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      • Comparison of controlled ovarian stimulation outcomes for fertility preservation in women with breast cancer according to KI-67, histologic grade, pathologic type, and cancer stage

        ( Eun Ji Oh ),( Yeon Hee Hong ),( Seul Ki Kim ),( Jung Ryeol Lee ),( Byung Chul Jee ),( Chang Suk Suh ),( Seok Hyun Kim ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

        Objective: This study aims to analyze that specific prognostic factors such as Ki-67 value, histologic grade, pathology type, and cancer stage can affect controlled ovarian stimulation outcomes(COS) for fertility preservation in women with breast cancer. Methods: This retrospective cohort study included 92 patients with breast cancer aged 21-44 who underwent COS from August 2012 to April 2020, excluding patients with previous gonadotoxic therapy history. All COS cycles were conducted letrozole-combined random start GnRH antagonist protocol. COS outcomes were compared according to prognostic factors;Ki-67 (< 30% vs. ≥ 30%), histologic grade (low vs. high), and pathologic type (intraductal carcinoma(IDC) vs. triple-negative breast cancer(TNBC)), and cancer stage (early (I, II) vs. advanced (III, IV)). Multivariate analysis was also conducted to find any parameter that can impact over 10 mature oocytes acquisition. Results: Among the 92 patients, 42 were Ki-67≥30% compared to 49 of Ki-67<30%. The number of oocytes, and initial mature oocytes were comparable between Ki-67<30% and ≥30 group. The maturation rate was significantly higher in Ki-67≥30% group than Ki-67<30% group (57.4±36.8% vs. 44.8±28.3%, p=0.041). The same results were drawn when divided according to IDC or TNBC. The maturation rate was significantly higher in TNBC than the IDC group (73.0±17.6% vs. 47.0±28.1% p=0.001). However, the histologic grade or stage did not show any difference in COS outcomes between high and low grade or early and advanced stages. With multivariate analysis, age and AMH are parameters associated with the acquisition of over 10 mature oocytes (OR 0.863, 95% CI [0.755-0.987], OR 1.408, 95% CI [1.145-1.732], respectively). Conclusion: Either Ki-67 or pathologic type can be a potential reliable marker for predicting COS outcome, especially maturation rate. Further study with larger sample size with specific conditions is necessary to clarify the correlation between breast cancer prognostic factors and COS outcomes.

      • SCOPUSSCIEKCI등재
      • 들잔디 성숙종자로부터 캘러스배양 및 식물체 재분화에 미치는 몇 가지 요인의 영향

        이상훈,김범수,원성혜,조진기,김기용,박근제,성병렬,이효신,이병현 Plant molecular biology and biotechnology research 2004 Plant molecular biology and biotechnology research Vol.2004 No.-

        In an effort to optimize tissue culture responses of zoysiagrass (Zoysia japonica Steud.) for genetic transformation, factors affecting callus induction and plant regeneration were investigated. MS medium containing 3 ㎎/L 2,4-D was optimal for embryogenic callus induction from mature seed. The plant regeneration frequency of 73.3% was observed when embryogenic calli induced in this medium were transferred to N6 medium supplemented with 0.1 ㎎/L 2,4-D and 5 ㎎/L BA. Among several basic media, MS and N6 medium were optimal for callus induction and plant regeneration, respectively. Regenerated plants were grown normally when shoots transplanted to the soil. A rapid and efficient plant regeneration system established in this study will be useful for molecular breeding of turfgrass through genetic transformation.

      • KCI등재

        통합심리치료의 인지분화훈련이 정신분열병 환자의 기초 인지기능에 미치는 영향

        이희상,현명호,조현상,이연희,김태용,장순아,노규식,정기립,이만홍,유계준 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

