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.

자연색 재현을 위한 색역 사상과 디더링

이채수,장주석 경운대학교 산업기술연구소 2001 産業技術硏究論文誌 Vol.3 No.2(C)

Recently many devices print electronic images in a variety of ways. The reproduced color, however, is different from the original color because of the difference of hardware characteristics. To maintain device independent color, gamut mapping method is proposed. The proposed color gamut mapping uses nonlinear intensity mapping and clipping for saturation mapping on HSI color space. In the dithering operation, expanded nonlinear ordered dithering and modified error diffusion are proposed. The proposed ordered dithering uses expanded nonlinear quantization which considers overlapping phenomena of neighbored printing dots. In the modified error diffusion, quantization error to be diffused are adjusted to improve both image blur and color change produced in the error diffusion. So, the printed image is similar to the image of monitor. Our results indicate that proposed algorithm can produce high quality image in the low bit color devices.

폐경 후 여성의 에스트로젠 보충요법시 병합 투여된 프로제스테론이 골밀도에 미치는 영향

채희동,김광례,서창석,최영민,김석현,신창제,김정구,문신용,이진용 대한폐경학회 1997 대한폐경학회지 Vol.3 No.1

It is well established that estrogen replacement therapy prevents the bone loss associated with postmenopausal state. And progestogens used alone, given in larger amount than that in estrogen replacement therapy, have been shown to reduce the postmenopausal bone loss. However, the impacts of added progestogen during estrogen replacement therapy on the bone mineral densities(BMD) are not well known. For this purpose, we analysed the changes in BMD of 104 postmenopausal women who underwent estrogen replacement therapy at least for 12 months: 36 women received estrogen only(Premarin 0.625mg/day), 41 women received estrogen with cyclic addition of progestogen(medroxyprogesterone, MPA, 10mg/day for 12 days per month), 27 women received estrogen with daily addition of progestogen(MPA 2.5mg daily). Our data revealed that continuous use of MPA in addition to estrogen for one year significantly increased the BMD of lumbar spines(L2-4) by 7.6±1.9% compared to that of before treatment while therapy with estrogen only did not(1.7±1.0%). Also cyclic addition of MPA for one year increased the BMD of lumbar spines by 6.2±1.3% compared to that of before treatment. And the increases in BMD of lumar spines derived from continuous or cyclic use of MPA in addition to estrogen were significantly greater than that from therapy with estrogen only. There was no significant difference in increases in BMD of lumbar spines between cyclic use and continuous use of MPA. And there was no significant difference in increases in BMD of femur neck among three groups. The patients who showed a decrease in BMD by more than 3% at 12 months of treatment compared to pretreatment were as follows: In BMD of lumbar spines, 16.7%(6/36) in therapy with estrogen-only, 2.4%(1/41) in the cyclic use of MPA, 3.7%(1/27) in the continuous use of MPA; In BMD of femur neck, 25.0%(9/36) in therapy with estrogen-only, 22.0%(9/41) in the cyclic use of MPA, 11.1%(3/27) in the continuous use of MPA. The unine calcium/creatinine ratio decreased during therapy in all gropus without a significant difference among three groups. These data showed that added progestogen(MPA) during estrogen replacement therapy significantly increased the bone mineral densities(BMD) of lumbar spines, and suggest that the continuous combined regimen of estrogen and progestogen may be the regimen of choice for the prevention or treatment of postmenopausal osteoporosis

일부 도시지역 주민들의 비만도와 관상동맥질환 위험인자와의 관련성

이영선,윤석화,조영채 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

The present study was intended to reveal the relationships between the severity of obesity and various risk factors for coronary heart disease. The studs subjects were 1.838 urban inhabitants (male: 962. female: 876) who went through a general health check-up during the period between January through December. 2001. The degree of obesity was estimated by BMI and its relation to coronary heart disease risk factors were investigated. With respect to the severity of obesity. the mean systolic and diastolic blood pressure. TC. LDL-C. TG and AI increased significantly. but HDL-C showed a reversed pattern. with a higher severity. On the other hand. no difference was found in FBS. The severity of obesity was directly correlated with SBP. DBP. TC. LDL-C. TG and AI. Multivariate logistic regression analysis showed that the risk factors relevant to the severity of obesity were sex. DBP and TG. The odds ratio was 2.3 times higher in women than in men. and DBP and TG were 3.8 and 1.8 times higher in the obesity group than in the normal weight group. respectively. In conclusion. blood pressure. TC. LDL-C. TG. and AI significantly increase. and HDL-C decreases in proportion to the severity of obesity. The maintenance of desirable body weight should be a target for intervention with the idea of coronary heart disease prevention.

