急性精神分裂障碍患者의 Haloperidol 治療時 臨床 好轉度와 血中 Prolactin 濃度의 關係

김성윤,주진형,우종인 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.2

저자들은 혈청 PRL농도가 급성 정신증에서의 haloperidol의 치료 반응에 대한 지표로서 임상적으로 이용가능한가를 규명하기 위하여 22명(남자 4, 여자 7)의 초발 정신분열양장애 환자들을 대상으로 하여 이 중 10명의 남자 환자군에 대해서는 11명의 남자 대조군과 기저 혈청 PRL치의 비교를 하였고 경구 haloperidol 치료를 받은 11명(남자 4, 여자 7)에 대해서는 치료전과 4주째의 혈청 PRL치와 haloperidol의 혈중 농도를 측정하고 동시에 Positive and Negative Syndrome Scale(PANSS)로 정신병리를 평가하였다. 결과는 다음과 같다. 1) 남자 환자군 10명의 치료전 혈청 PRL치는 정상 대조군의 혈청 PRL치와 유의한 차이를 보이지 않았다. 환자군에서 치료 개시전 PANSS로 측정한 정신상태 중 음성증상 subscale만이 혈청 PRL치와 유의한 상관관계(r=0.6636, p<0.05)를 보였다. 2) 4주간의 치료후 PANSS 점수 변화율은 기초 및 4주째의 혈청 PRL치와 유의한 상관관계를 보이지 않았고 PRL치의 변화율 및 변화치와도 유의한 상관관계를 보이지 않았다. 3) 4주간의 HALOPERIDOL 치료를 통해 PANSS 전체 점수는 유의한 감소를 보였으며(p<0.05), 양성증상(p<0.05)과 일반정신병리(p<0.05) subscale 점수상에서도 유의한 감소를 보였다. 혈청 PRL치도 기초 측정치에 비하여 4주째 혈청 PRL치, PRL치의 변화율 또는 변화치와 통계적으로 유의한 상관관계를 보이지 않았다. Objects : The authors investigated to evaluated the clinical utillity of serum prolactin(PRL) level as a therapeutic index of haloperidol treatment for acute psychotic patients. Methods : 22 patients(10 males, 12 females) first-onset schizophreniform disorder were studied. Among them 10 male patients' baseline PRL levels were compared to those of 11 agematched male volunteers and 11 patients who were treated with oral haloperidol(4 males, 7 females) were studied by measuring baseline and 4the week levels of serum PRL and haloperidol and administering Positive and Negative Syndrome Scale(PANSS) concurrently. Results : 1) The serum PRL level of 10 male patients showed no statistical difference from 11 healthy males. Only the patients' pre-treatment PANSS negative subscale score had significant correlation with the baseline serum PRL level. 2) Percentage of PANSS score change didn't show significant correlation with the baseline and 4th-week serum PRL level nor with amount and percentage of serum PRL level change. 3) The total PANSS score decreased significantly after 4 week treatment with haloperidol s well as positive symptoms subscale and general psychopathology(all, p<0.05), and 4th-week serum PRL level significantly increased(p<0.01) compared with the baseline. 4) The 4th-weeks plasma haloperidol level didn't show correlation with serum PRL level nor with amount and percentage of serum PRL level change. Conclusions : The findings suggest that serum PRL level has limitation for use as therapeutic index of haloperidol treatment for acute psychotic patients.

No Evidence of Association of Interleukin 1A (-889) Genetic Polymorphism with Alzheimer's Disease in Koreans

Jhoo, Jin Hyeong,Park, Woong Yang,Kim, Ki Woong,Lee, Kwang Hyuk,Lee, Dong Young,Youn, Jong Chul,Suh, Young Ju,Seo, Jeong-Sun,Woo, Jong Inn Korea Genome Organization 2004 Genomics & informatics Vol.2 No.2

