뇌동맥류의 수술중 파열

황성남,박관,김영백,민병국,석종식,최덕영 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.6

Intraoperative aneurysmal rupture can be defined as aneurysmal rupture that takes place during any procedure from the induction of anesthesia to the closing of the wound and may result in a disastrous surgical outcome if not managed properly. The author experienced 11 cases of intraoperative aneurysmal rupture among 134 cases of aneurysm surgeries over the past 7 years at Yong-San hospital. The intraoperative rupture rate was 8% and there was statistically significant higher incidence of rupture in the early operated group. Rupture occured during dissection in 5 cases and during the clipping procedure in 6. The early and late mortality was 27 %, which included one case that could also be attributed to the direct effect of subarachnoid hemorrhage.

고추역병의 생리, 유전, 역학 및 방제전략

황병국 高麗大學校 自然資源科學硏究所 1995 自然資源科學硏究 Vol.3 No.-

연에 의한 건강장해 및 생물학적 표식자

황규윤,이병국 가톨릭대학교 산업의학센터 2000 韓國의 産業醫學 Vol.39 No.3

Increasing evidence has demonstrated that adverse health effects of lead including neurobehavioral, reproductive, hematological, and growth problems occur at as low as acceptable blood lead level. The use of biomarkers is becoming important to detect biochemical and functional changes by lead at the cellular and molecular levels. Of the biomarkers of lead, blood lead is the most widely used as a measure of absorbed (internal) dose. The amount of plasma and urine after administration of a chelating agent reflects mobilizable pool of internal lead dose as bioavaliable lead burden. Lead in skeletal pools is an estimate of cumulative and past exposure. Lead toxicity is related to lead's affinity for a variety of enzyme systems such as heme synthesis pathway, sodium potassium ATPase, calcium transport and neurotransmitters. The range of health effects is diverse due to acquired and inherited susceptibility. This article briefly reviewed some of development and application of biomarkers of lead in relation to exposure, response, and susceptibility in occupational and public health research and practice. Particularly, biomarkers of lead were described in sequential progression between exposure and disease. This paper presented development of validated biomarkers that can contribute to occupational health efforts and applications that can bring to biological monitoring field.

연폭로 근로자들에서 빈혈증 관련 인자에 관한 연구

황보영,김용배,김화성,이성수,안규동,이병국 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

Objectives : This study intended to obtain the interrelationship of lead exposure indices and anemia related factors for the better health management of lead exposed workers. Methods : 502 male workers in storage battery industries as lead exposed group and 106 male office workers as contorl group were selected for this study. The examined variables wer age, work duration, smoking and alcohol crinking habit, blood zinc protoporphyin concentraion (ZPP), blood lead concentration (PbB), urinary δ-aminoevulinic acid (ALAU), hemoglobin (Hb), hematocrit (Hct), serum calcium (S-Ca), serum iron (S-Fe), total iron binding capacity (TIBC), and percentage trasferrin saturation (PTS). Results : The means of ZPP, PbB ALAU in lead exposed proup were 58.4±35.7 ㎍/㎗, 27.6±10.9 ㎍/㎗, and 1.61±2.00 mg/ℓ, respectively. These three values in lead exposed group were significantly higher than control group (P<.05). The means of Hb, Hct, S-Ca, S-Fe, TIBC, PTS in lead exposed group were 15.3±1.1 g/㎗, 47.2±4.5 %, 9.4±0.4 ㎍/㎗, 124.0±67.5 ㎍/㎗, 317.1±68.5 ㎍/㎗, and 38.7±15.2 %, respectively. Hb, Hct, S-Ca, S-Fe, and TIBC in lead exposed group were significantly lower than contrl group (P<.05). PTS was no significant difference in lead exposed group and control group (P> .05). Hct, S-Ca, S-Fe, PTS were significant positive correlation with Hb and ZPP, corrected PbB, AlAU were significant negaitive correlation with Hb in lead exposed group (P< .05). On multiple regression using ZPP as a dependent variable and PbB, S-Ca and S-Fe as independent variables after adjustment for possible confounder such as age, smoking and drinking habit, Pbb, S-Ca, S-Fe and age contributed to ZPP. Conclusions : As the result of this study, it was suggested that inclusion of S-Ca, S-Fe, PTS measurement as a anemia screening test for lead workers was highly recommended for the effective prevention and early diagnosis of anemia.

