정신분열병과 Glutathione S-Transferase M1유전자 다형성

배치운,조자현,김연주,김태석,김정진,이창욱,이수정,전태연,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : This study aimed to test the possible association between Glutathione S-Transferase Ml gene (GSTMl) variants and schizophrenia. Methods : One hundred and eleven inpatients with schizophrenia and 130 healthy controls were recruited. Genotyping was performed by polymerase chain reaction-based method. Results : The GSTMl null genotype was significantly more frequent in patients with schizophrenia than in controls (p=0.014, odd ratio=1.93, 95% confidence interva1=1.115-3.351), while GSTMl genotype vahants were not associated with either tardive dyskinesia (TD) or total Abnormal Involuntary Movement Scale (AIMS) scores. Conclusion : The present study suggests that the GSTMl polymorphism may confer susceptibility to the development of schizophrenia but not to TD, at least in Korean population.

주요 우울장애가 동반된 혈액 종양 환자에서 Paroxetine의 효과 및 안정성

배치운,이혁재,김정진,이창욱,이수정,이철,백인호 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.4

Objectives : The efficacy and safety of paroxetine in the treatment of depressive disorders are well known, however its efficacy and safety for the treatment of depression in patients with cancer has been poorly studied. This study therefore aimed to evaluate the efficacy and safety of paroxetine in treatment of depressed patients with hematological malignancy (HM). Methods : Fifty-two patients with major depressive disorder (MDD) based on DSM-IV criteria along with comorbid HM were allotted to 8 weeks trial with a flexible-dose regime of paroxetine in combination with their chemotherapy or supportive pharmacotherapy. Treatment response was assessed at baseline, week 2, week 4, and week 8 with 17-item Hamilton Rating Scale for Depression (HAM-D17), Montgomery A sberg Depression Rating Scale (MADRS), and Clinical Global Impression-severity (CGI-S). Side effects were collected with the reported adverse events and laboratory test throughout the study period. Results : 44.2% of 52 patients completed the eight weeks trial. Scores on the HAM-D17, MADRS, and CGI-s (last Observation carried forward, LOCF) at baseline were significantly reduced with mean reduction of 30.5%, 32.8%, and 39.1%, respectively, after 8 weeks treatment with paroxetine. Forty-six patients (88.5%) reported at least one adverse event. The most common adverse event observed in this study was nausea and no serious adverse event was found. Conclusion : In this preliminary study, overall results showed paroxetine could be used for the treatment of depressed patients with HM, but more controlled study is needed to confirm the efficacy and safety of paroxetine in this area.

Fluoxetine 투여와 관련된 양측 측두하악관절 손상 1예

배치운,김연주,김태석,김정진,이창욱,이수정,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

We hereupon present a case of injured temporomandibular joint (TMJ) associated with fluoxetine monotherapy-inducedrepeated yawning. Further information is needed regarding the relationship between fluoxetine administration and clinically significant yawning. Clinicians should be more careful to listen to their patients when they describe unexpected reactions to medications.

-G308A Tumor Necrosis Factor-α 유전자 다형성과 주요 우울장애의 연합연구

배치운,오해정,채정호,박원명,전태연,한훈,김광수 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2

Objectives : The present study was to examine possible association between the - G308A tumor necrosis factor (TNF)-α gene polymorphism and major depressive disorder (MDD) in Korean. Methods : 108 inpatients with MDD and 125 healthy controls participated in this study. Genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism. Results : Genotype and allele distributions in patients with MDD (p=0.02, P=0.01, respectively), were significantly different from those of the controls. Conclusion : The present study suggests that the -G308A TNF-α gene polymorphism may have a potential role for the susceptibility to MDD in Korean population.

