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    체언 μˆ˜μ‹ λΆ€μ‚¬μ˜ 역사적 연ꡬ

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    ν•™μœ„λ…Όλ¬Έ(박사)--μ„œμšΈλŒ€ν•™κ΅ λŒ€ν•™μ› :μΈλ¬ΈλŒ€ν•™ κ΅­μ–΄κ΅­λ¬Έν•™κ³Ό,2019. 8. μ΄ν˜„ν¬.An adverb is a part of speech modifies a certain part of a sentence, but sometimes modifies an entire sentence. Moreover, an adverb could have a different meaning depending on its scope or subject of modification. In the case of Korean, an adverb has acquired various usages while experiencing the change/expansion of its scope: in this process, just like a focus adverb and a degree adverb, it has acquired even the usage of modification of noun. The purpose of this study is to address the process of change in an noun modifying adverb from the perspective of polysemy. In this study, it was divided into three types: Baro, Got, Jeuk, and Junghi; Ggok, Ggokhi, Ddak, Ddakhi; and Hapil, Hapileemyeon. First, there are directive adverbs: Directive adverbs are used when a preceding element is used to strongly emphasize a following element and they include Baro, Got, Jeuk, and Junghi. During the middle age, λ°”α„…α†ž(η›΄, ζ­£) was used as a descriptive adverb, a time adverb, and a degree adverb, but in the modern Korean, it was used as a focus adverb as well. Since then, there has been no significant change in the usage of Baro(<λ°”α„…α†ž) till now. During the Middle Age, Got was used as a time adverb (卽, δΎΏ, θΌ’) and a focus adverb (卽, 則, η›΄), but in the modern Korea, it obtained the usage of sentence conjunction, and of noun phrase conjunction since the modern civilization and it has been used as a conjunctive adverb for typical paraphrase. Therefore, Got has been used as a time adverb, a focus adverb, and a conjunctive adverb for paraphrase. On the other hand, in the middle age, Jeuk(卽) was solely used as a focus adverb, but in the modern Korean, it was used as a time adverb, a focus adverb, and a conjunctive adverb for casual relation and paraphrase. However, its usage as a time adverb and a focus adverb was absorbed in Got, and now, it is only used as a conjunctive adverb for casual relation and paraphrase. In the middle age, ζ­£hi(ζ­£) was used as a descriptive adverb, a degree adverb, and a focus adverb, but from the 19th, its usage has been significantly decreased due to the influences of Baro, Got, and Jung, which are in the similar relation. Second, there are symbolic adverbs. Symbolic adverbs are the one derived from or closely related to onomatopoeia and mimetic words and they include Ggok, Ggokhi, Ddak, Ddakhi. Ggok is a mimetic word used since the modern age, but from the 19th, it has obtained various other usages such as a modal adverb, a degree adverb, a focus adverb, and so on. Ggokhi(<α„­α…©α†¨νžˆ) was used as a modal adverb, a degree adverb, a focus adverb from the late 19th to the 20th, but no longer in use since it was emerged with Ggok and Ddakhi around the mid-20th. Ddak(<ᄯᅑᆨ) was appeared around the 19th, mainly used as onomatopoeia or a mimetic word, but in the 20th, it obtained various other usages, including