Earticle

본 연구에서는 습지의 가치 도출 방안으로 개발 사업 추진으로 인하여 습지 등 자연생태계가 훼손 될 경우 이를 복원하는데 실제 소요된 비용을 파악하고, 회복과정에서 나타나는 생태과학적 지표인 생물종다양성지수를 이용하여 복원에 소요되는 한계비용 등을 산출함으로써 습지의 진정한 가치 도출에 기여해보고자 한다. 이는 경제적 분석에서 사용되는 두 가지 측면 중 하나인 비용 측면만으로는 훼손된 습지를 얼마만큼 복원해야 하는지 알 수 없음을 의미한다. 따라서 한계비용을 도출하여 복원비용을 파악하는 것이 습지관련 프로젝트를 진행하면서 보다 더 정확한 의사결정을 내릴 수 있을 것이다.

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Purpose: To investigate the association between binocular function and vision after cataract removal and primary posterior chamber intraocular lens (PC-IOL) implantation in children with unilateral cataract and to identify visual function differences according cataract type. Methods: Clinical records of 2- to 6-year-old patients with unilateral cataract removal and primary PC-IOL implantation were reviewed retrospectively. Visual acuity and ocular alignment were measured. Sensory fusion was assessed with the Worth 4-dot test, and stereoacuity with the Titmus stereo test. Cataracts were classified according to cause, lens opacity location, age at onset, and presence of strabismus. Clinical characteristics of patients who obtained good visual function were identified. Results: Forty-seven patients were included. Among 22 (46.8%) with good vision (20/40 or better), only 6 (27.3%) achieved good binocular function (the presence of fusion and 100 seconds of arc or better of stereoacuity). Visual acuity was better in eyes with good binocular function (p=0.002). No other variables were significant for achieving good binocular function. Conclusions: The removal of unilateral cataract in a visually immature child can result in a combination of good visual acuity and binocular function. Good binocular function is closely related to good visual acuity.

Primary non-function (PNF) after liver transplantation has been found to be the most common cause of early graft loss, which accounts for up to 36% of such failures. The cause of PNF is not known. The purpose of this study was to identify factors associated with and independently predictive of PNF after liver transplantation. Four hundreds twenty-four liver transplants performed at the Charles O. Strickler Transplant Center, University of Virginia were retrospectively reviewed. PNF was defined as the failure of an allograft after revascularization with no discernable cause, leading either to retransplantation or to patient death. Risk factors were analyzed using the Pearson chi-square test for univariate analysis and logistic regression for multivariate analysis. Factors found to be associated with PNF included: female recipient (6.4% vs. 2.6%, p=0.045), African-American donor (9.5% vs. 3.2%, p=0.043), inter-racial donor to recipient transplantation (9.5% vs. 2.8%, p=0.008), severe encephalopathy pretransplant (11.1% vs. 3.1%, p=0.034), pretransplant recipient PTT >50 seconds (10.9% vs. 2.8%, p=0.004), portal vein reconstruction with conduit (15.0% vs. 3.5%, p=0.011), and downsizing of graft (22.9% vs. 3.8%, p=0.007). Logistic regression identified the use of donor iliac vein conduit for the portal vein reconstruction (p=0.003, odds ratio=3.15, 95% confidence interval: 1.49-6.64) and the racial difference between donor and recipient (p=0.012, odds ratio=2.31, 95% confidence interval: 1.20- 4.45) to be independent predictors of PNF. The exact cause of these findings, whether physiologic or immunologic, remains unknown. If confirmed in larger data sets, the attention to these factors may minimize the possibility of PNF in non- emergency situations.

