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Imaging Neuroreceptors in the Living Human Brain

  • Wagner Jr Henry N.;Dannals Robert F.;Frost J. James;Wong Dean F.;Ravert Hayden T.;Wilson Alan A.;Links Jonathan M.;Burns H. Donald;Kuhar Michael J.;Snyder Solomon H.
    • The Korean Journal of Nuclear Medicine
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    • v.18 no.2
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    • pp.17-23
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    • 1984
  • For nearly a century it has been known that chemical activity accompanies mental activity, but only recently has it been possible to begin to examine its exact nature. Positron-emitting radioactive tracers have made it possible to study the chemistry of the human mind in health and disease, using chiefly cyclotron-produced radionuclides, carbon-11, fluorine-18 and oxygen-15. It is now well established that measurable increases in regional cerebral blood flow, glucose and oxygen metabolism accompany the mental functions of perception, cognition, emotion and motion. On May 25, 1983 the first imaging of a neuroreceptor in the human brain was accomplished with carbon-11 methyl spiperone, a ligand that binds preferentially to dopamine-2 receptors, 80% of which are located in the caudate nucleus and putamen. Quantitative imaging of serotonin-2, opiate, benzodiazapine and muscarinic cholinergic receptors has subsequently been accomplished. In studies of normal men and women, it has been found that dopamine and serotonin receptor activity decreases dramatically with age, such a decrease being more pronounced in men than in women and greater in the case of dopamine receptors than serotonin-2 receptors. Preliminary studies in patients with neuropsychiatric disorders suggests that dopamine-2 receptor activity is diminished in the caudate nucleus of patients with Huntington's disease. Positron tomography permits quantitative assay of picomolar quantities of neuro-receptors within the living human brain. Studies of patients with Parkinson's disease, Alzheimer's disease, depression, anxiety, schizophrenia, acute and chronic pain states and drug addiction are now in progress. The growth of any scientific field is based on a paradigm or set of ideas that the community of scientists accepts. The unifying principle of nuclear medicine is the tracer principle applied to the study of human disease. Nineteen hundred and sixty-three was a landmark year in which technetium-99m and the Anger camera combined to move the field from its latent stage into a second stage characterized by exponential growth within the framework of the paradigm. The third stage, characterized by gradually declining growth, began in 1973. Faced with competing advances, such as computed tomography and ultrasonography, proponents and participants in the field of nuclear medicine began to search for greener pastures or to pursue narrow sub-specialties. Research became characterized by refinements of existing techniques. In 1983 nuclear medicine experienced what could be a profound change. A new paradigm was born when it was demonstrated that, despite their extremely low chemical concentrations, in the picomolar range, it was possible to image and quantify the distribution of receptors in the human body. Thus, nuclear medicine was able to move beyond physiology into biochemistry and pharmacology. Fundamental to the science of pharmacology is the concept that many drugs and endogenous substances, such as neurotransmitters, react with specific macromolecules that mediate their pharmacologic actions. Such receptors are usually identified in the study of excised tissues, cells or cell membranes, or in autoradiographic studies in animals. The first imaging and quantification of a neuroreceptor in a living human being was performed on May 25, 1983 and reported in the September 23, 1983 issue of SCIENCE. The study involved the development and use of carbon-11 N-methyl spiperone (NMSP), a drug with a high affinity for dopamine receptors. Since then, studies of dopamine and serotonin receptors have been carried out in over 100 normal persons or patients with various neuropsychiatric disorders. Exactly one year later, the first imaging of opitate receptors in a living human being was performed [1].

