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.

간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

초등학생들의 체격지수가 체력요인에 미치는 영향

채정룡,윤석창,신현철 군산대학교 체육과학연구소 1999 體育科學硏究所 論文集 Vol.1 No.-

The aim of this study make it clear the trait of physical strength according to Physique index and help the Physical fitness leaders to raise the function of exercise and provide them with study programs by stage in the sport learning. For this study 620 students (male & female students in 5 and 6 class of elementary school) were selected. The result of study show outstanding physical trait in body weight ratio and chest girth ratio. The results are the following. (1) The physical characteristics of the investigated children, around 5 class or 6 class, show that female children's growth is faster than male's. (2) The trait of Physical Fitness shows it is superior in male's group and as grow older, but the group of 5 class is more superior than the group of 6 class, in male's and female's pull-ups. (3) The correlation between physique index shows the highest correlation(P< .01) in body weight and girth of chest, next is height and sitting height, height and girth of chest, followed by girth of chest and sitting height. (4) The correlation between 100m sprint and physical fitness shows high positive interrelation(P< .01) in 600m distance run, but negative interrelation(P< .01) in standing broad jump, pull-ups, sit-ups and ball throwing. (5) The correlation between standing broad jump and physical fitness shows positive interrelation(P< .01) in sit-ups, pull-ups and ball throwing, but negative interrelation(P< .01) in 100m sprint and 600m distance run. (6) The correlation between pull-ups and physical fitness shows positive interrelation(P< .01) in sit-ups, standing broad jump and ball throwing, but negative interrelation(P< .01) in100m sprint and 600m distance run. (7) The correlation between sip-ups and physical fitness shows positive interrelation(P< .01) in standing broad jump, sit-ups and ball throwing, but negative interrelation(P< .01) in 100m sprint and 600m distance run. (8) The correlation between ball throwing and physical fitness shows positive interrelation(P< .01) in standing broad jump, pull-ups, sit-ups and ball throwing, but negative interrelation(P< .01) in 100m sprint and 600m distance run. (9) The correlation between 600m distance run and physical fitness shows high positive interrelation (P< .01) in 100m sprint, but negative interrelation (P< .01) in standing broad jump, pull-ups, sit -ups and ball throwing. (10) The correlation between physical fitness and physique index shows the highest correlation in body weight ratio, next is chest girth ratio, followed by sitting height ratio. (11) The correlation between body weight ratio and physical fitness shows positive interrelation (P<.01) in 100m sprint (male and female students in 5 class) and standing broad jump, sip-up (female students in 5 class), ball throwing (male students in 5 class) and 600m distance run, but negative interrelation(P< .01) in pull-ups etc. (12) The correlation between chest girth ratio and physical fitness shows positive interrelation (p<. 01) in 100m sprint and 600m distance run, but negative interrelation(P<. 01) standing broad jump, pull-ups, sit-ups and ball throwing etc. (13) The correlation between sitting height ratio and physical fitness shows positive interrelation (P<. 01) in pull-ups, sit-ups and ball throwing, but negativ interrelation(P< .01) in 100m sprint, standing broad jump, sit-ups and 600m distance run etc. (14) The correlation between physical index shows positive interrational (P< .01) body weight ratio and chest girth ratio, chest girth ratio and sitting height ratio, but negative interrelation in(P< .01) body weight ratio and sitting height ratio.

네트워크 및 TCP 분석을 통한 TCP 공정성의 향상

이정재,채현석,조태경,최명렬 漢陽大學校 工學技術硏究所 2002 工學技術論文集 Vol.11 No.-

TCP Vegas는 TCP Reno에 비해 안정적이고 이로 인해 네트워크 자원을 보다 효율적으로 이용할 수 있다. 그러나 두 버전이 같이 사용되는 경우 TCP Reno에 비해 TCP Vegas는 일정하나 낮은 수준의 전송율을 보이고 있다. 본 논문에서는 TCP Reno와 Vegas의 공정성에 영향을 미치는 요소인 TCP Vegas의 알고리즘에서 사용하는 상수 요소인 α·β, TCP의 MSS, 라우터의 버퍼 크기에 의해 TCP Reno와 TCP Vagas의 공정성이 변화하는 모습을 시뮬레이션을 통해 확인하였으며, 이에 따른 향후 연구과제를 제시하였다. TCP Vegas are much more stable than those of TCP Reno, resulting in a much more efficient utilization of the network resource. But difference in performance in due to the fact that Teno vibrates in the high throughput level and Vegas almost stabilizes in the low level when those TCP versions are used in same network. We find out by simulation about α·β which is constant factor of TCP Vegas, MSS of TCP and router buffer size change the fairness of TCP Reno and TCP Vegas. So we proposed more studying about these factor which changes fairness of TCP Reno and TCP Vegas.