Background/Aims: This study aimed to detect the expressionof natural killer (NK) cell receptor natural killer group2D (NKG2D) in the peripheral blood of patients with primaryhepatocellular carcinoma and to discuss the correlation betweenNK cell cytotoxicity and liver function. Methods: Thenumber of NK cells and the expression of NK cell receptorNKG2D in peripheral blood were determined by flow cytometryin patients with primary hepatocellular carcinoma, hepatitisB cirrhosis, chronic hepatitis B, and healthy controls. Results: When compared with patients in the healthy andthe chronic hepatitis B groups, the primary hepatocellularcarcinoma group showed significant decreases in all parameters,including the cytotoxicity of NK cells on K562 cells,expression rate of NKG2D in NK cells, number of NKG2D+NK cells, expression level of NKG2D, and number of NK cells(p<0.05). The activity of NK cells showed a positive correlation,whereas the Child-Pugh scores in the primary hepatocellularcarcinoma and the hepatitis B cirrhosis groups showeda negative correlation with all parameters detected above. Conclusions: The decrease of NK cell activity in patientswith primary hepatocellular carcinoma is closely related totheir lower expression of NKG2D. Liver function affects theexpression of NKG2D and the activity of NK cells.

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

This study was undertaken to elucidate the underlying mechanisms of ATP depletion-induced membrane transport dysfunction and cell death in renal proximal tubular cells. ATP depletion was induced by incubating cells with 2.5 mM potassium cyanide(KCN)/0.1 mM iodoacetic acid(IAA), and membrane transport function and cell viability were evaluated by measuring $Na^+$-dependent phosphate uptake and trypan blue exclusion, respectively. ATP depletion resulted in a decrease in $Na^+$-dependent phosphate uptake and cell viability in a time-dependent manner. ATP depletion inhibited $Na^+$-dependent phosphate uptake in cells, when treated with 2 mM ouabain, a $Na^+$ pump-specific inhibitor, suggesting that ATP depletion impairs membrane transport functional integrity. Alterations in $Na^+$-dependent phosphate uptake and cell viability induced by ATP depletion were prevented by the hydrogen peroxide scavenger such as catalase and the hydroxyl radical scavengers(dimethylthiourea and thiourea), and amino acids(glycine and alanine). ATP depletion caused arachidonic acid release and increased mRNA levels of cytosolic phospholipase $A_2(cPLA_2)$. The ATP depletion-dependent arachidonic acid release was inhibited by $cPLA_2$ specific inhibitor $AACOCF_3$. ATP depletion-induced alterations in $Na^+$-dependent phosphate uptake and cell viability were prevented by $AACOCF_3$. Inhibition of $Na^+$-dependent phosphate uptake by ATP depletion was prevented by antipain and leupetin, serine/cysteine protease inhibitors, whereas ATP depletion-induced cell death was not altered by these agents. These results indicate that ATP depletion-induced alterations in membrane transport function and cell viability are due to reactive oxygen species generation and $cPLA_2$ activation in renal proximal tubular cells. In addition, the present data suggest that serine/cysteine proteases play an important role in membrane transport dysfunction, but not cell death, induced by ATP depletion.

Background: The aim of this study was to evaluate the mid-term changes in cardiac function by transthoracic echocardiogram (TTE) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) according to valsartan dose. Methods: Between April 2006 and February 2009, 78 subjects (mean age: 57 ± 12 years, M : F = 74 : 4) with STEMI who underwent primary PCI were enrolled. Fifty three patients received low dose valsartan (40 or 80 mg) and 25 patients received high dose valsartan (160 or 320 mg). Follow-up TTE was done approximately 2 years later. We evaluated the changes in left ventricular (LV) function between initial and final TTE after primary PCI and compared the changes between low and high dose valsartan group. Results: The mean follow-up TTE duration was 24 ± 8 months. Deceleration time (188.6 ± 56.3 msec vs. 221.5 ± 71.3msec, p = 0.01), E/e’ (12.24 ± 5.2 vs. 10.1 ± 4.9, p = 0.002), ejection fraction (52.7 ± 8% vs. 55.2 ± 8.4%, p < 0.01), and wall motion score index (1.45 ± 0.30 vs. 1.33 ± 0.32, p < 0.01) showed significant changes during the follow-up period. Wall motion improvement in injured myocardial segments was more frequently observed in the high-dose valsartan group compared to the low-dose group [18/25 (72%) vs. 24/53 (43.7%), p = 0.03]. There was no significant difference in the changes in cardiac dimensions and function between the low and high dose valsartan group. Conclusion: In patients with STEMI who undergoing primary PCI, high-dose valsartan treatment may be more helpful than low-dose in improving wall motion in the injured myocardium.

