• Title/Summary/Keyword: Chorea

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Minamata Disease and the Mercury Pollution of the Globe

  • Harada Masazumi
    • Journal of Environmental Health Sciences
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    • v.31 no.6
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    • pp.451-456
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    • 2005
  • Minamata disease made its first appearance in the world at Minamata City, Kumamoto Prefecture, in May 1956. In 1962 methyl mercury poisoning through the placenta was found for the first time in the world. This was called congenital Minamata disease. In all cases the clinical symptoms were consistent with those of cerebral palsy. The time and place of outbreak were the same as those for Minamata disease. Their mothers had eaten fish and shellfish during pregnancy. The principal symptoms of congenital Minamata disease are mentalretardation ($100\%$); primitive reflexes ($100\%$); disturbance of coordination ($100\%$); dysarthria ($100\%$); limb deformation (100%); growth disorders ($100\%$); nutritional disorders ($100\%$); chorea-athetose ($95\%$); and hypersalivation ($95\%$). However, today, when the world is polluted by mercury in various places and at various levels, the data we need is not represented by those severe cases, but rather by the chronic milder type. Even in Minamata, the issue of Minamata disease has not been resolved. And likewise, on a global scale the problem of Minamata disease is not yet over.

Stimulant Induced Movement Disorders in Attention Deficit Hyperactivity Disorder

  • Nam, Seok-Hyun;Lim, Myung Ho;Park, Tae Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.33 no.2
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    • pp.27-34
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    • 2022
  • Stimulants, such as amphetamine and methylphenidate, are one of the most effective treatment modalities for attention deficit hyperactivity disorder (ADHD) and may cause various movement disorders. This review discusses various movement disorders related to stimulant use in the treatment of ADHD. We reviewed the current knowledge on various movement disorders that may be related to the therapeutic use of stimulants in patients with ADHD. Recent findings suggest that the use of stimulants and the onset/aggravation of tics are more likely to be coincidental. In rare cases, stimulants may cause stereotypies, chorea, and dyskinesia, in addition to tics. Some epidemiological studies have suggested that stimulants used for the treatment of ADHD may cause Parkinson's disease (PD) after adulthood. However, there is still a lack of evidence that the use of stimulants in patients with ADHD may cause PD, and related studies are only in the early stages. As stimulants are one of the most commonly used medications in children and adolescents, close observations and studies are necessary to assess the effects of stimulants on various movement disorders, including tic disorders and Parkinson's disease.

Current Research Trend Analysis of Scalp Acupuncture Teatment for Parkinson's Disease Using the Search Results of China National Knowledge Infrastructure and PubMed (파킨슨병의 두침치료에 대한 최신 연구동향 분석: China National Knowledge Infrastructure, PubMed 검색을 중심으로)

  • Dong-June Lee;Byung-Cheul Shin
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.95-107
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    • 2023
  • Objectives The purpose of this study is to help find the future prospects by analyzing the trends of scalp acupuncture treatment for Parkinson's disease (PD) by searching the China National Knowledge Infrastructure (CNKI) and PubMed. Methods We searched clinical studies adopting scalp acupuncture treatment as a main intervention for PD through the searching the database of CNKI and PubMed. We analyzed the characteristics of selected studies especially according to study design, publication year, sample size, treatment period, treatment methods, outcomes criteria and adverse events. Results Twelve randomized controlled trials studies published from January 1, 2012 to July 1, 2023 were selected. In these studies, two types of scalp acupuncture treatments were performed and the most common treatment was Jiao shunfa's scalp acupuncture with fine needles. The most commonly used acupoints were "Chorea tremor control area", 風池 (GB20), 四神聰 (EX-HN1) and 百會 (GV20). The most commonly used outcome measures were effective rate, unified Parkinson disease rating scale (UPDRS) and UPDRS-III. Conclusions Through these results, we found that the Chinese review literature positively reported the effects of scalp acupuncture on PD. However, more high-quality evaluation using the well-designed studies including more objective outcomes should be required.

ORAL SELF-MUTILATION IN THE LESCH-NYHAN SYNDROME : CASE REPORT (Lesch-Nyhan syndrome 환아의 oral self-mutilation에 대한 증례보고)

  • Jeon, Jin-Yong;Lee, Jae-Ho;Choi, Hyung-Jun;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.1
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    • pp.151-156
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    • 1999
  • Self-injurious behavior is defined as deliberate harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, skin cutting, or finger biting and includes ocular, genital and oral self-mutilation. Lesch-Nyhan syndrome is a rare X-linked recessively inherited disorder, caused by complete absence of hypoxanthin-guanine phosphoribosyl transferase(HPRT) activity. Clinical presentation is characterized by mental retardation, chorea, athetosis, hyperuricemia, uricosuria and self-mutilating behavior. In these patients, the most typical feature is loss of tissue from biting themselves, even though they are not insensitive to pain. The dental management of self-mutilation includes treatment with appliances such as soft mouthguard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a 25-month-old boy who was a known case of Lesch-Nyhan syndrome and presented with severe self-mutilation wound on his lower lip. Vital pulpectomy and coronal resection was done as a more conservative approach than extracting all primary anterior teeth. Due to maintaining the root portion of the teeth in the bone, it is expected that the normal growth of the alveolar bone will be achieved.

