백혈병 마우스 모델의 동종골수이식에서 활성화된 자연살해세포들의 보충이 이식편대백혈병효과와 이식편대숙주반응에 미치는 영향

엄현석,한치화,박수정,김소연,정낙균,정대철,진종률,최일봉,양형모,서영훈,송현근,최인표,민우성,김춘추 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: 백혈병에서 동종골수이식 (allogeneic bone marrow transplantation)의 성공적 치료 효과를 얻기 위해서는 이식편대숙주반응 (graft-versus-host disease, GVHD) 발생의 극복과 재발의 방지가 중요한 과제이다. 골수를 역류원심성 세포분리 (counterflow centrifugal elutriation, CCE) 방법으로 분리하여 얻은 rotor off (R/O) 세포분획은 T 세포의 수는 적지만 조혈모세포들을 다량 포함하고 있어 동종골수이식에서 주조직적합복합체 (major histocompatibility complex, MHC) 차이를 극복할 수 있고, 이식편의 생착 성공과 GVHD 발생 예방에 효과적이다. 그러나 골수로부터 T 세포를 제거하면 백혈병세포를 공격하는 이식편대백혈병 (graft-versus-leukemia, GVL) 효과가 감소되기 때문에 백혈병 재발의 빈도가 높다. 자연살해세포 (natural killer cell, NK cell)의 보충 첨가는 동종골수이식 후 GVHD 발생을 줄이면서 충분한 GVL 효과를 얻을 수가 있다. 따라서 저자는 분리 후 IL-2로 활성화시킨 NK 세포들을 골수 R/O 세포분획과 함께 백혈병 마우스 모델에 동종이식함으로써 GVHD와 GVL에 미치는 효과를 관찰하였다. 방법: Balb/c (H-2^(d)) 마우스에서 유래된 A20 (murine B-lymphoma/leukemia cell line, H-2^(d)) 백혈병 세포를 이식 2 일 전에 Balb/c 마우스에 주입하고, 치사량의 전신 방사선을 조사한 직후에 Balb/c 또는 C57BL/6 (H-2^(b)) 마우스의 골수 R/O 세포분획을 꼬리정맥을 통하여 주입하였다. 이들은 모두 이식 후 6-8 주 이내에 사망하였다. 동종이식의 대조군 (n=9)에는 1 × 10^(7)의 R/O 세포분획만을 주입하였고, 실험군 (n=9)에는 C57BL/6 마우스의 비장세포들로부터 단클론항체들을 이용한 negative selection방법으로 분리한 후 IL-2로 활성화된 5 × 10^(5)의 NK 세포분획을 1 × 10^(7)의 R/O 세포분획과 함께 주입하였다. GVL 효과의 판정은 이식 후 14 일과 28 일 째 되는 날 마우스에서 골수, 비장, 간 등을 얻어 백혈병 세포들의 침윤을 조직학적으로 관찰하였으며, GVHD의 정도는 육안적 관찰법으로 평가하였다. 결과: R/O 세포분획만을 이식한 대조군의 골수, 비장, 그리고 간 조직에서는 A20 백혈병 세포의 침윤이 각각 89% (8/9), 78% (7/9)와 22% (2/9)에서 관찰되었고, R/O 세포분획과 NK 세포분획을 함께 이식한 실험군에서는 비장과 간을 제외한 골수에서만 89% (8/9)에서 A20 백혈병 세포의 침윤이 관찰되어 두 군 사이에 장기별 분포의 차이를 볼 수 있었다 (P= 0.0001). 한편 GVHD는 두 군 모두에서 경하게 나타나서 유의한 차이는 없었다. 또한 생착 부전으로 사망한 마우스는 없었다. 결론: CCE를 이용하여 T 세포를 제거한 동종골수이식에서 NK 세포의 보충은 GVHD의 악화는 일으키지 않으면서, 백혈병의 진행을 억제하는 GVL 효과를 얻을 수 있었다. Background: Allogeneic bone marrow transplantation (BMT) with T cell-depleted marrow accompanies engraftment failure and relapse of leukemia by a loss of the graft-versus-leukemia (GVL) effect frequently, while it can prevent GVHD. Supplement of NK cells could prevent GVHD and enhance GVL effect in several murine allogeneis BMT models Roter off (R/O) cell fraction obtained by counterflow centriation elutriatio (CCO) contains small number of T cells and many hematopoietic stem cells. The aim of this study was to determine the effect of R/O cell fraction supplemented with IL-2 activated NK cells on GVL and GVHD within the leukemic mouse BMT model. Methods: Inoculation of A20 (H-2d, murine B-lymphoma/leukemia, Balb/c origin) cells into Balb/c mice via the tail vein 2 days prior to lethal total body irradiation (TBI) and infusion of the Balb/c BM or C57BL/6 (H-2b) R/O fraction were performed. It resulted in 100% mortality within 6 to 8 weeks. The irradiated mice in the control group were injected with 1 × 107 R/O cell fraction alone (n=9) and in the experimental group mice were injected with 1 × 107 R/O cell fraction plus 5 × 105 negatively selected IL-2 activated NK cell fractions of the spleens via the tail vein (n=9). On day 14 and 28 after BMT, the bone marrows, spleens, and livers of mice were harvested for histopathologic analysis of the infiltrations of leukemic cells. We then evaluated the GVHD within the mice. Results: A histopathologic study of the recipients receiving R/O fraction alone showed infiltration of leukemic cells, 89% (8/9) in bone marrows, 78% (7/8) in spleens, and 22% (2/9) in livers. The experimental group of mice showed only the infiltration of leukemic cells 89% (8/9) in bone marrows, not in spleens and livers. There were the organ differences of the leukemic cells infiltrations between the two groups (P=0.0001). There were no obvious differences in the GVHD scores between these two groups, and severe GVHD was not observed. There was no engraftment failure among groups. Conclusion: Thus, our findings suggest that R/O cell fraction obtained by CCE and supplemented with NK cells can promote GVL effect without mediating clinically overt GVHD in allogeneic BMT of mouse leukemia.

