• Title/Summary/Keyword: Neuropsychology

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Study of the Amount and Share of Drug Cost in the Total Medical Fee under Medical Insurance Scheme (의료보험(醫療保險) 의약품(醫藥品)의 요양취급기관(療養取扱機關) 종별(種別), 약효군별(藥效群別), 상병별(傷病別) 사용(使用)에 관(關)한 조사연구(調査硏究))

  • Lee, Chu-Won;Hahn, Oh-Surk
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.223-235
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    • 1989
  • To grasp the idea about how drugs are used under Medical Insurance Scheme, the amount and share of drug cost in the total medical fee have been reviewed and analyzed for different types of patients (in-patient out-patient), medical institutions and frequently seen diseases and following findings were revealed. In 1986, drug cost took 32.78% of total medical fee for in-patients and 32.98% for out-patients averaged over 30% share as a whole. When drug cost per case in 1980 be indexed to 100, it has shown steady growth to become 200 for in-patients and about 150 for out-patients in 1986. The contribution of drug cost to the total medical fee is, regardless of patient type-in-patients and out-patients, the highest in University hospitals and followed by General hospitals, Hospitals and Clinics in decending order That for the most frequent 10 diseases came out the highest,79 a with the essential benign hypertension of out-patients in the General hospitals, 61% for the gastric ulcer of out-patients in Hospitals and 33% for the female genital diseases of out-patients in Clinics. The drug cost of oral formula was contributed the most, 7.93% by cardiovascular agents followed by hepatic detoxicants(5.47%) and out-patients(4.93%), and that of injectable formula was contributed the most by antibiotics(24.17%), followed by protein amino-acid preparations(6.19%). The order of drug usage by specialty for the in-patients was the highest with internal medicine followed by general surgery and E.N.T, and that for the out-parients was in the order of Internal medicine, neuropsychology and Ob/Gy. This study revealed that the drug dependency was characteristically different to specialty. In view of the fact that drug cost on average exceeds over 30% of total medical fee, proper drug administration appears to be vitally important for the stabilization of the financial standing of the Medical Insurance Scheme. As a consequence, drug usage guidelines including antibiotics usage shall be established first of all and the voluntary participation for the regulation of drug usage and propagation of the guidelines to medical institutions are strongly coerced.

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Prevalence Rate of Cognitive Impairment and Dementia Among the Elderly in Busan (부산지역 거주 노인의 인지기능장애 및 치매 유병률)

  • Kim, Jung-Soon;Lee, Su-Ill;Chung, Young-In;Hwang, In-Kyung;Yih, Bong-Sook;Kim, Min-Jeong;Cho, Eu-Soo;Chun, Jin-Ho;Jeong, Ihn-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.1
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    • pp.63-70
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    • 2003
  • Objectives : To investigate the prevalence of cognitive impairment and dementia in elderly people, aged 65 or above, residing in Busan Metropolitan City. Methods : Total of 1,101 old people, aged 65 or above, living in Busan as of December 31, 2001 were selected using stratified three-stage cluster sampling. Cognitive impairment was determined from the MMSE-K score, and dementia confirmed from five psychometric measures and the Barthel index. The crude prevalence, sex-age adjusted for the Korean population, were obtained. Results : With the cut-off point for cognitive impairment was set at 24 points, or below, on the MMSE-K scale, the crude rate of cognitive impairment was 29.3% (15.7% for men and 37.5% for women), and the sex-age adjusted prevalence was 30.5% (17.5% for men and 37.0% for women). When the cut-off point for cognitive impairment was set at 20 points, or below, on the MMSE-K scale, the crude rate of cognitive impairments were 10.0% (4.1% for men and 13.5% for women), and 10.6% (4.7% for men and 13.1% for women), respectively. The crude dementia, and the sex-age adjusted rates were 7.4% (2.4% for men and 10.5% for women), and 8.0% (2.7% for men and 10.0% for women), respectively. Conclusions : The prevalence of dementia in this study was somewhat lower than that reported by other domestic and foreign studies. Our results related to the difference in time and space, diagnostic tools, response rates, and distribution of male and female subjects, etc.

