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Preoperative Evaluation for the Prediction of Postoperative Mortality and Morbidity in Lung Cancer Candidates with Impaired Lung Function (폐기능이 저하된 폐암환자에서 폐절제술후 합병증의 예측 인자 평가에 관한 전향적 연구)

  • Perk, Jeong-Woong;Jeong, Sung-Whan;Nam, Gui-Hyun;Suh, Gee-Young;Kim, Ho-Cheol;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.1
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    • pp.14-23
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    • 2000
  • Background: The evaluation of candidates for successful lung resection is important. Our study was conducted to determine the preoperative predictors of postoperative mortality and morbidity in lung cancer patients with impaired lung function. Method; Between October 1, 1995 and August 31, 1997, 36 lung resection candidates for lung cancer with $FEV_1$ of less than 2L or 60% of predicted value were included prospectively. Age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness were considered as systemic potential predictors for successful lung resection. Smoking history, presence of pneumonia, dyspnea scale(l to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test were also included for the analysis. In addition, predicted postoperative(ppo) pulmonary factors such as ppo-$FEV_1$ ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-$FEV_1%{\times}$ppo-DLco% and ppo-maximal $O_2$ uptake($VO_2$max) were also measured. Results: There were 31 men and 5 women with the median age of 65 years(range, 44 to 82) and a mean $FEV_1$ of $1.78{\pm}0.06L$. Pneumonectomy was performed in 14 patients, bilobectomy in 8, lobectomy in 14. Pulmonary complications developed in 10 patients; cardiac complications in 3, other complications(empyema, air leak, bleeding) in 4. Twelve patients were managed in the intensive care unit for more than 48 hours. Two patients died within 30 days after operation. The ppo-$VO_2$max was less than 10 ml/kg/min in these two patients. MVV was the only predictor for the pulmonary complications. However, there was no predictor for the post operative death in this study. Conclusions: Based on the results, MVV was the useful predictor for postoperative pulmonary complications in lung cancer resection candidates with impaired lung function In addition, ppo-$VO_2$max value less than 10 ml/kg/min was associated with postoperative death, so exercise pulmonary function test could be useful as preoperative test. But further studies are needed to validate this result.

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Prognostic Value of the Expression of p53 and bcl-2 in Non-Small Cell Lung Cancer (비소세포폐암에서 p53과 bcl-2의 발현이 예후에 미치는 영향)

  • Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Keum, Joo-Seob;Kong, Gu;Lee, Jung-Dal
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.962-974
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    • 1998
  • Background: Alteration of p53 tumor suppressor genes is most frequently identified in human neoplasms, including lung carcinoma. It is well known that bcl-2 oncoprotein protects cells from apoptosis. Recent studies have demonstrated that bcl-2 expression is associated with favorable prognosis for patients with non-small cell lung carcinoma. However, the precise biologic role of bcl-2 in the development of these tumors is still obscure. p53 and bcl-2 have important regulatory influence in the apoptotic pathway and thus their relationship is of interest in tumorigenesis, especially lung cancer. Purpose: The author investigated to know the prognostic significance of the expression of p53 and bcl-2 in radically resected non-small cell lung cancer. Method: 84 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from 1980 to 1994 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for p53 and bcl-2. Results : The histologic classification of the tumor was based on WHO criteria., and the specimens included 45 squamous cell carcinomas(53.6%), 28 adeonocarcinomas(33.3%) and 11 large cell carcinomas(13.1 %). p53 immunoreactivity was noted in 47 cases of 84 cases(56.0%). bcl-2 immunoreactivity was noted in 15 cases of 84 cases(17.9%). The mean survival duration was $64.23{\pm}10.73$ months in bcl-2 positive group and $35.28{\pm}4$. 39 months in bcl-2 negative group. The bcl-2 expression was significantly correlated with survival in radically resected non-small cell lung cancer patients(p=0.03). The mean survival duration was $34.71{\pm}6.12$ months in p53 positive group and $45.35{\pm}6.30$ months in p53 negative group(p=0.21). The p53 expression was not predictive for survival. There was no correlation between combination of the different status of p53 and bcl-2 expression in our study. Conclusions : The interaction and the regulation of new biologic markers, such as those involved in the apoptotic pathway, are complex. bcl-2 overexpression is a good prognostic factor in non-small cell lung cancer and p53 expression is not significantly associated with the prognostic factor in non-small cell lung cancer.

