정신분열병 환자의 주관적 증상과 객관적 정신병리와의 관련성

주연호,김용식,정성훈,신민섭,이창인 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : 주관적 증상평가도구인 K-FBF(Kyung Hee-Frankfurter Beschwerde-Fragebogen)가 정신분열병 환자의 어떤 증상 영역을 반영하는지, 특히 정신분열병의 병태생리와 밀접한 관련을 가지며 객관적 평가도구로는 파악이 어려운 음성 증상 또는 인지 장애의 측면들을 반영하는지 조사하고자, 정신분열병 환자의 K-FBF 결과를 객관적 정신병리 평가도구인 PANSS(Positive and Negative Syndrome Scale for Schizophrenia), 대표적인 자기보고식 다차원 증상목록(multidimensional self-report symptom inventory)인 간이정신진단검사(SCL-90-R)의 평가 결과와 비교 분석하였다. 방 법 : 고졸이상의 학력으로 DSM-IV진단기준에 의한 정신분열병 환자 중 급성기가 경과한 66명을 대사으로 연구를 수행하였다. K-FBF, SCL-90-R을 시행한 날, 두 명의 정신과 의사가 PANSS를 수행하였다. K-FBF의 질문항목에 대한 반응양상을 조사하고, 10개 소척도에 대하여 요인분석을 시행하였다. K-FBF와 연령, 성별, 병식과의 상관관계를 조사하였다. 또한, K-FBF, PANSS, SCL-90-R제반 척도간에 상관관계 분석을 시행하였다. 결 과 : K-FBF는 높은 연령일수록 호소하는 항목의 수나 그 정도가 감소하였으며, 유병기간을 조절변수로 삼았을 때도 동일한 결과를 보였다. K-FBF의 소척도를 요인분석하여 두개의 합산척도를 추출, 각각 자각된 고통(RD, Recognized Distress)과 지각왜곡(PA, Perceptual Alteration)으로 명명하였다. 위의 합산척도와 PANSS의 상관관계에서, K-FBF 표준화 총점을 조절변수로 하여 편상관을 조사한 결과 PA척도와 PANSS 음성척도가 상관관계를 보였다. 이는 Huber의 기본증상이란 정신분열병의 음성증상을 주관적 측면에서 접근한 것이라는 평가와 관련된다. 한편, K-FBF표준화 총점과 SCL-90-R총점은 강한 상관관계를 나타낸 반면, SCL-90-R총점과 PANSS총점은 비록 통계적으로는 유의하지만 매우 미미한 상관관계만을 보였다. 따라서 평가척도의 상관성은 그 내용보다는 평가하는 주체에 더 큰 영향을 받는다고 판단되었다. 결 론 : 본 연구결과 K-FBF로 측정된 Huber의 기본증상은 정신분열병의 음성증상을 보다 더 반영하는 것으로 평가되었으며, 또 객관적 평가도구인 PANSS보다는 자기보고형 도구인 SCL-90-R과 더 높은 상관관계를 보인 것으로 나타났다. 그러나, 본 연구결과의 일반화를 위해서는 다른 질병단계, 다른 인구학적 변인을 가진 환자들을 대상으로 한 연구가 계속되어야 할 것이다. Objectives : Kyung Hee-Frankfurter Beschwerde-Fragebogen(K-FBF) is a representative subjective symptom measuring tool of schizophrenic patients. We performed psychopathology measurements using K-FBF, Positive and Negative Syndrome Scale(PANSS) and Symptom Checklist-90-Revised(SCL-90-R) in patients with schizophrenia and then compared the results of these three examinations one another, in order to examine which psychopathologic aspects K-FBF might reflect and to measure the possibility whether this instrument reflect the negative symptoms or cognitive impairments, which are difficult to measure by conventional objective instruments measuring psychopathology. Methods : All 66 patients satisfying DSM-IV criteria for schizophrenia, were approached. Their education level was more than high school and they were not in the acute stage of schizophrenia. They performed K-FBF and SCL-90-R, and at the same day, they were interviewed by one of both psychiatrists using PANSS. We examined the patterns of K-FBF response and performed facor analysis about 10 subscales. We examined the correlation between K-FBF and age, sex and insight. Also, we performed correlation analysis among the K-FBF, PANSS and SCL-90-R. Results : As for K-FBF, with increasing age, the number of positive response items and the symptom severity were decreased. Even when controlling prevalence period as control variable, the correlation remained unchanged. Performing factor analysis to the K-FBF subscales, we created 2 factors, ie summation subscales. We named those recognized distress(RD) and perceptual alteration(PA) each. Using K-FBF standardized total scores as controlling variable, we performed partial correlation between PA and PANSS negative symptom scale. The result was PA and PANSS have statistically significant correlation. This correspons with the view that Huber's basic symptoms are reflecting subjective approach of negative symptoms of schizophrenia. While K-FBF standardized total scores and PANSS total scores had statistically strong correlations, SCL-90-R total scores and PANSS total scores had statistically significant, but very mild correlations. So, we had the judgement that the correlations among the psychopathology measurement tools are more influenced by the rater than the contents of tools. Conclusion : We concluded that Huber's basic symptoms, measured by K-FBF, reflect more negative symptoms of schizophrenia than other symptoms. And K-FBF has more correlation with the PANSS, objective psychopathology. Measuring tool, than the SCL-90-R, self-report quetionnaire. But, more studies using patients with another disease stages and another demographic variables are needed in order to generalize the results of this study.

