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Cognitive Behavior Therapy of Bulimia Nervosa in a Male Patient: A Case Report.

Journal of Korean Neuropsychiatric Association.1999;38(4):915-924.

Bulimia nervosa is a disorder that is defined as binge eating combined with inappropriate ways of stopping weight gain. It is significantly more common in females than in males. Males in bulimia account for 10-15% of all bulimic patients. There are many methods of treatment, including drug therapy, or psychotherapy. Among them cognitive behavior therapy is reported to be the most effective method of improving the binge eating behavior and the cognitive distortion about body weight and body image. In this case, a male bulimic patient, who was hospitalized in the closed ward involuntarily, was treated with modified Fairburn's cognitive behavior therapy model. After 6 weeks of treatment, binge eating and self-induced vomiting behaviors were controlled and weight gain was nearly successful.
Body Image ; Body Weight ; Bulimia Nervosa* ; Bulimia* ; Cognitive Therapy* ; Drug Therapy ; Female ; Humans ; Male* ; Psychotherapy ; Vomiting ; Weight Gain

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A Case of Narcolepsy with Psychotic Symptoms.

Il Seon SHIN ; Jong Chul YANG ; Jin Sang YOON

Journal of Korean Neuropsychiatric Association.1999;38(4):909-914.

The case of a 19-year-old man with coexistent narcolepsy and psychotic symptoms was presented. The psychotic symptoms were induced and / or exacerbated by methylphenidate. In addition, they were considered as symptoms of schizophrenia which had been developed regardless of the use of methylphenidate. The case illustrates the difficulties in diagnosing and treating, in particular, pharmacotherapy.
Drug Therapy ; Humans ; Methylphenidate ; Narcolepsy* ; Schizophrenia ; Young Adult

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A Case of Delayed Risperidone-induced Neuroleptic Malignant Syndrome.

Heon Jeong LEE ; Bang Hyun CHO ; Leen KIM ; Min Soo LEE

Journal of Korean Neuropsychiatric Association.1999;38(4):904-908.

Risperidone is a relatively new antipsychotic agent. It is often referred to as 'atypical', because it has a mechanism of action that blocks post synaptic dopamine-2 and serotonin-2 receptors, it is associated with fewer extrapyramidal side effects, it is not yet associated with tardive dyskinesia, and it may have some efficacy on negative symptoms of schizophrenia. In despite of its 'atypical' nature, there are already more than 15 reports of risperidone-induced neuroleptic malignant syndrome. Only one case of risperidone-induced NMS was reported recently in Korea. We report one case of delayed risperidoneinduced neuroleptic malignant syndrome in young male patient and review the related articles.
Humans ; Korea ; Male ; Movement Disorders ; Neuroleptic Malignant Syndrome* ; Receptors, Serotonin, 5-HT2 ; Risperidone ; Schizophrenia

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The Induction of Immediate Early Genes and Phosphorylation of p42, p44 MAPK and Elk-1 by Kainic Acid in Developing Rat Hippocampus.

Hee Yeon JUNG ; Soo Jin KIM ; Jong Heun KIM ; Sun Ju CHUNG ; Joo Bae PARK ; Yong Sik KIM ; Soo Churl CHO

Journal of Korean Neuropsychiatric Association.1999;38(4):894-903.