Monocyte Chemoattractant Protein-1[MCP1] -2518 유전자 다형성과 주요 우울장애

배치운,이지현,신윤경,김태석,김정진,이창욱,이수정,전태연,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Object : This study was designed to examine the association between monocyte chemoattractant protein-l (MCPl) -2518poly morphism and major depressive disorder (MDD). Methods : Ninety patients with MDD and 114 healthy controls participated in this study. Genotyping was performed by the polymerase chain reaction-restriction fragment length polymorphism method. Results : Genotype and allele distributions in patients with MDD were significantly different from those of the controls, In particular, subjects with the allele A were found to have an increased risk of MDD. Conclusion : The present study suggests that the MCPl -2518 polymorphism may have a potential role for susceptibility to MDD in the Korean population and thus calls for consecutive studies in order to pile up the data with larger different ethnic background.

양극성 장애와 Monocyte Chemoattractant Protein-1 유전자 다형성

배치운,김태석,장우영,김정진,이창욱,이수정,전태연,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : Several studies suggested that cytokines could be involved in the pathogenesis of mood disorders, while data for bipolar disorder is relatively deficient (BD). BD, Knowned to have a inherited tendency, has been considered to be related with T-helper cell system. This study was designed to investigate the association between polymorphism of monocyte chemoattractant protein-1 (MCP1) gene at promoter-2518 and BD. Methods : Patients with BD (n=92) in accordance with DSM-FV criteria and control subjects (n=114) participated in this study. DNA was extracted from whole blood and the MCP-1 gene promoter region was amplified by polymerase chain reaction-based method. Results : Genotype and allele distributions in patients with BD were not different from those of control subjects (p=0.587 ; p=0.384). Genotype and allele distributions in accordance to presence or absence of suicide attempt (p=0.423), family history (p=0.733) and psychotic feature (p=0.436) were not different between the two groups. Conclusion : Present study suggests that the MCP1 promoter -2518 polymorphism may not affect the susceptibility and clinical diversity of the development of BD.

정신분열병 환자에서 올란자핀과 연관된 체중 증가에 대한 니자티딘과 효과 : 예비 연구 A Pilot Study

배치운,정유경,이창옥,이수정,이철,백인호 대한생물치료정신의학회 2003 생물치료정신의학 Vol.9 No.1

본 연구는 올란자핀을 투여 후 체증 증가가 관찰된 정신분열병 환자들을 대상으로 nizatidine의 효과를 조사하고자 시도되었다. 올란자핀을 처으 투여 받은 환자들 중 체중 증가가 발생된 10명을 대상으로 하였다. 모든 환자에게 nizatidine을 300mg/day로 투여하였으며 임상 증상에 미치는 영향을 배제하기 위하여 PANSS와 BPRS를 기저 시점과 nizatidine 투여 후 4주 및 8주 시점에 측정하여 임상 증상의 변화를 평가하였다. 연구 시작 후 4주 및 8주 시점에서 체중 변화는 각각 1.1kg(1.5%)와 2.5kg(3.5%)이었으며 BMI의 경우 4주와 8주 시점에서 각각 0.4(1.6%)와0.9(3.7%)로 연구 기간동안 모두 유의한 감소를 보였다. 올란자핀을 복용하여 체중 증가가 관찰되었던 10명의 정신분열병 환자를 대상으로 하여 8주간 nizatidine을 투여한 결과, 연구 방법상의 제한점이 있으나 nizatidine은 올란자핀 관련 체중 증가의 치료에 효과적인 약물로 생각된다. Objectives:This pilot study was conducted to evaluate the effect of nizatidine on olanzapine-associated weight gain(OAWG) in schizophrenic patients in Korea. Methods:Ten subjects with OAWG from outpatients clinic who were diagnosed with schizophrenia and schizophreniform disorder in accordance with DSM-IV criteria. Positive and Negative Syndrome Scale(PANSS) and Brief Psychiatric Rating Scale(BPRS) were measured at baseline, week 4 and week 8 as were weight and Body Mass Index(BMI). A flexible dose of olanzapine plus fixed 150mg(b.i.d) dose of nizatidine was administered to all patients. Weight and BMI(kg/m^2) were recorded at each visit. Results:A combination of nazatidine resulted in significant reversal of OAWG without worsening the psychopathology. In the with studies of Western populations, an add-on therapy of nizatidine could be an effective option for the control of weight gain in olanzapine-treated patients in Korea. Conclusion:Our finding call for further evaluation of the effect of this drug on schizophrenics, with randomized placebo-controlled studies, in Asian populations.