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A comparative study on the correlation between Korean foods and the fractures of PFG and all ceramic crowns for posterior applications (구치용 도재소부금관과 전부도재관에 파절을 일으키는 한국음식에 관한 연구)

  • Kim, Jeong-Ho;Lee, Jai-Bong
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.156-163
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    • 2009
  • Statement of problem: Recently, there have been increased esthetic needs for posterior dental restorations. The failure of posterior dental ceramic restoration are possible not only by the characters of the component materials but also by the type of food. Purpose: The research aim was to compare the in vitro fracture resistance of simulated first molar crowns fabricated using 4 dental ceramic systems, full-porcelain-occlusal-surfaced PFG, half-porcelain-occlusal-surfaced PFG, Empress 2, Ice Zirkon and selected Korean foods. Material and methods: Eighty axisymmetric crowns of each system were fabricated to fit a preparation with 1.5- to 2.0-mm occlusal reduction. The center of the occlusal surface on each of 15 specimens per ceramic system was axially loaded to fracture in a Instron 4465, and the maximum load(N) was recorded. Afterwards, selected Korean foods specimens(boiled crab, boiled chicken with bone, boiled beef rib, dried squid, dried anchovy, round candy, walnut shell) were prepared. 15 specimens per each food were placed under the Instron and the maximum fracture loads for them were recorded. The 95% confidence intervals of the characteristic failure load were compared between dental ceramic systems and Korean foods. Afterwards, on the basis of previous results, 14Hz cyclic load was applied on the 4 systems of dental ceramic restorations in MTS. The reults were analyzed by analysis of variance and Post Hoc tests. Results: 95% confidence intervals for mean of fracture load 1. full porcelain occlusal surfaced PFG Crown: 2599.3 to 2809.1 N 2. half porcelain occlusal surfaced PFG Crown: 3689.4 to 3819.8 N 3. Ice Zirkon Crown: 1501.2 to 1867.9 N 4. Empress 2 Crown: 803.2 to 1188.5 N 5. boiled crab: 294.1 to 367.9 N 6. boiled chicken with bone: 357.1 to 408.6 N 7. boiled beef rib: 4077.7 to 4356.0 N 8. dried squid: 147.5 to 190.5 N 9. dried anchovy: 35.6 to 46.5 N 10. round candy: 1900.5 to 2615.8 N 11. walnut shell: 85.7 to 373.1 N under cyclic load(14Hz) in MTS, fracture load and masticatory cycles are: 1. full porcelain occlusal surfaced PFG Crown fractured at 95% confidence intervals of 4796.8-9321.2 cycles under 2224.8 N(round candy)load, no fracture under smaller loads. 2. half porcelain occlusal surfaced PFG Crown fractured at 95% confidence intervals of 881705.1-1143565.7 cycles under 2224.8 N(round candy). no fracture under smaller loads. 3. Ice Zirkon Crown fractured at 95% confidence intervlas of 979993.0-1145773.4 cycles under 382.9 N(boiled chicken with bone). no fracture under smaller loads. 4. Empress 2 Crown fractured at 95% confidence intervals of 564.1-954.7 cycles under 382.9 N(boiled chicken with bone). no fracture under smaller loads. Conclusion: There was a significant difference in fracture resistance between experimental groups. Under single load, Korean foods than can cause fracture to the dental ceramic restorations are boiled beef rib and round candy. Even if there is no fracture under single load, cyclic dynamic load can fracture dental posterior ceramic crowns. Experimental data with 14 Hz dynamic cyclic load are obtained as follows. 1. PFG crown(full porcelain occlusion) was failed after mean 0.03 years under fracture load for round candy(2224.8 N). 2. PFG crown(half porcelain occlusion) was failed after mean 4.1 years under fracture load for round candy(2224.8 N). 3. Ice Zirkon crown was failed after mean 4.3 years under fracture load for boiled chicken with bone(382.9 N). 4. Empress 2 crown was failed after mean 0.003 years under fracture load for boiled chicken with bone(382.9 N).

