제2형 당뇨병 환자에서 Voglibose와 Acarbose의 비교임상연구

정인경,정재훈,민용기,이명식,이문규,김광원,정윤이,박중열,홍성관,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.2

연구배경:아카보스와 보글리보스는 ­glucosidase inhibitors로써 비록 약리학적 작용이나 부작용에 있어서 두 약물간에 차이가 있다는 것은 잘 알려져 있으나 당뇨병 환자를 대상으로 아직 이에 대한 두 약물간에 직접적인 비교에 대해 연구된 바는 없었다. 이에 저자등은 국내 2형 당뇨병 환자에 대해 유효성과 부작용 발현에 대해 두 약제를 비교하고자 무작위법에 의한 위약 대조군의 이중 맹검법 연구를 시행하였다. 방법:시험 약제 투여 4주간의 관찰기를 설정하여 공복혈당의 변화가 30㎎/dL 이하이고, 식후 혈당이 200㎎/dL 이상인 환자로 기타 제외 기준에 해당하지 않은 환자 53명을 대상으로 하여 보글리보스 군(24명)과 아카보스 군(29명)으로 무작위로 나누었다. 치료기간은 총 8주로 하였으며, 4주간 간격으로 혈청학적 검사와 부작용을 분석하여 치료 효과가 부작용을 평가하였다. 결과:1)혈당 변화:보글리보스군은 식후 1시간 혈당이 치료 후 4주, 8주째 의미 있게 감소하였도, 아카보스군은 식후 1시간과 2시간 혈당이 치료 후 4주, 8주째 의미있게 감소하였다. 또한 관찰기 혈당에 대한 치료 4주째 감소량은 아카보스군에서 더 큰 경향을 보였으나, 치료 8주째에는 두 군 간의 강하정도에 의미있는 차이가 없었다(p=0.569). 2)인슐린 치의 변화:보글리스 군은 식후 1시간 인슐린 치가 치료 전에 비해 치료 4주, 8주째 감소하는 경향을 보였고, 공복 인슐린이나 식후 2시간 인슐린치는 치료전 후에 의미 있는 차이가 없었다. 아카보스군에서는 치료 전후로 공복 인슐린, 식후 1시간과 2시간 인슐린치에 의미 있는 차이를 보이지 않았다. 두약제 간에 치료 전과 치료 8주사이의 식후 2시간 인슐린의 감소량이 보글리보스 군에서 의미있게 높았다(p=0.040). 3)당화혈색소:보글리보스 군은 치료 전에 비해 치료후 당화혈색소가 감소하는 경향을 보였고, 아카보스군은 치료 전에 비해 의미있게 감소하였다. 당화혈색소 변화량은 두 군간에 의미 있는 차이는 없었다(p=0.412). 4)지질대사의 변화:중성지방, 콜레스테롤, 고밀도 진단백 콜레스테롤에 대해 두 군간에 의미 있는 차이는 없었다. 5)부작용:소화기계 부작용의 빈도는 치료 4주째 보글리보스 군에서 의미 있게 낮았으나(p=0.028), 치료 8주째 부작용의 빈도는 두 군간에 의미 있는 차이가 없었다(p=0.215). 결론:2형 당뇨병 환자에서 보글리보스와 아카보스의 두 약제의 임상적 유효성과 부작용발현에 대해 비교한 결과 치료 후 8 주 후 혈당강화효과는 두 약제간에 유사한 효과를 보였으나 보글리보스군에서 4주째의 초기 위장관 부작용이 적었다. Background : Acarbose and voglibose are alpha-glucosidase inhibitors. Although different pharmacological effects and adverse abdominal events associated with the two drugs have been reported, no study directly compared acarbose and voglibose in diabetes has been undertaken. To compare the pharmacological effects and gastrointestinal adverse events between two drugs, a randomized, placebo-controlled, double-bind study was performed in type 2 diabetes patients. Methods : The period of study was 12 weeks(observation period: 4 weeks; treatment period: 8 weeks). Fifty-three patients were randomized into two groups(the acarbose group: 24 patients; the voglibose group: 29 patients). The serum glucose, insulin, fructosamine, HbA_1c, cholesterol, triglyceride and the incidence of adverse events were measured. Results : 1) The reduction of glucose from before treatment to 4 weeks after treatment was significantly higher in the acarbose group, but the change before treatment and 8 weeks after treatment in the two groups was similar(p=0.569). 2) The insulin significantly decreased after voglibose treatment(p=0.040). 3) HbAa_1c level tended to decrease in voglibose group, and there was a significant decrease after acarbose treatment. However, the change in HbA_1c level before and after treatment was similar between the two groups(p=0.412). 4) The two drugs did not cause any other changes in the total, HDL-cholesterol and triglyceride. 5) The number of patients with gastrointestinal adverse events was significantly low 4 weeks after voglibose treatment (p=0.049), but the incidence in the two groups was similar after 8 weeks(p=0.215). Conclusions : Acarbose and voglibose significantly improved postprandial hyperglycemia in diabetes. The incidence of gastrointestinal adverse events was low 4 weeks after voglibose treatment(J Kor Diabetes 26:134~145, 2002).

