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.

초등학생들의 체격지수가 체력요인에 미치는 영향

채정룡,윤석창,신현철 군산대학교 체육과학연구소 1999 體育科學硏究所 論文集 Vol.1 No.-

The aim of this study make it clear the trait of physical strength according to Physique index and help the Physical fitness leaders to raise the function of exercise and provide them with study programs by stage in the sport learning. For this study 620 students (male & female students in 5 and 6 class of elementary school) were selected. The result of study show outstanding physical trait in body weight ratio and chest girth ratio. The results are the following. (1) The physical characteristics of the investigated children, around 5 class or 6 class, show that female children's growth is faster than male's. (2) The trait of Physical Fitness shows it is superior in male's group and as grow older, but the group of 5 class is more superior than the group of 6 class, in male's and female's pull-ups. (3) The correlation between physique index shows the highest correlation(P< .01) in body weight and girth of chest, next is height and sitting height, height and girth of chest, followed by girth of chest and sitting height. (4) The correlation between 100m sprint and physical fitness shows high positive interrelation(P< .01) in 600m distance run, but negative interrelation(P< .01) in standing broad jump, pull-ups, sit-ups and ball throwing. (5) The correlation between standing broad jump and physical fitness shows positive interrelation(P< .01) in sit-ups, pull-ups and ball throwing, but negative interrelation(P< .01) in 100m sprint and 600m distance run. (6) The correlation between pull-ups and physical fitness shows positive interrelation(P< .01) in sit-ups, standing broad jump and ball throwing, but negative interrelation(P< .01) in100m sprint and 600m distance run. (7) The correlation between sip-ups and physical fitness shows positive interrelation(P< .01) in standing broad jump, sit-ups and ball throwing, but negative interrelation(P< .01) in 100m sprint and 600m distance run. (8) The correlation between ball throwing and physical fitness shows positive interrelation(P< .01) in standing broad jump, pull-ups, sit-ups and ball throwing, but negative interrelation(P< .01) in 100m sprint and 600m distance run. (9) The correlation between 600m distance run and physical fitness shows high positive interrelation (P< .01) in 100m sprint, but negative interrelation (P< .01) in standing broad jump, pull-ups, sit -ups and ball throwing. (10) The correlation between physical fitness and physique index shows the highest correlation in body weight ratio, next is chest girth ratio, followed by sitting height ratio. (11) The correlation between body weight ratio and physical fitness shows positive interrelation (P<.01) in 100m sprint (male and female students in 5 class) and standing broad jump, sip-up (female students in 5 class), ball throwing (male students in 5 class) and 600m distance run, but negative interrelation(P< .01) in pull-ups etc. (12) The correlation between chest girth ratio and physical fitness shows positive interrelation (p<. 01) in 100m sprint and 600m distance run, but negative interrelation(P<. 01) standing broad jump, pull-ups, sit-ups and ball throwing etc. (13) The correlation between sitting height ratio and physical fitness shows positive interrelation (P<. 01) in pull-ups, sit-ups and ball throwing, but negativ interrelation(P< .01) in 100m sprint, standing broad jump, sit-ups and 600m distance run etc. (14) The correlation between physical index shows positive interrational (P< .01) body weight ratio and chest girth ratio, chest girth ratio and sitting height ratio, but negative interrelation in(P< .01) body weight ratio and sitting height ratio.