The objective of this study was to find the primary function of ‘previous research use’ within Korean academic texts, to utilize as the fundamental reference material for guiding academic-purpose writing. Academic writing is a writing with a broadened definition of ‘source use’ as a prerequisite. Moreover, ‘previous research’ is the source applied by the writer of the academic text from the onset to the end-point to construct a more abundant and solid argument. Although interest toward the education of academic writing for international students undergoing the master’s and doctorate program has increased, the discussion of a constructive guidance concerning the ‘previous research use’ remains inadequate. This study confirmed the necessity to first review concepts and values of previous data and concentrate on the non-fixed characteristic of previous research placement within an academic text through existing research outcomes. Furthermore, the contemplation of the primary function of previous research use became imperative alike the importance of considering the technical strategies involved in the academic writing process. The examined six primary functions of previous research use within this study were ‘identification of primary(key) results’, ‘problem proposal and emphasis on the necessity of research’, ‘categorization of results and comprehension of direction’, ‘the re-application of methodology and subjectivity’, ‘the review(examination) of principal concepts perspective analysis’, and ‘the evidence provision and result analysis’. Since this study examines each function with its basis on actual examples of academic texts, the enclosed data will be able to usefully applied during the guidance of academic writing. Results from previous research is inarguably an important data to permit the academic text to be more academic. However, it is not advisable to rely entirely on previous research and the writer of scholarly text should be aware of how to apply strategically and effectively, the previous research to one’s writing, in accordance with one’s research objective and characteristic. This implies research, seeking a more constructive content and strategies on ‘previous research use’ in regards to the academic writing guidance, must also be pursued.(Yonsei University)

Purpose: The purpose of this study is to verify the test-retest reliability of the Korean version of the tinnitus primary function questionnaire (K-TPFQ) and to propose a simplified version of the K-TPFQ. Methods: In the test-retest reliability measure of the K-TPFQ, 31 participants were asked to complete the K-TPFQ on two occasions. Correlation between the results of the two questionnaires was confirmed by Pearson correlation coefficient. Then, a total of 110 subjects participated in the proposed, simplified version. Following factor analysis of the K-TPFQ, three items with high factor loadings for each subscale were selected as simplified version items. Internal consistency and validity were analyzed for the 12 items of the simplified version of the K-TPFQ. Results: The results of the test-retest reliability analysis of K-TPFQ showed significantly high correlations in all items, subscales, and total scores (r = 0.598-0.927). As a result of factor analysis, all items in each subscale showed high communalities. Therefore, we extracted 3 items with high content validity and high factor loadings from each subscale and adopted a total of 12 items for the simplified version. The results of the internal consistency test of the simplified version showed good validity and significantly high internal consistency of all items and subscales (α = 0.839-0.950). Conclusion: This study verified the high reliability and validity of the K-TPFQ. Therefore, it can be used to effectively evaluate the secondary effects of tinnitus in domestic clinics. In addition, the simplified version will reduce the time for evaluating tinnitus sufferers.

There is a growing interest in the application of primary hepatocytes for treatment of liver diseases in humans and for drug development. Several studies have focused on long-term survival and di-differentiation blocking of primary hepatocytes in an in vitro culture system. Therefore, the present study also aimed to optimize an in vitro culture system using primary rat hepatocytes. Primary rat hepatocytes from 6-week-old male Crl:CD rats were isolated using a modified two-step collagenase perfusion. Healthy $3.5{\times}10^6$ primary rat hepatocytes were seeded into a 2 dimensional (2D) culture in a 25T culture flask coated with collagen type I or into a 3D culture in a 125-ml spinner flask for 7 days. Production of plasma protein (ALB and TF), apoptosis (BAX and BCL2), and CYP (CYP3A1) related genes were compared between the 2D and 3D culture systems. The 3D culture system had an advantage over the 2D system because of the relatively high expression of ALB and low expression of BAX in the 3D system. However, the level of CYP3A1 did not improve in the 3D culture with and without the presence of a dexamethasone inducer. Therefore, 3D culture has an advantage for albumin production and primary rat hepatocyte survivability, but a low expression of CYP3A1 indicated that primary rat hepatocytes require a high-density culture for stress reduction by continuous flow.