a degree adverb, a time adverb, and a focus adverb. Ddakhi(<α„―α…‘α†¨νžˆ) is shown to make the first appearance in the modern age: it was used as a focus adverb for a negative sentence, but soon it became to be used as a modal adverb and a degree adverb. Recently, it is used for other than negative sentences. Third, there are appraisal adverbs. Appraisal adverb is a modal adverb, used for describing a speakers negative appraisal of the proposition, and Hapil and Hapileemyeon are included. In the middle age, 何必 was not an independent adverb, but started to be recognized as a single unit since the 19th. At the time, Hapil had three different meanings: how come, necessarily originated from its meaning in the modern Korea; as irony, as it so happens, the meaning of today; and intentionally, on purpose, the meaning connecting the two other meanings of the aforementioned, but after the mid-20th, only the meaning of today has survived. Hapileemyeon is an adverb, first appeared in the mid-20th, which reflects solely the modern meaning of Hapil. Many previous studies on noun modifying adverbs focus on the classification of word classes, or properties of individual adverb types. On the other hand, this study could find its significance from the fact that it has addressed various usages of noun modifying adverbs from the historical perspective and pursued the complete interpretation of every usage of the subject.λΆ€μ‚¬λŠ” λ¬Έμž₯ λ‚΄μ˜ νŠΉμ • 성뢄을 μˆ˜μ‹ν•˜λŠ” ν’ˆμ‚¬μ΄μ§€λ§Œ, λ•Œλ‘œλŠ” λ¬Έμž₯ μ „μ²΄μ˜ λͺ…μ œλ₯Ό μˆ˜μ‹ν•˜κΈ°λ„ ν•œλ‹€. 또 같은 뢀사라 해도 κ·Έ μˆ˜μ‹ λ²”μœ„λ‚˜ λŒ€μƒμ— 따라 μ˜λ―Έκ°€ λ‹¬λΌμ§ˆ 수 μžˆλ‹€λŠ” νŠΉμ§•λ„ μ§€λ‹ˆκ³  μžˆλ‹€. ν•œκ΅­μ–΄μ˜ λΆ€μ‚¬λŠ” μ—­μ‚¬μ μœΌλ‘œ μž‘μš©μ—­μ˜ λ³€ν™”Β·ν™•λŒ€λ₯Ό κ²½ν—˜ν•˜λ©΄μ„œ λ‹€μ–‘ν•œ μš©λ²•μ„ νšλ“ν•˜κ²Œ λ˜μ—ˆκ³ , κ·Έ κ³Όμ •μ—μ„œ μ •λ„λΆ€μ‚¬λ‚˜ μ΄ˆμ λΆ€μ‚¬μ²˜λŸΌ 체언을 μˆ˜μ‹ν•˜λŠ” μš©λ²•μ„ νšλ“ν•˜κΈ°λ„ ν•˜μ˜€λ‹€. 이 μ—°κ΅¬μ˜ λͺ©μ μ€ μ΄λŸ¬ν•œ 체언 μˆ˜μ‹ λΆ€μ‚¬μ˜ 역사적 λ³€ν™” 과정을 λ‹€μ˜μ„±μ˜ μΈ‘λ©΄μ—μ„œ λ…Όμ˜ν•˜λŠ” 것이닀. λ³Έ μ—°κ΅¬μ—μ„œλŠ” λ°”λ‘œ, 곧, 즉, μ •νžˆ, κΌ­, 꼭히, λ”±, λ”±νžˆ, ν•˜ν•„, ν•˜ν•„μ΄λ©΄μ„ μ„Έ λΆ€λ₯˜λ‘œ λΆ„λ₯˜ν•˜μ—¬ λ…Όμ˜λ₯Ό μ§„ν–‰ν•˜μ˜€λ‹€. 첫째, μ§€μ‹œμ„± 뢀사λ₯˜μ΄λ‹€. μ§€μ‹œμ„± 뢀사λ₯˜λŠ” μ„ ν–‰ μš”μ†Œκ°€ ν›„ν–‰ μš”μ†Œλ₯Ό 의미적으둜 κ°•ν•˜κ²Œ λΆ€κ°μ‹œν‚€λŠ” λΆ€μ‚¬λ‘œμ„œ, λ°”λ‘œ, 곧, 즉, μ •νžˆκ°€ 여기에 ν¬ν•¨λœλ‹€. 쀑세 ν•œκ΅­μ–΄ λ°”α„…α†ž(η›΄, ζ­£)λŠ” 성상뢀사, μ‹œκ°„λΆ€μ‚¬, μ •λ„λΆ€μ‚¬λ‘œ κΈ°λŠ₯ν•˜μ˜€μœΌλ‚˜ κ·ΌλŒ€ ν•œκ΅­μ–΄ μ΄ν›„λΆ€ν„°λŠ” μ΄ˆμ λΆ€μ‚¬ μš©λ²•λ„ νšλ“ν•˜μ˜€λ‹€. 이후 λ°”λ‘œ(<λ°”α„…α†ž)의 λͺ¨λ“  μš©λ²•μ€ 별닀λ₯Έ λ³€ν™” 없이 μ˜€λŠ˜λ‚ κΉŒμ§€ μ΄μ–΄μ‘Œλ‹€. 쀑세 ν•œκ΅­μ–΄ 곧은 μ‹œκ°„λΆ€μ‚¬(卽, δΎΏ, θΌ’)와 μ΄ˆμ λΆ€μ‚¬(卽, 則, η›΄)μ˜€λ‹€. 곧은 κ·ΌλŒ€ ν•œκ΅­μ–΄μ— λ¬Έμž₯ μ ‘μ†μ˜ μš©λ²•μ„, κ°œν™”κΈ° 이후뢀터 λͺ…사ꡬ μ ‘μ†μ˜ μš©λ²•μ„ νšλ“ν•˜μ—¬ μ „ν˜•μ  ν™˜μ–Έμ˜ μ ‘μ†λΆ€μ‚¬λ‘œλ„ μ“°μ΄κ²Œ λ˜μ—ˆλ‹€. κ·Έλ¦¬ν•˜μ—¬ μ˜€λŠ˜λ‚ μ˜ 곧은 μ‹œκ°„λΆ€μ‚¬, μ΄ˆμ λΆ€μ‚¬, ν™˜μ–Έμ˜ μ ‘μ†λΆ€μ‚¬λ‘œ 쓰이고 μžˆλ‹€. 즉(卽)은 쀑세 ν•œκ΅­μ–΄μ—μ„œ μ΄ˆμ λΆ€μ‚¬λ‘œλ§Œ κΈ°λŠ₯ν•˜μ˜€μœΌλ‚˜, κ·ΌλŒ€ ν•œκ΅­μ–΄λΆ€ν„° μ‹œκ°„λΆ€μ‚¬, μ΄ˆμ λΆ€μ‚¬, μΈκ³ΌΒ·ν™˜μ–Έμ˜ μ ‘μ†λΆ€μ‚¬λ‘œ μ“°μ΄κ²Œ λ˜μ—ˆλ‹€. κ·ΈλŸ¬λ‚˜ μ‹œκ°„λΆ€μ‚¬μ™€ μ΄ˆμ λΆ€μ‚¬μ˜ μš©λ²•μ€ 곧에 ν‘μˆ˜λ˜λ©΄μ„œ, μ˜€λŠ˜λ‚ μ˜ 즉은 인과와 ν™˜μ–Έμ˜ μ ‘μ†λΆ€μ‚¬λ‘œμ„œμ˜ μš©λ²•λ§Œ κ°–κ²Œ λ˜μ—ˆλ‹€. 