성인에서의 주의력결핍·과잉행동장애

반건호,조아랑 경희대학교 2002 慶熙醫學 Vol.18 No.3-4

민간건강보험에서 정신과 질환에 대한 보험비 지급 관련 약관 현황과 문제

반건호,김종우,조아랑,박진경,김영종,박준헌 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.4

Objectives : Recently, Korean psychiatrists have noticed the complaints from probands and family members that private health insurance companies do not pay for most psychiatric disorders. Furthermore, Probands cannot even apply for insurance because of their medical record of psychiatric disorders. Authors investigated and reviewed contracts of Korean private insurance companies to find reasons for banning psychiatric disorders from insurance policies. Methods : Authors reviewed more than 800 contracts from 48 insurance companies. Results : Among all the psychiatric diagnoses, few of them-dementia and some other organic mental disorders-are guaranteed to be paid from insurance companies. Less then 10 contracts say they pay for psychiatric illnesses. Most insurance companies have contracts prohibiting F codes ; however, there are not enough reasons in these contracts. Conclusions : In the private health insurance system, Psychiatric illnesses have almost no rooms. It is very urgent to add space for patients with psychiatric illnesses and psychiatrists in the insurance policies.

한국인 및 중국 한족 정신분열병 환자의 5-HT2A 수용체 유전자 -1438A/G 다형성

이장호,이광철,이승부,오용인,최영근,조아랑,정주호,장환일 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.1

Objectives : The purpose of the present study was to investigate the association between -1438A/G polymorphism of 5-HT2A receptor gene and schizophrenia in Korean and Han Chinese population. Methods : A sample of 184 Korean patients with schizophrenia and 96 Korean healthy normal controls and 96 Han Chinese patients with schizophrenia and 96 Han-Chinese healthy normal controls were genotyped for a single nucleotide polymorphism with in 5-HT2A receptor gene (promoter region, A-1438G) by Msp I Resthction Fragment Length Polymorphism (RFLP). Results : There was no difference in allelic frequencies and genotype frequencies of -1438A/G polymorphism between Korean schizophrenics and controls (p=0.13) and Han Chinese schizophrenics and controls (p=0.40). Also, -1438A/G Poly-morphism did not show ethnical difference between Korean and Han Chinese controls. The Scale for the Assessment of Negative Symptoms (SANS) scores showed no significant differences between genotypes of -1438A/G polymorphism in both of Korean and Han Chinese schizophrenics. Conclusion : These results suggest that -1438A/G polymorphism of the 5-HT2A receptor gene is not causally related to the development of schizophrenia in Korean and Han Chinese population, and there no ethnic difference between Korean and Han Chinese population.

주의력결핍-과잉운동장애의 비중추신경흥분제 치료의 최신지견

반건호,손소정,이서경,강원섭,조아랑,박진경 경희대학교 2006 慶熙醫學 Vol.22 No.1

Methylphenidate (MPH), amphetamine, and pemoline are cerebrostimulants that have been commonly prescribed for more than half century in the treatment of attention-deficit/hyperactivity disorder (ADHD). The use of such drugs, however, is often followed by untoward effects such as loss of appetite, insomnia, nausea, abdominal pain, vomiting, irritability, and etc. There are also debates about decrements in height and weight percentiles and drug dependency. Thus, in this study, we discussed new therapeutic drugs, non cerebro-stimulants, with possibly less adverse effects and more efficacies. Atomoxetine, highly selective inhibitor of the presynaptic noradrenaline transporter with little or no affinity for other neurotransmitter transporters and receptors, is a non-excitatory drug with a strong possibility to replace CNS excitatory drugs. It is also safer in relation to drug dependency since it does not affect nucleus accumbens or the striatum. Atomoxetine, therefore, can be used in patients who do not respond to the CNS excitatory drugs. Tricyclic antidepressants, imipramine and desipramine are also most extensively studied drugs as ADHD treatment modalities. They also exert inhibitory effect on the reuptake of norepinephrine. The use of these drugs in children, however, is limited because of cardiovascular effects. Bupropion is one of promising drugs in treating prepubertal children with ADHD. It is also useful for comorbid depression and conduct problems. Increasing attention is being given to a narcolepsy drug, modafinil. Modafinil acts on histamine pathway resulting in wakefulness. This effect is similar to that of neuropeptide orexin. Since the effect of modafinil is independent of catecholamine, drug dependency adverse effect is not expected. Recently, some new drugs, such as reboxetine, are reported as safe and efficacious for children with ADHD, but they need long-term safety and controlled studies.

