• 제목/요약/키워드: neuropsychiatric disease

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신경정신병 환자의 하지에서 발생한 신경통성 근위축증: 증례보고 (Neuralgic Amyotrophy of the Lower Extremity in a Neuropsychiatric Patient: A Case Report)

  • 문원식;모상준;배민준;황기훈
    • 대한근전도전기진단의학회지
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    • 제20권2호
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    • pp.124-129
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    • 2018
  • Neuralgic amyotrophy (NA) is an idiopathic disease characterized by muscular atrophy accompanied by neuralgia, where acute pain in the limb, mostly including the shoulders, leads to muscle weakeness and atrophy in the limb days to weeks after the onset of pain. Although its exact pathogenesis is unknown, genetic and nongenetic factors, such as infection, surgery, and trauma are suspected contributors. We report this case as we diagnosed NA of the right lower limb via enhanced MRI as well as EMG and have followed up the patient's prognosis and radiologic changes for one and a half years. In addition, the patient had been diagnosed with neuropsychiatric disorders, such as major depressive disorder and somatic symptom disorder.

메르스(Middle East Respiratory Syndrom)의 유행이 의사의 정신건강에 미치는 영향 : 확진자 발생 병원 근무 여부, 메르스 진료 참여 여부에 따른 비교 (Psychological Effects on Medical Doctors from the Middle East Respiratory Syndrome (MERS) Outbreak : A Comparison of Whether They Worked at the MERS Occurred Hospital or Not, and Whether They Participated in MERS Diagnosis and Treatment)

  • 엄대현;김장섭;이해우;이소희
    • 신경정신의학
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    • 제56권1호
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    • pp.28-34
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    • 2017
  • Objectives The purpose of this study was to evaluate psychological effects of an outbreak of Middle East respiratory syndrome (MERS), a newly emerged infectious disease, on doctors. Methods After the MERS outbreak was over, we conducted an online survey of doctors who worked at the hospitals in which exposure to MERS cases had been confirmed or who were directly involved in MERS diagnosis and treatment. The Patient Health Questionnaires-9 (PHQ-9) and the Impact of Event Scale-Revised (IES-R) assessment methods were used to assess the severity of depressive and posttraumatic stress symptoms among the 64 doctors participating in the survey. Results The results of the survey indicate that 26.6% (n=17) of participants exhibited depressive symptoms and 7.8% (n=5) had post-traumatic stress symptoms. The doctors employed at hospitals with MERS cases had higher PHQ-9 and IES-R mean scores than those in doctors were not so employed. In contrast, there was no significant difference in those test scores between doctors who participated directly in MERS diagnosis and treatment and those doctors who did not. Conclusion The survey demonstrated that 28.1% (n=18) of doctors involved in MERS care suffered from depressive or posttraumatic stress symptoms, even though the MERS infection was being controlled. Working at a hospital with MERS cases was the primary determinant of the adverse psychological outcomes among doctors ; however, direct participation in the diagnosis and care of MERS patients was not significantly related to such outcomes.

Postoperative delirium after cholecystectomy in older patients: A retrospective study

  • Young Mok Park;Hyung Il Seo;Byeong Gwan Noh;Suk Kim;Seung Baek Hong;Nam Kyung Lee;Dong Uk Kim;Sung Yong Han
    • 한국간담췌외과학회지
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    • 제27권3호
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    • pp.301-306
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    • 2023
  • Backgrounds/Aims: Postoperative delirium (POD) is a common complication that increases mortality and morbidity in older patients. This study aimed to evaluate the clinical significance of post-cholecystectomy delirium in older patients. Methods: This retrospective study included 201 patients aged > 75 years who underwent cholecystectomy for acute or chronic cholecystitis between January 2016 and December 2019. Patients were divided into the POD (n = 21) and non-POD (n = 180) groups, and their demographic features and clinical results were compared. Results: The mean patient age was 78.88 years; the female/male ratio was 44.8%/55.2%. Laparoscopic surgery was performed in 93.5% of patients. The univariate analysis showed that lower body mass index (BMI), immobilized admission status, neuropsychiatric disease history, preoperative intervention (percutaneous drainage), high C-reactive protein, hypoalbuminemia, neutrophilia, hypo-/hyperkalemia, and longer operative time were more frequently observed in the POD group. The multivariate analysis showed that lower BMI (odds ratio [OR], 2.796; p = 0.024), neuropsychiatric disease history (OR, 3.019; p = 0.049), hyperkalemia (OR, 5.972; p = 0.007), and longer operative time (OR, 1.011; p = 0.013) were significant risk factors for POD. Conclusions: POD was associated with inflammation degree, general condition, poor nutritional status, electrolyte imbalance, and stressful conditions. Recognizing risk factors requiring multidisciplinary team approaches is important to prevent and treat POD.