급성 조증에서 기분안정제와 리스페리돈의 병합 투여 효과 : 다기관 개방연구

김광수,배치운,윤진상,김영훈,이양현,지익성,이철,송혜경,최성구,박원명 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Ohjective : The primary purpose of this study was a replication of the effectiveness and tolerability of rispehdone in the treatment of patients with acute mania in very larger cohon in naturalistic treatment setting to extend the data on the effect and tolerability of risperidone in the treatment of patients with acute mania to Asian population. Methods : A total of 909 patients with DSM-TV criteria of bipolar disorder current manic and hypomanic episode, entered this large, open, multicentre study. The Young Mania Rating Scale (YMRS), Clinical Global Impression (CGI) and Simpson-Angus Rating Scale (SARS) were measured at baseline and weeks 1, 3 and 6, for the assessment of effectiveness and extra-pyramidal symptom (EPS). Results : This study showed statistically significant reduction of scores on the YMRS and CGI-s (mean change=-23.5±11.8, p<0.0001 ; mean change=-2.7±1.5, p<0.0001, respectively) from the baseline to the endpoint (week 6). Number of patients with 50% reduction or more in the YMRS and CGI-s scores was 693 (77.8%) and 630 (70.7%) at endpoint, respec-tively. There were no statistically significant increments of scores on SARS. Risperidone was generally well tolerated. Conclusion : The present larger open study demonstrates that hsperidone add-on therapy is effective and tolerable in treat-ment of bipolar disorder, replicating results in various controlled and uncontrolled studies from Western countries.

정신과 입원환자에서 Olanzapine의 처방경향에 대한 연구 : 한국과 미국의 일 대학병원에서 사용비교

박원명,배치운,김선경,채정호,전태연,김광수,유태열 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

Objective : Recently, domestic use of olanzapine and the studies for olanzapine have been increased. However, naturalistic studies for the practical use of olanzapine are rare. Therefore, this study was designed to evaluate the prescription trend for olanzapine and its related pharmacological variables at a university hospital in Korea, and to compare with those of university hospital in USA, simultaneously. Methods : Data of 33 Psychiatric inpatients who had been firstly treated with olanzapine at st. Mary's Hospital from October 1999 to March 2000 and of 109 at McLean Hospital, Hanard Medical School, USA from March 1998 to June 1998 were collected, respectively. Data on patient's age, sex, number of past admission, diagnosis distribution, duration of hospitalization, antipsychotic combination, combined psychotropics, combined mood stabilizer, and dosage of olanzapine were analyzed. Results : The mean age and number of past admission were significantly higher at McLean hospital than those of St. Mary's hospital. In terms of diagnosis, olanzapine was most widely prescribed to psychotic disorder, nextly to mood disorder at St. Mary's hospital, but in order of mood disorder, psychotic disorder, and other psychiatric disorder at McLean hospital and, these diagnostic distribution were significantly different. The mean initial dose was similar between two hospitals, but maximal and discharge dose of olanzapine were significantly higher at St. Mary's hospital than those of McLean hospital. In aspects of psychotropic combination , anxiolytic was highly used with statistical significance at St. Mary's hospital but antidepressant and mood stablizer were highly used at McLean hospital. Conclusion : Prescription trend of olanzapine for psychiatric inpatient between two hospital was different, olanzapine was prescribed mainly by diagnosis at St. Mary's hospital but by symptomatic management at McLean hospital. In future, further systematic study should be conducted including various clinical variables to refine these differences.

우울증과 심혈관 질환

전태연,배치운 한국의학사 2000 診斷과治療 Vol.20 No.11