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검색결과 141건 처리시간 0.03초

아동기 경계선 장애 : 8증례 (BORDERLINE DISORDER OF CHILDHOOD : 8 CASES)

  • 홍강의;이정섭;신민섭
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제6권1호
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    • pp.3-17
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    • 1995
  • 아동에서의 경계선 장애는 현실감각의 불안정, 대인관계의 장애, 충동조절의 장애, 심한 기능의 변동, 발달상의 불균형, 불안등을 보이며 현재의 진단 체계로는 진단하기 어려운 환아를 의미한다. 본 논문에서는 Bemporad등과 Vera등이 제안한 '경계선 아동'에 부합하는 7세에서 11세 사이의 8명의 소아정신과를 내원한 아동들을 대상으로 37개의 병인들을 비교하여 다음과 같은 결과를 얻었다. 1) 임상적인 특징으로는 모든 환아들이 다 남아였으며, 현재의 진단체계에서는 진단을 내리기가 어려웠고, 공존정신과적인 진단이 많았다. 주소는 산만하고 또래와 어울리지 못한다는 것이 많았다. 현실과 환상사이의 경계가 불명확한 것과 사고의 장애가 특징적인 증상이었다. 2) 심리학적 및 신경생리학 검사상 지능은 보통수준이었으며, 동작성 지능이 언어성 지능보다 우수한 경향이 있었다. 투사법 검사에서는 사고 장애의 지표는 보였으며, 정서적으로 불안정하고 공격성이 심하였다. 반수에서 주의력 검사상 주의력결핍을 시사하였다. 기질적인 요인은 뚜렷하지 않았다. 3) 발달력 및 가족력상 원하지 않았던 아이가 많았고, 주 양육자는 어머니였으나, 양육방식에 중등도의 문제가 있었다. 부모간에 불화가 많았고, 사회 경제적으로는 중하가 많았다. 언어발달은 대부분에서 지연이 되었거나, 성장하면서 점차로 정상이 되었다. 공격적이어서 또래들로 부터 따돌림을 많이 받았다. 4) 치료 및 경과상 6세경에 처음 병원에 방문하였으며, 평균 치료 기간은 2년이었고, 주로 외래에서 치료를 받았다. 약물치료에 대한 반응은 뚜렷하지 않았으며, 장기 놀이치료의 필요성이 암시되었다. 본 연구 방법에 여러 가지 제한점이 있으나 앞으로 이 장애의 명확한 진단 기준을 확립하고 역학 및 치료에 대한 연구들이 이루어져야 할 것이다.

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해마 조직 절편 배양을 이용한 무산소 손상에 대한 MK-801, CNQX, Cycloheximide 및 BAPTA-AM의 효과 (Effects of MK-801, CNQX, Cycloheximide and BAPTA-AM on Anoxic Injury of Hippocampal Organotypic Slice Culture)