골수이식 후 사이토카인과 골교체 생화학적표지자의 변화 및 상관관계

민우성,강무일,한제호,강성구,오기원,이원영,김혜수,문성대,손현식,신완식,김춘추,윤건호,차봉연,이광우,손호영 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.1

Background : Loss of bone mass is usually detected after BMT. The causes of bone loss are related with gonadal dysfunction and immunosuppressants. Cytokines, especially IL-6, play an important role in the pathogenesis of postmenopausal osteoporosis. However, the pathogenetic role of cytokines in post-BMT bone loss is unknown and data on the changes of cytokines in accordance with bone turnover markers are scarce. The aim of this study is to assess the relationship of bone turnover markers and cytokines of peripheral blood and bone marrow before and after allogeneic BMT. Methods : This prospective study included two analyses. The first was a study of 46 BMT recipients, examining the relationship between bone turnover markers and cytokines of serum which were measured before and 1, 2, 3, 4 week and 3 months after BMT. The second was a study of 14 BMT patients, measuring bone marrow plasma cytokines such as IL-6 and TNF-? at post-BMT 3 week and bone turnover marker at the same time to assess the relationship beween two parameters. Results : Serum ICTP, bone resorption marker, increased progressively until 4 weeks (peak) after BMT and then decreased thereafter. Serum osteocalcin, bone formation marker, decreased progressively until 3 weeks after BMT and then increased thereafter. There was positive correlation between serum ICTP and bone marrow IL-6 levels at the post-BMT 3 week with a statistical significance, but the correlation between bone turnover markers and bone marrow TNF-? or peripheral blood cytokines was not found. Conclusion : Our data suggest that the progressive increase of bone resorption after BMT is related with the increase of bone marrow IL-6, which is a potent stimulator of bone resorption in vivo(J Kor Soc Endocrinol 15:85-96, 2000).