Development of tiered approaches using alternative test methods for evaluating eye irritation

Ah Rang Cho,Hye Lyun Jeon,Seo Young Bang,Kwang Jin Kim 한국실험동물학회 2021 한국실험동물학회 학술발표대회 논문집 Vol.2021 No.1

Analysis of Image Distortion on Magnetic Resonance Diffusion Weighted Imaging

Ah Rang Cho,Hae Kag Lee,Heung Joon Yoo,Cheol-Soo Park 한국자기학회 2015 Journal of Magnetics Vol.20 No.4

The purpose of this study is to improve diagnostic efficiency of clinical study by setting up guidelines for more precise examination with a comparative analysis of signal intensity and image distortion depending on the location of X axial of object when performing magnetic resonance diffusion weighted imaging (MR DWI) examination. We arranged the self-produced phantom with a 45 mm of interval from the core of 44 regent bottles that have a 16 mm of external diameter and 55 mm of height, and were placed in 4 rows and 11 columns in an acrylic box. We also filled up water and margarine to portrait the fat. We used 3T Skyra and 18 Channel Body array coil. We also obtained the coronal image with the direction of RL (right to left) by using scan slice thinkness 3 mm, slice gap: 0mm, field of view (FOV): 450 × 450 ㎟, repetition time (TR): 5000 ms, echo time (TE): 73/118 ms, Matrix: 126 × 126, slice number: 15, scan time: 9 min 45sec, number of excitations (NEX): 3, phase encoding as a diffusion-weighted imaging parameter. In order to scan, we set b-value to 0 s/㎟, 400 s/㎟, and 1,400 s/㎟, and obtained T2 fat saturation image. Then we did a comparative analysis on the differences between image distortion and signal intensity depending on the location of X axial based on isocenter of patient’s table. We used “Image J” as a comparative analysis programme, and used SPSS v18.0 as a statistic programme. There was not much difference between image distortion and signal intensity on fat and water from T2 fat saturation image. But, the average value depends on the location of X axial was statistically significant (p < 0.05). From DWI image, when b-value was 0 and 400, there was no significant difference up to 2<SUP>nd</SUP> columns right to left from the core of patient’s table, however, there was a decline in signal intensity and image distortion from the 3<SUP>rd</SUP> columns and they started to decrease rapidly at the 4<SUP>th</SUP> columns. When b-value was 1,400, there was not much difference between the 1st row right to left from the core of patient’s table, however, image distortion started to appear from the 2<SUP>nd</SUP> columns with no change in signal intensity, the signal was getting decreased from the 3<SUP>rd</SUP> columns, and both signal intensity and image distortion started to get decreased rapidly. At this moment, the reagent bottles from outside out of 11 reagent bottles were not verified from the image, and only 9 reagent bottles were verified. However, it was not possible to verify anything from the 5<SUP>th</SUP> columns. But, the average value depends on the location of X axial was statistically significant. On T2 FS image, there was a significant decline in image distortion and signal intensity over 180mm from the core of patient’s table. On diffusion-weighted image, there was a significant decline in image distortion and signal intensity over 90 mm, and they became unverifiable over 180 mm. Therefore, we should make an image that has a diagnostic value from examinations that are hard to locate patient’s position.

