• Korean Journal of Biological Psychiatry
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• v.17 no.2
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• pp.70-78
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• 2010

Objectives : This study investigated the differences of working memory among the subtypes of ADHD. Methods : Eighty-one children and adolescents with ADHD and thirty normal controls were recruited. Children with any cognitive disorders and low intelligence were excluded. In order to evaluate the verbal and visuospatial working memory, Digit span and Finger windows tasks were measured, respectively. Performances on these measures between children with ADHD and controls were compared. Further, performances among the groups of ADHD predominantly inattentive(ADHD-IA)(n=40), predominantly hyperactive-impulsive(ADHD-HI)(n= 10), and combined type(ADHD-C)(n=31), were compared. Results : Scores of Finger windows forward task were lower in the ADHD group as compared to the control group, whereas, the Digit span forward showed no difference. Both scores of Digit span backward and Finger windows backward task were lower in the ADHD group than the controls. Children with ADHD-IA performed poorer than children with ADHD-C on the Finger windows backward task. Conclusion : The results of this study showed that children with ADHD have deficits in spatial short-term memory and verbal and visuospatial working memory when compared to normal children. The deficits were evident in children with ADHD-IA subtype and in particular, performance on the visuospatial working memory task in this group was poorer than the ADHD-C group.

• Journal of Korea Society of Industrial Information Systems
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• v.18 no.1
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• pp.37-45
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• 2013

Almost of stroke patients who experience aftereffects such as motor, sensory and cognitive disorders have to take some rehabilitation therapies. It is known that the consistent training for rehabilitation therapy in their home is more effective than rehabilitation therapy in hospital. A few home training programs were developed but these programs don't give any appropriate feedback messages to the client. Therefore, we developed a home training program which can provide appropriate feedback message to the clients using the Kinect sensor which can analyze user's 3-D dimensional motion. With this development, the client can obtain some feedback messages such as the knowledges of performance, results and self-controlled feedback. The program will be more effective than any existing programs.

• Molecules and Cells
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• v.37 no.11
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• pp.767-776
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• 2014

Alzheimer's disease (AD) is clinically characterized with progressive memory loss and cognitive decline. Synaptic dysfunction is an early pathological feature that occurs prior to neurodegeneration and memory dysfunction. Mounting evidence suggests that aggregation of amyloid-${\alpha}$ ($A{\alpha}$) and hyperphosphorylated tau leads to synaptic deficits and neurodegeneration, thereby to memory loss. Among the established genetic risk factors for AD, the ${\varepsilon}4$ allele of apolipoprotein E (APOE) is the strongest genetic risk factor. We and others previously demonstrated that apoE regulates $A{\alpha}$ aggregation and clearance in an isoform-dependent manner. While the effect of apoE on $A{\alpha}$ may explain how apoE isoforms differentially affect AD pathogenesis, there are also other underexplored pathogenic mechanisms. They include differential effects of apoE on cerebral energy metabolism, neuroinflammation, neurovascular function, neurogenesis, and synaptic plasticity. ApoE is a major carrier of cholesterols that are required for neuronal activity and injury repair in the brain. Although there are a few conflicting findings and the underlying mechanism is still unclear, several lines of studies demonstrated that apoE4 leads to synaptic deficits and impairment in long-term potentiation, memory and cognition. In this review, we summarize current understanding of apoE function in the brain, with a particular emphasis on its role in synaptic plasticity and the underlying cellular and molecular mechanisms, involving low-density lipoprotein receptor-related protein 1 (LRP1), syndecan, and LRP8/ApoER2.