9-Amino-1,2,3,4-Tetrahydroacridine 유도체의 COX-2 저해효과

강주연,신혜순 덕성여자대학교 약학연구소 2005 藥學論文誌 Vol.16 No.1

Several novel derivatives of 9-amino-1,2,3,4-tetrahydroacridine, that the drugs in use for the treatment of Alzheimer's disease, have been synthesized and tested for their activities. Cyclooxygenase-2 expression is associated with the deposition of beta-amyloid in neuritic plaques in brain inflammation. The series of 9-amino-1,2,3,4-tetrahydroacridine have been prepared through the alkly substitution or the ring expansion. They were screened with accumulation of prostaglandin by lipopolysaccharide in aspirin-treated murine macrophages to evaluate inhibitory effect of cyclooxygenase-2. Most of novel derivatives have showed significant cyclooxygenase-2 activities with 66.2~75.8% inhibition.

身體 微細畸形 및 産科的 合倂症과 精神分裂症의 家族歷

홍경수,주연호,김용식,신철진,강웅구,이중서,정희연,주은정 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.4

저자들은 정신분열병의 일부에서는 태생기 동안 유전 외적인 환경적 요인이 크게 작용할 것이라는 가정 하에 형제 정신분열병 환자군(남 15. 여 7)과 산발성 정신분열병 환자군(남 16, 여 7) 및 정상 대조군(남 16, 여 7)을 대상으로 가족력에 따른 산과적 합병증과 신체 미세 기형을 비교하였다. 산과적 합병증은 Lewis 척도를 이용하여 연구 대상의 어머니와 면담하여 평가하였고 신체미세기형은 Waldrop 척도를 이용하여 측정하였다. 또한 산과적 합병증 및 신체 미세기형과 가족력에에 따라 발병 연령 등의 임상 양상들이 차이를 보이는지 비교함으로써 정신분열병을 좀 더 동질적인 아형으로 나눌 수 있는지를 검토하였다. 1) 형제 환자군, 산발성 환자군 및 정상 대조군의 세균에서 산과적 합병증의 개개의 항목 및 전체 점수의 유의한 차이는 없었다. 신체 미세기형의 경우 입의 미세기 형에서 유의한 차이가 있었으나 그 외에 각 부위별 점수 및 전체 점수에서는 세 군간에 유의한 차이가 없었다. 그러나 대부분의 신체 미세기형 세부 항목 및 전체점수에서 산발성 환자군이 형제 환자군에 비해 높은 신체 미세기형의 점수를 보이는 경향이 있었다. 2) 산과적 합병증의 전체 점수와 신체 미세기형의 전체 점수 사이에 상호 연관성을 찾아볼 수 없었다. 3) 발병연령·정신병리·약물에 대한 반응·병전 기능수준·지연성 운동장애 유무 등의 임상 양상들을 비교하였을때 산발성 환자군과 형제 환자군간에 유의한 차이가 없었다. 4) 산과적 합병증 및 신체 미세기형과 임상 양상들을 비교하였을 때, 형제 환자군에서 분만시간과 회복시 전반적 기능수준간에, 산발성 환자군에서 산과적 합병증의 전체 점수와 발병 연령간에 상관관계가 있었으나 전체적으로 일관된 결과가 도출되지는 못하였다. 위와 같은 결과를 종합하여 볼 때, 산과적 합병증이나 신체 미세기형이 정신분열병의 원인을 밝히는데 유익한 도구가 될 수는 있지만, 가족력 유무에 따라 정신분열병을 보다 동질적인 아형으로 구분하기 힘들다고 생각되었다. In order to test the hypothesis that familial schizophrenics have fewer chances of receiving organic insults during the fetal neural development than sporadic schizophrenics, the authors compared obstetric complications, minor physical anomalies, and other clinical features in sibling schizophrenics, sporadic schizophrenics and controls. Obstetric complications were evaluated by the scale of Lewis, and minor physical anomalies were measured by the Waldrop scale. Sporadic schizophrenics had a significantly higher Waldrop score for mouth than sibling schizophrenics. Although there was some tendency of higher total scores for minor physical anomalies in sporadic schizophrenics, there were no statistically