노인정신장애 평가척도(Psychogeriatric Assessment Scale)의 한국판 표준화 연구

조맹제,박임순,신영민,김무진,정희연,정은기,최용성,조성진,서국희,함봉진 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.1

연구목적 : 본 연구는 치매와 우울증을 다차원적으로 평가할 수 있는 도구인 Psychogeriatric Assessment Scale(PAS)의 한국판(PAS-K)을 개발하기 위한 것이다. 방 법 : 번역, 역번역, 그리고 세차례의 예비조사를 통하여 PAS-K를 제작하였다. 60세 이상의 노인 291명(임상환자군 : 58명, 지역사회노인군 : 168명, 수용시설 거주자 : 67명)과 그들의 정보제공자들을 대상으로 PAS-K, Geriatric Depression Scale(GDS), Korean version of Mini-Mental State Examination(MMSE-K), Hamilton Rating Scale for Depression(HRSD), 그리고 Hachinski Ischemic Score 를 적용하고, Diagnostic Interview chedule(DIS-Ⅲ-R)을 사용하여 치매와 우울증을 진단하였다. PAS-K의 신뢰도와 타당도를 평가하고, 예민도와 특이도, Kappa값, 그리고 ROC커브 분석법을 이용하여 PAS-K의 6개의 소척도들(피검자면접 : 인지기능 장애척도, 우울척도, 뇌졸중척도, 정보제공자면접 : 인지기능 저하척도, 행동변화척도, 뇌졸중척도)의 최적 절단점을 구하였다. 결 과 : PAS-K는 높은 내적 일관성을 보였고, 검사자간 신뢰도도 만족할 만한 수준이었다. PAS-K의 소척도들을 다른 표준화된 검사도구들과 비교하였을 때 인지기능 장애척도와 인지기능 저하척도는 MMSE-K와, 우울척도는 GDS 및 HRSD와 유의한 상관관계를 보였으며, 뇌졸중척도는 Hachinski Ischemic Score와 통계적으로 의미있는 상관관계를 보였다. 최적절단점은 인지기능 장애척도 10점, 인지기능 저하척도 3점, 우울척도 5점, 피검자면접과 정보제공자 뇌졸중척도 모두 1점, 그리고 행동변화척도 2점으로 추정하였다. 결 론 : 본 연구를 통해 PAS-K의 신뢰도와 타당도가 검증되었고, 노인정신의학 역학연구나 보건분야에서 치매와 우울증의 임상경과관찰 및 일차 선별도구로서 유용하게 사용될 수 있게 되었다. Objectives : This study was designed to develop the Korean version of the Psychogeriatric Assessment Scale(PAS-K), a multidimensional screening tool for the dementia and depression. Methods : Through three times preliminary trials, the authors translated PAS into Korean. The PAS-K, Geriatric Depression Scale, Hamilton Depression Rating Scale, Hachinski Ischemic Scale and Mini-Mental State Examination-Korean version were administered to 291 subjects over the age of 60 and the same number of their informants(67 subjects were institutionalized, 168 subjects were in community, 58 subjects were psychiatric hospital patients). And the Diagnostic Interview Schedule(DSM-Ⅲ-R) was independently administered to exactly diagnose dementia and depression. The reliability and validity test, optimal cut-off point estimation for six each scale and ROC curve analyses were done to investigate the diagnostic validity of PAS-K. Results : Internal consistency and interrater reliability of the PAS-K were high. Concurrent validity of each scales of PAS-K was good in being measured with other standardized scales. The optimal cut-off points of each scale of the PAS-K were estimated as follows : 1) Stroke Scale of subject interview : 1, 2) Cognitive Impairment Scale of subject interview: 10, 3) Depression Scale of subject interview : 5, 4) Stroke Scale of informant interview : 1, 5) Cognitive Decline Scale of informant interview : 3, and 6) Behavioral Change Scale of informant : 2. conclusions : The PAS-K was valid and reliable screening tools for detecting dementia and depression. Therefore the PAS-K could be widely and extensively used in psychogeriatric epidemiological research or clinical setting of primary screening for dementia and depression.

하악과두의 인위적 병소에 대한 악관절 촬영법의 판독능 비교연구

조봉혜,정연화,정희정 大韓口腔顎顔面放射線學會 1997 Imaging Science in Dentistry Vol.27 No.2

The purpose of this study was to evaluate the detectability of various radiographic techniques for mandibular condylar lesions. Erowive lesion, osteophyte and flattening were formed on the artificial mandibular condyle, and panoramic, transcranial, transorbital radiography, lateral and frontal tomography were taken. The results were as follows; 1. The detectability for erosive lesions was superior in the order of frontal tomography(96%), lateral tomo-graphy (78%),transorbital(59%), transcranial(56%) and panoramic(48%)radiography. 2. The location of erosive lesion that showed the highest detectability was the medial third in panoramic, the lateral third in transcranial, the central portion of anteroposterior direction in transorbital, the central portion of mediolateral direction and the posterior third in lateral tomography. Frontal tomography disclosed all erosive lesions except one anterolateral lesion. 3. The detectability of osteophyte was 100% in lateral tomography, 78% in transcranial and 56% in panoramic radiography. 4. For flattening, lateral tomography showed the flattened condyle, but both panoramic and transcranial views showed only decreased bone density without the change of condylar shape.