Symplastic glomus tumor 1예

이원채,장윤환,김효진,이석종,정상립,이수경,배한익 대한피부과학회 2003 대한피부과학회지 Vol.41 No.8

Glomus tumor is a benign lesion characterized by vessels and glomus cells in the varying proportion and it classically presents as a solitary, painful papule or nodule. Occasionally it displays unusual histopathologic features diagnosed as "atypical" glomus tumor, including malignant glomus tumor, glomus tumor of uncertain malignant potential, glomangiomatosis, and symplastic glomus tumor. Glomangiomatosis and symplastic glomus tumor reveal benign biologic behavior. We report herein a typical case of symplastic glomus tumor showing marked nuclear atypia, its only unusual feature comparing with classical one, in addition to the typical clinical and pathological features. (Korean J Dermatol 2003;41(8) : 1118~1120)

Polymer Light Emitting Diode의 발광특성 연구 : A study on electoluminescence properties of PLED with poly [2-(2'-ethylhexyloxy)-5-methoxy-1,4-phenylenevinylene]

이상협;배형철;송석태;한찬수;채희백 순천향대학교 기초과학연구소 2010 순천향자연과학연구 논문집 Vol.16 No.2

In order to know how the [2-(2'-ethylhexyloxy)-5-methoxy-1,4-phenylenevinylene] (MEH-PPV) layer works in organic light emitting diode, two different types of devices were fabricated, which are MEH-PPV single layer devices and MEH-PPV/tris (8-hydroxy-quinoline)aluminium(Alq3) bilayer devices. On the indium-tin-oxide(ITO) glass anode MEH-PPV layer was first spin-coated, and the Alq3 layer and the aluminium(Al) anode were vapor-deposited sequentially. The devices shows a trend that has lower current, luminous efficiency in case the thickness of the device is larger. Some bilayer devices, however, show more improved performance than other devices of smaller total thickness. This results were discussed on the basis of improved exciton formation resulting from balanced carrier transport.

철화분청사기 철화안료로 사용한 석간주 연구

이재황,최석원,채상정,서만철 공주대학교 문화재보존과학연구소 2003 문화재과학기술 Vol.2 No.1

한국은 오랜기간 발전된 도자문화를 지니고 있다. 한국의 도예가들은 독창적인 문화를 토대로 활동적이며 예술적인 도자기를 생산해왔다. 14세기에 이르러 9세기의 고려청자를 바탕으로한 조선시대의 독특한 분청사기가 나타났으며 분청사기 가운데 철화분청사기는 백토분장위에 철분의 안료를 사용하여 붓으로 그림을 그려 제작하였다. 철화분청사기는 주로 15세기 후반부터 16세기 전반에 걸쳐 제작되었으며 이들은 민예적인 특성을 잘 반영하여 지역별로 서로 다른 독특한 양식으로 발달함으로써 계룡산 지역에서는 "계룡산 분청"이라는 별칭으로 불리었으나 현재는 철화분청사기의 제작기술이 소멸된 상태이다. 철화분청사기의 재현을 위해 철화분청사기편을 실험한 결과, 철화안료는 화강암내의 산화광물인 자철석으로 이루어져 있으며 이것은 석간주로 불리운다. 또한 철화분청사기편을 1230°C정도의 고온에서 소성한 결과 태토가 잘 견디었으며 사라진 광택이 다시 빛을 발하였다. 따라서 계룡산 분청의 재현 및 발전을 위해 문헌에 따른 채굴장소에 대한 연구가 이루어져야 할 것이다. Korea has a long and flourishing history of ceramics. Korean potters have established a dynamic artistic civilization rooted on its unique ceramic culture. In 14th century, they had created Buncheong, based on the tradtional Korean ceramics such as the Koryo celadons of 9th century. Among the Buncheongs, Chulhwa-Buncheong ceramics were produced by using iron oxide (ferric, ferrous) as the drawing stain. A fragment of a Chulhwa-Buncheong, with a manufacturing year stamp of 1492, was found in a kiln at mountain Kyeryong located in central Korea. Chulhwa-Buncheong ceramics, which have often abstract drawings on them, have been recognized worldwide for their artistic quality. But unfortunately, the production technique of Chulhwa-Buncheong has been lost. To provide the technical criteria for systematic restoration of Chulhwa-Buncheong, the iron oxide (ferric ferrous) material used for the drawings was explored. The iron oxide used for Chulhwa-Buncheong is the magnetite (Fe_(3)O_(4)). At 1230°C, it changes black color. With no flow effect at high plasticity level, it becomes dark color of chestnut and form ferrous crystal. As described in the Choseon Dynasty's memorandum of King Young Cho's period. the iron oxide was obtained traditionally from natural materials such as Seokanju, a special kind of minerals in granite. It is concluded that the magnetite from the rock cave which had been used as the drawing stain of Chulhwa-Buncheong can be used for the restoration of the Chulhwa-Buncheong.