        연구목적 : 정신분열별 환자들을 대상으로 통합심리치료의 소프로그램인 인지분화훈련을 실시하여 실행기능, 개념형성능력, 언어능력 및 추론력에 대한 훈련이 보다 더 하위단계의 인지기능인 주의력, 기억력, 반응시간 등을 호전시킬 수 있는 지를 알아보고자 하였다. 연구방법 : DSM-IV상 정신분열병으로 진단된 24명의 입원환자를 무작위로 양분하여 한 군은 인지분화훈련군으로 다른 한 군은 대조군으로 나누었다. 훈련군은 4주동안 1주일에 3회(매회 60분간)로 총 12회의 통합심리치료의 인지분화훈련을 받았으며 대조군은 동일한 시간동안 정신건강교육을 받았다. 훈련전후에 훈련군과 대조군을 대상으로 개정판 Wechsler 기억검사로 주의집중력, 장·단기 기억력을 측정하였고 Vienna test system중 결정반응시간검사로 반응시간, 반응결정시간, 반응운동시간을 평가하였다. 연구결과 : 1) 주의집중력에서는 훈련군과 대조군사이에 집단간 효과, 집단내 효과 및 상호작용 효과가 없었다. 2) 단기기억력에서는 훈련군과 대조군사이에 집단내 효과는 있었으나(F(1,24)=10.46. p〈.05). 집단간 효과, 상호작용 효과는 없었다. 3) 장기기억력에서는 훈련군과 대조군사이에 집단내 효과는 있었으나(F(1,24)=15.09. p〈.05). 집단간 효과, 상호작용 효과는 없었다. 4) 반응시간에서는 상호작용 효과(F(1,24)=5.18, p〈.05)가 있었다. 5) 반응운동시간에서는 집단간 효과, 집단내 효과 및 상호작용 효과가 없었다. 6) 반응결정시간에서는 상호작용 효과(F(1.24)=6.00, p〈.05)가 있었다. 결 론 : 통합심리치료의 인지분화훈련은 정신분열병 환자에서 하위단계의 인지기능 중 반응시간(특히 반응결정시간)을 단축시키는 효과가 있었다. Objectives : The purpose of this study was to investigate the effects of cognitive differentiation training of Integrated Psychological Therapy(a training program of executive function, concept formation, language, and abstraction) on micro-level cognitive function such as attention, memory and reaction time in patients time in patients with schizophrenia. Methods : Twenty-four inpatients diagnosed as schizophrenia using DSM-IV were randomly assigned to 2 groups. The training group went through a total of 12 sessions of cognitive differentiation training for 4 weeks. The control group received psychoeducation program during the same period. Wechsler Memory Scale-Revised and Decision-Reaction Timer of Vienna Test System were administered to all patients, both before and after the training program. Results : 1) In the attention and concentration scores of Wechsler Memory Scale-Revised, between group, within group and interaction effects of training were not significant. 2) In the short-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=10.46, p〈0.05), but the between group and interaction effects did not reach significance. 3) In the long-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=15.09, p〈0.05), but the between group and interaction effects did not reach significance. 4) In the reaction time scores of Decision-Reaction Timer, interaction effect of training was significant(F(1,24)=5.18, p〈0.05). 5) In the motor time scores of Decision-Reaction Timer, between group, within group and interaction effects of training were not significant. 6) In the decision time scores of Decision-Reaction Timer, interaction effect of training was significant(F(1,24)=6.00, p〈0.05). Conclusion : Our findings suggest that cognitive differentiation training of Integrated Psycho-logical Therapy is partly effective on improving micro-level cognitive functions such as reaction time(especially, decision time) in patents with schizophrenia.

      • KCI등재후보

        Ki-1 임파종 1 예

        김용진,김경재,박재복,이지현,안기성,강민모,최석문,황기석 대한내과학회 1993 대한내과학회지 Vol.45 No.4

        A 60-year-old man was admitted to our hospital complaining of fever with chillness and anarexia for 12 weeks. Physical examination revealed supraclavicular lymphadenopathy and left inguinal lymphadenopathy. Abdominal CT scan showed the evidence of maked lymphadenopathy on retraperitoneal, external iliac, obturator, left inguinal, and celiac lymph nodes. A pathologic diagnosis of Ki-1(+) lymphoma was made by the biopsed supraclavicular lymph node because the node consisted of large cells with pleomorphic nuclei, scanty cytoplasm, large basophilic nucleoli, atypical vacuoli and large cells were positive for leukocyte common antigen, Ber-H2, marker, and B-cell marker.

      • P196 : Effects of different electrical parameter settings on hair growth: the changes of dermal papilla cell in vitro and at microscopic level in animal tissue

        ( Ki Min Sohn ),( Kwan Ho Jeong ),( Joo Hyun Lee ),( Jung Eun Kim ),( Hoon Kang ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

        Background: Frequency electrical stimulation is clinically being used in variable skin therapeutic conditions such as skin rejuvenation and hair disorder. There have been several clinical studies demonstrating the positive effect of electrical stimuli on hair regrowth. However, its exact mechanism is yet to be clarified. Objectives: The objective of this study is to investigate effects of different electrical parameter settings on hair growth by revealing the changes of dermal papilla cell in vitro and at microscopic level in animal tissue. Methods: Cultured dermal papilla cells (DPCs) and dorsal skin of rabbit were electrically stimulated with different parameter settings at alternating-current to find the optimal condition for hair growth. Cell viability and proliferation were measured by MTT. In addition, Ki67, proliferation marker, expression was measured by immunofluorescence. Hair growth-related gene expression in DPCs and the skin of rabbit were measured by RT-PCR. Results: At certain electrical settings, DPCs responded well and their proliferation was successfully induced. Wnt/β -catenin, Ki67, p-ERK and p-AKT expressions in DPCs increased at certain frequency settings. Dermal thickness and hair related genes (PDGF, VEGF, SOX9 and KGF) expressions in the skin of rabbit also significantly increased. Conclusion: These data suggest that electrical stimulations at certain electrical settings, may give more effective therapeutic outcomes for hair growth.

      • THE VARIATIONS OF JAPANESE APRICOT (PRUNUS MUME) CULTIVATED AROUND IN MTS. JIRI.

