The Efficacy and Safety of 4-n-butylresorcinol 0.1% Cream for the Treatment of Melasma: A Randomized Controlled Split-face Trial

( Sun Young Huh ),( Jung Won Shin ),( Jung Im Na ),( Chang Hun Huh ),( Sang Woong Youn ),( Kyoung Chan Park ) 대한피부과학회 2010 Annals of Dermatology Vol.22 No.1

Background: Melasma is a common acquired symmetrical hypermelanosis that occurs on sun-exposed areas, and it is frequently observed among women. Various treatment modalities have been tried, but none are completely satisfactory. 4-n-butylresorcinol, which is a resorcinol derivative that has an inhibitory effect on both tyrosinase and tyrosinase-related protein-1, was introduced in 1995 and it has received increasing attention as a new hypopigmenting agent. However, the hypopigmenting effect of 4-n-butylresorcinol in human subjects has only been shown in a few studies. Objective: The aim of this study was to investigate the hypopigmenting efficacy and safety of 4-n-butylresorcinol 0.1% cream for the treatment of melasma. Methods: Twenty patients with melasma were enrolled to this randomized, double-blind, vehicle-controlled, split-face comparative study. The patients were instructed to apply 4-n-butylresorcinol 0.1% cream or vehicle to each side of the face twice daily for 8 weeks. Mexameter measurements were performed along with photography at baseline, 4 weeks and 8 weeks. Adverse events were observed and recorded throughout the study. Results: All the patients completed the study. Mexameter measurements demonstrated that the melanin index of the treated side showed a significant decrease when compared with that of the vehicle-treated side after 4 weeks (p=0.006) and after 8 weeks (p<0.0005). All the adverse reactions were mild and transient. Conclusion: 4-n-butylresorcinol 0.1% cream showed rapid efficacy and it was well tolerated when used for the treatment of melasma. (Ann Dermatol 22(1) 21∼25, 2010)

임상 ; 한국 산모와 신생아의 비타민 D 영양 상태 조사

나보미 ( Bo Mi Na ),노소정 ( So Jung No ),김미정 ( Mi Jung Kim ),한헌석 ( Heon Seok Han ),정은환 ( Eun Hwan Jeong ),한영희 ( Young Hee Han ),현태선 ( Tai Sun Hyeun ) 대한주산의학회 2007 Perinatology Vol.18 No.4

목적: 한국 산모와 신생아의 비타민 D 영양 상태를 조사하여 비타민 D 부족의 발생률과 그 정도를 알아보고, 이에 영향을 미치는 요인들을 분석하였다. 방법: 2004년 8월부터 2005년 7월까지 충북대학교병원 산부인과에서 출산한 총 181쌍의 산모와 건강한 만삭아를 대상으로 하였다. 분만시 산모와 제대혈의 혈청 25-OH 비타민 D3(25OHD3), alkaline phosphatase (AP), 칼슘(Ca), 인(P), 부갑상선 호르몬(PTH) 농도를 측정하였으며, 모성 면담과 설문 조사를 통하여 자외선 조사량과 비타민 D의 일일 평균 섭취량을 구하여 비교분석하였다. 결과: 1) 산모와 신생아의 혈청 25OHD3 농도는 각각 23.4±9.9과 16.9±7.5 ng/mL이었다. 2) 8 %의 산모와 22%의 신생아가 비타민 D 결핍 상태였으며, 70%의 산모와 신생아에서 부족 상태를 보였다. 3) 산모와 신생아의 25OHD3 농도는 강한 양의 상관관계를 보였다(r=0.7270, p<0.0001). 4) 산모와 신생아의 비타민 D 영양 상태에 가장 큰 영향을 미치는 요인은 출산 계절로 하절기(6~11월)에 높았다. 5) 다중회귀분석 결과, 산모에서는 출산 계절과 분만 방식이, 신생아에서는 산모의 25OHD3와 분만 방식이 비타민 D 농도와 연관성이 있는 것으로 나타났다. 결론: 한국 산모와 신생아는 비타민 D 영양 결핍이나 부족 상태에 있는 경우가 많았으며, 출산 계절이 비타민 D 영양 상태에 가장 큰 영향을 미치는 것으로 나타났다. Objective: To evaluate the vitamin D nutritional status and its influencing factors in Korean mothers and their newborn infants. Methods: Maternal (n=181) and cord blood (n=180) serum concentrations of vitamin D (25OHD3), calcium, inorganic phosphorus, alkaline phosphatase, intact parathyroid hormone were measured at the time of delivery. We defined vitamin D deficient, insufficient, and sufficient as 25OHD3 <11, 11~30, and >30 ng/mL, respectively. Using questionnaires, average duration of sun-light exposure (minutes/day) and dietary intake of vitamin D (μg/day) were obtained. Results: 1) The mean 25OHD3 level in mothers was 23.4±9.9 (range 4~71.6) ng/mL, and in newborns, 16.9±7.5 (range 0.9~53.6) ng/mL. 2) 8.3% of mothers and 22.2 % of newborns were vitamin D deficient, and 70% of both mothers and newborns were insufficient. 3) Maternal 25OHD3 showed a strong positive correlation with cord blood 25OHD3 (r=0.727, p<0.001). 4) The most significant risk factor for low 25OHD3 levels was the season of birth (June through November) in both mothers and newborns. 5) In multiple logistic regression analysis, the season of birth and the mode of delivery remained significant for maternal vitamin D status, whereas maternal 25OHD3 and the mode of delivery remained significant for neonatal vitamin D status. Conclusion: In conclusion, vitamin D deficiency or insufficiency was relatively common in Korean mothers and their newborn infants, and the most significant risk factor for low vitamin D status was the season of birth.

