• 수면정신생리
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• 제4권1호
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• pp.49-56
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• 1997

Nocturnal panic involves sudden awakening from sleep in a state of panic characterized by various somatic sensation of sympathetic arousal and intense fear. Many(18-71%) of the spontaneous panic attacks tend to occur from a sleeping state unrelated to the situational and cognitive context. Nocturnal panickers experienced daytime panics and general somatic sensation more frequently than other panickers. Despite frequent distressing symptoms, these patients tend to exhibit little social or occupational impairment and minimal agoraphobia and have a high lifetime incidence of major depression and a good response to tricyclic antidepressants. Sleep panic attacks arise from non-REM sleep, late stage 2 or early stage 3. The pathophysiology and the similarity of nocturnal panic to sleep apnea, dream-induced anxiety attacks, night terrors, sleep paralysis, and temporal lobe epilepsy are discussed.

• Journal of Oral Medicine and Pain
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• 제47권4호
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• pp.174-182
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• 2022

In chronic temporomandibular disorders (TMDs), constituent tissues such as muscles are sensitive to pain and psychological stress, which negatively affect the quality of life. In addition, since chronic TMDs is often accompanied by diseases such as psychological disorders and other chronic pain disorders, the diagnosis of those diseases and patient referrals are mandatory. The management of chronic pain in TMDs requires a multidisciplinary and holistic approach. Pharmacological therapy using cyclobenzaprine, serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, progressive relaxation, and psychological approaches using cognitive behavioral therapy such as shifting negative thoughts about pain are all valid treatment options.

• 대한임상독성학회지
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• 제9권1호
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• pp.26-29
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• 2011

Purpose: The role of a point of care test (POCT) is currently becoming important when treating patients and making decisions in the emergency department. It also plays a role for managing patients presenting with drug intoxication. But the availability of the test has not yet been studied in Korea. Therefore, we investigated the utility and the availability of POCT for drug screening used in the emergency department. Methods: This was a retrospective study for those patients with drug intoxication between January 2007 and December 2010 in an urban emergency department. Results: Between the study period, 543 patients were examined with a Triage$^{(R)}$-TOX Drug Screen. Among those, 248 (45.7%) patients showed negative results and 295 (54.3%) patients showed positive results. The sensitivity of the test for benzodiazepine, acetaminophen and tricyclic antidepressants were 85.9%, 100%, 79.2%, respectively. Conclusion: POCT of drug screening in emergency department showed good accuracy especially in patient with benzodiazepine, acetaminophen and tricyclic antidepressant intoxication. Therefore, it can be useful diagnostic tool for the management of intoxicated patients.

• The Korean Journal of Pain
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• 제23권2호
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• pp.99-108
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• 2010

Chronic pain is a multifactorial condition with both physical and psychological symptoms, and it affects around 20% of the population in the developed world. In spite of outstanding advances in pain management over the past decades, chronic pain remains a significant problem. This article provides a mechanism- and evidence-based approach to improve the outcome for pharmacologic management of chronic pain. The usual approach to treat mild to moderate pain is to start with a nonopioid analgesic. If this is inadequate, and if there is an element of sleep deprivation, then it is reasonable to add an antidepressant with analgesic qualities. If there is a component of neuropathic pain or fibromyalgia, then a trial with one of the gabapentinoids is appropriate. If these steps are inadequate, then an opioid analgesic may be added. For moderate to severe pain, one would initiate an earlier trial of a long term opioid. Skeletal muscle relaxants and topicals may also be appropriate as single agents or in combination. Meanwhile, the steps of pharmacologic treatments for neuropathic pain include (1) certain antidepressants (tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors), calcium channel ${\alpha}2-{\delta}$ ligands (gabapentin and pregabalin) and topical lidocaine, (2) opioid analgesics and tramadol (for first-line use in selected clinical circumstances) and (3) certain other antidepressant and antiepileptic medications (topical capsaicin, mexiletine, and N-methyl-d-aspartate receptor antagonists). It is essential to have a thorough understanding about the different pain mechanisms of chronic pain and evidence-based multi-mechanistic treatment. It is also essential to increase the individualization of treatment.

