• Title/Summary/Keyword: 자해

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PREVENTION OF SELF-MUTILATION IN PATIENT WITH LESCH-NYHAN SYNDROME: A CASE REPORT (Lesch-Nyhan 증후군 환아의 자해 예방)

  • Lee, Ji-Hyun;Kim, Ji-Hoon;Kim, Jae-Moon;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.306-311
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    • 2005
  • Lesch-Nyhan syndrome is a rare disorder of purine metabolism, first described in 1964. The incidence is estimated to be 1:100,000 birth. It is an X-linked recessive disorder in which affected males have a virtually complete deficiency of the enzyme hypoxanthine guanine phosphorybosyl transferase(HGPT). This enzyme deficiency gives rise to excessive uric acid production and consequent hyperuricemia. Lesch-Nyhan syndrome is clinically characterized by mental retardation, choreoathetosis, spastic cerebral palsy, and severe self-mutilation behavior. Patient with Lesch-Nyhan syndrome mostly bite their lip, tongue and finger. In severe cases, partial or total amputation of the lip and tongue is common. Self-inflicted bites are often further complicated by secondary infection to injuried site as well as pain. And tissue loss by biting results in esthetic problems. This report presents a Lesch-Nyhan syndrome patient with self-mutilation, who have a destruction of perioral tissue, especially the lower lip. He was treated successfully with soft mouthguard, psychological and pharmacological method.

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Factors Influencing of Smartphone Addiction among University Freshmen (대학신입생의 스마트폰 중독에 미치는 영향요인)

  • Gang, Moon-Hee;Oh, Eun-Jin;Kim, Seon-Hee;Park, Hyeok-Gyu
    • The Journal of the Korea Contents Association
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    • v.20 no.10
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    • pp.488-495
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    • 2020
  • The purpose of the study was to identify the associated factors on the smartphone addiction of university freshmen. Collected data were analyzed with SPSS 26.0 using t-test, Pearson's correlation coefficients and logistic regression. Depression and anxiety was statistically significant. As a result of the multiple regression I. the factors affecting were self-injury attempt experience, gender. The results of regression model II with depression and anxiety were depression and gender. It is intended to present the necessity of a program related to predicting smartphone addiction of university freshmen.

Semi-Fixed Lip Bumper in Lesch-Nyhan Syndrome: An Interim Treatment Modality (반 고정식 립 범퍼를 이용한 Lesch-Nyhan 증후군 환아의 자해습관 차단)

  • Lee, Junhee;Lee, Eungyung;Shin, Jonghyun;Kim, Shin;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.1
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    • pp.93-98
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    • 2020
  • Lesch-Nyhan syndrome is a rare X-linked, recessively inherited disorder of purine metabolism, caused by complete absence of the enzyme hypoxanthine-guanine phosphoribosyl transferase. This syndrome is characterized by 3 major features: neurological dysfunction, hyperuricemia, and cognitive and behavioral disturbances (e.g., self-mutilation, which begins at 2 to 3 years of age). Uncontrollable self-mutilation begins with biting of the perioral tissues and extends into patterns such as finger biting and head hitting. This report describes the case of a 31-month-old boy who was diagnosed with Lesch-Nyhan syndrome with severe lip injuries caused by self-mutilative behaviors. The behaviors were blocked with a semi-fixed lip bumper for a short period. The device was applied to the patient on the day of the visit without the requirement for an oral impression. It was easy to manage oral hygiene and adjust the device because it was detachable by clinicians and guardians. Therefore, a semi-fixed lip bumper may be useful as an interim appliance to block selfmutilative behaviors in children with Lesch-Nyhan syndrome.

