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홍경수,주연호,김용식,신철진,강웅구,이중서,정희연,주은정 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.4
저자들은 정신분열병의 일부에서는 태생기 동안 유전 외적인 환경적 요인이 크게 작용할 것이라는 가정 하에 형제 정신분열병 환자군(남 15. 여 7)과 산발성 정신분열병 환자군(남 16, 여 7) 및 정상 대조군(남 16, 여 7)을 대상으로 가족력에 따른 산과적 합병증과 신체 미세 기형을 비교하였다. 산과적 합병증은 Lewis 척도를 이용하여 연구 대상의 어머니와 면담하여 평가하였고 신체미세기형은 Waldrop 척도를 이용하여 측정하였다. 또한 산과적 합병증 및 신체 미세기형과 가족력에에 따라 발병 연령 등의 임상 양상들이 차이를 보이는지 비교함으로써 정신분열병을 좀 더 동질적인 아형으로 나눌 수 있는지를 검토하였다. 1) 형제 환자군, 산발성 환자군 및 정상 대조군의 세균에서 산과적 합병증의 개개의 항목 및 전체 점수의 유의한 차이는 없었다. 신체 미세기형의 경우 입의 미세기 형에서 유의한 차이가 있었으나 그 외에 각 부위별 점수 및 전체 점수에서는 세 군간에 유의한 차이가 없었다. 그러나 대부분의 신체 미세기형 세부 항목 및 전체점수에서 산발성 환자군이 형제 환자군에 비해 높은 신체 미세기형의 점수를 보이는 경향이 있었다. 2) 산과적 합병증의 전체 점수와 신체 미세기형의 전체 점수 사이에 상호 연관성을 찾아볼 수 없었다. 3) 발병연령·정신병리·약물에 대한 반응·병전 기능수준·지연성 운동장애 유무 등의 임상 양상들을 비교하였을때 산발성 환자군과 형제 환자군간에 유의한 차이가 없었다. 4) 산과적 합병증 및 신체 미세기형과 임상 양상들을 비교하였을 때, 형제 환자군에서 분만시간과 회복시 전반적 기능수준간에, 산발성 환자군에서 산과적 합병증의 전체 점수와 발병 연령간에 상관관계가 있었으나 전체적으로 일관된 결과가 도출되지는 못하였다. 위와 같은 결과를 종합하여 볼 때, 산과적 합병증이나 신체 미세기형이 정신분열병의 원인을 밝히는데 유익한 도구가 될 수는 있지만, 가족력 유무에 따라 정신분열병을 보다 동질적인 아형으로 구분하기 힘들다고 생각되었다. In order to test the hypothesis that familial schizophrenics have fewer chances of receiving organic insults during the fetal neural development than sporadic schizophrenics, the authors compared obstetric complications, minor physical anomalies, and other clinical features in sibling schizophrenics, sporadic schizophrenics and controls. Obstetric complications were evaluated by the scale of Lewis, and minor physical anomalies were measured by the Waldrop scale. Sporadic schizophrenics had a significantly higher Waldrop score for mouth than sibling schizophrenics. Although there was some tendency of higher total scores for minor physical anomalies in sporadic schizophrenics, there were no statistically significant differences in obstetric complications and the other minor physical anomalies among three groups. There was no significant correlation between obstetric complications and minor physical anomalies. The clinical features such as age of onset, psychopathology, response to drugs, premorbid functioning, and tardive dyskinesia were not significantly different between sibling and sporadic scizophrenics. In conclusion, while the obstetric complications and minor physical anomalies were suggested to be useful in the search for the cause of schizophrenia, it was difficult to categorize schizophrenics into more homogeneous groups according to family history of schizophrenia using the parameter of obstetric complications and/ or minor physical anomalies.
