뇌졸중 환자의 일상생활동작, 우울과 삶의 질의 관계

김원옥 ( Won Ock Kim ),강현숙 ( Hyun Sook Kang ),왕명자 ( Jmyung Ja Wang ),김정화 ( Jeong Hwa Kim ),최진이 ( Jin Yi Choi ) 경희대학교 동서의학연구소 2007 동서간호학연구지 Vol.13 No.2

본 연구는 뇌졸중 환자의 일상생활동작, 우울, 삶의 질의 관계를 파악하고자 하는 서술적 조사 연구로서 일상생활동작,’ 우울, 삶의 질 정효〉 관계가 있음을 확인하였다. 그러므로 본 안구의 주요한 결과를 중심으로 다음과 같이 고찰하였다. 뇌졸중 환자들의 일상활동 수행능력을 측정하는 도 구로 FIM, Modificd Barthel Index (MBI) 등이 많이 쓰 이고 있는데 FIM은 분야에 상관없이 표준화를 통한 높은 실용성,실행성, 이해도로· 인하여 널리 사. 하고 있는 도구로 이를 이용하여 측정한 본 연구에서는 872점으로 국내에서 만성 뇌졸중 환자와 퇴원 시 뇌졸중 환자를 대상으로 측정한 85. 9점 (Hw떼g, 2004) 과 85. 3점 (Kim, 2004) , 85. 8점 (Hong et al., 1998) 에 비하 여 약간 높아졌으나 비슷하였고, 일본 뇌졸중 환자를 대상으로 한 연구의 77. 1점보다는 높은 결과이었다 (Hama et al., 2007) . 특히 하부역역인 운동영역은 다 른 연구에 비해 높았으나 인지영역은 다른 연구에 비 해 낮은 편이었다 (Hwang, 2004二 Hama et al. , 2007, Hong 嫩 al. , 200긱 Kim, 2004) . 미국의 지역사회시설 에 있는 뇌졸중이 처음 발병한 환자들을 대상으로 재 활 후 5년간 환자를 추적한 연구에서 3년 후까지는 FIM점수가 상승하였으나 그 이후 감소되는 양상을 보였고 본 연구에서는 친단 후 경과 기간이 35.5개월 (87.2점)로 퇴원 후 3년 된 시점의 결과no도4점) 와 비교하였을 때 낮은 편이었다〈 Leonard, Mnler, Griffiths, Mcclatchie, & wherry, 1998) . 이러한 결과는 지역사 회와 집에서 간호를 받고 있는 뇌졸중 환자들에게 지속적인 재활 프로그램의 필요성이 높다는 것을 시사 한다고 볼 수 있다. 그러므로 입원을 한 직후부티 환 자에게 적절한 재활프로그램을 계획하여 시작하고 퇴원 후에는 연계되어 재활을 받을 수 있는 시설과 연결하여 환자가 지속적으로 재활을 할 수 있도록 돕는 병원과 지역사회가 공동으로 개발하고 시행하는 개활프로그램이 필요하다. 우울은 뇌졸중을 진단 받은 환자들의 급성기와 회 복기에 많이 동반되는 증상으로 본 연구에서도 CES- D를 이용하여 우울을 측정한 결과 23. 8점으로 Bak (2003) 의 연구와 비슷한 정도로 높게 측정되어 이 전의 연구결과와 같이 뇌졸중 환자의 가장 흔한 후유 증이 우울임을 다시 확인할 수 있었다 (Cho et al. 2003, `` Chon & Rhee, 1992, `` Kim, 2005, `` Kim, Seo, & Kang, 2000; singh et al. , 2000) . 그러므로 입원 시부터 신체적인 증상 뿐 아니라 우울도 같이 사정하고 우울이 진행되지 않도록 지속적인 관찰과 정서적인 간호가 뇌졸중 환자를 위한 재활프로그램에 포함이 되어야 한다. 삶의 질은 3 ``03점으로 뇌졸중 환자 l이명을 대상으로 한 chung (2000) 의 연구에서 의 3. 41점보다는 낮았으나 Kim과 Kim (2003) 의 연구의 3. 17점과는 비슷하였고 전체적으로 낮은 편이었다. 이런 결과는 최근 의학기술의 발전으로 뇌졸중으로 인한 사망률이 감소 되고 만성적인 뇌졸중 환자가 증가함에도 불구하고 재가뇌졸중 환자들에 대한 재활과 관리가 효과적으로 이루어지지 않고 있음으로 확인할 수 있었다. 따라서 뇌졸중과 삶의 질은 단기간에 향상되는 것이 아니므로 개활 프로그램이 단기적인 것보다는 체계적으로 계획되고 지속적으로 수행되어져 삶의 질을 관찰하는 연구가 필요할 것으로 생각된다. 또한 일상생활 동작을 잘 할수록 우울점수가 낮게 나타났고 삶의 질 정도가 높게 나타났다. 그리고 우 울 정도가 심할수록 삶의 질 정도가 낮은 것으로 나타났다. 뇌졸중 환자들에 대한 선행연구결과들을 살 펴보면 뇌졸중은 일상생활동작 수행과 같은 신체적인 문제, 우울, 대인관계 감소 등의 사회적 문제가 발생 되고 장기적인 치료와 간호를 요구하는 질병으로서 최종적으로. 삶의 질이 저하되는 것을 보고하고 있다 (Chung, 2000; Hama et al. , 2007, `` Ingrid, Kwakkel, Bruin, & Lindeman, 2007; Khan, 2004; Kim & Kim, 2003; singh et al. , 2007) . 