  • 문수현;권택현;박윤관;정흥섭;서중근
    • Journal of Korean Neurosurgical Society
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    • 제29권8호
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    • pp.1008-1018
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    • 2000
  • Objective : Glutamate induced excitotoxicity is one of the leading causes of cell death under pathologic condition. However, there is controversy whether excitotoxicity may also participate in the neuronal death under low intensity insult such as simple hypoxia or hypoglycemia. To investigate the role of NMDA receptor in low intensity insult, we chose anoxia as the method of injury and used organotypically cultured hippocampal slice as the material of experiment. Materials & Methods : The hippocampal slices cultured for 2-3 weeks were exposed to 60 minutes of complete oxygen deprivation(anoxia). Neuronal death was assessed with Sytox stain. Corrected optical density of fluorescence in gray scale, used as cellular death indicator, was obtained from pictures taken at 24 and 48 hours following the insult. The well-known in vivo phenomenon of regional difference in susceptibility of hippocampal sub-fields to ischemic insult was reproduced in HOSC(hippocampal organotypic slice culture) by complete oxygen deprivation injury. Results : $CA_1$ was the most vulnerable to complete oxygen deprivation in hippocampus while $CA_3$ was resistant. Oxygen deprivation for 10 and 20 minutes with glucose(6.5g/l) present was insufficient to induce neuronal death in the cultured hippocampal slice. However, after 30 minutes exposure under anoxic condition, neuronal death was able to be detected in the center of $CA_1$ area. The intensity and area of fluorescence indicating cell death correlated with the duration of oxygen deprivation. NMDA receptor and non-NMDA receptor blocking with MK-801(30 & $60{\mu}M$) and CNQX($100{\mu}M$) did not provide cellular protection to HOSC against damage induced by oxygen deprivation, but increased intracellular calcium buffering capacity with BAPTA-AM($10{\mu}M$) was effective in preventing neuronal death (p=0.01, Student's t-test). Cycloheximide($1{\mu}g/ml$, $10{\mu}g/ml$) provided no protection to HOSC against insult of complete oxygen deprivation for 60 minutes and combined therapy of MK-801(30 & $60{\mu}M$) and cycloheximide(1 & $10{\mu}g/ml$) was also ineffective in preventing neuronal death. Conclusion : The results of this study show that the another mechanism not associated with glutamate receptor(NMDA & non NMDA) may play major role in cell death mechanisms induced by complete oxygen deprivation and increased intracellular calcium during anoxia may participate in the neuronal death mechanism of oxygen deprivation. Further investigation of the calcium entry channel activated during oxygen deprivation is necessary to understand the neuronal death of anoxia.

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기분장애에서 risperidone의 양면성 (Risperidone as a Janus in Mood Disorder)

  • 윤도준
    • 생물정신의학
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    • 제4권2호
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    • pp.198-210
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    • 1997
  • To examine the double-faced thymoleptic(antidepressant and antimanic) effects of risperidone in mood disorders, this article reviews the psychotropic-induced mania, thymoleptic effects of antipsychotics, therapeutic effects of risperidone and risperidone(RIS)-induced mania(RIM) in mood disorders, risk factors of RIM, possible neurochemical mechanism of these thymoleptic effects, pathophysiological and clinical significance of thymoleptic effects, and suggestive clinical guideline of RIS in mood disorders. RIS appeared effective for bipolar disorder at a lower dose than that recommended for schizophrenia, especially in the cases of maintenance of mood stabilizers, and gradual titration from low doses. Manic induction/exacerbation can occur by chance during RIS treatment in mood disorders, schizoaffective disorders, and schizophrenias. The possible risk factors for RIM are refractory mood disorder, especially in bipolar I disorder with poor initial response ; refractory schizoaffective disorders, especially in bipolar type with poor initial response ; refractory chronic schizophrenias, especially with initial responses ; psychotic features ; higher initial doses ; rapid titration ; combined therapy with antidepressants in refractory depression ; and RIS monotherapy in mania/hypomania. RIS is a drug that preferentially block 5-HT2 receptors. The effects of low dose are due mainly to the blockade of 5-HT2 receptors. There are more gradual increase in D2 blockade with increasing dose and this D2 blocking properties become apparent at higher doses. This may be related to a modulation of dopaminergic transmission by 5-HT2 antagonism at lower doses with the direct action of RIS on DA receptors coming into play at higher dose. The serotonergic antagonistic effect may be important for its effects on depressive symptoms. This, together with adequate blo-ckade of D2 receptors, may not necessarily lead to destabilization of mood disorder, but rather to more therapeutic effects. Therefore, this dose-receptor affinity relationship with both antidepressant and antimanic effects according to treatment duration can explain a continuum of antidepressant effect, antimanic effect, behavioral stimulation, and manic/hypomanic induction/exacerbation. It was the recognition of a useful psychiatric side effects by a thoughtful observer with fertile minds that led to their ultimate utilization as psychotropic drugs, i.e., phenothiazine, MAOI, TCA, and lithium. And, in vivo pharmacological challenge by novel psychotropics, as a neurochemical probe, with more specific actions is a useful tool to select pharmacologically homogeneous subgroup of the same phenotypical(clinical) condition, to further study the unknown underlying pathogenesis of various mental illnesses. Finally, RIS may be a useful alternative or adjunctive drug for patients with mood disorders without psychotic features or refractory to treatment with standard antipsychotic drugs. The more conservative doses(tirated slowly from 1-3 mg/d) of RIS, and maintenance of mood stabilizer in the cases with risk factors of RIM are recommended in mood disorder.