흰쥐에서 Chloramphenicol에 의해 유도된 불면에 대한 전기경련충격의 효과

추일한,김정수,홍승철,한진희,이성필 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 수면인자의 하나로 밝혀진 muramyl peptide가 사람을 포함하여 여러 포유동물종에서 분리되었는데 이는 박테리아의 세포벽을 형성하고 있는 peptidoglycans의 구성성분으로 macrophage의 작용으로 생체에서 형성되어 수면을 유도한다고 알려져 있다. 이를 뒷받침하는 근거로는 사람과 쥐에서 항생제를 사용하면 수면이 감소한다는 연구결과가 있었으며 이는 장내 세균의 감소로 인한 결과로 생각되고 있다. 또한 전기경련충격(ECS)는 동물실험에서 서파수면(slow wave sleep)의 증가와 역설수면(paradoxical sleep)을 감소시킨다고 보고되었다. 저자들은 이제까지 연구되지 않았던 항생제 투여로 야기된 동물의 불면증에 대한 ECS의 효과를 조사하고자 한다. 방 법 : Sprague-Dawley 수컷 흰쥐 12마리에 뇌파(EEG)를 측정할 수 있는 장치를 단 다음 제1일째 baseline EEG를 측정하고 다음날을 chloramphenicol을 투여하여 불면을 유발시켰으며 제3일째는 6마리는 대조군으로 사용하고 나머지 6마리는 실험군으로 사용하여 전기경련충격을 시행함으로써 이에 대한 수면인자들을 통계적으로 비교 분석하였다. 결 과 : Chloramphenicol 투여 후 총 수면시간(t=3.757, p=0.003)이 감소하였고 수면인자별로는 주간 서파수면(t=4.944, p=0.000)과 주간 역설수면(t=3.887, p=0.003)도 감소하였다. 또한 불면상태에서 전기경련충격 후 실험군의 경우 대조군에 비해 전체 수면(t=-0.830, p=0.426)은 증가하는 경향을 보이고 야간 서파수면(t=-3.863, p=0.003)과 야간 역설수면(t=-2.458, p=0.034)이 유의하게 증가하였다. 결 론 : 이상의 결과로 볼 때 항생제에 의하여 유도된 불면이 전기경련충격에 의하여 향상됨을 확인할 수 있었고 대부분의 정신과 환자들이 호소하고 있는 불면증에 대한 기전을 알아내는 기초적 역할을 할 수 있을 것으로 기대되며 정신과 영역에서 흔히 사용되는 전기경련충격의 수면에 대한 관계를 이해하는데 도움을 줄 수 있을 것으로 기대된다. Objectives : Muramyl peptide derived from bacterial cell wall has been identified as one of several endogenous sleep-promoting factors. Several studies have shown that the administration of antibiotics decreased sleep amount as well as bacterial colony numbers in rats. Electroconvulsive shock(ECS) has been widely used in the treatment of many psychiatric disorders, including depression, bipolar disorder, and some cases of schizophrenia. However exact mechanism of ECS on the normal or psychiatric condition is not well understood so far. Previous studies indicated that ECS has diverse effects on sleep parameters both in the human and animal subjects. However, there was no report to examine the relationship between effects of ECS and sleep in the antibiotic imposed animal subjects. Therefore the author studied the effects of ECS on chloramphenicol-induced insomnia in rats. Methods : Twelve Sprague-Dawley strain rats were divided into control(N=6) and experimental group(N=6). The sleep-wake activity was recorded continuously for consecutive three days(baseline, day 1 and day 2). On day 1, both groups were intraperitoneally injected with chloramphenicol 150mg/kg. On day 2, the control group was intraperitoneally injected with chloramphenicol 150mg/kg only, whereas experimental group received ECS an hour after they were injected with chloramphenicol 150mg/kg. Results : 1) Chloramphenicol administration decreased light period slow wave sleep(SWS)(t=4.944, p=0.000) and paradoxical sleep(PS)(t=3.887, p=0.003) as well as total SWS(t=2.98, p=0.012) and total PS(t=4.391, p=0.001). 2) ECS increased dark period SWS(t=-3.863, p=0.003) and dark period Ps(t=-2.458, p=0.034) as well as total dark period sleep(t=-4.302, p=0.002). Conclusion : These results suggest that ECS may be effective to reverse chloramphenicol-induced insomnia in rats. Furthermore, chloramphenicol-induced insomnia in rats could be a useful animal model for the future sleep research.

DISC-TUBE TYPE MEMBRANE을 이용한 산업폐수재활용에 관한 연구

김동일,문추연,한성욱 경운대학교 산업기술연구소 2001 産業技術硏究論文誌 Vol.3 No.2(B)

The application of membrane technology to treat the industrial wastewater has some difficulties due to their various unique characteristics. That is, treated water from the industrial wastewater facility does not show any common water quality to predict a potential fouling problem in operating membrane facility. For that reason, it is not easy for specific type membrane to choose in treating an industrial wastewater. To select a best suitable membrane process in recycling treated water from the final wastewater treatment facility of roll mill and steel and iron making area at P Steel Works, the effluent was treated with type of disc tube membranes in the pilot-scale plant. The experimental results employing disc tube membrane(Test Ⅲ of roll mill area) revealed that the fouling was comparatively limited by operating the plant at 34 bar showing higher recovery ratio and flow rate of permeation water as 75% and 1,400L/hr respectively. Optimum pre-treatment process was composed of sand filter, BMF(Backwash able micro filter) for the spiral wound membrane, and dual-media filter, micro filter for the disc tube membrane.

