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.

Gene pyramiding effect of two major bakanae disease resistance gene using qBK1 and qBKWD

Sais-Beul Lee,Tae-Heon Kim,Su-Min Jo,Jun-Hyun Cho,Ji-Yoon Lee,Jong-Hee Lee2,Dongjin Shin,You-Chun Song,Myung-Kyu Oh,Dong-Soo Park 한국작물학회 2017 한국작물학회 학술발표대회 논문집 Vol.2017 No.-

돼지고기連動價格 制度의 施行效果와 改善方案에 관한 硏究

李季憲 건국대학교 1988 論文集 Vol.27 No.2

The consumer's price of pork in korea is administrated according to the shifting price table by the provincial government. The shifting price table is settled by the shifting price council under the governor of the provincial government. The pork shifting price table presents the pork consumer's price level corresponding to the level of pig producing district or wholesale carcass price. When either of the producing district price or whole - sale carcass price is deviated 3 % range of the current price for ten days, the governor is to settle again according to the shifting price table and officially noticed the newly settled price. Such price system has the purpose to plan the demand - supply stabilization of pork and to protect both the producers and consumers from the unstable of the pork price. But in actuality, many a person concerned raises an objection to the system : some consumers and producers are dissatisfied at the fact that some butchers do not observe the officially noticed price, so they cannot expect the effect of the demand - supply stabilization. Some butchers complain that governors would not adjust promptly, so they suffer a loss when wholesale carcass price or producing district price rises. Therefore, this study compared the standard deviations and the average differences between producing district price fluctuation in period of 1983-1984 to those of 1986-1987 in order to prove the true state of the contention of the persons concerned. The reason of division of period compared is that the pork shifting price system is put into operating actively in 1985 and this study is to compared the effect of the periods before and after 1985. The result of comparison is as follow : In areas of Seoul, Pusan, Daegu, Incheon, standard deviation of 1986-1987 is 149 and it is decreased in 25 as compared with 174 of 1983-1984. And the average price in period of 1986-1987 is 59 won, which is higher than the noticed price. In areas of Taejeon, Kwangju, Cheonju, Cuncheon, Chungju, standard deviation of 1986-1987 is 92 and it is decreased in 60 as compared with 152 of 1983-1984, And the average price difference between noticed price and consumer's price in period of 1986-1987 is 5 won, which is higher than the noticed price. Such results suggest that pork shift price leads the consumer's price to fluctuate according to the fluctuation of producing district price or wholesale carcass price and that consumer's price is higher than the officially noticed price. So we can see that the contention of persons concerned is not necessarily true.