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PEP-1-GSTpi protein enhanced hippocampal neuronal cell survival after oxidative damage

  • Sohn, Eun Jeong;Shin, Min Jea;Kim, Dae Won;Son, Ora;Jo, Hyo Sang;Cho, Su Bin;Park, Jung Hwan;Lee, Chi Hern;Yeo, Eun Ji;Choi, Yeon Joo;Yu, Yeon Hee;Kim, Duk-Soo;Cho, Sung-Woo;Kwon, Oh Shin;Cho, Yong-Jun;Park, Jinseu;Eum, Won Sik;Choi, Soo Young
    • BMB Reports
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    • 제49권7호
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    • pp.382-387
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    • 2016
  • Reactive oxygen species generated under oxidative stress are involved in neuronal diseases, including ischemia. Glutathione S-transferase pi (GSTpi) is a member of the GST family and is known to play important roles in cell survival. We investigated the effect of GSTpi against oxidative stress-induced hippocampal HT-22 cell death, and its effects in an animal model of ischemic injury, using a cell-permeable PEP-1-GSTpi protein. PEP-1-GSTpi was transduced into HT-22 cells and significantly protected against H2O2-treated cell death by reducing the intracellular toxicity and regulating the signal pathways, including MAPK, Akt, Bax, and Bcl-2. PEP-1-GSTpi transduced into the hippocampus in animal brains, and markedly protected against neuronal cell death in an ischemic injury animal model. These results indicate that PEP-1-GSTpi acts as a regulator or an antioxidant to protect against oxidative stress-induced cell death. Our study suggests that PEP-1-GSTpi may have potential as a therapeutic agent for the treatment of ischemia and a variety of oxidative stress-related neuronal diseases.

패턴된 폴리머를 이용한 중간엽줄기세포의 연골 분화 (Chondrogenic Differentiation of Human Mesenchymal Stem Cells on a Patterned Polymer Surface)

  • 허준석
    • 대한임상검사과학회지
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    • 제47권3호
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    • pp.117-124
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    • 2015
  • 중간엽줄기세포는 손상된 관절연골 치유능력을 가지고 있어 줄기세포 치료 분야에서 대표적인 성체줄기세포로 알려져 있다. 자외선이 조사된 생체 친화성 필름 조성물인 DTOPV (S-triazine bridged p-phenylenevinylene)는 친수성 특성의 표면을 가진 형광 화합물이다. 이전의연구에서 물질표면의 습윤성과 친수성이 세포부착 및 증식에 중요한 역할을 하는 것이 확인 되었으며, 이번 연구에서는 DTOPV를 이용하여 중간엽줄기세포의 연골분화능을 향상시키고자 하였다. 일반 배양용기로 사용하고 있는 TCPS (tissue culture polystyrene)와 자외선이 조사된 패턴된 DTOPV 필름을 이 실험에 사용하였고 TGF (transforming growth factor)-${\beta}3$가 포함된연골분화배지로 중간엽줄기세포를 2주동안 분화유도를 하였다. TCPS에서 배양된 중간엽줄기세포는 단층으로 자라면서 분화가 유도된 반면, 자외선이 조사된 DTOPV 필름 위에서 배양된 세포는덩어리진 구형으로 형태가 변하였으며, 연골세포에 특이적으로 염색되는 Safranine O 염색으로 DTOPV 조건에서 더 붉게 염색됨을 관찰하였다. 또한 연골세포 특이적인 유전자인 Type II collage이 DTOPV 조건에서 더 강하게 발현되는 것을 확인함으로써 TCPS보다 DTOPV에서 연골세포로 분화가 향상된 것을 알 수 있었다. 따라서 자외선이 조사된 생체 친화성 필름 조성물인 DTOPV을 이용한 경우에 일반 배양용기보다 빠르게 연골분화가 이루어짐을 알 수 있었다. 결론적으로 향후 조직공학 분야에서 DTOPV가 중간엽줄기세포의 효과적인 연골분화 물질로서 활용될 수 있는 가능성을 확인 하였으며, 더 나아가 약물 스크리닝과 같은 진단분야에 활용될 수 있음을 알 수 있었다.

