Prevalence of Unruptured Intracranial Aneurysm on MR Angiography

전태연,전평,김건하 대한영상의학회 2011 Korean Journal of Radiology Vol.12 No.5

Objective: To evaluate the prevalence of incidentally found unruptured intracranial aneurysms (UIAs) on the brain MR angiography (MRA) from a community-based general hospital. Materials and Methods: This was a prospectively collected retrospective study, carried out from January 2004 to December 2004. The subjects included 3049 persons from a community-based hospital in whom MRA was performed according to a standardized protocol in an outpatient setting. Age- and sex-specific prevalence of UIAs was calculated. The results by MRA were compared with intra-arterial digital subtraction angiography (DSA) findings. Results: Unruptured intracranial aneurysms were found in 137 (5%) of the 3049 patients (M:F = 43:94; mean age, 60.2years). The prevalence of UIAs was 5% (n = 94) in women and 4% (n = 43) in men, respectively (p = 0.2046) and showed no age-related increase. The most common site of aneurysm was at the distal internal carotid artery (n = 64, 39%),followed by the middle cerebral artery (n = 40, 24%). In total, 99% of aneurysms measured less than 12 mm, and 93% of aneurysms measured less than 7 mm. Direct comparisons between MRA and DSA were available in 70 patients with 83 UIAs;the results revealed two false positive and two false negative results. Conclusion: This community-hospital based study suggested a higher prevalence of UIAs observed by MRA than previously reported. These findings should be anticipated in the design and use of neuroimaging in clinical practice.

Value of Repeat Brain MRI in Children with Focal Epilepsy and Negative Findings on Initial MRI

전태연,김지혜,이지훈,유소영,황숙민,이문향 대한영상의학회 2017 Korean Journal of Radiology Vol.18 No.4

Objective: To evaluate the value of repeat brain magnetic resonance imaging (MRI) in identifying potential epileptogenic lesions in children with initial MRI-negative focal epilepsy. Materials and Methods: Our Institutional Review Board approved this retrospective study and waived the requirement for informed consent. During a 15-year period, 257 children (148 boys and 109 girls) with initial MRI-negative focal epilepsy were included. After re-evaluating both initial and repeat MRIs, positive results at repeat MRI were classified into potential epileptogenic lesions (malformation of cortical development and hippocampal sclerosis) and other abnormalities. Contributing factors for improved lesion conspicuity of the initially overlooked potential epileptogenic lesions were analyzed and classified into lesion factors and imaging factors. Results: Repeat MRI was positive in 21% (55/257) and negative in 79% cases (202/257). Of the positive results, potential epileptogenic lesions comprised 49% (27/55) and other abnormalities comprised 11% of the cases (28/257). Potential epileptogenic lesions included focal cortical dysplasia (n = 11), hippocampal sclerosis (n = 10), polymicrogyria (n = 2), heterotopic gray matter (n = 2), microlissencephaly (n = 1), and cortical tumor (n = 1). Of these, seven patients underwent surgical resection. Contributing factors for new diagnoses were classified as imaging factors alone (n = 6), lesion factors alone (n = 2), both (n = 18), and neither (n = 1). Conclusion: Repeat MRI revealed positive results in 21% of the children with initial MRI-negative focal epilepsy, with 50% of the positive results considered as potential epileptogenic lesions. Enhanced MRI techniques or considering the chronological changes of lesions on MRI may improve the diagnostic yield for identification of potential epileptogenic lesions on repeat MRI.