OBJECTIVES: In order to investigate the maturational process of intracellular signal transduction system in rat brain, we studied the induction of the immediate early genes(IEGs)c-fos, junB, and TIS1 in each developmental stage after kainic acid(KA)induced seizure in young rat hippocampus and then compared these with the results after electroconvulsive shock(ECS) And to elucidate the induction mechanism of c-fos via mitogen-activated protein kinase(MAPK)by KA in each developmental stage, we investigated the phosphorylation of p42, p44 MAPK and Elk-1 after KA treatment in young rat hippocampus. METHODS: We examined the induction patterns of IEGs by northern blot analysis, and the phosphorylation of p42, p44 MAPK and Elk-1 by immunoblotting in rat hippocampus at post-natal day 7, 14, and 21(P7, P14 & P21) respectively after intraperitoneal injection of KA. RESULTS: Unlike ECS, KA did not induce c-fos, junB, and TIS1 in P7 hippocampus. But these genes were apparently induced at P14 and to an adult level at P21. These three IEGs showed similar temporal patterns of induction in each developmental stage. Although the basal level of phosphorylated 42p, 44p MAPK was considerable in P7 rat hippocampus, the increase of phosphorylation after KA treatment was observed at P14 . While the phosphorylation of Elk-1 was detected with high basal level in P7 rat, the amount of phosphorylated Elk-1 was not changed after KA treatment. CONCLUSION: Our results suggest that the differences in IEGs induction patterns between KA and ECS may be due to the differences in the activated signal transduction pathways. And our results also implicate that the signal transduction system involved in MAPK phosphorylation after KA treatment mature with aging and c-fos induction via MAPK activation may be regulated through some pathways other than Elk-1 in rat hippocampus.
Adult ; Aging ; Animals ; Blotting, Northern ; Brain ; Genes, Immediate-Early* ; Hippocampus* ; Humans ; Immunoblotting ; Injections, Intraperitoneal ; Kainic Acid* ; Mitogen-Activated Protein Kinase 3* ; Phosphorylation* ; Rats* ; Seizures ; Signal Transduction

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Signaling Pathway of the Bacterial Lipopolysaccharide-induced Generation of Nitric Oxide in Rat Primary Astorcytes.

So KWANG ; Rae Kil PARK ; Sang Yeol LEE ; Min Cheol PARK

Journal of Korean Neuropsychiatric Association.1999;38(4):881-893.

OBJECTIVES: Nitric oxide(NO)plays an important role in pathophysiology of stroke and various neurodegenerative diseases. This study is designed to elucidate the mechanisms by which signaling pathway of LPS-stimulated NO generation in rat prmary astrocytes may be mediated by MAP kinase cascades and transcriptional activation of NF-kB. METHOD: The generation of NO from primary rat neonatal astrocytes was measured by using Greese's reagents and Western blot analysis with including Erk, JNK1 and p38 was assessed by in vitro immunecomplex kinase assay. Activation of transcriptional activator, NF-kB, was determined by using electrophoretic mobility shift assay. RESULTS: Treatment of cultured rat primary neonatal astorcytes with LPS results in the generation of NO as well as increase in the expression of inducible nitric oxide synthase(iNOS) LPS-induced NO generation is inhibited by the addition of inhibitors of MEK and JNK1/SPAK, PD 98059 and curcumin. LPS also imcreases the phosphotransferase activity of Erk as well as JNK1 and increases the phosphorylation of p38. Inhibition of Ras results in decrease of LPS-inudced NO generation. cAMP decreases the LPS-induced NO generation via inhibition of JNK1. Furthermore LPS activates transcriptional activator, NF-kB which is inhibited by the addition of inhibitors of MEK and JNK. CONCLUSION: These data suggest that MAP kinases, especially Erk and JNK1, may mediate the signaling cascade of LPS-induced NO generation in rat primary astrocytes via activation of transcriptional factor, NF-kB.
Animals ; Astrocytes ; Blotting, Western ; Curcumin ; Electrophoretic Mobility Shift Assay ; Indicators and Reagents ; MAP Kinase Signaling System ; Neurodegenerative Diseases ; NF-kappa B ; Nitric Oxide* ; Phosphorylation ; Phosphotransferases ; Rats* ; Stroke ; Transcriptional Activation

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Regulation of MAPK Activity by Seizure-induced MKP-1 in Rat Hippocampus.

Bum Hee YU ; Ung Gu KANG ; Yong Min AHN ; Sun Ju CHUNG ; Song Hee JEON ; Joo Bae PARK ; Yong Sik KIM

Journal of Korean Neuropsychiatric Association.1999;38(4):873-880.

