• Title/Summary/Keyword: Neuropsychiatry

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CLINICAL CHARACTERISTICS OF CHILDREN AND ADOLESCENTS WITH CONDUCT PROBLEMS ADMITTED INTO A PSYCHIATRIC UNIT (소아정신과 병동에 입원한 품행장애 소아 청소년의 임상 특성)

  • Pyo, Kyung-Sik;Kang, Yun-Hyong;Bahn, Geon-Ho;Cho, Soo-Churl;Lee, Eun-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.227-236
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    • 1998
  • Objectives:Conduct disorder is one of the most frequent diagnosis in outpatient and inpatient mental health facilities for children and adolescents. This study investigated the clinical characteristics of children and adolescents with conduct disorder. Methods:The study employed a retrospective review of 45 inpatients diagnosed with conduct disorder by DSM-IV criteria at SNUH Child Psychiatric Unit from 1993, March to 1998, September. Results:The results were as follows:1) The sex ratio was 2:1, male dominant. Mean age on admission was $12.8{\pm}2.4$ years old(male:$12.2{\pm}2.3$, female:$14.1{\pm}2.1$). The mean age of male subjects was significantly lower than that of female subjects(p<.05). 2) We classified all subjects according to child- or adolescent-onset type by DSM-Ⅳ. Childhoodonset type was 42.2%, and adolescent-onset, 57.8%. The onset of male subjects were significantly earlier than that of female subjects(p<.05). 3) The most common complaint was 'serious violation of rules'(77.8%) by DSM-Ⅳ dimensions, while the most common single symtom was 'run away from home overnight at least twice while living in parental or parental surrogate home'(48.9%). 4) The comorbid psychopathology of the subjects were frequently described as follows, in order of frequency:substance use(42.2%), ADHD(35.6%), depression(20.0%), tic disorder(11.1%), bipolar disorder(4.4%). 5) On MMPI, both Pd and Ma subscales got the highest scores. The mean of total IQ by KEDIWISC was $100.0{\pm}15.1$. Female subjects' IQ was higher than that of male subjects. 6) Regarding the number of visits to the OPD after discharge, many subjects(33.3%) had visited OPD fewer than four times. Conclusions:In this study, the male to female ratio of adolescent type showed a decreasing trend. An interesting finding was the fact that socio-economic circumstances, as well as the level of education among patients, were higher than those of previous studies. The subjects' problem were also principally self contered and posed no threat to others.

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THE EFFICACY AND SAFETY OF RISPERIDONE IN CHILD & ADOLESCENT PSYCHIATRIC INPATIENT (소아 청소년 정신과 입원 환자에서 Risperidone의 효과 및 안정성에 관한 연구)

  • Park Jeong-Hyun;Kim Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.239-250
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    • 2005
  • Objective : The purpose of this study was obtaining data on the efficacy and safety of risperidone in child and adolescent psychiatric patients. Method : Thirty one children and adolescents (males n=18, females n=13, age ranged from 5.4 to 17.3 years) treated with risperidone were selected among child and adolescent psychiatric inpatients of Seoul National University Hospital from January, 2001 to June, 2002, and charts for them were reviewed retrospectively. Results : The primary psychiatric disorders treated with risperidone were schizophrenia and other psychosis, bipolar I disorder with psychotic features, Tourette's disorder, autism spectrum disorders, mixed receptive and expressive language disorder, attention deficit-hyperactivity disorder, conduct disorder and obsessive-compulsive disorder. twelve of these had comorbid mental retardation. Primary target symptoms of risperidone were psychotic symptoms (n=13 or $41.9\%$), behavioral symptoms (n=10 or $32.3\%$) including aggression, impulsivity, hyperactivity, stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics (n=8, $25.8\%$). The efficacy of risperidone was measured by clinical global improvement (CGI) for target symptoms, $67.7\%$ of subjects showed moderate or marked improvements and its therapeutic effect appeared to be maintained during at least 7.5 months. Mean daily dosage of risperidone was $0.05{\pm}0.01mg/kg$, the group with psychotic symptoms had significantly higher mean daily dosage (0.07mg/kg) compared with other two groups (0.04mg/kg) with behavioral symptoms or tics. A variety of adverse events were reported in this study : weight gain (n=23) most commonly reported, extrapyramidal symptoms (n=15), autonomic symptoms (n=6), sedation (n=5) and symptoms related to hyperprolactinemia (n=2) etc. Although there was no drug change related to the adverse events of risperidone, and $90\%$ of subjects at their last visits were maintained on it, thus its tolerability appeared good. Conclusions Results suggest that risperidone may be relatively safe and effective drug in managing a wide variety of child and adolescent psychopathologies such as psychotic symptoms, behavioral symptoms including aggression, impulsivity, hyperactivity and stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics. Controlled and long-term studies of efficacy and safety of risperidone treatment for children and adolescents are recommended in the future.

