• Title/Summary/Keyword: Dementia Center

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The Realities in the Elderly Caregiving and Its New Direction: Revisiting Caregiving Researches in the 1990s (노인부양의 현실과 그 새로운 방향: 1990년대 연구를 중심으로)

  • 손태홍
    • Journal of the Korean Home Economics Association
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    • v.39 no.11
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    • pp.27-42
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    • 2001
  • This paper reviews researches related with the elderly caregiving, which hale published during the 1990s. After analyzingthe 29 articles in this field, the major findings are as follows: First, the advantageous position in life chances which is consisted of socioeconomic status and resources tends to reduce th burden for the elderly care. The higher in social status, the more resources older adults have, the more advantageous in controlling their relationship with their children and caregivers. Second, values based on familism is more associated with providing caregiving services for their parents than those of filial piety. Third, the tendency that daughter-in-law takes the role of the primary caregiver suggests a possibility of diminishing her enthusiasm, and finally comes to recognize her role as an enforced one, as time goes by. Fourth, cargiving burden affects the diverse aspects of caregiver's way of life. When the lower class elderly has dementia, caregiving stress and hassle have reached at their peak level. For meeting the needs of reducing the burden for the elderly care, this study suggests community- based approach for the elderly care. This approach attempts to share the caregiving burden with local community. To share the burden means that the boundaries of caregivers does not limit family members, but to expand community. This attempt includes a plan that establishes multipurpose community center which provides comprehensive services and care for the aged. The theoretical rationale of this approach are also discussed.

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Extracting of Interest Issues Related to Patient Medical Services for Small and Medium Hospital by SNS Big Data Text Mining and Social Networking (중소병원 환자의료서비스에 관한 관심 이슈 도출을 위한 SNS 빅 데이터 텍스트 마이닝과 사회적 연결망 적용)

  • Hwang, Sang Won
    • Korea Journal of Hospital Management
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    • v.23 no.4
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    • pp.26-39
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    • 2018
  • Purposes: The purpose of this study is to analyze the issue of interest in patient medical service of small and medium hospitals using big data. Methods: The method of this study was implemented by data mining and social network using SNS big data. The analysis tool were extracted key keywords and analyzed correlation by using Textom, Ucinet6 and NetDraw program. Findings: In the results of frequency, the network-centered and closeness centrality analysis, It was shown that the government center is interested in the major explanations and evaluations of the technology, information, security, safety, cost and problems of small and medium hospitals, coping with infections, and actual involvement in bank settlement. And, were extracted care for disabilities such as pediatrics, dentistry, obstetrics and gynecology, dementia, nursing, the elderly, and rehabilitation. Practical Implications: Future studies will be more useful if analyzed the needs of customers for medical services in the metropolitan area and provinces may be different in the small and medium hospitals to be studied, further classification studies.

The Effect of Aerobic Exercise on Brain-Derived Neurotrophic Factor (BDNF) in Individuals with Mild Cognitive Impairment: a Systematic Review and Meta-Analysis of a Randomized Controlled Trials

  • Kim, Hyun-Joong;Lee, DongJin;Lee, YeonSeop
    • Physical Therapy Rehabilitation Science
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    • v.11 no.3
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    • pp.304-310
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    • 2022
  • Objective: Mild cognitive impairment (MCI) is a condition in which cognitive and executive functions are reduced, and older adults with MCI are ten times more likely to develop dementia than healthy older adults. Expression of brain-derived neurotrophic factor (BDNF) through aerobic exercise is associated with increased cognitive and executive functions. in this review, randomized controlled trials (RCTs) on the effects of aerobic exercise on BDNF in individuals with mild cognitive impairment are summarized and qualitatively and quantitatively analyzed to suggest the necessity of aerobic exercise. Design: a systematic review and meta-analysis. Methods: RCTs were searched for changes in BDNF through aerobic exercise using four international databases. Quality assessment and quantitative analysis were performed using RevMan 5.4. Quantitative analysis was quantified with a standardized mean difference (SMD) and presented as a random effect model. Results: Three RCTs evaluated BDNF in 123 patients with MCI. There was a significant improvement in the experimental group that performed aerobic exercise compared to the control group. The results analyzed using the random effects model were SMD = 0.48. Conclusions: In this review, we reported the effects and mechanisms of aerobic exercise in individuals with MCI. As a result of synthesizing RCTs that performed aerobic exercise, a significant increase in BDNF was confirmed.