조혈모세포이식 후 골성장인자의 변화 및 골대사에 미치는 영향 : Impact on Bone Mineral Metabolism

백기현,오은숙,오기원,이원영,김혜수,권순용,한제호,강무일,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.5

연구배경: 각종 장기이식의 시행이 많아지고 이식 후 생존율이 증가함에 따라 이식 후 합병증에 대한 관심 또한 높아지고 있다. 조혈모세포이식 후에도 다양한 내분비적 합병증이 발생할 수 있으며 골격에 대한 합병증도 문제점으로 대두되고 있다. 조혈모세포 이식 후 발생하는 골소실에는 이식 후 초기의 골형성 저하와 골흡수 증가가 중요한 역할을 담당하리라고 추측되는데 이러한 골재형성불일치(biochemical uncoupling)에 골 성장인자들이 미치는 영향에 대해서는 알려진 바가 없다. 본 연구에서는 조혈모세포이식 전, 후로 말초 혈액에서 IGF-I, FGF-2, M-CSF같은 성장인자의 변화를 알아보고, 이들 성장인자의 변화가 조혈모세포이식 후의 골형과 골흡수에 미치는 영향 및 이식 후 발생되는 골량 소실과의 연관성을 확인해 보고자 하였다. 방법: 여러 가지 혈액질환으로 인해 동종 골수이식을 시행 받은 환자들을 전향적으로 관찰하였으며 이식 전 및 이식 후 1주, 2주, 3주, 4주 및 3개월, 6개월 1년에 말초 혈액에서 골교체표지자를 측정하였다. 이식 전 및 이식1년 후에 요추골 및 대퇴골 골밀도를 측정할 수 있었던 36명의 환자들을 대상으로 냉동 보관되어 있던 혈청을 이용하여 IGF-I, FGF-2 및 M-CSF를 시기별로 측정하였으며 이들 성장인자와 골교체표지자의 변화 및 골밀도 변화 사이의 상관관계를 확인하였다. 결과: 골흡수 표지자인 혈청 ICTP는 이식 전에 비해 이식 후 4주까지 점차 의의 있게 증가하다가 이후 6개월까지 더욱 증가한 후 감소하였다. 골형성 표지자인 osteocalcin은 이식 후 3주까지는 점차 감소하다가 이후 증가하여 이식 후 3개월 및 6개월에 기저치보다 통계적으로 유의하게 증가한 후 감소하였다. 혈청 IGF-I과 FGF-2는 각각 이식 후 3주 및 1주까지 의미있게 감소하다가 이후 증가하였으며 혈청 M-CSF는 이식 후 1주째에 기저치에 비해 의미 있게 증가하였다가 이후 기저치로 회복되었다. 이식 1년 후 평균 요추부 골밀도는 5.2% 감소하였고 평균 근위대퇴골 골밀도는 11.6% 감소하였다. 이식 전 및 이식 후 3주에 측정한 IGF-I과 같은 시기에 측정한 오스테오칼신 사이에 유의한 상관관계가 관찰되었으며 이식 후 3주째의 M-CSF와 골흡수표지자인 M-CSF 사이에서 의미 있는 양의 상관관계를 관찰할 수 있었다. 이식 후 3주 및 3개월에 IGF-I이 낮은 환자일수록 이식 1년 후 근위대퇴골에서의 골소실이 많은 것으로 분석되었다. 결론: 조혈모세포이식 후 발생하는 골소실에는 기존에 알려진 기저질환의 영향, 성호르몬의 감소, 면역억제의 투여, 골수기질세포와 조골세포의 손상 및 이식초기 사이토카인의 변화이외에도 골성장인자가 관련이 있음을 확인하였고, 이는 이식 후 발생되는 골량소실에 중요한 역할을 할 것이라고 사료된다. Background: A loss of bone mass is usually detected after a bone marrow transplantation (BMT), especially during the early post-transplant period. We recently reported that enhanced bone resorption following a BMT was related to both the steroid dose and the increase in IL-6. We also suggested damage to the marrow stromal microenvironment, by myoablation, partly explains the impaired bone formation following a BMT. It is well known that some growth factor play important role in bone growth and osteogenesis. However, the pathogenetic role of bone growth factors in post-BMT bone loss is unknown and data on the changes in the growth factors, in accordance with bone turnover markers and bone mineral density (BMD) changes are scarce. We investigated changes in bone growth factors such as IGF-I (Insulin-like growth