쀑세 ν•œκ΅­μ–΄ 正히(ζ­£)λŠ” 성상뢀사, 정도뢀사, μ΄ˆμ λΆ€μ‚¬μ˜€λ‹€. ν•˜μ§€λ§Œ 19μ„ΈκΈ°λ₯Ό 기점으둜, μ •νžˆ(<正히)λŠ” 유의 관계에 있던 뢀사 λ°”λ‘œλ‚˜ 곧, μ •μ˜ 영ν–₯에 λ°€λ € κ·Έ μš©λ²•μ΄ λŒ€ν­ μΆ•μ†Œλœ 채 μ˜€λŠ˜λ‚ μ— 이λ₯΄λ €λ‹€. λ‘˜μ§Έ, 상징성 뢀사λ₯˜μ΄λ‹€. 상징성 뢀사λ₯˜λž€ μ˜μ„±μ–΄Β·μ˜νƒœμ–΄μ—μ„œ λΉ„λ‘―ν•˜μ˜€κ±°λ‚˜, 그와 λ°€μ ‘ν•œ 연관이 μžˆλŠ” λΆ€λ₯˜λ‘œμ„œ, κΌ­, 꼭히, λ”±, λ”±νžˆκ°€ 여기에 ν¬ν•¨λœλ‹€. 꼭은 κ·ΌλŒ€ ν•œκ΅­μ–΄λΆ€ν„° λ“±μž₯ν•œ μ˜νƒœμ–΄μ˜€μ§€λ§Œ, 19μ„ΈκΈ° 이후뢀터 μ–‘νƒœλΆ€μ‚¬, 정도뢀사, μ΄ˆμ λΆ€μ‚¬ λ“±μ˜ μš©λ²•μ„ νšλ“ν•˜μ—¬ μ˜€λŠ˜λ‚ μ— 이λ₯΄λ €λ‹€. 꼭히(<α„­α…©α†¨νžˆ)λŠ” 19μ„ΈκΈ° ν›„λ°˜λΆ€ν„° 20μ„ΈκΈ°κΉŒμ§€ μ–‘νƒœλΆ€μ‚¬, 정도뢀사, μ΄ˆμ λΆ€μ‚¬λ‘œ κΈ°λŠ₯ν•˜μ˜€μ§€λ§Œ, 20μ„ΈκΈ° μ€‘λ°˜μ„ μ „ν›„ν•˜μ—¬ κΌ­κ³Ό λ”±νžˆμ— ν•©λ₯˜λœ μ΄ν›„λΆ€ν„°λŠ” 더 이상 쓰이지 μ•Šμ•˜λ‹€. λ”±(<ᄯᅑᆨ)은 19μ„ΈκΈ°λ₯Ό μ „ν›„ν•œ μ‹œκΈ°μ— λ“±μž₯ν•˜μ˜€λŠ”λ°, μ˜μ„±μ–΄μ™€ μ˜νƒœμ–΄κ°€ μ• μ΄ˆμ˜ μš©λ²•μ΄μ—ˆλ‹€. 딱은 20μ„ΈκΈ°λΆ€ν„° 정도뢀사, μ‹œκ°„λΆ€μ‚¬, μ΄ˆμ λΆ€μ‚¬μ˜ μš©λ²•μ„ νšλ“ν•˜μ—¬ μ˜€λŠ˜λ‚ μ— 이λ₯΄λ €λ‹€. λ”±νžˆ(<α„―α…‘α†¨νžˆ)λŠ” κ·ΌλŒ€ ν•œκ΅­μ–΄ μ‹œκΈ°λΆ€ν„° κ·Έ μ‘΄μž¬κ°€ ν™•μΈλœλ‹€. λ”±νžˆλŠ” λΆ€μ •λ¬Έμ—λ§Œ μ“°μ΄λŠ” μ΄ˆμ λΆ€μ‚¬μ˜€μœΌλ‚˜, 곧 μ–‘νƒœλΆ€μ‚¬μ™€ μ •λ„λΆ€μ‚¬μ˜ μš©λ²•μ„ νšλ“ν•˜μ˜€κ³ , μ˜€λŠ˜λ‚ μ—λŠ” 뢀정문이 μ•„λ‹Œ ν™˜κ²½μ—μ„œλ„ μ“°μ΄κ²Œ λ˜μ—ˆλ‹€. μ…‹μ§Έ, 평가성 뢀사λ₯˜μ΄λ‹€. 평가성 뢀사λ₯˜λŠ” λͺ…μ œμ— λŒ€ν•œ ν™”μžμ˜ 뢀정적 평가λ₯Ό λ“œλŸ¬λ‚΄λŠ” μ–‘νƒœλΆ€μ‚¬λ‘œμ„œ ν•˜ν•„κ³Ό ν•˜ν•„μ΄λ©΄μ΄ 이 λΆ€λ₯˜μ— μ†ν•œλ‹€. 쀑세 ν•œκ΅­μ–΄ 何必은 λ‹¨λ…μ˜ λ…λ¦½λœ 뢀사가 μ•„λ‹ˆμ—ˆμœΌλ‚˜, 19μ„ΈκΈ° 이후뢀터 ν•˜λ‚˜μ˜ λ‹¨μœ„λ‘œ μΈμ‹λ˜κΈ° μ‹œμž‘ν•˜μ˜€λ‹€. λ‹Ήμ‹œμ˜ ν•˜ν•„μ—λŠ” κ·ΌλŒ€ ν•œκ΅­μ–΄μ—μ„œ λΉ„λ‘―λœ μ–΄μ°Œ, μ–΄μ°Œ λ°˜λ“œμ‹œμ˜ 의미, ν˜„λŒ€ ν•œκ΅­μ–΄μ˜ 의미인 ꡳ이, κ³΅κ΅λ‘­κ²Œλ„, 이 두 의미λ₯Ό μ΄μ–΄μ£ΌλŠ” ꡳ이, κ΅¬νƒœμ—¬λΌλŠ” μ„Έ 가지 μ˜λ―Έκ°€ ν˜Όμž¬ν•΄ μžˆμ—ˆμœΌλ‚˜, 20μ„ΈκΈ° μ€‘λ°˜ 이후 μ˜€λŠ˜λ‚ μ˜ 의미만 λ‚¨κ²Œ λ˜μ—ˆλ‹€. 20μ„ΈκΈ° μ€‘λ°˜λΆ€ν„° λ“±μž₯ν•œ ν•˜ν•„μ΄λ©΄μ€ ν•˜ν•„μ˜ ν˜„λŒ€μ  의미만 λ°˜μ˜ν•œ 뢀사이닀. 체언 μˆ˜μ‹ 뢀사에 λŒ€ν•œ λ‹€μˆ˜μ˜ μ„ ν–‰ μ—°κ΅¬λŠ” ν’ˆμ‚¬ λΆ„λ₯˜μ˜ λ¬Έμ œλ‚˜, κ°œλ³„ λΆ€μ‚¬μ˜ νŠΉμ„±μ—λ§Œ μ£Όλͺ©ν•˜μ˜€λ‹€λŠ” ν•œκ³„κ°€ μžˆμ—ˆλ‹€. λ³Έ μ—°κ΅¬λŠ” 체언 μˆ˜μ‹ λΆ€μ‚¬μ˜ λ‹€μ˜μ  μš©λ²•μ„ μ—­μ‚¬μ μœΌλ‘œ κ³ μ°°ν•˜κ³ , 이λ₯Ό ν†΅ν•˜μ—¬ 연ꡬ λŒ€μƒμ˜ λͺ¨λ“  μš©λ²•μ— λŒ€ν•˜μ—¬ μ˜¨μ „ν•œ 해석을 μΆ”κ΅¬ν•˜μ˜€λ‹€λŠ” μ μ—μ„œ μ˜μ˜κ°€ μžˆλ‹€ ν•˜κ² λ‹€.1. μ„œλ‘  1 1.1. 연ꡬ λͺ©μ  1 1.2. μ„ ν–‰ 연ꡬ κ²€ν†  3 1.3. 연ꡬ λŒ€μƒκ³Ό 연ꡬ 방법 8 1.4. λ…Όμ˜μ˜ ꡬ성 13 1.5. 인용 자료 14 2. μ§€μ‹œμ„± 뢀사λ₯˜ 21 2.1. λ°”λ‘œ 22 2.1.1. ν˜„λŒ€ ν•œκ΅­μ–΄μ˜ λ°”λ‘œ 22 2.1.2. ν˜„λŒ€ ν•œκ΅­μ–΄ μ΄μ „μ˜ λ°”λ‘œ 31 2.2. 곧 60 2.2.1. ν˜„λŒ€ ν•œκ΅­μ–΄μ˜ 곧 60 2.2.2. ν˜„λŒ€ ν•œκ΅­μ–΄ μ΄μ „μ˜ 곧 68 2.3. 즉 85 2.3.1. ν˜„λŒ€ ν•œκ΅­μ–΄μ˜ 즉 85 2.3.2. ν˜„λŒ€ ν•œκ΅­μ–΄ μ΄μ „μ˜ 즉 89 2.4. μ •νžˆ 106 2.4.1. ν˜„λŒ€ ν•œκ΅­μ–΄μ˜ μ •κ³Ό μ •νžˆ 106 2.4.2. ν˜„λŒ€ ν•œκ΅­μ–΄ μ΄μ „μ˜ μ •νžˆ 110 3. 상징성 뢀사λ₯˜ 130 3.1. κΌ­λ₯˜ 131 3.1.1. ν˜„λŒ€ ν•œκ΅­μ–΄μ˜ κΌ­ 131 3.1.2. ν˜„λŒ€ ν•œκ΅­μ–΄ μ΄μ „μ˜ κΌ­ 137 3.1.3. ν˜„λŒ€ ν•œκ΅­μ–΄μ˜ 꼭히 150 3.1.4. ν˜„λŒ€ ν•œκ΅­μ–΄ μ΄μ „μ˜ 꼭히 153 3.2. λ”±λ₯˜ 158 3.2.1. ν˜„λŒ€ ν•œκ΅­μ–΄μ˜ λ”± 158 3.2.2. ν˜„λŒ€ ν•œκ΅­μ–΄ μ΄μ „μ˜ λ”± 165 3.2.3. ν˜„λŒ€ ν•œκ΅­μ–΄μ˜ λ”±νžˆ 179 3.2.4. ν˜„λŒ€ ν•œκ΅­μ–΄ μ΄μ „μ˜ λ”±νžˆ 184 4. 평가성 뢀사λ₯˜ 194 4.1. ν˜„λŒ€ ν•œκ΅­μ–΄μ˜ ν•˜ν•„ 196 4.2. ν˜„λŒ€ ν•œκ΅­μ–΄ μ΄μ „μ˜ ν•˜ν•„ 204 5. κ²°λ‘  232 μ°Έκ³ λ¬Έν—Œ 236 249Docto

