• Title/Summary/Keyword: 정신장애

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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.

IMPACTED PREMOLARS AND MOLARS ASSOCIATED WITH DENTIGEROUS CYSTS IN CHILDREN (어린이에서 함치성 낭과 연관된 매복 소구치와 대구치의 치료)

  • Shin, Cha-Uk;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.718-724
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    • 2008
  • Tooth impaction is a frequently observed eruption anomaly in pediatric dental practice. Young patients with impacted or unerupted teeth have more prediction for dentigerous cyst formation. Dentigerous cyst presents radiographic features, unilocular or multilocular radioluscency. Cysts occur most frequently in the premolar region except third molar. Dentigerous cysts can grow to a considerable size, and large cysts may be associated with a painless expansion of the bone in the involved area. Extensive lesions may result in facial asymmetry, osseous destruction, root resorption of proximal teeth and displacement of associated tooth. The nature of the causative tooth influences the type of surgical treatment required for the dentigerous cyst. If the cyst is associated with a supernumerary or wisdom tooth, complete enucleation of the cyst along with extraction of tooth may be the first treatment choice. Otherwise, preservation of the associated teeth should be considered to prevent a young patient from psychological and mental trauma because of the loss of tooth. We should consider the degree of tooth displacement, osseous destruction and growth pattern of oromaxillofacial area when planning treatment. Thus a proper and logical treatment planning can help a proper growth and development of oromaxillofacial area and can save the patient from a psychological and mental trauma. This report describes 4 cases of the management of impacted premolars and molars associated with dentigerous cysts in children.

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CLEIDOCRANIAL DYSPLASIA : CASE REPORT (쇄골두개 이형성증 환아의 증례 보고)

  • Park, Young-Ok;Kim, Eun-Jung;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.3
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    • pp.372-380
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    • 2004
  • Cleidocranial dysplasia(CCD) is a congenital disorder of skeletal and dental abnormality, which is mesodermal dysfunction influencing many tissues and organs. Skeletal abnormalities in CCD are delayed closure of cranial suture and fontanelle, presence of wormian bone and clavicle aplasia. And CCD has an effect on the long bones, phalanges, spine, pelvis, muscles, and central nervous system. Dental manifestations include retention of deciduous teeth, multiple supernumerary teeth, delayed or absent eruption of permanent teeth and formation of cysts around nonerupted teeth. But as a result in common with a lack of medical and physical disability patient may have no substantive complaint, there are many masticatory and psychological problem by absent eruption of permanent teeth after exfoliation of deciduous teeth. For this reason CCD is necessary fo early diagnosis and must be improvement of the patient's appearance as well as provision of a functioning masticatory mechanism by treatment of surgical removal of supernumerary teeth, followed orthodontically eruption of the natural permanent teeth at adequate time.

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LESCH-NYHAN SYNDROME: A CASE REPORT (Lesch-Nyhan syndrome: 증례보고)

  • Kim, Myoung-Gook;Yang, Kyu-Ho;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.284-289
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    • 2011
  • Lesch-Nyhan syndrome is a disease caused by metabolic disorder of purine. General muscle stiffness and hyposomia are shown from infancy and symptoms can include involuntary or irregular movements of arms and legs, mental retardation, and compulsive self-mutilating behaviors. Self-mutilating behaviors begin at approximately the first year or sometimes at late teens. The patients bite their lips, especially lower lip, tongue, buccal mucosa, hands and fingers. Tongue and lips can be injured or mutilated in severe cases. As the patient gets older, self-mutilating behaviors become more serious and extensive and secondary infection of injured areas is possible. Periodic soft tissue damage due to self-mutilating may evolve to cancer. Medical treatment, appliance treatment, extraction of tooth and surgical operation was attempted to control self-mutilaing behaviors. We hereby report the case of child Lesch-Nyhan syndrome patient who has self-inflicted labial damage as chief complaint. When patient was treated with conservate therapy, such as removable or fixed appliance, the frequency of labial damage could be subdued and yielded favorable results.

APERT SYNDROME : CASE REPORT (Apert syndrome : 증례보고)

  • Park, Kwang-Sun;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.3
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    • pp.539-547
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    • 2008
  • Apert syndrome is an autosomal dominant condition characterized by craniosynostosis, midface hypoplasia, and syndactyly of the hands and feet. It occurs in about 1 of every 65,000 to 160,000 births and is caused by a mutation in the fibroblast growth factor receptor 2(FGFR2) gene. Apert syndrome typically produces acrobrachycephaly(tower skull). The occiput is flattened, and there is a tall appearance to the fore head. Ocular proptosis is a characteristic finding, along with hypertelorism and downward slanting lateral palpebral fissures. The middle third of the face is markedly retruded and hypoplastic, resulting in a relative mandibular prognathism. The reduced size of the nasopharynx and narrowing of the posterior choana can lead to mouth breathing, contributing to an open-mouth apprance. Three fourths of all patients exhibit either a cleft of the soft palate or a bifid uvula. The maxillary hypoplasia leads to a V-shaped arch and crowding of the teeth. A 6-year-old male patient visited to the Department of Pediatric dentistry, Kangnung National University of Dental Hospital. He visited the hospital to get treatment of carious teeth. The purpose of this report is to present a specific dental manifestations about the apert syndrome.