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The Direction of Christian Education in the Post COVID-19 (코로나19 시기 이후의 기독교교육의 방향)

  • Kim, Sung-Joong
    • Journal of Christian Education in Korea
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    • v.63
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    • pp.39-64
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    • 2020
  • COVID-19 is sweeping the world, and it is in crisis in all aspects of politics, economy, culture, and religion. As people experience the beginning and spread of COVID-19, wince and re-spread, the people are living in anxiety and depression. Because of the COVOD-19 crisis, Korean churches were unable to provide on-site worship, and online worship began, and churches that started on-site worship also performed online worship. In the case of church schools, the functions of fellowship and education were paralyzed and many are offering online Sunday service only. Many people eagerly want to go back to what it was before COVID-19, but it seems difficult because COVID-19 has become a global issue and a pandemic situation. We can't wait to get better out of this. In the COVID-19 crisis, the church was unable to properly handle the church's original work and to fully fulfill the mission of education. The response of many churches was to postpone the planned ministry to the second half of 2020. Now, we should try to set a new direction and prepare specifically to move in the new direction. With this perspective, this paper studied the direction of Christian education in the post COVID-19. Specifically, the theoretical basis of the direction of Christian education in the post COVID-19 was found in the theory of Agape's encounter, Catechesis theory, and diakonia theory, and specific directions were suggested according to these theories. Specifically, based on the theory of Agape's encounter, Christian education that emphasizes the encounter with the natural environment, Christian education that emphasizes the encounter among family members, Christian education that emphasizes the encounter among citizens of the world, and Christian education that emphasizes the encounter through online were presented. Based on the Catechesis theory, Christian education copping with the attack of heresy was presented. Finally, based on the diakonia theory, Christian education of service for society and Christian education of service based on data were presented.

The Effect of Psychological Factors on Postoperative Pain in Gastric Tumor Patients after Endoscopic Submucosal Dissection (내시경 점막하 박리법을 시술 받은 위종양 환자에서 심리적 요인이 시술 후 통증에 미치는 영향)

  • Lee, Joon-Hyub;Jeon, Han Ho;Lee, San;Lee, Hyeok;Oh, Seung-Taek;Chang, Jhin Goo;Im, Woo Young;Park, Jaesub;Choi, Won-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.68-75
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    • 2018
  • Objectives : Since pain in cancer patients is an important factor that greatly affects the quality of life and prognosis, many attempts have been actively made to reduce the pain. Despite continuous effort on reducing pain after Endoscopic submucosal dissection (ESD), research has not been done on psychological factors as much as on biological factors affecting pain. The objective of this study is to investigate the psychological factors affecting postoperative pain in gastric tumor patients who underwent gastric ESD. Methods : 91 gastric tumor patients who visited National Health Service Ilsan Hospital in Korean between May 2015 and June 2016, and received ESD were evaluated. Baseline characteristics including sociodemographic factors, anxiety, depression, and resilience were evaluated before the procedure. Multivariate logistic regression was done to analyze factors affecting postoperative pain. Results : The group with high postoperative pain showed lower alcohol consumption and higher depressive symptom scores than the group with low postoperative pain. Also, the group with high postoperative pain showed lower total resilience score with lower subtotal scores in self-control and positive item. Multivariate logistic regression analysis of the postoperative pain showed that patients with lower score in self-control of resilience [odd ratio (OR), 0.911 ; 95% CI, 0.854-0.971, p=0.004) reported more pain after ESD. Conclusions : This study showed that patients with lower self-control ability of resilience felt more pain after ESD. Among the psychological factors evaluated in this study, resilience of an individual seems to have effect on pain.

Comparison of Antidepressants Tolerability in Cancer Patients Referred for Psychiatric Consultation (정신건강의학과 자문 의뢰된 암 환자의 항우울제 내약성 비교 연구)

