• 제목/요약/키워드: structural disorder

검색결과 172건 처리시간 0.028초

ADHD 아동 어머니의 삶의 질 구조모형 (A Structural Equation Model on Quality of Life of Mothers of Children with Attention Deficit Hyperactivity Disorder)

  • 박찬경;전미양
    • Child Health Nursing Research
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    • 제23권3호
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    • pp.279-291
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    • 2017
  • Purpose: The aim of this study was to explore how characteristics of ADHD children affect social support for mothers, parenting stress, parenting sense of competence, coping, and quality of life. The conceptual model was based on the Lazarus and Folkman's stress-evaluation-coping theory. Methods: Data were collected 208 mothers of children with ADHD. Data were analysed using SPSS 18.0 and AMOS 18.0 programs. Results: The proposed model was good fit for the data based on the model fit indices. Parenting stress, parenting sense of competence and coping directly affected quality of life but characteristics of the children and social support had only an indirect effect. The explanatory power of these variables was 52.1%. Conclusion: The results of this study indicate that nursing strategies to increase social support for mothers with ADHD children, lowers parenting stress, improves parenting sense of competence, and guides the parents to choose appropriate coping. In particular, as social support has the strongest influence on the quality of life, it is necessary to develop nursing intervention programs that utilize social support for parents with ADHD children.

Morphologic Alterations in Amygdala Subregions of Adult Patients with Bipolar Disorder

  • Lee, Hyun-Jae;Han, Kyu-Man;Kim, Aram;Kang, Wooyoung;Kang, Youbin;Kang, June;Won, Eunsoo;Tae, Woo-Suk;Ham, Byung-Joo
    • 생물정신의학
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    • 제26권1호
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    • pp.22-31
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    • 2019
  • Objectives Previous studies have revealed inconsistent results on amygdala volume in adult bipolar disorder (BD) patients compared to healthy controls (HC). Since the amygdala encompasses multiple subregions, the subtle volume changes in each amygdala nucleus might have not been fully reflected in the measure of the total amygdala volume, causing discrepant results. Thus, we aimed to investigate volume changes in each amygdala subregion and their association with subtypes of BD, lithium use and clinical status of BD. Methods Fifty-five BD patients and 55 HC underwent T1-weighted structural magnetic resonance imaging. We analyzed volumes of the whole amygdala and each amygdala subregion, including the anterior amygdaloid area, cortico-amygdaloid transition area, basal, lateral, accessory basal, central, cortical, medial and paralaminar nuclei using the atlas in the FreeSurfer. The volume difference was analyzed using a one-way analysis of covariance with individual volumes as dependent variables, and age, sex, and total intracranial volume as covariates. Results The volumes of whole right amygdala and subregions including basal nucleus, accessory basal nucleus, anterior amygdaloid area, and cortico-amygdaloid transition area in the right amygdala of BD patients were significantly smaller for the HC group. No significant volume difference between bipolar I disorder and bipolar II disorder was found after the Bonferroni correction. The trend of larger volume in medial nucleus with lithium treatment was not significant after the Bonferroni correction. No significant correlation between illness duration and amygdala volume, and insignificant negative correlation were found between right central nucleus volume and depression severity. Conclusions Significant volume decrements of the whole amygdala, basal nucleus, accessory basal nucleus, anterior amygdaloid area, and cortico-amygdaloid transition area were found in the right hemisphere in adult BD patients, compared to HC group. We postulate that such volume changes are associated with altered functional activity and connectivity of amygdala nuclei in BD.

제1형 양극성장애 환자에서 대뇌피질 주름 패턴의 변형 : Local Gyrification Index 분석 (Alterations of Cortical Folding Patterns in Patients with Bipolar I Disorder : Analysis of Local Gyrification Index)

  • 이준용;한규만;원은수;이민수;함병주
    • 생물정신의학
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    • 제24권4호
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    • pp.225-234
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    • 2017
  • Objectives Local gyrification reflects the early neural development of cortical connectivity, and is regarded as a potential neural endophenotype in psychiatric disorders. Several studies have suggested altered local gyrification in patients with bipolar I disorder (BD-I). The purpose of the present study was to investigate the alterations in the cortical gyrification of whole brain cortices in patients with BD-I. Methods Twenty-two patients with BD-I and age and sex-matched 22 healthy controls (HC) were included in this study. All participants underwent T1-weighted structural magnetic resonance imaging (MRI). The local gyrification index (LGI) of 66 cortical regions were analyzed using the FreeSurfer (Athinoula A. Martinos Center for Biomedical Imaging). One-way analysis of covariance (ANCOVA) was used to analyze the difference of LGI values between two groups adjusting for age and sex as covariates. Results The patients with BD-I showed significant hypogyria in the left pars opercularis (uncorrected-p = 0.049), the left rostral anterior cingulate gyrus (uncorrected-p = 0.012), the left caudal anterior cingulate gyrus (uncorrected-p = 0.033). However, these findings were not significant after applying the multiple comparison correction. Severity or duration of illness were not significantly correlated with LGI in the patients with BD-I. Conclusions Our results of lower LGI in the anterior cingulate cortex and the ventrolateral prefrontal cortex in the BD-I group implicate that altered cortical gyrification in neural circuits involved in emotion-processing may contribute to pathophysiology of BD-I.

