Gilbert 증후군에서 열량 제한 시험과 Phenobarbital 자극 시험의 의의(14예)

이헌영,채경훈,정재훈,강윤세,김연수,문희석,박기오,이엄석,김선문,김석현,성재규,이병석,이강욱 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Gilbert 증후군은 인구의 7%에서까지 나타날 수 있는 매우 흔한 증후군으로서 비진행성인 양성의 만성적 경과를 치하며, 간질환의 증상과 징후가 없는 경한 비포합형 고빌리루빈혈증이 특징인 일종의 체질적인 증상으로서 혈장 빌리루빈 농도에 대한 사춘기의 영향 때문에 10대와 20대에 자주 진단이 된다. 따라서 임상적인 중요성은 미약하지만 높은 빈도가 예상되는 점에 그 중요성이 부여되어야 할 것이다. 따라서 적정한 임상적 진단법으로 기왕에 소개된 열량제한 시험과 phenobarbital 유도 시험을 시행하고 이들의 진단적 가치를 알아보기 위하여 본 연구를 시행하였다. 1990년 7월부터 1999년 4월까지 충남대학교병원에 내원하여 HBsAg, IgG anti-HBc 및 anti-HCV가 음성이고, 간 초음파 스캔에서 이상이 없으며, 혈청 AST, ALT 및 AP가 정상인 비음주자에서 경한 비포합형 고빌리루빈혈증이 있는 14예의 환자들을 대상으로 ^(99m)Tc-DISID 스캔을 시행하였으며, 기저 치 총빌리루빈 및 포합형 빌리루빈 치를 측정한 다음에 하루에 400Kcal로 48시간동안 제한한 열량 제한 시험을 시행하였고, phenobarbital을 하루 60mg씩 5일간 투여한 후에도 각각 총빌리루빈과 포합형 빌리루빈 치를 검사하여 비포합형을 구하였다. 대상 환자들은 모두 14예로서 남자가 11예(78.6%)였고 여자가 3예(21.4%)여서 3.7:1로 남자에서 많았으며, 20대가 6예(42.9%), 30대가 역시 6예(42.9%) 및 40대가 2예(14.2%)로서 2,30대가 대부분(85.8%)이었다. 열량 제한 시험 후의 총빌리루빈 치, 비포합형 및 포합형 빌리루빈 치들은 평균 각각 5.5±2.7, 4.2±2.3 및 1.3±10mg/dL 로서, 시험 전 치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg/dL 보다 유의하게(p=0.001, p=0.001, p=0.023) 상승하였다. 포합형 빌리루빈 치도 유의하게 상승하였으나 비포합형의 상승보다는 훨씬 낮아서 주로 비포합형이 증가하였다. phenobarbital 투여 중 설사가 발생하여 중단한 1예를 제외한 13예에서 열량 제한 시험 후에 상승하였던 총, 비포합형 및 포합형 빌리루빈 치가 phenobarbital 유도 시험후에는 2.0±1.1, 1.5±0.8 및 0.5±0.4mg/dL로서 열량 제한 시험 결과보다 유의하게 낮아졌고(p=0.00, p=0.000, p=0.001), 열량 제한 시험 전의 기초치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg.dL 보다도 더욱 낮아졌으며 유의한 차이(p=0.001, p=0.02, p=0.005)를 나타내었다. 14예에서 시행한 ^(99m)-Tc DISIDA 스캔에서 9예(64.3%)가 정상이었고, 5예(35.7%)에서는 심장 및 신장으로의 간외 섭취가 3예였고, 60분까지 소장 배출이 없는 배설 지연 예와 담낭 수축 불량 예가 각각 1예 씩 발견되었다. Phenobarbital 투여시험에서 민감도가 열량제한시험에 비해 더 높았다(92.3%와 50.0%). Gilbert 증후군에서 1일 400 Kcal로 48시간의 열량제한 시험과 1일 60mg의 phenobarbital을 5일간 투여하는 유도 시험은 편리하고 유용한 임상적인 진단법으로 이용할 수 있다고 생각된다. 그러나 열량 제한 시험에서는 증가 기준의 통일이 필요하다고 유추되며 phenobarbital 유도 시험이 민감도가 더 높은 것으로 생각된다. Gilbert's syndrome is very frequent and benign chronic process characterized by mild, intermittent, unconjugated hyperbilirubinemia without any symptom and sign of liver disease. Previously intoduced caloric restriction test and phenobarbital stimulation test as two appropriate clinical tests had been examined and their diagnostic values were reevaluated. Fourteen patients with mild, persistent, unconjugated hyperbilirubinemia were included. Subsequently caloric restriction has been applicated by 400 Kcal/day for 48 hours and phenobarbital has been prescribed by 60 mg/day for 5 days. Therafter serum levels of total and direct bilirubin were measured. Most of the patients were third and fourth decade(85.8%) and male predominant. Each basal serum levels of total, indirect and direct bilirubin were 3.0±0.8, 2.2±0.8 and 0.7±0.4 mg/dL. After caloric restriction test, each levels were increased significantly to 5.5±2.7, 4.2±2.3 and 1.3±1.0 mg/dL(p=0.001, p=0.001, p=0.023). After phenobarbital stimulation test for 13 patients had been practiced, increased levels of each bilirubin after caloric restriction test were decreased significantly to 2.0±1.0, 1.5±0.8 and 0.5±0.4 mg/dL(p=0.000, p=0.000, p=0.001) and these levels were significantly lower than basal levels(p=0.001, p=0.02, p=0.005). The sensitivities of caloric restriction test were 85.7%, 50.0%, and 71.4%, 35.7%(1.0, 1.5 mg increase of total bilirubin and 1.0, 1.5 mg/dL increase of indirect bilirubin). The sensitivities of phenobarbital stimulation test were 93.2% and 92.3% at criteria of 1.5 mg/dL increase of total bilirubin and indirect bilirubin. On the diagnosis of Gilbert syndrome, caloric restriction test and phenobarbital stimulation test are convenient and useful diagnostic tools in clinical face. And also phenobarbital stimulation test has higher sensitivity than caloric restriction test. Furthermore, standardization of bilirubin increment would be necessary in caloric restriction test.