주요 우울증에서 종양괴사인자-베타 유전자의 다형성

전태연,배치운,김영호,장계호,이정태,박원명,김광수 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 주요 우울증은 역학적 유전연구 등을 통하여 유전적 영향이 높은 것으로 알려져 있으며 최근에는 분자 유전학적 연구로 유전자 다형성과 질병의 연관성을 밝히는 것이 정신질환의 유전학적 연구에서 중요한 부분을 차지하고 있다. 이에 본 연구는 중추신경계와 면역계간의 상호작용에 관여하는 싸이토카인 중 TNF-β 유전자의 다형성을 분석하여 주요 우울증과의 유전학적 관련성을 알아보고자 하였다. 방 법 : DSM-IV에 의하여 주요 우울증으로 진단된95명을 환자군으로 선정하였고 가톨릭조혈모세포정보은행에서 보유하고 있는 정상 한국인 202명의 자료를 정상 대조군으로 사용하였다. 전혈에서 DNA를 추출하고 TNF-β 유전자 부위를 증폭한 후 제한효소 Nco Ⅰ으로 절단하여 555bp와 185bp의 절편을 갖는 TNFB*1과 Nco Ⅰ절단부가 없는 740bp의 절편 TNFB*2등 2가지 대립유전자의 제한효소절편길이 다형성을 조사하였다. 모든 자료의 분석은 x²검증을 이용하였다. 결 과 : 1) 주요 우울증과 정상 대조군 간에 TNFB유전자인 TNFB*1/1, TNFB*1/2 및 TNFB*2/2의 발현 빈도에는 유의한 차이가 없었다. 2) 두 군 간에 TNFB*1 과 TNFB*2 두 대립유전자의 빈도에는 유의한 차이가 없었다. 결 론 : 본 연구에서는 주요 울울증군과 정상 대조군 간에 TNFB*1과 TNFB*2의 두 대립유전자 발현 빈도에 유의한 차이를 발견하지 못하였다. 따라서 TNFB 유전자다형성과 주요 우울증과의 유전학적인 연관성이 없었다. 향후 연구에서는 다양한 임상변인을 포함하여 보다 통합적이고 체계적인 연구가 이루어져야 할 것으로 생각되었다. Objective : Major depressive disorder is known to have high genetic predisposition and the main focus of recent genetic studies in major depressive disorder has been concentrated on association studies between genetic polymorphism and disease, since molecular genetic methods have been developed. This study was designed to investigate the relationship between major depressive disorder and immunogenetic influences by analyzing polymorphism of TNFB gene, which is involved in interaction of immune system and CNS. Method : 95 persons who had been diagnosed of major depressive disorder were assigned as patient group and, 202 data obtained from Catholic hemopoietic stem cell bank, College of medicine, the Catholic University of Korea, were used as normal controls in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by Nco Ⅰ.After that procedure, we obtained and assessd restriction fragment length polymorphism of two alleles, TNFV*1 which has 555bp and 185bp fragments and carries the Nco Ⅰ restriction site, and TNFB*2 of 740 bp fragment lacks the Nco Ⅰ restriction site. All data were analyzed by x²test with two-tailed Fisher's exact test. Results : 1) The frequencies of TNFB*1/1, TNFB*1/2, and TNFB*2/2 were not statistically different between major depressive disorder patients and control group. 2) The frequencies of TNFB*2 and TNFB*1 were not statistically different between major depressive disorder patient group and normal control group. Conclusion : We did not verified the differences of frequency in TNFB*1/TNFB*2 gene between the major depressive disorder and normal controls, respectively. Consequently, there is no genetic relationship between major depressive disorder and gene polymorphism of TNFB. We do suggest that further systematic studies including various clinical variables should be conducted.

양극성 장애 1형에서 종양괴사인자 베타 유전자 다형성

전태연,이경욱,배치운,김원,우영섭,채정호,박원명 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : Bipolar disorder is known to have a high genetic predisposition. Recently, the main focus of etiologic studies in bipolar disorder has been concentrated on molecular genetic approach including gene polymorphism analysis. The present study was conducted to investigate whether TNFB polymorphism is associated with bipolar I disorder in the Korean population. Methods : 89 bipolar I disorder patients diagnosed by DSM-IV criteria were assigned as the patient group and 202 normal population, matched on age and sex from Catholic hemopoietic stem cell bank (Seoul, Korea), were enrolled as the control group in this study. Genotyping was performed by a polymerase chain reaction-restriction fragment length polymorphism method. All data was analyzed by x² test. Results : There were no significant differences in frequency of TNFB*1/1,TNFB*1/2 and TNFB*2/2 between bipolar I disorder patient group and normal control group. The frequency of TNFB*1 was not statistically different between bipolar I disorder patient group and normal control group. Conclusion : The difference of frequency in TNFB*1/TNFB*2 gene between the bipolar I disorder gropup and the normal contro1 could not be verified. The present result suggested that the gene polymorphism of TNFB may not play a significant role in susceptibility to bipolar I disorder. Studies with a larger number of subjects from different ethnic backgrounds, considring clinical phenotype and controlling various factors, should be launched to further determine the role of TNFB in bipolar I disorder.

급성 및 만성 정신분열증에 있어 Chlorpromazine투여에 대한 Prolatin 값의 변화

전태연 가톨릭대학 (가톨릭신학대학) 대학원 1983 가톨릭大學醫學部 論文集 Vol.36 No.1

주요 우울장애에서 Cytotoxic T Lynphocyte Antigen(CTLA-4) 유전자의 다형성

전태연,배치운,김병균,채정호,박원명,김광수,유태열,한훈 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

