• 제목/요약/키워드: Withdrawal Behavior

검색결과 161건 처리시간 0.028초

금단기간 중 흡연관련 시각자극에 의한 교감신경 반응에 대한 신문혈 침자극의 억제 효과 (Inhibitory effect of acupuncture at HT7 on the sympathetic activations to smoking-related visual cues during smoking cessation)

  • 채윤병;이정찬;박경모;이혜정;강오석;김송이;이화진;인창식;박히준
    • Korean Journal of Acupuncture
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    • 제26권4호
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    • pp.39-52
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    • 2009
  • Objectives : Cue reactivity is a key factor that modulates motivational goal-directed behavior associated with compulsive drug-taking and relapse. We investigated whether acupuncture attenuated the skin conductance response and the heart rate response to smoking-related visual cues in smokers. Methods : Twenty-nine smokers were treated with real acupuncture (RA) or sham acupuncture (SA). The stress response inventory was measured on the 5th day after quitting smoking. The skin conductance response and the heart rate were measured to evaluate the autonomic changes to the smoking related visual cues on the same day. Results : The sympathetic alterations in skin conductance and the heart rate induced by the smoking-related visual cues were significantly lower in the RA group, as compared to the SA group. The stress response inventory, such as somatization and frustration, in the RA group was significantly lower than that of the SA group. Conclusions : Acupuncture ameliorated the stress symptoms as well as the sympathetic activation to smoking cues during withdrawal. These findings indicate that acupuncture might be a useful tool in smoking cessation by inhibiting smoking cues-induced autonomic responses.

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Medial prefrontal cortex nitric oxide modulates neuropathic pain behavior through mu opioid receptors in rats

  • Raisian, Dorsa;Erfanparast, Amir;Tamaddonfard, Esmaeal;Soltanalinejad-Taghiabad, Farhad
    • The Korean Journal of Pain
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    • 제35권4호
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    • pp.413-422
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    • 2022
  • Background: The neocortex, including the medial prefrontal cortex (mPFC), contains many neurons expressing nitric oxide synthase (NOS). In addition, increasing evidence shows that the nitric oxide (NO) and opioid systems interact in the brain. However, there have been no studies on the interaction of the opioid and NO systems in the mPFC. The objective of this study was to investigate the effects of administrating L-arginine (L-Arg, a precursor of NO) and N(gamma)-nitro-L-arginine methyl ester (L-NAME, an inhibitor of NOS) into the mPFC for neuropathic pain in rats. Also, we used selective opioid receptor antagonists to clarify the possible participation of the opioid mechanism. Methods: Complete transection of the peroneal and tibial branches of the sciatic nerve was applied to induce neuropathic pain, and seven days later, the mPFC was cannulated bilaterally. The paw withdrawal threshold fifty percent (50% PWT) was recorded on the 14th day. Results: Microinjection of L-Arg (2.87, 11.5 and 45.92 nmol per 0.25 µL) increased 50% PWT. L-NAME (17.15 nmol per 0.25 µL) and naloxonazine (an antagonist of mu opioid receptors, 1.54 nmol per 0.25 µL) inhibited anti-allodynia induced by L-Arg (45.92 nmol per 0.25 µL). Naltrindole (a delta opioid receptor antagonist, 2.45 nmol per 0.25 µL) and nor-binaltorphimine (a kappa opioid receptor antagonist, 1.36 nmol per 0.25 µL) were unable to prevent L-Arg (45.92 nmol per 0.25 µL)-induced antiallodynia. Conclusions: Our results indicate that the NO system in the mPFC regulates neuropathic pain. Mu opioid receptors of this area might participate in pain relief caused by L-Arg.