    Genetic factors affecting dopaminergic deterioration during the premotor stage of Parkinson disease

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    To estimate dopaminergic dysfunction in patients with Parkinson disease (PD) during the premotor stage and to investigate the effect of genetic factors on the trajectories. Using longitudinal dopamine transporter single-photon emission computed tomography data from 367 sporadic PD (sPD), 72 LRRK2 (G2019S), and 39 GBA (N370S) PD patients in the Parkinson's Progression Markers Initiative (PPMI) study, we estimated the temporal trajectories of putaminal-specific binding ratios using an integrating function between baseline values and their annual change rates. In order to test reproducibility, we computed another trajectory for sPD using positron emission tomography data of 38 sPD patients at Gangnam Severance Hospital (GSH). Temporal trajectories of sPD were compared between the groups separated by age at onset (AAO) and polygenic load for common PD risk variants, and also compared with genetic PD. sPD patients in both the PPMI and GSH cohorts showed similar onset of dopaminergic degeneration around 10 years before motor onset. Early-onset PD patients exhibited later onset of degeneration and a faster decline in dopaminergic activity during the premotor period than late-onset patients. sPD patients with high polygenic load were associated with earlier onset and slower progression of dopaminergic dysfunction. Compared to the sPD and LRRK2 PD groups, GBA PD patients exhibited faster deterioration of dopaminergic function during the premotor stage. Dopaminergic dysfunction in PD appears to start about 10 years before motor onset. Genetic factors may be contributing to the heterogeneity of dopaminergic deterioration during the premotor stage.ope