• The Journal of Information Technology
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• v.9 no.1
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• pp.21-32
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• 2006

Acrophobia is a symptom of feeling an abnormal fear of heights. Medications or cognitive-behavior methods have been mainly used to treat the acrophobia. In these days the virtua1 reality technology has been applied to treat such an anxiety disorders. In this thesis, an telemedicine assistant system for treatment of acrophobia using biomedical signals and virtual reality technique is proposed. I made two virtual reality simulations for treatment of acrophobia and telemedicine system for communication between doctor and patient using personal computer. A virtual environment provides patient with stimuli which arouses phobia, and exposition to such environment makes him have ability to overcome the fear. Recently, the patient can take diagnosis from a medical doctor in distance with the telemedicine system. Multimedia conference service, on-line questionary, signal transfer system are needed to configure such system. Virtual reality simulation system that composed of position sensor, head mount display, and audio system, is also included in this telemedicine system. I added virtual environment update system to this virtual reality telemedicine system for treatment of acrophobia. Former acrophobia treatment systems use only patient's score of the questionary to appraise. The new system developed in this thesis uses not only patient's score of the questionary but also biomedical signals such as HR, GSR amplitude, GSR RT to increase the objectivity and quantitativity. The experimental results show that HR and GSR amplitude are useful for decision of acrophobia. We will apply this system to the acrophobia patient in distance and be able to offer better medical treatment for mental illness in near future.

• Journal of Preventive Medicine and Public Health
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• v.45 no.4
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• pp.219-226
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• 2012

Objectives: To evaluate the risk of fractures related with zolpidem in elderly insomnia patients. Methods: Health claims data on the entire South Korean elderly population from January 2005 to June 2006 were extracted from the Health Insurance Review and Assessment Service database. We applied a case-crossover design. Cases were defined as insomnia patients who had a fracture diagnosis. We set the hazard period of 1 day length prior to the fracture date and four control periods of the same length at 5, 10, 15, and 20 weeks prior to the fracture date. Time independent confounding factors such as age, gender, lifestyle, cognitive function level, mobility, socioeconomic status, residential environment, and comorbidity could be controlled using the case-crossover design. Time dependent confounding factors, especially co-medication of patients during the study period, were adjusted by conditional logistic regression analysis. The odds ratios and their 95% confidence intervals (CIs) were estimated for the risk of fracture related to zolpidem. Results: One thousand five hundred and eight cases of fracture were detected in insomnia patients during the study period. In our data, the use of zolpidem increased the risk of fracture significantly (adjusted odds ratio [aOR], 1.72; 95% CI, 1.37 to 2.16). However, the association between benzodiazepine hypnotics and the risk of fracture was not statistically significant (aOR, 1.00; 95% CI, 0.83 to 1.21). Likewise, the results were not statistically significant in stratified analysis with each benzodiazepine generic subgroup. Conclusions: Zolpidem could increase the risk of fracture in elderly insomnia patients. Therefore zolpidem should be prescribed carefully and the elderly should be provided with sufficient patient education.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.271-280
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• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

• Anxiety and mood
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• v.8 no.1
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• pp.41-49
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• 2012

Introduction : Suicide in Korea has increased to 31.2 persons per 100,000 population, the world's highest level. Suicide is the 10th leading cause of death in the world, but in Korea, it is 4th leading cause of death. Therefore suicide is a serious problem in Korea. Many suicide prevention strategies have been proposed. Despite efforts to prevent suicides in Korea, a steady increases in the number of suicides has been brought into question the effectiveness of suicide prevention activities in Korea. Methods : Strategy of restricting suicide methods in many countries was reviewed. Systematic approach to restrict suicidal methods in Korea is proposed. Results : Restricting suicide methods is one of the effective suicide prevention strategies employed in the UK and other countries. Since many suicides occur impulsively, suicide attempt lethality is an important factor in determining the rate of deaths in suicidal attempts. Physical restriction of suicide methods is important in preventing suicide, but restriction of cognitive access to information about suicide and suicide method is more important in preventing suicide. In particular hanging is one of the most common methods of suicides in Korea, it is crucial to develop strategies to prevent suicide by hanging cognitively. Also information about suicide should be properly controlled. To do this, suicide news reporting guidelines should be observed, and website makers whose websites provoke thoughts about suicide should be more strictly sanctioned. Conclusion : Restricting suicide methods along with other suicide prevention plans may be the most effective way to prevent suicide in Korea.