Radiotherapy for pituitary adenomas: long-term outcome and complications

  • Rim, Chai-Hong;Yang, Dae-Sik;Park, Young-Je;Yoon, Won-Sup;Lee, Jung-Ae;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.29 no.3
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    • pp.156-163
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    • 2011
  • Purpose: To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. Materials and Methods: We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-five patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Results: Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing's disease). Amenorrhea was abated in 7 of 10 patients, galactorrhea in 8 of 8 patients, acromegaly in 7 of 11 patients, Cushing's disease in 4 of 4 patients. Long-term complication was observed in 4 patients; 3 patients with cerebrovascular accident, 1 patient developed dementia. Of these patients, 3 of 4 received more than 60 Gy of irradiation. Conclusion: EBRT is highly effective in preventing recurrence and reducing mass effect of non-secreting adenoma. Effort to improve tumor control of secreting adenoma is required. Careful long-term follow-up is required when relatively high dose is applied. Modern radiosurgery or proton RT may be options to decrease late complications.

The Effect of Adding Kami-guibi-tang to Acetylcholinesterase Inhibitor Treatment on the Cognitive Function of Mild Alzheimer's Disease Patients: Study Protocol of a Randomized, Placebo-Controlled, Double-Blind Pilot Trial

  • Yang, Seung-bo;Kim, Ha-ri;Shin, Hee-yeon;Kim, Jeong-hwa;Lee, Chang-woo;Jahng, Geon-ho;Park, Seong-uk;Ko, Chang-nam;Park, Jung-mi
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.326-338
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    • 2020
  • Background: Alzheimer's disease (AD) is a chronic neurodegenerative disease that causes disorientation, mood swings, problems with language, and difficulty remembering recent events. Acetylcholinesterase inhibitors (AchEIs) and memantine have been used to slow the course of the disease, but they can neither modify its progression nor prevent disease onset. Previous studies have suggested that Kami-guibi-tang (KGT) could be beneficial for supporting cognitive function in AD patients, but few clinical trials have been published. This pilot study aimed to evaluate the effect of KGT in improving cognitive function in AD patients. Methods: The study will be a randomized, placebo-controlled, double-blind, single-center trial conducted using subjects diagnosed with mild AD by neurologists. Study subjects will be randomly assigned to either a treatment or control group. The treatment group will receive KGT granules for 24 weeks, while the control group will receive placebo granules. AchEI administration will be maintained in both groups during the entirety of the study. Subjects will be assessed using the following exams: the Seoul Neuropsychologic Screening Battery (SNSB) for cognitive function; brain magnetic resonance imaging (MRI) for brain metabolite, neurotransmitter, and cerebral blood flow (CBF) measurements; the Korean version of Quality of Life-Alzheimer's Disease (KQol-AD) for quality of life; the Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI) for neurobehavioral symptoms; blood tests for amyloid and tau proteins and general blood parameters; and electrocardiography (ECG) before and after taking the medication. Discussion: Our findings will provide insight into the feasibility of large-scale trials to consolidate evidence for the efficacy of KGT for dementia treatment. Registration ID in CRIS: KCT0002904 (Clinical Research Information Service of the Republic of Korea).

Sub-acute toxicity and effect of Hwangryunhaedok-tang on human drug-metabolizing enzymes