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A Study on the Reliability and Factor analysis of Pattern Identification for Tic Disorders in children (틱(Tic) 장애의 한의변증유형 설문지에 대한 신뢰도 및 요인분석 연구)

  • Wei, Young-Man;Lee, Go-Eun;Jung, Song-Hwa;Lee, Hee-Kyung;Lyu, Yeoung-Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.1
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    • pp.59-82
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    • 2012
  • Objectives : We purposed to objectify the pattern diagnosis of Tic disorders through factor and reliability analysis regarding a pattern identification questionnaire concerning Tic disorders in children. Methods : We chose and studied 144 children who were pattern-diagnosed out of 200 tic disordered children who visited H hospital in Seoul from January 2006 to April 2011. Results : 1. TTD (50%) was the most common type and the occurrence rate in male children was higher(4.76:1). Also, the rate of hospital visits was highest at the age 8(23.6%). 2. In results concering pattern diagnosis, Gan-poong-nae-dong was most frequently diagnosed in 53 patients (36.8%), and Dam-hwa-yo-sin (42 patients), Gan-sin-um-her (30 patients), and Bee-her-gan-wang (6 patients). 3. In an attempt to verify the reliability of the questionnaire, the coefficient regarding the whole questions (Cronbach ${\alpha}$) came to 0.909. Moreover, the reliability coefficient foreach sub factor was 0.687 in Ganpoong-nae-dong, 0.817 in Dam-hwa-yo-sin, 0.851 in Bee-her-gan-wang, and 0.726 in Gan-sin-um-her, respectively. Thus, their consistency was ensured. 4. In exploratory factor analysis concerning the most common five questions in the questionnaire, the questions of Dam-hwa-yo-sin and Gan-poong-nae-dong appeared to be part of different factors. While, Gan-sin-um-her and Bee-her-gan-wang questions showed that they belong to the same factors. 5. In factor analysis excluding both Gan-sin-um-her and Bee-her-gan-wang questions, both showed significant results; however, the one excluding Gan-sin-um-her showed improved results. Conclusions : From the above results concerning the Pattern Identification Questionnaire for Tic Disordered children, three separated patterns of Bee-her-gan-wang, Dam-hwa-yo-sin, Gan-poong-nae-dong are thought to be available for clinical use. However, further validity studies are needed.

A Study on Homogeneity Analysis of the Guipi Decoction for Treatment of Insomnia Disorder -Focusing on Randomized Controlled Clinical Trials in CNKI (불면장애에 사용된 귀비탕의 동질성 연구 -CNKI에서 검색한 무작위배정 임상연구를 중심으로-)

  • Kim, Dong-Hee;Sakong, Jong-Won;Kang, Chang-Wan;Lee, Sang-Hyup;Ha, Ji-Won;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.29 no.3
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    • pp.145-163
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    • 2018
  • Objectives: The study was designed to provide clinical evidence of homogeneity in analysis of the herbal medicine, Guipi decoction in treating insomnia, using a t-test of randomized controlled trials (RCTs). Methods: This study included RCTs that verified homogeneity of Guipi decoction in treating insomnia. Literature studies of CNKI (Chinese National Knowledge Infrastructure Database) were performed. The basic components group was made to the Guipi decoction of the Yixuerumen?s text. The excluded group was created with the number of herbs excluded from the basic components group. T-test performed that the effective rate in the basic components group and excluded groups. Results: The basic components of Guipi decoction contain Atractylodis Rhizoma Alba, Poria Sclerotium (Poria Sclerotium Cum Pini Radix), Polygalae Radix, Astragali Radix, Zizyphi Semen, Angelicae Gigantis Radix, Aucklandiae Radix, Glycyrrhiza uralensis Fischer, Ginseng Radix (Codonopsis Pilosulae Radix), Longanae Arillus. Herbs excluded from the basic components group were Longanae Arillus, Ginseng Radix (Codonopsis Pilosulae Radix), Glycyrrhiza uralensis Fischer and herbs added to the basic components group were Polygonum multiflorum Thunberg, Schisandrae Fructus, Salviae Militiorrhizae Radix, Paeoniae Radix Alba (in order from the most used to the least). T-test revealed the effective rate in the basic components group was not statistically significant compared to the excluded groups (p=0.161/p=0.162/p=0.103). Conclusions: Effectiveness in treatment of basic components of Guipi decoction and excluded groups were revealed to be homogeneous in treating insomnia. As the number of herbs in the basic components group decreased, mean value in effectiveness of treatment also decreased consequentially. However, there were no statistical significances.