significant differences in obstetric complications and the other minor physical anomalies among three groups. There was no significant correlation between obstetric complications and minor physical anomalies. The clinical features such as age of onset, psychopathology, response to drugs, premorbid functioning, and tardive dyskinesia were not significantly different between sibling and sporadic scizophrenics. In conclusion, while the obstetric complications and minor physical anomalies were suggested to be useful in the search for the cause of schizophrenia, it was difficult to categorize schizophrenics into more homogeneous groups according to family history of schizophrenia using the parameter of obstetric complications and/ or minor physical anomalies.

Modified 9Cr-1Mo 강의 항온변태처리에 따른 미세조직 및 경도변화

유정훈,주성욱,허성강,신기삼,이수,정연길 국립7개대학공동논문집간행위원회 2003 공업기술연구 Vol.3 No.-

Evolution of microstructure and its relation with hardness in the modified 9%Cr-1%Mo steel which was isothermally heat-treated has been investigated in various heat-treatment temperatures and time of duration. For microstructural and crystallographic analyses, optical microscope, scanning and transmission electron microscopes, energy dispersive spectrometer, and X-ray diffractometer were used. Vickers microhardness tester were used for the measurement of hardness. Precipitates of the complex M23C6, M(C,N) formed at grain boundaries and interiors of grains had led to the secondary hardening. Normalized specimen and all of the isothermally heat-treated ones showed no evidence of retained austenite.

반복작업으로 유발된 수근관내의 굴곡근 건초염과 수근관 증후군 : 증례 보고 Case Report

김돈규,서경묵,신주연,강시현,송인섭 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.1

A 46 year-old woman who had worked repetitive manual job for 3 years visited our hospital because of aggravated right hand sensory symptom and newly developed limitation of 3, 4, 5th finger extension. In physical examination, moderate swelling of volar aspect of wrist and limitation of finger extension was noticed as well as positive tinnel sign. We confirmed carpal tunnel syndrome after electrodiagnostic studies and associated flexor tenosynovitis of 4th flexor tendon in the carpal tunnel through MRI (magnetic resonance imaging) study. She was successfully treated with conservative program including wrist splint and steroid injection. We also tracked the result of treatment using MRI and electrodiagnositic studies. Analyzing her work procedure, we concluded that repetitive and forceful exertional nature of job impose a high burden on hand and wrist region and it caused her carpal tunnel syndrome.

