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.

노년기 치매와 우울증의 유병률 및 위험인자

서국희,김장규,연병길,박수경,유근영,양병국,김용식,조맹제 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

경기도 연천군에 거주하는 만 65세이상 노인 1,037명을 대상으로 1996년 12월부터 1997년 8월까지 9개월간에 걸쳐 치매와 노년기 우울장애의 유병률과 위험인자에 관한 이 단계 역학조사(일차선별검사후 이차 진단적 면접)를 수행하였다. 다단계 층화집락표본추출에 의한 확률표본법으로 대상자 선정을 하였고, 반응률은 85.2%이 었다. 일차선별검사에는 노인정신장애 평가척도 한국어판(K-PAS)을 사용하였고, 일상생활 능력척도(ADL) 및 수단적 일상생활 능력척도(IADL)를 사용하여 기능을 평가했고, 지지도 척도(APGAR)를 사용하여 사회적 지지정도를 평가하였다. 이차 진단적 면접에서는 진 신장애의 진단 및 통계편람 제3판 개정판(DSM-III-R)의 진단기준을 따라 임상 진단을 확정하였다. 감별진단 및 장애 정도의 평가를 위하여 보조적인 진단도구들을 사용하였다. 1) 연령 보정된 치매의 유병률(%)[95% 신뢰구간]은 6.83[6.12∼7.54](남자 6.34[5.29∼7.40], 여자7.09[6.14∼8.04]이었다. 이중 알쯔하이머형 치매의 유병률(%)[95% 신뢰구간]은 4.17[3.61∼4.74] (남자 2.42[1.76∼3.08], 여자 5.31[4.48∼6.14]이었고, 혈관성치매의 유별률(%)[95% 신뢰구간]은2.38[1.95∼2.81](남자 3.46[2.67∼4.25], 여자 1.63[1.16∼2.10])이었다. 2) 연령 보정된 우울장애의 유병률(%)[95% 신뢰구간]은 10.99[10.11∼11.87](남자 7.59[6.44∼8.73], 여자 13.46[12.20∼14.73])이었다. 진단별로는 주요 우울장애의 유병률(%)[95% 신뢰구간] 이 7.50[6.76∼8.26](남자 4.42[3.54∼5.31], 여자 9.78[8.68∼10.88]), 기분부전장애의 유병률(%)[95% 신뢰구간]이 2.02[1.62∼2.42](남자 1.37[0.86∼1.87], 여자 2.46[1.88∼3.03], 달리 특정되지 않은 우울장애 유병률 (%)[95% 신뢰구간]이 1.49[1.15∼1.83](남자 1.85[1.47∼2.23], 여자 1.28[0.96∼1.60])이었다. 3) 알쯔하이머형 치매의 통계적으로 유의한 5가지 위험인자는 85셍상의 고령(O.R.= 10.27), 무학(O.R.= 4.01), 흡연[흡연년수 0.1∼30년(O.R.= 3.11), 흡연년수 30년 이상 (O.R.= 4.60)], 알코올남용(O.R.= 2.98)과 치매의 가족력 (O.R.= 4.85)이었다. 4) 혈관성 치매의 통계적으로 유의한 3가지 위험인자는 '무학' (O.R.= 3.78), 흡연[40년 이상 흡연년수 (O.R.= 11.15)]과 '뇌졸중의 과거력 (O.R.= 26.76)'이었다. 5) 우울장애의 통계적으로 유의한 3가지 위험인자는 '75∼79세 연령군' (O.R.= 2.87), '뇌졸중의 과거력' (O.R.= 3.33)과 '우울장애의 가족력' (O.R.= 7.16)이었다. 중심단어:알쯔하이머형 치매·혈관성 치매·우울장애·유병률·위험인자·흡연. An epidemiological survey was conducted to estimate the prevalence of and identify the risk factors of dementia and depression in the elderly between December 1997 and August 1998 in Yonchon County, Korea. A total of 1,037 elderly aged 65 years and over underwent a two phase diagnocstc procedure. Multiple stage, random cluster sampling method was used to select the subjects. Response rate was 85.4%. For the Ist stage screening survey, the Korean Psych-ogeriatric Assessment Scale was used as a primary screening tool, which had already been standardized in Korea, and functioning and social support were assessed by ADL, IADL and APGAR. At the 2nd stage, diagnoses were confirmed according to the DSM-Ⅲ-R. And several other scales were used as supporting information for differential diagnoses and for evaluating severity. 1) Age-sex adjusted prevalence(%)[95% C.I] of dementia was 6.83[6.12-7.54](male 6.34 [5.29-7.40], female 7.09[6.14-8.04]). Prevalence of the dementia of the Alzheimer's type was 4.17[3.61-4.74](male 2.42[1.76-3.08], female 5.31[4.48-6.14]) and that of the va-scular dementia was 2.38[1.95-2.81](male 3.46[2.67-4.25],female 1.63[1.16-2.10]). 2) Age-sex adjusted prevalence(%)[95% C.I.] of depressive disorder was 10.99[10.11-11.87](male 7.59[6.44-8.73], female 1346[12.20-14.73]. Among depressive disorders, prev-alence(%)[95% C.I.] of major depressive disorder was 7.50[6.76-8.26](male 4.42[3.54-5.31], female 9.78[8.68-10.88]), that of dysthymic disorder was 2.02[1.62-2.42](male 1.37[0.86-1.87], female 2.46[1.88-3.03]) and that of depressive disorder NOS was 1.49[1.15-1.83](male 1.85[1.47-2.23], female 1.28[0.96-1.60]). 3) Five statistically significant risk factors of the dementia of the Alzheimer's type were identified : age over 85(O.R. = 10.27), illiteracy (O.R. = 4.01), alcohol abuse (O.R. = 2.98), smoking [0 < pack year ≤30(O.R. = 3.11), pack year>30(O.R. = 4.60)] and family history of dementia (O.R. = 4.85). 4) Three statistically significant risk factors of the vascular dementia were identified : illiteracy (O.R. = 3.78), history of CVA(O.R. = 26.76) and smoking over 40 pack year(O.R. = 11.15). 5) Three statistically significant risk factors of the depressive disorder were identifed : age between 75 and 79(O.R. = 2.87), past history of CVA(O.R. = 3.33) and family history of depressive disorder(O.R. = 7.16). KEY WORDS:Dementia of the Alzheimer's Type·Vascular dementia·Depressive disorder·Prevalence·Risk factor·Smoking.

