Smoking as a Preventable Risk Factor for Rheumatoid Arthritis: Rationale for Smoking Cessation Treatment in Patients with Rheumatoid Arthritis

( Sungwon Roh ) 대한류마티스학회 2019 대한류마티스학회지 Vol.26 No.1

Rheumatoid arthritis (RA) is a chronic inflammatory disease of multifactorial etiology. Smoking is considered one of the most established environmental risk factors for RA development and severity. A large proportion of patients with RA have a high prevalence of smoking history. Previous studies have provided evidence suggesting that smoking is associated with the development of RA. Smoking has been associated with several pathogenic mechanisms on RA development such as oxidative stress, inflammation, and epigenetic changes. There is a need for public health campaigns to educate the public regarding these risks and preventive measures that reduce smoking are essential and may result in a decline in RA incidence. Encouragement of smoking cessation is especially warranted in relatives of patients with RA. Recently, RA-specific smoking cessation interventions have been developed. This review will summarize the knowledge accumulated to date concerning associations between smoking and RA. (J Rheum Dis 2019;26:12-19)

Safety and Effectiveness of Desvenlafaxine in Korean Patients with Major Depressive Disorder: A 6-month Postmarketing Surveillance Study

Sungwon Roh,Kang Soo Lee,Songhwa Choi,Jae-Min Kim 대한정신약물학회 2022 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.20 No.3

Objective: Although the safety and efficacy of desvenlafaxine have been demonstrated, long-term evidence in Asians is lacking. We examined the safety and effectiveness of desvenlafaxine for up to 6 months in routine clinical practice in Korea. Methods: This multicenter, open-label, prospective observational study was conducted from February 2014 to February 2020 as a postmarketing surveillance study of desvenlafaxine (ClinicalTrials.gov identifier: NCT02548949). Adult patients with major depressive disorder (MDD) were observed from the initiation of treatment for 8 weeks (acute treatment phase) and then up to 6 months (continuation treatment phase) in a subsample. Safety was evaluated by incidence of adverse events (AE) and adverse drug reactions. Treatment response was assessed using the Clinical Global ImpressionImprovement (CGI-I) scale. Results: We included 700 and 236 study subjects in the analysis of acute and continuation treatment phase, respectively. In acute treatment phase, AE incidence was 9.86%, with nausea being most common (2.00%). In continuation treatment phase, AE incidence was 2.97%, with tremor occurring most frequently. After acute treatment (n = 464), the treatment response rate according to the CGI-I score at week 8 was 28.9%. In long-term users (n = 213), the response rate at month 6 was 45.5%. During the study period, no clinically relevant changes in BP were found regardless of concomitant use of antihypertensive drugs. Conclusion: This study provides evidence on the safety and effectiveness of desvenlafaxine in adults with MDD, with a low incidence of AE, consistent AE profile with previous studies, and improved response after long-term treatment.

Scientific Evidence for the Addictiveness of Tobacco and Smoking Cessation in Tobacco Litigation

Roh, Sungwon The Korean Society for Preventive Medicine 2018 Journal of Preventive Medicine and Public Health Vol.51 No.1

Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others'. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one's choice by free will.

PAM-4 고속 직렬 통신용 ADC 기반 비동기식 온-다이 아이모니터를 위한 전디지털 심볼 주파수 추정기법

노성원(Sungwon Roh),김진태(Jintae Kim) 대한전자공학회 2021 전자공학회논문지 Vol.58 No.9

알코올정책의 개념과 효과성

노성원(Sungwon Roh),이해국(Hae Kook Lee),기선완(Seon Wan Ki) 한국중독정신의학회 2009 중독정신의학 Vol.13 No.2

This article describes the concept and efficacy of alcohol po-licy, including a brief historical review of interventions for alcohol-related problems, the basic concept of alcohol-related problems, interventions from a public health perspective, comprehensive prevention, community systems, frameworks, and practical prevention strategies in terms of evidence for their effectiveness, research support amounts, implementation costs, and other feasibility issues. Alcohol-related problems cannot be solved only by treatment models. More comprehensive preventions and interventions are needed, because evidence shows such problems have complicated and diverse characteristics. The prevailing view-point on alcohol-related problems has changed, from its being a sin, in the past, to being a disease, in the 70’s, and, recently, to being a biopsychosocial concept. Prevention frameworks require intervention strategies, establishing the severity of patients’ problems, establishing a concrete target group, and a range of target. Overall, the interventions with the greatest amount of empirical support are (1) low legal limits on blood alcohol concentration levels for driving while intoxicated, (2) controls on alcohol availability, (3) age limits on alcohol purchases, and (4) relatively high alcohol prices. Policy efforts in the developing countries should focus on improving countermeasures against driving while intoxicated, measures that alter the drinking context, and limits on alcohol’s physical availability. For developed countries, the goal should be to prevent any backsliding with regard to current drinking patterns and to reduce the overall volume of alcohol consumed. Many evidence-based policies clearly seem to have the potential for communities to substantially reduce their alcohol-related problems.