Development of a bivalent live vaccine against duck hepatitis A virus types 1 & 3 and vaccine program for breeder ducks in Korea

Jae?Hee Roh(노재희),Min Kang,Bai Wei,Se-Yeoun Cha,Jeong-Gon Cho,Hyung-Kwan Jang 한국가금학회 2017 한국가금학회 정기총회 및 학술발표회 Vol.2017 No.11

어린 오리에 치명적인 질병을 일으키는 오리바이러스성간염의 예방을 위해 혼합생백신 개발, 백신의 방어기전 연구 및 종오리백신 프로그램의 개발로 질병방어 및 제어를 목표로 연구를 진행하였다. 첫 번째, 국내에는 1형과 3형이 동시 유행하고 있으며, 최근에는 3형의 발생보고가 증가하는 추세이다. 특히 1형과 3형의 복합감염사례도 빈번히 발생하고 있다. 이런 상황에서 효율적인 질병관리를 위해 국내에 발생하는 오리간염 1형과 3형을 동시에 방어하는 혼합백신을 개발하고 그 효능을 확인하였으며, 운반 및 보관 용이성 향상을 위한 연구를 진행하였다. 두 번째, 오리감염 생백신의 3-5일 만에 조기면역을 획득하는 특성분석을 위해 세포성 및 체액성 면역반응을 평가하였다. Cytokine이 백신접종 그룹에서 증가하는 것을 확인하였고, 특히 IFN-α에서 강한 증가를 보였다. 또한 항체가 평가에서는 기존에 알려진 바와는 다르게 백신 후 3일째에 항체를 획득하였고, 10일째에는 최고수준의 항체가 수준을 나타냈다. 세 번째, 1주령이하의 어린 일령에 치명적인 질병의 특성상 모체이행항체에 의한 예방이 가장 효과적이라는 점에 착안하여 종오리백신 프로그램을 개발하고 농장에 적용하여 평가하였다. 종오리 농장 4개동 4천수의 종오리를 대상으로 백신을 실시하였으며, 모체의중화항체가(VN titer) 8 log2이상에서 후대병아리 14일령까지 100% 방어효능을 확인하였다. 모체이행항체의 전달률은 11%수준으로 나타났으며, 후대병아리의 항체가를 개체별 추적하여 계산한 결과 모체이행항체 반감기는 3-5일령임을 확인하였다. 본 연구에서는 오리에 치명적인 질병을 일으키는 오리바이러스성간염 예방을 위한 혼합생백신 개발에 관한 연구로 기존의 국내 상용화백신의 한계점을 극복하고, 국내에 유행하는 혈청형들을 단회백신으로 효과적으로 방어할 수 있는 혼합생백신을 개발하였으며, 백신의 특성상 조기면역에 대한 세포성 및 체액성 면역기전을 평가하였다. 또한 종오리백신 프로그램을 국내에 적용하여 모체이행항체에 의한 후대 병아리의 우수한 방어 효능을 확인하였다.

