• Title/Summary/Keyword: Psychiatric disease

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Wilson's Disease in Bangladeshi Children: Analysis of 100 Cases

  • Rukunuzzaman, Md.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.2
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    • pp.121-127
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    • 2015
  • Purpose: To evaluate clinical and laboratory profile of Wilson's disease (WD) in children. Methods: This cross sectional study was conducted at Bangabandhu Sheikh Mujib Medical University Hospital. Bangladesh, over a period of 3 years. One hundred consecutive children of WD between 3 to 18 years of age were evaluated. Results: Mean age was $8.5{\pm}1.5years$. Male female ratio was 2:1. Ninety-one percent of patients were Muslim and 9% Hindu. A total of 53% cases of hepatic WD presented between 5 to 10 years of age and most of the neurologic WD manifested in 10-15 years age group. Sixty-nine children presented only with hepatic manifestations, 6 only with neurological manifestations, 14 with both hepatic and neurological manifestation, 10 children was asymptomatic and 1 patient presented with psychiatric features. WD presented as chronic liver disease (CLD) in 42%, CLD with portal hypertension in 34%, acute hepatitis in 20% and fulminant hepatic failure in 4% cases. Stigmata of CLD were found in 18% patients. Keiser-Fleischser ring was found in 76% total patients. Elevated serum transaminase was found in 85% cases, prolonged prothrombin time in 59% cases and hypoalbuminaemia in 53% cases. A total of 73% patients had low serum ceruloplasmin, basal urinary copper of >$100{\mu}g/day$ was found in 81% cases and urinary copper following penicillamine challenge of >$1,200{\mu}g/day$ was found in 92% cases. Conclusion: Majority of studied WD children presented with hepatic manifestation of which 76% presented with CLD. Any child presented with jaundice after the age of 3 years should be investigated for WD.

A case report of Cardiac chest pain with dizziness and headache treated by Oriental Medicine (현훈(眩暈), 두통(頭痛)을 동반한 심장성(心臟性) 흉통(胸痛) 환자 1례의 한방치료에 의한 증례보고)

  • Koh, Young-Tak;Yoo, Yeoung-Eun;Shim, Sang-Min;Chung, Young-Hoon;Lee, Ki-Ha;Kim, Ki-Joo;Han, Eul-Joo
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.3
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    • pp.309-319
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    • 2007
  • Chest pain is classified into two major categories of cardiac chest pain and non-cardiac chest pain. Cardiac chest pain is caused by cardiovascular disease, for example, myocardial infarction, angina pectoris, valvular heart disease, cardiac enlargement or hypertrophy, dissecting aortic aneurysm, pericarditis, myocarditis, etc. When the chest pain is not attributed to heart disease, it is termed non-cardiac chest pain. Non-cardiac chest pain is caused by pulmonary, gastrointestinal, musculoskeletal disease, psychiatric factor, etc. In tills case, we treated a 54-year old female patient who was diagnosed with dilated cardiomyopathy and suspicious sick sinus syndrome. She complained of chest pain, exertional dyspnea, dizziness and headache. For treatment, we made use of Yugultangami(六鬱湯加味) and Daejobwan(大造丸). Before and after treatment, we measured Heart rate variability(HRV). In result, the clinical symptoms were improved and there was a significant increase in assessmeut by Heart rate variability(HRV). Tills result suggests that Yugultaugami aud Daejowhan have a good effect on cardiac chest pain.

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The Causes of Death of the Institutionalized Population of Kkottongnae : Comparison between Severe Mental Illness Group(SMI) and Non-Severe Mental Illness Group(Non-SMI) (SMI군과 Non-SMI군의 사망원인 비교분석 : 일 장기요양기설 입소자를 대상으로)

  • Moon, Su Jin;Kim, Kyoung Hoon;Song, Ji Young;Paik, Jong-Woo
    • Korean Journal of Biological Psychiatry
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    • v.16 no.3
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    • pp.198-204
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    • 2009
  • Objectives : Schizophrenia and other psychiatric disorder are associated with an increased risk of premature death. For decades, there have been reports of shorter life expectancy among those with severe mental illness. The purpose of this study was to compare the risk of mortality among institutionalized population, treated for severe mental illness to control group who did not have severe mental illness. Methods : The medical records and the death certificates of 2,029 institutionalized population who had died from 1985 to 2003 in Kkottongnae were investigated. Results : The mean age of the death of severe mental illness(SMI) group(51.4${\pm}$15.3 years old) was lower than that of non-severe mental illness(non-SMI) group(65.0${\pm}$19.3 years old) and it was statistically significant(p<0.0001). The most causes of death among the SMI group were respiratory diseases(23.3%), infectious disease (13.0%) and digestive disease(12.3%). Also, we found that the death due to injuries of the SMI group(8.9%) were three times higher than that of non-SMI group(2.5%). The most causes of death among the non-SMI group were respiratory disease(26.3%), circulatory disease(26.2%) and neoplasm(10.8%). Conclusion : The SMI group demonstrated higher mortality rates compared with the rate in the non-SMI group. The finding suggests that careful intervention is needed not only for menal health but also physical health in long-term facilities.

