나림광산 수계의 토양과 퇴적물에 관한 지구화학적 특성: 중금속 원소의 분산, 부화 및 기원

이찬희,이현구,이종창,Lee, Chan Hee,Lee, Hyun Koo,Lee, Jong Chang 대한자원환경지질학회 1998 자원환경지질 Vol.31 No.4

Geochemical characteristics of environmental toxic elements at the Narim mine area were investigated on the basis of major, minor, rare earth element geochemistry and mineralogy. Ratios of $Al_2O_3/Na_2O$ and $K_2O/Na_2O$ in soils and sediments range from 11.57 to 22.21 and from 1.86 to 3.93, and are partly negative and positive correlation against $SiO_2/Al_2O_3$ (3.41 to 4.78), respectively. These suggested that sediment source of host granitic gneiss could be due to rocks of high grade metamorphism originated by sedimentary rocks. Characteristics of some trace and rare earth elements of V/Ni (0.33 to 1.95), Ni/Co (2.00 to 6.50), Zr/Hf (11.27 to 53.10), La/Ce (0.44 to 0.55), Th/Yb (4.07 to 7.14), La/Th (2.35 to 3.93), $La_N/Yb_N$ (6.58 to 13.67), Co/Th (0.63 to 2.68), La/Sc (3.29 to 5.94) and Sc/Th (0.49 to 1.00) are revealed a narrow range and homogeneous compositions may be explained by simple source lithology. Major elements in all samples are enriched $Al_2O_3$, MgO, $TiO_2$ and LOI, especially $Fe_2O_3$ (mean=7.36 wt.%) in sediments than the composition of host granitic gneiss. The average enrichment indices of major and rare earth elements from the mining drainage are 2.05 and 2.91 of the sediments and are 2.02 and 2.60 of the soils, normalizing by composition of host granitic gneiss, respectively. Average composition (ppm) of minor and/or environmental toxic elements in sediments and soils are Ag=14 and 1, As=199 and 14, Cd=22 and 1, Cu=215 and 42, Pb=1770 and 65, Sb=18 and 3, Zn=3333 and 170, respectively, and extremely high concentrations are found in the subsurface sediments near the ore dump. Environmental toxic elements were strongly enriched in all samples, especially As, Cd, Cu, Pb, Sb and Zn. The level of enrichment was very severe in mining drainage sediments, while it was not so great in the soils. Based on the EPA value, enrichment index of toxic elements is 8.63 of mining drainage sediments and 0.54 of soils on the mining drainage. Mineral composition of soils and sediments near the mining area were partly variable being composed of quartz, mica, feldspar, amphibole, chlorite and clay minerals. From the gravity separated mineralogy, soils and sediments are composed of some pyrite, arsenopyrite, chalcopyrite, sphalerite, galena, goethite and various hydroxide minerals.

남동 - 황해 대륙붕의 준표층 니질퇴적물에서 산출되는 그레자이트

이찬희,진재화,장세원,이성록,이치원 ( Chan Hee Lee,Jae Hwa Jin,Se Won Chang,Sung Rock Lee,Chi Won Lee ) 한국광물학회 1995 광물과 암석 (J.Miner.Soc.Korea) Vol.8 No.1

신조직 검사로 입증된 루푸스 신염에 대한 치료 효과 및 예후 인자에 대한 후향적 연구

이찬희 ( Chan Hee Lee ),서창희 ( Chang Hee Suh ),이충원 ( Choong Won Lee ),이원기 ( Won Ki Lee ),이지수 ( Ji Soo Lee ),박용범 ( Yong Beom Park ),송정식 ( Jung Sik Song ),송창호 ( Chang Ho Song ),정현주 ( Hyeon Joo Jeong ),최규헌 ( 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1

