• Title/Summary/Keyword: Mental injury

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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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CLINICAL STUDY OF SENSORY ALTERATIONS AFTER SAGITTAL SPLIT RAMUS OSTEOTOMY (하악지 시상분할 절단술 후 감각 변화에 관한 연구)

  • Choi, Jun-Young;Yoo, Jun-Yeol;Yoon, Bo-Keun;Leem, Dae-Ho;Shin, Hyo-Keun;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.141-148
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    • 2010
  • The bilateral sagittal split ramus osteotomy (BSSRO) is preferred method of surgical correction for mandibular prognathism, retrognathism and asymmetry. This technique performed from primarily an intraoral incision to avoid a scar. After forward movement of the distal segment of the mandible, healing of bone by primary or secondary intention is easily accomplished through large areas of cancellous bony overlap. When rigid fixation is used for the BSSRO, it is possible to open the mouth during the immediate post-operative period because it promotes the healing process. Although this surgical procedure has been well-documented, the incidence of postoperative trigeminal neurosensory disorder in the region of the inferior alveolar nerve and the mental nerve remains one of the major complication. However, evaluation of objective methods for sensory recovery patterns is insufficient although most patients find their sensory return. Neurometer electrodiagnostic device performs automated neuroselective sensory nerve conduction threshold evaluation by determining current perception threshold (CPT) measures. The purpose of this study was to evaluate the sensory recovery patterns of inferior alveolar and mental nerve over time. Nerve examination with a neurometer was performed in 30 patients undergoing the BSSRO at pre-operative, post-operative 1-, 2-, 4- week, and 2-, 3-, 4-, 5-, 6- month follow-up visits after the osteotomy to compare the differences of nerve injury and recovery patterns after the BSSRO with or without genioplasty and sensory recovery patterns associated with the kind of nerve fiber.

SMITH-MAGENS SYNDROME (SMS) : A CASE REPORT (Smith-Magenis Syndrome (SMS) 환아의 증례 보고)

  • Kim, Eun-Young;Lee, Keung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.341-347
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    • 2003
  • Smith-Magenis syndrome (SMS) is a clinically recognizable multiple congenital anomaly and mental retardation syndrome caused by an interstitial deletion of chromosome 17 p11.2. Physical features include short stature, characteristic facial appearance: flattened mid-face, down-turned mouth, prominent and often rosy cheeks; prominent jaw in older children and adults, chronic ear infections, hearing impairment, eye problems, including: strabismus (an eye which turns in or out) and myopia (nearsightedness), hoarse voice, short fingers and toes, heart defects or murmurs, problems related to the urinary system, scoliosis (curvature of the spine), an unusual gait (walking pattern), and decreased sensitivity to pain. Behavioral and developmental characteristics include speech delay and articulation problems, developmental delay, learning disability, mental retardation, hyperactivity, self-injury, including: head banging; hand biting; picking at skin, sores and nails; pulling off finger- and toenails; inserting foreign objects into ears, nose, or other body orifices, explosive outbursts, prolonged tantrums, destructive and aggressive behavior, excitability, arm hugging or hand squeezing when excited. This report is the case of a Korean 3-year-3-month old male with Smith-Magenis syndrome referred from local clinic for the treatment of dental caries. The patient was treated by physical restraint after prophylatic administration of antibiotic(Amoxacillin 50mg/kg).

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Switching Genioplasty- a New Genioplasty Technique in Order to Resolve Asymmetry of Chin Area: Case Report (이부 비대칭 치료를 위한 새로운 이부 성형술의 소개 - 전환 이부성형술: 증례보고)

