정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구

조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.

Effects of anti-mullerian hormone supplementation on cryopreserved and transplanted ovarian tissues

Hyun Sun Kong,Jaewang Lee,Eun Jung Kim,Hye Won Youm,Jung Ryeol Lee,Byung Chul Jee,Chang Suk Suh,Seok Hyun Kim 한국발생생물학회 2014 한국발생생물학회 학술발표대회 Vol.2014 No.9

Ovarian tissue cryopreservation and transplantation causes follicle depletion. To overcome this problem, we investigate the effect of Anti-Müllerian hormone (AMH), a follicle recruitment control hormone, supplementation before and/or after mouse ovarian transplantation. A total of 120 5-week-aged BD F-1 female mice were used. The mice were randomly divided into four groups according to AMH doses (0, 5, 25, 125 μg/mL, respectively). AMH was injected intraperitoneally on every other day for a week before, after, or before and after transplantation of ovaries under kidney capsules was performed. One week after transplantation, follicular normality was evaluated by histological analysis and TUNEL assay. In Group A and C, morphologically intact follicle (G1) ratios of AMH treated groups showed no statistically significant difference. In Group B, G1 ratios of 25 and 125 μg/mL of AMH treated groups were higher than those of 5 μg/mL treated group, but there was no improvement in G1 ratio after AMH treatment. In every group, apoptotic follicle ratios did not show any trend according to AMH treatment. Proportions of primordial follicle were not significantly different according to AMH treatment in all groups. The result of the present study demonstrated that AMH treatment during on transplantation of cryopreserved ovaries has no significant effect on follicle survival and prevention of follicle depletion.

High rate of hepatitis B reactivation during tyrosine kinase inhibitor treatment among patients with chronic myeloid leukemia in Korea

Jee Hyun Kong,Jae Yeon Jang,Tae Hwa Ko,Seong Hee Kang,Yundeok Kim 대한혈액학회 2022 Blood Research Vol.57 No.4

Poster Session : PS 1407 ; Hemato-Oncology(Hematology) : Isolated Extramedullary Relapse of Acute Lymphoblastic Leukemia in the Breast

( Hyun Sung Pack ),( Jun Jeong Choi ),( Juwon Kim ),( Shin Young Hyun ),( Kwang Yong Shim ),( Chong In Lee ),( Jee Hyun Kong ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

An isolated extramedullary relapse of acute lymphoblastic leukemia (ALL) after allogeneic hematopoietic stem cell transplantation (HSCT) in the absence of marrow involvement is a rare event. It occurs most commonly in the central nervous system or the testes, but rarely in the breast. We recently experienced ALL in a patient with an isolated extramedullary relapse in the breast after allogeneic HSCT. The patient, a 32-year-old female was diagnosed with B-cell ALL. Cytogenetic analyses were normal and the RQ-PCR testing for BCR-ABL was negative. The patient achieved a complete remission after treatment with hyper CVAD chemotherapy. Also the patient underwent an allogeneic HSCT from a HLA full matched sibling. Neither a graft versus host disease nor an infection was developed during the follow up period. One year after the allogeneic HSCT, the patient complained about a painless, palpable nodule on the left breast. The ultrasonography revealed a 2.74x2.69x2.49 cm sized lobulated hetero- echogenous mass and the PET scan showed a strong FDG uptake mass in the left breast. Histologic examination revealed an infiltration of primitive cells found showing focal TdT and CD34 positive cells. However, the short tandem repeat PCR of bone marrow aspirates showed a complete chimerism. No leukemic lesions were identified in other sites such as the bone marrow or cerebrospinal fiuid. The patient was treated with localized radiotherapy (5000cGy) followed by chemotherapy with L-asparaginase containing regimen. She patient remained in complete chimerism during radiotherapy and chemotherapy. However, an intracranial hemorrhage was developed during the chemotherapy and the patient died 2 months after the extramedullary relapse. The breast could become one of the extramedullary relapse sites of ALL in adults. Further studies on risk factors, underlying mechanisms or therapeutic strategies of an extramedullary relapse are necessary.

