• Title/Summary/Keyword: Neuropsychiatry

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A CASE OF CLOZAPINE TRIAL FOR A MANIC EPISODE SUFFERED BY AN ADOLESCENT RECOVERING FROM NEUROLEPTIC MALIGNANT SYNDROME (신경이완제 악성증후군 회복후 지속되는 조증에 Clozapine을 사용한 청소년 환자 1례)

  • Cho, Soo-Churl;Hong, Kang-E;Kim, Yong-Sik;Chung, Sun-Ju;Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.247-252
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    • 1998
  • Neuroleptic malignant syndrome(NMS) is an acute, potentially fatal, idiosyncratic reaction to neuroleptic medication. Early recognition and intensive care are crucial. An important issue is whether NMS will recur after initial recovery and subsequent use of neuroleptic medication. The authors presented with a male adolescent who had suffered a bipolar disorder manic episode and been taking clozapine after recovering from MNS. He had been admitted into a psychiatric ward once before and similarly diagnosed. On the second admission, he showed muscle rigidity, autonomic instability, mild fever, severe diaphoresis, and altered mental status on the fourth hospital day following a haloperidol injection. He was diagnosed with NMS, according to the clinical signs and laboratory data. After the use of antipsychotics was discontinued, he was moved to intensive care unit and given dantrolene. His condition began to improve about 48 hours after the onset of NMS. Due to manic behavior, he returned to the psychiatric ward. On the 21 st hospital day, clozapine was administered to counter the manic symptoms. The final dose was 350mg and showed good remission signs without further recurrence of NMS.

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Association Analysis of Neuregulin 3 Gene with Schizophrenia in a Korean Population (한국인에서 Neuregulin 3(NRG3) 유전자와 조현병의 연합 연구)

  • Shin, Su-Jin;Choi, Jong-Taek;Kim, Ji-Won;Roh, Yang-Ho;Park, Byung-Lae;Bae, Joon-Seol;Shin, Hyoung-Doo;Choi, Ihn-Geun;Han, Sang-Woo;Hwang, Jae-Uk;Woo, Sung-Il
    • Korean Journal of Biological Psychiatry
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    • v.19 no.3
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    • pp.128-133
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    • 2012
  • Objectives : Located on chromosome 10q22-q23, the human neuregulin 3 (NRG3) is suggested as a strong positional and functional candidate gene involved in the pathogenesis of schizophrenia. Several case-control studies examining the association between polymorphisms on NRG3 gene with schizophrenia and/or its traits (such as delusion) have been reported recently in cohorts of Han Chinese, Ashkenazi Jews, Australians, white Americans of Western European ancestry and Koreans. Thus, this study aimed to investigate the association of one SNP in exon 9 (rs2295933) of NRG3 gene with the risk of schizophrenia in a Korean population. Methods : Using TaqMan assay, rs2295933 in the exon 9 of NRG3 was genotyped in 435 patients with schizophrenia as cases and 393 unrelated healthy individuals as controls. Differences in frequency distributions were analyzed using logistic regression models following various modes of genetic inheritance and controlling for age and sex as covariates. Results : Subsequent analysis revealed that the frequency distribution of rs2295933 of NRG3 was not different between schizophrenia patients and healthy controls of Korean ethnicity. Conclusions : This study does not support the role of NRG3 in schizophrenia in a Korean population.

Transcriptional Upregulation of Plasminogen Activator Inhibitor-1 in Rat Primary Astrocytes by a Proteasomal Inhibitor MG132

  • Cho, Kyu Suk;Kwon, Kyoung Ja;Jeon, Se Jin;Joo, So Hyun;Kim, Ki Chan;Cheong, Jae Hoon;Bahn, Geon Ho;Kim, Hahn Young;Han, Seol Heui;Shin, Chan Young;Yang, Sung-Il
    • Biomolecules & Therapeutics
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    • v.21 no.2
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    • pp.107-113
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    • 2013
  • Plasminogen activator inhibitor-1 (PAI-1) is a member of serine protease inhibitor family, which regulates the activity of tissue plasminogen activator (tPA). In CNS, tPA/PAI-1 activity is involved in the regulation of a variety of cellular processes such as neuronal development, synaptic plasticity and cell survival. To gain a more insights into the regulatory mechanism modulating tPA/PAI-1 activity in brain, we investigated the effects of proteasome inhibitors on tPA/PAI-1 expression and activity in rat primary astrocytes, the major cell type expressing both tPA and PAI-1. We found that submicromolar concentration of MG132, a cell permeable peptide-aldehyde inhibitor of ubiquitin proteasome pathway selectively upregulates PAI-1 expression. Upregulation of PAI-1 mRNA as well as increased PAI-1 promoter reporter activity suggested that MG132 transcriptionally increased PAI-1 expression. The induction of PAI-1 downregulated tPA activity in rat primary astrocytes. Another proteasome inhibitor lactacystin similarly increased the expression of PAI-1 in rat primary astrocytes. MG132 activated MAPK pathways as well as PI3K/Akt pathways. Inhibitors of these signaling pathways reduced MG132-mediated upregulation of PAI-1 in varying degrees and most prominent effects were observed with SB203580, a p38 MAPK pathway inhibitor. The regulation of tPA/PAI-1 activity by proteasome inhibitor in rat primary astrocytes may underlie the observed CNS effects of MG132 such as neuroprotection.

