정신증의 인지행동치료

Kang Shi-Hyun 대한조현병학회 2022 대한조현병학회지 Vol.25 No.1

Cognitive behavioral therapy for psychosis (CBTp) is recommended by the National Treatment Guidelines in both the U.K. and the U.S. Consistent reports of moderate effect sizes have led to such interventions being suggested as part of routine clinical practice. However. Access to CBTp is poor due to a variety of factors, including training and resources. Therapeutic developments should be based on the theoretical understanding of cognitive models and psychological process associated with stress-vulnerability model. Cognitive models of psychosis incorporate the role of negative core beliefs, hypervigilance for threat, scanning for confirmatory evidence and safety behavior. The current evidence about CBTp is reviewed regarding various methods such as low-intensity of CBTp, different formats of therapy (e.g., individual or group), and phase of illness (e.g., acute or treatment-resistant) of subjects. This review suggests that that patients with psychosis with various disease phase need to be derived more benefit from appropriate adjunctive CBTp.

Genetic Polymorphisms in the HTR2C and Peroxisome Proliferator-Activated Receptors Are Not Associated with Metabolic Syndrome in Patients with Schizophrenia Taking Clozapine

Shi Hyun Kang,Jong Il Lee,An Kee Chang,Yeon Ho Joo,김창윤,김성윤 대한신경정신의학회 2011 PSYCHIATRY INVESTIGATION Vol.8 No.3

Objective Genetic variation in the serotonin-2C receptor encoded by the HTR2C gene is one of the genetic determinants of antipsychotic-induced weight gain. Peroxisome proliferator-activated receptors are nuclear receptors regulating the expression of genes involved in lipid and glucose metabolism. In this cross-sectional study, we investigated whether HTR2C-759C/T, HTR2C-697G/C, PPARα V227A, and PPARγ 161C/T genotypes were associated with metabolic syndrome (MetS) in patients with schizophrenia taking clozapine. Methods One hundred forty-six Korean patients using clozapine for more than one year were genotyped for the HTR2C-759C/T, HTR2C-697G/C, PPARα V227A, and PPARγ 161C/T polymorphisms, and their weight, waist circumference, blood pressure, triglycerides, high-density lipoprotein-cholesterol, total cholesterol, and glucose were measured. We used the criteria for MetS proposed by the National Cholesterol Education Program-adapted Adult Treatment Panel III. Results The prevalence of MetS was 47.3% and was similar among men (49%) and women (42.9%). We found no significant differences between patients with and without MetS in terms of genotypes or allele frequencies. Logistic regression analyses also revealed no association between MetS and each genotype. Conclusion We did not find significant associations between four polymorphisms (HTR2C-759C/T, HTR2C-697G/C, PPARα V227A, and PPARγ 161C/T) and MetS in patients with schizophrenia taking clozapine. Objective Genetic variation in the serotonin-2C receptor encoded by the HTR2C gene is one of the genetic determinants of antipsychotic-induced weight gain. Peroxisome proliferator-activated receptors are nuclear receptors regulating the expression of genes involved in lipid and glucose metabolism. In this cross-sectional study, we investigated whether HTR2C-759C/T, HTR2C-697G/C, PPARα V227A, and PPARγ 161C/T genotypes were associated with metabolic syndrome (MetS) in patients with schizophrenia taking clozapine. Methods One hundred forty-six Korean patients using clozapine for more than one year were genotyped for the HTR2C-759C/T, HTR2C-697G/C, PPARα V227A, and PPARγ 161C/T polymorphisms, and their weight, waist circumference, blood pressure, triglycerides, high-density lipoprotein-cholesterol, total cholesterol, and glucose were measured. We used the criteria for MetS proposed by the National Cholesterol Education Program-adapted Adult Treatment Panel III. Results The prevalence of MetS was 47.3% and was similar among men (49%) and women (42.9%). We found no significant differences between patients with and without MetS in terms of genotypes or allele frequencies. Logistic regression analyses also revealed no association between MetS and each genotype. Conclusion We did not find significant associations between four polymorphisms (HTR2C-759C/T, HTR2C-697G/C, PPARα V227A, and PPARγ 161C/T) and MetS in patients with schizophrenia taking clozapine.

