No abstract available.
Sleep Apnea Syndromes*

The present study was carried out in order to investigate the relationship between immune function and the activity of hypothalamic-pituitary-adrenal(HPA) axis in patients with major depression. The subjects were 16 female major depressives and 16 female healthy controls. We measured mitogen-induced production of IL-1 beta, IL-2, IL-6 and serum level of IL-1 beta, IL-2, IL-6 and basal plasma cortisol levels at 8 00 a.m. We measured post-DST(dexamethasone suppression test) cortisol levels in 16 major depressives. The result were as follows : 1) Basal cortisol level was significantly higher in the patients with major depression than in the healthy controls(14.4+/-4.6 microgram/dl, 10.1+/-5.2microgram /dl, respectively, p<0.05). 2) IL-2 production was significantly lower in the patients with major depression than in the healthy controls(1747.3+/-387.9 pg/ml, 2520.2+/-884.1 pg/ml, respectively, p<0.05). There were no significant differences in IL-1 beta and IL-6 production between the patients with major depression and the healthy controls. 3) Serum level of IL-2 was detectable in 12 of 16 patients with major depression and in 10 of 16 healthy controls. There was no significant difference in serum level of IL-2 between two groups. Serum level of IL-1 beta was detectable in 3 of 16 patients with major depression and of 16 healthy controls. We could not detect serum level of IL-6 in both groups. 4) There was significant negative correlation between IL-2 production and post-DST cortisol level(r= -0.89) in the 16 patients with major depression. There was significant negative correlation between serum level of IL-2 and post-DST cortisol level(r= -0.97) in the 12 patients with major depression. There was significant negative correlation between serum level of IL-2 and basal cortisol level(r= -0.65) in the 12 patients with major depression. But there was no significant correlation between IL-2 production and basal cortisol level in the 16 patients with major depression. These findings suggest that immune function is decreased in major depression and the decreased immune function is highly related to the hyperactivity of the HPA axis.
Axis, Cervical Vertebra* ; Depression* ; Female ; Humans ; Hydrocortisone ; Interleukin-1* ; Interleukin-1beta* ; Interleukin-2 ; Interleukin-6 ; Interleukins ; Plasma

No abstract available.
Adult* ; Humans ; Seoul*

OBJECTIVE: Many evidences suggest that patients with bipolar disorder have functional abnormalities in their postreceptor signal transduction pathways, and mood stabilizing effect of lithium is exerted by modulating this dysfunctioning system. Carbamazepine, an antiepileptic agent, is also known to be effective in the treatment and prevention of bipolar disorder. But the precise mechanism of action of the drug is still poorly understood. This study was performed to elucidate the possible therapeutic mechanism of carbamazepine. METHOD: The effects of chronic carbamazepine administration on protein kinase A and protein kinase C activities in frontal cortex of rat brain after 2 weeks of drug administration were measured and compared with those of control subjects. RESULTS: Mean(+/-SE) value of activity(phosphate transfer micromol/mg of protein, min) or protein kinase A in control and test group was 0.249563+/-0.036 and 0.539853+/-0.078, and that of protein kinase C was 0.654817+/-0.053 and 1.146205+/-0.052 respectively, being increased in test group. And differences between the two groups were statistically significant for both enzymes(protein kinase A ; p<0.01, protein kinase C ;p<0.001). CONCLUSION: These results show that chronic carbamazepine administration increases protein kinase A and C activities, and concerning the possible mode of therapeutic action in bipolar disorder it is suggested that enhanced enzymes phosphorylate receptor-G-protein-effector complexes to dampen hyperfunctioning neuronal activity and thus stabilize the system.
Animals ; Bipolar Disorder ; Brain* ; Carbamazepine* ; Cyclic AMP-Dependent Protein Kinases* ; Humans ; Lithium ; Neurons ; Phosphotransferases ; Protein Kinase C* ; Protein Kinases* ; Rats* ; Second Messenger Systems ; Signal Transduction