  • Seo, Hyun-Soo;Lee, Young-Joo;Byeon, Kwang-Seob;Hong, Soon-Min;Park, Jun-Woo;Hong, Ji-Sook;Park, Yang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.55-61
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    • 2011
  • Conventional slinding genioplsty has the risk of mental nerve injury after operation and difficult to correct vertical asymmetry of chin. So, authors propose a new genioplasty to correct asymmetry of chin. Switching genioplasty is a modification method of conventional genioplasty. Between mandibular right and left canine, osteotomy line of triangular shape make until mandibular lower border. In large side, osteotome line of wedge shape is added to reduction. After osteotomy, segment of wedge shape was separated from chin. Distal segment was rotated to reduction side. Because of rotation of distal segment, space is made in opposite side. Seperated segement of wedge shape from large side is switched this space to fill. So, stability of distal segment is achieved. Authors applied to swiching genioplasty the patients who was remained the chin asymmetry after both sagittal split ramus osteotome was done because mandible asymmetry. After operation, patient and operator were satisfied with excellent esthetic results without any other complication. The switching genioplasty is effective surgical technique for chin asymmetry because it has more advantages than conventional sliding genioplasty. First, other donor side does not need for bone graft. Second, the switching genioplasty can reduce infection, bone resroption, dehiscence, capsular contraction after allograft. Third, have little mental nerve damage. Forth, anteroposterior correction is possible. Fifth, operation time is less than other genioplasty for chin asymmetry.

Implant Fixture Installation in the Anterior Mandible by Use of a Mucosa Supported Surgical Template Based on Computer Assisted Treatment Planning (컴퓨터보조 기반 점막지지 서지컬템프레이트를 이용한 하악전치부 임플란트 식립)

  • Lee, Jee-Ho;Kim, Soung-Min;Kim, Myung-Joo;Park, Jung-Min;Seo, Mi-Hyun;Myoung, Hoon;Lee, Jong-Ho;Kim, Myung-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.158-165
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    • 2011
  • A 73-year-old Korean female patient with a fully edentulous mandible was planned to have five implant fixtures installed in the anterior mandible for the fixed prosthesis. After 3-dimensional (3D) computed tomographic scanning was transferred to OnDemand3D$^{(R)}$ (Cybermed Co., Seoul, Korea) software program for the virtual planning, five fixtures of MK III Groovy RP implants of Branemark System$^{(R)}$ (Nobel Biocare AB Co., Goteborg, Sweden) were installed in the anterior mandible between both mental foramens using In2Guide$^{(R)}$ (CyberMed Co., Seoul, Korea) mucosa-supported surgical template with Quick Guide Kit$^{(R)}$ (Osstem Implant Co., Seoul, Korea) systems. Fixture installations were completed successfully without any complications, such as mental nerve injury, bony bleedings, fenestrations and other unexpected events. Postoperative computed tomographic scans were aligned and fused to the planned implant, then angular and linear deviations were compared with the planned virtual implants. The mean angular deviation between the planned and actual implant axes was $3.42{\pm}1.336^{\circ}$. The mean distance between the planned and actual implant at the neck area was $0.544{\pm}0.290$ mm horizontally and $0.118{\pm}0.079$ mm vertically. The average distance between the planned and actual implant at the apex area was $1.166{\pm}0.566$ mm horizontally and $0.14{\pm}0.091$ mm vertically. These results could be considered more precise and accurate than previous reports, and even our recent results. The entire procedures of this case are reported and reviewed.

The Effect of The Virtual Reality Rehabilitation System on Activities of daily living, cognitive function, self-esteem in Stroke (가상현실재활시스템 적용에 따른 뇌졸중 환자의 일상생활활동, 인지기능, 자아존중감의 개선효과)

  • Kim, Young-Geun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.8
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    • pp.5476-5484
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    • 2015
  • The purpose of this study was to verify the clinical usefulness of the virtual reality rehabilitation system which Academic-Industrial cooperation develop through clinical experiment for recovering the functional abilities in stroke. For this purpose, 24 Stroke(hemorrhage13, infarction11)participated in a clinical experiment. They were randomly assigned to the virtual reality rehabilitation system group(n=13) and conventional rehabilitation training(Activities of daily living, cognition training, motor control) group(n=11). All participant were evaluated with three standardized assessment tools(Functional Independent Measure; FIM, Mini-Mental State Examination for Korean; MMSE-K, Self-esteem scale) before and after the planned intervention sessions. All participant were intensively carried out for 8weeks, 3times a week. The results were as follows. The experimental group showed significant improvements for Activities of daily living, basic cognitive abilities and self-esteem related with life satisfaction after the interventions(p<.05). There were no significant differences between two groups for all assessment tool after interventions. Because of this experimental results, the virtual reality rehabilitation system showed the clinical utility for recovering the function in stroke. Further studies are needed to verify the clinical usefulness on the improvement of various functions in brain injury and dementia.