알코올사용과 의존에 미치는 유전적 영향:최근까지의 연구결과

노성원(盧聖元,Sungwon Roh),마츠시다 사치오(松下幸生,Sachio Matsushita),히구치 스스무(樋,口 進,Susumu Higuchi) 한국중독정신의학회 2008 중독정신의학 Vol.12 No.2

More than 100 studies have shown that alcohol dependence is a complex disorder that may be influenced by multiple polymorphisms of multiple genes. There is now abundant evidence for genetic influences on alcohol use and dependence. The over-all heritability of alcohol dependence has been estimated to be 50-60% with multiple genes each having a small effect. While genetics significantly contributes to elucidation of the mechanism of alcohol dependence, the role of the environment and of gene-environment interactions should not be ignored. Linkage approaches have been used to map chromosomal regions linked to alcohol use and dependence. Regions that can be confirmed include those on chromosome 1p, 4q close to the ADH gene cluster, 4p close to the GABA A receptor gene cluster, and 16p. These regions are definitely promising candidates for association stu-dies to identify narrower loci or single gene. Many genes have been suggested to possibly play roles in contributing to vulnerability to developing alcohol dependence. Yet, only two genes, ADH and ALDH2, have been identified as having defined effects on phenotypic variations in alcohol use and dependence. We, however, remain cautiously optimistic that current and novel methods of genetic analysis will add new genes to the list. Promising candidates include GABRA2 and CHRM2. Many genes combine to reach a threshold of clinical liability; therefore, no single gene is likely to be identified as the “alcoholism” gene. Nonetheless, neurobiological analyses of candidate genes will surely contribute to further understanding of the interindividual differences in risk and the cause of alcohol dependence.

Clozapine과 연관된 확장성 심근병증

노성원,안동현,김양석,이방헌 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.1

Clozapine is an atypical antipsychotic agent that is more effective than the typical neuroleptics in the treatment of refractory schizophrenia. However, clozapine is also a drug associated with potentially serious adverse effects, such as cardiac complications as well as agranulocytosis. Clozapine-related agranulocytosis has been reported in Korea, whereas clozapine-related cardiac complications have not. We report a 31-year-old male schizophrenia treated with clozapine who developed a dilated Cardio-myopathy. We also reviewed literatures on dilated cardiomyopathy associated with clozapine treatment. This report is an attempt to raise the awareness of clozapine-related cardiac complications.

한국에서 우울증의 특징과 비약물학적 치료

노성원,박용천,Roh, Sungwon,Park, Yong Chon 대한생물정신의학회 2006 생물정신의학 Vol.13 No.4

Depression is one of the most common mental disorders. Some characteristics of depression in Korea were elucidated. The tendency to express depressive feeling through somatic complaints is more prominent in Korea than in Western countries. Careful studies on depressive symptoms suggest that guilt and suicidal idea are apparent among Korean depressive patients as well as among Western subjects. But most depressive patients in Korea are reluctant to express suicidal idea, which is hidden under the somatic complaints. We should remember the possibility of research artifacts or cultural bias with regard to the evaluation of depressive symptoms of a country in comparison with other countries. Non-pharmacological treatment of depression includes dynamic psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, self-care treatment, etc. Some kinds of Korean culture relevant psychotherapies are introduced: Tea therapy, Imago therapy, Tao psychotherapy, and combined approach. Interest in the aged people is growing recently, and the research about the factors which affect the depressive disorders in older patients and treatment strategy for them is ongoing.

한국판 해리경험척도 II(KDES-II)의 요인 구조 : 정신과 환자군 대상

김대호,임효진,노성원 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.2

Objectives : Dissociative Experiences Scale (DES) is the most widely used and studied instrument for measuring disso-ciative symptoms with its favorable psychometric properties well described in the literature. However, recent debate on factor structure and multidimensionality has brought attention to factorial validity of the scale. This study tested the factor structure of a Korean translation of the scale (KDES-II) with confirmatory factor analysis m a clinical population. Methods : Exploratory principal component analysis were conducted with data from 340 psychiatric patients and confirmatory factor analysis (maximum likelihood estimation) with 262 psychiatric outpatients Results : Exploratory analysis revealed four factor structure of the scale with total variance of 55.9% : Depersonalization/derealization (Factor 1), Amnestic dissociation (Factor 2), Absorption (Factor 3), and Pseudopsychotic symptoms (Factor 4). However, original three- and one- factor model were also acceptable considering the goodness-of-fit indices. Conclusion : Despite heterogeneity ofthe sample, KDES-II showed factorial validity and supported a cross cultural stability of DES. We suggest use ofonginal three factor solution for Korean clinical population.

가상현실을 이용한 알코올중독자의 단서노출 치료

권효석(Hyoseok Kwon),노성원(Sungwon Roh),최준호(Joonho Choi),양병환(Byung-Hwan Yang),이장한(Jang-Han Lee) 한국HCI학회 2006 한국HCI학회 학술대회 Vol.2006 No.2