Objectives: To evaluate the clinicopathologic character, therapeutic outcome, and prognostic factor of biopsy-proven lupus nephritis. Methods: Biopsy proven lupus nephritis patients who were admitted at Yonsei Medical Center from January 1986 to June 1997 were included in this study. We retrospectively reviewed the medical records. Patients were treated with steroid regimen with or without cyclophosphamide. According to the therapeutic response, patients were divided into two groups: therapeutic response group and therapeutic nonresponse group. Results: The results are as follows; 1. Among 68 biopsy-proven lupus nephritis cases, 54 patients who were treated at least 6 months were included in this study. 2. The mean follow up duration was 51 months. Mean serum creatinine was 1.4mg/dl, 24-hour proteinuria was 4,868mg, and anti-DNA antibody was positive in 76% at the time of renal biopsy. 3. Diffuse proliferative nephritis was the most common pathologic findings(32 cases, 59%). Activity index was highest in diffuse proliferative nephritis. 4. Overall 5-year renal survival rate was 25% and there was no difference between steroid single therapy and cyclophosphamide combination therapy. In diffuse proliferative nephritis, 5-year renal survival rate was 18% and there was no difference according to treatment. 5. Factor affecting therapeutic response was pathologic classification; diffuse proliferative nephritis was associated with poor therapeutic response(p=0.032). 6. Six patients(11%) progressed to end stage renal disease. 7. Major complications with treatment were infections including herpes zoster. Conclusion: In our series of lupus nephritis, diffuse proliferative nephritis was poor prognostic factor.

Internal Texture, Geochemistry and Mineralogy of Manganese Nodules from the Clarion-Clipperton Fracture Zones, Pacific

이찬희(Chan-Hee Lee),이성록(Sung-Rock Lee),장세원(Se-Won Chang) 대한지질학회 1996 지질학회지 Vol.32 No.3

신경정신루프스에 대한 임상적 연구

이찬희 ( Chan Hee Lee ),이지수 ( Ji Soo Lee ),송창호 ( Chang Ho Song ),이수곤 ( Soo Kon Lee ) 대한류마티스학회 1996 대한류마티스학회지 Vol.3 No.2

