• Title/Summary/Keyword: Clinical neurology

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TELEPHONE PSYCHOTHERAPY WITH ADOLESCENTS (청소년 정신 장애자에 대한 전화 정신 치료의 효용)

  • Lee, Kil-Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.129-137
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    • 1992
  • This article describes several clinical usefullness of the telephone in psychotherapy with adolescents through case analysis by Tolchin, and discussed various management problems and some practical guidelines for therapists planning to utilize telephone psychotherapy with adolescents through literature analysis. In general, most adolescent patients in regular treatment benefit from knowing that the therapist can be reached by phone and that their call will be returned that same day. The therapist's telephone availability helps the young patient to develope a positive working alliance. Telephone psychotherapy had it's first widespread application in crisis intervention and suicide prevention. It's current uses also include enhancement of self-control in cases of self-destructive adolescents, and management of anxious, depressive, or anorexic adolescents. In addition, such widely divergent modalities of treatment as follow up of patients discharged from a psychiatric hospital, alcoholic rehabilitation programs, drug hotlines, sex counselling group therapy for visually impaired elderly, control of separation anxiety in girls, resolution of fear on the mental disorders, and helpful modality to continue psychotherapy without geographic barrier during longer periods of separation with therapist are currently available via telephone. But telephone psychotherapy is generally not suitable for more self-defensive and introverted cases, more dependent chronic callers, silent cases, test callers. the cases of telephone scatologias, the cases of intellectualized discussion, of more dependent cases calling phone in order to get attention from therapist. Telephone psychotherapy for adolescents serves as an important and useful method in the therapeutic armamentarium for this most challenging and rewarding population.

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Microbleeds in Patients with Primary Intracerebral Hemorrhages

  • Kim, Il-Man;Yim, Man-Bin;Son, Eun-Ik;Sohn, Sung-Il;Sohn, Chul-Ho
    • Journal of Korean Neurosurgical Society
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    • v.39 no.3
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    • pp.210-214
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    • 2006
  • Objective : We investigate risk factors of cerebral microbleeds[MBs] and their relation to concomitant magnetic resonance[MR] findings in intracerebral hemorrhages[ICHs] patients. Methods : We studied 100 consecutive patients with primary ICH over a 1-year period. These patients underwent brain MR images using 3.0-T scanners within the first week of the hemorrhage. MBs and old hematomas were located and counted by using $T2^*-weighted$ gradient-echo MR imaging. We also counted lacunes and graded white matter and periventricular hyperintensity on T1- and T2-weighted spin-echo sequences. The association between MBs and vascular risk factors and MR abnormalities were analyzed. Results : MBs were seen in 77 of ICH patients, and their number ranged from 1 to 65 lesions [mean 11, median 6]. The locations of MBs were subcortex-cortex [40.6%], basal ganglia [26.7%], thalamus [14.1 %], brain stem [12.5%], and cerebellum [9.1 %]. Analysis of clinical data revealed that age, hypertension, history of stroke, and duration of hypertension were frequently associated with MBs. The incidence of lacunes, old hematomas, and advanced leukoaraiosis was significantly higher in the MBs group, compared with the patients without MBs. Conclusion : MBs are frequently observed in ICH patients with advancing age, chronic hypertension, and previous hemorrhagic stroke, and are also closely related with morphological signs of occlusive type microangiopathy, such as lacunar infarct and severe leukoaraiosis.

Medical Student Career Choice and Career Planning (의과대학생들의 진로선택과 진로지도)

  • Kim, Sang Hyun;Yoon, Yoo-sag;Jeon, Woo-Tack;Yang, Eunbae
    • Korean Medical Education Review
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    • v.9 no.2
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    • pp.29-40
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    • 2007
  • Purpose: This study analysed the intention of medical students career choice, educational programmes, and mentoring and counseling system for career planning at Yonsei medical school in Korea. Methods: The data were collected based on four separate graduation questionnaires at Yonsei medical school in the years of 2005, 2006, 2007, and 2008. The number of the survey was 130 in 2005, 130 in 2006, 153 in 2007, and that of the latest was 120 in 2008. We analysed the career intention on medical specialties and activities, and perceptions of important factors in choosing medical specialty. Results : The results which can be drawn from this study are these: firstly. students had more intention for choosing clinical medicine as university faculty than any other activities. While male students preferred to major in surgery, neurosurgery, orthopedic surgery, urology, otorhinolaryngology, female students in internal medicine, neurology, anesthesiology and pain medicine, diagnostic radiology, laboratory medicine. Secondly, students perceived that the most important factor which can influence on choosing a medical specialty was individual factor such as one's interests and concerns, values, and aptitudes. In stead, they relatively less perceived mentor and role model's effects on choosing a medical specialty compared to those of the United States of America. Third, the career planning at Yonsei medical school was evaluated well, especially educational programmes for career planning such as self assessment programme, elective(specialized) courses, and conversation with a senior programme. Conclusions: Unexpectedly, there are high demands for career planning by medical students. Therefore, we will reorganize systematic devices for career planning such as mentoring and counseling system at medical school.

