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목적 : 학령전기 아동의 이야기이해 능력에 영향을 줄 수 있는 작업기억은 다양하다. 그러나 학령전기 아동을 대상으로 세분화된 작업기억을 이야기이해 능력과 관련지어 분석한 연구들은 많지 않다. 따라서 본 연구는 학령전기 아동을 대상으로 작업기억의 하위요소(음운루프, 시공간잡기장, 일화적완충기)를 모두 살펴보고, 학령전기 아동들을 위한 효과적인 이야기 이해 중재의 기초 자료를 제시하고자 한다. 방법 : 만 4~6세의 언어발달지연 아동 15명과 일반아동 21명 등 총 36명을 대상으로 3개의 작업기억과제(비단어따라말하기, 매트릭스, 단어목록회상)와 2개의 이야기이해 과제(사실, 추론)를 실시하였다. 통계적 처리는 독립표본 t검정과 피어슨 적률상관계수 및 단계적 중다회귀분석을 실시하였다. 결과 : 첫째, 집단에 따른 이야기 이해 과제수행 능력은 일반아동집단의 수행력이 언어발달지연 아동집단보다 높았다. 둘째, 작업기억능력과 사실 이해 능력 간의 관계는 전체의 경우 매트릭스, 단어목록회상 능력이, 일반 아동의 경우에는 비단어따라말하기 능력이 유의한 상관관계를 보였다. 작업기억 능력과 추론 이해 능력 간의 관계는 전체의 경우 비단어따라말하기, 단어목록회상 능력이 유의한 상관관계를 보였다. 셋째, 사실 이해 과제 수행력의 예측요인은 전체의 경우 매트릭스 능력, 일반 아동의 경우는 비단어따라말하기 능력이었다. 추론 이해 과제 수행력의 설명력이 가장 높은 것은 전체의 경우 단어목록회상 능력으로 나타났다. 결론 : 이야기 이해 과제수행 시 시각정보와 장기기억은 제한된 음운정보의 저장 능력과 단기기억의 한계를 보완할 수 있음을 나타내주며, 시공간잡기장과 일화적완충기가 학령전기 아동의 이야기이해 능력을 설명하는 변수가 될 수 있음을 보여준다. 학령전기 아동의 이야기이해 능력에 있어 세분화된 작업기억의 특성을 고려해서 평가와 중재를 할 필요가 있다.

Joon Young Choi,1,* Shin Young Kim,2,* Jae Ha Lee,3 Yong Bum Park,4 Yee Hyung Kim,5 Soo-Jung Um,6 Ki Suck Jung,7 Kwang Ha Yoo,8 Seoung Ju Park,9 Hyoung Kyu Yoon10 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 2Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 3Division of Pulmonology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea; 4Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul 134-701, Republic of Korea; 5Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea; 6Division of Respiratory Medicine, Department of Internal Medicine, Dong-A University College of Medicine, Dong-A University Medical Center, Busan, Republic of Korea; 7Division of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical School, Anyang, Republic of Korea; 8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea; 9Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, Republic of Korea; 10Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea*These authors contributed equally to this work.Correspondence: Hyoung Kyu YoonDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, #62 Youido-Dong Yeongdeungpo-Gu, Seoul, Republic of KoreaTel +82 2 3779 2213Fax +82 2 780 3132Email cmcyhg@gmail.comPurpose: The prevalence of chronic obstructive pulmonary disease (COPD) in females has increased, changing the concept of COPD as a disease mostly limited to males. In this study, the clinical characteristics of COPD in females were investigated.Patients and Methods: The study was based on a multicenter cohort of COPD patients recruited from 54 medical centers in South Korea. Sex-based differences in general characteristics, exposure risk factors, depression scores, results of pulmonary function tests, COPD exacerbation, symptom scores, and radiologic findings were evaluated. Sex-related differences in the annual FEV1 change over 5 years were analyzed in a linear mixed model.Results: Of the 2515 patients enrolled in this study, 8.1% were female. Female patients who had a higher BMI and a lower level of education were less likely to be smokers, were more exposed to passive smoking/biomass, and were more depressed compared to males. The rates of bronchiectasis, previous childhood respiratory infection, and asthma were higher in females. Female patients also had more symptoms and a poorer exercise capacity than males, but no significant differences were observed in terms of exacerbations. Radiologic findings revealed that male patients had worse emphysema, and female patients had worse bronchiectasis, as determined based on chest X-ray and computed tomography findings. On pulmonary function tests, female patients had less obstruction and less annual FEV1 loss over 5 years.Conclusion: This study revealed differences in the clinical parameters between male and female patients with COPD, including general characteristics, disease characteristics, and clinical outcomes.Keywords: COPD, gender difference, KOCOSS database, cohort study