이러한 연구 결과는 일상생활동작, 우울, 삶의 질이 단계적으로 순환되는 관계로 서 모두 뇌졸중환자를 위한 재활프로그램 내용에 포함되어야 함을 의미한다. 이런 연구결과들을 종합하여 볼 때 뇌졸중은 환자 의 뇌손상을 일으켜 장기적인 우울과 신체적인 기능 장애를 발생시킬 가능성이 높으므로 뇌졸중 환자의 재활프로그램은 입원을 하자마자 계획하여 치료와 동 시에 시작하고 특히 우울은 뇌졸중의 만성적인 건강 문제로 재활과정을 방해할 수 있으므로 신체적인 중 재와 더불어 정서적인 중재를 포함한 포괄적인 내용 의 프로그램이 바람직하고 장기적으로 삶의 질을 평 가함이 바랑직할 것이다. 또한 뇌졸중은 장기적인 재 활이 요구되는 질환이므로 단기간의 재활 프로그램을 병원에서만 시행하는 것이 아니라 퇴원 후 병원과 지 역 사회에서 연계하여 치료적인 연속성을 가지고 유지 할 수 있는 재활 프로그램의 개발이 반드시 필요할 것이 라고 본다. Introduction: The purpose of this study was to examine relationships among stroke patients`` activities of daily living(ADL), depression, and quality of life(QOL). Methods: Data were collected by questionnaires from 251 stroke patients at 5 hospitals and 2 public health centers in Seoul and Kyonggi-Do. The following Questionnaires were utilized for this study: Functional independence measure(FIM) from Grange, Hamilton, and Sherwin(1986), the Korean CES-D scale from Randloff(1977), and quality of life scale from Bang, Hwal-Lan(1991). Results: Data were analyzed using the pearson correlation, t-test, and ANOVA with SPSS/WIN 12.0. The results of this study were as follow; The subjects consisted of 110 females and 141 males. The mean score of activity of daily living was 87.2(range 18-126). Age, family history, comorbidity, paralysis site, and duration after diagnosis were significantly associated with activity of daily living. The mean score of depression was 23.8(range 11-44). Age, gender, education, and job were significantly associated with depression. The mean score of quality of life scale was 3.0(range 1-5). Gender, religion, education, job, economic status, and duration after diagnosis were significantly associated with quality of life. Relationships among activity daily living, depression, and quality of life scale: The activity of daily living had a negative relationship with depression score. The activity of daily living had a positive relationship with QOL score. The depression had a negative relationship with QOL score. Conclusion: Based on these results, it is necessary to run rehabilitation programs to improve stroke patients`` ADL, depression. Also, it research for of identifying stroke patients`` quality of life according to rehabilitation program.

