• 제목/요약/키워드: amnesia

검색결과 170건 처리시간 0.022초

Dissociative Identity Disorder in an Adolescent With Nine Alternate Personality Traits: A Case Study

  • Lee, Sang-Hun;Kang, Na Ri;Moon, Duk-Soo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제33권3호
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    • pp.73-81
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    • 2022
  • Since dissociative identity disorder (DID) has symptoms similar to schizophrenia, such as auditory hallucinations and delusional thoughts of being controlled, there are difficulties in its differential diagnosis. A 16-year-old adolescent male patient who was previously diagnosed with schizophrenia from a different hospital was admitted to our inpatient psychiatric unit for the evaluation of auditory hallucinations and suicide attempts. Through psychiatric evaluations, it was determined that the patient suffered from identity alternation, dissociation, and amnesia. As for the diagnostic evaluations, the following measures were implemented: a psychiatric interview regarding the diagnostic criteria, mental status examination, laboratory tests, brain imaging studies, electroencephalography, and full psychological test for adolescents, and the self-reported measure of the Adolescent Dissociative Experiences Scale. The patient was diagnosed with DID, and the following treatments were administered: pharmacotherapy, ego state therapy, psychoeducation regarding emotions, trauma-focused psychotherapy including stabilization, and family therapy. Following treatment, in the internal dimensions, the patient was able to recognize the nine alternate identities in charge of his emotions, which established a basis for the potential integration of identities. In the external dimensions, he showed improvements in the aspects of family conflicts and issue of school refusal. This is the first reported case of DID in an adolescent in Korea; it emphasizes the consideration of DID in the differential diagnosis of other mental illnesses such as schizophrenia, bipolar disorder, and posttraumatic stress disorder and expands the treatment opportunities for DID by sharing the procedures of ego state therapy.

Comparison of vital sign stability and cost effectiveness between midazolam and dexmedetomidine during third molar extraction under intravenous sedation

  • Jun-Yeop, Kim;Su-Yun, Park;Yoon-Sic, Han;Ho, Lee
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권6호
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    • pp.348-355
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    • 2022
  • Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pressure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer's assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05. Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had similar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000). Conclusion: DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.

노인(老人) 저혈압(低血壓)에 대(對)한 문헌적(文獻的) 고찰(考察) (A Literature Review of The Senile Hypotension)