살인 행동을 보인 정신분열병 환자에서 MMPI와 SCL-90-R 검사의 특징

강시현(Shi Hyun Kang),정석훈(Seockhoon Chung),정재열(Jaeyeul Jung),정혜윤(Hye Yoon Chung),성명제(Myung-Jae Sung),김민후(Min Hoo Kim),송해철(Hae-Cheol Song),권수희(Soo Hie Kwon),진영식(Young Sik Jin),백상빈(Sang-Bin Baek) 대한사회정신의학회 2005 사회정신의학 Vol.10 No.2

목 적: 공격성은 정신분열병 환자에게 나타나는 심각한 문제 중 하나이다. 공격성의 가장 극단적 형태인 살인 행동을 보인 정신분열병 환자들이 경험하는 주관적인 정신 증상 및 심리 상태의 특성을 알아보고자 본 연구를 시행하였다. 방 법: 살인 행동이 있었던 정신분열병 입원 환자(n=64)를 연구대상으로 하였고 살인 행동은 없었으며 실험군과 나이, 교육 연한, 항정신병 약물 용량을 짝짓기하여 선정한 정신분열병 입원 환자를 대조군(n=75)으로 선정하여 두 군간의 주관적 정신 증상 및 심리상태를 비교 연구하였다. 주관적 상태는 Minnesota Multiphasic Personality Inventory(MMPI)와 Symptom checklist-90-R(SCL-90-R)로 평가하였다. 살인 행동 환자군은 살인 행동 후 정신감정 시점에 검사된 MMPI와 SCL-90-R결과를 얻었다. 결 과: 살인 행동을 보인 환자군은 대조군에 비하여 MMPI와 SCL-90-R검사 모두에서 전반적으로 더 높은 점수를 받았다. MMPI 검사에서 우울증, 히스테리, 반사회성, 편집증, 내향성 척도가 살인 행동군에서 대조군에 비해 유의하게 높았다. SCL-90-R 검사에 서는 강박증, 대인관계 예민성, 불안, 편집증, 정신증 항목에서 살인 행동군에서 통계적으로 유의하게 높은 점수를 보였다. 결 론: 살인 행동을 보인 정신분열병 환자군은 주관적으로 사회적 상황에서 정서적으로 불안정하여 피해의식을 쉽게 느끼고 분노와 정감 조절이 어려울 때 인지적 왜곡에 부합하여 공격적 행동이 유발될 가능성이 있다. Objectives:Violence is a serious problem in some patients with schizophrenia. Homicide is one of the most extreme aggressive behavior. The purpose of this study was to investigate the characteristics of subjective symptomatology and psychological state of schizophrenia with homicidal behavior. Methods:Subjects were schizophrenia patients hospitalized in a mental hospital due to their homicidal behavior (n=64, group 1). Control subjects were schizophrenia patients without homicide also hospitalized in another mental hospital(n=75, group 2). Subjects were matched by age, years of education and dosage of antipsychotics. Minnesota Multiphasic Personality Inventory(MMPI) and Symptom checklist-90-R(SCL-90-R) were used to evaluate the subjective symptomatology. In group 1, the results of MMPI and SCL-90-R had been acquired following the incident that led to hospitalization. Results:Schizophrenia patients with homicide showed overall elevated MMPI clinical scales and SCL-90-R scales. The group with homicidal behavior had significantly higher scores than patients without homicidal behavior on the subscales of depression, hysteria, psychopathic deviance, paranoid, social introversion as assessed by the MMPI. They also had significantly higher scores on the subscales of obsessive-compulsive, interpersonal sensitivity, anxiety, paranoid ideation, psychoticism as assessed by the SCL-90-R. Conclusion:Schizophrenia patients with homicidal behavior did present different clinical subjective pictures : unstable emotion, more paranoid tendency, difficulty with control of anger, more perceptual disturbance. Under those subjective states they had a risk of violent behavior.

Inhibition of interleukin-12 and interferon-γ production in immune cells by tanshinones from Salvia miltiorrhiza

Kang, Bok Yun,Chung, Su Wol,Kim, Seung Hyun,Ryu, Shi Yong,Kim, Tae Sung 전남대학교 약품개발연구소 2000 약품개발연구지 Vol.9 No.1