아동의 내적 동기 및 자기효능감과 창의성의 관계 : 성별과 연령을 중심으로

김은아,정옥분,정순화 이화여자대학교 교육과학연구소 2007 교육과학연구 Vol.38 No.2

The purpose of this study was to investigate the relationships betweenintrinsic motivation, self-efficacy, and creativity of children. The subjects of thisstudy consisted of 304 fourth, fifth, and sixth grade public elementary schoolstudents in Seoul, Korea. The data were analyzed by using frequencies,percentiles, means, standard deviations, Cronbach’s a, two-way ANOVAs,Pearson’s correlations, and a multiple regression analysis. The major findings of this study were as follows: (1) There were significantdifferences in intrinsic motivation, self-efficacy, and creativity in terms ofgender and grade. Girls had higher scores in intrinsic motivation, self-efficacy,and creativity. Also, intrinsic motivation, self-efficacy, and creativity scoresincreased with grade. (2) Intrinsic motivation and creativity, self-efficacy andcreativity are significantly correlated each other. (3) Gender, intrinsic motivation(task difficulty preference), and grade were the variables that significantlypredict creativity. These variables explained 12.3% of children’s creativity. 본 연구의 목적은 아동의 내적 동기 및 자기효능감과 창의성의 관계를 살펴보는 데 있다. 연구대상은 초등학교 4~6학년 아동 304명이며, 자료에 대한 분석은 빈도와 백분율, 이원분산분석, 상관분석, 다중회귀분석방법을 사용하였다. 연구결과 내적 동기, 자기효능감 그리고 창의성은 성별과 학년에 따라 유의한 차이가 있는 것으로 나타났다. 내적 동기, 자기효능감, 창의성 총점에서 남아보다는 여아의 점수가 더 높은 것으로 나타났다. 또한 내적 동기, 자기효능감 그리고 창의성은 학년에 따라 증가하는 것으로 나타났다. 아동의 내적 동기, 자기효능감,창의성 간에는 밀접한 관련이 있는 것으로 나타났으며, 특히, 아동의 내적 동기와 창의성은 유의한 상관이 있는 것으로 나타났다. 아동의 창의성을 예측하는 변인은 ‘성별’과 내적 동기의 하위 영역 중 하나인 ‘도전적 과제선호’ 그리고 ‘학년’으로, 이 세 변인들의 설명력은 12.3%로 나타났다.

파일럿 채널지원 MMSE-RAKE 수신기의 성능분석

정인화,남옥우,김재형 창원대학교 정보통신연구소 2000 精報通信論文集 Vol.4 No.-

In this paper, we proposed pilot channel assisted MMSE-RAKE receiver, which use adaptive filter to provide relatively simple structure and good performance in the DS/CDMA downlink. Especially, utilizing normalized LMS(NLMS) algorithm to resolve the defect of LMS algorithms. And we explained pilot channel assisted method to estimate the multipath fading channel coefficients. With the result of performance analysis, we accepts that the adaptive MMSE-RAKE receiver much relys on the performance of channel estimator.

Hi-fi오디오 전송용 무선 송.수신기 설계

정인화,남옥우,김재형 창원대학교 정보통신연구소 2001 精報通信論文集 Vol.5 No.-

In this paper, a high-fidelity wireless microphone system with 16 channels in UHF band have been designed and implemented. According to the table of radio frequency allocation, a frequency for the wireless microphone is allocated in radio band from 740MHz to 752MHz and maximum frequency deviation is ±75KHz. The wireless microphone system have been designed with frequency modulation, PLL(Phase Locked Loop) frequency synthesized method, dual conversion, preemphasis/deemphasis and commander of 2:1 type. The wireless microphone system have been designed in this study has a frequency response from 50 to 20,000Hz and THD(Total Harmonic Distortion) lower then 1%. A high-fidelity audio can be transmitted through the air by the designed wireless microphone system Kevword'UHF Wireless Microphone, PLL, FM.

Influence of <i>Panax ginseng</i> on the offspring of adult rats exposed to prenatal stress

KIM, YOUNG OCK,LEE, HWA-YOUNG,WON, HANSOL,NAH, SEONG-SU,LEE, HWA-YOUNG,KIM, HYUNG-KI,KWON, JUN-TACK,KIM, HAK-JAE UNKNOWN 2015 INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE Vol.35 No.1

