• Title/Summary/Keyword: amnesia

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Dissociative Identity Disorder in an Adolescent With Nine Alternate Personality Traits: A Case Study

  • Lee, Sang-Hun;Kang, Na Ri;Moon, Duk-Soo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.33 no.3
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    • pp.73-81
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    • 2022
  • Since dissociative identity disorder (DID) has symptoms similar to schizophrenia, such as auditory hallucinations and delusional thoughts of being controlled, there are difficulties in its differential diagnosis. A 16-year-old adolescent male patient who was previously diagnosed with schizophrenia from a different hospital was admitted to our inpatient psychiatric unit for the evaluation of auditory hallucinations and suicide attempts. Through psychiatric evaluations, it was determined that the patient suffered from identity alternation, dissociation, and amnesia. As for the diagnostic evaluations, the following measures were implemented: a psychiatric interview regarding the diagnostic criteria, mental status examination, laboratory tests, brain imaging studies, electroencephalography, and full psychological test for adolescents, and the self-reported measure of the Adolescent Dissociative Experiences Scale. The patient was diagnosed with DID, and the following treatments were administered: pharmacotherapy, ego state therapy, psychoeducation regarding emotions, trauma-focused psychotherapy including stabilization, and family therapy. Following treatment, in the internal dimensions, the patient was able to recognize the nine alternate identities in charge of his emotions, which established a basis for the potential integration of identities. In the external dimensions, he showed improvements in the aspects of family conflicts and issue of school refusal. This is the first reported case of DID in an adolescent in Korea; it emphasizes the consideration of DID in the differential diagnosis of other mental illnesses such as schizophrenia, bipolar disorder, and posttraumatic stress disorder and expands the treatment opportunities for DID by sharing the procedures of ego state therapy.

Comparison of vital sign stability and cost effectiveness between midazolam and dexmedetomidine during third molar extraction under intravenous sedation

  • Jun-Yeop, Kim;Su-Yun, Park;Yoon-Sic, Han;Ho, Lee
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.6
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    • pp.348-355
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    • 2022
  • Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pressure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer's assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05. Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had similar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000). Conclusion: DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.

A Literature Review of The Senile Hypotension (노인(老人) 저혈압(低血壓)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Kwak, Ik-Hoon;Kim, Jong-Dae;Jeong, Ji-Cheon
    • The Journal of Dong Guk Oriental Medicine
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    • v.4
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    • pp.161-187
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    • 1995
  • This study was perfomed to investigate causes of the senile hypotension, pathogenic mechanism, symptoms, and therapies through medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows ; 1. The senile hypotension has major symptoms of dizziness, weakness, syncope, palpitation, shortness of breath, and deficiency of Qi. Additionally, it has minor symtoms of letharhy, isomnia, tinnitus, amnesia etc... 2. The prodromal symptoms of Kwul and Kwul are relating to the symptoms of tachycardia, facial pallor, sweating, anxietas, ambiguous consciousness, and fainting. Weakness and dizziness due to deficiency make the symptoms of exhaustion, fatigue, vertigo, lethargy, and brachycardia. 3. The most principal cause of the senile hypotension is deficiency of Shen due to aging, congenital deficiency, and chronic illness. The rest of causes are defciency of Qi and blood, phlegm of retention, stagnation of Qi, blood stasis, blood prostration etc... In the view of the occidental meicine, the causes of the senile hypotension came from the reduction of cardiac output, the decretion of cardiovascular system's extention due to aging, hereditary factor, secondary factor due to exsanguination, diabetes mellitus, C.V.A etc..., and factor of neurogenic system's degeneration. 4. The principal pathogenic mechanisms are the insufficiency of Xing-Yang, the deficiency of Qi in middle jiao, and deficiency of Shen-Qi. The rest of mechanisms are the deficiency of both Qi and blood, stagnation of the Gan-Qi, and the deficiency of Gan and Shen. Zang-Pu Organs have something to do with Xing, Bi, and Shen. 5. As principal therapies, there are warming and recuperation the Xing-Yang, strengthing the middle-jiao and replenishing Qi, replenishing vital essence to tonify the Shen, and warming and recuperation the Shen-Yang. Additionally, the therapies of invigorating the Bi and relieving mental stress, strengthning the Bi and tonifing the Shen, invigorating Qi and nourishing Yin, soothing the Gan and regulating the circulation of Qi, and tonifing the Shen and nourishing the Gan help the cure of the senile hypotension. In prescriptions there are Baohe Yuan Tang, Buzhong Yigi Tang, Zuoguei Yin, Yougui Yin, Guipi Tang, Zhu Fu Tang, Shengmai San, Sini San, and Qi Ju Dihuang Wan. The medical herbs of Astragali Radix, Codonopsitis Pilosulae Radix, Ginseng Radix, Aconiti Tuber, Ephedrae Herba, Cinnamomi Ramulus, Cinnamomi Corfex Spissus, Zingiberis Rhizoma, Polygalae Radix, Liriopis Tuber, Polygonati Sibirici Rhifoma, Lycii Fructus, Schizandrae Fructus, and Glycyrrhizae Radix can be treated. 6. According to the clinical report, the principal causes are the deficiency of Qi, and insufficiency of Yang which symptoms are dizziness, vitality fatigue and acratia, amnesia, body cold and alger of extremity, spontaneous perspiration, and therady and weak pulse. It was improved by taking WenYang YiQi Tang, Zhu Fu Tang about 20-30 days. The improvement was shown on disappearance of subjective symptoms or the ascending of blood pressure to normal figure, and the rate of improvement was over 70%. 7. As regimens, taking warming and recuperating food(a sheep mutton, juglans regia, chiness date, longan aril etc...) and pungent food(chinese green onion, fress ginger, pipers fructns etc...), doing physical training, not being ill in bed at a long time, and preventing descent of blood pressure coming from sudden change of posture are needed. Additionally, the usage of diuretic, abirritant, and depressor needs to be extra cautious.

