편집형 정신분열병 환자에서 뇌의 구조적 변화와 기능적 변화 : 뇌자기공명영상소견, 신경인지기능 및 정신증상간의 상관관계

강철민,이영호,정영조,이정흠,김수지,박현진,Kang, Cheol-Min,Lee, Young-Ho,Jung, Young-Jo,Lee, Jung-Heum,Kim, Su-Ji,Park, Hyun-Jin 대한수면의학회 1998 수면·정신생리 Vol.5 No.1

연구배경 : 본 연구는 정신분열병에서 뇌의 해부학적 변화가 있는가를 관찰하고 이런 변화와 인지기능, 신경학적변화, 임상증상과의 상관관계를 알아보기 위해 시도하였다. 방법 : 편집형 정신분열병 환자군 20명(남15, 여5)과 성별, 연령을 조합한 정상대조군 23명(남15, 여8)을 대상으로하여 뇌자기공명촬영의 면적측정을 하여 비교하였다. 또한 환자군을 대상으로 신경심리학적검사, 연성신경학적 증후, 그리고 임상증상을 평가하여 뇌자기 공명 촬영 측정치와 상관관계를 보았다. 결과 : 1) 정신분열병 환자군에서 대조군에 비해 모든 뇌설계와 기저핵의 크기가 유의하게 커져 있었으며, 통계적으로 유의하지는 않았으나 환자군에서 대조군에 비해 우측 전두엽이 작아져 있는 경향을 보였고(p=0.057), 좌측 측두엽의 크기가 환자군에서 작아져 있는 경향을 보였다(p=0.089). 2) 뇌실의 크기 증가가 이전의 입원 횟수의 증가와 정상관관계를 보였고(p<0.01), 이외에 다른 구조물에 대한 측정치와 임상적 요인들 사이에는 유의한 상관관계를 보이지 않았다. 3) 위스콘신 카드 분류검사 점수와 유의한 상관을 보인 구조물은 좌측 측두엽과 좌측 피각이었다. 이중 좌측 측두엽의 크기와 위스콘신 카드 분류 검사의 보속 오류검사 점수사이에는 정상관관계를 보였고(r=0.5636, p<0.05), 피각은 역상관관계를 보였다.(r=-0.5733, p<0.01). 대조군과의 유의한 차이를 보였던 구조물 중 웩슬러 지능검사 점수와 유의한 상관을 보이는 구조물은 하나도 없었고, 좌측 편도(r=0.5727, p<0.05)와 좌측 피각(r=0.4686, p<0.05) 이 각각 언어성 지능 점수와 정상관관계를 보여 주었다. 벤톤 신경심리검사의 유의한 상관을 보여 주었던 구조물은 우측 전두엽과 좌측 편도이었다. 이외에 좌우측 측두엽은 촉각형태 지각 검사 점수(각각 r=0.4998, p<0.05; r=0.5018, p<0.05)와 유의한 정상관관계를 보였고 좌우측 미상핵(각각 r=0.4611, p<0.05; r=0.4726, p<0.05) 및 좌측 피각(r=0.5370, p<0.05)은 직선지남력 검사와 유의한 정상관관계를 보였다. 이상에서 뇌실 측정치는 어떠한 신경심리 검사와도 유의한 상관을 보이지 않았다. 4) 우측 전두엽의 크기가 작을수록 연성 신경학적 징후 총점수도 높은 경향을 보였으며(r=-0.6174, p<0.01), 복합적 연성 신경학적 징후 점수와 유의한 상관을 보이는 구조물은 좌우측 편도(r=-0.4548, p<0.05; r=-0.4597, p<0.05)와 우측 담창구(r=- 0.4646, p<0.05) 이었다. 뇌실 측정치는 연성 신경학적 징후와 유의한 상관을 보이지 않았다. 5) 우측 측두엽은 간이정신상태 검사상의 양성 증상 척도 점수와 역 상관관계를(r=-0.4483, p<0.05) 보였고 좌측 해마는 양성 및 음성 증상척도의 양성 증상점수(r=0.5028, p<0.05)와 일반증상점수(r= 0.5696, p<0.01) 및 간이 정신상태 검사의 총점수(r=0.6050, p<0.01)와 유의한 정상관관계를 보였다. 이외에 우측 측뇌실의 측두각은 간이 정신상태 검사 상의 양성증상과 유의한 정상관관계를(r=0.4729, p<0.05) 를 보였다. 기저핵중에서는 우측 담창구가 양성 및 음성 증상 척도의 음성 증상 점수(r=-0.6062, p<0.01), 간이 정신상태 검사상의 음성 증상 척도(r=-0.5016, p<0.05) 와 유의한 역상관관계를 보였고 좌측 담창구가 간이 정신상태 검사상의 음성 증상 척도 (r=-0.4683, p<0.05) 와 유의한 역상관관계를 보였다. 결론 : 이상과 같은 결과를 통해 정신분열병 환자에서 뇌의 구조 변화는 임상적 경과에 따른 변화인 뇌실 확장 및 뇌의 신경발달학적 이상에 기인하는 기저핵의 증가, 우 Objectives : The purpose of this study is to evaluate the role of structural and functional changes of the brain in the pathophysiology of schizophrenia. Methods : The authors measured the regions of interest on the magnetic resonance imaging of the brain in 20 