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        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.

      • 비·부비동에 발생한 모균증 : 3례보고

        최영석,진흥률,연제엽 충북대학교 의과대학 충북대학교 의학연구소 2005 忠北醫大學術誌 Vol.15 No.1

        Sinonasal mucormycosis is a form of invasive fungal infection of the sinonasal track that often extends to the orbit, brain, and palate. It is caused by the order Mucorales and commonly associated with immuconcompromised conditions such as diabetic ketoacidosis, HIV infection, hematologic malignancy. Treatment includes aggressive debridement, systemic antifungal therapy and control of underlying factors. We experienced 3 cases of sinonasal mucormycosis: rhino-orbital, isolated sphenoid sinus, palatal mucormycosis. Each patients had undergone wide surgical debridement including a case with orbital exenteration and systemic antifungal therapy. We present our successful management with literature reviews. 비·부비동에 발생하는 모균증은 안와, 두 개내, 또는 구개 침범이 흔한 진균성 감염이고 mucorales종의 일종으로 당뇨병케토산증이나 AIDS환자, 혈액 악성종양과 같이 면역이 저하된 환자에게서 주로 발생한다. 치료로는 환자의 원인 요소를 치료하고 광범위한 수술적 절제와 장기간의 항진균제의 사용이 이용되고 있지만 치료효과가 만족하지 못하다. 저자들은 안구를 침범하여 안구를 제거한 경우, 장기간의 두통을 호소한 환자에게서 발견된 접형동 단독의 감염 사례, 그리고 구개를 침범하여 구개의 일부를 절제한 사례를 경험하였고 광범위한 감염부위의 절제와 장기간의 항진균제 치료를 이용하여 완치하였기에 문헌 고찰과 함께 보고하고자 한다.

      • Contribution of stress and coping strategies to problematic Internet use in patients with schizophrenia spectrum disorders

        Lee, Ju-Yeon,Chung, Young-Chul,Song, Je-Heon,Lee, Yo-Han,Kim, Jae-Min,Shin, Il-Seon,Yoon, Jin-Sang,Kim, Sung-Wan Elsevier 2018 Comprehensive psychiatry Vol.87 No.-

        <P><B>Abstract</B></P> <P><B>Introduction</B></P> <P>Internet use is already high and increasing rapidly among people with psychotic disorders, but there have been few studies on problematic Internet use (PIU) among patients with schizophrenia spectrum disorders. This study aimed to measure the prevalence of PIU and identify the factors associated with PIU among patients with schizophrenia spectrum disorders.</P> <P><B>Methods</B></P> <P>A cross-sectional survey was performed that included 368 outpatients with schizophrenia spectrum disorders: 317 with schizophrenia, 22 with schizoaffective disorder, 9 with schizophreniform disorder, and 20 with other schizophrenia spectrum and psychotic disorders. The severity of psychotic symptoms and levels of personal and social functioning were assessed by the Clinician-rated Dimensions of Psychosis Symptom Severity (CRDPSS) scale and the Personal and Social Performance (PSP) scale, respectively. PIU was evaluated using Young's Internet Addiction Test (IAT). Additionally, the Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Rosenberg Selfesteem Scale (RSES), and Brief Coping Orientation to Problems Experienced (COPE) Inventory were administered.</P> <P><B>Results</B></P> <P>PIU was identified in 81 (22.0%) of the 368 patients with schizophrenia spectrum disorders. Subjects with PIU were significantly younger and more likely to be male. Scores on the HADS, PSS, and dysfunctional coping dimension of the Brief COPE Inventory were significantly higher, and RSES scores were significantly lower, in the PIU group. Logistic regression analysis indicated that PIU in patients was significantly associated with scores on the PSS and dysfunctional coping dimension of the Brief COPE Inventory.</P> <P><B>Conclusions</B></P> <P>Patients with schizophrenia spectrum disorders and PIU were significantly more likely to have high levels of perceived stress and dysfunctional coping strategies. Patients with schizophrenia spectrum disorders who also engage in PIU may benefit from interventions that help them to develop appropriate skills for coping with stress.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Patients with schizophrenia spectrum disorders showed a high prevalence (22.0%) of problematic internet use (PIU). </LI> <LI> High levels of perceived stress rather than psychopathology itself contributes to the development of PIU in stabilized patients with schizophrenia. </LI> <LI> Our results indicate that managing stress and developing coping strategies are important for the prevention of PIU among this group of patients. </LI> </UL> </P>

      • KCI등재

        정신과 입원환자의 서비스 만족척도의 개발

        김철권,이지연,송영선,김규호,김경률,김제원,이동기,최병무 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.3