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Effects of the Deer Antler Extract on Scopolamine-induced Memory Impairment and Its Related Enzyme Activities (녹용 추출물이 치매 동물모델의 기억력 개선과 관련효소 활성에 미치는 효과)

  • Lee, Mi-Ra;Sun, Bai-Shen;Gu, Li-Juan;Wang, Chun-Yan;Fang, Zhe-Ming;Wang, Zhen;Mo, Eun-Kyoung;Ly, Sun-Young;Sung, Chang-Keun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.4
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    • pp.409-414
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    • 2009
  • The aim of this study was to investigate the ameliorating effects of deer antler extract on the learning and memory impairments induced by the administration of scopolamine (2 mg/kg, i.p.) in rats. Tacrine was used as a positive control agent for evaluating the cognition enhancing activity of deer antler extract in scopolamine-induced amnesia models. The results showed that the deer antler extract-treated group (200 mg/kg, p.o.) and the tacrine-treated group (10 mg/kg, p.o.) significantly ameliorated scopolamine-induced amnesia based on the Morris water maze test. Although there was no statistical significance of brain ACh contents among the experimental groups, the brain ACh contents of the deer antler extract-treated group was slightly higher than that of the scopolamine-treated group. The inhibitory effect of deer antler extract on the acetylcholinesterase activity in the brain was significantly lower than that of scopolamine-treated group. The tacrine- and the deer antler-treated groups reduced the MAO-B activity compared to the scopolamine-treated group, but not significantly. These results suggest that the deer antler extract could be an effective agent for the prevention of the cognitive impairment induced by cholinergic dysfunction.

Effects of Carnosic Acid on Muscle Growth in Zebrafish (Danio rerio) (제브라피쉬 근육성장에서의 carnosic acid의 효과)

  • Kim, Jeong Hwan;Jin, Deuk-Hee;Kim, Young-Dae;Jin, Hyung-Joo
    • Korean Journal of Ichthyology
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    • v.26 no.3
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    • pp.171-178
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    • 2014
  • Myogenesis is the formation process of multinucleated myofiber with a contractile capacity from muscle satellite cell (MSCs) during life. This process is tightly controlled by several transcription factors such as Pax3 and Pax7 (paired box protein 3 and 7), MEF2C (myocyte enhancer factor 2) and MRFs (myogenic regulatory factors) etc. On the contrary, myostatin (MSTN) is a transforming growth factor-${\beta}$ superfamily, which functions as a negative regulator of skeletal muscle development and growth. Carnosic acid (CA) is a major phenolic component in rosemary (Rosmarinus officinalis) and have been reported various biological activities such as anticancer, antioxidant, antimicrobial and therapeutic agents for amnesia, dementia, alzheimer's disease. This study was confirmed to effects of CA on muscle cell line and muscle tissue alteration of zebrafish by intramuscular injection or feeding methods. $10{\mu}M$ CA showed a non-cytotoxic on myoblast and a complete inhibition effect against myostatin activity on luciferase assay. In intramuscular injection experiment, the total protein and triglyceride amount of $10{\mu}M/kg$ of CA injected group increased by 11% and decreased by 13% compared to these of the no injected group. In histology analysis of muscle tissues by hematoxylin/eosin staining, the number of muscle fiber of $10{\mu}M/kg$ of CA injected group decreased by 29% and fiber area increased 40% compared to these of no injected group. In feeding experiment, the total protein and triglyceride amount no significance difference compared to these of the normal feeding group. In histology analysis, the number of muscle fiber of 1% CA fed group decreased by 35% and fiber area increased 56% compared to these of normal fed group. We identified that CA have an effect on hypertrophy of muscle fiber in adult zebrafish and the results of this study are considered as the basic data that can reveal the mechanisms of muscle formation via gene and protein level analysis.