온도자극이 충전된 치질에 미치는 영향

김재곤,노용관,이영수,양정숙,백병주 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.2

본 연구에서는 수복에 따른 치질 내부 구조물의 열적변화를 평가하기 위하여 와동이 형성된 인공 치아모형에 아말감 충전, 아말감과 스테인레스 스틸관 수복, 금인레이와 금관수복, ZOE 이장 및 아말감 충전등으로 수복한 후 온도변화를 관찰하였다. 각 실험군에 4℃와 60℃로 2초와 4초 동안 자극을 가한 후 치아내부의 온도분포를 2차원적으로 분석하였고, 치수 중앙부에서 외측으로 층을 형성하여 3차원적인 해석을 시행한 결과, 다음과 같은 결론을 얻었다. 1. 4℃의 자극이 2초간 가해진 아말감 충전 경우, 아말감 충전과 스테인레스 스틸관을 장착한 경우에서는 1℃ 내외의 차이를 보였으며, 치수와 상아질 경계면에서 3초 경과시에 29℃까지 급격한 온도 하강을 보였으며 9초 후에 25℃에 도달하였다. 또한 금으로 수복한 경우에서는 3초 후 25℃까지 하강하여 그 온도를 유지하였으며, ZOE 이장 경우에서는 최저온도가 4℃ 이상 높게 나타났다. 2. 4℃ 자극을 4초간 가한 경우에서는 9초 후에서 2초 자극시보다 2-3℃ 낮았으며, 금 수복 경우에는 5초 후에 21℃의 최저온도를 보인 후 점차 회복되었다. 3. 아말감 충전 및 스테인레스 스틸관을 같이 장착한 경우에 60℃, 2초간 자극에는 3초 후 40℃의 온도로서 상승하였으나 9초 후에 30℃로 하강 하였으며, 금 수복에서는 2초 후 41℃까지 온도가 상승하였고, 9초 후 28℃를 보여 13℃의 차이가 있었다. ZOE 이장 경우에는 온도차이가 5℃로서 안정된 양상을 보였다. 4. 60℃, 4초 자극에 대한 아말감 충전 및 스테인레스 스틸관을 같이 장착한 경우에서 5초 후 42℃, 9초후 35℃를 보였으나 금 수복 경우에서는 3초 후 49℃, 9초 후 31℃의 온도변화를 나타내었다. 5. 3차원 분석에서 치수 중앙부에서 멀어질수록 온도변화가 심하였다. The dental structure substituted by restorative materials may produce discomfort resulting from hot or cold stimuli. To investigate the effects of this stimuli on the human teeth, thermal analysis was carried out by calculation of general heat conduction equation in a modeled tooth using numerical method. The method has been applied to axisymmetric and two-dimensional model, analyzing the effects of constant temperature 4℃ and 60℃. That thermal shock was provided for 2 seconds and 4 seconds, respectively and recovered to normal condition of 20℃ until 10 seconds. The thermal behavior of tooth covered with a crown of gold or stainless steel was compared with that of tooth without crown. At the same time, the effects of restorative materials(amalgam, gold and zinc oxide-eugenol(ZOE)) on the temperature of PDJ(pulpo-dentinal junction) has been studied. The geometry used for thermal analysis so far has been limited to two-dimensional as well as axisymmetric tooth models. But the general restorative tooth forms a cross shaped cavity which is no longer two-dimensional and axisymmetric. Therefore, in this study, the three-dimensional model was developed to investigate the effect of shape and size of cavity. This three-dimensional model might be used for further research to investigate the effects of restorative materials and cavity design on the thermal behavior of the real shaped tooth. The results were as follows: 1. When cold temperature of 4℃ was applied to the surface of the restored teeth with amalgam for 2 seconds and recovered to ambient temperature of 20℃, the PDJ temperature decreased rapidly to 29℃ until 3 seconds and reached to 25℃ after 9 seconds. This temperature decreased rather slowly with stainless steel crown, but kept similar temperature within 1℃ differences. Using the gold as a restorative material, the PDJ temperature decreased very fast due to the high thermal conductivity and reached near to 25℃ but the temperature after 9 seconds was similar to that in the teeth without crown. The effects of coldness could be attenuated with the ZOE situated under the cavity. The low thermal conductivity caused a delay in temperature decrease and keeps 4℃ higher than the temperature of other conditions after 9 seconds. 2. The elapse time of cold stimuli was increased also until 4 seconds and recovered to 20℃ after 4 seconds to 9 seconds. The temperature after 9 seconds was about 2-3℃ lower than the temperature of 2 seconds stimuli, but in case of gold restoration, the high thermal conductivity of gold caused the minimum temperature of 21℃ after 5 seconds and got warm to 23℃ after 9 seconds. 3. The effects of hot stimuli was also investigated with the temperature of 60℃. For 2 seconds stimuli, the temperature increased to 40℃ from the initial temperature of 35℃ after 3 seconds of stimuli and decreased to 30℃ after 9 seconds in the teeth without crown. This temperature was sensitive to surface temperature in the teeth with gold restoration. It increased rapidly to 41℃ from the initial temperature of 35℃ after 2 seconds and decreased to 28℃ after 9 seconds, which showed 13℃ temperature variations for 9 seconds upon the surface temperature. This temperature variations were only in the range of 5℃ by using ZOE in the bottom of cavity and showed maximum temperature of 37℃ after 3 seconds of stimuli. 4. In case of 4 seconds hot stimuli, the temperature increased 42℃ after 5 seconds and decreased 35℃ after 9 seconds in the teeth without crown. But in gold restoration, showed 49℃ after 3 seconds and 31℃ after 9 seconds, temperature variation was up to 18℃. Temperature variation of ZOE base case was only 5℃. 5. In three-dimensional analysis, we could find higher and lower thermal distribution pattern at the outer layer.