본 연구는 Fonagy 등(2016)이 개발한 성찰기능 질문지(8문항)를 한국 청소년을 대상으로 타당화 하고자 하였다. 이를 위해 서울 및 경기지역의 중·고등학생 총 457명의 자료를 분석하였다. 먼저 200명을 대상으로 탐색적 요인분석을 실시하여 원척도와 동일하게 성찰기능 확실성 척도와 성찰기능 불확실성 척도를 포함하는 2요인을 설정하였다. 내적 합치도는 .650∼.686으로 나타났으며 257명을 대상으로 확인적 요인분석을 실시한 결과, 수용 가능한 적합도를 나타냈다(GFI=.951, TLI=.862 CFI=.898, RMSEA=.05). 준거타당도 검증 결과, 정신화 질문지, 정서조절곤란 척도와 유의미한 상관을 나타냈으며, 공감 척도와는 성찰기능 불확실성 척도를 제외하고는 유의미한 상관을 나타내지 않았다. 또한 지난 1년 동안 비자살적 자해 경험이 없는 집단과 있는 집단 간의 성찰기능 확실성, 성찰기능 불확실성 점수의 차이를 살펴본 결과 성찰기능 확실성에서 유의미한 차이가 나타났다. 연구결과 한국 청소년 대상 성찰기능 질문지(8문항)는 청소년의 성찰기능 능력을 측정하기에 유용한 도구임이 시사되었다. 마지막으로 본 연구의 제한점과 후속 연구를 위한 제안을 논의하였다.

This study validated reflective functioning questionnaire (8item) developed by Fonagy et al(2016) in Korean adolescents. For this purpose, data of 457 middle and high school students in Seoul and Gyeonggi area were analyzed. First of all, exploratory factor analysis was performed on 200 subjects, and two factors including eflective functioning certainty (RFQY_C) and the reflective functioning uncertainty (RFQY_U) were set as the same as the original scale. The internal consistency was .650∼.686, and the confirmatory factor analysis of 257 another subjects showed acceptable fit (GFI=.951, TLI=.862 CFI=.898, RMSEA=.05). The results of the validity test showed that there were significant correlations with the mentalization questionnaire and emotional adjustment difficulty scale, and no significant correlation with the empathy scale except the RFQY_U. Point differences in RFQY_C and RFQY_U between the two groups with and without experience in non-suicidal self-injury were examined and there were significant differences in RFQY_C. The results of this study suggest that the reflection functioning questionnaire (8 items) for Korean youth is a useful tool for measuring the reflection function ability of adolescents. Finally, limitations of this study and suggestions for future research were discussed.

Pulmonary function tests were conducted on 815 healthy primary school children (390 males and 425 female) in rural area using Collins Survey Spirometer (Warren E. Collins, Inc., U.S.A.) with X-Y Recorder. Respiratory symptoms(cough, sputum, sore throat, chest pain, chest tightness, dyspnea, coryza) were surveyed by the interviews. Multiple regression analysis and regression diagnostics were done for prediction equations of FVC, $FEV_1,\;PEFR\;and\;FEF_{25-75%}$. FVC, $FEV_1,\;PEFR\;and\;FEF_{25-75%}$ values in 3 groups of children classified by the number of symptom were compared each other through standard variable value. FVC, $FEV_1,\;PEFR\;and\;FEF_{25-75%}$ showed highly significant correlation with age, height and weight. Prediction equations for FVC, $FEV_1,\;PEER,\;FEF_{25-75%}$ are functions of height only in both male and female children aged between 6 and 12 years old. PEFR showed a significant difference related with the number of symptom in female. These results suggest that the PEFR is sensitive PFT parameter in this study.

This study analyzes the effects of high- and low-variability phonetic training on learners’ perception of Korean intonation. The participants were twenty Chinese primary learners studying Korean as a foreign language; they were and divided into two groups. The experiment consisted of a pretest, five exercises, a post-test, and a generalization test. The results are as follows. First, high- and low-variability phonetic training have the same effect on increasing the accuracy of learners’ perceptions of the grammatical function of intonation. Second, both high- and low-variability phonetic training are needed to improve the accuracy of primary learners’ perceptions of the emotional/attitudinal function of intonation. Because high-variability phonetic training can compensate for the key disadvantage of low-variability phonetic training, namely that learners find it difficult to master various intonation patterns.; and On the other hand, low-variability phonetic training can compensate for the key disadvantage of high-variability phonetic training, namely that the effect is not stable.