Ameliorating Effects of the Cognitive-Enhancing Korean Herbs on Neurotoxic-Induced Amnesia in Rats (새로운 제형의 치매치료제제의 효능연구)

  • Kim Ji Hyun;Jung Jin Yong;Chae Yoon Byung;Hahm Dae Hyun;Park Yang Jin;Lee Hye Jung;Shim Insop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.2
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    • pp.303-310
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    • 2002
  • Ancient Korean physicians have used several oriental herbs to cure dementia and these effects were described in the Korean herbal books. Some cognitive-enhancing oriental herbs have been widely used as a herbal medicine against dementia. However, few of studies have proved their efficacy in treatment for dementia. In the present study, we investigated the effects of herbal compounds, which are mainly consisted of Uncaria sinensis, Corydalis yanhusuo and Acorus gramineus on learning and memory in Mortis water maze task and the central cholinergic system of the rats with neurotoxic medial septum lesion. In water maze test, the animals were trained to find a platform in a fixed position during 6 days and then received a 60-s probe trial in which the platform was removed from the pool on the 7th day. Ibotanic and 192 saporin lesion of the medial septum (MS) impaired the performance of maze test and degenerated choline acetyltransferase (ChAT) in the brain, which is a marker of the central cholinergic system. Daily administrations of herbal medicine (100mg/kg, p.o.) for 21 consecutive days produced significant reversals of the neurotoxic-induced deficit in learning and memory. These treatments also reduced the loss of cholinergic immunoreactive neurons in the brain induced by neurotoxin. These results demonstrated that herbal compounds ameliorated learning and memory deficits through effects on the central nervous system, partly through effect on the acetylcholine system. Our studies suggest an evidence of these herbs as treatment of Alzheimer's disease.

Effects of the Water Extract from Albizzia julibrissin on Apoptosis and Cell Cycle Progression in the Human Leukemic Jurkat Cells (백혈병 세포주 Jurkat의 세포고사 유도 및 세포주기 억제에 미치는 합산피 추출물의 효과)

  • Park Young Jun;Jung Woo Cheal;Jeong Dae Young;Lee Yong Un;Lee In;Lee Key Sang;Jeon Byung Hun;Sung Kang Keyng;Moon Byung Soon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.6
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    • pp.1383-1392
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    • 2003
  • Apoptosis is a morphologically and biochemically district form of cell death that occurs in many different cell types in a wide variety of organisms. Albizzia julibrissin belonging the family Leguminosae has been used for the treatment of contusion, sore throat, amnesia, and insomnia in oriental traditional medicine. This study investigates whether the water extract of A. julibrissin induce apoptotic cell death in Jurkat T-acute lymphoblastic leukemia (ALL) cells. Jurkat cells were increased inhibitions of cell viability in a concentration-dependent manner by A. julibrissin. This herbal medicine also caused apoptosis as measured by cell morphology and DNA fragmentation. The capability of A. julibrissin to induce apoptosis was associated with proteolytic cleavage of specific target proteins such as poly (ADP-ribose)polymerase (PARP) and beta-catenin proteins suggesting the possible involvement of caspases. Our result showed that Bcl-2 and Bax protein levels were not changed in all A. julibrissin-treated groups compared to control group. These results suggest that A. julibrissin-mediated apoptosis is independent with Bcl-2 related signaling pathway in this cells. The purpose of the present study is also to investigate the Effect of A. julibrissin on cell cycle progression. Our results showed that G1 checkpoint related gene products (cyclin D1, cyclin dependent kinase 4, retinoblastoma, E2F1) were decreased in their protein levels in a dose-dependent manners after treatment of the extract. These results indicate that the increase of apoptotic cell death by A. julibrissin may be due to the inhibition of cell cycle progression in wild type p53-lacking Jurkat cells.

