Factors Associated with Caregiver Burden in Patients with Alzheimer’s Disease

HyoShin Kang,Woojae Myung,Duk L. Na,Seong Yoon Kim,JaeHong Lee,SeolHeui Han,SeongHye Choi,SangYun Kim,Seonwoo Kim,DohKwan Kim 대한신경정신의학회 2004 PSYCHIATRY INVESTIGATION Vol.1 No.2

Objective-Caregivers for patients with Alzheimer’s disease (AD) suffer from psychological and financial burdens. However, the results of the relationship between burden and cognitive function, performance of activities of daily living, and depressive symptoms have remained inconsistent. Therefore, the aim of this study was to examine which factors are more significant predictors of heightened burden, cognitive impairment or functional decline, besides neuropsychiatric symptoms. Methods-A cross-sectional study was conducted in a sample comprised of 1,164 pairs of patients with AD and caregivers from the Clinical Research of Dementia of South Korea study cohorts. The cognitive function of each sub-domain, functional impairments, depressive symptoms, and caregiver burden were assessed using the dementia version of Seoul Neuropsychological Screening Battery (SNSB-D), Barthel Index for Daily Living Activities (ADL), Seoul-Instrumental Activities of Daily Living (S-IADL), the Clinical Dementia Rating Sum of Box (CDR-SB), the Global Deterioration Scale (GDS), the Korean version of the Neuropsychiatric Inventory (K-NPI), and the 15-item Geriatric Depression Scale. Results-We found that higher severity (higher CDR-SB and GDS scores) and more functional impairment (lower ADL and higher SIADL scores) were significantly associated with higher caregiver burden. In addition, depressive symptoms of patients (higher Geriatric Depression Scale scores) were associated with higher caregiver burden. Conclusion-Therefore, interventions to help maintain activities of daily living in patients with AD may alleviate caregiver burden and improve caregiver well-being.

Factors Associated with Caregiver Burden in Dementia: 1-Year Follow-Up Study

SangHong Shim,HyoShin Kang,JiHae Kim,DohKwan Kim 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.1

Objective-Dementia symptoms (cognitive function, daily-living function, and neuropsychiatric symptoms) become more serious over time, which is likely to increase caregiver burden. The aim of this study is to investigate which dementia-related symptoms, and how the progression of these symptoms, have influenced caregiver burden during a 1-year follow-up assessment. Methods-A total of 110 patients with dementia were assessed for their cognitive function, daily-living function, and neuropsychiatric symptoms. Caregivers were assessed for their caregiver burden. Bivariate analyses were conducted between caregiver burden and dementia patients’ symptoms, in order to examine which particular symptoms were significantly associated with caregiver burden at the baseline. A multiple regression analysis was then conducted with each significantly associated variable with a view to identifying determinants, influencing caregiver burden. Additionally, bivariate analyses were conducted between the changes in caregiver burden and the changes in patients’ symptoms, to investigate which patient variable could best describe caregiver burden from baseline to the 1-year follow-up. A multiple regression analysis was conducted with each significantly-associated change in symptom, in order to identify determinants that influence a change in caregiver burden. Results-Neuropsychiatric symptoms, such as irritability, aberrant motor-behavior, delusions and disinhibition were found to be significant predictors of caregiver burden at baseline, according to multiple regression analysis. In addition, changes in neuropsychiatric symptoms, such as delusions, agitation and memory-related functioning in daily-living significantly predict a change in caregiver burden. Conclusion-Our results demonstrate that neuropsychiatric symptoms and memory impairment in daily-living functions are significant predictors of an increase in caregiver burden.

