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.

천연 Zeolite를 이용한 매립지 침출수의 고농도 암모니아성 질소 제거에 관한 연구

오재일,홍성효,이선구,최영화,안봉규 중앙대학교 기술과학연구소 2002 기술과학연구소 논문집 Vol.32 No.-

천연 제올라이트의 일종인 Clinoptilolite를 이용하여 매립지 침출수내의 암모니아성 질소를 제거하는 실험을 수행하였다. 고정상 칼럼을 이용한 인공 침출수와 실제 침출수 조건의 실험에서 배출농도가 유입농도의 5%인 시점을 파과점으로 상정할 때, 인공 침출수 조건에서의 파괴시간은 53hr, 실제 침출수 조건에서의 파과시간은 32.5hr으로 나타났다. 또한, 허용 파과점 및 소모점에서의 제올라이트 100g(건조중량)당 제거된 암모늄 이온 성분량은 인공 침출수의 경우 각각 79.30meq/100g, 93.34meq/100g이었으며, 실제 침출수의 경우 각각 48.60meq/100g, 57.60meq/100g으로 나타났다. 침출수 조건의 경우 인공 침출수에 비해 약 39% 가량의 제거 효율 저하를 보이고 있으며, 이는 실제 침출수에 존재하고 있는 공존 양이온의 영향으로 사료된다. 실제 침출수 내에서 공존 양이온의 용출 특성을 보면, Na, Ca, Mg의 용출량은 증가하나 K는 용출량이 감소하는 것으로 나타났다. This experiment was conducted to remove the ammonia nitrogen in the landfill leachate by Clinoptilolite which is a sort of the natural zeolite. In fixed-bed column test driven in the artificial and actual condition of the leachate, when the ejection concentration was supposed the point of 5% of the initial concentration as the breakthrough point, the breakthrough time was 53hr in the artificial condition of the leachate and was 32.5hr in the actual condition of the leachate. The ingredient volume of the removed ammonium ion per 100g(based upon the dry weight) of the zeolite in the allowed breakthrough point and exhaustion point were individually 79.30meq/100g, 93.34meq/100g in the artificial leachate and 48.60meq/100g, 57.60meq/100g in the actual leachate. In case of the actual condition of the leachate, the removal efficiency was decreased by 39% than the artificial condition of the leachate, and it seems to be caused by the coexist cation in the actual leachate. The ejection characteristics of the coexist cation in the actual leachate was observed that Na, Ca, Mg was increased and K was decreased.

뇌하수체 종양 제거술 시행 후 뒤늦게 발생한 횡문근 융해증과 동반된 중추성 열

장제혁,최규남,김일환,노은지,김윤정,유충헌,고정해,박봉수,김태균,권민정,이순희,박정현 인제대학교 2008 仁濟醫學 Vol.29 No.-

Body temperature is controlled by thermoregulatory center of the hypothalamus. We report a case of 24 years old man with central fever. He was subjected to a partial excision of pituitary tumor compressing optic chiasm four years ago. He has received hormonal therapy for panhypothyroidism after removal of pituitary tumor. And He received gamma knife operation for partially contrast-enhancing masses in suprasellar and both hypothalamic areas that is probably postoperatively remnant or recurrent tumor of pituitary adenoma. One year after gamma knife operation, he presented with a febrile syndrome of unknown origin including rhabdomyolysis. All usual investigations proved negative. We diagnosed him as central fever with rhabdomyolysis. He received medical ICU care with cooling bed, ice pack. And his symptom improved. Postoperative hyperthermia may result following resection of the pituitary tumor. When central fever is suspected taking note of past history, a quick recognition of course of fever can help reduce the using of unnecessary antibiotics and hospital stay.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