OBJECTIVES: Both electroconvulsive shock(ECS) and kainic acid-induced seizures activate mitogenactivated protein kinases(MAPKs)in rat hippocampus. They can also induce the expression of MAPK phosphatase-1(MKP-1)in rat hippocampus. MKP-1 is known as a specific MAPK deactivator. This study aimed to elucidate the role of MKP-1 in the deactivation of MAPKs in rat hippocampus. METHODS: In order to induce MKP-1 in the hippocampus, ECS was given to the rats. At the time points when MKP-1 was sufficiently induced, the second ECS was given to them and the subsequent phosphorylation or activation of MAPKs were measured in the hippocampus. A second group of rats were injected with kainic acid and the relationship between MKP-1 expression and MAPK phosphorylation was examined in their hippocampi. RESULTS: The expression of MKP-1 did not influence the phosphorylation or activation of MAPKs following ECS in rat hippocampus. Kainic acid-induced expression of MKP-1 did not significantly reduce the phosphorylation of MAPKs. CONCLUSION: MKP-1 did not play a significant role in the deactivation of MAPKs which were activated by ECS or kainic acid in rat hippocampus.
Animals ; Electroshock ; Hippocampus* ; Kainic Acid ; Phosphorylation ; Rats* ; Seizures

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The Effect of Haloperidol on Regional Cerebral Blood Flow Assessed with 99m-Tc-ECD SPECT In Schizophrenic Patients.

Keun Ah CHEON ; Jong Doo LEE ; Sung Kil MIN ; Se Joo KIM ; Suk Kyoon AHN

Journal of Korean Neuropsychiatric Association.1999;38(4):861-872.

OBJECTIVES: Regional cerebral blood flow(rCBF)in schizophrenics is confounded by various factors including medication status. Previously, there have been numerous studies regarding the effects of antipsychotics on rCBF. However, these works have shown contradictory and inconsistent findings due to the different of type, dose and exposed duration of antipsychotics. The aim of this study was to observe the effect of antipsychotic medication on rCBF and exposed duration of antipsychotics under control. METHODS: Eighteen drug-naive schizophrenics and 19 schizophrenics medicated with haloperidol were included in the study. Regional cerebral blood flow was assessed with the singlephoton emission computed tomography(SPECT)under a resting state. Relative rCBF was compared between two groups. Haloperidol was selected as the antipsychotic drug as it has relatively selective action at the D2 receptor and less active metabolites. Exposed duration was limited from one to three weeks. RESULTS: Haloperidol-medicated schizophrenic patients had a significantly greater increase of relative cerebral perfusion in the right inferior temporal lobe, left inferior frontal lobe, both basal ganglia, left thalamus, both parieto-occipital lobes, and right parietal lobe than drug-naive schizophrenic patients. Haloperidol-medicated schizophrenic patients had a significant decrease of relative cerebral perfusion in left inferior temporal lobe. However, no significant differences in relative rCBF were found between drug-naive and haloperidol-medicated schizophrenic patients in right inferior frontal lobe, right thalamus, both superior temporal lobes, both superior frontal lobes, and left parietal lobe. CONCLUSION: These findings suggest that antipsychotics affect regional cerebral blood flow, and antipsychotic medication status must be considered in the relative rCBF studies of schizophrenic patients.
Antipsychotic Agents ; Basal Ganglia ; Frontal Lobe ; Haloperidol* ; Humans ; Parietal Lobe ; Perfusion ; Schizophrenia ; Temporal Lobe ; Thalamus ; Tomography, Emission-Computed, Single-Photon*

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D3 Receptor Gene Variant and Tardive Dyskinesia in Schizophrenic Patients.

Jong Won NAM ; Min Soo LEE

Journal of Korean Neuropsychiatric Association.1999;38(4):853-860.