To examine whether the IL-1A (-889) polymorphism associates with a risk for Alzheimer's disease (AD) and acts interactively with the apolipoprotein (APOE) $\epsilon$4 in the development of AD, we performed genotype analyses of the IL-1A and the APOE of the 102 Korean AD patients and 200 Korean non-demented controls. We failed to detect a significant difference in genotypic and allelic frequencies of IL-1A between the AD group and control group. No overexpression of the IL-1A C/T genotype and IL-1A T allele was found when we analyzed the late-onset and early-onset patients, separately. There was no significant genetic interaction between IL-1A polymorphism and the APOE polymorphism. I n conclusion, the IL-1A polymorphism did not contribute to the development of AD independently or interactively with the APOE $\epsilon$4 allele in Koreans.

노화, 치매 그리고 건축

朱鎭亨(Jhoo Jin-Hyeong) 대한건축학회 2006 建築 Vol.50 No.11

두 가지 한글판 간이정신상태평가(Mini-Mental State Examination)의 비교 : MMSE-KC와 K-MMSE

주진형,김기웅,이동영,윤종철,이태주,추일한,고혜정,서은현,우종인 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.1

Objectives : We compared the scores of the MMSE-KC (Korean version of MMSE in the Korean version of CERAD As-sessment Packet) and K-MMSE (Korean MMSE), and analyzed the influences of age, gender, and educational level on the differences between the two. Methods : We administered the MMSE-KC and K-MMSE simultaneously along with geriatric depression scale (GDS-K) to 733 community-dwelling elderly aged 50 or over in three districts of Suwon. The differences between the MMSE-KC scores and K-MMSE scores were examined by repeated measure ANOVA computing the MMSE for intra-individual factor, age, gender, and educational level as inter-individual factor, and GDS-K score as a covariate. Results : The scores of MMSE-KC and K-MMSE were identical only in the 17.8% of the subjects and the difference between the MMSE-KC score and K-MMSE score were significantly influenced by the educational level of the subjects (F (3,173) =8.21, p<0.001). The MMSE-KC score was higher than the K-MMSE score in illiterate subjects, and lower than the K-MMSE score in literate or educated subjects. Although the main effect of the kind of MMSE was not significant in total MMSE scores (F (1,731)=0.91, p>0.1), it was highly significant in 'judgement and writing/reading' subscores (F (1,731)=16.35, P<0.001) and its influences were significantly varied by the educational level of the subjects (F (1,731) =20.82, P<0.001). Conclusion : The MMSE-KC and K-MMSE which were standardized differently are not identical in scores as well as in content, and the difference between the two is greatly influenced by the educational level of the subject. When interpreting or comparing the MMSE scores of the two different versions of Korean MMSE, the comparability of the scores among them observed in this study should be considered.

Retraction to “Korean Version of Mini Mental Status Examination for Dementia Screening and Its Short Form”

Kim Tae Hui,Jhoo Jin Hyeong,Park Joon Hyuk,Kim Jeong Lan,Ryu Seung Ho,Moon Seok Woo,Choo Il Han,Lee Dong Woo,Yoon Jong Chul,Do Yeon Ja,Lee Seok Bum,Kim Moon Doo,Kim Ki Woong 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.2

Influence of Sensory Impairments on Incidence of Dementia in the Korean Population

Oh Gyu han,Jhoo Jin Hyeong,Park Sang-a,Jang Jae-Won,Kim Yeshin,Choe Young Min,Byeon Gihwan 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.6

