정신분열병 환자의 반응시간

최형식,정범석,김한규,송현주,이재원,김창윤 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

연구배경: 주의력은 인지적인 정보처리과정(information processing)의 가장 기본적인 단계이다. 반응시간 (reaction time)은 주의력을 가장 잘 반영하는 검사 중 하나로서, 자극이 제시된 후 반응이 시작되기까지 반응 여부를 결정하는데 걸리는 시간인 판단 시간(decision time)과 반응이 시작되면서 목표에 도달할 때까지 시간인 운동시간(motor time)으로 나누어 볼 수 있다. 기존의 연구결과로는, 정신분열병 환자군에서 반응시간의 수행이 떨어져 있다는 보고는 많이 되어왔으나 차이가 없다는 보고도 있으며, 판단시간과 운동시간 중 어느 부분에 장애가 있는지 명확하지 않다. 또한 반응시간 측정값은 질병의 진단적 유형(diagnostic subtype), 증상, 경과 등의 영향을 받으며 개체간의 변동(inter-individual variation)이 크고, 같은 피험자라도 측정시점이 다를 때마다 차이를 보이는 개체내 변동(intra-individual variation)이 커서 검사결과마다 차이를 보이고 있는 상태이다. 목적: 환자군은 개체간 변동이 크고 다른 임상적 요소에 의해 영향받는 점을 고려하여, 임상적으로 안정적인 경과에 있는 정신분열병 환자만을 대상으로 정상인 군과 반응시간의 차이를 비교하고자 하였다. 또한 반응시간을 판단시간과 운동시간으로 나누어 측정하여 각각을 비교분석 하고자 하였고, 개체내 변동이 큰점을 고려하여 25회 반복 측정을 실시하고 이에 따른 변동의 경향성을 조사하고자 하였다. 방법: DSM-Ⅳ에 의해 '정신분열병'으로 진단된 환자로서, 급성기 이후 항정신병약물을 유지하고 있으며BPRS(brief psychiatric rating scale) 30점 이하의 임상적으로 안정적인 상태가 3개월 이상 유지된10명이 환자군으로 포함되었고, 정상인은 자원자 10명이 포함되었다. 검사도구는 비엔나 테스트 시스템 반응유닛(Reation Unit) 파라미터 S8을 이용하였다. 총 6가지의 자극이 무작위로 1측정시기(session) 당 총 32회 주어지고, 피험자는 이중 특정 자극에 8번만 반응하도록 되어 있다. 시작 전 1회 연습 후 총 25측정시기를 5분 간격으로 반복하였다. 반응 시간을 판단시간과 운동시간의 합으로 정의하고 세 가지 모두 컴퓨터를 이용하여 자동 측정되었다. 반응·판단·운동 시간의 비교에는 반복 측정을 고려한 분산분석(repeated measures analysis of variance)을 사용하였다. 결과: 환자군은 정상인에 비하여 유의하게 반응시간의 수행속도가 저하되어 있었다(p<0.01). 판단시간과 운동시간으로 나누어 볼 때, 환자군에서 판단시간이 유의하게 느렸고(p<0.01), 운동시간은 수행저하의 경향을 보였으나 통계적으로 유의하지는 않았다. 25회 반복측정시 양군 모두 측정시기에 따른 유의한 변화를 보였고(p<0.01), 환자군의 반응시간은 개체간의 차이뿐 아니라 개체내 변동이 큰 경향을 보였다. 옳게 반응한 횟수(correct response)는 환자군에서 저하되는 경향을 보였으나 통계적으로 유의하지는 않았다. 고찰: 정신분열병 환자군에서 판단시간이 유의하게 저하된 것은, 반응시간의 저하가 운동요소 보다는 인지적 요소에 의한 것임을 시사하는 것으로, 정보처리과정의 기본적인 단계인 주의력 장애를 보여주는 것으로 생각된다. 비교적 안정적이고 임상적인 특성이 동일한 환자군에서도 반응시간이 대조군에 비해 큰 개체간 차이와 개체내 변동성의 경향을 보였으며, 이는 단순한 측정오차라기 보다는 정신분열병 환자군의 인지기능의 특성을 반영하는 것으로 생각된다. 중심단어:정신분열병·반응시간·판단시간·운동시간·개체간 변동·개체내 변동. The reaction time(RT) has been known to reflect attention that controls the flow of information processing. Extensive research has demonstrated cognitive impairment in schizophr-enia subjects using RT taske. However, little work has been done examining the relative contribution of DT(decision time) and MT(motor time) to slowed RT in schizophrenics. Also, recent investigators have observed that schizophrenic patients exhibit larger intra-individual variability in RT than do normal comparison subjects. The purpose of this study, using multi-stimulus convergent RT task, was to explore the speed of RT, relative contribution of decision time(DT) and motor time(MT) to slowed RT, overall sequential profile in 25 repeated-time measurements in 10 schizophrenic out-patients and 10 normal control subjects. Overall reaction time and decision time were slower in schizophrenic subjects than in normal controls. The motor time was not shown to be significantly different between the two groups with 0.05 significance level, although there was some trend indicating schizophrenic subjects were slower consistently in repreated measurements over time. These results suggested that the slower reaction time in schizophrenic subjects was mostly determined by cognitive component, decision time rather than motor time. Sequential profile of repeated measurements showed greater intraindividual and interindividual variations in schizphrenics than in normal controls. These results indicate that high variabilities are not merely measurement errors but characteristic of schizophrenic psychopathology. KEY WORDS: Schizophrenia·Reaction time·Decision time·Motor time·Inter-individual variation·Intra-individual variation.

