Risperidone 조기 중단군 및 장기 유지군의 임상적 특성 비교

김광수,박원명,전태연,배치운,김대진,백인호,이철,김정수,한상익,최보문,장계호,고효진 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : Risperidone 투여후 조기 중단한 환자들과 장기적으로 계속 risperidone을 복용하고 있는 환자의 임상적 특성을 평가하고 나아가 risperidone장기 유지와 조기 중단의 요인을 분석하고 정신병리가 약물 투여에 미치는 영향을 조사하고자 하였다. 방 법 : 연구 대상자는 1996년 1월부터 1996년 12월까지 가톨릭대학교 의과대학 부속 8개 병원 정신과에서 risperidone을 투여 시작한 환자 580명중 DSM-IV기준에 의해 정신분열병으로 진단받고 투여 기간이 6개월 미만(조기 중단군)이거나 2년 이상(장기 유지군)을 경과하였으며 의무기록의 누락이 없는 210명을 선정하였다. 두 군간 임상적 특성을 조사하기 위하여 인구학적 변인, 정신병리학적 변인, 약물 투여기록 및 부작용 등을 과거 의무기록을 근거로 평가하였다. 결 과 : 대상환자 210명 중 조기 중단군이 67명(31.9%)이었고 장기 유지군은 143명(68.1%)이었으며 두 군간 인구학적 변인과 정신병리학적 변인에 따른 특징에는 두 군간 차이가 없었다. 두 군간 risperidone의 시작 용량과 변인과 정신병리학적 변인에 따른 특징에는 두 군간 차이가 없었다. 두 군간 risperidone의 시작 용량과 최대 용량은 유의한 차이가 없었으나 유지용량은 조기 중단군에서 4.49(±1.44)mg,장기 유지군에서 3.67(±1.50)mg으로 유의한 차이가 있었다(t=3.698, p<0.05). 또한, 이전 항정신병약물의 사용 기왕력 변인에서 조기 중단군은 기왕력이 없는 환자가 39명(58.2%), 고역가 항정신병약물을 사용한 기왕력이 있는 환자는 27명(40.3%), 저역가 항정신병약물을 사용한 기왕력이 있는 환자는 1명(1.5%)이었고, 장기 유지군은 기왕력이 없는 환자가 58명(40.6%), 고역가 항정신병약물을 사용한 기왕력이 있는 환자는 77명(53.8%), 저역가 항정신병약물을 사용한 기왕력이 있는 환자는 8명(5.6%)으로 유의한 차이가 있었다.(x²=6.559, df-=2, p<0.05). 결 론 : 본 연구결과에 의하면 가급적 환자 상태에 따라 낮은 최적 치료 용량을 투여하는 것이 장기잔의 투여를 바람직한 것으로 생각된다. 본 연구와 같은 대규모의 후향적 자연적 연구는 일반 실제 진료에서 risperidone의 효과 및 기타 다른 측면에서의 유용한 정보를 얻을 것으로 기대된다. Objective : This retrospective naturalistic study was designed to compare the clinical characteristics including psychopathology of two groups of patients, long-term maintenance group and short-term drop-out group, who were taking risperidone. Method : Datas were collected for 210 schizophrenic patients with complete medical records among 580 patients who were enrolled with risperidone administration from January 1996 to December 1996 in 8 affiliated hospital of the Catholic University. The short-term drop-out patients group were assigned to whom treatment period was less than 6 month, and the long-term maintained patients group, treatment period was more than 2 years. We assessed demographics, psychopathology, and other variables related with medication based on past medical records. Results : Among subjects of 210, short-term drop-out patients group were 67(31.9%) and long-term maintained patients group were 143(68.1%). Demographics and psychopathology were not significantly different between two groups. The stating and maximal dosage of risperidone was not significantly different between two groups but the maintenance dosage of risperidone was lower in long-term medicated patients group than short-term drop-out patients group(t=3.698, p<0.05). Additionally, the result of this study showed differences in experiences of past antipsychotic use as following. The number of no previous use of antipsychotic was 39(58.2%), the number of high potency amtipsychotic use was 27(40.3%), and the number of no previous use of antipsychotic was 58(40.6%), the number of high potency ntipsychotic use was 77(53.8%), the number of low potency antipsychotic use was8(5.6%) in long-term maintained group.(x²=6.559, df-=2, p<0.05). Conclusions : According to these results, administration of low therapeutic dosage should be recommended for long-term maintenance as if possible. Multi-center based retrospective naturalistic study like this would be useful for getting informations about efficacy and some other aspects of antipsychotic administration in practial field.