  • 곽익훈;김종대;정지천
    • 동국한의학연구소논문집
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    • 제4권
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    • pp.161-187
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    • 1995
  • This study was perfomed to investigate causes of the senile hypotension, pathogenic mechanism, symptoms, and therapies through medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows ; 1. The senile hypotension has major symptoms of dizziness, weakness, syncope, palpitation, shortness of breath, and deficiency of Qi. Additionally, it has minor symtoms of letharhy, isomnia, tinnitus, amnesia etc... 2. The prodromal symptoms of Kwul and Kwul are relating to the symptoms of tachycardia, facial pallor, sweating, anxietas, ambiguous consciousness, and fainting. Weakness and dizziness due to deficiency make the symptoms of exhaustion, fatigue, vertigo, lethargy, and brachycardia. 3. The most principal cause of the senile hypotension is deficiency of Shen due to aging, congenital deficiency, and chronic illness. The rest of causes are defciency of Qi and blood, phlegm of retention, stagnation of Qi, blood stasis, blood prostration etc... In the view of the occidental meicine, the causes of the senile hypotension came from the reduction of cardiac output, the decretion of cardiovascular system's extention due to aging, hereditary factor, secondary factor due to exsanguination, diabetes mellitus, C.V.A etc..., and factor of neurogenic system's degeneration. 4. The principal pathogenic mechanisms are the insufficiency of Xing-Yang, the deficiency of Qi in middle jiao, and deficiency of Shen-Qi. The rest of mechanisms are the deficiency of both Qi and blood, stagnation of the Gan-Qi, and the deficiency of Gan and Shen. Zang-Pu Organs have something to do with Xing, Bi, and Shen. 5. As principal therapies, there are warming and recuperation the Xing-Yang, strengthing the middle-jiao and replenishing Qi, replenishing vital essence to tonify the Shen, and warming and recuperation the Shen-Yang. Additionally, the therapies of invigorating the Bi and relieving mental stress, strengthning the Bi and tonifing the Shen, invigorating Qi and nourishing Yin, soothing the Gan and regulating the circulation of Qi, and tonifing the Shen and nourishing the Gan help the cure of the senile hypotension. In prescriptions there are Baohe Yuan Tang, Buzhong Yigi Tang, Zuoguei Yin, Yougui Yin, Guipi Tang, Zhu Fu Tang, Shengmai San, Sini San, and Qi Ju Dihuang Wan. The medical herbs of Astragali Radix, Codonopsitis Pilosulae Radix, Ginseng Radix, Aconiti Tuber, Ephedrae Herba, Cinnamomi Ramulus, Cinnamomi Corfex Spissus, Zingiberis Rhizoma, Polygalae Radix, Liriopis Tuber, Polygonati Sibirici Rhifoma, Lycii Fructus, Schizandrae Fructus, and Glycyrrhizae Radix can be treated. 6. According to the clinical report, the principal causes are the deficiency of Qi, and insufficiency of Yang which symptoms are dizziness, vitality fatigue and acratia, amnesia, body cold and alger of extremity, spontaneous perspiration, and therady and weak pulse. It was improved by taking WenYang YiQi Tang, Zhu Fu Tang about 20-30 days. The improvement was shown on disappearance of subjective symptoms or the ascending of blood pressure to normal figure, and the rate of improvement was over 70%. 7. As regimens, taking warming and recuperating food(a sheep mutton, juglans regia, chiness date, longan aril etc...) and pungent food(chinese green onion, fress ginger, pipers fructns etc...), doing physical training, not being ill in bed at a long time, and preventing descent of blood pressure coming from sudden change of posture are needed. Additionally, the usage of diuretic, abirritant, and depressor needs to be extra cautious.

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녹용 추출물이 치매 동물모델의 기억력 개선과 관련효소 활성에 미치는 효과 (Effects of the Deer Antler Extract on Scopolamine-induced Memory Impairment and Its Related Enzyme Activities)

  • 이미라;손백신;고리주안;왕춘년;방철명;왕젠;모은경;이선영;성창근
    • 한국식품영양과학회지
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    • 제38권4호
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    • pp.409-414
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    • 2009
  • 본 연구는 녹용 추출물이 scopolamine으로 기억손상을 유발한 실험동물의 기억력 개선과 AChE, MAO-B의 활성억제, 신경전달 물질인 ACh 함량을 치매 치료제인 tacrine과 비교하여 분석하였다. 공간인지력을 평가하는 Morris water maze test에서 scopolamine(2 mg/kg, i.p.)으로 기억손상을 유발한 경우 4일간의 인지훈련에도 불구하고 platform을 찾아가는 escape latency 시간이 증가되었으며, tacrine과 녹용추출물 투여군은 훈련 2일째부터 유의적으로 escape latency 시간이 감소하였다. 실험 5일째 platform을 제거한 probe test에서도 녹용 추출물 처리군은 scopolamine 처리군보다도 escape latency 시간이 유의적으로 감소하여 장기기억 개선효과가 있음을 보여주었다. 뇌의 신경전달물질인 ACh 생성은 대조군 대비 scopolamine 투여군은 84.7% 감소하였으나, 녹용 추출물 투여군(97.5%)은 치매 치료제인 tacrine(97.8%)과 비슷하게 정상적인 수치로 ACh 생성량을 증가시켰다. Tacrine 처리군은 scopolamine 투여로 상승한 뇌조직과 혈청의 AChE 활성을 유의적으로 감소시켰고, 녹용 추출물 처리군은 뇌조직의 AChE 활성을 유의적으로 감소시켰다. 뇌조직의 MAO-B 활성은 그룹 간 유의적인 차이는 없었으나, tacrine과 녹용 추출물 처리군이 scopolamine 투여군보다 MAO-B 활성을 감소시키는 경향을 보였다. 따라서 녹용 추출물은 scopolamine으로 기억손상을 유발한 치매 동물모델에서 신경전달물질을 분해하는 효소의 활성을 저해함으로써 장기기억 활성을 촉진하고 콜린성 신경계를 자극하여 기억 및 학습 증진에 효과적으로 작용하는 천연물 유래 기능성 물질로 사료된다.

