• 제목/요약/키워드: Neuropsychiatric Disease

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투석 환자에서 연령에 따른 우울, 불안 및 긍정사고의 차이 (The Differences of Depression, Anxiety and Positive Thinking between Adult and Elderly Hemodialysis Patients)

  • 노기원;하주원;임세원;이재은;이규백;김향;오강섭
    • 대한불안의학회지
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    • 제9권1호
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    • pp.38-44
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    • 2013
  • 본 연구는 혈액 투석 중인 성인 환자 집단과 노인 환자 집단 간의 우울, 불안 및 자율신경기능의 차이를 비교해 보고자 하였다. 정신의학적 특징들과 자율신경기능을 비교해보았을 때 만성질환에 견디어 내는 능력에 있어서 노인 환자 집단이 성인 환자 집단에 비해 취약하지 않은 결과를 보였다. 이는 만성질환을 앓고 있는 동일한 상황에서 노인들이 보다 긍정적 사고 경향을 가지고 있는 것과 관련되어 있을 것으로 생각된다.

인지기능 저하평가를 위한 MR 영상 소견 조합의 진단능 (Diagnostic Performance Using a Combination of MRI Findings for Evaluating Cognitive Decline)

  • 변진영;이민경;정소령
    • 대한영상의학회지
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    • 제85권1호
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    • pp.184-196
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    • 2024
  • 목적 인지기능 저하를 진단하기 위해서 자기공명영상을 이용한 영상 소견의 진단능을 평가하였다. 대상과 방법 총 138명의 주관적인 인기지능 저하를 호소하며, MRI 검사를 시행한 환자를 대상으로 하였다. 이 환자 그룹은 신경정신학적 평가를 통해 알츠하이머군과 비알츠하이머군으로 분류되었다. 우리는 이들의 white matter hyperintensity와 cerebral microbleed를 평가하였으며, Kruskal- Wallis test를 통해 그룹 간의 비교를, receiver operating characteristic (이하 ROC)를 통해 영상학적 소견의 진단능을 평가하였다. 결과 인지기능 정상인 경우와 경도인지장애 환자와 비교해서 알츠하이머 환자에서 엽 혹은 심부 미세출혈이 빈번하게 관찰되었으며, 심한 심부 혹은 뇌실주위, 전체 백질 신호강도 또한 인지기능 정상에 비해서 알츠하이머 환자에서 많이 관찰되었다. 알츠하이머 환자와 다른 환자 그룹(정상 혹은 경도인지장애)을 비교할 때 엽미세출혈과 뇌실주위 뇌백질 신호강도 증가가 같이 존재하는 경우 가장 높은 진단능을 보였다(area under the ROC curve = 0.702[95% 신뢰구간: 0.599-0.806], p < 0.001). 결론 자기공명영상에서 확인한 영상 소견을 바탕으로 인지기능 저하의 진단능을 평가하였다. 인지기능 저하의 진단에 있어서 엽미세출혈과 뇌실주위 뇌백질 신호강도 증가가 같이 존재하는 경우에 높은 진단능을 보였으며, 이러한 소견을 바탕으로 인지기능 저하를 진단하는 데 있어 영상 소견이 도움을 줄 수 있을 것이라는 가능성을 보여주었다.

한방 변증과 양방 협진에 의한 전신성 홍반성 낭창(Systemic Lupus Erythematosus) 치료 1예 (One Case of Systemic Lupus Erythematosus treated by Integrated Therapy of Western Medicine with Oriental Differential Diagnosis of Symptoms and Signs)

  • 정대영;백동기;황상일;신선호;김동웅;한명아
    • 대한한방내과학회지
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    • 제23권2호
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    • pp.306-312
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    • 2002
  • Systemic Lupus Erythematosus(SLE) is a autoimmune disease characterized by combined symtoms of malar rash, discoid rash, neuropsychiatric disorder, renal disorder, hematologic disorder, photosensitivity immunologic disorder, oral ulcer, anti-nuclear antibody, arthritis, pleuritis and pericarditis, etc. Multiple genetic or environmental causes are supposed to facilitate antiboby production to autoantigen such as ds-DNA, histone, phospholipid, red blood cell, platelet, etc. And defective complementary system fail to remove autoantigen-antibody complex, which deposit in multiple organs and result in inflammatory damages. SLE does not correctly correspond to any specific category of oriental medicine. But, accoring to previous reports, it can be controlled by herb medications used differently patients-to-patients. So we are to report this one SLE case being successfully controlled by classic corticosteroids with herb medications based on oriental diffrential diagnosis of symptoms and signs.

