The Code of Medical Ethics for the Korean Academy of Child and Adolescent Psychiatry: Why Is It Important?

This article provides an overview of the developmental history and rationale of medical ethics to establish the code of ethics and professional conduct of the Korean Academy of Child and Adolescent Psychiatry (KACAP). Most medical professional organizations have their own codes of ethics and conduct because they have continuous responsibility to regulate professional activities and conducts for their members. The Ethics and Award Committee of the KACAP appointed a Task-Force to establish the code of ethics and conduct in 2012. Because bioethics has become global, the Ethics Task Force examined global standards. Global standards in medical ethics and professional conduct adopted by the World Medical Association and the World Psychiatric Association have provided the basic framework for our KACAP's code of ethics and professional conduct. The Code of Ethics of the Americal Academy of Child and Adolescent Psychiatry has provided us additional specific clarifications required for child and adolescent patients. The code of ethics and professional conduct of the KACAP will be helpful to us in ethical clinical practice and will ensure our competence in recognizing ethical violations.

Comparison of alpha-synuclein immunoreactivity in the spinal cord between the adult and aged beagle dog / 한국실험동물학회지

Alpha-synuclein (alpha-syn) is a presynaptic protein that is richly expressed in the central and peripheral nervous systems of mammals, and it is related to the pathogenesis of Parkinson's disease and other neurodegenerative disorders. In the present study, we compared the distribution of the immunoreactivity of alpha-syn and its related gliosis in the spinal cord of young adult (2-3 years) and aged (10-12 years) beagle dogs. We discovered that alpha-syn immunoreactivity was present in many neurons in the thoracic level of the aged spinal cord, however, its protein level was not distinct inform that of the adult spinal cord. In addition, ionized calcium-binding adapter molecule-1 (a marker for microglia) immunoreactivity, and not glial fibrillary acidic protein (a marker for astrocytes) immunoreactivity, was somewhat increased in the aged group compared to the adult group. These results indicate that alpha-syn immunoreactivity was not dramatically changed in the dog spinal cord during aging.

The Effect of Mother's Object Relation on Mother's Rearing Attitude and Children's Self-Esteem in Children with Attention-Deficit Hyperactivity Disorder

OBJECTIVES: This study examined maternal object relations, child's and mother's perception on rearing attitude, and children's self-esteem in children with attention-deficit hyperactivity disorder (ADHD) and their mothers. METHODS: 64 children with ADHD and their mothers were included in the study group. In the control group, there were 85 children and their mothers. Mothers completed the following tests : Bell object relation inventory (BORI), maternal behavior research instrument (MBRI), Beck Depression Inventory (BDI), and Korean ADHD Rating Scale (K-ARS). Children completed Children's Report of Parental Behavior Inventory (CRPBI) and Rosenberg self-esteem scale. RESULTS: Mothers of ADHD children displayed more rejecting and controlling parenting style than mothers in the control group. ADHD children showed lower self-esteem and perceived their parents as not affectionate, but rejecting and controlling. Mothers with ADHD children who belonged to object relations pathological group showed more rejecting rearing attitude and their children believed that they were more controlling, compared with children and mothers in other conditions. Among factors in mother's object relations, insecure attachment and ego-centricity impacted the rearing attitude. In turn, affective rearing attitude mainly influenced children's self-esteem. CONCLUSION: This study suggests that the approach focused on mother's object relations may help with the treatment of children with ADHD.

The Effect of Mother's Object Relation on Mother's Rearing Attitude and Children's Self-Esteem in Children with Attention-Deficit Hyperactivity Disorder

OBJECTIVES: This study examined maternal object relations, child's and mother's perception on rearing attitude, and children's self-esteem in children with attention-deficit hyperactivity disorder (ADHD) and their mothers. METHODS: 64 children with ADHD and their mothers were included in the study group. In the control group, there were 85 children and their mothers. Mothers completed the following tests : Bell object relation inventory (BORI), maternal behavior research instrument (MBRI), Beck Depression Inventory (BDI), and Korean ADHD Rating Scale (K-ARS). Children completed Children's Report of Parental Behavior Inventory (CRPBI) and Rosenberg self-esteem scale. RESULTS: Mothers of ADHD children displayed more rejecting and controlling parenting style than mothers in the control group. ADHD children showed lower self-esteem and perceived their parents as not affectionate, but rejecting and controlling. Mothers with ADHD children who belonged to object relations pathological group showed more rejecting rearing attitude and their children believed that they were more controlling, compared with children and mothers in other conditions. Among factors in mother's object relations, insecure attachment and ego-centricity impacted the rearing attitude. In turn, affective rearing attitude mainly influenced children's self-esteem. CONCLUSION: This study suggests that the approach focused on mother's object relations may help with the treatment of children with ADHD.