제브라피쉬 근육성장에서의 carnosic acid의 효과 (Effects of Carnosic Acid on Muscle Growth in Zebrafish (Danio rerio))

  • 김정환;진덕희;김영대;진형주
    • 한국어류학회지
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    • 제26권3호
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    • pp.171-178
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    • 2014
  • 로즈마리의 주요 성분인 carnosic acid는 carnosol, rosmarinic acid, ursolic acid 등과 같은 폴리페놀의 한 성분으로 다양한 생리활성 기능이 보고되어 있다. 본 연구에서는 로즈마리 유래 폴리페놀인 carnosic acid가 제브라피쉬 근육성장에 미치는 영향을 근육 내 주사와 사료를 통해서 확인해 보았다. 근육 내 주사 실험을 통해서 CA는 제브라 피쉬의 근육 내 단백질 함량을 증가시키고 중성지방의 함량을 감소시켰다. 또한 조직학적 분석 결과 근섬유의 평균 면적이 커지는 근섬유의 과비대 효과를 나타내었다. 사료 실험 결과 근육 내 단백질 및 중성지방의 함량에는 영향을 미치지 않았으며 조직학적 분석 결과 근육 내 주사 실험에서와 마찬가지로 근 섬유의 과비대를 유도하였다.

새로운 제형의 치매치료제제의 효능연구 (Ameliorating Effects of the Cognitive-Enhancing Korean Herbs on Neurotoxic-Induced Amnesia in Rats)

  • 김지현;정진용;채윤병;함대현;박용진;이혜정;심인섭
    • 동의생리병리학회지
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    • 제16권2호
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    • pp.303-310
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    • 2002
  • Ancient Korean physicians have used several oriental herbs to cure dementia and these effects were described in the Korean herbal books. Some cognitive-enhancing oriental herbs have been widely used as a herbal medicine against dementia. However, few of studies have proved their efficacy in treatment for dementia. In the present study, we investigated the effects of herbal compounds, which are mainly consisted of Uncaria sinensis, Corydalis yanhusuo and Acorus gramineus on learning and memory in Mortis water maze task and the central cholinergic system of the rats with neurotoxic medial septum lesion. In water maze test, the animals were trained to find a platform in a fixed position during 6 days and then received a 60-s probe trial in which the platform was removed from the pool on the 7th day. Ibotanic and 192 saporin lesion of the medial septum (MS) impaired the performance of maze test and degenerated choline acetyltransferase (ChAT) in the brain, which is a marker of the central cholinergic system. Daily administrations of herbal medicine (100mg/kg, p.o.) for 21 consecutive days produced significant reversals of the neurotoxic-induced deficit in learning and memory. These treatments also reduced the loss of cholinergic immunoreactive neurons in the brain induced by neurotoxin. These results demonstrated that herbal compounds ameliorated learning and memory deficits through effects on the central nervous system, partly through effect on the acetylcholine system. Our studies suggest an evidence of these herbs as treatment of Alzheimer's disease.

