급성기 뇌졸중 환자에서 신경 및 정신 증상간 상호관계

강희주,배경열,김성완,김재민,신일선,박만석,조기현,윤진상,Kang, Hee-Ju,Bae, Kyung-Yeol,Kim, Sung-Wan,Kim, Jae-Min,Shin, Il-Seon,Park, Man-Seok,Cho, Ki-Hyun,Yoon, Jin-Sang 한국정신신체의학회 2012 정신신체의학 Vol.20 No.2

연구목적 : 본 연구는 뇌졸중 급성기에 신경 및 정신 증상간의 연관성을 조사하고자 하였다. 방 법 : 뇌졸중 환자 412명을 대상으로, 신경증상 중 뇌졸중의 심각성는 미국국립보건원 뇌졸중척도(NIHSS), 일상생활 수행장애는 바델지수(BI) 및 수정 랑킨척도(mRS), 인지기능은 한국판 간이정신상태검사(K-MMSE), 그리고 근력은 표준화된 악력측정을 통해 평가하였다. 정신증상은 간이정신진단검사(SCL-90-R)를 통해 9가지의 증상영역(신체화, 강박증, 대인예민성, 우울, 불안, 적대성, 공포불안, 편집증, 정신증)과 한가지의 부가적 항목을 조사하였다. 신경 및 정신 증상간 연관성은 입원 당시와 퇴원직전(뇌졸중 치료시작 전과 후)에 각각 분석하였다. 결 과 : 입원 당시 NIHSS 점수는 공포불안 및 부가항목과 연관이 있었고, BI와 mRS 점수는 우울, 공포불안, 그리고 부가항목과 연관성을 보였다. 퇴원 당시의 NIHSS 점수는 신체화, 우울, 공포불안, 부가 항목과 연관이 있었고, BI와 mRS 점수는 우울, 공포불안, 부가항목과 연관이 있었으며, MMSE 점수는 강박증, 우울, 공포불안, 부가 항목과 연관을 보였고, 악력은 신체화, 우울, 불안, 부가항목과 연관되었다. 결 론 : 뇌졸중의 급성기에는 신경 증상이 심할수록 우울, 공포불안, 수면 및 식욕 장애 등 정신 증상이 동반될 가능성이 높았다. 뇌졸중 후 신경증상이 심각한 환자에 대해 신경학적 치료와 함께 적극적인 정신과 치료가 필요하다. Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.

소쇄원의 공간 유형에 따른 소리경관 특성에 관한 연구

강희주(Hee-Ju Kang),국찬(Chan Kook),신용규(Yong-Gyu Shin) 한국소음진동공학회 2021 한국소음진동공학회 논문집 Vol.31 No.2

아동과 부모의 경험을 통해 본 코로나19 이후 아동 일상 변화에 대한 질적 연구

강희주(Hee-Ju Kang),구슬이(Sally Ku),윤은영(Eun-young Yun),정익중(Ick-Joong Chung) 충남대학교 사회과학연구소 2021 사회과학연구 Vol.32 No.4

알츠하이머병과 영양 생체지표

강희주(Hee Ju Kang),홍종우(Jong Woo Hong),한지원(Ji Won Han),양수진(Soo Jin Yang),김성완(Sung Wan Kim),신일선(Il Seon Shin),김기웅(Ki Woong Kim),윤진상(Jin Sang Yoon),김재민(Jae Min Kim) 대한생물치료정신의학회 2014 생물치료정신의학 Vol.20 No.3

It is unachievable to cure Alzheimer disease(AD) with current medical technologies. It is essential to screen high risk group and diagnose early stage patients in the diagnosis and treatment of AD patients. Neuroimaging and cerebrospinal fluid tests are used for diagnosing AD, but these are expensive and invasive. It is mandatory to develop a blood based biomarker which is cheap, non-invasive, and easy to carry out. If a nutritional biomarker, which is modifiable, can be developed, it might be possible to delay the onset and to treat the disease. Based on the current knowledge, only the homocysteine is known to be associated with AD. A combination of nutritional materials rather than an individual one could be used as more accurate and useful biomarkers in AD.

