• 대한의사협회지
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• 제61권12호
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• pp.758-764
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• 2018

Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors-donepezil, rivastigmine, galantamine-and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.

• 한국군사과학기술학회지
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• 제14권5호
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• pp.920-931
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• 2011

Nerve agents are irreversible inhibitors of the cholinesterase enzyme. Exposure causes a progression of toxic signs, including hypersecretions, fasciculations, tremor, convulsions, respiratory distress, epileptiform seizures, brain injuries and death. A combined regimen of prophylaxis and therapy is the most effective medical countermeasure for dealing with the threat of nerve agent poisoning to military personnel. In this paper, the author investigated the updated technologies regarding various pre- and post-treatment drugs for nerve agents detoxification which are under development in several countries including Korea. Some characteristics of active ingredients in the formulations of drugs, their action mechanisms, and effectiveness were analyzed. Additionally, part of experimental data on the transdermal patch studied in ADD using beagle dogs was introduced.

• 생물정신의학
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• 제23권2호
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• pp.41-47
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• 2016

Dementia with Lewy bodies (DLB) is the second most common causes of dementia. It can exhibit a variety of clinical symptoms including cognitive decline, cognitive fluctuation, visual hallucinations, parkinsonism, REM sleep behavior disorder, hypersensitivity to neuroleptics and autonomic dysfunctions. Despite more well-known criteria for DLB, there are often misdiagnosis and inappropriate treatment. It gives a lot of clinical burden to the clinician as well as to patients and families. When reducing the misdiagnosis, the burden of all will be reduced. The special concern and solicitation are needed in order not to miss the diagnosis when the cardinal features of DLB may not be volunteered by patients and the caregivers. To control the symptoms, clinicians must find and reduce drugs that can have the negative effects on DLB symptoms. There is limited evidence about specific interventions but available data suggest cholinesterase inhibitors improve the cognitive and behavioral symptoms and menmantine slightly improves the global impression.

• 한국연초학회지
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• 제21권1호
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• pp.49-56
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• 1999

Classification of esterase isozymes of the apterous green peach aphids (Myzus persicae Sulzer) collected in tobacco fields were investigated by the native polyacrylamide gel electrophoresis (PAGE). A total of twelve esterase bands were identified in adult apterous aphid, and the difference of enzyme band activity in the clones was observed at the first and second bands group. Esterases of green peach aphids reacted with specific substrate were more stained $\alpha$-naphthyl acetate than $\alpha$-naphthyl propionate, and $\alpha$-naphthyl acetate more than $\beta$-naphthyl acetate. Twelve esterases on the basis of inhibition by the three types of inhibitors (organophosphates: 2.5$\times$10$^{-3}$ M paraoxon, 4$\times$10$^{-3}$ M DFP; eserine sulfate : 2$\times$10$^{-3}$ M eserin; sulfhydryl reagents: 2$\times$10$^{-3}$ M p-HMB) were classified into three class, namely, cholinesterase (ChE) I, II, carboxylesterase (CE) and arylesterase (ArE), and these classes contained 3, 4, 3 and 2 isozymes, respectively.

• 생물정신의학
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• 제23권3호
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• pp.80-88
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• 2016

Vascular dementia is a very frequent form of dementia. Debates over classification and diagnostic criteria, and controversy over identifiable treatment targets will continue until distinct pathophysiological mechanism of vascular dementia is found. Clinical diagnostic criteria are sufficiently strong to be useful for clinical trials, but need further refinement. Cognitive changes in vascular dementia are more variable than other disorders, and are dependent on the vascular pathology. Accurate diagnosis of vascular dementia is known to need the presence of reliable cerebrovascular disease on brain imaging. Although it seems obvious that cerebrovascular disease causes pathological damage and impaired cognition, it is very difficult to find the accurate contribution of cerebrovascular pathology to cognitive decline. Most studies have shown a small but significant benefit of cholinesterase inhibitors on cognition, the significance of this effect has been slight and benefits on global functioning, activities of daily living, and behaviour have not been consistently reported. Management of vascular dementia should focus on identifying and managing vascular risk factors.

• 한국연초학회지
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• 제20권1호
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• pp.80-86
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• 1998

Changes in activity and classification of esterase isozymes during the tire cycle or Plodia inteipunctella (Hiibner) were investigated by the native polyacrylamide gel electrophoresis. The stage specificity in esterase activity and isozyme pattern was observed throughout the larvalpupal-adult transformation. The activity esterase was highest at the 3-day old adult stage, and the lowest level at the prepupal stage. A total of 12 esterase bands were identified throughout the development, and the bands showing high enzyme activity was observed in the middle part of gel. Twelve esterases on the basis of inhibition by the three types of inhibitors (organophosphates, eserine sulfate and sulfhydryl reagents) were classified into three class, namely, carboxylesterase (CE), arylesterase (ArE) and cholinesterase (ChE), and these classes contained 7, 3 and 2 isozymes, respectively.