연구배경 및 방법: 신경정신루프스의 임상적인 특징과 진단방법, 혈청학적 검사, 치료법에 대하여 알아봄으로써 신경정신 루프스와 연관이 있는 인자를 알아보고자, 1994년 1월부터 1996년 3월사이에 연세대학교 의과대학 부속 세브란스병원에 입원한 전신성 홍반성 루프스 환자중 신경정신루프스로 진단받은 환자를 대상으로 하여 임상적인 특징과 진단방법, 혈청학적 검사, 치료법에 대하여 알아보았다. 결과: 1. 동기간 동안 전신성 홍반성 루프스로 입원한 환자는 144명이었고, 그중 신경정신루프스로 분류된 환자는 24명이었으며, 신경정신루프스의 발병횟수는 한 환자당 1-3회로 총 28회였다. 2. 대상환자는 남자가 1명, 여자가 23명이었고, 연령은 14세에서 41세였다. 3. 신경정신루프스에 의한 증상으로 내원하여 전신성 홍반성 루프스로 진단받은 환자가 8명이었고, 나머지 16명의 환자는 전신성 홍반성 루프스로 추적관찰중 2개월에서 9년사이에 신경정신루프스에 의한 증상을 나타내었다. 4. 다른 원인에 의하여 신경정신루프스와 유사한 증세를 나타낸 경우가 7예였으며, 그중 약물과 관계된 경우가 1예, 감염으로 인한 경우가 2예, 반응성 우울증이 2예, 혈소판 감소에 의한 출혈이 2예였다. 5. 광범위한 양상을 보이는 22예 중 20예에서 항칼디오리핀 항체나, 루프스 항응고인자를 측정하였고 그 중 6예에서 양성반응을 보였으며, 국한성 양상을 보이는 6예중 3예에서 항칼디오리핀 항체나, 루프스 항응고인자를 측정하여 3예에서 양성반응을 보였다(p<0.01). 6. 신경정신루프스의 진단방법 양성율은 뇌척수액검사를 14명에서 실시하여 1명에서 이상소견을 보였으며, 뇌파검사는 8명에서 실시하여 5명에서 이상소견을 보였으며, 뇌전산화 단층촬영이 17명에서 실시하여 9명에서 이상소견을 보였으며, 핵자기공명 촬영이 9명에서 실시하여 6명에서 이상소견을 보였으며 뇌혈관 촬영은 실시한 한 환자에서 이상소견을 보였고, 척수강조영술을 시행한 한 환자에서 이상 소견을 발견하지 못하였다. 7. 치료로 사용된 방법은 고용량스테로이드나, 스테로이드 충격요법을 시행한 경우가 13예이며, 고용량스테로이드와 정신과약물을 투여한 경우가 3예, 스테로이드 충격요법으로 반응이 없어 혈장교환술을 시행하면서 cytoxan을 투여한 경우가 1예, 스테로이드 충격요법으로 반응이 없어 혈장교환술을 시행하면서 항경련제를 투여한 경우가 1예, 스테로이드충격요법으로 반응이 없어 혈장교환술을 시행한 경우가 3예, 스테로이드 충격요법과 항경련제를 투여한 경우가 1예, 고용량의 스테로이드와 warfarin을 투여한 경우가 1예, 정신과약물만을 투여한 경우가 2예, 소량의 스테로이드와 진통제를 투여한 경우가 1예였고, 소량의 스테로이드를 투여한 경우가 1예였고, 26명의 환자에서 치료에 대한 반응을 보였다. 치료받지 않은 한명의 환자도 입원기간동안 증상의 호전이 있었다. 8. 신경정신루프스환자 24명중 3예에서 사망하였으며 사망 원인은 폐출혈, 패혈증, 경련충첩증이였다. 결론: 이상으로 본원에서 진단된 신경정신루프스환자들의 임상적 특징과 진단방법, 검사실 소견, 치료법을 관찰하였으며, 국소적인 증상을 보이는 경우 항인지질 항체와 상관관계가 있는 것을 알 수 있었고, 향후 이에 대한 보다 많은 증례에서의 검토가 필요할 것으로 생각된다. Objectives: To evaluate the clinical characteristics, diagnostic methods, serologic tests and treatment modalities of neuropsychiatric lupus (NPSLE). Methods: Systemic lupus erythematosus(SLE) patients manifesting NPSLE at Severance Hospital, Yonsei University College of Medicine were retrospectively studied in the period of Jan 1994 to March 1996. Results: The results were as follows; 1) Neuropsychiatric manifestations were observed in 24 patients of the total 144 SLE patients (16.6%). 2) Of the 24 NPSLE patients, there was 1 male, 23 female and the mean age was 32 years (range 14-70). 3) Eight patients presented neuropsychiatric symptoms as an initial manifestation and the rest presented during the follow up period (mean: 25 months, range: 2 months-10 years). 4) Preceding cause was identified in seven patients and was classified as secondary NPSLE: drug in 1 case, infection in 2 cases, reactive depression in 2 cases, and cerebral hemorrhage due to thrombocytopenia in 2 case. 5) NPSLE was classified into diffuse manifestation and focal manifestation. The diffuse manifestation was found in 22 cases and the focal manifestation was found in 6 cases. Patients with focal manifestation showed higher rate of anticardiolipin antibody or lupus anticoagulant test than patients with diffuse manifestation with of 100% (3/3) in the former and 30% (6/20) in the latter(p<0.01). 6) The sensitivity of diagnostic tests were as follows: cerebrospinal fluid study 7.1% (1/11), electroencephalogram 62.5% (5/8), brain computed tomogram 52.9% (9/17) , magnetic resonance imaging 66.7% (6/9), cerebral angiogram 100% (1/1), and myelogram 0% (01). 7) The treatment modalities were as follows; high dose steroid (1mg/kg/day) or steroid pulse therapy (intravenous methylpredinisolone 1g/day for 3 days) alone in 13 cases, high dose steroid or steroid plus other drugs (anticonvulants, psychiatric medication, warfarin) in 5 cases, steroid pulse plus plasmapheresis in 3 cases, steroid pulse and plasmapheresis plus other drugs (intravenous cyclophosphamide, anticonvulsant) in 2 patients, low dose steroid (alone or with analgesics) in 2 patient, psychiatric treatment in 2 patients and no treatment in 1 patient. 26 patients responded to treatment. 8) The mortality rate was 12.5% (3/24) and the cause of death was pulmonary hemorrhage, septic shock, and status epilepticus. Conclusions: NPSLE is a frequent and morbid manifestation of SLE but diagnosis is difficult due to lack of specific test. Focal manifestation of NPSLE was associated with anti phospholipid antibody.

