• Journal of Ginseng Research
• /
• v.33 no.4
• /
• pp.349-354
• /
• 2009

This study was conducted to develop a new method for enhancing ginsenoside $Rg_3$, which is abundant in black ginseng. The cognition-enhancing effect of black ginseng extract was investigated via the assay of acetylcholinesterase (AChE) activity. Black ginseng I was prepared through the traditional method (by steaming and drying nine times repetitions). Black ginseng II, on the other hand, was prepared by steaming the ginseng three times at $120^{\circ}C$ for 30 min after soaking it in grape juice for 24 h. The ginsenosides of white, red, and black ginseng I, and II were investigated using the HPLC method, respectively. In black ginseng II, the ginsenoside $Rg_3$ contents, which cannot be found in white ginseng, amounted to 10.91 mg/g, approximately 18 times more than that in red ginseng. In the in-vivo study, black ginseng extract (200 mg/kg, p.o.) inhibited the AChE activity after 24 h by a single administration in the brain. Thus, the new manufacturing method for black ginseng was found to more effective in the conversion of ginsenoside $Rg_3$ compared to the traditional method. Black ginseng may also have the effect of preventing the cognitive impairment induced by cholinergic dysfunction.

• Radiation Oncology Journal
• /
• v.38 no.1
• /
• pp.35-43
• /
• 2020

Purpose: This retrospective study compares higher-dose whole-brain radiotherapy (hdWBRT) with reduced-dose WBRT (rdWBRT) in terms of clinical efficacy and toxicity profile in patients treated for primary central nervous system lymphoma (PCNSL). Materials and Methods: Radiotherapy followed by high-dose methotrexate (HD-MTX)-based chemotherapy was administered to immunocompetent patients with histologically confirmed PCNSL between 2000 and 2016. Response to chemotherapy was taken into account when prescribing the radiation dose to the whole brain and primary tumor bed. The whole brain dose was ≤23.4 Gy for rdWBRT (n = 20) and >23.4 Gy for hdWBRT (n = 68). Patients manifesting cognitive disturbance, memory impairment and dysarthria were considered to have neurotoxicity. A median follow-up was 3.62 years. Results: The 3-year overall survival (OS) and progression-free survival (PFS) were 70.0% and 48.9% with rdWBRT, and 63.2% and 43.2% with hdWBRT. The 3-year OS and PFS among patients with partial response (n = 45) after chemotherapy were 77.8% and 53.3% with rdWBRT, and 58.3% and 45.8% with hdWBRT (p > 0.05). Among patients with complete response achieved during follow-up, the 3-year freedom from neurotoxicity (FFNT) rate was 94.1% with rdWBRT and 62.4% with hdWBRT. Among patients aged ≥60 years, the 3-year FFNT rate was 87.5% with rdWBRT and 39.1% with hdWBRT (p = 0.49). Neurotoxicity was not observed after rdWBRT in patients aged below 60 years. Conclusion: rdWBRT with tumor bed boost combined with upfront HD-MTX is less neurotoxic and results in effective survival as higher-dose radiotherapy even in partial response after chemotherapy.

• Korean Journal of Psychosomatic Medicine
• /
• v.16 no.2
• /
• pp.69-74
• /
• 2008

Delirium is an organic psychiatric syndrome characterized by an acute onset, prominent disturbance of consciousness and cognitive impairment with fluctuating course. Although there is not a clear consensus concerning the optimal classification system for delirium subtypes, Lipowski(1983) firstly classified delirium by psychomotor activity, namely hyperactive, hypoactive, and mixed. According results of several following studies, prevalence of hypoactive delirium were not less than that of hyperactive delirium. But a diagnosis of hypoactive delirium often missed, which is most frequently misdiagnosed as depression and dementia. Hyperactive delirium can be caused by alcohol or benzodiazepine withdrawal, would be related with excessive dopamine and cholinergic deficiency, and is more responsive to high-potency antipsychotics therapy. Hypoactive delirium would be caused by metabolic encephalopathy, and tends to present a less responsiveness to antipsychotics and poorer overall prognosis with a prolonged duration of admission than hyperactive delirium. Delirium is not a homogenous syndrome. Because of different subtypes, it may have dissimilar underlying pathogenetic pathways. So different treatment strategies between various subtypes may be needed.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.8 no.1
• /
• pp.22-28
• /
• 2008

Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.15 no.1
• /
• pp.40-44
• /
• 2019

Moyamoya disease (MMD) is a chronic, occlusive cerebrovascular disease of unknown etiology characterized by progressive stenosis at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain. The clinical presentations of MMD include transient ischemic attacks (TIA), ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment. MMD is the most important cause of stroke or TIA in children in East Asian countries. A 5-year-3-month old boy with MMD experienced cerebral infarctions five times. Cerebrovascular anastomosis surgery was performed on him four years ago. He had dysphagia, developmental delay, hemiplegia, and strabismus. Besides, a number of dental caries in primary dentition were identified during clinical oral examination. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation and underlying systemic disease. MMD is associated with various medical diseases requiring thoughtful consideration during dental treatment. Crying and hyperventilation in MMD patients may cause hypocapnia and have a cerebral vasoconstrictive effect. If dental treatment is required, control of pain and anxiety is very important. General anesthesia may be considered for dental treatment in uncooperative or very young patients with MMD.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.9
• /
• pp.167-174
• /
• 2019

The propose od this study was to examine the extent of using physical restraint on elderly patients (over 65 years old) and who were patients in long-term care hospitals. The data was collected, from March 3 2018 to March 29 2018, from the electronic nursing records by using a recording tool, and clinical observation was also used for assessing the use of physical restraint and the related factors. Descriptive statistics, Pearson correlation coefficients and logistic regression were then performed. The usage rate for physical restraints in long-term care hospital was 83.7%, and the most common type of physical restraint was side rails. The use of physical restraints showed a positive correlation with the fall risk scores and a negative correlation with the MMSE. Logistic regression analysis showed that the Fall Risk Score (OR=1.02, 95% CI=1.01~1.03), MMSE (OR=0.94, CI=0.88~0.99) and the use of medical devices (OR=0.80, 95% CI=0.65~0.98) were related with using physical restraints. Therefore, it was confirmed that physical restraint was used in cases of a high risk of falling, severe cognitive impairment and the use of complex and fragile medical devices to treat the patient. Clinical nursing practice should be changed so that treatment alternatives can be applied for elderly patients rather than using too many physical restraints.

• Journal of Korean geriatric psychiatry
• /
• v.21 no.1
• /
• pp.35-40
• /
• 2017

Objective : This study aimed to investigate the effect of community-based Goal-Achieving program in geriatric depressive symptoms preliminarily. Methods : We obtained data from elderly Korean subjects with major depressive disorder (n=51) aged 60 years or older at baseline, taking case management from community mental health center. Subjects were randomly assigned to intervention group (n=24) and control group (n=27). We investigated depressive symptoms through Short Form Geriatric Depression Scale-Korean version (SGDS-K) at baseline and every month for 3 months to all subjects. We tested interaction between group and time in SGDS-K score to evaluate the effect of program. And post hoc test examined between group differences of SGDS-K at each time points. Results : In quadratic linear mixed effects model analysis, interaction between group and time was statistically significant (Total SGDS-K score : coefficient=0.29, p<0.001 ; SGDS-K dysphoria subscale : 0.18, p<0.001 ; SGDS-K hopelessness subscale : 0.05, p=0.089 ; SGDS-K cognitive impairment subscale : 0.06, p=0.003). And significant between group difference was shown in post hoc test at time points of third month (SGDS-K score of control group : SGDS-K score of intervention group=$10.74{\pm}3.482$ : $7.25{\pm}4.475$, p=0.0184). Conclusion : These results may suggest that 'Community-based the Goal-Achieving program' has efficacy in reducing geriatric depressive symptoms.

