• Title/Summary/Keyword: 임상 경과

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Relationship between Clozapine-Induced Therapeutic Responses and Plasma Homovanillic Acid and 5-Hydroxyindoleacetic Acid Levels in Patients with Chronic Schizophrenia (만성 정신분열증 환자에서 Clozapine의 치료반응과 혈장 Homovanillic Acid 및 5-Hydroxyindoleacetic Acid 농도와의 관계)

  • Kim, Chan-Hyung;Lee, Hong Shick;Kim, Kwang Hyeon;Yoo, Kae Joon
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.84-94
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    • 1997
  • This study was done to examine changes of plasma homovanillic acid(HVA), 5-hydroxyindoleacetic acid(5-HIAA), and HVA/5-HIAA ratio during an 8-week clozapine trial and to investigate the relationship between the plasma monoamine metabolites and treatment responses. Twenty-seven chronic schizophrenic patiens were treated for 8 weeks with clozapine. The psychopathology was assessed at baseline just clozapine trial and then every 2 weeks until the end of 8-week clozapine treatment using the Positive and Negative Syndrome Scale(PANSS) and the Clinical Global Impression scale(CGI). The plasma HVA and 5-HIAA levels were measured also biweekly using high preformance liquid chromatography with electrochemical detection method. Plasma HVA and 5-HIAA levels were significantly decreased during a 8-week clozapine treatment, although plasma HVA/5-HIAA ratio showed no significant change. The changes of plasma HVA levels were in significant correlations with the changes of PANSS positive scores, of general psychophathology scores, and changes of total socres. The changes of plasma 5-HIAA levels were in signfificant correlations with the changes of PANSS negative scores. But the changes of plasma HVA/5-HIAA ratio had no significant correlation with any PANSS subscale score changes. 48% of the patients treated with clozapine was categorized as responders, who showed at least a 20% decrease in PANSS total socre and a CGI severity score of mildly ill or less(${\leq}3$) at the end pint of the study. The baseline plasma HVA levels and HVA/5-HIAA ratio were significantly higher in responders(N=13) than in nonresponders (N=14). But no significant difference in baseline levels of plasma 5-HIAA was found between responders and nonresponders. At the end point of the study, there was significant difference in the change of plasma HVA between responders(40.3% decrement) and nonresponders(3.1% increment). But no signficant differences in the change of plasma 5-HIAA and the change of plasma HVA/5-HIAA ratio between responders and nonresponders were observed. These results suggest that the antipsychotic effect of clozapine on positive symptoms may be associated with dopaminergic blocking activity, and that on negative symptoms may be associated with serotonergic blocking activity. The baseline plasma HVA levels and the change of HVA levels from baseline may be useful predictors of treatment response with clozapine.

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An epidemiological study of human paragonimiasis by means of micro-ELISA (면역효소진단법을 이용한 폐흡충증 유행의 역학조사)

  • 조승열;이동근강신영김석일
    • Parasites, Hosts and Diseases
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    • v.21 no.2
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    • pp.246-256
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    • 1983
  • As epidemiological parameters of human paragonimiasis, the positive rates of intradermal test and the sputum/stool ekaminations have long been employed in population surveys. However, both the specificity of the intradermal test and the sensitivity of sputumjstool examination have been gradually declined as the endemicity was lowered; thus the gap between above two parameters widened. In such context, the development of a new epidemiologic parameter or tool which makes it possible to accurately discriminate the active paragonimiasis cases was necessary. In the present study, the detection rate of Paragonimus-speclac IgG antibody by micro-ELISA was evaluated as an indicator of epidemiologic status of human paragonimiasis in a population. A total of 4, 285 students and inhabitants living in Bukpyeong Myeon and Bukil Myeon, Haenam Gun, Jeonlanam Do was surveyed in October, 1983 by intradermal test first. Out of them, 244 cases (5.7%) were found positively reacted to VBS antigen of F. westermani. Out of 168 positive reactors, 7 cases (4.2%) were egg positive either by two times of sputum examination or by one stool examination. That indicated that only 0. 16% of total surveyed were confirmed as active paragonimiasis by egg detection. When sera collected from 239 positive reactors of Intradermal test were tested by micro-ELISA for their specific IgG antibody, 40 cases(16.7%) were found to be positive. All of 7 egg positive cases were again positive for specific IgG antibody. Among remaining 232 intradermal test positive cases, 33 cases were positive for IgG antibody. In contrast to those, none of 42 positive reactors to intradermal test for Cloncrchis and of 128 intradermal test negative cases showed positive for Paragcnimus-specIfic IgG antibody. The rate of specific IgG antibody as detected by micro-ELISA appeared to be increased with the wheal size of the intradermal test. When the wheal sixte was over 13mm in diameter, about 50% of them were positive for specific IgG antibody. Thirty-one specific antibody positive cases were clinically evaluated by laboratory examinations (repeated sputum examination, peripheral eosinophil count and chest roentgenogram) and by history taking. Out of them 24 cases were associated with one or more positive laboratory findings: thus considered as active paragonimiasis cases. Out of 7 lab. finding-free cases 3 revealed past history of typical paragonimiasis symptoms, suggesting that they were in chronic or in convalescent stages. The remaining 4 cases were considered as either mild or ectopic infection cases; the possibility of cross-reaction with other helminthiases could not be ruled out. From the above results, it was inferred that the detection of Paragonimus-specIfic IgG antibody by micro-ELISA was very much helpful in detecting the active cases as well as in proper evaluation of the endemicity of human paragonimiasis in a population. The convenience of mass haildling of sera in micro-ELISA was considered another superiority as an epidemiologic tool.