우울증상이 노년기 신경인지장애 환자의 인지기능 및 일상생활 기능에 미치는 영향 : 심각도에 따른 집단비교

김서유(Kim, Seoyoo),강효신(Kang, Hyoshin) 한국재활심리학회 2021 재활심리연구 Vol.28 No.1

노년기의 대표적 정신질환인 신경인지장애는 만성적이고 진행성 양상을 보이며, 노년기 우울증은 신경인지장애와 밀접한 관련이 있다. 이에 본 연구에서는 신경인지장애의 심각도에 따라 우울증상이 인지기능과 일상생활 기능에 미치는 영향을 알아보고자 하였다. 부산소재 종합병원에 내원하여 주요 또는 경도 신경인지장애 진단을 받은 환자 407명에게 신경심리검사를 실시하였으며, 신경인지장애의 심각도를 구분하기 위하여 임상 치매 평가 척도(Clinical Dementia Rating: CDR) 점수에 따라 0.5, 1, 2, 세 집단으로 나누었다. 연구 결과, 신경인지장애의 심각도가 클수록 우울증상이 인지기능에 미치는 영향은 적은 것으로 나타났다. CDR 0.5 집단에서는 우울증상이 있는 경우 인지기능 총점, 시공간 기능 및 전두엽/집행 기능에서 저하를 보였으며, CDR 1 집단에서는 숫자 바로 따라 말하기 소검사에서 저조한 수행을 보였다. 반면, CDR 2 집단에서는 유의한 차이를 보이지 않았다. 일상생활 기능에서도 인지기능에서와 마찬가지로 신경인지장애의 심각도가 높을수록 우울증상이 미치는 영향이 감소하였다. 본 연구를 통해 노년기 신경인지장애 환자의 우울증상이 인지기능과 일상생활 기능에 미치는 영향이 질병의 심각도에 따라 차이가 있음을 확인하였으며, 이는 향후 우울증상을 보이는 신경인지장애 환자의 치료적 개입에 도움이 될 것이라 기대한다. This study investigated the effects of depression on cognitive function and daily living ability in older adults according to the severity of neurocognitive disorder. Participants were 407 elderly patients diagnosed with mild to severe neurocognitive disorder. Clinical Dementia Ratings were divided into 0.5, 1, and 2 groups to analyze whether there was a difference in cognitive function and daily living ability according to the presence or absence of depression. The results indicated that the more severe the neurocognitive disorder, the less depression affected cognitive function or daily living ability. This study confirmed that the effects of depression on cognitive function and daily living ability in elderly patients with neurocognitive disorder differ according to disease severity.

Additional Value of Metagenomic Sequencing in Diagnosis of Ventilatorassociated Pneumonia

( Ha Won Hwang ),( Jinwoo Lee ),( Hyoshin Son ),( Chang Kyung Kang ),( Hong Yeul Lee ),( Sang-min Lee ),( Jangsup Moon ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Background Ventilator associated pneumonia (VAP) is associated with high mortality and morbidity. Unfortunately, conventional Methods often fail to identify the etiology of VAP and accurate microbial diagnosis remains difficult. As a result, broad-spectrum antimicrobial treatment is frequently used for long durations without clear evidence. We compared the use of nanoporebased metagenomic sequencing to conventional diagnostic Methods in the diagnosis of VAP. Method Patients who underwent bronchoscopy with suspicion of VAP between February 2020 and February 2021 in a medical intensive care unit of a university affiliated hospital were screened for analysis. There were 37 cases in which both the conventional diagnostic Methods and nanopore sequencing were performed using bronchial washing or bronchoalveolar lavage specimens. The nanopore sequencing Results were compared to the conventional diagnostic Methods. Results Among the 37 cases, conventional culture was positive in 12 cases and negative in 25 cases. In culture-positive cases, nanopore sequencing detected the same pathogen in 11 cases (concordance rate 91.7%). Nanopore sequencing did not detect S.maltophilia in 1 case. In culture-negative cases, nanopore sequencing also were negative in 6 cases and upper respiratory tract flora was detected in 5 cases (concordance rate 44%). Additional microbiological diagnosis was possible using nanopore in 14 cases. The additional microorganisms detected were E.faecium, A.baumanni, S,maltophilia, P.jirovecii, E.coli, S.aureus, L.pneumophilia, etc (table 1). Conclusion In patients with clinical suspicion of VAP, nanopore sequencing of bronchoscopic specimens showed high concordance rate with the conventional diagnostic Methods. In culture-negative cases, additional microbiologic diagnosis was also possible using nanopore sequencing.

