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.

日本地域의 韓國學 및 數學의 硏究動向

柳基龍,李基東,李仁錫,李尙憲 慶北大學校 東洋文化硏究所 1982 東洋文化硏究 Vol.9 No.-

보드 레벨 플립칩의 4점 굽힘 시험 시 파단 특성 연구

이용성,정종설,이재헌,신기훈,정성균 한국공작기계학회 2008 한국공작기계학회 춘계학술대회논문집 Vol.2008 No.-

In general, circuit board assemblies experience various mechanical loadings during assembly and in actual use. The repeated cyclic bending can cause electrical failures due to circuit board cracks, solder interconnects cracks, and the component cracks. In this paper, we report on the failure characteristics of board level flip chips under the repeated cyclic bending. We first describe a new 4-point bending tester, which is developed according to JEDEC standard No.. 22B113. The performance of the tester is then estimated through actual experiments . Test results reveal that the cracks first occur on the outer balls around 20,000 cycles and gradually propagate to the inner balls where cracks are found around 70,000 cycles.

전기도금한 교정용 스테인레스스틸 선재의 세포독성에 관한 연구

이계형,조진형,이기헌,황현식 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.2

본 연구는 전기도금을 이용하여 교정용 스테인레스스틸 선재의 직경을 증가시킨 후 세포독성을 알아봄으로써 이의 임상적 적용 가능성을 알아보고자 시행되었다. 시판되고있는 교정용 스테인레스스틸 선재에 전기도금 방법을 이용하여 니켈을 도금한 후, 이를 도금하지 않은 교정용 스테인레스스틸 선재 그리고 티타늄 또는 구리와 비교하기 위하여 이들을 배지에 넣고 72시간 배양하였다. 이 배양액을 금속 유리량 측정을 위해 ICP-AES(inductively coupled plasma atomic emission spectrophotometer) 분석을 시행한 결과 전기도금한 선재에서 많은 양의 니켈 이온이 유리되었으며, 구리에서는 많은 양의 구리 이온이 유리되었다. Microplate에 Balb/c 3T3 mouse fibroblast를 넣고 각 선재를 배양한 배양액을 75%, 50%, 25%로희석시켜 첨가한 후 MTT (3-[4.5-dimethylthiazol-2yl]-2.5-diphenyl tetrazolium bromide)분석을 시행하여 이를 배지만을 첨가한 경우와 흡광도를 비교하였다. 티타늄은 모든 농도에서 배지만을 첨가한 경우에 비해 흡광도 차이를 보이지 않았지만전기도금한 선재(p<0.001), 스테인레스스틸선재(p<0.05), 구리(p<0.001)는 배지만을 첨가한 경우보다 통계적으로 유의한 흡광도 감소를 보였다. ISO 10993, part5에 따라 구리는 "강한 독성"을 보이는 반면 티타늄과 스테인레스스틸 선재는 "무독성", 그리고 전기도금 선재는 "중등도 독성"으로 나타났다. 이상의 결과는 전기도금을 이용하여 교정용 선재의 직경을 증가시키는 방법이 임상에 적용되기 위해서는 세포독성을 줄이기 위한 추가의 연구가 필요함을 시사하였다. The purpose of this study was to examine the cytotoxicity of orthodontic wire which had an increased diameter through electroplating, and to evaluate its possoble clinical applications. First nickel plating was carried out on the commercially available stainless steel wire using an electroplating technique. For the comparison of the electroplated wire with ready made stainless steelwire and titanium or copper, each wire was incybated for 72 hours in a medium. The release of the metal ion was measured using ICP-AES(Inductively Coupled Plasma Atomic Emission Spectrophotometer). Balb/c 3T3 mouse fibroblast was put on a microplate and placed in an incubated medium of 75%, 50%, and 20% dilation. An MTT analysis was used to compare with the medium only. The changein absorbency value of each wire group and the difference of absorbency value according to the change of dilution was measured. The results of ICP-AES analysis showed that great amount nickel ion was isolated from electrpolated orthodontic wires and great amount copper ion was isolated from copper.The results of the MTT analysis showed that there was no difference in the absorbency value of titanium at any dilution. However the electroplated wires(p<0.001), the stainless steel wires(p<0.05) and the copper(p<0.001) were statistically significantly lower than those of medium only at all dilutions. Assessment as per ISO 10993, part5, showed that electroplated wire was alloted to "moderate cytotoxic", the titanium and stainless steel wire were "non-cytotoxic". The results of this study indicate that the electroplated or thodontic wires need additional efforts to dectease cytotoxicity for their clinical applications.