Furosemide에 의한 소디움 운반체 발현의 변화

오윤규 ( Yoon Kyu Oh ),나기영 ( Ki Young Na ),이재욱 ( Jay Wook Lee ),장혜련 ( Hye Ryun Chang ),박영선 ( Young Sun Park ),박정환 ( Jung Hwan Park ),주권욱 ( Kwon Wook Joo ),김근호 ( Gheun Ho Kim ),이정상 ( Jung Sang Lee ),한진석 ( 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.2

배경 : 임상에서 흔히 사용하는 이뇨제 furosemide는 비후상행각에서 Na+-K+-2CI- cotranspoter (NKCC2)를 억제하여 NaCl 재흡수를 차단하여 이뇨작용을 나타낸다. Furosemide를 장기간 투여하면 내성과 대사성 알카리증의 부작용이 발생할 수 있는데, 이는 집합관에 도달하는 소디움 증가와 관련 있을 가능성이 있다. 방법 : 저자들은 furosemide의 내성이나 부작용이 집합관 상피 소디움 통로 (ENaC) 단백발현의 변화와 관련이 있는지를 확인하고자, Sprague-Dawley rat에서 farosemide (12 mg/day)을 7일간 지속적 피하 주입한 후 반정량적 immunoblotting과 면역조직화학법을 이용하여 NKCC2, Na +-CL- cotransporter (NCC), ENaC 단백의 발현을 관찰하였다. 실험기간 동안 수분과 전해질 용액 (0.8% NaCl & 0.1% KCl)을 자유롭게 섭취하도록 하여 체액 감소를 방지하였다. 결과 : 부형약 (vehicle)을 투여한 대조군에 비하여, furosemide를 투여한 군에서 각각 요량과 요 소디움 배설이 증가하였으나, 체중, 혈청 알도스테론치 및 크레아티닌 청소율은 차이가 없었다. Furosemid 투여 후 NKCC2 단백은 피질 (151±10 vs. 100±10%, p<0.05)과 외수질 (122±5 vs. 100±3%, p<0.01)에서 증가해 있었다. ENaC 단백은 세 가지 subunit 모두 furosemide 투여 후 대조군에 비하여 피질 (α:187±25 vs. 100±22%, p<0.05; β:155±8 vs. 100±15%, p<0.05; γ:168±16 vs. 100±9%, p<0.05)과 외수질 (α:171±27 vs. 100±17%, p<0.05; β :986±91 vs. 100±33%, p<0.01; γ :242±24 vs. 100±22%, p<0.01)에서 증 가하였다. 면역조직화학법에서도 furosemide를 투여한 군의 집합관 주세포에서 ENaC β-subunit가 더 강하게 염색되었다. 결론 : 이상에서 장기간 furosemide 투여시 집합관 ENaC 발현이 증가하며, 이러한 원위부네프론의 적응 반응이 이뇨제 내성을 유발하는데 기여할 것으로 생각한다. Background : Furosemide inhibit NaCl absorption in the thick ascending limb and produce an increase in distal delivery of Na+. We carried out semiquantitative immunoblotting and immunohistochemistry of rat kidneys to investigate whether chronic furosemide infusion is associated with compensatory increases in the abundance of Na+ transporters in distal nephron. Methods : Osmotic minipumps were implanted into Sprague-Dawley rats to deliver 12 mg/day of furosemide(n=6) with simultaneous administration of 0.8% NaCl and 0.1% KCl in drinking water for 7days. Results : Compared with vehicle infused controls, urine volume and urine sodium amount were increased. However, there were no differences in body weight, serum aldosterone, and creatinine clearance. The abundance of Na+-K+-2CI - cotransporter after furosemide infusion was increased in cortex (151±10 vs. 100±10%, p<0.05) and outer medulla (122±5 vs. 100±3%, p<0.01). In furosemide infusion group, the abundance of all three subunits of epithelial sodium channel (ENaC) was increased both in cortex (α:187±25 vs. 100±17%, p<0.05; β:155±8 vs. 100±15%, p<0.05; γ :168±16 vs. 100±9%, p<0.05) and outer medulla (α:171±27 vs. 100±17%, p<0.05; β :986±91 vs. 100±33%, p<0.01; γ :242±24 vs. 100±22%, p<0.01). Consistent with these results, ENaC β-subunit immunohistochemistry showed a remarkable increase in immunoreactivity in the principal cells of collecting ducts with furosemide treatment. Conclusion : These increases in the abundance of ENaC protein may account for the generation of diuretic tolerance.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