납노출지표와 적혈구내 protein kinase C 활성도의 연관성

황규윤,황보영,안현철,김용배,리갑수,이성수,안규동,이병국 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

목적 : Protein kinase C는 칼슘-인지질 의존형인산화 효소로 'H VJ'tfO에서 납에 의하여 활성화되지만, 납에 노출된 인체내에서 그 영향을 평가한 경우는 얼다. 본 연구의 목적은 납에 직업적으로 노출되는 근로자를 대상으로 납 노출이 적혈구막의 단백질내에서 PKC 활성에 의한 인산화 수준에 영향을 주는지 알아보고자 하였다. 방법 : 1998년부터 국내 납 근로자를 대상으로 납에 의한 건강 영향조사가 4년간의 코호트 연구로 실행하였다. 1차년도에 630명의 납 근로자와 135명의대조군이 조사되었고 이들중 본 연구에서는 직업적노출이 되는 사업장에 근무하는 212명의 근로자를대상하였다. 156명의 남자와 56명의 여자 근로자를 대상으로 인구학적, 과거병력, 직업력 등을 구조화된 설문과 면접으로 조사되었고 납 노출 평가는 혈중 납농도 및 ZPP, 경골중 납농도를 측정하였다. PKC의 활성도는 적혈구막 단백질내 PKC 의존형인산화 수준으로 평가하였다. 적혈구막 단백질인spectrin과 band 4.9의 후인산화수준을 측정하여각 납 노출지표(혈중 납, ZPP, 경골중 납. 노출기간)와의 관련성은 다중회귀분석을 이용하였다. 결과 : 조사대상자의 평균(SD) 연령은39.1(10.0)세, 근무기간은 8.1(6.5)년 이었으며, 경골중 납농도는 범위가 0.8에서 290.8 trg Pb/gbone mineral로 평근(SD) 34.4(35.2) rig Pb/gbone mineral이었다. 적혈구막 단백질의 후인산화수준은 개인간 변이가 매우 컸으며, spectrin은 평균(SD) 540 7(304.1), band 4.9 SfkDa는198.6(78.2), 48 kDa는 247.7(83.3) PSL이었다.경골중 납농도와 노출 기간은 이들 후인산화 수준과역상관성을 보였으나(p(0.05), 혈중 납 농도와 ZPP는 상관성이 없었다(p)0.05). 가능성 있는 혼란변수를 통제한 상태에서도 경골중 납 농도와 노출기간은 이들 후인산화수준과 유의한 회귀계수를 나타내었다. 결론 : 만성적 납 노출에 의하여 적혈구내 PKC활성도는 영향을 받아 증가되어있는 것으로 평가되어 적혈구막 단백질의 인산화수준은 납의 노출지표로 이용될 수 있을 것이다. 납의 신경독성은 부분적으로 PKC의 활성도왁 관련되어 있을 기전을 배제하기 어렵기 때문에 PfC 활성도와 신경행동학적 기능과의 관련성 평가가 진행되어야 할 것이다. Objectives : Protein kinase C(PKC) , a calcium and phospholipid dependent enzyme, is activated by lead in vitro at picomolar concentrations. However, the effect of lead on PKC has never been studied in a human population. The purpose of the study was to evaluate whether lead exposure was associated with PKC mediated-phosphorylation in erythrocytes among lead workers. Methods : Two hundred and twelve lead workers were studied. To determine the levels of phosphorylation ir vivo, an in vivo back phosphorylation technique was used by adding PKC and γ-32P to preparations of erythrocyte membranes. We measured back phosphorylations of erythrocyte membrane proteins, spectrin, and 52 kDa and 48 kDa, as an indirect measure of PKC activation if vivo. Results : The mean(SD) age and exposure duration was 39.1(10.0) years and 8.1(6.5) years, respectively. Tibial lead ranged from 0.8 to 290.8 μg Pb/g bone mineral with a mean (SD) of 34.4(35.2) μg Pb/g bone mineral. The means(SD) of back phosphorylation levels of the three proteins were 540.7(304.1), 198.6(78.2), and 247.7(83.3) photostimulated luminescence units (PSL), respectively, by phosphoimager. After adjustment for potential confounding factors, tibial lead and exposure duration were significantly and inversely associated with back phosphorylation levels. One unit of increase in tibial lead (1 μg Pb/g bone mineral) is associated with a decline in spectrin, band 4.9 52 kDa, and band 4.9 48 kDa back phosphorylation levels by 1.4(p〈0.05), 0.34(p〈0.05), and 0.47(p〈0.01), respectively However, there were no associations between the back phosphorylation levels and either blood lead or ZPP levels. Conclusions : These findings suggest that the PKC activity in erythrocytes is increased by chronic lead exposure and that erythrocyte membrane protein phosphorylation may be a biomarker of lead exposure.