Pharmacological control of interleukin-12 (IL-12) and interferon-gamma (IFN-γ) production may be a key therapeutic strategy for modulating immunological diseases dominated by Th1-derived cytokine response. In this study, we investigated the effects of three different tanshinone pigments from Solvia miltiorrhiza (tanshinone I, dihydrotanshinone, and cryptotanshinone) on IL-12 production in mouse macrophages and on IFN-γ production in lymph node cells. All tested tanshinones significantly inhibited IL-12 production in lipopolysaccharide (LPS)-activated macrophages and also IFN-γ production in keyhole limpet hemocyanin (KLH)-primed lymph node cells in a dose-dependent manner. Dihydrotanshinone was more effective than tanshinone I or cryptotanshinone. Tanshinones significantly inhibited the expression of IL-12 p40 gene at the mRNA level. Furthermore, tanshinones potently inhibited the promoter activation of IL-12 p40 gene and nuclear factor (NF)-κB binding to the κB site, suggesting that tanshinones may negatively regulate IL-12 production at the transcription level. These results may explain some known biological activities of tanshinones including their anti-inflammatory effect, and suggest a possible use of tanshinones in the treatment of immunological diseases dominated by Th1-derived cytokine responses.

Guided Bone Regeneration Effect by Chitosan/Hydroxyapatite Membrane on Repair of Rat Calvarial Defect

( Shi Hyun Lee ),( Bok Joo Kim ),( Sang Hun Shin ),( Hong Sung Kim ),( Kyu Cheon Kim ),( Cheol Hun Kim ),( Young Hoon Kang ),( Ji Bong Jo ) 한국조직공학·재생의학회 2009 조직공학과 재생의학 Vol.6 No.4

The synthetic scaffolds for bone augmentation fill the cavity, and act as a template for initial cell ingrowth and subsequent tissue formation. The desirable material as a scaffold need resorbable biomimetics, biocompatibility, mechanical stability, and cell viability. Hydroxyapatite is a synthetic calcium phosphate that resembles bone mineral. Its surface is highly reactive and favorable for attachment. Hydroxyapatite has properties such as biocompatibility, non-toxicity, osseoconductivity. And chitosan is one of the biodegradable polymers in nature. Chitosan has non-toxicity, flexibility, anti-bacterial effect, resistance to heat, and biocompatibility. Mixture of hydroxyapatite and chitosan promotes osteoblastic adhesion, migration, differentiation, and proliferation. This mixture were prepared for the function of guided bone regeneration(GBR). This study makes the chitosan/fibroin-hydroxyapatite composite membrane be a prospective biodegradable GBR membrane for future applications.

지연성 수면위상증후군 청소년에서 기상 시 어려움과 주간 졸림에 대한 Dawn Simulation 효과 연구

강시현,유한익,정석훈,왕희령,안준호,윤인영,김창윤 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Delayed sleep phase syndrome (DSPS) is characterized by difficulties in falling asleep and waking up at a desired time. Dawn simulation is a technique using a light that gradually increases in intensity before awakening in the morning, to imitate a natural sunrise. It has been found to be effective in decreasing both morning drowsiness and difficulty in awakening as well as treating symptoms of seasonal affective disorder. The aim of this study was to determine whether dawn simulation is helpful in decreasing difficulty in morning awakening and daytime sleepiness in adolescents with DSPS. Methods : Twelve adolescents with DSPS participated in a 2-week dawn simulation trial. Each subject self-assessed level of difficulty in awakening, morning drowsiness and daytime sleepiness during a 2-week baseline period and a following 2-week trial period with dawn simulator. Subjects used Stanford Sleepiness Scale (SSS) for measuring morning drowsiness and Epworth Sleepiness Scale (ESS) for measuring daytime sleepiness. Difficulty in awakening was assessed by a single-item questionnaire. Results : Dawn simulation trial decreased morning drowsiness (p=0.016) and daytime sleepiness (p=O.013) significantly compared to baseline. It also seemed to improve difficulty in awakening, but the effect was not statistically significant (p=0.092). Conclusion : Dawn simulation may help waking up in the morning and may improve daytime functioning by deceasing both morning drowsiness and daytime sleepiness in adolescents with DSPS.

Poster Session:PS 0528 ; Nephrology : Risk of Major Cardiovascular Events in the Incident Chronic Dialysis Patients: A Population-Based Study in Korea