Changes of the surface roughness depending on immersion time and powder/liquid ratio of various tissue conditioners (수종의 조직 양화재의 침수시간과 분액비에 따른 표면 거칠기의 변화)

  • Kim, Kyung-Soo;Moon, Hong-Suk;Shim, June-Sung;Jung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.108-118
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    • 2009
  • Statement of problem: Volume stability, microstructure reproducibility and fluidity along with compatibility with dental stone must be in consideration in order to use tissue conditioner as a material for functional impression. There are few studies concerning the influence of time factor in oral condition on surface roughness of the stone and optimal retention period in the oral cavity considering such changes in surface roughness. Purpose: The purpose of this study was to find out the influence of various kinds of tissue conditioner, its powder/liquid ratio and immersion time on surface roughness of the stone. Material and methods: Materials used in this study were the three kinds of tissue conditioners(Coe-Comfort, Visco-Gel, Soft-Liner) and were grouped into three: group R-mixed with standard powder/liquid ratio that was recommended by the manufacturers, group M-mixed with 20% more powder, group L-mixed with 20% less powder. Specimens were made with the size of 20 mm diameter and 2 mm width. Each tissue conditioner specimens were subdivided into 5 groups according to the immersion time(0 hour, 1 day, 3 days, 5 days, 7 days), completely immersed into artificial saliva and were stored under $37^{\circ}C$. Specimens of which the given immersion time elapsed were taken out and were poured with improved stone, making the stone specimens. Surface roughness of the stone specimens was measured by a profilometer. Results: Within the limitation of this study, the following results were drawn. 1. Major influencing factor on surface roughness of the stone model made from tissue conditioner was the retention period(contribution ratio($\rho$)=62.86%, P<.05) of the tissue conditioner in oral cavity to make functional impression. 2. In case of Coe-Comfort, higher mean surface roughness value of the stone model with statistical significance was observed compared to that of Soft-Liner and Visco-Gel as immersion time changes(P<.05). 3. In case of group L(less), higher mean surface roughness value of the stone model with statistical significance was observed compared to that of R(recommended) and M(more) group as immersion time changes(P<.05). Conclusion: We may conclude that as the retention period of time in oral cavity influences surface roughness of the stone model the most and as the kind of tissue conditioner and its P/L ratio may influence also, clinician should well understand the optimal retention period in oral cavity and choose the right tissue conditioner for the functional impression, thus making the functional impression with tissue conditioner usefully.

Effects of Sodding and Seeding Time and Rate of Seed Mixture on the Establishment of Cool-Season Turfgrasses (한지형 잔디의 조성시기, 초종 혼합 비율이 잔디 피복에 미치는 영향)

  • Shim Gyu Yul;Kim Chang Soo;Lee Seong Ho;Joo Young Kyoo
    • Asian Journal of Turfgrass Science
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    • v.18 no.4
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    • pp.179-191
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    • 2004
  • This study was conducted to find out the effect of sodding and seeding time and rate of seed mixtures on the establishment of cool-season turfgrasses by evaluating the turf coverage rates for two years. In fall planting, the required establishment period of full coverage($100\%$) was 1.5 months with a rolled turf sodding(Kentucky bluegrass $100\%$, Kentucky bluegrass $80\%$+perennial ryegrass $20\%$). The $100\%$ turf establishment was achieved in 7 months with Perennial ryegrass $100\%$, and 7.5 months by seeding with Kentucky bluegrass $100\%$(KB 100), Kentucky bluegrass $80\%$+perennial ryegrass $20\%$(KB80+PR20), Kentucky bluegrass $70\%$+perennial ryegrass $30\%$(KB70+PR30). In spring planting, the establishment periods far sod with KB 100 or KB80+PR20 were taken one month. However, in the case of seeding, the establishment periods were 3 months, 3.5 months, 3.5 months and 4 months with PR100, KB80+PR20, KB70+PR30, and KB 100, respectively Comparing the turf establishment vigor between fall and spring planting, the vigor was higher In spring planting than in fall planting in both sodding and . seeding. In the case of spring planting, the most proper time for turf establishment was tested on April, May, and June trials. The effect was significant in establishment vigor. The result showed highest on April planting. On May and June trials, establishment vigors were decreased gradually As the mixture rate of PR increased, ryegrass, establishment vigor was decreased with the rates. These results indicated that perennial ryegrass has relatively less tolerant to summer heat than Kentucky bluegrass. Number of shoots in 95 days after seeding was higher in KB100 by 16,600 per $m^2$ than in PR100 by 12,400 per $m^2$, while the lowest number showed in KB50+PR50 by 3,300 per $m^2$. Those in KB80:PR20, KB70:PR30 were 6,700 and 4,900 per $m^2$, respectively. The ratios of tillers according to mixture rates between Kentucky bluegrass and perennial ryegrass were KB80:PR20=87:13, KB70:PR30=78:22, and KB50:PR50=48:52. According to results in this study, Ideal seeding time might be spring (April) than in fall (September), and proper mixture rate was $80\%$ of Kentucky bluegrass with $20\%$ of perennial ryegrass.