    A Patient Self-Checkup App for COVID-19: Development and Usage Pattern Analysis

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    Background: Clear guidelines for a patient with suspected COVID-19 infection are unavailable. Many countries rely on assessments through a national hotline or telecommunications, but this only adds to the burden of an already overwhelmed health care system. In this study, we developed an algorithm and a web application to help patients get screened. Objective: This study aims to aid the general public by developing a web-based application that helps patients decide when to seek medical care during a novel disease outbreak. Methods: The algorithm was developed via consultations with 6 physicians who directly screened, diagnosed, and/or treated patients with COVID-19. The algorithm mainly focused on when to test a patient in order to allocate limited resources more efficiently. The application was designed to be mobile-friendly and deployed on the web. We collected the application usage pattern data from March 1 to March 27, 2020. We evaluated the association between the usage pattern and the numbers of COVID-19 confirmed, screened, and mortality cases by access location and digital literacy by age group. Results: The algorithm used epidemiological factors, presence of fever, and other symptoms. In total, 83,460 users accessed the application 105,508 times. Despite the lack of advertisement, almost half of the users accessed the application from outside of Korea. Even though the digital literacy of the 60+ years age group is half of that of individuals in their 50s, the number of users in both groups was similar for our application. Conclusions: We developed an expert-opinion-based algorithm and web-based application for screening patients. This innovation can be helpful in circumstances where information on a novel disease is insufficient and may facilitate efficient medical resource allocation.ope

    Temporal trajectory of biofluid markers in Parkinson's disease

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    Full dynamics of biofluid biomarkers have been unknown in patients with Parkinson's disease (PD). Using data from 396 PD patients and 182 controls in the Parkinson's Progression Markers Initiative (PPMI) database, we estimated long-term temporal trajectories of CSF Ξ±-synuclein (Ξ±-syn), amyloid-Ξ² (AΞ²), total tau (t-tau), phosphorylated tau (p-tau) and serum neurofilament light chain (NfL) by integrating function between the baseline levels and annual changes. At baseline, PD patients showed lower CSF Ξ±-syn, AΞ², t-tau and p-tau levels than those of the controls. In all PD patients, CSF Ξ±-syn and AΞ² decreased in a negative exponential pattern before the onset of motor symptoms, whereas CSF t-tau and p-tau, and serum NfL increased. Patients with cognitive impairment exhibited faster decline of AΞ² and Ξ±-syn and faster rise of t-tau, p-tau and NfL, when compared to those without. Similarly, low AΞ² group showed earlier decline of Ξ±-syn, faster rise of t-tau, p-tau and NfL, and faster decline of cognitive performances, when compared to high AΞ² group. Our results suggest that longitudinal changes in biomarkers can be influenced by cognitive impairment and AΞ² burden at baseline. PD patients with AΞ² pathology may be associated with early appearance of Ξ±-synuclein pathology, rapid progression of axonal degeneration and neurodegeneration, and consequently greater cognitive decline.ope