백혈병 세포주 Jurkat의 세포고사 유도 및 세포주기 억제에 미치는 합산피 추출물의 효과 (Effects of the Water Extract from Albizzia julibrissin on Apoptosis and Cell Cycle Progression in the Human Leukemic Jurkat Cells)

  • 박영준;정우철;정대영;이용운;이인;이기상;전병훈;성강경;문병순
    • 동의생리병리학회지
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    • 제17권6호
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    • pp.1383-1392
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    • 2003
  • Apoptosis is a morphologically and biochemically district form of cell death that occurs in many different cell types in a wide variety of organisms. Albizzia julibrissin belonging the family Leguminosae has been used for the treatment of contusion, sore throat, amnesia, and insomnia in oriental traditional medicine. This study investigates whether the water extract of A. julibrissin induce apoptotic cell death in Jurkat T-acute lymphoblastic leukemia (ALL) cells. Jurkat cells were increased inhibitions of cell viability in a concentration-dependent manner by A. julibrissin. This herbal medicine also caused apoptosis as measured by cell morphology and DNA fragmentation. The capability of A. julibrissin to induce apoptosis was associated with proteolytic cleavage of specific target proteins such as poly (ADP-ribose)polymerase (PARP) and beta-catenin proteins suggesting the possible involvement of caspases. Our result showed that Bcl-2 and Bax protein levels were not changed in all A. julibrissin-treated groups compared to control group. These results suggest that A. julibrissin-mediated apoptosis is independent with Bcl-2 related signaling pathway in this cells. The purpose of the present study is also to investigate the Effect of A. julibrissin on cell cycle progression. Our results showed that G1 checkpoint related gene products (cyclin D1, cyclin dependent kinase 4, retinoblastoma, E2F1) were decreased in their protein levels in a dose-dependent manners after treatment of the extract. These results indicate that the increase of apoptotic cell death by A. julibrissin may be due to the inhibition of cell cycle progression in wild type p53-lacking Jurkat cells.

재가급여 장기요양인정 노인들의 신체기능 상태 및 관련요인 (Physical Functioning and Related Factors in the Elderly People Admitted Long-term Home Care Insurance)

  • 윤석한;이광성;조영채
    • 한국산학기술학회논문지
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    • 제14권5호
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    • pp.2338-2348
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    • 2013
  • 본 연구는 재가급여 장기요양인정노인들을 대상으로 그들의 신체적 기능 상태를 평가하고 그에 관련된 요인을 검토하고자 실시하였다. 조사대상은 대전광역시에 거주하고 있으면서 재가급여 요양자로 등록되어 있는 65세 이상 노인 618명으로 하였다. 자료 수집은 2011년 12월 1일부터 2012년 3월 31일까지의 기간 동안에 표준화된 무기명식 면접조사용 설문지를 사용하여 면접조사를 실시하였다. 연구결과, 전체 조사대상자의 ADL에 대한 기능장애군의 분포는 45.6%로 나타났으며, IADL에 대한 기능장애군의 분포는 48.4%로 나타나 ADL보다 IADL에서의 기능장애 비율이 더 높았다. ADL과 IADL에서의 기능장애군에 속할 위험비는 여자보다 남자에서, 혼자 산다는 군보다 배우자나 자녀와 함께 산다는 군에서, 생활비조달을 자신이 한다는 군보다 자녀가 해 준다는 군에서, 의료보호군보다 건강보험군에서, 규칙적인 운동을 한다는 군보다 하지 않는다는 군에서, 외출을 자주 한다는 군보다 거의 하지 않는 다는 군에서, 취미활동을 자주 한다는 군보다 거의 하지 않는 다는 군에서, 주관적인 건강상태가 좋다는 군보다 좋지 않다는 군에서, 신체의 부자유가 없다는 군보다 있다는 군에서, 눈의 부자유가 없다는 군보다 있다는 군에서, 귀의 부자유가 없다는 군보다 있다는 군에서, 치아의 부자유가 없다는 군보다 있다는 군에서, 요실금이 없다는 군보다 있다는 군에서, 건망증이 없다는 군보다 있다는 군에서 유의하게 증가하였다. 결론적으로 재가급여인정노인들의 신체적 기능 상태는 ADL보다 IADL 기능이 더 감소되어 있었으며, ADL과 IADL 모두 인구사회학적 특성, 건강관련행위 특성 및 건강상태의 다양한 요인이 관련되어 있었다.