MANAGEMENT OF LESCH-NYHAN SYNDROME PATIENTS WITH SELF-MUTILATION BEHAVIOR USING THEIR TEETH : CASE REPORTS (레쉬니한 증후군(Lesch-Nyhan syndrome) 환자의 치아와 연관된 자해행동의 관리: 증례보고)

  • Lee, Ji-Mi;Lee, Sang-Ho;Lee, Nan-Young;Jih, Myeong-Kwan
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.14 no.2
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    • pp.97-101
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    • 2018
  • Lesch-Nyhan syndrome is a rare X-linked recessive genetic disorder. During purine metabolism, the hypoxanthine guanine phosphribosyl transferase (HGPRT) enzyme is deficient causing phosphoribosyl transferase to accumulate and resulting in excessive uric acid. Clinical symptoms include hypercalcemia, choreoathetosis, spasticity, mental retardation, and self-injury to lips, tongue or fingers. This results not only in pain caused by the self-injury but also secondary infection of the wound site and the esthetic damage of the soft tissue defect. Dental treatments include conservative methods using intraoral appliances such as soft mouthguards, fixed lip bumpers, and occlusal guards, and invasive methods such as extraction of all teeth or forming an artificial anterior open bite. We report two cases of Lesch-Nyhan syndrome patients with self-mutilation behavior; one was treated with a preservative method using a soft mouthguard, and the other was treated with extraction of all teeth.

Psychological Characteristics of Psychiatric outpatients with High Suicide Risk : Using MMPI-2-RF (정신건강의학과 외래 환자 중 자살 고위험 집단의 심리적 특성 : MMPI-2-RF를 이용하여)

  • Nam, Jisoo;Kim, Daeho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.8-19
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    • 2020
  • Objectives : The purpose of this study was to examine whether the MMPI-2-RF serves as a useful tool to differentiate between the subtypes of high risk of suicide among psychiatric outpatients. Methods : Patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. Their medical records were reviewed retrospectively. And participants were put into 4 groups (Suicide ideation, Suicide attempt, Non-suicidal self-injury, and general psychiatric diagnosis as a control group). For statistical comparison, the MANCOVA with gender as a covariate was used. Results : The results indicated that as previous research with non-clinical sample suggested, psychiatric outpatients with high suicide risk also have significantly higher Emotional/Internalizing Dysfunction, Helplessness/Hopelessness, Suicidal/Death Ideation, Demoralization, Cognitive complaints, Cynicism, Dysfunctional negative thoughts than general psychiatric patients group. But group differences within the high suicide risk patients have not been observed. However, suicide attempt group and NSSI group has higher Behavioral/Externalizing Dysfunction, RC4, AGG than general psychiatric patients group. But there was no difference between suicidal idea group and general psychiatric patients group. Conclusions : There was no group difference observed between all three subtypes, which mean the MMPI2-RF may not be the useful diagnostic tool to navigate high suicide risk subtypes. Even though there was no difference observed in the suicide ideation group, suicide attempt group and NSSI group have higher aggression and externalization. So those indexes could serve as a useful marker to investigate riskiness of suicide related symptoms.

TREATMENT OF SELF-INJURIOUS LIP BITING WITH POSTERIOR BITE BLOCK APPLIANCE IN A BRAIN LESION PATIENT (교합 거상판을 이용한 뇌병변장애 환아의 자해성 구강 손상의 치료)

  • Jun, Hyelim;Song, Je-Seon;Lee, Jae-Ho;Lee, Hyo-Seol
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.2
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    • pp.93-96
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    • 2014
  • Brain disorder disability is assessed when organic brain lesion such as cerebral palsy, traumatic brain injury, or stroke causes physical impairment which limits daily activites substantially according to its level and range of paralysis or the presence of involuntary movement. According to the disabled person welfare law in Korea, grade I brain disorder is assessed when one is in continuous irreversible state of coma without the ability to prolong one's life without other's help. Self-injurious behavior is defined as the non-suicidal intentional or unintentional injury to one's own body which can occur repetitively temporarily or chronically. People with decreased consciousness often exhibit increased self-injurious behavior which is most commonly associated with tongue or lip biting. This report documents a successful self -injurious lip biting treatment of a brain lesion patient within a short time by applying a removable acrylic resin appliance including posterior bite block.

