• The Korean Journal of Pain
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• 제33권2호
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• pp.108-120
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• 2020

From the perspective of the definition of pain, pain can be divided into emotional and sensory components, which originate from potential and actual tissue damage, respectively. The pharmacologic treatment of the emotional pain component includes antianxiety drugs, antidepressants, and antipsychotics. The anti-anxiety drugs have anti-anxious, sedative, and somnolent effects. The antipsychotics are effective in patients with positive symptoms of psychosis. On the other hand, the sensory pain component can be divided into nociceptive and neuropathic pain. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are usually applied for somatic and visceral nociceptive pain, respectively; anticonvulsants and antidepressants are administered for the treatment of neuropathic pain with positive and negative symptoms, respectively. The NSAIDs, which inhibit the cyclo-oxygenase pathway, exhibit anti-inflammatory, antipyretic, and analgesic effects; however, they have a therapeutic ceiling. The adverse reactions (ADRs) of the NSAIDs include gastrointestinal problems, generalized edema, and increased bleeding tendency. The opioids, which bind to the opioid receptors, present an analgesic effect only, without anti-inflammatory, antipyretic, or ceiling effects. The ADRs of the opioids start from itching and nausea/vomiting to cardiovascular and respiratory depression, as well as constipation. The anticonvulsants include carbamazepine, related to sodium channel blockade, and gabapentin and pregabalin, related to calcium blockade. The antidepressants show their analgesic actions mainly through inhibiting the reuptake of serotonin or norepinephrine. Most drugs, except NSAIDs, need an updose titration period. The principle of polypharmacy for analgesia in case of mixed components of pain is increasing therapeutic effects while reducing ADRs, based on the origin of the pain.

• 동의생리병리학회지
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• 제19권1호
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• pp.254-261
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• 2005

The effects on memory and learning ability of the Korean herbal medicine, Xingyo-tang(XGT, 神交湯), which consists of Ginseng Radix(人蔘) 4 g, Liriopis Tuber(麥門冬) 40 g, Morindae Officinalis Radix(巴戟天) 40 g, Biotae Semen(柏子仁) 20 g, Dioscoreae Rhizoma(山藥) 40 g, Euryales Semen(?實) 20 g, Scrophulariae Radix(玄蔘) 40 g, Salviae Miltiorrhizae Radix(丹蔘) 12 g, Poria(茯神) 12 g, Cuscutae Semen(免絲子) 40 g, was investigated. The effects of XGT on learning and memory performance were examined in normal or memory impaired mice by using avoidance tests, Pentobarbital -induced sleep test, fear conditioning task, novel object recognition task, and water maze task. Hot water extract from XGT was used for the studies. Learning ability and memory are based on modifications of synaptic strength among neurons that are simultaneously active. Enhanced synaptic coincidence detection leads to better learning and memory. The XGT-treated (30 mg/100 g and 60 mg/100 g, p.o.) mice exhibit superior ability in learning and memorizing when performing various behavioral tasks. XGT did not affect the passive avoidance responses of normal mice in the step through and step down tests, the conditioned and unconditioned avoidance responses of normal mice in the shuttle box, lever press performance tests, and the ambulatory activity of normal mice in normal condition. In contrast, XGT produced ameliorating effects on the memory retrieval impairment induced by ethanol. XGT also improved the memory consolidation disability induced by electric convulsive shock (ECS). XGT extended the sleeping time induced by pentobarbital dose-dependently, suggesting its transquilizing or antianxiety action. These results suggest that XGT has an improving effect on the impaired learning through the effects on memory registration and retrieval.

• The Korean Journal of Pain
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• 제28권1호
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• pp.4-10
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• 2015

Etifoxine (etafenoxine, $Stresam^{(R)}$) is a non-benzodiazepine anxiolytic with an anticonvulsant effect. It was developed in the 1960s for anxiety disorders and is currently being studied for its ability to promote peripheral nerve healing and to treat chemotherapy-induced pain. In addition to being mediated by $GABA_A{\alpha}2$ receptors like benzodiazepines, etifoxine appears to produce anxiolytic effects directly by binding to ${\beta}2$ or ${\beta}3$ subunits of the $GABA_A$ receptor complex. It also modulates $GABA_A$ receptors indirectly via stimulation of neurosteroid production after etifoxine binds to the 18 kDa translocator protein (TSPO) of the outer mitochondrial membrane in the central and peripheral nervous systems, previously known as the peripheral benzodiazepine receptor (PBR). Therefore, the effects of etifoxine are not completely reversed by the benzodiazepine antagonist flumazenil. Etifoxine is used for various emotional and bodily reactions followed by anxiety. It is contraindicated in situations such as shock, severely impaired liver or kidney function, and severe respiratory failure. The average dosage is 150 mg per day for no more than 12 weeks. The most common adverse effect is drowsiness at the initial stage. It does not usually cause any withdrawal syndromes. In conclusion, etifoxine shows less adverse effects of anterograde amnesia, sedation, impaired psychomotor performance, and withdrawal syndromes than those of benzodiazepines. It potentiates $GABA_A$ receptor-function by a direct allosteric effect and by an indirect mechanism involving the activation of TSPO. It seems promising that non-benzodiazepine anxiolytics including etifoxine will replenish shortcomings of benzodiazepines and selective serotonin reuptake inhibitors according to animated studies related to TSPO.

