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치매 환자에서 뇌 자기공명영상의 특징과 비정형 항정신병 약제 사용여부의 상관 관계
최종택,김지원,노양호,류석환,우성일,한상우,황재욱,Choi, Jongtaek,Kim, Jiwon,Roh, Yangho,Rhu, Sukhwan,Woo, Sungil,Hahn, Sangwoo,Hwang, Jaeuk 대한생물정신의학회 2013 생물정신의학 Vol.20 No.3
Objectives We aimed to identify the neuroimaging marker for prediction of the use of atypical antipsychotics (AAP) in dementia patients. Methods From April 2010 to March 2013, 31 patients who were diagnosed as dementia at the psychiatric department of Soonchunhyang University Hospital, completed the brain magnetic resonance imaging scan and cognitive test for dementia. Ten patients were treated with AAP for the improvement of behavioral and psychological symptoms of dementia (BPSD) and the other 21patients were not. Using T1 weighted and Fluid Attenuated Inversion Recovery (FLAIR) images of brain, areas of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF) and white matter hyperintensities (WMH) have been segmented and measured. Multivariate logistic regression models were applied for assessment of association between AAP use and the GM/WM ratio, the WMH/whole brain (GM + WM + CSF) ratio. Results There was a significant association between AAP use and the GM/WM ratio (odds ratio, OR = 1.18, 95% confidence interval, CI 1.01-1.38, p = 0.037), while there was no association between AAP use and the WMH/whole brain ratio (OR = 0.82, 95% CI 0.27-2.48, p = 0.73). Conclusions The GM/WM ratio could be a biological marker for the prediction of AAP use and BPSD in patients with dementia. It was more likely to increase as dementia progress since atrophy of WM was more prominent than that of GM over aging.
양극성 장애, 조증 삽화 입원 환자에서 조증 증상 경과 예측과 관련있는 임상 변인 연구
김채리(Chae-Ri Kim),박진완(Jin-Wan Park),백두현(Doo-Hyun Pak),이연정(Yeon-Jung Lee),한상우(Sang Woo Hahn),우성일(Sungil Woo),황재욱(Jaeuk Hwang) 대한생물치료정신의학회 2017 생물치료정신의학 Vol.23 No.3
Objectives:This study was aimed to investigate clinical factors associated with the prediction of symptom improvement in hospitalized patients with bipolar disorder, manic episode. Methods:We performed a retrospective observational study based on the medical records review of 53 bipolar disorder manic patients, who had been hospitalized in the psychiatric ward. During the hospitalization, Young Mania Rating Scales(YMRS) have been measured periodically. Demographic information and clinical characteristics including medications and history of prior hospitalization have been collected in each patient. Linear mixed effect model has been used to assess the effect of clinical factors on the changes of YMRS over time. Selection of clinical factors was conducted using backward elimination with the minimization of Akaike Information Criterion. Results:Mean days of hospitalization were 29.74±16.96. Mean YMRS at the admission was 33.64±7.57. Effective factors for the model included YMRS at baseline, combination of mood stabilizer, and the history of prior hospitalization. Predicted YMRS at the discharge was 10.43(95% confidence interval 7.13–13.72). Conclusion:The current findings suggest the model which may predict the clinical course of the bipolar disorder manic patients. It would be useful to establish the treatment plan for the patients.
경도인지장애와 치매 환자에서 숫자 거꾸로 따라하기로 측정한 작업기억에 대한 우울증의 영향
노양호(Yang-Ho Roh),김민재(Min-Jea Kim),김채리(Chae-Ri Kim),박진완(Jin-Wan Park),이연정(Yeon-Jung Lee),우성일(Sungil Woo),한상우(Sang Woo Hahn),황재욱(Jaeuk Hwang) 대한노인정신의학회 2015 노인정신의학 Vol.19 No.2
Objective:We aimed to explore the influence of depression on working memory in patients with mild cognitive impairment (MCI) and dementia. Methods:Clinical and neuropsychological data of 43 subjects with mild cognitive impairment (MCI) (n=17) and dementia (n= 26) who had visited Department of Psychiatry at Soonchunhyang University Seoul Hospital, were collected. The subjects were di-vided into depressed (n=18) and non-depressed (n=25) groups based on the Korean version of Short Geriatric Depression Scale. Two-way analysis of variance test was conducted to evaluate the influence of diagnosis (MCI and dementia), the presence of depres-sion and their interaction on working memory which was measured by digit forward and backward span test. Results:Among the patients with MCI, test score of digit backward span test in depressed group was significantly lower than in non-depressed group. However, among the patients with dementia, there was no significant difference in digit backward span test between depressed and non-depressed groups. Conclusion:This study suggests that the depression could deteriorate working memory measured by digit backward span test in patients with MCI, relative to in patients with dementia and it also implicates the diagnostic assessment for depression has clinically importance in patients with MCI.