  • Ko, Eunmi;Park, Jin-Seong;Ha, Juwon;Lim, Sewon;Kim, Tae-Suk;Ha, Jee Hyun;Paik, Jong-Woo;Lee, Boung Chul;Choe, Byeong Moo;Lee, Kang-Joon;Kim, Sung-Wan;Yang, Jong-Chul;Ko, Young-Hoon;Oh, Kang-Seob
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.3-10
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    • 2013
  • Objectives : Many patients diagnosed with cancer suffer from various psychiatric symptoms such as depression, anxiety and insomnia as well as cancer itself. Patients with cancer are more vulnerable to possible adverse events of psychotropic medications. Although antidepressants are widely used among cancer patients, there is little information about tolerability of antidepressants. This study was conducted to compare tolerability of antidepressants in cancer patients referred for psychiatric consultation. Methods : The participants were cancer patients who had been referred to psychiatrist for their psychiatric symptoms. We retrospectively analyzed the data of patients diagnosed with cancer from 9 general hospitals in Korea. The discontinuation rate for a 6 months period after treatment initiation for three antidepressants(Escitalopram, Mirtazapine, Paroxetine) were compared. Results : Antidepressants were prescribed for 96.3% of subjects and Escitalopram 150(47.2%), Mirtazapine 92(28.9%) and Paroxetine 76(23.9%) were prescribed frequently in order There were no significant differences in discontinuation rates among the three antidepressants during the 6 month period after initiation of pharmacotherapy. But there was a difference in discontinuation rates between inpatients versus outpatients(p<0.0001). Conclusions : In a naturalistic setting for the antidepressant treatment for cancer patients, it seems that there are no differences in discontinuation rates among these three antidepressants. It is therefore essential that such interactions are carefully considered when treating patients of antidepressants who already have cancer.

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The Effect of Insomnia Severity on Daytime Sleepiness in Obstructive Sleep Apnea Syndrome (불면증 정도가 폐쇄성 수면무호흡 증후군에서의 주간졸림 정도에 끼치는 영향)

  • Nam, Ji-Won;Shin, Byoung-Hak;Shin, Hyeon-Sil;Park, Minji
    • Sleep Medicine and Psychophysiology
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    • v.22 no.1
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    • pp.11-19
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    • 2015
  • Objectives: Whether daytime sleepiness is proportional to the severity of sleep apnea in obstructive sleep apnea syndrome (OSAS) is controversial. In this study we investigated how insomnia severity affects the association between daytime sleepiness and sleep apnea severity in OSAS. Methods: The present study included 235 male subjects who were diagnosed with OSAS based on clinical history and nocturnal polysomnography. Pearson's correlation analysis was conducted among sleep and mood-related self-reported data, polysomnographic data and demographic data of all subjects. Based on Pittsburgh Sleep Quality Index (PSQI), the subjects were divided into 2 groups; group A (n = 75; $PSQI{\leq}5$) and group B (n = 160; PSQI > 5). Partial correlation analysis was performed between the Epworth Sleepiness Scale (ESS) and other data in both groups. Multiple linear regression analysis was conducted to investigate the factors which affected the ESS in group A. Results: Pearson's correlation analysis showed weak or non-existent correlations between ESS and apnea severity data such as apnea-hypopnea index (AHI) (r = 0.148, p = 0.023), apnea index (AI) (r = 0.137, p = 0.036), hypopnea index (HI) (r = 0.058, p = 0.377), oxygen desaturation index (ODI) (r = 0.149, p = 0.022) and arousal total index (ATI) (r = 0.129, p = 0.048). Positive correlations between ESS and apnea severity data such as AHI ($r_p=0.313$, p = 0.008), AI ($r_p=0.339$, p = 0.004), ODI ($r_p=0.289$, p = 0.015) and ATI ($r_p=0.256$, p = 0.031) were observed only in group A. Multiple regression analysis showed that AI (t = 2.996, p = 0.004) and BAI (t = 2.721, p = 0.008) were associated with ESS in group A. Conclusion: The correlation between daytime sleepiness and sleep apnea severity was shown only in group A. This result suggests that associations between daytime sleepiness in OSAS and sleep apnea severity will become prominent when controlling for insomnia-related variables.

