• Title/Summary/Keyword: Psychosis

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Recurrent Herpes Zoster on the Supraorbital Counter Area -A case report- (반대편 눈확위신경 영역에 재발된 대상포진 1예)

  • Son, Ji-Seon;Oh, Kwang-Jo;Han, Young-Jin;Lee, Jun-Rae;Choe, Huhn
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.266-270
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    • 2001
  • An 85-year old female patient visited our pain clinic because of pin pricking pain and allodynia on the left forehead area for 2 days. Vesicular eruptions were seen along the left supraorbital nerve distribution. She experienced similar pain and eruptions on the contralateral forehead, the supraorbital counter area, 8 years previous. She had been taking antihypertensive medications for 15 years. She also had suffered from diabetes mellitus. She received a total hysterectomy and anterior posterior colporrhapy due to procidentia uteri and severe cystocele and rectocele. She had been treated intermittently for back pain due to advanced osteoarthritis and spondylosis. She was treated with famciclovir and triamcinolone acetonide with daily stellate ganglion block and supraorbital nerve block. Nortriptyline (a tricyclic antidepressant) and midazolam was prescribed to relieve pain and difficulty in sleeping. After 3 days, all treatment was ended because it was impossible to assess the severity of pain due to the senile psychosis of the patient. She eventually expired after 2 months. We report this case because it is rare for herpes zoster to recur, and particularly on the contralateral counter area.

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The Thought of Che-Qi-Jung concerned with Phenomenon of Stress (STRESS 현상(現象)과 관련(關聯)된 제기증(諸氣證)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Koh, Tae Joon;Lee, Sang Ryong
    • Journal of Haehwa Medicine
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    • v.8 no.2
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    • pp.317-327
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    • 2000
  • Through the study about Che-Qi-Jung(諸氣證) concerned with phenomenon of stress, we concluded as fallow. 1. Stressors are recognized three parts, internal cause, external cause, non-interexternal cause, in the oriental medicine. And the reaction of the body about stressors, was expressed change of Qi(氣). 2. The vascular system and autonomic nervous system are tensed or relexed. Because the etiology of Yuk-Em(六淫), Chil-Jeong(七情) make lose up and down, in and out, circulation of Gi(氣). The symtom caused with stress are explained, divided into Chil-Qi(七氣), Gu-Qi(九氣), Joong-Qi(中氣), Qi-Tong(氣痛), Qi-Yuk(氣逆), Qi-Wool(氣鬱). 3. The symtom of Chil-Qi is recognized into psycholoQical stress and Mae-Haek-Qi(梅核氣). The symtom of Gu-Qi is composed of Chil-Qi and Han(寒), Youl(熱), Ro(勞). 4. The symtoms of Qi-Yuk and Joong-Qi are caused by the ascent of Hwa-Qi(火氣). And Hwa-Qi is made by rage and depression. Qi-Yuk is chronic symtom that the ascent of Hwa-Qi is made by out of function in up and down mechanism of Qi. Joong-Qi is acute symtom that patholoQical state of Qi-Yuk take place for a while by sudden psycholoQical shock. 5. The symtom of Qi-Wool is loss of funtion made by depressed state in physioloQical mechanism, and Qi-Wool is observed in depressive psychosis and hypochondriasis and psychogenic. 6. The symtom of Qi-Tong is the pain caused by interference of circulation of Qi-Hyul(氣血). PsycholoQical stimulation such as rage and depression, tense autonomic nervous system. This make convulsion in gastro-intestine or vascular circuluation or abdominal muscles, and the pain is caused by convulsion.

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The Prescribing Patterns of Antipsychotic Drugs and Antiparkinsonian Drugs in Elderly Patients with Dementia (노인 치매 환자의 항정신병약물 및 항파킨슨약물 처방 현황)

