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.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

비대칭 경로를 지원하는 개선된 DSR 라우팅에 관한 연구

이광배,김현욱,곽승욱,박용정 명지대학교 산업기술연구소 2001 産業技術硏究所論文集 Vol.20 No.-

This paper introduces a dynamic source routing protocol supporting asymmetric routes on mobile ad hoc network. For performance evaluation, average route discovery time, average data transfer time, average route recovery time and data reception rate were considered with several scenarios relating to connection pattern, moving scenario, usage of secondary route chche in intermediate nodes and periodic hello message interval. As the results, we found that the data reception rate increased as the node mobility went down and the number of maximum connections between nodes was reduced. In the case that secondary route cache was used in the intermediate nodes, the average data transfer time was decreased because the possibility of route discovery to destination node was increased. In addition, it was found that the hello message interval at 0.1 to 1 second was fairly good.

양방향 링크를 갖는 개선된 DSR Ad Hoc 라우팅에 관한 연구

김현욱,이광배,김정일,최동근 명지대학교 산업기술연구소 2001 産業技術硏究所論文集 Vol.20 No.-

In this paper, we enhanced the existing DSR routing protocol for ad hoc networks with bidirectional link. In mobile ad hoc network, mobile nodes themselves have router capability. Thus, for communication between two mobile nodes, the routing protocol for route set-up is required. DSR routing protocol, which is one of famous mobile ad hoc routing protocols, has the following problem: when route error occurs, the sending data packets drop as route recovery is delayed. In order to alleviate such problem, we modified route maintenance process of the existing DSR protocol so that the route recovery time from route error was shortened. As the result of performance evaluation, it was found the route recovery time of the proposed routing protocol was about 12 times faster than that of the existing DSR protocol. In addition, the data reception rate was more than 90 % for mobile ad hoc networks with slow mobility.

클로자핀이 치료 저항 정신분열병 환자의 삶의 질에 미치는 영향

서경란,이강욱,이소희 국립서울정신병원 2000 臨床硏究論文集 Vol.2000 No.-

지연성 운동장애와 양성, 음성 정신분열병 환자에서의 인지기능 장애

유범희,김지혜,배주미,이강욱,우종민,김승태 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

저자들은 정신분열병 환자에서 양성, 음성 증후군에 따라 각각 특징적으로 어떤 인지기능의 장애를 보이는지 알아보며, 또 지연성 운동장애의 존재 여부가 인지기능에 어떤 영향을 미치는지 조사해보고자 지연성 운동장애 환자 31명과 대조군 32명에게 PANSS 검사를 시행하였고, 인지기능 검사로는 KWIS 검사와 Grooved Pegboard test, Trail making test A/B, Wisconsin card sorting test, Wecshler memory scale을 시행하였다. 그 결과 다음과 같은 성적을 얻었다. 1) KWIS 지능검사상 이해 소검사에서 양성 증후군 환자들이 음성 증후군에 비해 우수한 수행도를 보였으며 빠진 곳 찾기 소검사에서는 지연성 운동장애가 없는 집단이 있는 집단에 비해 우수한 수행도를 보였다. 2) Trail making test A형에서 양성 정신분열병 환자 집단이 음성 정신분열병 환자 집단에 비해 전반적으로 빠르고 효율적인 수행을 보였다. 3) 그밖의 다른 인지기능 검사상에서는 양성, 음성 정신분열병과 지연성 운동장애 유무에 따른 검사 결과의 차이는 보이지 않았다. 결론적으로 음성 증후군 환자들의 경우 양성 증후군에 환자들에 비해 실행 기능과 같은 전두엽 기능의 장애와 기억 능력의 저하가 좀더 분명하게 나타나 음성 증상과 인지기능 장애 사이에 통계적으로 의미있는 상관관계가 있는 것으로 나타났다. 반면 지연성 운동장애의 경우는 음성 증후군과 함께 나타날 때만 현실 검증력, 주의력의 저하가 두드러져서 지연성 운동장애 자체만으로 인지기능의 장애가 유발된다고 보기는 어려웠다. Objective : The goal of this study was to examine cognitive dysfunctions in positive and negative schizophrenic patients and investigate the effect of tardive dyskinesia on cognitive dysfunctions in them. Methods : Thirty two schizophrenic patients with tardive dyskinesia and thirty two schizophrenic patients without tardive dyskinesia as a control group were selected from psychiatric inpatients at a lunatic asylum and the cognitive dysfunctions of these patients were assessed with some neuropsychological tests including KWIS test, Grooved Pegboard test, Trail making test A and B, Wisconsin card sorting test, and Wechsler memory scale test. From these patients, we classified eighteen schizophrenic patients as a positive syndrome group and twenty five patients as a negative syndrome group with positive and negative syndrome scale and compared the results of neuropsychological tests between these two groups. Results : Patients without tardive dyskinesia showed better performances than those with tardive dyskinesia on picture completion subtest of KWIS. Positive schizophrenic patients showed better performances than negative schizophrenic patients on comprehension subtest of KWIS and trail making test A. Conclusion : Negative schizophrenic patients showed frontal lobe dysfunction and more memory impairment than positive schizophrenic patients. In conclusion, negative syndrome of schizophrenia is significantly associated with cognitive dysfunctions although tardive dyskinesia is not.

