• Title/Summary/Keyword: The psychologic therapy

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A Case Report of Symptomatic Torus Palatinus (구개 융기의 치험례)

  • Kwon, Jun-Seong;Choi, Hwan-Jun;Yang, Hyung-Eun;Tark, Min-Seong
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.473-476
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    • 2010
  • Purpose: Torus palatinus is a bony prominence at the middle of the hard palate. The size varies from barely discernible to very large, from flat to lobular. This oral exostosis is not a disease or a sign of disease, but if large, may be a problem. So, we present the clinical and histopathologic features and applied therapy and provide a comprehensive review of the rare case of the symptomatic exostoses. Methods: A 37-year-old woman had slowly growing exophytic nodular mass of the bone that arises the midline suture of the hard palate. The patient was concerned about discomfort associated with movement of her tongue and about frequent irritation of the palatal mucosa during mastification of the hard food. The patient had a large, unilobulated torus palatinus. It extended from the area adjacent to the canine to a point beyond the junction with the soft palate. The mass was oblong in shape, measuring about 3 cm long, 2 cm wide, and 0.8 cm in height. Results: Before surgical intervention a CT was obtained for the sake of estimating the thickness of the bone between the exostoses and the maxillary antrum and floor of the nose. The surgical procedure was performed with the patient under general anesthesia. Removal of the exostosis was performed after midline mucoperiosteal incision with osteotome and diamond burr. Histologic finding revealed decalcified dense bony tissue, the presence of lacunae, and normal osteocytes. Conclusion: Surgical removal is recommended when one or more of the following condition exist: interference with the construction of prosthesis, interference with oral function, irritation or pathology of the overlying tissue, inability of the patient to maintain proper oral hygiene, and fear of malignancy or other psychologic trauma. We report a rare case of the torus arising in hard palate with symptoms.

A Literature Study of Senile Constipation (노인(老人) 변비(便秘)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Jeong, Chang-Hwan;Shin, Hyeon-Chul;Jeong, Ji-Cheon
    • The Journal of Internal Korean Medicine
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    • v.16 no.1
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    • pp.40-61
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    • 1995
  • This study was performed to investigate concept, systoms, causes of disease, pathogenic mechanisms, therapies and precriptions about senile constipation through the successive medical literature, recent chinese medical literature and chinese medical joumals. Senile constipation seems to be applicable to dryness syndrom and constipation of insufficiency type, have something to do with kidney(the most), lung, spleen and large intestine. The most principal cause of disease is yin-fluid, the rest deficiency of qi, insufficiency of yang, stagnation of qi and retention of fever etc. There are enriching the blood and moistening dryness in principal therapy, the rest are invigorating qi and loosing the bowel, warming and invigorating the spleen and kidney, regulating the flow of qi and promoting the stagnancy of qi and expelling the pathogenic heat etc. In prescriptions there are Yunjangtang, Jengaektang, Hwanggitang, Jechunjeon, Yukmatang and Majainhwan as the causes of disease, meanwhile are Yungjang-tang, Jechunjeon and Majainhwan in the vulgaris prescriptions. And in medical herbs there are nourishing yin medicines as Rhizoma rehmanniac, Radix ophiopogonis and Radix scrophulariae etc., invigorating qi medicines as Radix astragali, Radix codonopsitis and Radix polygoni multiflori etc, invigorating yang medicines as Caulis cistanchis and Semen psoraleae etc., promoting qi circulating medicines as Radix saussurea, Lignum aquilariae and Radix linderae etc., and reducing fever and therapeutic method to keep the adverse qi flowing downward medicines as Semen cannabis, Rhizoma rhei, Fructus immaturus ponciri, and Cortex magnoliae etc.. Meantime Rhizoma rehmanniae, Radix ophiopogonis, Caulis cistanchis, Radix angelicae gigantis, Semen cannabis, Semen biotae, Semen pruni japonicae and Semen persicae in principal herb-medicines. In clinical reports the process of disease was between 10 to 20 years, the evacuation cycle between 4 to 7 days, generally possessed chronic diseases as hypertension, diabetes, arteriosclerosis and cerebro- vascular disorders etc. and the efficiency rate was more than 90%. The senile constipation is occured in succession or promoted by chronic diseases as obesity, hypertension, diabetes, arteriosclerosis. hrperlipemia, cerebro- vascular disorders etc., so diet-regulating, adequate exercise, proper evacuation-habit and psychologic rest etc. are important more than medicine-treatments.