중추에서 Prostaglandin계가 Renin-angiotensin System에 미치는 영향

최영태,김종승,문성호,오형균,김재훈,전제열,염철호,윤평진 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.1

Role of prostaglandins on the renin-angiotensin system in the central nervous system was examined in normotensive and 2-kidney, 1 clip (2K1C) hypertensive rats. The experiment was done under thiopental (50 ㎎/㎏, IP) anesthesia. Captopril and indomethacin were injected into the right lateral cerebral ventricle. Arterial blood pressure and heart rate were recorded from the femoral artery. Intracerebroventricular (ICV) captopril (1 ㎎) caused a decrease in mean arterial pressure in both normotensive and 2K1C hypertensive rats. The depressor response to captopril was more sensitive in hyper-tensive rats than in normotensive rats. Indomethacin treatment (ICV, 200 ㎎) altered the depressor response to captopril neither in normotensive nor in hypertensive rats. These results suggest that the cardiovascular effect of renin-angiotensin system in the central nervous system may not be mediated via prostaglandin systems in normotensive and 2KlC hypertensive rats.

기능성 Catechol-O-Methyltransferase 유전자 다형성과 한국인 정신분열병의 관련성

박태원,홍영준,박임순,김형섭,최인미,배수영,윤경식,강대희 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : Catechol-O-Methyltransferase(COMT)는 카테콜아민 신경전달물질의 불활성화를 담당하는 효소로서, 정신분열병과 관련된 후보 유전자로서 알려져 왔다. 최근, 기능성 COMT유전자 다형성과 정신분열병의 관련성이 제기되었는데, 한국인 정신분열병에서도 이러한 관련성이 있는지를 살피기 위해 본 연구를 시행하였다. 방 법 : 정신분열병으로 진단된 환자군 103명과 성별 및 연령별로 1:1 짝짓기 대조군 사이에 유전자형과 대립유전자의 분포를 비교하였다. 또한, 환자군은 공격적 행동, 가족력, 아동기 발병 여부에 따라 두 군으로 나누어 비교하였다. DNA의 다형성 부의를 중합효소연쇄반응에 의해 증폭한 후 ,NlaⅢ제한효소법과 전기영동을 실시하여 유전자형을 판별하였다. 결 과 : 환자군 전체와 대조군 사이에 유전자형과 대립유전자 빈도의 차이가 없었다. 가족력이 있는 환자군을 대조군과 비교하였을 때는, 대립유전자 L을 포함하는 유전자형과 그렇지 않은 유전자형의 분포에 있어 유의한 차이를 보였다(p=0.02, OR=3.9, 95% Cl=1.1∼14.3). 결 론 : 한국인 정신분열병과 기능성 COMT 유전자 다형성 사이에 유의한 관련성이 없었다. 따라서, 기능성 COMT 유전자 다형성이 한국인 정신분열병의 발병에 영향을 주지 못한다. 그러나, 정신분열병 가족력과 기능성 COMT유전자 다형성의 관련성이 시시돠어, 향후 본 연구에서 나타난 방법론적인 문제점을 보완하고 추가 대상자를 확보한 연구가 필요하다. Objectives : Catechol-O-methyltransferase(COMT) is involved in the degradation of catecholamine meurotransmitters and has been investigated as a candidate gene in schizophrenia. Recently, possible relationship between functional COMT gene polymorphism and schizophrenia has been suggested. To address the possible role of functional COMT gene polymorphism in the predisposition to schizophrenia, we carried out an association study in Korean schizophrenic patients and controls. Methods : One hundred and three Korean inpatients diagnosed as schizophrenia and 103 age and sex matched controls were selected as study subjects. Patients were subgrouped into two groups on the basis of history of aggressive behavior, family history of schizophrenia and related disorders, and age at onset. We determined COMT genotypes using PCR of the relevant region followed by digestion with NlaⅢ and electrophoresis. Results : No significant differences of allele and genotype frequencies were noted between patients and controls. However, when patients were categorized by the presence of family history of schizophrenia and related disorders, patients with family history showed almost 4 fold higher frequency of having COMT L allele containing genotype compared to controls(p=0.02, OR=3.9, 9.5% CI=1.10-14.33). Conclusion : Although our results do not support an association between functional polymorphism of COMT gene and schizophrenia overall, the findings suggest an association between functional COMT gene polymorphism and familial schizophrenia. Further studies with large samples are needed to confirm this association.