  • Jin, Seong Eun;Lee, Mee-Young;Seo, Chang-Seob;Shin, Hyeun-Kyoo;Cho, Jae-Woo;Ha, Hyekyung
    • The Journal of Korean Medicine
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    • v.38 no.2
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    • pp.15-30
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    • 2017
  • Objectives: Hwangryunhaedok-tang (HHT; Huanglianjiedu-tang, Orengedoku-to), a traditional herbal formula, is used for treating inflammation, hypertension, gastritis, liver dysfunction, cerebrovascular diseases, dermatitis and dementia. The objective of this study was to assess the sub-acute toxicity of HHT in Sprague-Dawley (SD) rats, and its effect on the activities of human microsomal cytochrome P450s (CYP450s) and UDP-glucuronosyltransferases (UGTs). Methods: Male and female SD rats were orally administered HHT once daily at doses of 0, 500, 1000 and 2000 mg/kg for 4 weeks. We analyzed mortality, clinical observations, body weight, food consumption, organ weights, urinalysis, hematology, serum biochemistry, and histopathology. The activities of major human CYP450s (CYP1A2, CYP3A4, CYP2B6, CYP2C9, CYP2C19, CYP2D6, and CYP2E1) and UGTs (UGT1A1, UGT1A4, and UGT2B7) were assessed using in vitro fluorescence- and luminescence-based enzyme assays, respectively. Results: No toxicologically significant changes related to the repeated administration of HHT were observed in both male and female SD rats. The no observed adverse effect level (NOAEL) value was more than 2000 mg/kg/day for both sexes. HHT inhibited the activities of human microsomal CYP1A2, CYP2C19, CYP2D6, and CYP2E1, whereas it weakly inhibited the activities of CYP2B6, CYP2C9, CYP3A4, and UGT1A1. In addition, HHT negligibly inhibited the activities of human microsomal UGT1A4 and UGT2B7 with $IC_{50}$ values in excess of $1000{\mu}g/mL$. Conclusions: Our findings indicate that HHT may be safe for repeated administration up to 4 weeks. In addition, these findings provide information on the safety and effectiveness of HHT when co-administered with conventional drugs.

Paeonia Radix decreases Intracerebral Hemorrhage-induced Neuronal Cell Death via Suppression on Caspase-3 Expressionin Rats

  • Kim Ho-Jun;Kim Sung-Soo;Lee Jong-Soo
    • The Journal of Korean Medicine
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    • v.25 no.4
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    • pp.95-107
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    • 2004
  • Objective : The inappropriate or excessive apoptosis has been known to be associated with neurodegenerative disorders including intracranial hemorrhage(ICH). Paeoniae radix, in traditional Korean medicine, has played its role as blood­nourisher and yin-astringent. In the present study, the effect of Paeoniae radix on the inhibition of neurodegeneration in the brain of rats after artificial ICH and on the resulting apoptosis was investigated. Methods : 30 rats were divided into 6 equal groups ; the sham-operation group, the hemorrhage-induction group, the hemorrhage-induction with 10, 50, 100, and 200 mg/kg Paeoniae radix-treated group, respectively. Stereotactic surgery was performed and collagenase was infused to induce ICH in the region of CA1 of hippocampus of rats. The sham group took only saline infusion. For 7 days after the surgery, 4 testing groups had intraperitoneal injections of Paeoniae radix extract. The step-down inhibitory avoidance task, measurement of neurodegeneration degree in the CA1 region of the hippocampus, and detection of caspase-3 and newly generated cells in the dentate gyrus were done after animal sacrifice. Results : Rats receiving Paeoniae radix extract showed increased latency time in the inhibitory avoidance task. The extension of neuron-deprived areas in the CA1 region was significantly suppressed in the Paeonia treated groups. Also expressions of caspase-3 in the CA1 region and cortex were significantly inhibited in the Paeonia treated groups. The cell proliferation was evaluated by means of BrdU methods and proved to be decreased in the Paeonia treated groups. Conclusion : These results suggest that Paeoniae radix has potential to suppress short-tenn memory loss after devastating neurologic accidents. Also it was proved that Paeoniae radix has a neuroprotective effect and alleviates central nervous complications following intracerebral hemorrhage. Furthermore, it may imply that this medicinal plant can be widely used for vascular dementia and other neurodegenerative disorders.

