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경도인지장애에서 추체외로 증상과 영역별 인지기능 저하 :A Clinical Research Center for Dementia of South Korea (CREDOS) Study
박진홍(Jin Hong Park),명우재(Woojae Myung),최준배(Junbae Choi),김상하(Sangha Kim),강효신(Hyo Shin Kang),나덕렬(Duk L. Na),김성윤(Seong Yoon Kim),이재홍(Jae-Hong Lee),한설희(Seol-Heui Han),최성혜(Seong Hye Choi),김상윤(SangYun Kim),김도 대한노인정신의학회 2015 노인정신의학 Vol.19 No.2
Objective:This study investigated the association between extrapyramidal signs (EPS) and five cognitive sub-domains in a large number of patients with mild cognitive impairment (MCI). Methods:Our analyses considered 1,943 patients with MCI drawn from the nationwide Clinical Research of Dementia of South Korea study. EPS were defined as presence in patients with at least 1 of 11 operationally specified features. We assessed five cognitive sub-domains : attention, language, visuospatial function, memory, and frontal/executive function using the Seoul Neuro-psychological Screening Battery-Dementia version. The associations of EPS with each cognitive sub-domain were analyzed with a multiple linear regression model after controlling for confounding factors : sex, age, education years, diabetes, hypertension, sever-ity of global function, depressive symptoms, and white matter hyperintensities (WMH). Results:138 MCI patients (7.1%) had EPS. This group had more global cognitive deterioration and severe WMH. MCI pa-tients with EPS showed lower performance compared to those without EPS in 3 cognitive sub-domains: attention (p=0.05), vi-suospatial function (p=0.02), and frontal/executive function (p<0.0001). The language sub-domain and the memory sub-domain did not differ between the EPS positive and the EPS negative groups. Conclusion:EPS in MCI are associated with greater cognitive impairment in specific functional sub-domains rather than with global greater cognitive deterioration.
알츠하이머 치매 환자에서의 추체외로 증상과 영역별 인지기능의 연관성
최준배(Junbae Choi),명우재(Woojae Myung),송지혜(Jihye Song),김상하(Sang Ha Kim),윤혜연(Hyeyeon Yoon),강효신(Hyo Shin Kang),나덕렬(Duk L. Na),김성윤(Seong Yoon Kim),이재홍(Jae-Hong Lee),한설희(Seol-Heui Han),최성혜(Seong Hye Choi),김상윤 대한노인정신의학회 2013 노인정신의학 Vol.17 No.1
Objectives:We aimed to investigate the prevalence of Extrapyramidal signs (EPS) and the associations between EPS and cognitive subdomains in patients with Alzheimer disease (AD). Methods:We recruited 1,324 patients with AD from the Clinical Research of Dementia of South Korea (CREDOS), a hospital based cohort study with fifty-six participating hospitals. We estimated cognitive subdomain using the Seoul Neuropsychological Screening Battery-Dementia version (SNSB-D). Dementia severity was measured by Clinical Dementia Rating Sum of Boxes (CDR- SB) and Korean version of Mini-Mental Status Examination (K-MMSE). The EPS group was defined by the presence of at least one EPS based on a focused neurologic examination. Results:The prevalence of patients with EPS was 11%. These had higher CDR-SB scores than non-EPS group. After controlling for demographic, radiological, and dementia severity (CDR-SB) factors, EPS group showed lower cognitive ability in the subdomains for visuospatial and frontal-executive function than non-EPS group. The patients with EPS were showed significantly higher scores in the subdomain for memory function. Conclusion:The presence of EPSs in patients with AD was associated with lower visuospatial, frontal-executive function and higher memory function.
경도인지장애에서 성별에 따라 교육 성취도가 영역별 인지기능에 미치는 영향
이춘수(Chunsoo Lee),명우재(Woojae Myung),이경상(Kyung Sang Lee),이준노(Jun Ro Lee),강효신(Hyo Shin Kang),임신원(Shin Won Lim),나덕렬(Duk L. Na),김성윤(Seong Yoon Kim),이재홍(Jae-Hong Lee),한설희(Seol-Heui Han),최성혜(Seong Hye Choi) 대한노인정신의학회 2016 노인정신의학 Vol.20 No.2
Objective:This study aimed to find the sex differences of the way how educational attainment influence on cognitive function in the mild cognitive impairment patients. Methods:A total of 1,704 patients were recruited from a large hospital-based multi-center cohort. Cognitive subdomains were evaluated using the Seoul Neuropsychological Screening Battery-Dementia version. We employed multiple linear regression analysis to compare the score of cognitive subdomains between the groups with high versus low educational attainment based on the high school graduate. Interaction between educational attainment and sex was also included in the analysis Results:High and low educational attainment group had 41.2% and 58.8% of patients in the study population. In the multiple regression analysis, score of all cognitive subdomains were significantly higher in the high educational attainment group. The score of attention, language, and visuospatial function were also significantly affected by interaction between educational attainment and sex. Conclusion:In the female patients, educational attainment showed higher influence on the attention, language, and visuospatial function score.