CORBA 기반 망관리 시스템 통합에 관한 연구

윤채운,김명균,허정석 울산대학교 1999 공학연구논문집 Vol.30 No.2

통신망이 커지고 복잡해짐에 따라 통신망 관리는 더욱 중요해지고 있다. 이러한 통신망을 효율적으로 관리하기 위해 국제 표준화 그룹인 ITU와 ISO는 CMIS/CMIP 기반의 OSI망 관리 모델 [1]을 표준화하고 IAB에서는 SNMP [7] 기반 망관리 모델을 표준화하였다. 이들 망관리 모델은 통신망 요소들의 관리에는 효율적이지만 복잡한 망들의 관리나 서비스 관리에는 많은 문제들이 있다. 이러한 문제들을 해결하기 위해 본 논문에서는 분산 객체 지향 기술인 CORBA[3]를 이용하여 기존의 망관리 시스템들을 통합하기 위한 방법에 대해 기술한다. CORBA 기반 통합 망관리 구조를 제시하고 CORBA와 OSI망관리 모델사이의 관리정보 및 관리기능 변환 기능을 위한 CORBA/CMIP 게이트웨이 구조를 제시한다. 또한 COBRA 관리자에서 OSI객체들을 접근하기 위� 기법과 OSI객체에서 발생하는 이벤트를 CORBA 관리자에 전달하기 위한 기법들에 대해 기술한다. Network management systems become more important as the communications networks evolve larger and more complicated. For the efficient management of the communications networks, the international standard organizations, ITU and ISO, have standardized OSI network management model [1] based on CMIS/CMIP, and IAB has proposed SNMP [7]as the Internet management model. The traditional management models are efficient in managing simple communications netwrks, but have many problems in managing complicated networks and services. To solve those problems, this paper proposes an integration method of network management systems based on CORBA [3] which is a distributed and object-oriented technology. We describe an integrated network management architecture based on CORBA/CMIP gateway. The CORBA/CMIP gateway converts the management systems. We also describe how the CORBA managers access the OSI managed objects and how the events occurred in the OSI managed objects are delivered to the CORBA managers.

한국인에서의 CYP2C19 돌연변이 유전자형의 다형성에 관한 연구

채석,채상우,양동규,김형기,권준택,염윤기 순천향의학연구소 2000 Journal of Soonchunhyang Medical Science Vol.6 No.2

The S-mephenytoin 4'-hydroxylase (CYP2C19) metabolizes a number of clinically used drugs and shows a marked interethnic difference in the incidence of the poor metabolizer (PM). Recent studies have found a third (CYP2C19*4) and forth (CYP2C19*5) mutations in Caucasians. In the present study, we genotyped 536 healthy unrelated Koreans for functionally defective alleles, CYP2C19*2, CYP2C19*3, CYP2C19*4, and CYP2C19*5. Detection of the normal (CYP2C19*1) and defective alleles was performed by polymerase chain reaction/restriction enzyme analysis. The genomic DNA was isolated from peripheral blood. The allelic frequencies of the wild-type (CYP2C19*1) and CYP2C19*2 were 72.6% and 27.4%, and the wild-type (CYP2C19*1) and CYP2C19*3 were 85.1% and 14.9%, respectively. For each CYP2C19*2 and CYP2C19*3 the observed number of three genotypes were similar to those calculated in accordance with the Hardy-Weinberg equation. The frequencies of homozygotes for CYP2C19*2, CYP2C19*3 and compound heterozygotes were 9.7%, 2.8% and 4.2%, respectively. The mutants of CYP2C19 were identified in 36 subjects (16.7%). The mutated CYP2C19*4 and CYP2C19*5 alleles were not detected in this study. These results suggest that frequency of mutants of CYP2C19 in Koreans resembled the Orientals rather than Caucasians, and we founded the racial variability of the frequencies of the CYP2C19*4 and CYP2C19*5 alleles in the Orientals.