Association between Methylenetetrahydrofolate Reductase (MTHFR) Gene Polymorphisms and Korean Patients with Schizophrenia

Ah Rang Cho,Yong Ho Kim,Bum Shik Kim 대한스트레스학회 2008 스트레스硏究 Vol.16 No.2

산화적 스트레스를 증진시키는 고농도의 호모시스테인(homocysteine)과 비정상적인 호모시스테인 대사는 정신분열병을 포함한 신경발생 질환과 관련이 있다. Methylenetetrahydrofolate reductase (MTHFR)은 5,10-methylenetetrahydrofolate를 5-methylenetetrahydrofolate로 변환한다. 또한 5-methylenetetrahydrofolate는 호모시스테인의 재메틸화에 보조기질로 사용된다. 본 연구는 MTHFR 유전자와 한국인 정신분열병과의 상관 관계를 연구하였다. 279명의 정신분열병 환자와 296명의 정상인을 대상으로 하였다. 단일염기다형성(SNP, rs2274976과 rs1801133)은 염기서열 분석 방법으로 확인하였다. 두 SNPs 모두 코딩 영역에 위치하며 단백질이 바뀌는 missense SNP로 rs2274976는(Arg594Gln) 엑손 12에 rs1801133(Ala222Val)는 엑손 5에 위치한다. 유전자 분석은 SNPStats, Haploview, HapAnalyzer, SNPAnalyzer과 Helixtree 프로그램을 이용하였다. Multiple logistic regression (codominant, dominant 및 recessive 모델) 분석을 하였다. 정신분열병 환자군은 Operational Criteria Checklist (OPCRIT) 분석을 하였다. 실험결과 MTHFR 유전자의 두 개의 단일염기다형성(rs2274976과 rs1801133)은 정신분열병과 연관이 없었다. 임상 phenotype 분석 시에 하나의 SNP (rs1801133)은 psychotic 현상과 유의한 상관 관계가 있었다. 즉 임상적으로 중요한 auditory hallucination인 running commanding voices는 rs1801133과 recessive 모델(p=0.018; Bonferroni correction 시 p=0.036)에서 유의한 상관 관계를 보였다. 최근 SNP database인 BUILD 129에서 rs1801133가 rs59514310로 표시하고 있다. 결론적으로 running commanding voices와 rs1801133는 유의성 있는 상관 관계를 보였다. 이러한 결과는 MTHFR 유전자가 정신분열병의 auditory hallucination에 영향을 미칠 것이라 생각한다. High levels of homocysteine promote oxidative stress, and aberrant homocysteine metabolism is linked to neurodevelopmental disorders including schizophrenia. Methylenetetrahydrofolate reductase (MTHFR) catalyzes the conversion of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate, a cosubstrate for homocysteine remethylation to methionine. The present study was conducted to examine the association between the MTHFR gene and schizophrenia in Korean population. Subjects of 279 patients with schizophrenia and 296 healthy controls were recruited. We genotyped two single nucleotide polymorphisms (SNPs, rs2274976 and rs1801133) using the Illumina Sentrix Array Matrix chip and direct sequencing. The rs2274976 (Arg594Gln) is located on exon 12 of the MTHFR gene region, and the rs1801133 (Ala222Val) located on exon 5. For the analysis of genetic data, SNPStats, Haploview, HapAnalyzer, SNPAnalyzer, and Helixtree programs were used. Multiple logistic regression analysis (codominant, dominant, and recessive models) was also used. Patients with schizophrenia were evaluated according to clinical manifestations using the Operational Criteria Checklist (OPCRIT). Two SNPs (rs2274976 and rs1801133) were not associated with schizophrenia. However, one SNP showed a significant association with one phenotype of psychotic symptoms. Running commanding voices, which could be clinically considered serious feature of auditory hallucinations, was different in the recessive model (p=0.018; p=0.036 after Bonferroni correction). Recently, rs59514310 replaces rs1801133 as new number (SNP database, BUILD 129). In present study, a significant association was observed between rs1801133 and running commanding voices. The result suggests that the MTHFR gene may be a susceptibility gene for schizophrenia with auditory hallucination.