자살 시도의 심각도와 혈청 지질농도의 관련성

이헌정,최낙경,김린,이민수,김용구 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 낮은 혈청 콜레스트롤 농도와 자살과 같은 폭력적 행동에 관한 관련성에 관한 논란이 있어왔다. 본 연구는 자살 시도 후 응급실로 내원한 환자에서 혈청 총 콜레스테롤 농도만이 아닌 전반적인 혈청 지질 농도의 저하 여부를 조사하였으며, 자살 시도 상황을 평가하는 객관적 척도를 통하여 자살 시도 상황에서 자살 시도의 심각도와 혈청 지질 농도의 관계에 대하여 연구하였다. 방 법 : 1998년 7월부터 1999년 6월 사이에 자살 시도후 고려대학교 의료원 응급실로 내원한 50명의 자살 시도자를 연구대상으로 하였다. 이들은 정신과 의사의 면담을 통하여 정신과적 진단을 받았으며 동시에 위험-구조척도(RRR). HDRS, BPRS 등이 평가되었다. 또한 동 기간에 본원 정신과에서 입원 치료를 받은 자살 시도가 없었던 환자중, 대상군과 나이, 성별, 진단을 맞추어서 50명의 환자를 선정하여 정신과 환자 대조군으로 하였다. 자살 시도군과 대조군의 혈청 지질농도가 t-test를 통하여 비교되었으며, RRR점수와 혈청 지질 농도, HDRS,BPRS와의 사이의 연관성 Spearman순위 상관계수로 분석되었다. 결 과 : 자살 시도자중 주요우울증이 29명, 정신분열병이 2명, 인격장애가 19명이었으며, 자살 시도군의 혈청 총 콜레스트롤 농도(t=---3.29, p=.001). 총 지질 농도(t=-2.62, p=.01), LDL농도(t=-2.64, p=.011)가 대조군보다 유의하게 낮았다. 진단별로는 주요우울증에서는 총 콜레스트롤 농도, 총 지질 농도, LDL 농도가 대조군에 비하여 낮았으나, 인격장애에서는 혈청 콜레스트롤 농돤이 대조군보다 낮았다. 자살 시도군에서 RRR 점수는 혈청 콜레스테롤 농도와 부적 상관관계를 보였으나 (γ=.-293,p=.039), BPRS(γ=.544, p<.001)와 HDRS(γ=.488, p=.001)와는 정적 상관관계를 보였다. 결 론 : 자살 시도군에서 혈청 지질 농도 중 총 콜레스테롤, 총 지질, LDL농도가 유의하게 저하되어있음을 확인하였다. 또한 자살의 심각도를 평가한 RRR 정수가 혈청 총 콜레스테롤 농도와 유의하게 상관성이 있음이 확인되었다. 이는 낮은 혈청 총 콜레스테롤 농도가 심각한 자살 시도와 연관이 있음을 보여주는 것이다. Objectives : Many studies have demonstrated that suicide is related to low serum cholesterol level, whereas conflicting results have also reported. The aims of the present study are to determine whether suicidal attempters have low lipid concentration and to identify the relationship between suicidal attempt severity and serum lipid levels. Methods: Subjects were 50 suicidal attempters who visited the emergency room in Korea University Medical Center between July 1998 and June 1999. All subjects had been interviewed by psychiatrist and evaluated with Risk-rescue rating, HDRS and BPRS. They were diagnosed as major depressive disorder(n=29), personality disorder(n=19), and schizophrenia(n-=2). Serum lipid levels in 50 suicidal attempters were compared with those in 50 nonsuicidal psychiatric inpatients corresponding to the age, sex and diagnosis of the suicidal attempters. We also examined the Spearman's rank correlations between serum lipid levels and risk-rescue score. Results : The serum total cholesterol level(t=-3.29, p=.001), total lipid level(t=-2.62, p=.01), and LDL level(t=-2.64, p=.011) in suicidal attempters were significantly lower compared with nonsuicidal controls. In major depressive patients, total cholesterol level, total lipid level, and LDL level in suicidal attempters were significantly lower than those of nonsuicidal controls. In personality disorder patients, however, only serum total cholesterol level was significantly lower. Risk-rescue rating score was negatively correlated with serum total cholesterol level(p=.-293, p=.039), and positively correlated with BPRS(p=.544, p<.001), and HDRS(p=.488, p=.001). Conclusion : The lipid levels in suicidal attempter were significantly lower. Suicidal attempt severity was also significantly correlated with serum total cholesterol level. These findings suggest that low serum cholesterol should be related with severs violent suicidal attempt.

중심압축력을 받는 高强度 RC기둥의 띠철근 配筋形態에 關한 實驗的 硏究

이영인,이영호,곽노현,정헌수 중앙대학교 기술과학연구소 1998 기술과학연구소 논문집 Vol.28 No.-

An objective of this study is to experimentally investigate the strength and ductility of reinforced concrete columns under uniaxial load and several test variables. To do this, we have conducted tests on twelve 20×20×60cm specimens with 8 and 12 longitudinal steel bars subjected to monotonic uniaxial compression. The main variables considered in this test are the configuration of ties, the strength of concrete, and the space of ties. The results indicate that the strength and the ductility of reinforced concrete columns have been influenced on the configuration of ties, the space of ties, and the strength of concrete.

남제주 화력발전소의 증설과 저감대대책의 영향 분석

이화운,김유근,정우식,오은주,임헌호,노순아,반수진,최현정,김민선,김헌숙 부산대학교 환경문제연구소 2002 環境硏究報 Vol.20 No.-

In the view of the results investigated the effect of air pollutants that is emitted from a new generator facilities, the total estimated concentration which is the summation of a contributional concentration and observational concentration is much less than that of atmospheric environment criterion for the air pollutants. So we can predict that the operation of the new generator facilities with mitigation equipment don't seriously affect around environment. At the same time, we compared the contributional concentration of before mitigation equipment with that of after it to examine the decreasing amount due to mitigation equipment. The result showed that the concentration of SO2, NO2 and PM-10 is reduced to 25%, 30% and 26% of original value, respectively.