        목적 본 연구의 목적은 국내 정신의료기관(정신병원, 종합병원 정신과)에서 간편하게 사용할 수 있는 신뢰도와 타당도가 검증된 입원환자의 서비스 만족척도를 개발하기 위한 것이다. 방법 여러 단계를 거쳐 국내 실정에 맞는 문항을 개발하였고,정신병원, 종합병원, 대학병원 정신과 병동에서 퇴원하는 348명의 환자들을 대상으로 신뢰도와 타당도를 조사하였다. 요인분석 결과 5개의 요인이 추출되었으며 전체 변량의 63.04%를 설명하였다. 내적 일관성에 대한 신뢰도 계수 (Crohnbach's α)는 0.95로 상당히 높은 수준이었고, 수정된 개별문항-총점 상관계수는 0.50부터 0.72까지의 범위에 속하였다. 요인분석을 통해 추출된 서비스 만족척도의 각 하위척도 점수와 서비스 만족척도에 첨부된 각 영역에 대해 전반적인 만족도를 묻는 세 개의 문항 점수 간의 상관성 역시 유의하게 높았다. 결과 진단명에 따른 서비스 만족척도의 전체 점수에서는 불안/신체형/강박장애 환자군과 기분장애 환자군이 각각 정신분열병 및 기타 정신병 환자군과 알코올중독 장애 환자군에 비하여 유의하게 높은 점수를 보였으며, 입원형태에 있어서는 자발적 입원군이 강제 입원군에 비하여 전체 만족점수가 유의하게 높았다. 그러나 성별, 월수입, 학력, 직업, 종교, 결혼상태 등의 변수에서는 서비스 만족척도의 전체 점수에서 유의한 차이가 발견되지 않았으며, 마찬가지로 연령, 입원일수, 입원횟수, 첫 발병나이, 유병기간 등의 임상적 변수에서도 서비스 만족척도의 전체 점수와 유의한 관계를 보이지 않았다. 서비스 만족척도의 전체점수에서 대학병원 환자군이 정신병원 환자군과 종합병원 환자군에 비하여 각각 유의하게 높았다. 결론 결론적으로 국내 정신의료기관에 입원한 환자들의 서비스 만족을 평가하기 위한 목적으로 개발된 본 척도는 높은 수준의 신뢰도와 타당도를 보였으며, 또 국내 정신의료 환경에 맞는 요인구조를 보였다. 따라서 정신의료 서비스에 대한 정신과 환자의 만족도에 대한 연구가 거의 없는 실정에서 본 척도의 개발은 향후 국내 정신의료의 질과 치료결과를 높이는 도구로 활용될 수 있을 것으로 기대된다. Objectives : To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale : SSS) for routinely assessing the quality of service in psychiatric ward inpatients. Methods : A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and University hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. Results : Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. Conclusion : SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring Satisfaction of psychiatric inpatients in Korea.

      • KCI등재후보

        전경대원에서 발생한 결핵의 임상 양상

        문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

        Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

      • 랫드에서 신우황청심원의 급성 및 아급성독성시험

        오승민,남혜윤,김준수,연제덕,신대희,이진영,박대규,조명행,정규혁 성균관대학교 약학연구소 1998 成均藥硏論文集 Vol.10 No.1

        The acute and subacute toxicity of New Woohwangchungsimwon(NWCH) which was used l-muscone as substitutive material of musk were investigated in S.D. rats. In intraperitoneal acute toxicity test, rats(Sprague-Dawley, SPF) were injected intraperitoneally with dosages of 0, 540, 750, 1,070, 1,500 and 3,000 ㎎/㎏. Body weights were significantly decreased at 540 ㎎/㎏ dose group in both sexes and abnormal autopsy findings were founded in both sexes at all treated groups. Intraperitoneal LD_50 of NWCH was 812.3 ㎎/㎏ in male and 872.3 ㎎/㎏ in female rats. In the subacute toxicity study, NWCH was administrated orally to both sexes of rats for 4 weeks as several doses(0, 320, 800 and 2,000 ㎎/㎏). There were neither dead animals nor significant changes of body weights during the experimental period. In addition, no differences were found between control and treated groups in clinical signs, urinalysis, hematology, serum biochemical analysis, and other findings. Above data strongly suggest that no observed adverse effect level of NWCH might be over 2,000 ㎎/㎏/day in this study.