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The Association between Blood Selenium Level and the Gastric Diseases (혈중(血中) 셀레늄 농도(濃度)와 위장질환(胃臟疾患)의 관련성(關聯性))

  • Lee, Jong-Young;Kim, Doo-Hie;Park, Seoung-Kook
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.172-182
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    • 1988
  • To reveal the association between blood selenium level and the gastric diseases, 180 persons received the gastrofiberscopic examination at the outpatients department of the two university hospitals from July to September 1987, after the exclusion of the persons having the esophageal varix, were randomly selected. Their general characteristics such as age, sex and educational level and so on, were inverstigated. Five mi venous blood was collected from each subjects and stored at $0^{\circ}C$ in heparinized vaccum tube. The blood selenium level was measured by the flameless atomic absorption spectrophotometry. In the procedure of data analysis, five subjects having benign tumor and anomaly of the stomach, were also excluded. The mean blood selenium levels of the $155.5{\mu}g/{\ell}$ among gastritis cases, the $154.8{\mu}g/{\ell}$ gastric ulcer and the $133.0{\mu}g/{\ell}$ gastric malignancy were significantly lower(p<0.05) than that of the $173.3{\mu}g/{\ell}$ among normal controls. In men the mean blood selenium levels .among gastritis, gastric ulcer and gastric malignancy cases were significantly lower(p<0.05) than that among normal controls. In females, the mean blood selenium levels among gastritis and gastric maligancy cases were significantly lower(p<0.05) than that among normal controls($169.7{\mu}g/{\ell}$), but that among gastric ulcer cases($177.7{\mu}g/{\ell}$) was not significantly higher. In the logistic analysis, coefficient of the blood selenium level was -0.0436(p<0.05 : odds ratio 0.957) for gastritis, -0.0197(p=0.17 : 0.981) for gastric ulcer, -0.4876(p<0.05 : 0.614) for gastric malignancy and -0.0411(p<0.05 ; 0.960) for gastric diseases including the gastritis, the gastric ulcer and the gastric malignancy. These data support the hypothesis that the gastric diseases are to be associated with the low selenium level but, for the gastric ulcer, the further research is recommended.

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Combined Chemotherapy and Radiotherapy versus Radiotherapy alone in the Management of Localized Angiocentric Lymphoma of the Head and Neck (국한성 두경부 혈관 중심위 림프종에서 화학방사선 병용치료법과 방사선치료 단독요법의 비교)

  • Chang Sei Kyung;Kim Gwi Eon;Lee Sang-Wook;Park Hee Chul;Pyo Hong Ryull;Kim Joo Hang;Moon Sun Rock;Lee Hyeong Sik;Choi Eun Chang;Kim Kwang Moon
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.17-23
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    • 2002
  • Purpose : To clarify the clinical benefit derived from the combined modality therapy (CMT) consisting of chemotherapy (CT) and involved field radiotherapy (RT) for stage I and II angiocentric lymphomas of the head and neck. Materials and Methods : Of 143 patients with angiocentric lymphoma of the head and neck treated at our hospital between 1976 and 1995, 104 patients (RT group) received involved field RT alone with a median dose of 50.4 Gy (range : 20~70 Gy), while 39 patients (CMT group) received a median 3 cycles (range : 1~6 cycles) of CT before involved field RT. The response rate, patterns of failure, complications, and survival data of the RT group were compared with those of the CMT group. Results : Despite a higher response rate, local failure was the most common pattern of failure in patients of both groups. The patterns of failure, including the systemic relapse rate were not influenced by the addition of combination CT. Although both modalities were well tolerated by the majority of patients, aberrant immunologic disorders or medical illnesses, such as a hemophagocytic syndrome, sepsis, intractable hemorrhage, or the evolution of second primary malignancies were more frequently observed in patients of the CMT group. The prognosis of patients in the RT group was relatively poor, with a 5-year overall actuarial survival rate of 38% and disease-free survival rate of 32%, respectively. However, their clinical outcome was not altered by the addition of systemic CT. Achieving complete remission was the most important prognostic factor by univariate and multivariate analyses, but treatment modality was not found to be a prognostic variable influencing survival. Conclusions : Involved field RT alone for angiocentric lymphoma of the head and neck was insufficient to achieve an improved survival rate, but the addition of CT to involved field RT failed to demonstrate any therapeutic advantage over involved field RT alone.

