• Title/Summary/Keyword: Mental injury

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Neuropsychiatric Evaluation of Head-Injured Patients(I) : Comparison of Structural and Functional Brain Studies in Post-Traumatic Organic Mental Disorder (두부외상 환자의 신경정신의학적 평가(I) : 외상후 기질성정신장애 환자에서 뇌의 구조적 및 기능적 검사소견의 비교)

  • Yi, Jang Ho;Chang, Hwan-Il
    • Korean Journal of Biological Psychiatry
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    • v.3 no.1
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    • pp.57-65
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    • 1996
  • The Evaluation of patients complaining of psychiatric symptoms following head injury is much affected by the results of various tests. The objecive of this paper is to investigate the effectiveness of each lest by comparing the structual and fuctional brain studies. The subjects were 93 organic menial disorder in and out patients at the Dept. of Neuropsychiatry of the Kyung Hee University Hospital. After carrying out MRI, CT, SPECT, EEG, the results of each were analysed for the sesitivity and ability to detect focal lesion. The degree of inter-test correlations of lest results were also investigated. Furthermore, the characteristic features of psychological tests were studied and the relationship between each of above mentioned tests and psychological test was examined. As for the test sensitivity to diagnosis, the SPECT was the most superior followed by MRI, CT, EEG in thai order. In the case of abnormality, SPECT ranked 1st in detection of focal lesion, followed by MRI, CT in that order. In the inter-test result correlation, the correlation of SPECT-MRI was statistically significant. When mare than moderate abnormality EEG finding was reported, it correlated significantly with that of MRI findings. In the MMPI, the average scores on F, Hs, D, Hy, Pa, Pt, Sc subscales were above 60. Abnormal SPECT group scored significantly high on the F, Pd, Pa, Sc, Ma scales and therefore in comparison ot the SPECT normal group, displayed more psychotic features. In K-WAIS, the mean full scale IQ was down to 77. 23(Verbal IQ : 78.76, Performance IQ : 77.44) but there was no characterogic significant relationship between the lowered to and abnormal SPECT, MRI, CT and EEG results. In conclusion, 1) The SPECT was mast superior in sensitivity and detection of focal lesions. In comparision with other tests, the results of SPECT correlated well with MRI had thus is thought to be very usefull testing method in the evaluation of organic mental disorder patients. 2) The MRI had relatively high sensitivity, ability to detect focal lesion and superior correlation with other test. 3) Although EEG fared less an sensitivity in comparison to other tests, the results of above moderate abnormal grade group and that of MRI correlated significantly. 4) In the MMPI highly scored in F, Hs, D, Hy, Pa, Pt, Sc subscales and abnormal SPECT patients were shown to display more sever psychotic features. There was no significant character relationship between the lowered IQ(in K-WAIS) and abnormal findings on MRI, CT, SPECT, EEG.

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Assessment of Availability of Korean Computerized Neurobehavioral Test in Patients with Brain Injury (뇌손상 환자에서 컴퓨터 신경행동검사의 유용성 평가)

  • Kim, Tae-Hoon;Jeon, Man-Joong;Sakong, Joon
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.339-349
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    • 2013
  • This study was conducted to evaluate the correlation between the Korean version of Mini Mental State Examination (MMSE-K) and the Korean Computerized Neurobehavioral Test (KCNT) and the usefulness of KCNT for discriminating the patients with suspected dementia from normal persons in patients with a brain injury. The results of each items of KCNT had passed the test for normality. T test for group comparison and bivariate correlation analysis for correlation between two tests were used. There were no significant differences in characteristics of two groups. The differences in results of eight tests of KCNT between two groups were statistically significant (p<.05) and the Pearson correlation coefficients (r) between two tests were statistically significant (p<.05) : simple reaction time (-.580), choice reaction time (-.341), color word vigilance (-.661), digit classification (-.703), 2-digit addition (-.582), 3-digit addition (-.610), symbol digit substitution (-.642), and digit span (.807). These results suggested that simple reaction time and 2-digit addition were useful in discriminating the patients with suspected dementia from normal persons because the Pearson correlation coefficients of the two items of KCNT showed anticlastic association between two groups. And each items of KCNT may use in follow up cognitive function for patients in two groups.