    Dynamic network model reveals distinct tau spreading patterns in early- and late-onset Alzheimer disease

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    Background: The clinical features of Alzheimer's disease (AD) vary substantially depending on whether the onset of cognitive deficits is early or late. The amount and distribution patterns of tau pathology are thought to play a key role in the clinical characteristics of AD, which spreads throughout the large-scale brain network. Here, we describe the differences between tau-spreading processes in early- and late-onset symptomatic individuals on the AD spectrum. Methods: We divided 74 cognitively unimpaired (CU) and 68 cognitively impaired (CI) patients receiving 18F-flortaucipir positron emission tomography scans into two groups by age and age at onset. Members of each group were arranged in a pseudo-longitudinal order based on baseline tau pathology severity, and potential interregional tau-spreading pathways were defined following the order using longitudinal tau uptake. We detected a multilayer community structure through consecutive tau-spreading networks to identify spatio-temporal changes in the propagation hubs. Results: In each group, ordered tau-spreading networks revealed the stage-dependent dynamics of tau propagation, supporting distinct tau accumulation patterns. In the young CU/early-onset CI group, tau appears to spread through a combination of three independent communities with partially overlapped territories, whose specific driving regions were the basal temporal regions, left medial and lateral temporal regions, and left parietal regions. For the old CU/late-onset CI group, however, continuation of major communities occurs in line with the appearance of hub regions in the order of bilateral entorhinal cortices, parahippocampal and fusiform gyri, and lateral temporal regions. Conclusion: Longitudinal tau propagation depicts distinct spreading pathways of the early- and late-onset AD spectrum characterized by the specific location and appearance period of several hub regions that dominantly provide tau.ope

    {-고뎌,: 과뎌} γ…Žγ€ ꡬ성에 λŒ€ν•œ ν†΅μ‹œμ  연ꡬ

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    2011λ…„ 2μ›” κ΅­μ–΄ν•™ μ„μ‚¬ν•™μœ„ λ…Όλ¬Έ, μ§€λ„κ΅μˆ˜ μ΄ν˜„ν¬ 선생

    Analysis of dysphagia handicap index(DHI) in stroke patients and associated factors

