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.

建蘭 Rhizome의 繼代培養에 關한 硏究 : Ⅰ.MS基本培地에서 生長調節物質과 Sucrose의 添加量이 Rhizome의 增殖에 미치는 影響 Ⅰ.The effects of growth regulating substance and addition quantity of sucrose on proliferation of rhizom in M.S basic culture ground.

姜鎬宗,朴相眩,蔡潤錫 진주산업대학교 1984 論文集 Vol.22 No.-

東洋系 Cymbidium屬인 建蘭의 rhizome을 大量 증식할 目的으로 MS基本 培地에 生長調節 物質의 滴定濃度와 Sucrose의 濃度를 알고저 本試驗을 遂行하였던 바 그 結果는 다음과 같다. 1. 生長調節劑의 濃度에 關係없이 Sucrose의 濃度가 2%정도일 때 rhizome의 증식이 양호하였다. 2. Sucrose의 濃度가 3% 以上이며 NAA 濃度가 1ppm이상 일때는 rhizome이 짧아지고 數도 현저히 감소하는 현상이었다. 3. 엽 분화는 대게 rhizome이 신장하여 많은 마디를 形成하고 1.5㎝이상 자랐을 때 그 선단에서 잎이 분화하였다. 4. rhizome을 치상할 때 횡식(橫殖)으로 치상하면 個體數가 증가하며 上向性의 경향이고 종식(縱殖)할 경우는 rhizome이 세장하면서 下向性의 경향이었으나 대체로 下向性이었다. This experiment was carried out to find the optimum concentration of growth regulate substrates and sucrose for mass production of the orient ochid plant (cymbidium ensifolium) and the result was follows. 1. Whether the growth regulate substrates were applied or not the growth of rhizome of tested orchid was increased in the treatment of 2% Sucrose. 2. When sucrose concentration in more than 3% and NAA is more than 1ppm in the media the length of rhizome become shoter and the number of rhizome decreased. 3. After the rhizome growth up to 1.5㎝ highet in length and formed a number of nodes the leaves were seperated from the tip of the rhizomes. 4. When the rhizome were planted horizontally the number of plants increased and the rhizome growed in the air, where as when the rhizome was planted verfically it become thin and most of rhizome growed in the media

젊은 무월경환자의 골밀도에 관한 연구

강길전,이기환,박윤석 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

To examine the impact of amenorrhea on bone mineral density in women of reproductive age, 22 amenorrheic women aged 16-40 were studied Bone mineral density in the lumbar spine(L1-L4) as measured by dual energy X ray absorptiometry. The amenorrheic group showed a mean reduction in bone mineral density of 155 as compared with controls. Bone loss was related to the duration of amenorrhea and the severity of estrogen deficiency rather than to the underlying diagnosis. Patients with a history of fracture had significantly lower bone density than those without a history of fracture. In conclusion, amenorrhea in young women should be investigated and treated to prevent bone mineral loss. Menopausal women with a past history of amenorrhea should be considered to be at high risk of osteoporois.

KAL기 추락에 의한 대량재해의 개인식별

강신몽,이원태,고영창,최상규,김윤희,이홍석,서재관,윤중진,이혜경,최득린,김종열,윤창육,변명식,이장홍 大韓法醫學會 1991 대한법의학회지 Vol.15 No.2

Individual identification is an important part in medicolegal field especially in mass disaster. At July, 27, 1989, KAL KE-803 was crashed on landing at Tripoli International Airport, Liba. The plane was caught in fire and sixty eight Koreans were sacrified. The majority of victims were severely charred and injured. The authors examed all dead bodies and successfully identified all the cases through visual, anthropological, odontological, radiological and pathological methods including fingerprint and blood typing.

Estrogen 보충요법의 임상적 연구

강길전,이기환,박윤석 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

Thirty-eight healthy, perimenopausal women (aged 42-54 years) were allocated to 6 months of over of treatment with a cyclic combination of 2 mg estradiol valerate and 1 mg cyproterone acetate. 1. Satisfactory response to hormonal treatment was noticed in 32 patients (84.2%), but unsatisfactory response was noticed in 6 patients (15.8%). 2. Unsatisfactory response was especially noticed in group of patients who were in regular menstruation but complaines of menoparsal wymtoms. Accordingly, if unsatisfactory response was noticed, other couses of menopausal symptoms were evaluated, especailly ofr psychologic factor or stress factor. 3. After hormonal treatment body weight and blood pressure were not singificantly chanded. 4. After hormonal treatment GOT, GPT, alkaline phospatase, BUN, FBS, creatinine, triglycerid, HDL-cholesterol and total cholesterol were not significantly changed. 5. Side effects of durg were negligible and patiens were well tolerated the drug and compliance were good. On conclusion, it has suggested that a combination of estradiol valerate and cyproterone acetate was safe and effective for the treatment of menopausal symptoms without side-effects. However effects on bone density with this durg should be evaluated.