Proportion of Non-Medical Opioid Use of Prescription Opioids among Cancer Patients in Korea

  • Se-Il, Go;Jung Hye Kwon;Sung Woo Park;Gyeong-Won Lee;Jung Hun Kang;Eduardo, Bruera
    • Journal of Hospice and Palliative Care
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    • 제26권4호
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    • pp.185-189
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    • 2023
  • Purpose: Limited research has been conducted on the prevalence of non-medical opioid use (NMOU) in Korean cancer patients who have received prescription opioids (PO). This study aimed to identify the potential proportion of NMOU in cancer patients who had been prescribed opioids in Korea. Methods: A retrospective cohort analysis was conducted on 14,728 patients who underwent cancer-related treatment between January 2009 and December 2019, using electronically collected data from a tertiary hospital in Korea. Information regarding the type and duration of opioid use was gathered. A detailed review of medical charts was carried out, focusing on patients who had been prescribed opioids for over 60 days beyond a 12-month period following the completion of their cancer treatment (long-term PO users). Results: Out of the 5,587 patients who were prescribed PO and followed up for at least 12 months, 13 cases of NMOU were identified, representing 0.23% of the patient population. Among the 204 long-term PO users, the rate was 6.37% (13/204). The most commonly misused opioids were oxycodone and fentanyl. For the group confirmed to have NMOU, the median duration of prescription was 1,327 days in total. Of the 13 patients diagnosed with NMOU, 9 reported withdrawal symptoms, 3 exhibited craving behavior for opioids, and 1 experienced both symptoms. Conclusion: This study found that 0.23% of cancer patients who had been prescribed opioids in Korea demonstrated NMOU. Despite this relatively low rate, careful monitoring is necessary to minimize the risk of NMOU in this population, especially among long-term PO users.

몰핀에 민감화된 흰쥐의 내관부위 자침이 행동과 측핵의 도파민 유리에 미치는 효과 (Effect of Acupuncture(PC6) on Behavior, Dopamine Release in the Nucleus Accumbens in Rats Sensitized to Morphine)

  • 김상호;류승준;김태헌;강형원;류영수
    • 동의생리병리학회지
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    • 제19권4호
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    • pp.982-992
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    • 2005
  • Acupuncture as a therapeutic intervention is widely used for the treatment of many functional disorders such as substance abuse and mental dysfunction. Clinical trials are currently underway to determine the effectiveness of acupuncture in the treatment of drug addiction. Yet, there are still many unanswered questions about the basic mechanism of acupuncture. Studies have shown that both the psychomotor stimulant effects and rewarding properties of addictive drugs, including morphine, are sensitized by repeated drug administration and raised the possibility that both of these effects may De linked to the same or closely overlapping the mesolimbic dopamine systems. Neiguan (PC6) point on the pericardium channel which is associated with the brain and its mental function, has been used to treat mental, psychosomatic disorders and gastroenterological disorders. The present study was designed to investigate the effect of acupuncture on repeated morphine-induced changes in extracellular dopamine levels using in vivo microdialysis and to measure the effect of acupuncture on repeated morphine-induced behavioral changes. Male Sprague-Dawley rats were treated twice a day for three days with increasing doses of morphine (10, 20 and 40 mg/kg, s.c.) or with saline. After 15 days of withdrawal, rats were challenged with morphine hydrochloride (5 mg/kg, s.c.). Acupuncture was applied at bilateral Neiguan (PC6) points for 1min after the morphine challenge. Results showed that acupuncture at the specific acupoint PC6, but not at control points (tail and HE8) significantly decreased both dopamine release, behavior induced by a systemic morphine challenge or a single s.c. morphine injection in the morphine-repeated animals. These results suggest that reduction in sensitization may be one mechanism whereby acupuncture alleviates morphine craving in addicts. Moreover, in a more general sense these results suggest that acupuncture can be used as a therapeutic intervention for correcting reversible malfunction of the body by direction of brain pathway and thus acupuncture can contribute to the biochemical balance in the central nervous system by regulating neurotransmitters.