두경부 림프관종의 증례보고

정연화,조봉혜,나경수 대한구강악안면방사선학회 2000 Imaging Science in Dentistry Vol.30 No.1

Lymphangiomas are uncommon benign congenital tumors. Most occur in the head and neck and most lesions present by the age of 2 years. We present our experience with four patients who have iymphangiomas of the head and neck with tongue involvement. First case is a 7-year-old male who has the cystic iymphangioma of left submandibular area. Second a 22-year-old female has a lesion involving the border outright tongue. Third case is the iymphangioma which occurs in the right upper lip of a 6-year old male. The last patient is a 28-year old male who fell down and whose right face was swollen up. He had undergone an operation and been treated with steroid before. The characteristic appearances of imaging methods were described and all lesions best depicted on T2-weighted images. Our experience indicates that MRI is useful in the diagnosis and treatment planning of iymphangioma. (Korean J Oral Maxillofac Radiol 2000; 30: 87-91)

주변성 거대세포 육아종의 증례보고

정연화,조봉혜,나경수,김성수 大韓口腔顎顔面放射線學會 1997 Imaging Science in Dentistry Vol.27 No.2

The authors experienced one case of peripheral giant cell granuloma occurred at the gingiva of right maxillary molar in a 12-year-old male patient. The lesion showed amorphous calcification within soft tissue mass which made difficult to differentiate this lesion from peripheral ossifying fibroma and peripheral odontogenic fibroma clinically and radiographically. The final diagnosis was made histologically.

측두하악관절 내장 환자의 관절원판과 관절원판 후조직의 자기공명영상 신호강도

정연화,조봉혜 대한구강악안면방사선학회 2001 Imaging Science in Dentistry Vol.31 No.2

Purpose : To analyze the possible association between magnetic resonance imaging signal intensity of temporomandibular joint disk and posterior attachment, and the type and extent of disk displacement, disk configuration, effusion and clinical signs in patients with internal derangement. Materials and Methods : Magnetic resonance images of the 132 temporomandibular joints of 66 patients with temporomandibular joint displacement were analyzed. The clinical findings were obtained by retrospective review of the patients' records. The type and extent of disk displacement, disk configuration and effusion were evaluated on the proton density MR images. The signal intensity from the anterior band, posterior band and posterior attachment were measured on MR images. The associations between the type and extent of disk displacement, disk configuration, effusion and clinical signs and the MR signal intensity of disk and posterior attachment were statistically analyzed by student's t-test. Results : Of 132 joints, 87 (65.9%) showed anterior disk displacement with reduction (ADR) and 45 (34.1%) showed anterior disk displacement without reduction (ADnR). The signals from posterior attachments were lower in joints with ADnR than those of ADR (p〈 0.05). The results showed statistically significant (p〈 0.05) association between the type and extent of disk displacement and disk configuration, and decreased signal intensity of posterior attachment. There were no statistical associations between pain, noise and limited mouth opening, and signal intensity of disk and posterior attachment. Conclusions : The average signal from posterior attachment was lower in joints with ADnR than that of ADR. The type and extent of disk displacement and disk configuration appeared to be correlated with the signal intensity from posterior attachment. (Korean J Oral Maxillofac Radiol 2001;31:93-9)

하악 비대칭의 방사선학적 연구

정연화,조봉혜 大韓口腔顎顔面 放射線學會 1998 Imaging Science in Dentistry Vol.28 No.1

The purpose of this study was to perform the radiographic measurements and temporomandibular joint evaluation in mandibular asymmetry. For this study, thirty-two patients who have mandibular asymmetry were selected and submentovertex, panoramic and lateral corrected tomographic radiographs were taken. Horizontal and vertical analysis using various landmarks on these radiographs were performed. Also radiographic and clinical evaluation of temporomandibular joint were obtained. The results were as follows; 1. On the submentovertex radiograph, the mean distance of Pogonion to midline was 5.0±3.8mm. 2. The mean distance of Pogonion to Gonion was 100.6±9.2mm in deviated side and 104.3±9.1mm in contra-lateral side, and there was a significant difference between the deviated and the contra-lateral side(p<0.001). 3. The distance difference of Pogonion to Gonion between the deviated and the contra-lateral side was significantly related to the degree of asymmetry(p<0.001). 4. On panoramic radiograph, the condylar height of the contra-lateral side was significantly longer than the one of the deviated side(p<0.001). 5. On lateral corrected tomogram, bony changes of temporomandibular joint were observed in 11 condyles of the deviated side and 9 condyles of the contra-lateral side. Erosion and osteophyte were the most common changes in both the deviated and the contra-lateral sides.

