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Background: The rate of cognitive change and prognostic factor in Alzheimer's disease are important for clinical management, but little is known in Korea. We report a one year follow-up study of comprehensive evaluation including cognitive functions, behavioral and psychological symptoms of dementia (BPSD) and activity of daily living (ADL). Methods: 43 patients with Alzheimer's disease were enrolled. All subjects received the Korean version of Mini-Mental State Examination (K-MMSE), the Severe Dementia Scale (SDS), the extended version of Korean Clinical Dementia Rating Scale (CDR) and Sum of Box (CDR-SB), the Barthel index of Activity of Daily Living (B-ADL), the Korean Instrumental Activity of Daily Living (K-IADL) and the Korean version of the Neuropsychiatric Inventory (K-NPI). We retested each scale after 1 year and evaluated the changes. Results: The mean change rates of K-MMSE, SDS, CDR, CDR-SB and B-ADL scores were 2.0±3.2 (-7~8) mean±SD (range), 3.5±4.9 (-7~14), -0.4±0.7 (-2~1), -0.8±4.4 (-10~9) and 1.5±3.7 (-7~9). The change of K-MMSE and B-ADLscore according to CDR were significantly different. The annual rates of changes of scores on K-MMSE, B-ADL and CDR were largest in CDR 1 group (K-MMSE: 4.0±2.7, B-ADL: 3.4±2.8, CDR: -1±0.7). The change rate of SDS was largest in CDR 4 (7.2±4.3). There were not any significant factors that affected the change of K-MMSE, SDS, B-ADL or CDR. Conclusions: These results suggest that K-MMSE is sensitive to the early stage and SDS is sensitive to the later stage. The deterioration rate of cognitive function in Alzheimer's disease is large at middle stage.
The evaluation of behavioral and psychological symptoms (BPSD) is important for the diagnosis and management of Alzheimer's disease (AD). Previous studies have reported the prevalence and severity of BPSD changes. However, these studies have mainly focused on the AD patients with mild to moderate severity. Our study investigated the BPSD in AD patients with more advanced stages and looked at the prevalence and severity of BPSD with the progression of disease. Methods: One hundred thirty six patients with probable AD received the Korean version of the neuropsychiatric inventory along with the expanded version of the Korean Clinical Dementia Rating Scale (CDR) and the Korean version of the Mini-Mental State Examination (K-MMSE). Results: The mean K-MMSE, CDR and NPI scores were 10.1 (SD=7.1), 2.0 (SD=1.5) and 32.7 (SD=26.2), respectively. CDR and K-MMSE scores did not correlate with the total NPI score but did correlate with some of the subscale NPI scores. Apathy had the highest relationship to CDR (r=0.39, p<0.01). Aberrant motor was most correlated with the total score of NPI (r=0.65, p<0.01). The mean number of positive NPI items was 4.3, which ranged from 2.1 (CDR 5 group) to 5.4 (CDR 2 group). The most frequent symptom was apathy and the least was euphoria. The severity of BPSD increased as the dementia severity increased to CDR 2 except apathy. Night-time behavior and anxiety were frequent in the early stages whereas apathy and aberrant motor were frequent symptoms in later stages. Conclusions: These observations suggest that BPSD is relatively independent of cognitive functions. The prevalence and severity of BPSD with the exclusion of apathy, increased as the dementia severity increased from CDR 0.5 to CDR 2 and then declined declined except apathy.
CO2 injection well sealant is vulnerable to supercritical CO2 (scCO2) exposure. To develop an alternative to the conventional sealant system (class G cement/class F fly ash), the performance of slag cement (SPC) systems containing class F fly ash (FFA) or class C fly ash (CFA) was evaluated and compared with the conventional sealant under scCO2 conditions. All sealant systems showed an immediate increase in compressive strength upon scCO2 exposure and, at 37.6 MPa, SPC/CFA showed the highest compressive strength after 14 days, which was much higher than the 29.8MPa of the conventional sealant system. Substantial decreases in porosity were observed in all sealant systems, which were partly responsible for the increase in strength. Carbonation reactions led to pH decreases in the tested sealants from 12.5 to 10~11.6. In particular, the greatest decrease in pH in slag cement/class C fly ash probably supported relatively sustainable alkali activation reactions and the integrity of cement hydrates in this system. XRD revealed the presence of CaCO3 and a decrease in the content of cement hydrates in the tested sealants upon scCO2 exposure. TGA demonstrated a greater increase of CaCO3 and calcium-silicate-hydrate phases in SPC/CFA than in the conventional sealant upon scCO2 exposure.
The domestic liquefied natural gas project has been carried out as a national energy scheme since the late 1980's in Korea. The natural-gas supply for civilian demand is limited to the Kyung-In area. In addition, seven major city gas corporations which now participate in the project occupy the monopolistic service area. In this study, objective cost evaluation criteria for gas distribution and an improved proposal in the evaluation method are suggested. They will go forward in solving the problems to promote demand and prevent excess profit or deficit according to the physical characteristics of the monopolistic service area.