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Importance of CADASIL research in Jeju: a review and update on epidemiology, diagnosis, and clinical spectrum (제주도에서 CADASIL 연구의 중요성: 역학, 진단 및 임상양상에 대한 고찰)

  • Choi, Jay Chol;Lee, Jung Seok;Kim, Kitae
    • Journal of Medicine and Life Science
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    • v.17 no.3
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    • pp.65-73
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    • 2020
  • Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a single-gene disease of the cerebral small blood vessels caused by mutations in the NOTCH3 gene on chromosome 19. Although CADASIL was known as a rare disease, recent research has suggested that the NOTCH variants could be found frequently even in the general population. The main clinical features included recurrent stroke, migraine, psychiatric symptoms, and progressive cognitive decline. On brain magnetic resonance imaging, patients with CADASIL showed multifocal white matter hyperintensity lesions, lacunar infarcts, microbleeds, and brain atrophy. Among them, lacunar infarcts and brain atrophy are important in predicting the clinical outcomes of patients with CADASIL. In the Jeju National University Hospital, we have diagnosed 213 CADASIL patients from 2004 to 2020. Most NOTCH3 mutations were located in exon 11 (94.4%), and p.Arg544Cys was the most common mutation. The mean age at diagnosis was 61.0±12.8 years. The most common presenting symptoms were ischemic stroke (24.4%), followed by cognitive impairment(15.0%), headache (8.9%), and dizziness(8.0%). Although the exact prevalence of CADASIL in Jeju is still unknown, the disease prevalence could be as high as 1% of the population considering the prevalence reported in Taiwan. Therefore, it is necessary to discover efficient biomarkers and genetic tests that can accurately screen and diagnose patients suspected of having CADASIL in this region. Ultimately, it is urgent to explore the exact pathogenesis of the disease to identify leading substances of treatment potential, and for this, multi-disciplinary research through active support from the Jeju provincial government as well as the national government is essential.

Prevalence and Impact of Comorbidities in Individuals with Chronic Obstructive Pulmonary Disease: A Systematic Review

  • dos Santos, Natasha Cordeiro;Miravitlles, Marc;Camelier, Aquiles Assuncao;de Almeida, Victor Durier Cavalcanti;Maciel, Roberto Rodrigues Bandeira Tosta;Camelier, Fernanda Warken Rosa
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.3
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    • pp.205-220
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    • 2022
  • This study aimed to describe the prevalence of comorbidities associated with chronic obstructive pulmonary disease (COPD) and their relation with relevant outcomes. A systematic review based on the PRISMA methodology was performed from January 2020 until July 2021. The MEDLINE, Lilacs, and Scielo databases were searched to identify studies related to COPD and its comorbidities. Observational studies on the prevalence of comorbidities in COPD patients and costs with health estimates, reduced quality of life, and mortality were included. Studies that were restricted to one or more COPD pain assessments and only specific comorbidities such as osteoporosis, bronchitis, and asthma were excluded. The initial search identified 1,409 studies and after applying the inclusion and exclusion criteria, 20 studies were finally selected for analysis (comprising data from 447,459 COPD subjects). The most frequent COPD comorbidities were: hypertension (range, 17%-64.7%), coronary artery disease (19.9%-47.8%), diabetes (10.2%-45%), osteoarthritis (18%-43.8%), psychiatric conditions (12.1%-33%), and asthma (14.7%-32.5%). Several comorbidities had an impact on the frequency and severity of COPD exacerbations, quality of life, and mortality risk, in particular malignancies, coronary artery disease, chronic heart failure, and cardiac arrhythmias. Comorbidities, especially cardiovascular diseases and diabetes, are frequent in COPD patients, and some of them are associated with higher mortality.