의료영상처리를 위한 고해상도 LCD 컨트롤러 개발

이채욱,황재석,박재훈 대구대학교 2005 대구대학교 학술논문집 Vol.1 No.1

In this paper we proposes the Implementation of Medical Image LCD Controller Using Multi-Image Equipment. Existent LCD is incongruent in resolution to use by medical. Therefore, proposed LCD is system that can do high definition display of suitable WUXGA (1900 * 1200) to medical. the existent LCD displays to detect TV signal or PC's signal, so developed LCD can detect PC's signal as well as TV signal. Five video signal is DVI, D-SUB, S-Video, Composite, Component and designed so that AUTO-SELECTION of five signal may be possible. This has advantage that detecting PC's signal as well as TV signal can make use of TV and monitor together doing unlike existent monitor. 본 논문에서는 의료영상처리를 위한 고해상도 LCD(Liquid Crystal Display) 컨트롤러의 구현 방법에 대하여 논한다. 기존의 LCD는 해상도 면에서 의료용으로 사용하기에는 부적합하다. 따라서 의료용에 적합한 WUXGA(1900 * 1200)의 고해상도 디스플레이를 해 줄 수 있는 고해상도 LCD를 개발하고자 한다. 또한 기존의 LCD는 TV신호 또는 PC신호만을 DETECTING해서 DISPLAY시켜주는 반면 본 LCD는 TV신호 뿐만 아니라 PC의 신호도 동시에 DECTECTING이 가능한 LCD 시스템이다. 5개의 영상신호는 PC신호인 DVI, D-SUB이며, TV 신호인 S-Video, Composite, Component이며 5개의 신호의 AUTO-SELECTION이 가능하도록 설계하였다. 이는 기존의 모니터와는 달리 TV신호 뿐만 아니라 PC의 신호도 DECTECTING함으로써 TV와 모니터를 같이 사용할 수 있는 장점을 가지고 있다.

손가락에 발생한 피하 석회화 결절 1예

이원채,차영창,이석종,나건연,김도원,이수경 대한피부과학회 2003 대한피부과학회지 Vol.41 No.10

Subepidermal calcified nodule is a rather uncommon, but peculiar subtype of calcinosis cutis. It presents as a single asymptomatic, hard, yellowish white nodule which commonly occurs on the face of chileren. Histopathologic examination reveals the multifocal various-sized papillary dermal collection of dark blue amorphous globular deposits confirmed by von Kossa stain for calcium. We report a 42-year-old man who had small white hyperkeratotic papule on finger tip for more than 20 years. He could recall neither preceding trauma nor systemic illness. Excisional biopsy, with the clinical impression of verruca or corn, showed typical histopathologic features of the subepidermal calcified nodule.(Korean J Dermatol 2003;41(10) : 1414~1416)