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문화와 신체화 (Culture and Somatization)

  • 김광일
    • 정신신체의학
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    • 제11권1호
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    • pp.3-14
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    • 2003
  • 문헌고찰을 통하여 최근 임상에서 문제되고 있는 신체화에 관한 문화정신의학적인 소견과 그 의미를 정리하였다. 신체화는 인류 공통의 범세계적인 정신병리이며 그 빈도나 양상은 문화 따라 차이가 난다. 그러나 단순히 서구-비서구 혹은 전통사회 대 근대화된 사회를 나누어 그 빈도차이를 논하는 것은 의미가 없다. 최근의 황문화적 연구에 따르면 이런 이분법식의 논리는 사실과는 전혀 다르다. 또한 어떤 차이가 나더라도 그 해석에서는 종족 뿐 아니라 그 종족이 처하고 있는 여러 사회문화적인 상황을 중요한 변인으로 고려해야 한다. 그리고 철저한 횡문화적 조사연구를 통하여 발생빈도와 그 의미를 확인해야 한다. 마음의 고통이 신체증상으로 나타나는 과정에서 1) 고통에 대한 문화적 표현양식 즉 문화적 은유, 2) 전통적인 질병개념, 3) 적응을 위한 사회적 매개체로서의 역할, 4) 신체화를 조장하는 의료제도 내지는 의료분위기 등의 문화사회적 요인들이 중요하게 작용하고 있다. 마음의 고통을 호소하는 통로로서 문화가 매채체 역할을 하고 있는 것이다. 세계화되고 있는 사회에서 횡문화적인 진료가 불가피하게 되고 이에 따라 신체화에 대한 이해와 접근기술이 새로운 과제로 등장하고 있다. 횡문화적 치료적 접근 원리에 대하여 간단히 소개하였고 아울러 한국 문화에서 신체화의 원인과 의미를 고찰하였다.

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Developing New Mammalian Gene Expression Systems Using the Infectious cDNA Molecular Clone of the Japanese Encephalitis Virus

  • Yun Sang-Im;Choi Yu-Jeong;Park Jun-Sun;Kim Seok-Yong;Lee Young-Min
    • 한국미생물학회:학술대회논문집
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    • 한국미생물학회 2003년도 International Meeting of the Microbiological Society of Korea
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    • pp.83-86
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    • 2003
  • Major advances in positive-sense RNA virus research have been facilitated by the development of reverse genetics systems. These systems consist of an infectious cDNA clone that encompasses the genome of the virus in question. This clone is then used as a template for the subsequent synthesis of infectious RNA for the generation of synthetic viruses. However, the construction of infectious cDNA for the Japanese encephalitis virus (JEV) has been repeatedly thwarted by the instability of its cDNA. As JEV is an important human pathogen that causes permanent neuropsychiatric sequelae and even fatal disease, a reliable reverse genetics system for this virus is highly desirable. The availability of this tool would greatly and the development of effective vaccines as well as facilitate studies into the basic biology of the virus, including the molecular mechanisms of viral replication, neurovirulence, and pathogenesis. We have successfully constructed a genetically stable infectious JEV cDNA containing full-length viral RNA genome. Synthetic RNA transcripts generated in vitro from the cDNA were highly infectious upon transfection into susceptible cells, and the cDNA remained stable after it had been propagated in E. coli for 180 generations. Using this infectious JEV cDNA, we have successfully expressed a variety of reporter genes from the full-length genomic and various subgenomic RNAs in vitro transcribed from functional JEV cDNAS. In summary, we have developed a reverse genetics system for JEV that will greatly facilitate the research on this virus in a variety of different fields. It will also be useful as a heterologous gene expression vector and aid the development of a vaccine against JEV.

