정신분열병과 22번 염색체 인터루킨-2 수용체 β-chain 유전자의 연관성

김용구,이민수,김 인,곽동일,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.3

연구배경 : 정신분열병이 유전적이라고 제시하는 많은 역학 연구와 유전자 연구에도 불구하고, 이 질환의 유전방식과 질병유전자는 밝혀져 있지 않다. 본 연구에서는 정신분열병과 22번 염색체 장완의 11.2-12부위에 위치한 Interleukin-2수용체 β chain 유전자간에 유전적 연합을 조사하고자 정신분열병 환자 93명과 정상대조군 97명 대상으로 중합효소연쇄반응을 이용하여 Interleukin-2 수용체 β chain (IL-2Rβ) 유전자의 다형성 분포를 조사하였다. 연구방법 : 환자군은 DSM-Ⅲ-R 진단기준에 따라 임상아형(망상형, 붕괴형, 미붕괴형, 잔류형)으로 분류하였다. 음성 및 양성 정신분열병으로 분류하기위해 Positive and Negative Syndrome Scale(PANSS)을 사용하였다. Genomic DNA를 전혈 임파구에서 추출한 후, IL-2Rβ 유전자좌를 분석하기 위해 dinucleotide(GT)n 염기배열순서를 중합효소연쇄반응을 이용하여 증폭시켰다. 연구결과 : IL-1Rβ의 대립유전자는 모두 8가지 종류이고, guanine-thymine의 반복된 149 염기쌍을 시작으로 151, 153, 155, 157, 159, 161, 163 염기쌍의 형태를 보였다. 정신분열병 환자군과 정상대조군간에 도형접합체 및 이형접합체 빈도의 유의한 차이는 없었다. 환자군과 정상대조군의 대립유전자 분포의 빈도는 통계적으로 유의한 차이가 없었다. 더욱이 각각의 대립유전자 분포에서도 양군간 유의한 차이는 없었다. 또한 동질의 아형으로 분류해 보기위해 임상아형, 양성 및 음성증상군, 가족력의 유무에 따라 비교적 동질적인 표현형을 가진 집단으로 나눈 후 대립유전자 분포를 비교해 보았으나 통계적으로 유의한 차이를 보이지 않았다. 결 론 : 본 연구에서는 Interleukin-2 수용체 β chain 유전자가 정신분열병의 병인론에 관련된다는 가설을 지지할 만한 긍정적 소견을 얻지 못했다. Background : While a significant genetic predisposition to schizophrenia has been proposed, the mode of inheritance or nature of etiological factors is unknown. Previous reports of a genome-wide survey for schizophrenia susceptibility genes have indicated a possible region of linkage on chromosome 22. In order to test the possibility that the interleukin-2 receptor β chain(IL-2Rβ) gene on chromosome 22 is of etiological importance in schizophrenia, a case-control association study was conducted. Methods : Subjects were ninety-three schizophrenic patients with a diagnosis of schizophrenia by DSM-Ⅲ-R criteria and ninety-seven normal controls, Schizophrenic patients were divided by clinical phenotypes such as DSM-Ⅲ-R diagnostic subtypes, positive and negative symptoms, and family history so as to increase the homogeneity of schizophrenics. Genomic DNA was extracted from whole blood lymphocytes according to standard procedures. The DNA was used to study a dinucleotide repeat in the IL-2Rβ gene. To reveal the dinucleotide polymorphism. genomic DNA of subjects was amplified by polymerase chain reactions(PCR). Results : At the IL-2Rβ gene locus, all the previously reported alleles(eight different alleles) of a dinucleotide polymorphism were identified. There was no significant difference between number of heterozygosity in schizophrenic patients and in normal controls. There was no significant difference in the distribution of frequencies of alleles between schizophrenics and normal controls. In addition, there was no significant difference in the allele frequencies among subtypes of schizophrenic patients according to DSM-Ⅲ-R diagnostic subtypes, positive and negative symptoms, and family history. Conclusion : The present study did not detect a difference in frequencies of alleles of a dinucleotide polymorphism at the IL-2Rβ gene locus between schizophrenic patients and normal controls. These results do not supports an evidence that IL-2Rβ gene plays, a major role in the etiology of schizophrenia.