Tomatotone과 Gibberellin(GA3)의 處理가 輸出用 가지(Solanum melongena. L)의 生育 및 收量에 미치는 影響

최성관,이재필,진동호,오주성,박흥식,정순재 동아대학교 농업생명과학연구소 2001 農業生命資援硏究 Vol.10 No.1

These grafting seeding "Torobambica", rootstock "Jang Ja" and "Chuk Yang" were tested to investigate the differences between the growth of eggplants and the number of eggplants which can be influenced by the growth retardant aerosol. For the test of the growth retardant aerosol, the flower clusters were sprayed with one hundred units of Tomatotone liquid and with three hundred units of GA3 on the day they flowered and sprayed two or three days before flowering. The results were as follows: 1.According to the growth retardant aerosol of Tomatotone, the plant height was the tallest at 226.21 cm with foliar spray and the high Marketable fruit was good at the percent of 77.38 with a flowering spray and Tomatotone on the day they flowered. 2.According to the growth retardant aerosol of GA3, the plant's height was the tallest at 229.27cm with foliage which was sprayed every week. The high quality fruit was good at the percent of 69.11 with a flowering spray and GA3 on the day they flowered. 3.According to Tomatotone and GA3 treatments of the plant growth regulators, the plant's height was the tallest sprayed every week and the high Marketable fruit was good at the flowering spray and Tomatotone on the day they flowered. and Yield per 10a was good at the flowering spray and Tomatotone on the day they flowered.

裁植距離가 輸出用 가지(Solanum melongena. L)의 生育 및 收量에 미치는 影響

최성관,이재필,진동호,오주성,박흥식,정순재 동아대학교 농업생명과학연구소 2001 農業生命資援硏究 Vol.10 No.1

This study was carried out to investigate effect of the planting distance of Eggplant(Solanum melongena. L). These grafting seeding "Torobambica", rootstock "Jang Ja" and "Chuk Yang" were tested to investigate the differences between the growth of eggplants and the numbers of eggplants which can be influenced by the planting distance such as 100×50cm, 100×60cm and 100×70cm. The results are summarized as follows: 1.The plant height, leaf length, leaf, width, leaf area and the number were good for the growth change of each cultivar from planting distance such as 100×70cm. 2.The grafting seedlings "Chuk YanglTorobambica" grew and developed better than "Jang Ja" and "Jang Ja/Torobambica" 3.Effects of scion on the rootstock for planting distance "Chuk Yang" grew and developed better than "Jang Ja"

退行性關節炎 韓方治療에 對한 最近 硏究 動向 : 臨床硏究 方法論을 中心으로 Herbal Medicines in the Treatment of Osteoarthritis in Pubmed and Chinese Medical Journals

서병관,류성룡,이송실,허정은,백용현,이재동,최도영,조윤제,김남재,박동석 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2004 東西醫學硏究所 論文集 Vol.2004 No.-