Association between FABP3 Polymorphism (rs10914367, -283A/G) and Obesity in Korean Population

Hyo Chul Youn,Dong Hwan Yun,Soo-Cheol Kim 대한스트레스학회 2011 스트레스硏究 Vol.19 No.4

비만은 다양한 질환의 위험요소로 널리 알려져 있으며, 수년 동안 여러 연구자들에 의해 비만에 대한 후보 유전자의 단일염기다형성(single nucleotide polymorphism, SNP)에 관한 연구가 급격히 증가하고 있다. 심장타입지방산결합단백질 (heart type fatty acid-binding protein, fatty acid-binding protein 3, FABP3)은 지방과 지방산의 수송과 골격근에서의 축적의 양상을 조절하는 것으로 알려져 있으며, 비만과도 연관이 있을 것으로 여겨진다. 따라서, 본 연구의 목적은 이러한 FABP3 유전자의 다형성이 고지혈증 및 비만에 미치는 영향을 알아보고자, 265명의 실험 참여자를 분석하였다. FABP3 유전자의 프로모터(promoter) 영역에서 1개(rs10914367, -283A/G)의 SNP을 선정하고 염기서열 분석기를 이용하여 유전자형(genotype)을 분석하였다. SNPStats 및 SNPAnalyzer Pro 소프트웨어를 이용하여 데이터 분석을 하였다. 실험 결과, rs10914367 유전자형이 비만에서 유의성이 있었다(p=0.017 in codominant2 model, p=0.028 in dominant model, p=0.014 in log-additive model, p=0.007 in allele frequencies). rs10914367의 A allele 빈도는 정상그룹(46.0%)보다 비만그룹 (58.2%)에서 높았으며, 반면에 G allele 분포는 정상그룹(54.0%)보다 비만그룹(41.8%)에서 낮았다. rs10914367는 혈중 total triglyceride 및 total cholesterol 농도와는 관련이 없었다. 이러한 결과는 FABP3 유전자의 다형성이 비만 발생과 관련이 있으며, rs10914367의 A allele는 한국인 비만의 위험요소임을 시사한다. Fatty acid binding proteins (FABPs) are a family of intracellular lipid-binding proteins. They play critical roles in intracellular fatty acid transport by binding lipids and regulating metabolic homeostasis. Heart FABP (H-FABP, also known as FABP3) is the most widely distributed FABP. To test the relationship between FABP3 polymorphism and dyslipidemia and obesity in Korean population, we analyzed 265 subjects. One single nucleotide polymorphism (SNP) (rs10914367, -283A/G) in the promoter region of the FABP3 gene was selected and was genotyped by direct sequencing. SNPStats and SNPAnalyzer Pro programs were performed to obtain odds ratio (OR), 95% confidence interval (CI), and p value. Multiple logistic regression models were conducted to analyze genetic data. The rs10914367 SNP was associated with obesity (p=0.017 in codominant2 model, p=0.028 in dominant model, p=0.014 in log-additive model, p=0.007 in allele frequencies). The A allele frequency of rs10914367 was higher in the overweigh/obese group (58.2%) than in the control group (46.0%), whereas the G allele frequency of rs10914367 was lower in the overweigh/obese group (41.8%) than in the control group (54.0%). The rs10914367 SNP was not related to the levels of total triglyceride and total cholesterol. These results suggest that a FABP3 polymorphism may be associated with obesity, and the A allele of rs10914367 may be a risk factor for the development of obesity in Korean population. (Korean J Str Res 2011;19:377∼382)