Dopamine Receptor Interacting Proteins (DRIPs) of Dopamine D1-like Receptors in the Central Nervous System

  • Wang, Min;Lee, Frank J.S.;Liu, Fang
    • Molecules and Cells
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    • 제25권2호
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    • pp.149-157
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    • 2008
  • Dopamine is a major neurotransmitter in the mammalian central nervous system (CNS) that regulates neuroendocrine functions, locomotor activity, cognition and emotion. The dopamine system has been extensively studied because dysfunction of this system is linked to various pathological conditions including Parkinson's disease, schizophrenia, Tourette's syndrome, and drug addiction. Accordingly, intense efforts to delineate the full complement of signaling pathways mediated by individual receptor subtypes have been pursued. Dopamine D1-like receptors are of particular interest because they are the most abundant dopamine receptors in CNS. Recent work suggests that dopamine signaling could be regulated via dopamine receptor interacting proteins (DRIPs). Unraveling these DRIPs involved in the dopamine system may provide a better understanding of the mechanisms underlying CNS disorders related to dopamine system dysfunction and may help identify novel therapeutic targets.

Adult hippocampal neurogenesis and related neurotrophic factors

  • Lee, Eu-Gene;Son, Hyeon
    • BMB Reports
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    • 제42권5호
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    • pp.239-244
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    • 2009
  • New neurons are continually generated in the subgranular zone of the dentate gyrus and in the subventricular zone of the lateral ventricles of the adult brain. These neurons proliferate, differentiate, and become integrated into neuronal circuits, but how they are involved in brain function remains unknown. A deficit of adult hippocampal neurogenesis leads to defective spatial learning and memory, and the hippocampi in neuropsychiatric diseases show altered neurogenic patterns. Adult hippocampal neurogenesis is not only affected by external stimuli but also regulated by internal growth factors including BDNF, VEGF and IGF-1. These factors are implicated in a broad spectrum of pathophysiological changes in the human brain. Elucidation of the roles of such neurotropic factors should provide insight into how adult hippocampal neurogenesis is related to psychiatric disease and synaptic plasticity.

알츠하이머병의 최신지견 (Recent Advances in Diagnosis and Treatment of Alzheimer's Disease)

  • 이정재;이석범
    • 생물정신의학
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    • 제23권2호
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    • pp.48-56
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    • 2016
  • Alzheimer's disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.

지역사회 거주 치매환자에서 한국판 삶의 질 -알쯔하이머병 척도 개발을 위한 예비연구 (A Preliminary Study on the Korean Version of Quality of Life-Alzheimer's Disease (QOL-AD) Scale in Community-dwelling Elderly with Dementia)

  • 신희영
    • Journal of Preventive Medicine and Public Health
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    • 제39권3호
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    • pp.243-248
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    • 2006
  • Objectives: The Quality of Life-Alzheimer's Disease (QOL-AD) scale is a reliable and valid tool for assessing the quality of life (QOL) in the elderly with dementia. This study aimed to develop the Korean version of Quality of Life-Alzheimer's Disease (KQOL-AD) scale for the demented elderly living in the community. Methods: KQOL-AD was administered to two groups: 24 demented elderly and 72 cognitively impaired elderly with no dementia (CIND) who were living in the community Each elderly person and their caregiver rated the elderly QOL. The Korean version of mini-mental state examination (MMSE-K), the clinical dementia rating (CDR), the activities of daily living (ADL), and the neuropsychiatric inventory (NPI) were also assessed. The reliability and validity of the KQOL-AD were examined. Results: In the dementia group, the internal consistency (Cronbach's $\alpha$), the split half and the test-retest reliabilities of the KQOL-AD were excellent. Scores on the KQOL-AD were significantly correlated with the scores of the NPI, but they were not significantly correlated with scores of the MMSE-K, CDR and ADL. In addition, the CIND group showed similar results to the dementia group. Conclusions: KQOL-AD might be a reliable and valid instrument for assessing QOL in the elderly with dementia It could be used as an important outcome measure for research on the demented elderly.