목적 본 연구에서는 아동의 집행기능 곤란, 지능, 학업수행능력 간의 구조적 관계를 탐색하고 이러한 관계가 초등학교 저학년과고학년 집단에 따라 유의한 차이가 나타나는지를 검증하고자 하였다. 방법 이를 위해 한국아동패널 9차년도 자료 802명, 13차년도 자료 563명 총 1,365명의 자료를 가지고 다음과 같이 분석하였다. 먼저 연구변인들의 기술통계치를 산출하고 Pearson의 적률상관분석을 통해 연구변인 간 관련성을 살펴보았다. 다음으로 집행기능곤란, 지능, 학업수행능력을 토대로 설정한 연구모형에 대해 구조방정식 모형분석을 실시하고, 부트스트랩 방법을 통해 집행기능곤란과 학업수행능력 간의 관계에서 지능의 매개효과에 대한 통계적 유의미성을 확인하였다. 마지막으로 동일성 검증을 토대로 초등학교 학년 집단에 따른 경로계수의 차이를 확인하고자 다집단 분석을 실시하였다. 결과 첫째, 초등학생의 집행기능 곤란은 지능과 학업수행능력에 각각 유의한 부적 영향을 주고 지능은 학업수행능력에 정적 영향을주는 구조모형을 확인할 수 있었다. 둘째, 집행기능 곤란이 학업수행능력에 미치는 영향에서 지능의 매개효과가 나타났다. 셋째, 집행기능 곤란이 학업수행능력에 미치는 경로에서 초등학교 저학년과 고학년 집단에 따라 유의한 차이가 있는 것으로 나타났다. 결론 본 연구의 결과는 아동의 발달 수준에 따라 학업 수행에 도움을 줄 수 있는 인지적 요인들을 고려하여 교육적 중재를 제공해야함을 시사한다.

Objectives In this study, we looked at the relationship between executive function difficulty, intelligence, and academic performance in primary school children, and tried to verify whether this relationship showed a significant difference according to the elementary school grade group. Methods For the purpose of the study, a structural equation model analysis and multi-group analysis were conducted through the data of 1,365 of the Panel Study on Korean Children. Results First, it was found that the executive function difficulty of children had a significant negative effect on intelligence and academic performance, respectively, and intelligence had a positive effect on academic performance. Second, the mediating effect of intelligence was found in the effect of executive function difficulty on academic performance ability. Third, there was a significant difference in the influence of executive function difficulty on academic performance ability according to the elementary school grade group. Conclusions The results of this study suggest that educational interventions should be provided by considering cognitive factors that can help academic performance according to the child's developmental level.

본 연구는 장애유아의 감각통합 기능 특성에 대한 주양육자와 교사의 인식을 비교․분석함으로써 감각통합에 문제를 보이고 있는 장애유아를 조기선별하고, 그들 특성에 적절한 감각통합 조기 중재 프로그램을 계획하고 시행하는데 기초자료를 제공하기 위한 목적으로 실시되었다. 본 연구의 목적을 달성하기 위하여 4~6세의 정신지체, 자폐성 장애, 뇌성마비 유아의 주양육자 및 교사(N=261)를 대상으로 감각통합장애 유아 조기 선별척도를 통해 조사한 결과 다음과 같은 주된 결론을 얻었다. 먼저 장애유아의 감각통합 기능 특성은 전반적으로 위험 단계에 속하는 것으로 인식되고 있었으며, 주양육자 보다는 교사가 보다 이상 단계에 가깝게 응답함으로써 장애유아의 감각통합 기능을 낮게 인식하고 있는 것으로 나타났다. 이와 같은 결과는 주양육자와 교사가 인식하는 감각통합 기능 특성에 차이가 있음을 나타내는 것으로 향후 아동의 감각통합 발달을 증진시키기 위해서는 부모와 교사를 대상으로 한 감각통합 교육을 통해 부모와 교사의 견해를 일치시킬 필요성이 있음을 시사한다. 둘째, 장애유아의 성, 연령, 장애유형 및 장애정도에 따른 감각통합 기능 특성에서는 장애정도 가 심할수록 주양육자와 교사의 인식에 있어서 차이가 나타났는데, 주양육자보다는 교사가 감각통합 기능을 보다 낮게 인식하고 있는 것으로 나타났다. 특히, 하위영역 중에서는 4세 유아의 감각 민감성과 정신지체 유아의 감각민감성 및 촉각, 그리고 1급 장애유아의 고유-전정감각과 2급 장애유아의 촉각 영역에서 주양육자보다는 교사가 보다 감각통합 기능을 낮게 인식하고 있는 것으로 나타났다. 이와 같은 결과는 장애정도가 심한 유아 및 정신지체 유아에게 효과적인 감각통합 프로그램을 제공함으로써 그들의 정상적인 발달을 조속히 증진시키기 위해서는 그들 주양육자와 교사를 대상으로 한 감각통합 교육이 반드시 선행되어야 함을 시사한다 하겠다.

