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        부신피질 자극호르몬 단독결핍 1례

        박경식,이승현,최석영,박태규,이동화,이찬우,정성복,이인규 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.3

        부신피질 자극호르몬 단독결핍은 국내에서 7례만이 보고된 희귀 질환이며 병인 및 경과 등 아직 불분명한 측면이 많다. 이는 질환지체의 희귀성도 있지만 치료후 자연경과에 대한 장기적인 추적검사가 이루어진 경우가 드물기 때문이기도 하다. 저자들은 비특이적인 전신증상을 주소로 내원한 폐경기후의 56세 여자 환자에서 자가면역질환의 증거없이 고프로릭틴혈증을 보인 부신피질 자극호르몬 단독결핍 1례를 경험하고 1년간의 부신피질호르몬 대치요법후 추적검사를 실시하였기에 문헌 고찰과 함께 보고하는 바이다. Isolated ACTH deficiency is a rare disorder which shows secondary adrenal insufficiency with normal states of other pituitary hormones. A 56-year-old postmenopausal woman complaining general weakness and intermittent mental confusion presented negligible serum cortisol and ACTH level with hyperprolactinemia and mild hyponatremia. Rapid ACTH stimulation test did not show significant increase of serum cortisol level. Combined pituitary stimulation test showed negligible response of cortisol and ACTH, and slightly decreased response of prolactin and gonadotropin. But the responses of TSH and GH were normal. There was no evidence of organic pituitary of hypothalamic lesion in brain MRI and antithyroid autoantibody was not detected in serum. After receiving 12 months of glucocorticoid replacement therapy, she skipped the medicine for 3 weeks and we performed follow-up endocrinologic tests. Serum ACTH and cortisol level was also negligible and prolonged ACTH simulation test showed normal response of serum cortisol. CRF stimulation test showed no response of serum ACTH. Basal prolactin level was decreased to near normal and combined pituitary stimulation test showed normal response of prolactin with slightly blunted response of TSH and GH. We concluded that the case was nonautoimmune origined isolated ACTH deficiency which was accompanied by hyperprolactinemia and resultant deficiency of gonadotropin, so we report this case with review of literatures.

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      • 글루코오스의 분해반응에 미치는 금속이온의 영향

        이민규,허목,이송우,송승구 濟州大學校工科大學附屬産業技術硏究所 1991 尖端技術硏究所論文集 Vol.2 No.-

        The objective of this research was to study the chemical kinetics of the decomposition of glucose in the presence of acid catalyst and metal ion. In this experiment, the range of variables investigated was covered temperature from 160℃ to 180℃ and concentration of 4% to 11%(W/V) sulfuric acid and metal sulfate concentrations, ?? to ??g㏖/l. It is shown that glucose disappearance follows a first-order reaction. mechanism and the glucose decomposition reaction is dependent on both the reaction temperature and the catalyst concentration. And the presence of chromic ion accelerates the decomposition reaction of glucose, but presence of ferric and nickel ion rarely influence the reaction.

