정신분열병의 생물학적 원인

강병조,원승희,김상헌 대한생물치료정신의학회 1998 생물치료정신의학 Vol.4 No.2

The authors reviewed the biological etiologies of schizophrenic disorder such as genetic, viral, neurodevelopmental, neural network, sunspots and cerebral diabetic hypothesis. The etiology of schizophrenic disorder remains to be confirmed. Although genetic possibilities were suggested by many investigators, the genetic genes and their transmission methods have not been clarified yet. The neurodevelopmental hypothesis was reviewed in detail. This hypothesis includes genetic hypothesis, viral hypothesis, obstetrical complication hypothesis, neutritional deficience theory, NMDA receptor hypofunction theory and neural network theory. The neurdevelopmental hypothesis means that several developmental trajectories, related to early brain insults as well as the genetic factors affection postnatal neurodevelopment, possibly lead to this illness. An excessive pruning of the prefrontal corticocortical, and corticosubcortical synapses, perhaps involving the excitatory glutaminergic inputs to pyramidal neurons, may underlie schizophrenia.

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

퇴원한 정신분열병 환자의 외래 통원 치료에 미치는 요인

박기국,원승희,김상헌,김휘동,강병조 대한생물치료정신의학회 1998 생물치료정신의학 Vol.4 No.2

목적 : 저자는 외래 통원 치료를 지속적으로 받는 환자들과 중단한 환자들의 현황을 조사 비교했다. 그리고 외래 통원 치료를 지속적으로 받는 환자들 중 투약 약물 종류에 따른 치료 순응도에 영향을 미칠 수 있는 변인들을 비교했다. 연구 대상과 방법 : 첫 번째 1997년 4월 1일부터 1998년 4월 30일 동안 퇴원한 정신분열병 환자 140명을 대상으로 자료를 조사한 후 분석했다. 두 번째 1998년 5월 18일부터 1998년 6월 17일까지 한달 동안 외래를 방문한 후 순응도 요인에 관한 설문지의 항목을 작성한 46명 환자의 자료를 분석했다. 결과 : 외래 통원 치료를 지속적으로 받는 환자군과 통원 치료를 중단한 환자군을 비교했을 때, 성별, 연령, 교육 수준, 결혼 여부, 직업, 종교, 정신분열병 아형, 발병 연령, 유병 기간, 입원 횟수, 복용 약물들의 하루 총복용 횟수에서 통계학적으로 의미 있는 차이는 없었다. 퇴원 당시 clozapine을 투약했던 환자들에서 외래 치료지속율이 가장 높게 나타났다. 외래 통원 치료를 받는 환자들의 투약 약물 종류군에 따라 경제적 곤란도, 교육 수준, 유병 기간, 입원 횟수에서 유의한 차이가 있었다. 약물 종류군(clozapine, risperidone, typical anti-psychotics)에 따라 경제 상태, 향후 기대 치료 기간, 약물에 대한 인식도, 약물 효과에 대한 기대, 현재 약의 부작용, 약물의 부작용 경험도, 성별, 연령, 결혼 여부, 직업, 종교, 정신분열병 아형, 발병 연령, 1일 약물 복용 총 횟수의 차이가 없었다. 결론 : 클로자핀 약물을 투약한 환자들이 다른 종류의 항정신병 약물 투약 환자들에 비해 외래 통원 치료를 지속적으로 받는 비율이 높았다. Objectives : The authors compared the status of discharged schizophrenics between who are continuously followed and who are not in the treatment. Also we compared compliance factors among administered drug groups of the follow-up schizophrenics. Methods : First, we surveyed and analysed one hundred-four schizophrenics after discharge. Second, we analysed the questionnaires which were written by the forty-six follow-up patients who were asked about compliance factors. Results : There were no significant differences between patients who are continuously follow-up and who are not in the treatment on sex, age, educational level, marriage, occupation, religion, subtypes of schizophrenia, age of onset, duration of illness, admission rate, and complexity of drug administration methods Clozapine administered group had higher follow-up rate than that of other antipsychotics(rispendone and typical antipsychotics) administered groups among the discharged schizophrenics. Among the follow-up patients, there were significant differences between atypical antipsychotics patients and typical antipsychotics patients on economic difficulty, educational level, duration of illness, admission rate. There were no significant differences on the other of demographic and psychiatric characteristics. Conclusion : Clozapine administered group had higher follow-up rate than that of ther antipsychotics administered groups among the discharged schizophrenics.