장기요양시설 노인들의 신체적 기능(ADL, IADL) 수준 및 관련요인 (Physical Function(ADL, IADL) and Related Factors in the Elderly People Institutionalized in Long-term Care Facilities)

  • 안권숙;박승경;조영채
    • 한국산학기술학회논문지
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    • 제17권3호
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    • pp.480-488
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    • 2016
  • 본 연구는 요양시설에 입소하여 생활하고 있는 노인들을 대상으로 ADL과 IADL을 측정하고 그에 관련된 요인을 검토하고자 실시하였다. 조사대상은 장기요양시설에 입소하여 장기요양급여를 받고 있는 노인 205명으로 하였으며, 조사는 2015년 6월 1일부터 7월 31일까지의 기간 동안에 면접조사를 통해 이루어 졌다. 연구결과, 전체 조사대상자의 ADL 수준은 $16.67{\pm}2.11$점(총득점 합계 범위: 6~18점)이었으며, IADL 수준은 $15.13{\pm}3.79$점(총득점 합계 범위: 7~21점)이었다. ADL에 관련된 요인으로는 배우자 유무, 외출 빈도, 주관적인 건강상태, 치아의 부자유 유무가 선정되었으며, IADL에 관련된 요인으로는 성별, 배우자 유무, 외출 빈도, 주관적인 건강상태, 신체의 부자유 유무, 건망증 유무가 선정되었다. 위와 같은 결과는 요양시설 입소 노인들의 신체적 기능은 인구사회학적 특성, 건강관련행위 및 건강상태 등 여러 요인들이 관련되어 있음을 시사한다.

드라이클리닝 근로자들의 유기용제 폭로와 자각증상 (Study on the Exposure Levels of Organic Solvents and Subjective Symptoms of Dry-cleaning Workers)

  • 김수영;김정윤;이연경;이석구;이영수;조영채;이태용;이동배
    • Journal of Preventive Medicine and Public Health
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    • 제31권4호
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    • pp.628-643
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    • 1998
  • To investigate the exposure levels of organic solvents and subjective symptoms of dry-cleaning workers, 77 male and 52 female dry-cleaning workers who had been worked in a small city of Chungnam province, and a large city, Taejon were selected for the study group. Air concentrations of organic solvents in the working environment were analyzed, and subjective symptoms of dry-cleaning workers were surveyed, from July to August 1996. The results obtained were as follows : 1. The concentrations of organic solvents in the working environment were within permissible TLV-TWA limits. 2. For the 13 symptom clusters, the most frequently complained symptom clusters were fatigue as 71.3%, and followed by depression and urinary disturbances as 53.5% and 51.9%. Other symptom clusters complained were below 50%. 3. Positive response rates of subjective symptoms were significantly higher in worker groups such as lived in a large city, female, higher education level, more frequently alcohol drinking, higher concentration of organic solvent in working environment, work in alone. 4. Workers who had used solvent B showed 2.3 point higher scores of subjective symptoms than those of solvent A. Of the subjective symptoms scores, amnesia and nervousness were higher in solvent B user group than solvent B user group. 5. As a result of factor analysis, 3 factors such as depression, urinary disturbance and neurologic disturbance were selected. 6. As a result of the logistic regression analysis, sex, the number of fellow workers, working time, region, job tenure, smoking, alcohol drinking, ventilating system, concentration of organic solvent in working environment and place of residence were selected for the related variables. For the conclusion, even though the concentrations of organic solvents in the working environments of dry-cleaning workers were within permissible limit of TLV-TWA, many dry-cleaning workers complained symptoms, such as fatigue, depression, urinary disturbances and so on. And the factors affecting to the symptoms of dry-cleaning workers were the number of fellow workers, work hours, region, job tenure, smoking and alcohol drinking.

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