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The Analysis of Dental Hospital Patients with Trigeminal Neuralgia (치과병원에 내원한 삼차신경통환자의 치험예 (34예 분석))

  • Kim, In-Jung;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.25 no.2
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    • pp.235-240
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    • 2000
  • This study was carried out among 34 patients who visited Yonsei Dental Hospital from 1996. 1. to 1999. 5 for trigeminal neuralgia. By studying the patient's treatment prior to visiting our hospital, features of trigeminal neuralgia, treatment process of trigeminal neuralgia, prognosis of treatment, consultation with other professions and involvement of surgery, etc., the results are as follows: 1. 67.7% of onset age range from 40s to 60s, and average age is 50.2. 2. Ratio of right to left involvement is 1:2.1, male to female ratio is 1:1.9. 3. Occurrence rate of each branch is V3(44.1%), V2(11.8%), V1+V2+V3(11.8), V1+V2(8.8%). 4. Treatments prior to admission to our hospital are extraction(5.9%), endodontic treatment(5.9%), medication(11.8%), Oriental Medicine treatment(5.9%). 5. Routes of admittance to our hospital are by their preference(55.9%), local clinic referral(32.4%), E.N.T referral(5.9%), Neurology referral(5.9%). 6. 70.6% of patients treated at our hospital who were relieved of symptoms, were referred to Neurology(66.7%) and Pain Clinic(33.3%) for the reason of relapse, side effects of the drug itself, incomplete relief of pain. 7. 2 patients who were referred to medical part showed brain vessels contacting trigeminal nerve root on Brain MRangiography. But pain is being controlled by medication and no specific surgical procedure was carried out. The results show that 17.7% of patients admitted received inappropriate early treatment. In order to relieve tooth loss and patient's psychologic stress due to inappropriate treatment, precise differential diagnosis must be made among local teeth disease and idiopathic facial pain. Medication may show side effects of the drug itself, incomplete relief of pain or relapse of symptoms. Therefore, to treat trigeminal neuralgia appropriately by drug injection, surgery or radiation therapy, consultations among dentists, neurologists and anesthesiologists are required.

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Automatic Nerve Activity to Physiologic Response in Adult With Psychiatric Disorder: A Systemic Review (성인 정신장애의 청각자극에 따른 생리학적 반응 측정에 대한 체계적 고찰)

  • Jung, Hye-Rim;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.1
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    • pp.45-52
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    • 2011
  • Objective : The aim of this study was to provide the method to measure physiologic response using equipments and auditory stimulation, and the physiologic response features of adult psychiatric disorders through a systemic review. Methods : The systemic review was executed using PubMed. The key words for search were "auditory stimulation, auditory startle, electromyograph, skin conductance, heart rate, psychiatric disorder, anxiety disorder, schizophrenia, depression". 8 studies were used for data analysis, and all of levels of evidence were level II. The substances of the review were subject(population), auditory stimulation, measure equipments and physiologic response features of psychiatric disorder. Results : 1. The subjects for the studies were anxiety disorder(4) and schizophrenia(4). 2. Auditory stimulation was used in 8 studies and visual stimulation with auditory stimulation was used in 2 studies to induce physiologic response. 3. Every study used electromyograph, and skin conductance was used in 2 studies and heart rate was used in 2 studies with electromyograph to measure physiologic response. 4. The subjects for the studies, schizophrenia and anxiety disorder(PTSD, OCD) have different physiologic response features with the normal control group. Conclusion : All studies used simple tones as an auditory stimulation and electromyograph to measure physiologic response. Psychiatric disorders indicated larger response, shorter and delayed habituation. The objective and systematic study using physiologic measure to investigate the sensory feature of psychologic disorders.