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THE DIFFERENCE OF THE BEHAVIORAL PROBLEM AND MATERNAL REARING PATTERN BETWEEN ADOLESCENT PSYCHIATRIC PATIENTS IN PEER NEGLECT OR REJECT AND THOSE IN NON-NEGLECT - A PRELIMINARY STUDY - (외톨이 혹은 왕따 상태인 청소년 정신과 환자와 비외톨이 환자의 문제 행동 및 어머니의 양육 태도의 차이 - 예 비 연 구 -)

  • Son, Jung-Woo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.177-188
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    • 2002
  • Objectives:The major goal of this study was to investigate and compare the behavior problems and mothers' rearing pattern between adolescent psychiatric patients either neglected or rejected by peer and those who were neither neglected nor rejected by peer. Methods:Adolescent psychiatric patients(N=25) performed peer neglect scale, peer reject scale. And their mothers performed the part of Child Behavior Checklist(CBCL), Maternal Behavior Research Instrument(MBRI), the scale for the maternal concern about the social life of their own patients, and the scale for maternal concern about the friendship of their own patients. According to the score of the peer neglect scale and the peer reject scale, we divided the patients into 'peer neglect-reject' group(n=15) and ‘on-loneliness’ group(n=10), and compared the scores of other scales between each group. Also, we investigated the correlation among all scales. Results:1) The scores of the part of CBCL(p<.05), depressed/anxious subscale of CBCL(p<.05) and thought problem subscale of CBCL(p<.01) in peer neglect-reject group were significantly higher than those in non-neglect group. The score of peer neglect scale was significantly correlated with that of the part of CBCL(r=.516), depressed/anxious subscale of CBCL(r=.483), thought problem subscale of CBCL (r=.651), social problem subscale of CBCL(r=.517). And the score of peer reject scale was significantly correlated with that of attention subscale of CBCL(r=.414), thought problem subscale of CBCL(r=.446), social problem subscale of CBCL(r=.531). 2) But, each group was not significantly different on the scores of MBRI, the scale for the maternal concern about the social life of their own patients, and the scale for maternal concern about the friendship of their own patients. And there were no significant correlation between the scores of peer neglect / peer reject scale and those of scales for maternal rearing pattern. Conclusion:The thought problem and depression/anxiety problem of adolescent psychiatric patients neglected or rejected by peer were estimated more higher than those of adolescent psychiatric patients neither neglected nor rejected by peer. But, from the view of maternal rearing pattern, each 2 groups seemed not to be different. Further research using more subjects will be needed.

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A STUDY ON THE TEMPERAMENTAL CHARACTERISTICS OF KOREAN CHILDREN USING TODDLER TEMPERAMENT SCALE (걸음마기 기질평가척도를 이용한 한국 아동의 기질 특성 연구)