        Lee,Jun-Ki,Hyun,Sang-Ki,Lee,Sang-Sun,Chai,Jung-Ki 한국자원식물학회 2002 Plant Resources Vol.5 No.1

        Twenty-three plants of Japanese apricot (Prunus mume) were collected from several sites around Mountains JIRI in Korea. Japanese apricots having the different morphological features were evenly distributed in the groups made from the cluster analysis, indicating no geographic distributions but artificial vegetations in Korea. Japanese apricots were, as based on the PCR-RAPD techniques, clustered into the three groups; a group (prototype) having the five white petals with the five red sepals, a group (green type) having the five white petals with the five green sepals, and a group (hybrid type) having the more than five red petals with various colored sepals. The prototype apricots showed higher toxicities than other type apricot against bacteria and production of less compounds in TLC plates. The polypetal types of Japanes apricot were related to those of p. armebiaca in the characteristics of seed (the ruggedness), but also to be closed to those of p. armebiaca in PCR-RAPD analysis. The cluster analysis of the twenty three apricots and its related species calculated from the two primers were shown to distinguish relationships of cultivars within species, or of individual plants within cultivars, but also to display the two overlapping bands resulted from PCR-RAPD technique.

      • KCI등재

        관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

        이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

        목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

      • KCI등재

        심인성 어지럼증 환자의 정신과적 증상에 관한 연구

        이경규,이지영,김현우,이정엽,백기청,김재일,이근호 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

        연구목적 : 어지럼증을 호소하는 환자들 중에 심인성 어지럼증 환자가 상당수 있다는 것은 알려져 있고, 이러한 심인성 어지럼증과 동반되는 정신질환으로는 불안장애, 우울장애, 인격장애 등이 있다. 이에 본 연구에서는 심인성 어지럼증 환자들의 빈도와 정신과적 증상을 알아보고자 하였다. 방 법 : 어지럼증 환자들에게 평형검사, 자세운동측정검사, 자세변화검사, caloric testing을 시행하여 심인성, 말초성 및 중추성의 3군으로 분류한 후 각각 14명, 16명, 32명을 대상으로 하였다. 대상환자들에게 한국판 Beck 우울척도검사(K-BDI), Spielberg의 상태-특성 불안검사(STAI). 간이정신진단검사(SCL-90-R)를 이용하여 정신과적 증상을 측정하여 이들 세 군을 비교분석하였다. 결 과 : 1) 심인성 어지럼증을 가진 환자는 어지럼증을 나타내는 환자 총 62명중에서 14명으로 22.6%를 차지하였다. 2) K-BDI에 따른 세 군간의 비교에서는 세 군간에 유의한 차이를 보이지 않았다. 3) STAI에 따른 세 군간의 비교에서 상태불안(STAI-S) 및 특성불안(STAI-T) 모두에서 세 군간에 유의한 차이를 보이지 않았다. 4) SCL-90-R에 따른 세 군간의 비교에서는 9개의 척도 중에서 공포불안척도에서만 중추성 어지럼증군이 47.56±6.90, 말초성 어지럼증 군이 53.50±13.74, 심인성 어지럼증 군이 58.50±16.05로 심인성 어지럼증 환자군이 중추성 어지럼증 환자군에 비하여 유의하게 높은 것으로 나타났다(p<0.01). 5) 통증 증상에 있어서는 세 군간에 유의한 차이를 보이지 않았고, 위장관 증상과 성기능 장애 증상은 중추성과 말초성 어지럼증 군이 심인성 어지럼증 군에 비하여 유의하게 높은 것으로 나타났다(p<0.01). 결 론 : 상기 결과를 토대로 했을 때 어지럼증 환자들에 대한 정신과적 접근을 위하여 각 군을 나누는 것은 별 의미가 없으며 어지럼증 환자들의 어지럼증 자체에 대한 직접적이고 집중적인 치료가 더욱 필요할 것으로 생각된다. Objectives : This study was aimed to investigate psychiatric symptoms in patients with psychogenic dizziness and compare these findings with those of patients with central and peripheral dizziness. Methods : A total of 62 patients with dizziness was the subject of investigation, and patients were classified into 32 with central type, 16 with peripheral type, and 14 with psychogenic type. Korean standardized Beck Depression Inventory(K-BDI), State and Trait Anxiety Inventory(STAI), and Korean standardized edition of Symptom Checklist 90 Revised(SCL-90-R) were used for the assessment. Statistically, Pearson's chi-square test and one-way ANOVA with Scheffe's test were used with SPSS/PC for windows 6.0. Results : The results were as follows : 1) The proportion of psychogenic dizziness was 22.6% of the total subjects. 2) Total scores of K-BDI were not significantly different among the 3 groups. 3) Total scores of state anxiety and trait anxiety were not significantly different among the 3 groups. 4) In SCL-90-R, psychogenic dizziness group showed significantly higher score of phobic anxiety only(p<0.01) than central dizziness group. And others were not significantly different among the 3 groups. 5) In additional somatic symptoms, pain score was not different among the 3 groups, but gastrointestinal and sexual symptoms scores of central and peripheral dizziness group were significantly higher than those of psychogenic dizziness group(p<0.01). Conclusion : These results suggest that psychiatric symptoms in patients with psychogenic dizziness are not different from those of patients with central or peripheral dizziness. Therefore, the more direct and intensive treatment may be necessary regardless of the type of dizziness.

      • 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.

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