The purpose of this study was to compare and analyze the recognition of primary caregivers and teachers on characteristics to sensory integration function of infants with disability. There are some implications of early screening and implementing educational program to infants with sensory integration deficiency through this study. The subjects of this study were 261 primary caregivers and teacher of children aged 4-6. These disabled children were diagnosed with mental retardation, autism, and cerebral paralysis. The method used was Early Screening Scale of Sensory Integration Function. The results are as follows. First, the overall?Characteristics to Sensory Integration function of Infant with Disability appeared critical and showed low recognition in teachers group than primary caregivers group. Second, in these types of disability and variable factors, a significant distinction was shown. Sensory integrations function between two groups in sex, age, types of disability and degree of disability showed meaningful difference. Specifically, it was shown that 4 year old infants have lower sensory sensitivity while mentally retarded children are low in sensory sensitivity and tactile. It was also shown that infants of profound disability are lower in proprioception-vestibular and those with severe disability are lower in tactile.

본 논문은 각급 지방자치단체에 근무하는 지방공무원들 중에서, 6급 ‘지방행정주사’라는 특정 직급의 지방공무원의 실태와 문제점을 심층적으로 분석한 것이다. 분석을 위한 자료는 주로 대구광역시 및 경상북도의 내부자료를 활용하였으며, 면접조사도 주로 이들 자치단체의 본청 및 산하 기초자치단체에 근무하는 지방공무원을 대상으로 행하였다. 논의의 전개는 우선은 지방행정주사의 현황을 타 직급과의 관계 속에서 전반적으로 파악해 보고, 다음에는 이들이 지방행정에서 차지하는 위상을 역할의 측면과 인사관리의 측면으로 구분하여, 광역자치단체, 기초자치단체, 그리고 일선행정기관의 세 차원으로 분류하여 분석하였다. 마지막으로, 지방행정주사가 실제 지방행정에서 수행하는 기능을 알아보기 위해서, 이들이 결재과정에서 어떠한 기능을 수행하고 있는 지를 중심으로, 전술한 세 가지 차원에서 비교론적으로 논의하였다.

본 연구의 목적은 감각 결손이 있는 만성 뇌졸중환자를 대상으로 경 두개 직류 전류 자극을 체성감각피질에 적용했을 때, 감각의 회복과 상지 기능의회복을 알아보고자 하는 것이다. 만성 뇌졸중 환자20명을 실험군 10명, 대조군 10명으로 나누어 실시하였다. 실험군은 환측 체성감각피질에 경 두개 직류전류 자극을 적용하였으며, 대조군은 위상 자극을 실시하였다. 중재는 총 2주간, 10회, 회기 당 20분씩 진행되었다. 체성감각 평가는 The Erasmus MC modifications to the (revised) Nottingham Sensory Assessment(EmNSA), Semmes-Weinstein monofilament examination(SWME), 상지기능 평가는 퍼글마이어평가(FMA), 운동 활동 척도(MAL), 가속도계를 사용하였다. 연구 결과, 실험군은 대조군보다 전체적인 촉각감각과 고유수용성 감각, 피질 감각, 지각의 민감도에서 유의한 개선을 보였으며, 환측 상지의 사용량에서 통계학적 유의한 차이를 나타냈다. 본 연구 결과를 기반으로 체성감각 회복과 상지기능의 회복을 위한 tDCS의 효과적인 임상 적용의 가능성을 높일 수있을 것으로 생각된다.