김진영(Jinyoung Kim),김상하(Sangha Kim),명우재(Woojae Myung),강효신(Hyo Shin Kang),나덕렬(Duk L. Na),김성윤(Seong Yoon Kim),이재홍(Jae-Hong Lee),한설희(Seol-Heui Han),최성혜(Seong Hye Choi),김상윤(Sang Yun Kim),김도관(Doh Kwan Kim) 대한노인정신의학회 2014 노인정신의학 Vol.18 No.2
Objective:Patients with mild cognitive impairment (MCI) are at high risk for dementia. Excessive alcohol consumption is known to adversely affect cognitive function. This study aimed to investigate the relationship between alcohol consumption and the risk for dementia in a cohort of MCI patients. Methods:Participants (n=416) with (MCI) who met Petersen’s criteria were recruited from a nationwide, prospective cohort study of dementia and were followed for a median of 17.52 months (range 5.4-63.48). Alcohol consumption was evaluated at baseline. Results:One hundred twenty seven individuals (30.5%) developed incident dementia (115 Alzheimer disease) during follow-up. Patients with current alcohol consumption at baseline had a higher rate of progression to Alzheimer’s dementia than those without current alcohol consumption (hazard ratio 1.61 ; 95% confidence interval 1.03 to 2.53). Conclusion:Alcohol consumption may increase the risk of progression to Alzheimer’s dementia in patients with MCI.
알츠하이머 치매 환자에서의 인지영역별 기능과 병식과의 연관성
김영돈(Youngdon Kim),김상하(Sang Ha Kim),명우재(Woojae Myung),최준배(Junbae Choi),윤혜연(Hyeyeon Yoon),강효신(Hyo Shin Kang),나덕렬(Duk L. Na),김성윤(Seong Yoon Kim),이재홍(Jae-Hong Lee),한설희(Seol-Heui Han),최성혜(Seong Hye Choi),김 대한노인정신의학회 2014 노인정신의학 Vol.18 No.2
Objective:The aim of this study was to investigate the association between cognitive subdomains and insight into one’s cognitive impairment in patients with Alzheimer disease (AD). Methods:We recruited 1,722 patients with AD from the Clinical Research of Dementia of South Korea study and designed a cross-sectional study. Each patient’s cognitive subdomain was assessed by using the Seoul Neuropsychological Screening Battery-Dementia version. Severity of dementia was evaluated by Korean version of Mini-Mental Status Examination (K-MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SB). Insight into one’s cognitive impairment was categorized as ‘with insight’ and ‘without insight’ through interview with patient’s caregivers. Results:Among the 1,722 patients with AD, 1,475 patients were included in the ‘with insight’ group and the remaining 247 patients were included in the ‘without insight’ group. Subjects in the ‘without insight’ group had lower K-MMSE and CDR-SB scores than those in the ‘with insight’ group. After controlling for demographic data and dementia severity, higher scores on both attention function (odds ratio=1.12, 95% confidence interval : 1.03-1.21) and frontal-executive function (odds ratio=1.03, 95% confidence interval : 1.01-1.05) significantly predicted the membership to ‘with insight’ group. Conclusion:In patients with AD, attention and frontal-executive function were associated with insight into one’s cognitive impairment.
공황 발작으로 인한 응급실 내원과 대기 오염의 연관성 : 시간-층화 환자-교차 연구
문영경(Young Kyung Moon),이원윤(Wonyun Lee),오세현(Sehhyun Oh),김호(Ho Kim),명우재(Woojae Myung),이혜원(Hyewon Lee),김도관(Doh Kwan Kim) 대한신경정신의학회 2021 신경정신의학 Vol.60 No.3
Objectives This study investigates the association between short-term exposure to air pollutants and panic attacks requiring emergency department (ED) visits. Methods We identified 1926 patients who visited EDs in Seoul with panic attacks as the primary cause during the period from 2008 to 2014. We estimated short-term exposure to particles <2.5 μm (PM2.5), particles <10 μm (PM10), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), ozone (O₃), and carbon monoxide (CO). We applied a time-stratified case-crossover study design and conducted a conditional logistic regression analysis to assess the association between air pollutants levels and ED visits due to panic attacks. Results Increasing O₃ concentration was significantly associated with an increased risk of panic attacks requiring ED visits (odds ratio: 1.15; 95% confidence interval: 1.04-1.27) on the same day of exposure. This association was robust to the sensitivity analysis using two pollutant models. Conclusion Our results show that short-term exposure to elevated O₃ concentration is associated with the exacerbation of panic attacks. This finding strongly suggests the detrimental effects of O₃ on major public health problems and provides insights for further research to investigate the causal associations between air pollution and poor mental health.