patients with paranoid schizophrenia(15 men and 5 women) and 23 control subjects(15 men and 8 women). We also assessed the neurocognitive functions with the Wisconsin Card Sorting Test, the Benton Neuropsychological Assessment, and the Weschler IQ test-Korean version, soft neurologic signs, and psychiatric symptoms in the patient group. Results : In the patient group, all ventricles and basal ganglia including caudate nucleus and globus pallidus were significantly enlarged. Although there were no significant differences between the two groups in the values of right frontal lobe and left temporal lobe, there was a tendency of decrease in the values of right frontal lobe and left temporal lobe. There were significant positive correlations between the values of ventricles and the frequency of previous hospitalization. However, there were no significant correlations between other values of regions of interest and clinical data. The value of the right frontal lobe was significantly correlated with the score of soft neurologic signs, which is suggestive of the neurodevelopmental abnormalities. There were significant correlations between the value of frontal lobe and the scores of the various subscales of Benton Neuropsychiatric Inventory. In contrast, the value of left amygdala and putamen showed significant correlation with the score of verbal IQ on the Weschler IQ test. Structural changes of the temporal lobe areas were related with the positive and general symptom scores on PANSS, while those of the basal ganglia were related with the negative symptom scores. Conclusions : These results suggest that the structural changes of the brain in the patients with schizophrenia show the dual process, which is suggestive that the enlarged ventricle show the neurodegenerative process, while enlarged basal ganglia, and shrinked right frontal and left temporal lobe show the neurodevelopmental abnormalities. Among these changes, structural changes of the frontal lobe related with various neuropsychological deficits, while those of left temporal lobe related with language abnormality. Relative to the relation between structural changes and psychiatric symptoms, structural changes of the temporal lobe areas were related with the positive and general symptoms, while those of the basal ganglia were related with the negative symptoms.