연구목적 : 세포의 면역 기능 조절에 관여하는 CTLA-4의 유전자 다형성을 분석하여 주요 우울장애와의 면역 유전학적 관련성을 알아보고자 하였다. 방 법 : DSM-Ⅳ진단 기준에 따라 주요 우울장애로 진단된 환자 77명을 선정하였으며 가톨릭대학교 의과대학 조혈모세포은행에서 보유하고 있는 149명의 정상 한국인 자료를 대조군으로 사용하였다. 전혈에서 DNA를 추출하였으며 중합효소반응으로 CTLA-4유전자 exon 1 부위를 증폭한 후 SSCP방법으로 유전?? 형별 분석하였다. 결 과 : 대조군과 주요 우울장애 환자군 사이의 CTLA-4 유전자형과 대립유전자의 발현 빈도를 비교시 유의한 차이가 없었다. 결 론 : 본 연구 결과 exon 1 CTLA-4 유전자형 및 대립유전자의 발현빈도는 주요 우울장애 환자군과 정상 대조군 사이에 차이가 없어, exon 1 영역은 후보 유전자로서의 가능성이 없었다. 향후 연구에서는 다양한 변인들에 따라 대상군을 임상적으로 동질성을 지닌 집단으로 세분하여 조사대상 유전자와의 관련성에 대한 연구가 이루어져야 하겠다. Objectives : This study was carried out to explore the relationship between major depressive disorder and CTLA-4 which is related to the immunologic function such as T cell regulation. Methods : Among the korean patients diagnosed as major depressive disorder according to DSM-Ⅳ, 77 patients without neurological illness, hormonal disorder, or comorbid mental illness were selected. The stored data of 149 normal Koreans from the Catholic Hemopoietic Stem Cell Bank of Korea, were used as a normal control group. The data of Korean control group were compared with those of the studies of different ethnics. DNA was extracted from whole blood and the exon I region of CTLA-4 gene was amplified by polymerase chain reaction. Gene typing was performed by using SSCP and then, the results were assessed. Results : There were no significant differences in genotype frquencies of CTLA-4*G/G, CTLA-4*G/A, and CTLA-4*A/A between the patients with major depressive disorder and the control group in Korean population(48.1% vs 46.3%, 41.6% vs 39.6%, 10.3% vs 14.1%, respectively).There were no significant differences in allelic frequencies of CTLA-4*G and CTLA-4*A between the patients with major depressive disorder and the control group in Korean population(68.8% vs 66.1%, 31.2% vs 33.9%, respectively). Conclusion : Considering negative result for the association of the exon I polymorphism of CTLA-4 gene with major depressive disorder in this study, the exon I polymorphism does not appear to be possible candidate gene for major depressive disorder. Moreover, further systematic researches including diverse clinical variables would required.

단순 및 연성전기충격요법에 의한 혈청 Cortisol5 Prolactin 및 성장 Hormone 값들의 변화

전태연,백인호 대한신경정신의학회 1982 신경정신의학 Vol.21 No.2

Recently it has been shown in numerous experimental studies that a series of electroconvulsive therapy (ECT) affects neurohormonal function in man, though the results of the studies have not yet confirmed the mechanisms of ECT. The authors measured serum cortisol, prolactin and growth hormone (GH) values before and after the induction of plain and softening ECT to trace if there is any significant quantitative change. The subjects consisted of 26 cases of plain ECT group and 9 cases o f softening ECT group. ECT was induced by the application of 110 volts for a period 0.3ᅳ2.0 sec., using bitemporal electrodes. Serum cortisol, prolactin and GH were measured by radioimmunoassay technique. The results were as follows; 1. It was revealed that cortisol value in the female group and the GH value in the male group increased significantly follow ing ECT, while prolactin value of both sex groups increased almost equally. 2. In plain ECT group, cortisol value and GH value increased significantly at 15,30,60 minutes follow ing the treatment. In the softening ECT group, significant increases were noted in the cortisol value at 15,30, 60 minutes follow ing the treatment and GH value at 15, 30,60 and 120 minutes following the treatment, while prolactin value increased without statistical significance. 3. It was considered that while the changes in the values of cortisol and of prolactin following ECT might be regarded as non-specific, the increase in the value of GH after ECT might have some specific meanings which may well require further verification.