  • Choi, Sung-Ku;Hong, Sung-Do;Son, Jung-Woo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.163-176
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    • 2002
  • Objectives:This study was designed to investigate the temperamental characteristics and the differences of temperamental characteristics in Korean children according to the sociodemographic and family environment factors using Toddler Temperament Scale(TTS). Methods:The samples consisted of 1,175 children who were attending twenty-five Samsung Child Care Centers nationwide. Both Korean version of TTS and child developmental questionnaire(designed by the Department of Psychiatry, Samsung Medical Center) were distributed to the parents of these children. Score of 9 temperamental categories was determined using the result of TTS, and determination of 5 temperamental clusters was conducted by the Fullard's criteria. Statistical analyses were performed according to the sex, birth order, existence of siblings, residential city, residential province, marital state of child's parents, and parental relationship to compare the scores of temperamental categories and the distribution of temperamental clusters. Results:The distribution of temperamental clusters was as follows;Easy 35.8%, Intermediate Low (IL) 33.1%, Intermediate High(IH) 11.1%, Slow-To-Warm-Up 6.3%, and Difficult 13.6%. Some of 9 temperamental categories were statistically different according to the sex, birth order, existence of siblings, residential city, residental province, marital state of child's parents, and parental relationship. From the viewpoint of 5 temperamental clusters, there were statistically more Easy and less Difficult children in good relation between each parent(p=.022). In spite of no statistical significance, the children in conditions of first-born, non-existence of siblings, middle or small residential city, Chung-Cheong province, married state of parent had a tendency to be easier to care. Conclusions:The toddler temperamental characteristics of Korean children showed some differences in several sociodemographic and family environment factors. We could confirm that the 'Goodness of Fit' was very important in child temperament.

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Effect of Germinated Black Sticky Rice with Giant Embryo on Alcohol Intake in C57BL/6 Mice (흑찰거대배아미 발아현미배아의 섭취가 C57BL/6 생쥐의 알코올 섭취에 미치는 영향)

  • Shin, Dong-Hun;Kim, Sung-Gon;Kim, Hyeon-Kyeong;Huh, Sung-Young;Byun, Won-Tan
    • Journal of Life Science
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    • v.30 no.3
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    • pp.260-266
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    • 2020
  • Alcohol impacts many central nervous systems, such as dopamine, serotonin, opioids, and gamma-aminobutyric acid (GABA), leading to addiction. Many studies have investigated the relationship between GABA and alcoholism. The purpose of this study was to investigate the effects of GABA high and low rice intake on the alcohol intake behavior of mice. Black sticky rice with giant embryo (BSRGE), black sticky rice (BSR), giant embryo rice (GER), and rice (Rice) were germinated for 48 hr in brown rice. The embryos were then collected and used in the study. The diets were fed to respective C57BL/6 mouse groups ad libitum for 16 days and investigated for 2 hr alcohol intake, 22 hr water intake, 24 hr feed intake, and body weight. As a result of the repeated measure of ANOVA for the daily change of alcohol intake for 2 hr daily between the BSRGE and BSR groups, there was a significant difference in the number of days of intake (DF = 7, F = 4.812, p = 0.026). A significant daily decrease in alcohol intake was observed in the BSRGE group compared to the BSR group. This reduction was consistent from Day 10 to Day 16. Alcohol consumption also significantly decreased in the GER group compared to the Rice group. This decrease was observed from Day 12 to Day 16. In conclusion, BSRGE and GER resulted in decreased alcohol intake in C57BL/6 mice compared to BSR and rice. This suggests that BSRGE may prevent relapse in patients with alcohol use disorder.

The Role of Sympathetic Activity in the Early Phase of Liver Regeneration after Partial Hepatectomy (간-부분절제(肝-部分切除) 후 나타나는 재생과정(再生過程)에서 교감신경계(交感神經系)의 역할(役割)에 관(關)한 연구(硏究))

