연폭로 근로자들에 있어서 신(腎)기능 장해 지표에 관한 연구

이상주,홍영습,김성률,김동일,김준연,정갑열 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

A range of indicators is available to assess renal dysfunction in lead exposure. This study was undertaken to find out which indicators were most valuable as markers of renal dysfunction. We selected 75 male workers from the secondary lead smelter, plastic stabilizer and radiator manufacturing industries (the "exposed" group) and 64 male office workers (the "control" group). Blood lead; blood zinc protoporphyrin; urine lead; urine coproporphyrin; δ-aminolevulinic acid dehydratase activity; and urine δ-aminolevulinic acid were chosen as indicators of lead exposure. Blood urea nitrogen; serum creatinine; serum uric acid; N-acetyl-β-D-glucosaminidase; urine albumin; urine α₁-microglobulin; and urine β₂-microglobulin were used as indicators of renal dysfunction. Urine α₁-microglobulin level was significantly associated with the lead exposre level. Blood urea nitrogen, urine N-acetyl-β-D-glucosaminidase and urine α₁-microglobulin levels were highly correlated with indicators of lead exposure. Urine α₁-microglobulin had the highest correlation with other indicators of renal function. In addition, the proportion of subjects with high urine α₁-microglobulin levels showed a gradient with lead exposure. Conclusively, blood urea nitrogen, urine N-acetyl-β-D-glucosaminidase and urine α₁-microglobulin are useful indicators, but urine α₁-microglobulin is the early and the most valuable indicator of renal dysfunction related to lead exposure.

우리나라 도시와 농촌 지역 주민의 혈중 연 및 혈중 Zinc Protoporphyrin농도 비교 연구

김준연,김병권,홍영습,이용언,정갑열 동아대학교 부설 산업의학연구소 1997 산업의학연구소 논총 Vol.- No.3

The study was carried out on healthy population in urban and rural area, in order to compare the level of blood lead (PbB) and blood zinc protoporphyrin (ZPP) between the population living in each area from July 1 1994 to December 31 1994. We stratificated the results with sex, age and area. The results obtained were as follows; 1. In urban area, overall mean of the PbB level was 7.08±1.61㎍/dl and both men and women had the highest level of PbB, which were 8.15±0.85㎍/dl, 6.90±1.48㎍/dl, in less than 39 years old group. In rural area, overall mean of the PbB level was 6.75±1.61㎍/dl and both men and women had the highest levels of PbB, which were 7.25±2.29㎍/dl, 7.00±2.92㎍/dl in 40∼49 years old group. And there was statistically significant difference between mean of the men's PbB level in urban area and that in rural area (p<0.05). 2. In urban area, overall mean of the ZPP level was 32.08±8.28㎍/dl and men had the highest level of ZPP, which was 29.59±5.13㎍/dl, in 40∼49 years old group, and women had that, which was 36.83±7.95㎍/dl, in less than 39 years old group. In rural area, overall mean of the ZPP level was 34.54±11.31㎍/dl and men had the highest level of ZPP, which was 32.10±5.45㎍/dl, in less than 39 years old group and women had that, which was 40.17±14.02㎍/dl, in 40∼49 years old group. And there was statistically significant difference between mean of the men's ZPP level in urban area and that in rural area (p<0.05). 3. There was statistically significant difference in PbB and ZPP between men and women group in both area (p<0.05) but not significant among age group in both area (p>0.05).

Renal Dysfunction Indicators, Lead Exposure, Urine - microglobulin Blood urea Nitrogen, Urine N-acetyl-β-D-glucosaminidase