지난 2년간의 학회지 "신경정신의학" 심사 평가보고

김찬형,김세주,김도관,김성곤,박원명,송동호,박용천,이영문,오강섭,정영철,이상열,김주한,이동영,이헌정,함병주,김율리,김문두,김정진,이강욱,천근아,김재진,홍진표,홍승철 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

DRD2 Genotypic and Haplotype Variation Is Associated With Improvements in Negative Symptoms After 6 Weeks’ Amisulpride Treatment

Kang, Seung-Gul,Na, Kyoung-Sae,Lee, Heon-Jeong,Chee, Ik-Seung,Lee, Kwanghun,Lee, Jonghun Wolters Kluwer Health, Inc. All rights reserved. 2015 JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY Vol.35 No.2

ABSTRACT: The aim of this study was to identify the association between the rs1079597 and rs1800497 genetic polymorphisms of the gene encoding the dopamine D2 receptor (DRD2) protein and the treatment response to the selective dopamine receptor antagonist amisulpride. After 6 weeks of treatment with amisulpride, 125 schizophrenia patients were interviewed based on the Positive and Negative Syndrome Scale and the Clinical Global Impression-Severity Scale. Genotyping for rs1079597 and rs1800497 was performed using the TaqMan single nucleotide polymorphism genotyping assay. There were significant differences in the genotype frequency of the recessive model (&khgr; = 5.73, P = 0.017) and allele frequency (&khgr; = 5.16, P = 0.023) of rs1079597 between the responders and nonresponders based on the Positive and Negative Syndrome Scale negative symptoms scores. There was no significant finding in this regard for the rs1800497 polymorphism. The T-C and C-C haplotype of rs1079597-rs1800497 were associated with the negative symptom treatment response to amisulpride after permutation test. To the best of our knowledge, this is the first report of the positive finding in the association study between rs1079597 polymorphism and the treatment response to amisulpride in schizophrenic patients. A larger scale study involving more single nucleotide polymorphisms of DRD2 will progress the research into the pharmacogenetics of the treatment response to amisulpride.

Prevalence and Clinical Implications of Lateral Wall Dehiscence in the Sphenoid Sinus: Sternberg’s Canal

Kang Seung Heon,Huh Gene,Kim Minju,Bae Yun Jung,Won Tae-Bin,Kim Jeong-Whun,Rhee Chae-Seo,Cho Sung-Woo 대한비과학회 2023 Journal of rhinology Vol.30 No.2

Background and Objectives: Sternberg’s canal is known to result from incomplete fusion of bony compartments constituting the sphenoid bone during the developmental process. This study aimed to evaluate the prevalence and clinical implications of Sternberg’s canal. Methods: A retrospective review of patients over the age of 18 years who had undergone endoscopic sinus surgery from 2014 to 2019 at a single institution was performed. Patients (n=98) were categorized into those with sphenoid fungal ball (SFB) (n=39), those with primary chronic rhinosinusitis (CRS) (n=39), and controls (n=20) and were evaluated radiologically. A small pit in the lateral wall, located medial to the maxillary division of the trigeminal nerve (V2), in front of the opticocarotid recess was regarded as Sternberg’s canal. Children under the age of 12 years (n=39) without any sinus disease were also evaluated to determine the prevalence of Sternberg’s canal in the pediatric population. Results: Patients with SFB showed the highest prevalence of Sternberg’s canal (56.4%), followed by those with CRS (20.5%) and controls (10.0%) (p<0.001). Logistic regression revealed that Sternberg’s canal was associated with osteitis of the sphenoid wall, and not with age, sex, or sphenoid sinus pathology. Children under the age of 12 years showed a significantly higher prevalence of the defect than adult controls (46.2%, p<0.001). Conclusion: Sternberg’s canal was frequently identified in children under the age of 12 years. Sphenoid sinus pathology was often accompanied by osteitis. However, the presence of the canal alone did not predict skull base involvement in patients with SFB. A comprehensive evaluation should hence be performed if skull base involvement is suspected in such patients. Additionally, other clinical implications of Sternberg’s canal should be further evaluated.