Comparison of the Forage Quality and Productivity According to Varieties and Plant Parts of Imported Silage Corn (Zea mays, L) (도입 사일리지용 옥수수의 품종과 식물체 부위에 대한 사료가치와 생산성 비교)

  • Kim, Jong Geun;Li, Yan Feng;Wei, Sheng Nan;Jeong, Eun Chan;Kim, Hak Jin
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.40 no.2
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    • pp.98-105
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    • 2020
  • This experiment was conducted to a comparison of the productivity according to variety and forage quality by plant parts of imported silage corn (Zea mays, L) in Pyeongchang. The corns evaluated in this experiment were 8 varieties (P1184, P1151, P1194, P1543, P1345, P1429, P1443, and P2105) introduced from the United States, Pioneer Hybrid Co. The harvested corn was divided into 5 plant parts (leaf, stem, cob, husk, and grain), and the ratio of each part was calculated using dry weight and the feed value was analyzed. The emergence rate of corn was generally good except for the P1151 and P2105 varieties. The average tasseling date was July 24th and the silking date was July 27th, but the P2105 variety was late to July 28th and August 1st, and the remaining varieties were similar. P1345 was the highest (289 and 123 cm), and P1151 varieties were the lowest (267 and 101 cm) in the plant and ear height. Disease resistance was low in P1184, P1443 and P1429, and P1197 and P1345 were high. In the case of stover, the dry matter (DM) content was the lowest at 19.6% in the P1151 and the highest at 24.9% in the P1429. DM content of ear was the highest in the P2105 (55.5%), and P1184 (54.2%) and P1345 (54.3%) were also significantly higher (p<0.05). The DM yield of stover of P2105, P1429 and P1194 varieties was significantly higher (p<0.05), and ear yield of P2105, P1345 and P1443 was higher. The proportions of each part of plants (leaf, stem, cob, husk, and grain) divided by 5 was high, with 50-60% of the ear(grain+cob) ratio. The ratio of husk and cob was roughly similar, and the leaf and stem part showed a ratio of about 20%. The crude protein (CP) content was highest in leaf, followed by grain. The CP content of the stem was the lowest, and the husk was not significantly different among the varieties (p>0.05). The acid detergent fiber (ADF) content was similar to the rest parts except grain, but the leaf part tended to be lower, and other parts except the stem and leaf showed no significant difference between varieties (p>0.05). There was no significant difference in NDF (neutral detergent fiber) content in husk, but there was a difference between varieties in other parts (p<0.05). In addition, there was a special difference by plant parts for each variety, P2015 on the stem, P1197 on the leaf, P1151 on the cob, P1197 on the husk, and P1197 on the grains with high NDF content. IVDMD (in vitro dry matter digestibility) was not significantly different between stems and grains, but there was a difference between varieties in cobs and husks. According to the results, DM yield of P2105 variety was the best in the experiment, and the ratio of grain was excellent in P1543 and P1345. In addition, it was found that the feed value was higher in the leaves and grains, and the leaf and stem had higher feed values than husk or cob.

The Effect of VDT Work on Vision and Eye Symptoms among Workers in a TV Manufacturing Plant (텔레비젼(TV)생산업체 근로자들의 영상단말기(VDT)작업이 시력과 안증상에 미치는 영향)

