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      • KCI등재

        한국인 알코올중독 환자의 예후인자에 관한 연구 : 심리적, 사회적, 생물학적 요인을 중심으로

        성상경,장환일,Sung, Sang-Kyung,Chang, Hwan-Il 대한생물정신의학회 1995 생물정신의학 Vol.2 No.2

        The author studied prognostic indicators of sixty Korean male alcoholics in psychological, social and biological aspects who were divided into abstinent and drinking groups. Thirty patients were assigned to each group. They were controlled in age and sex. Both groups were compared in terms of the demographic characteristics, past drinking history, treatment history, famaily history, ego strength and personality factors differences and distribution of dopamine $D_2$ receptor gene Al allele. Also the author studied relation of clinical course, alcoholic family history and dopamine $D_2$ receptor gene Al allele in both groups. The results were as follows; 1) The abstinent group had higher rate of married state, higher economic status, longer education years and maintained more stable job than the drinking group. But made no differences in occupation and religion. 2) The abstinent group showed higher rate of living with family members than the drinking group, and wives and fellows of the alcoholics anonymous were important factors for maintenance of abstinence. Family loading and parent's characters were not different. 3) The abstinent group had longer maximal length of abstinence but mean amount of alcohol consumption per day were larger than the drinking group. But there were no differences in duration of past drinking, drinking pattern, main drinking time, first drinking age and preference of the kind of alcoholic beverage in the past drinking history. 4) The abstinent group showed stronger treatment motivation, absolute abstinence in treatment goal, more voluntary adimission and maintained longer therapeutic relationship otter discharge than the drinking group. But both groups showed negative attitude toward antabuse therapy. 5) The abstinent group had higher mean score in ego strength scale than the drinking group. 6) In the personality factor questionnaire, the abstinent group showed strong laugh poise and the trait of praxernia, conservatism personality but the drinking group showed tough poise, the trait of weak ego strength(unstableness) and tough mindedness personality. 7) In comparision of dopamine $D_2$ receptor gene A1 allele, the prevalence of A1 allele was seventy percent and the frequency was 0.38 in the abstinent group. The prevalence of A1 allele was sixty percent and the frequency was 0.42 in the drinking group. Both groups were not significantly different in A1 allele prevalence and frequency. 8) In comparision of dopamine $D_2$ receptor gene A1 allele according to alcoholic family history, the prevalence of A1 allele was seventy percent and the frequency was 0.43 in the family history positive group. The prevalence of A1 allele was sixty-one percent and the frequency was 0.38 in the family history negative group. Both groups were not significantly different in A1 allele prevalence and frequency. In comparision of past drinking history according to alcoholic family history, the family history positive group showed earlier first drinking and problem drinking, but the family history negative group hod longer duration of past drinking. The mean amount of alcohol consumption per day, the longest duration of abstinence and Alcoholism Screening Test of Seoul Natoinal Mental Hospital(NAST) results were not significant. In conclusion, the results suggest that successful prognostic indicators of Korean alcoholics are married state, higher economic status, longer education years, stable job, living with family members, longer abstinence during past drinking history, strong treatment motivation, absolute abstinence in treatment goal, voluntary adimission, maintained therapeufic relationship, strong ego strength and the trait of praxernia, conservatism personality. But occupation, religion, alcoholic family history, parent's characters, duration of past drinking, drinking pattern, main drinking time, first drinking age, preference of the kind of alcoholic beverage, attitude to an