A Study on a Countermeasure Program using the Martial Arts for a Security Guard Caused by an Accidental Situation (우발상황시 경호무도 대응방안)

  • Park, Jun-Seok;Kang, Young-Gil
    • Korean Security Journal
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    • no.6
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    • pp.327-340
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    • 2003
  • As a countermeasure under accidental occurrence situation, First, as application form of martial arts, A security guard foster ability that can protect a target person of guard and own body under accidental occurrence situation through incessant martial arts practice. To achieve this purpose, incessant training mental power and physical strength reinforcement should be kept on to prevent, therefore make a safety control function for such as weapon, small arms, explosive, vehicles terror etc. happened under accidental occurrence situation. Second, according to the contents of training based on the classification category of martial arts for security guard under accidental situation, a security guard must keep safety distance necessarily lest a target person of gurad should be attacked by attacker, therefore, intercept an attack opportunity if a safety distance between a target person of guard and attacker is not kept. Third, It is to practice confrontation techniques based on the type of attack. A security guard must develp situation disposal ability that can cope properly with the attack using empty hands, murderous weapon, small arms, explosive by case or individual or mass of threat that impose danger and injury in a target person's body of guard.

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Rupture of the Trachea and the Esophagus Following Blunt Trauma: A Report of a Case (Blunt Trauma 에 의한 기관-식도 파열의 치험 1례)

  • 정윤채
    • Journal of Chest Surgery
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    • v.8 no.2
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    • pp.119-124
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    • 1975
  • This is a case report of the rupture of the trachea and the esophagus following external blunt trauma without any associated injury. A 7 year old male patient was brought to the emergency room. Hanyang University Hospital, on 23 Jul, 1974 while he played under the pile of pingpong table A table was fall down over the patient accidentally. The patient was injured by the table and found lying in unconsciousness on the ground.There was subcutaneous emphysema on his anterior chest and neck. A contusion on the upper part of the sternum was noted. The breathing sound were diminished over the left side of the chest. Ronchi were heard over the right lung field. This patient was suffered from vomiting, dypsnea, and irritable mental state after this accident. On the chest roentgenogram in A-P view, hyperlucency at the mediastinum and parapericardiac area suggested the pneumomediastinum. On the next day, a diagnosis of the tracheal and esophageal rupture was confirmed by the esophagogram with Lipiodol swallowing. A right thoracotomy was performed and ruptured orifice of the trachea and the esophagus were closed with interrupted sutures. Postoperative course was uneventful and primary closure of the rupture of the trachea and the esophagus were succeeded.

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Milk-alkali syndrome secondary to the intake of calcium supplements (칼슘 제제 복용 후 발생한 우유알칼리증후군)

  • Lee, In Hee;Noh, Sin Young;Kang, Gun Woo
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.48-51
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    • 2016
  • Milk-alkali syndrome (MAS), a triad of hypercalcemia, metabolic alkalosis, and renal failure, is associated with ingestion of large amounts of calcium and absorbable alkali. MAS is the third most common cause of hypercalcemia in hospital, after primary hyperparathyroidism and malignant neoplasm. MAS is not often reported in the Korean literature. We describe MAS secondary to intake of calcium citrate for the treatment of osteoporosis with thoracic spine compression fracture. A 70-year-old man presented to our hospital with a 1-week history of general weakness and lethargy. He was found with acute kidney injury (serum creatinine, 4.6 mg/dL), hypercalcemia (total calcium, 14.8 mg/dL), and alkalosis. Laboratory evaluation excluded both hyperparathyroidism and malignancy. Mental status and serum calcium level was normalized within a week after proper hydration and intravenous administration of furosemide. However, he developed aspiration pneumonia, pseudomembranous colitis, and sepsis with multi-organ failure. Despite intensive treatment including inotropics, mechanical ventilation, and renal replacement therapy, he expired with no signs of renal recovery on the 28th hospital day.

A Study of Primiparous Womens Breastfeeding Experience (초산모의 모유수유 경험)

  • 김신정;양숙자
    • Journal of Korean Academy of Nursing
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    • v.27 no.3
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    • pp.477-488
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    • 1997
  • The purpose of this study was to understand the subjective breastfeeding experience of primiparous women to identify how breastfeeding was started and to explore the process of breastfeeding. The Grounded theory methodology was used. Data was collected from 6 primiparous women who had breastfed their infants for at least over 8weeks, recently breastfeeding or having breatfed their infants within the last 6 months. With the permission of the subjects, the interviews were recorded and transcribed. The data were analysed in the framework of grounded theory method as mapped out by Strauss and Corbin(1990). 105 concepts and 21 subcategories were confirmed in the analysis. In the process of data analysis, "Identity as a mother" was found to be the core phenomenon. The 21 sub-categories were as follows : natural food, neighbour inducement, self purpose, good feeling, tenderness, breast pain, change of breast shape, physical discomfort, loss of physical energy, confirmation of maternal role, formation of affection feeling of adhesion, one body through coupling, tie, capacity, role performance, mental comfort, healthy mother, healthy infant, confidence of breast milk, feeling of satisfaction. The sub -categories were again grouped into 14 categories including infant nutritious food, formation of breastfeeding opportunity, feeling of satisfaction, injury of the breast, physical suffering, awareness of mothering, formation of maternal affection, connecting, coupling, acceptance, effort, emotional stability, mother and child health and feeling of achievement.hievement.

