• 한국콘텐츠학회논문지
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• 제18권4호
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• pp.653-663
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• 2018

본 연구는 중장년층의 치매관련 태도 및 치매예방행위의 정도, 그리고 상관관계를 확인하기 위한 서술적 조사연구이다. 본 연구에서는 2017년 10월 1일부터 9일까지 국내의 40~60대 중장년층을 대상으로 온라인 설문조사를 통해 자료를 수집하였으며 최종 220부의 설문지가 수거되었다. 자료는 t-test, One way ANOVA, Pearson's correlation coefficient 등을 통해 분석되었다. 연구결과는 다음과 같다. 첫째, 연구대상자 중 52.7%가 치매예방에 대한 관심이 높았으나 단지 5.9%만이 치매와 관련된 교육을 받은 경험이 있었다. 둘째, 암, 뇌혈관질환, 심혈관질환에 비해 치매 발병에 대한 두려움은 높았으나, 질병극복에 대한 자신감, 일상생활 유지 가능성에 대한 기대감, 가족 및 주변인의 도움에 대한 기대감, 국가의 의료 및 경제적 지원에 대한 기대감은 유의하게 낮았다. 셋째, 치매예방행위를 실천할수록 질병극복에 대한 자신감, 일상생활 유지가능성에 대한 기대감, 가족 및 주변인의 도움에 대한 기대감, 국가의 의료 및 경제적 지원에 대한 기대감이 높아졌으며, 치료비의 부담감이 낮아졌다. 본 연구결과를 통해 노인질환으로만 생각하였던 치매에 대해 중장년층의 인식 변화와 조기예방을 위한 사회적 제도 마련 및 교육, 홍보 활동이 필요하다는 것을 확인하였다. 결과적으로 이러한 개인적, 사회적 노력은 치매로 인한 신체적, 심리적, 사회 경제적인 문제를 감소시켜 국민의 삶의 질을 향상시킬 것이라 사료된다.

• 동의생리병리학회지
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• 제18권6호
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• pp.1881-1891
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• 2004

Daejowhan-gamibang(DJG) is used to prevention and treatment of cerebrovascular disease, heart disease, dementia, hyperlipdemia circulatory disturbance. Korean traditional herbal prescriptions and herb medicines in neuronal cells, which have been used for the treatment of stroke and brain diseases in Korean traditional medicine were screened to study the antioxidant effects and its mechanism. Daejowhan-gamibang water extract(DJGWE) was tested on their antioxidant activity using radical scavenging effects against ABTS. It showed significant antioxidant capacities at 50㎍ concentration. The antioxidant activity of DJGWE was determined in the different concentration (10㎍, 50 ㎍, and 100㎍). At the same time, the antiperoxidation effects was determined. Lipid peroxidation in brain homogenates induced by NADPH and ADP-Fe/sup 2+/ was significantly inhibited by DJGWE in vitro. DJGWE showed a potent antioxidant and antiperoxidative activity, further investigation, in vitro and in vivo, will be needed for the confirm of possibility as an antioxidant therapeutic agents and their optimal treatment of brain diseases in human. In searching the mechanism of antioxidant effects of DJGWE, it showed the inhibition of activity of JNK, p38, ERK and caspase 3 induced by hypoxia. So, DJGWE should be surveyed for the use of the potential therapeutic prescription for stroke and brain degenerative diseases such as pakinson's disease, dementia.

• 대한방사성의약품학회지
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• 제6권2호
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• pp.116-130
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• 2020

The aging society is globally one of biggest issue because it is related with various degenerative brain disease such as dementia, Parkinson's disease, Alzheimer's disease, multiple sclerosis, and cerebrovascular disease. These diseases are characterized by misfolded-protein aggregation; another pathological trait is "neuroinflammation". In physiological state, the resting microglia cells are activated and it removes abnormal synapses and cell membrane debris to maintain the homeostasis. In pathological state, however, microglia undergo morphological change form 'resting' to 'activated amoeboid phenotype' and the microglia cells are accumulated by neuronal damage, the inflammatory reactions induced nerve metamorphosis with a variety of neurotoxic factors including cytokines, chemokines, and reactive oxygen species. Thus, the activated microglia cell with various receptors (TSPO, COX, CR, P2XR, etc.) was perceived as important biomarkers for imaging the inflammatory progression. In this review, we would like to introduce the current status of the development of radiotracers that can image activated microglia.

