia in patients with DAT. Methods: The subjects were 20 old adults (OA: 8 males, 12 females), 20 patients with mild cognitive impairment (MCI) (8 males, 12 females), 20 patients with mild DAT (8 males, 12 females), and 14 patients with moderate DAT (6 males, 8 females). All subjects underwent the Seoul Verbal Learning Test (SVLT). Results: Compared to patients with MCI, patients with mild DAT showed lower scores on immediate recall, delayed free recall, and recognition discrimination, but significant difference was not found in the variables evaluating memory strategies between the two groups. A significant difference was not found in any of the variables between the mild and moderate DAT groups. However, between the MCI and moderate DAT groups, differences were found in the 1-3th learning slope and the recall consistency. Conclusion: There was no difference in memory strategies between healthy elders and patients with DAT. It is expected that training memory strategies will be helpful for preventing dementia and alleviating dementia symptoms in healthy elders and patients with early DAT.

파킨슨병 말초신경병증과 당뇨병성 말초신경병증에 대한 호모시스테인의 임상적 가치

최현아(Hyun-Ah Choi),김영도(Young-Do Kim),조현지(Hyun-Ji Cho),송인욱(In-Uk Song),정성우(Sung-Woo Chung) 대한임상노인의학회 2012 대한임상노인의학회지 Vol.13 No.4

연구배경: 말초신경병증이 파킨슨병 또는 당뇨병과 동반된 환자에서 발생이 높다고 알려져 있다. 하지만 말초신경병증의 발생 기전이 매우 다양하여 아직까지 명확히 확립되어 있지 않다. 최근에 고호모시스테인혈증이 산소성 스트레스를 증가시켜 혈관내피에 병변을 일으킬 수 있다고 주장하고 있어 말초신경병증 발생을 유발하는데 기여할 수 있으리라 생각되고 있다. 따라서 저자들은 파킨슨병 및 당뇨병이 동반된 말초신경병증에 혈중 호모시스테인 농도가 영향을 주는지를 평가하고 당뇨병이 동반된 말초신경병증과 파킨슨병에 동반된 말초신경병증사이에 호모시스테인의 차이에 대해 연구하고자 한다. 방법: 본 연구에 파킨슨병이 동반된 말초신경병증을 가진 환자 31명, 당뇨병에 동반된 말초신경병증 환자 36명, 그리고 정상군 43명이 선택되었다. 모든 대상군은 신경생리검사를 통해서 말초신경병증을 확인하였고, 양 질환군사이의 혈중 호모시스테인의 농도에 대한 분석을 하였다. 파킨슨병을 동반한 말초신경병증 환자에 대해서는 Hoehn and Yahr Stage를 사용하여 운동증상의 심한 정도와 호모시스테인의 관련성을 분석하였다. 결과: 혈중 호모시스테인 농도는 두 질환군에서 정상군보다 의미있는 증가를 보였고, 두 질환군의 비교에서도 파킨슨병을 동반한 말초신경병증에서 의미 있게 높은 혈중 호모시스테인 농도를 보였다. 하지만 파킨슨병 증상의 심한정도와 호모시스테인 농도와는 관련성을 보이지 않았다. 결론: 본 연구에서 저자들은 호모시스테인의 혈중농도는 파킨슨병과 당뇨병이 동반된 말초신경병증의 위험인자로써 작용할 수 있다는 것을 추정할 수 있었다. 뿐만 아니라 파킨슨병의 발생에도 호모시스테인의 혈중농도 증가가 위험 인자로써 영향을 줄 수 있다고 조심스럽게 추정하는 바이다. Background: Peripheral neuropathy (PN) has been described in significantly higher proportions in patients with Parkinson’s disease (PD) or diabetes mellitus (DM) than in healthy controls. However, pathophysiological mechanisms underlying the development of PN are not well understood. It is currently thought that hyperhomocysteinaemia may induce endothelial dysfunction through increasing oxidative stress. It is not known if hyperhomocysteinemia is associated with PN and may thus be a contributing factor in the pathogenesis of PN. In view of these considerations, we investigated to clarify relationship between hyperhomocysteinemia and PN with PD or DM and to assess difference between the role of homocysteine in PN with PD and DM. Methods: We recruited 31 PD with PN, 36 type 2 DM with PN and 43 healthy controls. All subjects underwent electrophysiological test to clarify presence of PN and subjects with PD were evaluated the motor severity by using modified Hoehn and Yahr Stage. We analyzed correlation between plasma homocysteine level and neuropathy with PD or DM. Results: Plasma homocysteine levels in patients with PN showed higher plasma concentration than those in healthy controls. Interestingly, this study also demonstratedsignificant higher plasma homocysteine concentration in PN with PD than those in PN with DM. Conclusion: The present study showed that hyperhomosyteinemia might play a role in risk factor of PN in patients with PD and DM. Moreover, we could also suggest that increased plasma homocysteine concentration may contribute to the pathogenesis of PD because PN patients with PD have higher plasma homocysteine concentration than those with DM.