Effect of Acupuncture Treatment for Functional Dyspepsia;A Randomized Controlled Trial (기능성 소화불량증에 대한 침치료의 효과;무작위배정 대조군 연구)

  • Park, Yang-Chun;Jo, Jeong-Hyo;Son, Chang-Gyu;Hong, Kwon-Eui;Jeong, In-Cheol;Kang, Wee-Chang;Choi, Sun-Mi
    • Journal of Acupuncture Research
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    • v.24 no.1
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    • pp.1-12
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    • 2007
  • Objectives : Functional dyspepsia is a prevalent disease. It impedes subjective quality of life. The purpose of this research is to examine the effect of acupuncture treatment for functional dyspepsia. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture for the treatment of functional dyspepsia. Volunteers who satisfied the requirements were enrolled in study. Severity of dyspepsia was measured by Nepean Dyspepsia Index(NDI) and Functional Dyspepsia Quality fo Life(FD-QOL) before and after treatments. Results : 68 subjects finished study. There were not difference between two groups on age, sex, weight, height, severity of dyspepsia, subtype, Byeonjeung, surmise of treatment. After treatment total key symptoms score, improve rate of key symptoms were decreased than before treatment in active acupuncture group, but there were no statistical significance compared with sham acupuncture group. After treatment "pressure in upper abdomen" and " cramps in upper abdomen" were more decreased in active acupuncture group compared with sham acupuncture group(p=0.001, p=0.014). After treatment total symptom score and QOL of NDI were decreased than before treatment in active acupuncture group, but there were no statistical significance compared with sham acupuncture group. After treatment eating status of FD-QOL in active acupuncture group was significantly increased than sham acupuncture group(p=0.008). After treatment liveliness status of FD-QOL and total score of FDQOL in active acupuncture group was increased than sham acupuncture group though statistically insignificant(p=0.095, p=0.077). Conclusion : Acupuncture treatment is effective to improve the symptoms and quality of life in patients with functional dyspepsia.

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The Neuroanatomy and Psychophysiology of Attention (집중의 신경해부와 정신생리)

  • Lee, Sung-Hoon;Park, Yun-Jo
    • Sleep Medicine and Psychophysiology
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    • v.5 no.2
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    • pp.119-133
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    • 1998
  • Attentional processes facilitate cognitive and behavioral performance in several ways. Attention serves to reduce the amount of information to receive. Attention enables humans to direct themselves to appropriate aspects of external environmental events and internal operations. Attention facilitates the selection of salient information and the allocation of cognitive processing appropriate to that information. Attention is not a unitary process that can be localized to a single neuroanatomical region. Before the cortical registration of sensory information, activation of important subcortical structures occurs, which is called as an orienting response. Once sensory information reaches the sensory cortex, a large number of perceptual processes occur, which provide various levels of perceptual resolution of the critical features of the stimuli. After this preattentional processing, information is integrated within higher cortical(heteromodal) systems in inferior parietal and temporal lobes. At this stage, the processing characteristics can be modified, and the biases of the system have a direct impact on attentional selection. Information flow has been traced through sensory analysis to a processing stage that enables the new information to be focused and modified in relation to preexisting biases. The limbic and paralimbic system play significant roles in modulating attentional response. It is labeled with affective salience and is integrated according to ongoing pressures from the motivational drive system of the hypothalamus. The salience of information greatly influences the allocation of attention. The frontal lobe operate response selection system with a reciprocal interaction with both the attention system of the parietal lobe and the limbic system. In this attentional process, the search with the spatial field is organized and a sequence of attentional responses is generated. Affective, motivational and appectitive impulses from limbic system and hypothalamus trigger response intention, preparation, planning, initiation and control of frontal lobe on this process. The reticular system, which produces ascending activation, catalyzes the overall system and increases attentional capacity. Also additional energetic pressures are created by the hypothalamus. As psychophysiological measurement, skin conductance, pupil diameter, muscle tension, heart rate, alpha wave of EEG can be used. Event related potentials also provide physiological evidence of attention during information process. NI component appears to be an electrophysiological index of selective attention. P3 response is developed during the attention related to stimulus discrimination, evaluation and response.