A PRESERVATIVE APPROACH TO PREVENTION OF SELF-MUTILATION IN PATIENT WITH LESCH-NYHAN SYNDROME ; A CASE REPORT (Lesch-Nyhan 증후군 환아의 자해 예방을 위한 보존적 접근 : 증례보고)

  • Kang, Dong-Gyun;Kim, Tae-Wan;Kim, Young-Jin
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.2 no.2
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    • pp.147-152
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    • 2006
  • Lesch-Nyhan syndrome is rare X-linked genetic disorder involving absence of the enzyme hypoxanthine guanine phosphoribosyl transferase (HGPRT) related to purine metabolism. The deficiency of HGPRT activity leads to an excesscive uric acid production and consequent hyperuricemia. It occurs almost exclusively in males, and the incidence is estimate to be 1/100,000~380,000. Clinical presentation is characterized by developmental delay, mental retardation, choreoathetosis, spastic cerebral palsy, nephrolithiasis, obstructive nephropathy and acute gouty arthritis. A characteristic feature of Lesch-Nyhan syndrome is the appearance of intractable self-mutilation behavior. Self-mutilation behavior is complicated by secondary infection and tissue loss as well as pain. The dental management of self-mutilation includes presertive methods of using appliances such as lip bumper or soft mouthguard and radical methods such as extraction of all teeth or orthognathic surgery. A case of Lesch-Nyhan syndrome patient with self-mutilation and severe lower lip injury is presented. He was treated successfully with soft mouthguard.

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Self-inflicted Tongue Ulceration in a Patient with Tourette Syndrome: A Case Report (뚜렛 증후군 환자에서 자해로 인한 혀 손상 : 증례 보고)

  • Lee, Kkotnim;Kim, Miae;Hwang, Inkyung;Park, Jihyun;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.3
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    • pp.327-333
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    • 2016
  • Tourette's syndrome is a chronic neuropsychiatric disorder characterized by the presence of vocal and multiple motor tics. Tics are defined as brief, intermittent, repetitive, unpredictable, purposeless, and stereotyped movements or sounds. Some patients experience physical pain from intense and complex tics. In addition, motor tics can result in self-injury which is a common feature of Tourette's syndrome. A 9-year-old boy was referred by the department of neuropsychiatry because of a severe tongue laceration. His parents reported that he had been biting his tongue irregularly for 2 months before referral and suffered from an intense burning sensation. The repeated biting resulted in ulcers on the tongue, which quickly worsened and led to progressive difficulty chewing and swallowing food. We offered to give him a two-piece removable appliance to limit tongue biting; it was made of soft silicone and fitted to both the maxillary and mandibular arches. As we emphasized that the device could help alleviate his pain, he agreed to accept it and adapted well. Just 3 weeks later, his tongue lesions had healed significantly.

Clinical Characteristics of NSSI and Predictors of Suicide Attempts in Clinically Depressed Korean Adolescents (일 대학병원에 방문한 우울한 청소년에서 비자살성 자해행동의 임상적 특성과 자살 시도 예측요인)

  • Kim, Gyung-Mee
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.69-76
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    • 2019
  • Objectives : The purpose of this study was to examine the prevalence and clinical characteristics of nonsuicidal self-injury (NSSI), and its association with suicide attempts among clinically depressed adolescents in Korea. Methods : In total, 113 depressed adolescents aged 12-18 years in South Korea were enrolled in this study. We assessed sociodemographic and clinical characteristics including suicidality and non-suicidal self-injury (NSSI) using various self-reported scales and semi-structured interview for diagnosis of psychiatric disorders. Demographic and clinical characteristics of the subjects were compared between NSSI and non-NSSI groups. We examined significant predictors of suicide attempts using logistic regression analysis. Results : Among 113 depressed participants, 48 (42.1%) adolescents were classified into the NSSI group. In the NSSI group, there were significantly more females, showed higher depression, higher state-anxiety, and more suicide ideation. The most predictive factors of suicide attempts were history of NSSI, observed suicide/NSSI behaviors of their family or friends, and total state anxiety score. Conclusions : NSSI is more common problem among clinically depressed adolescents and history of NSSI is a significant predictor of present suicide attempts. To include the assessment of NSSI for clinically depressed adolescent may be crucial for intervention programs for high risk adolescents of suicide in Korea.