• Journal of the Korean Society of Radiology
• /
• v.15 no.4
• /
• pp.555-564
• /
• 2021

Thalamus is known to play an important role in the regulation of nerve function. Thalamus, located in the center of the brain, is involved in sleep, arousal, and emotional regulation, and has been reported to be associated with multiple sclerosis, essential tremors, and neurodegenerative diseases such as Parkinson's disease. In addition, it has been reported that iron deposits in the thalamus can cause depressive symptoms with age. Although there are discrepancies between studies, it can be deduced that the thalamus region has a clear effect on neurological disorders due to a strong relationship between the thalamus and neurological functions such as emotional control and processing. Through tractography analysis, the connectivity between the detailed areas of each subcortical region was investigated in the form of a matrix, showing strong connectivity and weak interhemispheric connectivity. In the 59> group, the WM connectivity of thalamus was found to be weaker than those of the two groups. Comparisons between the two groups showed that the young groups (10-39 and 40-59) had higher connection intensity than the 59> group and that statistically significant differences in 3 connection pathways were found in each hemisphere. A decrease in thalamus-related connection strength in aging has shown that it can affect emotional and neurological disorders such as anxiety and depression, and network measurements can help assess cognitive impairment across clinical conditions.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.24 no.3
• /
• pp.288-294
• /
• 2021

Purpose: Despite aggressive medical and nutritional management, patients with methylmalonic acidemia (MMA) often suffer from multi-organ damage. Early deceased donor liver transplantation (DDLT) has emerged as an intervention to prevent disease progression. We investigated the efficacy of living donor LT (LDLT) with a potential carrier of MMA and a small volume of graft in patients with MMA as an alternative to DDLT. Methods: Of five patients (three male, two female; median age 5.7 years; range, 1.3-13.7 years), four underwent carrier LDLT, while one underwent non-carrier auxiliary LDLT. All patients received pre- and post-LT continuous renal replacement therapy and were provided with minimal restriction diet according to serum MMA level after LT. MMA levels in the serum and urine, the incidence of metabolic crisis, and clinical findings before and after LT were compared. Results: The survival rate was 100% during 2.2 years of follow up period after LT. In all five cases, MMA titer in the serum after transplantation decreased with less restrictive diet. Metabolic crisis was not observed during the follow-up period. In addition, no patient showed progression of severe renal impairment requiring hemodialysis. Progression of delayed cognitive development was not observed. Social functioning with improved neuropsychiatric development was observed. Conclusion: This study showed that LDLT achieved improved quality of life with less restrictive diet, therefore it could be a feasible alternative option to DDLT for the treatment of patients with MMA, even with an auxiliary LT.

• Journal of Life Science
• /
• v.32 no.5
• /
• pp.362-367
• /
• 2022

Hempseed, a dehulled Cannabis fructus, has high nutraceutical potential. It has plenty of essential amino acids, vitamins, and essential polyunsaturated fatty acids, including α- and γ-linolenic acid. Increased exercise capacity, cognitive function, and ameliorative effects against hypercholesterolemia, neuro-inflammation, thrombus formation, and learning and memory impairment were reported in hemp-seed oil-administered models. Therefore, the market prices of hempseed oil are 45~140-fold higher than the other plant-derived oils, such as soy, corn, olive, canola, or linseed oil. In this study, instead of FTIR (Fourier Transform Infrared Spectroscopy) or FTIR-Raman spectroscopy, a simple UV-Vis spectrophotometry method was developed to authenticate the hempseed oil. Measurements of absorbance at 245, 305, and 415 nm of oils and calculations of 245/415 and 315/415 nm provided that the ratios of 245/415 and 315/415 nm of authentic hempseed oils were 12.9 and 9.6, respectively. The 245/415 and 315/415 nm of soy oil, corn oil, canola oil, and linseed oil were 35.4~61.8 and 29.7~50.8, respectively. This simple UV-Vis spectrophotometry method could also be applied to differentiate hempseed oil from blended oil products in markets.