수면장애의 인지행동치료를 위한 스마트폰 애플리케이션 개발과 활용

김주완(Ju-Wan Kim),이용성(Yong-Sung Lee),박철(Cheol Park),유혜영(Hye-Young Yu),이가영(Ga-Young Lee),강희주(Hee-Ju Kang),이주연(Ju-Yeon Lee),김선영(Seon-Young Kim),배경열(Kyung-Yeol Bae),김재민(Jae-Min Kim),신일선(Il-Seon Shin),윤진상(J 대한사회정신의학회 2016 사회정신의학 Vol.21 No.2

연구목적 : 불면증 치료에 인지행동치료는 약물치료에 비하여 부작용 및 의존성의 가능성이 낮아 효과적이다. 본 논문은 불면증 인지행동치 료를 위한 스마트폰 앱 개발 과정과 정신보건학적 의의에 대해 기술하였다. 방 법 : 전남대학교병원 정신건강의학과와 광주북구정신건강증진센터의 의료진과 정신보건전문요원들이 모바일 솔루션 개발업체와 협력하여 수면인지행동치료를 위한 스마트폰 앱을 개발하였다. 결 과 : 앱의 주요 기능은 수면제한, 자극조절, 수면위생, 이완요법, 인지 재구조화 등의 치료 원리를 바탕으로 개발되었다. 총 8개의 모듈로 구성되어 있는데, 이는 수면상태 평가, 나의 수면일지, 수면위생 자가체크, 나의 잘못된 수면 습관, 점진적 근육이완, 하지불안증 후군 선별, 불면증 역기능 사고, 수면앱 소개 등이다. 모바일 기기의 특성 중 하나인 간편성과 앱을 통한 환자와 치료자 간 상호작용을 통해 수면인지행동치료를 촉진하고자 하였다. 결 론 : 본 수면 앱의 개발과 활용은 첨단기술을 의료와 정신사회적 치료에 접목한 것으로 향후 다양한 방식의 서비스 툴 개발과 확산에 기여할 것으로 기대된다. 향후 수면 앱의 안정성, 임상 효용성 및 사용자 만족도에 대한 연구가 추후 이루어져야 할 것이다. Objectives : Cognitive behavioral therapy for insomnia (CBT-I) is an effective non-pharmacologic treatment without the risk of dependence or adverse effects associated with hypnotics. This article aims to describe the development of smartphone application for CBT-I of patients with insomnia. Methods : Chonnam National University Hospital and Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (HYM-Sleep) for CBT-I. The development of the application involved psychiatrists, nurses, social workers, psychologists, and software technicians from a software development company (Goosl Corp.). Results : Development of the HYM-Sleep application was based on theory of CBT-I including sleep restriction, stimulus control, sleep hygiene, relaxation, and cognitive restructuring of insomnia. This application is composed of eight main modules including ‘Sleep assessment’, ‘Sleep diary’, ‘Sleep hygiene education’, ‘Sleep habits correction’, ‘Relaxation training’, ‘Restless legs syndrome screening’, ‘Cognitive therapy’, and ‘App introduction’. Checking on this application by client is shared with case manager/therapist, who can provide feedback in real time. Conclusion : This application is expected to have potential to enhance CBT-I through technical aid. In addition, this application’s interactive function between client and therapist is the key characteristic that distinguishes it from other mobile application. This smartphone application may contribute to further development of various psychological and technical intervention of insomnia.

