정신분열병 환자에서 얼굴 영상의 작동기억 장애 : 기능자기공명영상연구

이창욱,김태석,주라형,박주미,박여진,김종진,전신수,배치운,김정진,이수정,이철,백인호 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : Impaired processing of facial information is one of the broad ranges of cognitive deficits seen in patients with Schi-zophrenia. We aimed to elucidate the differences in brain activities involved in the process of facial working memory between schizophrenic patients and healthy comparison subjects. Methods : Twelve patients with schizophrenia were recruited along with twelve demographically matched healthy volunteers as a comparison group. Functional magnetic resonance imaging (fMRI) was used to assess cortical activities during the Perfor-mance of a 2-back working memory paradigm using images of neutral faces as mnemonic content. Rcsults : The patient group performed the tasks with reduced accuracy. Group analysis revealed that the left fusiform gyrus, the right superior frontal gyrus, the bilateral middle frontal gyri/insula, the left middle temporal gyrus, the precuneus, the quadrangular lobules and the vermis of cerebellum showed decreased cortical activities in the patient group. On the other hand, an increased level of activation in the lateral prefrontal cortex and the pahetal lobule was observed from the patient group, all in the right hemisphere. Conulusion : A decreased level of activity in the left fusiform gyrus among the patient group implicates inefficient processing of facial information. An increased level of activation in prefrontal and parietal neural networks from the patient group confirms earlier findings on the impaired working memory of patients with schizophrenia.

톨루엔을 포함한 유기용제의 직업적 폭로로 인한 신경내분비계 영향

이채언,이종태,정의화,손혜숙,문덕환,전진호,강정학,이창희,김휘동,김종한,정귀옥 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.2

Long term occupational exposure to solvent mixtures may cause adverse effects to the central nervous system with neurobehavioral symptoms. And some organic slovents have been suggested to cause impairment of tuberoinfundibular dopaminergic activity and neurochemical mechanisms controlling pituitary secretion. For the purpose of assessing neuroendocrine effects in occupational solvents exposure, hormonal study settings (shoes-manufacturing industry & fishing products industry) and compared with nonexposed controls(33 men, 85 women). Male workers exposed to solvent mixtures had significantly lower plasma level of follicle-stimulating hormone(FSH) than nonexposed male controls. While female workers exposed to solvent mixtures had significantly lower plasma levels of growth hormone(GH), and thyroid-stimulating hormone(TSH) than nonexposed female controls. The results of significant decrease in plasma concentrations of pituitary hormones(FSH, GH, and TSH) in workers exposed solvent mixtures indicate that occupational exposure to solvent mixtures may induce neuroendocrine effects through an effect on hypothalamic pituitary axis.

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.

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.

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.

임신중 산전 초음파로 진단된 자궁근종의 임상적 고찰

서정호,김윤숙,김대원,이동운,최규연,이정재,이임순 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Objectives: To study the clinical manifestations; time, mode of delivery, size of myomas and outcome of pregnancy in cases of myomas that were detected prior to pregnancy or during the antenatal care and after delivery. Methods: We statistically analyzed 76 patients with uterine myomas in pregnancy admitted to Soonchunhyang Seoul Hospital during the period of Jan. 1999 and Dec. 2001. Results: The results are as follows. 1. The mean age of patients in the detected group and undetected group were 32.9 years and 32.3 years, respectively. There was no difference in the proportion of primarity between the detected group(98.2%) and the undetected group(79.6%) 2. The most common type of uterine myoma in both groups was intramural myoma (detected group 94.1% vs undetected group 81.3%). The uterine myomas were most commonly located in the anterior portion and fundus(detected group 52.9% and 23.5% respectively vs undetected group 47.4% and 23.7% respectively) and the proportion was not significantly different between the two groups. Uterine myomas with a diameter of 3cm or more in the detected group were detected by clinical examination and ultrasonogram. Rate of uterine myomas with a diameter of 3cm or more in the detected group is 76.5% and less than 3cm is 54.2% which detected incidentally at delivery. 3. The proportion of term infants were detected group 88.2% vs undetected group 91.5%. 4. The most common indications for cesarean section in both groups were cephalopelvic disproportion and repeated cesarean section (detected group 41.2% and 45.8% respectively vs undetected group 11.8% and 18.6% respectively) and there was no significant difference between the two groups. 5. Secondary pathologic changes in the all myomectomy specimens were degeneration in both groups but there was no necrosis or sarcomatous change. 6. Antenatal complications were preterm labor, premature repture of membranes, spontaneous abortion, malpresentation, and placenta previa. Intrauterine growth retardation and placental abruption were not seen in both groups. Conclusion: Myoma detected by ultrasonogram before or during pregnancy is not a significant implication of pregnancy outcome.