Changes in Orthostatic Hypotension According to the Levels of Head-up Position during Sleep in Patients with Parkinsonian Disorders (파킨슨증 환자에서 수면 시 두부거상 정도에 따른 기립성 저혈압의 변화)

  • Kim, Sung Reul;Chae, Hyun Sook;Yoon, Mi Jung;Park, Su Young;Jung, Da Hee;Lee, Hyang Hee;Chung, Sun Ju;An, Young Hee;Kim, Kyoung Ok
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.2
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    • pp.275-285
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    • 2011
  • Purpose: Head-up position during sleep is one of the non-pharmacologic interventions for the treatment of orthostatic hypotension. Because the head-up position causes discomfort in many patients, this approach may not be acceptable to all patients. We compared the systolic blood pressure in erect position, orthostatic hypotension, orthostatic disability score, and the improvement rates of orthostatic hypotension between the 20 cm head-up group and the 10 cm head-up group. Methods: A control pre/post-test design was used. Between August 1, 2009 and November 15, 2010, we consecutively enrolled patients who showed orthostatic hypotension in patients with Parkinsonian disorders. Sixty-seven patients were prospectively enrolled and forty-four patients were completed the study. Results: There were no statistically significant differences found in the systolic blood pressure in erect position, orthostatic hypotension, and orthostatic disability scores between the two groups. However, five patients showed improvement in 20 cm head-up group and one patient was showed improvement in 10 cm head-up Group. Conclusion: Orthostatic hypotension is decreased with 20 cm head-up position in some patients with Parkinsonian disorders (p=.034). Further research investigating the relationships between orthostatic hypotension and head-up position are warranted.

Is meconium exposure associated with autism spectrum disorders in children?

  • Jenabi, Ensiyeh;Ayubi, Erfan;Khazaei, Salman;Bashirian, Saeid;Khazaei, Mojtaba
    • Clinical and Experimental Pediatrics
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    • v.64 no.7
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    • pp.341-346
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    • 2021
  • Background: The results differ among published studies regarding exposure to meconium and the risk of developing autism spectrum disorders (ASDs). Purpose: The present study pooled all of the epidemiologic studies retrieved from broader databases on the association between meconium exposure and risk of developing ASD in children. Methods: The Web of Science, PubMed, Scopus, and Google Scholar databases were searched without language restrictions for articles published between their inception to February 20, 2020, using relevant keywords. The pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated as random-effect estimates of the associations among studies. A subgroup analysis was conducted to explore any potential sources of heterogeneity among studies. Results: The pooled estimate of OR reported a weakly significant association between meconium exposure and ASD development in children (OR, 1.13; 95% CI, 1.03-1.24). There was low heterogeneity among the articles reporting risk for ASD among children (I2=19.3%; P=0.259). The results of subgroup analysis based on meconium exposure showed a significant association between a meconium-stained neonate and ASD development (OR, 1.18; 95% CI, 1.11-1.24). Couclusion: Meconium exposure was weakly associated with an increased risk of ASD. However, more evidence based on large prospective cohort studies is required to provide conclusive evidence about whether meconium exposure is associated with an increased risk of ASD development.