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A Study on Developing Computer Models of Neuropsychiatric Diseases (신경정신질환의 컴퓨터모델 개발에 관한 연구)

  • Koh, In-Song;Park, Jeong-Wook
    • Korean Journal of Biological Psychiatry
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    • v.6 no.1
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    • pp.12-20
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    • 1999
  • In order to understand the pathogenesis and progression of some synaptic loss related neuropsychiatric diseases, We attempted to develop a computer model in this study. We made a simple autoassociative memory network remembering numbers, transformed it into a disease model by pruning synapses, and measured its memory performance as a function of synaptic deletion. Decline in performance was measured as amount of synaptic loss increases and its mode of decline is sudden or gradual according to the mode of synaptic pruning. The developed computer model demonstrated how synaptic loss could cause memory impairment through a series of computer simulations, and suggested a new way of research in neuropsychiatry.

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The Inhibitory Activity of the Taraxacum mongolicum on Monoamine Oxidase (민들레의 Monoamine Oxidase 저해활성)

  • Hwang, Keum-Hee;Park, Tae-Kyu
    • Korean Journal of Pharmacognosy
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    • v.37 no.4 s.147
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    • pp.229-234
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    • 2006
  • We examined the inhibitory activities against monoamine oxidase (MAO) of Taraxacum mongolicum in vitro and in vivo methods. Methanol extract of T. mongolicum showed significantly inhibitory activities on MAO-A and MAOB that were prepared from rat brain and liver in vitro. MAO-A and MAO-B activities were potently inhibited by chloroform fraction of T. mongolicum in vitro tests. The $IC_{50}$ values of each fraction on MAO-A are as followed; methanol extracts (0.90 mg/ml), $CHCl_3$ fraction (0.10 mg/ml), EtOAc fraction (0.36 mg/ml). and those on MAO-B are methanol extracts $(0.39{\mu}g/ml)$, $CHCl_3$ fraction $(0.18{\mu}g/ml)$, BuOH fraction $(0.22{\mu}g/ml)$. Those MAO-A and MAO-B activities in vivo tests have different tendency each other. MAO-A activity was increased by the oral administration of ethanol extract of T mon golicum, while MAO-B activity was decreased. The concentration of serotonin of brain tissue after oral administration of ethanolic extract of T. mongolicum is slightly increased in rat. This tendency is not different from the activity of deprenyl which is the well known MAO inhibitor used as a positive control. Based on these results, we can suggest that T. mongolicum may have the effects on the inhibitory activities against MAO. Thess activities of T. mongolicum is considerable for development of functional materials for the purpose of treatment and control of depressant, dementia, Parkinson' disease, stress and promoting exercise.

Study of Anti-Alzheimer Activities from Scrophularia buergeriana Water Extract by Alzheimer's Protein APP-transgenic Fly (현삼(玄蔘) 수추출물(水抽出物)이 아밀로이드 전구단백질(前驅蛋白質)로 형질전환(形質轉換)된 초파리에 미치는 효과)

  • Kim, Jin-Woo;Lee, Soon-E;Lee, Jong-Hwa;Min, Sang-Jun;Kim, Tae-Heon;Lyu, Yeoung-Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.2
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    • pp.121-131
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    • 2009
  • Objectives : From Scrophularia buergeriana water extract(SBW), has been used in vivo test for its beneficial effects on neuronal survival and neuroprotective functions, particularly in connection with APP-related dementias and Alzheimer's disease(AD). $A{\beta}$ oligomer derived from proteolytic processing of the ${\beta}$-amyloid precursor protein(APP), including the amyloid-${\beta}$ peptide($A{\beta}$), play a critical role in the pathogenesis of Alzheimer's dementia. Methods : Using drosophila APP model on APP-induced neuronal cytotoxicity, we demonstrated that SBW prevents neurotoxicity of $A{\beta}$ oligomer, which are the behavior, and possibly causative, feature of AD. We investigated the neuroprotective effects of SBW against the effects of oligomeric $A{\beta}$ and fly behaveior and life span by UAS-GRIM/APP-GAL within transgenic flies. Results and Conclusions : SBW repaired damage leading to the behaveior of APP-induced fly and delayed life span. These results suggest that neuronal damage in AD might be due to two factors: a direct $A{\beta}$ oligomer toxicity and multiple cellular and molecular neuroprotective mechanisms, including attenuation of apoptosis and direct inhibition of $A{\beta}$ oligomer, underlie the neuroprotective effects of SBW.

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