다발성 골수종에서 저용량 thalidomide, cyclophosphamide, dexamethasone (TCD) 요법의 효과

류충헌,정재현,고정해,장제혁,박영진,최규남,박봉수,이상민,주영돈 인제대학교 2008 仁濟醫學 Vol.29 No.-

Background and Objectives : The immunomodulatory drug thalidomide can inhibit angiogenesis and induce apoptosis in experimental models. It can also induce marked and durable response in newly diagnosed myeloma patients. Thalidomide has been used at doses ranging from 200 to 800 mg with significant toxicity. No data are available on the impact of low-dose thalidomide, cyclophosphamide and dexamethasone as initial therapy for myeloma patients. Design and Methods : To address this issue, newly diagnosed myeloma patients were treated with 50 mg/day thalidomide continuously and cyclophosphamide 150 mg/m², days 1-4 and dexamethasone 20 mg/m², days 1-5 and day 15-19, every month. Between October 2005 and October 2006, 14 patients (median age 54.5 years) were treated with low-dose thalidomide, cyclophosphamide and dexamethasone. Results : After a minimum of two cycles of treatment, 5 patients (55.5%) showed a partial remission. After four cycles of treatment, 10 patients (83.3%) showed a partial remission (n=6) and complete remission (n=4). After a median follow-up of 15.4 months, 1 year overall survival rate was 82.0%. Thalidomide was well tolerated without serious toxic effects. Conclusions : The combination of low-dose thalidomide, cyclophosphamide and dexamethasone demonstrates favorable response rate and 1 year overall survival rate in newly diagnosed myeloma. Severe toxicities were not seen with this combination.

일부 인쇄회로기판 납땜근로자들의 눈, 호흡기, 피부의 증상에 대한 조사연구

유재영,우극현,김진석,함정오,최태성,하봉구,정상재,박신구,김일룡 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

목적 : 이 연구는 납점작업자를 대상으로 납점작업으로 유발될 가능성이 높은 눈, 호흡기, 피부 등의 증상호소율 및 노출강도에 따른 관련성을 파악하기위해 수행되었다. 방법 : 연구참가자 146명중 연구목적에 적합한 20명을 제외한 126명을 대상으로 '눈이 가렵고 충혈됨', '코가 가렵거나 파가움', '재채기', '콧물'. '코막힘' , '목이 따끔거림' , '목에 무언가가 걸려있는것 같음' , '갑자기 연속적인 기침을 함' , '운동 시에 다른 사람에 비해 숨이 가쁨', '숨을 쉴 때 쌕쌕하는 소리가 남', '가래가 끓음', '손이나 안면에 가려움을 느낌' , '안면에 여드름이 날' '손이나 안면에 붉은 반점이 남' 등 14가지 증상에 대한 경험유무와 혈중연농도, 납점작업의 건강위험요인에 대한 지식상태 등을 조사하였다. 결과 : 조사된 14가지의 증상 중, '갑자기 연속적인 기침을 함'이 하루 납점시간 4시간 이상인 군아서 4시간 미만인 군보다 유의하게 증상호소율이 높았으며, 다른 증상의 경우 하루 납땜시간에 따라 유의한 결과를 보이지 않았다. 납땜작업의 건강위험요인에 대한 질문에 12.8 %가 플럭스에 의한 건강위험을 지적하였다. 전체 대상자의 평균 혈중연농도는6.05 rg/dL였으며, 히고치는 15.50 rg/dL이었다.결론 : 납땜작업자에게 호흡기 증상의 위험이 높을 가능성이 있으며, 납땜작업의 건강위험에 대한추가적인 연구와 납점작업자들을 대상으로 납점작업에 의해 유발될 수 있는 건강장해에 대한 적극적인교육 및 홍보활동을 필요로 한다. Objectives : This study was conducted to evaluate the prevalence of ocular, respiratory and skin symptoms among solderers and to investigate the relationship between symptom prevalence and exposure intensity. Methods : We analyzed 126 eligible participants out of a population of 146 male solder-ers who completed the symptom questionnaires. Fourteen symptoms including 'itchy and red eyes', 'itchy or prickly nose', 'sneezing', 'rhinorrhea', 'blocked nose', 'prickly throat', 'foreign body sensation in throat', 'sudden bouts of coughing', 'exertional breathlessness', 'wheezing', 'sputum production', 'itchy face or hands', 'acneiform erup-tions on the face' and 'red spots on the face or hands' were contained. Blood lead levels of all the 126 participants were tested and the participants' own assessments of the health risk of soldering were collected. Results : Of the 14 investigated symptoms, 'sudden bouts of coughing' was significantly more prevalent in solderers who worked 4 hours or more a day than those who worked less than 4 hours a day, as for the other symptoms, there were no significant differences in the prevalences related to daily soldering hours. 2.8% of the solderers considered the risk of flux exposure to be serious. The mean blood lead bevel was 6.05 μg/dL (maximum 15.50 μg/dL). Conclusions : Soldering may increase the risk of respiratory symptoms. Further invert tigations on the hazards of soldering processes are warranted and solderers should be educarted on these hazards.