Protective Effect of Nitroglycerin on the Ischemia-Reperfusion Model of the Isolated Rat Lung (흰쥐의 분리 폐장 관류 모델에서 Nitroglycerin의 폐장 보존 효과)

  • Jheon, Sang-Hoon;Lee, Sub;Lee, Jong-Hoon;Son, Bok-Kyoung;Cho, Gong-Rae;Chung, Jin-Yong;Cho, Soung-Kyung;Kim, Bong-Il;Lee, Young-Man;Choh, Joong-Haeng
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.894-903
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    • 2003
  • Protection against ischemia-reperfusion injury is crucial for successful transplantation of the lung. It has been known that nitric oxide has many favorable effects on the donor lungs but at the same time, has some potential side effects of cytotoxicity. In this regards, we investigated whether the administration of nitroglycerin could decrease ischemia-reperfusion injury in isolated rat lung reperfusion model for the confirmation of the effect of nitroglycerin, a donor of nitric oxide, on lung transplantation. Material and Method: 35 Sprague-Dawley species male white rats were used for this experiment. For nitroglycerin group (n=18), nitroglycerin was administered intravenously followed by mixed in flushing solution for preservation. As a control group (n=17), we used the same amount of normal saline. To evaluate the effect of nitroglycerin on the lung, heart-lung block was obtained, weighed and stored in University of Wisconsin Solution at 1$0^{\circ}C$ for 24 hours. In each group of the isolated lungs, reperfusion was carried out with Krebs-Hensleit-diluted human blood for 60 minutes. As parameters of the state of the isolated lung, peak inspiratory and pulmonary arterial pressures were continuously recorded. Oxygen and carbon dioxide tension of reperfusing blood were measured before and after 30, 60 minutes of reperfusion. After sixty minutes of reperfusion, protein content in bronchoalveolar lavage fluid was measured also for the evaluation of the degree of alveolar flooding. Lung myeloperoxidase activity was determined to verify the accumulation of neutrophils. Results: Although statistically significant differences were not noted in peak inspiratory and pulmonary arterial pressure between control and nitroglycerin group, latter group showed lowering tendency of pulmonary arterial pressure during the entire reperfusion period. Oxygen tension was higher (p<0.05) in nitroglycerin group compared with that of the control group, in contrast, there were no differences in carbon dioxide tension, protein content in bronchoalveolar lavage fluid and myeloperoxidase activity between the groups. In the examination of ultrastructural changes, nitroglycerin denoted the protective effect on the pulmonary architecture compared with that of control group. Conclusion: Collectively, on the bases of these experimental results, prior treatment of donor lung with nitroglycerin could result in better preservation of the lung. Consequently, these nitroglycerin preserved lungs are thought to be more suitable for successful transplantation of the lung.

Alexithymia in Patients with Ulcerative Colitis and Irritable Bowel Syndrome (궤양성대장염 환자와 과민성대장증후군 환자의 감정표현불능증 비교 연구)

