• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권1호
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• pp.38-43
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• 2011

Chronic tic disorder or Tourette syndrome is known to be a chronic neuro-behavioral disease for which cognitive behavioral therapy (CBT) strategies have recently been introduced. Here, we report the effectiveness of CBT in a case of childhood chronic tic disorder, which is very common in clinical settings. The DSM-IV clinical diagnosis was applied by a child psychiatrist. The Yale Global Tic Severity Scale, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, and the Dupaul ADHD Rating Scales were used. This case involved a pharmacological treatment-refractory patient over the previous year. Thus, psychiatric consultation was undertaken. Subsequently, we administered five sessions of CBT for four weeks, consisting of symptom evaluation and planning, habit reversal training, and ventilation training. Following four weeks of CBT administration, there were improvements in the scores of the Yale Global Tic Severity Scale and the Clinical Global Improvement scale. Our observations indicate that CBT may be effective in the treatment of childhood tic disorder.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.5313-5318
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• 2012

Psycho-educational interventions are not a substitute for analgesics, but they may serve as adjuvant therapy. Nurses can provide psychoeducational programmes to cancer patients to assist them in optimizing behavior that strengthen adjustment. The aim here was to determine the effects of psychoeducation on levels of adjustment to cancer in stage I-II breast cancer patients who met the study criteria (experimental group: 38 women, control group:38 women). The psychoeducational program consisted of eight 90 minute weekly sessions and data were collected using a questionnaire and the Mental Adjustment to Cancer Scale three times: before, six weeks and six months after the intervention. Data analysis was performed using descriptive statistical methods as well as the Chi square test, the Mann Whitney U test, repeated measures analysis of variance, the matched pairs t test and the Post Hoc Bonferroni test. The results at 6 weeks and 6 months after the program revealed that the experimental group had higher levels of "fighting spirit", lower levels of "helplessness/hopelessness, anxious preoccupation and fatalism" but there was no significant change in levels of "avoidance/denial" compared to the control group with regard to adjustment to cancer. In this study, psychoeducation was shown to cause positive changes in levels of adjustment to cancer in breast cancer patients

• Journal of Korean Neurosurgical Society
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• 제47권4호
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• pp.282-286
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• 2010

Objective : The aim of the present study was to assess the effect of lumbar disc herniation surgery for low back pain on the erectile functioning. Methods : Thirty-eight patients, with age ranging from 22 to 56 years, who had presented with pain due to herniated lumbar discs were included in the study. International Index of Erectile Function (IIEF) Short Form questionnaire was used to evaluate the erectile functioning. Patient visits on the 1st week,1st month and 3rd month postoperatively were analyzed. Pain scores were also noted together with side effects and the complications of the surgery. Results : Of the 38 patients, 18 patients had reported erectile dysfunction; 10 patients mild and 8 patients moderate erectile dysfunction. Twenty patients did not report erectile problems. The herniation levels mostly were L5-S1 in 12 (31.6%). Overall, erectile dysfunction rates have improved in 31.7% of those previously with erectile dysfunction in a 3 month period after the surgery. Best results were obtained in those patients with mild erectile dysfunction preoperatively. Conclusion : Mild erectile dysfunction together with radiculopathy tends to improve after lumbosacral disc surgery. Moderate and severe erectile dysfunction may be related to a more severe nerve injury or to vascular and/or psychiatric factors. An evaluation of erectile functioning should routinely be performed in patients with lumbosacral disc disease both for data accumulation and for medico legal causes since the documentation of the correlation between erectile dysfunction and lumbosacral disc disease is still lacking.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.71-74
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• 1997

MR acoustic sound or noise due to gradient pulsings has been one of the problems in MRI, both in patient scanning as well as in many areas of psychiatric and neuroscience research, such as brain fMRI. Especially in brain fMRI, sound noise is one of the serious noise sources which obscures the small signals obtainable from the subtle changes occurring in oxygenation status in the cortex and blood capillaries. Therefore, we have studied the effects of acoustic or sound noise arising in fMR imaging of the auditory, motor and visual cortices. The results show that the acoustical noise effects on motor and visual responses are opposite. That is, for the motor activity, it shows an increased total motor activation while for the visual stimulation, corresponding (visual) cortical activity has diminished substantially when the subject is exposed to a loud acoustic sound. Although the current observations are preliminary and require more experimental confirmation, it appears that the observed acoustic-noise effects on brain unctions, such as in the motor and visual cortices, are new observations and could have significant consequences in data observation and interpretation in future fMRI studies.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.550-554
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• 1997