Outbreak of Hepatitis A caused by Groundwater Contamination in a Long-term Psychiatric Hospital in Korea (장기 요양 정신병원에서 지하수 오염에 의하여 발생한 A형간염 집단발병)

  • Keun-Sang Kwon;Myung Ok Lee;Hee Ju Bae;Jung Im Park;Cheon-Hyeon Kim;Ju-Hyung Lee
    • Journal of agricultural medicine and community health
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    • v.48 no.2
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    • pp.71-80
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    • 2023
  • 목적: 2017년 지하수를 식수로 사용하고 있는 한 장기요양 정신병원(H병원)에서 A형간염 환자가 집단 발병하여 이에 대한 역학조사를 실시하고 조치 결과를 기술하고자 하였다. 방법: 노출기간 동안 H병원의 근로자 및 재원 환자 234명을 대상으로 사례군 조사 디자인으로 역학조사를 실시하였고, IgM, IgG 혈청검사 및 A형간염 바이러스(HAV)에 대한 PCR검사를 시행하였다. 또한 오염원으로 의심되는 지하수, 병원에서 제공되는 식품 및 인근 저수지의 물에서 HAV 검사를 실시하였고, 검출된 HAV는 유전형 검사를 진행하였다. 결과: H병원 환자 및 직원 234명 중 IgG 양성인 168명을 제외한 66명 중 19명이 최종적으로HAV 감염자로 확인되어 감수성자 중 발병률은 28.8%로 나타났다. 환자, 지하수, 식품(석박지) 및 저수지에서 동일 유전형의 HAV가 검출되어 지하수 오염에 의한 집단발병으로 결론 내렸으나, 최초 오염원은 확인하지 못하였다. 유행 종결 선언 이후 지하수에 대한 관리로 염소소독과 UV 조사를 하였음에도 불구하고 6개월 동안 지속적으로 HAV가 검출되어 새로운 관정을 개발하여 상황을 종결하였다. 결론: 본 연구에서 지하수를 식수로 사용하는 장기요양 정신병원에서 지하수 오염에 의한 19명의 HAV 집단발병을 조사하였다. HAV 항체가 없는 대상자 중에서 HAV의 높은 발병률을 확인하였다. 지하수 수질검사에서 바이러스 검사는 포함되어 있지 않기 때문에 지하수가 HAV에 오염시 HAV 집단발병 가능성이 높고 상당기간 지속적으로 검출되기 때문에 지하수에 대한 관리지침에 바이러스 검출을 위한 방안을 추가하고 관련 법을 정비할 필요가 있다.

The Association between the T102C Polymorphism of the HTR2A Serotonin Receptor Gene and HDL Cholesterol Level in Koreans

  • Choi, Jin-Ho;Zhang, Shu-Ying;Park, Kyung-Woo;Cho, Young-Seok;Oh, Byung-Hee;Lee, Myoung-Mook;Park, Young-Bae;Kim, Hyo-Soo
    • BMB Reports
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    • v.38 no.2
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    • pp.238-242
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    • 2005
  • 5-HT2A is one of major serotonin receptor that is involved in the action of serotonin-targeting drugs. Previous clinical studies have shown an unexpected association between lower cholesterol level and psychiatric diseases, in which T102C polymorphism of HTR2A, gene of 5-HT2A serotonin receptor, might be involved. Therefore, we hypothesized a potential association between lower cholesterol level and T102C polymorphism. The effect of the T102C polymorphism on the serum lipid profiles of 646 subjects without specific psychiatric disease was investigated. Genotype was determined by polymerase chain reaction and restriction fragment length polymorphism analysis. There were significantly lower levels of total cholesterol ($193.6{\pm}35.0$ versus $202.1{\pm}45.5\;mg/dl$, p = 0.016) and HDL-cholesterol ($42.7{\pm}11.6$ versus $46.3{\pm}12.7\;mg/dl$, p = 0.004) in CC genotype than non-CC genotypes. Moreover, multivariate analysis showed that the CC genotype is a strong predictor of a lower HDL-cholesterol level (p < 0.001). In conclusion, this study shows that the CC genotype of the HTR2A gene is related to lower HDL-cholesterol level in Koreans. This is the first demonstration showing the potential genetic relationship between the serotonin receptor gene polymorphism and the HDL-cholesterol level.

A SURVEY OF PATIENTS WITH DISABILITIES VISITING THE DEPARTMENT OF PEDIATRIC DENTISTRY OF CHONBUK NATIONAL UNIVERSITY DENTAL HOSPITAL IN 2016 (2016년 전북대학교 치과병원 소아치과를 방문한 장애인환자에 관한 조사연구)