<P>The exposure of pregnant females to stress during a critical period of fetal brain development is an environmental risk factor for the development of schizophrenia in adult offspring. Schizophrenia is a group of common mental disorders of unclear origin, affecting approximately 1% of the global population, showing a generally young age at onset. In the present study, a repeated variable stress paradigm was applied to pregnant rats during the final week of gestation. The effects of an extract of <I>Panax ginseng</I> C.A. Meyer (PG) on rats exposed to prenatal stress (PNS) were investigated in terms of behavioral activity and protein expression analyses. In the behavioral tests, grooming behavior in a social interaction test, line-crossing behavior in an open-field test and swimming activity in a forced-swim test were decreased in the rats exposed to PNS compared with the non-stressed offspring; the changes in behavioral activity were reversed upon oral treatment with PG (300 mg/kg). Subsequently, western blot analysis and immunohistochemical analyses of the prefrontal cortex and hippocampus revealed that the downregulation of several neurodevelopmental genes which occurred following exposure to PNS was reversed upon treatment with PG. The current findings demonstrate that the downregulation of several genes following exposure to PNS may affect subsequent behavioral changes, and that these phenomena are reversed following treatment with PG during pregnancy. Our results suggest that oral treatment with PG reduces the incidence of psychiatric disorders, such as schizophrenia.</P>

Reversion after spontaneous sputum conversion in noncavitary nodular bronchiectatic Mycobacterium avium complex lung disease

( Ock-hwa Kim ),( Tae Sun Shim ),( Kyung-wook Jo ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Background: Although spontaneous sputum conversion can occur in noncavitary nodular bronchiectatic (NC-NB) Mycobacterium avium complex lung disease (MAC-LD), little is known about reversion after spontaneous conversion. We investigated the reversion phenomenon after spontaneous sputum conversion in patients with NC-NB MAC-LD. Methods: Among patients diagnosed with NC-NB MAC-LD between 2000 and 2013, 140 patients who experienced spontaneous sputum conversion and whose follow up duration after conversion for ≥6 months were enrolled at a tertiary referral center in South Korea. Their medical records were retrospectively reviewed. Results: Of the 140 patients, 30 (21.4%) underwent reversion during the median follow-up period of 54.5 months (interquartile range [IQR], 28.5-74.0). Reversion occurred at a median duration of 25.5 months (IQR, 12.8-44.3) after spontaneous sputum conversion. The mean age of the 30 patients with reversion was 63.3 years, and 70.0% were women. The mean body mass index at diagnosis was 21.8 kg/m2. No statistically significant differences in baseline characteristics were noted between the 30 patients with reversion and the 110 with persistent conversion. Among the 30 patients with reversion, 6 received treatment at a median duration of 8 months (IQR, 1.5-16.8) after reversion. No significant differences in baseline characteristics were noted between the 6 treated and 24 untreated patients. Conclusion: At least approximately 20% of patients with spontaneous sputum conversion in NC-NB MAC-LD experienced reversion, and a portion of them required treatment. These findings suggest that long-term follow- up is necessary for patients with NC-NB MACLD even who experience spontaneous sputum conversion.

Annual Case Volume and One-Year Mortality for Endovascular Treatment in Acute Ischemic Stroke

Kim Jun Yup,Kang Jihoon,Kim Beom Joon,Kim Seong-Eun,Kim Do Yeon,Lee Keon-Joo,Park Hong-Kyun,Cho Yong-Jin,박종무,Lee Kyung Bok,Cha Jae-Kwan,Lee Ji Sung,Lee Juneyoung,Yang Ki Hwa,Hong Ock Ran,Shin Ji Hyeon 대한의학회 2022 Journal of Korean medical science Vol.37 No.36

Background: The association between endovascular treatment (EVT) case volume per hospital and clinical outcomes has been reported, but the exact volume threshold has not been determined. This study aimed to examine the case volume threshold in this context. Methods: National audit data on the quality of acute stroke care in patients admitted via emergency department, within 7 days of onset, in hospitals that treated ≥ 10 stroke cases during the audit period were analyzed. Ischemic stroke cases treated with EVT during the last three audits (2013, 2014, and 2016) were selected for the analysis. Annual EVT case volume per hospital was estimated and analyzed as a continuous and a categorical variable (in quartiles). The primary outcome measure was 1-year mortality as a surrogate of 3-month functional outcome. As post-hoc sensitivity analysis, replication of the study results was examined using the 2018 audit data. Results: We analyzed 1,746 ischemic stroke cases treated with EVT in 120 acute care hospitals. The median annual EVT case volume was 12.0 cases per hospital, and mortality rates at 1 month, 3 months, and 1 year were 12.7%, 16.6%, and 23.3%, respectively. Q3 and Q4 had 33% lower odds of 1-year mortality than Q1. Adjustments were made for predetermined confounders. Annual EVT case volume cut-off value for 1-year mortality was 15 cases per year (P < 0.02). The same cut-off value was replicated in the sensitivity analysis. Conclusion: Annual EVT case volume was associated with 1-year mortality. The volume threshold per hospital was 15 cases per year.