한국인의 우울증 진단기준의 특성

장성만,손지훈,이준영,최지환,조성진,전홍진,함봉진,이동현,조맹제 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.5

목적 국내의 여러 역학 조사에 따르면 한국인은 서구에 비하여 우울증의 유병률이 낮은 것으로 보고되고 있다. 낮은 유병률에 대하여 서구에서 정의하는 우울증의 진단 기준이 한국인의 문화에 맞지 않다는 진단 기준의 오류를 제시하거나, 실제로 유병률이 낮다는 설명을 시도하기도 하였다. 본 연구는 DSM-IV에서 제시하는 우울증의 진단 기준에 대하여 한국인의 반응 특성을 알아보고자 한다. 방법 2001년 KECA 연구에 응답한 만 18세 이상 65세 미만의 6,275명을 대상으로 하였다. 한국어판 CIDI (K-CIDI)를 통해 정신장애의 이환을 진단하였으며, K-CIDI 내의 우울장애 진단 기준만을 추출하여 분석하였다. 분석은 문항반응이론(Item Response Theory)을 적용하였다. 결과 한국인에서 DSM-IV의 주요우울장애 진단 기준의 오류는 없었으나, 진단 기준의 역치는 높았다. 한국인이 호소하는 우울증상으로서 "피로감"과 "집중력 저하", "수면 변화"는 진단되는 우울증의 초기부터 잘 나타나는 증상 들이며, "정선운동변화", "죽음/자살사고", "무가치함/죄책감"은 보다 심한 우울증에서 잘 나타나는 증상들이었다. 결론 DSM-IV가 제시하는 주요우울장애 진단 기준은 한국인의 우울증을 평가하는 데 있어 타당하기는 하나, 진단 기준의 역치가 높다. 우울증의 중증도에 따라 호소하는 증상들이 달랐다. Baekgrounds : Many Korean epidemiologic studies reported lower prevalence rates of depression than those of Western countries. For the low prevalence, it is explained that there's something wrong in the direct application of diagnostic criteria of depression to Korean culture, i.e. categorical fallacy, or it may be truly low-prevalent. We will analyze diagnostic criteria for depression detined by Western. Methods : Six thousand and two hundred seventy-five cummunity dwelling subjects, aged 18-64 years were interviewed by using Korean version of Composite International Diagnostic Interview (K-CIDI). Diagnostic criteria for depression defined by DSM-IV were analyzed using the item response theory. Rcsults : We could not find any fallacies of diagnostic critcria tbr depression defined by DSM-IV when assessing depre-ssion among Koreans. Fatigue, concentration difficultics, and sleep disturbance appeared more fequently in mild depression, while psychomotor change, death/suicide, and worthlessness/guilt did not appear until severe depression. Cunclusion : The diagnostic criteria for depression defined by DSM-IV arc appropriate for the Koreans. There are different responding levels, i.e. threshold, of depressive criteria according to severities of depression. Koreans with depression are more likely to complain of appetite change, but less of worthless or guilty feelings than Western people.

