대한정신약물학회의 영문 학술지 창간과 관련하여

정인원,신철진 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.1

Recently, the Korean College of Neuropsychopharmacolgy (KCNP) published an English language journal "Clinical Psychopharmacology and Neuroscience" for the purpose of internationl communications in the area of neuropsychopharmacology and related biological psychiatry. Historically, it is the first foreign language journal published in the Korean psychiatric society. This is writing to the background of publishing an English language journal in the perspectives of the limitations of Korean language journal and the internationl communications with researchers all over the world. The major concerns in publishing an English language journal are discussed. The future plan of continuously publishing "Clinical Psychopharmacology and Neuroscience" and some suggestions for the researchers who are going to submit manuscripts and to read this journal are described. We hope this is helpful for the publication of English language journal planning in the editorial committee of the Korean Neuropsychiatric Association.

알코올 의존과 후보 유전자들간의 연관성 연구

정인원,김헌,홍주봉,지경환,이규영 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.6

연구목적 : 알코올 대사와 중추신경계내의 알코올 작용부위와 관련한 일부 후보유전자들이 알코올 의존과 관련이 있는지를 확인하고자 하였다. 방 법 : DSM-IV로 진단된 알코올 의존 환자 128명과 정상 대조군 128명을 대상으로 후보 유전자들의 다형성을 중합효소 연쇄반응과 제한효소처리법을 이용하여 동정하였다. 여기서 분리된 대립유전자와 유전자형에 따른 빈도의 차이를 유전자별로 각각 비교하였으며, 알코올 의존에 작용하는 서로 다른 유전자들에 의한 영향력을 배제하기 위하여 logistic regression 분석을 적용하였다. 결 과 : 알코올 의존군에서는 ALDH_2 유전자의 NN(wild type)형이 정상대조군에 비하여 유의하게 많았다(chi-square test, p<0.001). logistic regression analysis를 통하여 다른 유전자들에 의한 영향을 보정한 상태에서 ALDH_2가 NN(wild type)인 경우 다른 아형에 비하여 알코올 의존에 대한 odds ratio는 130.312이며 그 신뢰구간은 (17.22, 986.43)이었다. 한편, ASA는 N-glycosylation 부위에 변이형 대립유전자를 갖고 있는 경우(AG or GG)는 wild type에 비하여 알코올 의존에 대한 위험도는 2.344배이며 그 95% 신뢰구간은 (1.128, 4.871)이었다. 결 론 : 알코올 의존과 ALDH_2 유전자간에는 밀접한 연관성이 확인되었다. 또한 다른 유전자들은 개별 연관분석에서 의미있는 연관성이 관찰되지는 않았지만 logistic regression analysis를 통하여 N-glycosylation 부위에 다형성이 있는 ASA 유전자가 알코올 의존과 관련이 있음을 시사하였다. Objectives : This study was to explore the association between alcohol dependence and five candidate genes related to the metabolism of alcohol and the enzymes of the suspected sites in CNS. Methods : The genotype and allele frequencies of five candidate genes in 128 male hospitalized patients who met DSM-IV criteria for alcohol dependence were compared with 128 age-matched healthy male control subjects using polymerase chain reaction and restriction fragment length polymorphism. A logistic regression analysis was applied in order to exclude the reciprocal interactions among five candidate genes. Results : The NN genotype frequency of the ALDH_2 gene was significantly higher in alcoholic patients than in control subjects(chi-square test, p<0.001). No difference in frequency was found in the other four genes. In a logistic regression analysis, the odds ratio for alcohol dependence in the NN genotype of the ALDH_2 gene and AG or GG genotypes of the N glycosylation site on the ASA gene were 130.312(95% confidence interval, 17.22-986.43) and 2.344(95% confidence interval. 1.128-4.871), respectively. Conclusion : The result reiterates the association of the ALDH_2 gene polyporphism and the alcohol dependence. Logistic regression analysis additionally suggested that the N-glycosylation site on the ASA gene was associated with alcohol dependence.

서울大學校病院 神經精神料에서 退院한 主要 精神障碍者의死亡率

鄭寅元,李定均,李符永,趙斗英,洪剛義,金容植 서울대학교 의과대학 정신과학교실 1989 서울醫大 精神醫學 Vol.14 No.2

알코올 의존과 파킨슨병 병태생리에서의 살소리놀(Salsolinol)

정인원,정성훈,김진영 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.3

Salsolinol, a dopamine-derived tetrahydroisoquinoline, is one of the endogenous alkaloids structurally related to morphine. It has been implicated in the pathophysiology of alcohol dependence and Parkinson's disease since it’s first discovery in 1970’s. Salsolinol is involved in many neurophysiological processes, including modulation of dopamine activity, facilitation of prolactin release and reinforcement of additive substance craving. In addition, salsolinol exerts highly neurotoxic effects on dopaminergic neurons ultimately leading to apoptosis, which is mediated by inhibition of endogenous antioxidants and, thereby, production of reactive oxygen species (ROS). These properties are considerably based in alcohol dependence and several neurodegenerative disorders including Parkinson's disease. Salsolinol is synthesized by the condensation of dopamine with acetaldehyde or Pyruvate through enzymatic or non-enzymatic processes in the dopamine-rich neurons. Acute alcohol ingestion increase the level of acetaldehyde and salsolinol is structurally related to endogenous opioids. Therefore, it has been suggested that salsolinol may be the missing link between alcohol ingestion and the activation of reward pathway in the mesolimbic brain. The reinforcing effect of both alcohol and salsolinol in self-administration setting also strongly supports this hypothesis. N-methylsalsolinol, the major metabolite of salsolinol, is highly neurotoxic and responsible for the selective destruction of dopaminergic neurons in Parkinson's disease. In contrast to this, several structural analogs of salsolinol act as endogenous anti-parkinsonism substances. Delicate Structural differences may underlie this peculiar properties. It may become possible to introduce fine structural modifications, even stereo-specific manipulations, to develop entirely newer kinds of antiparkinsonism drugs. Although the implication of salsolinol in the pathophysiology of alcohol dependence had been suggested long ago, the progression of the related research was at most very limited up to now. Even now, this important chemical, deeply involved in a wide range of essential neurophysiological processes, still is relatively neglected by psychiatric researchers. However, it is expected that the accumulating knowledge of salsolinol's neuromodulatory and neurotoxic effects will give new insights into the many dopamine related psychiatric disorders including substance dependence, parkinsonism and schizophrenia. We expect that many psychiatrists will give proper attention to this highly promising research subject.