      • KCI등재

        선택적 세로토닌 재흡수차단제들이 만성 경도 스트레스 후의 백서에서 수동적 회피학습에 미치는 영향

        이기철,장환일,Lee, Gi-Chul,Chang, Hwan-Il 대한생물정신의학회 1997 생물정신의학 Vol.4 No.2

        The study was designed to evaluate the significant roles of SSRI in rat of depression model. Chronic exposure to mild unpredictable stress has been found to depress the consumption of sweet 1% sucrose solutions in the Sprague-Dawley rats. We applied the variety of 11 types of stress regimens and identified depressive behaviours(developed by Willner) in 70 Sprague-Dawley rats. Rats in experiments were stratified into 6 groups, ie ; 3 kinds of SSRI(paroxetine, fluoxetine, sertraline), clomipramine, choline and saline control. Memory function was evaluated by passive avoidance learning and retention test. The authors determined how long memory retention would remain improved with 24 hour, 1 week, 2 weeks, 3 weeks, and 4 weeks at training-testing interval in depressive states of the Sprague-Dawley rats. The results were as follows ; 1) There were no significant differences between the 6 groups at the 24 hour training-testing interval. 2) The paroxetine treated group showed significant differences from the control group at the 1 week and 2 weeks training-testing interval. 3) The paroxetine and the fluoxetine treated groups showed singificant differences from the control group at 3 week training-testing interval. 4) The paroxetine and the choline treated groups showed significant differences from the control group at 4 week training-testing interval. In summary, paroxetine had an effect on long term memory processing from 1st week to 4th week. Also, fluoxetine(at 3rd week) and choline(at 4th week) had effect on long term memory processing. Sertraline, clomipramine were ineffective on memory processing during 4 weeks observation. Possible explanations why paroxetine had early effect on memory processing than the other selective serotonin reuptake inhibitors are rapid bioavailability, which is the characteristics of pharmacokinetics of paroxetine. In clinical situation, author carefully suggest that SSRI would be beneficial to improve the memory function caused by depressive neurochemical changes.

      • KCI등재

        노화된 흰쥐의 뇌줄기에 분포하는 NADPH-Diaphorase 및 Neuropeptide Y양성 신경세포에 관한 연구

        김순희,장환일,허영범,안희경,Kim, Soon-Hee,Chang, Hwan-Il,Huh, Young-Buhm,Ahn, Hee-Kyung 대한생물정신의학회 1996 생물정신의학 Vol.3 No.2

        This study was aimed to charily the change of NADPH-diaphorase(NADPH-d) and neuropeptide Y(NPY) associated with aging of the rots. To verily the effect of aging of NPY and NADPH-d-positive neurons in the brain stem, the neurons were stained by the immunohistochemical and histochemical method. In the aged group, the number of NADPH-d-positive neurons was significantly decreased in substantia nigra lateralis, supragenual nucleus, raphe magnus nucleus and raphe obscurus nucleus as compared with control group. The number of NADPH-d-positive neurons was not significantly decreased in superior colliculus, interpeduncular nucleus, central gray. dorsal raphe nucleus, retrorubral nucleus, pedunculopontine tegmental nucleus, laterodorsal tegmental nucleus, pontine reticular nucleus, prepositus hypoglossal nucleus and nucleus solitarius of the aged rats. The NADPH-d and NPY-positive neurons were found in the interpeduncular nucleus, central gray, substantia nigra lateralis, laterodorsal tegmental nucleus, nucleus solitarius, raphe magnus nucleus, raphe obscurus nucleus of the control and aged groups. The coexistence of NADPH-d and NPY in the some cell was not found in the brain stem of both groups.

      • KCI등재

        두부외상 환자의 신경정신의학적 평가(I) : 외상후 기질성정신장애 환자에서 뇌의 구조적 및 기능적 검사소견의 비교

        이장호,장환일,Yi, Jang Ho,Chang, Hwan-Il 대한생물정신의학회 1996 생물정신의학 Vol.3 No.1

        The Evaluation of patients complaining of psychiatric symptoms following head injury is much affected by the results of various tests. The objecive of this paper is to investigate the effectiveness of each lest by comparing the structual and fuctional brain studies. The subjects were 93 organic menial disorder in and out patients at the Dept. of Neuropsychiatry of the Kyung Hee University Hospital. After carrying out MRI, CT, SPECT, EEG, the results of each were analysed for the sesitivity and ability to detect focal lesion. The degree of inter-test correlations of lest results were also investigated. Furthermore, the characteristic features of psychological tests were studied and the relationship between each of above mentioned tests and psychological test was examined. As for the test sensitivity to diagnosis, the SPECT was the most superior followed by MRI, CT, EEG in thai order. In the case of abnormality, SPECT ranked 1st in detection of focal lesion, followed by MRI, CT in that order. In the inter-test result correlation, the correlation of SPECT-MRI was statistically significant. When mare than moderate abnormality EEG finding was reported, it correlated significantly with that of MRI findings. In the MMPI, the average scores on F, Hs, D, Hy, Pa, Pt, Sc subscales were above 60. Abnormal SPECT group scored significantly high on the F, Pd, Pa, Sc, Ma scales and therefore in comparison ot the SPECT normal group, displayed more psychotic features. In K-WAIS, the mean full scale IQ was down to 77. 23(Verbal IQ : 78.76, Performance IQ : 77.44) but there was no characterogic significant relationship between the lowered to and abnormal SPECT, MRI, CT and EEG results. In conclusion, 1) The SPECT was mast superior in sensitivity and detection of focal lesions. In comparision with other tests, the results of SPECT correlated well with MRI had thus is thought to be very usefull testing method in the evaluation of organic mental disorder patients. 2) The MRI had relatively high sensitivity, ability to detect focal lesion and superior correlation with other test. 3) Although EEG fared less an sensitivity in comparison to other tests, the results of above moderate abnormal grade group and that of MRI correlated significantly. 4) In the MMPI highly scored in F, Hs, D, Hy, Pa, Pt, Sc subscales and abnormal SPECT patients were shown to display more sever psychotic features. There was no significant character relationship between the lowered IQ(in K-WAIS) and abnormal findings on MRI, CT, SPECT, EEG.

