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      • 치매환자의 비인지 기능장애에 관한 예비적 연구

        한설희 충북대학교 의과대학 충북대학교 의학연구소 1999 忠北醫大學術誌 Vol.9 No.2

        연구목적: 행동장애/행동이상(behavioral disturbances)는 치매환자에서 비교적 흔히 관찰되는 증상이기는 하나 기억장애와 같은 인지기능이상이 두드러진 현상이기 때문에 최근까지 연구대상에서 제외되어 있었다. 그러나 환자들이 나타내는 비인지기능 증상들 (non-cognitive symptoms; NCS)은 치매의 진단, 예후 및 치료에 있어 매우 중요한 의미를 갖는다. 본 연구의 목적은 치매환자의 NCS의 임상적 특징을 면밀히 파악하여 향후 치매환자의 치료에 있어 인지기능을 개선시키려는 노력 이외에 NCS에 대한 적극적인 치료방침을 마련하는 데 있다. 대상 및 방법: 충북대학교병원 치매크리닉에 내원한 환자중 DSM IV 및 NINDS-ADRDA 진단기준에 맞는 알쯔하이머형 치매환자 42명, NINDS-AIREN 진단기준에 적합한 혈관성치매환자 13명, 혼합형치매환자 12명을 대상으로하여 이상행동적도를 평가하였다. 결과: 치매척도인 Hasegawa scale과 행동척도인 Behavioral Rating Scalerks의 상관지수는 0.805로 상당한 유의성이 관찰되었다. 질병의 종류에 무관하게 과격한 행동, 밤-낮의 뒤바뀜, 초조증 등이 가장 흔히 관찰되는 행동장애이었다. 결론: 본 연구의 결과 치매환자의 치료에 있어 비인지기능장애의 중요성을 인식할 수 있었으며 이를 조기에 발견 치료해줌으로써 환자들를 돌보는 간호인력이나 보호자들의 삶의 질을 향상시키는데 많은 기여를 할 것으로 기대된다. 비인지기능 장애의 발병기전을 밝히기 위하여 향후 좀더 잘 기획된 전향적 방법으로 치매환자에서 비인지기능 장애가 어떻게 진행되는 가에 대한 추시 연구가 필요할 것으로 생각된다. Purpose: Behavioral symptoms in dementias, although common, have not received much attention until recently. This report attempts to describe the frequencies and characteristics of such symptoms in patients with dementia. Materials and Methods : The author cross-sectionally investigated the prevalence, phenomenolgy, and clinical correaltes of noncognitive symptoms (NCS) in a consecutive series of 67 patients with dementia (42 with Alzheimer's disease, 13 with vascular dementia, 12 with mixed dementia). Cognitive function was rated using the Hasegawa scale and NCS was measured with modified Behavioral Rating Scale (BRS). Results: The correlation between Hasegawa scale and BRS was 0.805 at the time of initial evaluation. Among various delusional symptoms, picture sign was noted only in patients with Alzheimer's disease. Aggressive behavior, day-night-disturbances, and agitation were most frequently observed NCS regardless of disease entities. Conclusion: The findings of the present study underlie the importance of NCS in the management of patients with dementia. Further longitudinal study using well-designed structured interview should be performed to clarify the evolution of NCS in patients with dementia.

      • KCI등재

        일 초등학교 1·2학년 아동과 학부모의 시력관련 지식 및 행태에 관한 조사

        김설이,강혜영 韓國學校保健學會 2002 韓國學校保健學會誌 Vol.15 No.1

        The purpose of this study was to investigate the visual acuity and the degree of vision-related knowledge and behaviors of the 1st and 2nd graders of primary school and their parents in a city. The research design was a descriptive study and the subjects were 579 pupils and their parents in Namwon City, Chonbuk province. Children's vision screening was conducted with Han's test by author, school nurse according to the guidelines. The data were analyzed by frequency, percentage, mean, S.D., t-test, ANOVA, Pearson's correlation coefficient, χ^2-test with SAS program. Subnormal visual acuity group (SVAG) in children was 17.3%, and was higher in girls and in the 2nd graders, but there were no significant differences statistically. The mean score of the vision-related knowledge in children was 6.8 points out of 10 points and that of vision-related behaviors was 23.5 points out of 33 points. The mean scores of the vision-related knowledge were significantly higher in 2nd graders (p= .02), in girls (p= .02) and SVAG (p= .01) and the group of high scores in vision-related knowledge presented significantly high scores in vision-related behaviors(p= .001). The mean score of the vision-related knowledge in parents was 6.4 points out of 10 points and that of vision-related behaviors was 28.4 points out of 33 points. The group with high scores of vision-related knowledge in parents presented significantly high scores in vision-related behaviors (p= .003). As SVAG were higher in 2nd graders and the group of high scores of vision-related knowledge showed also high scores in vision-related behaviors in both children and their parents, From the above results, the author suggests a school-based visual health program for them.