김준연,김성률,홍영습,김동일,정갑열,이상주 동아대학교 부설 산업의학연구소 1997 산업의학연구소 논총 Vol.- No.3

A range of indicators is available to assess renal dysfunction in lead exposure. This study was undertaken to find out which indicators were most valuable as makers of renal dysfunction. We selected 75 male workers from the secondary lead smelter, plastic stabilizer and radiator manufacturing industries (the "exposed" group) and 64 male office workers (the "control" group). Blood lead; blood zinc protoporphyrin; urine lead; urine coproprphyrin; δ-aminolevulinic acid dehydratase activity; and urine δ-aminolevulinic acid were chosen as indicators of lead exposure. Blood urea nitrogen; serum creatinine; serum uric acid; urine N-acetyl-β-D-glucosaminidase; urine albumin; urine α₁-microglobulin; and urine β₂-microglobulin were used as indicators of renal dysfunction. Urine α₁-microglobulin level was significantly associated with the lead exposure level. Blood urea nitrogen, urine N-acetyl-β-D-glucosaminidase and urine α₁-microglobulin levels were highly correlated with indicators of lead exposure. Urine α₁-microglobulin had the highest correlation with other indicators of renal function. In addition, the proportion of subjects with high urine α₁-microglobulin levels showed a gradient with lead exposure. Conclusively, Blood urea nitrogen, urine N-acetyl-β-D-glucosaminidase and urine α1-microglobulin are useful indicators, but urine α₁-microglobulin is the early and the most valuable indicator of renal dysfunction related to lead exposure.

석면관련 폐질환의 진단에 있어서 흉부고해상도전산화단층촬영검사(HRCT)의 유용성

이현재,손지언,,홍영습,,이영일,예병진,유창훈,정갑열,김상훈,임형준,장은철,김정만,김준연 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 석면에 노출된 근로자에서 석면관련 폐질환의 양상을 분석하고 진단에 있어 HRCT의 유용성을 연구하여 석면에 대한 의학적 감시프로그램의 개발에 기여하고자 하였다. 방법: 석면에 직접 노출되는 작업자 68명과 간접 노출되는 작업자 94명 등 총 162명에 대해 OSHA 석면 표준, 의학적 감시 프로그램에 따라 단순 흉부방사선검사, 폐활량검사 및 우리나라 실정에 맞게 일부 수정한 의학적 설문지를 통해 면접조사의 방식으로 환자에 관한 정보를 수집하였으며, 자료의 신뢰성을 확보하기 위하여 면접조사는 1달 이상의 기간을 두고 2차례에 걸쳐 실시된 후 확인, 수정하였다. 또한, 석면관련 폐질환을 확진하기 위하여 HRCT를 추가적으로 실시하였다. 결과: HRCT결과 석면관련 폐질환의 유병율은 162명의 근로자중 17명으로 10.5%였는데, 직접 노출군에서 10명 (14.7%), 간접 노출군에서 7명 (7.4%)이었다. HRCT와 비교할 때 단순 흉부방사선검사의 민감도와 특이도는 각각 70.6%와 98.6%이었고, 양성 예측도와 음성 예측도는 각각 85.7%와 96.6%으로, HRCT는 단순흉부방사선검사에 비해 민감도가 높아 초기 석면관련 폐질환을 진단하는데 효과적이었다. 석면관련 폐질환의 진단에 있어 HRCT와 폐활량검사 사이에 유의한 관련성이 관찰되었다. HRCT 결과 석면관련 폐질환의 유무와 의학적 설문조사 결과의 빈도분석을 실시한 결과, 유의한 변수는 작업기간, 흡연량, 호흡기질환의 과거력, 기침, 호흡곤란이었다. 결론: HRCT는 석면관련 폐질환의 진단에 있어 단순 흉부방사선검사와 비교하여 민감도가 높아 초기 진단에 유용하므로 단순 흉부방사선선검사 결과 석면관련 폐질환소견을 보일 때뿐만 아니라, 정상소견을 보이더라도 폐활량 검사결과와 근무력, 흡연력, 호흡기질환의 과거력, 기침, 호흡곤란 등의 호흡기 증상을 참고하여 HRCT검사를 고려해야 한다. 또한, 본 연구에서 관련성이 없었던 요인들에 대해서도 향후 연관성을 규명하는 광범위한 전향적 연구가 필요하다. Objectives: This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease. Methods: The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveilance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveilance program consists of simple chest x-ray, spirometry and medical questionnarie. Results: Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT, HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea. Conclusions: In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.