• 대한한방내과학회지
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• 제39권6호
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• pp.1272-1280
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• 2018

Introduction: The aim of this study is to report the effect of Ling-Gui-Gan-Zao-Tang (LGGZT) effectively improves anxiety disorder following traumatic brain injury (TBI). Case Presentation: 50-year-old female with traumatic brain injury after falling down from golf cart. After injury, symptoms like anxiety disorder, diarrhea, dizziness, headache were occurred. She took medications like antidepressants, antianxiety drugs and antipsychotic agent, but symptoms deteriorated consistently. After being prescribed LGGZT, patients' symptoms were significantly improved. Result of Impact Event Scale-Revised (IES-R-K) was changed from 24 to 5 and Beck Anxiety Inventory (BAI) was changed from 21 to 3. Also, side effects were not observed during the treatment period. Conclusion: LGGZT can be considered as an effective treatment for anxiety disorder following traumatic brain injury.

• 대한약리학회지
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• 제24권2호
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• pp.189-195
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• 1988

인체 정관 평활근에서 각종 자율신경전달체 수용체의 유무를 조사하고 benzodiazepine계의 진정-항불안제인 diazepam이 평활근 운동성에 미치는 작용을 관찰하기 위하여, 32내지 45세의 건강한 지원자로부터 정관절편을 얻었다. 정관 절제술은 국소마취하에 시행되었고, 정관절편의 수축력 측정은 등장성장력측정기에 의하였다. 적출장기실험조 내에서 정관절편의 자율수축은 관찰되지 않았으나, norepinephrine에 대한 반응성은 $33^{\circ}C$에서 가장 예민하였던 바, 이 norepinephrine에 의한 농도의존적 수축력증가작용은 알파-아드레날린성 차단제인 phentolamine에 의해 억제되었다. 또 인체 정관절편은 본 실험의 조건하에서 isoproterenol 의하여 수축하였고, 이 수축작용은 베타-아드레날린성 차단제인 propranolol 의하여 완전히 제거되었다. 동시에 인체 정관절편은 acetylcholine에의해서도 비교적 강하게 수축하였고, 이 수축작용은 콜린성 무스카린성 차단제인 atropine에 의하여 완전히 억제되었다. Diazepam은 norepinephrine에 의한 수축을농도 의존적으로 억 제 하였다. 이상의 결과를 종합하면, 인체 정관 평활근은 체온보다 낮은 $33^{\circ}C$에서 그 활동성이 가장 강하고, 자율신경에 대하여서는 아드레날린성 및 콜린성 수용체가 공존하고 있으며, diazepam은 그 수축력을 약화시킨다고 사료된다.

• Journal of Ginseng Research
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• 제38권4호
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• pp.256-263
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• 2014

Background: Korean Red Ginseng (KRG) is known to have antianxiety properties. This study was conducted to investigate the anxiolytic effects of KRG extract (KRGE) during ethanol withdrawal (EW) and the involvement of the mesoamygdaloid dopamine (DA) system in it. Methods: Rats were treated with 3 g/kg/d of ethanol for 28 d, and subjected to 3 d of withdrawal. During EW, KRGE (20 mg/kg/d or 60 mg/kg/d, p.o.) was given to rats once/d for 3 d. Thirty min after the final dose of KRGE, anxiety-like behavior was evaluated in an elevated plus maze (EPM), and plasma corticosterone (CORT) levels were determined by a radioimmunoassay (RIA). In addition, concentrations of DA and 3,4-dihydroxyphenylacetic acid (DOPAC) in the central nucleus of the amygdala (CeA) were also measured by high performance liquid chromatography (HPLC). Results: The EPM test and RIA revealed KRGE inhibited anxiety-like behavior and the over secretion of plasma CORT during EW. Furthermore, the behavioral effect was blocked by a selective DA D2 receptor (D2R) antagonist (eticlopride) but not by a selective DA D1 receptor (D1R) antagonist (SCH23390). HPLC analyses showed KRGE reversed EW-induced decreases of DA and DOPAC in a dose-dependent way. Additionally, Western blotting and real-time polymerase chain reaction (PCR) assays showed that KRGE prevented the EW-induced reductions in tyrosine hydroxylase (TH) protein expression in the CeA and TH mRNA expression in the ventral tegmental area (VTA). Conclusion: These results suggest that KRGE has anxiolytic effects during EW by improving the mesoamygdaloid DA system.