Acoustic or sound noise due to gradient pulsing has been one of the problems in MRI, both in patient scanning as well as in many areas of psychiatric and neuroscience research, such as unctional MRI (fMRI). Our recent observations in MRI or the visual and motor cortex show very different results with sound noise in comparison with the results obtained without sound noise. Although a number of ideas has been suggested in the literature about the possible elimination or reduction of sound noise, progress has been slow due to the basic role of gradient pulsing in MR imaging. Therefore, we report on some typical behavior of sound noise observed from MRI scanners and the analyses of their characteristics. Data are obtained both from a commercial MRI scanner (GE Signa 1.5-T EPI system).

• 생물정신의학
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• 제3권1호
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• pp.30-36
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• 1996

Tardive dyskinesia is a syndrome of involuntary hyperkinetic abnormal movements that occurs during or shortly after the cessation of neuroleptic drug treatment. Typically, the movements are choreoatheoid. Other movements such as tics and dystonia may be present. Nonetheless, any dyskinesia seen in a neuroleptic-treated patient is not always neuroleptic-induced tardive dyskinesia. The prevalence of tardive dyskinesia varies widely, which reflects many methodological problems, such as differential diagnosis. symptom fluctuation, masking effect of neuroleptics, validated diagnostic criteria. Of suggested risk factors, only old age has been consistently found to be associated with an increased frequency of tardive dyskinesia. Many hypotheses about the pathophysiolgy of tardive kinesia are proposeed, but time-honored ones are not present. No consistently safe and effective treatments are found. Various treatment modalities signifies the general ineffectiveness of these agents for most patients. In general, reduction or cessation of neuroleptics, if possible, is recommended. Remission or improvemets of tardive dyskinesia after neuroleptics withdrawal usually occurs among most patients within three months.

• 대한불안의학회지
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• 제8권2호
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• pp.161-166
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• 2012

Though infanticide, killing the baby after birth of the neonate and denial of pregnancy, are very rare psychiatric disorder, they have been receiving a lot of social concerns. We report and review infanticide and denial of pregnancy administration in a 19 year-old adolescent with bipolar disorder and borderline personality disorder. Patients with a young age, cognitive immaturity, an unwanted child, hid the pregnancy facts were consistent with the results of previous studies. In addition, the patient's impulsivity and emotional instability is affecting infanticide. After inpatient care with pharmacotherapy (escitalopram 20mg, alprazolam 1.5 mg, clonazepam 0.5 mg, valproate sodium 1,100-1,300 mg, and quetiapine 100-400 mg) and supportive psychotherapy, and there were significant improvement of clinical symptoms.

• 사상체질의학회지
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• 제29권4호
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• pp.311-316
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• 2017

Objectives The purpose of this study was to investigate the relationship between counseling skills and Sasang constitutional medicine(SCM). Methods Reviewing the texts relevant to SCM, comparison between counseling skills and the excerpt from the relating books was conducted in terms of the attitude of the counselor, the observation method, the evaluation of the counselee, the relationship between the counselor and counselee, and the counseling method. Results As the attitude of the counselor, many kinds of attitudes and skills including respecting the counselee and reciprocal belief were needed. The excerpt from "Gyeokchigo" meant that the counselor or a doctor should have the virtue of Truth. To evaluate the patient's problems in SCM and the counseling, diet, digestion, and sleep could be asked, but questions about the emotions such as Joy, Anger, Sorrow and Pleasure should be more carefully modified in a modern way, when applying clinical practices. Empathy as the main principle of the counseling could be attributed to the main idea of Dongmu Lee Jema, in which all the people could be in the same status in a natural way reflecting that they like the virtue and dislike the evil. Recommendations of regimen and directives could be followed according to SCM Conclusions Several items of counseling skills and SCM coincide but some of the modern counseling skills are still needed to apply SCM to make the patients with psychiatric problems treated efficiently.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권4호
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• pp.191-199
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• 2019

Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.

• Journal of Audiology & Otology
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• 제25권4호
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• pp.217-223
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• 2021

Background and Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation. Subjects and Methods: All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer. Results: A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure (n=1), electrode migration (n=1), infection (n=1), and other (n=1). All patients showed better or similar postreimplantation audiological performance compared with pre-reimplantation results. Conclusions: It is very important to provide a safe school and home environment and educate the family for reducing reimplantation due to trauma. Especially for active children, psychiatric consultation should be continued postoperatively.