  • Woo, Kuck-Hyeun;Choi, Gwang-Seo;Jung, Young-Yeon;Han, Gu-Wung;Park, Jung-Han;Lee, Jong-Hyeob
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.3 s.39
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    • pp.247-268
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    • 1992
  • This study was conducted to evaluate the effect of VDT work on eyes and vision among workers in a TV manufacturing plant. The study subjects consisted of 264 screen workers and 74 non-screen workers who were less than 40 years old male and had no history of opthalmic diseases such as corneal opacities, trauma, keratitis, etc and whose visual acuity on pre-employment health examination by Han's test chart was 1.0 or above. The screen workers were divided into two groups by actual time for screen work in a day : Group I, 60 workers, lesser than 4 hours a day and group II, 204 workers, more than 4 hours a day. From July to October 1992 a questionnaire was administered to all the study subjects for the general charateristics and subjective eye symptoms after which the opthalmologic tests such as visual acuity, spherical equivalent, lacrimal function, ocular pressure, slit lamp test, fundoscopy were conducted by one opthalmologist. The proportion of workers whose present visual acuity was decreased more than 0.15 in comparison with that on the pre-employment health examination by Han's test chart was 20.6% in Group II. 15.0% in Group I and 14.9% in non-screen workers. However, the differences in proportion were not statistically significant. The proportion of workers with decreased visual acuity was not associated with the age, working duration, use of magnifying glass and type of shift work (independent variables) in all of the three groups. However, screen workers working under poor illumination had a higher proportion of persons with decreased visual acuity than those working under adequate illumination (P<0.05) . The proportion of workers whose near vision was decreased was 27.5% in Group II, 18.3% in Group I, and 28.4% in non-screen workers and these differences in proportion were not statistically significant. Changes of near vision were not associated with 4 independent variables in all of the three groups. Six out of seven subjective eye symptoms except tearing were more common in Group I than in non-screen workers and more common in Group II than in Group I (P<0.01). Mean of the total scores for seven subjective symptoms of each worker(2 points for always, 1 point for sometimes, 0 point for never) was not significantly different between workers with decreased visual acuity and workers with no vision change. However, mean of the total scores for Group II was higher than those for the Group I and non-screen workers (P<0.01). Total eye symptom scores were significantly correlated with the grade of screen work, use of magnifying glass, and type of shift work. There was no independent variable which was correlated with the difference in visual acuity between the pre-employment health examination and the present state, the difference between far and near visions, lacrimal function, ocular pressure, and spherical equivalent. Multiple linear regression analysis for the subjective eye symptom scores revealed a positive linear relationship with actual time for screen work and shift work(P<0.01). In this study it was not observed that the VDT work decreased visual acuity but it induces subjective eye symptoms such as eye fatigue, blurred vision, ocular discomfort, etc. Maintenance of adequate illumination in the work place and control of excessive VDT work are recommended to prevent such eye symptoms.

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The Body Shape Satisfaction and Body Shape Esteem according to the State of Obesity in 12-year old Children (초등학생 6학년 학생의 비만상태에 따른 체형만족도와 체형존중감에 관한 연구)

  • 백경신
    • Korean Journal of Health Education and Promotion
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    • v.18 no.1
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    • pp.79-91
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    • 2001
  • The purpose of this study was to identify the body shape satisfaction and body shape esteem according to the state of obesity in elementary school students. The data were collected from May 1st to 31th, 1999 using the questionnaire and the physical examination record. The subjects were 669 in 12-year old children. Data were analyzed with frequency, percentages, crosstabs, ANOVA, pearson correlation using the SPSS program. The results were as follows: 1. The prevalence of overweight was 14.0% of total students, 21.4% of mail students and 6.6 % of female students. 2. There were significant differences in the body shape satisfaction according to the state of obesity in total students(($chi^2$ = 110.31, p = .000), in mail students(($chi^2$ = 99.97, p = .000), in female students(($chi^2$ = 62.23, p = .000). The percentages of the body shape satisfaction were highest the underweight group in total and female students but in mail students the normal weight group was highest 3. There were significant differences in the body shape esteem according to the state of obesity in total students(F = 8.634, p = .000), in mail students(F = 11.738, p = .000), in female students(F = 4.502, p = .004). The mean scores of body shape esteem were highest the normal weight group in total students, overweight group in mail students and underweight group in female students. The higher the state of obesity was, the lower body shape esteem. 4. The relationships between body shape satisfaction, body shape esteem and obesity index were significant. Obesity index were significantly and negatively related to body shape satisfaction(r = -.2081, P = .000), to body shape esteem(r = -.2250, p = .000). 5. There were significant differences in the state of obesity according to sex(($chi^2$ = 88.136, p = .000) and the perception of body shape(($chi^2$ = 242.371, p = .000) in total students. There were significant differences in the state of obesity according to the body shape of father(($chi^2$ = 15.11, p = .019), the perception of body shape(($chi^2$ = 138.95, p = .000) in mail students. There were significant differences in the state of obesity according to the education of mother(($chi^2$ = 19.46, p = .022), the perception of body shape(($chi^2$ = 143.35, p = .000) in female students.