• Journal of Yeungnam Medical Science
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• 제9권2호
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• pp.382-395
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• 1992

GABA는 중추신경계의 대표적인 신경전달 물질로서 $GABA_A$수용체 또는 $GABA_B$수용체에 작용하여 진정 작용, 항 불안 작용, 및 근이완 작용을 하는 것으로 알려져 있다. 근래에는 말초조직에도 GABA가 존재하며 신경조정인자 혹은 신경전달인자로서 작용한다는 보고가 있다. 정관에 대한 자율신경 지배는 아드레날린성, 콜린성과 비콜린성 비아드레날린성 신경섬유들이 분포하고 있으나, 종 혹은 부위에 따라 이들 구성요소들의 수축성에 대한기여도가 다른 것으로 알려져 있다. 본 실험에서는 흰쥐의 전립선 부위 정관의 기본장력 및 전기장 유발 수축에 대한 교감 신경성, 부교감 신경성 및 퓨린성 효현제의 영향을 관찰하였으며, 정관의 흥분성 약물 및 전기장 유발 수축에 미치는 GABA 및 GABA 관련 약물의 영향을 관찰함으로서 정관의 수축운동에 대한 GABA의 작용기전을 규명해 보고자 흰쥐(Sprague-Dawley)의 전립선 부위 정관 절편을 적출 근편 실조에 현수하고, 등척성 장력을 측정하여 다음과 같은 결과를 얻었다. 1. GABA, muscimol 및 baclofen은 전기장자극(0.2 Hz, 1 msec, 80 V) 유발 수축을 농도 의존적으로 억제하였으며 그 효력은 GABA, baclofen 그리고 muscimol 순이었다. 2. GABA의 억제작용은 $GABA_B$ 수용체 길항제인 DAVA에 의하여 길항되었으나, $GABA_A$ 수용체 길항제인 bicuculline에 의해서는 길항되지 않았다. 3. Baclofen의 억제작용은 DAVA에 의하여 길항되었으나 muscimol의 억제작용은 bicuculline에 의해서는 길항되지 않았다. 4. Norepinephrine과 ATP는 농도 의존적으로 정관의 수축력을 증가 시켰으나 acetylcholine은 영향을 미치지 못하였다. 5. GABA, baclofen 및 muscimol은 정관의 기본 장력에는 영향을 미치지 않았으며, GABA는 norepinephrine과 ATP 유발 수축에는 영향을 주지 못하였다. 6. 적출 정관을 20초간 전기장 자극을 가하였을 때 ATP 수용체 탈감작제인 mATP를 전처치한 경우에는 FPC가 감소되었고, 신경원에서 catecholamine을 고갈시키는 reserpine을 전처치한 경우에는 STC가 감소되었다. 7. GABA는 mATP를 전처치한 군에서는 정관의 전기장 유발 수축에 영향을 주지 못하였으나, reserpine을 전처치한 군에서는 전기장 유발 수축을 억제하였다. 이상의 결과로 보아 흰쥐정관의 전립선 부위에는 아드레날린성 신경전달기전과 퓨린성 신경전달기전이 동시에 작용하고 있으며, GABA는 주로 신경원의 $GABA_B$ 수용체를 통하여 ATP의 유리를 억제하는 것으로 사료된다.

• Journal of Korean Biological Nursing Science
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• 제2권1호
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• pp.1-19
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• 2000