Objective Previous studies have shown the influence of visual and auditory sensory impairment on dementia incidence. In this study, we tested the hypothesis that the incidence of dementia will increase with visual and auditory impairments than with visual or auditory impairment.Methods Data from the Korea National Health Insurance Service database were used, including disease and medication codes from 2009 to 2018, and the 2011 national health check-up results. Participants were grouped based on their sensory abilities: normal, visual impairment, auditory impairment, and both visual and auditory impairments (dual sensory impairment). To compare the incidence of dementia, hazard ratios were calculated for each group, with reference to the normal sensory (NS) group. Sensitivity analyses were performed comparing dementia incidence from 2014 to 2018, excluding the onset of the disease in 2012 and 2013.Results We identified 8,289 cases of dementia during the seven-year follow-up. In the multiple Cox regression analysis, adjusted for sex, social economic status, age, comorbidities, smoking, alcohol consumption, and activity level, the auditory impairment (hazard ratio= 1.1908) and visual impairment (hazard ratio=1.3553) groups showed a significantly higher dementia incidence than the NS group. Dual sensory impairment (hazard ratio=1.5267) showed the highest incidence. The sensitivity analysis yielded similar results.Conclusion Visual and auditory impairments are associated with an increased risk of dementia, particularly in individuals with dual sensory impairment. Hence, visual and auditory impairments might have increased the risk of dementia through independent pathological processes. Therefore, preventing and correcting sensory impairment is necessary to reduce the risk of dementia.

Anxiety Symptoms are Associated with Progression to Dementia in Patients with Amyloid-Positive Mild Cognitive Impairment

Hee seok Kim,Jin Hyeong Jhoo,Jae Won Jang 대한노인정신의학회 2018 노인정신의학 Vol.22 No.2

Objective:Anxiety is prevalent in patients with mild cognitive impairment (MCI) and are considered to be a risk factor for conversion to dementia. The purpose of this study was to evaluate whether Anxiety symptoms in MCI promote disease progression in a manner related to amyloid status, and to determine the relationship between anxiety symptoms and longitudinal cerebral structural changes. Methods:Baseline data for 230 patients with amyloid-positive MCI (52 with anxiety and 178 without) from the Alzheimer’s Disease Neuroimaging Initiative study were analyzed. All participants underwent comprehensive cognitive testing, volumetric MRI, and [18F]AV45 positron emission tomography amyloid imaging. Anxiety symptoms were measured using the Neuropsychiatric Inventory Questionnaire. A voxel-based morphometric analysis using volumetric brain MRI data was used to compare longitudinal structural changes related to anxiety symptoms. Results:The conversion rate to dementia was different between patients with and without anxiety in amyloid-positive MCI (37.7% vs. 16.1%, respectively ; p=0.001). Anxiety in amyloid-positive MCI was associated with longitudinal cortical atrophy in the left superior temporal gyrus, left Heschl’s gyrus, left parahippocampal gyrus, left anterior cingulum, bilateral anterior cingulum and right superior orbital gyrus. Conclusion:Our study indicates that the presence of anxiety in patients with amyloid-positive MCI is associated with higher conversion to dementia and longitudinal cortical atrophy.

한국어판 중증간이정신상태평가의 신뢰도와 타당도

박준혁,최진영,윤종철,이원혜,정지운,도연자,최은애,이석범,주진형,이동영,김기웅 대한신경정신의학회 2008 신경정신의학 Vol.47 No.2

Objectives : We developed the Korean version of Severe Mini-Mental Status Examination (SMMSE-K) which is a brief cognitive test for the severely demented patients. Methods : The translation was carried out keeping the basic structure of the English version Severe Mini-Mental Status Examination (SMMSE). The SMMSE-K, Korean version of Mini Mental State Examination (MMSE-KC), and Clinical Dementia Rating (CDR) were administered to 84 Alzheimer's disease (AD) patients and 36 cognitively normal elderly subjects. For evaluating the reliability of the SMMSE-K, Cronbach alpha coefficient, inter-rater reliability, and test-retest reliability were examined. For confirming the validity of the SMMSE-K, the correlations of the SMMSE-K with MMSE-KC and CDR were examined, and factor analysis was performed using principal component analysis with Varimax rotation. Results : SMMSE-K was found to have a high internal consistency (Cronbach alpha coefficient=0.906, P<0.01), inter-rater reliability (Pearson correlation coefficient=0.980, P<0.01) and test-retest reliability (Pearson correlation coefficient= 0.940, p<0.01). Performances on the SMMSE-K and MMSE-KC were found to correlate significantly in the subjects with CDR of 2 (Pearson correlation coefficient=0.827, P<0.001) and 3 (Pearson correlation coefficient= 0.929, P<0.001). In the subjects with CDR of 3, the MMSE-KC showed a floor effect (2.93±3.21), whereas the SMMSE-K did not (11.00±8.48). Exploratoiy factor analysis yielded two factors (automatic informational processing, controlled informational processing) accounting for 76.1% of the total variance. Conclusion : The SMMSE-K was found to be a reliable and valid test for assessing the cognition of severely demented patients.