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Prediction of Salvaged Myocardium in Patients with Acute Myocardial Infarction after Primary Percutaneous Coronary Angioplasty using early Thallium-201 Redistribution Myocardial Perfusion Imaging (급성심근경색증의 일차적 관동맥성형술 후 조기 Tl-201 재분포영상을 이용한 구조심근 예측)

  • Choi, Joon-Young;Yang, You-Jung;Choi, Seung-Jin;Yeo, Jeong-Seok;Park, Seong-Wook;Song, Jae-Kwan;Moon, Dae-Hyuk
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.219-228
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    • 2003
  • Purpose: The amount of salvaged myocardium is an important prognostic factor in patients with acute myocardial infarction (MI). We investigated if early Tl-201 SPECT imaging could be used to predict the salvaged myocardium and functional recovery in acute MI after primary PTCA. Materials and Methods: In 36 patients with first acute MI treated with primary PTCA, serial echocardiography and Tl-201 SPECT imaging ($5.8{\pm}2.1$ days after PTDA) were performed. Regional wall motion and perfusion were quantified with on 16-segment myocardial model with 5-point and 4-point scaling system, respectively. Results: Wall motion was improved in 78 of the 212 dyssynergic segments on 1 month follow-up echocardiography and 97 on 7 months follow-up echocardiography, which were proved to be salvaged myocardium. The areas under receiver operating characteristic curves of Tl-201 perfusion score for detecting salvaged myocardial segments were 0.79 for 1 month follow-up and 0.83 for 7 months follow-up. The sensitivity and specificity of Tl-201 redistribution images with optimum cutoff of 40% of peak thallium activity for detecting salvaged myocardium were 84.6% and 55.2% for 1 month follow-up, and 87.6% and 64.3% for 7 months follow-up, respectively. There was a linear relationship between the percentage of peak thallium activity on early redistribution imaging and the likelihood of segmental functional improvement 7 months after reperfusion. Conclusion: Tl-201 myocardial perfusion SPECT imaging performed early within 10 days after reperfusion can be used to predict the salvaged myocardium and functional recovery with high sensitivity during the 7 months following primary PTCA in patients with acute MI.

Structural and Functional Changes of The Brain in The Patient with Schizophrenia, Paranoid type : Correlation among Brain MRI Findings, Neurocognitive Function and Psychiatric Symptoms (편집형 정신분열병 환자에서 뇌의 구조적 변화와 기능적 변화 : 뇌자기공명영상소견, 신경인지기능 및 정신증상간의 상관관계)

  • Kang, Cheol-Min;Lee, Young-Ho;Jung, Young-Jo;Lee, Jung-Heum;Kim, Su-Ji;Park, Hyun-Jin
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.54-70
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    • 1998
  • Objectives : The purpose of this study is to evaluate the role of structural and functional changes of the brain in the pathophysiology of schizophrenia. Methods : The authors measured the regions of interest on the magnetic resonance imaging of the brain in 20 patients with paranoid schizophrenia(15 men and 5 women) and 23 control subjects(15 men and 8 women). We also assessed the neurocognitive functions with the Wisconsin Card Sorting Test, the Benton Neuropsychological Assessment, and the Weschler IQ test-Korean version, soft neurologic signs, and psychiatric symptoms in the patient group. Results : In the patient group, all ventricles and basal ganglia including caudate nucleus and globus pallidus were significantly enlarged. Although there were no significant differences between the two groups in the values of right frontal lobe and left temporal lobe, there was a tendency of decrease in the values of right frontal lobe and left temporal lobe. There were significant positive correlations between the values of ventricles and the frequency of previous hospitalization. However, there were no significant correlations between other values of regions of interest and clinical data. The value of the right frontal lobe was significantly correlated with the score of soft neurologic signs, which is suggestive of the neurodevelopmental abnormalities. There were significant correlations between the value of frontal lobe and the scores of the various subscales of Benton Neuropsychiatric Inventory. In contrast, the value of left amygdala and putamen showed significant correlation with the score of verbal IQ on the Weschler IQ test. Structural changes of the temporal lobe areas were related with the positive and general symptom scores on PANSS, while those of the basal ganglia were related with the negative symptom scores. Conclusions : These results suggest that the structural changes of the brain in the patients with schizophrenia show the dual process, which is suggestive that the enlarged ventricle show the neurodegenerative process, while enlarged basal ganglia, and shrinked right frontal and left temporal lobe show the neurodevelopmental abnormalities. Among these changes, structural changes of the frontal lobe related with various neuropsychological deficits, while those of left temporal lobe related with language abnormality. Relative to the relation between structural changes and psychiatric symptoms, structural changes of the temporal lobe areas were related with the positive and general symptoms, while those of the basal ganglia were related with the negative symptoms.

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