Renal Sympathetic Denervation Induces Acute Myocardial Inflammation through Activation of Caspase-1 and Interleukin-1β

Dong Won Lee(이동원),Il Young Kim(김일영),Ihm Soo Kwak(곽임수) 한국생명과학회 2018 생명과학회지 Vol.28 No.2

원심성, 구심성 교감신경 신호는 고혈압 및 심부전의 발생과 밀접한 관련이 있다. 혈관 내 카테터를 이용한 교감신경절제술(RDM)은 난치성 고혈압의 대체치료로 시행되어 왔다. 시술과 관련하여 장기간 신장의 안정성에 대해서는 보고가 있었으나 단기간 심근의 안정성에 대한 연구 결과는 없었다. 저자들은 RDN 시술로 인한 교감신경차단 후 염증성 심근손상이 발생할 수 있음을 가정하여 실험으로 검증하고자 하였다. 25마리의 암컷돼지를 3군으로 나누고–정상대조군(n=5), Sham군(n=5), RDN 시술군(n=15)–RDN 시술군을 시술 후 sacrifice 시기에 따라 다시 세분하였다–시술 후 즉시 sacrifice한 RDN-0 (n=5), 시술 1주 후 sacrifice한 RDN-1 (n=5), 시술 2주 후 sacrifice한 RDN-2 (n=5). 조영제의 영향을 배제하기 위해 설정했던 Sham군과 정상대조군 간에는 의미있는 차이를 보이지 않았다. IL-1β, TNF-α 등의 염증 싸이토카인은 시술 1주 후 증가하여 2주째 감소하였다. 항염증 싸이토카인 IL-10은 시술 직후부터 증가하여 2주째 감소하였다. Inflammasome에 의해 위험신호(danger signal)를 전달받고 활성화되는 Caspase-1 및 inflammasome을 매개하는 도메인 ASC는 시술 직후 활성화되어 발현이 증가하였고 2주까지 지속되었다. 그러나 caspase-1을 매개할 것으로 추정되었던 NLRP3 inflammasome의 발현은 의미있는 차이를 보이지 않았다. RDN 시술에 의한 교감신경차단은 caspase-1, IL-1β 등의 활성화에 의해 염증성 심근손상을 초래할 수 있으며 RDN 시술 후에는 그 위험성을 고려해야 하겠다. NLRP3 외에 다른 NLRP inflammasome pathway의 관련성에 대한 추가연구가 필요하다. Efferent and afferent sympathetic nerves are closely related to the development of hypertension and heart failure. Catheter-based renal sympathetic denervation (RDN) is implemented as a strategy to treat resistant hypertension. We investigated whether RDN procedure causes inflammatory damage on myocardium in the early phase of sympathetic denervation. Twenty-five female swine were divided into 3 groups: normal control (Normal, n=5), sham-operated control (Sham, n=5), and RDN groups (RDN, n=15). The RDN group was further subdivided into 3 subgroups according to the time of sacrifice: immediately (RDN-0, n=5), 1 week (RDN-1, n=5), and 2 weeks (RDN-2, n=5) after RDN. There were no significant changes in the clinical parameters between the normal control and sham-operated group using contrast-media. In the myocardium, inflammatory cytokines, IL-1β and TNF-α increased at the first week, and then decreased at the second week after RDN. Anti-inflammatory cytokine, IL-10 increased immediately, and then decreased at the second week after RDN. Caspase-1 activity and apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) expression increased immediately after RDN until the second week. However, nucleotide-binding oligomerization domain, leucine rich repeat and pyrin domain containing protein 3 (NLRP3) expression did not show any significant differences among the groups. The RDN can cause acute myocardial inflammation through activation of caspase-1 and IL-1β. We should pay attention to protecting against early inflammatory myocardial damage after RDN.