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Increase of Spoken Number of Syllables Using MIT(Melody Intonation Therapy) : Case Studies on older adult with stroke and aphasia (MIT(Melodic Intonation Therapy) 중심의 음악활동을 이용한 실어증을 가진 뇌졸중 노인의 음절 수 증가에 대한 사례 연구)

  • Hong, Do Kyoung
    • Journal of Music and Human Behavior
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    • v.2 no.2
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    • pp.57-67
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    • 2005
  • Most of stroke patients have not only physical difficulty but speech and neurological disorder because of hemiplegia and such unexpected changes cause psychologic disadaptability and absent-mindedness. Particularly, lowering of physical ability can lead to serious emotional problem from failure or frustration in daily life. Generally, treatment of patient with stroke put emphasis on physical rehabilitation but actually this patient had considerable speech disorder such as aphasia or articulation disorder. Moreover, failing of recognition function, mental disorder as hypochondria, and even visual and auditory disorder are represented. So it is effective to integrate verbal remediation and other treatments in medical care environment. In particular, patients with language disorder very often wither psychologically therefore it is efficient to use of music therapy that gives opulent emotion to aphasia patients. And primarily to investigate the effects of 10 sessions treatments; change in spoken total number of syllables, to confirm their own value by success of given task and reassure about themselves ability. All of 10 sessions stages were scored by MIT manual and its improvement were measured, that is, accomplishment was analyzed within each level in order to prove detail change of spoken total number of syllables. The result of this program organized from 2 syllables to 4 syllables is summarized as follows. Subject A completed in preliminary stage Level I, in 2 syllables case advanced to Level III in fifth session and to Level IV in seventh session, in 3 syllables case advanced to Level III in seventh session and to Level IV in ninth session, and in 4 syllables case showed 8% low success rate in first session but after repeated practice increased considerably in sixth session and in advanced to Level III in eighth session to Level IV in tenth session. Subject B also completed in preliminary stage Level I, in 2 syllables case advanced to Level III in forth session and to Level IV in sixth session, in 3 syllables case advanced to Level III in fifth session and to Level IV in seventh session, and in 4 syllables case showed 10% low success rate in first session and increased considerably in fifth session and in advanced to Level III in seventh session but could not reach to Level IV until tenth session. As a result, it was shown that music therapy using MIT was not statistically meaningful but improved spoken total number of syllables and success rate of task had improved as a whole. Therefore, music intervention using MIT it has positive affect on verbal ability of patients with Broca's Aphasia and their language rehabilitation.

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Effects of Horticultural Therapy on the Improvement of the Self-Esteem and Sociality of Mentally Retarded Persons (원예치료프로그램의 적용이 정신지체장애인의 자기주장 및 사회성 향상에 미치는 영향)

  • 박민희;차영주;유영원;부희옥;이숙영
    • Korean Journal of Plant Resources
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    • v.17 no.3
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    • pp.339-351
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    • 2004
  • This study was conducted to evaluate the effect of phased horticultural therapy(HT) program on the experience of psychologic therapy and the development of job and social integration in the mentally handicapped persons. In this study, the mentally handicapped persons participated in HT program were chosen in disabled person's welfare institute of Jeonnam. HT program was performed twice a week with 1 hour activity for 4 months. As a results, the mentally handicapped persons participated in HT program showed high interest of horticulture and improvement of self-respect and the high satisfactory degree of HT program. Therefore, the mentally handicapped persons were showed the experience of both physical and mental therapy, improvement of self-esteem scale and sociality in HT program. Also, the application of HT program with continuously interest will be showed high improvement of physical, psychological and sentimental. In the course of this HT program progress, horticultural therapist and social welfare officer were showed the limitation of role. Therefore the leaders of group for successful HT program be required the comprehensive plan of more efficient HT program and induced technique of continuously up-phased improvements in HT program progress.