  • Jang, Ji-Hye;Lee, Dae-Woo;Kim, Jae-Gon;Yang, Yeon-Mi
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.1-5
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    • 2017
  • According to the Ministry of Health and Welfare, the portion of physical disability was 51.4% which was the highest among the registered disabled in December 2015, followed by visual disability(10.1%), disability of the brain lesions(10.0%), hearing disability(10.0%). The aim of this study is to investigate the types of disability in patients with disabilities visiting the Pediatric Dentistry, Chonbuk National University Dental Hospital in 2016. Of the patients who visited the pediatric dentistry, 196 patients (7.5%) had disabilities, and 19 patients had two or more disabilities. Twelve patients (6.1%) had both disabilities of brain lesion and intellectual disorder. Of the 177 patients with only one disability, 54 patients (30.5%) had physical disorders and 123 patients (69.4%) had psychiatric disorders. In psychiatric disorders, intellectual disorder was the most with 98 patients (55.3%), followed by autistic disorder with 23 patients (12.9%). In physical disorders, disability of brain lesion was the most with 37 patients (20.9%), followed by speech disability with 8 patients (4.5%). In this study, as a result of analyzing the types of disability with the patients who visited the Pediatric Dentistry of Chonbuk National University Dental Hospital, most of them had either intellectual disorder, disability of brain lesion, or autistic disorder. Dentists need to understand their general and dental characteristics to treat children and adolescents with disabilities. Since the most chief complaint of the patients was dental caries, early interventions should be made by dentist to reduce the incidence of the disease.

Literatures Review in Hwabyung Research (홧병 연구에 관한 고찰)

  • Park, Young-Sook;Chae, Sun-Ok
    • Research in Community and Public Health Nursing
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    • v.12 no.3
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    • pp.705-715
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    • 2001
  • This study examined 19 papers published from 1977 to 2000 based on the objective frame evaluation. This purpose of this study was to examine the trend of Hwabyung research and to serve as a guide for the future 'Hwabyung' study. The results of studies were as follow. In the design of research, clinical studies are definitely dominant. As for the fields of research, the concept of Hwabyung was studied more frequently than the others. As for the authorship. psychiatrists prevailed but nursing professionals are on the increase. Research subject in clinical and survey study, patient was definitely dominant and the place of study was almost always a hospital (75%), data collection was higher on interview (58.3%). Hwabyung was considered unique culture bounded syndrome related to Korean culture. Frequent etiologic factor of Hwabyung were a husband's extra-marital affair, conflicts between houses wives and mothers-in-laws, and financial loss and suffering. From the incidence of Hwabyung, a greater number of patients with Hwabyung were middle aged women in the low economic and educational classes, and these were connected with the culture and the family system. The symptoms of Hwabyung included psychological and physical symptom, neurological disorder and disease behavior. Defense mechanisms and coping strategies for Hwabyung were somatization, suppression, orality, withdrawal, isolation, regression, help-seeking, complaining, and wreaking anger. Treatment of Hwabyung were medication, effort by herself, communication with families, consultation with psychologist, acupuncture, negative therapy, moxa, and Qi-kong. Psychiatric therapy, behavior therapy, nursing intervention on multi-interdisciplinary approach and psychiatric nursing approach were recommended for the nursing care of a Hwabyung patient.

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Managing Mental Health during the COVID-19 Pandemic: Recommendations from the Korean Medicine Mental Health Center

  • Hyo-Weon Suh;Sunggyu Hong;Hyun Woo Lee;Seok-In Yoon;Misun Lee;Sun-Yong Chung;Jong Woo Kim
    • The Journal of Korean Medicine
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    • v.43 no.4
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    • pp.102-130
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    • 2022
  • Objectives: The persistence and unpredictability of coronavirus disease (COVID-19) and new measures to prevent direct medical intervention (e.g., social distancing and quarantine) have induced various psychological symptoms and disorders that require self-treatment approaches and integrative treatment interventions. To address these issues, the Korean Medicine Mental Health (KMMH) center developed a field manual by reviewing previous literature and preexisting manuals. Methods: The working group of the KMMH center conducted a keyword search in PubMed in June 2021 using "COVID-19" and "SARS-CoV-2". Review articles were examined using the following filters: "review," "systematic review," and "meta-analysis." We conducted a narrative review of the retrieved articles and extracted content relevant to previous manuals. We then created a treatment algorithm and recommendations by referring to the results of the review. Results: During the initial assessment, subjective symptom severity was measured using a numerical rating scale, and patients were classified as low- or moderate-high risk. Moderate-high-risk patients should be classified as having either a psychiatric emergency or significant psychiatric condition. The developed manual presents appropriate psychological support for each group based on the following dominant symptoms: tension, anxiety-dominant, anger-dominant, depression-dominant, and somatization. Conclusions: We identified the characteristics of mental health problems during the COVID-19 pandemic and developed a clinical mental health support manual in the field of Korean medicine. When symptoms meet the diagnostic criteria for a mental disorder, doctors of Korean medicine can treat the patients according to the manual for the corresponding disorder.