Brain Frailty and Outcomes of Acute Minor Ischemic Stroke With Large-Vessel Occlusion

Je-Woo Park,Joon-Tae Kim,Ji Sung Lee,Beom Joon Kim,유준상,Jung Hoon Han,Bum Joon Kim,김치경,Jae Guk Kim,Sung Hyun Baik,Jong-Moo Park,Kyusik Kang,Soo Joo Lee,박형종,차재관,Tai Hwan Park,이경복,Jun Lee,Keun-Sik Hong,B 대한신경과학회 2024 Journal of Clinical Neurology Vol.20 No.2

Background and Purpose The influence of imaging features of brain frailty on outcomes were investigated in acute ischemic stroke patients with minor symptoms and large-vessel occlusion (LVO). Methods This was a retrospective analysis of a prospective, multicenter, nationwide registry of consecutive patients with acute (within 24 h) minor (National Institutes of Health Stroke Scale score=0–5) ischemic stroke with anterior circulation LVO (acute minor LVO). Brain frailty was stratified according to the presence of an advanced white-matter hyperintensity (WMH) (Fazekas grade 2 or 3), silent/old brain infarct, or cerebral microbleeds. The primary outcome was a composite of stroke, myocardial infarction, and all-cause mortality within 1 year. Results In total, 1,067 patients (age=67.2±13.1 years [mean±SD], 61.3% males) were analyzed. The proportions of patients according to the numbers of brain frailty burdens were as follows: no burden in 49.2%, one burden in 30.0%, two burdens in 17.3%, and three burdens in 3.5%. In the Cox proportional-hazards analysis, the presence of more brain frailty burdens was associated with a higher risk of 1-year primary outcomes, but after adjusting for clinically relevant variables there were no significant associations between burdens of brain frailty and 1-year vascular outcomes. For individual components of brain frailty, an advanced WMH was independently associated with an increased risk of 1-year primary outcomes (adjusted hazard ratio [aHR]=1.33, 95% confidence interval [CI]=1.03–1.71) and stroke (aHR=1.32, 95% CI=1.00–1.75). Conclusions The baseline imaging markers of brain frailty were common in acute minor ischemic stroke patients with LVO. An advanced WMH was the only frailty marker associated with an increased risk of vascular events. Further research is needed into the association between brain frailty and prognosis in patients with acute minor LVO.

