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.

학교체육 활성화 방안에 대한 연구(Ⅰ) : 강원대학교 교양체육 운영방법의 개선을 중심으로

이광재,문병용,노성규,박기동,홍관이,한상준,유옥재,엄기진,정청자,오수일,김윤래,박장평,부기원 江原大學校附設 體育科學硏究所 1986 江原大學校附設體育科學硏究所論文集 Vol.- No.11

Try to find a scheme for activation to College Physical Education, this Report informs the various kinds of Survey and process those were projected for improvement of management methods on Cultural Physical Education in Kang Weon National University. From experimentally carried out "Sports events Choosing System" not as usual be inforced "Total practical Skill System", Following Positive effects and sujestions were Presented; 1. "Sports events choosing system" gave birth to more students' interesting and more voluntary participation to the sports events they chose, and sports skill and instruction level was elevated due to charge of expert according to each sports events. This system would be managed continuously hereafter for it related to life sports. 2. This System needs to closed cooperations between College and Community, for the facilities of community are utilized by college. 3. To complete the plan for activation of college Physical Education, additionally, the successional study ; namely "autonomous extracurricular sports activity" should be excuted hereafter.

음주 외상 환자

이성우,문준동,최성혁,문철규,홍윤식 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: We studied the incidence of trauma caused by alcohol related accidents, and the effects that alcohol has on the occurrence, the extent, and the outcome to the patient. Methods: In our study we studied trauma patients excluding pediatric patients(15 years old and under) who came to the Emergency department of Korea University Medical School Anam Hospital from the 1st of January 1996 to 30th of June 1996, looked into their medical records, and studied the records in a retrospective manner. The trauma patients were devided into two groups, a) alcohol-related and b) alcohol-non-related. The two groups were then subdivided according to their sex, age, the time they came in, the anatomical part of the trauma, the mechanism of their injury, the extent of the injury, the length of their hospital stay, the length of their ED stay and were seperately compared and analyzed. Statistically, ANOVA and logistic regression analysis using SAS were used in the study and then was assessed in Chi-square analysis methods. Results: The total of the trauma patients, added up to 832 people, 577:male and 255:female. Among this sum, 163 trauma patients were alcohol related(male:127 & female:36). 115 people were in the age group of 21-40. Compared to the non-alcohol related trauma group, the alcohol-related group had more facial & scalp injuries and tended to come in the hours between 0-6 AM. The cause of the injuries were mostly by fist-fighting and suicide, compared to mostly accidental-slipping injuries in the non alcohol-related group. There were no difference in the degree of the injury(ISS) and the length of hospital stay between the two groups, whereas the length of the stay at the ED was longer to the alcohol-related trauma patients. Conclusion: Alcohol related trauma patients were mostly in their 20s and 30s, came to the hospital at a late time and the reason for their visit were mostly because of fist fighting. In the Emergency department, because prompt and correct diagnosis is quite difficult to make in this group, their ED stay tended to be longer. We can conclude that measuring the blood alcohol level of these patients, continuing the psychological therapy and educating people is needed.

직렬과 병렬방식 이중효용 흡수식 냉동사이클의 성능 시뮬레이션

이윤환,오종택,오후규,박기원 麗水水産大學校産業技術硏究所 1998 産業基術硏究所 論文集 Vol.7 No.-

Condensing the global environmental problems such as CFCs, energy losses in heat recovery systems as well as summer peak time power demands, the development of high efficiency absorption refrigeration systems is one of the most promising method in this problems. In this study, simulation models of both series and parallel type, both using double-effect absorption cycle refrigeration systems. The results summarized as follows : ⑴ In the parallel type, the solution maximum temperature and the pressure of high temperature generator were adjusted by varing the distribution ratio of the solution, and the optimum value was found to be about 0.4. ⑵ The efficiency of the cooling cycle in both parallel and series systems were increased by decreasing the solution circulation ratio in the absorbers, while the solution maximum temperature and high temperature generator pressure were slightly increased.