일부 제조업 사업장의 작업환경실태 및 특수건강진단에 대한 조사 연구

황주성,황규윤,안규동,이병국 순천향대학교 산업의학연구소 1997 순천향산업의학 Vol.3 No.1

The purpose of this study was to obtain information on the working environment, rate of environmental measurement over TLVs, the number of workers who were exposed to hazardous agents and, the examined rate of special health examination(SHE) in different types of industries. Authors investigate the reports on the working environmental status of the 101 industries in Cheonan area and result of SHE of those industries. The results were as follows : 1. Out of 101 industries under study, only 54 industries took special health examination. 2. While 85.3%(6,590) of 7,726 workers working in 101 industries were exposed to one or more hazardous agents, 88.4% of 5,867 workers working in 54 industries with special health examination were exposed to those agents & 75..4% of 1,859 workers working in 47 industries without any special health examination were exposed to those agents. But according to the criteria of selecting eligible workers for special health examination, only 32%(1,935/5,867) of total workers in the later industries were classified as eligible for the special health examination. 3. While rate of environment measurement of 101 industries TLVs who 25.5%, that of 54 industries with SHE was 29.8 & that of 47 industries without SHE was 16.1%, while the rate of noise and dust measurement over TLVs of 54 industries with SHE was 31.7%, and 25.3%, those of 47 industries without SHE was 13.6% & 35.6%, among 54 industries with SHE the rate of environmental measurement over TLVs was highest in clothes & leathers(47.0%) and that of foods(32.3%) and primary metal(31.3%). One the other hand, among 47 industries without SHE the rate of environmental measurement over TLVs was highest in paper & printing(44.9%) and that primary metal(15.8%), metaloid mineral(15.5%). 4. The examined rate of SHE of 54 industries was 92.7% as a whole. By type of industries the rate of primary metal(221.4%), foods(181.7%), chemicals(120.4%) were exceeded expected percent(100%) but the rate of metalloid mineral(53.0%), paper & printing(63.8%), machinery(72.2%) were far below the expected percent. 5. Only 4.7% of total workers working in 47 industries without SHE were classified as eligible workers for SHE. Among those eligible workers 48.9% were belonged to potential workers for SHE of noise. 6. The response rate of questionnaire was 70.4%(38/54) in 54 industries wirh SHE & 48.9%(23/47) in 47 industries. The necessity of environment measure was positively answer in 81.6% of 38 with SHE & 87% of 23 without SHE. On the other hand, the necessity of SHE was positively answered in 68.4% with SHE & 21.7% without SHE.

정신과 환자들의 의료서비스 이용에 관한 연구 : 경기도 연천 지역에서 In Yonchon Area of Kyunggi Province

황성혜,홍진표,권준수,우종인,김중술,조두영,이부영,조맹제,양병국,배재남 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.4

본 연구는 농촌지역 정신과 환자들의 의료서비스 이용 형태를 알아보고자 하여 행하여졌다. 경기도 연천군 주민중 1993년 1년간 지역 의료보험과 의료보호자료에서 정신과적 진단을 받은 사람들 1295명 중 209명을 대상으로 하였다. 연구자들이 제작한 반구조화된 면담도구를 사용하여 13명의 훈련된 면담자에 의해 증상을 처음 느낀 후 이용한 의료서비스를 차례대로 조사하였다. 결과는 다음과 같다. 정신증적 장애 환자들은 정신과 치료만을 받은 경우가 28.8%이며 처음 방문한 의료서비스는 정신과 45%, 일반의 28%, 약국 6%, 한방치료 5%, 요양원 6%, 기타 10%였다. 비정신증적 장애 환자들은 정신과를 한번이라도 이용한 경우는 32.1%였고 처음 방문한 의료서비스는 정신과 15%, 일반의59%,약국 17%, 한방치료8%, 기타1%였다. 진단에 따라서는, 정신분열병의 경우 64.5%가 처음에 정신과를 방문하였고 정동형 정신병의 경우는 20.8%에 불과했고 64.1%가 일반이나 약국을 처음에 방문하였다. 신경증적 장애(ICD-9 300)는 40.0%가 일반의만을 방문했다. 이상의 결과로 정신분열병 환자들은 대다수가 정신과 치료를 받는 것으로 나타났으나 정동형 정신병과 신경증적 장애는 다수가 일반의를 이용하는 것으로 나타났다. 지역사회 정신보건에서 일반의의 역할이 매우 중요하며 일반의에 대한 정신과 교육이 절실하고, 보다 전문적인 치료환경과 기술을 요하는 경우에는 정신과와의 연계 체계의 필요성도 요구된다. The purpose of this study was to investigate the pathways of health care seeking by the psychiatric patients at a well - defined rural area in Korea. Among 1,295 patients diagnosed to have mental disorders by ICD-9 in a year, all the psychotic patients(184 in number) and randomly selected 15% of nonpsychotic patients(162 in number) were selected as subjects of this study. Thirteen well - trained interviewers collected the data using semi-structurd inter-view instrument developed by the authors. Two hundred nine patients(60.4%) fully responded to the interviews. As for psychotic patients, 28.8% used only psychiatric services, and the first visits for help were psychiatrists, general practitioners, pharmacists, asylums and oriental herb medicine in the order of decreasing frequency. Only 32.1% of nonpsychotic patients used mental health specialties during the course of their illness, and their most common first visits for care were general practitioners(59%) followed by pharmacists(17%) and psychiatrists(15%). Majority(64%) of schizophrenic patient visited psychiatrist first, while 64.1% of affective psychosis patients visited general practitioners and pharmacists first. The forty percent of neurotic patients(ICD-9 300) visited general practitioners only for their health care.