A Proposal for Modification of the Barcelona Clinic Liver Cancer Staging System Considering the Prognostic Implication of Performance Status

Hyo Jung Cho,Soon Sun Kim,So Young Kang,Min Jae Yang,Choong Kyun Noh,Jae Chul Hwang,Sun Gyo Lim,Sung Jae Shin,Kee Myung Lee,Byung Moo Yoo,Kwang Jae Lee,Jin Hong Kim,Sung Won Cho,Jae Youn Cheong, 거트앤리버 소화기연관학회협의회 2019 Gut and Liver Vol.13 No.5

Background/Aims: Barcelona Clinic Liver Cancer (BCLC) C stage demonstrates considerable heterogeneity because it includes patients with either symptomatic tumors (performance status [PS], 1–2) or with an invasive tumoral pattern reflected by the presence of vascular invasion (VI) or extrahepatic spread (EHS). This study aimed to derive a more relevant staging system by modification of the BCLC system considering the prognostic implication of PS. Methods: A total of 7,501 subjects who were registered in the Korean multicenter hepatocellular carcinoma (HCC) registry database from 2008 to 2013 were analyzed. The relative goodness-of-fit between staging systems was compared using the Akaike information criterion (AIC) and integrated area under the curve (IAUC). Three modified BCLC (m-BCLC) systems (#1, #2, and #3) were devised by reducing the role of PS. Results: As a result, the BCLC C stage, which includes patients with PS 1-2 without VI/EHS, was reassigned to stage 0, A, or B according to their tumor burden in the m-BCLC #2 model. This model was identified as the most explanatory and desirable model for HCC staging by demonstrating the smallest AIC (AIC=70,088.01) and the largest IAUC (IAUC=0.722), while the original BCLC showed the largest AIC (AIC=70,697.17) and the smallest IAUC (IAUC=0.705). The m-BCLC #2 stage C was further subclassified into C1, C2, C3, and C4 according to the Child-Pugh score, PS, presence of EHS, and tumor extent. The C1 to C4 subgroups showed significantly different overall survival distribution between groups (p<0.001). Conclusions: An accurate and relevant staging system for patients with HCC was derived though modification of the BCLC system based on PS.

Improvement of Nonalcoholic Fatty Liver Disease Reduces the Risk of Type 2 Diabetes Mellitus

Hyo Jung Cho,Sunhyuk Hwang,Jong Ik Park,Min Jae Yang,Jae Chul Hwang,Byung Moo Yoo,Kee Myung Lee,Sung Jae Shin,Kwang Jae Lee,Jin Hong Kim,Jae Youn Cheong,,Sung Won Cho,Soon Sun Kim 거트앤리버 소화기연관학회협의회 2019 Gut and Liver Vol.13 No.4

Background/Aims: Little evidence is available about the effect of change in nonalcoholic fatty liver disease (NAFLD) status on risk of diabetes mellitus (DM) development. In this study, we tried to analyze the DM risk according to change in NAFLD status over time. Methods: Among a total of 10,141 individuals for whom routine healthcare assessment was performed, 2,726 subjects were selected according to the inclusion/exclusion criteria. NAFLD status change was determined by using serial abdominal ultrasonography and fatty liver index (FLI) during the follow-up period. Results: Subjects were categorized according to change in NAFLD status as follows: 670 subjects in the persistent NAFLD group, 155 subjects in the resolved NAFLD group, 498 subjects in the incident NAFLD group, and 1,403 subjects in the no NAFLD group. Multivariate Cox regression analysis revealed that incident NAFLD (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.08 to 3.50; p=0.026) and persistent NAFLD (HR, 3.59; 95% CI, 2.05 to 6.27; p<0.001) were independent risk factors for predicting DM development, whereas the risk with resolved NAFLD was not significantly different from that with no NAFLD. FLI could reproduce the results acquired by ultrasonography. Conclusions: This study demonstrated that future DM risk could be influenced by changes in NAFLD status over time. Resolution of NAFLD could reduce the risk of future DM development, while the development of new NAFLD could increase the risk of DM development.