계획된 간호 정보가 수면량에 미치는 영향에 관한 연구 -개심술 환자를 중심으로- (The Effect of Structured Information on the Sleep Amount of Patients Undergoing Open Heart Surgery)

  • 이소우
    • 대한간호학회지
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    • 제12권2호
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    • pp.1-26
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    • 1982
  • The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

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중년 남성의 죽음에 대한 태도에 영향을 미치는 요인 (Factors Influencing Middle-Aged Men's Attitude towards Death)

  • 정영미
    • Journal of Hospice and Palliative Care
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    • 제16권3호
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    • pp.166-174
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    • 2013
  • 목적: 본 연구는 우리나라 중년 남성의 죽음에 대한 태도를 살펴보고 이에 대한 영향요인을 파악하여 올바른 자아성찰이 포함된 건강증진 프로그램 개발을 위해 시도되었다. 방법: 대구광역시에 거주하는 만 40~59세 중년 남성을 편의 표출하였다. 구조화된 설문지 문항에는 일반적 특성, 생활스트레스, 자아존중감, 생활만족도, 우울, 대처행동, 죽음에 대한 태도 등을 포함시켰다. 자료는 기술통계, 피어슨 상관계수 및 단계적 다중회귀 분석을 이용하였다. 결과: 중년 남성의 죽음에 대한 태도는 교육 정도, 종교, 자원봉사활동, 인지된 건강상태에 따라 유의한 차이가 있었으며, 죽음에 대한 태도는 생활스트레스, 우울과는 음의 상관관계를, 자아존중감, 생활만족도, 대처행동과는 양의 상관관계를 나타내었다. 또한 단계적 다중회귀분석을 통한 죽음에 대한 태도 영향요인은 생활만족도, 생활스트레스, 종교, 대처행동이 유의한 영향요인으로 나타났으며, 이들 변수의 죽음에 대한 태도 설명력은 25.7%였다. 결론: 중년 남성이 죽음을 올바로 이해하고 긍정적이면서 수용적인 태도를 지니기 위해서는 대상자가 가지고 있는 교육수준이나 경제수준과 같이 당장 변경이 어려운 요인보다는 보다 접근이 용이한 심리적인 요인에 초점을 두고 개입이 시행되어야 할 것이다. 또한 이런 중재는 일반 중년 남성뿐만 아니라 말기 암이나 호스피스 치료를 받고 있는 중년 남성, 더 나아가 중년 여성이나 다른 연령층에게 본 연구결과가 적용될 수 있을 것이다.

Beyond Clot Dissolution; Role of Tissue Plasminogen Activator in Central Nervous System

  • Kim, Ji-Woon;Lee, Soon-Young;Joo, So-Hyun;Song, Mi-Ryoung;Shin, Chan-Young
    • Biomolecules & Therapeutics
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    • 제15권1호
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    • pp.16-26
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    • 2007
  • Tissue plasminogen activator (tPA) is a serine protease catalyzing the proteolytic conversion of plasminogen into plasmin, which is involved in thrombolysis. During last two decades, the role of tPA in brain physiology and pathology has been extensively investigated. tPA is expressed in brain regions such as cortex, hippocampus, amygdala and cerebellum, and major neural cell types such as neuron, astrocyte, microglia and endothelial cells express tPA in basal status. After strong neural stimulation such as seizure, tPA behaves as an immediate early gene increasing the expression level within an hour. Neural activity and/or postsynaptic stimulation increased the release of tPA from axonal terminal and presumably from dendritic compartment. Neuronal tPA regulates plastic changes in neuronal function and structure mediating key neurologic processes such as visual cortex plasticity, seizure spreading, cerebellar motor learning, long term potentiation and addictive or withdrawal behavior after morphine discontinuance. In addition to these physiological roles, tPA mediates excitotoxicity leading to the neurodegeneration in several pathological conditions including ischemic stroke. Increasing amount of evidence also suggest the role of tPA in neurodegenerative diseases such as Alzheimer's disease and multiple sclerosis even though beneficial effects was also reported in case of Alzheimer's disease based on the observation of tPA-induced degradation of $A{\beta}$ aggregates. Target proteins of tPA action include extracellular matrix protein laminin, proteoglycans and NMDA receptor. In addition, several receptors (or binding partners) for tPA has been reported such as low-density lipoprotein receptor-related protein (LRP) and annexin II, even though intracellular signaling mechanism underlying tPA action is not clear yet. Interestingly, the action of tPA comprises both proteolytic and non-proteolytic mechanism. In case of microglial activation, tPA showed non-proteolytic cytokine-like function. The search for exact target proteins and receptor molecules for tPA along with the identification of the mechanism regulating tPA expression and release in the nervous system will enable us to better understand several key neurological processes like teaming and memory as well as to obtain therapeutic tools against neurodegenerative diseases.