( Hyun Wook Kim ),( Song Vogue Ahn ),( Shi Na Lee ),( Seung Jung Kim ),( Duk Hee Kang ),( Kyu Bok Choi ),( Dong Ryeol Ryu ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: To date, there has been no data on the detailed analyses for the incidences of major cardiovascular events in large-scale, Asian population-based cohort. Therefore, in this study, we approached these issues using the Korean Health Insurance Review and Assessment Service (HIRA) database. Methods: We analyzed eligible 30279 [22892 hemodialysis (HD) patients and 7387 peritoneal dialysis (HD) patients] incident chronic dialysis patients who were defi ned as starting dialysis therapy and remaining on that modality at least 3 months. The events were assessed by “major adverse cardiac (MACE) and cerebrovascular events” (“MACCE”). To estimate and to compare the incidence rate of each event, Poisson regression models and Cox proportional hazards models with the propensity score matching were used. Results: During median follow-up of 24.5 months, crude incidence rates of MACCE, MACE, all-cause mortality, non-fatal AMI, TVR, and non-fatal stroke were 182 (95% CI, 178-185), 138 (95% CI, 135-141), 116 (95% CI, 113-118), 18 (95% CI, 17-19), 17 (95% CI, 16-18), and 60 (95% CI, 58-62) per 1000 patient-years, respectively. When comparing all baseline covariate-adjusted relative risks of each end point between HD and PD patients, MACCE, MACE, all-cause mortality, non-fatal AMI, and TVR occurred signifi cantly more frequently in the patients on PD than in those on HD, whereas hemorrhagic subtype of non-fatal stroke was more frequent in the patients on HD than in those on PD. Conclusions: The results suggest that HD is overall superior to PD in terms of MACCE, as a composite end point, but analyzed by the separate end points, the comparison results are rather complex. The results of our study can help to give some basis for risk stratifi cation and customized care for major cardiovascular events in ESRD patients.

Detection of cerebral metabolites in a canine model of ischemic stroke using ¹H magnetic resonance spectroscopy

Kang, Byeong-Teck,Jang, Dong-Pyo,Lee, Jong-Hwan,Jung, Dong-In,Gu, Su-Hyun,Lim, Chae-Young,Kim, Young-Bo,Quan, Fu-Shi,Kim, Hyung-Joong,Woo, Eung-Je,Cho, Zang-Hee,Park, Hee-Myung Elsevier 2009 Research in veterinary science Vol.87 No.2

<P><B>Abstract</B></P><P>Proton magnetic resonance spectroscopy (<SUP>1</SUP>H MRS) provides <I>in vivo</I> biochemical information on tissue metabolites. The purpose of this study was to investigate the serial metabolic changes of <SUP>1</SUP>H MRS in the cerebrum of ischemic dogs. An ischemic stroke was induced in five health laboratory beagle dogs by permanent middle cerebral artery occlusion using a silicone plug. <SUP>1</SUP>H MRS was serially performed three times with a 1.5-T MR system: before, three days after and 10days after the stroke. Immunohistochemical staining was performed to determine the expression of neuronal nuclei (NeuN) and glial fibrillary acidic protein (GFAP) at both the ipsilateral and contralateral cerebral cortex. Reduced levels of <I>N</I>-acetyl-asparate (<I>p</I><0.05), choline (Cho), creatine (Cr) and myo-inositol (mI), and a marked increase in the lactate (Lac) level (<I>p</I><0.01) were found at three days after the stroke. At 10days after the stroke, the levels of Lac significantly increased (<I>p</I><0.01); however, the other metabolites were partially elevated. The changes of Cr, Cho and mI were not statistically significant (<I>p</I>>0.05) when the before and after stroke values were compared. There was a significant loss of NeuN and GFAP immunoreactivity at the ischemic core. <SUP>1</SUP>H MRS may be to a useful diagnostic tool for the evaluation of ischemic stroke in dogs.</P>

중 란탄족 산화물의 결합구조와 전기전도성

강영환,최재시,윤기현 연세대학교 대학원 1980 延世論叢 Vol.16 No.2

The electrical conductivity of highly pure polycrystalline Gd₂O₃, Ho₂O₃ and Yb₂O₃ has been measured from 650 to 1050℃ under oxygen pressure range of 10^(-6) to 10² torr. Plots of logσ vs. T at constant oxygen pressure are found to be linear. and the conductivity dependence of oxygen pressure in the high temperature region (750-1050℃) is approximated by σ α po₂1/5.3. This shows that the conduction mechanism is associated with doubly ionized metal vacancies. Fairly low activation energy and the lack of oxygen pressure dependence are found over the temperature range of 650 to 750℃. The conduction mechanism is explained by not metal vacancies, but hopping oxygen ions in the oxides. The sesquioxides exhibit mixed conduction with some ionic conduction and major electronic conduction carriers.

The effect of Cu flux variation on 3 stage process in the CIGS thin films

Hyun-Jun Jo,In-Ho Bae,Myoung-Kun Leem,Shi-Joon Sung,Jin-Kyu Kang,Dae-Hwan Kim 한국진공학회 2010 한국진공학회 학술발표회초록집 Vol.39 No.-