Paeoniflorin ameliorates neuropathic pain-induced depression-like behaviors in mice by inhibiting hippocampal neuroinflammation activated via TLR4/NF-κB pathway

  • Bai, Hualei;Chen, Shize;Yuan, Tiezheng;Xu, Dongyuan;Cui, Songbiao;Li, Xiangdan
    • The Korean Journal of Physiology and Pharmacology
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    • v.25 no.3
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    • pp.217-225
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    • 2021
  • Neuropathic pain (NP) that contributes to the comorbidity between pain and depression is a clinical dilemma. Neuroinflammatory responses are known to have potentially important roles in the initiation of NP and depressive mood. In this study, we aimed to investigate the effects of paeoniflorin (PF) on NP-induced depression-like behaviors by targeting the hippocampal neuroinflammation through the toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signaling pathway. We used a murine model of NP caused by unilateral sciatic nerve cuffing (Cuff). PF was injected intraperitoneally once a day for a total of 14 days. Pain and depression-like behavior changes were evaluated via behavioral tests. Pathological changes in the hippocampus of mice were observed by H&E staining. The levels of proinflammatory cytokines in the hippocampus were detected using ELISA. Activated microglia were measured by immunohistochemical staining. The TLR4/NF-κB signaling pathway-associated protein expression in the hippocampus was detected by western blotting. We found that the PF could significantly alleviate Cuff-induced hyperalgesia and depressive behaviors, lessen the pathological damage to the hippocampal cell, reduce proinflammatory cytokines levels, and inhibit microglial over-activation. Furthermore, PF downregulated the expression levels of TLR4/NF-κB signaling pathway-related proteins in the hippocampus. These results indicate that PF is an effective drug for improving the comorbidity between NP and depression.

The Levels of Vitamin D, Vitamin D Receptor, Homocysteine and Complex B Vitamin in Children with Autism Spectrum Disorders

  • Altun, Hatice;Kurutas, Ergul Belge;Sahin, Nilfer;Gungor, Olcay;Findikli, Ebru
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.383-390
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    • 2018
  • Objective: Autism spectrum disorder (ASD) is a complex neurodevelopmental syndrome with an increasingly prevalent etiology, yet not fully understood. It has been thought that vitamin D, complex B vitamin levels and homocysteine are associated with environmental factors and are important in ASD. The aim of this study was to examine serum vitamin D, vitamin D receptor (VDR), homocysteine, vitamin B6, vitamin B12 and folate levels in ASD. Methods: In this study, serum vitamin D and VDR, homocysteine, vitamins B6, B12 and folate levels were determined in 60 patients with ASD (aged 3 to 12 years) and in 45 age-gender matched healthy controls. In addition, calcium, phosphorus and alkaline phosphatase, which are associated with vitamin D metabolism, were measured from serum in both groups. ASD severity was evaluted by the Childhood Autism Rating Scale (CARS). Results: Serum vitamin D and VDR were substantially reduced in patients with ASD in comparision to control group. However, homocysteine level was significantly higher and vitamin B6, vitamin B12 and folate were also reduced in patients with ASD. Total CARS score showed a positive association with homocysteine and a negative correlation with vitamins D,B6, B12, folate and VDR. Conclusion: This comprehensive study, which examines many parameters has shown that low serum levels of vitamins D, B6, B12, folate and VDR as well as high homocysteine are important in the etiopathogenesis of ASD. However, further studies are required to define the precise mechanism(s) of these parameters and their contributions to the etiology and treatment of ASD.

Understanding Neurogastroenterology From Neuroimaging Perspective: A Comprehensive Review of Functional and Structural Brain Imaging in Functional Gastrointestinal Disorders

  • Kano, Michiko;Dupont, Patrick;Aziz, Qasim;Fukudo, Shin
    • Journal of Neurogastroenterology and Motility
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    • v.24 no.4
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    • pp.512-527
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    • 2018
  • This review provides a comprehensive overview of brain imaging studies of the brain-gut interaction in functional gastrointestinal disorders (FGIDs). Functional neuroimaging studies during gut stimulation have shown enhanced brain responses in regions related to sensory processing of the homeostatic condition of the gut (homeostatic afferent) and responses to salience stimuli (salience network), as well as increased and decreased brain activity in the emotional response areas and reduced activation in areas associated with the top-down modulation of visceral afferent signals. Altered central regulation of the endocrine and autonomic nervous responses, the key mediators of the brain-gut axis, has been demonstrated. Studies using resting-state functional magnetic resonance imaging reported abnormal local and global connectivity in the areas related to pain processing and the default mode network (a physiological baseline of brain activity at rest associated with self-awareness and memory) in FGIDs. Structural imaging with brain morphometry and diffusion imaging demonstrated altered gray- and white-matter structures in areas that also showed changes in functional imaging studies, although this requires replication. Molecular imaging by magnetic resonance spectroscopy and positron emission tomography in FGIDs remains relatively sparse. Progress using analytical methods such as machine learning algorithms may shift neuroimaging studies from brain mapping to predicting clinical outcomes. Because several factors contribute to the pathophysiology of FGIDs and because its population is quite heterogeneous, a new model is needed in future studies to assess the importance of the factors and brain functions that are responsible for an optimal homeostatic state.