알쯔하이머병에서 행동심리증상과 환자 및 부양자의 삶의 질의 관계 (Relationship between Behavioral and Psychological Symptoms and Patient and Caregiver Quality of Life in Alzheimer's Disease)

  • 김성완;신일선
    • 생물정신의학
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    • 제14권1호
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    • pp.48-54
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    • 2007
  • Objectives : This study aimed to examine the relationship between behavioral and psychological symptoms of dementia(BPSD) and patient and caregiver QOL in Alzheimer's disease(AD). Methods : Fifty-one AD patients and their caregivers participated. Measures about patients were Neuropsychiatric Inventory(NPI), Korean version of QOL-Alzheimer's Disease(KQOL-AD), Activities of Daily Living(ADL), Clinical Dementia Rating(CDR), and Korean version-Mini Mental State Examination(K-MMSE). Caregiver QOL was assessed with KQOL-AD and General Health Questionnaire/Quality of Life-12(GHQ/QOL-12). Results : Patient QOL-AD on patient ratings was negatively correlated with appetite/eating change and NPI scores. Patient QOL-AD on caregiver ratings was negatively correlated with hallucinations, depression/dysphoria, and NPI scores. Caregiver QOL assessed by the GHQ/QOL-12 was negatively correlated with agitation/aggression, depression/dysphoria, and NPI scores and was negatively correlated with distress related to agitation/aggression, depression/dysphoria, and NPI scores. Conclusion : BPSD of AD patients was associated with low QOL of both patients and caregivers. Thus, interventions of BPSD were needed to improve both patient and caregiver QOL.

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지언고론(至言高論)에 의한 한의학적(韓醫學的) 정신치료(精神治療)에 대(對)한 연구(硏究) (의안(醫案)을 중심으로) (A study of psychotherapy by means of oriental medicine though the Giungoroen(至言高論)-Focusing on Ancient clinical document)

  • 구병수;김근우
    • 동의신경정신과학회지
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    • 제12궈1호
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    • pp.29-45
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    • 2001
  • Objectives: In order to overcome psychotherapeutic problems though the theory of oriental medicine by means of the Giungoroen(至言高論-wise saying and lofty opinion). Methods: This research was done by comparing the contents of psychotherapeutic ancient clinical document with the western medical method of psychotherapy Results: 1. Inquire into the clinical document, the psychotherapy is used treatment of wide area disease inclusive of neuropsychiatric disease different from the western medicine. 2. Inquire into the method of psychotherapy, the supportive psychotherapy and behavior therapy is applied. 3. In case of psychotherapy and treatment of medicines is done at the same time, treatment of medicines followed psychotherapy. 4. A viewpoint of Yusic(唯識-vijnaptim-atra)-a field of Buddhism, possibility of psychotherapy is showed. 5. A doctor's oriental thought and oriental medical Preservation of Health view was based. 6. The change of patient's the emotion and will is focused than disease itself. Conclusion: When western medical method of psychotherapy is complemented by a oriental thought and oriental medical Preservation of Health view, the good effects is hoped in psychotherapy.

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가슴쓰림 환자 30례에 대한 소건중탕 과립제의 임상적 고찰 (Clinical Study of Sogunjung-tang Granules in 30 Cases of Heartburm)

  • 이다은;장혜연;이유림;이영수
    • 대한한방내과학회지
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    • 제40권6호
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    • pp.1193-1201
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    • 2019
  • Objectives: This study aimed to assess the clinical characteristics of patients who complained of heartburn and to report the effects of Sogunjung-tang granules on heartburn. Methods: Observation was carried out on 30 patients with heartburn who were treated in Dongshin University Oriental Medicine Hospital from 1 October 2018 to 3 July 2019. For relieving heartburn, an oriental medical therapy of Sogunjung-tang granules was administered. To evaluate the effect of treatment, the visual analog scale (VAS) was used. Results: Females predominated among the patients (86.7% of the total). The patients were mostly aged in their 50s and the average age was 56.8 years. In the medical histories of the patients, other diseases (neuropsychiatric disease, cardiovascular disease, cerebrovascular disease, urologic disease, uterine disease etc.) were the most common (34.7%) and gastrointestinal disease was the second most common (22.4%). The patients took Sosiho-tang granules plus Sogunjung-tang granules for a maximum of 282 days. The number of patients who took medication within 10 days of experiencing heartburn was the highest and the number of patients who took medication more than 30 days of experiencing heartburn was the lowest. The scores on the visual analog scale (VAS) were significantly improved after treatment, the average decreasing from 7.0 to 3.1. Before taking the granules, the average rate of improvement for patients who recorded less than VAS 6 was 80%. Six out of seven inpatients showed more than two VAS changes on 3.8 day of taking medicine, and 23 outpatients showed more than two VAS changes on the second visit. Conclusions: This study suggests that Sogunjung-tang granules is probably effective in the treatment of heartburn.