  • Choi, Sang-Hyun;Lee, Joong-Geun;Park, Chung-San;Chun, Boe-Gwun;Chun, Yeon-Sook
    • The Korean Journal of Pharmacology
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    • v.26 no.2
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    • pp.177-183
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    • 1990
  • This study was undertaken to confirm whether or not the sympathetic nervous system takes part in the liver regeneration after partial hepatectomy. The male Sprague-Dawley rats were pretreated with I.P. injection of guanethidine 25 mg/kg: single dose (G-1); multiple doses once a day for 3 days (G-3), for 5 days (G-5), or for 6 days (G-6). The rats were subjected to partial hepatectomy $(70.4{\pm}1.99%)$ under light anesthesia of diethyl ether. 1) The systolic blood pressure of control rat was $98.0{\pm}3.9\;mmHg$ and was not affected by G-1. But after the pretreatment with G-3, G-5 or G-6, the pressure was markedly decreased by over 25 %. 2) Both of plasma norepinephrine and epinephrine levels showed the marked increases 3 hrs after the hepatectomy. However, the increases are entirely inhibited by G-1 or G-6. 3) All the liver contents of putrescine, spermidine and spermine showed the significant increases 6 hrs after the hepatectomy and were not affected by G-1 or G-6 with the exception of the inhibition of putrescine increase by only G-6. The present results suggest that the sympathetic activation appeared after partial hepatectomy seems not to play an important role in rat liver regeneration.

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The Changes in Polysomnographic Sleep Variables by Periodic Limb Movements During Sleep (주기성 사지운동증에 따른 수면다원검사 상 수면 변수들의 변화)

  • Choi, Jongbae;Choi, Jae-Won;Lee, Yu-Jin;Koo, Jae-Woo;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.24-31
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    • 2017
  • Objectives: Periodic limb movement disorder (PLMD) has been debated with regard to its clinical significance and diagnostic criteria. The current diagnostic criterion for PLMD in adults has been changed from periodic limb movement index (PLMI) > 5/hour to PLMI > 15/hour by the International Classification of Sleep Disorders (ICSD). In this study, we aimed to investigate the changes in polysomnographic sleep variables according to PLMI and to determine the relevance of the diagnostic criterion for PLMD. Methods: Out of 4195 subjects who underwent standard polysomnography, we selected 666 subjects (370 males and 296 females, aged $47.1{\pm}14.8$) who were older than 17 years and were not diagnosed with primary insomnia, sleep apnea, narcolepsy, or REM sleep behavior disorder. Subjects were divided into three groups according to PLMI severity: group 1 ($PLMI{\leq}5$), group 2 (5 < $PLMI{\leq}15$), and group 3 (PLMI > 15). Demographic and polysomnographic sleep variables and Epworth sleepiness scale (ESS) were compared among the three groups. Results: There were significant differences among the three groups in age and gender. Sleep efficiency (SE) and stage 3 sleep percentage in group 1 were significantly higher than those in groups 2 and 3. The wake after sleep onset (WASO) score in group 1 was significantly lower than those in groups 2 and 3. However, there were no significant differences in SE, stage 3 sleep percentage, or WASO between groups 2 and 3. Sleep latency (SL) in group 1 was significantly lower than that in group 3, but there was no difference in SL between group 2 and group 3. ESS score in group 1 was significantly higher than that in group 3, but there was no difference between group 2 and group 3. Partial correlation analysis adjusted by age showed that PLMI was significantly related to SE and WASO. Conclusion: This study suggests that PLMI influences polysomnographic sleep variables. In addition, we found the individuals who did not have PLMD but had PLMI > 5 were not different in polysomnographic sleep variables from the individuals who had PLMD according to the current criterion. These results raise questions about the relevance of the current diagnostic criterion of PLMD.

Experimental Models of Schizophrenia (정신분열병의 실험적 모델)

  • Cheon, Jin-Sook
    • Korean Journal of Biological Psychiatry
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    • v.6 no.2
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    • pp.153-160
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    • 1999
  • Animal models can provide a useful tool for the study of some aspects of psychiatric disorders and their treatment. The four criteria for the evaluation of animal models of psychiatric disorders are as following : 1) similarity of inducing conditions 2) similarity of behavioral state 3) common underlying neurobiological mechanisms 4) reversal by clinically effective treatment techniques. Several animal models have been proposed for schizophrenia : phenylethylamine model, L-dopa model, hallucinogen model, cocaine model, amphetamine model, phencyclidine model, noradrenergic reward system lesion model, reticular stimulation model, social isolation model, conditioned avoidance reaction, catalepsy test, paw test, self-stimulation paradigms, latent inhibition paradigms, blocking paradigms, prepulse inhibition of the startle reflex, rodent interaction, social behavior in monkeys, hippocampal damage, high ambient pressure, and models using selective breeding. Among them, animals with bilateral lesion of the hippocampus may provide an adequate animal model for several symptoms of schizophrenia, and ketamine model can reproduce negative symptoms and cognitive deficits as well as positive symptoms of schizophrenia. In conclusion, no model of schizophrenia is entirely representative of the disease, and findings gleaned from model systems must be cautiously interpreted. Furthermore, the process of developing and validating animal models must work in concert with the process to identify reliable measures of human phenomenology.

