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정신분열병 환자를 위한 인지재활훈련 프로그램의 개발 : Korean-Cognitive Differentiation Program 한국형 인지분화훈련 프로그램
현명호,안석균,이만홍,조현상,최충식,이연희,송선미,유계준,김장우,김태용,이희상 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2
연구배경 : 정신분열병 환자들은 인지장애를 보이는바, 저자들은 이들을 대상으로 한국형 인지분화훈련 프로그램을 개발하여 정신분열병 환자들을 대상으로 인지재활훈련을 실시한 후 환자들의 인지기능, 정신병리 및 문제해결기술에 미치는 효과를 조사하였다. 방 법 : 28명의 정신분열병 환자를 훈련군(n=14)과 대조군(n=14)으로 나누어 훈련군에게 한국형 인지분화훈련 프로그램을 1회 60분씩, 주당 2회씩, 11주간 총 22회를 실시하였다. 환자들의 인지기능은 K-WAIS의 산수, 빠진곳찾기, 어휘, 공통점찾기 소검사로 측정하였고 정신병리는 양성 및 음성증상 척도로 측정하였으며 문제해결기술은 사회문제해결척도로 평가하였다. 인지재활훈련의 효과를 평가하기 위해 훈련 전후의 인지기능, 정신병리 및 문제해결기술의 변화를 종속변수로 하고 훈련 유무를 독립변수로 하여 반복측정에 의한 변량분석으로 자료를 분석하였다. 결 과 : 한국형 인지분화훈련이 시간에 따른 인지기능검사 중 산수 소검사, 문제해결기술 중 시회문제해결척도의 전체 점수와 문제해결기술 소척도의 점수의 변화에 유의한 영향을 미쳤으나, 시각적 주의력, 개념화 능력 및 정신병리의 점수의 변화에 유의한 영향을 미치지 않았다. 결 론 : 한국형 인지분화훈련 프로그램은 정신분열병 환자에서 청각적 주의력 및 문제해결기술의 호전을 꾀할 가능성이 있음을 시사한다. Objectives : The purpose of this study was to investigate the effects of cognitive differentiation training program- Korean version(a training program of attention and conceptual abilities) on cognitive function, psychopathology and problem solving skills in patients with schizophrenia. Methods : A total of patients diagnosed as schizophrenia using DSM-Ⅳ were randomly assigned to 2 groups. The training group went through a total of 22 sessions of cognitive differentiation training(60 min/ session×2 sessions/wk×11 wks). The attention-placebo control group received psychoeducation program during the same period. Arithmetic, vocabulary, similarities, picture completion of Wechsler Adult Intelligence Scale-Korean version, Positive and Negative Syndrome Scale, and Social Problem Solving Scales were administered to all patients, both before and after the training program. Results : In the arithmetic scores(F=6.35, af=1, p=0.018) of Wechsler Adult Intelligence Scale-Korean version, and total scores(F=6.35, af=1, p=0.018) and problem solving skill scale scores(F=4.88, af=1, p=0.036) of social problem solving scale, interaction effects of training was significant. Conclusion : Our findings suggest that cognitive differentiation training program-Korean version is effective on improving auditory attention and problem solving skills in patients with schizophrenia.