Superconducting MgB2 Wire Drawing Considering Anisotropic Hardening Behavior and Hydrostatic Effect

Young‑Seok Oh,Ho Won Lee,Kook‑Chae Chung,Duck‑Young Hwang,Seong‑Hoon Kang,Jeong Whan Yoon 대한금속·재료학회 2022 METALS AND MATERIALS International Vol.28 No.7

Numerical modeling was conducted to investigate the deformation behavior of powder mixture during multi-pass drawingprocesses for multi-filamentary MgB2wire. A modified Drucker-Prager Cap (DPC) model with an elliptical cap surface usingthe new material characterization method was developed to capture the anisotropic hardening behavior and hydrostatic effectof the powder mixture. A number of uniaxial die compaction, cold isostatic pressing, diametrical compression, and uniaxialcompression tests were conducted using different powder densities to characterize the modified DPC model. A commercialfinite element software ABAQUS with a user subroutine was used to simulate the drawing of the MgB2wire. The densityand area fraction of the powder mixture during the wire-drawing process were verified with experimental results. The differencein packing density at the inner and outer filaments of the MgB2wire was successfully captured by simulation. Inaddition, the effect of the initial packing density on the superconducting properties of MgB2wire was numerically studied. It is shown that the increase in the superconducting area, which results from a high initial packing density, should be moreeffective compared to the increase in the grain connectivity in enhancing the critical current properties for the MgB2wirewhen the final packing density is saturated after a number of drawing processes.

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.

자가 면역성 간염에서 자가항체의 발현 양상과 스테로이드 치료의 효과

박기오,채경훈,허원석,강윤세,정재훈,김연수,문희석,이엄석,김선문,이병석,김남재,이헌영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 최근 8년간 본원에서 경험한 자기면역성 간염의 혈액학적 특징과 스테로이드의 치료효과를 알아보고자 본 연구를 시행하였다. 방법 : 1996년 이후부터 2002년까지 충남대학교 병원에서 1999년 International Autoimmune Hepatitis Group(LAHG)에서 제시한 수정 진단 기준안에 의거하여 총 진단점수가 probable 이상에 해당하는 환자들을 대상으로 임상적 특징, 검사실 및 조직 소견과 스테로이드와 azathioprine의 치료 효과를 후향적으로 조사하였다. 결과 : 9예의 환자들은 여성이 78%, 40대가 많았고, 급성 발병이 33.3%, 피로감, 식욕부진 및 황달 등이 나타났으며, 항핵항체가 55.6%에서 그리고 항평활근 항체가 77.8%에서 양성이었고, 동반 질환은 류마치스 관절염이 2예, 특발성 혈소판 감소증 1예, Henoch-Sch nlein 자반증 및 그레브스병이 각각 1예 씩이었다. 7예에 대해서 스테로이드와 azathioprine으로 치료하여 생화학적 임상적 완해가 이루어져서 유효한 치료 결과를 얻었다. 결론 : 자가면역성 간염은 우리 나라에서 원인을 찾을 수 없는 만성 간질환의 경우, 특히 중년여성에서 다른 자가면역성 질환이 동반되었을 때 자가면역성 간염을 의심하여 자가항체 선별검사를 시행해 보아야 할 것으로 생각된다. 향후 다기관 연구를 통하여 좀 더 많은 증례를 모으고 전향적인 연구를 시행하여야 할 필요가 있다. Although autoimmune hepatitis(AIH) is common in western contries, some studties have been reported in Korea. The aim of the study was to analyze the clinical and histological features and expression pattern of the autoantibody and to examine clinical course of AIH in Korea. For 9 patients diagnosed as having AIH in our hospital since 1996, we reviewed medical records and analyzed clinical and laboratory findings retrospectively. They had a probable or definite AIH according to the revised criteria of International AIH group. The mean age was 42.7(21∼68)years and 7(77.8%) were female. Three of them(33.3%) showed acute hepatitis and five of them showed cirrhosis. Fatigue and anorexia were the most frequently complained symptoms(55.6%). Four patients(44.4%) were accompanied with other autoimmune diseases. Antinuclear antibody was detected in 5(55.6%) and anti-smooth muscle antibody was detected in 7(77.8%). Three patients showed focal picemeal necrosis and four showed periportal fibrosis. Among 7 patients who received immunosuppressive therapy, six patients(85.7%) showed initial response. and biochemical and serologic remission were achived in 5(71.4%) and 3(42.8%) patients, AIH seems to be partly responsible for chronic liver disease of unknown etiology in Korea. AIH should be suspected in female patients with unknown chronic liver disease of unknown etiolgy, especially accompanied with other autoimmune disease. The clinical characteristics of AIH may not be quite different from those of Western countries.