鉛暴露 作業者의 鉛中毒 早期發見을 위한 集團檢診法 改善方案에 관한 硏究

홍대용,김장락,정주화,최현림,윤형렬 慶尙大學校 1995 論文集 Vol.34 No.1

This study was carried out to evaluate the feasibility of current lead indicators used in screening lead who were sspeted to have been exposed to lead were selected as 'case'and 207 female workers from non-lead industry were selected for 'control'. The results obtained were as follows: 1. The mean values of blood lead for case and control were 31.4㎍/dl, 22.2㎍/dl,respectively. The difference observed in the mean concentration between case and control was statistically signifi-ant(P<0.01) 2. The mean values for blood ZPP by hematofluorometer for case and control were 31.3㎍/dl, 25.4㎍/dl,respectiely. And difference between two groups was statistically significant(P<0.01). 3. No statistically significant correlation was found between working duation and blood lead, blood ZPPlovel. 4. According to the simple correlation analysis,ZPPand urine lead were found to be statistically correlated with blood lead(P<0.01) 5. According to the discriminant analysis using blood lead as a dependent variable, it showed 89.1% predictability when using 40㎍/dl as a cutting value which is used as a screenig cutting value for industry workers health examination, while 81.8% for 30㎍/dl,77.54% for 20㎍/dl, respectively. 6. Lead related simptons which is used for screening the lead ntoxicated patients were used as a dependent variables in multiple regression analysis to find useful lead indicator. And significant independent variables were found to be ZPP, Age, and Hct. 7. Above results suggest that objective evalution of feasibbility of several lead indicators should be developed to correct the disutility of current lead screeng system in Korea.

Antioxidant vitamins and magnesium and the risk of hearing loss in the US general population

Choi, Yoon-Hyeong,Miller, Josef M,Tucker, Katherine L,Hu, Howard,Park, Sung Kyun American Society for Clinical Nutrition 2014 The American journal of clinical nutrition Vol.99 No.1

<P><B>Background:</B> The protective effects of antioxidant vitamins on hearing loss are well established in animal studies but in few human studies. Recent animal studies suggest that magnesium intake along with antioxidants may act in synergy to prevent hearing loss.</P><P><B>Objective:</B> We examined associations between intake of antioxidant vitamins (daily β-carotene and vitamins C and E) and magnesium and hearing thresholds and explored their joint effects in US adults.</P><P><B>Design:</B> We analyzed cross-sectional data from 2592 participants aged 20–69 y from NHANES 2001–2004. Hearing thresholds as pure tone averages (PTAs) at speech (0.5, 1, 2, and 4 kHz) and high frequencies (3, 4, and 6 kHz) were computed.</P><P><B>Results:</B> When examined individually, modeled as quartiles, and after adjustment for potential confounders, higher intakes of β-carotene, vitamin C, and magnesium were associated with lower (better) PTAs at both speech and high frequencies. High intakes of β-carotene or vitamin C combined with high magnesium compared with low intakes of both nutrients were significantly associated with lower (better) PTAs at high frequencies (−14.82%; 95% CI: −20.50% to −8.74% for β-carotene + magnesium and −10.72%; 95% CI: −16.57% to −4.45% for vitamin C + magnesium). The estimated joint effects were borderline significantly larger than the sums of the individual effects [high β-carotene/low magnesium (−4.98%) and low β-carotene/high magnesium (−0.80%), <I>P</I>-interaction = 0.08; high vitamin C/low magnesium (−1.33%) and low vitamin C/high magnesium (2.13%), <I>P</I>-interaction = 0.09].</P><P><B>Conclusion:</B> Dietary intakes of antioxidants and magnesium are associated with lower risks of hearing loss.</P>

Environmental Polycyclic Aromatic Hydrocarbons and Insulin Resistance in Elderly Men and Women

Yoon-Hyeong Choi(최윤형),Jin Hee Kim(김진희),Yun-Chul Hong(홍윤철) 환경독성보건학회 2014 한국독성학회 심포지움 및 학술발표회 Vol.2014 No.5

Unexpected potential protective associations between outdoor air pollution and cataracts

Choi, Yoon-Hyeong,Park, Su Jin,Paik, Hae Jung,Kim, Mee Kum,Wee, Won Ryang,Kim, Dong Hyun Springer 2018 Environmental Science and Pollution Research Vol. No.