The influence of π-conjugation on competitive pathways: charge transfer or electron transfer in new D–π–A and D–π–Si–π–A dyads

Cho, Yang-Jin,Lee, Ah-Rang,Kim, So-Yoen,Cho, Minji,Han, Won-Sik,Son, Ho-Jin,Cho, Dae Won,Kang, Sang Ook The Royal Society of Chemistry 2016 Physical chemistry chemical physics Vol.18 No.33

<P>In order to elucidate the influence of pi-conjugation on photoinduced electron transfer (PET) and intramolecular charge transfer processes, donor-pi-acceptor dyads (D-pi-A (1) and D-pi-Si-pi-A (2)) were newly synthesized. In these dyads, carbazole and triazine moieties acted as the electron donor and acceptor, respectively. The fluorescence of dyad 1 red-shifted as the solvent polarity was increased. The electron charge distribution of the excited state of dyad 1 was delocalized in the acceptor moiety, forming the charge transfer D delta+-pi-A(delta-) dyad in the excited state. In the excited state of dyad 1, the pi-conjugation acted as the linker for charge transfer between the donor and acceptor moieties. A large dipole moment change (Delta mu = 45.6 D) between the ground and excited states was determined using the Lippert-Mataga plot. Furthermore, the fluorescence of dyad 1 was observed upon two-photon excitation. In contrast, dyad 2, in which the pi-conjugation is disconnected by a Si-atom in the linker, displayed weak dual-emission: a short-wavelength emission at around 350 nm arising from the monomeric species and a long-wavelength one assigned to the emission from an intramolecular exciplex between the donor and acceptor moieties. The weak emission of dyad 2 indicates that the D+center dot-pi-Si-pi-A(-center dot) species was generated through a PET process in the excited state. The cationic radical species of the carbazole and the anionic radical species of the triazine, which show transient absorption (TA) bands at around 780 and 530 nm, respectively, were characterized using the femtosecond TA method.</P>

An Association Study between Four Polymorphisms in the Dopamine Beta-Hydroxylase Gene and Schizophrenia in Korean Population

Ah Rang Cho(조아랑),Jin Kyung Park(박진경),Jong Woo Kim(김종우),Ji Young Song(송지영),Joo Ho Chung(정주호),Geon Ho Bahn(반건호) 대한생물치료정신의학회 2007 생물치료정신의학 Vol.13 No.1

목적 : Dopamine beta-hydroxylase(DBH) 유전자는 정신병적 증상과 관련하여 정신분열병의 후보유전자 중의 하나이다. 본 연구는 DBH 유전자 내 새로운 단일염기다형성의 유전자형을 확인하고 정신분열병과의 유전적 연관성을 알아보고자 하였다. 연구대상 및 방법 : DSM-Ⅳ에 의해 정신분열병으로 진단된 입원환자 89명과 정신질환의 과거력과 가족력이 없는 대조군 109명을 대상으로 하였다. DBH 유전자의 네 번째 엑손 부위를 다중효소중합연쇄반응(Polymerase Chain Reaction, PCR)으로 증폭하여 DNA sequencing 기법으로 유전자형을 확인하고 연관성을 알아보기 위한 통계 분석을 시행하였다. 결과 : DBH 유전자 내 4개의 단일염기다형성(DBH5818G/A, DBH5990G/A, DBH6153C/T, DBH6259A/G)을 확인하였다. 이 4개의 단일염기다형성 모두에서 정신분열병 환자군과 정상 대조군 간 유전자형 분포와 대립유전자 빈도 및 일배체형 빈도에서의 유의한 차이는 없었다. DBH와의 관련성이 보고된 양성 정신병적 증상이 두드러지는 편집형 정신분열병 환자군과 정상 대조군 간 일배체형 빈도에서도 유의한 차이는 보이지 않았다. 결론 : DBH5818G/A, DBH5990G/A, DBH6153C/T, 그리고 DBH6259A/G 다형성은 한국 정신분열병 환자군과 유전적 관련성이 없을 것으로 추정된다.

정신과 외래에서 살펴본 노년기 부부관계

조아랑 ( Ah Rang Cho ),박진경 ( Jin Kyung Park ) 경희대학교 경희의료원 2007 慶熙醫學 Vol.23 No.2