Unusual isolated extramedullary relapse of acute lymphoblastic leukemia in the breast despite complete donor hematopoietic chimerism after allogeneic hematopoietic stem cell transplantation

Pack Hyun Sung,Changjo Im,Shin Young Hyun,Kwang Yong Shim,Jong In Lee,Jee Hyun Kong 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.1

증례 : 그레이브스씨병(Graves` disease) 환자에서 수질암(medullary thyroid carcinoma)이 동반된 1예

공지현 ( Jee Hyun Kong ),김철식 ( Chul Sik Kim ),조민호 ( Min Ho Jo ),안철우 ( Chul Woo Ahn ),김경래 ( Kyung Rae Kim ),장항석 ( Hang Seok Jang ),홍순원 ( Soon Won Hong ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-

본 저자들은 54세 여자 환자가 그레이브스씨병으로 치료받던 중 발견된 갑상선 결절을 주소로 내원하여, 수질암으로 전갑상선절제술 및 중앙경부림프절 절제술을 시행받은 증례를 경험하였기에 문헌보고와 함께 보고하는 바이다. It is believed that Graves` disease is associated with an increased prevalence of thyroid carcinoma, but the reported incidence is variable, ranging between 0% and 9.8% generally of differentiated thyroid carcinoma type. The majority of thyroid carcinomas in patients with Graves` disease are papillary, followed in frequency by follicular carcinoma. Medullary thyroid carcinoma in combination with Graves` disease appears to be very rare. To our knowledge, only 11 cases have been described in which medullary thyroid carcinoma associated Graves` disease and all of them, at foreign countries. So we experienced medullary thyroid carcinoma associated Graves` disease, we report this case with review of literature. (Korean J Med 69:S851-S855, 2005)

<small>L</small>-Ascorbic acid 2-phosphate and fibroblast growth factor-2 treatment maintains differentiation potential in bone marrow-derived mesenchymal stem cells through expression of hepatocyte growth factor

Bae, Sung Hae,Ryu, Hoon,Rhee, Ki-Jong,Oh, Ji-Eun,Baik, Soon Koo,Shim, Kwang Yong,Kong, Jee Hyun,Hyun, Shin Young,Pack, Hyun Sung,Im, Changjo,Shin, Ha Cheol,Kim, Yong Man,Kim, Hyun Soo,Eom, Young Woo,L Informa UK Ltd. 2015 Growth factors Vol.33 No.2

<P>L-ascorbic acid 2-phosphate (Asc-2P) acts as an antioxidant and a stimulator of hepatocyte growth factor (HGF) production. Previously, we reported that depletion of growth factors such as fibroblast growth factor (FGF)-2, epidermal growth factor (EGF), FGF-4 and HGF during serial passage could induce autophagy, senescence and down-regulation of stemness (proliferation via FGF-2/-4 and differentiation via HGF). In this study, we investigated the proliferation and differentiation potential of BMSCs by FGF-2 and Asc-2P. Co-treatment with FGF-2 and Asc-2P induced optimal proliferation of BMSCs and increased the accumulation rate of BMSC numbers during a 2-month culture period. Moreover, differentiation potential was maintained by co-treatment with FGF-2 and Asc-2P via HGF expression. Adipogenic differentiation potential by FGF-2 and Asc-2P was dramatically suppressed by c-Met inhibitors (SU11274). These data suggest that co-treatment with FGF-2 and Asc-2P would be beneficial in obtaining BMSCs that possess 'stemness'' during long-term culture.</P>

The Distribution and Morphology of Calbindin D28K- and Calretinin-immunoreactive Neurons in the Visual Cortex of Mouse