양극성장애에서 HLA 대립형의 빈도

전태연 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.1

연구목적 : HLA는 면역반응을 유발하는 중요한 인자로서 가족력을 지니는 질환에 면역유전학적 작용을 하는 것으로 알려져 있다. 양극성장애의 병인으로서 유전전 요인을 알아보기 위한 연구의 일환으로 이들 환자에서의 HLA 대립형 빈도를 조사하여 유전적 연합연구를 시행하였다. 방 법 : DSM-Ⅲ-R 또는 DSM-Ⅳ 기준에 따라 양극성장애의 진단을 받은 환자 87명과 정상 대조군 206명을 대상으로 하여 HLA 대립형을 조사하였다. HLA class Ⅰ에 대하여는 미세림프구세포독성방법을 사용하였으며, class Ⅱ 형별은 역점적교잡법을 이용하여 유전자형을 동정하였다. 빈도간의 차이는 χ²test with two-tailed Fisher's exact test로 전산 분석하였다. 결 과 : 환자군과 정상대조군 사이의 HLA 대립형 빈도를 비교 분석하여 다음과 같은 결과를 얻었다. 1) 양극성장애 환자군에서 HLA-A29와 B54 대립형이 대조군보다 유의하게 높은 것으로나타났다. 2) 양극성장애 환자군에서 HLA-B51과 DRB1*02 대립형이 대조군에 비하여 유의하게 감소된 빈도를 보였다. 결 론 : 저자는 본 실험을 통하여 HLA의 일부 대립형과 양극성장애가 연관이 있음을 확인하였으며 이러한 결과의 유전적 의미를 알아내기 위해서는 보다 체계적인 연구가 지속되어야 할 것이다. Objectives : To evaluate the potential of HLA as a candidate gene for the genetic marker of bipolar disorder, we carried out the association study between allelic frequency of HLA and bipolar disorder. Methods : HLA classⅠand class Ⅱ allelic frequencies were assessed in 87 Korean bipolar disorder patients and were compared with the data from 206 normal controls. HLA classⅠtyping was performed with microlymphocytotoxicity method and HLA class Ⅱ(DQBI and DRBI) genotyping with reverse dot hybridization. The allelic frequencies were analyzed using χ²test with two-tailed Fisher's exact test. Results : Bipolar patients showed increased allelic frequencies of HLA-A29 and B54 and decreased allelic frequencies of HLA-B51 and DRBI*02 compared to normal controls. Conclusions : These results suggest the possibility of association between HLA gene and bipolar disorder. To clarify the genetic influences of HLA on bipolar disorder, further systematic studies should be conducted.

정신분열병에서 Interleukin-10 유전자의 제한효소절편길이 다형성

전태연,배치운 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 중추신경계와 면역기능의 조절에 관여하는 싸이토카인 중 Interleukin-10 유전자다형성을 분석하여 정신분열병과의 면역·유전학적 관련성을 알아보고자 하였다. 방 법 : DSM-IV에 의거하여 정신분열병으로 진단된 환자 114명을 선정하였으며 가톨릭조혈모세포정보은행에서 보유하고 있는 정상한국인 146명의 자료를 대조군으로 이용하였다. 전혈에서 DSP(direct sample preparation) 방법으로 DNA를 추출한 후 중합효소 연쇄반응(polymerase chain reaction)을 이용하여 IL-10유전자 부위를 증폭하였다. 이들 중폭산물을 제한 효소(MaeⅢ)로 분절 후 IL10*C와 IL10*T의 2가지 대립유전자에 대한 제한효소절편길이다형성을 조사하였다. 결 과 : 1) 정신분열병 군과 정상 대조군 간에 IL-10유전자형 IL-10*T/T, IL-10*T/C및 IL-10*C/C의 발현 빈도에서 유의한 차이가 없었다 (각 46.8%대 48.6%,44% 대 42.5%, 9.2% 대 8.9%). 2) 두 군간 IL-10*T와 IL-10*C 유전자 발현 빈도에는 유의한 차이가 없었다.(각 68.8%대 69.9%, 31.2% 대 30.1%). 결 론 : IL-10 유전자형 및 대립유전자의 발현빈도는 정신분열병 환자군과 정상 대조군 사이에 차이가 없었다. 향후 연구에서는 다양한 임상적 변인 등을 포함한 통합적인 조사가 이루어져야 하겠다. Objective : Recently, molecular genetic methods have been progressed, this study was to investigate the relationship between schizophrenia and immunologic aspects by analyzing polymorphism of IL-10 gene, which is involved in interaction of immunologic system and CNS. Method : 141 schizophrenic patients diagnosed by DSM-IV were included and data of 146 normal controls obtained from the Catholic Hemopoietic Stem Cell Information Bank of Korea were used in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by MaeⅢ After that procedure, we obtained and assessed RFLP of two alleles, IL-10T and IL-10C. All data were analyzed by x² test with two-tailed Fisher's exact test. Results : 1) There were no significant differences genotype frequencies of IL-10*T/T, IL-10*T/C, and IL-10*C/C in between schizophrenic patients group and control group. 2) There were no significant differences gene frequencies of IL-10*T and IL-10*C in between schizophrenic patients group and control group. Conclusion : We did not verified the frequency differences of IL-10*T/*IL-10*C gene between schizophrenic patients and normal controls, respectively. We do suggest that further systematic studies including various clinical variables should be conducted.

우울증과 심혈관 질환

전태연,배치운 한국의학사 2000 診斷과治療 Vol.20 No.11