Candida albicans에 의한 허리근 농양 1예
정승기,김수연,봉정민,백은기,이규훈,이상오,서일혜,조용균 대한감염학회 2003 감염과 화학요법 Vol.35 No.5
칸디다는 우리 몸의 여러 곳에서 발견되는 상재 진균으로 Candida albicans가 가장 흔히 질병을 일으킨다. 대부분 표재성 감염을 일으키며 칸디다에 의한 심부 감염은 드물다. 심부 감염은 주로 면역약화 환자에서 혈류를 따라 여러 장기에 퍼지는 파종성 칸디다증으로 발생하며, 한 곳의 심부 장기에만 농양을 형성하는 경우는 상대적으로 덜 흔하다. 저자들은 당뇨병과 알코올성 간경변을 가진 환자에서 혈액 및 농 배양 검사에서 C. albicans가 동정된 허리근 농양 1예를 경험하였고 배농과 amphotercin-B, fluconazole로 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다. Candida species are ubiquitous human commensals, of which Candida albicans is most commonly associated with human disease. Candida infections usually involve superficial tissues, but the infections of deep tissues are relatively uncommon. Among the Candida infections of deep organs, disseminated candidiasis is the most common presentation particularly in immunosuppressed patients, however, a single abscess formation in deep organ is rare. We experienced a case of psoasabscess by C. albicans in a patient who had diabetes and alcoholic liver cirrhosis, which was treated successfully by drainage of the abscess and administration of amphotericin-B, followed by fluconazole. We report this case with review of the pertinent literatures.
운동신경원성 질환을 동반한 전두측두엽치매의 임상양상과 신경심리소견
박기정,정용,김은주,진주희,강수진,나덕렬 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.1
Backgrounds:Frontotemporal dementia (FTD) is rarely associated with motor neuron disease (MND). This comorbidity (FTD-MND), a subtype of FTD, results in progressive dementia and muscle weakness. Among the few available reports of series of patients, however, there have been controversies about the clinical course of FTD-MND. This study, the first report of a series of FTD-MND patients in Korea, investigated demographic and clinical features, clinical course, and neuropsychological findings of nine patients with FTD-MND. Methods:Nine FTD-MND patients (2 men and 7 women with mean age 55.6±7.2 years) were selected among 45 FTD patients who met the FTD criteria proposed by the Lund and Manchester Groups. Their clinical and neuropsychological findings were analyzed retrospectively. Results:Mean age of onset was 54.3±8.0 years. The time interval from onset to death was 27±11.3 months. Presenting symptoms were personality change, hyperphagia, nonfluent speech or motor weakness. In most cases (8/9), dementia preceded the muscle weakness;in only one patient the muscle weakness preceded the cognitive decline. Regarding the muscle weakness, bulbar symptoms occurred earlier than limb weakness in four patients;bulbar and limb weakness occurred simultaneously in another four patients;in the remaining one patient limb weakness preceded bulbar weakness. Neuropsychologic tests showed no specific patterns but diffuse dysfunction in all cognitive domains. Conclusions:Our study suggests that FTD-MND predominantly affects the bulbar muscles rather than the limb muscles in early stage and symptoms related to MND occurs later than those related to FTD. The time from diagnosis to death was 10.6±6.5 months, suggesting that FTD-MND is a rapidly progressive disease. This rapid clinical course may account for our neuropsychological findings that showed general cognitive deficits father than predominant frontal dysfunctions.