소화불량을 호소하는 만성위염 환자에서 Guaiazulene과 Dimethicone 복합제제 투여의 임상적 효과

이기천,정현용,이헌영,김영건 최신의학사 1993 最新醫學 Vol.36 No.9

운동 후 스포츠마사지가 혈중젖산 농도에 미치는 영향

이철원,박기헌,이희창 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.3

The Purpose of this study is to investigate the effect of sports massage on the Hood lactate concentration during the post-exercise recovery phase, Fifteen male university students were selected as subjects, Each subjects was grouped into three groups(rest recovery group, an exercise recovery group and a sports massage group) using systematic random sampling, ALL of the subjects who participated in this study were healthy and diagnosed that they were not suffering from any internal diseases. Work rate was loaded to all-out condition during thirty second by (body weight multiple 0.05)Kp load using a bicycle ergometer. Mood was sampled on the capillary blood-vessel of the finger tip at the pre-exercise stage and at 3, 5, 10 and 20 minutes after exercise, the Blood lactate concentration was analyzed by YSI, 1500, USA belonging to the Physical Education department laboratory, The main results of this study were as followings: First, At 20 minutes. in the post-exercise recovery phase, the Blood lactate concentration of RR group was 6.48±0.36(mmd/(L), ER group was 5.62±0.37(mmd/L), and that of the SM group was 5.71±0.62(mmd/L). the Blood lactate concentration removed more rapidly with exercise recovery and sports massage than with rest recovery(p<.05). Second, The recovery time of blood lactate concentration was significantly different from 3 minutes to 20 minutes during the post- exercise recovery phase(p<.05).

제Ⅲ급 부정교합자의 안정위시와 /s/발음시 혀의 위치에 관한 두부방사선계측학적 연구

이기헌,김종철 전남대학교 치과대학 1992 전남치대논문집 Vol.4 No.1

Tongue posture at rest position of Class Ⅲ malocclusion is very important in malocclusion and phonation. Because Class Ⅲ malocclusion showes low tongue position, speech defect is commonly occured. This study was attempted to evaluate the correlationship between the tongue posture at rest position and during /s/ phonation and facial skeleton in centric occlusion. Thirty subjects with Class Ⅲ malocclusion who had no orofacial defects such as cleft palate, medical history of neurologic pathology, hearing defect and any previous speech therapy were selected. Ninety sheets of lateral cephalometric radiographs taken at rest position, during /s/ phonation and centric occlusion were traced, measured and statistically analysed. The results obtained were as follows : 1. In Class Ⅲ malocclusion, the posture of tongue was positively correlated with the position of hyoid body. The hyoid body was positioned anteriorly and inferiorly as the vertical facial skeleton was increased in centric occlusion. 2. In Class Ⅲ malocclusion, the vertical position of tongue tip at rest position was not correlated with facial skeleton in centric occlusion, but the horizontal position had low correlation with mandibular body length, APDI, and ?? to SN. 3. In Class Ⅲ malocclusion, there was the tendency that the dorsal position of the tongue was lowered as the vertical facial skeleton was increased. 4. In Class Ⅲ malocclusion, the vertical and horizontal position of tongue tip during /s/ phonation was not correlated with facial skeleton in centric occlusion.