The Study on Correlation between Traffic Accident Severity with Period and Cost of Treatment in Traffic Accident Outpatients Visiting a Korean Medicine Hospital (한방병원에 내원한 교통사고 외래환자에 있어서 사고규모와 치료기간 및 치료비용 간의 상관관계에 대한 연구)

  • Park, Ji-Yong;Hong, Nam-Jung;Lee, Min-Jung;Ahn, Ji-Hoon;Shin, You-Bin;Kim, Byung-Jung;Shin, Min-Geun;Ha, In-Hyuk;Lee, Jin-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.1
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    • pp.65-76
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    • 2014
  • Objectives The purpose of this study is to investigate the corelation between traffic accident severity and treatment period and cost by traffic accident. Methods Outpatients who visited Jaseng Korean medicine hospital traffic accident clinic were investigated by hospital computer system about period and cost of treatment. And we requested for repair cost of car, a sort of car groups and agreement date with car insurance company to insurance company. Therefore we could analysis statistical correlation of traffic accident severity (repair cost of car) with period of treatment, cost of treatment, number of treatment in same sort of car groups. For statistics, we used SPSS version 18.0 for windows. Results A significant positive correlation was found between traffic accident severity (repair cost of car) with repair cost of car, cost of treatment and number of treatment in semi-midsize car, midsize car group. But, any significant correlation wasn't found between traffic accident severity (repair cost of car) with repair cost of car, cost of treatment and number of treatment in small car, full-sized car group. In SUV (sport utility vehicle) car group some significant correlation was found, but it isn't between traffic accident severity (repair cost of car) with repair cost of car, cost of treatment and number of treatment. Conclusions It was found that traffic accident severity (repair cost of car) had an effect on cost of car, cost of treatment and number of treatment by statistical analysis. But, it was also suggested strongly that other factors like a cost of car and ages had an effect on them.

Study on Level of Anxiety on Admitted Patient도s Family (입원환자 가족의 불안정도에 관한 연구)

  • 김현실;김주희
    • Journal of Korean Academy of Nursing
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    • v.13 no.1
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    • pp.42-53
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    • 1983
  • The purpose of this study is to help the care of patient and to his family through comparison of the level of anxiety which between the family of admitted patient and the family without in patient, and to his family through comparison of the level of anxiety which between the family of admitted patient and the family without inpatient and exclude the factors which raised the level of anxiety in them. The experimental group in this study were samples of 200 patient's family selected by random sampling in H. University hospital located in Seoul (Department of patient were internal medicine, surgery, pediatrics and neuropsychiatry). The control group were samples of 70 family without inpatient selected by random sampling in Seoul. The data were collected through STAI (State-Trait Anxiety Inventory) by Spielberger (1970) for measurement to level of state and trait anxiety from April 1st to April 15th in 1982. The contents of data analysis by EDPS included the difference of level of anxiety between experimental and control group, correlationship between general characteristics of experimental group and level of anxiety, and correlation of trait and state anxiety in experimental group. The Findings of this study were as follows: 1) Level of anxiety of experimental group is higher than control group. 2) In the correlation between general characteristics and level of anxiety of experimental group, there were no significant difference which revealed in correlation with age of family member, family life cycle, marital status, the relation between patient and family member, the degree of symptom, number of admission, admission or nonadmission of medical insurance, number of family member, and division of disease to level of anxiety However, according to the sex of family member, hospitalization period, a monthly income of family, the degree of confidence toward medical team, religion of family, academic background of family, a tendency of significant differences to level of anxiety were seen. To put them in the concrete, they were as follow; a) Level of. anxiety on female family member is higher than male in experimental group. b) Admission period of patient is positively related to the level of anxiety of patient's family. c) The degree of confidence of patient's family toward medical team is in inverse proportion to the level of anxiety. d) A monthly income of patient's family is in inverse proportion to the level of anxiety. e) Levlt of anxiety of believer in patient's family is lower than unbeliever. f) The academical background of patient's family is in inverse proportion to the level of anxiety g) Level of state anxiety of patient's family at the time of admission is positively related to the level of trait anxiety.