외상 환자에서 의식소실 유무와 외상후 스트레스 장애의 유병율, 증상 양상, 우울 및 불안에 관한 연구

이유진,연규월,우행원,김영철,임원정 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.4

연구목적 : 본 연구에서는 의식 소실 유무에 따른 외상후 스트레스 장애 유병율 및 증상, 우울, 불안 증상을 알아보기 위해 외상을 당한 환자를 의식 소실이 있었던 환자군과 의식 소실이 없었던 환자군으로 구분하여 두 집단의 외상후 스트레스 장애의 유병율, 증상 및 불안 정도를 비교해보고자 하였다. 방 법 : 사고를 당하고 1달 이상 경과한 환자 120명(남자 69명, 여자 51명)을 대상으로 하였다. 대상군을 의식 소실 유무에 따라 소실군과 비소실군으로 구분하고 사회인구학적 변수, 사고 당시 의식 소실의 유무, 의식 소실 시간, 사고의 종류, 사고에 대한 기억, 사고의 심각도, 손상 심각도 점수(Injury Severity Score)를 조사하여비교하였다. 또한 외상후 스트레스 장애 척도(Clinician Adminstered PTSD Scale), Beck의 우울증 척도(Beck Depression Inventory), 상태 특성 불안처도- Ⅰ, Ⅱ(State Trait Anxiety Inventory- Ⅰ, Ⅱ)를 이용하여 조사하여 두 군 사이의 외상후 스트레스 장애유병율 및 증상, 우울, 불안 정도를 비교하였다. 결 과 : 통 연구 대상자 120명중 의식 소실이 있었던 환자군(소실군)은 56명(46.7%)이었고 의식 소실이 없었던 환자군(비소실군)은 64명(53.3%)이었다. 총 대상자 120명중 30명(25%)이 외상후 스트레스 장애로 진단되었으며 소실군 56명중 17명(30.4%)이 비소실군 64명중 13명(20.3%0이 각각 외상후 스트레스 장애로 진단되었으나 두 군간의 차이는 통계적으로 유의하지 않았다(x^2=1.607, P>0.05). 외상후 스트레스 장애 증상 척도에서는 소실군에서 사고에 대한 기억 상실, 흥미 상실, 이탈, 감정 둔마, 수면자애, 예민함, 집중력 감소 증상의 빈도가 유의하게 높았다(P<0.05). 비소실군에서느 반복적인 회상과 놀람 반응 빈도가 유의하게 높았다(p<0.05). Beck의 우울증 척도 점수는 소실군에서 38.8±8.8, 비소실군에서 31.0±7.9로 의식 소실을 보고한 환자군의 점수가 유의하게 높았으며(t=-3.16, 0<0.05) 상태 특성 불안 척도-I, II는 소실군에서 각각 44.5±3.3, 44.6±3.9, 비소실군에서 각각 42.9±3.0, 42.3±3.4로 소실군의 점수가 유의하게 높았다(t=-2.75, p<0.05, t=-3.38, p<0.05). 결 론 : 사고 당시 의식 소실이 없었던 환자군과 비교하여 외상후 스트레스장애가 비슷한 빈도로 진단되며 의식 소실이 외상후 스트레스 장애의 발생에 유의한 영향을 미침은 물론 불안 및 우울에도 유의한 영향을 미친다고 할 수 있다. Objectives :This study investigated PTSD prevalence, symptoms, depressed mood and anxiety, comparing two groups of the patients in trauma ; one who had experienced the loss of consciousness(group "A" here after) and the other group of patients who had not(group "B" here after). Method : subjects were 120 patients(age18-66) who had received trauma(traffic accident, fall down) more than 1 month. Before they consisted of 56 patients who had experienced the loss of the consciousness(46.7%) and 64 who had not(53.3%). Men were 69 and women were 51. Clinician administered PTSD Scale, Beck Depression Inventory, State Trait Anxiety Inventory-I, II were administered. The factors such as sociodemographic variables, unconsciousness at the time of trauma, memory about tranmatic accidents were considered. Result : Out of 120 subjects, 30 patients(25%) were diagnosed as PTSD : 17 from 56(30.4%) and 13 from 64(20.3%) were found in the group "A" and "B" respectively. Prevalence of PTSD was higher in the group "A" showed significant difference between two groups(x^2=1.607,p>0.05). The CAPS of group "A" showed significantly high frequency in the loss of interest, detachment, restricted affect, sleep difficulty, irritability/anger. concentration difficulty(p<0.05), while the group "B" scored high in intrusive recall and increased startle. The scores of BDI, STAI-I, II were significantly higher in the group "A"(t=-3.16, p<0.05)(t=-2.75, p<0.05, t=-3.38, p<0.05). Conclusion : PTSD was mre frequent and depressed mood and anxiety appeared more often in the group qho experienced the loss of consciousness. Thus the loss of the consciousness at the time of trauma prones of the aevelopment PTSD and symptom of aepression and anxiety.

Fosfomycin의 항균효과 및 capillary electrophoresis에 의한 측정법에 관한 연구

윤효인,박승춘,이규승,권진욱,조준형,신광순,김무열,허강준,조명행 충남대학교 수의과대학 동물의과학연구소 1996 動物醫科學硏究誌 Vol.4 No.-

Fosfomycin, a low molecular antibiotic, is to be easily synthesized, therefore to be possibly used in veterinary sectors due to econimic reasons. In this study, we determined the antibacterial activities of fosfomycin against some domestic animal-origin pathogens, and its combined effects with some important antibacterials available. We also compared detection methods of fosfomycin from various measuring instruments. The results obtained through this experiment were as follows: 1. Antibacterial activities of fosfomycin against the pathogens used in this experiment were appeared fairly low. We found the antobacterial activities depanded on the kinds of media and the addition of some material thereins, which suggests the importance of appropriate medium so as to judge the antibacterial activity of fosfomycin. 2. Fosfomycin showed varying antibacterial effects in combination with other antibacterials, which should be taken into consideration when combining other antobacterials especially in the clinical settings. Of the combined antivacterials, fosfomycin had synergistic effects in combination with amoxicillin but antagonistic effects with oxytetracyline. 3. Conventional detection methods using HPLC, GC and spectrophotometer were not appropriate to measure fosfomycin. Capillary electrophoresis by the way of the indirect ultraviolet detection method was good enough to detect fosfomycin in the range of expected concentration in tissues, with the limit of quantitation (LOQ) of 1.25 ㎍/㎖. We recommend the eletrophoresis method could be used to detect fosfomycin, thereby being able to set the optimal dosage for animals and providing the measures in relation with the residual concentration in the meat.

