• Title/Summary/Keyword: Involuntary

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A Review of Cognitive and Behavioral Interventions for Tic Disorder

  • Kim, Kyoung Min;Bae, Eunju;Lee, Jiryun;Park, Tae-Won;Lim, Myung Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.32 no.2
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    • pp.51-62
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    • 2021
  • Objectives: Tic disorder is a neurodevelopmental disorder characterized by multiple involuntary movements of muscles or vocalization. Although tic symptoms subside as the patient ages, some patients suffer from significant functional impairments related to severe tic symptoms. This manuscript aimed to review the latest scientific evidences for the effect of cognitive-behavioral interventions on tic disorder. Methods: The relevant studies were identified by searching medical research databases. We focused our search on studies published between 2000 and 2020 in order to reflect the latest scientific evidence. A total of 821 articles were identified in the initial database search and 27 articles were finally included for the review after the exclusion of duplicated and irrelevant articles. Results: Behavioral therapies including habit reversal training, Comprehensive Behavioral Intervention for Tics, and exposure and response prevention were the most widely studied interventions for tic disorder and are recommended as first-line treatments for tic disorders with high confidence. Cognitive psychophysiologic approaches were also reported to be effective. Conclusion: Further studies are needed to support the future treatment of tics with low-cost and more widely available treatments, in order to ensure better treatment outcomes.

Differences in Patient Characteristics between Spasmodic Dysphonia and Vocal Tremor (연축성 발성장애와 음성 진전 환자의 감별)

  • Son, Hee Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.1
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    • pp.9-14
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    • 2021
  • Spasmodic dysphonia, essential tremor, and vocal tremor related with Parkinson's disease are different disorders showing fairly similar symptoms such as difficulty in the speech onset, and tremble in the voice. However, the cause and the resulting treatment of these diseases are different. Spasmodic dysphonia is a vocal disorder characterized by spasms of the laryngeal muscles during a speech, invoking broken, tense, forced, and strangled voice patterns. Such difficult-to-treat dysphonia disease is classified as central-origin-focal dystonia, of a yet unknown etiology. Its symptoms arise because of intermittent and involuntary muscle contractions during speech. Essential tremor, on the other hand, is characterized by a rhythmic laryngeal movement, resulting in alterations of rhythmic pitch and loudness during speech or even at rest. Severe cases of tremor may cause speech breaks like those of adductor spasmodic dysphonia. In the case of hyper-functional tension of vocal folds and accompanying tremors, it is necessary to distinguish these disorders from muscular dysfunction. A diversified assessment through the performance of specific speech tasks and a thorough understanding for the identification of the disorder is necessary for accurate diagnosis and effective treatment of patients with vocal tremors.

A Case Report of Valproic Acid-Induced Tremor by Korean Traditional Medicine (Valproic Acid 투여로 인한 약인성 떨림 환자의 한방 치료 치험 1례)

  • Jang, Hansol;Ha, Yu-bin;Jung, Seung-hyun
    • The Journal of Internal Korean Medicine
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    • v.42 no.6
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    • pp.1319-1330
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    • 2021
  • A 56-year-old male patient with a sudden onset of tremor and involuntary movement of right upper and lower extremities, head, and voice was diagnosed as having a drug-induced tremor, with valproic acid being the culprit drug. The patient had undergone admission treatment at an internal Korean medicine department with herbal medicine according to constitutional diagnosis, acupuncture, moxibustion, cupping, and rehabilitation. The change in the severity of tremor was assessed with the Fahn Tolosa Marine scale. After discharge, the patient took herbal medicine for two more months. After 20 days of admission and 2 months of treatment with herbal medicine, the patient's tremor improved. In this case, the patient with valproic acid-induced tremor showed improvement in symptoms after 20 days of hospitalization and further reduction of tremor and improvement of quality of life were confirmed through follow-up for 2 months.

Transfer anxiety in parents of children transferred from pediatric intensive care units to general wards in South Korea: a hybrid concept analysis

  • Park, Jisu;Choi, Eun Kyoung
    • Child Health Nursing Research
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    • v.28 no.2
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    • pp.154-165
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    • 2022
  • Purpose: This study aimed to analyze the concept of transfer anxiety in parents of children transferred from pediatric intensive care units to general wards. Methods: The hybrid model by Schwarz-Barcott and Kim was used to analyze the characteristics of transfer anxiety in parents of children transferred from pediatric intensive care units to general wards. Results: Transfer anxiety was defined by the following attributes: 1) stress concerning the adaptation process, 2) concern about the child's condition worsening due to the parent's caregiving, and 3) involuntary changes in daily life due to the treatment. Transfer anxiety has the following antecedents: 1) uncertainty; 2) a lack of knowledge about the illness, medical devices, and caregiving; and 3) a lack of social support. It resulted in 1) caregiver burden, 2) a decrease in the capacity for coping with caregiving, 3) delays in the child's physical and psychological recovery, and 4) decreased quality of life. Conclusion: It is necessary to develop an assessment scale that considers the attributes of transfer anxiety in parents of children transferred from pediatric intensive care units to general wards. Furthermore, an effective nursing intervention should be developed to reduce transfer anxiety.