Toluene, Xylene, Trichloroethylene 투여가 흰쥐의 시상하부와 뇌하수체의 GnRH, GnRH Receptor, Pit-1 유전자 발현에 미치는 영향

기노석,이종태,강대성,김대환,이채관,이헌,전진호,김정호,이채언 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.2

The workplace exposure of chemicals has steadily increased, therefore the concern for subsequent effect on reproductive outcome has been an important issue in occupational medicine. In previous studies, higher rates of spontaneous abortion, reduced fertility and menstrual disorder among women, and an impairement of sperm quantity and quality among men have been associated with a wide variety of chemical agents. This study was conducted to evaluate the effects of toluene, xylene and trichloroethylene(TCE) injection on the mRNA levels of GnRH, GnRH receptor and Pit-1 genes in male rats hypothalamus and pituitary and the effects on the plasma levels of FSH, LH, prolactin and testosterone. Sprague-Dawley male rats were divided into five groups of five each according to concentration of toluene, xylene and TCE. The rats were injected subcutaneously to 0, 50, 100, 200, 400 mg/kg body weight/day of toluene, xylene and TCE, respectively for 6 days. Rat brains were excised and hypothalamus and pituitary were separated. Reverse transcription-polymerase chain reaction (RT-PCR) and RNase protection assay(RPA) were used to evaluate the GnRH, GnRH receptor and Pit-1 mRNA levels. Plasma concentrations of FSH, LH, prolactin and testosterone were assayed by radioimmunoassay(RIA). The results were as follows; 1. GnRH, GnRH receptor and Pit-1 mRNA levels in toluene and xylene injected groups, and GnRH receptor mRNA levels in TCE injected group were lowered dose-dependently. Especially, GnRH receptor and Pit-1 mRNA levels in 200mg/kg of toluene injected group, and GnRH, GnRH receptor and Pit-1 mRNA levels in 400mg/kg of toluene injected group were significantly lower than control group (p<0.05). GnRH receptor and Pit-1 mRNA levels in 400mg/kg of xylene injected group, and GnRH receptor mRNA levels in 400mg/kg of TCE injected group were significantly lower than control group(p<0.05). 2. The plasma levels of prolactin and testosterone in 400mg/kg of toluene injected group, and LH in 100, 200 and 400mg/kg of xylene injected group, and testosterone in 400 mg/kg of TCE injected group were significantly lower than control group(p<0.05). In conclusion, we speculated that toluene and xylene affected reproductive system secondarily through hypothalamus-pituitary axis, and TCE affected directly through steroidogenesis. And we recommended that further study for assessment of the reproductive toxicity of mixed organic solvent exposures should be conducted.

한랭작업 근로자들의 건강위해에 관한 연구

박호추,정설미,문덕환,이종태,김대환,김정호,최재일,황용식,이용희,이채언 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.1

In order to evaluate the status of cold exposure and its health hazards of workers at cold storage workplaces and to provide basic data for effective health care, the author measured core temperature and also observed clinical symptoms and signs, past and present history, and general health examination data on 99 cold exposed workers for exposure group and 96 non-exposed workers for control group working at 2 food refrigerating companies in Pusan area from January 6, 1998 to February 24, 1998. The results were as follows: 1. There was statistically significant difference in water intake between the exposure and control group and increased urine volume, urine frequency in exposure group without statistically significant difference. 2. Past and present illness in exposure group were hypertension (18.2%), hepatopathy (8.1%), gastro-intestinal disease(7.1%), arthritis (4.0%), intervertebral disc herniation(4.0%), and so on, and hypertension, arthritis was statistically significant difference compared to control group. 3. Symptoms in exposure group were fatigue(89.9%), headache (64.6%). drowsy(63.6%), neck stiffness(59.6%), excessive food intake(59.6%). general weakness(58.6%), hunger(58.6%), numbness(54.5%), and so on, and there was statistically significant difference between the exposure and control group except fatigue, drowsy. 4. As results of clinical test abnormality rate of the systolic, diastolic blood pressure and electrocardiogram were significantly higher in exposed group than control. 5. Core temperature in exposure group was statistically significantly lower than control group and the highest statistically significant inverse correlation with the working hours and working frequency of daily mean cold storage. As above results, the author suggested that the further studies should be conducted to evaluate the health status of workers about chronic health effects in cold workplaces and to establish effective health care methods for them.