• Title/Summary/Keyword: Insomnia disorder

Search Result 195, Processing Time 0.023 seconds

A Case of Successful Endoscopic and Conservative Treatment for Intentional Ingestion of Sharp Foreign Bodies in the Alimentary Tract (고의로 섭취한 커터칼날의 내시경 및 보존적 치료 증례 보고)

  • Park, Jong-Min;Kim, Seong Yup;Chung, Il Yong;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Yeong Cheol;Park, Sei Hyeog
    • Journal of Trauma and Injury
    • /
    • v.26 no.4
    • /
    • pp.304-307
    • /
    • 2013
  • Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.

Delayed Continuous Venovenous Hemodiafiltration in Chronic Lithium Intoxication (만성 리튬 중독환자의 지연성 정정맥 혈액 투석여과 사례)

  • Kim, Tae Su;Cha, Yong Sung;Kim, Hyun;Kim, Oh Hyun;Cha, Kyoung Chul;Lee, Kang Hyun;Hwang, Sung Oh
    • Journal of The Korean Society of Clinical Toxicology
    • /
    • v.11 no.1
    • /
    • pp.28-30
    • /
    • 2013
  • A 66-year-old male with chronic alcoholism presented with tremor, gait disturbance, memory impairment, insomnia, decreased appetite, and confusion. The patient had been taking lithium daily for treatment of bipolar disorder. Brain CT showed no specific abnormality, and serum lithium and ammonia levels were 3.63 mEq/L (therapeutic range, 0.6~1.2 mEq/L) and $85{\mu}g/dL$ (reference range: $19{\sim}54{\mu}g/dL$), respectively. Therefore, the initial differential diagnosis included chronic lithium intoxication, hepatic encephalopathy, Wernicke encephalopathy, or alcohol withdrawal syndrome. Even with the provision of adequate hydration, the patient's neurologic status did not show improvement, so that lactulose enema, thiamine replacement, and continuous venovenous hemodiafiltration (CVVHDF) were started on the third admission day. By the fifth admission day he had made a rapid neurologic recovery, and was discharged on the 20th admission day. Therefore, CVVHDF might be a treatment for patients with chronic lithium intoxication, because, even if serum lithium concentration is normal, lithium concentration in the brain may be different from that of the serum.

  • PDF

2-Nonadecanone Alleviates Depression through Inflammation Relief in SD Rat

  • Lee, Gil-Hyun;Hyun, Kyung-Yae
    • Biomedical Science Letters
    • /
    • v.24 no.3
    • /
    • pp.206-212
    • /
    • 2018
  • Depression is a type of mood disorder characterized by hypochondriasis, decreased appetite, and insomnia. Depression is a disease that affects more than 100 million people worldwide. 2-Nonadecanone (NAC) is a bioactive substance that constitutes Fomes fomentarius, and NAC is expected to have an antidepressant effect. By using the forced swimming test (FST), we investigated the effects of treatment with NAC on immobility subacutely in rats after oral dosing once a day for 2 days. Serum levels of cytokine interleukin-1 beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) were determined by enzyme-linked immunosorbent assay (ELISA). Nuclear factor-2 (Nrf-2) and inducible nitric oxide synthases (iNOS) were analyzed by western blot method. NAC dose-dependently decreased immobility in the FST. NAC dosedependently decreased FST-induced increase of cytokine levels, as manifested by significantly stronger effects on $IL-1{\beta}$ and $TNF-{\alpha}$ levels at higher doses than the lowest dose of NAC. Western blot analysis showed that Nrf-2 was significantly lower in the NAC-treated group than in the disease-induced group. The iNOS results were also significantly lower in the NAC-treated group than in the other groups. Considering FST results, the antidepressant effect of NAC is effective. Considering the results of cytokine and protein expression, this anti-depressant effect may be related to the anti-inflammatory effect. Therefore, it can be said that the anti-inflammatory effect of NAC increases the antidepressant effect in the FST experiment.

A Study on Overall Status and Statistical Analysis of Hospitalized Patients after Gynecological Surgery (부인과영역 질환 수술 후 한방입원치료를 받은 환자에 대한 전반적 현황분석 및 통계적 고찰)

  • Lee, Jin-Wook;Kang, Na-Hoon;Yoo, Eun-Sil;Park, Nam-Chun;Park, Kyoung-Sun;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bok;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.30 no.3
    • /
    • pp.40-53
    • /
    • 2017
  • Objectives: This study aims to analyze the current status of hospitalized patients and effects of Korean medical treatment after gynecological surgery. Methods: We analyzed the medical records of patients admitted to our hospital from January 2015 to May 2017 and categorized the pre-operative and post-operative contents. We performed statistical analysis using SPSS ver.20 for the patients' pains among symptoms. Results: Among total 87, patients 82.8% had hysterectomy. The most cause of the surgery were adenomyosis. The average duration of hospitalization was $10.4{\pm}5.7days$ and all patients were treated with acupuncture. Gami-sibjeon-tang was used most frequently. Among the symptoms that occurred after the operation, abdominal pain, low back pain, pelvic pain were in the order of pain and statistically significant decrease in the mean NRS score. In the symptoms of system, general weakness, insomnia, digestive disorder were in the order of the frequency and were improved respectively. Conclusion: We were able to find out the effectiveness of post-operative Korean medical treatment through hospitalized patients. More data collection and systematic research designs are needed.