• Bulletin of the Korean Chemical Society
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• 제35권2호
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• pp.655-658
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• 2014

• Parasites, Hosts and Diseases
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• 제31권4호
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• pp.321-330
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• 1993

Fibricola seoulensis의 피낭유충을 흰쥐에게 경구 감염시켜 3, 4, 5. 6, 7일 별로 부 검 회수하여 생리 식염수로 씻은 후, 10% neutral formalin buffer에 고정 후 세척하였다. Acetylcholinesterase 염색은 기질로 acetylthiocholine iodide를 사용한 효소조직화학적 방법으로 피낭유충과 여러 성장 과정에 있는 충체의 신경계 분포 발달과정을 관찰하고 억제제로는 eserine, iso-OMPA, BW284C51를 사용하였다. 신경계는 피낭유충과 성충의 전반부 부위의 인두와 구흡반과 후반부의 배설 신경총을 연결하는 3쌍의 종주신경간과 그들을 연결하는 횡신경 연합과 환상신경 연합으로 구성되어 있으며, 다수의 환상신경 연합은 충체표면 가까이에 위치한 종주신경간과도 연결되어 있다. 충체 발달의 모든 단계에서 구흡반 및 복흡반, 인두, 신경계에 acetylcholinesterase와 nonspeciaccholinesterase의 염색반응이 관찰되었다. F. seoulensis의 acetylcholinesterase 동위효소 유형은 분자량 69 kDa. 132 kDa의 2개의 분획이 분리되었으며 그 중 69 kDa 분획대가 주분획을 이루었다.

• 대한임상독성학회지
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• 제12권2호
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• pp.77-84
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• 2014

Purpose: Carbamate insecticides are potent cholinesterase inhibitors capable of causing severe cholinergic toxicity. Use of carbamate rather than organophosphate insecticides has been increasing. Compared with organophosphate poisoning, relatively few studies have investigated carbamate-associated acute pancreatitis. We investigated general characteristics and pancreatitis of carbamate poisoning and the predictors, among those readily assessed in the emergency department. Methods: We performed a retrospective review of consecutive patients, aged over 18 years, who were admitted between January 2008 and April 2012 to an emergency department (ED) of an academic tertiary care center for treatment of carbamate poisoning. Patients who exhibited poisoning by any other material, except alcohol, were excluded. After application of exclusion criteria, patients were divided according to carbamate-induced pancreatitis and non-pancreatitis groups. Results: A total of 41 patients were included in this study. Among these 41 patients, the prevalence of acute pancreatitis was 36.6% (15 patients). Initial blood chemistry tests showed a statistically higher glucose level in the pancreatitis group, compared with the non-pancreatitis group (222, IQR 189-284 vs. 137, IQR 122-175 mg/dL, P<0.05). Regarding clinical courses and outcomes, a significantly higher proportion of patients developed pneumonia [10 (66.7%) vs. 6 (23.1%), P<0.05] and had a longer hospital stay (7 days, IQR 6-12 vs. 5 days, IQR 2-11, P<0.05), but no difference in mortality, in the pancreatitis group vs. the non-pancreatitis group. In multivariate analysis, the initial glucose was showing significant association with the presentation of carbamate-induced acute pancreatitis (odds ratio 1.018, 95% confidence interval 1.001-1.035, P<0.05). Conclusion: Carbamate-induced acute pancreatitis is common, but not fatal. Initial serum glucose level is associated with acute pancreatitis.

• 대한임상독성학회지
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• 제5권1호
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• pp.74-78
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• 2007

The carbamates are a group of insecticides derived from carbamic acid, with a broad spectrum of uses as agricultural and household garden insecticides. Carbamate insecticides are reversible cholinesterase inhibitors. Their inhibitory action is mediated by reversible carbamylation of acetylcholine, as with the organophosphate insecticides. Carbamates are absorbed by the body through multiple routes, including inhalation, ingestion, and dermal absorption. Although poisoning can result from occupational exposure or accidental ingestion, in most cases there is suicidal intent. This is particularly true in developing countries, where the highest incidence of morbidity and mortality from this cause occurs. Cardiac complications often accompany poisoning by carbamate compounds, which may be serious and often fatal. The extent, frequency, and pathogenesis of cardiac toxicity from carbamate compounds has not been clearly defined. Possible mechanismsinclude sympathetic and parasymphatetic overactivity, hypoxemia, acidosis, electrolyte derangements, and a direct toxic effect of the compounds on the myocardium. Patients with carbamate poisoning should immediately be transferred to an intensive or coronary care unit where appropriate monitoring and resuscitative facilities are available. We here report a case of acute coronary syndrome resulting from acute carbamate ingestionthat resulted in a healthy discharge.