• Korean Journal of Schizophrenia Research
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• v.22 no.1
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• pp.1-7
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• 2019

Objectives: Clozapine is the drug of choice in treatment-resistant schizophrenia. However, its use is often delayed and a significant proportion of clozapine treated patients fails to respond and experience potentially dangerous side-effects. The aim of this retrospective study was to describe the clinical characteristics of patients started on clozapine and the rate and reason of discontinuation of clozapine. Methods: Medical records of 83 patients started on clozapine during the period of 2012-2016 were reviewed. Results: Clozapine started on patients in chronic phase; the mean age of start was 38.1 years old and the mean number of psychiatric admission was 6.5. A majority (80.7%) of the patients had been subjected to antipsychotic polypharmacy prior to clozapine and most (61.5%) of them were being treated with polypharmacy including clozapine. Overall, 39 (47.0%) subjects had continued clozapine whereas 15 (18.1%) discontinued it; 29 (34.9%) were lost to follow-up. The most common reason for discontinuation was side-effects (n=13) including six life-threatening cases, most of which occurred within 6 months of its start. Conclusion: This study demonstrated that there is some evidence of delays to clozapine use, high rates of polypharmacy and significant rate of discontinuation during the early phase of clozapine treatment.

• Journal of Korean Academy of Nursing
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• v.6 no.1
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• pp.80-90
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• 1976

정신과 영역의 환자를 위해 간호원의 역활을 필요로 한 이래 여러 가지 간호의 개념으로 간호원의 역할이 변화되어오고 있다. 정신과 환자의 안전만이 가장 큰 치료의 중심일 때는 병동열쇠의 위엄에 곁따라 보호관리에만 치중해 왔으며 정신의학에서 약물요법, 전기요법의 치료과정이 생기면서 간호원의 역할 변화 및 지식의 요구를 필요로 하게 되었으며, 환경과 개인의 밀접한 관계를 중시해오면서 치료적 환경속으로 환자의 인간적 치료가 강조되었을 때 의사소통과 대인관계의 인적 환경으로써 또한 간호원의 역활이 중요시 되어왔다. 이런 관점에서 치료적 환경에 대한 정확한 이해는 간호행위과정의 불완전을 제거하며 보다 활발한 정신과 환자간호에 기여하는 일 일 것이다. DR. Bartom은 병실 환경이 비생산적이고 비 치료적일때 성격의 변화는 물론 행동적 특성의 변화까지 가져올 수 있다고 말했다. 즉 무감동적이고, 무조건적 순종이 있으며 솔선하여 행하는 행위가 줄고 장래 계획에 대한 자극이 줄어들고 될대로 되어 가는 상태 그 자체에 머물러 있어 인간의 특징적 의미와 가치를 상실하게 된다는 것이다. 정신과 병실은 잠정적 체류지로 보아야 하겠고 이 체류지에서의 영향이 환자에게 보다 유익하게 끼칠려면 간호원이 지속적으로 치료적 분위기를 유지해야 할 것이다. 치료적 입장으로서의 간호의 활동 초점은 대인관계에서 환자의 의식수준과 자아관련 수준에서의 취급이 무의식 수준에서의 탐구조사보다 바람직하다. 치료적 가치로써 치료적 환경의 이론적 근거를 DR. Sullivan 은 인간의 상호관련 문제에 두고 있다. 즉 상호작용이 존재하는 환경은 어떠한 곳이든 성격에 영향이 있고 이 성격은 대인관계의 복잡성으로부터 결코 떨어질 수 없다는 얘기다. 자아구성 또한 환경의 영향을 받는데 Cumming은 병동환경과 자아구성 재동기간에 밀접성을 시사한바 있다. Visher와 O'sullivan은 정신과적 치료중에서 일상생활에서 경험되어지는 의사소통과 대인관계속에서 학습되어지는 여러 가지가 있기 때문에 매일의 활동획이 치료적 방향으로 계획되어 져야 한다고 말했다. Maxwell Jones 또한 치료적 환경의 유용한 가동은 전 직원의 기여에 있으며 이는 정신건강을 최적으로 올려 줄 것이다. 라고 말했다. 이러한 상황에서 간호원은 의미 없이 환자의 감정 욕구를 깨닫지 못하고 감정지지를 주지 못하며 정서적 긴장을 예방하지 못한 체 환자와의 관계를 유지한다면 현대간호의 개념에서 이탈되어지고 발달되어지지 못한 미숙아 현상이 유지 될 것이다. 보다 바람직한 치료적 환경 유지는 간호로써 환자에게 기여해 주는 일이다. 간호의 역활과 더불어 전문적 태도는 따뜻하고 포용성 있게 그리고 융통성 있게 대함은 물론 간호인 자신의 "자기이용"을 깊이 그리고 치료적으로 이용할 것을 깨달아야 할 것이다. 즉 정신과 병실에서의 간호원 존재 자제가 환자에게 미치는 영향도 고려해야 한다는 것이다. 덧붙여 환자를 위한 일주일 병동 행사표를 Model로 제시하였고 그 안에서의 간호원의 역활을 약술하였다.