• Journal of Ginseng Research
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• 제17권3호
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• pp.187-195
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• 1993

We have examined the functional role of central dopaminergic processes on the behavioral pharmacological effects induced by psychotropics and red ginseng saponins of normal rats and compared with that of brain damaged rats. Desipramine and clomipramine produced, a significant depression of the locomotor activity in normal rats, but in brain damaged rats, they did not have any effect throughout the experimental period of 4 hours. Total saponin (50~200 mg/kg), PT (25~50 mg/kg), PD (25~50 mg/kg), $Rg_1$(12.5~25 mg/kg), $Rb_1$ (12.5~50 mg/kg) did not change, and high concentrations of PT (100 mg/kg), PD (100 mg/kg) and $Rg_1$ (50 mg/kg) showed a significant decrease in the locomotor activity of one hour after administration but total saponin (100 mg/kg), PD (25~50 mg/kg), Rgl (12.5 mg/kg), $Rb_1$ (12.5 mg/kg) markedly increased the locomotor activity of four hour after administration in normal rats. On the other hand, total saponin (50 mg/kg), PT (100 mg/kg) and PD (100 mg/kg) Produced a prominent stimulation of the locomotor activity in brain damaged rats. These results suggest that the inhibition of the locomotor activity induced by antidepressants was not affected by the sensitivity of cerebral DA system, whereas red ginseng saponin showed antifatigue effect and also the stimulation of the locomotor activity induced by red ginseng saponin was mediated by the inhibition of cerebral DA system. These psychotropic action of red ginseng saponins could be responsible for the beneficial effects on conditions of fatigue and decreased alertness.

• Journal of Oral Medicine and Pain
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• 제41권1호
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• pp.21-25
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• 2016

Purpose: Burning mouth syndrome (BMS) is a chronic pain condition involving the oral and perioral regions, often characterized by a burning sensation and pain in elderly patients. In this study, we investigated the effectiveness of pharmacological agents for the treatment of BMS patients through a retrospective chart review. Methods: We enrolled 61 BMS subjects (57 females, 4 males; $66.4{\pm}10.9$ years of age) from among consecutive patients treated pharmacologically from January 2014 to June 2015 at Chonnam National University Dental Hospital. Patients with secondary BMS associated with local factors were excluded. The treatment period, number of pharmacological agents tried, and effectiveness of the drugs administered to each subject were analyzed. Results: The mean treatment period for the management of BMS was 2.5 months. More than three agents were tried to control BMS symptoms in 17 subjects (27.9%); two agents were used in 10 subjects (16.4%), and a single agent in 24 subjects (39.3%). Clonazepam was prescribed most frequently and was effective at relieving symptoms in 30 of 39 subjects (76.9%). Paroxetine was moderately effective, relieving symptoms in 7 of 17 subjects (41.2%). Some of the subjects benefited from tricyclic antidepressants, gabapentin, and lipoic acid. A topical local anesthetic used to supplement other systemic agents had ameliorating effects in four of six subjects. Conclusions: Within the study limitations, clonazepam was the most effective drug and antidepressants were efficacious in some subjects for relieving the symptoms of BMS. These pharmacological agents could be considered as first-line drugs for the management of BMS.

• 한국진공학회:학술대회논문집
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• 한국진공학회 2015년도 제49회 하계 정기학술대회 초록집
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• pp.59.1-59.1
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• 2015

In the Linford group at Brigham Young University we have recently developed three new sets of materials for three different areas of separations science: thin layer chromatography (TLC), high performance liquid chromatography (HPLC), and solid phase microextraction (SPME). First, via microfabrication we have grown patterned carbon nanotube (CNT) forests on planar substrates that we have infiltrated with inorganic materials such as silicon nitride. The coatings on the CNTs are conformal and typically deposited in a process like low pressure chemical vapor deposition. The resulting materials have high surface areas, are porous, and function as effective separation devices, where separations on our new TLC plates are typically significantly faster than on conventional devices. Second, we used the layer-by-layer (electrostatically driven) deposition of poly (allylamine) and nanodiamond onto carbonized poly (divinylbenzene) microspheres to create superficially porous particles for HPLC. Many interesting classes of molecules have been separated with these particles, including various cannabinoids, pesticides, tricyclic antidepressants, etc. Third, we have developed new materials for SPME by sputtering silicon onto cylindrical fiber substrates in a way that creates shadowing of the incoming flux so that materials with high porosity are obtained. These materials are currently outperforming their commercial counterparts. Throughout this work, the new materials we have made have been characterized by X-ray photoelectron spectroscopy, time-of-flight secondary ion mass spectrometry, scanning electron microscopy, transmission electron microscopy, etc.