      • KCI등재후보

        Research Articles : Physiological characteristics of the Large Copper butterfly, Lycaena dispar (Lepidoptera: Lycaenidae)

        ( Seong Hyun Kim ),( Seong Jin Hong ),( Young Bo Lee ),( Hae Chul Park ),( Yeon Ho Je1 ),( Nam Jung Kim ) 한국잠사학회 2011 International Journal of Industrial Entomology Vol.23 No.2

        To establish an indoor-rearing system for the Large Copper butterfly, Lycaena dispar and the Small Copper butterfly, Lycaena phlaeas, the effect of temperature, photoperiod and host plants on larval development was investigated. The larvae of Lycaena dispar fed on Rumex crispus, whereas the larvae of Lycaena phlaeas ate both Rumex crispus and Rumex acetosa. The duration of the larval period of Lycaena dispar was 13.8 days on R. crispus and that, of Lycaena phlaeas was 15.9 days and 15.2 days on R. acetosa and R. crispus respectively. Laboratory experiments show that the Large Copper larvae are able to feed on other Rumex species without harming their overall survival and can utilize these alternative host plants at least as efficiently as their natural host plant. This result suggests that plant chemistry is not responsible for their lack of utilization of the alternative host plants in the wild. Host plant choice by ovipositing females was measured with the two alternative hosts. Lycaena dispar preferred R. crispus to R. acetosa, wheareas Lycaena phlaeas preferred R. acetosa to R. crispus. Temperature has been proposed as an important determinant of developmental rate, lifespan and mortality in invertebrates. As temperature increased, length of the developmental period gradually decreased. The developmental period of the Large Copper larvae was 11.0 days and 28.5 days at 30oC and 17.5oC, respectively.

      • KCI등재후보

        한국인 알코올 의존 환자에서 알코올 대사 효소 유전자형 빈도의 남녀 차이

        김성곤,김철민,이덕기,황인복,이현숙,김성연,전은숙,송영상,박제민,최병무,김명정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

        Objectives : There are a number of preceding epidemiological studies reporting gender differences in the genetic etiology of alcohol dependence. The author investigated gender difference in the frequencies of ADH2 and ALDH2 genoypes between the patients with alcohol dependence and normal control. Methods : The subjects were 141 alcohol dependent patients (104 males, 37 females) and 138 normal control (79 males, 59 females). The frequencies of 1/1 and 1/2+2/2 (2+ afterward) genotypes for ADH2 and ALDH2 were investigated in male and female between alcohol dependence and normal control group. DNA was extracted from WBC in peripheral venous blood and PCR-RFLP method was used out for genotyping. Results : First, the frequency of ADH2 1/1 genotype was significantly higher in alcohol dependent patients than normal control in both genders. Second, while there was no gender difference in the frequency of ADH2 1/1 genotype in normal controls, in the patient group however, the frequency was significantly higher in females than males. Third, in male subjects with alcohol dependence, the frequency of ALDH2 1/1 genotype was significantly higher than in male normal control subjects. On the other hand, in female subjects with alcohol dependence, the frequency of ALDH2 2+ genotype was significantly higher than in female normal control subjects. Conclusion : These results suggest that while the risk of alcohol dependence is predominantly affected by ALDH2 1/1 geno-type in male, the female ADH2 1/1 genotype is mainly associated with the risk of alcohol dependence. This means that there are gender differences in the genetic etiology of alcohol dependence.

      • Functional analysis and molecular characterization of two acetylcholinesterases from the German cockroach, Blattella germanica

        Young Ho Kim,Jae Young Choi,Yeon Ho Je,Young Ho Koh,Si Hyeock Lee 한국응용곤충학회 2010 한국응용곤충학회 학술대회논문집 Vol.2010 No.10

        Two acetylcholinesterases (AChEs; BgAChE1 and BgAChE2) from Blattella germanica were functionally expressed using the baculovirus system. Kinetic analysis demonstrated that BgAChE2 had higher catalytic efficiency but lower substrate specificity than BgAChE1. Except paraoxon, BgAChE1 was generally less sensitive to inhibitors than BgAChE2. Western blot analysis using anti-BgAChE antibodies revealed that BgAChE1 was far more abundant in all examined tissues compared to BgAChE2, which is only present in the central nervous system. Both BgAChEs existed in dimeric form, covalently connected via a disulfide bridge under native conditions. Most fractions of BgAChE1 had a glycophosphatidylinositol (GPI) anchor, but a small fraction comprised a collagenlike tail. BgAChE2 appeared to have a collagen-GPI-fused tail. Based on the kinetic and molecular properties, tissue distribution and abundance, BgAChE1 was confirmed to play a major role in postsynaptic transmission.

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