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노년기 우울증 환자의 수면의 질 저하가 삶의 질에 미치는 영향 (Poor Sleep Quality and Its Effect on Quality of Life in the Elderly with Late Life Depression)

  • 최진영;박준혁
    • 생물정신의학
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    • 제21권2호
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    • pp.74-80
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    • 2014
  • Objectives More than half of the elders suffer from chronic sleep disturbances. Moreover, sleep disturbances are more prevalent in patients with depressive disorder than in community dwelling elderly. In this study, we aim to estimate the risk factors of poor sleep quality and its effect on quality of life in patients with late life depression. Methods This study included 159 depressive patients aged 65 years or older who completed Pittsburgh Sleep Quality Index (PSQI). A global PSQI score of 5 or greater indicates a poor sleeper. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview (MINI). Depression was evaluated by the Korean form of Geriatric Depression Scale (KGDS). Global cognition was assessed by Mini-Mental State Examination in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet. Quality of life was evaluated by the Korean version of Short-Form 36-Item Health Survey (SF-36). Results The frequencies of poor sleepers were 90.5% in major depressive disorder, 71.8% in minor depressive disorder, 47.1% in subsyndromal depressive disorder, and 73.0% in all types of depressive disorders. Multivariate logistic regression analysis indicated that female [odds ratio (OR) = 2.83, 95% confidence interval (CI) = 1.20-6.67] and higher KGDS score (OR = 1.13, 95% CI = 1.05-1.21) were risk factors of poor sleep quality in patients with late life depression. In the analysis of ANCOVA adjusted for age, gender, education and KGDS score, the mean scores of vitality mental health and mental component summary of SF-36 were lower in poor sleepers than in good sleepers. Conclusions Poor sleepers among patients with late life depression are very common and are associated with female and higher KGDS scores. Poor sleep quality causes a significant negative effect on mental health quality. So researchers and clinicians should be more vigilant in the evaluation and treatment of sleep disturbances in patients with late life depression.

일개 한방병원에서 산후풍으로 내원한 환자 실태 분석 및 치료 고찰 (The Clinical Analysis of Sanhupung Patients and Treatment at an Oriental Medicine Hospital)

  • 황현지;김동철
    • 대한한방부인과학회지
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    • 제33권4호
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    • pp.56-74
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    • 2020
  • Objectives: The purpose of this study is to analyze the current characteristics of outpatients using herbal medicine for treating Sanhupung and provide treatment instructions in the clinical field. Methods: To analyze characteristics of outpatients with postpartum disease, I searched medical records from July 1, 2017 to June 30, 2020 using O94 (Sequelae of complication of pregnancy) in an oriental medicine hospital and 73 Sanpuhung patients were analyzed. Results: 1. The average age of Sanpuhung outpatients was 32.83±3.14 years old. The mean body weight difference between full-term pregnancy and visiting date was -7.79±4.23 kg. 2. The most chief complaints of Sanpuhung outpatients were musculo-skeletal symptoms in 57 (78.08%) patients followed by neuropsychiatric symptoms and circulatory symptoms. In musculo-skeletal symptoms, the most chief complaint area was wrist in 48 (65.75%) patients followed by waist, shoulder and knee. 3. 68 (93.15%) patients gave birth between 38 and 42 weeks of pregnancy, 33 (45.20%) patients gave birth by caesarean operation. Patients delivered in July visited the hospital most frequently for postpartum care. 4. 68 (93.15%) patients gave birth to single-born babies. The average birth weight was 3.13±0.45 kg. 5. In distribution from delivery to visitation period, the average was 65.08±103.2 days. The number of visits less than two times was 72 (98.63%). 6. A total of 73 outpatients got herbal medicine. Depending on the symptoms, herbal medicines were different from each other. Ikgibohyeol-tang-gagambang, Ojeok-san-gagambang and Gunggui-tang-gagambang were mostly used. Conclusions: These results could be helpful to treat Sanhupung patients in Korean gynecologic clinical fields.

소아에서 방사선 조영제 유해반응의 임상적 특징 (Clinical characteristics of adverse reaction to radiocontrast media in children - A single center experience)