Artificial Neural Network Discrimination of Multi-PD Sources Detected by UHF Sensor

Kang-Won Lee,Dong-Uk Jang,Jae-Yeol Park,Seong-Hwa Kang,Kee-Joe Lim 대한전기학회 2003 KIEE International Transactions on Electrophysics Vol.3C No.1

The Effect of Choline Acetyltransferase Genotype on Donepezil Treatment Response in Patients with Alzheimer’s Disease

Lee, Kang Uk,Lee, Jung Hie,Lee, Dong Young,Youn, Jong Chul,Kim, Jeong Lan,Moon, Seok Woo,Kim, Bong-Jo,Ryu, Seung-Ho,Kim, Moon Doo,Lee, Chang-Uk,Lee, Nam-Jin,Chang, Sung Man,Kim, Young Hoon,Kim, Do Hoo Korean College of Neuropsychopharmacology 2015 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.13 No.2

<P><B>Objective</B></P><P>We examined the difference in responses to donepezil between carriers and non-carriers of the A allele at the +4 position of the choline acetyltransferase (ChAT) gene in Koreans.</P><P><B>Methods</B></P><P>Patients who met the criteria for probable Alzheimer’s disease (AD) (n=199) were recruited. Among these, 145 completed the 12-week follow-up evaluation and 135 completed the 26-week scheduled course. Differences and changes in the Korean version of the mini-mental state examination (MMSE-KC) score, Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Assessment Battery (CERAD-K[N]) wordlist subtest score (WSS), CERAD-K(N) total score (TS), and the Korean version of geriatric depression scale (GDS-K) score between baseline and 12 weeks or 26 weeks were assessed by the Student’s <I>t</I>-test.</P><P><B>Results</B></P><P>At 12 weeks, the changes in the MMSE-KC score, CERAD-K(N) WSS, and CERAD-K(N) TS from baseline were not significant between ChAT A allele carriers and non-carriers; however, at 26 weeks, these changes were significantly larger in ChAT A allele carriers than in non-carriers (<I>p</I>=0.02 for MMSE-KC and <I>p</I>=0.03 for CERAD-K(N) WSS respectively).</P><P><B>Conclusion</B></P><P>Our findings in this study suggested that presence of the A allele at the +4 position of ChAT might positively influence the treatment effect of donepezil in the early stages of AD in Koreans.</P>

cDNA Cloning and Developmental Expression of Hemolin in Bombyx mandarina

Kang Min Uk,Kim Kyung-A,Lee Jin Sung,Kim Nam Soon,Kang Seok-Woo,Nho Si-kab Korean Society of Sericultural Science 2005 International Journal of Industrial Entomology Vol.10 No.2

In this study, we describe the Bombyx mandarina hemolin cDNA. A sequence analysis of cDNA revealed a single open reading frame (ORF) of 1233 nucleotides. The deduced 410 amino acid sequence of B. mandarina hemolin contains 4 imunoglobulin (Ig) C-2 type domains. B. mandarina hemolin cDNA showed the highest sequence homology to known those of B. mori. The developmental profile in terms of expression level of hemolin mRNA was determined in the absence of a bacterial challenge. Hemolin mRNA was detected only in mid-gut, but not in hemocytes, fat body, testis, and silkglands. Hemolin mRNA in mid-gut was not detected until the spinning stage of the last instar larva, however, lit dramatically increased at the beginning of spinning and gradually decreased until pupal stage.

Gastrointestinal stromal tumors in patient with neurofibromatosis type 1: Associated with NF-1 Gene mutation

( Kang Kook Lee ),( Jung Min Lee ),( Sun Kyung Park ),( Jin Young Kim ),( Keon Uk Park ),( Young Rok Do ),( Ki Young Kwon ),( Hong Suk Song ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.-