분편 인플루엔자백신(split influenza vaccine)의 임상효과 및 면역원성에 관한 연구

우흥정,김동림,정희진,천병철,이주연,안정배,김지희,박찬,신영규,김우주,김민자,박승철 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.1

목적 : 아단위 인플루엔자 백신 접종 후 백신의 인플루엔자 예방효과, 인플루엔자 방어 항체형성, 인플루엔자 백신의 안전성을 조사하고자 하였다. 방법 : 총 571명을 대상으로 인플루엔자 백신 접종을 하였고, 이들 접종자에서 인플루엔자 양질환의 이환을 조사하여 인플루엔자 백신의 인플루엔자예방효과를 알아보았고, 백신의 접종 전 및 접종 4주 후 혈청에서 혈구응집억제물(Hemagglutination Inhibition : HAI) 항체 검사를 실시하여 백신의 방어항체생성을 조사하였고, 백신의 안전성을 알아보기 위해 백신접종 후 1주일 이내의 부작용을 조사하였다. 결과 :백신 접종군과 백신 비접종군에서 인플루엔자 양 질환의 이환을 조사한 결과 접종군 28.35%, 비접종군 35.88%으로 나왔으며, p 값이 0.001로 통계적으로 접종군에서 유의하게 낮았고, 인플루엔자 양 질환의 예방 효과는 20.97%를 보였다. 백신의 방어항체 형성의 평가를 위해 유럽의 인플루엔자 백신 허가 기준을 조사하였는데 B/Guangdong/5/94균주의 백신접종 후 항체가 40이상의 비율을 제외한 다른 기준은 모두 만족 시켰다. 부작용은 전체 조사자 521명중 149명(29%)으로 주로 접종 부위의 국소 부작용을 호소했고, 전신 부작용은 2% 내외였으며 특별히 심각한 부작용은 발견되지 않았다. 결론 : 분편 인플루엔자 백신은 인플루엔자양질환의 예방과 방어항체생성에 효과 있으며 안전한 것으로 사료된다. Background : The safety and effectiveness of influenza vaccine are well known in developed country. The influenza vaccination has been recommended as one of the tentative immunization schedule for indicated persons since 1997 in Korea. But there are still no available data about them, even though nearly 5 million doses of influenza vaccine were used in 1997-1998 season. So it is immediately needed to investigate the safety. efficacy and immunogenicity of influenza vaccine among Korean. Methods : We studied the clinical efficacy of influenza vaccine by monitoring Occurrence of influenza-like illness in influenza risk group(vaccination ; 300, non-vaccination; 215) from December in 1997 to March in 1998. We used the split quadrivalent influenza vaccine containing 15 microgram of hemagglutinin of A/Beijing/262/95(HlNl), A/Wuhan/359/95(H3N2), B/Mie/1/93 and B/Guangdong/5/94. Hemagglutination inhibition(HA1) antibody titers were determined before immunization and 1 months after vaccination And we evaluated adverse effect of influenza vaccination at 7 days after vaccination. Results : Influenza vaccination was associated with si@icant reductions in influenza-like spptoms(vaccination group; 28.35%, non-vaccination group, 35.88%, p=0.001). The preventive effect of influenza-like i3lne.s among influenza risk goup was 20.97%. And immunogenicity of influenza A and B exceeded all of the European licensure criteria for immunogenicity except postvaccination proportion of titers 240 of B/Guangdong/5/94 strain. And the adverse effects were mainly local injection site problem and no serious adverse effect was noted. Conclusion : Split influenza vaccine is safe, inmunogenic and eff'tive in influenza risk group in Korea.