The purpose of this study is to investigate the recovery of sensation and the restoration of upper limb function according to transcranial direct current stimulation over the primary somatosensory cortex in patients with chronic stroke with sensory deficit. 20 patients with chronic stroke divided into 10 experimental groups and 10 control groups. Patients received transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion, and The control group applied sham tDCS to the same location. Intervention was conducted 5 times a week, 20 minutes per session for a total of 2 weeks. Assessment was performed using the Erasmus MC modifications to the Nottingham Sensory Assessment(EmNSA), Semmes-Weinstein monofilament examination(SWME) for somatosensory, and Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and accelerometer for upper extremity function. Assessment was conducted before and after the intervention. As a result of the study, the experimental group showed a significant improvement in the overall tactile sense, proprioception, cortical sense, and perception sensitivity than the control group, and showed a statistically significant difference in the usage amount of the upper limb. Based on the results of this study, it is thought that the possibility of effective clinical application of transcranial direct current stimulation for recovery of somatosensory and upper extremity function is thought to be increased.

목적 본 연구의 목적은 한국아동패널의 9차 자료를 사용하여 초등학교 2학년 아동의 지능이 학업수행에 영향을 미치는 관계에서행동문제의 매개효과, 그리고 지능, 행동문제, 학업수행의 관계에서 집행기능의 조절효과를 분석하는 것이다. 방법 연구자료는 한국아동패널 9차 자료에서 결측치를 제거한 초등학교 2학년 아동 930명의 자료이다. 연구과정은 먼저, 잠재프로파일분석을 통해 집행기능의 잠재계층 수를 확인하였다. 다음으로, 실행기능의 잠재집단 별로 지능과 학업수행 관계에서 행동문제의 매개효과가 나타나는지 분석하였다. 마지막으로, 다중집단분석을 통해 실행기능의 수준에 따라 지능, 행동문제, 학업수행의 관계가 조절되는지 분석하였다. 결과 첫째, 초등학교 2학년 아동의 집행기능 분포는 2개의 잠재집단으로 분류되어, 집행기능이 상대적으로 ‘높은’ 집단(31.4%)과‘낮은’ 집단(68.6%)으로 명명하였다. 둘째, 아동의 지능은 학업수행에 직접적으로 영향을 미칠 뿐만 아니라 행동문제를 매개로 하여학업수행에 간접적으로 영향을 미쳤다. 셋째, 지능에 따른 행동문제와 학업성취도의 변화는 실행기능이 상대적으로 ‘낮은’ 집단에서더 크게 나타났다. 결론 이러한 결과를 근거로 초등학교 아동의 행동문제 해결 및 학업수행 향상을 지원하는 데 있어 집행기능 수준이 낮은 집단에 대한중재가 더 효과적일 수 있음을 논의하였다.

Objectives The purpose of this study is to analyze the mediating effect of behavioral problems of 2nd graders in elementary school on the relationship between their intelligence and academic performance and the moderating effect of executive function on the relationships of those three variables using the most recently published 9th data of the Panel Study on Korean Children. Methods The research data is those of 930 second graders with missing values removed from the panel data. The first research process confirmed the number of potential layers of executive function through latent profile analysis. Then, the mediating effect of behavioral problems on the relationship between intelligence and academic performance for each potential group of executive function was analyzed. Lastly, it was analyzed, using multi-group analysis, whether the relationship between intelligence, behavioral problems, and academic performance was moderated according to the level of executive function. Results First, the distribution of executive function of the 2nd graders was classified into two potential groups, and the group with relatively ‘high’ executive function (31.4%) and ‘low’ group (68.6%) were named. Second, intelligence of the children not only directly affected academic performance, but also indirectly affected academic performance mediated through behavioral problems. Third, the changes in behavioral problems and academic performance according to intelligence were greater in the group with a relatively ‘low’ executive function. Conclusions Based on these results, it was discussed that interventions in groups with ‘low’ executive function might be more effective in supporting to solve the behavioral problems and improve academic performance of elementary school students.