폭력과 자살의 병리와 치료에서 세로토닌의 역할

정인원,Chung, In-Won 대한생물정신의학회 1997 생물정신의학 Vol.4 No.2

Along with psychosocial factors of suicide, biological backgrounds of suicide are explored by extensive works mostly on biological markers, neurobiological models, genetic bases, and relationships with aggression and violence. The biology of suicide confers on neurotransmitters in central nervous system exploring metabolites, receptor binding affinities, neuroendocrine challenge tests in brain, cerebrospinal fluid, blood and etc. The major concerns with suicide are focused mainly on serotonin system : low CSF 5-HIAA concentration, higher $5-HT_2$ receptor binding, and blunt prolactin response to fenfluramine. Postmortem study, in vivo study, genetic contributions, and some other issues such as suicidal methods, serum cholesterol, alcohol, and selective serotonin reuptake inhibitors are reviewed and discussed.

조현병 환자에서 보이는 혼잣말 증상의 이해

정인원,정성훈,김임열,윤탁,김세현,김용식 대한신경정신의학회 2016 신경정신의학 Vol.55 No.4

Soliloquy is a significant symptom in schizophrenia and is usually regarded as being related to auditory hallucination. Elucidation of the psychopathology of soliloquy is incomplete. Soliloquy is also a normal human behavior that has multidimensional functions such as guiding internal cognitive processes and managing social interaction. In the young, soliloquy appears as egocentric speech and arises before maturation of the third-person perspective. Soliloquy has been regarded as indicative of an intermediary stage during the transformation of social speech into internalized thinking. Every thought process retains a social dimension because language itself is based on intersubjectively shared meanings, and internal thinking originates from interpersonal communication. Thus, soliloquy can be seen as a kind of thought process that accentuates the social dimension. This approach may help in understanding soliloquy in normal and pathological situations. Soliloquy was actively discussed in the late nineteenth and early twentieth century in European psychiatry. Since then it has received less attention and has been neglected as an academic concern, except in child developmental theory. Recently however, soliloquy has attracted more attention among neuroscientific researchers. To attain an advanced understanding of soliloquy, it is necessary to integrate the early European perception of soliloquy with current developmental theory. In this paper, we review past literature on the conceptualization of soliloquy and integrate those concepts into an explanatory framework. In addition, a case series and a discussion of the applicability of the explanatory framework are presented. Our results may help provide an insight into the contemporary understanding of soliloquy.

항정신병약물에 의한 안구운동발작과 발작성 지각변화 증후군

정인원,김임열,윤탁,정성훈,정희연,김용식 대한조현병학회 2018 대한조현병학회지 Vol.21 No.1

During antipsychotic drug treatment, clinicians occasionally encounter sudden attacks of oculogyric crisis (OGC) and/or paroxysmal perceptual alteration (PPA) which occur mostly in the afternoon or early evening lasting for minutes to hours and are eventually remitted with rests or short sleep and/or medications such as benzodiazepines, anticholinergics and so forth. Moreover, these attacks are usually accompanied with psychiatric symptoms such as various modalities of hallucinations and illusions, delusions, obsessive thoughts, panic attacks, agitation as well as autonomic symptoms. These accompanying psychiatric symptoms can be perceived as a worsening of psychiatric symptoms if the clinician does not understand the symptoms due to the side effects of antipsychotic drugs, which may result in increasing the dosage of antipsychotics instead of reducing doses or switching to less offending drugs. On the other hand, patients could easily recognize the symptoms as the adverse effects of drugs. This literature review and case-series study is aimed to raise awareness of OGC and PPA by providing clinical cases and author’s views with the literature reviews about concepts, recognitions and managements from the works of Japanese authors who first reported the clinical importance of these attacks, particularly PPA.

향정신성 약물의 맞춤형 약물치료

정인원,이규영 대한정신약물학회 2002 대한정신약물학회지 Vol.13 No.3

The pharmacotherapeutic responses such as clinical efficacy and adverse events exhibit wide variabilities in individuals and even in different races and populations. The human genetic diversity has been known as the one of the main factors in the variations of drug responses expressed in the area of pharmacokinetics and pharmacodynamics. Polygenetic implications have been suggested in the pathophysiology of psychiatric disorders. The risks in psychiatric disorders could be explored by combining the polymorphisms of multiple candidate genes. This suggests that drug therapy should be tailored to the genetic make-up of the individual. The emerging field of pharmacogenomics could be a landmark for the development of more effective clinical efficacy and less adverse events by individually tailored drugs.

醫療 倫理와 生死觀

鄭寅元 동국대학교 일본학연구소 2006 일본학 Vol.25 No.-

한국인의 죽음관을 통해 바라본 안락사 문제

정인원,정성훈 동국대학교 일본학연구소 2006 일본학 Vol.25 No.-