Physical Functioning and Related Factors in the Elderly People Admitted Long-term Home Care Insurance (재가급여 장기요양인정 노인들의 신체기능 상태 및 관련요인)

  • Yoon, Seok-Han;Lee, Kwang-Sung;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2338-2348
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    • 2013
  • This study was performed to determine the levels of physical functioning and to reveal its association with socio-demographic characteristics, health status and health related behaviors in the elderly people admitted long-term home care insurance. The interviews were performed, during the period from December 1, 2011 to March 31, 2012, to 618 home care elderlies admitted long-term care insurance dwelling in Daejeon city. As a results, the distribution of impaired ADL and IADL group of all subjects were 45.6% in ADL, and 48.4% in IADL. in consequently, the rate of impaired IADL group was higher than that of impaired ADL group. In logistic regression analysis, the adjusted odds ratio of the impaired ADL and IADL group were significantly increased in the group of male, living with spouse or family, bear for living expenses with son and daughter, health insurance, irregular exercise, seldom with frequency of going out, seldom with activity of hobbies, Subjective health status is good, and disability of body, visual acuity, hearing ability and mastication ability is good, and without urinary incontinence and amnesia. In conclusion, the level of physical functioning in the elderly people admitted long-term home care insurance was decreased in IADL than ADL. And the level of ADL and IADL were related with the various variables of socio-demographic characteristics, health status and health related behaviors.

Physical Function(ADL, IADL) and Related Factors in the Elderly People Institutionalized in Long-term Care Facilities (장기요양시설 노인들의 신체적 기능(ADL, IADL) 수준 및 관련요인)

  • Ahn, Kwon-Suk;Park, Sung-Kyeong;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.480-488
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    • 2016
  • This study examined the levels of ADL and IADL among elderly people who were institutionalized in long-term care facilities and determined their association with socio-demographic characteristics, health status, and health related behaviors. Interviews were performed, during the period from June 1 to July 31, 2015, to 205 elderlies received from long-term care service. As a results, the total mean score was $16.67{\pm}2.11$ for ADL (range: 6~8) and $15.13{\pm}3.79$ for IADL (range: 7~21). The selected factors associated with ADL were with or without a spouse, frequency of going out, subjective health status, and mastication ability. The factors associated with ADL were selected, such as gender, with or without a spouse, frequency of going out, subjective health status, disability of body, and amnesia. In conclusion, the level of ADL and IADL in the elderly people selected from long-term care insurance were influenced by the socio-demographic characteristics, health status and health-related behaviors.

Study on the Exposure Levels of Organic Solvents and Subjective Symptoms of Dry-cleaning Workers (드라이클리닝 근로자들의 유기용제 폭로와 자각증상)

  • Kim, Soo-Young;Kim, Jeong-Yun;Lee, Yeon-Kyeng;Lee, Sok-Goo;Lee, Young-Soo;Cho, Young-Chae;Lee, Tae-Young;Lee, Dong-Bae
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.628-643
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    • 1998
  • To investigate the exposure levels of organic solvents and subjective symptoms of dry-cleaning workers, 77 male and 52 female dry-cleaning workers who had been worked in a small city of Chungnam province, and a large city, Taejon were selected for the study group. Air concentrations of organic solvents in the working environment were analyzed, and subjective symptoms of dry-cleaning workers were surveyed, from July to August 1996. The results obtained were as follows : 1. The concentrations of organic solvents in the working environment were within permissible TLV-TWA limits. 2. For the 13 symptom clusters, the most frequently complained symptom clusters were fatigue as 71.3%, and followed by depression and urinary disturbances as 53.5% and 51.9%. Other symptom clusters complained were below 50%. 3. Positive response rates of subjective symptoms were significantly higher in worker groups such as lived in a large city, female, higher education level, more frequently alcohol drinking, higher concentration of organic solvent in working environment, work in alone. 4. Workers who had used solvent B showed 2.3 point higher scores of subjective symptoms than those of solvent A. Of the subjective symptoms scores, amnesia and nervousness were higher in solvent B user group than solvent B user group. 5. As a result of factor analysis, 3 factors such as depression, urinary disturbance and neurologic disturbance were selected. 6. As a result of the logistic regression analysis, sex, the number of fellow workers, working time, region, job tenure, smoking, alcohol drinking, ventilating system, concentration of organic solvent in working environment and place of residence were selected for the related variables. For the conclusion, even though the concentrations of organic solvents in the working environments of dry-cleaning workers were within permissible limit of TLV-TWA, many dry-cleaning workers complained symptoms, such as fatigue, depression, urinary disturbances and so on. And the factors affecting to the symptoms of dry-cleaning workers were the number of fellow workers, work hours, region, job tenure, smoking and alcohol drinking.

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