• 대한치과의사협회지
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• 제48권9호
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• pp.688-695
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• 2010

Burning mouth disorders (sometimes referred to as burning mouth syndrome) are characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. Affected patients often present with multiple oral complaints, including burning, dryness and taste alterations. Burning mouth complaints are reported more often in women, especially after menopause. Typically, patients awaken without pain, but report increasing symptoms through the day and into the evening. Conditions that have been reported in association with burning mouth syndrome include chronic anxiety or depression, various nutritional deficiencies, diabetes and changes in salivary function. However, these conditions have not been consistently linked with the syndrome, and their treatment has had little impact on burning mouth symptoms. Recent studies have pointed to dysfunction of several cranial nerves associated with taste sensation as a possible cause of burning mouth disorders. The most common central mechanism that likely explains burning mouth disorders is a centrally mediated continuous neuropathic pain. Given in low dosages, benzodiazepine, tricyclic antidepressants or anticonvulsants may be effective in patients with burning mouth disorders.

• 정신신체의학
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• 제29권2호
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• pp.95-101
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• 2021

신체증상장애를 포함하여 다양하게 신체증상을 호소하는 환자는 여러 영역의 임상현장에서 자주 접할 수 있는 정신질환이지만 분류 및 개념이 명확하지 않음으로써 정확한 진단과 치료가 이뤄지지 못하는 경우가 많다. 치료는 환자에게서 원인을 찾거나 정신사회적 원인을 강조하면서 지나치게 인지행동치료를 포함한 정신치료에만 초점을 맞추기보다는 환자의 고통을 줄일 수 있는 대증요법을 시행하여야 한다. 정신사회적 원인론에 대한 과도한 강조는 신체증상장애 환자들에게 도움이 되지 않을 뿐만이 아니라 이 질환의 약물치료에 대한 이해 및 연구를 더욱 어렵게 할 뿐이다. 신체증상장애의 약물치료에 관한 연구는 개념과 경계의 불명확성, 그리고 기능성 신체증후군과의 중첩 등으로 인해 제대로 된 연구가 어렵다. 몇몇 체계적 연구들의 결과를 살펴보면 정신약물은 단기간에서는 효과적인 것으로 나타났다. 대부분의 항우울제가 신체증상을 호소하는 환자들에게 효과가 있으며, 선택적 세로토닌 재흡수 차단제는 신체추형장애 및 건강염려증에서 그리고 세로토닌 노르아드레날린 재흡수 차단제는 통증이 주된 증상인 환자들에게서 다른 항우울제보다 더 효과적이다. 정신건강의학과 의사들은 신체증상을 호소하는 환자들에게 적용할 수 있는 인지행동치료를 포함한 다양한 정신치료적 기법뿐만이 아니라 약물치료에서 정신약물 및 비정신약물의 사용을 잘 알고 사용함으로써 이 환자들을 도울 수 있을 것이다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제18권1호
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• pp.16-25
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• 2007

The objective of this review is to propose the Korean practice guideline for pharmacological treatment of attention-deficit hyperactivity disorder (ADHD). For making the guideline, the authors used the evidence-base approaches derived from a detailed review of literature including wide range of controlled clinical trials, studies of side effects of drugs, toxicological reports, and meta-analyses published in United States and Europe, as well as inside Korea. The review committee composed of experts in ADHD inkoreahasreviewedtheparameter. The practice parameter for pharmacological treatment describes the use of stimulants, atomoxetine, modafinil, bupropion, tricyclic antidepressants, and alpha-adrenergic agonists and their side effects. The recommendations of pharmacological treatment are proposed at the end of the article.