한랭노출과 고혈압의 연관성

장태원,김윤규,윤동영,이창희,홍영습,신해림,정갑열,김준연 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

Objectives : This study was carried out to suggest preventive methods for hypertension in cold-exposed workers. Methods : In 11 refs·iteration industries, 68 workers working in refrigerated areas more than one time per day were selected as the exposed group, and 68 workers not exposed to cold were selected as the control group. We interviewed the subjects with a questionnaire covering occupational history, and conducted clinical and laboratory tests including measurements of blood pressure and core temperature. Results : The systolic blood pressure in the exposed group(130.0±13.3 mmHg) was significantly higher than that recorded In the control group(118.3±12.1 mmHg), as was the diastolic blood pressure in the exposed group(82.7±8.5 mmHg) versus the control group(77.4±8.7 mmHg). The core temperature in the exposed group(36.1±0.7℃) was significantly lower than that experienced in the control group (36.4±0.5℃). In logistic regression analysis, age, cold exposure severity and milk intake were significant variables, with odds ratios of 5.204(95 % CI 1.440∼18.812), 2.674(95 % CI 1.080∼6.618), and 0.364(95 % Cl 0.141∼0.942) , respectively. Conclusions : Our study suggests that cold-exposed workers have higher a higher risk of hypertension, and that their core temperature is lower. Risk factors affecting hyper-tension of cold-exposed workers include age, cold exposure severity and milk intake. For the prevention of hypertension, cold-exposed workers should minimize cold-exposure time as much as possible.

상지 단순반복작업 근로자의 수근관 증후군 유병률에 관한 조사

손지언,장태원,김윤규,홍영습,정갑열,김동일,이강진,하남진,김상범,김준연 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 본 연구는 수근관 증후군의 발생위험이 높은 작업형태에 종사하는 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장과 목재소 근로자에서 근전도검사를 이용하여 수근관 증후군의 유병률을 조사하고자 하였다. 방법 : 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장 근로자 69명과 목재소 근로자 17명을 실험군으로, 관리직, 경리, 경비등 상지의 단순반복작업이 없는 근로자 28명을 대조군으로 선정하여, 작업적 및 병력조사, 이학적 검사와 근전도검사를 통해 수근관 증후군의 유병률을 조사하였다. 결과 : 수근관 증후군의 유병률은 육류 및 어류 가공 사업장과 목재소에서 각각 26.09 % (18명)와 29.41 %(5명)로 조사되었으며, 육류 및 어류가공사업장과 목재소 근로자를 '7년 이상과 미만의 작업기간'으로 층화하여 비교한 결과 '상지부위의 통증 호소 유무', 'Visual Analogue Scale(VAS: 총 10점) 4점 이상 여부', 'Tinel teat 양성 유무', 'Phalen test 양성 유무'는 모두 단기 작업근로자군에서 양성의 빈도가 증가되었고 '수근관 증후군 유무'는 장기작업근로자군에서 양성의 빈도가 증가되었다. 결론 : 육류 및 어류 가공 사업장과 목재소의 수근관 증후군 유병률은 각각 26.09 %와 29.41 %로 육류 및 어류 가공 사업장과 목재소는 1996년 OSHA가 지정한 바와 같이 위험한 작업요인이 있는 작업장으로 분류하여 관리되어야 할 것으로 생각된다. Objectives : This study was carried out to survey on the prevalence of Carpal Tunnel Syndrome(CTS) in high risk jobs(meat and fish processing plant and wood plant), by application of Nerve Conduction Study(NCS), a confirmatory diagnostic method. Methods : Experimental group was 69 workers sampled from meat and fish processing plants and 17 workers sampled from wood plants, who were simple, repetitive workers using upper extremities and control group was 28 workers sampled from managers, secretaries and keepers. All employees were examined through work history, physical examination and NCS. Results : 18 workers(26.09%) in meat and fish processing plants, and 5 workers(29.41%) in wood plants had compatible findings to NIOSH diagnostic criteria for CTS. The experimental group had more symptoms (complaint of upper extremities, Visual Analogue Scale ≥4(VAS: total 10 point)), signs(Tinel and Phalen test) and prevalence of CTS than control group(p<0.05). The prevalence of symptoms and signs were higher in short term workers(<7 years), but the prevalence of CTS was higher in long term workers(≥7 years). Conclusions : The prevalence of CTS in meat and fish processing plant and wood plant were 26.09% and 29.41% respectively. Authors propose that meat and fish processing and wood plants should be managed as a risk job category which were designated by OSHA in 1996