Humidifier disinfectant lung injury, how do we approach the issues?

  • Choi, Jihyun Emma;Hong, Sang-Bum;Do, Kyung-Hyun;Kim, Hwa Jung;Chung, Seockhoon;Lee, Eun;Choi, Jihyun;Hong, Soo-Jong
    • Environmental Analysis Health and Toxicology
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    • v.31
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    • pp.19.1-19.7
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    • 2016
  • A large portion of the Korean population has been exposed to toxic humidifier disinfectants (HDs), and considering that the majority of the victims are infants, the magnitude of the damage is expected to be considerably larger than what has currently been revealed. The current victims are voicing problems caused by various diseases, including but not limited to lung, upper respiratory tract, cardiovascular, kidney, musculoskeletal, eye, and skin diseases, etc. However, there has been difficulty in gaining validation for these health problems and identifying causal relationships due to lack of evidence proving that toxic HD is the specific causes of extrapulmonary diseases such as allergic rhinitis. Furthermore, the victims and bereaved families of the HD case have not received any support for psychological distress such as post-traumatic stress disorder, depression, feelings of injustice, and anger caused by the trauma. In addition, because the underlying mechanisms of the toxic materials within the HDs such as polyhexamethylene guanidine phosphate, poly(oxyalkylene guanidine) hydrochloride, chloromethylisothiazolinone /methylisothiazolinone have yet to be determined, the demand for information regarding the HD issue is growing. The victims of the HD cases require support that goes beyond financial aid for medical costs and living expenses. There is a desperate need for government-led integrated support centers that provide individualized support through health screenings; in other words, we need an integrated facility that provides the appropriate social support to allow the victims to recover their physical and mental health, so as to well prepare them to return to a normal life. The implementation of such a plan requires not only the close cooperation between those departments already directly involved such as the Ministry of Environment and the Ministry of Health and Welfare, but also active support on a national scale from pan-governmental consultative bodies.

Lower Serum Cholesterol Level is Associated with More Serious Injury in Psychiatric Patients with Suicide Attempt (자살을 시도한 정신과 환자에서 낮은 혈청 콜레스테롤 농도와 심각한 자살 수행과의 연관성)

  • Kim, Yong Ku;Lee, Heon Jeong;Kim, Ji Yeon;Choi, So Hyun;Lee, Min Soo
    • Korean Journal of Biological Psychiatry
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    • v.6 no.2
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    • pp.227-234
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    • 1999
  • An association of low total cholesterol in blood with psychiatric diseases and suicidal behavior has been suggested. As part of an attempt to further explore this relationship, we examine first, whether serum cholesterol levels in psychiatric patients with suicidal attempt would be lower than in non-suicidal psychiatric inpatients or normal controls, second, whether such significant difference of cholesterol levels would be present when the diagnostic groups are analyzed separately, third, whether low cholesterol level would be associated with a history of serious suicidal attempts, and finally, whether low cholesterol level in suicide attempters is a state or a trait marker. We determined the serum cholesterol levels in 231 patients admitted to an emergency room following an suicidal attempt, in the same numbers of age-, sex- and diagnosis- matched non-suicidal psychiatric controls, and in the same numbers of age-, sex matched normal controls. The seriousness of an attempt was divided into 5 grades according to the degree of the resulting medical injury. Total cholesterol levels in suicide attempters were significantly lower compared with both psychiatric and normal controls, when sex, age, and nutritional status (i.e., body mass index) were controlled for. This significant relationship was observed in major depressive disorders and personality disorders, but not in schizophrenia and bipolar type I disorders. The severity of suicide by a lowering of blood cholesterol was related to the magnitude of the cholesterol reduction. After treatment of their psychiatric ailments, the cholesterol levels in suicide attempters were significantly increased. This result suggests that low cholesterol level in psychiatric patients might be a potential biological marker of suicide risk. It is hypothesized that low cholesterol levels is associated with the suicide by modifying the serotonin metabolism, the production of interleukin-2 and melatonin metabolism in psychiatric patients.

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