Anti-obesity Effect of Komulkosiraegi [Gracilaria vermiculophylla (Ohmi) Papenfuss] Extract in 3T3-L1 Cells

Hyo-Min Kim,강성일,Hye-Sun Shin,Hee-Chul Ko,Youn-Suk Hong,Seung-Woo Kang,Sun-A Yoon,Jeong-Hwan Kim,김세재 한국식품과학회 2012 Food Science and Biotechnology Vol.21 No.1

The ingestion of edible seaweed has long been believed to be beneficial to human health due to its numerous biological actions. In the present study, the ethyl acetate fraction of a komulkosiraegi [Gracilaria vermiculophylla (Ohmi) Papenfuss] ethanol extract (GEFr) was found to potently inhibit adipogenesis of 3T3-L1 preadipocytes,decreasing triglycerol accumulation and the expression of peroxisome proliferator-activated receptor γ (PPARγ),members of the CCAAT/enhancer-binding protein (C/EBP) family, and fatty acid binding protein 2 (aP2). In mature adipocytes, GEFr was found to significantly activate AMP-activated protein kinase (AMPK) by activating liver kinase B1 (LKB1) and stimulating intracellular reactive oxygen species generation. The mRNA levels of genes involved in lipid catabolism were up-regulated. Also, GEFr increased lipolysis in a dose-dependent manner. Taken together, these results suggest that GEFr has potential for use in therapies designed to improve obesity.

Long-term efficacy of tenofovir disoproxil fumarate therapy after multiple nucleos(t)ide analogue failure in chronic hepatitis B patients

( Hyo Jin Kim ),( Ju Yeon Cho ),( Yu Jin Kim ),( Geum Youn Gwak ),( Yong Han Paik ),( Moon Seok Choi ),( Kwang Cheol Koh ),( Seung Woon Paik ),( Byung Chul Yoo ),( Joon Hyeok Lee ) 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.1

Background/Aims: The efficacy of tenofovir disoproxil fumarate (TDF) for the treatment of chronic hepatitis B (CHB) patients following prior treatment failure with multiple nucleos(t)ide analogues (NAs) is not well defined, especially in Asian populations. In this study we investigated the effi cacy and safety of TDF rescue therapy in CHB patients after multiple NA treatment failure. Methods: The study retrospectively analyzed 52 CHB patients who experienced failure with two or more NAs and who were switched to regimens containing TDF. The effi cacy and safety assessments included hepatitis B virus (HBV) DNA undetectability, hepatitis B envelop antigen (HBeAg) seroclearance, alanine transaminase (ALT) normalization and changes in serum creatinine and phosphorus levels. Results: The mean HBV DNA level at baseline was 5.4 ± 1.76 log10 IU/mL. At a median duration of 34.5 months of TDF treatment, the cumulative probabilities of achieving complete virological response (CVR) were 25.0%, 51.8%, 74.2%, and 96.7% at 6, 12, 24, and 48 months, respectively. HBeAg seroclearance occurred in seven of 48 patients (14.6%). ALT levels were normalized in 27 of 31 patients (87.1%) with elevated ALT at baseline. Lower levels of HBV DNA at baseline were signifi- cantly associated with increased CVR rates (p < 0.001). However, CVR rates did not differ between TDF monotherapy or combination therapy with other NAs, and were not affected by mutations associated with resistance to NAs. No significant adverse events were observed. Conclusions: TDF is an effi cient and safe rescue therapy for CHB patients after treatment failure with multiple NAs.

Chronological trends in patients undergoing cholecystectomy in Korea: a nationwide health insurance claims study

Chul Hyo Jeon,Jinwook Hong,Jaehun Jung,Jong Youn Moon,Ho Seok Seo 대한외과학회 2022 Annals of Surgical Treatment and Research(ASRT) Vol.102 No.4