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

GPS/INS를 활용한 항공 정사영상 제작에 관한 연구

박병욱,이창재,서상일 한경대학교 2008 論文集 Vol.40 No.-

In this study we took the aerial photos scaled 1:5,000 with aircraft equipped GPS/INS. DEM was generated by automatic image matching method using the exterior orientation parameters obtained by GPS/INS, and the ortho-images were produced by differential rectification based on that. As the result of measurement of RMSE based on digital map for ortho-images produced with GPS/INS data, the horizontal position error was 61cm that was good enough to satisfy the precision demand of 1:1,000 ortho-image map. There were no big differences in precision of ortho-images between GPS/INS and aerial triangulation process. It seems that the producing method of ortho-image using GPS/INS data can be speedier and more efficient method than traditional method using aerial triangulation

TFSCAN 검색 프로그램 TFSCAN의 개발

이병욱,박기정,김기봉,박완,박용하 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.3

TFD는 기능이 알려진 짧은 DNA sequence(signal)들과 그와 연관된 저널 자료로 구성된 데이타베이스이다. 임의의 DNA에서 이 데이타베이스의 sequence들을 검색하여 signal을 찾는 프로그램으로 Dan S. Prestridge가 개발한 SIGNAL SCAN이라는 프로그램이 사용되고 있는데, 이는 간단한 문자열 비교 알고리즘을 사용한다. 본 연구에서는 계산상 보다 효율적인 검색을 위해서, TFD의 sequence를 검색하기 위한 automata를 구성하는 프로그램과, 이 automata에 따라 signal을 검색하도록 하는 TFSCAN이라는 프로그램을 개발하였다. 검색된 signal에 대한 관련 문헌의 검색에서도 인덱싱 방법을 이용하여 계산 속도를 향상시켰다. 프로그램의 사용을 단순화시켰고, 결과 내용을 signal과 관련된 모든 정보를 일목요연하게 보여줄 수 있도록 구성하였다. 이 프로그램을 Web을 통해서도 사용할 수 있도록, GINet Web 서버에 TFSCAN 입력용 form과 CGI 프로그램을 개발·설치하였다. 본 연구의 특정 Motif 패턴으로 구성된 데이타베이스 검색에서, automata를 응용한 알고리즘을 이용하여 계산상 급격히 향상된 결과를 얻을 수 있음을 알 수 있었는데, 이는 생물학의 여러 패턴 검색에 응용될 수 있을 것이다. 더욱 민감한(sensitive) signal 검색을 위해서, 이와 같이 automata를 활용하고, 이 automata를 최적화하는 알고리즘 연구를 계속하고 있다. TFD is a transcription factor database which consists of short functional DNA sequences called as signals and their references. SIGNAL SCAN, developed by Dan S. Prestridge, is used to determine what signals of TFD may exist in a DNA sequence. This program searches TFD database by using a simple algorithm for character string comparison. We developed TFSCAN that aims at searching for signals in an input DNA sequence more efficently than SIGNAL SCAN. Our algorithms consist of two parts, one constructs an automata by scanning sequences of TFD, the other searches for signals through this automata. Searching for signal-related references is radically improved in time by using an indexing method. Usage of TFSCAN is very simple and its output is obvious. We developed and installed a TFSCAN input form and a CGI program in GINet Web server, to use TFSCAN. The algorithm applying automata showed drastical results in improvement of computing time. This approach may apply to recognizing several biological patterns. We have been developing our algorithm to optimize the automata and to search more sensitively for signals.