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GENDER DIFFERENCES IN EMOTIONAL AND BEHAVIORAL PROBLEMS OF KOREAN ADOLESCENTS (청소년기 정서 및 행동문제의 성차)

  • Lee, Hyunji;Ha, Eun-Hye;Oh, Kyung-Ja
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.117-123
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    • 2005
  • Objectives : The purpose of the present study was to investigate the gender differences in behavior problems and social competences of Korean Adolescents. Methods : K-YSR (Korean-YSR) data from 6570 Korean adolescents (2549 boys and 4021 girls) and K-CBCL (Korean-CBCL) data from 2373 parents (boys 1173 and girls 1200) between the ages of 12 to 17 were analysed. Results : The results showed that boys reported higher mean scale scores on the Social Problems, Delinquent Behavior, whereas girls showed higher mean scale scores on the Withdrawn, Somatic Complaints, Anxious/Depressed and Aggressive Behaviors as well as Internalizing Problems and Total Behavior Problems in K-YSR. Girls also reported higher scores on the Social. as well as Total Competence Scale. Also parents reported higher mean scale scores on the Attention Problems, Delinquent Behavior in their boys, whereas reported higher mean scale scores on the Withdrawn, Somatic Complaints, Anxious/Depressed and Aggressive Behaviors as well as Internalizing Problems in their girls in K-CBCL. Parents reported no differences between boys and girls in social competence scales. Conclusion : In both K-YSR and K-CBCL, girls consistently showed higher scores in the Internalizing Problem scales and there was no significant difference between boys and girls in the Externalizing Problem scores, but girls showed higher mean score in the Aggressive Behavior scale.

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A CLINICAL STUDY OF CHILD AND ADOLESCENT PSYCHIATRIC CONSULTATION IN A GENERAL HOSPITAL (종합병원 소아정신과에 자문의뢰된 환아에 대한 임상적 고찰)

  • Kim Yeoung-Rang;Hong Sungdo D.;Lee Sang-Sin;Lim Seong Hu;Park Jeoung Hwan
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.72-78
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    • 2005
  • Objectives : This study is to investigate the clinical characteristics of psychiatric consultation for children and adolescents in a general hospital. Methods : Hospital records of 302 children and adolescents who were referred for psychiatric consultation in a general hospital over 4 years were reviewed and analyzed. Results : The mean referral rate for psychiatric consultation for school age children and adolescents was $2.15\%$. While more girls were referred in middle and high school age group, more boys were referred in pre-school age group. Fifty percent of the consultation was requested from department of internal medicine and pediatrics. Main reason for requesting psychiatric consultation was fur the assessment of the patients from psychiatric point of view $(31.1\%)$, followed by the management of depression $(11.6\%)$ and anxiety $(11.3\%)$. Most frequently rendered psychiatric services for the treatment was psychosocial education and supportive therapy $(21.2\%)$. Conclusion : There are differences in clinical nature of psychiatric consultation and referral patterns between adult patients and child and adolescent patients. Future research is needed to strengthen the services for child and adolescent psychiatric consultation.

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A STUDY OF RELATIONSHIP BETWEEN SELF-IMAGE AND SOCIAL SENSITIVITY IN ADOLESCENTS : THE STRUCTURAL RELATION AMONG SELF-IMAGE, DEPRESSION, ANXIETY, AND SOCIAL SENSITIVITY (청소년의 자아상과 사회적 민감성간의 관계에 대한 연구: 자아상-우울-불안-사회적 민감성간의 구조적 관계분석)

  • Shin, Min-Sup;Soh, Jun-Hyun;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.61-67
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    • 1996
  • The purpose of the present study was to investigate empirically the relationship among self-image, depression, anxiety, and social sensitivity in adolescents. 1602 normal adolescents(697 males and 905 females) responded to self report scales-Offer Self-Image Questionnaire-Revised, 3 subscales of Symptom Checklist-90-Revised. The data were analyzed with ANOVA and LISREL to examine the effect of self-image on depression, anxiety, and social sensitivity, and to test the relationship among the above 4 variables. Adolescents with low self-image showed significantly higher scores in the scales of depression, anxiety, and social sensitivity than did adolescents with high self-image. The result of LISREL showed that the low self-image leads to the emotional state of depression and anxiety, and those of depression and anxiety lead to the increase of social sensitivity, suggesting that self-image has a direct effect on depression and anxiety, and has a direct effect on social sensitivity in adolescent. These results were discussed in terms of implications for the prevention and treatment of adolescent social phobia.