The Relationship between Object Relations and Parenting Behavior of Mothers of ADHD Children

OBJECTIVES: This study was conducted to compare the object relations and parenting behavior of the mothers of children with attention-deficit hyperactivity disorder (ADHD) with that of the mothers with normal children. METHODS: In this study, we studied 64 mothers of children who were diagnosed with ADHD and 90 mothers of normal children. The mothers completed the Bell Object Relations Inventory (BORI), the Parenting Behavior Inventory (PBI), the Parenting Stress Index (PSI) and the Parenting Sense of Competence (PSOC) scale. RESULTS: As compared with the mothers of normal children, the mothers of children with ADHD showed significantly different results for the parenting stress and parenting efficacy. For parenting behavior, the mothers of children with ADHD perceived their mothering as being more neglectful. On the other hand, the mothers of the normal control group perceived their mothering as being more affectionate and the fathers as being more reasonable and monitoring. CONCLUSION: This study suggests there is a significant difference of object relation between the mothers of children with ADHD and the mothers with normal children. The object relation pathology of the mothers of children with ADHD might contribute to impaired parenting behavior. The result of the present study indicate that inadequate grandparental rearing behavior affects the insecure object relation of their child (the mother), and a mother's insecure object relation affects their parental stress and parenting efficacy.

The Relationship between Object Relations and Parenting Behavior of Mothers of ADHD Children

OBJECTIVES: This study was conducted to compare the object relations and parenting behavior of the mothers of children with attention-deficit hyperactivity disorder (ADHD) with that of the mothers with normal children. METHODS: In this study, we studied 64 mothers of children who were diagnosed with ADHD and 90 mothers of normal children. The mothers completed the Bell Object Relations Inventory (BORI), the Parenting Behavior Inventory (PBI), the Parenting Stress Index (PSI) and the Parenting Sense of Competence (PSOC) scale. RESULTS: As compared with the mothers of normal children, the mothers of children with ADHD showed significantly different results for the parenting stress and parenting efficacy. For parenting behavior, the mothers of children with ADHD perceived their mothering as being more neglectful. On the other hand, the mothers of the normal control group perceived their mothering as being more affectionate and the fathers as being more reasonable and monitoring. CONCLUSION: This study suggests there is a significant difference of object relation between the mothers of children with ADHD and the mothers with normal children. The object relation pathology of the mothers of children with ADHD might contribute to impaired parenting behavior. The result of the present study indicate that inadequate grandparental rearing behavior affects the insecure object relation of their child (the mother), and a mother's insecure object relation affects their parental stress and parenting efficacy.

Combination Chemotherapy with Mitomycin C, Vinorelbine, and Cisplatin (MVrP) in Patients with Advanced Non-Small Cell Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: A phase II study was conducted in patients with advanced non-small cell lung cancer (NSCLC) in order to evaluate the efficacy and toxicity of the combination chemotherapy regimen of mitomycin C, vinorelbine, and cisplatin (MVrP). MATERIALS AND METHODS: Between June 1996 and December 2000, fifty-nine patients with unresectable stage IIIB to IV, pathologically documented NSCLC were enrolled in this study. One cycle consisted of mitomycin C 10 mg/m2 i.v. day 1, vinorelbine 30 mg/m2 i.v. days 1 & 15, and cisplatin 80 mg/m2 i.v day 1 and the next cycle consisted of vinorelbine 30 mg/m2 i.v. days 29 & 43, and cisplatin 80 mg/m2 i.v day 29. Each cycle was alternated and treatments were repeated every 8 weeks. RESULTS: We were able to evaluate fifty-three of 59 patients. Objective responses were seen in 22 (41.5%) patients (CR 0%, PR 41.5%). The median duration of response was 13.7 weeks and the median time to progression was 17.7 weeks. The median overall survival was 45.6 weeks. There was a significantly longer survival seen in responders (p=0.041). The toxicities of this regimen were acceptable without treatment related toxic death. CONCLUSION: This study suggests that a combination regimen of mitomycin C, vinorelbine, and cisplatin is relatively effective and well tolerated for the treatment of advanced NSCLC.