      • 조선시대 花鳥木版畵 연구

        이승일,장규희 홍익대학교 산업디자인 연구소 2004 미술디자인 논문집 Vol.- No.9

        The woodcut of flowers and birds is a field that has not been almost covered in studies of old prints. This seems related to the lack of modernistic studies on the paintings of flowers and birds (hwajohwa). During the Chosun Period, this painting genre was popular among high officials and commoners as well as in painters' circles. While having received influence from China and its neighboring countries, it is used to create unique painting styles with the change of the times. This suggests that the painting genre has played an important role in the Korean painting history-and so should not be easily ignored. Since there was much influence from Japan during the Japanese colonial period, however, those flowers-and-birds paintings were recognized to belong to a Japanese painting genre even after the restoration of Korea's independence in 1945. That would be why little attention is being paid to the painting genre today. As a result, such recognition has led to the lack of studies regarding the flowers-and-birds paintings, and in turn it has influenced a lack of understanding concerning the importance of those woodcuts, in addition to the reality that there are few remaining woodcuts of flowers and birds. Accordingly, this study is focused on the flowers-and-birds woodcut that has not been almost dealt with in the previous studies on old prints. Its purposes are to promote the understanding about the woodcut confirm its position as an old printing area and provide a new basis for the study of flowers-and-birds paintings. The woodcut of flowers and birds is a form of woodprint which is same as a pure colored style of flowers-and-birds paintings in its expression and includes all pieces of work created using wood-engraving techniques. In this study, the woodcut of flowers and birds is considered as including both of the simple flowers-and-birds paintings printed from woodblock and the ones colored in specific styles on the woodblock prints. This study focuses on the Chosun Period compared to other periods in the number of available pieces of flowers-and-birds woodcut. To examine their characteristics, it categorizes those woodblock prints into flowers-and-birds woodcut for space decoration, book, flowers-and-birds woodcut, writing paper with flowers and birds, envelopes with flowers and birds, and character paintings with flowers and birds according to the purposes for which they were used and into beast woodcut and floral woodcut according to what is the subject matter used with. Mostly, the flowers-and-birds woodcut for space decoration-in other words, produced for the purpose of decorating everyday living spaces-engraves the outlines forming its frame and the patterns of trees, flowers, birds, waves, and rocks infine lines emphasizing their characteristics, texture, and shapes and has a style colored with a brush on the engraving. The book flowers-and-birds woodcut is divided into two main types: One reveals its subject through its used subject matters, and the other focuses on documentary and decorative characteristics. When categorized as wiring paper or an envelope, most pieces of woodcut contain flowers and birds as their main subject matters. In particular, they were created as part of the way to express one's own unique personality, so there were many dilettantes who enjoyed working on them. Since most bear a engraver's signature, it is not difficult to infer when and where they were created and to find out information about their users. Shown in character paintings, flowers and birds are printed from their woodblock patterns engraved in black-colored letters. Their bold contrast of black and white makes a strong visual impression, and the rare overlaps between subject matters gives a weak sense of spatiality, but a strong sense of planarity. In the categorization based on the used subject matters, most of the floral woodcut works discovered have been made for a decorative purpose rather than with an incantatory intention, while a significant number of beast woodcut works with flowers and grass as their main subject matters seem to have come from an incantatory intention, even though they bear a decorative purpose in part. In general, the woodcut of flowers and birds is not a simple woodblock engraving print with a single color, but a piece of work colored and finished with a brush on the print. This way of creation would probably be attempted to avoid having to draw a rough sketch whenever it was produced in large quantities. This serves as a main factor that makes the woodcut distinct from the pure-colored paintings of flowers and birds. The patterns printed from the engraving give the iconographic contour accuracy and definition so that undesired expressions can be minimized. And the woodblock-printed book is planned precisely, but not created temporarily or impromptu, so the overall iconographic composition can maintain balance and stability. Therefore, the finished work could be equipped with refinement and delicacy, although there might be limits in liberal expressions. These are some of critical features shown in the woodcut of flowers and birds, which are why the woodcut works are balanced and stable in their iconographic composition. So far, this study has focused on the flowers-and-birds woodcut, which has been seldom discussed in the existing studies, reviewing its meanings and historical background as well as types and characteristics. Most of difficulties in conducting the study came from the lack of studies on the woodcut and the shortage of its remaining works. If this study leaves something to be desired, the reason is that those difficulties acted as obstacles to a comprehensive and detailed discussion.

      • 목재셀룰로오스의 산촉매 가수분해 반응속도론

        이민규,송승구 제주대학교 1991 논문집 Vol.33 No.-

        목재셀룰로오스의 가수분해에서 세가지 반응속도모델을 검토한 결과, 가수분해 반응은 A(셀룰로오스)→B(글루코오스)→C(분해물질)의 비가역 연속 1차반응으로 근사됨을 보여주었으며, 황산농도 4∼12%, 반응온도 170∼190℃에서 구한 반응속도 상수는 다음과 같았다. 셀룰로오스의 가수분해(A→B): k₁=6.6x10¹??(S)¹??exp(-39,500/RT) 글루코오스의 분해(B→A): k₂=6.4x10¹??(S)¹??¹exp(-30,800/RT) 반응속도식 결과에 의하면 당생성 수율 및 당농도는 반응온도 및 산농도가 증가함에 따라 증가하였으나. 그에 따른 반응시간의 감축으로 공정 취급상의 어려움을 안고 있었다. The experimental analysis of batch hydrolysis of wood cellulose at moderate sulfuric acid concentration showed that the hydorlysis of wood cellulose could be modeled by consecutive irreversible first order reactions. The kinetic parameters were evaluated covering the conditions of 170 to 190℃ and 4.4∼12.2% sulfuric acid. Hydrolysis of cellulose: k₁=6.6X10¹??(S)¹??exp(-39,500/RT) Decomposition of glucose: k₂=6.4X10¹??(S)¹??¹exp(-30,800/RT) Results showed that the sugar yield and concentration would increase with reaction temperature and acid concentration.