Sleep-promoting and Anti-anxiety Effects of Shihogayonggolmoryo-tang in Mice (동물모델에서 시호가용골모려탕(柴胡加龍骨牡蠣湯)의 수면유도 및 항불안 효과)

  • Lim, Junsik;Leem, Kanghyun;Kim, Taeyeon
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.35 no.1
    • /
    • pp.8-14
    • /
    • 2021
  • Shihogayonggolmoryo-tang (ST) is a Korean medical herb cocktail which has been used to treat anxiety induced insomnia. In this study, we will examine sleep-promoting and anti-anxiety effects of ST, and investigate its mechanism. ICR mice were divided into three groups for the first examination : control group (n=11), ST50 group (50 mg/kg, po, n=11), ST200 group (200 mg/kg, po, n=11). Sleep-promoting effect was confirmed by measuring the sleeping duration time and sleeping onset time after thiopental sodium treatment (50 mg/kg, ip). ICR mice were divided into five groups for the second examination : control group (n=11), ST200 group (200 mg/kg, po, n=11), ST200+Flumazenil group (ST 200 mg/kg, po, flumazenil 0.3 mg/kg, ip, n=11), diazepam group (1 mg/kg, ip, n=11), diazepam+flumazenil group (diazepam 1 mg/kg, ip, Flumazenil 0.3 mg/kg, ip, n=11). Anxiety behavior and sleep-promoting effect was confirmed by open field test and measuring the sleeping duration time and sleeping onset time. Expression levels of c-fos in tuberomammillary nucleus (TMN) and ventrolateral preoptic nucleus (VLPO) were analyzed by immunohistochemistry. ST treated group showed significantly decreased anxiety behavior and enhanced sleeping duration time and sleeping onset time concentration dependently. The expression of c-fos was significantly upregulated in VLPO as sleep-inducing center and TMN as downregulated in arousal center by ST treatment. In addition, all effects of ST were reversed by flumazenil. Our results suggest that ST has sleep-promoting and anti-anxiety effects through regulating arousal center (TMN) and sleep-inducing center (VLPO).

A Systematic Review of Placenta Pharmacopuncture for Neuropsychiatric Diseases in Practice (자하거 약침의 신경정신과 임상 응용에 관한 체계적 문헌 고찰)

  • Shin, Haegue;Lee, Jae-Hyok;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
    • /
    • v.33 no.2
    • /
    • pp.157-180
    • /
    • 2022
  • Objectives: To perform a systematic review of placenta pharmacopuncture for treating neuropsychiatric diseases, focusing on its efficacy and the safety so that evidence on its clinical use could be obtained, thus contributing to further studies. Methods: Through Korean, English, and Chinese databases (OASIS, Korean TK, KISS, RISS, ScienceON, Pubmed, Cochrane, EMBASE, CINAHL, AMED, CNKI, and Wanfang), combinations of keywords (placenta, pharmacopuncture, etc.) were used to select clinical studies published until January 2021 about placenta pharmacopuncture for neuropsychiatric diseases. Interventions included combined treatments. Study design included cases studies, series, and clinical trials. Cohort studies, literature reviews, in vitro and animal experiments were excluded. The primary outcomes involved measurements of symptoms, Visual Analogue Scale, or questionnaires. Data extracted from databases were imported to Endnote X7 to remove duplicates. The quality of the literature was assessed based on CAse REports Guidelines and Cochrane's Risk of Bias (ROB). Results: Twenty-one studies were selected, including ten case reports, three case series, two one-armed clinical trials, one non-randomized clinical trial, and five randomized clinical trials. There were six studies on sleep disorders, five studies on stroke sequela, two on mood disorders, two on enuresis, two on Guillain-Barré syndrome, two on multiple sclerosis, one on neurocognitive disorder, and one on vertigo. The most frequent combined treatment was acupuncture in both the experimental group (n=10) and the control group (n=3). Acupoints were ST36, SP6, BL23, CV4, GB20, GV20, N-HN54, and so on. All studies reported improvement of symptoms. The quality of case studies was relatively high. Assessment of ROBs resulted in low risks. Conclusions: Placenta pharmacopuncture is effective for neuropsychiatric diseases such as sleep disorders, mood disorders, enuresis, and neurocognitive disorders. Regarding insomnia, several studies have reported significant improvements with placenta pharmacopuncture. There was no adverse event associated with placenta pharmacopuncture.