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Systematic Review of the Cause of Drug-Induced Liver Injuries in Korean Literature (약인성 간손상의 원인물질에 관한 국내연구의 체계적 고찰)

  • Yun, Young-Ju;Shin, Byung-Cheul;Lee, Myeong-Soo;Cho, Sung-Il;Park, Jae-Hyeon;Lee, Hye-Jung
    • The Journal of Korean Medicine
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    • v.30 no.2
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    • pp.30-45
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    • 2009
  • Background: The safety of herbal products is an important issue in Korea. It is more complicated because of the concomitant use of conventional western drugs and herbal medicine, including prescribed medicine, folk herbs and food supplements. Although both western and traditional Korean medical doctors have studied on the safety of HMP, their results did not show relevant or consistent conclusions because of the poor quality of studies, including bias. Objectives: The aim of this study was to review the studies in Korea related to drug induced liver injury (DILI) systematically. We tried to estimate the proportion of causative materials of DILI and evaluate the clinical difference of DILIs from different materials. Methods: Systematic searches were performed on MedRIC and MEDLIS in Korea. The extraction of data as well as selective screening of the studies was carried out independently by two of the authors. There were no restrictions on the types of publication, including grey literature. Results: Twenty-one articles were included. Of them only 7 adapted prospective design and only 6 were published in peer-reviewed journals. The proportion of conventional drugs associated with hepatotoxic injuries in all DILI ranged from 15.8% to 83.3% and that of herbal medicine was from 28.9% to 44.7%. However, the criteria for herbal medicine were not clearly defined and concomitant medications were not fully investigated in most studies. There were limited objective data in the clinical differences of liver injuries from different materials and their results were conflicting. Conclusions: The causality assessments regarding DILI of herbal medicine were not performed properly and causative materials were misclassified in most of the studies published in Korea. These make the safety issue still ambiguous because of the limitations and lack of objectivity of the studies. More rigorous studies are required for clearly addressing these conflicting issues with cooperative investigation between traditional Korean and western medicine.

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The Differences of EEG Coherence between Schizophrenia and Bipolar Disorder (정신분열병과 양극성장애에서 뇌파 동시성의 비교분석)

  • Kim, Yong-Kyu;Shin, Jae-Kong;Park, Chong-Won;Hong, Kyung Sue;Lee, Seung-Yeoun;Oh, Hong-Seok;Lee, Yong-Suk;Kwak, Yong-Tae;Chang, Jae Seung;Lee, Yu-Sang
    • Korean Journal of Biological Psychiatry
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    • v.12 no.2
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    • pp.123-135
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    • 2005
  • Objectives:EEG coherence could imply the connectivity between two different areas of the brain, which is known to be important in the pathophysiology of bipolar I disorder(BPD I) and schizophrenia. The authors investigated EEG coherence in patients with BPD I and schizophrenia to examine the connectivity of the neural circuit. Methods:EEGs were recorded in 15 schizophrenia and 14 bipolar disorder patients, and 14 age-matched normal control subjects from 16 electrodes with linked-ear reference. Spectral parameters and coherence were calculated for the alpha bandwidth(8-13Hz) by a multi-channel autoregressive model using 20 artifact-free 2-seconds epochs and the differences were compared among three groups by two different statistical methods;F-test and Kruskal-Wallis test. Furthermore, when there were significant differences among three groups, Scheffe's multiple comparison tests were provided and Jonckheere-Terpstra tests for the ordered alternative were given. Results:In the intra-hemispheric comparison, left frontal coherence was increased in order of control, BPD I and schizophrenia. In the inter-hemispheric comparison, 1) inter-prefrontal coherence in BPD I was signifi- cantly higher than in normal controls, and 2) inter-prefrontal coherence in schizophrenia was significantly lower than in controls. Conclusion:These results suggest that 1) both schizophrenia and BPD I are diseases having the abnormality of neural circuit connectivity in both frontal and prefrontal lobes, and 2) the abnormality is more severe in schizophrenia than in BPD I. Furthermore, the data support that a common pathogenetic process may reside in both schizophrenia and BPD I.

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