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[ ${\ulcorner}$ ]Standard Principles for the Designing of Prescriptions - The Theory for Monarch, Minister, Adjuvant and Dispatcher${\lrcorner}$ ("방제구성의 표준적 규격 - 군신좌사(君臣佐使)")

  • Kim Do-Hoy;Seo Bu-il;Kim Bo-Kyung;Kim Gyeong-Cheol;Shin Soon-Shik
    • Herbal Formula Science
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    • v.11 no.2
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    • pp.1-18
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    • 2003
  • The Theory for Monarch, Minister, Adjuvant and Dispatcher (or the Theory of Principal, Assistant, Adjuvant and Guiding Korean Oriental Herbal Medicines) has served as a standard principle for newly developed prescription formulas as well as established ones. Despite its significance, however, this theory hasn't been thoroughly studied and covered in the academic journals of Korean Oriental Herbal Medicines (KOHM) yet. This paper inquires into the origin of the theory while presenting the definitions and functions of Principal, Assistant, Adjuvant, and Guiding KOHM. In the end, the recommended doses and number of the KOHM comprising each of Principal, Assistant, Adjuvant, and Guiding KOHM are suggested. The compatibility theory of Principal, Assistant, Adjuvant, and Guiding KOHM can be traced back to the Warring States Period during which it was recorded in the treatise of the various schools of thoughts and their exponents. The theory was firmly established as a full system in ${\ulcorner}Shinnong's\;Pharmacopoeia{\lrcorner}\;and\;{\ulcorner}Yellow\;Emperor's\;Cannon\;of\;Internal\;Medicine{\lrcorner}$. While ${\ulcorner}Shinnong's\;Pharmacopoeia{\lrcorner}$ focuses on the classification of the properties of KOHM, ${\ulcorner}Yellow\;Emperor's\;Cannon\;of\;Internal\;Medicine{\lrcorner}$ mainly deals with the principles for writing prescriptions. In this regard, it is ${\ulcorner}Yellow\;Emperor's\;Cannon\;of\;Internal\;Medicine{\lrcorner}$ that systemized the Theory of Principal, Assistant, Adjuvant, and Guiding KOHM in a real sense. Principal KOHM aims at the causes of diseases and treat main symptoms. The doses are greater than Assistant, Adjuvant and Guiding KOHM. With their comprehensive effects, Principal KOHM is a leading ingredient of any prescription formula. Assistant KOHM are similar to Principal KOHM in its natures and flavors. Although its natures, flavors as well as efficacies may slightly differ from those of Principal KOHM, Assistant KOHM strengthens the therapeutic effects, jointly working with Principal KOHM. They mainly treat accompanying diseases and symptoms. Adjuvant KOHM is divided into two types: facilitator and inhibitor. Facilitators with the similar properties to those of Principal and Assistant KOHM help strengthen the therapeutic effects. Since they usually treat accompanying symptoms or secondary accompanying symptoms (minor accompanying symptoms), there are two kinds of facilitators. (1) The first kind of facilitators assists Principal KOHM, targeting accompanying symptoms. (2) The second ones supporting Assistant KOHM are for accompanying or secondary accompanying symptoms (or minor accompanying symptoms). Inhibitors counteract and thereby complement Principal and Assistant KOHM. Some of them inhibit the side effects or toxicity of Principal KOHM for the sake of the safety of the whole prescription formula while the others generate induced interactions. Guiding KOHM can be used for two purposes: guiding and mediating. The Guiding KOHM for the former purpose leads the other KOHM in a prescription formula to the lesion. But, the Guiding KOHM for mediating coodinate and harmonize all the ingredients in a prescription formula. The number of KOHM for those Principal, Assistant, Adjuvant and Guiding KOHM and their doses are different, depending on the types of prescriptions: classical prescriptions, prescriptions after ${\ulcorner}$Treatise of Cold-Induced Diseases${\lrcorner}$ and prescriptions of Sasang Constitutions Medicines. In the case of the prescriptions after ${\ulcorner}$Treatise of Cold-Induced Diseases${\lrcorner}$, it is highly recommended to follow the view of ${\ulcorner}$Thesaurus of Korean Oriental Medicine Doctors in Chosun Dynasty${\lrcorner}$ for the number of KOHM to be used. For the doses, however, ${\ulcorner}$Elementary Course for Medicine${\lrcorner}$, is found to be more accurate. The most appropriate number of KOHM per prescription is 11-13. To be more specific, for one prescription formula, it is recommended to administer one kind of KOHM for Principal KOHM, 2-3 for Assistant KOHM, 3-4 for Adjuvant KOHM and 5 for Guiding KOHM. As for the proportion of the doses, when 10 units are to be administered for Principal KOHM in a formula, the doses for the other three should be 7-8 units for Assistant KOHM, 5-6 for Adjuvant KOHM and 3-4 for Guiding KOHM. The doses of the KOHM added to or taken out of the prescription correspond to those of Adjuvant and Guiding KOHM.