Hyun-Jung Park,Jee-Hyun Kong,Youn-Sil Kang,Won-Mee Park,Seong-Ah Jeong,So-Min Park,Jin Kyu Lim,Chang Jin Jeon 한국분자세포생물학회 2002 Molecules and cells Vol.14 No.1

We studied the distribution and morphology of cal-bindin D28K- and calretinin-immunoreactive (IR) neurons in the mouse visual cortex with immunocyto-chemistry. Most of the calbindin D28K-IR neurons were located in layers II/III and V, while calretinin-IR neurons were predominantly located in layers II/III. The labeled neurons showed variations in morphology. The majority of the calbindin D28K-IR neurons were stellate and round or oval cells with multipolar den-drites. The majority of calretinin-IR neurons were ver-tical fusiform cells with long processes traveling per-pendicular to the pial surface. In the mouse visual cor-tex, 20.2% of calbindin D28K-IR neurons contained calretinin and 27.2% of calretinin-IR neurons con-tained calbindin D28K. These results indicate that the calcium-binding proteins, calbindin D28K and cal-retinin are distributed in specific layers and in selec-tive cell types of the mouse visual cortex.

Simulation of ECT Bobbin Coil Probe Signals to Determine Optimum Coil Gap

Kong, Young-Bae,Song, Sung-Jin,Kim, Chang-Hwan,Yu, Hyung-Ju,Nam, Min-Woo,Jee, Dong-Hyun,Lee, Hee-Jong The Korean Society for Nondestructive Testing 2006 한국비파괴검사학회지 Vol.26 No.6

Eddy current testing (ECT) signals produced by a differential bobbin coil probe vary according to probe design parameters such as the number of turns, geometry and coil gap size. In the present study, the characteristics of a differential bobbin coil probe signals are investigated by numerical simulation in order to determine the optimum coil gap. For verification of numerical simulation accuracy, a specially designed bobbin probe of which the coil gap can be adjusted is fabricated and a series of experiments to acquire signals from two kinds of standard tubes with the variation in coil gap is performed. Then, the experimental signals are compared to the simulation results. Based on this investigation, a decision on the optimum range of coil gap is made. The theoretically predicted signals agree very well to the experimental signals. In fact, this excellent agreement demonstrates a high potential of the simulation as a design optimization tool for ECT bobbin probes.

Poster Session : PS 1453 ; Hemato-Oncology(Oncology) : Higher Rate of Receiving Palliative Sedation in Whom Completed Advance Directives

( Jee Sun Jeong ),( Ho Jung An ),( Hyun Seon Kim ),( Bong Han Kong ),( Yi Jin Kang ),( Hoon Kyo Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Advance directives (ADs) has been recently issued and gradually accepted in Korea. Palliative sedation (PS) is used in terminal cancer patients suffering from refractory symptoms. The decision for PS is usually made not by patients but by family. Since October 2012, we have recommended the ADs and ask about PS to terminal cancer patients. We plan this study to find out the association between completing the ADs and performing the PS. Methods: From October 2012 to September 2013, medical chart of 214 new patients in hospice and palliative unitwas retrospectively reviewed. Results: Seventy-six patients (35.5%) completing the ADs, but the ADs were not completed in patients with poor performance or family`s disagreement. Sixty-eight (31.8%) agreed PS. The PS was actually performed in 37 (17.4%) of 214 patients; 20/138 patients without ADs (14.5%), 17/68 patients who agreed PS (25.0%), none (0/8, 0%) patients who did not agree PS on ADs. Higher trend of performing PS in patients who completed ADs comparing to patients who did not (25.0% vs. 14.5%, P=0.057). The decision at the time of performing PS was made by patients themselves, spouses, and son/daughters in 2.8%, 38.9%, and 36.1% respectively. Among patients receiving PS and completing ADs, the decision of PS was made by same proxy written in ADs (82.4%). Conclusions: Most patients completing ADs agreed PS, and they showed higher rates of receiving PS comparing to patients without ADs. Completing ADs in advance might infiuence the decision making of PS for family members in a positive way.