Skeletal and dentoalveolar effects of different types of microimplant-assisted rapid palatal expansion

Hyeong-Yoon Choi,Sang-Min Lee,Jin-Woo Lee,Dong-Hwa Chung,Mo-Hyeon Lee 대한치과교정학회 2023 대한치과교정학회지 Vol.53 No.4

Sex-dependent and body weight-dependent associations between environmental PAHs exposure and insulin resistance: Korean urban elderly panel

Choi, Yoon-Hyeong,Kim, Jin Hee,Hong, Yun-Chul BMJ Publishing Group 2015 Journal of epidemiology & community health Vol.69 No.7

<P><B>Background</B></P><P>The prevalence of metabolic diseases rises rapidly with an ageing population. Recent studies suggest the potential involvement of environmental chemicals in insulin resistance (IR) that plays a core role in the development of metabolic diseases. Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous components of outdoor and indoor air pollution. The influence of PAHs on IR may differ depending on sex and weight.</P><P><B>Objectives</B></P><P>We examined the association between exposure to environmental PAHs and IR in Korean urban elderly adults controlling for major risk factors that contribute to an increase in IR.</P><P><B>Methods</B></P><P>Between 2008 and 2010, PAH metabolite levels (urinary 1-hydroxypyrene (1-OHP)) and the homoeostatic model assessment index (HOMA-IR) were repeatedly measured in 502 adults aged ≥60 years. Linear mixed effect models were fit to evaluate the associations of 1-OHP concentration with HOMA-IR. Subgroups were modelled by sex and weight.</P><P><B>Results</B></P><P>After adjusting for sociodemographics, air pollution and metabolic disease status, the highest (vs lowest) quartile of 1-OHP was associated with an 0.57 (95% CI 0.10 to 1.04) increase in the HOMA-IR score (p trend=0.037). When stratified by sex, women presented a significantly dose-dependent trend of 1-OHP with HOMA-IR (p trend=0.013), whereas no association was observed in men (p trend=0.904). When further stratified by weight (body mass index ≥25 vs <25 kg/m<SUP>2</SUP>), a significant association was found only in overweight women (p trend=0.023).</P><P><B>Conclusions</B></P><P>Our results suggest that environmental exposure to PAHs is associated with increased IR in elderly adults and that the association may be limited to overweight women.</P>

Urinary benzene metabolite and insulin resistance in elderly adults

Choi, Yoon-Hyeong,Kim, Jin Hee,Lee, Bo-Eun,Hong, Yun-Chul Elsevier 2014 Science of the Total Environment Vol.482 No.-

<P>Background: Benzene is a volatile organic compound present in traffic-related and indoor air pollution. It is of particular concern since it is known to induce oxidative stress, which can affect insulin resistance (IR). We therefore examined the association between exposure to environmental benzene and IR in the elderly. Study Design: Between 2008 and 2010, benzene metabolite levels (urinary trans,trans-muconic acid (t,t-MA)) and homeostatic model assessment index (HOMA-IR) were repeatedly measured in 505 adults aged 60 years. Linear mixed-effect models and marginal logistic models were used to evaluate associations of t,t-MA concentration with HOlVIA-IR score and elevated IR, defined as HOMA-IR >= 2.6. Results: After adjustment for sociodemographic and behavioral factors, environmental co-exposures, and metabolic conditions, quartile levels of urinary t,t-MA demonstrated a dose-dependent association with elevated IR (p-trend < 0.001) and the level of oxidative stress estimated by urinary malondialdehyde (p-trend < 0.001). As compared to the lowest quartile, the upper quartiles of t,t-MA (t,t-MA concentration >0.017 mg/g CR) were associated with elevated IR [odds ratio = Q2: 2.00 (95% confidence interval (CI): 1.16-3.46); Q3: 3.33 (95% CI: 1.90-5.84); Q4: 2.07 (95% CI: 1.02-4.22)]. Conclusion: Urinary benzene at levels currently observed in the urban elderly population is associated with IR, independent of traditional risk factors. Reduction of community-level exposure to benzene is therefore important for the effective prevention of IR in older adults. (C) 2014 Elsevier B.V. All rights reserved.</P>