• Title/Summary/Keyword: mental disorders

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Review of pediatric cerebrovascular accident in terms of insurance medicine (소아뇌졸중의 보험의학적 고찰)

  • Ahn, Gye-Hoon
    • The Journal of the Korean life insurance medical association
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    • v.29 no.2
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    • pp.29-32
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    • 2010
  • Moyamoya disease (MMD) is a progressive occlusive disease of the cerebral vasculature with particular involvement of the circle of Willis and the arteries that feed it. MMD is one of cerebrovacular accident,which is treated with sugical maeuver in pediatic neurosurgery. Moyamoya (ie, Japanese for "puff of smoke") characterizes the appearance on angiography of abnormal vascular collateral networks that develop adjacent to the stenotic vessels. The steno-occlusive areas are usually bilateral, but unilateral involvement does not exclude the diagnosis. The exact etiology of moyamoya disease is unknown. Some genetic predisposition is apparent because it is familial 10% of the time. The disease may be hereditary and multifactorial. It may occur by itself in a previously healthy individual. However, many disease states have been reported in association with moyamoya disease, including the following: 1) Immunological - Graves disease/thyrotoxicosis 2) Infections - Leptospirosis and tuberculosis 3) Hematologic disorders - Aplastic anemia, Fanconi anemia, sickle cell anemia, and lupus 4) Congenital syndromes - Apert syndrome, Down syndrome, Marfan syndrome, tuberous sclerosis, Turner syndrome, von Recklinghausen disease, and Hirschsprung disease 5) Vascular diseases - Atherosclerotic disease, coarctation of the aorta and fibromuscular dysplasia, 6)cranial trauma, radiation injury, parasellar tumors, and hypertension etc. These associations may not necessarily be causative but do warrant consideration due to impact on treatment.(Mainly neurosurgical operation.) The incidence of moyamoya disease is highest in Japan. The prevalence of MMD is 1 person per 100,000 population. The prevalence and incidence of moyamoya disease in Japan has been reported to be 3.16 cases and 0.35 case per 100,000 people, respectively. With regard to sex, the female-to-male ratio is 1.4:1. A bimodal peak of incidence is noted, with symptoms occurring either in the first decade(5-10yr) or in the third and fourth decades (30-40yr)of life. Mortality rates of moyamoya disease are approximately 10% in adults and 4.3% in children. Death is usually from hemorrhage. In aspect of life insurance, MR is 1700%, EDR is 16 per 1000 persons. Children and adults with moyamoya disease (MMD) may have different clinical presentations. The symptoms and clinical course vary widely from asymptomatic to transient events to severe neurologic deficits. Adults experience hemorrhage more commonly; cerebral ischemic events are more common in children. Children may have hemiparesis, monoparesis, sensory impairment, involuntary movements, headaches, dizziness, or seizures. Mental retardation or persistent neurologic deficits may be present. Adults may have symptoms and signs similar to those in children, but intraventricular, subarachnoid, or intracerebral hemorrhage of sudden onset is more common in adults. Recently increasing diagnosis of MMD with MRI, followed by surgical operation is noted. MMD needs to be considered as the "CI" state now in life insurance fields.

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Assessment of Cognitive Disorders in Alcoholics Using the 7 Minute Screening Battery (주정의존 환자에서 7분선별검사를 이용한 인지장애의 평가)

  • Cheon, Jin-Sook;Yoon, Han-Cheol;Lee, Kwang-Young;Oh, Byoung-Hoon
    • Korean Journal of Biological Psychiatry
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    • v.8 no.2
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    • pp.258-265
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    • 2001
  • Objectives : Chronic alcohol consumption has been known to result in various neurocognitive deficits. Many neuropsychological studies revealed that the major disturbances occurred in the executive function, learning and short-term memory, visuospatial performance function, perceptuo-motor skills, and abstraction and problem solving abilities. This study was done to identify which cognitive areas might be mainly affected. Methods : The cognitive disturbance was evaluated using the Korean Version of the Mini Mental State Examination(MMSEK) and the 7 Minute Screen(7MS) in male inpatients with alcohol dependence(N=3 : as well as in age and education level matched healthy male controls(N=30). Four individual tests of the 7MS were consisted of the Benton Temporal Orientation Test, the Enhanced Cued Recall, the Clock Drawing and the Category Fluency. Results : 1) The average scores of four individual test of the 7MS for the alcoholics were $2.77{\pm}4.38$ for the Benton Temporal Orientation Test, $13.90{\pm}2.02$ for the Memory Test(the Cued Recall $6.77{\pm}1.94$, the Uncued Recall $7.10{\pm}2.45$), $5.84{\pm}1.86$ for the Clock Drawing, and $12.58{\pm}3.29$ for the Category Fluency. Except the Benton Temporal Orientation Test, there were statistically significant differences between test scores of alcoholics and those of controls(p<0.01). 2) The alcoholics who had MMSE-K score <24 were 9.68%. The average(${\pm}S.D.$) score of the MMSE-K for the patient group($27.23{\pm}2.62$) was significantly(p<0.001) lower than that of the healthy controls($29.20{\pm}1.24$). There were no statistically significant differences between four individual test scores of the 7MS of alcoholics with the MMSE-K score <24(N=3) and those of alcoholics with the MMSE-K score ${\geq}24$(N=28). 3) Four individual test scores of the 7MS seemed to have statistically significant association with such variables as MMSE-K, duration of alcohol drinking, blood magnesium concentration, liver function and thyroid function. Conclusion : Mild deficits of cognitive areas such as orientation, memory, visuospatial abilities and verbal fluency could be found in alcohol dependence.