  • Lee, Sang-Bin;Lee, Seong-Yong;Kim, Sang-Heon;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.69-76
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    • 2003
  • Objectives: Many researches have been done to compare psychopathology of functional gastrointestinal disorder and inflammatory bowel disease which involves structural change. Recently, many studies focused on the topic of alexithymia. The results from these studies were questionable for lack of valid measures of alexithymia and valid diagnostic criteria of functional gastrointestinal disorders. Therefore, we tried to overcome these two problems and to assess alexithymia, personality characteristics, and other psychopathology. Methods: The subjects consisted of ulcerative colitis group(N=28) who were diagnosed by colonoscopy and biopsy, irritable bowel syndrome group(N=27) who were diagnosed by Rome II criteria and normal control group(N=22). All patients were diagnosed at outpatient department of Kyungpook National University Hospital. All these groups completed three psychological tests, including MMPI, Rorschach test, and well validated TAS-20K(The Korean Version of the 20-Item Toronto Alexithymia Scale). Results: Twenty-five percent of the ulcerative colitis group and 22% of the irritable bowel syndrome group scored in the alexithymia range, compared with 0% of the normal group. In Rorschach test, irritable bowel syndrome group showed high levels of weighted Sum C and EA. Most of clinical scales of MMPI were higher in two gastrointestinal groups than the normal control group. And two gastrointestinal groups showed low ego strength level, but there was no statistical significant difference between them. Conclusion: Two gastrointestinal groups showed high rate of alexithymia, other psychopathological profiles, and low ego strength but there was no significant difference between two groups.

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A study on enamel thickness of maxillary incisors using X-ray micro computed tomography (MicroCT를 이용한 상악 전치의 법랑질 두께에 관한 연구)

  • Cho, Young-Won;Cho, Jin-Hyun;Lee, Kyu-Bok
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.4
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    • pp.301-307
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    • 2010
  • Purpose: The objectives of the current study are to assess the accuracy of X-Ray Micro Computed Tomography (microCT) in measuring enamel thickness and to evaluate enamel thickness in maxillary incisors of Koreans. Materials and methods: Five maxillary incisors were embedded in resin block. These teeth were longitudinally sectioned labiolingually through the medial axis. After polishing, the teeth were scanned using a microCT (X-EYE SYSTEM; DRGEM, Seoul, Korea). On a scanning electron microscope (S-4300; Hitachi, Tokyo, Japan) (${\times}20$) and a microCT, nearly identical planes were reconstructed. In each tooth, the thickness of labial enamel was measured 1, 3 and 5 mm above the cementoenamel junction (CEJ). Thus, the accuracy of the microCT was evaluated. In addition, using 26 maxillary central incisors and 11 maxillary lateral incisors, in the medial axis and 2 mm remote areas mesially and distally from the medial axis, the thickness of labial enamel was measured 1, 3 and 5 mm above the CEJ along the long axis of the teeth. Results: Measurements from nearly identical planes in physical and microCT sections differed by 3.81%. An independent t-test was performed and this showed that there were no significant differences in the measurements between the two methods. Mean values of labial enamel thickness in maxillary central incisors 1, 3 and 5 mm above the CEJ were $0.32{\pm}0.01$, $0.50{\pm}0.0.2$ and $0.70{\pm}0.02\;mm$, respectively. Mean values of labial enamel thickness in maxillary lateral incisors 1, 3 and 5 mm above the CEJ were $0.30{\pm}0.01$, $0.55{\pm}0.03$ and $0.80{\pm}0.02\;mm$, respectively. Conclusion: In measuring enamel thickness, microCT is one of useful way of measurement. So according to the results of this research, when restoring a porcelain laminate veneer on maxillary incisors in Koreans, careful consideration is needed in the amount of enamel reduction.

Sinus Node Function after Extended Transseptal Approach for Mitral Valve Surgery: 164 Clinical Cases (경중격 절개방식을 좌심방 상부까지 연장시킨 방법을 통한 승모판막 수술 후 동방 결절 기능부전에 대한 164예 임상분석)

  • Ryu Se Min;Kim Hyun Koo;Cho Yang Hyun;Sim Jae Hoon;Sohn Young-sang;Choi Young Ho;Kim Hark Jei
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.214-220
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    • 2005
  • Extended transseptal approach can provide an excellent view of the mitral valve but the safety of this approach is controversial because this incision requires transaction of the sinus node artery, which in most cases and can result postoperative arrhythmia. The purpose of this study was to evaluate perioperative and longterm conduction disturbances and the cardiac rhythms of patients who underwent an extended transseptal approach for mitral valve surgery. Material and Method: Postoperative cardiac rhythms were analyzed in the 164 consecutive patients who received mitral valve replacements with a extended transseptal approach between March 1992 and July 2003. Result: Of the 84 patients in normal sinus rhythm, 34 ($39\%$) had developed transient junctional rhythm and atrial fibrillation after operation, lasting less than 72 hours in most of cases. No intractable arrhythmias occurred. Most of these arrhythmia were not detected at the time of discharge and only 8 patients ($9\%$) had atrial fibrillation at discharge. Postoperative PR intervals increased for 1 week, then decreased within 2 weeks postoperatively, and returned to normal range by 6 months postoperatively. During the postoperative period, 4 of the 78 patients with preoperative atrial fibrillation developed normal sinus thythm. Conclusion: The post-operative arrhythmias were temporary and showed no significant complications after extended transseptal approach for the mitral valve surgery.