• 대한임상검사과학회지
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• 제38권3호
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• pp.179-183
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• 2006

Alzheimer's disease (AD) is characterised neuropathologically by the accumulation of neuritic plaques and neurofibrillary tangles as well as by cerebrovascular amyloid deposition and neuronal cell loss. Current advances have shown the apolipoproteinE-epsilon 4 (ApoE4) allele to be highly associated with late-onset familial and sporadic Alzheimer's disease (AD) in Western populations. The association of ApoE allele frequencies and dementia remains unknown in populations from many countries. We recently initiated a project to examine ApoE frequencies in non-demented healthy Koreans. Genomic DNA in hair root from a thousand persons was collected and ApoE gene type was investigated with the methods of polymerase chain reaction (PCR) and restriction fragment length polymorphism. A group of a thousand non-demented Koreans over the age of 40 years were found to be positive in 15.7% of the cases for ApoE4. AD and ApoE4 were closely related. ApoE epsilon 4 was a dangerous factor of AD and ApoE 4 allele made a contribution to the heterogenicity of AD.

• 대한치매학회지
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• 제22권1호
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• pp.28-42
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• 2023

Background and Purpose: We investigated the correlation between the deep distribution of white matter hyperintensity (WMH) (dWMH: WMH in deep and corticomedullary areas, with minimal periventricular WMH) and a positive agitated saline contrast echocardiography result. Methods: We retrospectively recruited participants with comprehensive dementia evaluations, an agitated saline study, and brain imaging. The participants were classified into two groups according to WMH-distributions: dWMH and dpWMH (mainly periventricular WMH with or without deep WMH.) We hypothesized that dWMH is more likely associated with embolism, whereas dpWMH is associated with small-vessel diseases. We compared the clinical characteristics, WMH-distributions, and positive rate of agitated saline studies between the two groups. Results: Among 90 participants, 27 and 12 met the dWMH and dpWMH criteria, respectively. The dWMH-group was younger (62.2±7.5 vs. 78.9±7.3, p<0.001) and had a lower prevalence of hypertension (29.6% vs. 75%, p=0.008), diabetes mellitus (3.7% vs. 25%, p=0.043), and hyperlipidemia (33.3% vs. 83.3%, p=0.043) than the dpWMH-group. Regarding deep white matter lesions, the number of small lesions (<3 mm) was higher in the dWMH-group(10.9±9.7) than in the dpWMH-group (3.1±6.4) (p=0.008), and WMH was predominantly distributed in the border-zones and corticomedullary areas. Most importantly, the positive agitated saline study rate was higher in the dWMH-group than in the dpWMH-group (81.5% vs. 33.3%, p=0.003). Conclusions: The dWMH-group with younger participants had fewer cardiovascular risk factors, showed more border-zone-distributions, and had a higher agitated saline test positivity rate than the dpWMH-group, indicating that corticomedullary or deep WMH-distribution with minimal periventricular WMH suggests embolic etiologies.

• 보건행정학회지
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• 제21권3호
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• pp.381-396
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• 2011

This study is to investigate the factors affecting the regional rate of certification for long-term care insurance benefits. Analyzed data were the 253,935 certified beneficiaries (equivalent to 4.9% of total elderly population) as long-term care degree (LTC degree) 1~3 extracted from the applicants for long-term care in the beginning stage of the system from April 15 2008 to July 1 2009. Although the data were collected from individuals, after restructured into regional data and then analysed in the unit of 225 administrative regions for the Korean Long-term Care Insurance. The rate of certification was operated as the percentage of people of LTC degree 1~3 to the elderly population in each region. The average rate of certification among regions was 4.91%, and ranged from 2.20% to 8.32%. In the analysing regression models, most socio-demographic variables, applicants' disease characteristics, regional service infrastructure, and the certification interviewer's characteristics were included. The most influencing variables were the disease factors of applicants, especially dementia or cerebrovascular disease rather than arthritis, osteoporosis, or fracture patients were strong factors for the regional rate of certification. However, advanced studies adding more explainable factors on the regional variance of certification rate would be necessary to provide political agenda and measures for evidence-based certification process with high reliability and validity for a sustainable LTC system in Korea.