factor-I), fibroblast growth factor-2 (FGF-2) and Macrophage colony stimulating factor (M-CSF), during the post-BMT period, and assessed whether the growth factor changes influenced the bone turnover and post-BMT bone loss. The present study is the first prospective study to describe the changes in bone growth factors following a BMT. Methods: We prospectively investigated 110 patients undergoing a BMT, and analyzed 36 patients (32.4±1.3 years, 17 men and 19 women) whose BMDs were measured before, and 1 year after, the BMT. The serum biochemical markers of bone turnover were measured before, 1, 2, 3 and 4 weeks, 3 and 6 months, and 1 year, after the BMT. The serum, FGF-2, IGF-I and M-CSF levels were measured before and 1 and 3 weeks, and 3 months after the BMT. The correlation between the changes of growth factors and various bone parameters was analyzed. Results: The mean bone losses in the lumbar spine and total proximal femur, calculated as the percentage change from the baseline to the level at 1 year, were 5.2(p<0.05) and 11.6%(p<0.01), respectively. the serum type I carboxyterminal telopeptide(ICTP), a bone resorption marker, increased progressively until 6 months after the BMT, but thereafter decreased, to the base value after 1 year. Serum osteocalcin, a bone formation marker, decreased progressively, until 3 weeks after the BMT but then increased transiently, and finally returned to the base level at 1 year. The serum IGF-I and FGF-2 also decreased progressively until 3 weeks 1 week after the BMT, respectively, then increased to the base values at 3 months. The serum M-CSF increased briskly at 1 week post-BMT, then decreased to the base level. There were positive correlations between the percentage changes from the baseline proximal femur BMD and the IGF-I levels 3 weeks and 3 months (r=0.52, p<0.01, r=0.41, p<0.05) post BMT. A significant correlation was found between the IGF-I and osteocalcin levels pre-BMT, and 3 weeks after the BMT. Another positive correlation was found between the M-CSF and the ICTP levels at 3 weeks post BMT (r=0.54, p<0.05). Conclusion: In conclusion, there were significant changes in the serum IGF-I, FGF-2 and M-CSF levels in the immediate post-BMT period, which were related to a decrease in bone formation and loss in the proximal femoral BMD during the year following the BMT (J Kor Soc Endocrinol 17:664∼674, 2002).