임신경과에 영향을 미치는 건강위험행위 (Health Risk Behaviors Affecting the Process of Pregnancy)

  • 박재순;문미선;홍진희;이정은
    • 여성건강간호학회지
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    • 제6권4호
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    • pp.549-565
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    • 2000
  • Comprehensive review of the literature was conducted to determine 1) selected risk factors and its impact that affect pregnancy outcome such as smoking, alcohol consumption, and substance abuse 2) these factors can facilitate future strategies for health promotion and prevention for both pregnant women and fetus. Review of literature were extracted from searching MEDLINE(1966 - Oct. 2000). CINAHL (1982 - Oct. 2000) and the domestic literature. The following factors were identified: 1. The effects of risk behaviors on pregnancy. ${\cdot}$Maternal smoking was associated with the occurrence of premature or LBW delivery, fetal growth retardation, extremities defects, heart defects and sudden infant death syndrome. ${\cdot}$Maternal alcohol consumption was associated with spontaneous abortion, premature or LBW delivery, morphologic/neurologic problems, especially fetal alcohol syndrome. ${\cdot}$Heroin was associated with withdrawal after birth in which were born to heroine addicts for gestational age and lung maturation in animal studies. ${\cdot}$Cocaine was associated with spontaneous abortion, abruptio placenta and a poor response to environmental stimuli. ${\cdot}$So far, the effects of caffeine on pregnancy was controversial, but severe caffeine consumption was associated with premature or LBW delivery, spontaneous abortion, still birth and dystocia. 2. Intervention methods and its effects identified were as follows ${\cdot}$Conducted intervention for smoking, alcohol and drug consumption were single or combined. ${\cdot}$Intervention methods were counseling, phone contact, mailing, use of educational videotape, booklet, support person and alternatives such as nicotine patch. ${\cdot}$The interventions increased the rates of smoking cessation during pregnancy and awareness of the risk of drug consumption, and decreased amount of alcohol consumption. ${\cdot}$The intervention outcome found positive effect on birth weight and length. 3. Our recommendations were as follows ${\cdot}$The personal and social cognition should be enhanced through education and the mass media. ${\cdot}$It's necessary to educate and give information of preconceptional care, planned pregnancy and early prenatal care for optimal pregnancy outcome. ${\cdot}$It's necessary to develop comprehensive assessment tool which is reliable and valid on smoking, alcohol consumption and substance abuse to identify supportive or interventional program.

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인생과 월경 전기 증후군과의 상관관계에 관한 연구 (Premenstrual Syndrome and Personality)

