• Health Policy and Management
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• v.20 no.1
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• pp.19-36
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• 2010

Fee for long-term care insurance in Korea are determined in proportion to resources utilized according to severity rather than based on categorization of beneficiaries in consideration of the characteristics of resource utilization. This adoption is based on the assumption that as beneficiaries of long-term care insurance, characteristically, demands social services rather than needs medical treatments, the characteristics of beneficiaries and the quality of utilized resources are comparatively homogenous. Therefore, the proposition is that the size of resource consumed by beneficiaries in the same grade is identical. However, even in the same grade, the level of utilized resources is different depending on the characteristic of beneficiaries. In this regard, this study is to examine whether there are differences in the volumes of utilized resources depending on the characteristics of beneficiaries even in the same grade. We analyzed time study data for 2003, 2005, 2006 which conducted by the Korea Institute for Health and Social Affairs. To look at differences in the volumes of utilized resources, we identified characteristics of beneficiaries that influence utilized resource volumes and categorized services provided by facilities into the rehabilitation treatment category, the problematic behavior category, and the physical malfunction category. Then, we examined each service in consideration of service difficulty levels and wage weights. The result of examination showed that differences in utilized resource volumes exist in all three grades depending on the characteristics of beneficiaries. Especially, in the first grade with a high level of seriousness, utilized resource volumes were different for those three service categories and the problematic behaviour category considered dementia was found to consume the largest volume of resources. Moreover, there was the inversion phenomenon of utilized resources volumes between the grades. This result indicates that utilized resource volumes are different even in the same grade depending on the characteristics of beneficiaries and it is required to consider case-mix for reflection of the volumes of utilized resources depending on the characteristics of beneficiaries.

• 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.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.3
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• pp.556-561
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• 2008

ChongMyeong-Tang (CMT) have been used clinically to treat patient with amnesia and dementia. In addition, CMT have been also used for examinee to improve learning ability in Korea. This study was designed to investigate the effects of Gagam-ChongMeong-Tang (GCMT) on cognitive dysfunction recovery after ischemic brain injury in rats. Rats were divided into three groups; (1) normal, (2) commercial diet after ischemic brain injury (control), (3) CMT diet after ischemic brain injury (experiment). In our study, we carried out Morris water maze test for cognitive motor behavior test and immunohistochemistry study through the change BDNF in the hippocampus($7^{th},\;14^{th}\;day$). In Morris water maze test, cognitive motor function recovery was significantly increased in the experiment group as compared with control group on $7^{th}\;and\;14^{th}\;day$ day (p<0.01). In immunohistochemistric response of BDNF in the hippocampus, more immune reaction was investigated in the experiment group as compared with control group on $7^{th}\;and\;14^{th}\;day$. Especially more immune reaction was experimented $14^{th}$ day. These results imply that GCMT can play a role in facilitating recovery of cognitive function after ischemic brain injury in rats.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.1
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• pp.43-51
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• 2006

This experiment was designed to investigate the effect of Amomum villosum(AMV) on the Alzheimer's disease. The effects of AMV extract on amyloid precursor proteins(APP), acetylcholinesterase(AChE), glial fibrillary acidic protein(GFAP) mRNA of PC-12 cell line treated by amyloid $\beta$ protein($A{\beta}$) : IL-$1{\beta}$, IL-6, TNF-$\alpha$ mRNA of THP-1 cell line treated by lipopolysaccharide(LPS) : AChE activity of PC-12 cell lysate treated by $A{\beta}$ : serum glucose, uric acid, AChE activity of memory deficit rats induced by scopolamine : behavior of memory deficit mice induced by scopolamine were investigated, respectively. AMV extract suppressed APP, AChE, GFAP mRNA in PC-12 cell treated by $A{\beta}$ : IL-$1{\beta}$, IL-6, TNF-$\alpha$ mRNA in THP-1 cell treated by LPS , AChE activity in cell lysate of PC-12 cell treated by $A{\beta}$. AMV extract increased glucose, decreased uric acid and AChE significantly in the serum of the memory deficit rats induced by scopolamine. AMV extract group showed significantly inhibitory effect on the memory deficit of mice induced by scopolamine in the experiment of Morris water maze. According to the above results, it is suggested that AMV extract might be usefully applied for prevention and treatment of Alzheimer's disease.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.42-57
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• 2020

Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

• Journal of Korean Academy of Nursing
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• v.51 no.3
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• pp.294-304
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• 2021

Purpose: This study aimed to investigate objectively measured physical activity (PA) in institutionalized older adults with mild cognitive impairment (MCI) and to elucidate the influence of autonomic nervous function, salivary cortisol, and PA on cognitive functions based on neurovisceral integration model. Methods: Overall cognitive function was evaluated using the mini-mental state examination (MMSE) and executive function was evaluated using semantic verbal fluency test and clock drawing test. Actigraph for PA, HRV and sAA for autonomous function, and the geriatric depression scale for depression were used. Saliva specimens were collected in the morning for sAA and cortisol. Results: Ninety-eight older adults from four regional geriatric hospitals participated in the study. They took 4,499 steps per day on average. They spent 753.93 minutes and 23.12 minutes on average in sedentary and moderate-to-vigorous activity, respectively. In the multiple regression analysis, lower salivary cortisol level (β = - .33, p = .041) and greater step counts (β = .37, p = .029) significantly improved MMSE score. Greater step count (β = .27, p = .016) also exerted a significant influence on verbal fluency, and greater sAA (β= .35, p = .026) was significantly associated with a better clock drawing test result. Conclusion: Salivary cortisol, sAA and physical activity were significantly associated with cognitive functions. To prevent older adults from developing dementia, strategies are needed to increase their overall PA amount by decreasing sedentary time and to decrease salivary cortisol for cognitive function, and to maintain their sympathetic nervous activity for executive function.

• Journal of Oriental Neuropsychiatry
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• v.26 no.3
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• pp.319-336
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• 2015

Objectives: The object of this study was to evaluate the cognition and motor function recovery effects of Sungshim-san (SSS), a traditional Korean cardio-protective polyherbal formula in the severe rat stroke, permanent middle cerebral artery occlusion (pMCAO) model. Methods: The experimental animals were divided into 6 groups. SSS aqueous extracts (yield=16.82%; 400, 200 and 100 mg/kg) were administered orally by using Sonde, once daily, for 28 continuous days from 24 hrs post-pMCAO. Donepezil 10 mg/kg, a representative drug for dementia, was used as a reference drug. The body weight changes, infarct/defect sizes, sensorimotor function and cognitive motor behavior were serially monitored. Limb placing and body-swing test for sensorimotor functions were conducted at 1 day before operation (base line), and 1, 3, 7, 14, 21 and 28 days post-pMCAO; and water maze test for the cognitive motor behavior was conducted at 14 and 28 days post-pMCAO, respectively. Results: Focal cerebral cortex infarct and defects due to pMCAO resulted in marked decreases of body weight, disorders of sensorimotor functions and cognitive motor behaviors. However, the pMCAO-related ischemic damages were markedly and dose-dependently inhibited by treatment with SSS 400 and 200 mg/kg, respectively. Donepezil markedly decreased the body weight and gains, as compared with pMCAO control rats; however, SSS 400 and 200 mg/kg favorably ameliorated the pMCAO-induced decreases in body weight and gains. SSS 100 mg/kg treated rats did not show any favorable effects on the pMCAO-related ischemic damages, as compared with pMCAO control rats. Conclusions: The results of the study indicated that oral administration of SSS 400 and 200 mg/kg accelerated cognition and motor function recovery in the rat pMCAO model. The treatment effect was potentially mediated by neuroprotection via the known augmentation of cerebral antioxidant defense system of SSS itself or its individual herbal components. Especially, the overall effects of SSS 200 mg/kg were similar to those of donepezil 10 mg/kg, but less toxic.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.2
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• pp.580-586
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• 2019

