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불안신경증과 알코올남용·의존 환자에서 Tofisopam의 항불안 및 항우울 효과 검증
김승태(Seungtai. Peter Kim),홍경수(Kyung-Sue Hong),김도관(Doh Kwan Kim),홍성도(Sungdo David. Hong),유범희(Bum-Hee Yu) 한국중독정신의학회 1997 중독정신의학 Vol.1 No.1
The study aims at evaluating antianxiety and antidepressant effects of tofisopam, a benzodiazepine-related chemical substance with some variations in its nitrogen number and positions. The study subjects were 27 adult outpatients, namely, 11 anxiety neurosis patients(M 6, F 5) and 16 alcohol abuse or alcohol dependence patients(M 13, F 3), diagnosed according to DSM-IV. Tofisopam, doses ranging 100-150mg per day, was administered to each patient in an open clinical trial, over a period of 6-8 week. Each patient was administered with Hamilton Anxiety Scale(HAS) and Hamilton Depression Scale(HDS) twice, before the initiation of tofisopam admininistration and at the completion of 6-8 weeks of the medication administration, to assess the degree and extent of improvements of anxiety and depression symptoms. The following results were obtained from the study: (1) Tofisopam showed noticeably significant antianxiety effects and less significant antidepressant effects. (2) There were no clinically observable or reported untoward CNS effects(e.g. drowsiness, impaired memory, disturbance in attention, etc.) by tofisopam. (3) The more significant improvements among the anxiety symptom clusters were physical(musculomotor and sensory) and autonomic nervous system symptoms. (4) During and immediately after the completion of 6-8 weeks of tofisopam adminstration, alcoholic patients reported of significantly reduced or extinct alcohol cravings. However, it remains to be carefully evaluated whether anticraving effects of tofisopam is transient, long lasting, or psychogenic, etc. The study results warrants further careful revalidations by use of a longitudinal double-blind crossover design and on a large number of patients.
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김도관,김수정,최도선,복혜숙,김승태,Kim, Doh Kwan,Kim, Soo Jeong,Choi, Do Sun,Bok, Hae-Sook,Kim, Seungtai Peter 대한생물정신의학회 1996 생물정신의학 Vol.3 No.2
전기경련요법을 시행받은 9명의 정동자애 환자들과 2명의 정신분분열형장애 환자들에서 각각 3분 간격으로 혈액을 채취하여 각 채취하여 AVF, ACTH, PRL, cortisol 등의 호르몬에 대해 기저농도 및 전기경련요법 후의 농도 변화를 측정함으로써 각 호르몬 분비 반응 사이의 시간적인, 그리고 양적인 관계를 비교분석하였다. 또한 경련 지속 시간과 각 호르몬 분비반응들 사이의 상관관계도 검토하였다. 상기 호르몬 모두에서 전기경련요법 대한 의미있는 분비반응이 관찰되었다. 즉, AVP는 1.2pg/ml에서 33.3pg/ml(P<0.001). PRL은 21.8ng/ml에서 102.2ng/ml(P<0.005)로 cortsol은 20.1ug/dl에서 31.1ug/dl(P<0.001)로 각각 중가 되었다. 뇌하수체에서 분비되는 AVP, ACTH, PRL 세가지 호르몬 모두는 전기경련 요법 후 3분내에 분비 반용이 시작되었지만, 최고 농도에 도달하는 시간은 각각 3분, 6분, 12~15분대로 분명히 구별되는 소견을 보였다. cortisol은 6분후부터 증가하기 시작하여 20~30분 사이에 최고 농도를 보였다. 경련 지속 시간과 분비 반응과는 의미있는 상관관계를 보이지 않았다. 이상의 연구결과를 토대로 저자들은 다음과 같은 결론에 도달하였다. 1) 전기경련 요법에 대한 뇌하수체 호르몬의 반응은 동시적이라기 보다는 순차식으로 일어나는 것이다. 2) AVP는 다른 어떤 호르몬 보다도 아주 빠르고 양적으로 많은 반응을 보였다. 3) AVP 반응 후에 뒤따르는 ACTH 반응은 대부분의 과거 연구들에서 보고된 것보다 빠르고 강력했다. 4) 이러한 결과들은 뇌하수체 호르몬이 전기 자극보다는 경련의 결과로 분비된다는 가설을 지지해 주는 소견이다. 5) 시상하부-뇌하수체-부신피질 축 호르몬들의 순차적 반웅 양상은 각 호르몬의 분비 반응에 되먹임 조절 기전이 관여할 수 있음을 추정케 한다. Background : Most studies of the pituitary hormonal responses to electroconvulsive therapy(ECT) have used limited blood sampling schedules. Little is known about the precise sequence of neuroendocrine events immediately following en ECT application. or