연구논문(硏究論文) : 일본의 요보호 노인 기본권보호제도의 동향과 한국에의 시사점

송인욱 ( In Uk Song ),백윤철 ( Yun Chul Baek ) 단국대학교 법학연구소 2011 법학논총 Vol.35 No.1

Social welfare has transformed from a provider-centered welfare into a user-centered welfare. This trend have to increase the right to welfare and convenience for users. If the goal of social welfare guaranteed the respecting man`s life and dignity, we had not regarded service users as the weak in the welfare system. Japan has already prepared administrative care system for positive solution for social welfare service receipt right of the frail elderly who the decision ability is insufficient and the handicapped. It is important in us at point become accomplished policy approach of government that prepared for increase of old person who need longterm care. The purpose of this study is to analyze the structure and characteristics of the advocacy system, which has been institutionalized to aid the use of social welfare services in Japan`s social welfare systems recently. In order to conduct such purpose, this paper examined the develpomental process and the background of institutionalization of Majority Guardianship System and advocacy system in Japan.

앤더슨(Andersen)모형을 이용한 장애노인 우울 예측요인

송인욱(Song, In Uk),원서진(Won, Seo Jin) 한국장애인재활협회 2014 재활복지 Vol.18 No.3

본 연구는 앤더슨모형에 입각하여 우리나라 장애노인들이 경험하게 되는 우울의 영향요인을 파악하고 노년기 우울의 예방적 개입을 위한 함의를 제공하고자 하였다. 이를 위해 4차년도 고령화연구패널조사(KLoSA)를 2차 자료분석하였으며, 65세 이상 장애노인 444명을 분석대상으로 하여 우울에 대한 관련 변수들의 영향력을 살펴보기 위해 위계적 다중회귀분석을 실시하였다. 분석결과 선행요인에서는 연령이 높을수록 우울 수준이 높았고, 자원요인에서는 기초노령연금을 받고, 사회적 지지가 많을수록 우울 수준이 낮았으며, 욕구요인에서는 지체장애, 뇌병변장애, 시각장애, 심장장애를 가진 노인의 우울 수준이 상대적으로 높은 것으로 나타났다. 연구결과를 토대로 장애노인의 우울에 미치는 것으로 확인된 우울예측요인의 특성을 고려한 실천적 개입방안을 제시하였다. This study aims to identify effects of predisposing, enabling, and need factors on depression among older adults with disability applying Andersen model. And it is also to provide preventive intervention strategies of depression in the later life. Researchers conducted secondary data analysis using the 4th wave of Korean Longitudinal Study of Ageing(KLoSA). 444 older adults who were 65years old and older with disability were included in the study. Researchers used stepwise multiple regression to address factors related to depression of older adults with disability. Findings identified that those who were younger, received senior pension, and had more social support tended to be less depressed. In addition, older adults with a physical disability, brain related disability, vision impairment, and heart problem were more depressed than those without these disabilities. Based on the findings, researchers indicated factors affecting depression of older adults with disability and clinical intervention methods for preventing depression in the later life.