  • 김민정;이보라;최영훈;강동윤;강혜련;서동인
    • Allergy, Asthma & Respiratory Disease
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    • 제6권6호
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    • pp.315-321
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    • 2018
  • Purpose: Radiocontrast media are widely used in medical imaging to improve diagnostic accuracy. However, studies on the adverse reactions of radiocontrast media in children are limited. We aimed to describe the characteristics of adverse reactions to radiocontrast media among children who had a computed tomography scan or magnetic resonance imaging in a tertiary university hospital. Methods: We retrospectively collected data on adverse reactions to radiocontrast media by the reporting system of a tertiary university hospital. We selected data from children under the age of 19 from July 2011 to December 2017 and analyzed their characteristics. We focused mainly on the characteristics of the index case which is defined by the first adverse event of each subject. Results: During the period, a total of 88,050 radiocontrast media-enhanced imaging studies were performed and 184 cases of adverse reactions were reported. A total of 71 were identified as index cases. Forty-nine (69.0%) were male and the mean age was $12.7{\pm}3.2$ years. The incidence of radiocontrast media-related adverse reactions was 0.09% and severe reactions were 0.002%. The most common clinical feature was skin manifestations (54.9%), followed by gastrointestinal symptoms (40.8%) and neuropsychiatric symptoms (7.4%). Conclusion: Adverse reactions to radiocontrast media rarely occur in children and the incidence of severe reactions is low. Most reactions are mild and are related to the skin and gastrointestinal system. This report would provide good evidence for establishing a management strategy in children scheduled for imaging studies using radiocontrast media.

반려견 인지기능장애증후군에 대한 한의 진단 및 한약치료 적용 가능성 고찰: 치매환자 국내한의치료기술과 비교 분석 (Potential application of herbal medicine treatment based on pattern identification for canine cognitive dysfunctional syndrome: a comparative analysis of Korea medicine therapy for patients with dementia)

  • 정경숙;조혜연;최유진;장정희
    • 대한수의학회지
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    • 제62권3호
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    • pp.25.1-25.9
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    • 2022
  • Canine cognitive dysfunction syndrome (CDS) is a neurodegenerative disease that causes cognitive and behavioral disorders and reduces the quality of life in dogs and their guardians. This study reviewed the complementary and alternative medicine (CAM) for CDS and compared the diagnosis and therapy of CAM between CDS in canines and dementia in humans. The evaluation tools for the diagnosis of CDS and dementia were similar in the neurological and neuropsychiatric examinations, daily life activity, cognitive tests, and neuroimaging, but the evaluation for dementia was further subdivided. In CAM, pattern identification is a diagnostic method for accurate, personalized treatment, such as herbal medicine. For herbal medicine treatment of cognitive impairment in canines and humans, a similar pattern identification classified as deficiency (Qi, blood, and Yin) and Excess (phlegm, Qi stagnation, and blood stasis) is being used. However, the veterinary clinical basis for verifying the efficacy and safety of CAM therapies for CDS is limited. Therefore, based on CAM evidence in dementia, it is necessary to establish CDS-targeted CAM diagnostic methods and therapeutic techniques considering the anatomical, physiological, and pathological characteristics of dogs.

영화 속 정신증상 분석이 정신질환 이해에 미치는 영향에 대한 초보적 고찰 - 일개 한의과대학 대학생을 대상으로 (A Basic Study on Effects of Psychological Symptom Analysis in a Movie on Understanding of Psychiatric Disease - Focusing on Students at a Korean Medical University)

  • 김경수;배진수;정서윤;정현우;김경옥
    • 동의신경정신과학회지
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    • 제32권4호
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    • pp.329-335
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    • 2021
  • Objectives: The purpose of this study was to determine how analyzing movies, including mental symptoms, according to a certain method, might affect the understanding of psychiatric disorders. Methods: Forty-four oriental medicine students who had completed Korean medicine neuropsychiatric science were required to submit reports on episode analysis, psychiatric personal history investigation, diagnostic criteria, and the connection between Korean medicine and psychiatric diseases after watching a movie, including psychiatric symptoms. After submitting the report, a questionnaire related to understanding before and after watching the movie was asked to be filled out. Demographic survey, frequency analysis, and response sample t-test were performed based on 42 questionnaires. Results: Results of analyzing the questionnaire were as follows. 1. The average number of movies watched was three. 2. Psychiatric disorders and psychiatric symptoms, diagnostic criteria, psychiatric personal investigation, and understanding of the connection between Korean medicine and psychiatric diseases all increased statistically significantly. 3. A separate process might be needed to improve the understanding of psychiatric personal strength investigation and oriental medicine connection. Conclusions: Movie analysis, including individual mental symptoms, could improve students' understanding of psychiatric disorders in psychiatric symptoms, diagnostic criteria, and psychiatric personal investigation, but some students might need feedback.