• Korean Journal of Biological Psychiatry
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• v.5 no.1
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• pp.83-94
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• 1998

Objectives : Phencyclidine(PCP) or PCP-like substances such as ketamine have been known to rekindle the cognitive dysfunction in schizophrenia. The aims of this study were to identify whether PCP-like substances can produce cognitive deficit in schizophrenia, to discuss relation with aging process, and finally to speculate underlying neurochemical mecha-nisms by various drug responses. Methods : In experiment I, radial maze tests were done in 24 Sprague-Dawley rats for 3 days to get baseline data. Being divided into 4 groups(6 rats respectively) of normal aged, normal adult controls, atropine-treated and ketamine-treated, the radial maze tests were repeated on every week for 6 weeks, and then the rats were sacrificed by intracardiac perfusion with phosphate-buffered 10% formaldehyde solution for histology. The brain specimen was stained with hematoxylin-eosin to count cells in the prefrontal cortex and hippocampus. In experiment II, radial maze tests were done for 48 rats before any drug treatment and only after ketamine administration. Thereafter, haloperidol, bromocriptine, clonidine, nimodipine, tacrine, valproic acid, naloxone and fluoxetine were intramuscularly injected on every other day in addition to ketamine. Radial maze tests were repeated on every week for 6 weeks, and then rats were prepared by the same procedure for histology. Results : 1) Reaction times of radial maze tests of atropine-treated rats were significantly prolonged than those of normal aged(p<0.05) or normal adult controls(p<0.05). Cell numbers of prefrontal cortex & hippocampus in ketamine-treated rats were significantly reduced than those in normal aged (p<0.05) or normal adult controls(p<0.005). 2) Reduced cell numbers by ketamine became significantly raised by tacrine administration in prefrontal cortex & hippocampus(p<0.05), while there were no significant changes on radial maze tests. Cell numbers also tended to be raised by nimodipine, fluoxetine and haloperidol administration. Conclusions : In conclusion, the visuospatial memory disorders in ketamine-induced psychotic rats might be partly asso-ciated with aging process. Furthermore, the responses to the various drugs suggested cholinergic system might have an important role in the neurochemical mechanism of the cognitive dysfunction in ketamine-induced psychosis. Otherwise, calcium metabolism as well as serotonergic and dopaminergic systems seemed to be possibly related.

• The Korean Journal of Pain
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• v.25 no.4
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• pp.254-257
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• 2012

Background: Elderly patients visiting pain clinic may be at greater risk of misunderstanding the explanation because of age-related cognitive decline. Video instruction may provide a consistent from of teaching in a visual and realistic manner. We evaluated the effect of educational video on the patient understanding and satisfaction in a group of geriatric patients visiting pain clinic. Methods: Ninety two patients aged more than 60 years old who were scheduled for transforaminal epidural block were recruited. After exposure to either video or paper instruction process, each patient was asked 5-item comprehension questions, overall satisfaction and preference question. During follow-up period, number of outpatient referral-line call for further explanation was counted. Results: We observed significantly better comprehension in the video education compared with paper instruction (P < 0.001). Patient satisfaction was also higher in the video group (P = 0.015), and patients visiting pain clinic were more preferred video instruction (P < 0.001). Proportion of referral-line call for further explanation were similar (P = 0.302). Conclusions: Video approach to instruction process before consent improves treatment comprehension in geriatric patient visiting pain clinic.

• Korean Medical Education Review
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• v.18 no.3
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• pp.125-131
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• 2016

Recent changes in educational paradigms that emphasize the performance or outcomes of education are redefining how learning objectives are being described as 'learning outcomes' in various academic disciplines. Medical education is not an exception to this trend. However, it has come to our attention that the key concepts and appropriate descriptions of learning outcomes have not been well understood among educators and that this lack of understanding has hindered our efforts to implement the practice in the field. This study aims to provide a direction to establish and describe learning outcomes by examining previous studies that have focused on setting learning objectives as well as learning outcomes. Setting and describing learning outcomes starts from reflection on the approach of behavioral learning objectives, which overemphasizes learner's acquired knowledge, skills, and attitude in each classroom rather than actual performance. On the other hand, the learning outcome approach focuses on what the learner is able to do as a result of a learning experience. This approach is more learner-friendly and encourages students to lead and be responsible for their learning process. Learning outcomes can best be described when the relevance of actual contexts and the hierarchy of learning objectives are considered. In addition, they should be in the form of context, task, performance, and level, as well as be planned with proper assessment and feedback procedures. When these conditions are met, the learning outcome approach is beneficial to students as it presents a curriculum that is more open to learners. Despite these advantages of the learning outcome approach, there is a possible concern that setting the learning outcomes and describing them can restrict evaluation to lower cognitive skills if the concept of learning outcome is narrowly interpreted or is set too low. To avoid such narrow applications, it is important for educators to understand the comprehensiveness of the learning outcome setting and to consider long-term outcomes embedded in an organizational vision rather than only short-term behavioral outcomes.