초기 파킨슨병에서의 Cardiac 123I-Metaiodobenzylguanidine Image를 통한 임상적 예후 평가에 대한 연구(예비연구)

호성희(Seong Hee Ho),송인욱(In Uk Song),정용안(Yong An Chung) 대한임상노인의학회 2016 대한임상노인의학회지 Vol.17 No.2

Background: 123I-metaiodobenzylguanidine (MIBG) image is a well-known tool to evaluate cardiac sympathetic denervation in the idiopathic Parkinson’s disease (PD). Therefore, MIBG images have been reported as a useful tool for diagnosing PD and differentiating PD from other diseases with parkinsonian clinical features. However, relationship between MIBG images and prognosis in PD are unclear. Therefore, we investigated via this study whether MIBG image have a role as predictor of the progression of symptoms in PD or not. Methods: We prospectively enrolled 20 patients with PD who also had decreased striatal uptake on FP-CIT PET/CT. All subjects underwent cardiac 123I-MIBG planar scintigraphy and SPECT separately. Myocardial 123I-MIBG uptake was interpreted on planar and SPECT/CT images separately by visual and quantitative analysis. The clinical evaluations were assessed according to the Hoehn and Yahr (HY) stage, the Unified PD Rating Scale (UPDRS) and general neuropsychological tests on 1 year after first diagnosis. Results: All PD patients showed more severe HY stage and UPDRS motor part on 1-year follow-up than first visit (baseline). However, there was no difference of HY stage, UPDRS motor and neuropsychological tests between PD-Def and PD-NL on 1-year follow-up. Conclusion: We cannot find a role of 123I-MIBG as predictor of disease progression in PD in this study. In addition, we suggest that further researches with larger study populations need to be done to clarify the role of 123I-MIBG image as biomarker of disease progression in PD.

급성기 뇌경색 환자에서 뇌경색 아형에 따른 내원 시 혈당과 예후의 연관성

김태원(Tae Won Kim),소정민(Jeong Min So),정성우(Sung Woo Chung),송인욱(In Uk Song) 대한임상노인의학회 2017 대한임상노인의학회지 Vol.18 No.2

Background: Studies evaluating the prognostic value of admission glucose level (AGL) by stroke subtypes are rare. We aimed to evaluate the association between AGL and short-term outcome by each stroke subtype. Methods: We recruited 265 patients with acute infarction who were consecutively admitted to our hospital after acute stroke. We classified the patients into lacunar, large artery artherosclerosis (LAA) or cardioembolic infarction according to the TOAST stroke classification. AGL were measured at admission. The National Institutes of Health Stroke Scale (NIHSS) were evaluated initially and at 5 admission days. Results: Fifty patients were lacunar group, 190 were LAA group and 25 were cardioembolic group. All enrolled patients with higher AGL had significantly worse functional outcomes in acute stage compared to the low AGL group (P=0.005). In respect to stroke suptype, AGL was significantly associated with worse functional outcome in acute stage only in LAA group (P=0.002). There were no association between AGL and functional outcome in lacunar or cardioembolic infarction. Conclusion: The prognostic implication of AGL in acute ischemic stroke was different depending on each stroke subtype. Although AGL predicted worse functional outcome only in LAA group, it did not associate with functional outcome in the lacunar or cardioembolic infarction.

지떨림 증상으로만 발현된 일과성 허혈성 발작

송인욱(In-Uk Song),정성우(Sung-Woo Chung) 대한임상노인의학회 2009 대한임상노인의학회지 Vol.10 No.2

일과성 허혈성 발작으로 인한 지떨림은 매우 드문 임상적 증후군으로서 일반적으로 경동맥의 협착 또는 폐색으로 인한 뇌관류저하로 발생하게 된다. 대개의 지떨림은 간결하고 규칙적이며 반복적인 떨림 양상을 보이게 된다. 하지만 저자들은 상하지에서 규칙적인 진전양상이 아닌 간질발작양상의 움찔 운동으로 나타난 지떨림을 가진 67세 남자 환자를 경험하여 보고하고자 한다. 본 환자는 자기공명혈관사진상 우측 내경동맥의 폐색 소견을 보였으나 뇌파상 간질파는 보이지 않았다. 증상은 3시간 정도 지속한 이후 자연스럽게 완화되었고 다시 재발하지는 않았다. Limb shaking due to transient ischemic attacks represent a rare clinical syndrome that has been ascribed to focal cerebral ischemia attributable to insufficient brain perfusion, usually resulting from carotid artery occlusive disease. Most often, the limb shaking is brief, repetitive and regular in frequency, which has been described as shaking, twitching, swing, or trembling movements. However, we experienced a 67-year-old man with limb shaking syndrome of jerky movement on upper and lower limbs, resembling simple focal seizure disorder. The patient showed right carotid artery occlusion. The involuntary movements spontaneously disappeared and never relapse. The patient was treated conservatively with adjustment of anti-platelet medications.