Regulatory Dendritic Cells Induced by Mesenchymal Stem Cells Ameliorate Dextran Sodium Sulfate-Induced Chronic Colitis in Mice

  • Jo, Hannah;Eom, Young Woo;Kim, Hyun-Soo;Park, Hong Jun;Kim, Hee Man;Cho, Mee-Yon
    • Gut and Liver
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    • 제12권6호
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    • pp.664-673
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    • 2018
  • Background/Aims: Regulatory dendritic cells (rDCs), which can be induced by mesenchymal stem cells (MSCs), play an important role in inducing and maintaining homeostasis of regulatory T cells and exhibit anti-inflammatory functions. In this study, we investigated whether MSCs could differentiate DCs into rDCs and compared the therapeutic effects of rDCs and MSCs on dextran sodium sulfate (DSS)-induced chronic colitis mice. Methods: Immature DCs (imDCs) and lipopolysaccharide (LPS)-treated mature DCs (mDCs) were co-cultured with MSCs for 48 hours, and then the profiles of surface markers and cytokines and regulatory roles of these DCs for primary splenocytes were analyzed. In addition, the therapeutic effects of MSCs and DCs co-cultured with MSCs were compared in chronic colitis mice. Results: After co-culture of imDCs (MSC-DCs) or LPS-treated mDCs (LPS+MSC-DCs) with MSCs, the expression of CD11c, CD80, CD86, interleukin 6 (IL-6), tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), and interferon-${\gamma}$ (IFN-${\gamma}$), was decreased, but that of CD11b, IL-10, and transforming growth factor-${\beta}$ (TGF-${\beta}$) was increased. Furthermore, MSC-DCs and LPS+MSC-DCs induced the expression of CD4, CD25, and Foxp3 in primary splenocytes isolated from mice. In DSS-induced colitis mice, MSCs and MSC-DCs increased colon length, body weight, and survival rate and induced histological improvement. Moreover, in the colon tissues, the expression of IL-6, TNF-${\alpha}$, and IFN-${\gamma}$ decreased, but that of IL-10, TGF-${\beta}$, and Foxp3 increased in the MSC- and MSC-DC-injected groups. Conclusions: Our data suggest that MSCs differentiate DCs into rDCs, which ameliorate chronic colitis. Thus, rDCs stimulated by MSCs may be therapeutically useful for the treatment of chronic inflammatory diseases.

지역사회기반 인지자극 프로그램이 경도인지장애 노인의 인지기능과 주관적 기억에 미치는 영향 (The Effect of Community-Based Cognitive Stimulation Program on Cognitive Fincion and Subject Memory in the Elderly with Mild Cognitive Impairment)