한국 성인에서 제2형 당뇨병의 예측인자로서 공복 혈장 혈당과 당화혈색소의 조합

이찬희 ( Chan Hee Lee ),장우진 ( Woo Jin Chang ),정현희 ( Hyun Hee Chung ),김현정 ( Hyun Jung Kim ),박상현 ( Sang Hyun Park ),문준성 ( Jun Sung Moon ),이지은 ( Ji Eun Lee ),윤지성 ( Ji Sung Yoon ),천경아 ( Kyung Ah Chun ),원규장 ( 대한당뇨병학회 2009 Diabetes and Metabolism Journal Vol.33 No.4

연구배경: 당뇨병의 선별 검사로서 경구당부하검사는 재현성이 낮으면서 시행하기 어려운 단점이 있어, 좀 더 쉬운 검사가 요구된다. 본 연구에서는 공복 혈장 혈당과 당화혈색소의 조합이 한국 성인의 당뇨병을 예측하는데 있어서 유용한지 알아보고자 하였다. 방법: 2002년 1월부터 2003년 12월까지 영남대학교병원 건강 증진 센터를 방문한 환자 2,045명(남자 1,276명, 평균 연령 47.8±9.0세)를 대상으로 공복 혈장 혈당과 당화혈색소, 다른 생화학적 검사를 시행하였고 4년 후 추적 검사를 시행하였다. 기저시점 검사에서 AST, ALT, 총 빌리루빈치가 높은 환자와 당뇨병이 있는 환자는 제외되었다. 결과: 4년 후 새롭게 당뇨병으로 진단 받은 사람은 2,045명 중 32명(1.6%)이었다. 당뇨 발생군은 비발생군에 비해 나이가 많았으며 혈압, 공복 혈장 혈당, 당화혈색소, 중성지방, 고밀도 지단백 콜레스테롤, GGT, LDH가 높았다(P<0.05). 다중 회귀분석에서 공복 혈장 혈당(OR 1.124)과 당화혈색소(OR 4.794)는 당뇨병의 발병과 유의한 상관관계가 있었다(P<0.05). 공복 혈장 혈당과 당화혈색소의 교호작용에 대한 OR은 1 이상으로, 두 가지의 조합은 당뇨병의 발병을 예측하는데 있어 상승 작용을 나타내었다. 당뇨병 예측을 위한 두 인자의 ROC curve에서 당화혈색소와 공복 혈장 혈당의 기준치는 각각 5.35% (AUC=0.944), 102.5 mg/dL (AUC=0.930)였다. 결론: 한국 성인에서 5.35% 이상의 당화혈색소와 102.5 mg/dL 이상의 공복 혈장 혈당을 가진 경우에 각각의 경우보다 당뇨병의 발생을 더 잘 예측할 수 있었다. 이 결과로 한국 성인에서 제2형 당뇨병의 예측 인자로서 공복 혈장 혈당과 당화혈색소의 조합이 유용할 것으로 생각된다. Background: The oral glucose tolerance test (OGTT) for detection of diabetes is difficult to perform in clinical settings. The aim of this study is to evaluate the performance of a more practical detection test, combined fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c), as a predictor of diabetes mellitus (DM) in a Korean sample. Methods: We examined 2,045 (M=1,276, mean age=47.8±9.0 yrs) medical check-up program participants between January 2002 to December 2003. FPG, HbA1c and a number of other biochemical tests were performed at baseline and four after years after initial screening. Patients who originally presented with diabetes were excluded. The characteristics of newly-diagnosed DM patients and non-diabetic patients were compared. Results: The incidence of newly diagnosed diabetes was 1.6% (32/2,045) after four years of follow up. The subjects in the DM group were older, had higher levels of SBP, DBP, FPG, HbA1c, triglyceride, HDL cholesterol, GGT and LDH (P<0.05). In multivariate logistic regression analysis, FPG (odds ratio [OR] 1.124) and HbA1c (OR 4.794) were significantly correlated with onset of diabetes (P<0.05). The interaction parameter between FPG and HbA1c was more than 1.0, indicating that the two effects are synergistic. The predictive cut-off values of HbA1c and FPG were 5.35% (area under curve [AUC]=0.944) and 102.5 mg/dL (AUC=0.930), respectively. Conclusion: The combination of HbA1c above 5.35% and FPG above 102.5 mg/dL predicted the onset of diabetes in a Korean sample. These results suggest that the combination of FPG and HbA1c may be useful for predicting progression to type 2 diabetes in east Asians. (Korean Diabetes J 33:306-314, 2009)