지역간 비교를 통한 중고령자의 생산적 활동과 우울의 관계

송인욱(Song, In-Uk),원서진(Won, Seo-Jin) 한국지역사회복지학회 2013 한국지역사회복지학 Vol.0 No.45

본 연구는 50세 이상 중고령자를 대상으로 생산적 활동이 우울에 미치는 영향을 분석하고자 하였다. 또한 생산적 활동과 우울의 관계에서 사회적 관계망의 조절효과를 파악하는데 그 목적이 있다. 3차년도 국민노후보장패널조사를 2차 자료분석한 결과, 성별, 연령, 학력 및 결혼상태가 대도시 거주 중고령자의 우울에 영향을 미치는 것으로 나타났으며, 도 거주 중고령자의 경우 연령, 학력, 결혼상태, 가구소득이 우울에 유의미한 관계를 나타내었다. 생산적 활동에서는 유급노동과 손자녀돌봄이 대도시 거주 중고령자의 우울을 감소시키는 것으로 나타났으나 자원봉사는 오히려 우울을 증가시키는 요인이었다. 도 거주 중고령자의 경우 유급노동이 우울에 유의미한 영향을 미쳐, 유급노동을 하는 중고령자의 우울이 유급노동을 하지 않는 중고령자에 비해 낮았다. 사회적 관계망은 지역에 상관없이 우울을 감소시키는 것으로 나타났고, 사회적 관계망의 조절효과는 친구 및 가족과의 관계 만족도와 몇가지 생산적 활동의 관계에서 유의미한 결과를 보였다. This study aimed to address the relationship between productive aging and depression of people over 50 years old. Also, it was to identify the moderating effect of social network on the relationship between productive aging and depression. Findings indicated that gender, age, education, and marital status were significantly related to depression of seniors living in the metropolitan area. For non metropolitan residents, age, education, marital status, and income were significant factors to the depression. Among productive aging factors, paid work and grandparenting decreased depression of those in the metropolitan area while volunteer activity increased their depression. For those living in the non metropolitan area, paid work had a significant positive impact on the depression. Social network factors decreased depression regardless of the area of living. Moderating effect was on the satisfaction of friend and family relationship to some of productive aging factors.

급성 양측성 상부 중뇌경색으로 발생한 수직 주시 마비

송인욱(In-Uk Song),한수정(Soo-Jeong Han),정성우(Sung-Woo Chung) 대한임상노인의학회 2009 대한임상노인의학회지 Vol.10 No.2

양측 상하주시마비는 양측 중뇌의 병변이 반드시 발생하여야 하므로 뇌혈관질환에 의한 발생은 거의 발생하고 있지 않다. 78세 남자환자가 상하 수직 주시 마비가 동시에 발생하여 복시 및 어지럼증을 호소하며 내원하였다. 뇌 자기공명사진상에서는 양측 중뇌의 급성기 허혈성 뇌졸중 소견을 보였고, 뇌혈관사진상 후뇌동맥의 1분지가 조영되지 않는 소견을 보였다. The bilateral upward plus downward gaze palsy is a rare neurological manifestation caused by vascular insult, because it happens due to bilateral vascular lesions. We experienced a 78-year-old patient presenting diplopia and dizziness due to vertical gaze palsy. The magnetic resonance imaging of brain showed acute ischemic lesions in bilateral rostral paramedian midbrain, including rostral interstitial nucleus of the medial longitudinal fasciculus. And the magnetic resonance angiography didn't show left first branch of posterior cerebral artery.