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.

간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

홈 네트워크에서 스케일러블 어플리케이션 서비스 방법

이윤주(Yun-Ju Lee),임태범(Tae-Beom Lim),김경원(Kyung-Won Kim),문재원(Jae-Won Moon),이석필(Seok-Pil Lee) 한국멀티미디어학회 2010 한국멀티미디어학회 학술발표논문집 Vol.2010 No.2

홈 네트워크 상에서 다양한 디지털 기기들 간에 멀티미디어 콘텐츠를 공유/연동하는데 있어, IPTV환경에서 응용프로그램을 비디오, 오디오, 그리고 이미지 파일과 같이 공유/연동할 수 있도록 하는 방법을 제안하고 사용자의 편의성을 증진시키고 시청 환경이 서로 다른 디지털 기기에 동시 적용 가능하며 다양한 시청 환경에 최적화된 사용자 인터페이스를 제공하도록 한다.

공통과학(화학) 수행평가의 적용 효과

이석희,이상은,박종근,문성배 부산대학교 사범대학 과학교육연구소 2001 科學敎育硏究報 Vol.28 No.-

The purpose of this study is to examine the effects of the application of experimental practices, descriptive tests, and research papers among the performance assessments on the students' accomplishment, their scientific research abilities and their attitudes to science in high schools. Two classes among the first grade ones were selected and assigned to the control group and the experimental group respectively. T-analysis of pre-test showed that the two groups have the same quality(p>.05). The questionnaire made by the Korean Educational Development Institute(KEDI) was used. Its reliability is .689. The experimental process was evaluated on the basis of the criterion table and reports. T-tes and ANOVA were enforced with the SPSS/WIN(ver10.0) for the purpose of analyzing the mean difference between the two groups. The results of this study are as follows. First, though the application of the performance assessments showed that there were little significant differences between the scientific research abilities of the experimental group with the experimental practice and those of the control group(p>.05), and the results of the pre-test and the post-test on the experimental group revealed that there were significant effects on improving the students' scientific research abilities(p<.05). Second, the result of the test using ANOVA at each research course factor showed that there was no significant difference at most research course factors that there were significant differences between the two groups in expanding the scientific research abilities of classification and measurement(p<.05). Finally, the results of the pre-test and the post-test by application of the performance assessments showed that they had significant effects on changing the students' attitude to science subject positively(p<.05). In addition, the results of the pre-testing and the post-testing on the sub-factors of the attitude related to science showed that there were significant changes in the concept of 'self-consciousness' and the attitude to learning(p<.05). In conclusion, the application of the performance assessments has positive effects on improving the high school students' scholastic achievement, scientific research abilities, and attitudes to related to science. Consequently, science teachers should be willing to use various performance assessments in the class.

복합비타민 유제의 제조와 평가

이문석,조혜영,이용복 전남대학교 약품개발연구소 2002 약품개발연구지 Vol.11 No.-

Water-lipid soluble multivitamin formulations were widely used to reduce the disease and stress of animals as husbandry has made a remarkable progress in recent. But the efficiency of these formulations is far from satisfactory. So, this study was attempted to develop the physically and chemically stable and useful multivitamin o/w emulsion. Multivitamin o/w emulsion composed of water, soybean oil (10%, v/v), vitamin A, D, E, K, B_2, B_6, B_12 and panthenol. To make a stable o/w emulsion , the egg lecithin (2%, w/v) and glycerin (2.5%, w/v) were used for emulsifier and thickening agent, respectively. The oil in water emulsion system was manufactured by microfluidizer and the physicochemical stability of this emulsion was evaluated. The average particle size and interfacial tension were measured. From the result of interfacial tension tested, critical micelle concentration of the egg lecithin was 0.5% (w/v) and optimal concentration for the preparation of emulsion was 2% (w/v). The mean particle size was about 0.6 ㎛ which was suitable for injections. Short-term accelerated stability as physical stability study was tested by centrifuging and freeze-thawing the emulsion samples. The additions of vitamins resulted in the increment of particle size and reduction of physical stability of emulsion. But it is not an enormous problem for the stability of emulsion. Also, we have performed the long-period preservation stability test for the vitamins. All vitamins were analysed by HPLC. The result of storage under 4℃ and dark conditions demonstrated that all vitamins were maintained stable at least 16 weeks, except for vitamin B_12.