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A CASE OF PANDAS WITH CHILDHOOD DISINTEGRATIVE DISORDER (소아기 붕괴성 장애의 양상을 보이는 PANDAS 1례)

  • Cho, Soo-Churl;Seong, Deock-Kyu
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.149-156
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    • 2001
  • After the fact that obsessive-compulsive symptoms or tic symptoms are common in Sydenham's chorea which is a sequale of rheumatic fever produced by group A beta-hemolytic streptococcus was reported, the association between group A beta-hemolytic streptococcus and a subgroup of obsessivecompulsive disorder(OCD) or tic disorder has been attentioned. This subgroup shared a unique clinical course, characterized by an abrupt onset of symptoms and/or dramatic exacerbations. And this subgroup was distinguished by pre-pubertal onset of symptoms, neurological abnormalities(choreiform movements and a unique pattern of motoric hyperactivity), as well as by relapsing and remitting symptom course. Acronym PANDAS(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection) was used to denote a subgroup of OCD or tic disorder patients with these clinical characteristics. Then, there was a report suggesting that PANDAS category include some of attention-deficit/hyperactivity disorder(ADHD) and were two case reports of anorexia nervosa and body dysmorphic disorder with characteristics of PANDAS. This case is a patient who developed normally until age of 7, but after pharyngeal inflammation with high fever, he showed disturbance of cognition, social relationship, and language and communication, as well as tic symtoms and abnormal movement on face, hand, and foot. We report this case with review of literatures, because we think that this case belongs to the PANDAS category. Based on this observation, we suggest that PANDAS category include some of childhood disintegrative disorder as well as OCD, tic disorder, and ADHD.

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Early Results of Extracardiac Fontan Operation (심장외폰탄수술의 조기성적)

  • 김웅한;정도현;김수철;전홍주;이창하;김욱성;오삼세;정철현;나찬영
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.650-659
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    • 1998
  • Between August 1996 and August 1997, 22 patients underwent extracardiac Fontan operations. The basic diagnoses included univentricular heart of the right ventricular type (n=12); univentricular heart of the left ventricular type (n=4); tricuspid atresia (n=4); left isomerism, transposition of great arteries, ventricular septal defect and pulmonary stenosis (n=1); and criss-cross heart with uneven ventricle (n=1). The median age of the 14 men and 8 women was 29 months (range from 21 months to 26 years). Previous procedures included bidirectional cavopulmonary shunt (n=15, interval=15.6$\pm$3.4 months), Kawashima operation (n=4, interval=37.5$\pm$20 months), and classic Glenn shunt (n=1, interval=14 years). In 2 patients, extracardiac Fontan operations were done without any previous procedures. A 16- to 22-mm flexible Gore-Tex tube graft (n=18), Hemashield graft (n=3), or, alternatively, a nonvalved aortic allograft (n=1) was cut and anastomosed end-to-end between inferior vena cava and undersurface of pulmonary artery using Gore-Tex or Prolene suture in a running fashion. In risk Fontan patients (n=12), a communication between the extracardiac conduit and the right atrium was constructed. In the most 13 recent patients, the procedures were done without cross-clamping of the aorta and with a beating heart. Operative mortality was 9.1% (n=2). Complications included persistent chest tube drainage for more than 7 days (n=5), chorea (n=2), and low cardiac output (n=1). There were no late deaths. Follow-up echocardiogram (mean: 6 months) demonstrated satisfactory hemodynamic results in the surviving 20 patients. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, creationof a uniform and stable inferior vena cava-to-pulmonary artery conduit, and increased flexibility and safety in certain high-risk patients such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired ventricular function. Further investigations during a longer follow-up are needed to confirm the intermediate and long-term results, especially the reduction of late atrial arrhythmias.

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One Stage Total Repair of the Aortic Arch Anomaly using the Regional Perfusion (대동맥궁 이상이 동반된 선천성 심장병에서 국소 순환을 이용한 일차 완전 교정)

  • Jang Woo-Sung;Lim Cheong;Lim Hong-Kook;Min Sun-Kyung;Kwak Jae-Kun;Chung Eui-Seuk;Kim Dong-Jin;Kim Woong-Han
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.434-439
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    • 2006
  • Background: Deep hypothermic circulatory arrest during repair of aortic arch anomalies may induce neurological complications or myocardial injury. So we surveyed if the regional cerebral and myocardial perfusion might eliminate those potential side effects. Material and Method: From March 2000 to December 2004, 62 neonates or infants with aortic arch anomaly underwent one stage biventricular repair using the regional perfusion technique by single surgeon. Preoperative diagnosis of the arch anomaly consisted of coarctation (n=46), interruption of the aorta (n=12), hypoplastic left heart syndrome (n=2) and truncus areteriosus (n=2). Combined anomalies were ventricular septal defect (n=51), TAPVR (n=1), PAPVR (n=1) and atrioventricular septal defect (n=2). Arterial cannula was inserted at the innominate artery. Result: The mean regional perfusion time of brain was $28{\pm}10min$. Operative mortality rates was 0 (0/62). Late death was 1 (1/62) during $11{\pm}7$ months of follow-up. Neurologic complications consisted of transient chorea in 1 case. There was no reoperation associated with arch anolamy. Pulmonary complication associated with arch repair occurred in f case which was managed by aortopexy. Conclusion: One-tage rch repair using the regional profusion is safe and effective in minimizing the neurologic and myocardial complications.