Performance of GenoType® NTM-DR Assay for Identification and Drug Resistance Detection in Nontuberculous Mycobacteria

( Ock-hwa Kim ),( Tae Sun Shim ),( Kyung-wook Jo ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-

Background We evaluated the performance of GenoType^® NTM-DR assay (NTM-DR assay) for identification and drug resistance detection in nontuberculous mycobacteria. Methods Performance was assessed on 73 clinical mycobacterial isolates (15 Mycobacterium avium complex [MAC], 58 Mycobacterium abscessus complex [MAB]) with poor treatment response or confirmed resistance to clarithromycin and/or amikacin by phenotypic drug susceptibility testing (DST). NTM-DR assay Results were compared with those of multigene sequence-based typing for identification and those of phenotypic DST for the detection of drug resistance. Results The concordance of NTM-DR Results with sequencing Results for identification was 94.5% (69/73). Four isolates identified as Mycobacterium intracellulare by sequencing were identified as Mycobacterium chimaera by NTM-DR assay. All MAB isolates were identified at the subspecies levels. NTM-DR assay detected rrl mutations in 18 isolates and rrs mutations in 2 isolates, yielding 94.5% (69/73) and 97.3% (71/73) concordant Results with phenotypic DST for resistance to clarithromycin and amikacin, respectively. Among 45 MAB strains susceptible to clarithromycin, phenotypic inducible resistance to clarithromycin was detected in 29 MAB isolates, which all had the erm(41) T28 genotype. Conclusion NTM-DR assay is useful for identifying MAC species and MAB subspecies and rapid detection of resistance to clarithromycin and amikacin.

Multiplex PCR Using Conserved and Species-Specific 16S rDNA Primers for Simultaneous Detection of Fusobacterium nucleatum and Actinobacillus actinomycetemcomitans

( Kim Mi Kwang ),( Hwa Sook Kim ),( Byung Ock Kim ),( So Young Yoo ),( Jin Hyo Seong ),( Dong Kie Kim ),( Shee Eun Lee ),( Son Jin Choe ),( Joo Cheol Park ),( Byung Moo Min ),( Moon Jin Jeong ),( Do K 한국미생물생명공학회 2004 Journal of microbiology and biotechnology Vol.14 No.1

Inhibitory effect of pomegranate extract powder on periodontitis in rat

( Joong-hwa Kim ),( Kyung-hyun Lee ),( Se-jin Sung ),( Kyung-min Kang ),( Yun-kyong Lim ),( Joong-ki Kook ),( Won-pyo Lee ),( Byung-ock Kim ),( Sang-joun Yu ) 조선대학교 치의학연구원(구 조선대학교 구강생물학연구소) 2020 Oral Biology Research (Oral Biol Res) Vol.44 No.1

This study aimed to investigate the effect of pomegranate extract (PE) on the progression of periodontal disease in an experimental rat model of periodontitis. Periodontitis was induced in rats by placing a 5-0 black silk ligature and injecting a lipopolysaccharide of Porphyromonas gingivalis into the gingiva. Distilled water (DW) or PE solution was orally administered daily, and the animals were sacrificed after 3 weeks. Tissue specimens of the periodontitis model were analyzed using an enzyme-linked immunosorbent assay kit and by micro-computed tomography (CT) imaging. The expression levels of cyclo-oxygenase (COX)-1 and COX-2 were significantly reduced in ligation (Lig)+PE 22 μg/mL and Lig+PE 44 μg/mL groups, but there was no statistically significant difference in matrix metalloproteinase (MMP)-8 levels. Furthermore, micro-CT imaging demonstrated that alveolar bone resorption was inhibited in Lig+PE 22 μg/mL and Lig+PE 44 μg/mL groups compared with that in the Lig+DW group. These results demonstrate that PE has an inhibitory effect on the progression of alveolar bone loss caused by periodontal inflammation by reducing the expression levels of COX-1 and COX-2 in the process of periodontal disease.