      • KCI등재

        두부외상 환자의 신경정신의학적 평가(II) : 뇌의 구조적 영상검사상의 병변 유무에 따른 두부외상 환자군의 비교 - 기능적 및 심리적 검사소견과의 연관성을 중심으로

        조성욱,장환일,Cho, Seoung Wook,Chang, Hwan-Il 대한생물정신의학회 1996 생물정신의학 Vol.3 No.1

        There has been an increase in head trauma due to rapid industralization and improvement in transportation. This poses difficulties in differentiating between neuropsychiatric disabilities resulting from real organic changes and those arising from compensation issues. It is the purpose of this study to seek out the differences between normal and abnormal finding group in the structural brain imaging studies via the results of the functional brain imaging studies and psychological tests. Out of 132 subjects, 62 comprised normal and 70 the abnormal finding group. EEG and SPECT were chosen for inspection of functional brain imaging. MMPI and K-WAIS were chosen for psychological test. The subjects were further divided into right hemispheric damage, left hemispheric damage, both hemispheric damage, diffuse damage group and negative group in order to find out whether any differences in the psychological lest results could be localized. The results are as follows : 1) The abnormal finding group, the EEG and SPECT were proven to be a good predictor of brain lesion. This implies that even in the functional brain studies, abnormalities are more easily detected if there are visible brain lesions. 2) The FSIQ of the abnormal finding group is lower than that of normal finding group. this difference is mainly due to low V1Q. The left hemispheric damage group lend to shaw low V1Q. This lowered in was the difference between left hemispheric damage group and negative group. Furthermore, there were no group differences in the PIQ. It is concluded that K-WAIS is effective as evaluator of VIQ mainly of those patients with left hemispheric damage and it is ineffective as a evaluator of PIQ. 3) In the MMPI profile, the both groups displayed high neurotic profiles. There was no difference in the psychotic profiles. The scores of the Depression and Hystery were high in abnormal finding group. This can be seen as one of the lypical findings of chronic head trauma patients. 4) The abnormal finding group tend to be diagnosed as organic mental disorder in the psychological tests more frequently.

      • KCI등재

        아편양 순응제가 백서의 억제된 자발적 교대행동에 미치는 영향

        이기철,전성일,장환일,이정호,최영민,김성호,류정환,최미,Lee, Gi-Chul,Jeon, Seong-Il,Chang, Hwan-Il,Lee, Jung-Ho,Choi, Young-Min,Kim, Seong-Ho,Ryu, Jeong-Hwan,Choi, Mi 대한생물정신의학회 1999 생물정신의학 Vol.6 No.2

        This study was designed to evaluate the effects of opioid receptor agonists on the spontaneous alternation behaviour in an animal model of obsessivecompulsive disorder in rats. According to the theory that dopamine is related to the biological etiology of obsessive-compulsive disorder, the effect of the nalbuphine(opioid kappa agonist) and the tramadol(opioid mu agonist), which act as manipulating agents on the inhibition or stimulation of dopamine release, in the spontaneous alternation behaviour were evaluated. 24 hours prior to the experiment, rats were food-deprived. These rats were put into the T-maze, in which white and black goal boxes were baited with small amounts of chocolate milk. Each rat was given 2 set of 7 trials during which it was placed in the start box and allowed to choose the one of the goal boxes for each time. After identifying the stable baseline of spontaneous alternation behaviour, nonselective 5-HT agonist 5-MeODMT(1.25mg/kg/IP) disrupted spontaneous alternation. Rats were stratified into fluoxetine(10mg/kg/IP), nalbuphine(10mg/kg/IP), tramadol(46.4mg/kg/IP), and saline(0.5cc/IP) injection group with experimental drug treatment for 21 days. The effects on the 5-MeODMT(1.25mg/kg/IP) induced disruption of spontaneous alternation behaviour were checked at the next day of discontinuation of drug treatment. The results were as follows ; 1) At the day after 21 days of the drug treatment, the nalbuphine treated group and the fluoxetine treated group showed significant difference from the tramadol treated group and the saline treated group in the 5-MeODMT(1.25mg/kg/IP) induced suppression of spontaneous alternation behaviour. 2) Within each drug treatment group, the fluoxetine treated group showed significant difference between before and after the treatment of fluoxetine in the 5-MeODMT(1.25mg/kg/IP) induced suppression of spontaneous alternation behaviour. And also, the nalbuphine treated group showed significant difference between before and after the treatment of nalbuphine in the 5-MeODMT(1.25mg/kg/IP) induced suppression of spontaneous alternation behaviour. There was no difference between the baseline and after the treatment of nalbuphine in the 5-MeODMT(1.25mg/kg/IP) induced suppression of spontaneous alternation behaviour. We indentified that the opioid kappa agonist that act as dopamine release inhibitor affect the spontaneous alternation behaviour which is an animal model of obsessive-compulsive disorder in rat.