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A Classification Method of Delirium Patients Using Local Covering-Based Rule Acquisition Approach with Rough Lower Approximation (러프 하한 근사를 갖는 로컬 커버링 기반 규칙 획득 기법을 이용한 섬망 환자의 분류 방법)

  • Son, Chang Sik;Kang, Won Seok;Lee, Jong Ha;Moon, Kyoung Ja
    • KIPS Transactions on Software and Data Engineering
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    • v.9 no.4
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    • pp.137-144
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    • 2020
  • Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

One Case of Combination Therapy of Acupuncture, Herbal medication and Thought Field Therapy on Hysterical Aphonia lasting for 1 year (1년 이상 지속된 히스테리성 실성증(失聲症)의 사고장요법(Thought Field Therapy)과 한방요법 병행치료 1례)

  • Park, Jong-Hoon;Cho, Sung-Hoon;Chung, Sun-Yong;Hwang, Ui-Wan;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.2
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    • pp.183-189
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    • 2003
  • Hysterical aphonia is one of the frequent symptoms in conversion disorders. If it has a recent onset, a manifest induced factor, and a good premorbid adaptation, and another mental disorder is not accompanied, its prognosis is good. We report one case of hysterical aphonia that was bad prognosis. This patient was suffering traumatic event before and after onset, and major depressive disorder was accompanied. Having hysterical aphonia, the patient who had no progress after over an years medicine therapy and often felt strong suicidal urge, was successfully treated by TFT(Thought field therapy) and oriental medicine therapy. Several case studies on hypnotic cure of hysterical aphonia has been reported but they are uncommon internally and have good prognosis. In addition, there were no relevant studies concerning alternative therapy and oriental medication. Our case report is focused on treatment through these methods.

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Review of Recent Clinical Trials for Depression in Traditional Chinese Medicine-Based on Randomized Controlled Trials and Systematic Reviews- (우울증 치료의 중의학 최신 임상연구 동향-무작위 대조군 임상연구와 체계적 문헌 고찰을 중심으로-)

  • Woo, Jeong A;Nam, Yu Jin;Park, Yoon Jin;Kwon, Young Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.6
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    • pp.458-466
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    • 2015
  • The purpose of this study was to review the research on treating depression in Traditional Chinese Medicine(TCM) over the last 5 years to set the foundation for further studies. We searched for and analyzed articles about depression in CNKI(China National Knowledge Infrastructure) from January 2010 to December 2014. The results were as follows : The most frequently used diagnostic criteria was CCMD-3(The Chinese Classification of Mental Disorders-3), and the most used evaluation criteria was HAMD(Hamilton Depression Rating Scale). Prescription of decoction of medical herbs was most frequently used as a therapeutic method. Acupuncture, traditional Chinese psychotherapy, and music therapy were also used for some studies. The most frequent TCM Syndrome Differentiation Type was stagnation of liver-QI. For decoction of Chinese herbs, Soyo-san(Xiaoyao-san) and Sihosogan-san(Chaihushugan-san) were most often prescribed, and Bupleuri Radix, Paeoniae Radix Alba, Curcumae Radix, Poria cocos wolf, Angelicae Gigantis Radix, Atractylodis Rhizoma Alba were mainly used for medical herbs. BaekHoi(GV20) and Yindang(Ex-HN3) were often used as acupuncture sites. Post-Stroke Depression was the most common case of intercurrent or secondary depression. According to the Jadad Quality Assessment Scale, the quality of the reports was not high as most of the reports had a score of 3 or below. Most systematic reviews on depression were conducted by Chinese researchers. The problem with Clinical research on depression, according to those reviews, was that there were no standardized criteria for the diagnosis and treatment and the trials were usually not randomized nor controlled. We found out there are various clinical methods for treating depression in TCM, and hope that this research could provide the preliminary data for designing and conducting clinical trials for depression.