• 대한한방내과학회지
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• 제28권4호
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• pp.850-862
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• 2007

Background : Cerebrovascular disease is a major cause of death and disability in adults. Silent cerebral infarction (SCI) portends more severe cerebral infarction or may lead to insidious progressive brain damage resulting in vascular dementia. Known cardiovascular risk factors, such as arterial hypertension, diabetes mellitus, smoking, hyperlipidemia and ischemic heart disease may increase the risk of SCI. This study was designed to evaluate the risk factors of SCI in an apparently normal adult population. Methods : We divided 340 neurologically normal adults (mean age=59.90$\pm$8.30, men:women = 146:194) who underwent brain computed tomography (CT) or magnetic resonance imaging (MRI) at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital in two groups, Silent inf. and Controls,and analyzed risk factors of SCI by interview, physical examination and blood test. Risk factors of SCI were assessed by interview, physical examination and blood test. We performed Pearson's chi-square test and two-sample t-test for univariate analysis and multiple logistic regressions for multivariate analysis to evaluate risk factors of SCI. Results : Old age, diabetes mellitus, and high lactate dehydrogenase (LDH) levels were associated with SCI on univariate analysis. Diabetes mellitus was demonstrated to be an independent risk factor for SCI on multivariate analysis. Conclusions : Advanced age, diabetes mellitus, and LDH levels are associated with SCI.

• 보건행정학회지
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• 제28권4호
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• pp.352-359
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• 2018

Background: The purpose of this study is to propose an analysis of trends and characteristics of high-cost patients who take over 40% of total national health insurance medical expenses. Methods: It has been analyzed the tendency of high-cost patients by open data based on the medical history information of 1 million people among national health insurance subscriber from 2002 to 2015. To conduct detailed study of characteristics of high-cost patients, multiple regression has been performed by sex, age, residence, main provider, and admission status based on the top 5% group. Results: The amount of medical expenses and the number of high-cost patients have gradually increased in decades. The number of high-cost patients for Korean won (KRW) 5,000,000 category has increased by 7.6 times, KRW 10,000,000 category has increased by 14.1 times in comparing of year 2002 and 2015. Top 5% medical expenses have increased by 4.6 times. In consideration of the characteristics of patients, the incidence of high medical expenses has been higher in female patients than male ones, the older patients than in the younger. Patients residence in Gyeonsang or Jeonla province have had a high incidence of medical expenses than other area. The disease including dementia, cerebral infarction, and cerebrovascular disease for high-cost patients has been also increased. Conclusion: The major increase factor for high medical expenses is the aging of population. The elderly population receiving inpatient care residing in the province that increases high medical costs have to management. There is an urgent need to develop a mechanism for predicting and managing the cost of high-cost medical expenses for patients who have a heavy financial burden.

• 보건행정학회지
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• 제32권4호
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• pp.389-399
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• 2022

Background: This study aimed to analyze changes in medical utilization and cost before and after long-term care (LTC) implementation. Methods: We used the National Health Information Database from National Health Insurance Service. The participants were selected who had a new LTC grade (grade 1-5) for 2015. Medical utilization was analyzed before and after LTC implementation. Segmented regression analysis of interrupted time series was conducted to evaluate the overall effect of the LTC implementation on medical costs. Results: The total number of participants was 41,726. A major reason for hospitalization in grade 1 was cerebrovascular diseases, and dementia was the top priority in grade 5. The proportion of hospitalization in grade 1 increased sharply before LTC implementation and then decreased. In grade 5, it increased before LTC implementation, but there was no significant difference after LTC implementation. As for medical cost, in grades 1 to 4, the total cost increased sharply before the LTC implementation, but thereafter, changes in level and trend tended to decrease statistically, and for grade 5, immediately after LTC implementation, the level change was decreasing, but thereafter, the trend change was increasing. Conclusion: Long-term care grades showed different medical utilization and cost changes. Long-term care beneficiaries would improve their quality of life by adequately resolving their medical needs by their grades.

• 대한영상의학회지
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• 제84권5호
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• pp.1140-1145
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• 2023

대뇌 아밀로이드 혈관병증 관련 염증은 베타 아밀로이드가 혈관에 침착되어 혈관 주위의 급성 염증성 반응으로 발생하는 뇌병증이다. 이 질환은 주로 고령자에게서 발생하는 드문 질환으로, 급격히 진행하는 치매, 두통, 발작, 국소 신경학적 결손을 동반한 증상으로 나타나며 특징적인 뇌자기공명영상 소견을 보인다. 또한 스테로이드 또는 기타 면역억제요법에 반응하는 가역적인 질병이다. 대뇌 아밀로이드 혈관병증 관련 염증을 처음에는 아급성 경색으로 오진하였다가 추적 관찰 중 뇌 자기공명영상 소견을 분석하면서 대뇌 아밀로이드 혈관병증 관련 염증이 진단되었고, 자연 관해가 이뤄진 대뇌 아밀로이드 혈관병증 관련 염증 증례를 보고한다.