• Journal of Korean Academy of Nursing
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• v.49 no.6
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• pp.724-735
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• 2019

Purpose: This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model. Methods: This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24. Results: In the final model, admission via emergency department (Β=.06, p=.019), age over 65 years (Β=.11, p=.001), unconsciousness (Β=.18, p=.001), dependent activities (Β=.12, p=.001), abnormal vital signs (Β=.12, p=.001), pressure ulcer risk (Β=.12, p=.001), enteral nutrition (Β=.12, p=.001), and use of restraint (Β=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (Β=.06, p=.038), hospital length of stay (Β=5.06, p=.010), and discharge to another facility (not home) (Β=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium. Conclusion: The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.

• 한국약용작물학회:학술대회논문집
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• 2011.09a
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• pp.31-45
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• 2011

The amyloid ${\beta}$-peptide ($A{\beta}$), which originates from the proteolytic cleavage of amyloid precursor protein (APP), plays a central role in the pathogenesis of Alzheimer's disease (AD). Mounting evidence indicates that different species of $A{\beta}$, such as $A{\beta}$ oligomers and fibrils, may contribute to AD pathogenesis via distinct mechanisms at different stages of the disease. Importantly, elevation and accumulation of soluble $A{\beta}$ oligomers closely correlate with cognitive decline and/or disease progression in animal models of AD. In agreement with these studies, oligomers of $A{\beta}$ have been shown to directly affect synaptic plasticity, a neuronal process that is known to be essential for memory formation. Our previous studies showed that $A{\beta}$ induces the breakdown of phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2), a phospholipid that regulates key aspects of neuronal function. PI(4,5)P2 breakdown was found to be a key step toward synaptic and memory dysfunction in a mouse model of AD. To this end, we seek to identify small molecules that could elevate the levels of PI(4,5)P2 and subsequently block $A{\beta}$ oligomer-induced breakdown of PI(4,5)P2 and synaptic dysfunction.. We found that (20S)Rg3, an active triterpene glycoside from heat-processed ginseng, serves as an agonist for phosphatidylinositol 4-kinase IIalpha (PI4KIIalpha), which is a lipid kinase that mediates a rate-limiting step in PI(4,5)P2 synthesis. Consequently, (20S)Rg3 stimulates PI(4,5)P2 synthesis by directly stimulating the activity of PI4KIIalpha. Interestingly, treatment of a mouse model of AD with (20S)Rg3 leads to reversal of memory deficits. Our data suggest that the PI(4,5)P2-promoting effects of (20S)Rg3 may help mitigate the cognitive symptoms associated with AD.

• Journal of Korean Critical Care Nursing
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• v.8 no.2
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• pp.55-65
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• 2015

Purpose: The purpose of this study was to identify the attributes, antecedents, and consequences of post-intensive care syndrome. Methods: The study was conducted in accordance with Walker and Avant's conceptual analysis process. We searched the Medline, ProQuest, Google scholar, NANET (Korean National Assembly Library), and RISS (Korean Education and Research Information Service) databases resulting in 29 studies for in-depth review. Results: The attributes of post-intensive care syndrome include (1) new or worsening impairment persisting after discharge, (2) physical impairment, (3) psychological impairment, (4) cognitive impairment, and (5) symptom experience. The antecedents of the concept include a critical condition that requires intensive care, stressful events, immobility, sedation, delirium, insomnia, frailty, and invasive procedures. The consequences of post-intensive care syndrome are increased dependency in activities of daily life, decreased social interaction, delayed return to previous occupation, decreased quality of life, familial post-intensive care syndrome, and readmission/death. Conclusion: The concept of post-intensive care syndrome has multifaceted and integrative features. Further research needs to be conducted to develop a measurement tool that reflects the attributes of the concept and to develop multidisciplinary interventions to prevent post-intensive care syndrome.

• Journal of the Korea Society of Computer and Information
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• v.20 no.9
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• pp.31-37
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• 2015

Symmetry is easily found in animals and plants as well as in artificial structures. It is useful not only for human cognitive process but also for image understanding by computer. Application areas include face detection and recognition, indexing of image database, image segmentation and detection, and analysis of medical images. The method used in this paper extracts edges, and the perpendicular bisector of any pair of selected edge points is considered to be a candidate axis of symmetry. The coefficients of the perpendicular bisectors are accumulated in the coefficient space. Axis of symmetry is determined to be the line for which the histogram has maximum value. This method shows good results, but the usefulness of the method is restricted because the amount of computation increases proportional to the square of the number of edges. In this paper, an acceleration method is proposed which performs $2^{2n}$ times faster than the original one. Experiment on 20 test images shows that the proposed method using level-3 image segmentation performs 63.9 times faster than the original method.