Clinical Characteristics of Panic Disorder Patients in Korean University Hospital : A Multi-Center, Retrospective Study (국내 대학병원 공황장애 환자들의 임상적 특징에 대한 연구 : 다기관, 후향적 연구)

  • Oh, Jae-Young;Lee, Jae-Hon;Han, Sang-Woo;Chee, Ik-Seung;Koo, Bon Hoon;Woo, Jong Min;Yang, Jong-Chul;Gim, Min-Sook;Lee, Sang Hyuk;Heo, Jung-Yoon;Yu, Bum-Hee
    • Anxiety and mood
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    • v.10 no.1
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    • pp.11-16
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    • 2014
  • Objective : Despite the high prevalence and clinical importance of panic disorder, studies on the clinical characteristics and course of panic disorder are relatively rare. This study is a multi-center, and retrospective study to examine the clinical characteristics and course of Korean panic disorder patients who visit university hospital. Methods : The study subjects were panic disorder patients who had visited the psychiatric outpatient clinics of 8 university hospitals in South Korea from January to December in 2008. Finally, 238 panic patients were included in this study. Their medical charts were retrospectively reviewed and reassessed by experienced psychiatrists to examine their clinical characteristics, demographic data and clinical course in repose to pharmacotherapy. Results : Among the 238 patients (121 males vs. 117 females), the mean age of disease onset was $41.3{\pm}12.7$ years and female patients showed 5 years older age of disease onset, compared with male patients. The mean score of PSR scale was $4.5{\pm}1.0$ at the first visit, reflecting a 'marked' level of severity of illness and impairment in functioning. Only 110 patients (46.4%) completed the whole follow up visits, whereas 128 patients (53.6%) dropped out during the treatment. After $17.7{\pm}0.5$ months of mean follow up period, the mean score of PSR scale at the last visit was reduced into $2.1{\pm}0.9$, reflecting a 'residual' severity of illness and impairment in functioning. The cumulative recovery rate was 62.1% in the completer group, whereas that of the drop-out group was 47.7%. Conclusions : The mean age of disease onset in Korean panic disorder patients who had visited university hospital was about 10 years older than that of Western panic disorder patients in previous studies, and the Korean panic disorder patients who had visited university hospital showed a relatively higher cumulative recovery rate. These differences might result from an ethnic difference in clinical characteristics and course in response to pharmacotherapy of panic disorder.

The effect of antipsychotics and antidepressants on the TREK2 channel (TREK2 채널에 대한 항정신성약물 및 항우울제의 효과)

  • Kwak, Ji-Yeon;Kim, Yang-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.5
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    • pp.2125-2132
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    • 2012
  • Fluoxetine and tianeptine are commonly used as antidepressants (AD), and haloperidol and risperidone are widely used as antipsychotic drugs (APD), and it modulates various ion channels. TREK2 channel subfamily is very similar to physiological properties of TREK1 channel which can play important roles in the pathophysiology of mental disorders such as depression and schizophrenia, therefore, the pharmacological effect of psychiatric and depression drug on TREK2 channel may be similar to those of TREK1. Using the excised inside-out patch-clamp technique, we have examined the effects of APD and AD on cloned TREK2 channel expressed CHO cells. Fluoxetine (selective serotonin release inhibitor, SSRI) inhibited the TREK2 channel in a concentration-dependent manner ($IC_{50}$ $13{\mu}M$), whereas selective serotonin reuptake enhancer (SSRE) tianeptine increased without reducing the TREK2 channel activity. Haloperidol also inhibited the TREK2 channel in a concentration-dependent manner ($IC_{50}$ $44{\mu}M$), whereas even higher concentration ($100{\mu}M$) of risperidone did not completely inhibit on the activity. This study showed that TREK2 channel was preferentially blocked by fluoxetine rather than tianeptine, and inhibited by haloperidol rather than risperidone, suggesting differential effect of TREK2 channels by APD and AD may contribute to some mechanism of adverse side effects.