수복재에 함유된 불소가 치질의 미세경도와 불소 함유량에 미치는 영향

이수종,조영곤,김종욱,박병철 大韓齒科保存學會 2004 Restorative Dentistry & Endodontics Vol.29 No.1

The purpose of this study was to compare the microhardness and the fluoride content of enamel and dentin around fluoride- or non fluoride-containing restorations. Forty extracted human teeth were used and prepared cervical cavities on proximal surface. Experimental teeth were divided into five groups. Group 1 : Prime & Bond NT and Z100. Group 2 : Prime & Bond NT and F2000. Group 3 : Scotchbond Multi-Purpose and Z100. Group 4 : Scothcbond Multi-purpose and F2000. Group 5 : Fuji II LC. The cavities were filled with dentin adhesives and restorative materials. After each tooth was bisected, one half was tested microhardness and the other half was analyzed the fluoride at the enamel and dentin by an EPMA-WDX device. The results were as follows: 1. There was no statistical difference among the microhardness of enamel surface in all group. 2. The microhardness at dentin of 100 ㎛ point in Group 2 and 20 ㎛ point in Group 4 was lower than that of normal dentin (p>0.05) 3. There was no statistical difference among the fluoride content of enamel surface in all group. 4. The fluoride content at the dentin of 30 ㎛ point in Group 2 and 5 were higher than those at 100 ㎛ and 200 ㎛ point in Group 2 and normal dentin (p<0.05) 5. At the dentin of 30 ㎛ point, Group 2 showed higher fluoride content than Group 1 and 3, and Group 5 showed higher fluoride content than other groups.

烏貝散이 흰쥐 胃의 Gastrin, Histamine, Somatostatin 면역반응세포에 미치는 영향

이시섭,나현욱,고병문,이광규,이창현 대한동의병리학회 2001 동의생리병리학회지 Vol.15 No.5

To investigate the elects on the administration of Opae-san in rats. Opae-san (500mg/day) and omeprazole(10mg/day) were administration with stomach tube for 4 weeks and 8 weeks. This experiment were investigated numerical change of immunoreactive cells of gastric, histamine and somatostatin in rat stomach mucosa by the immunohistochemical method. The results were as follows : 1. In Opae-san administration group for 4 weeks, the number of gastric immunoreactive cells were increased in one and a half times than that of control group. In omeprazole administration group for 4 weeks, the number of gastric immunoreactive cells were increased in four times than that of control group. In Opae-san administration group for 8 weeks, the number of gastric immunoreactive cells were increased four times than that of control group. In omeprazole administration group for 8 weeks, the number of gastrin immunoreactive cells were increased in six times than that of control group. 2. In Opae-san administration group for 4 weeks, the number of histamine immunoreactive cells were increased in two times than that of control group. In omeprazole administration group for 4 weeks, the number of histamine immunoreactive cells were increased in six times than that of control group. In Opae-san administration group for 8 weeks, the number of histamine immunoreactive cells were increased three times than that of control group. In omeprazole administration group for 8 week, the number of histamine immunoreactive cells were increased in seven times than that of control group. These results suggest that Opae-san extracts inhibit the secretion of gastric acid and this extract use to therapeutic herb of gastric disorders related to the hyperacidity and gastric ulcer.

小波動 技法을 이용한 可變 베타의 長期 持續性 분석

이한식,윤병욱 서강대학교 경제학연구원 2004 시장경제연구 Vol.33 No.2

The properties of CAPM betas play a key role in characterizing capital asset pricing mechanism. An attempt is made in this paper to examine whether systematic risk(the beta of an asset) is stationary and/or mean-reverting. In doing so, we use the wavelet analysis to estimate the fractional differencing parameter of the ARFIMA (Autoregressive Fractionally Integrated Moving Average) model for time-varying betas. Specifically we apply the wavelet OLS method to stock's betas of four emerging markets : namely, Korea, Hong Kong, Singapore, and Malaysia. Unlike alternative estimating methods which are very sensitive to model mis- specification of short-term parameters in ARFIMA models, the wavelet OLS estimator is invariant to the specification of short-term ARMA parameters. Our empirical findings show that time-varying betas of the four markets appear to have a mean-reverting pattern although they may have a long-memory property.