외상 후 스트레스 장애의 신경기반 : 부적점화과제와 기능자기공명영상 연구 (Neural Substrates of Posttraumatic Stress Disorder : Functional Magnetic Resonance Imaging Study Using Negative Priming Task)

  • 이병택;유정;이동훈;손명호;강내희;함병주;최남희
    • 생물정신의학
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    • 제15권2호
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    • pp.110-117
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    • 2008
  • Objectives : Posttraumatic stress disorder(PTSD) has been primarily associated with emotional problems. Recently, however, the impact of PTSD on cognitive processes has interested a growing number of researchers. The current study is aimed at investigating the cognitive aspects of PTSD at both behavioral and neurological levels. Methods : We recruited individuals with PTSD who survived the Daegu subway explosion in 2003 as well as non-PTSD individuals as a control group. To evaluate the inhibitory processes and the neural mechanisms, we had these individuals perform the negative priming task simultaneously with functional MRI scanning. Results : Behaviorally, the negative priming effect was intact in the control group but was not evident in the PTSD group. In the imaging results, only the PTSD group showed the negative priming effect (i.e., increased activation of the negative priming condition as opposed to the neutral condition) in the dorsolateral prefrontal cortex, anterior cingulate cortex, and inferior temporal gyrus. The PTSD group also showed increased activity for the positive priming condition as opposed to the neutral condition in the claustrum. These results confirm and extend the previous findings that the integrity of the ACC is compromised in the trauma survivors due to disrupted white matter tract. Conclusions : The current results suggest that deteriorated performance of the PTSD group may be due to the functional problem as well as the structural abnormalities.

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소아(小兒) stress에 관한 문헌적(文獻的) 고찰(考察) (A study on stress in Children)

  • 김기봉;김장현
    • 대한한방소아과학회지
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    • 제16권1호
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    • pp.105-124
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    • 2002
  • With the progress of civilization, the disorders due to the stress, which derived from the social-structural complexity and diversity, are on an increasing trend in our times. Accordingly, the accurate diagnosis and appropriate treatment for them are required. Especially in the current years, children's disorders delivered by the emotional problems keep increasing. In this research, the researcher tried to figure out the cause of the children's stress and its treatment, studied the theories of the stress in the modem medicine and the sever emotions in oriental medicine, and came to the conclusion as follows: 1. The stress can be defined as the combination of the reaction to noxious stimuli and its defense mechanism of the body, In oriental medicine, it is considered as pathological notions which includes seven emotions as the internal factor, six evils as the external factor and other foods, expectoration, ecchymoma as the non-internal/external factors. 2. Children usually get stressed by various reasons in a growth process such as schooling, relationship with friends, the opposite sex of family, or change of surroundings, and these can cause the various disorders. 3. In the study of the children's stress symptoms, it is found that the silent reaction is uncommon. It usually appeared in both reactions: firs, physical reactions such as stomachache, vomiting, headache, neural frequent urination, bronchial asthma or excessive respiration and/or, second, behavioral reactions such as a decline of performance, alimentary disorder, e.g. anorexia nervosa or bulimia, sleep disorder, e.g. nightmare or panic in sleep, anthrophobia, refusal to a school attendance or hyperactiveness. Besides, the peculiar mental disorder such as paroxysm of anger, tic, autism, nocturnal enuresis, lack of attentiveness, impediment in linguistic development, learning difficulty, intellectual decline, etc. can be appeared, and the heavy stress during the babyhood can cause the regression of behavior or the immaturity of formation of character. 4. The appropriate treatments for the children's stress are Osteopathy, Manpulation, Aroma Therapy, Alexander Technique, Autonomic Never Control Treatment, Biofeedback, Chiropractic, Dance Therapy, Feldenkrasis Technique, Gravity Therapy, Homepathy, Aquatherapy, Hypnotherapy, Naturopathy and Meditation.