인천지역 TDI 노출 작업자에서 직업성천식 유병율

김형렬,김철우,홍윤철,전형준,김치년,김현수,이지나,신주연,고동희,노재훈 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : TDI는 직업성천식을 일으키는 대표적인 물질로 알려져 있다. 과거 TDI에 노출된 작업자들의 천식 발생률을 5~6%가량 보고하였고, 국내에서도 2-20%에 이르는 유병율을 보고한바 있다. 작업환경이 많이 개선되고, 노출량이 감소된 최근에도 TDI에 의한 직업성천식에 대한 보고가 많이 이루어지고 있어, 이에 대한 적극적인 조사와 진단과정을 통해 유병율을 구하고 질병발생의 변화양상을 파악해 보고자 하였다. 방법 : 인천지역에서 특수건강진단을 수행하는 2개 기관의 TDI 노출 근로자 400여명 중, 사업장의 규모가 50인 이상이며 사업주가 연구진행을 허락한 사업장에서 근무하는 근로자 중 직접적으로 TDI에 노출되는 작업에 종사하는 근로자 170명을 연구대상으로 하였다. 이들에 대해 설문지와 산업의학의사의 면담을 통한 작업관련성 평가를 근거로 정밀대상자를 선정하고 이들에 대해 메타콜린 유발시험, TDI 유발시험 등을 수행하여 직업성천식을 확인하였다. 결과 : 설문조사 결과 11명이 직업과 관련하여 천식증상을 보이는 것으로 나타났고(6.9%), 이중 7명에서 메타콜린 유발검사 양성소견을 보였다. TDI에 의한 특이유발시험 결과 1명에서 양성반응이 나타나, 이 집단에서 TDI에 의한 직업성천식의 유병율은 0.58%였다. 결론 : 과거 국내연구에서 TDI에 의한 직업성천식의 유병율이 2~20%에 이르렀던 데 비해, 본 연구에서는 0.58%로 나타났다. 이는 국외 논문에서도 나타나는 경향으로 작업장 노출량 감소로 점차 발생률이 감소하는 양상을 보이고 있다. 그러나 이미 증상이 나타난 근로자들이 부서를 옮기거나, 직장을 그만둠으로 인해 그 유병율이 과소평가되었을 가능성도 있다고 판단된다. Objecdives: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. Methods: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. Results: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma. and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1 %). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. Conclusions: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

Spatially resolved transcriptomics provides new insights into the role of onychofibroblasts in onychomatricoma pathogenesis

( Yeon Joo Jung ),( Dong Min Shin ),( Jongeun Lee ),( Se Jin Oh ),( Joon Ho Shim ),( Ji-hye Park ),( Jong Hee Lee ),( Joo-heung Lee ),( Dongyoun Lee ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.73 No.1

Background: Onychomatricoma (OM) is an uncommon benign tumor, originating from the nail matrix. Although clinicopathological characteristics of OM have been well defined, the transcriptional profile and cellular heterogeneity of this tumor remain largely unknown. Objectives: To provide key molecular features and pathways involved in the development of OM. Methods: We collected 7 OM samples and selectively profiled epithelial and stromal compartments of two OM using the spatial transcriptomic approach, GeoMXTM Digital Spatial Profiling (DSP). We compared these findings with those of nail matrix and normal skin. In addition, we combined single-cell RNA sequencing of polydactyly and DSP to uncover the cellular heterogeneity of OM. Results: We detected previously reported genes, expected to express in the nail epithelium, uniquely expressed in the OM epithelium, such as KRT84, KRT85, and SPINK6. Significantly higher expression of onychofibroblast-related genes including RSPO4 was observed in OM stroma. We also estimated the absolute abundance of nail appendage-cell types and observed that onychofibroblast was the most abundant cell type in the OM stroma. Further, we identified RSPO4-LGR6 crosstalk between OM epithelium and stroma, suggesting a potential role of the Wnt/β-catenin pathway in disease development. Conclusion: We provide a comprehensive atlas of OM and a new resource for understanding the roles of onychofibroblast in OM pathogenesis.