유지 투석중인 만성 신부전환자에서 허혈성 심질환의진단 지표로서의 심장트로닌-I의 유용성

신병철,강대웅,정지용,류봉관,서영욱,김정인,김범윤,김현리,정종훈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background : Coronary disease is highly prevalent in patient with end stage renal disease (ESRD) and account for much of their observed morbidity and mortality. Troponin-I consistently maintains a high sensitivity and specificity and is most sensitive marker for ischemic heart disease (IHD). Method : We examed 49 hernodialyzed patients (22 male, 27 female) without evidence of acute coronary syndrome (ACS) for 6 months. Biochemical markers were measured in serial predialysis blood samples. For analysis, we used two cardio-specific assays for troponin-T (cTnT) as well as for troponin-I (cTnI) and compared the results with CK-MB (reference value ≤ 4.0 ng/mL) concentration. Results : Myocardial ischemia was observed in 47% (23/49) of patients. cTnT level above 0.1 ng/mL. and cTnI level above 0.5 ng/mL, were observed in 22% (11/49) and 20% (10/49) of patients respectively. cTnI revealed significantly higher positive rate in patients with myocardial ischemia than the patients without myocardial ischemia (43 % vs 30%) (p<0.05). cTnT and CK-MB revealed no difference in positive rate between the patients with and without myocardial ischemia (cTnT : 30% vs 15% and CK-MB : 30% vs 19%). The sensitivity and specificity of cTnI to myocardial ischemia were higher than those of cTnT and CK-MB (sensitivity 43% vs 30% and 30%. specificity 100% vs 85% and 81%). Conclusion: Both cTnT and cTnI are useful in ruling out myocardial injury in chronic renal failure patients. But. cTnI is a more sensitivity and excellent specificity of ischemic heart disease than cTnT and CK-MB in hemodialyzed patients. In patients with ischemic heart disease, the presences of DM and advanced age were higher than those in patients without ischemic heart disease (p<0.05). Among the baseline characteristics old age, elevated LDH and diabeties were significant more frequent in the patients with elevation of cardiac troponin-I (p>0.5 ng/mL) than those with cardiac troponin-I (p<0.5 ng/mL), p=0.038, p=0.049, and p=0.045, respectively. Our results suggest that these cTnI is the potential diagnostic marker for the prediction of IHD in ESRD patients.

실용적인 이취미 측정법을 이용한 상수원수 내 이취미 모니터링

배병욱,김영일,이병은 대전대학교 환경문제연구소 2001 환경문제연구소 논문집 Vol.5 No.-

In order to investigate the occurrence characteristics of teste and odor(T&O) in drinking water supplies, water quality data of the Songchon water treatment plant(WTP) copes with T&O episode were used. Three kinds of water, such as raw and filtered water of the Songchon WTP, and tap water of consumer's house, were monitored by using three sensory methods, including TON, 2-out-of 5 odor test, and attribute difference test for the presence of absence of geosmin. The population densities of algae species were high correlate with Chlorophyll-a during T&O episode. At that time, dominant genus of algae were blue-green algae which were Microcystis, Oscillatoria, Aphanizomenon, and Anbaena. TON values of raw water increased about 40 since July, but decreased below 10 after July due probably to the heavy rain lasted for a long time. TON values of filtered water were maintained less than 5, because of added PAC(powdered activated carbon) in raw water of the Songchon WTP. For identifying geosmin and 2-MIB in raw and filtered water of the Songchon WTP were measured by Deajeon University and Philadelphia Suburban Water Company(PSWCO). PSWCO Showed some difference in absolute values, there might be somewhat clear relationship between CLSA data and Ton values. The maximum geosmin was about 45 ng/l on July 14. Comparing the results of 2-out-of 5 odor test and TON, it seems that 2-out-of 5 odor test is more sensitive than TON for the samples with TON below 5. Like 2-out-of 5 odor test, it was found that the attribute difference tedt might be more sensitive and appropriate than TON when the odor intensity of sample is low.

골관절염 환자에 대한 Tenxicam(Tilcotil^(�))의 효과에 대한 임상시험 결과

최창욱,나수균,이병일 최신의학사 1990 最新醫學 Vol.33 No.1