B형 만성 활동성 간염 환자에서 Prednisolone 단기이탈 및 Alpha Interferon 병합요법의 효과

이종선,김병호,성자원,허승식,이기천,정현용,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

To evaluate the safety and efficacy of Pd withdrawal followed by recombinant alpha- Interferon 2b therapy. Nine patients were given a single daily subcutaneous injection of ^α-Interferon at a dose of 3 x 10 exp(6) units/day for first weeks and thrice weekly for next 15 weeks (maintenance) after pd tappered over 6 weeks. To evaluate the efficacy of therapy, we measured serum aminotransferase activities monthly during and after therapy, and also measured serm HBsAg, HBeAg and DNA probe before and after therapy. To evaluate the safety of therapy, all patients checked peripheral blood WBC, Hemoglobin, Platelet, BUN and Creatinine. The results were as follows : 1. In control group, the normalization of s-AST & ALT level, negative seroconversion of DNA probe & HBeAg were observed in 1/12(8%) & 7/10(17%), 0/10(0%) & 0/12(0%) at 6 months later, and maintained response in 1/11(9%) & 1/11(9%), 2/9(22%) & 2/11(18%) until 1 years later. 2. In treatment group, Serum AST and ALT returned to normal in 8/9 & 8/9 cases (89%) after 1 montns Tx. (mean serum AST : 33±8, ALT : 34±12 IU/ml) and maintained to normal response in 5/9(56%) & 6/9 cases(67%)after 6 months Tx. (mean s-AST : 55±43, ALT : 66±84 IU/ml), 3/9(33%) & 4/9 cases(44%) after 1 years Tx. It was statistically significant reponse except s-AST of after 1 years Tx. 3. In treatment group, s- HBeAg returned to normal in 3/9 cases(33%) after 1 months Tx., and maintained to normal response in 1/7 & 1/4 cases among follow up patients in after 6 & 12 months Tx. Serm DNA probe level were observed significantly negative seroconversion in 8/9 cases(89%) after 1 months Tx. (p<0.003), and maintained to negative response in 2/6 & 1/3 cases after 6 & 12 months Tx. 4. Serum AST, ALT, HBeAg and DNA probe were not significantly correlated with therapeutic response in relation to histologic diagnosis. 5. Fever and myalgia were noted in 9(100%) & 6(67%) cases. Headache, mild hair loss, anorexia, nausea, facial flushing & diarrhea were noted in few cases. Peripheral WBC(3cases) & platelet counts(3cases) were decreased transiently. This study shows that Pd withdrawal followed by recombinant alpha Interferon 2b therapy may be safe and effective in decrease the level of s-DNA probe, transaminase activity, loss of HBeAg and less adverse effect of clinical and hematologic examinations in patients with CAH type B. But it was necessary for study with large number of patients, more prolonged follow up duration and more strict control study.

위암 환자에게 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김상용,김영건 忠南大學校 癌共同硏究所 1991 癌共同硏究所 硏究誌 Vol.1991 No.-

백서 두개관세포에서 Ipriflavone이 골조직 개조에 미치는 영향

이용승,김영준,이기헌,황현식 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.4

본 연구는 ipriflavone (isopropoxyisoflavone)의 투여가 백서 두개관세포의 증식과 골조직 개조에 미치는 영향을 알아보고자 시도되었다. 태령 20-21일째의 백서 두개관세포를 분리 배양한 후, 10^(-9) M부터 10^(-5) M까지 농도의 ipriflavone을 투여하고 1일째와 3일째에 MTT 분석을 시행하여 흡광도를 평가한 결과, 모든 농도에서 백서 두개관세포의 증식을 보이지 않았다. 한편 골조직 개조에 미치는 영향을 알아보기 위하여 14일째에 alizarin red염색을 시행하여, 형성된 석회화 결절 면적을 측정하였을 때, 10^(-8) M, 10^(-7) M, 10^(-6) M 농도를 투여한 경우 석회화 결절 형성이 유의하게 증가하였다. 골아세포의 분화에 미치는 영향을 알아보기 위하여 ipriflavone을 투여하고 7일째와 14일째에 추출한 RNA를 역전사 중합효소 연쇄반응(RT-PCR)을 시켜 bone sialoprotein (BSP), type 1 collagen (COL I), osteocalcin (OCN) 유전자 발현을 관찰한 결과 BSP와 COL I 유전자는 배양 7일째 높은 발현을 보였고, OCN 유전자는 배양 14일째 높은 발현을 보였다. 이상의 연구결과 ipriflavone이 백서 두개관세포에서 석회화를 촉진시키고 골아세포의 분화에 관여하는 BSP, COL I 및 OCN 유전자 발현을 증가시켜 골조직의 개조를 빠르게 할 수 있음을 시사하였다. lpriflavone (isoprofoxyisoflavone), a synthetic derivative from soy isoflavone diazein, has been shown to inhibit bone resorption and perhaps stimulate bone formation. This study was performed to examine the effects of ipriflavone on the proliferation and bone remodeling in rat calvarial cells in vitro. The rat calvarial cells were isolated from fetus aged 20 to 21 days and cultured in BGJb media. The graded concentration of ipriflavone (10^(-9)-10^(-5) M) was administered into cultured cells. When the cell proliferation was estimated through the measurement of MTT assay, there was no increase in cellular proliferation of the rat calvarial cell at any ipriflavone concentration. The cellular activity was evaluated through the formation of mineralized nodules stained by alizarin red. The formation of mineralized nodules significantly increased at concentrations of 10^(-8) M, 10^(-7) M and 10^(-6) M ipriflavone. Reverse transcription-polymerase chain reaction analyses (RT-PCR) were done at 7 and 14 days after culture to detect the expression of Bone Sialoprotein (BSP), Type I collagen (COL I) and Osteocalcin (OCN). As a result, the expressions of BSP and COL I increased of the 7th day of culture and the expression of OCN increased on the 14th day of culture. These results indicate that ipriflavone facilitates the bone remodeling process by promoting rat calvarial cell differentiation and stimulating mineralization through increased expression of extracellular matrix genes, such as BSP, COL I and OCN.