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Awareness and direction of paramedics work and image in hospitals - Focusing on paramedics and nurses in the emergency room - (의료기관의 1급 응급구조사 이미지와 업무에 대한 인식과 방향 - 응급실 내 1급 응급구조사와 간호사를 중심으로 -)

  • Jung, Sang-Woo;Kang, Kyung-Hee
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.2
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    • pp.81-97
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    • 2016
  • Purpose: This study aimed to investigate the awareness and direction of paramedics work and image in hospitals. Methods: From April 16 to May 5, 2015, data were collected through structured questionnaires from 45 paramedics and 81 nurses working in emergency medical institutions. The data were analyzed using SPSS version 18.0. Results: The work of paramedics is evaluated to be highly worthy at the in-hospital level rather than at the injury first-aid treatment level. It appears that paramedics are often forced to do what their hospitals tell them to do concerning matters related to conflicts with them and nurses. Paramedics stated that they experienced greater mental stress than those engaging in other professions, a finding similar to those of other studies. There was no statistically significant difference in opinions between the two groups about a desirable direction for the development of first-aid services at hospitals. More than two thirds of the respondents said that paramedics should be given the right to enter acting check for patients. Conclusion: Paramedics work is shown to differ in the opinions of paramedics themselves and nurses. Paramedics need for reform is associated with expanding the work of the law.

A Bibliographic Study on the Types of Differential Diagnosis of Amnesia (건망(健忘)의 변증분형(辨證分型)에 대(對)한 연구(硏究))

