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.

말초신경 손상이 실험적으로 유발된 흰쥐의 척수신경절 및 척수등쪽뿔내 신경세포의형태학적 변화에 관한 연구

이원택,손민균,정경승,이홍석,박경아 대한해부학회 1997 Anatomy & Cell Biology Vol.30 No.5

기능성 외벽체 마감재 개발

이종석,홍승익,정경호 한국공업화학회 2004 응용화학 Vol.8 No.2

This study is on the development of functional exterior finishing materials such as light-weighted putty-type finishing material, light-weighted vit-type material and improved adhesive agent. Its superiority was confirmed by the numeric data using analytic instruments ignoring visual test to compare it with existing products. We applied qualitative and quantitative analysis to the raw materials of finishing materials and adhesive agent. We tested the color chips of finishing material and adhesive material products with surface analysis, qualitative and quantitative analysis, and with gloss test. The field application analysis of the finishing materials were processed by the tests on volatile organic compounds. The field application analysis of the adhesive agent was processed by the tests on noncombustible material, anion, quality of water fit to drink, radioactive rates and energy, antibacterial, deodorization, anti-mold.

TIPS 펜타신 유기 박막 트랜지스터의 전기적 특성에서 솔벤트의 영향 연구

김경석,정관수,곽성관 경희대학교 레이저공학연구소 2006 레이저공학 Vol.17 No.-

In this paper, we investigated the effect of solvent on electrical properties of triisopropylsilyl (TIPS) pentacene organic thin-film transistors (OTFTs). The TIPS pentacene was spin coated by using anisole, chlorobenzene, p-xylene, chloroform and toluene as solvent. Fabricated OTFT with anisole showed field-effect mobility of 0.02㎠/V·s, on/off ratio 1.3×10^(3) and threshold voltage of 2.8V. In contrast, with chloroform the mobility was 5.8×10^(-7)㎠/Vs, on/off ratio 1.1×10^(2) and threshold voltage of 1.7 V.

척추질환 입원환자의 연도별 변동추이에 대한 통계적 고찰

박경수 ( Kyung Su Park ),이준환 ( Jun Hwan Lee ),정석희 ( Seok Hee Chung ) 한방재활의학과학회 2006 한방재활의학과학회지 Vol.16 No.4

Objectives : The aim of this study was to find the change in the number of inpatient with spine disease, data were reviewed on inpatients who was diagnosed as spine disease in the Kyung-hee Medical Center(KHMC) for 25 years(1980~2004). Methods : Analysis data of the number of spinal disease was based on the KHMC annual report for 25 years(1980~2004). Results : 1. The number of inpatient in KHMC with spine disease has been increasing during 25years from 1980 to 2004(p-value:0.000) 2. The number of inpatient in KHMC with ankylosing spodylitis(AS) is increasing during 25years from 1980 to 2004(p-value=0.000) 3. The number of inpatient in KHMC with spinal stenosis is increasing during 25years from 1980 to 2004(p-value=0.000) 4. The number of inpatient in KHMC with herniated nucleus pulposus of cervical spine(HNP of C-spine) is increasing during 25years from 1980 to 2004(p-value=0.000) 5. The number of inpatient in KHMC with herniated nucleus pulposus of Lumbar spine(HNP of L-spine) is increasing during 25years from 1980 to 2004 (p-value=0.007) Conclusions : It is suggesting that the number of patients of spinal stenosis and HNP of L-spine increase at KHMC.

白茯笭이 肥滿誘導 흰쥐의 體重, 副睾丸,脂肪組織, 血液 및 遺傳子 變化에 미치는 影響

류은경,정석희,이종수,김성수,신현대 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2000 No.-

Objectives : These experimental studies were designed to investigate the effects of Poria cocos extract on the weight control and the lipid metabolism of the obese rats induced by high fat diet. They were designed to find out what was changed in the serum, and how the leptin and the leptin m-RNA were affected. Methods : The measurement has been performed for 6 weeks with obese rats. Results: 1.In the sample I (fat diet & Poria cocos group), the weight decrease significantly occurred throughout the whole research period, whereas in the sample II(normal diet & Poria cocos group), the ratio of weight decrease was significantly observed at the 4th, 5th, and 6th week(p < 0.05) 2.In the sample I, the epididymal fat weight and average size significantly decreased at the 6th week(p < 0.05). 3.In the sample I, the number of epididymal fat cell significantly decreased at the 3rd & 6th week(p < 0.05). 4.With the view of hematologic findings, I observed the increasing tendency of glucose in the sample I & II, and the significant decreasing of triglyceride at the 6th week(p < 0.05). 5.The leptin decreased in the sample I, whereas it came to increasing tendency in the sample II(p > 0.05). 6.The leptin m-RNA decreased a little in the sample I, whereas it increased in the sample(p > 0.05).

혈관외피종 -1증례 보고-

강유미,지미경,양기화,강석진,김병기,김선무,정수일 대한병리학회 1990 Journal of Pathology and Translational Medicine Vol.25 No.5

혈관외피종 -1증례 보고-

강유미,지미경,양기화,강석진,김병기,김선무,정수일 대한병리학회 1990 Journal of Pathology and Translational Medicine Vol.24 No.2

한국인 얼굴 연조직의 두께

김창헌,허경석,김희진,강민규,정인혁 大韓法醫學會 1999 대한법의학회지 Vol.23 No.2

Neisseria gonorrhoeae 분리균의 항생제 내성 양상 분석

성원근,정경태,길준영,김석하,오희복 대한감염학회 2001 감염 Vol.33 No.5

Background : The aim of this study was to monitor trends in antimicrobial susceptibilities of Nesseria gonorrhoeae isolates, in particular, to examine the possibility of increasing prevalence of fluoroquinolone resistance in Korea and the relationship between patterns of mutations involving gyrA and parC genes and the ciprofloxacin resistance level. Methods : The antimicrobial susceptibilities of 489 gonoccocal isolates which were nationwide collected from patients visiting Health Centers were determined by NCCLS disk diffusion and agar plate dilution methods. PCR and direct DNA sequencing of the amplicons were performed to identify mutations within the quinolone resistance-determining regions of gyrA and parC genes. Results : The proportion of resistance to penicillin, tetracycline, or both remained as high as 94%. The isolates with ciprofloxacin resistance remarkably increased from 1% in 1999 to 5% in 2000 and also resistance to cefoxitine and ceftriaxone were shown to be increased. The strains resistant to spectinomycin was little reported. Four isolates with 16 ㎍/mL of MIC for ciprofloxacin all showed the same alternations of Ser-91 to Phe, Asp-95 to Gly in GyrA and Ser-87 to Arg in ParC, but ciprofloxacin-susceptible strains have little amino acid substitution. Conclusion : Considering the increasing prevalence of isolates with resistance to ciprofloxacin and ofloxacin, it is likely that the antibiotics such as spectinomycin, or ceftriaxone are recommended as the first-line treatment for gonoccocal infections in Korea. The results from this study suggest that mutation analysis for quinolone resistance-determining regions of gyrA and parC genes are important in epidemiological studies for the spread of ciprofloxacin resistant strains.(Korean J Infect Dis 33:338∼345, 2001)