저속 충격을 받는 적층판의 충격거동과 손상에 관한 연구

안국찬,김규수,박승범,황병선 한국산업안전학회 2002 한국안전학회지 Vol.17 No.1

This paper presents the impact behavior and damage of laminated composite plates subjected to the low-velocity impact. For this purpose, a pendulum impact test for impact behavior and C-scan for impact damage are done. Test materials are carbon/epoxy laminated composite plates and stacking sequences [0/90]_4, [0/45_2/-45]_s, [45_2/-45/90]_s, [0/45/-45/90]_s and [0/26/51/77/-77/-51/-26/0].

연작업자들의 신기능 평가에서 요중 δ-aminolevulinic acid 측정의 의의

이병국,이숙,김용배,리갑수,김화성,황규윤,장봉기,이성수,안규동 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

To clarify the effect of occupational lead exposure on renal function 241 lead workers working and 56 non lead workers were studied in 5 lead acid battery industries. Study variables for renal effect were urinary N-acetyl-β-D-glucosaminidase(NAG), urinary total protein(U-TP), blood urea nitrogen(BUN), serum creatinine(S-Cr), and serum uric acid(S-Ua). On the other hand, blood lead(PbB), zinc protoporphyrin in whole blood(ZPP), and delta-aminolevulinic acid in urine(δ-ALA) were selected for the variables of lead exposure. Information on age, work duration, smoking and drinking history were also obtained. The results obtained were as follows. While the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of BUN, U-TP and S-Cr of renal function indicators of exposed were also different from non-exposed. BUN, U-TP and NAG showed statistically significant correlation with PbB and ZPP, and NAG revealed also statistically strongly significant correlation with δ-ALA. On multiple regression using renal fuction indicators as a dependent variable and δ-ALA, age, work duration,lead exposure,smoking and drinking as independent variables, only δ-ALA contributed to NAG.

납 폭로 근로자에서 δ-aminolevulinic acid dehydratase 유전형질이 zinc protoporphyrin 및 δ-aminolevulinic acid에 미치는 영향

이병국,황규윤,장봉기,김용배,리갑수,안현철,김화성,이성수,안규동,박종범 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

The inhibition of δ-aminolevulinic acid dehydratase (ALAD) in the heme synthetic pathway results in increased protophoryphyrin (ZPP) and δ-aminolevulinic acid (ALA) and is responsible for some of toxicological effects of lead. This enzyme is coded by the ALAD gene containing 2 co-dominant alleles. The polymorphisms of ALAD gene may be related to differential effects of lead on ZPP and ALA, ALAD genotype was measured in 975 Korean male lead workers, of whom 897 were homozygous for ALAD1 (ALAD 1-1 genotype) and 96 were heterozygous for ALAD2 (ALAD 1-2 genotype). Blood lead in subjects with ALAD1 was significantly higher than those with ALAD2 (p = 0.01). No difference between ALAD genotypes was found for age, exposure duration, ZPP, ALA, hemoglobin, hematocrit, body mass index, tobacco and alcohol use. After adjustment for possible confounders, ALA and ZPP became significantly elevated in ALAD1 subjects (p = 0.004 and 0.055, respectively). This result suggests that ALAD1 subjects may be more susceptible to the hematotoxicologic effects of lead than ALAD2 subjects.