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Chung J, Park DH, Yoon SH
J Korean Med Sci. 2008 Apr
PMID:18437024
Abstract
A 7-yr-old boy visited our surgical center with Pfeiffer syndrome type 1, presenting with macrocrania, broad big toe and thumb, exophthalmos, tongue protrusion, malocclusion with midfacial retrusion, mild respiratory difficulty due to minor upper airway obstruction, and developmental delay. He also exhibited anthrophobia with a passive character. The patient was treated with internal monoblock distraction osteogenesis to increase the intracranial and intraorbital volumes, and the nasal and pharyngeal airway spaces using two modular mid-facial internal distractors. For distraction, the latency period was 1 week, the daily activation of 1.0 mm was 20 days (total advancement 20 mm at the midline), and the consolidation period was 3 months. The follow-up computed tomography 12 months after surgery showed expansion of the brain and proper ossification in the distracted area. The patient also showed aesthetically good cranial contours, improved tongue and eyeball protrusion, no respiratory difficulty, and improved learning. We suggest that the internal distraction may last longer than an external type, resulting in a better bone fusion rate and successful expansion of craniofacial bones.
Tanaka-Matsumi J
Cult Med Psychiatry. 1979 Sep
PMID:520018
Abstract
Taijin Kyofusho or 'anthrophobia' is a Japanese culture-specific disgnostic label for the presenting problems of various fear reactions in interpersonal situations. The starting point of the present study was accumulating studies on Japanese cases of Taijin Kyofusho and the assertion in Japanese psychiatry that the symptom complex called Taijin kyofusho is Japanese culture-bound. In light of previous works on culture-bound disorders, the present study examines whether or not American mental health professionals could diagnose Japanese case descriptions of Taijin Kyofusho and what kinds of labels they applied to these Japanese cases. The results showed that American judges were able to diagnose Japanese cases nearly as well as American cases. However, there were considerable variability and inconsistency in their judgments of both the Japanese and American cases. The rate of disgnostic agreement dropped considerable as judges were asked to proceed from broad categories to specific categories. American judges grouped the Japanese cases of Taijin Kyofusho into a number of heterogeneous categories using labels such as paranoid schizophrenia, paranoid personality, phobic neurosis, and anxiety neurosis, among others. These results are discussed in terms of psychopathological diagnostic criteria and present conceptualization of culture-bound disorders, value judgments of mental health professionals, and the social contexts in which Taijin Kyofusho reactions occur.