3상단락 상태에서 차단기 결상 투입시 전류분포 해석

김국태(Guk-Tae Kim),곽은섭(Eun-Sub Kwak),이제형(Je-Hyung Lee),강상욱(Sang-Uk Kang),박지한(Ji-Han Park),김동현(Dong-Hyun Kim) 대한전기학회 2025 대한전기학회 학술대회 논문집 Vol.2025 No.7

Production Technology of High Quality Seedlings for Mass Propagation of Domestic Genetic Resources in Adenophora triphylla

Ki Hyun Kim(김기현),Cheol Ku Youn(윤철구),Kyung Ja Lee(이경자),Ik Je Kim(김익제),Seong Tack Hong(홍성택),Young Guk Kim(김영국),Sun Hee Woo(우선희) 한국약용작물학회 2019 한국약용작물학회 학술대회논문집 Vol.2019 No.1

변형률을 이용한 복합재 평판 후퇴익 구조물의 변위 예측

김문국(Mun-Guk Kim),유제균(Je-Gyun Yoo),김소영(So-Yeong Kim),김인걸(In-Gul Kim),김근상(Gen-Sang Kim),전민혁(Min-Hyeok Jeon) 한국항공우주학회 2017 한국항공우주학회 학술발표회 논문집 Vol.2017 No.4

변형률을 이용한 복합재 평판 후퇴익 구조물의 변위 예측

김문국,유제균,김소영,김인걸,김근상,전민혁,Kim, Mun-Guk,You, Je-Gyun,Kim, So-Young,Kim, In-Gul,Kim, Geun-Sang,Jeon, Min-Hyeok 한국복합재료학회 2017 Composites research Vol.30 No.5

The complex deformation of the swept composite wing occurs due to the torsional load and bending load during the flight. Therefore, prediction for displacement of swept composite wing is required for structural health monitoring. Wing displacements can be predicted by using relationship between displacements and strains. The strain distributions on the fixed-end are complex due to the geometric shape of the swept wing. Because of those strain distribution, the wing displacement can be diversely predicted by the strain sensing locations. In this paper, displacements prediction of swept composite wing was performed by considering complex strain distributions. The predicted displacements under various loading condition were consistent with those calculated by FEA and verified through the bending test.

Interactive Audio Scene Description for Audio Object Control and 3D Audio Effects

Young Han Lee,Jin Ah Kang,Yong Guk Kim,Duk Su Kim,Hong Kook Kim,Choong Sang Cho,Je Wook Kim (사)한국CDE학회 2010 한국CAD/CAM학회 국제학술발표 논문집 Vol.2010 No.8

A User Information Based Scene Description for Immersive Audio

Young Han Lee,Jin Ah Kang,Yong Guk Kim,Duk Su Kim,Hong Kook Kim,Choong Sang Cho,Je Woo Kim 대한전자공학회 2010 ICEIC:International Conference on Electronics, Inf Vol.1 No.1

In this paper, we propose a user information based scene description for immersive audio in order to enhance user experiences via audio object controls or 3D audio effects. We demonstrate that the proposed scene description fulfills the user’s satisfaction in real time with the help of binary encoding for the proposed scene description.

An effective and intelligent Windows application filtering system using software similarity

Kim, Dongjin,Kim, Yesol,Cho, Seong-je,Park, Minkyu,Han, Sangchul,Lee, Guk-seon,Hwang, Young-sup Springer-Verlag 2016 SOFT COMPUTING Vol.20 No.5