Taxonomic Study of the Tribe Chlaeniini (Coleoptera: Carabidae) from Korea

Ik Je CHOI,Jinyoung PARK,Bong Woo LEE,Shin Young PARK,Jong Kyun PARK 한국응용곤충학회 2014 한국응용곤충학회 학술대회논문집 Vol.2014 No.04

The present study was carried out to revise the species of Chlaeniini in Carabidae from South Korea, using both classic taxonomy and molecular analysis. Another aim is to decide the taxonomic position of Chlaenius micans Fabricius of which subgeneric status in the genus has been in question. As a part of the results, Chlaenius spathulifer Bates, 1873 was newly recognized to Korean insect fauna. With this new addition Korean Chlaeniini contains now in total 34 species and two genera. Molecular analyses using CO1 sequences of representative species for six subgenera in Chlaenius were conducted to determine the position of C. micans. The result of the analyses suggested that C. micans did not belong to the subgenus Achlaenius where C. micans had been doubtfully positioned despite distinct morphological differences from the other four species of the variicornis-group (C. sericimicans, C. variicornis, C. kurosawai and C. ocreatus) in the subgenus. This study provids a key to species, photos of adult habitus, photos of male genitalia and redescriptions of 28 Korean species in Chlaeniini.

대학입학경쟁과 사교육: 공교육 강화와 교육비 보조 정책의 효과

최봉제 ( Bong Je Choi ),전영준 ( Young Jun Chun ),김진영 ( Jin Yeong Kim ) 한국경제학회 2016 經濟學硏究 Vol.64 No.2

본 연구는 차입제약 하에서 부모소득과 자녀능력에서 서로 구별되는 가구들의 소비와 자녀의 대학진학 및 사교육비 지출에 관한 선택 문제를 이론적으로 분석한다. 입학정원의 제한으로 인해 우수 대학에 진학하기 위해서는 진입경쟁을 거쳐야 하며 이 경우 사교육을 통해 성적을 향상시킬 여지가 많은 고소득층 자녀의 우수 대학 진학률이 높은 경향이 나타난다. 정부의 공교육 강화나 교육비 보조정책을 통해 이러한 교육기회의 불평등을 교정할 수는 있으나 그 효과는 제한적이며 등록금 상승에 대한 규제가 선행되지 않을 때 이러한 경향은 더 두드러진다. 한편, 등록금 상승에 대한 통제 하에서 두 정책은 모두 교육기회의 불평등을 개선하는 효과를 가지며 특히 교육비 보조가 공교육 강화에 비해 더 효과적이다. This study theoretically analyzes the households’ choice regarding child’s university attendance jointly with household consumption and private tutoring under borrowing constraint where the households are differentiated by parental income and child ability. Due to the enrollment limit, the entrance into the high-quality university entails an intense competition. This may incur the cost of private tutoring that leads to the overrepresence of children from rich families in high-quality university attendance. By reinforcing public education or providing more education subsidy to households, the government can mitigate wealth bias. However, its effect is limited in reducing the inequality of educational opportunity without tuition control. With tuition control, however, both policies are effective in improving equality of educational opportunity. Especially, providing more education subsidy is more effective than reinforcing public education.

First record of Cydia kamijoi Oku (Lepidoptera: Tortricidae), infesting the cones of Abies koreana E. H. Wilson on new to Korea

Young Min Shin,Jong Woo Nam,Ik Je Choi,Bong Kyu Byun,Il Kwon Kim 한국응용곤충학회 2015 한국응용곤충학회 학술대회논문집 Vol.2015 No.10

In the present study, Cydia kamijoi Oku is newly recognized in korean insect fauna. This tortricid moth was first found damaging the cones of Abies koreana in Jeju Island 2014. The moth can be a serious insect pest on A. koreana because of high damage rate on the cones, up to 71% average. The genus Cydia now was 11 korean species including C. kamijoi. Regarding this species, some basic information such as collection records, morphological characters, and ecology were provided