No abstract available.
Narcolepsy*

OBJECTIVES: It is very important to understand the personality characteristics of chronic insomniacs far diagnosis and treatment in clinical practice. The authors investigated the personality factors and the ways of coping to define the personality characteristics which underly the development of insomnia. METHODS: The authors used the diagnostic criteria of International Classification of Sleep Disorders to diagnose chronic insomnia, and performed 16 Personality Factors(PF) test and the Ways of Coping Checklist to both chronic insomniacs and normal controls. The diagnosis of chronic insomnia included psychophysiologic insomnia, poor sleep hygiene, and hypnotics dependent insomnia. The subjects were 21 chronic insomniacs and 26 normal controls. RESULTS: The chronic insomniacs showed significantly lower stableness(C factor ; 4.57 +/-1.89 VS 7.38+/-1.83), intelligence(B factor ; 3.76+/-2.23 VS 6.54+/-1.96), motivation distorsion(B factor ; 3.76+/-2.23 VS 6.54+/-1.96) factor scores, and higher guilt-proneness(O factor ; 6.67+/-2.11 VS 3.81+/-1.65), tension and anxiety(Q4, factor ; 7.57+/-2.29 VS 3.46+/-1.88) factor scores than controls in 16 PF. The chronic insomniacs had significantly higher emotional-focused coping(30.30+/-9.53 VS 24.52+/-5.71) and passive coping pattern scores(50.75+/-13.76 VS 43.26+/-8.73) than controls in the Ways of Coping Checklist. CONCLUSION: The authors suggest that chronic insomniacs are characterized by depressive mood and anxiety-proneness from low ego strength, high levels of anxiety and guilty feelings, and passive and emotion-concentrated coping pattern. This traits are supposed to be factors contributing the state of emotional arousal and resultant physiological activation that has developed and maintained the insomnia.
Anxiety ; Arousal ; Checklist ; Classification ; Diagnosis ; Ego ; Hygiene ; Hypnotics and Sedatives ; Motivation ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: The purpose of this study was to investigate the neurocognitive and psycho-physiological effects of total sleep deprivation by using the objective and quantifiable methods of Vienna Test System (Reaction Unit, Cognitrone, Vigilance) and P300 event-related potential. METHODS: Thirty healthy medical students(22 men, 8 women) participated in this study. Subjects remained awake for 38 hours under continuous surveillance. In the morning and the evening of two consecutive study days, the Vienna tests and P300 were performed. RESULTS: In Vigilance test of the Vienna Test System, a significant functional impairment occurred as a result of total sleep deprivation(p<.001). In Reaction unit, reaction time significantly increased (p<.01). However, in Cognitrone, a functional improvement was revealed. The P300 latency was significantly prolonged(p<.001) and amplitudes decreased(p<.01) as a consequence of total sleep deprivation. Comparing the results of Vigilance and Reaction unit each taken in the morning and evening, the performance decrements were prominent in morning sessions. In Cognitrone, evening session result showed the improvemed performance. CONCLUSIONS: The cognitive impairment resulting from 38 hours of sleep deprivation are considerable in alertness and reaction time tests, but not in higher complex cognitive functions such as fine perceptual analyses, visual discrimination, and short term memory. Considering the results with P300 latency and amplitudes, it may be concluded that the P300 changes as a result of total sleep deprivation are due to the decrement in the alertness which prolongs reaction time. More deterioration of cognitive performance shown in the morning, could be explained by considering circadian rhythm.
Circadian Rhythm ; Discrimination (Psychology) ; Event-Related Potentials, P300 ; Humans ; Male ; Memory ; Reaction Time ; Sleep Deprivation*

No abstract available.
Thrombocytosis*

PURPOSE: Poor sleep hygiene can complicate any other syndrome producing insomnia complaint and must always be considered in any treatment. In clinical situation, it is important for Insomniacs to practice the sleep hygiene rule in treatment strategies. The authors investigated the recognition of sleep hygiene and the practice of it in general population, then provided the data available for physician to educate the sleep hygiene in treatment of insomnia. METHOD: The 330 subjects were at the age above 18 in Seoul, Korea. The questionnaire included the experience of insomnia and knowledge of caffeine, and 4 categories of sleep hygiene instruction, eg, homeostatic drive far sleep, circadian factors, drug effects, and arousal in sleep sleeper. The interview was done face to face by the investigators. RESULTS: In general, the knowledge about the drug effects on sleep was relatively poor. The degree of recognition of each item indicating organization of sleep and arousal in sleep setting was various. Poor sleeper showed no difference in recognition of sleep hygiene categories except drug effects on sleep compared to good sleeper, but they practiced sleep hygiene rules poorly in categories of homeostatic drive and arousal in sleep setting, though various by items. CONCLUSION: The findings, in which the degree of recognition of the items in 4 sleep hygiene categories was venous, indicated that sleep hygiene education should be done in details by each item. It seems like the poor sleeper practiced sleep hygiene poorly in categories of homeostatic drive and arousal in sleep setting compared to good sleeper. this finding suggested that the efforts, which reflected the behavioral patterns of insomniacs shown in clinical setting to get good sleep, frustrated the practice of sleep hygiene actively.
Arousal ; Caffeine ; Education ; Humans ; Hygiene* ; Korea ; Surveys and Questionnaires ; Research Personnel ; Seoul* ; Sleep Initiation and Maintenance Disorders

OBJECTIVE: To evaluate the clinical efficacy of adjuvant sertraline treatment in chronic schizophrenic patients, we carried out a double-blind, placebo controlled study. METHOD: Thirty six inpatients who fulfilled DSM-III-R criteria for chronic schizophrenia were randomly assigned to sertraline and placebo groups in a double-blinded fashion. A history of at least 2 years of illness and at least six months of hospitalization were prerequisities for inclusion in the study. Patients were received sertraline 50mg or placebo for 8 weeks in addition to their routine haloperidol regimen, Positive and Negative Syndrome Scale(PANSS), Clinical Global Impression(CGI), Simpson-Angus Scale(S-A) were evaluated at 5 points ; baseline, 2, 4, 6 and 8 weeks of treatment. RESULTS: The groups were controlled for age, gender, and length of illness. There were no significant differences in three PANSS factros(positive, negative, general), CGI and S-A scale scores at any between sertraline and placebo treatment. CONCLUSION: This placebo controlled study showed no significant effects of sertraline on negative and positive symptoms in chronic schizophrenic patients.
Haloperidol ; Hospitalization ; Humans ; Inpatients ; Schizophrenia* ; Sertraline*