Posterior Cruciate Ligament and Posterolateral Structure Reconstruction using Bilateral Hamstring Tendons (양측 슬괵건을 이용한 후방 십자 인대 및 후외측 지대 재건술)

  • In, Yong;Kim, Seok-Jung;Lee, Gyu-Yeong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.167-173
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    • 2005
  • Purpose: The purpose of this study is to evaluate the clinical results of posterior cruciate ligament (PCL) and posterolateral structure (PLS) reconstruction using bilateral hamstring tendon autografts. Materials and Methods: From October 2002 to March 2004, ten patients were received PCL and PLS reconstruction simultaneously using bilateral hamstring autografts. PCL was reconstructed using ipsilateral hamstring tendon and fixed with cross pins and Intrafix (Mitek, Norwood, MA). PLS was reconstructed using contralateral hamstring tendon. The mean follow up was 17 months. Clinical assessments consisted of Lysholm knee scores, International Knee Documentation Committee (IKDC) evaluation form and posterior stress radiographs. External rotation of tibia was evaluated at $30^{\circ}\;and\;90^{\circ}$ knee flexion using Noyes and Barber-Westin's classification. Contralateral harvest site morbity was evaluated using IKDC evaluation form and flexion power of the knee. Results: Mean posterior displacement of tibia using stress radiographs was improved from 13.3 mm to 3.7 mm. In tibial external rotation evaluation, 7 patients were functional, 2 patients were partially functional and one failure. The average Lysholm knee score improved from 54 preoperatively to 86 postoperatively. At the final IKDC evaluation, 8 patients were graded as nearly normal, 2 were graded as abnormal. In contralateral harvest site morbidity evaluation, 2 patients complained of numbness around the wound but negligible. Conclusion: PCL and PLS reconstruction using bilateral hamstring autografts was considered as a good treatment method with minimal contralateral harvest site morbidity.

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Effects of Knee Position during the Graft Fixation of the Arthroscopic Anterior Cruciate Ligament Reconstruction with Autogenous Hamstring Graft (이식 건 고정 시 슬관절 위치가 자가 슬괵건을 이용한 관절경적 전방 십자 인대 재건술 후 결과에 미치는 영향)

  • Lee, Churl-Woo;Yoo, Jae-Doo;Roh, Kwon-Jae;Park, Seong-Pil
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.143-147
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    • 2005
  • Purpose: In case of anterior cruciate ligament (ACL) reconstruction, graft tendon is generally fixed in tibial tunnel with knee extended. When reconstructing ACL using hamstring tendon, the authors aim to find out the effect of knee joint position during graft fixation on postoperative knee joint stability and range of motion. Materials and Methods: Prospective study was done on patients who have undergone ACL reconstruction using hamstring tendon from May 2002 to January 2003 We used Rigifix system (Mitek Product, Johnson and Johnson, USA) and Intrafix system for fixation. Thirty nine patients received ACL reconstruction during this period. Excluding 2 patients lost in the follow-up, 37 patients were analyzed. The mean follow-up period was 14 months $(13{\sim}25months)$. Knee position was decided alternatively without any bias. Clinical evaluation was based on Lachman test, pivot shift test, Lysholm score, IKDC(international knee documentation committee) assessment and side to side KT-1000 maximal manual arthrometer difference. Results: After the last follow-up, average postoperative Lysholm score was 93.1 poins(65-98points). According to IKDC score, 26 cases were normal, 10 cases were nearly normal, 1 case was abnormal and we had no case of severe abnormality. The mean difference from the normal side was 2.5 mm under maximal manual loading KT-1000 arthrometer. According to postoperative Lachman test, 32 cases were normal,2 cases were grade I and 1 case was grade II. There were 34 cases of normal, 2 cases of grade I and 1 case of grade II. When using maximal manual KT-1000 arthrometer side to side difference, the difference from the normal side while fixing the tibia at 20'knee flexion was 2.3 mm and at full extention the difference was 2.7 mm. The range of motion at postoperative 1 year showed 5 degree flexion contracture in 1 case at 20 degrees knee flexion and 10 degrees of flexion limitation was observed in 2 cases at full extension. Conclusion: When ACL reconstruction using autogenous hamstring tendon, anterior laxity showed no difference in its stability between two groups. Tibial side fixation at full extension may be helpful in preventing flexion contracture due to overconstrained graft tendon.

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