• Journal of Haehwa Medicine
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• v.21 no.2
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• pp.95-104
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• 2013

스트레스로 인한 인체의 반응은 중추신경계, 시상하부, 변연계 및 기타 표적기관으로부터 시작되는데, 자율신경계 반응, 내분비계 반응, 면역계 반응 등을 통하여 복합적인 신체 증상으로 발현되며, 스트레스 상황에서는 시상하부-뇌하수체-부신 축 (HPA axis)과 교감신경계의 작용으로 여러 신경전달물질 방출에 변화가 생기며 이러한 변화는 면역기전에 중요한 역할을 하고 일부는 면역세포의 활성에 직접적으로 영향을 미쳐 신체 각종 질병의 원인이 될 것으로 추정된다. 한의학에서는 천인상응(天人相應)의 관점에서 육기(六氣)를 생체자극의 외적 요인으로 간주하고, 생체내적 현상인 정신이 외적 자극을 통하여 나타나는 생체반응을 칠정(七情)으로 보았으며, 이러한 관점에서 스트레스는 신체에 오장(五臟)의 허실(虛實), 혈허(血虛), 정손(精損), 기역(氣逆), 기(氣)의 순환장애, 담연(痰涎), 화(火) 등의 병적인 요인을 만들어 준다. 본 연구에서 재료로 사용된 호초 (Piper nigrum Linne)는 후추나무의 과실을 말린 것으로서 세계적으로 널리 사용되는 향신료이며, 한의학에서는 온중제한하기(溫中除寒下氣), 쾌격소담(快膈消痰), 해독(解毒)등의 효능으로 한담식적(寒痰食積) 완복냉통(脘腹冷通) 곽란(癨亂) 토사(吐瀉)등의 치료에 활용되어 왔다. 특히 쾌격소담(快膈消痰)하는 작용은 정신적 스트레스에 유효할 것으로 생각되므로 본 연구에 이용하게 되었다. 실험동물은 ICR계 생쥐를 이용하였으며, 심리적 스트레스는 옆쪽 cage에서 다른 마우스의 신체에 가해지는 전기 충격을 하루 1시간 동안 지켜보게 하는 것으로 유발하였으며, 이 상태에서 약물을 투여한 그룹을 실험군, 그렇지 않은 그룹을 대조군으로 하였다. 정상군은 아무런 자극 없이 하루 1시간 동안 일정 공간에 가두어 두는 것으로 하였다. 실험 결과, 호초(胡椒) 추출물을 100mg/kg/day 용량으로 5일간 투여한 실험군은 아무런 처치를 하지 않은 대조군에 비해 혈장 중 corticosterone 함량이 유의하게 감소되었고, 뇌에서의 noradrenalin 분비량이 유의하게 증가되었으며, plus maze test에서의 머무름 시간이 연장되는 것으로 나타나 호초(胡椒)가 심리적 스트레스를 효과적으로 억제하고 진정작용이 있는 것으로 사료되나 구체적인 작용기전 및 인체에서의 효과에 대해서는 향후의 보다 자세한 연구가 필요할 것으로 생각된다.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.294-304
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• 2021

Ankylosing spondylitis causes ankylosis of the spine due to ossification of the articular cartilage and ligaments around the vertebral body as well as the sacroiliac joint. This pathophysiology limits joint movement and, in many cases, causes pain and deformity of the spine. If this disease is left untreated, it ultimately causes ankylosis and ossification of the whole-body joints. The symptoms generally develop before age 30 years, and the gradual progression of the disease adversely affects the physical function, professional ability, and quality of life. This increases the likelihood of developing psychiatric disorders, such as depression. The authors are aware of this severity and introduce recent trends and studies to prevent surgical treatment with various medications before systemic ossification. This paper presents various surgical treatments and complications in patients who were unable to prevent progression and underwent surgical treatment.