제어모드 순위 자동 선정에 관한 연구

나만균,정동원,신선호 조선대학교 에너지.자원신기술연구소 2003 에너지·자원신기술연구소 논문지 Vol.25 No.1

제어계통의 고신뢰도는 제어 알고리즘의 강인성 및 성능의 향상으로 표현될 수 있으며, 고등 제어 알고리즘의 개발과 진단을 통한 발전소 조건의 변화에 따른 적절한 제어모드를 선정하므로써 달성될 수 있을 것이다. 본 연구에서는 여러 제어 알고리즘의 라이브러리로부터 요구된 필수 요건을 반드시 만족시키면서 목적 비용함수를 최소화하는 제어모드 순위 선정 자동화 기술을 개발하였다 개발된 방법은 발전소 상태의 변화 (운전조건의 변화, 기기고장 및 이상상태 등이 진단기술에 의하여 탐지), 필수 요건 혹은 최적화 요건의 변화에 의하여 적절한 제어모드 순위를 결정하여 운전원에게 제시하므로써 적절한 조치를 취하게 하거나 필요한 정보를 제공하여 준다. High reliability of control systems can be expressed as enhancement of their robustness and performance and can be accomplished by designing advanced control algorithms and selecting appropriate control modes according to changes of plant conditions through diagnostics. In this work, by combining control and diagnostic algorithms, we have developed the automatic design technology of control systems that candetermine control mode priority among a variety of control algorithm libraries according to operating conditions and key requirements of plants. The developed method enables operators to take appropriate actions or provide necessary information to operators by determining the control mode priority according to changes of key and optimizing requirements and/or changes in the states of nuclear power plan.

만성신부전 환자에서 발생한 파종결핵

정가영,나선경,윤혜원,송하응,류정화,류동열 이화여자대학교 의과학연구소 2013 EMJ (Ewha medical journal) Vol.36 No.1

Patients with chronic renal failure (CRF) are known to be more susceptible to tuberculosis infection due to impairment of the host defense mechanism. Although extrapulmonary tuberculosis is more prevalent in those subjects and it may induce dismal outcome, its diagnosis has been challenging since there is no specific symptoms of the disease and the clinical course is usually atypical. Herein, We report a case of disseminated tuberculosis diagnosed by ultrasound-guided liver biopsy in a 31-year-old CRF patient presenting sustained fever despite broad-spectrum antimicrobial therapy and progressive cholestatic jaundice.