      • KCI등재

        치매의 행동심리증상의 개관 : An Overview

        한설희 대한치매학회 2004 Dementia and Neurocognitive Disorders Vol.3 No.1

        Behavioral and psychological symptoms of dementia (BPSD) are among the most distressing manifestations of dementia and results in considerable social and economic burden. They are highly prevalent in Alzheimer's disease (AD) and other progressive degenerative dementias. BPSD are one of main reasons for premature institutionalization and are major causes of significant loss of quality-of-life for the patient and his/her family and caregivers. Recent investigations indicate that BPSD are not an epiphenomenona of cognitive impairment, but could be attributed to specific biological brain dysfunction. This brief review provides an overview of recent advances in the field of BPSD research.

      • 원발성진행성 실어증

        한설희 충북대학교 의과대학 충북대학교 의학연구소 1996 忠北醫大學術誌 Vol.6 No.2

        원발성진행성실어증은 수년간에 걸쳐 대뇌고위 기능중 언어영역만 고립적으로 침범되어 서서히 진행하는데 임상적으로 치매와 구별되어야 하는 비교적 드문 증후군이다. 저자는 최근에 62세 여자환자가 약 4년간에 걸쳐 서서히 진행한 언어장애를 주소로 본원 치매크리닉을 방문하여 신경심리검사, 뇌파검사, 뇌핵자기공면영상, 단일광자방출단층촬영술 등에서 전형적인 원발성진행성실어증으로 확인된 우리 나라 최초의 예를 경험하였기에 간단한 문헌고찰과 함께 보고하는 바이다. A 62-year-old right-handed woman presented with a progressive deterioration in her ability to name common object used in everyday life. Her initial language disturbance, word-finding difficulty, got worsened gradually over the next 4 years, She was able to point to the correct object when the word is provided by the examiner despite being unable to name it spontaneously. Her memory, attention, visuospatial skills and comportment were all intact. She is doing well in her daily living activities including taking care of herself, shopping and paying bills. MRI showed left perisylvian atrophy and dilated left frontal horn. SPECT study revealed decreased perfusion in left temporal lobe. Her clinical presentation together with the characteristic structural and functional neuroimaging findings were typical of 'primary progressive aphasia'.

      • 결절성경화증 환자에서의 SPECT 뇌영상 : 예비적 연구 A preliminary report

        한설희,이상수,정승연 충북대학교 의과대학 충북대학교 의학연구소 1991 忠北醫大學術誌 Vol.1 No.1

        간질발작을 포함한 전형적인 삼징후가 동반된 결절성경화증 환자를 대상으로 뇌파검사, 뇌전산화단층촬영술 및 단일광자방출단층촬영술을 시행하였다. 뇌전산화단층촬영술에서는 상의하석회화병소와 조영제증강이 뚜렷하지 않은 피질에 연한 저음영 소견이 관찰되었으며 이어서 시행한 단일광자방출단층촬영술에서는 뇌전산화단층촬영술 소견보다 더 광범위한 부위에 관류결손이 관찰되었다. 단일광자방출단층촬영술은 결절성경화증 환자에서 간질발현 병소인 피질결절을 발견하는데 있어서 전산화단층촬영술 및 뇌파검사보다 더 유용한 방법이며 치료방침 결정이나 예후판정에 있어서도 큰 도움을 줄 것으로 기대된다. Two patients with a well-established diagnosis of tuberous sclerosis and epilepsies as their principal clinical symptom were examined by conventional surface electroencephalography(EEG), computed tomography, and single photon emission computed tomography(SPECT) using the 99mTc hexamethyl prophyleneamine oxime(99mTc-HMPAO). The interictal EEG showed various abnormalities of poor localizing value. Brain computed tomography surely demonstrated subependymal calcifications, although the cortical lesions were not so conspicuous. However, the SPECT images of each patient clearly demonstrated decreased cerebral perfusion in cortical areas. It may be assumed that such perfusion defect areas represent the epileptic cortical tubers or those of altered myelination, which are characteristics of the disease.