• Journal of the Korean Society of School Health
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• v.3 no.1
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• pp.101-118
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• 1990

This study was intended to investigate actual conditions and problems relating to a variety of substance which have been used by students. A Questionnaire survey was carried out with the subject of 2411 students in an academic boys' high school, academic girls' high school, technical boys' high school and technical girls' high school in Pusan, from the 15th day to 29th day of March, 1989. The summarized results were as follows. There was not a remarkable difference in distribution of these subjects in boys' & girls' high school. The common and good health condition of subjects accounted for 90 percent or higher. 24.4 percent of them also had smoking experience, 11.6 percent of which continues to smoking. The understanding rate of these substances name other than sedative, psychostimulants and antihypnotic accounted for 90 percent or higher. The experience rate taking these substances for one year showed that anodyne, digestive and nutritive tonic accounted for 70 percent, antihypnotic for 15.6 percent, sedative for 1.4 percent, respectively, and psychostimulants for 0.5 percent. Moreover. it was shown that drugs accounted for 1.5 percent, bond for 1.4 percent, and thinner for 0.5 percent. The rate of the daily experiencers who took anodyne, digestive, nutritive tonic, sedatives, and psychostimulants and so on was 7.7 percent, 6.2 percent, 5.2 percent, 5.9 percent, and 5.0 percent respectively. This fact implied that there was a serious problem in high school students' non - narcotic abuse. The usage rate of these substances for treatment purpose showed that anodyme accounted for 90 percent or higher, and digestive for 70-80 percent, respectively, where girl students showed higher rate than one of boy students. Additionally, there was higher the usage rate for other purposes. The usage rate of drugs was highest when these students felt melancholy and curiousity. Their obtaining place appeared that these students mainly obtained these drugs, bonds and thinners from a small shop or peddler and their friend while they usually obtained other substance from the pharmacy and medical institute. The first usage time of these substances appeared during the middle school (the age of 14-15) which was the highest rate. The smoker of all subjects used remarkly large substances as compared with one of no-smoker. Particularly, it appeared that the usage of drugs was very closely related to smoking. The large number of students did not use these substances for oesrable purposes even though they understood the name of these substances. For this reason, from primasy schools it is required to teach the students dependence and harmful effects caused by these substances abuse. Moreover, it was shown that these students firstly used these substances during the middle school (the age of 14-15)due to curiosity. As a result, it is very urgent to give the students health education suitabale for prevention of these substance abuse, when considering harmful effects of these substances. And so health education for no-smoking. Finally, considering that it is very easy to obtain these substances from a small shop and pharmacy, the regulation of these substances control should be considered and completed in the future.

• Journal of Physiology & Pathology in Korean Medicine
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• v.33 no.4
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• pp.207-218
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• 2019

It is necessary to investigate the efficacy of commercial Korean herbal medicine for cognitive disorder. The purpose of this study is to select candidates among licensed herbal medicines that are expected to be effective in the treatment of cognitive disorders and can be used in future clinical trial. From laboratory experiments, we first found individual single herbal drugs that could be effective for cognitive disorder, and then through experts recommendation, selected five priorities of single herbal drug and obtained the information of the best herb as a combination of each herbal drug. To derive the final herbal prescriptions, we searched the KFDA drug information system for licensed herbal medicines containing each drug and its combination. As a result of laboratory experiments and experts recommendation, we found that the five effective single herbal drugs for cognitive disorders. They are Ginseng Radix, Acori Graminei Rhizoma, Cyperi Rhizoma, Coptidis Rhizoma, Pinelliae Rhizoma, Hoelen cum Pini Radix, and Rehmanniae Radix Preparata(Pinelliae Rhizoma, Hoelen cum Pini Radix, and Rehmanniae Radix Preparata were tied for $5^{th}$). And licensed herbal prescriptions derived from the planned search are Palbohoichoon-tang, Taehwa-hwan, Bosim-hwan, and so on. Among these, in consideration of the feasibility of research and possibility of success in development, Yukgunja-tang, Samhwangjichul-hwan can be selected as future study subjects. Through experimental studies and expert recommendations, we have derived herbal prescriptions that can be effective in treating cognitive disorders from licensed herbal medicines.

• Journal of Korean Medical classics
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• v.18 no.4 s.31
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• pp.27-43
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• 2005