      • KCI등재

        Olanzapine이 백서의 Schedule-Induced Polydipsia에 미치는 영향

        이기철,이경규,장환일,이정호,김현우,하준명,정재현,정홍경,Lee, Gi-Chul,Lee, Kyung-Kyu,Chang, Hwan-Il,Lee, Jung-Ho,Kim, Hyun-Woo,Ha, Jun-Myung,Jeong, Jae-Hyun,Jeong, Hong-Kyung 대한생물정신의학회 1999 생물정신의학 Vol.6 No.2

        Object : This study was designed to evaluate the effects of olanzapine on the schedule-induced polydipsia(SIP) which is one of animal model of obsessive-compulsive disorder in rats. We administered olanzapine as a serotonin and dopamine blocking agent, fluoxetine as a selective serotonin reuptake inhibitor, and haloperidol for the dopamine antagonist to rats which showed schedule-induced polydipsic behavior. Methods : Spraque-Dawley rats weighing 200-250gm were individually housed and maintained and allowed free access to water. The rats were placed on a restricted diet. To induce polydipsia, rats were placed in the cage where a pellet dispenser automatically dispensed 90mg pellets on a fixed-time 60 seconds(FT-60s) feeding schedule over 150 minute test session per day. Water was available at all times in the cage. After 4 weeks of daily exposure to the FT 60s feeding schedule, experimental rats met a predetermined criterion for polydipsic behavior(greater than 3 times of water per session on average). 5 groups of rats were administered olanzapine(3mg/kg, i.p), olanzapine(10mg/kg, i.p), fluoxetine(5mg/kg, i.p.), haloperidol(0.1mg/kg, i.p.), and vehicle(1cc/kg, i.p.) for 3 weeks. The rats were tested once a week to access schedule induced polydipsic behavior. Water bottles were weighed before and after the 150-minute test session. The chronic effects of administration of experimental drugs on schedule induced polydipsic behavior were analyzed with ANOVA and Scheffe test as a posthoc comparison. In order to measure water consumption in non-polydipsic food-deprived rats, a separate group of rats(N=8) were individually housed and given a single bolus(14.5gm) of food per day which maintained them at their average body weight. Results and Conclusion : The results were as follows ; 1) After 4 weeks of scheduled feeding procedure, the experimental group showed significant differences than the bolus control in the amount of water consumption as compared with their average water intakes for 4 weeks. At the same periods, there were no differences between the experimental group and the bolus control in the body weight. 2) The fluoxetine group showed significant decrease in the amount of water intake over the 3 weeks of drug treatment as compared with their average amount of polydipsic water intakes. The olanzapine 3mg group showed significant decrease in the amount of water intake at 3rd weeks of drug treatment as compared with their average amount of polydipsic water intakes. The olanzapine 10mg group showed significant decrease in the amount of water intake at 2nd and 3rd weeks of drug treatment as compared with their average amount of polydipsic water intakes. However, the haloperidol group and the vehicle control group showed no changes of amounts of water intake for 3 weeks of treatment as compared with their average amount of polydipsic water intakes. 3) The fluoxetine group showed significantly lower amounts of water intake than the haloperidol group at 2nd weeks of drug treatment. And also the fluoxetine group showed significantly lower amounts of water intake than the haloperidol group and the vehicle control at 3rd weeks of drug treatment. The olanzapine 3mg group and the olanzapine 10mg group showed significantly lower amounts of water intake than the haloperidol group and the vehicle control at 3rd weeks of drug treatment. Above findings suggest that the fixed time feeding procedure for schedule-induced polydipsia as an animal model of obsessive compulsive disorder was effective to the evaluation of pharmacological challenge study. The authors assume that the serotonin hypothesis and the serotonin-dopamine interaction hypothesis are preferred to the dopamine hypothesis in the biological etiology of obsessive-compulsive disorder.

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