A Study on the Physiological and Psychological Factors related to Successful Weaning from a Mechanical Ventilator (기계환기기 이탈의 성공과 관련된 생리적${\cdot}$심리적 요인에 관한 조사 연구)

  • Kim, Cho-Ja;Kim, Hwa-Soon;Jang, Yeon-Soo;Kim, Eun-Sung
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.995-1005
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    • 2000
  • This study was performed to identify the physiological and psychological variables related to successful weaning from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as follows; Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between the both groups, therefore future studies are needed to focus on searching other variables besides physiological parameters related to weaning outcome.

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Surgical Treatment of Gastric Cancer

  • Kim, Sang-Woon
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.105-116
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    • 2003
  • Definitely, treatment for gastric cancer is primarily surgical. Detection in early stage of disease and complete surgical resection is the best way to cure gastric cancer. If surgery is planned, careful preoperative evaluation and corrections of physiologic and psychologic abnormalities are essential to reduce perioperative morbidity or mortality. Basic principle of gastrectomy for gastric cancer is an en bloc resection of tumor with adequate margins of normal tissue and with regional lymph nodes and omental tissues. To complete these principles, regional lymph nodes and all omental tissues should be removed altogether during performing various types of gastric resection. The lymph node dissection is one of the most effective procedures for gastric cancer to achieve curative resection. The basic types of gastric resection are distal subtotal gastrectomy and total gastrectomy according to the condition of primary lesions and the status of lymph node metastases. When the primary lesion is located near the esophagogastric junction, it is sometimes hard for a surgeon to select adequate surgical method. Postoperative quality of life in a patient has become a very important factor to be considered in every step of surgical therapy. With increasing incidence of early gastric cancer, a number of surgical trials for limited surgery or endoscopic procedures have been performed, but the long-term clinical results should be carefully analyzed to define the clinical relevance of these new techniques. For patients with disseminated gastric cancer, a palliative procedure can be performed to improve quality of life of patients and to avoid immediate death due to the cancer-related complications.

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Sports Psychiatry (스포츠 정신의학)

  • Han, Doug-Hyun;Na, Chul;Lee, Young-Sik
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.95-102
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    • 2004
  • Backgrounds: It was thought that sport was related with mentality. Compared to psychology, psychiatry has so far paid rather little attention to athletes. In this overview, I attempted to introduce the ideas of various observers of sports with the view of clinical psychiatry and summarized basic principle role of psychiatrist. Results and Discussions : To understand the athletic frame of mind, it is helpful to observe athletes in their psychologic development and when we do so we can quickly see trends that are not apparent by observing mature athletes alone. Psychobiology of sport would discuss some of the endogenous neurochemicals(hormone, neurotransmitter) that may be part and parcel of the athlete's psychiatric status. The psychological problems that frequently interfere with training and competition may be divided into five categories 1) choke, 2) slump, 3) injury, 4) interpersonal problem, 5) training dilemma. Psychiatric problem also arise in athletes like general people. various method for psychiatric patients like psychotherapy, group therapy, family systems perspective, and pharmacotherapy could been applied to sports psychiatry. Conclusions Although the contribution of sports psychiatry to sport is clinical one, psychiatrist's interest in role and conflict of athlete would enhance the molding of humanistic athletes who enjoy their life and sports.