PRELIMINARY STUDY OF MENTAL REPRESENTATIONS OF PRESCHOOL CHILDREN EXPERIENCING SINGLE, SEVERE TRAUMA (심한 정신적 외상 경험을 한 학령 전기 아동의 정신적 표상에 대한 예비연구)

  • Eon, So-Yong;Song, Won-Woung;Oh, Kyung-Ja;Choi, Eui-Gyum;Shim, Eun-Ji;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.61-74
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    • 2004
  • Objectives:This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods:Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient at kindergarten, were evaluated for psychological assessments;Intelligence test, MSSB(MacArthur Story-Stem Battery), H-T-P test(House-Tree-Person test). And their parents completed rating scale, KPI-C(Korean Personality Inventory for Children about children’s psychological conditions). Results:With respects to the contents and emotional reactions of MSSB, 9 preschool children showed generally high levels of anxiety, depression, avoidance, aggression, probably related to the traumatic experiences. Even though children couldn't verbally report directly about their traumatic experiences, in both MSSB, structured play narrative assessment tool, and HPT, free drawing and association test, they demonstrated psychiatric problems through reenactment plays, regardless of clinical diagnoses. Conclusion:Present study allowed us the chance to see beyond the outer pathological behaviors of PTSD in preschool children, through deeper evaluations of their mental representation. These preliminary data suggest deep understanding of internal representation would be of help for thorough evaluations and treatment plan for preschool children, experiencing severe trauma.

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THE CHARACTERISTICS OF CHILD AND ADOLESCENT INPATIENTS WITH SEVERE OBSESSIVE-COMPULSIVE DISORDER (심각한 소아 ${\cdot}$ 청소년 강박장애로 입원한 환아들의 특징)

  • Hwang, Jun-Won;You, So-Young;Chang, Jun-Hwan;Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.143-151
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    • 2004
  • Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

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Effects of Minor Stressful Events on Sleep in College Students (대학생에서 스트레스가 수면에 미치는 영향)

  • Kang, Seung-Gul;Yoon, Ho-Kyoung;Ham, Byung-Joo;Choi, Yun-Kyeung;Kim, Seung-Hyun;Joe, Sook-Haeng;Suh, Kwang-Yoon;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.48-55
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    • 2002
  • Objective: Stress is known to be a common cause of short-term insomnia and insomniacs often complain that stress induces sleep problems. However, previous studies on the correlation between stress and sleep do not show consistent results. We aimed to investigate the effects of minor stressful events on sleep among college students. Method: Physically and mentally healthy college student volunteers filled out a self-assessment questionnaire to evaluate their stress and sleep. To find out the status of average stress and sleep, the volunteers filled out K-DSI and daily sleep assessments on three consecutive days. In addition, we surveyed the amount of caffeine beverage intake and assessed the degree of depression and anxiety. Results: The total number of students participating in this study was 202, 101 men and 101 women. Minor stress turned out to significantly affect non-restorative sleep and secondary symptoms of insomnia (awakening difficulty, displeasure, feeling of dissatisfaction with sleep, physical uneasiness or pain at awakening, daytime sleepiness, depressive moods, tiredness and concentration difficulty). However, global PSQI score, self-reported sleeping hours, sleep latency, awakening frequency, frequency and duration of napping, were not explained by stress scores. Conclusion: In this study, minor stresses seemed to affect sleep, especially secondary symptoms caused by non-restorative sleep. We can thus infer that minor stresses impair the restorative effects of sleep by inducing arousal, and the direct relationship the two can be confirmed by polysomnogram.

