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심인성 조루증의 성치료 : 실제 치료과정을 중심으로 A Practical Aspect of Therapeutic Process
이홍식 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.5
The author reported nine sessions of sex therapy in a 37 year old married male with psychogenic premature ejaculation. Also, the tasks and contents of treatment in each session were presented. This treatment format was a modified structured couple sex therapy emphasizing the educational intervention. The author discussed the techniques of therapy as well as the mechanisms of therapeutic effects. The summary of treatment procedures were as follows : 1) Requested an active participation of female partner and prohibited the sexual intercourse until therapist allowed it. 2) Explained a historical background and successful rate of sex therapy, and therapeutic goal in order to enhance the therapeutic effect of sexual tasks in the session. 3) Conducted the scheduled educational intervention for the corrected understanding and knowlege of sex related with premature ejaculation in every sessions. 4) Tried to practice sensate focus exercise for ehnancing the sexual communication of the couple and reducing the anxiety of sexual performance. 5) Had him learn a premonitory sensation with stop-start training to enhance a ejaculatory ability. 6) Every sessions were preceeded according to a structured schedule of treatment format.
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도파민 $D_4$ 수용체 유전자 Variants와 정신분열증과의 연관성
이홍식,신동원,Lee, Hong Shick,Shin, Dong Won 대한생물정신의학회 1995 생물정신의학 Vol.2 No.1
Objects : Clozapine, prototype of the atypical neuroleptics, was known to have unique antipsychotic effect with a few extrapyramidal effects. While most typical antipsychotic agents mainly block $D_2$ receptors, clozapine has higher affinity for dopamine $D_4$ receptor than for $D_2$ receptor. Many researchers have tried to find out the relationship between schizophrenia and the abnormality of the genes coding dopamine receptors. But no consistent findings were reported. Recently, dopamine $D_4$ receptor was fully sequenced, and the alleles of dopamine $D_4$ receptor gene was found in unusual form on the 48th base pair. Our study was performed to identify the distribution of the dopamine $D_4$ receptor alleles of schizophrenics and normal controls, and whether any difference between the dopamine $D_4$ receptor alleles of schizophrenics and that of normal controls exists. Methods : DNA was extracted from the blood of schizophrenic patients(N=60) and normal controls(N=60). Part of the dopamine $D_4$ receptor gene was amplified by PCR, and amplified DNA was electrophoresed. Authors compared the distribution of the alleles of dopamine $D_4$ receptor gene of normal controls and that of schizophrenic patients. Results : Six kinds of alleles of $D_4$ receptor were observed both groups. The fourth repeat form of alleles was the most common in both schizophrenic patients(75.8%) and normal controls(70.3%), so there was not significant difference between two groups. Conclusion : The Difference in the distribution of the dopamine $D_4$ receptor gene alleles is not thought to be responsible for the pathophysiology of the schizophrenia. However, the difference in the expression of the dopamine $D_4$ receptor gene between normal and schizophrenia is left to be scrutinized.
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만성 정신분열증 환자의 인지기능에 미치는 Clozapine 장기치료의 효과
이홍식,김지현,전지용,정민정,Lee, Hong-Shick,Kim, Ji-Hyeon,Jeon, Ji-Yong,Jeong, Min-Jung 대한생물정신의학회 1994 생물정신의학 Vol.1 No.1
It is not known whether negative symptoms and cognitive functions are dissociable or improvements in symptoms are reflected in improvements in cognitive functions in chronic schizophrenic patients. We administered clozapine to evaluate its effect on cognitive functions in chronic schizophrenic patients and to show correlations between improvement in psychotic symptoms and in cognitive functions. Neuropsychological tests such as Wisconsin Card Sorting Test, Digit Span test and Judgment of Line Orientation Test were applied to 16 chronic schizophrenic patients at baseline and after 9 months of treatment with clozapine. Using BPRS we assessed psychopathology before initiation of clozapine and at 9 months. Clozapine improved both positive and negative symptoms in chronic schizophrenic patients significantly. After nine months of clozapine treatment, significant improvements occurred in attention, short-term memory and visual perception ability. And interestingly we noted the trend of improvement in executive functions even though they were not statistical significant. Any significant correlations between the clinical improvement and change in congnitive functions were not observed. Long-term treatment with clozapine improved parts of cognitive functions of chronic schizophrenics. The results of the study suggest that deficits in simple cognitive functions as well as psychotic symptoms are improved after 3 month period of short-term treatment, but executive functions requiring more sophisticated processing of information could be improved after more than 9 months of long-term treatment.
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