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Neuropsychological Mechanism of Perceptual Disorder (지각 장애의 신경 심리학적 기전)

  • Lee, Sung-Hoon;Park, Yun-Zo;Kim, Dong-Wha;Park, Hae-Jung;Kim, Ji-Woong
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.143-148
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    • 1999
  • Objectives: We studied correlations between neuropsychological tests and perceptual disorder in patients with head trauma and psychiatric patients in order to explore the functional localization of brain in perceptual disorders. Methods: Halstead Reitan Neuropsychological Test Battery, Korean Wechsler Intelligent Scale, and Minnesota Multiphasic Peronality Inventory(MMPI) were administered to one hundred ninteen patients consisting of sixty nine psychiatric patients and fifty patients with brain damage. We tested the correlation between results of neuropsychological tests and peceptual disorder scale PDS) made from nine items related with perceptual disorder in MMPI. T-tests between twenty one higher scorers and seventeen lower scorers of PDS were also performed in the psychiatric group. Results: In brain damage group, significant correlations were found in tests related with function of frontal lobe such as category tests, trail making tests, tactual performance test, and fingertip number writing test, and significant correlations were also noted in the tests related with function of right hemisphere such as tactual performance test, performance, picture completion, picture arrangement and block design. Tests related with subcortical function such as digit symbol test, arithmetic and digit span were signigicantly correlated, too. In psychiatric group, there were significant differences of PDS in the tests related with function of right hemisphere such as picture completion, block design, and right laterality index, and in the tests related with function of left hemisphere such as comprehension, vocabulary, and similarities. Conclusion: Perceptual disorder seems to be related with functions of frontal lobe, right hemisphere, and subcortex in both groups. In a psychiatric group, left hemisphere may be also partially related with perceptual disorder.

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Neuropsychological Mechanism of Delusion (망상의 신경심리학적 기전)

  • Lee, Sung-Hoon;Kim, Dong-Wha;Park, Yun-Zo;Park, Hae-Jung;Shin, Yoon-Sik
    • Sleep Medicine and Psychophysiology
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    • v.7 no.1
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    • pp.60-66
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    • 2000
  • Objectives: The Psychopathology of schizophrenia was expected to be related with focal dysfunction of brain while schizophrenia is recognized and studied as the brain disease. Authors studied correlation between neuropsychological tests and delusion which is representative symptom of schizophrenia in patients with head trauma and psychiatric patients in order to explore the functional localization of brain in delusional symptom. Methods: Halstead Reitan Neuropsychological Test Battery and Korean Weschler Intelligent Scale and Minnesota Multiphasic Personality Inventory(MMPI) were administered to one hundred ninteen patients consisted of sixty nine psychiatric patients and fifty patients with brain damage. We tested correlation between results of neuropsychological tests and delusional scale made from twenty four items related with delusion in MMPI. T-test between eighteen higher delusion scorers and twenty one lower scorers was examed in psychiatric group. Results: In brain damage group, signigicant correlations were found in the tests related with function of frontal lobe such as category test, trail making AB test, tactual performance test, digit symbol test and fingertip number writing test, and significant correlations were also noted in the tests related with function of left temporal and parietal lobes such as information, comprehension, vocabulary, similarities and speech sound perception test. The tests related with the function of right hemisphere such as tactual performance test location, picture completion and performance, and the tests related with subcortical function such as arithmetic, digit span, attention, digit symbol test, digit symbol and trail making AB test were signigicantly corelated with delusional scale too. In psychiatric group there were significant difference of delusional score in the tests related with function of left hemisphere such as vocabulary, vocable IQ, comprehension and language, and in the tests related with subcortical function such as N 120 voltage, digit symbol and arithmetic. Conclusions: Delusion seems to be related with function of frontal lobe, left hemisphere and subcortex in both groups. Right hemisphere may be also partially related with delusion.

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