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Effect of Bright Light Exposure on Adaptation to Rapid Night Shift : A Field Study of Shift Work Nurses in Psychiatric Ward (순환제교대근무자에서 야간 근무 적응에 대한 광치료 효과)

  • Ko, Young-Hoon;Joe, Sook-Haeng
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.41-47
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    • 2002
  • Objectives: In a number of simulated night shift studies, timed exposure to bright light improves sleep quality and work performance. We evaluated the effect of bright light on adaptation to night shift work with a field study. Methods: Five female nurses working shifts at Korea University Hospital were recruited for participation in this study. We investigated two series of six consecutive shift rotations comprising three day and three night shifts, using wrist Actigraphy, the Stanford Sleepiness Scale, Visual-analogue scales, STIM and tympanic membrane temperature for daytime sleep quality, alertness, subjective feeling, attention performance, and temperature rhythm. The subjects were exposed to bright light (2,500 lux) from 24:00 to 04:00 a.m. on three consecutive night shifts during the second series, whereas they worked under normal lightening (650 lux) conditions during the first series. Results: Actigraphic assessment of daytime sleep showed no significant difference between the first and third night shift in both baseline and light exposure phase. The mean lowest temperature shifted earlier during baseline phase but not during the light exposure phase. Also, the score for subjective feelings of depression, anxiety, physical discomfort and sleepiness was significantly higher in the third night shift than the first during baseline phase but not during the light exposure phase. Attention and attention switching ability was significantly improved in the third night shift compared to the first night during the light exposure phase but there were no significant changes during the baseline phase. Conclusion: This result suggests that there were no significant differences between the two phases in measures of quality of daytime sleep, but subjective feelings, attention and alertness were enhanced during light exposure. Although some placebo effects and learning effects might influence this result, bright light exposure between midnight and 4:00 a.m. may improve adaptation to night shift. In future, further controlled studies with a larger sample size, including melatonin measurement, are needed for real shift workers.

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Reliability and Validity of the Fatigue Severity Scale among University Student in South Korea (대학교 재학생에서 Fatigue Severity Scale의 신뢰도 및 타당도 연구)

  • Lee, Junghyun H.;Jeong, Hyeonseok S.;Lim, Soo Mee;Cho, Han Byul;Ma, Ji-Young;Ko, Eun;Im, Jooyeon J.;Lee, Sun Hea;Bae, Sujin;Lee, Yu-Jin;Lyoo, In Kyoon;Jeong, Do-Un
    • Korean Journal of Biological Psychiatry
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    • v.20 no.1
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    • pp.6-11
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    • 2013
  • Objectives There are only a limited number of studies on instruments assessing fatigue in university students, although fatigue exerts negative influences on their health and academic performances and fatigue-related complaints are more frequently reported in young adults than middle-aged adults. The aim of this study was to validate the 9-item Fatigue Severity Scale (FSS) among university students including both undergraduate and graduate students in South Korea. Methods A total of 176 university students completed a battery of self-report questionnaires, including the FSS, the Brief Fatigue Inventory (BFI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Medical Outcomes Study Short Form 36 version 2 (MOS-SF36v2), and the Inclusion of Community in the Self Scale (ICS). The data were collected from February of 2012 to June of 2012. The reliability, convergent validity, divergent validity, and exploratory factor analyses were conducted to assess psychometric properties of the FSS. Results The mean FSS score was 3.20 (standard deviation = 1.43). The FSS demonstrated an excellent internal consistency (Cronbach's ${\alpha}$ = 0.93) and item-total correlations ranged from 0.56 to 0.90. Correlations of the FSS with the BFI (r = 0.71, p < 0.01), BDI-II (r = 0.54, p < 0.01), BAI (r = 0.46, p < 0.01), MOS-SF36v2 physical component summary (r = -0.28, p < 0.01), MOS-SF36v2 mental component summary (r = -0.55, p < 0.01), and ICS (Spearman's rho = -0.07, p = 0.33) showed acceptable convergent and divergent validity. Exploratory factor analysis defined one underlying factor (eigenvalue = 5.67) that explained 93.50% of the total variance. Conclusions To the best of our knowledge, this is the first study to investigate reliability and validity of the FSS in university students. The FSS exhibits good psychometric properties for evaluation of fatigue among university students in South Korea. Since the FSS is easy to administer, score, and interpret, it could be a useful tool in research and practice for assessing fatigue among university students.