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박시성 대한생물치료정신의학회 1999 생물치료정신의학 Vol.5 No.2
In psychiatric field, it is difficult to define male climacterium. Because the male climacteric changes occur gradually and vary individually, and it is not certain that the neuropsychiatric manifestations of male climacterium are caused by the decrease of testosterone. However, many clinical characteristics of low- testerone syndrome are similar to those of major psychiatric disorders. Sexual dysfunction, sleep disturbances, depression, mood change, and decline in cognitive function are inclusives of the neuropsychiatric manifestations of male climacterium. The author reviewed male climacteric changes and its neuropsychiatric manifestations with respect to the treatment approaches.
박시성,유충선 고신대학교 의학부 1998 高神大學校 醫學部 論文集 Vol.13 No.1-2
The authors reported a 35-year-old man who had never experienced a seizure but had psychotic disorder with symptoms such as persecutary delusion, hallucinatory behavior, aggressive act with excitement, mutism and loosening of association during postictal period following repetitive tonic-clonic seizures of first onset. The cause of seizure was not identified, but it might be due to a certain general medical condition such as metabolic disturbances. There are many hypotheses to explain the relationship between psychopathology and seizure, however it is not clear. Clinicians also must consider various aspects to evaluate, diagnose and treat the patient with comorbid seizure and psychotic condition. This case illustrates many clinical implications like these.
중심성 뇌교 및 뇌교외 수초용해에 병발된 정신증적 장애
박시성,유봉구,임학,Park, Si-Sung,Yoo, Bong-Goo,Rim, Hark 한국정신신체의학회 2002 정신신체의학 Vol.10 No.1
중심성 뇌교 수초용해 (CPM) 및 뇌교의 수초용해(EPM) 은 대사 이상을 수반하는 여러 질환에서 뇌 세포 내외의 삼투질농도의 급속한 변화와 관련하여 발생하는 신경학적 질환이다. 저자들은 당뇨병성 신중에 의한 만성 신부전으로 신장이식을 받은 43세 남자 환자에서 발현한 CPM과 EPM 증례를 보고하였다. 환자는 망상, 연상이완, 환각, 부적절한 정동, 공격성, 기억장애 등을 수반한 정산병적 증상과 언어실조를 특징적으로 보인 경우로서, CPM과 EPM에서 비교적 드물게 발생하는 정신증상, 특히 정신병적 증상을 보인 증례이기에, 정선과적으로 중요한 임상적 의의를 가진다고 판단하여 문헌고찰과 함께 보고하는 바이다. Central pontine myelinolysis(CPM) and Extrapontine myelinolysis(EPM) are uncommon neurologic disorders associated with osmotic inequality between the extracellular fluid compartment and intracellular fluid compartment in the brain. Myelinolysis can occur in hyponatremia and after rapid correction of hyponatremia. It may be caused by various metabolic disturbances such as chronic alcoholism, malnourishment, cancer, chronic renal failure and organ transplantation. The authors reported a 43-year-old male patient who have received a kidney transplantation because of chronic renal failure due to diabetic nephropathy. The patient manifested psychotic symptoms such as delusion, loosened association, hallucination, inappropriate affect and aggressiveness as a sequele of CPM and EPM. He also showed neurocognitive impairment such as disorientation, memory impairment, decresed intelligence and aphasia. These manifestations are rare in CPM and EPM. We discuss the clinical features, diagnosis, course and management of the patient which may be clinically significant in the neuropsychiatric aspect especially at the consultation-liaison field.