오니토 제거 공사에 의한 한강 수질 개선에 관한 연구

이찬열,조봉연 동국대학교 산업기술연구원 2000 산업기술논문집 Vol.11 No.2

한강은 수질개선 및 홍수방지의 목적으로 1982년에 "한강종합개발사업"을 시작으로 하구개선, 하수처리장 및 분류 하수관거 건설, 한강주변 도로 건설이 1986년 완성되어 도시 미관뿐만 아니라 수질도 어느 정도 개선되었다. 그런, 현재에 이르러 한강상류에서 홍수시 떠내려온 각종 토사와, 부영양화의 오염원인 질소, 인등을 포함한 오염 물질들의 퇴적과 이동에 따른 수질악화가 현저하게 나타나고 있는 실정이다. 이에 따라 서울시는 1993년에 '한강하류 수질 보전 대책수립'을 세워 상수원 보호구역인 잠실 수중보에서 오니 준설사업을 실시하였다. 특히 각 지천 하구의 퇴적된 오니토가 부영양화와 녹조 발생 등 수질을 악화시킴에 따라, 매년 한강 본류에 악영향을 끼치는 각 지천의 오니토 제거를 병행하여 한강 오니토 제거공사를 해오고 있다. 그 결과 저질의 오염도는 개선되었다. 즉, 수질개선을 위해 지속적인 준설 작업을 시행하고, 보다 근본적이고 장기적인 차원의 수질 보전과 관리 대책이 강구되어야 할 것이다. 또한, 수질개선을 위해, 오염원을 사전에 예방하여야 하며, 또한 하수처리시설 확충 및 처리방법 개선 등을 통한 처리효율을 향상시켜야 한다. Since in 1986, the water quality of the Han river has been improved after finishing the integral development project of the Han river started in 1982. The propose of this project was to keep good water quality and prevent flood by improvement of the couth of a river, sewage treatment works, separate sewage line construction and road construction around the Han river. However, the water quality of the Han river is now getting worse due to lots of earth and sand coming from the upper stream during flood and water pollutants including nitrogen and phosphorus, known as source of eutrophication. The city of Seoul, therefore, established the preservation measures for the water qualities in the downstream of the Han river. After performing polluted mud dredge project at Chamshil's underwater beam, which is in water supply facilities, the bottom water quality became better. To improve the water quality of the Han river, it is necessary to establish systematic strategies for the water preservation. The basic strategy is to directly prevent the pollutant emission from the sources and increase the treatment efficiency in terms of the construction of sewage works at several locations as well as the improvement of treatment method.

生物膜 ?過裝置에 의한 下水處理에 관한 硏究

姜龍太,全裕燦,趙奉衍 東亞大學校 1986 東亞論叢 Vol.23 No.1

This study, through the filtration experiment by biofilm, was explained the operation for each processes in its system, and were investigated the actual(filtration experiment by biofilm) applicational propriety for the existing headloss quation and the correlation of factors. The results of the experiment are the following. 1. When the raw water quality was reached to standars of the treated water quality in about a week, the average removal rates of SS, BOD and COD were 92%, 91% and 74%, respectively. 2. In case that the experimental conditions were water quantity, 0.67㎥/day, BOD 100㎎/ℓ, oxygen absorption efficiency, 16%, air quantity was 15N㎥ and showed high BOD removal rate. 3. The backwashing water quantity was required the twice or the three times of the packed volume. 4. When thd BOD loading was less then 5 ㎏/㎥·day, the BOD removal rate showed more than 95%. 5. The headloss of this experiment was approximated to the value obtained from substiting the filtration Model Ⅰ for the Kang's headloss equation corrected for the Kozeny-Carman's.

나선형 이중 평행판 축전기형 Blumlein 전송회로를 사용한 소형 질소레이저의 동작 특성 연구

양준묵,이치원,조돈수,이봉연 충남대학교 기초과학연구소 1995 忠南科學硏究誌 Vol.22 No.1

The design and performance of a compact nitrogen laser which consists of a Spiral multiple parallel plate capacitor type Blumlein transmission line circuit are described. The laser tube is made by 50 ㎜ long with a 2.5 ㎜ main electrode gap spacing. The output power increased with the spark gap distance. The peak power of 3.0 μJ has been obtained with a spark gap distance of 3.5 ㎜ and a repetition rate of 30㎐. The optimum nitrogen gas pressure was about 60torr independent of the variation of spark gap distance. The laser operates with repetition rate of up to 70 ㎐.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.