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CPTED 사업으로 인한 근린의 물리적 환경변화가 빈곤지역 주민들의 범죄두려움과 동네만족도, 동네애착 형성에 미치는 영향 - 부산 사하구 감천2동을 대상으로 - (The Effects of Neighborhood Physical Changes caused by CPTED Project on Resident's Fear of Crime, Neighborhood Satisfaction, and Neighborhood Attachment in the Poverty Area - Focused on the Gamcheon 2-dong, Saha-gu, Busan -)

  • 박주현;이경환
    • 대한건축학회논문집:계획계
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    • 제36권1호
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    • pp.105-111
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    • 2020
  • The purpose of this study was to empirically analyze the effects of physical environment change on the Crime Prevention Through Environmental Design (CPTED) project implemented in Gamcheon 2 Dong on the fear of crime, neighborhood satisfaction, and neighborhood attachment in the poor. In this study, the data collected through field surveys and questionnaires were analyzed using a structural equation model, specifically the SPSS AMOS 25 program. From the results of the analysis, it was found that the neighborhood satisfaction was enhanced by the improvement in the walking environment and the reduction in the neighborhood disorder level of the target area through the installation of major CPTED facilities. The results of the statistical analysis show that the reduction in the neighborhood disorder due to the CPTED project enhanced the neighborhood satisfaction and the level of neighborhood attachment in the local residents. In addition, the changes in the walking environment caused by the CPTED project had a positive effect on the neighborhood satisfaction, and as the degree of neighborhood disorder decreased, the neighborhood satisfaction increased and the local people's attachment level increased.

Disrupted Association Between Empathy and Brain Structure in Attention-Deficit/Hyperactivity Disorder

  • Lee, Jeonghwan;Son, Jung-Woo;Kim, Siekyeong;Kim, Ji-eun;Chung, Seungwon;Ghim, Hei-Rhee;Lee, Sang-Ick;Shin, Chul-Jin;Ju, Gawon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제32권4호
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    • pp.129-136
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    • 2021
  • Objectives: To investigate the relationship between brain structure and empathy in early adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods: Nineteen early adolescents with ADHD and 20 healthy controls underwent 3T MRI. All the participants were assessed for different aspects of empathy using measures including the Interpersonal Reactivity Index and Empathy Quotient. Cortical thickness and subcortical structural volume based on T1-weighted scans were analyzed using FreeSurfer. Results: Cognitive empathy (t=-2.52, p=0.016) and perspective taking (t=-2.10, p=0.043) were impaired in the ADHD group compared with the control group. The cluster encompassing the left posterior insular, supramarginal, and transverse temporal cortices [cluster-wise p-value (CWP)=0.001], which are associated with emotional empathy, was significantly smaller in the ADHD group, and the volume of the left nucleus accumbens was greater than that of the control group (F=10.12, p=0.003, effect size=0.22). In the control group, the left superior temporal (CWP=0.002) and lingual cortical (CWP=0.035) thicknesses were positively associated with cognitive empathy, while the right amygdala volume was positively associated with empathic concern (Coef=14.26, t=3.92, p=0.001). However, there was no significant correlation between empathy and brain structure in the ADHD group. Conclusion: The ADHD group had a smaller volume of the cortical area associated with emotional empathy than the control group, and there was no brain region showing significant correlation with empathy, unlike in the control group.

자폐장애 아동의 뇌자기공명영상 소견 (MAGNETIC RESONANCE IMAGING FINDINGS OF THE BRAIN IN AUTISTIC CHILDREN)