The purpose of this study was to define the content of the requisite knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for clinical knowledge for nursing practice. Contents of knowlege on pathological physiology, clinical microbiology, and mechanisms and effects of drugs were constructed from syllabus of basic nursing subjects in 4 colleges of nursing, and textbooks. The degree of need of 72 items was measured with a 4 point scale. The subjects of this study were college-graduated 136 nurses from seven university hospital in Seoul and three in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, and hospice ward. The results were as follows : 1. The highest scored items of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice were side effects of drugs, anticoagulants, mechanisms of drugs, antihypertensive drugs, tolerance and addiction of drugs, interactions among drugs, hospital infection in the order of importance. The lowest scored item was structure of microorganisms. 2. The highest order of need according to unit was repair in tissue injury unit, definition etiology classification of inflammation in inflammation unit, transplantation and immunologic response in alterations in immunity unit, thrombus and thrombosis in disorders of cardiovascular function unit, gene disorders in genetic disorders unit, hospital infection in infection unit, virus in microorganisms unit, side reactions of drugs in introduction unit, anticonvulsants in drugs for central nervous system unit, local anesthesia in anesthesia unit, anticoagulants in drugs for cardiovascular system unit, anti-inflammatory drugs in antibiotics unit, anti-ulcer drugs in drugs for digestive system unit, and bronchodilators in drugs for respiratory system unit. 3. The common content of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for all clinical areas in nursing were side effects of drugs, anticoagulants, interactions among drugs, and hospital infection. However, the degree of need of each pathological physiology, clinical microbiology, clinical microbiology, and mechanisms and effects of drugs was different depending on clinical areas. 4. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as tissue changes due to injurious stimuli, degenerative changes of tissue, alterations in metabolism of carbohydrates, ischemia, hyperemia and congestion, hospital infection, structure of microorganism, classification of microorganism, bacteria, virus, antidepressants, antipsychotic drugs, antiemetic drugs, antiparkinsonism drugs, antianxiety drugs, antibiotics, tuberculostatics, antiviral drugs, antifungal drugs, parasiticides, antiulcer drugs, antidiarrheais, and anti constipation drugs were shown according to the work area. 5. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as transplantation and immunologic response, alterations in the metabolism of uric acid, structure of microorganism, classification of microorganism, immunosuppressants, drugs for congestive heart failure were demonstrated according to the duration of work. Based on these findings, all the 72 items constructed by Korean Academic Society of Basic Nursing science should be included as contents of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs.

• 정신신체의학
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• 제8권1호
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• pp.31-45
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• 2000

연구목적 : 여성 및 남성 탈모중의 개인적 특성이나 탈모양상, 정신의학적특성, 동반 신체질환 및 치료 방법에 관한 비교 분석을 통해 여성 탈모증의 치료 및 예방 지침을 수립하기 위해 연구를 시도 하였다. 방법 : 1998년 1월부터 12월까지 중앙대학교 용산병원 피부과에 내원하여 정신과로 의뢰된 여성 탈모증 환자 51명을 연구집단으로, 남성 탈모증환자 42명을 대조군으로 선정하여 남녀별 차이를 비교 분석하였다. 수집된 자료는 SPSS-$PC^+$ 9.0V 프로그램을 통해 자료 처리를 하였고, 집단간의 차이는 교차 분석 및 변량 분석을 통해 비교 분석하였다. 결과 : 1) 여성일수록 남성에 비해 경제 수준이나 교육 수준이 낮고, 하류 직종에 종사하며, 부친이 무직자가 많고, 형제 자매 수가 많으며, 여자형제만 있는 비율이 높다. 2) 여성일수록 피부과 내원빈도가 많고, 최근 두정부나 전두부 탈모가 많으며, 여성가족 중에 탈모 경험자가 많은 반면에 남성 가족중에는 탈모자가 적고, 후두부 탈모가 적으며, 손톱의 변화는 적다. 3) 여성일수록 가정내 갈등이나 경제적 변화로 인해 스트레스를 받고, 가정내 갈등이나 내성적 성격으로 인해 갈등을 겪는 반면 직장문제나 건강 변화 등 생활 변동을 겪거나, 작업 수행 능력의 부진으로 인한 갈등은 적고 직장 적응에 있어 어려움을 겪는 비율도 낮다. 4) 여성일수록 우울증이나 전환장애가 많고, 불안 증상들이나 우울 증상들을 흔히 호소하며, 불안수준이 높은 반면 신체화증상이나 강박증상은 덜 호소하며, 불안장애는 적다. 5) 여성일수록 남성에 비해 내향화 성향이나 허구 성향 억압 성향 여성화 성향이 높다. 6) 여성일수록 관절염이나 비뇨생식계장애가 많은 반면 위장관장애나 지루성피부염은 적다. 7) 여성일수록 etizolam이나 tretinoin은 많이 사용하는 반면 향정신성 의약품은 적게 사용하며, 특히 clotiazepam이나 prednicarbonate를 적게 사용한다. 결론 : 여성 탈모증 환자는 남성 환자에 비해 우울증이 많고, 불안 및 우울 증상을 흔히 호소하며, 가정 문제로 인해 발병하고, 내향화 성향이나 허구 성향, 억압 성향, 여성화 성향이 높다. 이 결과는 여성 환자가 남성 환자에 비해 더 심각한 정신병리를 보여 준다는 것을 의미하고, 여성 탈모의 예방 및 치료를 위해 정신과적 개업이 필요함을 말해 주고 있다. 따라서 피부과 의사들은 병발하는 정신장애에 대해 깊은 관심을 갖고, 정신과와 피부과가 공동 치료 계획을 세워야 한다.