통과대(通過對)${\ulcorner}$내경(內經)${\lrcorner}$ 중출현적조신적개념급용조신치병적방법적연구(中出現的調神的槪念及用調神治病的方法的硏究), 득출여하결론(得出如下結論): 조신이양생지의(調神以養生之意), 용우지금(用于至今). ${\ulcorner}$내경(內經)${\lrcorner}$중신지의(中神之意), 우기표현위여우주자연지신(尤其表現爲與宇宙自然之神)[천신(天神)]상응적인체지신(相應的人體之神)[인신(人神)]상(上), 즉천인상응적사상교위돌출(卽天人相應的思想較爲突出) 형신상호관계상(形神相互關係上), 재유지형신합일적사상적동시(在維持形神合一的思想的同時), 비기양형경가중시어조신(比起養形更加重視於調神). 재양생방면(在養生方面), 조신의조시간급공간(調神依照時間及空間), 분위사시조신화오장신조신(分爲四時調神和五臟神調神). ${\ulcorner}$소문(素問).사기조신대론(四氣調神大論)${\lrcorner}$적요지시이사시출현적자연계적변화규율(的要旨是以四時出現的自然界的變化規律), 응대청정적우주정신래수련신심(應對淸靜的宇宙精神來修練身心). ‘이념요법(移念療法)’시통과개변재인체오장내정기적운행위치(是通過改變在人體五臟內精氣的運行位置), 진행치료적방법(進行治療的方法). 기내용개괄료기타각종정신요법(其內容槪括了其他各種精神療法). 대지언고론요법적한의학해석(對至言高論療法的韓醫學解釋), 불시이이유오행혹음양이론작위의거(不是以已有五行或陰陽理論作爲依據), 이시가종사상의학중조도. 기원인시사상의학적출발점(其原因是四象醫學的出發點), 불시이단순적육체무병작위기목적(不是以單純的肉體無病作爲其目的). 저일점(這一點), 종명확지표현재수세보원적성명사단론중(從明確地表現在壽世保元的性命四端論中). 대생리병리독특적유심론관(對生理病理獨特的唯心論觀), 시이제마선생탁월관점(是李濟馬先生卓越觀点). 한방음악치료초월료이행동주의심리학위중심(韓方音樂治療超越了以行動主義心理學爲中心), 발전기래적기유적음악요법적국한성(發展起來的旣有的音樂療法的局限性), 약여약물(若與藥物), 침구치료병용(鍼灸治療倂用), 불근가이치료신경정신질환(不僅可以治療神經精神疾患), 환가이치료기타각종신체질환(還可以治療其他各種身體疾患). 기공시이응신(氣功是以凝神), 의수(意守), 의념등표현(意念等表現), 작위기주요조신방법적일종수신법(作爲其主要調神方法的一種修身法).

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.161-165
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• 2012

Lowe syndrome, also known as oculocerebrorenal syndrome, is a rare genetic disorder involving eyes, kidney, brain and musculoskeletal system, and occurs predominantly in males. The patient with Lowe syndrome is characterized with congenital cataracts, glaucoma, prominent forehead, thin and sparse hair, mental and growth retardation, muscular hypotonia, renal dysfunction, and metabolic bone disease. We have experienced a 10-year-old boy with Lowe syndrome who had poor oral hygiene and trouble for teeth brushing. To manage his behavior and systemic metabolic disorder, sedation was performed during dental care. Excessive calculus formation in this patient is caused by both medication and lack of ability to maintain oral hygiene. The dental management of those patients has to be focused on prevention due to difficulties in dental treatment and dangers of general anesthesia for the Lowe syndrome.

• Korean Journal of Schizophrenia Research
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• v.21 no.2
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• pp.74-80
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• 2018

Objectives : This study investigated whether long-acting injectable (LAI) paliperidone is different from its oral form in terms of the effect on cognitive function in schizophrenia spectrum and other psychotic disorders. Methods : We reviewed the medical records of patients in Seoul National University Bundang Hospital who were diagnosed as having schizophrenia and/or other psychotic disorders based on DSM-5 from 2016 to 2017. Seven patients were treated with oral paliperidone and 11 were treated with paliperidone palmitate. All patients underwent clinical and neuropsychological assessment, including the Korean version of the MATRICS Consensus Cognitive Battery (MCCB) at their first visit or within one month of their initial treatment. MCCB was repeated within three to 12 months after the initial assessment. Results : There was no significant difference between the two groups in most cognitive domains including speed of processing, attention and vigilance, working memory, verbal learning, visual learning and reasoning and problem solving domain. However, patients treated with paliperidone palmitate showed better improvement in social cognition domain than those taking oral paliperidone. The standardized values of social cognition domain scores had significantly improved over time in patients under paliperidone palmitate, demonstrating a significant time-by-group interaction. Conclusion : Our results show that long-acting injectable paliperidone could be helpful in some aspects of improving cognitive function in schizophrenia spectrum and other psychotic disorders. Further studies with other antipsychotics are necessary to generalize the results.

• Korean Journal of Schizophrenia Research
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• v.24 no.1
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• pp.1-7
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• 2021

Clozapine is the first and most effective atypical antipsychotic drug for treatment-resistant schizophrenia (TRS). After withdrawal of clozapine due to concerns of agranulocytosis, clozapine was reintroduced with a comprehensive safety monitoring system, the clozapine patient monitoring system (CPMS). The reintroduction was a response to the pressure from psychiatrists and patients with TRS and their families. Clozapine is still the best single agent for the treatment of TRS. However, approximately 30% of patients with TRS still show psychotic symptoms. In patients with clozapine-resistant schizophrenia (CRS), augmentation of other antipsychotic agents could be considered after a thorough evaluation of proper clozapine treatment. In this review, the status of clozapine in patients with TRS and CRS will be discussed.