RED 게이트웨이에서의 응답 메시지 처리 알고리즘

이상민,채현석,최명렬 漢陽大學校 工學技術硏究所 2001 工學技術論文集 Vol.10 No.-

본 논문에서는 RED 게이트웨이간의 전송률을 최대로 유지하며 종단에서 실제로 처리되어 전송되는 패킷의 양을 늘릴 수 있는 응답 메시지 처리 알고리즘을 제안한다. 본 논문에서 제안한 응답메시지 처리 알고리즘을 RED 게이트웨이에 적용하여 패킷의 손실을 줄이고 전송 효율을 높였으며, 모의 실험을 통해 성능의 향상을 확인하였다. 일련의 모의 실험에서는 응답메시지 처리 성능을 분석하고, 차후의 연구 방향을 제시한다. 본 논문은 네트워크 NS-2 시뮬레이터를 사용하여 다양한 TCP 버전의 조합과 RED 게이트간의 연결속도와 게이트의 개수에 변화를 주어 모의 실험 하였다. This paper proposes an act message processing algorithm to increase the throughput at the end of the telecommunication node, when it uses RED gateway to include various TCP versions with keeping the highest throughput between two RED gateways. This paper shows the results in Kbytes/s from a series of simulation experiments designed to analyze the performance of ark message processing algorithm. Using the ns-2 simulator, the simulation results have been conducted by changing the link speed between two RED gateways using the combination TCP Vegas and TCP NewReno.

Schiff Base에 의한 구리 부식 억제

정병구,이현석,장영학,문채주 木浦大學校 應用科學硏究院 2001 應用科學硏究誌 Vol.1 No.-

The inhibiting action of copper in 5% hydrochloric acid(HCI) solutions with or without Schiff base, 1,2-bis(naphthylideneimine)ethane(NET), 1,3-bis(naphthylideneimine) propane(NPR), 1,4-bis(naphthylideneimine)butane(NBU), and 1,5-bis(naphthylideneimine) pentane(NPE), has been studied by the Tafel method and AC impedance technique. The corrosion parameters were obtained at different inhibitor concentrations and the temperature effect was also investigated. The inhibiting efficiency increases with a decrease in temperature or increase in concentration of the Schiff base. NPE is the best inhibitor in this series and the maximum inhibition efficiency at a concentration of 5×10^-4 M at 298 K approached 90.07%. Schiff base with longer-chain are superior to shorter-chained analogues in inhibition efficiency.

Schift Base에 의한 구리 부식 억제

정병구,이현석,장영학,문채주 국립7개대학공동논문집간행위원회 2001 공업기술연구 Vol.1 No.-

The inhibiting action of copper in 5 % hydrochloric acid(HCl) solutions with or without Schiff base, l,2-bis(naphthylideneimine)ethane(NET), l,3-bis(naphthylideneimine)propane (NPR), l,4-bis(naphthylideneimine)butane(NBU), and l,5-bis(naphthylideneimine)pentane(NPE), has been studied by the Tafel method and AC impedance technique. The corrosion parameters were obtained at different inhibitor concentrations and the temperature effect was also investigated. The inhibiting efficiency increases with a decrease in temperature or increase in concentration of the Schiff base. NPE is the best inhibitor in this series and the maximum inhibition efficiency at a concentration of 5 × 10 exp (-4) M at 298 K approached 90.07%. Schiff base with longer-chain are superior to shorter-chained analogues in inhibition efficiency.

구미지역 직업성질환 감시체계

김성아,김진석,전혜리,정상재,김상우,이채용,함정오,유재영,최태성,하봉구,조민환,우극현 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.1