  • Yoon, Soo Mi;Lee, Sungwon;Chang, Ji-Eun;Lee, Young Sook;Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.2
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    • pp.81-86
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    • 2020
  • Background: The number of patients with dementia continues to increase as the age of aging continues to grow. Psychiatric symptoms caused by senile dementia are controlled using antipsychotics. However, these antipsychotics can lead to Parkinson's disease, and abuse of dopamine derivatives such as levodopa among Parkinsonian drugs can lead to psychosis. Therefore, we evaluated the patterns of prescribed antipsychotics and antiparkinsonian drugs in patients with senile dementia. Methods: We used data from the sample of elderly patients from the Health Insurance Review and Assessment Service (HIRA-APS-2016). We analyzed the patterns of prescribing antipsychotics and antiparkinsonian drugs including prescribed daily dosage, period of prescription, and number of patients with both antipsychotics and antiparkinsonian drugs for senile dementia. Results: Among the 159,391 patients with dementia included in this analysis, 4,963 patients (3.1%) and 16,499 patients (10.4%) were prescribed typical and atypical antipsychotic drugs, respectively. The most frequently prescribed typical antipsychotic was haloperidol (4,351 patients with dementia), whereas the atypical agent was quetiapine (12,719 patients). The most frequently prescribed antiparkinsonian drugs were in the order of levodopa/carbidopa, benztropine, and ropinirole. In addition, 1,103 and 3,508 patients prescribed typical and atypical antipsychotics, respectively, were co-prescribed antiparkinsonian drugs. Conclusions: Atypical antipsychotics were the preferred prescription in patients with senile dementia. The prescription dose was relatively low; however, the average treatment duration was mostly long-term. Selection of antipsychotics and/or antiparkinsonian drugs should be made carefully in senile dementia and the causal relationship of adverse drug reactions needs further study.

A Case of Negative Symptoms of Schizophrenia (전증(癲證) 환자의 치험 1례)

  • Heo, Eun-Jung;Kim, Ji-Hyon;Lyu, Heui-Yeong
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.2
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    • pp.215-227
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    • 2010
  • Objectives : Jeon-Jeung(癲證) is one of negative symptoms from schizophrenia in Western medecine, which causes flattening of affect, emotional bluntness, and avolition. Compared with positive symptoms of schizophrenia, there is no established treatments that have been proved to be effective for negative symptoms, and since negative symptoms are chronically processed, they finally lead to devastate the mental health. Since Jeon-Jeung(癲證) is usually in set in adolescent period and tends to become chronic through life time, it is important to start getting treatments in early stage by being distinguished from other diseases, such as anxiety disorder. A patient in this case was affective blunting, general weakness, and delusion when sixteen years old. However, he refused to get Western medicine treatment and wanted oriental medicine treatment. Methods : The patient in this case had been suffered from severe stress from his family since he was young and had kept having irregular and unhealthy eating habits. Therefore, he diagnosed stagnant qi transforming into fire(氣鬱化火), heart blood deficiency(心血虛), and spleen-stomach deficiency cold(脾胃虛寒) and since then he had received several treatments including herbal treatment, acupumcture treatment, supportive therapy, and family therapy. These treatments were successful and reduced the level of symptoms. After discharged from the hospital, he had continued receiving outpatient treatment with his family for 8 months and his progress had been still observed after the discharge. Results : The symptoms of patient had been almost reduced and eliminated after he received 29days of admission treatment and the patient got better and better and now lives a normal life 8 months outpatient treatment. Conclusions : This result suggests that our oriental medical treatments and family treatments was effective on schizophrenia.

Two Cases of Systemic Lupus Erythematosus with Cerebrovascular Involvement (뇌 혈관계를 침범한 전신성 홍반성 루푸스 2례)

  • Kim, Bong-Jun;Lee, Eun-Young;Hong, Young-Hoon;Park, Ki-Do;Song, Young-Doo;Lee, Choong-Ki;Shim, Young-Ran
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.371-380
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    • 1998
  • Systemic lupus erythematosus(SLE) is an autoimmune disease which may affect many different organs and disclose various clinical manifestations. Recently central nervous system(CNS) involvement has been recognized as an increasingly significant contributor to morbidity and mortality of SLE. The clinical manifestations of CNS-lupus are highly variable and range from mild cognitive dysfunction, movement disorder, headache, psychosis to life-threatening stroke and coma. Among the neuropsychiatric disorders encountered in patients with SLE, cerebrovascular disease has been a relatively rare complication. The diagnosis and management of CNS-lupus is difficult because of the lack of useful diagnostic methods. If cerebrovascular involvement is suspected, aggressive treatment such as high dose steroid, immunosuppressive therapy, plasma exchange may be required to reduce high mortality rate. We experienced 2 cases cerebrovascular dis eases occurring in SLE patients which presented with various neuropsychiatric manifestations. They were diagnosed as CNS-lupus by neuropsychiatric symptoms, brain MRI, and BEG, and showed good response to high dose steroid pulse therapy.