about the regulation of the hormonal responses. Methods : Blood was sampled at three minute intervals from eleven patients(two schizophrenics and nine affective disorder patients) undergoing ECT. Each sample was immunologically assayed for arginine vasopressin(AVP), adrenocorticotropic hormone(ACTH), prolactin(PRL), and cortisol. Baseline hormone concentrations and several measures of response were determined for each hormone. The temporal and quantitative relationships among the hormonal responses were determined. Correlations were calculated between seizure duration and secretory responses. Results : All four hormones demonstrated significant secretory responses to ECT, with AVP increasing from 1.2 to 33.3pg/ml(P<0.001), ACTH from 5.4 to 32.3fmol/ml(P<0001). PRL from 21.8 to 102.2ng/ml(P<0.005) and cortisol from 20.1 to 31.1ug/dl(P<0.001). The three pituitary hormones showed consistent time courses of secretion with onset of responses by three minutes but clearly differing peak times of 3, 6, and 12-15 minutes for AVP, ACTH, and PRL, respectively. Cortisol began to rise after 6minutes and pecked between 20-30minutes. There ware no significant correlations between seizure duration and any of the secretory response measures. Conclusions : 1) The pituitary hormone response to ECT is sequential rather than synchronous 2) The AVP response was extremely rapid and more massive than those of any other hormones. 3) The ACTH response of this study was more rapid and mare robust than thai revealed by the mast of past studies. 4) The results strongly suggest that the pituitary hormones are released as a result of the seizure rather tho, the electrical stimulus. 5) The sequential pattern of responses suggests that neuroendocine feedback-regulatory mechanisms determine the response profile.
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구영진(Young-Jin Koo),황준원(Jun-Won Hwang),이문수(Moon-Soo Lee),양영희(Young-Hui Yang),방수영(Soo-Young Bang),강제욱(Je-Wook Kang),이대환(Dae-Hwan Lee),이주현(Ju-Hyun Lee),곽영숙(Young-Sook Kwack),김승태(Seungtai Peter Kim),노경선(K 대한소아청소년정신의학회 2016 소아청소년정신의학 Vol.27 No.1
This article provides an overview of the developmental history and rationale of medical ethics to establish the code of ethics and professional conduct of the Korean Academy of Child and Adolescent Psychiatry (KACAP). Most medical professional organizations have their own codes of ethics and conduct because they have continuous responsibility to regulate professional activities and conducts for their members. The Ethics and Award Committee of the KACAP appointed a Task-Force to establish the code of ethics and conduct in 2012. Because bioethics has become global, the Ethics Task Force examined global standards. Global standards in medical ethics and professional conduct adopted by the World Medical Association and the World Psychiatric Association have provided the basic framework for our KACAP’s code of ethics and professional conduct. The Code of Ethics of the Americal Academy of Child and Adolescent Psychiatry has provided us additional specific clarifications required for child and adolescent patients. The code of ethics and professional conduct of the KACAP will be helpful to us in ethical clinical practice and will ensure our competence in recognizing ethical violations.
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