목적: 구미지역 내 대학병원이자 특수건강진단·보건관리대행기관의 산업의학전문의, 보건관리대행 간호사, 사업장 간호사를 중심으로 직업성질환감시체계를 구축하여 주요 직업성질환들의 발생현황과 규모를 파악하고자 하였다. 또한 연차적으로 산업, 직업, 업무내용 등에 따른 분포나 원인을 기존 자료원(특수건강진단의 직업병 유소견자와 산재요양승인 되는 직업병자)과 비교하여 분석·기술하고 예방 및 관리를 포함한 보건의료기술개발까지을 포함하는 종합적인 감시체계를 구축하고 운용하고자 하였다. 방법: 구미지역의 산업적 특성에 맞는 직업성질환감시체계를 구축하고 지역 감시체계의 모델을 제시하였다. 6대 감시대상 직업성질환(독성 간염, 직업성천식, 직업성 근골격계질환, 직업성 피부질환, 직업성 암, 수지진동증후군)의 실행적 환례정의, 보고양식 및 보고체계 개발, 분석양식 및 결과 배포 형식을 개발하였으며, 그 유병규모를 파악하고, 감시질환의 분포 및 특성, 관련인자 등을 분석·기술하고자 하였다. 이때, 1년간의 환례분석시 직업병 유소견자 및 직업병 요양자에 대한 자료와 함께 비교 분석하였으며, 노동통계자료를 이용하여 년간 발생률을 추정하였다. 결과: 2001. 1. 1일부터 2002.4.30일까지 총 287건이 보고되었으며, 직업성 근골격계질환 132건(46.0%), 직업성 피부질환 100건(34.8%), 독성간염 34건 (11.8%), 직업성천식 16건 (5.6%), 수지진동증후군 5건 (1.7%) 이었으며 직업성 암은 한건도 보고되지 않았다. 보고경로별로는 보건관리대행에서 33건 (11.5%), 해당 유해인자별로 실시되는 특수검진 외의 각종 건강진단업무 수행 중 발견된 환례에 대한 보고가 206건(71.7%)이었다. 직종별 분류의 결과는 섬유업종사자, 단순노무종사자, 음식업종사자 등이 다수를 차지하였다. 근골격계질환의 경우, 수근관증후군이 42건(33%), 외상과염/내상과염이 39건(30%)로 가장 많았다. 직업성 피부질환은 97건이 접촉성 피부염으로 유기용제류가 59건(59%)으로 가장 많고, 니켈 및 에폭시수지에 의한 알레르기성 접촉성 피부염이 각각 6건과 5건이었다. 독성 간염은 모두 DMF 나 DMAc에 의한 것으로, 근무시작 후부터 간기능이상이 발견되기까지의 근무기간은 대부분이 3개월 이하이며, 1개월 이하인 경우도 10건이나 되었다. 동 기간 중 감시환례에 대해 산재요양 자료와 중복여부를 확인한 결과, 중복되는 것은 하나도 없었다. 특수건강진단에서 직업병유소견자로 판정된 경우는 독성간염에서 3건이 있었으며, 나머지 질환은 중복되는 것은 없었다. 2001도 구미지역의 근로자수와 보고환례건수를 이용하여 연간 발생률을 추정하였다. 근로자 10만 명당 연간 발생률은 상지 근골격계질환은 63.6명, 피부질환 48.2명, 독성 간염 17.9명, 천식 7.7명, 수진진동증후군 2.4명이었다. 참여예상인원은 총 46명이었으며, 실제 참여자수는 21명, 평균참여율은 46%, 실제 참여 1이당 평균 보고건수는 산업의학전문의가 28건으로 가장 많았고, 대행간호사는 45,건, 사업장 간호사는 3.3건이었다. 결론: 지역 감시체계는 기존 통계자료들에서 발견되지 않았던 직업성질환의 발견에 유용한 통계원이며, 특히 지역의 특성과 여건을 고려하여 체계화된 시스템을 구축하여 운용한다면 더 성과가 클 것이다. Objectives: Area-based occupational disease surveillance in Kumi (KODS) was used to collect data on occupational diseases. The data was used to estimate the magnitude of the diseases, to analyze for their characteristics and to find links for their intervention and prevention. Methods: Since January 2001, occupational physicians and nurses in Occupational Health Service (OHS) have reported six major occupational diseases; occuaptional musculoskeletal disorders of the upper extremities (MSDUE), occupational dermatoses, toxic hepatitis, occupational asthma (OA), hand-arm vibration syndrome (HAVS), and occupational cancer. For the respective diseases, a reporting sheet and operational diagnostic criteria were developed by the KODS. An analysis of the KODS data, collected over a certain period, was compared with data from the Korea Labor Workers Corporation (KLWC) and the Specific Health Examination (SHE), and the incidence rates of the diseases estimated. Results: Between Jan 2001 and Apr 2002, 287 cases of the six major occupational disease were reported. Of these, there were 132 (46.0%), 100 (34.8%), 34 (11.8%), 16 (5.6%), and 5 (1.7%), cases of MSDUE, occupational dermatoses, toxic hepatitis, OA, and HAVS, repectively. But, there were no cases of occupational cancer. 33 (11.5%) of the incidence were reported via the OHS, 206 (71.7%) from health checkups, and the other 48(16.8%) from other routes. The synthetic fibers and electronic components manufacturing industries accounted for the greatest number of reported cases. With resport to occupation, the greatest numbers of incidence were reported from the elementary occupations, textile workers, assemblers, and cooks and food services worker, in that order. Of the MSDUE cases, carpal tunnel syndrome and epicondylitis were the two most common diseases. Most of the occupational dermatoses were due to contact dermatitis, with organic solvents (59%), nickel (6%), and epoxy resin (5%) accounting for the majority of these cases. All cases of toxic hepatitis were induced by dimethylformamide or dimethylacetamide, which were reported by a unique monitoring system. During same period, there were no cases claimed by workers to the KLWC, and only three cases from SHE, were identified. Using data from workers' number and surveillance, the annual incidence of MSDUE, dermatoses, hepatitis, OA, and HAVS, per 100,000 workers were 63.6, 48.2, 17.9, 7.7, and 2.4, respectively. Conclusions: These results show that an area-based surveillance system can be very effective for the collection of data on work-related diseases, at least in Kumi.