한국인에서 도파민 D4 수용체 다형성과 Novelty Seeking 성격 특성의 연관성

이헌정,이홍석,강화연,김린,이민수,서광윤,변영찬 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.4

연구목적 : 저자들은 한국인에서 도파민 D4 수용체(DRD4) 유전자의 다형성과 성격의 관련성을 알아보고자 본 연구를 시행하였다. 방 법 : 173명의 건강한 한국인 여자 청소년(13.88±0.29세)을 대상으로 하여 성격 기질 설문지(Temperament and Character Inventory : TCI)를 작성하도록 하였으며, 이들에서 DRD4 exon Ⅲ 48-bp VNTR(variable numbers of tandem repeats) 다형성을 분석하였다. 결 과 : DRD4 exon Ⅲ Vntr에서 긴 대립유전자(≥5 repeats)를 가진 군이 긴 대립유전자를 가지지 않은군에 비하여 Novelty Seeking 척도 점수가 유의하게 높았다(t=2.11,p=0.037). 결 론 : 본 연구 결과는 DRD4-exon Ⅲ의 긴 대립유전자가 Novelty Seeking 성격과 관련이 있다는 기존의 외국에서의 연구결과를 다시금 확인해주는 것이다. Objectives : We investigated the relationship of personality traits with dopamine D4 receptor(DRD4) exon Ⅲ polymorphism in a Korean population. Methods : We analysed DRD4 exon Ⅲ 48-bp repeats polymorphism in 173 Korean heakthy female adolescents(age=13.88±0.29years) who also completed Temperament and Charater Inventory(TCI). Results : Novelty seeking score of the TCI was significantly higher in the subjects with DRD4 long alleles(≥5 repeats) compares with the subjects without these (t=2.11, p=0.037). Conclusion : The present study supports the previous reports that long repeats of the DRD4-exon Ⅲ polymorphism are relatedwith Novelty Seeking personality.

靈樞·五邪에 對한 硏究

李載胎,鄭憲瑩,琴坰樹,朴炅 대한한의진단학회 1998 大韓韓醫診斷學會誌 Vol.2 No.2

Young Chou O Sa(靈樞 五邪) described the symptoms of a disease when injurious factors permeated the five viscera and the location of a meridian point and the acupuncture in curing them according to the five viscera. When there are injurious factors within the lungs, you ought to acupuncture Woon Moon Hul(雲門穴), Joong Bu Hul(中府혈穴), Pae Soo HuI(肺輸穴 B13), and Geol Boon Hul(缺盆穴 S12), when there are injurious factors within the liver, acupuncture Hang Gan HuI(行間穴 LIV2) and Jok Sam Ri HuI(尺三里穴 S36), within the spleen, do acupuncture Yong Chul HuI(湧泉穴 K1) and Gon Ryun HuI(崑崙穴 B60), and when there are injurious factors within the heart, do so in the place of Shin Moon Hul(神門穴 H7).

월경주기 증상의 요인 분석

이수일,유태혁,강종선,안석철,이병욱,김헌,석재호 大韓神經精神醫學會 1986 신경정신의학 Vol.25 No.1

404 nurses and nurse-aids rated their experiences of 45 symptoms(Moos' Menstrual Distress Questionnaire) of the menstrual, premenstrual and intermenstrual phase on a 4 point scale separately. The 45 symptoms were inter-related and factor analyzed separately for each phase. six common clusters of symptoms emerged from 3 phases, which were labeled concentration, motor tension, pain, pleasurable affect, autonomic reactions and water retention. Four clusters of symptoms emerged from premenstrual phase. These clusters were labeled instabillity, withdrwal reactions, depression and headache. The factor named unpleasurable affect emerged from intermenstrual and menstrual phase. Above findings were differed from the results of Moos' study in which eight basically replicated clusters of symptoms emerged from three phases. Through discussion of validity of this scale, and differences between results of Moos' and this study, we came to the conclusion that sampling of subjects, prospective longitudinal symptoms reporting, amount of variance in a symptom over the course of menstrual cycle and proper choice of factor analysis method would be salient variables to construct valid scale for measuring menstrual cycle symptoms.

혐기성여상 반응조에서 여재 충진량이 미생물 유실에 미치는 영향

이헌모,노종수 동의공업대학 2000 論文集 Vol.26 No.1

Sludge retention tests were conducted to crossflow filter media in an-hybrid reactors. Sections of this crossflow filter media were cut to fit a laboratory scale reactor. Five an-hybrid reactors with media volume to reactor volume of 0, 20, 40. 60 and 80% were run under various air flow and hydraulic retention time to estimate sludge retention. The result shows that the concentration of microorganism in effluent was generally higher in the reactor having lower media volume. And 40% media volume of total reactor volume in an-hybrid reactor was evaluated to be sufficient to prevent the wash-out of biological solids and thus to reduce start-up period of the an-hybrid reactor.