• Journal of Environmental Health Sciences
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• v.50 no.2
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• pp.81-82
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• 2024

Urban air mobility (UAM) is emerging as an innovative transportation solution for cities. However, the potential noise impact on urban life must be carefully examined. Continuous exposure to UAM noise, with its unique frequency characteristics and temporal variability, may adversely affect citizens' health by causing sleep disorders, cardiovascular disease, and cognitive impairmenet, particularly in children. NASA has formed a UAM Noise Working Group to study this issue comprehensively. In Korea, the Seoul Metropolitan Government's UAM demonstration project is expected to accelerate related research and development. Scientific analysis, including noise measurement, prediction modeling, and health impact assessment, must be prioritized. Measures to minimize noise should be established based on this evidence, such as optimizing flight modes, developing noise reduction technologies, and establishing new noise management standards. Transparency and social consensus are crucial throughout this process. Expert review and open communication with civil society are necessary to address related concerns. Sharing demonstration project results and providing opportunities to experience UAM noise through digital twin simulations can help address public concerns and build social consensus. Proactively and scientifically tackling noise issues is essential for the sustainable development and successful integration of UAM into daily life.

• The Journal of Korean Medicine
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• v.35 no.1
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• pp.145-156
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• 2014

Objectives: Korean medicine hospitals, since they first emerged in the early 1970s, have rapidly become a new member of the hospital population. As it was a new organizational frame for traditional medicine, we tried to analyze the changes of Korean medicine hospitals coping with institutional environment and their relative positioning in the whole health care sector. Methods: On the basis of Scott and his colleagues' identification of the three components of institutional environments, changes in organizational logics, actors, and governance of Korean medicine hospitals during the period from 1971 to 2010 were analyzed. Results: First, Similar to previous literature on institutional eras of Korean health sector, three distinct periods were characterized: the foundation of Korean medicine hospitals to consolidate the legal status(1971~1986), a rapid increase of entrepreneurial hospitals through cultural-cognitive legitimacy(1987~2001), and the reinforcement of specialization and competition(2002~present). Conclusions: Results suggested that: (1) changes in institutional environments hada heavy impact on structural and behavioral changes among Korean medicine hospitals, but the pace was slower than that of western medicine hospitals. (2) In structure, Korean medicine hospitals have positioned themselves as unofficial long-term care hospitals, focusing on chronic diseases(e.g. cerebrovascular disease). Our study demonstrated that organizational theories can provide useful framework for the analysis of Korean medicine and related policies. Indeed, one of the most important implications of this study is that understanding changes in institutional environments is important to understand the process of how members of the health care sector live, grow, change, decline and survive.

• Journal of Pharmacopuncture
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• v.27 no.1
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• pp.27-37
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• 2024

Objectives: Posttraumatic stress disorder (PTSD) is a prevalent mental health condition, and techniques using sensory stimulation in processing traumatic memories have gained attention. The Emotional Freedom Techniques (EFT) is a psychotherapy that combines tapping on acupoints with exposure to cognitive reframing. This pilot study aimed to assess the feasibility of EFT as a treatment for PTSD by answering the following research questions: 1) What is the compliance and completion rate of patients with PTSD with regard to EFT protocol? Is the dropout rate reasonable? 2) Is the effect size of EFT protocol for PTSD sufficient to justify a future trial? Methods: Thirty participants diagnosed with PTSD were recruited. They received weekly EFT sessions for five weeks, in which they repeated a statement acknowledging the problem and accepting themselves while tapping the SI3 acupoint on the side of their hand. PTSD symptoms were evaluated using the PTSD Checklist for DSM-5 (PCL-5) before and after the intervention. Results: Of the 30 PTSD patients (mean age: 34.1 ± 9.1, 80% female), 96.7% showed over 80% compliance to the EFT sessions, and 86.7% completed the entire study process. The mean PCL-5 total score decreased significantly after the intervention, with a large effect size (change from baseline: -14.33 [95% CI: -19.79, -8.86], p < 0.0001, d = 1.06). Conclusion: The study suggests that EFT is a feasible treatment for PTSD, with high session compliance and low dropout rates. The effect size observed in this study supports the need for a larger trial in the future to further investigate EFT as a treatment for PTSD. However, the lack of a control group and the use of a self-rated questionnaire for PTSD symptoms are limitations of this study. The findings of this pilot study can be used to plan a future trial.