복막투석복막염 환자에서 발생한 창자벽공기증 1예

정선영,나지훈,최윤정,고성애,조규향,박종원,도준영,윤경우 영남대학교 의과대학 2009 Yeungnam University Journal of Medicine Vol.26 No.1

Peritonitis is a serious problem in patients undergoing peritoneal dialysis. Rarely pneumatosis intestinalis can occur as a complication of this infectious process. Pneumatosis intestinalis is a potential life threatening condition with a challenging management. The mortality of peritoneal dialysis patients with pneumatosis intestinalis secondary to mesenteric ischemia is almost 100%. We describe a rare case of pneumatosis intestinalis in a peritoneal dialysis patient who developed Staphylococcus aureus peritonitis which was initially treated with appropriate antibiotics. Since initial response to therapy was not achieved, an abdominal computerized tomography was done which revealed a pneumatosis intestinalis. A laparotomy was performed and small bowel necrosis was seen. A segmented resection with ileostomy, jejunostomy was done. Though surgical treatment was performed, the patient died in 2 weeks after admission. Pneumocystitis intestinalis in peritoneal dialysis peritonitis is a uncommon complication which requires prompt evaluation to rule out mesenteric ischemia as it carries a high mortality and its management will be surgical.

콜리플라워를 이용한 피클제조 최적화

정현아,윤지영,황재선,주나미 한국식생활문화학회 2004 韓國食生活文化學會誌 Vol.19 No.2

The purpose of this study was to determine the organoleptic characterisitcs of cauliflower pickles made in various compounding ratio according to central conposite design for optimum organoleptic characteristics of the cauliflower pickles. The optimum mixing condition of cauliflower pickles were optimized, using central composite design with 3 variables and 3 levels, by response surface methodology. The various kinds of cauliflower pickle were made in various compounding ratio of vinegar, salt and sucrose - critical ingredients of pickle recipe - and were presented to reliable panels, who graded the subjects in 7 degrees for 4 items : color, lavor, hardness and overall quality. The optimum mixing conditions of cauliflower pickle were 603.50g of vinegar, 80.13g of salt and 251.079 of sucrose in the maximum point of overall quality.

Pseudomonas fluorescens의 Salicylate hydroxylase를 암호하는 유전자의 클로닝

정유선,민경희,이나리 숙명여자대학교 자연과학연구소 1997 자연과학논문집 Vol.- No.8

Pseudomonas fluorescens SME11로 부터 salicylate hydroxylase를 암호하는 nahG 유전자를 클로닝하기 위하여 NAH플라스미드를 주형으로 하여 PCR을 수행하였다. PCR방법으로 얻은 1.6kb DNA절편을 pT7Blue(R)벡터에 삽입시켜 재조합 플라스미드 pNY1을 제조하였으며 이것을 E. coli에 형질전환하였다. 재조합 DNA를 제한효소로 처리하여 EcoRⅤ, KpnⅠ, PvuⅡ, StuⅠ등이 존재함을 확인하였으며, 이것으로 간단한 제한효소지도를 작성하였고 재조합 DNA를 한 방향으로 deletion하여, nahG유전자를 포함한 DNA절편의 염기서열을 결정하였다. 재조합 플라스미드인 pNY1에는 1,305bp크기의 open reading frame이 존재하였으며, salicylate hydroxylase에 해당하는 434개의 아미노산을 암호하였다. 아미노산서열을 비교한 결과, P.putida KF715와 84.1%, P.putida PpG7과 71.4%, P.putida S-1 과 48.7%의 homology를 보였으며, 또한 Sphingmonas sp.와 26.8%의 homology를 보였다. Pseudomonas fluorescens SME11 carrying NAH plasmid was isolated from wastewater. To clone nahG gene encoding salicylate hydroxylase, 1.6kb DNA fragment of PCR product from NAH plasmid was inserted to pT7Blue(R) vertor and resulting recombinant DNA was named pNY1. The transformants, E.coli SMY1, clone containing the recombinant plasmid pNY1 were able to convert salicylate to catechol and produced dark brown color caused by accumulation and auto-oxidation of catechol. Restriction endonuclease mapping of 1.6kb size of the insert of the recombinant plasmid pNY1 was carried out with EcoRⅤ, KpnⅠ, PvuⅡ, StuⅠ. By means of unidirectional ExoⅢ deletion and dideoxynucleotide chain termination, we determined the nucleotide sequence of the DNA fragment containing nahG gene. One open reading frame of 1,305 bp corresponding to 434 amino acids was found in the insert DNA. Deduced amino acid sequences of the nahG gene showed 84.1%, 71.4%, 48.7%, and 26.8% homologies to those from P.putida KF715, P. putida PpG7, P. putida S-1, and Sphingmonas sp., respectively.