THE DENIAL MANAGEMENT OF SELF-INFLICTED ORAL MUTILATION (자해로 인한 구강내 손상의 치과적 조절 : 증례 보고)

  • Lee, Sang-Ik;Kim, Young-Jae;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.244-250
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    • 2005
  • Self-injurious behavior is defined as deliberated harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, body hitting, skin cutting, or finger biting and includes ocular, genital, and self-inflicted oral mutilation. Self-injurious behavior can occur with mental retardation, coma, psychotic problem, poisoning, or character disorders. In pediatric patients, self-injurious behavior usually is reported to lip, cheek and tongue biting, and many kinds of dental management methods have been introduced to prevent self-injurious behavior patients from self biting. This report presents two self-inflicted oral mutilation patients who were all treated successfully with appliances such as modified activator without wire for retention, modified tongue-rake appliance and mouth guard.

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A Systematic Review on Sensory Integration Intervention in Korea: Focusing on Ayres Sensory Integration (ASI) (국내 감각통합치료 중재에 관한 체계적 고찰 - Ayres의 감각통합중재(ASI)를 중심으로)

  • Jung, Hyerim;Choi, Yeon-Woo;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.11 no.2
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    • pp.27-40
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    • 2013
  • Objective : The aim of this study was to investigate how many studies for sensory integration intervention in Korea reflect the principle of Ayers' sensory integration through a systemic review. Methods : The systemic review was executes using RISS, NDSL, KISS, DBpia. The key words for search were 'sensory integration therapy', 'sensory integration intervention', 'sensory integration program', 'sensory integration training' to search the articles, published in 2000-2012. To analyze ASI fidelity of 49 studies included in the present study, the numbers of items were calculated if the study describe the ASI principle. Results : The IV was the most levels of evidence, and the subjects for the studies were mental intellectual disability (15), developmental disability (14) and autism spectrum disorders (13) etc. It was described the most that presenting sensory opportunities (43), challenging postural, ocular, oral and/or bilateral motor control (37) of ASI fidelity. The studies using more than 4 ASI principle were 26.5%(13), and 7 studies using 8 or more than 8 were studied in OT. Conclusion : In OT, 34 of 49 studies performed, and they used several principles of ASI. To have unity for sensory integration principle and to improve therapy professionalism the study using various data and systematic review study will be needed in the future.

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An Oriental Medical Study on the Anorexia An Emphasis on the Etiology and Pathology of the Anorexia (식욕부진(食慾不振)에 대(對)한 한의학적(韓醫學的) 고찰(考察) - 병인병리(病因病理)를 중심(中心)으로 -)

  • Choi, Su-Deock;Won, Jin-Hee
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.194-210
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    • 1998
  • The main purpose of this work is the study on the etiology and pathology of the anorexia in oriental and western medicine. An appetite is stimulated by the need of supply of nutrition for life and the physical desire of hunger which appeared as the alternative of taste. In this paper, I investigated the anatomical and the physiological function system, the Piwei functional system and meridian distribution, and the differentiation of the disease according to the Zangfu(internal organs) in association with the anorexia. And conclusion could be summarized as follows : 1. The tongue, one of the Piwei functional system(脾胃機能系), is connected with Pi(脾), Xin(心), Gan(肝) and Shen(腎) meridian. Especially Pi and Xin meridian have the close relations with taste. 2. The appetite has the close relations with Piwei. The appetite and digestion is influenced by the function of smoothing and regulating and bloodflow of Ki(肝主疏泄), warming the Shen to activate the function of Pi(腎主溫養), cleansing the inspired air and keeping the Ki flowing downward(肺主肅降). 3. The cause of anorexia is the insufficiency of Ki of Piwei(脾胃氣虛), the attack of Wei by hyperactive Gan Ki(脾氣犯胃), the insufficiency of Wei Yin(胃陰不足), the declination of the fire from the vital gate(命門火衰) and the retention or stagnancy of undigested food (飮食停滯). Especially, the main cause of anorexia is the insufficiency of Ki of the Piwei(脾胃氣虛). 4. Recently the attack of Wei by hyperactive Gan Ki(脾氣犯胃) is raised by the main cause of anorexia. 5. The mental function of anorexia, which is induced by the unbalance of Pi, is directly associated with Xin(心) and Xin meridia(心經). 6. The goal of the treatment of the anorexia is dependent on the recovery of the weakness of the Pi. And for this goal, the disorders of the other organs is also treated. 7. In the point of the anatomy and physiology, the main cause of anorexia is the loss of function of the autonomic nerve system and the vagus nerve.

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