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

The Relationship DNA Methylation of $p16^{INK4a}$ and Colorectal Cancer

Hong, Young-Seoub,You, Chang-Hun,Roh, Mee-Sook,Kim, Na-Young,Lee, Kyung-Eun,Kim, Hyo-Jun,Lee, Hyun-Jae,Kwak, Jong-Young,Kim, Joon-Youn The Korean Society of Toxicogenomics and Toxicopro 2007 Molecular & cellular toxicology Vol.3 No.4

Promoter hypermethylation of the $p16^{INK4a}$ gene was investigated in 52 sets of samples of tumor tissue and adjacent normal tissue from Korean patients with colorectal cancer, using the proposed modified the Real-time PCR/SYBR Green detection method presented in this study. In normal tissue, 29 of 52 patients (56%) were methylated and in tumor tissue, 23 of 52 patients (44%) were methylated. The 34 cases (65.4%) showed a concordant DNA methylation pattern in both normal tissue and tumor tissue. Analyzing the association between the clinicopathologic features and DNA methylation status of the $p16^{INK4a}$ gene, the DNA methylation status according to by Duke's stage was different while other clinicopathological characteristics, including the age, sex, tumor stage, and histologic type of the patient were not found to be correlated with $p16^{INK4a}$ methylation. With multivariate logistic regression, it was observed that the DNA methylation status of $p16^{INK4a}$ gene in normal tissue was correlated with the DNA methylation status of the $p16^{INK4a}$ gene in tumor tissue (P=0.026). According to a Kaplan-Meier survival analysis, a difference in the survival rate by DNA methylation status was found, but it was not significant.

A two-stage case-control study of EGFR polymorphisms and breast cancer risk.

Hong, Young-Seoub,Deming, Sandra L,Gao, Yu-Tang,Long, Ji-Rong,Shu, Xiao-Ou,Cai, Qiuyin,Lu, Wei,Zheng, Wei American Association for Cancer Research 2009 Cancer Epidemiology, Biomarkers & Prevention Vol.18 No.2

Four Cases of Abnormal Neuropsychological Findings in Children with High Blood Methylmercury Concentrations

Young-Seoub Hong,Dae-Seon Kim,Seung-Do Yu,Seong-Hwan Kim,Jong-Kuk Kim,Yu-Mi Kim,Jae-Ho Yu,Ji-Hyun Jung,Byoung-Gwon Kim 대한직업환경의학회 2013 대한직업환경의학회지 Vol.25 No.-

Background: Methylmercury (MeHg) easily crosses the blood?brain barrier and accumulates in the brain. Accumulated MeHg will cause neurological symptoms. We report four pediatric cases of neuropsychological findings with high blood MeHg concentrations. Case presentation: Four children were admitted for follow-up study because their total mercury (THg) concentration in the blood was found to be high during a national survey. Case 1 was a 9-year-old female with a 16.6 μg/ℓ blood THg concentration in the survey. During admission, the blood THg, hair THg, and blood MeHg concentration(mercury indices) were 21.4 μg/ℓ, 7.2 μg/g, and 20.1 μg/ℓ, respectively. In our neuropsychological examination, cognitive impairment and attention deficit were observed. Her diet included fish intake 2?3 times per week, and she had been diagnosed with epilepsy at 3 years of age. Case 2 was a 12-year-old male with blood THg of 15.4 μg/ℓ in the survey and the mercury indices were 12.7 μg/ℓ, 5.7 μg/g, and 11.8 μg/ℓ, respectively, on admission. He was also observed to have attention-deficit/hyperactivity disorder. Case 3 was a 10-year-old male child with blood THg of 17.4 μg/ℓ in the survey, and the mercury indices on admission were 21.6 μg/ℓ, 7.5 μg/g and 21.5 μg/ℓ, respectively. In his case, mild attention deficit was observed. Case 4 was a 9-year-old male with blood THg of 20.6 μg/ℓ in the survey and the mercury indices were 18.9 μg/ℓ, 8.3 μg/g, and 14.4 μg/ℓ, respectively, on admission. Mild attention difficulty was observed. Conclusion: We suggest that fish consumption may be the main source of MeHg exposure, and that MeHg may have been the cause of the neuropsychological deficits in these cases.