      • 이행성 협심증 환자에서 운동부하 심전도 검사

        이정우,박형서,박용규,노상필,이유선,정승현,김보영,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

        목적 : 관상동맥의 경련에 의한 이형성 협심증환자에 있어서 운동부하 심전도 검사의 결과는 매우 다양하다. 이에 저자들은 충남대학교병원 순환기내과에서 관상동맥조영술상 이형성 협심증으로 확진된 환자를 대상으로 운동부하 심전도 검사를 시행하여 이에 대한 결과를 연구하였다. 방법 : 1995년 1월부터 2002년 3월까지 흉통을 주소로 충남대학교병원 순환기 내과에 입원하여 관상동맥조영술을 시행하여 관상동맥의 내경이 50% 미만의 협착이 있고, 에르고노빈(ergonovine) 유발검사도 이형성 협심증으로 진단을 받은 233명중 운동부하 심전도 검사를 시행 받은 183명의 환자를 연구 대상으로 하였다. 운동부하 심전도 검사 결과의 판독시 발생할 수 있는 오류를 줄이기 위해서 운동부하 심전도 검사를 시행하기전 심전도상 ST분절의 상승(5예)이나 하강(8예)이 있는 경우 EH한 T파의 역위(19예)가 있는 32명의 환자를 제외한 총 151명의 환자를 대상으로 하였다. 운동부하는 Marquette사의 case 15 답차를 이용하였고, Bruce protocol에 따라 증상이 나타날 때까지 최대로 실시하였으며 각 stage 및 운동후의 혈압을 측정하고 12 유도 심전도를 기록하였다. 결과 : 1) 임상적 특성 - 내원시 임상 상은 안정형 협심증이 39예(25.8%), 불안정형 협심증이 103예(68.2%), 심근경색증이 9예(6.0%)이었다. 운동부하 심전도 검사 결과 양성 군과 음성군간에 있어서 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연 여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도, 연축의 수 등을 조사하였는 바 어떠한 인자들도 유의한 차이를 발견할 수 없었다. 2) 운동부하 심전도 검사 - 운동부하 심전도 검사를 시행 받은 151명의 환자중 음성인 경우는 134예(88.8%)이었고, 양성인 경우는 17예(11.2%)이었다. 양성 소견을 보인 환자들중 ST 분절의 상승이 4예(2.6%), ST 분절의 하강이 13예(8.6%)이었다. 3) 관상동맥조영술 - 관상동맥조영술상에서 혈관 경력 위치는 우관상동맥이 70예(46.1%), 좌전하동맥이 44예(28.9%), 좌회선동맥이 17예(11.2%)의 순으로 나타났다. 운동부하 심전도 검사상 ST 분절의 상승이 있었던 예중 Ⅱ, Ⅲ, aVF에서 ST 분절의 상승이 있었던 1예는 관상 동맥조영술상 우관상동맥에서 경련이 발생하였고, V2-V4에서 ST 분절의 상승이 있었던 2예중 관상동맥조영술상에도 좌전하행동맥에서 경련이 나타난 예는 1예이었으며 다른 1예는 좌회선동맥에서 경련이 나타났고, V5-V6에서 ST 분절의 상승이 있었던 1예는 관상동맥조영술상에도 좌회선동맥에서 경련이 나타났다. 운동부하 심전도 검사상 V5 또는 V6에서 ST 분절의 하강이 있엇던 13예중 6예(46.1%)는 관상동맥조영술상 우관상동맥에서 경련이 발생하였고, 3예(23.1%)는 좌전하행동맥에서, 1예(7.7%)는 좌회선동맥에서, 나머지 3예(23.1%)는 2개의 혈관이나 기타 분지에서 경련이 발생하였다. 결론 : 1) 이형성 협심증 환자는 운동부하 심전도 검사에서 11.2%의 양성소견을 보였다. 이중 ST 분절의 상승은 2.6%이었고, ST 분절의 하강은 8.6%이었다. 2) 이형성 환자중 운동부하 심전도 검사를 실시하여 음성을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 3) 이형성 협심증 환자중 운동부하 심전도 검사를 실시하여 ST 분절의 상승을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 4) 운동부하 심전도 검사 결과에 대한 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도 등 어떠한 인자들도 3그룹(ST 분절의 상승, ST 분절의 하강, 음성)간에 유의한 차이를 발견할 수 없었다. 5) ST 분절의 상승 부위와 관상동맥조영술상 관상동맥의 연축이 일어나는 혈관과의 상관관계는 매우 높았다. No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina. 151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed. Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed. Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%). Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.

      • 글루코오스의 분해반응에 미치는 금속이온의 영향

        이민규,이송우,허목,송승구 濟州大學校 工科大學 産業技術硏究所 1991 産業技術硏究報告 Vol.2 No.-

        The objective of this research was to study the chemical kinetics of the decompo-sition of glucose in the presence of acid catalyst and metal ion. In this experiment. the range of variables investigated was covered temperature from 160℃ to 180℃ and concentration of 4% to 11% (W/V) sulfuric acid and metal sulfate concentrations, 1.0×10^(-3) to 2.5×10^(-2) gmol/l. It is shown that glucose disappearance follows a first-order reaction mechanism and the glucose decomposition reaction is dependent on both the reaction temperature and the catalyst concentration. And the presence of chromic ion accelerates the decompo-sition reaction of glucose, but presence of ferric and nickel ion rarely influence the reaction.

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