• Dementia and Neurocognitive Disorders
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• v.16 no.3
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• pp.72-77
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• 2017

Background and Purpose Although sleep disturbances are common and considered a major burden for patients with Alzheimer's disease (AD), the fundamental mechanisms underlying the development and maintenance of sleep disturbance in AD patients have yet to be elucidated. The aim of this study was to examine the correlation between regional cerebral blood flow (rCBF) and sleep disturbance in AD patients using technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPECT). Methods A total of 140 AD patients were included in this cross-sectional study. Seventy patients were assigned to the AD with sleep loss (SL) group and the rest were assigned to the AD without SL group. SL was measured using the sleep subscale of the Neuropsychiatric Inventory. A whole-brain voxel-wise analysis of brain SPECT data was conducted to compare the rCBF between the two groups. Results The two groups did not differ in demographic characteristics, severity of dementia, general cognitive function, and neuropsychiatric symptoms, with the exception of sleep disturbances. The SPECT imaging analysis displayed decreased perfusion in the bilateral inferior frontal gyrus, bilateral temporal pole, and right precentral gyrus in the AD patients with SL group compared with the AD patients without SL group. It also revealed increased perfusion in the right precuneus, right occipital pole, and left middle occipital gyrus in the AD with SL group compared with the AD without SL group. Conclusions The AD patients who experienced sleep disturbance had notably decreased perfusion in the frontal and temporal lobes and increased rCBF in the parietal and occipital regions. The findings of this study suggest that functional alterations in these brain areas may be the underlying neural correlates of sleep disturbance in AD patients.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.957-966
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• 2019

Carbon monoxide intoxication leads to hypoxia, which eventually leads to tissue ischemia. Delayed neuropsychiatric syndrome (DNS) can be a consequence and appears in the form of cognitive impairment and movement disorders after a lucid interval. A 58-year-old Korean male was admitted to our hospital with delayed neuropsychiatric sequelae (DNS) after an 11-day lucid interval following recovery from acute carbon monoxide intoxication. We treated him with herbal medication, acupuncture, electroacupuncture, and moxibustion. The effects were assessed by the activity index and Mini Mental State Examination-Korea (MMSE-K) scores, and by changes in gait disturbance. In this case, the clinical symptoms, including gait disturbance, and the activity index and MMSE-K scores, improved after traditional Korean treatment. The findings of this case report suggest that traditional Korean medicine treatment can be effective for treatment of symptoms of delayed neuropsychiatric sequelae due to CO intoxication.

• YAKHAK HOEJI
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• v.58 no.5
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• pp.328-336
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• 2014

Anticholinergic drugs are included in the efficacy group of various antidepressants, antihistamines, antispasmodics like skeletal muscle relaxants. Elderly patients are often taking anticholinergic drugs due to various diseases such as sleep disorders and dysuria. But the use of anticholinergic drugs is restricted in guidelines such as Beers Criteria or STOPP due to the anticholinergic adverse effects including dry mouth, constipation, difficult urination, delirium, hallucinations and especially cognitive impairment. In this study, we investigated the usage of anticholinergic drugs in out-of-hospital prescription of 4,442 elderly patients. Results of the study were obtained that 32% (n=1,421) of overall patients were prescribed with 1~6 products (average 1.37) of anticholinergic drugs. 70.9% of the 1,421 patients (n=1,007) were prescribed with one drug, 22.7% (n=323) were two drugs and 4.9% (n=70) were three drugs. 27.1% of the 1,421 patients (n=430) were 70~74 years old patients who were the most commonly prescribed with anticholinergic drugs. Amitriptyline, chlorpheniramine, dimenhydrinate and quetiapine were most frequent component of ACB Score 3 drugs and amantadine, baclofen, carbamazepine, cyproheptadine and oxcarbazepine were most frequent of ACB Score 2 drugs. Anticholinergic Drug Scale (ADS) of individual patients presented one point (48.5%, n=689), 2 points (15.4%, n=219), more than 3 points (36.1%, n=513), and up to maximum 12 point (n=1). More than 2 points were more than half (51.5%, n=732). Therefore, additional prospective study in the use and adverse effects of anticholinergic drugs for elderly patients will be required. And national management such as DUR program will be required for elderly drug administration from now on.