박동연,이유상,조은영,조승희,장용이,전현옥,장수연,윤세창,김종원,홍경수 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.3
Objectives : The authors recently found a suggestive evidence of linkage of chromosome 8p21-12 to schizophrenia in Korean multiplex families. Neuregutin 1 (NRGI) was identified in this locus as a positional and functional candidate gene for Schizo-phrenia, through several independent studies with European and Chinese populations. The purpose of this study is to determine whether NRGl is associated with schizophrenia in Korean population. Methods : Three SNPs (SNP8NRG221533, SNP8NRG241930, SNP8NRG243177) and two microsatellites markers (478B14-848,420M9-1395) located at the 5' end of NRGI were genotyped for 242 unrelated schizophrenia patients and the same num-ber of normal controls. Genetic association was tested by χ²-test (df=1). Not only for the whole patients group but also for asubgroup of patients with auditory hallucination. This subtype showed stronger linkage with chromosome 8p12 in the prior study of the authors with multiplex families. Results : G allele of SNP8NRG241930 was significantly in excess in the subgroup of patients with auditory hallucination compared to the control group (p=0.03, 0R=1.76). We also found that 3 SNPs haplotype TTC (p=0.04, 0R=0.58) and five markers haplotype TTC53 (p=0.01,0R=0.49) were associated with schziophrenia with a protective effect. Three SNPs haplotype CGT which is a part of the at-risk haplotype of the Icelandic schizophrenia families was found in excess in the patients group but no significant association was observed. Conclusion : NRGI might either play a mle in the predisposition to schizophrenia or be in linkage disequilibrium with a causal locus of this illness.
( Sue In Choi ),( Ji Young Park ),( Eun Joo Lee ),( Gyu Young Hur ),( Kyung Hoon Min ),( Seung Heon Lee ),( Sung Yong Lee ),( Sang Yeub Lee ),( Je Hyeong Kim ),( Jae Jeong Shim ),( Chol Shin ),( Kwang 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Graft-versus-host disease (GVHD) occurs in 5-20% patients after autologous SCT, but most complications are involved in skin lesion. Pulmonary GVHD is rare and most reported cases are chronic GVHD in allogeneic SCT. We reported a very rare case of pulmonary GVHD that developed after autologous SCT. 60-year-old male was referred complaining of cough and dyspnea. 2 years ago, he was diagnosed peripheral T-cell lymphoma (stage IV), and took 2nd cycle chemotherapy and autologous peripheral blood stem cell transplantation. Pulmonary function test showed FVC 1.92 (44%), FEV1 1.53 (48%), FEV1/FVC 80%, DLCO 69% and it was worse than that of 6 months ago. HRCT scan revealed bronchiolitis in right lower lobe, air trapping in right upper and both lower lobes. As a confirmative step, surgical lung biopsy was attempted. Pathologic finding showed peribronchiolar and perivascular lymphocytic infiltration mostly CD3+ T cell, perivascular lymphocytic cuffing underlying organizing pneumonia pattern, suggesting of GVHD. His symptoms and pulmonary function test were gradually improved without treatment.
Linkage of schizophrenia with chromosome 1q32 in Korean multiplex families'
Jang, Yong Lee,Kim, Jong Won,Lee, Yu-Sang,Park, Dong Yeon,Cho, Eun-Young,Jeun, Hyun Ok,Lee, Dongsoo,Hong, Kyung Sue Wiley Subscription Services, Inc., A Wiley Company 2007 American Journal of Medical Genetics Part B: Neuro Vol. No.
<P>Chromosome 1q contains a few loci for which modest evidence of linkage with schizophrenia has been reported in several independent studies. However, markers showing the peak linkage signal are dispersed over a large chromosomal region. In addition, inconsistent findings have been generated from different populations or different subgroups of the same populations. The purpose of the current study is to determine whether those loci are linked to schizophrenia in the Korean population. We investigated 46 Korean multiplex schizophrenia families, initially using 11 microsatellite markers spanning around 91 cM region of 1p22∼42. In a non-parametric linkage analysis, D1S249 located on 1q32.1 showed statistical evidence suggestive of linkage. At the second stage analysis for narrowing down the region, four additional nearby markers were genotyped. In the single point analysis, we found another suggestive linkage signal at D1S2891. The highest NPL score of 2.67 (P = 0.0039) was obtained in the multi-point analysis. This study provides supportive evidence for linkage of chromosome 1q32 with schizophrenia. © 2006 Wiley-Liss, Inc.</P>