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Effect of $K^+-channel$ Blockers on the $A_1-adenosine$ Receptor-Coupled Regulation of Electrically-Evoked Norepinephrine Release in the Rat Hippocampus (흰쥐 해마에서 Norepinephrine 유리를 조절하는 $A_1-adenosine$ 수용체의 역할에 미치는 $K^+$ 통로 차단제의 영향)

  • Choi, Bong-Kyu;Kim, Sang-Hoon
    • The Korean Journal of Pharmacology
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    • v.32 no.3
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    • pp.301-309
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    • 1996
  • Since it has been reported that the depolarization-induced NE release is inhibited by activation of presynaptic $A_1-adenosine$ heteroreceptor in hippocampus, a large body of experimental data on the post-receptor mechanism of this process has been accumulated. But, the post-receptor mechanism of presynaptic $A_1-adenosine$ receptor on the NE release has not been clearly elucidated yet. Therefore, it was attempted to clarify the participation of $K^+-channel$ in the post-receptor mechanisms of the $A_1-adenosine$ receptor-mediated control of NE release in this study. Slices from rat hippocampus were equilibrated with $^3H-norepinephrine$ and the release of the labelled products was evoked by electrical stimulation (3 Hz, 5 $VCm^{-1}$, 2 ms, rectangular pulses), and the influence of various agents on the evoked tritium-outflow was investigated. Adenosine, in concentrations ranging from $1{\sim}30\;{\mu}M$, decreased the NE release in a dose-dependent manner, without affecting the basal rate of release. 4AP $(1{\sim}30{\mu}M)$, a specific A-type $K^+-channel$ blocker, increased the evoked NE release in a dose-related fashion, and the basal rate of release is increased by 10 and $30{\mu}M$. TEA $(1{\sim}10{\mu}\;M)$, a nonspecific $K^+-channel$ blocker, increased the evoked NE release in a dose-dependent manner without affecting basal release. The adenosine effects were significantly inhibites by 3 ${\mu}M$ 4AP and 10 mM TEA treatment. 4AP $(30{\mu}M)-$ and TEA (10 mM)-induced increments of evoked NE release were completely abolished in $Ca^{++} free, but these were recoverd in low $Ca^{++} medium. And the effects of $K^+-channel$ blockers in low $Ca^{++} medium were inhibites and abolishes by $Mg^{++} (4 mM) adding and TTX $(0.3{\mu}M)$ adding medium, respectively. These results suggest that the decrement of the evoked NE-release by $A_1-adenosine$ receptor is mediated by 4AP and TEA sensitive $K^+-channel$.

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