  • 김미영;박우권
    • 문화기술의 융합
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    • 제9권2호
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    • pp.67-71
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    • 2023
  • 본 연구의 목적은 지역사회 기반 인지자극 프로그램이 경도인지장애 노인의 인지기능과 주관적 기억에 미치는 영향을 조사하는 것이다. 경기도 소재 G시 D치매안심센터에서 2021년 4월부터 2021년 8월까지 3개월 이상 쉼터 프로그램에 참여하는 이용자 중 연구의 목적을 이해하고 참여에 동의한 15명으로 선정하여 적용하였다. 프로그램은 3 개월 동안 주 3회 총 36회 인지자극프로그램으로 구성하여 진행되었다. 인지자극프로그램은 지남력 강화, 인지훈련, 회상과 음악, 미술, 신체 놀이 등 다양한 활동으로 인지 기능을 자극하고, 사회기능 향상 목적으로 동용. 민요, 타악기, 국민체조, 춤, 게임, 전래놀이 등으로 구성되었다. 인지자극 프로그램 진행한 결과 인지기능은 인지자극프로그램 실시 전 평균이 26.33점에서 실시 후 평균이 28.46점으로 2.13점 증가 하였고, 통계적으로도 유의한 결과가 나왔다(p=0.000). 주관적 기억은 인지자극프로그램 실시 전 평균이 7.13점에서 실시 후 평균이 3.60점으로 3.53점 감소 하였고, 통계적으로도 유의한 결과가 나왔다(p=0.000). 이 결과를 통해 경도인지장애 노인에게 인지자극프로그램이 효과가 있다고 확인할 수 있다. 치매로 인한 비용 부담으로 이어지고 있으며 특히나 인지기능 저하는 노인의 삶의 질이 떨어지고 그로인한 다양한 부담을 가져온다. 앞으로 다양한 환경에 적용되는 인지자극프로그램 연구가 필요하다.

자폐스펙트럼장애 아동과 비장애 형제간 상호작용 향상을 위한 협력적 악기연주 프로그램 적용 사례 (Improving Social Interaction Between Children With Autism Spectrum Disorder and Their Neurotypical Siblings Through a Cooperative Music Playing Intervention)

  • 정진원
    • 인간행동과 음악연구
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    • 제20권2호
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    • pp.61-88
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    • 2023
  • 본 연구는 자폐스펙트럼장애(Autism Spectrum Disorder, 이하 ASD) 아동과 비장애 형제를 대상으로 협력적 악기연주 프로그램을 실행하여 형제간 상호작용에 긍정적인 영향을 미치는지를 알아보기 위한 사례연구이다. 대상자는 만 7-12세 ASD 아동 3명과 만 6-11세 비장애 형제 3명으로 ASD 아동과 비장애 형제로 구성된 각 그룹이 40분씩, 주 2회, 총 8회기의 중재에 참여하였다. 중재는 동시적 행동 수행의 단계, 상호보완적 행동 수행의 단계, 협력을 통한 공동의 목표 성취의 단계 총 3단계로 구성되었다. 매회기 중재 시 ASD 아동과 비장애 형제에게 나타난 상호작용 시작·반응행동, 연쇄적 상호작용 행동 및 협력적 연주 행동을 관찰하여 측정하였으며 중재 전후 비장애 형제는 형제관계척도를 보호자는 보호자가 지각한 형제관계척도를 평정하도록 하였다. 연구 결과, 상호작용 시작·반응행동, 연쇄적 상호작용 행동, 협력적 연주 행동이 중재 회기가 진행됨에 따라 점차 증가하는 양상을 보였다. 보호자와 비장애 형제가 평정한 형제관계척도의 평정 점수 또한 프로그램 후 증가하였으나 형제 갈등 및 경쟁의식 하위 영역에서는 뚜렷한 변화가 나타나지 않았는데 이는 형제간 접촉이 증가하면서 갈등과 경쟁의식을 경험하는 기회 역시 증가할 수 있음을 나타낸다. ASD 아동과 비장애 형제가 함께 참여하는 중재 연구의 필요성이 증가하는 시점에서 본 연구 결과는 공동의 목표를 가지고 협력적으로 연주하는 중재가 형제간 상호작용 시도 및 친밀감 증가에 효과적일 수 있음을 시사한다.