Song, Joon Seon,Chang, Hee Jin,Kim, Dae Yong,Kim, Sun Young,Baek, Ji Yeon,Park, Ji Won,Park, Sung Chan,Choi, Hyo Seong,Oh, Jae Hwan Wiley Subscription Services, Inc., A Wiley Company 2011 Cancer Vol.117 No.17
<P><B>Abstract</B></P><P><B>BACKGROUND:</B></P><P>Pericolorectal tumor deposits (TDs) are associated with adverse outcomes in patients with colorectal cancer, and the seventh edition of the American Joint Committee on Cancer (AJCC) staging system recently classified TDs without regional lymph node metastasis as category N1c. However, the definition of TDs has varied. Moreover, with the recent, widespread application of preoperative chemoradiotherapy (CRT) in rectal cancers, residual primary tumor confined to the mesorectum is not infrequent, and it is unclear whether the N1c category is appropriate for these tumors.</P><P><B>METHODS:</B></P><P>To evaluate the prognostic significance of the N1c classification in patients with rectal cancers after preoperative CRT, the authors reviewed the histologic features of 136 rectal cancers that were classified previously with a tumor classification of 3 [T3], negative lymph nodes [N0], and no metastasis [M0] based on the pathologic extent of disease (ypT3N0M0). These tumors were reclassified according to the new AJCC staging system, and patient outcomes were analyzed.</P><P><B>RESULTS:</B></P><P>Perirectal TDs were detected in 16 of 136 patients (11.8%). Patterns of TD included a separate nodule pattern in 6 patients (38%), a perivascular pattern in 4 patients (25%), a perineural pattern in 4 patients (25%), and a lymphatic pattern in 2 patients (12%). By using the new N1c category, 120 patients (88.2%) were classified with yp‐stage IIA disease, 6 patients (4.4%) were classified with yp‐stage IIIA disease, and 10 patients (7.4%) were classified with yp‐stage IIIB disease. Kaplan‐Meier survival analysis indicated that there were no significant differences between the TD‐positive and TD‐negative groups in disease‐free survival (DFS) or overall survival (OS) (<I>P</I> = .48 for both; log‐rank test). In addition, the reclassified TMN stage was not related to DFS (<I>P</I> = .17) or OS (<I>P</I> = .072).</P><P><B>CONCLUSIONS:</B></P><P>The category N1c may not be appropriate for patients with rectal cancer after preoperative CRT, because the definition of ypN1c was confusing and did not have prognostic significance. Cancer 2011;. © 2011 American Cancer Society.</P>
Song, Do Seon,Nam, Soon Woo,Bae, Si Hyun,Kim, Jin Dong,Jang, Jeong Won,Song, Myeong Jun,Lee, Sung Won,Kim, Hee Yeon,Lee, Young Joon,Chun, Ho Jong,You, Young Kyoung,Choi, Jong Young,Yoon, Seung Kew WJG Press 2015 WORLD JOURNAL OF GASTROENTEROLOGY Vol.21 No.8
<P>To investigate the efficacy and safety of transarterial chemoembolization (TACE)-based multimodal treatment in patients with large hepatocellular carcinoma (HCC).</P>
( Do Seon Song ),( Si Hyun Bae ),( Myeong Jun Song ),( Sung Won Lee ),( Hee Yeon Kim ),( Young Joon Lee ),( Jung Suk Oh ),( Ho Jong Chun ),( Hae Giu Lee ),( Jong Young Choi ),( Seung Kew Yoon ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background: Hepatic arterial infusion chemotherapy (HAIC) is used in advanced Hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). The objective of this study was to evaluate the prognostic factors and anti-tumor effects of HAIC in HCC with PVTT. Methods: Fifty HCC patients with PVTT were treated by HAIC via a subcutaneously implanted port. The ECF chemotherapeutic regimen consisted of 35 mg/m2 epirubicin on day 1, 60 mg/m2 cisplatin for 2 h on day 2, and 500 mg/m2 5-fluorouracil for 5 hours on days 1-3. Treatments were repeated every 3 or 4 weeks. Results: Three (6%) of the 50 patients achieved a complete response (CR), 13 (26%) showed partial response (PR), and 22 (44%) had stable disease (SD). The median survival and time to progression were 7 months and 2 months, respectively. Signifi- cant pre-treatment prognostic factors were a tumor volume of <400 cm3 (P=0.007) and normal levels of protein induced by vitamin K absence or antagonist (PIVKA)-II (P=0.016). After two cycles of treatment, disease control (CR+PR+SD) and PIVKA-II reduction of over 50% were independent factors for survival (P=0.048 and P=0.025). Objective response (CR+PR) and PVTT response were also significant prognostic factors (P=0.043 and P=0.005). Conclusions: HAIC may therefore be considered as an effective treatment modality for advanced HCC with PVTT in patients with good prognostic factors.