Asiatic Acid Protects Dopaminergic Neurons from Neuroinflammation by Suppressing Mitochondrial ROS Production

  • Chen, Dong;Zhang, Xiao-Ya;Sun, Jing;Cong, Qi-Jie;Chen, Wei-Xiong;Ahsan, Hafiz Muhammad;Gao, Jing;Qian, Jin-Jun
    • Biomolecules & Therapeutics
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    • v.27 no.5
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    • pp.442-449
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    • 2019
  • This study sought to evaluate the effects of Asiatic acid in LPS-induced BV2 microglia cells and 1-methyl-4-phenyl-pyridine ($MPP^+$)-induced SH-SY5Y cells, to investigate the potential anti-inflammatory mechanisms of Asiatic acid in Parkinson's disease (PD). SH-SY5Y cells were induced using $MPP^+$ to establish as an in vitro model of PD, so that the effects of Asiatic acid on dopaminergic neurons could be examined. The NLRP3 inflammasome was activated in BV2 microglia cells to explore potential mechanisms for the neuroprotective effects of Asiatic acid. We showed that Asiatic acid reduced intracellular production of mitochondrial reactive oxygen species and altered the mitochondrial membrane potential to regulate mitochondrial dysfunction, and suppressed the NLRP3 inflammasome in microglia cells. We additionally found that treatment with Asiatic acid directly improved SH-SY5Y cell viability and mitochondrial dysfunction induced by $MPP^+$. These data demonstrate that Asiatic acid both inhibits the activation of the NLRP3 inflammasome by downregulating mitochondrial reactive oxygen species directly to protect dopaminergic neurons from, and improves mitochondrial dysfunction in SH-SY5Y cells, which were established as a model of Parkinson's disease. Our finding reveals that Asiatic acid protects dopaminergic neurons from neuroinflammation by suppressing NLRP3 inflammasome activation in microglia cells as well as protecting dopaminergic neurons directly. This suggests a promising clinical use of Asiatic acid for PD therapy.

Electron Transfer to Hydroxylase through Component Interactions in Soluble Methane Monooxygenase

  • Lee, Chaemin;Hwang, Yunha;Kang, Hyun Goo;Lee, Seung Jae
    • Journal of Microbiology and Biotechnology
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    • v.32 no.3
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    • pp.287-293
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    • 2022
  • The hydroxylation of methane (CH4) is crucial to the field of environmental microbiology, owing to the heat capacity of methane, which is much higher than that of carbon dioxide (CO2). Soluble methane monooxygenase (sMMO), a member of the bacterial multicomponent monooxygenase (BMM) superfamily, is essential for the hydroxylation of specific substrates, including hydroxylase (MMOH), regulatory component (MMOB), and reductase (MMOR). The diiron active site positioned in the MMOH α-subunit is reduced through the interaction of MMOR in the catalytic cycle. The electron transfer pathway, however, is not yet fully understood due to the absence of complex structures with reductases. A type II methanotroph, Methylosinus sporium 5, successfully expressed sMMO and hydroxylase, which were purified for the study of the mechanisms. Studies on the MMOH-MMOB interaction have demonstrated that Tyr76 and Trp78 induce hydrophobic interactions through π-π stacking. Structural analysis and sequencing of the ferredoxin domain in MMOR (MMOR-Fd) suggested that Tyr93 and Tyr95 could be key residues for electron transfer. Mutational studies of these residues have shown that the concentrations of flavin adenine dinucleotide (FAD) and iron ions are changed. The measurements of dissociation constants (Kds) between hydroxylase and mutated reductases confirmed that the binding affinities were not significantly changed, although the specific enzyme activities were significantly reduced by MMOR-Y93A. This result shows that Tyr93 could be a crucial residue for the electron transfer route at the interface between hydroxylase and reductase.