  • Choi, Yong-Jun;Seong, Gang-Gyoung;Mun, Byoung-Sun
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.374-406
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    • 1996
  • This study has been carried out to investigate the types of differential diagnosis of amnesia. The results are as follows; 1. Amnesia has various types of differential diagnosis(辨證分型) ; deficiency of both the heart and spleen(心脾兩虛型), deficiency of the heart(心虛型), deficiency of the kidney(腎虛型), breakdown of the coordination between the heart and the kidney(心腎不交型), mental confusion due to phlegm(痰迷心竅型), accumulation of stagnant blood(蓄血型), internal injury by seven emotion (七情所傷型). 2. The type of deficiency of both the heart and spleen(心脾兩虛型) occurs when the heart and spleen is injured by overthinking(思慮過度), The symptoms are heart palpitation(心悸), continuous palpitation(??), insomnia(少寐), hypochondric discomfort(心煩), dream disturbed sleep(多夢), being easy to be scared(易驚), dizziness(眩暈), these are caused by blood deficiency of the heart(心血不足), poor appetite(飮食不振), loss of appetite(納?), short breath(氣短), sense of turgid abdormen(腹部膨滿感), loose stool(泥狀便), these are caused by deficiency of the spleen(脾虛), lassitude and weakness (身倦乏力), lassitude of the extremities (四肢無力), dim complexion (面色少華), pale lips(舌質淡), thready and feeble(脈細弱無力), these are caused by deficiency of both qi and the blood(氣血虛損). The remedy is nourishing the heart-blood(養心血) and regulating the spleen(理脾土). I can prescribe the recipes such as Guibitang(歸脾湯), Gagambosimtang(加減補心湯), Seongbitang(醒脾湯), Insin-guisadan(引神歸舍丹), Insamyangyoungtang(人蔘養榮湯), Sojungjihwan(小定志丸), Yungjigo(寧志膏), Palmijungjihwan(八味定志丸), etc., 3. The type of deficiency of the heart(心虛型) occurs when the heart-blood is injured by the mental tiredness(神勞) and so blood cannot nourish the heart. The symptoms are amnesia(健忘), short breath(氣短), heart palpitation(心悸), perspire spontaneously(自汗), facial pallidness(顔面蒼白), pale lips (舌質淡白), feeble pulse and lassitude(脈虛無力), intermittent pulse(結代脈). The remedy is nourishing the hart and blood and allaying restlessness(補心益血安神). I can prescribe the recipes such as Chenwangbosimdan(天王補心丹), Jeongji-hwan(定志丸), Gaesimhwan(開心丸), Youngjigo(寧志膏), Chilseonghwan(七聖丸), Baegseogyoungtang(白石英湯), Oseohwan(烏犀丸), Yangsinhwan(養神丸), Guisindan(歸神丹), Bogsinsan(茯神散), Jinsamyohyangsan(辰砂妙香散), Cheongeumboksinsan(千金茯神散), Samjotang(蔘棗湯), jangwonhwan(壯元丸), Sa gunjatang(四君子湯) minus rhizoma atractylodis macrocephalae(白朮) plus rhizoma acori graminei(石菖蒲), radix polygalae(遠志), cinnabaris(朱砂), etc. 4. The type of deficiency of the kidney(腎虛型) occurs when the kidney-qi and kidney-essence is deficient(腎氣腎精不足) and so it cannot nourish the brain. The symptoms arc amnesia(健忘), ache at the waist and lassitude in the lower extremities(腰산腿軟), dizziness and tinnitus(頭暈耳嗚), emmission and premature ejaculation(遺精早泄), burning sensation of the five centres(五心煩熱), flushed tongue(舌紅), rapid and small palse(脈細數). The remedy is nourishing the kidney and strengthen the essence(補腎益精). I can prescribe the recipes such as Gagamgobonhwan(加減固本丸), Jeongjihwan(定志丸), Gongseongchlmjungdan(孔聖枕中丹), Yugmigihwanghwan(六味地黃丸) plus ra-dix polygalae(遠志), fructus schizandrae(五味子), Yugmigihwanghwan(六味地黃丸) plus radix polygalae(遠志), fructus schizandrae(五味子), rhizoma acori graminei(石菖蒲), semen zizyphi spinosae(酸棗仁), Palmihwan(八味丸) plus fructus schizandrae(五味子), semen zizyphi spinosae(酸棗仁). etc., 5. The type of breakdown of the coordination between the heart and the kidney (心腎不交型) occurs when the heart-fire(心火) and kidney-fluid(腎水) are imbalanced. The symptoms are amnesia(健忘), hypochondric discomfort(心煩), insomnia(失眠), dizziness and tinnitus(頭最耳嗚), feverish sensation m the palms and soles(手足心熱), emmision(遺精), ache at the waist and lassitude in the lower extremities(腰?腿軟), flushed tongue(舌紅), rapid pulse(脈數). The remedy is coordinating each other(交通心腎). I can prescribe the recipes such as Gangsimdan(降心丹), Jujaghwan(朱雀丸), Singyotang(神交湯), Simsinyang- gyotang(心腎兩交湯), Yugmihwan(六味丸) plus fructus schizandrae(五味子), radix polygalae(遠志), Yugmihwan(六味丸) plus fructus schizandrae(五味子), radix polygalae(遠志), rhizoma acari graminei(石菖蒲), semen zizyphi spinosae(酸棗仁), etc., 6. The type of mental confusion due to phlegm(痰迷心竅型) occurs when the depressed vital energy(氣鬱) create phlegm retention(痰飮) and phlegm stagnancy(痰濁) put the heart and sprit(心神) out of order. The symptoms arc amnesia(健忘), dizziness(頭暈), chest distress(胸悶), nausea(惡心), dull(神思欠敏), dull and slow facial expression(表情遲鈍), tongue with yellow and greasy fur(舌苔黃?), sliperry pulse(脈滑). The remedy is removing heat from the heart to restore consciousness and dispersing phlegm(淸心化痰開竅) I can prescribe the recipes such as Gamibogryeongtang(加味茯?湯), Goa-rujisiltang(瓜蔞枳實湯), Jusaansinhwan(朱砂安神丸), Dodamtang(導痰湯) plus radix saussurea(木香), Yijintang(二陳湯) plus succus phyllostachyos(竹瀝), rhizoma zingiberis(生薑) Ondamtang(溫膽湯) plus rhizoma acori graminei(石菖蒲), rhizoma curcumae aromaticae(鬱金), etc., 7. The type of accumulation of stagnant blood(蓄血型) occurs when the blood is accumulated in the lower part of body. The symptoms are amnesia(健忘), chest distress(胸悶), icteric skin(身黃), rinsing the mouth but don't wanting eat(漱水不欲燕), madness(發狂), black stool(屎黑), pain in the lower abdomen(小腹硬痛). The remedy is dispersing phlegm and absorb clots (化痰化瘀), I can prescribe the recipes such as Jeodangtang(抵當湯), Daejeodanghwan(代抵當丸), Hyeolbuchugeotang (血府逐瘀湯) plus rhizoma acori graminei (石菖蒲), rhizoma curcumae aromaticae(鬱金), Jusaansinhwan(朱砂安神丸) plus rhizoma curcumae aromaticae(鬱金), radix polygalae(遠志), semen persicae(桃仁), cortex moutan radicis(收丹皮), etc., 8. The type of internal injury by seven emotion(七情所傷型) occurs when the anger injures the will stored in the kidney(腎志). The symptoms are amnesia(健忘), heart palpitation(心悸). hot temper(易怒), being easy to be scared(善驚), panic(易恐). The remedy is relieving the depressed liver and regulating the circulation of qi(疏肝解鬱). I can prescribe the recipes such as Tongultang(通鬱湯), Sihosogantang(柴胡疏肝湯) plus rhizoma acari graminei(石菖蒲), rhizoma curcumae aromaticae(鬱金), etc.