A Role for Leu247 Residue within Transmembrane Domain 2 in Ginsenoside-Mediated α7 Nicotinic Acetylcholine Receptor Regulation

  • Lee, Byung-Hwan;Choi, Sun-Hye;Pyo, Mi Kyung;Shin, Tae-Joon;Hwang, Sung-Hee;Kim, Bo-Ra;Lee, Sang-MoK;Lee, Jun-Ho;Lee, Joon-Hee;Lee, Hui Sun;Choe, Han;Han, Kyou-Hoon;Kim, Hyoung-Chun;Rhim, Hyewhon;Yong, Joon-Hwan;Nah, Seung-Yeol
    • Molecules and Cells
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    • 제27권5호
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    • pp.591-599
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    • 2009
  • Nicotinic acetylcholine receptors (nAChRs) play important roles in nervous system functions and are involved in a variety of diseases. We previously demonstrated that ginsenosides, the active ingredients of Panax ginseng, inhibit subsets of nAChR channel currents, but not ${\alpha}7$, expressed in Xenopus laevis oocytes. Mutation of the highly conserved Leu247 to Thr247 in the transmembrane domain 2 (TM2) channel pore region of ${\alpha}7$ nAChR induces alterations in channel gating properties and converts ${\alpha}7$ nAChR antagonists into agonists. In the present study, we assessed how point mutations in the Leu247 residue leading to various amino acids affect 20(S)-ginsenoside $Rg_3$ ($Rg_3$) activity against the ${\alpha}7$ nAChR. Mutation of L247 to L247A, L247D, L247E, L247I, L247S, and L247T, but not L247K, rendered mutant receptors sensitive to $Rg_3$. We further characterized $Rg_3$ regulation of L247T receptors. We found that $Rg_3$ inhibition of mutant ${\alpha}7$ nAChR channel currents was reversible and concentration-dependent. $Rg_3$ inhibition was strongly voltage-dependent and noncompetitive manner. These results indicate that the interaction between $Rg_3$ and mutant receptors might differ from its interaction with the wild-type receptor. To identify differences in $Rg_3$ interactions between wild-type and L247T receptors, we utilized docked modeling. This modeling revealed that $Rg_3$ forms hydrogen bonds with amino acids, such as Ser240 of subunit I and Thr244 of subunit II and V at the channel pore, whereas $Rg_3$ localizes at the interface of the two wild-type receptor subunits. These results indicate that mutation of Leu247 to Thr247 induces conformational changes in the wild-type receptor and provides a binding pocket for $Rg_3$ at the channel pore.

Staged Improvement in Awareness of Disease for Elderly Cancer Patients in Southern China

  • Li, Xing;Dong, Min;Wen, Jing-Yun;Wei, Li;Ma, Xiao-Kun;Xing, Yan-Fang;Deng, Yun;Chen, Zhan-Hong;Chen, Jie;Ruan, Dan-Yun;Lin, Ze-Xiao;Wang, Tian-Tian;Wu, Dong-Hao;Liu, Xu;Hu, Hai-Tao;Lin, Jia-Yu;Li, Zhuang-Hua;Liu, Yuan-Chao;Xia, Qing;Jia, Chang-Chang;Wu, Xiang-Yuan;Lin, Qu
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6311-6316
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    • 2015
  • Background: In mainland China, awareness of disease of elderly cancer patients largely relies on the patients' families. We developed a staged procedure to improve their awareness of disease. Materials and Methods: Participants were 224 elderly cancer patients from 9 leading hospitals across Southern China. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between family and patients, patient awareness of their disease and participation in medical decision-making. After first cycles of treatment, increased information of disease was given to patients with cooperation of the family. Then patient awareness of their disease and participation in medical decision-making was documented. Results: Among the 224 cancer elderly patients, 26 (11.6%) made decisions by themselves and 125 (55.8%) delegated their rights of decision-making to their family. Subordinate family members tended to play a passive role in decision-making significantly. Patients participating more in medical decision-making tended to know more about their disease. However, in contrast to the awareness of disease, patient awareness of violation of medical recommendations was reversely associated with their participation in medical decision-making. Improvement in awareness of diagnosis, stages and prognosis was achieved in about 20% elderly cancer patients. About 5% participated more actively in medical decision-making. Conclusions: Chinese elderly cancer patient awareness of disease and participation in medical decision-making is limited and relies on their family status. The staged procedure we developed to improve patient awareness of disease proved effective.