Outcomes of Cephalomedullary Nailing in Basicervical Fracture

( Seok Hyun Kweon ),( Sung Hyun Lee ),( Seng Hwan Kook ),( Young Chae Choi ) 대한고관절학회 2017 Hip and Pelvis Vol.29 No.4

Purpose: A basicervical femoral fracture is defined as a fracture of base of neck of femur that occurs medially from intertrochanteric line above lesser trochanter. In this study, we intended to evaluate radiological and clinical results of basicervical femoral fractures treated by intramedullary nailing. Materials and Methods: Fifteen patients, who underwent intramedullary nailing among 50 patients, out of 50 who were diagnosed with basicervical femoral fractures from July 2012 to May 2015 were studied. All of 15 patients’ fracture were two-part basicervical fractures. Using radiography, we characterized the: i) state of reduction, ii) location of the lag screw, iii) tip apex distance (TAD), and iv) sliding distance of lag screw and bone union. Additionally, we performed clinical assessment before injury and at final follow-up. Results: In radiological assessment, we achieved acceptable reduction state in all patients. All lag screws were fixated on appropriate locations. Mean TAD was 17.3 mm (11.0-21.1 mm), which showed insertion point of <25 mm in all cases. The mean sliding distance of the lag screw was 5.1 mm (0.1-16.0 mm) at the final follow-up. The mean bone union period was 4.8 months (3-10 months) with achieving in all cases. In clinical assessment, Harris hip score, visual analogue scale score and Western Ontario and McMaster Universities Arthritis Index score, all of them significantly improved postoperatively compared with preoperative scores (P<0.05). Conclusion: In elderly patients with basicervical femoral fractures, treatment with intramedullary nailing showed satisfactory results, considered to be a useful method if performed with skilled technique.

High-Speed Growth of ZnO Nanorods in Preheating Condition Using Microwave-Assisted Growth Method

Chae, Hyun Uk,Rana, Abu ul Hassan Sarwar,Park, Ye-Jin,Kim, Hyun-Seok American Scientific Publishers 2018 Journal of nanoscience and nanotechnology Vol.18 No.3

<P>In this study, we present the microwave-assisted growth (MAG) of ZnO nanorods (ZNRs) using a preheating hydrothermal method under tailored preheating and postheating growth conditions. The perimeters such as solution concentration, preheating time, and postheating time, were changed to optimize ZNR growth and the growth was carried out in a domestic 850 watt microwave oven. Preheated solution was utilized as an accelerator to increase the aspect ratio of the ZNRs and reduce the fabrication time. Because of a long fabrication time and limited length in the conventional MAG method, preheating condition was used for efficient growth of nanorods through homogeneous nucleation in the solution and then heterogeneous nucleation of the formed ZNRs on seeded substrate during postheating process. The nanostructures were characterized with scanning electron microscopy to look at the morphology and dimensions. Dimensions of ZNRs kept on increasing as the molar concentration went higher. Preheating time highly affected the morphology, dimensions, and aspect ratio of ZNRs and postheating time not only ensured the stability of ZNRs with substrate due to heterogeneous nucleation process but also influenced the morphology of ZNRs.</P>