A Preliminary Study on the Potential Protective Role of the Antioxidative Stress Markers of Cognitive Impairment: Glutathione and Glutathione Reductase

Sang-a Park,Gihwan Byeon,Jin Hyeong Jhoo,Hyung-Chun Kim,Myoung-Nam Lim,Jae-Won Jang,Jong Bin Bae,Ji Won Han,Tae Hui Kim,Kyung Phil Kwak,Bong Jo Kim,Shin Gyeom Kim,Jeong Lan Kim,Seok Woo Moon,Joon Hyuk 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.4

Objective: To investigate the relationship between reduced glutathione (GSH), a key molecule of the antioxidant defense system in the blood, and glutathione reductase (GR), which reduces oxidized glutathione (glutathione disulfide [GSSG]) to GSH and maintains the redox balance, with the prevalence of Alzheimer’s dementia and cognitive decline. Methods: In all, 20 participants with Alzheimer’s dementia who completed the third follow-up clinical evaluation over 6 years were selected, and 20 participants with normal cognition were selected after age and sex matching. The GSH and GR concentrations were the independent variables. Clinical diagnosis and neurocognitive test scores were the dependent variables indicating cognitive status. Results: The higher the level of GR, the greater the possibility of having normal cognition than of developing Alzheimer’s dementia. Additionally, the higher the level of GR, the higher the neurocognitive test scores. However, this association was not significant for GSH. After 6 years, the conversion rate from normal cognition to cognitive impairment was significantly higher in the lower 50th percentile of the GR group than in the upper 50th percentile. Conclusion: The higher the GR, the lower the prevalence of Alzheimer’s dementia and incidence of cognitive impairment and the higher the cognitive test scores. Therefore, GR is a potential protective biomarker against Alzheimer’s dementia and cognitive decline.

경도인지손상 환자에서 야간수면과 전두엽기능의 연관성

김성재,정재석,주진형,이정희 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.3

Objectives : Nocturnal sleep disruption has been considered as a risk factor for cognitive impairment in the elderly. And the frontal lobe dysfunction was suggested to predict the progression to dementia. We aimed to illustrate the relationship of nocturnal sleep with frontal lobe function in mild cognitive impairment (MCI) patients. Methods : Thirty MCI patients and 30 age- and sex-matched normal control (NC) subjects were selected. Frontal lobe function tests including Stroop Test, Similarity Test, Digit Span Test (DST), and Benton Visual Retention Test (BVRT) were administrated. Nocturnal polysomnography was done for each subject. Results : There was no significant difference in the sleep parameters and diagnostic distributions of sleep disorders between the MCI and NC groups. In MCI patients, the mean hypopnea index (HI) of the ApoE4 positive group was higher than that of ApoE4 negative group. In the NC group, the wake time after sleep onset (WASO) was negatively correlated with the DST score (r=-0.545). In the MCI group, WASO tended to be negatively correlated with the Similarity Test score (r=-0.376, p=0.053), and slow wave sleep amount (SWS) was negatively correlated with the error score of BVRT(r=-0.489). Conclusion : Although there was no difference in the sleep quality and frequency of SAS between the MCI and NC groups, the severity of SDB was higher in MCI patients with ApoE4 compared to those without ApoE4. In the MCI group, the difficulty in maintaining sleep was associated with decreased executive function, and the decreased SWS was associated with impaired working memory. The relationship of nocturnal sleep with the frontal lobe function in MCI patients appears to be different from that of normal elderly subjects.