Quantitative Determination of Absorption and First-Pass Metabolism of Apicidin, a Potent Histone Deacetylase Inhibitor

Shin, Beom Soo,Yoo, Sun Dong,Kim, Tae Hwan,Bulitta, Jurgen B.,Landersdorfer, Cornelia B.,Shin, Jeong Cheol,Choi, Jin Ho,Weon, Kwon-Yeon,Joo, Sang Hoon,Shin, Soyoung American Society for Pharmacology and Experimental 2014 Drug metabolism and disposition: the biological fa Vol.42 No.6

<P>Apicidin, a potential oral chemotherapeutic agent, possesses potent anti-histone-deacetylase activity. After oral administration, the total bioavailability of apicidin is known to be low (14.2%–19.3%). In the present study, we evaluated the factors contributing to the low bioavailability of apicidin by means of quantitative determination of absorption fraction and first-pass metabolism after oral administration. Apicidin was given to rats by five different routes: into the femoral vein, duodenum, superior mesenteric artery, portal vein, and carotid artery. Especially, the fraction absorbed (<I>F</I><SUB>X</SUB>) and the fraction that is not metabolized in the gut wall (<I>F</I><SUB>G</SUB>) were separated by injection of apicidin via superior mesenteric artery, which enables bypassing the permeability barrier. The <I>F</I><SUB>X</SUB> was 45.9% ± 9.7%, the <I>F</I><SUB>G</SUB> was 70.9% ± 8.1% and the hepatic bioavailability (<I>F</I><SUB>H</SUB>) was 70.6% ± 12.3%, while the pulmonary first-pass metabolism was minimal (<I>F</I><SUB>L</SUB> = 102.8% ± 7.4%), indicating that intestinal absorption was the rate-determining step for oral absorption of apicidin. The low <I>F</I><SUB>X</SUB> was further examined in terms of passive diffusion and transporter-mediated efflux by in vitro immobilized artificial membrane (IAM) chromatographic assay and in situ single-pass perfusion method, respectively. Although the passive diffusion potential of apicidin was high (98.01%) by the IAM assay, the in situ permeability was significantly enhanced by the presence of the P-glycoprotein (P-gp) inhibitor elacrider. These data suggest that the low bioavailability of apicidin was mainly attributed to the P-gp efflux consistent with the limited <I>F</I><SUB>X</SUB> measured in vivo experiment.</P>

Systemic Human T Cell Developmental Processes in Humanized Mice Cotransplanted With Human Fetal Thymus/Liver Tissue and Hematopoietic Stem Cells

Joo, Sung-Yeon,Chung, Yun Shin,Choi, Bongkum,Kim, Miyoung,Kim, Jong-Hwa,Jun, Tae-Gook,Chang, Jun,Sprent, Jonathan,Surh, Charles D.,Joh, Jae-won,Kim, Sung Joo Lippincott Williams Wilkins, Inc. 2012 Transplantation Vol.94 No.11

BACKGROUND: In many humanized mouse models, there are few T cells in the engrafted human cell, whereas the number of B cells is high. We attempted to overcome this limitation and investigate whether the entire process of human T cell development arose similarly to the process in humans, as previously reported. METHODS: To produce an advanced humanized mice model, we transplanted human fetal liver/thymus tissue subrenally and injected human CD34 stem cells intravenously into NOD/SCID/IL2Rgamma null (NSG) mice. RESULTS: Humanized mice transplanted with fetal thymus/liver tissues and fetal liver-derived CD34 stem cells (FLT+FLCD34) showed higher levels of human cells and T cells than mice transplanted with fetal liver-derived CD34 stem cells only (FLCD34). In the transplanted thymus tissue of FLT+FLCD34 mice, thymus seeding progenitors (TSPs), early thymic progenitors (ETPs), pre-T cells, and all the other human T cell populations were identified. In the periphery, FLT+FLCD34 mice have high levels of CD45RA T cells; conversely, FLCD34 mice have higher levels of CD45RO T cells. The CD45RO T cells of FLCD34 mice proliferated rapidly after stimulation and exhibited innate T cells properties, expressing PLZF (promyelocytic leukemia zinc finger protein). CONCLUSION: Human T cells educated by mouse MHC II in mice without a human thymus differ from normal human T cells. On the basis of these findings, numerous T cell-tropic human diseases could be explored in our humanized mice and molecular aspects of human T cell development could be also studied extensively.