This study selected 2,134 fertile women aged 20 to 44 years as the final study subjects using the 6th source data of the National Health and Nutrition Survey. The purpose of this study was to investigate the relationship between female characteristics, chronic diseases and oral health behavior, and the effects of each factor on periodontal diseases. There were statistically significant differences in age(p<0.001), education level(p<0.001), income(p<0.05), marital status(p<0.001), smokes(p<0.05) and pregnancy(p<0.001). Chronic disease factors showed statistically significant differences in hypertension(p<0.001), obesity(p<0.001), diabetes(p<0.001), hypercholesterolemia(p<0.05), hypocholesterolemia(p<0.001) and hypertriglyceridemia(p<0.001). Oral health behaviors were statistically significant in terms of toothache(p<0.05), orthodontic treatment(p<0.05) and chew discomfort(p<0.05). As a result of examining the risk factors affecting periodontal disease, the risk of chronic disease was 1.576 times higher in the obese group, and 2.569 times higher in the diabetic group than in the normal group. The subjective oral health status was 1.372 times higher for normal women and 1.614 times higher for bad women than for good ones. As a result, diabetes has shown the greatest risk among chronic diseases in women, and diabetes and obesity are highly relevant and therefore are considered important variables for the risk factors of dementia. In this regard, it is necessary to examine the risks of chronic and periodical diseases, expand oral health education programs for women's dental disease, and prepare oral health policies.

• 한국노년학
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• v.40 no.4
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• pp.747-760
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• 2020

The purpose of this study is to prepare basic data necessary for the development of services or systems that can enhance the accessibility of health and medical services or enhance the efficiency of health and medical use of senior citizens by identifying factors for predicting health and medical use behavior of senior citizens in Incheon Metropolitan City through the Korea health panel data(version 1.5). Through the structural equation model established through the SPSS and AMOS, it was confirmed that the predisposing factors, health behaviors and needs factors had significant direct and indirect effects on the use of health care services. Since the imbalance in demand and supply of health and medical services is more severe than in other regions, the results of this study can be used as basic data when checking whether the current health and medical system in Incheon Metropolitan City can operate effectively in an aged society and discussing how to provide health and medical services to the elderly in Incheon.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.665-679
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• 2022

Objective : Patients with mild ischemic stroke experience various sequela and residual symptoms, such as anxious behavior and deficits in movement. Few approaches have been proved to be effective and safe therapeutic approaches for patients with mild ischemic stroke by acute stroke. Sildenafil (SIL), a phosphodiesterase-5 inhibitor (PDE5i), is a known remedy for neurodegenerative disorders and vascular dementia through its angiogenesis and neurogenesis effects. In this study, we investigated the efficacy of PDE5i in the emotional and behavioral abnormalities in rats with mild ischemic stroke. Methods : We divided the rats into four groups as follows (n=20, respectively) : group 1, naïve; group 2, middle cerebral artery occlusion (MCAo30); group 3, MCAo30+SIL-pre; and group 4, MCAo30+SIL-post. In the case of drug administration groups, single dose of PDE5i (sildenafil citrate, 20 mg/kg) was given at 30-minute before and after reperfusion of MCAo in rats. After surgery, we investigated and confirmed the therapeutic effect of sildenafil on histology, immunofluorescence, behavioral assays and neural oscillations. Results : Sildenafil alleviated a neuronal loss and reduced the infarction volume. And results of behavior task and immunofluorescence shown possibility that anti-inflammation process and improve motor deficits sildenafil treatment after mild ischemic stroke. Furthermore, sildenafil treatment attenuated the alteration of theta-frequency rhythm in the CA1 region of the hippocampus, a known neural oscillatory marker for anxiety disorder in rodents, induced by mild ischemic stroke. Conclusion : PDE5i as effective therapeutic agents for anxiety and movement disorders and provide robust preclinical evidence to support the development and use of PDE5i for the treatment of mild ischemic stroke residual disorders.