      • 초고속 HMC 주축계의 열특성 해석

        김석일,김기상,김기태,나승표 한국공작기계학회 2001 한국공작기계학회 춘계학술대회논문집 Vol.2001 No.-

        This paper presents the thermal characteristics analysis of a high-speed HMC spindle system with angular contact ball bearings, built-in motor, oil-jet lubrication method, oil jacket cooling method, and so on. The spindle system is composed of the main spindle and sub-spindle which are mechanically connected by a flexible coupling. The spindles are supported by two front and rear bearings, and the built-in motor is located between the front and rear bearings of the sub-spindle. The thermal analysis model of spindle system is constructed by the finite element method, and the thermal characteristics in the design stage are estimated based on temperature distribution and heat flow under the various testing conditions related to material of bearing ball, spindle speed and coolant temperature.

      • KCI등재

        부검으로 확진된 알쯔하이머병 1예 : An Autopsy Report

        한설희,이건국,양기화,장순환 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.1

        While the clinical diagnostic accuracy of probable Alzheimer′s disease (AD) is 87-96% with a diagnostic sensitivity/specificity of 0 81-0 87, the unequivocal diagnosis of AD rests on histopathological evidence at brain autopsy and/or biopsy We report here a 92-year-old woman whose clinical presentation suggested a far advanced Alzheimer′s disease Formal neuropsychological evaluations were not applicable due to severe cognitive impairments With a relatively good general physical condition she could walk with aid during her last days no focal neurological signs were noted on a detailed examination Brain MRI revealed a diffuse cortical atrophy with a marked reduction in the hippocampal volume The brain obtained weighted 780g The cerebral hemispheres examined after fixation disclosed moderately severe atrophy in prefrontal and temporal lobes on coronal section, the hippocampus was likewise severely atrophied the lateral ventricles were moderately dilated On microscope examination, there were numerous senile plaques and neurofibrillary tangles in the neocortices. hippocampus and amyglada, compatible with advanced Alzheimer′s disease In summary we report the first Korean autopsy-proven case with advanced Alzheimer′s disease.

      • KCI등재

        유아의 구강보건관리에 영향을 미치는 요인에 관한 연구

        김설악 韓國學校保健學會 1999 韓國學校保健學會誌 Vol.8 No.2

        This study was performed to find variables which affect oral health care of infants. The subjects were 439 infants and their mothers who live in suburban area. Oral examinations for the infants were conducted and the questionnairs were given to infants' mothers. Toothbrushing frequency, oral hygiene score, the percentage of filled teeth among decayed teeth, and dental treatment experience of infants were used as dependent variable, respectively. Demographic, socio-economic variables and the other variables which might affect oral health care of infants were used as independent variables. Correlation analysis and analysis of variance were used for the independent variables of toothbrushing frequency, oral hygiene score, and the percentage of filled teeth among decayed teeth of infant. Chi-Square and Student's t-test were used for the dependent variables of dental treatment experience of infant. The obtained results were as follows; 1. Toothbrushing frequency of mother and internal locus of oral control of mother were the factors which affect toothbrusing frequency of infants. 2. Oral health belief of mother was the factor which affect oral hygiene score of infants. 3. Age of infant was the factor which affect the percentage of filled teeth among decayed teeth. 4. Age of infant and educational level of infant's mother were the factors which affect the infants' consumption of dental treatment.

      • 신문에 나타난 동래읍성의 변화

        이설혜,박승범 東亞大學校 建設技術硏究所 2009 硏究論文集 Vol.32 No.2

        After Dongnae Fortress, the fortress established to guard the frontier from Japan’s invasion, lost its original function under the rule of Japanese imperialism, some parts of it which live at the present age have recently converted into a place of new functions, that is, a place giving a chance for citizens to experience history and culture and contributing to their relaxation and emotional development. The purpose of this study is to examine the potential variables that can affect future changes of Dongnae Fortress and to offer basic materials for the right direction establishment of the conservation of it by understanding the conservation process of the historical environment of Dongnae Fortress. The result of the frequency analysis on the number of newspaper articles dealing with Dongnae Fortress during 1990~2007, when the cultural properties of Dongnae Fortress were made the most use, showed that the recognition degree of Dongnae Fortress is tending upwards, especially since 2003 it has sharply been rising. The result of classification of the articles based on the subjects showed that the public administrational acts related to Dongnae Fortress had a great effect on the newspaper articles, accounting for 33% followed by the utilization 23%, the scholarship 21%, the others 14% and the management 9%. This study has a significant meaning in examining the change process of Dongnae Fortress shown in news reports focused on after the independence of Korea and during 1990~2007 period, and ultimately offering basic data for the right direction establishment of the conservation of Dongnae Fortress.

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