노인 인구에서 신경인지기능저하와 혈청 지질농도와의 상관성

유영선,최석주,정성수,김지은,윤성욱,전동욱,백준형,박성우,이정구,추일한,김영훈 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.6

Objectives : In this study, the authors evaluated the correlation between eurocognitive impairments and serum lipids levels among Korean elderly over the age of 65. Methods : A total of 609 elderly individuals participated in this study. Screening for cognitive impairments were carried out using the Mini-Mental Status Examination-Korean version (MMSE-KC). There were 197 subjects above 1.5SD Of MMSE- KC and they were evaluated using the Korean versions of the Consortium to Establish a Registry for Alzheimer's Disease (AD) (CERAD-KC) and Geriatric Depression Scale (GDS-K). Results : There was a correlation between old age/low levels of education and AD (p<0.05, P<0.01). There was an inverse correlation between the serum level of total cholesterol and the word list recognition test scores. The serum levels of LDL cholesterol were inversely correlated with the scores on the constructional praxis test, word list recall test and word list recognition test. Inverse correlations between the serum level of triglyceride and scores on the word list recall test and word list recognition test were also observed. Conclusion : There were inverse correlations between the serum levels of lipids and language/memory function in subjects with AD.

A Single Baseline Amyloid Positron Emission Tomography Could Be Sufficient for Predicting Alzheimer’s Disease Conversion in Mild Cognitive Impairment

IL Han Choo,Ari Chong,Ji Yeon Chung,Jung-Min Ha,Yu Yong Choi,Hoowon Kim 대한신경정신의학회 2022 PSYCHIATRY INVESTIGATION Vol.19 No.5

Objective Baseline amyloid burden in mild cognitive impairment (MCI) has been linked to conversion to Alzheimer’s disease (AD), but the comparison of baseline and longitudinal changes in amyloid burden for predicting AD remains unresolved. The objectives of this study aimed to compare the prognostic ability of baseline and longitudinal changes in amyloid burden in MCI patients.Methods Seventy-five individuals with MCI were recruited and examined annually by clinical interviews for a mean follow-up of 24 months (range, 11.6–42.0). [18F]Florbetaben positron emission tomography (PET) scans were performed. T1-weighted 3D volumes were acquired for co-registration, and to define regions of interest. We examined whether baseline and longitudinal amyloid burden changes can improve AD conversion by Cox proportional hazard model analysis and receiver operating characteristic (ROC) curve analysis.Results Cox proportional hazards model analysis showed that baseline amyloid burden was significantly associated with increased risk of conversion to AD (hazard ratio [HR]=10.0; 95% confidence interval [CI], 1.15–85.39; p=0.04), but longitudinal amyloid burden changes was not (HR=0.2; 95% CI, 0.02–1.18; p=0.07). When predicting AD, longitudinal amyloid burden changes had better ROC accuracy of 65.2% (95% CI, 48.4–82.0) than baseline amyloid burden of 59.6% (95% CI, 40.3–79.0), without statistical significance in pairwise comparison.Conclusion A single baseline amyloid PET could be sufficient in the prediction of AD conversion in MCI.

Diagnosis of primary CNS lymphoma presenting with abrupt neuropsychiatric features

IL Han Choo 조선대학교 의학연구원 2019 The Medical Journal of Chosun University Vol.44 No.1

Primary CNS lymphoma (PCNSL) accounts for 1-5% of all primary brain tumors. Early and accurate diagnosis of PCNSL is crucial for proper management and is more likely if a tumor is observed on imaging. We present the PCNSL case of 77-year-old man who developed abrupt neuropsychiatric features from 5 days ago. This case suggests that clinicians should be alert on the possibility of PCNSL and apply prompt MRI evaluation, when elderly patient with chronic heavy alcohol drinking history present abrupt complex neuropsychiatric symptoms in outpatient clinic.

Topographic Patterns of Brain Functional Impairment Progression According to Clinical Severity Staging in 116 Alzheimer Disease Patients: FDG-PET Study

Choo, IL Han,Lee, Dong Young,Youn, Jong Choul,Jhoo, Jin Hyeong,Kim, Ki Woong,Lee, Dong Soo,Lee, Jae Sung,Woo, Jong Inn RAVEN PRESS PUBLISHERS 2007 ALZHEIMER DISEASE AND ASSOCIATED DISORDERS Vol.21 No.2

The study aimed to explore topographic progression pattern of brain functional impairment according to clinical stage in Alzheimer disease (AD). One hundred and sixteen AD patients and 25 normal subjects underwent a [F] fluorodeoxyglucose-positron emission tomography scan. Regional cerebral glucose metabolism was compared between severity groups based on the Clinical Dementia Rating through voxel-based analyses. As clinical severity progressed, hypometabolic areas gradually increased, involving initially posterior cingulate cortex, later temporoparietal, and finally frontal and some subcortical areas. The results indicate that progression patterns of hypometabolism in AD are close to that of typical neuropathology, but that they do not fully coincide with it.

지역사회 기억상실 경도인지장애 조기발견을 위한 2가지 다단계 프로그램 비교

추일한(IL Han Choo) 대한노인정신의학회 2020 노인정신의학 Vol.24 No.1

Objective: Amnestic mild cognitive impairment (aMCI) has high conversion risk to dementia. However, it is not easy to detect aMCI patient early in the community. This study aimed to compare two-step and three-step program for early detection of aMCI in the community. Methods: Overall 5,155 persons participated who were already registered with Korean version of Mini-Mental Status Examination for Dementia Screening (MMSE-DS) evaluation. It was conducted across 5 all districts of Gwangju, Republic of Korea from Jan 1, 2018 to March 31, 2018. As first step, we screened them applying inclusion criteria of age, sex, education adjusted norm based MMSE Z score between -1.5 and 0. Second evaluations which are not included in two-step program, were done by telephone interviews with asking subjective memory complaints and 5 word lists recall tests. And third assessments of neuropsychological tests and clinical diagnosis with visit were performed. Author compared two-step program and three-step program for aMCI diagnostic rate. Results: Two multi-step programs had no significant difference on aMCI diagnostic rate (p=0.81). Conclusion: Our study suggests that two multi-step programs are similar for early detection of aMCI in the community.