( Do Seon Song ),( Won Kim ),( Sang Hoon Ahn ),( Hyung Joon Yim ),( Jae Young Jang ),( Young Oh Kweon ),( Yong Kyun Cho ),( Yoon Jun Kim ),( Gun Young Hong ),( Dong Joon Kim ),( Young Kul Jung ),( Joo 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.2
Background/Aims: Besifovir dipivoxil maleate (BSV), an acyclic nucleotide phosphonate, shows potent antiviral activity against hepatitis B virus. Our previous 48-week trial revealed that BSV has comparable antiviral efficacy to tenofovir disoproxil fumarate (TDF) and better safety profiles in terms of improved renal and bone safety. This extension study evaluated the prolonged efficacy and safety of BSV in treatment-naive chronic hepatitis B patients. Methods: Patients continued to participate in an open-label BSV study after an initial 48-week double-blind comparison of BSV and TDF treatment. The antiviral efficacy and drug safety was evaluated up to 192 weeks in two groups: patients continuing BSV treatment (BSV-BSV) and patients switching from TDF to BSV after 48 weeks (TDF-BSV). Results: Among 197 patients receiving randomized treatments, 170 (86%) entered the open-label phase and 152 (77%) entered the 192-week extension study. Virological response rates over 192 weeks were 92.50% and 93.06% in the BSV-BSV and TDF-BSV groups, respectively (P=0.90). Hepatitis B envelop antigen seroconversion and alanine aminotransferase normalization rates were similar between the groups (P=0.75 and P=0.36, respectively). There were no drug-resistant mutations to BSV. Bone mineral density and renal function were well preserved in the BSV-BSV group, whereas these initially worsened then recovered after switching therapy in the TDF-BSV group. Conclusions: BSV maintained potent antiviral efficacy after 192 weeks and showed no evidence of drug resistance. BSV was safe, well tolerated, and effective in patients who switched from TDF to BSV. Trial Registration Number: NCT01937806 (date: 10 Sep 2013). (Clin Mol Hepatol 2021;27:346-359)
The Usefulness of Liver SPECT to Assessment of Liver Function in Patient with Cirrhosis
( Seon Young Ahn ),( Hyun Jae Lee ),( Suk Bae Kim ),( Jae Hyun Lee ),( Ki Bae Bang ),( Joon Ho Choi ),( Hyun Deok Shin ),( Jung Eun Shin ),( Hong Ja Kim ),( Il Han Song ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: It is not easy to evaluate the liver function in patient with cirrhosis although there are many methods such as Child-Pugh, MELD score, etc. We aimed to study the usefulness of liver SPECT to assessment of liver function in patient with cirrhosis and the correlation with other methods. Methods: We enrolled patients with liver cirrhosis who were taken the liver SPECT at Dankook University Hospital from Apr. 2013 to Sep. 2015. Before regular imaging, total counts of syringe were calculated for 1 minute and after injection, remnant radioactivity counts of syringe and intravenous injection site during 1 minute were assessed so that total net injected counts (TNC) into each patient was achieved using these counts. Region of interest (ROI) in liver were drawn manually and we calculated organ specific radioactive count (OSRC) on each ROI. We got the two images (anterior and posterior side) and got the OSRC from them. Then, Absolute uptake ratio (AUR) of liver and spleen on each projection image was calculated as 100 x each OSRC/TNC. Geometric mean value (GMV) of liver and spleen was calculated as 100 x √(anterior ORSC x posterior ORSC)/TNC. Their liver functions were analyzed and compared with liver SPECT results. Results: Total 77 patients (male 56, female 21) were enrolled and their mean age was 54.3±9.0 years old. The alcohol (84.4%) was the main cause of liver cirrhosis and followed by chronic hepatitis B (6.5%), chronic hepatitis C (5.2%), unknown (3.9%). The GMV of the liver was 11.7±5.2. GMV according to Child-Pugh class was 15.5±4.8 in class A, 12.3±4.4 in class B, 6.8±2.8 in class C, respectively. Pearson correlation coefficient between Child-Pugh score and GMV was -0.668 and showed strong correlation. Pearson correlation coefficient between MELD score, MELDNa and GMV was -0.636, -0.526, respectively. Conclusions: GMV in liver SPECT showed good correlation with liver functions such as Child-Pugh, MELD, MELDNa score. It could be used as good method to assess liver functions in patients with cirrhosis.