Cognitive Behavioral Therapy Using a Mobile Application Synchronizable With Wearable Devices for Insomnia Treatment: A Pilot Study

Kang, Seung-Gul,Kang, Jae Myeong,Cho, Seong-Jin,Ko, Kwang-Pil,Lee, Yu Jin,Lee, Heon-Jeong,Kim, Leen,Winkelman, John W. American Academy of Sleep Medicine 2017 Journal of clinical sleep medicine Vol.13 No.4

<P>Conclusions: Our pilot study suggested the clinical usefulness of a CBT-I-MA. We expect that our findings will lead to further development and replication studies of CBT-I-MA.</P>

Possible association between G-protein β3 subunit C825T polymorphism and antipsychotic-induced restless legs syndrome in schizophrenia

Kang, Seung-Gul,Lee, Heon-Jeong,Choi, Jung-Eun,Park, Jae-Hong,Lee, Sang-Shin,Han, Changsu,Kim, Yong-Ku,Kim, Seung-Hyun,Lee, Min-Soo,Joe, Sook-Haeng,Jung, In-Kwa,Kim, Leen Blackwell Publishing Ltd 2007 Acta neuropsychiatrica Vol.19 No.6

<P>Objective</P><P>The incidence of restless legs syndrome (RLS) is presumed to be higher among people with schizophrenia who take antipsychotic medication, most of which blocks the dopamine D2 receptor. The purpose of this study was to determine whether the G-protein β<SUB>3</SUB> subunit (<I>GNB3</I>) C825T polymorphism is associated with antipsychotic-induced RLS in schizophrenia.</P><P>Methods</P><P>We examined 178 Korean patients with schizophrenia. All of the subjects were evaluated using the diagnostic criteria of the International Restless Legs Syndrome Study Group and the International Restless Legs Scale. Genotyping was performed for the C825T polymorphism in the <I>GNB3 </I>gene.</P><P>Results</P><P>The genotype distribution did not differ significantly between antipsychotic-induced RLS patients and patients who had no-RLS symptoms (<I>χ</I><SUP>2</SUP> = 4.30, <I>p </I>= 0.116). The genotypes of the C825T single-nucleotide polymorphism (SNP) were classified into two groups: C+ (CC and CT genotypes) and C– (TT genotype). The presence of the C allele (C+) was associated with an increased likelihood of RLS (<I>χ</I><SUP>2</SUP> = 4.14, <I>p </I>= 0.042; odds ratio = 2.56, 95% confidence interval = 1.02–6.47).</P><P>Conclusions</P><P>These results suggest that the GNB3 C825T SNP is associated with RLS in schizophrenia. However, confirming this association requires future larger scale studies in which the effects of medication are strictly controlled.</P>

S-78 Tuberculous appendix: a Case and Review of Clinical Presentations in Korea

( Seung Heon Kang ),( Jeong Rok Lee ),( Ho Hyun Park ),( Gwang Mo Kim ),( Soon Young Ko ),( Joon Ho Wang ),( Jae Dong Lee ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

Introduction:?Tuberculous appendix is suprisingly rare, even in countries where infection like tuberculosis (TB) remain endemic and common. Herein, we report the case of a patient with intestinal TB presenting as tuberculous appendix and review clinical presentations of them in Korea. Case:?A 16-year-old woman was admitted for right lower quadrant pain for 4 days. On abdominal CT scan, diffuse wall thickening of ascending colon and dilated appendix (8 mm) were detected with contrast enhancement. After laparoscopic appendectomy, histopathological results revealed chronic granulomatous inflammation with caseous necrosis of the appendix. On day 6 since operation, a colonoscopy showed diffuse geographic, irregular ulcerations in the cecum and ascending colon. The patient was discharged successfully ten days after surgery. Anti-TB medication was prescribed for 6 months. Currently, she finished the medication and is doing well.?Conclusions: Tuberculous appendix can present as acute appendicitis and the diagnosis is often made after operation. Delayed treatment can lead to significant complications. Despite the rarity of this state, it is important for physicians to be aware of this infection. The details of the patients in Korea are shown in Table 1, including this patient.

Comparison of Psychiatric Symptoms in Patients With Obstructive Sleep Apnea, Simple Snoring, and Normal Controls :

Kang, Jae Myeong,Cho, Seong-Jin,Lee, Yu Jin,Kim, Ji-Eun,Shin, Seung-Heon,Park, Kee Hyung,Kim, Seon Tae,Kang, Seung-Gul Ovid Technologies (Wolters Kluwer) - Lippincott Wi 2018 Psychosomatic medicine Vol.80 No.2

<P>Conclusions This study found that individuals with suspected OSA experienced more severe psychiatric symptoms than NCs and that psychiatric symptoms were more severe in the SS group than in the OSA group. The psychiatric symptoms of suspected OSA patients were associated with subjective sleep quality rather than with the apnea-hypopnea index.</P>