Efficacy and Safety of Banhahubak-Tang for Depression Treatment: Study Protocol for a Randomized, Waitlist-Controlled Trial

  • Seung-Ho, Lee;Yunna, Kim;Dohyung, Kwon;Seung-Hun, Cho
    • Journal of Oriental Neuropsychiatry
    • /
    • v.33 no.4
    • /
    • pp.389-400
    • /
    • 2022
  • Objectives: Depression is a highly prevalent disease, and the market for antidepressant drugs continues to grow at a steady rate. Although current antidepressants are reported to be effective, because of their low remission rate and side effects, new antidepressants are needed. The use of Banhahubak-tang (BHT) to treat the symptoms of depression is supported by experimental evidence. The proposed study will evaluate the efficacy and safety of BHT in treating depression. Methods: A randomized, waitlist-controlled, parallel clinical trial will be conducted to assess the efficacy of BHT in depression. A total of 84 participants with depression will be randomized into the intervention group or waitlist-control group at a 1:1 ratio. Patients in the intervention group will be administered BHT three times a day for four weeks and followed up for four more weeks after therapy completion. Patients in the waitlist-control group will undergo the same intervention and follow-up after a four-week waiting period. The primary outcome is change in the Korean version of the Hamilton Depression Rating Scale (K-HDRS) scores for major depressive disorders after four weeks. The secondary outcomes include scores on the K-HDRS, Korean Symptom Check List 95 (KSCL-95), Insomnia Severity Index (ISI), State-Trait Anxiety Inventory-Korean version (STAI-K), State-Trait Anger Expression Inventory-Korean version (STAXI-K), and the Instrument on Pattern Identifications for Depression and EuroQol-5 Dimension (EQ-5D). Conclusions: This trial will provide high-quality clinical evidence of the efficacy and safety of BHT in the management of depression.

Method and Indication of Tongue Acupuncture Treatment: A Narrative Review (설침요법의 적응증과 침법에 대한 연구 동향 분석)

  • Chang-Yul Keum;Aram Han;Chae-Rim Yoon;Su-Hyun Choi;Dahee Jeong;Nahyun Jeong;Hae-in Jeong;Na-yeon Ha;Jinsung Kim
    • The Journal of Internal Korean Medicine
    • /
    • v.44 no.6
    • /
    • pp.1109-1117
    • /
    • 2023
  • Tongue acupuncture is not only a body acupuncture treatment for the tongue but also a new microacupuncture treatment. Tongue acupuncture is a very promising treatment from a diagnostic and therapeutic point of view. According to several studies, Guan's tongue acupuncture and tri-tongue acupuncture are frequently used. Tongue acupuncture can be used for dysphagia, dysarthria, aphasia, insomnia, autism spectrum disorder, burning mouth syndrome, and cerebral palsy.

Clinical Trial Protocol Development of Acupuncture for Disaster Survivors: Results from an Expert Survey (전문가 설문조사에 기반한 재난 경험자에 대한 침치료 임상연구 프로토콜 개발)

  • Huiyong Kwak;Chanyoung Kwon;Jungtae Leem;Sang-Ho Kim
    • Journal of Oriental Neuropsychiatry
    • /
    • v.35 no.1
    • /
    • pp.15-26
    • /
    • 2024
  • Objectives: The objective of this study is to develop a specialized clinical research protocol for acupuncture treatment specifically designed for disaster survivors based on insights from an expert survey. Methods: An expert panel comprising specialists in neuropsychiatry, acupuncture, and clinical research methodology was assembled. Initial data to inform the clinical research protocol design was collected utilizing open-ended responses, multiple-choice questions, and a 5-point Likert scale to gauge agreement levels. Next, this data was disseminated to a panel of experts. A cohesive clinical research protocol was then formulated during a core panel meeting by integrating insights from a panel of 10 experts. Results: The protocol developed herein entails a non-randomized controlled study involving participants aged 19~64 years old who have been identified as high-risk or cautious according to the National Trauma Center screening test. The study design includes the establishment of an active control group, which allows for the assessment of an additional effect through comparison with conventional therapy. The selected acupuncture approach involves a combination of manual acupuncture and ear acupuncture. For clinical outcome assessment, the Clinician-Administered Posttraumatic Stress Disorder Scale for DSM-5 was proposed to gauge trauma symptoms. Representative scales for various domains such as depression, anxiety, anger, insomnia, pain, and quality of life were also provided for reference. Conclusions: The developed protocol is anticipated to streamline the swift design and initiation of clinical trials during disaster scenarios. It is also designed to be scalable, thereby enabling its application in both non-randomized control group studies and single-group before-and-after comparisons.

Treatment Adherence of Osmotic-Controlled Release Oral Delivery System Methylphenidate in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 아동에서 Osmotic-Controlled Release Oral Delivery System Methylphenidate의 치료순응도)

  • Kim, Bongseog;Lee, Jeong-Seop;Kim, Eui-Jung;Sung, Hyung-Mo;Shin, Yun Mi;Hwang, Seong-Hye;Yoo, Hanik K.
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.25 no.2
    • /
    • pp.65-72
    • /
    • 2014
  • Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.