脊椎移植을 爲한 麻醉의 臨床的 硏究

郭一龍,申玄羽,金東權,黃圭現 한국의 현대의학사 1975 한국의 현대의학 Vol.8 No.2

Case Reports : Appearance of Psoriasis after Tumor Necrosis Factor-α Blocker and Use of Ustekinumab or Tocilizumab for Refractory Monoarthritis

( Jinyoung Moon ),( Nakwon Kwak ),( Jin Lim ),( Dong Jin Go ),( Jae Hyun Lee ),( Jin Kyun Park ),( Eun Bong Lee ),( Yeong Wook Song ),( Jai Il Youn ),( Eun Young Lee ) 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.4

Nowadays, tumor necrosis factor-α (TNF-α) blockers are used for treatment of rheumatoid arthritis, inflammatory bowel diseases, ankylosing spondylitis, psoriatic arthritis, and psoriasis. Paradoxically, there are some reports on the appearance of psoriasis after administration of TNF-α blockers. Here, we report on a patient with monoarthritis in a knee joint who experienced psoriasis after TNF-α blocker therapy (adalimumab and etanercept). Oral medication was not a treatment option due to patient intolerance; thus, we tried ustekinumab, an anti-interleukin (IL)-12/23 monoclonal antibody used for treatment of psoriasis. Following ustekinumab injection, psoriatic skin lesions and joint symptoms were much improved. However, in the following period, joint pain and swelling became aggravated and synovial fluid cytokine levels including IL-6 and IL-17 were elevated. The treatment was changed to tocilizumab, a humanized monoclonal antibody against IL-6 receptor. After injection, knee joint swelling rapidly subsided without worsening of psoriatic skin lesions. (J Rheum Dis 2015;22:263-268)

24시간 혈중농도와 신배설률을 이용한 리튬 치료량 예측법의 평가비교

곽동일,정인과,김진세 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.4

Cooper's method using 24 hour serum lithium level and Norman's method using renal lithium clearance after a single loading dose were compared to determine which predicted therapeutic lithium dose better. The author concluded the Norman's method was superior after evaluating the accuracy, the rapidity, and the utility of the two methods. And the author suggest the availability of the predicting methods to overcome the limitations of lithium therapy, such as the narrow range of therapeutic level, the time-consumption reaching therapeutic level, and the individual variation of therapeutic dose. The summary of results were as follows : 1) In Cooper's method, the objects included in the acute therapeutic level, 0.80∼1.20mEq/l, were only 10 of 19 objects after taking prdeicted lithium dose. 2) In Norman's method, the objects included in the acute therapeutic level were all of 19 objects, and the actual serum lithium level, 0.80∼1.15mEq/l, were predicted with average error ±4.89%.

진행마비에 대한 임상적 고찰

곽동일,김용진 大韓神經精神醫學會 1974 신경정신의학 Vol.13 No.3

Five cases of general paresis, who visited the Department of Neuro-psychiatry, Woo Sok Hospital, Korea University during last one year, presented and discussed in the view of their clinical characteristics and diagnostic problems. Then the following results and suggestions were obtained. 1. Three patients out of five cases were difficult to differentiate from manic-depressive psychosis or psychotic depression on the first psychiatric and neurological examinations. 2. Pupillary changes and convulsive episodes, previously reported as characteristic symptoms of general paresis, were not found in all of the cases. 3. One out of all their spouses showed positive reaction in the blood serological test. 4. Two out of five cases showed abnormal tracings in Electroencephalogram. 5. It was the author's impression that not only the primary syphilitics but also the general patretics was increasing in our country. 6. It is strongly recommended that those of patients over the age 30 manifesting major functional psychosis on the 1st psychiatric interview should have blood serological test as a routine examinations.

子宮頸癌의 疫學的 硏究

郭顯模,金馹舜,鄭淳五,黃東薰 대한의학협회 1972 대한의학협회지 Vol.15 No.3

酒精中毒

郭東日 大韓法醫學會 1979 대한법의학회지 Vol.3 No.1

The category of alcoholism is for patients whose alcohol intake is great enough to damage their physical health, or their personal or social functioning, or when it has become a presequisite to normal functioning. The author described the epidemiology and social consequences, the physiological effect of alcohol, the personality factors, the causes and the treatment of alcoholism.

身體型障碍의 臨床的 樣相과 診斷基準

곽동일 한국의학사 1984 診斷과治療 Vol.4 No.5

소화성 궤양에 대한 정신의학적 고찰

곽동일 최신의학사 1984 最新醫學 Vol.27 No.2