노인의 신체질환과 자살사고 간의 연관성

박철,강희주,이주연,김선영,배경열,김성완,김재민,신일선,윤진상,Park, Cheol,Kang, Hee-Ju,Lee, Ju-Yeon,Kim, Seon-Young,Bae, Kyung-Yeol,Kim, Sung-Wan,Kim, Jae-Min,Shin, Il-Seon,Yoon, Jin-Sang 대한불안의학회 2014 대한불안의학회지 Vol.10 No.1

Objectives : This study aimed to investigate the associations between physical disorders and prevalent/incident suicidal ideation in a community dwelling older population aged 65 years or over. Methods : 1204 people aged 65 years or over evaluated at baseline. Suicidal ideation was identified using the questions from the community version of the Geriatric Mental State Schedule ("GMS B3"). Reported physical disorders covering 11 common and generally chronic health problems were ascertained. Covariates included were depression, age, gender, years of education, accommodation status, past occupation, and current occupation. Of 1066 without suicidal ideation at baseline, 805 (76%) were followed 2 years later, and incident suicidal ideation was evaluated. Results : Prevalent suicidal ideation was significantly associated with 4 of 11 physical disorders: eyesight problems, persistent cough, heart disease and paralysis or weakness in one leg or arm. Incident suicidal ideation was associated with 3 physical disorders: asthma, high blood pressure and paralysis or weakness in one leg or arm. Both prevalent and incident suicidal ideation were significantly associated with increased number of physical disorders. Conclusions : Certain physical disorders were comorbid and precipitating factors of suicidal ideation in elders. And appropriate intervention and treatment of physical disorders might prevent suicidal ideation in elderly.

뇌졸중 후 불안의 유병률 및 예측인자

김규온(Gyu On Kim),강희주(Hee Ju Kang),김주완(Ju Wan Kim),배경열(Kyung Yeol Bae),김성완(Sung Wan Kim),김준태(Joon Tae Kim),박만석(Man Seok Park),조기현(Ki Hyun Cho),김재민(Jae Min Kim) 대한노인정신의학회 2018 노인정신의학 Vol.22 No.2

Objective:This study aimed to investigate the prevalence and predictors of poststroke anxiety (PSA) at acute and chronic stage. Methods:PSA was defined as 7 or higher score on Hospital Anxiety and Depression Scale-anxiety subscale within 2 weeks (n=286) and at 1 year (n=222) after the index stroke. Following variables were examined at baseline: sociodemographic characteristics (age, sex, education years, marital status, living alone, and unemployment), risk factor of vascular disease, stroke location on brain imaging, severity of stroke (National Institute of Health Stroke Scale), physical impairment (Barthel Index), etc. These variables were compared by PSA initially using t-test or χ2 test. Those variables shown significant associations (p<0.05) entered simultaneously to logistic regression analysis for evaluating independent predictive factors. Results:PSA was observed in 27 patients (9.4%) at acute stage, and in 35 patients (15.8%) at chronic stage. Acute PSA was associated with younger age and higher Hamilton Depression Rating Scale (HAM-D) score, and chronic PSA was associated with hypertension and higher HAM-D score. Conclusion:PSA was prevalent and was associated with those variables on poor prognosis of stroke outcome. Therefore, early screening of PSA and referral to proper treatment may reduce stroke burden.

2015노년기 신체질환이 불안의 발생에 미치는 전향적 연구

김상대(Sang-Dae Kim),강희주(Hee-Ju Kang),이주연(Ju-Yeon Lee),김선영(Seon-Young Kim),배경열(Kyung-Yeol Bae),김성완(Sung-Wan Kim),김재민(Jae-Min Kim),신일선(Il-Seon Shin),윤진상(Jin-Sang Yoon) 대한생물치료정신의학회 2015 생물치료정신의학 Vol.21 No.3

저압 분사 회전 노즐을 이용한 도기 세척 기술 개발

정다운(Da Woon Jung),강희주(Hee Ju Kang),안중근(Joong Keun An),이진욱(Jin Uk Lee),권선덕(Sun Dug Kwon),박찬정(Chan Jung Park) 대한기계학회 2015 대한기계학회 춘추학술대회 Vol.2015 No.11

A bidet gets rid of residues with clean water after using the toilet. Beyond its primary purpose, bidet hygiene maintenance should be taken into account in that sanitary ceramics are a place of the spreading of germs and bacteria. In order to keep then clean, the inner part of the sanitary ceramics should be cleaned whenever using the toilet, but people are reluctant to doing it. To prevent the spreading of germs and bacteria, the sanitary ware cleaning technology with small size and strong cleaning power should be realized in bidet products. Therefore, this study is conducted to discuss the cleaning technology that is small but rotation, upward and downward mobility are available.