  • 김은주
    • 대한간호학회지
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    • 제18권1호
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    • pp.80-93
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    • 1988
  • This study was planned and carried out to investigate the correlation between premenstrual syndrome and personality in order to provide informations basic to the prevention, alleviation, and care for the premenstrual syndrome. Data on premenstrual syndrome were gatherd from October 20 to 25, 1986 by questionnaire modified by the researcher based on Endicott's Premenstrual Assessment Form. Reliability of the instrument was tested by Cronbach's $\alpha$. Data on personality were gathered in March, 1986, by the high school autorities by standardized Personality Inventory Scale developed by Eung Yun Hwang were used. Subjects numbered 457, 95.2% of the first grade students of H. Girls High School located in Seoul. The correlation and difference between personality traits and premenstrual syndrome analysed by Pearson's Correlation Coefficient, and difference between groups were analysed by the t-test. Personality traits influencing premenstrual syndromal categories were analysed by the multiple regression. The results are as follows : I. The five highist categories of premenstrual syndrome among 18 categories revealed to be Social withdrawal, General discomfort, Lability, Fatigue and Hostility / Anger in rank order. II. Personality traits and Premenstrual syndrome ; 1. Tendency of Psychoneuroses(r=0.43, p<.001), psychoses(r=.39, p<.001) and anti-social behaviors (r=0.43, p<.001) revealed to be significantly correlated to premenstrual syndrome. Hypothesis 1 is accepted. 2. Emotional stability(r= -0.38, p<.001), reflectiveness (r= -0.14, p<.01), masculinity (r= -0.10, p<05) and antonomy (r= -0.12, p<.05) revealed significant correlation, While activity, dominance, sociability and achivement revealed no significant correlation. Hypothesis 2 is partially accepted. III. Significant models of personality traits influencing the premenstrual syndromal categories are ; 1. 5 personality traits : tendency of psychoneuroses, emotional stability, dominance, activity and autonomy revealed to influence Low mood / loss of pleasure significantly. ($R^2$=.19) 2. 3 personality traits ; tendency of psychoneuroses, emotional stability and sociability revealed to influence Lability significantly. ($R^2$=.15) 3. 5 personality traits ; tendency of psychoneuroses, activity, emotional stability, sociability and achievement revealed to influence Anxiety significantly.($R^2$=.18) 4. 3 personality traits : tendency of psychoneuroses, emotional stability and sociability revealed to influence Miscellaneous mood / behavior changes significantly.($R^2$=.18) 5. 3 personality traits : tendency of psychoneuroses, psychoses and reflectiveness revealed to influence Hysteroid features significantly.($R^2$=.16) IV. No significant correlation between irregularity of menstruation and premenstrual syndrome was revealed. No significant difference between group of dysmenorrhea and group of non-dysmenorrhea in premenstrual syndrome was revealed.

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스마트폰 중독의 중재 프로그램에 관한 체계적 고찰 (A Systematic Review on the Intervention Program of Smartphone Addiction)

  • 김덕주
    • 한국산학기술학회논문지
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    • 제21권3호
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    • pp.276-288
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    • 2020
  • 본 연구의 목적은 스마트폰 중독의 중재 프로그램에 대해 체계적으로 분석함으로써, 스마트폰 중독 치료에 대한 근거를 제시하고자 하는 것이다. 연구 분석을 위해 2010년 1월부터 2019년 7월까지 출판된 문헌들을 대상으로 하였으며, 국외 문헌은 'Pubmed, Science Direct'에서 검색하였고, 국내 문헌은 'RISS, Keris, KISS'를 통하여 검색하였다. 총 310편의 논문이 검색되었고, 포함기준과 배제기준을 바탕으로 분석하여 최종 16편의 논문이 분석에 사용되었으며, 근거수준 I이 13편(81%), III이 3편(19%)이었다. 분석결과 스마트폰 중독을 위한 중재 방법에는 미술치료가 6편(37.5%)으로 가장 많았으며, 운동치료가 4편(25.0%), 인지행동치료가 3편(18.6%)을 차지하였다. 분석에 포함된 대상자는 초등학생이 가장 많았으며, 중재기간은 6~8주 사이, 치료 회기는 6회기 혹은 12회기가 가장 많았다. 대부분의 프로그램 중재 후 스마트폰 중독의 금단증상 감소, 우울, 불안 및 충동성과 같은 부정적인 감정 감소, 자아존중감과 같은 긍정적인 감정의 증가 등 좋은 결과를 나타내었다. 평가항목을 보면, 스마트폰 중독 진단척도가 가장 많이 사용되었으며, 인터넷 중독진단, 불안평가, 우울평가, 충동평가, 애착평가 등과 같이 심리적인 부분을 측정하는 평가가 대다수를 차지하였다. 향후 이러한 연구들이 스마트폰 중독의 치료를 위한 중재도구로 효과적으로 활용될 수 있을 것으로 기대한다.