Analysis on electrical and thermal characteristics of MI-SS racetrack coil under conduction cooling and external magnetic field

Yoon Seok Chae,Ji Hyung Kim,Huu Luong Quach,Sung Hoon Lee,Ho Min Kim 한국초전도저온학회 2021 한국초전도저온공학회논문지 Vol.23 No.4

This paper presents the analysis and experiment results on the electrical and thermal characteristics of metal insulation (MI)REBCO racetrack coil, which was wound with stainless steel (SS) tape between turn–to–turn layers, under rotating magnetic fieldand conduction cooling system. Although the field windings of superconducting rotating machine are designed to operate on adirect current, they may be subjected to external magnetic field due to the unsynchronized armature windings during electrical ormechanical load fluctuations. The field windings show the voltage and magnetic field fluctuations and the critical current reductionwhen they are exposed to an external magnetic field. Moreover, the cryogenic cooling conditions are also identified as the factorsthat affect the electrical and thermal characteristics of the HTS coil because the characteristic resistance changes according to thecryogenic cooling conditions. Therefore, it is necessary to investigate the effect of external magnetic field on the electrical andthermal characteristics of MI–SS racetrack coil for further development reliable HTS field windings of superconducting rotatingmachine. First, the major components of the experiment test (i.e., HTS racetrack coil construction, armature winding of 75 kW classinduction motor, and conduction cooling system) were fabricated and assembled. Then, the MI racetrack coil was performed underliquid nitrogen bath and conduction cooling conditions to estimate the key parameters (i.e., critical current, time constant, andcharacteristic resistance) for the test coil in the steady state operation. Further, the test coil was charged to the target value underconduction cooling of 35 K then exposed to the rotating magnetic field, which was generated by three phrase armature windings of75 kW class induction motor, to investigate the electrical and thermal characteristics during the transient state.

Analysis on electrical and thermal characteristics of MI-SS racetrack coil under conduction cooling and external magnetic field

Yoon Seok Chae,Ji Hyung Kim,Huu Luong Quach,Sung Hoon Lee,Ho Min Kim 한국초전도저온공학회 2021 초전도와 저온공학 Vol.23 No.4

This paper presents the analysis and experiment results on the electrical and thermal characteristics of metal insulation (MI) REBCO racetrack coil, which was wound with stainless steel (SS) tape between turn–to–turn layers, under rotating magnetic field and conduction cooling system. Although the field windings of superconducting rotating machine are designed to operate on a direct current, they may be subjected to external magnetic field due to the unsynchronized armature windings during electrical or mechanical load fluctuations. The field windings show the voltage and magnetic field fluctuations and the critical current reduction when they are exposed to an external magnetic field. Moreover, the cryogenic cooling conditions are also identified as the factors that affect the electrical and thermal characteristics of the HTS coil because the characteristic resistance changes according to the cryogenic cooling conditions. Therefore, it is necessary to investigate the effect of external magnetic field on the electrical and thermal characteristics of MI–SS racetrack coil for further development reliable HTS field windings of superconducting rotating machine. First, the major components of the experiment test (i.e., HTS racetrack coil construction, armature winding of 75 kW class induction motor, and conduction cooling system) were fabricated and assembled. Then, the MI racetrack coil was performed under liquid nitrogen bath and conduction cooling conditions to estimate the key parameters (i.e., critical current, time constant, and characteristic resistance) for the test coil in the steady state operation. Further, the test coil was charged to the target value under conduction cooling of 35 K then exposed to the rotating magnetic field, which was generated by three phrase armature windings of 75 kW class induction motor, to investigate the electrical and thermal characteristics during the transient state.