Objective : The aim of this study was to review systemically clinical trials on the effectiveness and safety of herbal medicines in the treatment of osteoarthritis. Methods : Computerized literature searches were carried out on seven electronic databases, and hand-searching on some chinese medical journals in library of Kyung Hee Medical Center. Trial data were extracted in a standardized, predefined manner and assessed independently. Results : 1. Thirty reports of clinical trials and two reports of meta-analyses concerning herbal medicine were collected and reviewed Among these reports three medical herbs were applied as topical medicine and others as internal medicine. 2. The western studies established NSAIDs or placebo as their control group. Five chinese reports established formulated herb pill(Ruanshnagshenjin pill) as their control group and Six did not establish a control group at all. 3. ACR was the most highly used diagnostic criteria in the western studies while the Chinese used their official criteria established by their government or the criteria of their text books. 4. 20 reports chose the Lequesne functional index, SHAQ, WOMAC OA index, AIMS, and their own unique scoring system as the criteria of analysing the effect. Others chose clinical symptoms, articular functions, and lab finding as their criteria. 5. 7 single herbs and 19 formulated herbs were studied. Among the formulated herbs, Achyranthes japonica was studied in 10 of the studies and Angelica gigantis Radix in 8, making them the most often studied herbs among the studies.

폐기 목질 재료로 제조한 학생용 책상 천판의 성능에 미치는 성형조건의 영향

노정관,김재경,김사익,조종수,윤승락,나종범,도정락 한국목재공학회 2002 목재공학 Vol.30 No.4

폐기 목질재료를 사용하여 학생용 책상 천판의 성형시 각 제조조건에 따른 천판의 성능을 검토하였다. 책상 천판의 파티클 구성은 고운 파티클과 거친 파티클을 적절히 혼합한 것이 고운 파티클이나 거친 파티클만으로 제조한 것보다는 전체적으로 성능이 양호하였으며, 특히 표층에는 고운 파티클을 중층에는 거친 파티클을 구성하는 것이 표면 마감성이 가장 우수하였다. 그리고 밀도가 높을수록 박리강도, 휨 강도는 우수하나, 흡수두께 팽창율은 증가하였으며, 수지 도포량이 많을수록 박리강도, 흡수두께 팽창율은 양호하나, 포름알데히드의 방출량은 높았다. 가압온도는 높을수록 대부분의 성능이 향상되었으며, 190℃가 가장 적절하였다. 가압시간은 1단계 2분과 2단계 2분이 비교적 양호하나 2단계의 가압시간을 1분으로 단축하여도 성능에는 큰 문제가 없어 앞으로 생산성의 향상을 기대할 수 있을 것으로 생각된다. This research was performed to investigate the effect of moulding conditions on properties of the table top for student desk manufactured by wood waste materials. The table top manufactured using the mat mixed properly with fine particles and coarse particles generally showed better physical properties than those manufactured using either fine particles or coarse particles did. Especially, highest performance for overlaying was observed when fine particles were used for face layer and coarse particles were used for core layer. The internal bond (IB) strength, the bending strength and thickness swelling increased with the increase of density. Most of physical properties were improved with the increase of hot pressing temperature. The best physical properties were found at 190℃ when the first hot pressing and the second hot pressing times were two minutes. However, the effect of the second hot pressing time of two minutes on the physical properties was not markedly different from that of one minute. This result suggests that the second hot pressing time of one minute is enough to increase the productivity in manufacturing the table top with the least decrease of the physical properties.

연속 드레싱을 이용한 CNC Creep Feed 연삭기의 개발 및 연삭 평가에 관한 연구

이영욱,정재운,김종관,정윤교 한국공작기계학회 2006 한국공작기계학회 추계학술대회논문집 Vol.2006 No.-

The method of creep feed grinding is an effective technology process. It is used to improve the productivity & efficiency in form grinding. However there are some inherent difficulties throughout the grinding process. The progress of abrasive wear around the cutting edge is remarkable. The grinding force become intense and burn marks occur frequently. To grind a work piece of large length is clearly a tremendously difficult task. Also, domestically, creep feed grinding is a scarce development. We crucially depend on the imports of goods from abroad. Therefore, the purpose of this research is that developing the localization creep feed grinding with continuous dressing device and we must research more into this complex technology to discover the most efficient dressing conditions and dresser to wheel speed ratio(qd).