기질레진의 조성에 따른 복합레진의 물리적 성질에 관한 연구

이연신,최경구,박상진 大韓齒科保存學會 2002 Restorative Dentistry & Endodontics Vol.27 No.1

Current composites are made with dimethacrylate monomers and silane-treated silica microfillers, either alone or with silane treated glass fillers. The main reasons for clinical failure of dental composites are secondary caries, wear and fracture. Most of practitioner want to get a composite which is more tougher under occlusal stress, less polymerization contraction, and better handling properties in application clinically. The aim of this study was to investigate the influence of resin matrix with various flows on the physical properties such as facture toughness and degree of conversion of the experimental resins. It was hypothesized that flexible or tough resin compoties can be designed by judicious choice of monomer comptosition Various flow resin matrices containing Bis-GMA, UDMA, and TEG-DMA were made by altering the proportion of the monomers. After the unfilled resins were light-cured for different light intensity. the fracture toughness(K_1c) was measured according to ASTM standard using the the single edge notched geometry, and degree of conversion(DC) was measured by FTIR. And experimental composites were formulated with variations in the proportion of silanated quartzz and strontium glass fillers as 60, 75, and 77wt%. Also, the physical properties of composites with various filler contents were evaluated as same manner. All resulting data were compared by ANOVA/Tukeys test at 0.05 level. The results were as follows; 1. The degree of conversion of high flow resin containing less Bis-GMA was higher than that of low flow unfilled resin. 2. While the degree of conversion of unfilled resin was increased according to light intensity for polymerization, there was no significant increase with moderate and high light intensity. Also, the fracture toughness was not increased by high light intensity 3. The fracture toughness was high in the flow unfilled resin containing higher contents of Bis-GMA. 4. There was a significant increase for fracture toughness and a tendency for degree of conversion to be reduced when the content of fillers was increased. 5. In the experimental composites, the flow of resin matrix did not affected on the fracture toughness, even, which was decreased as increase of viscosity. These results showed that the physical properties of a dental composite could be attributed to the flow of resin matrix with relative content of monomers. Specific combination of resin monomers should be designed to fulfill the needs of specific indication for use.

신사구체 경변증을 나타내는 FGS/NgaKist mice 간장에서 사이토크롬 P4501A1/2 단백질 발현

정규식,현병화,이철호,박상준,최양규,류시윤,이차수,민병길 대한해부학회 1997 Anatomy & Cell Biology Vol.30 No.2

유산소성 운동이 여성 노인들의 체력과 반응시간에 미치는 영향

이규문,최종환,류석윤 忠北大學校 平生體育硏究所 1998 平生體育硏究所 論文集 Vol.10 No.-

This study was performed to investigate the effect of aerobic exercise program on physical fitness and whole body reaction time, and to see the relationship between the level of physical fitness and level of whole body reaction time in the elderly women. The study subjects were consisted of 44 old women with mean age of 67.3 years. They were tested on their physical fitness and whole body reaction time level at the begin and end of the 12-week program(pre-post tests). Assessment included measures of strength, power, balance, agility, flexibility, %body fat, endurance, and body simple and choice reaction times in the elerly women. For data analysis, mean and standard deviation scores were calculated, and paired t-test and person's correlation coefficient were used. The results were follow: 1. After the aerobic exercise program, power, balance, agility, flexibility, %body fat, and endurance were significantly imroved in the elerly women. 2. After the aerobic exercise program, body simpel and choice reaction times were also significantly improved in the elderly women. 3. After the aerobic exercie program, old womens' simple and choice reaction time of whole body were significantly related to strength, power, balance, agility, and flexibility. In conclusion, even though the elderly women had participated in the aerobic exercise program for the short period time(3 months), they showed the improved physical fitness and whole body reactin time, which are related to physical health.

iTECH 바닥 슬래브의 시공단계별 진동특성에 관한 연구

이윤경,주영규,윤성원,김도현,김상대 대한건축학회 2005 大韓建築學會論文集 : 構造系 Vol.21 No.3

The story height of the tall buildings is the significant factor due to the limited construction area within the central city such as Seoul. Therefore we developed iTECH(Innovative Technical Economical & Convenient Hybrid) system to reduce story height. Since the top flange of the proposed beam is within the slab, the vibrational characteristics have to be verified by the test. The purpose of this paper is to study on vibration characteristics of floor with iTECH composite system and to evaluate the serviceability. In this research, natural frequency, damping ratio and peak acceleration were measured at experiments for each construction step such as steel erection stage, concrete casting stage and finishing stage. The test results are compared with that of the code. As a result, the proposed composite slab showed enough vibrational characteristics.