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    μ–Έμ–΄λ³‘λ¦¬ν•™ν˜‘λ™κ³Όμ •μ‚Όν‚΄μž₯μ• λŠ” λ‡Œμ‘Έμ€‘ ν™˜μžμ˜ 신체 κ±΄κ°•λΏλ§Œ μ•„λ‹ˆλΌ μ‚Άμ˜ μ§ˆμ—λ„ 영ν–₯을 λΌμΉœλ‹€. λ”°λΌμ„œ ν™˜μž μ€‘μ‹¬μ˜ 주관적 ν‰κ°€λŠ” 객관적 평가 λͺ»μ§€μ•Šκ²Œ μ€‘μš”ν•˜λ‹€. ν˜„μž¬κΉŒμ§€ 주관적 μ‚Όν‚΄ 평가 도ꡬλ₯Ό ν™œμš©ν•˜μ—¬ μ‚Όν‚΄ κ΄€λ ¨ μ‚Άμ˜ μ§ˆμ„ μ‘°μ‚¬ν•œ 연ꡬ가 λ‹€μˆ˜ μ§„ν–‰λ˜μ—ˆμ§€λ§Œ, λ™μ§ˆμ (homogeneous) μ§ˆν™˜μ˜ ν™˜μžκ΅°μ„ λŒ€μƒμœΌλ‘œ ν•œ μ—°κ΅¬λŠ” λ“œλ¬Όμ—ˆμœΌλ©° μ‚Όν‚΄ κ΄€λ ¨ 변인을 μ„ΈλΆ„ν™”ν•˜μ—¬ μƒλŒ€μ  영ν–₯λ ₯을 λΆ„μ„ν•œ μ—°κ΅¬λŠ” 거의 이뀄지지 μ•Šμ•˜λ‹€. λ”°λΌμ„œ λ³Έ μ—°κ΅¬λŠ” λ‡Œμ‘Έμ€‘ ν™˜μž 45λͺ…을 λŒ€μƒμœΌλ‘œ μ‚Όν‚΄μž₯μ• μ§€μˆ˜(DHI)λ₯Ό μ‘°μ‚¬ν•œ ν›„, μ‚Όν‚΄ κ΄€λ ¨ μ‚Άμ˜ μ§ˆμ— 영ν–₯을 λ―ΈμΉ˜λŠ” μ£Όμš” 변인을 ꡬ체적으둜 λΆ„μ„ν•˜μ˜€λ‹€. λ‡Œμ‘Έμ€‘ ν™˜μžκ΅°μ˜ DHI μ μˆ˜λŠ” μ„ ν–‰ μ—°κ΅¬μ—μ„œ 보고된 정상ꡰ μ μˆ˜μ— λΉ„ν•΄ ν˜„μ €νžˆ λ†’μ•˜μœΌλ©°, ν•˜μœ„ μ˜μ—­λ³„λ‘œλŠ” κΈ°λŠ₯적 및 신체적, μ •μ„œμ  μ˜μ—­ 순으둜 μ μˆ˜κ°€ λ†’μ•˜λ‹€. DHIλŠ” 일반적 νŠΉμ„±μΈ μœ λ³‘κΈ°κ°„, λ‡Œμ‘Έμ€‘ ν›„ μƒνƒœμ— κ΄€ν•œ μ§€ν‘œμΈ 인지 κΈ°λŠ₯(K-MMSE), λ‡Œμ‘Έμ€‘ ν›„ 쀑증도(NIHSS), 우울 μˆ˜μ€€(GDS)κ³Ό μœ μ˜ν•œ 상관관계가 μžˆμ—ˆμœΌλ©°, μ‚Όν‚΄ κΈ°λŠ₯ μ§€ν‘œμΈ 침슡 및 흑인 정도(PAS), κΈ°λŠ₯적 μ‚Όν‚΄μž₯μ•  정도(FDS), 식이 단계(ASHA NOMS)와 높은 상관관계λ₯Ό λ³΄μ˜€λ‹€. 일반적 μ‚Όν‚΄ κΈ°λŠ₯ κ΄€λ ¨ 변인 쀑 DHI에 κ°€μž₯ 큰 μƒλŒ€μ  영ν–₯λ ₯을 λ―ΈμΉ˜λŠ” 변인은 FDS, PAS 순으둜, 이듀 두 변인은 κ²°ν•©μ μœΌλ‘œ DHIλ₯Ό 66.3% μ„€λͺ…ν•˜μ˜€λ‹€. ν•˜μ§€λ§Œ μ‚Όν‚΄ κΈ°λŠ₯을 μ„ΈλΆ„ν™”ν•  λ•Œ κ°€μž₯ 영ν–₯λ ₯이 큰 변인은 침슡 및 흑인, μž…μˆ  폐쇄, μ‚Όν‚΄ ν›„ 인두벽 μ½”νŒ… μˆœμ΄μ—ˆμœΌλ©°, 이듀은 DHIλ₯Ό 61.8% μ„€λͺ…ν•˜μ˜€λ‹€. ꡬ강 및 인두 λ‹¨κ³„μ˜ κΈ°λŠ₯적 μ‚Όν‚΄μž₯애정도(FDS)만 μ‚΄νŽ΄λ³΄μ•˜μ„ λ•ŒλŠ” 인두 이동 μ‹œκ°„, μŒμ‹λ©μ΄ ν˜•μ„±, μ‚Όν‚΄ ν›„ 인두벽 μ½”νŒ… 순으둜 큰 영ν–₯λ ₯을 κ°€μ‘ŒμœΌλ©°, 이듀 μ„Έ 변인은 DHI에 λŒ€ν•˜μ—¬ 60.2%의 μ„€λͺ…λ ₯을 λ³΄μ˜€λ‹€. 결둠적으둜 인두 λ‹¨κ³„μ˜ μ‚Όν‚΄ λ¬Έμ œκ°€ ꡬ강 λ‹¨κ³„μ˜ λ¬Έμ œλ³΄λ‹€ μ‚Όν‚΄ κ΄€λ ¨ μ‚Άμ˜ μ§ˆμ— λŒ€ν•˜μ—¬ μƒλŒ€μ μœΌλ‘œ 큰 영ν–₯을 λ―ΈμΉ˜λŠ” κ²ƒμœΌλ‘œ λ‚˜νƒ€λ‚¬λ‹€. Since swallowing disorders affect not only physical health but also the quality of life, it is important to evaluate the self-perception of swallowing problems. However, there have been few studies which investigated the effect of swallowing functions on the swallowing-related quality of life in detail. Thus, this study aimed to analyze the key factors of the swallowing-related quality of life by Dysphagia Handicap Index(DHI) in 45 stroke patients. The average DHI of stroke patients was higher than that of normal group reported by previous studies. This suggested that patients were generally aware of their own swallowing problems. They experienced discomforts in order of functional, physical, and emotional aspects due to their swallowing disorder. The DHI of stroke patients showed significant correlation with the post onset time(POT), K-MMSE, NIHSS, GDS, PAS, FDS, and ASHA NOMS scale. However, DHI had no significant correlation with gender, age, diagnosis, stroke lesion, MBI, and FAC. At the total score level, the most influential factors of DHI were FDS and PAS, accounting for 66.3% of DHI. However, in the further analysis with sub-items, β€˜the level of penetration or aspiration’ showed the greatest effects. In the last model, β€˜the level of penetration or aspiration’, β€˜lip closure’, β€˜coating of pharyngeal wall after swallow’ accounted for 61.8% of DHI. When dealing with only FDS sub-items, β€˜pharyngeal transit time’, β€˜bolus formation’, β€˜coating of pharyngeal wall after swallow’ showed the most influence, accounting for 60.2% of DHI. In conclusion, the swallowing dysfunctions in pharyngeal phase had more impact on swallowing-related quality of life compared to those in oral phase.open석

    고뎌, 과뎌 ν•˜ ꡬ성에 λŒ€ν•œ ν†΅μ‹œμ  연ꡬ

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    ν•™μœ„λ…Όλ¬Έ (석사)-- μ„œμšΈλŒ€ν•™κ΅ λŒ€ν•™μ› : κ΅­μ–΄κ΅­λ¬Έν•™κ³Ό, 2011.2. μ΄ν˜„ν¬.Maste