여성 요도증후군에서 Terazocin의 효과에 대한 연구

우승효,신관희,한광희,정원일,이형래,이상철,김용태,김원재 충북대학교 의학연구소 2000 忠北醫大學術誌 Vol.10 No.2

연구목적: 여성 요도증후군을 보이는 환자에서 교감신경차단제인 terazocin을 복용한 후 치료 효과에 대한 각 증상의 변화와 부작용을 알아보고자 하였다. 대상 및 방법: 1997년부터 1999년까지 충북대학교병원 비뇨기과에 내원한 35명의 여성 중 요검사 및 요배양 검사, 그리고 다른 이학적 검사에서 이상이 없는 요도증후군 환자를 대상으로 간질성방광염 증상점수(ICSS)를 terazocin (3mg/day for 3 months) 투여 전후에 조사하였고, 치료 후 3개월과 1년에 Likert scale 점수를 조사하였다. 결과: ICSS는 비치료군은 18.3±5.9점, 치료군은 16.5±6.8점으로 두군간의 차이는 없는 것으로 나타났다(p=0.52). 치료군은 치료 후 3개월에 시행한 ICSS가 9.9±7.8점으로 치료 전에 비해 현격히 증상이 호전되는 것으로 나타났다(p=0.0001). 특히 3개월에 시행한 Likert scale에서는 주간 및 야간빈뇨, 절박뇨, 배뇨통의 횟수 및 강도, 그리고 전체적인 증상정도에서 40-70% 가량 호전된 것으로 밝혀졌으며 이는 1년 후에도 증상의 호전이 지속되는 것으로 나타났다. 비치료군에서의 1년 후 Likert scale은 6명 중 2명이 전체적인 증상의 호전이 있는 것으로 나타났다. 결론: Terazocin은 환자의 약 70%가량에서 증상의 호전을 가져왔고, 비치료군에서도 환자의 33%가 저절로 증상이 좋아진 것으로 보아 Terazocin은 여성 요도증후군에서 분명히 효과가 있으나 증상이 심할 경우 보조적인 치료로 이용되는 것이 바람직할 것으로 사료된다. Purpose: We performed to assess the effects and complications of terazocin in women with chronic female urethral syndrome. Materials and Methods : Thirty-five women with chronic female urethral syndrome were studied from March 1997 to August 1999. The subjects exhibited normal findings without the pyuria and bacteriuria in urinalysis and urine culture and were invested the interstitial symptom score(ICSS). 29 subjects of them took a terazocin 1-4 mg/day for 3 months. They were reevaluated for the ICSS and Likert scale after 3 months and for Likert scale after 1 year. Results: The ICSS before treatment were showed 18.3±5.9 in the untreated patient group and 16.5±6.8 in the treated patient group, and no statistically difference between both patient groups(p=0.52). In the treated patient group, the ICSS after treatment were showed 9.9±7.8, significant difference between before and after treatment(p=0.0001). The Likert scale was showed at 3 months after treatment that frequency, nocturia, urgency, pain frequency, pain intensity, daily activities, and overall symptoms were improved in 65.5%, 55.2%, 24.1%, 41.4%, 41.4%, 70%, 70%, and 70% of 29 subjects, each other. Overall symptom score assessed at 1 year were showed that 3 subjects was aggravated. In untreated patient group, 2 of 6 was improved in overall symptom score. Conclusion: Terazocin was effective above 70% in the treated group, and symptoms were improved spontaneously in a third of the untreated group. So, we thought that terazocin would be useful as supportive treatment in period of severe symptoms.

일시적인 피질맹과 인지기능장애로 발현한 간성 뇌병증 1예

윤고운,박민정,박경원,차재관,김재우 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

A 55-year-old woman presented with transient cortical blindness and multiple cognitive impairments as initial symptoms of hepatic encephalopathy. Her past history was negative for chronic liver disease or gastrointestinal bleeding. Neurologic examinations showed bilateral visual loss with a normal pupillary reflex to light and neuropsychological test showed significant impairments in all cognitive domains. Laboratory tests revealed increased liver enzymes, ammonia level, and positive IgG HbcAb. Ultrsonography of the liver showed findings consistent with liver cirrhosis with splenomegaly. The visual evoked potential study resulted in no wave formation on both sides. T1-weighted brain MRI showed high signal intensity lesions in both globus pallidus and cerebral peduncles of the midbrain. After treatment with lactulose, cortical blindness and cognitive dysfunctions disappeared within several days. In rare cases of hepatic encephalopathy, cortical blindness with cognitive impairments may occur before alteration of consciousness and usually recovers following treatment of the hepatic encephalopathy.