Evolutionary Model of Depression as an Adaptation for Blocked Social Mobility

  • Park, Hanson;Pak, Sunyoung
    • Korean Journal of Biological Psychiatry
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    • v.29 no.1
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    • pp.1-8
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    • 2022
  • Objectives In regard to the social competition hypothesis, depression is viewed as an involuntary defeat strategy. A previous study has demonstrated that adaptation in microenvironments can result in a wide range of behavioural patterns including defense activation disorders. Using a simulation model with evolutionary ecological agents, we explore how the fitness of various defence activation traits has changed over time in different environments with high and low social mobility. Methods The Evolutionary Ecological Model of Defence Activation Disorder, which is based on the Marginal Value Theorem, was used to examine changes in relative fitness for individuals with defensive activation disorders after adjusting for social mobility. Results Our study examined the effects of social mobility on fitness by varying the d-values, a measure of depression in the model. With a decline in social mobility, the level of fitness of individuals with high levels of defense activation decreased. We gained insight into the evolutionary influence of varying levels of social mobility on individuals' degrees of depression. In the context of a highly stratified society, the results support a mismatch hypothesis which states that high levels of defence are detrimental. Conclusions Despite the fact that niche specialization in habitats composed of multiple microenvironments can result in diverse levels of defensive activation being evolutionary strategies for stability, decreased social mobility may lead to a decrease in fitness of individuals with highly activated defence modules. There may be a reason behind the epidemic of depression in modern society.

A Case of Solitary Fibrous Tumor of the Chin (하악부에 발생한 고립성 섬유종 1예)

  • Taesik Kim;Sung Gyun Jung;In Pyo Hong;Young Joong Hwang
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.35-39
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    • 2023
  • Solitary fibrous tumor (SFT), which was initially believed to be a subtype of mesothelioma, has been reported to occur outside the pleura. In the head and neck region, it primarily manifests in the oral or nasal cavity, with rare occurrences in the facial region. A 40-year-old woman visited our hospital with a mass on her chin. Prior to surgery, involuntary movement was observed in the ipsilateral corner of the mouth upon palpation of the mass. Special care was taken during the surgical procedure to avoid damaging the facial nerve. The mass was excised, and histological examination and immunohistochemical analysis confirmed the diagnosis of an SFT. Here, we present the first reported case of an SFT diagnosed in a jaw mass in Korea. The objective of this study was to highlight the importance of the diagnostic accuracy of SFTs in lower jaw masses.

Study on the Effects of Podam-hwan on Brain GABA and Glutamate Levels in the Picrotoxin-induced Convulsion (포담환이 Picrotoxin-유도 경련시 뇌중 GABA 및 Glutamate 함량변화에 미치는 영향에 관한 연구)

  • 안철효;이원창;구병수
    • The Journal of Korean Medicine
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    • v.23 no.3
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    • pp.211-222
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    • 2002
  • Currently convulsion is considered to be a chronic central nerve disease characterized by involuntary and severe muscle contraction or spasm. In many recent studies, convulsion's mechanism is due to unbalance between stimulation and suppression of the central nerve system, such as GABA and glutamic acid. Objectives : This study was performed to examine the anticonvulsant effects of Podam-hwan on brain GABA levels and glutamate content in picrotoxin-induced convulsions and to determine the inhibitory activity on GABA transaminase. Methods : Brain GABA levels and glutamate content in the brains of picrotoxin-induced mice using reverse phase HPLC method, anticonvulsant effect in vivo, and the inhibitory effect on GABA transaminase activity in vivo have been investigated. Results : Podam-hwan significantly lengthened the onset time of picrotoxin-induced convulsion at a concentration of 15mg/kg, but did not show a dose-dependent pattern. Also, Podam-hwan shortened the duration of convulsion by 52.2% at a dose of 30mg/kg in comparison with the control group. Podam-hwan inhibited dose-dependently GABA transaminase activity by 35.5% at 30mg/kg, comparing with the control gmup. Podam-hwan also increased the brain GABA level by 38.7% and 68.8% at doses 15mg/kg and 30mg/kg, respectively. In addition, Podam-hwan decreased the brain glutamate level by 9.6% and 17.8% at doses 15mg/kg and 30mg/kg, respectively. Conclusions : Podam-hwan can be prescribed for the treatment of convulsion by enhancement of brain GABA level and inhibition of GABA transaminase activity.

