Korean Traditional Medicines as Novel Drugs for Neuropsychiatric Disorders

This paper reviews history of new drug development in Korea as well as researchs on development of new psychotherapeutic drug from traditional medicines or natural products in Korea. Korea has a long history of traditional medicine and accumulated knowledge of natural resources. However, only a few new drug have been developed from those natural products. Now many researchers in Korea are devoting themselves to test the possibility of natural products as antipsychotic drugs, antidepressants, anxiolytic drugs and cognitive enhancers. However, only a few graduates from traditional medical schools in Korea are engaging in research on developing new drug from natural products and they are not familiar to research methods of western medicine and pharmacology. For research and development of new drug from natural products or traditional medicines, many researchers should be trained for methodology of basic medicine, pharmacology, pharmacognosy, and oriential pharmacy. Government and pharmaceutical companies need to provide more investment for R & D for new drug from natural products including establishment of data base for component of traditional medicines and natural products, system development integrating information technology, bio-technology and nanotechnology, and international collaboration with advanced countries which have common interest in new drug development from natural products.ope

노인에서 ApoE 유전자형에 따른 머리둘레와 인지기능과의 관계

Dept. of Graduate Program in Science for Aging/박사[한글]목적 : 이 연구는 노인 인구에서 ApoE 유전자형이 대사증후군 및 대사증후군의 하부진단요소들과 인지장애와의 관계에 미치는 영향을 알아보기 위해 이루어졌다.방법 : GDEMCIS (Gwangju Dementia and Mild Cognitive Impairment Study) 자료 중 60세 이상 2944명 (남자 883명 여자 2061명)이 분석에 이용되었다. 대사증후군은 modified NCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III)의 진단기준에 의해 평가되었다. 인구사회학적 요인, 현재 및 과거 질환력, 약물력, K-MMSE (Korean version-Mini Mental State Examination)를 조사하였다. ApoE 유전자형을 조사하여 대사증후군과 관련된 요인들을 분석하였다. 이 연구는 연구윤리심의위원회의 승인을 받았다.결과 : 대사증후군은 전체 대상자 중에서 53.8%였으며, 남자 중에서 36.8%, 여자 중에서 61.1%였다. 다중로지스틱회귀분석에서 대사증후군은 나이, 성별, 교육수준, 현재 흡연력을 보정하였을 때 인지장애 (K-MMSE score < 18)와 통계적으로 유의한 관련이 없었다. 다중로지스틱회귀분석에서 대사증후군의 5개 하부진단요인 중 ApoE ε4 대립유전자가 존재할 경우에만 나이, 성별, 교육수준, 현재 흡연력을 보정하였을 때 수축기혈압 또는 혈중 중성지방이 높을수록 (OR = 1.03, 95% CI = 1.00-1.06; OR = 1.006 , 95% CI = 1.00-1.01) 또는 혈중 고밀도지단백 콜레스테롤이 낮을수록 (OR = 0.96, 95% CI = 0.92-1.00) 인지저하 (K-MMSE score < 18)의 위험도를 높였다.결론 : 이는 노인 인구에서 ApoE ε4 대립유전자가 존재할 경우 수축기 혈압과 혈중 중성지방 및 고밀도지단백 콜레스테롤이 인지기능과 관련이 있음을 의미한다. [영문]Objective : The purpose of this study was to find out the effect of the ApoE genotype on the relationship between metabolic syndrome and its diagnostic components and cognitive impairment in the elderly.Methods : A total of 2944 subjects (883 men and 2061 women) aged over 60 years were analyzed from the data of GDEMCIS (Gwangju Dementia and Mild Cognitive Impairment Study). The metabolic syndrome was assessed as defined by the modified NCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III). We examined demographic characteristics, current and past illness history, drug history, K-MMSE (Korean version-Mini Mental State Examination). We also examined ApoE genotype and analyzed associated factors with metabolic syndrome. This study was approved by the institutional review board.Results : Metabolic syndrome was present in 53.8% of the subjects (36.8% of men and 61.1% of women). On multiple logistic regression analysis, metabolic syndrome was not associated with cognitive impairment (K-MMSE score < 18) adjusted for age, sex, educational level, current smoking status. On multiple logistic regression analysis with the 5 diagnostic components of metabolic syndrome, as systolic blood pressure or the level of blood triglyceride was higher (OR = 1.03, 95% CI = 1.00-1.06; OR = 1.006 , 95% CI = 1.00-1.01), or the level of blood high density lipoprotein (HDL) cholesterol was lower (OR = 0.96, 95% CI = 0.92-1.00), the risk of cognitive impairment increased after adjusting for age, sex, educational level, current smoking status in the presence of ApoE ε4 allele.Conclusion : These results suggest that systolic blood pressure, blood triglyceride and HDL cholesterol may affect cognitive function in the elderly in the presence of ApoE ε4 allele.ope

(The) 3 year follow up study of posttraumatic stress disorder of North Korean defectors