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CLINICAL SUBTYPING AND TREATMENT STRATEGY OF COLLEGE ENTERANCE EXAMINATION STRESS SYNDROME (입시병의 아형과 대처방안)

  • Lee, Young-Sik;Ku, Young-Jin;Lee, Kil-Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.43-48
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    • 1991
  • The College entrance examination stress syndrome is a kind of anxiety disorder. The underlying cause of this disorder is not a test anxiety itself. One's hidden inner and familial conflicts are more likely attributed to this disorder. Patient's the most common complaints are various psychosomatic symptoms but in severe cases underlying psychopathology may be activated and progress to major psychosis. In a broad sense adolescent's delinguent behavior, drug abuse, school drop-out and sucide are closely related to this syndrome. In clinical management of these patients, considering the special situation of impending examination, the therapist must access to central conflict theme in a short time without severe resistance. The authors classified this syndrome into 5 clinical subtypes ; 'the anxious group', 'the exhaustion group', 'the despair group', 'the emptyness group' and 'the boredome group'. Typical case of each subtype and it's management methods were presented briefly.

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Analysis of the Important Herb Medications Corresponded with Neuropsychiatry of "Bang-Yak-Hap-Pyun" (방약합편(方藥合編)에 수재된 신경정신과(神經精神科) 관련 주요 처방(處方)에 대한 연구(硏究))

  • Kim, Jee-Hoon;Koo, Byung-Soo;Kim, Geun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.1
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    • pp.89-106
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    • 2009
  • Objectives : The purpose of this study is to analysis of the herb medications corresponded with neuropsychiatry of "Bang-Yak-Hap-Pyun". Methods : The herb medications of "Bang-Yak-Hap-Pyun" Sang.Jung.Ha-Tong(上.中.下統) and "Enlargement side prescriptions" (增補方) are selected by comment on the chief virtue including reference word of corresponded with neuropsychiatry. Results and Conclusion : "Bang-Yak-Hap-Pyun" is a book most people who have a background or career in Han Medicine(韓醫學) would pore over. They corresponded with neuropsychiatry among the herb medications of "Bang-Yak-Hap-Pyun" Sang.Jung.Ha-Tong(上.中.下統) are 55 prescriptions that Sang-Tong(上統) is 8 prescriptions, Jung-Tong(中.統) is 23 prescriptions and Ha-Tong(下統) is 24 prescriptions. And the herb medications corresponded with neuropsychiatry of "Enlargement side prescriptions" (增補方) are 40 prescriptions. And then the herb medications corresponded with neuropsychiatry of "Bang-Yak-Hap-Pyun" received much influence from "Dong-Eui-Bo-Gam". Incidentally the herb medications corresponded with neuropsychiatry of "Bang-Yak-Hap-Pyun" Sang.Jung.Ha-Tong showed the high percentage in Neurosis. And the herb medications corresponded with neuropsychiatry of "Enlargement side prescriptions" showed the high percentage in Psychosis. Besides not only put "Enlargement side prescriptions a premium on "Dong-Eui-Bo-Gam", but also made it the herb medications which were recorded on books flowed after "Dong-Eui-Bo-Gam" known. It was entered up books quoted from "Bang-Yak-Hap-Pyun" Sang.Jung.Ha-Tong but the herb medications were that were not succeeded from "Bang-Yak-Hap-Pyun" Sang.Jung.Ha-Tong. Therefore "Enlargement side prescriptions" shows the efforts for supplement of "Bang-Yak-Hap-Pyun" Sang.Jung.Ha-Tong.

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Comparison of Clinical Characteristics between Patients with Early-Onset and Adult-Onset Schizophrenia : A Retrospective Study (조기 발병 조현병과 성인기 발병 조현병의 임상적 특성의 비교 : 후향적 연구)

  • Kim, Pyung-Soon;Shin, Jae-Ho;Lee, Chang-Hwa
    • Korean Journal of Biological Psychiatry
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    • v.20 no.4
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    • pp.179-186
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    • 2013
  • Objectives This study is designed to compare the clinical characteristics of patients with early onset schizophrenia to those of adult onset schizophrenia patients in first episode. Methods Authors reviewed medical records of 16 early-onset schizophrenia patients and 22 adult-onset schizophrenia patients who had been admitted in the psychiatric ward and diagnosed as schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, fourth Edition (DSM-IV) at Eulji University Hospital during 2004-2008. Socio-demographic data and clinical characteristics such as duration between onset and active phase, number of significant positive and negative symptoms, positive and negative symptom scores of Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S) scores, duration from onset to admission, duration of admission, and equivalent dose of antipsychotics were reviewed. These clinical characteristics of early-onset group were compared to those of adult-onset group. Correlation between age of onset and other clinical characteristics was also analyzed. Results Early-onset group showed more insidious onset pattern and had longer duration of hospitalization than adult-onset group. Early onset group also exhibited more negative symptoms, higher negative symptom scores, and higher CGI-S scores than adult-onset group after treatment. However, there were no significant differences in family history of psychosis, positive symptom frequency at discharge and equivalent dose of antipsychotics between two groups. Conclusions This study revealed that patients with early-onset schizophrenia exhibited more insidious onset, more negative symptoms, and more severe symptoms than those with adult-onset schizophrenia after treatment.