크론병에 대한 CoPPLX의 방어효과에 대한 연구

이호학,김유림,문창기,이재일,양병윤,김종수,이정민,정재혁,안석진,박상준,김윤권,김소연,김영중,조민구,최영자,장성조 圓光大學校 醫科學硏究所 2005 圓光醫科學 Vol.20 No.1

增損五積丸(碑積方)이 사람의 各種 癌細胞株의 成長沮碍에 미치는 效果

李竝求,元秦喜,文錫哉,金東雄,元京淑,文九 한국전통의학연구소 2002 한국전통의학지 Vol.12 No.1

chemosensitivity test of Geungsonojukwhan-Bijukbang was performed on the three different human cancer cell lines originated from liver, cervix and colon tissue, namely Hep 3B, Hela and HCT-15, which have similar doubling times. Semiautomated sulforhodamine B(SRB) assay appears to offer an valuable tool for chemosensitivity of unknown compounds, since it is a simple, valid and inexpensive method of assessing drug monitoring for large samples in a short time. The results obtained in this study were as follows 1. Good correlations were shown from the results of SRB assay and those of clogenetic assay. 2. As a result of exposure to Geungsonojukwhan, the proliferation of Hela cell and Hep 3B cell was slightly decreased in Geungsonojukwhan-Bijukbang(GIP), Geungsonojukwhan-Pejukbang(LUP) and Geungsonojukwhan-Sinjukbang(RTP). 3. As a result of exposure to Geungsonojukwhan, GIP showed better anticancer effect to HCT-15 cell lines than those of LUP and RTP. 4. The extract of Geungsonojukwhan-Bijukbang in 40℃ were more effective in cytotoxic response than those in 100℃. 5. The research showed that the higher concentration the more effective in the inhibition of proliferation of the cancer cell lines, however, the cytotoxic effect of Geungsonojukwhan-Bijukbang in the concentration of 1.60mg/㎖ and 3.20mg/㎖ showed the most effective inhibition rate according to the increase of concentration.

실험·실습법에 의한 수행평가 실시가 중학생의 학업성취도 및 정의적 영역에 미치는 영향

이석희,문성배 부산대학교 사범대학 과학교육연구소 2001 科學敎育硏究報 Vol.28 No.-

The purpose of this study is to see the effects of an application of the experimental practice which is one of the performance assessments on student's accomplishment and affective domain in the middle school science department. The results of this study are following. First, the experimental group with the experimental practice was better than the control group in the achievement (p<.05). It also showed that there was a significant differences in the "mid" and "low" groups. In case of the "high" group, there was little differences. Second, there was not significant differerences at affective domain(p>.05), while control group changed negatively, experimental group changed positively. In all three groups, there was no significant effect in the item 'self-consciousness'(p>.05). But the result showed that experimental practice was efficient for the students' attitude on learning in the "mid" and "low" groups(p<.05). And it also showed that experimental practice was efficient for the students' studying habit in the 'low' group(p<.05).

제6차 교육과정에 따른 고등학교 화학Ⅰ 교과서의 STS 내용 분석

이석희,김용권,문성배 부산대학교 사범대학 과학교육연구소 2001 科學敎育硏究報 Vol.28 No.-

The STS contents, emphasized in the 6th curriculum, in the chemistry Ⅰ textbooks were analyzed. The STS contents of textbooks showed average of 10.7%. The Chapter in "water and air" were included 34.8% in STS contents, 11.0% in "metal and nonmetal", 9.7% in "organic compound" and 15.1% in "our livelihood and medicine goods". When the STS contents were analyzed by STS topics of Piel, the results are as follows; 51.1% on environmental quality and utilization of natural source, 38.6% on effect of technological developments. 9.5% on energy, 0.8% on sociology of science. However, there were no topics on human engineering, population, space research and national defense. When the STS contents were analyzed by student activities of SATIS, most of the activities were research study and case study. There were few field activities of practical investigation, role play, simulation, and research design.