Effects of Naltrexone on the Tyrosine Hydroxylase Expression in the Hypothalamic Areas in Rats with Chronic Ingestion of 5% Ethanol / 대한정신약물학회지

OBJECTIVE: This study was designed to evaluate the effects of nonselective opioid antagonist naltrexone on the expression of tyrosine hydroxylase (TH) in variable areas of hypothalamus in rats with chronic ingestion of 5% ethanol using immunohistochemical measures. METHODS: To induce polydipsia with 5% ethanol, Spraque-Dawley rats were placed in automatic cage where a pellet dispenser automatically dispensed 90 mg pellets at fixed time 60 seconds (FT 60s) feeding schedule over 150-minute test session. After 4 weeks of daily exposure to the FT 60s feeding schedule, experimental rats were administered naltrexone (0.25 mg/kg, i.p), vehicle (1 cc/kg, i.p) for 3 weeks. After completing the 3 weeks of naltrexone and vehicle injections, the polydipsic rats were sacrificed. The brains were removed and postfixed in the same overnight fixation, then frozen sections of 40microM thickness were made in the coronal plane. Sections were stained for detection of tyrosine hydroxylase (H) according to the immunohistochemical method. RESULTS: 1) Both experimental animals with schedule-induced polydipsia (IP) and the bolus with 5% ethanol control showed significant increase in the amounts of 5% ethanol ingestion as compared with their baseline. The naltrexone treated group showed significant decrease in the amount of 5% ethanol ingestion at 2nd and 3rd week as compared with their baseline. Meanwhile, the vehicle control showed no changes in the amount of 5% ethanol ingestion for 3 weeks as compared with their baseline. 2) There was diffused and definite decreases in the TH immunoreactive cells in the bolus control with chronic ingestion of 5% ethanol. The SIP with water group showed marked increase in TH immunoreactive cells in the paraventricular nucleus and the periventricular hypothalamic nucleus. The SIP with 5% ethanol group showed definite decrease of TH immunoreactive cells in the paraventricular nucleus and the periventricular hypothalamic nucleus. The naltrexone treated group showed significant increase of TH immunoreactive cells in the paraventricular nucleus but no changes in the periventricular hypothalamic nucleus. CONCLUSION: These results suggest that the fixed time feeding procedure for schedule induced polydipsia as an animal model of alcoholism was not suitable. The author identified that naltrexone has suppressed the ingestion of ethanol. The chronic ingestion of 5% ethanol suppress the TH immunoreactive cells in the paraventricular nucleus and the periventricular hypothalamic nucleus. Naltrexone increases the TH immunoreactive cells which was suppressed by chronic ingestion of 5% ethanol in the paraventricular nucleus.

Acute Phlegmonous Gastritis Diagnosed Early Endoscopically and Treated Successfully with Antibiotics / 대한소화기내시경학회지

Phlegmonous gastritis is a rare disorder caused by suppurative bacterial infection of the gastric wall. The mortality rate remains extremely high and the gastrectomy has been thought to be an effective form of treatment. We report a case of acute phlegmonous gastritis developed in a patient with advanced alcoholic liver cirrhosis, and recovered with early endoscopic diagnosis and antibiotics alone.

Effects of Fluoxetine on Tyrosine Hydroxylase Expression in Schedule-Induced Polydipsia Rats / 신경정신의학

OBJECTIVE: It has been suggested that fluoxetine inhibits the dopaminergic neurotransmission by serotonergic mediation. And also, it has been shown to inhibit synthesis of DOPA in dopamine-rich areas of the rat forebrain. These dopamine-antagonistic capacity of fluoxetine is only supported by anecdotal report that the increased amount of motor disability in patients with idiopathic Parkinson's disease after exposure to fluoxetine. However, there is still no evidence of the direct effect of fluoxetine on dopaminergic neuronal cell body in the substantia nigra, VTA, caudate & putamen. This study was designed to evaluate the effects of fluoxetine in rat brain which showed decreased numbers of dopaminergic neuronal cell body induced by schedule-induced polydipsia(SIP). METHODS: We incidentally found that 4 weeks of schedule-induced polydipsic rats revealed the suppression of tyrosine hydroxylase expression in the substantia nigra, VTA, caudate & putamen with the immunohistochemistric measures. After 3 weeks of intraperitoneal injection of 10mg/kg of fluoxetine to the schedule induced polydipsic rats, the tyrosine hydroxylase expression was also measured with immunohistochemistry. We compared the tyrosine hydroxylase expression among the normal control, the polydipsic rats, and the rats with fluoxetine treatment. RESULTS: 1) By contrast with the control, the polydipsic rats revealed the evidence of decreased tyrosine hydroxylase expression in the substantia nigra, VTA, caudate & putamen. 2) After daily injection of fluoxetine for 3 weeks, the polydipsic rats showed increment of tyrosine hydroxylase expression in those areas. CONCLULSION: In previous studies, a great deal of results suggest that fluoxetine negatively influence the dopaminergic systems indirectly via serotonergic activation such as inhibition of dopamine synthesis or transport system. Although our results are obtained from rodents, we suggest that fluoxetine directly and positively enhance the dopamine system in the substantia nigra, VTA, caudate & putamen. The chronic adminstration of fluoxetine may be helpful to dopamine-depleted condition in clinical situations. We anticipate the replication studies of our findings and well-controlled clinical trial.