Clinical Evaluation of Surgical Treatment for Thoracic Empyema (농흉의 외과적 치료에 대한 임상적 고찰)

  • Oh, Chull-Su;Kim, Kun-Ho
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.516-522
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    • 1978
  • In spite of recent improvement of the medical and surgical treatments, there are many significant problems in the management of thoracic empyema. This is a clinical analysis of 49 cases of thoracic empyema who underwent lung decortication for a period of 6 years and 5 months extending from May, 1972 to Aug. 1975. The following results were obtained: Male to female ratio was 2. S to 1. The age ranged between Sand 69, bnt was mostly 2r.d and 5th decade. The underlying diseases were pulmonary tuberculosis (30 cases, 61. 1 SO, , ), posttraumatic hemothorax (7 cases, 14.396). pneumonia (6 cases, 12.2%), lung abscess (2 cases, 4.2%), paragonimiasis (2 cases, 4.2%). spontaneous pneumothorax (1 case, 2.1%), and unknown origin (1 case, 2.1%). In 13 cases (26.5%), positive bacterial growth on culture was reported. There were single infection in 11 cases and mixed infection in 2 cases. The organisms grown were Staphylococcus, alpha-hemolytIc Streptococcus, Alkaligenes fecalis, Escherichia coli, Pseudomonas, SerratIa, Enterobacter agglomerans, and Enterococcus in order of frequency. Staphylococcus, Streptococcus, and Serratia were sensitive to several different kinds of antibiotics. But Pseudomonas, Escherichia co:i, and Enterococcus were sensitive to only one or two antibiotics. Leukocytosis was observed In acute empyema, but not in chronic empyema. Hemoglobin and hematocrit were all within normal limits. Preoperative liver function tests were within normal limits in most of the cases. In 49 cases, lung decortication alone was performed in 40 cases (S1. 696), and for the remaining 9 cases (1S. 4%), additional surgical procedures were necessary, i. e., lobectomy (6cases). partial thoracoplasty (2 cases), and lobectomy & partial thoracoplasty (1 cases). The results of lung decortication in thoracic empyema were goed. 38 cases (77.5%) healed with no complication, and 10 cases (20.4%) were complicated by bleeding, wownd infection, pleural infection, chondritis, and psychosis. These complications resolved ultimately leaving no sequelae. One death was recorded (2.1%), and the causes of death were postoperative pleural infection, sepsis and hepatic insufficiency.

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The Early Experience of Laparoscopy-assisted Gastrectomy for Gastric Cancer at a Low-volume Center

  • Yang, Shi-Jun;Ahn, Eun-Jung;Park, Sei-Hyeog;Kim, Jong-Heung;Park, Jong-Min
    • Journal of Gastric Cancer
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    • v.10 no.4
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    • pp.241-246
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    • 2010
  • Purpose: Laparoscopy-assisted gastrectomy (LAG) has become a technically feasible and safe procedure for early gastric cancer treatment. LAG is being increasingly performed in many centers; however, there have been few reports regarding LAG at low-volume centers. The aim of this study was to report our early experience with LAG in patients with gastric cancer at a low-volume center. Materials and Methods: The clinicopathologic data and surgical outcomes of 39 patients who underwent LAG for gastric cancer between April 2007 and March 2010 were retrospectively reviewed. Results: The mean age was 68.3 years. Thirty-one patients had medical co-morbidities. The mean patient ASA score was 2.0. Among the 39 patients, 4 patients underwent total gastrectomy and 35 patients underwent distal gastrectomy. The mean blood loss was 145.4 ml and the mean operative time was 259.4 minutes. The mean time-to-first flatus, first oral intake, and the postoperative hospital stay was 2.8, 3.1, and 9.3 days, respectively. The 30-day mortality rate was 0%. Postoperative complications developed in 9 patients, as follows: anastomotic leakage, 1; wound infection, 1; gastric stasis, 2; postoperative ileus, 1; pneumonia, 1; cerebral infarction, 1; chronic renal failure, 1; and postoperative psychosis, 1. Conclusions: LAG is technically feasible and can be performed safely at a low-volume center, but an experienced surgical team and careful patient selection are necessary. Furthermore, for early mastery of the learning curve for LAG, surgeons need education and training in addition to an accumulation of cases.