동적전압보상장치에서의 울트라커패시터 동작 특성

권윤혁(Yoonhyeok Kwon),강진아(Jina Kang),최효신(Hyoshin Choi),박완기(Wanki Park) 대한전기학회 2006 대한전기학회 학술대회 논문집 Vol.2006 No.11

에너지저장소자로 커패시터를 이용하여 순간정전 또는 순간전압강하 방지의 목적으로 사용되는 동적전압보상장치(Dynamic Voltage Restorer)에 울트라커패시터를 적용/시험하였다. 이로부터 울트라커패시터의 적용가능성을 에너지저장소자들 간의 출력특성 관점에서 비교하였다.

Light quality affects shoot regeneration, cell division, and wood formation in elite clones of Populus euramericana

Kwon, A-Reum,Cui, Hae-Yeon,Lee, Hyoshin,Shin, Hanna,Kang, Kyu-Suk,Park, So-Young Springer-Verlag 2015 ACTA PHYSIOLOGIAE PLANTARUM Vol.37 No.3

Extrapyramidal Signs and Risk of Progression from Mild Cognitive Impairment to Dementia: A Clinical Research Center for Dementia of South Korea Study

Woojae Myung,JinHong Park,SookYoung Woo,Seonwoo Kim,SangHa Kim,JaeWon Chung,HyoShin Kang,ShinnWon Lim,Junbae Choi,Duk L. Na,SeongYoon Kim,JaeHong Lee,SeolHeui Han,SeongHye Choi,SangYun Kim,Bernard J. 대한신경정신의학회 2017 PSYCHIATRY INVESTIGATION Vol.14 No.6

Objective-Extrapyramidal signs (EPS) are common in patients with mild cognitive impairment (MCI). However, few studies have assessed the effect of EPS on the clinical course of MCI. We aimed to evaluate whether patients with EPS show more frequent progression from MCI to Alzheimer’s disease (AD) and to other types of dementia. Methods-Participants (n=882) with MCI were recruited, and were followed for up to 5 years. The EPS positive group was defined by the presence of at least one EPS based on a focused neurologic examination at baseline. Results-A total of 234 converted to dementia during the follow-up period. The risk of progression to AD was lower in the patients with EPS after adjusting for potential confounders [hazard ratio (HR)=0.70, 95% confidence interval (CI)=0.53-0.93, p=0.01]. In contrast, the patients with EPS had a six-fold elevated risk of progression to dementia other than AD (HR=6.33, 95%CI=2.30–17.39, p<0.001). Conclusion-EPS in patients with MCI is a strong risk factor for progression of MCI to non-Alzheimer dementia. The careful neurologic examination for EPS in patients with MCI can yield important clinical information for prognosis.

현사시나무 원형질체에서 리보핵산단백질을 활용한 유전자 교정 방법 연구

박수진(Su Jin Park),최영임(Young-Im Choi),장현아(Hyun A Jang),김상규(Sang-Gyu Kim),최현모(Hyunmo Choi),강범창(Beum-Chang Kang),이효신(Hyoshin Lee),배은경(Eun-Kyung Bae) 한국식물생명공학회 2021 JOURNAL OF PLANT BIOTECHNOLOGY Vol.48 No.1

Targeted genome editing using the CRISPR/Cas9 system is a ground-breaking technology that is being widely used to produce plants with useful traits. However, for woody plants, only a few successful attempts have been reported. These successes have used Agrobacterium-mediated transformation, which has been reported to be very efficient at producing genetically modified trees. Nonetheless, there are unresolved problems with plasmid sequences that remain in the plant genome. In this study, we demonstrated a DNA-free genome editing technique in which purified CRISPR/Cas9 ribonucleoproteins (RNPs) are delivered directly to the protoplasts of a hybrid poplar (Populus alba × Populus glandulosa). We designed three single-guide RNAs (sgRNAs) to target the stress-associated protein 1 gene (PagSAP1) in the hybrid poplar. Deep sequencing results showed that pre-assembled RNPs had a more efficient target mutagenesis insertion and deletion (indel) frequency than did non-assembled RNPs. Moreover, the RNP of sgRNA3 had a significantly higher editing efficacy than those of sgRNA1 and sgRNA2. Our results suggest that the CRISPR/Cas9 ribonucleoproteinmediated transfection approach is useful for the production of transgene-free genome-edited tree plants.