GABA와 Benzodiazepine 수용체 및 그 기능

정영조,한기석 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.3

GABA is ubiquitously distributed throughout the CNS. It is probably the major central inhibitory aminoacid neurotransmitter which hyperpolarizes the postsynapic neurons and inhibits the release of neurotransmitters. Generally inhibition of GABA activity causes excitation leading to anxiety and convulsions, whereas activation of its activity causes antiexpressive. anticonvulsive activity and sedation. The GABA receptors have been divided into two distinct groups named GABA(A) and GABA(B) receptors by their pharmacological and physiological properties. GABA(A) receptors are coupled with Bz binding site and that in conjunction with a CI­ channel they form a supramolecular receptor complex which mediates rapid increasing of CI­ influx into postsynaptic neurons. thus contributing to the prompt inhibition of cellular excitability. On the contrary, the GABA(B) receptor does not contain an integral ion channel and is responsible for slow responses through receptor-G protein-effector complexes. GABA(B) receptors appear to be localized on presynaptic nerve terminals and stimulation of presynaptic GABA(B) receptors reduced Ca²+ influx, resulting in decreased release of neurotransmitters. Stimulation of presynaptic GABA(B) receptors increases K efflux, resulting in inhibition of cell firing. A division of function among the two types of GABA receptors appears to exist : GABA(A) receptor complex mediates anxiety, anticonvulsive activity and feeding, GABA(B) receptors, on the other hand, are involved in depression and analgesia. In those cases where GABA(A) and GABA(B) receptors mediate similar functions (e.g., cardiovascular regulation), they do so by affecting different transmitter systems and cellular mechanisms. The putative involvement of GABA(A) and GABA(B) receptors in various behavioral and physiological effects is summarized in Table 3. There are two types of Bz receptors in brain which are central and peripheral type Bz receptors. Central Bz receptors are in many regions of the brain, coupled with the receptors for GABA and they mediate the acute actions of Bz in CNS. Although there is general acceptance that Bz evert their major actions via the GABA(A) receptor, more recent studies suggest that other systems may be involved. In addition, endogenous anxiogenic ligands that interact with Bz receptors in several ways have been discovered, which of these,β-carbolines and DBI may produce anxiety and convulsion in human, The recent investigation of endogenous ligands and specific receptor agonist or antagonist and inverse agonist provide important new conceptual tools for the studies of anxiety and depression mechanisms. It is expected that a better understanding of GABA and Bz receptors will eventually help to demonstrate the biology of anxiety and depression.

다문화 가족 한국인 남편의 결혼생활 커미트먼트와 가족관계 지속의사의 관계

정영조,박지선,윤정수,김정숙,나카즈마 카즈오 사단법인 한국민족연구원 2013 민족연구 Vol.0 No.55

The purpose of this research is to find out the relationship between the marriage commitment of a multi-cultural family's Korean husband to his married life and the intention to continue his family relations so that we may obtain basic data necessary to give social support to multi-cultural families. The research subjects were 885 Korean husbands of marriage immigrant women who were using multi-cultural family support centers located in A and B provinces. The investigated items consisted of the basic personal information of Korean husband and immigrant wife, each Korean husband's marriage commitment to his married life and the intention to continue his family relations. For statistical analysis, the data of 407 subjects who had given answers to all the items out of the total collected data of the 495 subjects was used. The analysis result shows that, in case of Korean husbands' intention to continue their family relations, affective commitment and behavioral commitment that are subordinate concepts of attitudinal commitment had a statistically significant relation. It was also confirmed that affective commitment had influence on . Korean husbands' intention to cotinue their family relations was explained by 46.3%, while were explained by 47.2%. This result academically practically implies that it is necessary to strengthen and develop programs related to improving married life commitment and of the husband and the wife of a multi-cultural family through the functions of multi-cultural family support centers.

Cell/Microparticle Hybrid Spheroid System for Cell Survival and Osteogenic Differentiation

정영조,김민지,이진호,오세행 한국고분자학회 2019 한국고분자학회 학술대회 연구논문 초록집 Vol.44 No.2

우울증환자의 신체증상에 관한 연구

정영조 최신의학사 1982 最新醫學 Vol.25 No.6

판매자간 경쟁과 구매자간 경쟁을 고려한 온라인 마켓플레이스의 수수료 구조 분석

정영조(Young-Jo Jung),장대철(Dae-Chul Jang),안병훈(Byong-Hun Ann) 한국경영과학회 2009 韓國經營科學會誌 Vol.34 No.1

An online marketplace, such as eBay, is an example of two-sided markets. In online marketplaces, there are transactions between sellers and buyers and direct competition effects among sellers and among buyers. Previous research on two-sided market has not handle these competition effects and mostly focused on indirect network externalities between sellers and buyers. We analyze the fee structure of an online marketplace considering direct competition effects among sellers and among buyers. We find that when fees for sellers and buyers can be imposed, an auction or fixed-pricing rule can be chosen according to the characteristics of a product traded. But when only fees for sellers can be imposed, an auction can be taken as a trading mechanism solely.

應急室을 通한 精神科 入院患者에 關한 臨床的 考察 : 應急室 入院및 外來入院의 比較考察을 中心으로 A Comparative Study of Cases Via E.R. with those Via O.P.D.