상황별 맞춤 신용카드 애플리케이션 제안

정광희(Jung, Kwang Hee),권도연(Kwon, Do Yeon),강희주(Kang, Hee Ju),양지윤(Yang, Ji yoon),김승인(Kim, Seung In) 한국디지털디자인협의회 2015 디지털디자인학연구 Vol.15 No.1

국내 신용카드 사용이 증가되면서 일인당 신용카드 소지 및 사용 개수가 점차 늘어나고 있다. 그에 따라 신용카드 사용자들은 상황에 맞는 적절한 카드와 혜택을 알기 힘들고, 여러 개의 신용카드를 복합적으로 사용함으로써 통합된 사용내역의 정확한 인지가 어려워 과소비를 조장할 수 있다는 문제점을 가지고 있다. 따라서 본 연구는 서비스 디자인 방법론을 통하여 이러한 문제점을 해소할 수 있는 모바일 애플리케이션(mobile application)을 제안하는 데 목적이 있다. 연구 목적 달성을 위해 더블 다이아몬드 디자인 프로세스 모델(the double diamond design process model)을 기반으로 한 4D 방법론을 적용하였다. Discover와 Define 단계에서 사용자들이 여러 개의 신용카드를 사용하는 가장 큰 이유는 다양한 혜택과 부가서비스를 누리기 위함이며, 카드 사용 시 느끼는 불편함보다 혜택을 더 크게 생각한다는 것을 알 수 있었다. 이러한 결과를 바탕으로 Develop 단계에서 사용자 니즈(needs)에 맞는 서비스콘셉트(service concept)를 도출하였다. 위치 파악 기술인 비콘(beacon)과 이미지 처리 알고리즘 중 모델 기법을 적용하여 특정 장소에 갔을 때 상황에 맞는 혜택을 쉽고 빠르게 누리고, 맞는 카드가 없다면 적절한 카드를 제안하여 사용자가 맞는 카드를 사용할 수 있는 모바일 애플리케이션을 제안하였다. 본 연구에는 결제 시스템이 포함되어 있지 않아 결제 시스템이 구축된 후속 연구가 필요하며 개인 정보 유출 등의 문제로 정보사용의 제한이 많아 빅데이터 활용에 어려움이 있을 수 있으나, 사용자들은 이 서비스를 통하여 상황에 맞는 혜택 카드를 쉽게 알 수 있고 소지한 신용카드의 전체 사용내역을 한 눈에 확인할 수 있기 때문에 신용카드 사용성이 올라갈 것으로 기대된다. 또한 본 연구는 기존 프로세스의 효율화뿐만 아니라, 금융과 IT산업의 융합이라는 사업모델 혁신을 통한 새로운 가치를 창출하는데 의의가 있다. Recently, due to the increase in credit card usage, its possession and number of used credit cards has gradually increased. Credit card users have hard time finding the appropriate cards and benefits at the right time and through use of multiple cards, users are unaware of the accurate combined usage, which could lead to excessive consumption. Therefore, the purpose of this research is to propose a mobile application that solve problems through service design methodology. In order to pursuit/achieve the purpose of this research, we applied 4D method based on the double diamond design process model. In Discover and Define stage, it shows the biggest reason that people use several cards are to receive various benefits and additional services. Also, the value of benefits is more important to credit card holders rather than the inconvenience. Based on these results, the service concept that accord with users’ needs is the outcome in the Develop stage. This research suggests the mobile application that recommends personalized benefits or cards in any situations to people so consumers can enjoy their lives by using image recognition algorithm and beacon to attract attention to a specific location. Through this service, usability of the credit card will increase. For future research, this application should provide secure and safe electronic payment system that can prevent the leak of the private information even if there are meticulous internal access policies and procedures of using Big Data. This study is not only presenting efficiency of the existing process but also converging finance and IT industry to create a new value of innovative business model.