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A Study of the Effect of Structured Rehabilitation Education on the Stress of the Family with Stroke Patients (구조화된 재활교육이 뇌졸중환자 가족의 스트레스에 미치는 영향)

  • Kim, Byung-Eun;Lee, Jung-Min;Lee, Hyang-Yeon
    • Journal of East-West Nursing Research
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    • v.1 no.1
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    • pp.22-39
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    • 1997
  • Purpose: The purpose of this study is to evaluate the effect of rehabilitation education on the reduction of the stress of family members who have patients suffering from stroke and to find a new way to nurse the patients and their family. Subjects & Methods: The subjects were sixty-one family members with the patients who had been hospotalized in K hospital of oriental medicine from september the 9th, 1996 to september the fourteen, 1996. This study was performed by simulated control group pretest-posttest design; pretest was done on the control group through a questionnaire, counselling and observation while posttest was done on the experimental group 1-2 days after systemic rehabilitation education. To teach the patients and their family, the amended version of a book written by Lee Hae-jin was used as a tool for systemic rehabilitation education. As a method to estimate ADL score, modified Kang's method was applied and ADL score was measured by well-trained technician. As for the tool to estimate the degree of family stress, Choi's method adjusted to this study was applied. In the analysis of the data, social property of the patient and the characteristic of the disease were surveyed in $X^2$ examination to confirm the consistency between the experimental group and the control group. The diffrence in the degree of the stress, which is a dependent factor, was examined by t-test. The difference in ADL score between the experimental group and the control group was examined by t-test. The difference in the degree of the stress according to the general feature of the family with stroke patient, social property of the patients and the characteristic of the disease were surveyed by F examination. The difference in family stress according to the degree of ADL was surveyed by F examination. RESULTS: 1. After hypothetically-examined systemic rehabilitation education, the total of the score of family stress surveyed in 34 items of three domains was compared between the experimental group and the control group. There was no statistically significant difference between two groups; mean score of experimental group=2.28, that of control group=2.93(t=.17, df=59, p=. 66). 2. In the survey on family stress in 34 items, the items over mean score 3.0 were firstly the anxiety of possible disability and relapse of the disease and secondly to watch the patient's suffering without doing anything in the domain of the change of the disease and the difficulty in caring. And the items of the lowest stress with less than mean 2.0 score were little chance to meet the relative and friends, inconsistent treatment and attitude of the medical workers and the change of the attitude of the relative due to the patient orderly in the domain of social and personal relation and the responsibility as the family. The items which showed the difference between two groups were aggravation of neighboring patient(t=3.36, df= 59, p=.001) and the possibility of patient's death(t=2.19, df=58.38, p=.033) in the domain of the change of the disease and the difficulty in caring. 3. In the study on the stress difference according to general features of the family with the stroke patient, the score of family stress with the occupation was higher with mean 2.49 than that of the family stress without occupation with mean 2.16, but there was no significant difference. (F=5.21, df=1/59, p=.026). 4. In the study on the stress difference according to social property of the patient and the characteristic of the disease, there was significant difference in the age of the patients (F=2.98, df=3/57, p=.039). These results show that even if there is no statistically significant difference between two groups, sixteen of the experimental group are less than 3.0 in ADL score(standard 6 score)while eight of the control group are less than 3.0 and that ten of the experimental group are in the year range of 39-49 while four of the control group are in the year range of 39-49 which showed significant difference in family stress. These imply that there is a possibility that the experimental group have serious and fundamental stress resulting in high pretest stress compared with the control group. It might be due to the characteristic of simulated control group pretest-posttest design that the psychologic-supportive effect by the education was not observed. On the basis of these results, the followings are suggested. 1) A study on the nursing-mediated method to reduce the stress in the items which are not resolved by rehabilitation education, a study on nursing according to the patient's age and a study on the supportive nursing toward the family with occupation are required. 2) More than two times consecutive nursing-mediated rehabilitation education to measure the family stress is required. 3) Comprehensive and multilateral systemic education program including the instruction on western-eastern medicine, physical therapy, exercise and diet through collaboration of the experts in each field is required. 4) Family stress at home as well as in the hospital needs to be estimated and home rehabilitation and home-nursing needs to be continued.

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