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The Study for the Spatial Distribution and Ethnic Background of Female Marriage Immigrants in Korea (결혼이주여성의 거주 분포와 민족적 배경에 관한 소고 : 베트남.필리핀을 중심으로)

  • Ryu, Ju-Hyun
    • Journal of the Korean association of regional geographers
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    • v.18 no.1
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    • pp.71-85
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    • 2012
  • Marriage Immigrants have greater impact on local communities than migrant workers and foreign students, all the more because their children are relatively more important. Therefore, this study aims to inquire into the fundamental cause on the choice of residential location of marriage immigrants. Residential segregation is often considered to be one of the social problems that intensify locality of residential district. Although migrant workers and foreign students cannot freely decide their residential location at the outset, they could change their residence later on. However marriage immigrants are not free from the residential location choice continuously. The intentional(involuntary) residential segregation brings differential residence of marriage immigrants. The residential segregation of marriage immigrants is concerned with the close relationship of their ethnic background and the community characteristic with focus on Vietnamese and Filipino. The results of this study could be used basic guideline for community development policy for marriage immigrants.

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TREATMENT OF LINGUAL ULCERS CAUSED BY TONGUE THRUST WITH HYPOXIC-ISCHEMIC ENCEPHALOPATHY (저산소성 허혈성 뇌병변 환아에서 혀내밀기에 의해 발생된 혀 궤양의 치료: 증례 보고)

  • Oh, Mee-Hee;Kim, So-Jung;Choi, Sung-Chul;Kim, Kwang-Chul;Park, Jae-Hong
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.1
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    • pp.22-25
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    • 2012
  • Hypoxic ischemic encephalopathy(HIE) is a condition that occurs when the entire brain is deprived of an adequate oxygen supply and associated in most cases with oxygen deprivation in the neonate due to birth asphyxia. Children with HIE develop problems such as cerebral palsy, mental retardation, learning difficulties, and other disabilities. We hereby report the case of treating a child patient with HIE whose chief complaint of severe lingual ulceration. A 12-month-old boy referred to our hospital to treat ulcers of ventral surface of tongue. He has been suffering from lingual ulceration due to persistent tongue thrusting. He has bitten his own tongue involuntary. The ulceration was apparently seemed to be not healed because of the constant irritation by lower incisors. So we designed tongue protector to prevent lingual ulcers. The appliance was proved to be effective to reduce tongue trauma by lower incisors and periodic follow-up is needed.

THE MANAGEMENT OF TONGUE BITE IN A PATIENT OF CEREBRAL PALSY AFTER DENTAL TREATMENT UNDER GENERAL ANESTHESIA -CASE REPORTT- (뇌성마비환자의 전신마취 하 치과치료 후 혀 깨물기 손상 관리)

  • Shin, Teo-Jeon;Seo, Kwang-Suk;Kim, Hyun-Jeong;Park, Sung-Soo;Kim, Hye-Jeong;Yang, So-Young
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.6 no.2
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    • pp.116-119
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    • 2010
  • Trauma to the lips and tongue can occur by accidental self-biting after dental treatment. After local anesthesia, it is likely that the patient may feel painless even in biting the tongue. In case of young children and disabled patients, the dentists should be careful not to bite the tongue. In this report, we present a case of deep lingual laceration due to biting the tongue in the course of dental treatment under general anesthesia. A 33 year-old male was transferred to our hospital to treat tongue laceration. Before 2 hour on arrival, he had received dental care under general anesthesia at a dental hospital for the disabled because of cooperation difficulty and cerebral palsy. During recovery from general anesthesia, he tried to bite his own tongue involuntary. The doctors and nurses tried to prevent the patient from being injured. Despite these efforts, massive bleeding occurred from the injured sites of the tongue. Because we could not communicate with him, we decided to evaluate the extent of the injury and treat the injured sites under general anesthesia. The laceration wound was sutured for nearly 1 hr general anesthesia. During recovery we inserted mouth prop into the oral cavity to prevent further injuries from tongue biting. After full recovery from general anesthesia he didn't try to bite his tongue. After 4 hour admission, he was discharged without other complications.

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