Purpose: The incidence of gallstone disease and cholecystectomy is increasing worldwide. The aim of this study was to determine trends in the incidence of cholecystectomy in Korea. Methods: The National Health Insurance Services database was used to determine patterns in proportion of cholecystectomy and cholecystostomy in the total population of Korea from 2003 to 2017. The age-standardized rate (ASR) was calculated to compare the cholecystectomy and cholecystostomy according to changes in the population structure over time. The ASR was investigated according to patient age, sex, socioeconomic status, use of computed tomography, and type of hospital to identify trends. Results: The ASR per 100,000 based on the 2010 population of cholecystectomy cases increased markedly from 67.7 to 211.4 between 2003 and 2017. The ASR was consistently higher in female than male (71.9 vs. 63.6 in 2003, 221.8 vs. 201.8 in 2017). Furthermore, the ASR for cholecystectomy increased with age, and surgery for gallstone disease was performed more often at a specialized center than at other medical facilities. The length of hospital stay of cholecystectomy decreased steadily from 10.6 days in 2003 to 6.9 days in 2017. Conclusion: This study shows that the incidence of cholecystectomy and cholecystostomy has steadily increased over the years in Korea, with a trend toward older age and higher socioeconomic status in patients undergoing cholecystectomy. Increasing use of computed tomography investigations could be a primary cause for this trend. An integrated strategy is needed to manage the increase in older patients undergoing cholecystectomy and shorten their hospital stay with medical safety.

Electrohydrodynamic micropatterning of silver ink using near-field electrohydrodynamic jet printing with tilted-outlet nozzle

Youn, Doo-Hyeb,Kim, Seong-Hyun,Yang, Yong-Suk,Lim, Sang-Chul,Kim, Seong-Jin,Ahn, Su-Han,Sim, Hyo-Sun,Ryu, Seung-Myoung,Shin, Dong-Wook,Yoo, Ji-Beom Springer-Verlag 2009 APPLIED PHYSICS A MATERIALS SCIENCE AND PROCESSING Vol.96 No.4

Improvement of Nonalcoholic Fatty Liver Disease Reduc-es the Risk of Incidence of Type 2 Diabetes Mellitus

( Hyo Jung Cho ),( Gil Ho Lee ),( So Young Yoon ),( Min Jae Yang ),( Jae Chul Hwang ),( Jin Hong Kim ),( Jae Youn Cheong ),( Sung Won Cho ),( Soon Sun Kim ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: There is little evidence about the effect on risk of diabetes mellitus (DM) development according to change in nonalcoholic fatty liver disease (NAFLD) status over time. We attempted to analyze the DM risk according to change in NAFLD status. Methods: A total of 10,141 individuals for whom routine healthcare assessment was performed were reviewed, and 2,816 subjects were included. NAFLD was assessed using abdominal ultrasonography and fatty liver index. The included subjects were categorized into four groups according to changes in NAFLD status over time: persistent NAFLD, resolved NAFLD, incident NAFLD, and never NAFLD groups. Results: Subjects were categorized according to change in NAFLD status as follows: 702 subjects into the persistent NAFLD group, 157 subjects into the resolved NAFLD group, 505 subjects into the incident NAFLD group, and 1,452 subjects into the never NAFLD group. Multivariate Cox regression analysis revealed that in addition to old age, higher fasting plasma glucose, and higher alanine aminotransferase level, incident NAFLD (hazard ratio = 1.94, 95% confidence interval = 1.08-3.49, P=0.027) and persistent NAFLD (hazard ratio = 3.76, 95% confidence interval = 2.16-6.55, P<0.001) were independent risk factors for predicting DM development, whereas the risk of resolved NAFLD was not significantly different from that of never NAFLD. fatty liver index could reproduce the result acquired by ultrasonography. Conclusions: This study demonstrated that future DM risk could be influenced by changes in NAFLD status over time. Resolution of NAFLD could reduce the risk of future DM develop ment, while the development of new NAFLD could increase the risk of DM development.

Poster Session 1 : Inhibition of NF-kB-mediated pro-inflammatory gene expressions by Smad6

( Kyung Chul Choi ),( Hyo Kyong Choi ),( Youn Sook Lee ),( Eun Kyung Lee ),( Seok Hee Park ) 한국생화학분자생물학회 (구 한국생화학회) 2005 생화학분자생물학회 춘계학술발표논문집 Vol.2005 No.-