Tardive dyskinesia(TD)is one of the serious side effects caused by long-term treatment with neuroleptic medication. It has been known that dopamine D3 receptors are mainly located on the postsynaptic membrane where they display an inhibitory action on locomotor activity. In this study, we investigated the genetic variation of the dopamine D3 receptor gene(DRD3)as a putative risk factor for TD in schizophrenic patients receiving long-term antipsychotic medication. Fifty schizophrenic patients previously treated neuroleptic medication, were assessed for TD severity using Extrapyramidal Symptom Rating Scale(ESRS) Genomic DNA was amplified by PCR and Digestion with MluI yield two bands of 111bp and 47bp in all subjects. Subjects with a 304bp band were classified a1a1, those with 206bp and 98bp bands a2a2, and those with all five bands a1a2. The allelic distributions in TD patients and non-TD patients were not significantly different(x2=.852, df=2, p=.653) The number of each genotype observed in the schizophrenic group, did not differ significantly from the values expected according to Hardy-Weinberg equilibrium(x2=.29, df=2) This result did not support that dopamine D3 receptor gene variant were susceptible to TD in schizophrenic patients. The role of dopamine D3 receptors as a putative risk factors of TD may therefore be less important than previously thought.
Digestion ; DNA ; Genetic Variation ; Genotype ; Humans ; Membranes ; Motor Activity ; Movement Disorders* ; Polymerase Chain Reaction ; Receptors, Dopamine D3 ; Risk Factors ; Schizophrenia

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An Association Study between the HUMTH01-VNTR Polymorphism of the Tyrosine Hydroxylase Gene and Schizophrenia.

Taeyoun JEON ; Yongsil KWEON

Journal of Korean Neuropsychiatric Association.1999;38(4):843-852.

OBJECTIVES: To investigate the genetic relation of the Tyrosine Hydroxylase gene, a rate-limiting enzyme in the synthesis of catecholamine, with schizophrenia, we designed the association study between the microsatellite HUMTH01-VNTR polymorphic locus, located in the first intron of the TH, and the Korean schizophrenic patients. METHOD: We typed 6 different alleles of the HUMTH01-VNTR locus using PCR and automated sequencer in 105 schizophrenic patients meeting DSM-IV criteria and 142 normal controls. The frequencies of allele and genotype were compared between patients and normal controls. And the allele frequencies were compared respectively in terms of positive and negative subtypes according to the PANSS and family history. RESULTS: The frequencies of allele and genotype were not significantly different between the patient and normal controls. In patient group, the frequencies of allele between positve and negative symptom subtypes and family history were not significantly different. CONCLUSION: The authors can not find an association between the HUMTH01-VNTR poly-morphic locus and Korean schizophrenic patients. And these results indicate that the TH gene does not likely play a major role in the genetic predisposition to schizophrenia.
Alleles ; Diagnostic and Statistical Manual of Mental Disorders ; Gene Frequency ; Genes, vif ; Genetic Predisposition to Disease ; Genotype ; Humans ; Introns ; Microsatellite Repeats ; Polymerase Chain Reaction ; Schizophrenia* ; Tyrosine 3-Monooxygenase* ; Tyrosine*

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Influenza A (H1N1) Outbreak at a Psychiatric Closed Ward and Infection Control.

Jung Hoon KIM ; Kang Uk LEE

Journal of Korean Neuropsychiatric Association.2017;56(4):203-210. doi:10.4306/jknpa.2017.56.4.203

OBJECTIVES: In this study, we propose effective policies for preventing transmission in the closed ward of psychiatry department at the subject hospital. METHODS: 15 patients (9 in 2010, 3 in 2012, and 3 in 2013) infected by 2009 H1N1 Influenza A were treated with Tamiflu® (Roche), and preventive Tamiflu® was administered to patients without symptoms as well as healthcare workers. Infected patients were placed in cohorts or isolation rooms with droplet and contact precautions. The ward was cleaned daily with chloride. Influenza vaccinations were administered to immunosuppressed patients and long-term patients. In addition, respiratory etiquette posters were posted on the closed ward during the latter half of 2012. The 2013 outbreak involved the same controls as 2012. RESULTS: The incidence of outbreak among patients during the three outbreaks was 53%, 18%, and 19%. The incidence of infection among healthcare workers was 0% throughout the three periods, and there was no additional infection. CONCLUSION: In a closed ward of the psychiatry department, there is constant contact between healthcare workers and patients. Therefore, the possibility of influenza transmission is expected to be high. It is important to maintain constant inspection to detect outbreaks. Effective infection control should be applied to block the virus.
Cohort Studies ; Delivery of Health Care ; Disease Outbreaks ; Humans ; Incidence ; Infection Control* ; Influenza, Human* ; Vaccination

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