3교대 근로자에서 교대근무기간과 혈압 및 심박수 변동성

하미나,김재용,박정선,정호근 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

목적 : 교대근무가 심혈관계에 미치는 만성적인 영향을 살펴보기 위하여 본 연구를 수행하였다. 방법 : 4조 3교대의 빠른 순환주기의 교대근무를 하는 1개 제조업체 남성근로자 134명을 대상으로 교대근무마다 혈압 및 심박수 변동성을 측정하였다. 교란변수로서 Karasek의 직무긴장도 모델에 의거한 49항목의 직무스트레스설문지를 이용하여 직무스트레스를 측정하였고, 수면유형과 흡연, 음주력 및 과거병력 등의 사항에 관한 설문조사를 실시하였다. 반복측정 자료의 분석을 위해 mixed model을 이용한 다변량 회귀분석을 수행하여, 교대근무기간과 혈압 및 심박수 변동성과의 관련성을 살펴보았다. 결과 : 대상 근로자의 평균연령은 29 세였다(범위 25∼44). 이들 중 77.9 % 는 현재도 흡연을 하고 있었고, 50 % 는 직무긴장도 모형에서 수동형이었다. 평균 총 교대근무기간은 5.21 년(범위 5.4 개월∼10년)이었다. 수면유형검사에서는, 극단적인 아침형이나 극단적인 저녁형은 없었다. 연령, 직무스트레스, 수면유형 및 흡연을 보정한 다변량 분석에서, 혈압은 총 교대근무기간이 증가함에 따라 통계학적으로 유의하게 증가하는 소견을 보였다(p(0.05). 심박수 변동성은 저주파 및 고주파 영역 모두에서 총 교대근무기간이 증가함에 따라 유의한 감소양상을 나타냈다(p<0.05) . 결론 : 본 연구의 결과는 교대근무가 혈압을 상승시키고 심박수 변동성을 감소시키는 것으로써 심혈관계 기능에 영향을 미침을 보여주었다. Objectives : This study was performed to investigate the chronic health effect of shift-work on cardiovascular system. Methods : We checked blood pressure(BP) and heart rate variability (HRV) at every shift on 134 male workers whose shift type was 8-hour and short rotating of 3 days shift interval. As confoundings, job stress was measured by Karasek's JCQ 49 items questionnaire and circardian type was assessed by morningness-eveningness questionnaire. Smoking and alcohol drinking habit, marital status and past medical history were also acquired. We used the method of repeated measured data analysis with mixed model to show the association between shiftwork duration and BP or HRV. Results : Average age of workers was 29 years olds(range 25∼44). Among them, 77.9 % were current smokers, 50 % were the passive type of job strain in Karasek's model. Mean shiftwork duration was 5.21 years(range 5.4 months∼10 years). In circadian type, no one was definitely morning type or definitely evening type. In multivariate analyses adjusted by age, job strain, shift, circadian rhythm and smoking, blood pressure were showed significantly increasing trends according to shiftwork duration in both systolic and diastolic (p(0.05) . Heart rate variability were also showed significantly decreasing trends according to shiftwork duration in both parasympathetic and sympathetic functions (p(0.05) . Conclusions : The results of this studs suggests the chronic negative health effect of shiftwork on cardiovascular system.