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- 저자 : 천영훈(Young-Hoon Cheon):노승호(Seung-Ho Rho) (검색결과 2 건)
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알코올 의존 환자에서 혈청 콜레스테롤 농도와 충동-공격성과의 상관관계
천영훈(Young-Hoon Cheon):노승호(Seung-Ho Rho) 한국중독정신의학회 2000 중독정신의학 Vol.4 No.1
Objective:The purpose of this study was to examine the relationship between impulsivity-aggressiveness and serum cholesterol level in patients with alcohol dependence. Method: The authors examined fifty-nine male patients with alcohol dependence who had been admitted to Wonkwang Neuropsychiatric Hospital between April, 1999 and October, 1999 except who had apparent other major psychiatric disorders, personality disorders, cognitive impairment, or severe physical disorders (e.g., liver cirrhosis, hereditary lipid metabolic disorders, pancreatitis) which need intense medical care. The patients were divided into two groups according to the Irwin’s criteria and assigned to Type Ⅰ and Type Ⅱ. And also the patients were divided into three groups by the level of serum cholesterol, in order to compare the characteristics between lower group (lower 1/3 of serum cholesterol level in total group) and higher group (upper 1/3 of serum cholesterol in total group). We examined serum cholesterol level at 2 weeks after the admission. Alcoholism Screening Test (AST-F;rated by patient’s family, AST-P;rated by patient), Impulsivity scale (Imp-F;rated by patient’s family, Imp-P;rated by patient), Brief Anger-aggression Questionnaire (BAQ), and Overt Aggression Scale (OAS) were used to measure the patient’s impulsivity and aggressiveness. Results:Serum cholesterol level and scores for impulsivity-aggressiveness were compared between subgroups. 1) Type Ⅱ showed significantly higher score on AST-F than Type I (p<.01), but there’s no significant difference on AST-P. AST-F score was significantly higher than ASP-P score in Type Ⅱ (p<.01), but there’s no significant differences in Type Ⅰ. 2) Type Ⅱ showed significantly higher score on Imp, BAQ and OAS (p<.05, p<.01, p<.01), as well as significantly lower serum cholesterol level (p<.01) than Type Ⅰ. 3) The lower-cholesterol group showed significantly higher score on Imp (p<.01) and BAQ (p<.01) than higher-cholesterol group. Fog OAS, lower-cholesterol group showed clear tendency tohave higher score than highercholesterol group but failed to reach statistical significance. Conclusion:The results suggest that there are significant relationship between low serum cholesterol level and impulsivity in patients with alcohol dependence. This finding suggest that serum cholesterol level may be available as a biological marker of impulsivity in patients with alcohol dependence. But more systematized studies should be needed supporting the correlation between serum cholesterol level and impulsivity in patients with alcohol dependence.
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Combined Antitumor Chemotherapy in a Refractory Schizophrenic Receiving Clozapine
Lee, Sang-Yeol,Cheon, Young-Hoon,Rho, Seung-Ho,Lee, Kuy-Haeng,Park, Min-Cheol 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.1
Clozapine을 투여 받고 있는 정신분열병 환자에게 항암제 병합투여는 clozapine과 항암제 모두의 무과립구증 유도 가능성 때문에 권고되지 않고 있다. 그러나 무과립구증 치료에 granulocyte-colony stimulating factor(G-CSF)가 소개된 이후로, G-CSF는 항암제 또는 Clozapine과 연관된 무과립구증의 치료에 사용되어 왔다. 저자들은 clozapine을 투여 받고 있던 치료 불응성 정신분열병 환자에서 성선간질 종양이 발견되어 항암제와 병합 치료하던 중 발생한 무과립구증을 G-CSF를 이용하여 성공적으로 치료한 1예를 보고하는 바이다. Clozapine과 항암제 병합 투여 전의 혈액학적 소견은 정상이었으며, 항암제 치료를 받는 도중 발생한 무과립증은 G-CSF 치료에 의해서 회복되었다. 본 증례는 clozapine 유지 치료 중이던 치료 불응성 정신분열병 환자에서 종양이 발생한 경우, clozapine에 대한 치료 효과가 좋았고 clozapine과 항암제 치료전의 혈액학적 소견이 정상이었다면, 종양 전문의사와 정신과 의사에 의해서 혈액학적 추적조사를 지속해 나가면서, 무과립구증 발생을 예견하여, G-CSF 사용을 고려하는 경우에 clozapine 치료를 유지해 갈 수 있다고 조심스럽게 제안한 증례이다. It has been known that clozapine treatment combining with cytotoxic antitumor therapy for schizophrenia is not recommended because both drugs have agranulocytosis as their side effect. Since the introduction of granulocyte colony-stimulating factor(G-CSF), it has been used to treat agranulocytosis or granulocytopenia associated with antitumor chemotherapy or clozapine. We report a case with schizophrenia on clozapine treatment who developed agranulocytosis following combined cytotoxic chemotherapy for a sex-cord stromal tumor which was successfully treated with G-CSF. The hematological status before combining with antitumor chemotherapy had been within normal range, and agranulocytosis following the antitumor chemotherapy returned to normal after treatment with G-CSF. This suggests that clozapine could be administered in combination with cytotoxic antitumor agents if the following indications are met : normal hematological status before starting antitumor chemotherapy, carefully monitoring hematological status by oncologist and psychiatrist, and prepared G-CSF administration when agranulocytosis is anticipated.
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