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Development of the Korean version of Postconcussional Syndrome Questionnaire (한글판 뇌진탕후증후군 척도의 개발)

  • Yoon, Mi-Ri;Ko, Young-Hoon;Han, Chang-Su;Joe, Sook-Haeng;Jeon, Sang-Won;Han, Chang-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.26-35
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    • 2015
  • Objectives:The purpose of this study was to evaluate reliability and validity of the Korean version of the Postconcussional Syndrome Questionnaire(KPCSQ) which was originally developed in 1992 by Lees-Haley. Methods:Patients with traumatic brain injury were recruited from April 2009 to December 2011 from the Korean University Ansan Hospital. We selected patients that met the ICD-10 diagnostic criteria of postconcussional syndrome and organic mental disorder including organic mood disorder, organic emotionally labile disorder, organic anxiety disorder and organic personality disorder. The KPCSQ, Trait and State Anxiety Inventory(STAI-I, II), and Center for Epidemiologic Studies Depression Scale(CESD) were administered to all subjects. Factor analysis of the items were performed and test-retest correlation were evaluated. Internal consistency of the KPCSQ and its subscales was assessed with Cronbach's alpha. External validity of the KPCSQ were examined by correlation coefficient with the STAI-I, II, and CESD. Results:The Cronbach's alpha coefficient of the total PCSQ was 0.956. The test-retest reliability coefficient was 0.845. The PCSQ showed significant correlation with STAI-I, II and CESD. The factor analysis of the PCSQ yielded 4 factors model. Factor 1 represented 'affective and cognitive symptoms', factor 2 represented 'somatic symptoms', factor 3 represented 'infrequent symptoms' and factor 4 represented 'exaggeration or inattentive response'. There was no significant difference between the PCS group and the organic mental disorder group in the score on each measure. The scores on KPCSQ and its subscales in the subjects that had scored 5 or more in 'exaggeration or inattentive response' are significantly higher than those in the subjects had scored 4 in 'exaggeration or inattentive response'. Conclusions:This study suggests that the Korean version of PCSQ is a valid and reliable tool for assessing psychiatric symptomatology of patients with traumatic brain injury. Further investigations with greater numbers of subjects are necessary to assess the clinical usefulness of the KPCSQ.

Tc-99m HMPAO Brain SPECT in Patients with Post-Traumatic Organic Mental Disorder (두부외상후 만성 기질성 정신장애 환자에서 Tc-99m HMPAO Brain SPECT 분석)

  • Lee, Kang-Wook;Lee, Jong-Jin;Shong, Min-Ho;Kang, Min-Hee;Ghi, Ick-Sung;Shin, Young-Tai;Ro, Heung-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.293-300
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    • 1994
  • It is well known that Tc-99m HMPAO brain SPECT can reflect the functional lesions better than X-ray computerized tomography(CT) and magnetic resonance imaging(MRI) in the cerebral disorders. In order to evaluate the clinical utilities of Tc-99m HMPAO brain SPECT in patients with post-traumatic chronic organic mental disorder(OMD), we included 28 patients diagnosed as OMD in department of psychiatry after traumatic head injury. And we compared the results of Tc-99m HMPAO SPECT with those of MRI, EEG and MINI mental status ex amination(MMSE). The results were as follows 1) All patients diagnosed as OMD showed diffuse or focal decreased cerebral perfusion on Tc-99m HMPAO SPECT. 2) Most frequent lesion on brain Tc-99m HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain Tc-99m HMPAO SPECT showing normal brain MRI result was also decreased both frontal perfusion. 3) Eight of 28 patients showed focal brain MRI lesions(4 small frontal hygroma, 3 small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain Tc-99m HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20 points. In conclusion, we think that Tc-99m HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disorder.

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