    Factors associated with perioperative epilepsy of supratentorial meningioma

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    μ˜ν•™κ³Ό/μ„μ‚¬μ„œλ‘ : μˆ˜λ§‰μ’…μ€ 비ꡐ적 ν”ν•œ λ‡Œμ’…μ–‘μœΌλ‘œ 전체 λ‘κ°œλ‚΄ μ’…μ–‘μ˜ 20% κ°€λŸ‰μ„ μ°¨μ§€ν•œλ‹€. λ‘κ°œλ‚΄ μˆ˜λ§‰μ’… ν™˜μžμ—μ„œ λ°œμž‘μ€ λΉˆλ²ˆν•˜κ²Œ μΌμ–΄λ‚˜λŠ” 신경학적 증상이닀. μ €μžλŠ” μˆ˜λ§‰μ’… ν™˜μžμ—μ„œ 수술 μ „ν›„μ˜ λ°œμž‘μ„ μΌμœΌν‚€λŠ” μ—°κ΄€ μΈμžλ“€μ„ μ‘°μ‚¬ν•˜μ—¬ λΆˆν•„μš”ν•œ ν•­λ‡Œμ „μ¦μ œμ˜ νˆ¬μ•½μ„ μ€„μ΄κ³ μž ν•˜μ˜€λ‹€. 재료 및 방법: 2006λ…„ 7μ›”λΆ€ν„° 2015λ…„ 9μ›”κΉŒμ§€ κ°•λ‚¨μ„ΈλΈŒλž€μŠ€ λ³‘μ›μ—μ„œ μ²œλ§‰μœ„ μˆ˜λ§‰μ’… μˆ˜μˆ μ„ μ‹œν–‰ν•œ 성인을 λŒ€μƒμœΌλ‘œ ν•˜μ˜€λ‹€. 의무기둝, λ‡Œμ˜μƒ, λ‡ŒνŒŒκ²€μ‚¬κΈ°λ‘, λ°œμž‘μ˜ νŠΉμ„±, 절제 λ²”μœ„, λ³‘λ¦¬μ†Œκ²¬μ„ ν›„ν–₯적으둜 λΆ„μ„ν•˜μ˜€λ‹€. κ²°κ³Ό: 총 307λͺ…μ˜ ν™˜μžκ°€ ν¬ν•¨λ˜μ—ˆκ³  이쀑 58λͺ…(18.9%)의 ν™˜μžκ°€ 수술 μ „ν›„ λ°œμž‘μ„ ν•˜μ˜€μœΌλ©° 이쀑35λͺ…(11.4%)은 수술 μ „ μ¦μƒμœΌλ‘œ λ°œμž‘μ„ ν•˜μ˜€κ³  40λͺ…(13.0%)의 ν™˜μžλŠ” 수술 후에 λ°œμž‘μ„ λ³΄μ˜€λ‹€. λ‹€λ³€λŸ‰ λ‘œμ§€μŠ€ν‹± νšŒκ·€λΆ„μ„μ„ μ‹œν–‰ν•˜μ˜€κ³  수술 μ „ν›„μ˜ λ°œμž‘κ³Ό μ—°κ΄€λœ 독립적인 μœ„ν—˜μΈμžλŠ” μ’…μ–‘κ·Όμ²˜ λΆ€μ’…(OR=2.299; 95% CI, 1.174-4.505, p=0.015)κ³Ό μ’…μ–‘μ˜ 크기(OR=1.020; 95% CI, 1.002-1.039, p=0.030)μ˜€λ‹€. κΈ‰μ„± 증상성 λ°œμž‘μ€ μ΄μ „μ˜ λ‡Œ λ³‘λ³€μ˜ κ³Όκ±°λ ₯(OR=6.211; 95% CI, 1.130-34.483, p=0.036)κ³Ό λ‡Œμ‹ κ²½ 증상(OR=4.348; 95% CI, 1.143-16.393, p=0.031)이 μ—°κ΄€λ˜μ—ˆκ³ , 지연성 λ°œμž‘μ˜ 경우 μ’…μ–‘μ˜ 크기(OR=1.046; 95% CI, 1.018-1.074, p=0.001)μ™€λ§Œ 연관성을 λ³΄μ˜€λ‹€. κ²°λ‘ : λ³Έ μ—°κ΅¬μ—μ„œ 수술 μ „ν›„ λ°œμž‘μ˜ κ°€μž₯ 큰 μœ„ν—˜μΈμžλŠ” μ’…μ–‘κ·Όμ²˜ λΆ€μ’…κ³Ό ν¬κΈ°μ˜€μœΌλ©° ν–₯ν›„ λ‡Œμ „μ¦μœΌλ‘œ μ§„ν–‰λ˜μ—ˆλ‹€κ³  λ³Ό 수 μžˆλŠ” 지연성 λ°œμž‘μ€ μ’…μ–‘μ˜ 크기만이 μ—°κ΄€λ˜μ—ˆλ‹€. μˆ˜λ§‰μ’… ν™˜μžμ—κ²Œ 예방적 ν•­λ‡Œμ „μ¦μ œλŠ” ꢌμž₯λ˜μ§€ μ•ŠμœΌλ‚˜ μ’…μ–‘μ˜ 크기가 큰 ν™˜μžμ—μ„œ μ„ νƒμ μœΌλ‘œ κ³ λ €ν•  수 μžˆκ² λ‹€.ope
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