器內培養에 의한 Denphalae의 大量增殖

강호종,박상현,채윤석 진주산업대학교 1992 論文集 Vol.31 No.-

Denphalae(Dendrobium phalaenopsis)의 대량증식에 관한 실험을 실시한 결과를 요약하면 다음과 같다. 1. 식물재료의 소독은 sodium Hypochlorite에 먼저 씻은 후 Ethylalcohol 70%에 l0초, Ca(CIO)_2 5%에 5분, 껍질 제거후 1% Ca(ClO)_2에 10분, 그후 미세조정후 치상하는 것이 가장 양호하였다. 2. MS기본배지에 Sucrose 3%, NAA O.5, BA O.5ppm, 사과즙액 10%, 감자즙액 10%, 참가한 pH 5.4의 액체진탕에서 가장 증식이 양호하였고 진탕속도는 30~40rpm/min이 좋았다. 3. 배양환경의 적용범위는 대체로 넓었으며 온도는 24~28℃, 일장은 8~l6시간, 조도는 1,000∼3,000Lux에서 별 차이를 보이지 않았으나 온도는 26℃土1℃, 일장은 l6시간, 조도는 l,500Lux로 조정하여 배양한 결과는 배우 양호 하였다. Effects of Sterilization on the Shoot-tip and medium, Temperature, Vibration and Photolength on the growth of Denphalae were studied using tissue cultural method 1. It is evident that the treatment of 1% calsium hypoclorne for 10 minutes after taking off the outer covers, 5% Ca(C10)_2 for 5 minuter and 70% ethyl alcohol for l0 seconds on the shoot-tip is an useful technique in sterilizaton. 2. The medium with the addition of 3% sucrose, 0.5ppm NAA, 0.5ppm BA, l0% apple juice, and 10% potato extract in pH 5.4 under the vibration speed of 30 to 40 rpm for 1 minuter showed a good effect on the growth of Denphalae. 3. The optimum range of the growth temperature, day lenth and photoperiod for Denphalae found to be 24 to 28℃, 8 to 16 hours and l,000 lux respectively. The enviromental condition of temperatue, day length and photoperiod for mass production of Denphalae showed 26^± 1℃ 16 hours and 1,500 lux respectivery.

微量要素 複合肥料 "그린 올"의 處理가 딸기의 生産量과 品質에 미치는 影響

姜鎬宗,蔡潤錫 진주산업대학교 농업기술연구소 2000 農業技術硏究所報 Vol.13 No.-

Effect of micronutrient element complex fertilizer "Green All" upon the product quantity, fruit weight, and brix degree in strawberry was investigated. "Green All' solutions of 500 times and 1000 times were treated on strawberry at 10 and 15days interval. The results were summarized as followings; 1. The number of fruit per plant were 15.2 at 15days interval treatment of 500 times solutions, and followed by 15.1 at 10days interval treatment of 500 tmes solution. Non treatment showed about 3.5 fruits per plant. 2. The highest fruit weight was 14.2g at 15days interval of 500 times solution. Non treatment showed 12.7g 3. The brix degree was 7.2°, the highest at 10days interval of 500 times solution. This value is a little higher than 6.5° of control. These results showed that 10days interval treatment of 500 times solution might be most proper, when micronutrient element complex fertilizer "Green All" was used for strawberry production.