  • 박필상;정철호;최상용
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제8권1호
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    • pp.113-122
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    • 1997
  • 자폐장애아동들에서 기질적 원인 규명의 일환으로 뇌자기공명촬영 소견의 이상유무를 알아보기 위함이다. 1991년 4월부터 1996년 3월까지 계명대학교 동산의료원 정신과 외래를 방문한 자폐장애 아동에서 뇌자기공명촬영이 시행되었던 환아중 경련성 질환이나 선천성 질환이 동반된 경우를 제외한 22명의 남자 환아군을 선택하고 계명대학교 동산의료원의 타과의 입원 또는 외래치료를 받았던 비자폐장애 아동중 자기공명촬영 소견이 정상인 17명을 대조군으로 하여 뇌자기 공명촬영상 뇌의 각 구조를 정량적으로 측정하여 t-test로 비교분석하였다. 현재까지 자폐장애아동에서 이상소견이 많이 나타나는 것으로 보고된 정중시상단면과 횡단면에서의 제4뇌실의 크기, 뇌교의 크기를 측정하고 소뇌의 크기, 후두와의 소뇌의 비율을 측정하고 그 외 대뇌의 각 구조와 전체 대뇌와의 크기의 비율을 측정했다. 구조물의 측정법은 선상측정법을 사용했으며 자기공명촬영기는 본원의 GoldStar Spectro 2000 초전도 자기공명영상 단층촬영기를 사용했다. 대조군과 비교하여 자폐장애 아동에서의 소견은 다음과 같다. 1) 우측 측뇌실에 대한 좌측 측뇌실의 비율(La/Ra)이 증가되었다. 2) 후두와에 대한 뇌교의 비율(m/j)이 증가되었다. 3) 후두와에 대한 소뇌의 비율(o/p)이 감소되었다. 자폐장애 아동에서 전두엽, 뇌교 그리고 소뇌 부위에서의 기질적인 이상이 있을 가능성을 시사한다.

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주요우울장애 환자에서 소뇌 국소 부위의 부피와 피질 두께의 차이 (Changes in the Volume and Cortical Thickness of the Specific Regions of Cerebellum of Patients with Major Depressive Disorder)

  • 강지원;한규만;원은수;태우석;함병주
    • 생물정신의학
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    • 제25권3호
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    • pp.60-71
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    • 2018
  • Objectives A growing body of evidence has suggested that morphologic changes in cerebellum may be implicated with pathophysiology of major depressive disorder (MDD). The aim of this study is to investigate a difference in the volume and cortical thickness of the specific region of cerebellum between patients with MDD and healthy controls (HC). Methods A total of 127 patients with MDD and 105 HC participated in this study and underwent T1-weighted structural magnetic resonance imaging. We analyzed volume and cortical thickness of each twelve cerebellum regions divided by left and right and the volume and cortical thickness of the whole cerebellum from T1-weigted image of participants. One-way analysis of covariance was used to investigate the volume and cortical thickness difference of total and specific regions between two groups adjusting for age, gender, medication, and total intracranial cavity volume. Results We found that the patients with MDD had significantly greater volume in the left cerebellum lobule III region [false discovery rate (FDR)-corrected p = 0.034] compared to HC. Also, our findings indicate that cortical thickness of left lobule VIIB (FDR-corrected p = 0.032) and lobule VIIIB (FDR-corrected p = 0.032) are significantly thinner in the patients with MDD compared with the HC. No significant volume and cortical thickness differences were observed in other sub-regions of the cerebellum. The volumes and cortical thickness of whole cerebellum between patients with MDD and HC did not differ significantly. Conclusions We observed the region-specific volume and cortical thickness difference in cerebellum between the patients with MDD and HC. The results of our study implicate that the information about structural alterations in cerebellum with further replicative studies might provide a stepping stone toward a specific marker to diagnose MDD.

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인두 이물감 환자의 식도 운동성 장애 (ESOPHAGEAL DYSMOTILITY IN PATIENTS WITH GLOBUS SENSATION)

  • 이흥만;오승철;이우섭;김경현;최건;박영태
    • 대한기관식도과학회지
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    • 제2권2호
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    • pp.232-237
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    • 1996
  • Burning and lump sensation in the throat is a common disorder in middle aged woman. It is generally considered to be a neurotic origin but its pathophysiology is still remained unknown. The purpose of this study was to evaluate the prevalence of the Pharyngoesophageal structural lesions and the esophageal motility disorders among the patients with globus pharyngeus and to elucidate whether any specific manometric abnormality might have any causative role in the pathogenesis of the globus sensation, and we also wanted to know whether such tests were necessary in evaluating those patients. Structural lesions were demonstrated in 21 cases(17.5 %) among 120 patients. But among 44 controls, there were also Two cases(4.5 %) of structural lesions, and there was less significantly difference in the prevalence of the structural lesions between the patients and controls(p=0.0625) Manometric abnormalities over the lower esophageal sphincter and the lower esophageal body were demonstrated in 28 cases (23.3 %) of the patients, while only one case (2.3 %) of the controls revealed such abnormality ( p=0.0037). Various manometric parameters of the upper esophageal sphincter and pharynx showed no difference between the patients and controls except the upper esophageal sphincter pressure at lateral sides which was lower in patients than in controls (p=0.0034). Globus sensation is a kind of symptom of esophageal dysmotility, and esophageal manometry is necessary to detect such abnormality in patients with globus sensation, Careful physical examination is also necessary to detect structural lesions in the pharynx and esophagus.

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