의학과/석사[한글] 본 연구는 2001년에 남한에 입국한 북한이탈주민 200명을 대상으로 외상후스트레스장애(Posttraumatic Stress Disorder; 이하 PTSD)와 북한내 및 탈북과정에서의 외상경험을 조사한 1차 연구의 추적 조사이다. 입국 후 3년 동안 남한사회를 경험한 1차 조사 대상자 200명 중 연락가능하고 연구에 참여하기로 동의한 151명을 대상으로 partial PTSD 및 full PTSD의 유병율 변화와 이에 영향을 준 요인들을 알아보는 것을 목적으로 하였다. 20명의 조사원들이 일대일 면담을 하여 북한이탈주민들의 인구 사회학적 변인과 SCID(Structured Clinical Interview for DSM-IV)를 통해 PTSD를 조사하였다. 3년 동안 북한이탈주민의 partial PTSD 유병율은 31.8%에서 5.3%로, full PTSD 유병율은 27.2%에서 4.0%로 큰 폭으로 감소하였다. 특히 1차 조사에서 partial PTSD로 진단된 48명 중에서는 43명이, full PTSD로 진단된 41명 중에서는 36명이 non PTSD로 진단되어 full PTSD 및 partial PTSD의 88.8%가 3년 사이에 회복되었다. 그리고 만성 PTSD와 지연성 발병 PTSD를 가진 사람들이 공통적으로 경험한 외상의 내용을 조사하였다. 본 연구는 북한이탈주민의 PTSD에 대한 최초의 대규모 전향적 추적연구로 partial PTSD의 독립된 진단분류 가능성을 제시하고, PTSD 만성화와 외상 사건과의 관계, 그리고 partial PTSD 및 full PTSD의 자연경과를 밝힌 것에 그 의의가 있다. 이번 연구는 난민들의 정신건강을 지원하는 것에 있어 향후 남한 내 북한이탈주민들의 정신건강 지원 프로그램의 개발과 그들의 사회 적응 지원에 중요한 자료로 사용될 것으로 기대된다. [영문]This study is follow-up study of 1st survey to explore the relationship between PTSD and traumatic events in North Korea and during defection for two hundred North Korean defectors who entered South Korea in 2001. The purpose of this study is to examine the change of prevalence of partial PTSD and full PTSD for 3 years and to evaluate related factors. 151 North Korean defectors were followed up from 1st survey and 20 researchers conducted face to face interviews and assisted defectors to perform self-report assessment of this survey. Study questionnaire was consisted with demographic characteristics, and PTSD part of Structured Clinical Interview of DSM-IV Korean version. For 3 years, the prevalence rate of partial PTSD is reduced from 31.8% to 5.3%, and prevalence rate of full PTSD is also reduced from 27.2% to 4.0%. Especially, 88.8 percent of those who have been diagnosed as full PTSD and partial PTSD in 1st survey was recovered after 3 years. Common traumatic events which participants with chronic PTSD and delayed onset PTSD experienced were examined respectively. It is anticipated that this study will provide important data for the subsequent development of a mental health support program for North Korean defectors living in South Korea.ope

Characteristics of Behavioral and Psychological Symptoms by Dementia Stage : Evaluated by the Korean Version of Neuropsychiatric Inventory

Objectives : This study aimed to compare the behavioral psychological symptoms of dementia by stages and to suggest the proper management treatment plan. Methods : We examined behaviral psychological symptoms in 17 dementia patients with mild stage (CDR=0.5, 1), 18 de-mentia patients with moderate stage (CDR=2) and 24 dementia patients with severe stage (CDR=3, 4). We compared the prevalence and the composite scores (frequency x seventy) of each behavioral domain in K-NPI among three groups. The MMSE-K, GDS, Barthel ADL were also administrated to evaluate the general cognitive function, seventy of the patients and activity of daily living. Results : The most common behavioral disturbances were apathy/indifference, depression/dysphoria, and aberrant motor behavior. The mean composite score of aberrant motor behavior increased by stages of dementia severity with statistical significance. The total score of the K-NPI increased with severer stages of dementia the result didn't show statistical significance. The K-NPI score showed the positive correlation with CDR, GDS and the negative correlation with MMSE-K, B-ADL. But, there was no statistically significant correlation. Conclusion : Behavioral and Psychological Symptoms of Dementia (BPSD) change by the stages of dementia. The practical guideline for BPSD management according to dementia stage is needed. Re-evaluation and new therapeutic inter-vention must be considered by the stages of dementia.ope

Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea

The number of North Korean defectors entering South Korea has been increasing rapidly since 1994. Two hundred North Korean defectors in South Korea were studied to identify their experiences of traumatic events in North Korea and during defection, and the correlation with Posttraumatic Stress Disorder (PTSD). Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, the Traumatic Experiences Scale for North Korean Defectors, and the PTSD part of the Structured Clinical Interview for DSM-III-R Korean version. Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: Physical Trauma, Political-Ideological Trauma, and Family-Related Trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors: Physical Trauma, Detection and Capture-Related Trauma, Family-Related Trauma, and Betrayal-Related Trauma. In multifactorial logistic regression analysis, Family-Related Trauma in North Korea had a significant odds ratio.restrictio

Relationship between Traumatic Events and Posttraumatic Stress Disorder among North Korean Refugees.

Objectives: The purpose of this study is to find out the relationship between the traumatic experiences and the prevalence of PTSD among North Korean refugees in South Korea. Methods: Two hundred North Korean refugees in South Korea were voluntarily participated. Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, Traumatic Experiences Scale for North Korean Defectors, and PTSD part of the Structured Clinical Interview for DSM-III-R Korean version. Results: Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: physical trauma, political-ideological trauma, and family-related trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors: physical trauma, discovery and capture-related trauma, family-related trauma, and betrayal-related trauma. In multi-factorial logistic regression analysis, family-related trauma in North Korea had a significant odds ratio. Conclusion: Family-related trauma experienced in North Korea is related to the prevalence of PTSD among North Korean refugees in South Koreaope