수박 接木苗 生産에 관한 硏究

姜鎬宗,蔡潤錫,李相雨 진주산업대학교 농업기술연구소 1999 農業技術硏究所報 Vol.12 No.-

수박의 우량접목묘 생산을 위한 기초자료를 얻기 위하여 조사 및 실험을 수행한 결과를 요약하면 다음과 같다. 1. 시판되고 있는 수박종자의 포장단위별 입수가 동일하지 않았으며 221립에서 많은 것은 257립까지 매우 다양하였다. 개체별 중량도 다양하여 30mg이하가 9.8%, 30-35mg이 17.9%, 36-41mg이 25.9%, 42-47mg이 27.7%였으며, 48mg이상은 18.7%로 조사되었다. 2. 수박의 종자중량에 따라 발아 후의 배축경이 달랐는데 46mg이상의 대립종자에서는 1.96mm로 굵었고, 45-36mg에서는 1.82mm로 중간정도이고 35mg이하의 소립종자에서는 1.51mm로 가늘게 나타났다. 3. 접목당시 수박의 배축경이 굵을 수록 묘의 소질이 좋은 결과로 나타났으며, 평균과 중도 높게 나타났다. Experiments were conducted to obtain basic data on the production of high-quality grafted seedlings of watermelon, and the results are summarized as follows: 1. The number of watermelon seeds contained in commercial packages was not consistent, ranging from 221 to 257. In addition, weight of individual dry seed was also variable. The mean % compositions by size of seeds were 9.8% 30mg or less, 17.9% 30-35mg, 25.9% 36-41mg, 27.7% 42-47mg, and 18.7% 48mg or greater. 2. The diameter of hypocotyl after germination was dependent upon the seed weight. Large seeds with 46mg or greater dry seed weight had a thick hypocotyl with an average diameter of 1.96mm. However, medium size seeds with 45-36mg dry weight had 1.82mm, and smaller seed with 35mg or less dry weight had 1.51mm of an average hypocotyl diameter. 3. The greater the diameter of hypocotyl at the time of grafting, the higher the quality of the grafted seedling, and the greater the mean weight of fruits harvested.

定植方法이 딸기의 發根및 生育에 미치는 影響

姜鎬宗,朴相眩,蔡潤錫 진주산업대학교 농업기술연구소 2000 農業技術硏究所報 Vol.13 No.-

In order to improve the method of raising seedling and planting in strawberry "jang hee", effect of pot shape and planting method upon the growth of the plants were investigated. The results were summarized as followings; 1. In general, root growth was better at round pot and I pot(conventional pot) than at other pots. Number of root was 26, the highest at round pot, and followed by 20 at I pot. Maximu root length was 29.4cm at round pot, longer than 26.5 at I pot. Root dry weight was 3.72g at I pot, and followed by 2.87g at round pot. 2. When the strawberry seedling adhering bed soil were planted uprightly, root number and root dry weigth were 17.7 and 1.63g respectively, a little higher than 17.0 and 1.45g at conventional method. However, maximum root length was 28cm at the conventional method, longer than 20cm at planting uprightly with bed soil. 3. Leaf area was 62.1㎠ at bed soil adhered and 46.2㎠ at bed soil removed. Petiol length was 1cm longer at bed soil adhered than at bed soil removed. Root dry weight was 4.7g at bed soil adhered and 1.6g at bed soil removed.

딸기 育苗方法에 관한 硏究 : (Fragaria grandiflora E.)

姜鎬宗,蔡潤錫,李相雨 진주산업대학교 1998 論文集 Vol.37 No.-

"아끼히메"의 공중육묘에 관한 기초자료를 얻기 위해 7월 10일에 조사하여 정리한 실험결과를 요약하면 다음과 같다. 1. 모주의 분지 발생율은 편아가 6.3%, 2아가 36.8%, 3아가 44.3%, 4아가 12.4% 그리고 5아가 0.2%로 나타났다. 2. 주당 런너발생수는 1아에서 7.33개, 2아에서 14.67개, 3아에서 20.00개, 4아에서 24개가 발생되었으며, 분지당 런너발생수는 6.0∼7.3개였다. 3. 런너당 자묘발생수는 1.4∼3.0주 였다. 4. 묘의 차수별 중량은 1차 자묘가 5.23g, 2차 자묘가 4.52g, 3차 자묘가 2.85g, 4차 자묘가 1.37g으로 나타났다. 5. 삽목시 발근에 소요되는 일수는 10∼14일이었다. This study aims at obtaining basic data on aerial raising of strawberry seedling, 'AKIHIME', The results of study are as follows: 1. The ratio of ramification from stock plant was 6.3% in the first shoot, 36.8% in the second, 44.3% in the third, 12.4% in the fourth and 0.2% in the fifth, respectively. 2. The number of runners per plant was 7.33 in the first shoot, 14.67 in the second, 20.00 in the third and 24.00 in the fourth, and the number of runners per branch was 6.0˚≠7.3. 3. The number of daughter seedlings per runner was 1.4˚≠3.0. 4. The fresh weight at each stage of seedling was 5.23 at the first daughter seedling stage, 4.52g at the second, 2.85g at the third, and 1.37g at the fourth. 5. 10-14 days were required for rooting after seedlings had been cut.