Needs for Integrated Care for Older Adults in Seoul (서울특별시 지역사회 거주 노인의 통합돌봄 요구)

  • Kim, Hyeongsu;Ko, Young;Son, Miseon
    • Journal of Convergence for Information Technology
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    • v.10 no.5
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    • pp.177-187
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    • 2020
  • The purpose of this study was to classify the care needs of the older adults aged 65 and over and to identify characteristics of care need groups. This was a secondary analysis study using data from 2017 National Survey of Older Persons in Seoul. There were 50.4% in the general group without any support needs, 17.9% in the medical needs group, 14.2% in the welfare needs group with support needs of daily living or social activity, and 17.5% in the complex needs group with both medical and welfare needs. Significant differences were shown in most variables of the general characteristics, grading of long-term care or disability, financial burden and caregiving, health behaviors, health status, and life satisfactions among groups (p<.001). The complex care need group should be provided with integrated care service for medical and welfare through multidisciplinary team approach.

A Study on the Precedence of the Risk of Problem Features of Senile Dementia Patients (치매노인의 문제특성에 대한 위험순위에 관한 연구)

  • You, Ji-Hye;Lee, Hang-Woon;Eom, Jin-Sup;Park, Soo-Jun;Lee, Bong-Soo;Lee, Jeong-Whan;Tack, Gye-Rae;Chung, Soon-Cheol
    • Science of Emotion and Sensibility
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    • v.10 no.1
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    • pp.79-86
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    • 2007
  • Selected cognitive ability test and survey of basic & problem characteristics were conducted on 110 hospitalized senile dementia patients to extract important problem features. Twenty important problem features were extracted by the factor analysis. In this study, the precedence of the risk of 20 problem features was determined for care of senile dementia patients. Questionnaire was conducted on 32 clinical psychologists who had experienced the diagnosis and treatment of senile dementia patients. Using AHP (Analytic Hierarchy Process), relative risk levels were studied and the precedence of risk was determined by making 20 important problem features in order of the risk. Results of two analyses indicated that during normal daily activities of senile dementia patients the cognitive problem such as memory impairment, judgement disorder and disorientation is the most dangerous risk factor.

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Clinical Study for Conversion Disorder in 41 Admission Cases (전환장애(轉換障碍)로 입원(入院)한 환자(患者) 41례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Kim Myung-Jin;Choi Byung-Man;Lee Sang-Ryong
    • Journal of Oriental Neuropsychiatry
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    • v.11 no.2
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    • pp.131-140
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    • 2000
  • The clinical study was carried out the 41 patients with conversion disorder who were treated in Dae Jeon University Oriental Hospital from 26 september 1998 to 21 september 2000.The results were summarized as follows.1. The ratio of male and female was 4:37 and in the age distribution, the highest frequence was 40s, in descending order over 50s, 30s, 20s, 10s and mental attack was the most inducing factor.2. In distribution of the period of the clinical history. within one day was the highest percentage and in admission period most of the patients were from four days to seven days.3. In symptoms and signs, physical symptoms were more than mental symptoms, physical symptoms had many muscle-skeleton-system symptoms and they were in descending order general body weakness. headache, anorexia, chest discomfort, dyspepsia, dizziness, four extremities numbness, insomnia, dysarthria, anxiety, four extremities tremor. palpitation. nausea, vomiting, facial numbness.4. In classification of Four Human coporeal constitution the number of patients, Sho-Eum-In(少陰人) was remarked mostly and most of female patients had no past history of the conversion disorder.5. In distribution of the prescription, drugs of regulating gi such as BUNSIMGIEUM(分心氣飮) were many, in descending order drugs of growing heart and warming gall bladder such as ONDAMTANGGAMI(溫膽湯加味), drugs of maintaining patency for the flow of gi such as CHUNGGANSOYOSAN(淸肝逍遙散), drugs of decomposing food and asending gi such as PYUNGJINGUNBITANG(平陳健脾湯), drugs of storing blood and relaxing the mind such as SAMULGUIBITANG(四物歸脾湯). drugs of removing sputum and cooling heart such as CHUNGSIMDODAMTANG 淸心導痰湯).6. In distribution of the treatments, the group of drug and acupuncture and aroma-therapy was many, in acup uncture TAEGUKCHIMBUP(太極針法) was mainly used. in therapy inhalation type of Lavender and Rosewood was many and the type of Peppermint and Rosemary massaging epigastric-chest, and neck was many.7. In distribution of the treatment result, in 15 patients(36.6%) symptoms were eliminated from four to seven days, in 13 patients(31.7%) symptoms were not changed. in 12 patients(29.3%) symptoms were eliminated from two to three days. in 1 patients(2.4%) symptoms were eliminated whin one day.

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