• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.140-146
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• 2013

Objectives: We compared the characteristics of the pain threshold and pain experience between demented group and non-demented group. Methods: This study was part of Gangwon projects for early detection of dementia in 2010. We recruited 8302 local resident ages over 65 years old. Of theses, 1259 people who scored low MMSE were selected and 365 of them completed CERAD-K(Consortium to Establish a Registry for Alzheimer's disease). Finally, 90 in non-demented group and 57 in demented group(mild to moderate Alzheimer's disease) were analyzed. Pain threshold was experimentally measured by pressure algometer and we investigated the pain experience, by Brief pain inventory (BPI), a self-report test. Results: In the demographic characteristics, there are more female, higher ages, lower education in the demented group. There was no significant difference between the two groups in the pain threshold. On the BPI results, 'shoulder pain', 'the number of pain' and 'interference of working' were significantly more prevalent in non-demented group. However, there are no significant differences between the groups in the 'pain severity', 'prevalence of pain' and 'pain treatment'. Conclusions: Demented group report less pain experience but, still perceived pain. It support previous studies that patient with dementia have increased pain tolerance but preserved pain threshold. Thus, active pain assessment and treatment for patients with dementia is needed.

• Korean Journal of Biological Psychiatry
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• v.23 no.2
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• pp.63-68
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• 2016

Objectives Haenyeo are Korean professional women breath-hold divers in Jeju island. The aim of this study was to investigate the clinical characteristics of depressed Haenyeo group, compared to non-Haenyeo depressed group. Methods This study included 75 Haenyeo and 340 non-Haenyeo with depressive disorders recruited from the Dementia Early Detection Program in Jeju island. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview. All patients completed the questionnaires, including the Subjective Memory Complaints Questionnaire (SMCQ), the Patient Health Questionnaire-15 (PHQ-15), and the Blessed dementia scale. Depression was evaluated by the Korean version of short form the Geriatric Depression Scale (K-SGDS) and cognition was assessed by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment packet. Results Although the mean scores of the K-SGDS were similar between Haenyeo and non-Haenyeo depressed groups, the Haenyeo group showed a higher mean score on the PSQ-15 (p < 0.001, ANCOVA adjusting for age, the K-SGDS and education). The Haenyeo group showed poorer performance on the Korean Version of Frontal Assessment Batter (p < 0.001), the Mini-Mental State Examination in the Korean version of the CERAD Assessment Packet (p < 0.018), the word fluency test (p < 0.001), and the word list memory test (p = 0.012) in ANCOVA adjusting for age and education. The mean SMCQ score was higher in the Haenyeo depressed group than in the non-Haenyeo depressed group. Conclusions The Haenyeo depressed group shows cognitive dysfunction, especially frontal lobe dysfunction, compared to the non-Haenyeo depressed group, indicating the Haenyeo depressed group may have more severe frontolimbic dysfunction due to chronic exposure to hypoxia. The Haenyeo depressed group suffers more somatic symptoms than the non-Haenyeo depressed group.

• Biomedical Science Letters
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• v.18 no.4
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• pp.399-405
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• 2012

The brain is the body's most organized and controlled organ, and it governs various psychological and mental functions. A brain abnormality could greatly affect one's physical and mental abilities, and consequently one's social life. Brain disorders can be broadly categorized into three main afflictions: stroke, brain tumor, and dementia. Among these, stroke is a common disease that occurs owing to a disorder in blood flow, and it is accompanied by a sudden loss of consciousness and motor paralysis. The main types of strokes are infarction and hemorrhage. The exact diagnosis and early treatment of an infarction are very important for the patient's prognosis and for the determination of the treatment direction. In this study, texture features were analyzed in order to develop a prototype auto-diagnostic system for infarction using computer auto-diagnostic software. The analysis results indicate that of the six parameters measured, the average brightness, average contrast, flatness, and uniformity show a high cognition rate whereas the degree of skewness and entropy show a low cognition rate. On the basis of these results, it was suggested that a digital CT image obtained using the computer auto-diagnostic software can be used to provide valuable information for general CT image auto-detection and diagnosis for pre-reading. This system is highly advantageous because it can achieve early diagnosis of the disease and it can be used as supplementary data in image reading. Further, it is expected to enable accurate medical image detection and reduced diagnostic time in final-reading.

• The Korean Journal of Nuclear Medicine
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• v.37 no.6
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• pp.374-381
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• 2003

Purpose: Determining an appropriate thresholding is crucial for PDG PET analysis since strong control of Type I error could fail to find pathological differences between eariy Alzheimer' disease (AD) patients and healthy normal controls. We compared the SPM results on FDG PET imaging of early AD using uncorrected p-value, random-field based corrected p-value and false discovery rate (FDR) control. Materials and Methods: Twenty-eight patients ($66{\pm}7$ years old) with early AD and 18 age-matched normal controls ($68{\pm}6$ years old) underwent FDG brain PET. To identify brain regions with hypo-metabolism in group or individual patient compared to normal controls, group images or each patient's image was compared with normal controls usingthe same fixed p-value of 0.001 on uncorrected thresholding, random-field based corrected thresholding and FDR control. Results: The number of hypo-metabolic voxels was smallest in corrected p-value method, largest in uncorrected p-value method and intermediate in FDG thresholding in group analysis. Three types of result pattern were found. The first was that corrected p-value did not yield any voxel positive but FDR gave a few significantly hypometabolic voxels (8/28, 29%). The second was that both corrected p-value and FDR did not yield any positive region but numerous positive voxels were found with the threshold of uncorrected p-values (6/28, 21%). The last was that FDR was detected as many positive voxels as uncorrected p-value method (14/28, 50%). Conclusions FDR control could identify hypo-metaboiic areas in group or individual patients with early AD. We recommend FDR control instead of uncorrected or random-field corrected thresholding method to find the areas showing hypometabolism especially in small group or individual analysis of FDG PET.

• Journal of Korean Public Health Nursing
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• v.26 no.1
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• pp.101-112
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• 2012

Purpose: The purposes of this study were to identify differences of duties, tasks, and task elements of care helpers between long term care (LTC) facilities and client's home (CH), and to provide data for the development of educational programs and policies. Methods: This study was a descriptive investigation; the subjects of the study were 418 care helpers. Duties, tasks, and task elements were measured using the framework proposed by Shin et al. (2012). Data were analyzed by t-test using PASW 18.0. Results: All of the jobs were statistically significant differences between LTC and CH. Dietary assistance and Daily work assistance were more frequently in CH, and the frequency of other tasks was higher in LTC than CH. Tasks with higher-reported difficulty by those who worked in LTC were as follows: personal hygiene, position change and movement, exercise and activity assistance, safety care, communication assistance, dietary assistance, environment management, daily work assistance, emergency prevention, early detection and speedy reporting, and dementia patient care. Conclusion: These findings suggest that training for care helpers of each facility type will be differentiated. Tasks and task elements reported by care helpers were modified and added to the standard textbook.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.201-210
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• 2016

Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.