鄭榮照 최신의학사 1979 最新醫學 Vol.22 No.5

당뇨성 신경병환자들에서 우울증상

정영조,이영호,한기석,권오영,임경호,Chung, Young-Cho,Lee, Young-Ho,Han, Ki-Seok,Kwon, Oh-Young,Lim, Kyung-Ho 한국정신신체의학회 1993 정신신체의학 Vol.1 No.1

Before studying the effectiveness of amitriptyline in alleviating the pain of diabetic neuropathy, this study was designed to compare the severity and nature of depressive symtoms of diabetic patients with neuropathy with those of diabetic patients without neuropathy and patients with somatoform disorder whose complaints were mainly somatic pain, respectively. The authors administered Beck Depression Inventory(BDI) to the three groups of patients. The mean total scores of BDI were relatively low in all groups and not significantly different among the three groups. The mean scores of four subscales of BDI were also not significantly different among the three groups. These results might suggest that the pain of diabetic neuropathy did not influence on the severity and the nature of depressive symptoms of preexisting diabetes.

Gamma Knife Radiosurgery for Brain Metastases in Patients Harboring Four or More Lesions : Survival and Prognostic Factors

정영조,이정일,임용석,남도현,박관,김종현 대한신경외과학회 2004 Journal of Korean neurosurgical society Vol.36 No.3

Objective : This study is performed to evaluate the role of gamma knife radiosurgery(GKS) for treatment of patients with large number of metastatic brain lesions. Methods : The authors retrospectively reviewed the clinical outcome of 99 patients who underwent 124 GKS procedures for a total of 564 metastatic lesions. Sixty-three patients presented with 1 to 3 lesions (group A) and 36 patients presented with 4 or more lesions (group B) at initial GKS. The authors assessed survival according to a variety of possible prognostic factors. Results : Median survival from the GKS for all cases was 28 weeks. The recursive partitioning analysis (RPA) class (p<0.0001) and the total tumor volume (p=0.0174) were significant factors influencing survival. The number of lesions, whole brain radiotherapy, primary tumor site, age, and sex were not significant. Median survival of group A (28 weeks) was not different from that of group B (28 weeks) (p=0.4027). Median survival was 66, 28, and 13 weeks for RPA class I, II, and III respectively in group A and 44, 36, and 11 weeks in group B. Conclusion : It is suggested that GKS provides a survival gain even in patients with a large number (4 or more) of metastatic lesions. Concerning the survival and the selection of patients for radiosurgery, RPA class and the total tumor volume should be considered as more important factors than the number of lesions. Multiplicity of the lesions alone should not be a factor for contraindication of radiosurgery.

알쯔하이머 질환의 신경생물학

정영조,서승우,이승환,Chung, Young-Cho,Seo, Seung-Woo,Lee, Seung-Hwan 대한생물정신의학회 2001 생물정신의학 Vol.8 No.1

Alzheimer's disease(AD) is associated with a characteristic neuropathology. The major hallmarks of AD are senile plaques (SPs) and neurofibrillary tangles(NFTs). ${\beta}$-amyloid protein($A{\beta}$) is derived from the proteolysis of amyloid precursor protein(APP) and then converted to SPs. Mature SPs produce cytotoxicity through direct toxic effects and activation of microglia and complement. NFTs are composed of paired helical filaments(PHFs) including abnormally phosphorylated form of the microtubule-associated protein(MAP) tau and increased tau level in cerebrospinal fluid may be observed in most AD. The aggregation of $A{\beta}$ and tau formation are thought to be a final common pathway of AD. Acetylcholine, dopamine, serotonin, GABA and their receptors are associated with AD. Especially, decreased nicotinic acetylcholine receptors(nAChRs) in AD are reported. Genetic lesions associated with AD are mutations in the structural genes for the APP located on chromosome 21, presenilin(PSN)1 located on chromosome 14 and PSN2 located on chromosome 1. Also, trisomy 21, Apo-E gene located on chromosome 19, PMF locus, low density lipoprotein receptor-related protein and ${\alpha}$-macroglobulin increase risk of AD. In this article, we will review about the neurobiology of AD and some newly developed research areas.