Alcohol Withdrawal and Serum Nitrite Concentration

OBJECTIVE: Nitric oxide(NO) has been known to be associated with tolerance and preference to alcohol. It has also been known to affect various alcohol drinking behavior, alcohol withdrawal symptoms and alcohol-induced brain damage. The purpose of this study was to determine the difference, among alcohol dependence group, alcohol drinking group and abstinence group, in serum concentration of nitrite, a stable metabolite of NO, and it's relationship to clinical and biochemical markers of alcoholism. METHODS: Forty subjects diagnosed as alcohol dependence according to DSM-IV diagnostic criteria were evaluated for the clinical characteristics and biochemical markers of alcohol dependence including nitrite with their CIWA-Ar scores checked just after admission. Thirty-nine healthy controls were also evaluated, divided into twenty-three alcohol drinking group and sixteen abstinence group. Clinical characteristics were evaluated by CIWA-Ar, CAGE and AUDIT questionnaires. Aspartate aminotransferase(AST), alanine aminotransferase (ALT), gamma glutamyltransferase(GGT) and mean corpuscular volume(MCV) were used as the biochemical markers of alcohol dependence. Serum nitrite concentrations were measured by Griess reaction. RESULTS: 1) The concentrations of nitrite in alcohol dependence patients were not different from those in the control subjects. 2) There were no significant association between the nitrite concentrations and the CIWA-Ar scores in alcohol dependence patients. 3) Nitrites are significantly increased in alcohol dependence group and alcohol drinking group compared with abstinence group. CONCLUSIONS: These findings suggest that serum nitrite concentration has no relation with alcohol withdrawal symptoms, but alcohol drinking increases serum nitrite concentration influenced by general condition of the body.

Association of Serotonin Transporter Gene Polymorphism with Alcohol Dependence

OBJECTIVE: Under the hypothesis that 5-HTTLPR polymorphism plays some role in the susceptibility or vulnerability of some subgroup of alcohol dependence, associations of 5-HTTLPR polymorphism with alcohol dependence were examined. METHOD: This association analysis included 109 Korean alcohol dependent and 113 Korean control subjects. DNA of all subjects were genotyped for the biallelic functional polymorphism in the 5-HTTLPR. Considering the likelihood of heterogeneity in the alcohol dependence phenotype, alcohol dependent subjects were subgrouped by onset age, family history of alcohol dependence and severity of withdrawal symptoms. RESULTS: There were no significant differences in the frequencies of either the 5-HTTLPR genotype or the short vs. long allele in alcohol dependent and control subjects. The frequency of the S allele and S-carrier (LS or SS genotype) was significantly increased in the early onset alcohol dependent subjects and the familial alcohol dependent subjects compared with that in the control subjects. CONCLUSION: The results suggest that the 5-HTT 'S' promoter polymorphism is associated with an increased susceptibility or vulnerability to develop early onset alcohol dependence and familial alcohol dependence, which characterize Cloninger's type 2 alcohol dependence.

Reliability and Analysis of Symptom Category Scores of the Behavior Pathology in Alzheimer's Disease Rating Scale, Korean Version(BEHAVE-AD-K)

OBJECTIVE: The aims of this study were to (1) validate the inter-rater reliability of the BEHAVE-AD, Korean version, to (2) analyze the quantitative relationship between severity of Alzheimer's disease (AD) and mean scores on each of the BEHAVE-AD categories and mean total BEHAVE-AD score. DESIGN: Cross-sectional study of geriatric patients with AD evaluated at a mental hospital for the elderly. SAMPLE: Fifty-two consecutive patients diagnosed with probable Alzheimer's disease (AD) according to NINCDS-ADRDA diagnostic criteria. RESULTS: In reliability study, significant correlations were obtained for all BEHAVE-AD symptoms category scores and for mean total BEHAVE-AD scores. Analysis of BEHAVE-AD scores as a function of disease severity demonstrated a non-linear relationship between severity of behavioral symptoms and the global and cognitive advance of AD. Score analysis of the BEHAVE-AD indicates that these behavioral disturbances become most severe in the moderate and moderately severe stages of AD. CONCLUSION: All the results proved the cross-cultural validity and reliability of the BEHAVE-AD, Korean version. Furthermore, these results have implications for the methodology of pharmacological trials of putative cognitive enhancer compounds in AD.

Comparison of Psychiatric Symptoms between Total Mastectomy and Breast Conserving Surgery in Breast Cancer Patients

PURPOSE: There is a continuing question as to whether breast conserving surgery confers a measure of psychological comfort superior to that of total mastectomy for women diagnosed with breast cancer. The purpose of this study was to determine the differences of the psychiatric symptoms experienced between modified radical mastectomy and breast conserving surgery patients. METHODS: We compared 38 patients who underwent modified radical mastectomy with 16 patients who underwent breast conserving surgery from a psychiatric aspect. Psychiatric symptoms and distress were measured following surgery with two self-rating scales: the Symptom Check List-90-Revision (SCL-90-R) and the General Health Questionnaire (GHQ: 28-item version). RESULTS: There were no statistically significant differences between the modified radical mastectomy patients and the breast conserving surgery patients on the two scales. CONCLUSION: From our findings, it appears that breast conserving surgery is not superior to modified radical mastectomy in terms of psychiatric morbidity for breast cancer patients. The absence of differences between modified radical mastectomy patients and breast conserving surgery patients on psychiatric measures is probably due to several factors. In this study, these factors appeared to be a fear of cancer recurrence, the nature of breast cancer itself, the burden of radiation therapy, a late post operative period and selection bias.