Morphological Classification of the Manganese Nodules from the Clarion-Clipperton Fracture Zones, Pacific

이찬희(Chan Hee Lee),장세원(Se-Won Chang),이성록(Sung-Rock Lee),공기수(Gee-Soo Kong),강중석(Jung-Seock Kang),장정해(Jeong-Hae Chang) 대한지질학회 1995 지질학회지 Vol.31 No.5

류마티스 관절염의 초치료와 불응성 류마티스 관절염의 치료에 있어 Bucillamine의 효과

송창호 ( Chang Ho Song ),이지수 ( Ji Soo Lee ),이찬희 ( Chan Hee Lee ),이충원 ( Choong Won Lee ),송정식 ( Jung Sik Song ),이수곤 ( Soo Kon Lee ),( Chang Hee Suh ) 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.1

저자들은 DMARD를 사용한 경험이 없는 류마티스 관절염의 초치료 환자 10명과 DMARD에 반응이 없는 불응성 류마티스 관절염 환자 9명을 대상으로 bucillamine을 투여하여 다음의 결과를 얻었다. 1. 치료 종료시 초치료군에서 조조강직의 지속시간, VAPS, 압통관절의 수, 종창관절의 수, ESR 및 CRP가 치료전에 비하여 유의하게 감소 하였으나 불응성 환자군에서는 대부분의 지표가 감소하지 않았다. 2. 치료약제와 관련된 부작용은 초치료군에서 4예, 불응성 환자군에서 5예에서 발생하였으며, 상부위장관 장애가 양군을 합하여 5예로 가장 흔하였다. 이상의 결과로 bucillamine은 류마티스 관절염의 초치료에 효과적이며 비교적 안전한 약제임을 알 수 있었다. Objective: To assess the clinical effect of bucillamine in rheumatoid arthritis (RA), we performed an open clinical trial for 3 months. Methods: 10 out of 12 patients completed bucillamine trial(200mg/day) for their initial treatment against arthritis, and 9 out of 11 patients with refractory RA completed the bucillamine trial. Disease activity was assessed by the duration of morning stiffness(MS), visual analogue pain scale(VAPS), functional capacity(FC), tender joint counts(TJC), swollen joint counts(SJC), ESR, and CRP every month. Adverse effects were monitored monthly. Results: At the end of trial, all parameters were decreased in the initial treatment group except of CRP. No parameters were decreased in the refractory group. Gastrointestinal disturbance was the most common adverse effect. Skin rash, stomatitis, proteiuria and elevated hepatic enzyme were minor adverse effects. Conclusion: Bucillamine was effective in the initial treatment of rheumatoid arthritis, but not effective in the patients with refractory rheumatoid arthritis. Bucillamine is relatively safe in the treatment of rheumatoid arthritis in both groups.

소포 림프종에 동반된 강직성 척추염 1예

박희진 ( Hee Jin Park ),이상원 ( Sang Won Lee ),이찬희 ( Chan Hee Lee ),김선정 ( Sun Jung Kim ),김미현 ( Mi Hyun Kim ),홍지영 ( Ji Young Hong ),박용범 ( Yong Beom Park ),장명희 ( Myung Hee Chang ),한정우 ( Jung Woo Han ),이수곤 ( 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.4

강직성 척추염은 류마티스관절염처럼 만성적인 염증성관절 질환이지만 이전 연구들에서 강직성 척추염은 다른 자가면역 질환과 달리 림프종의 발생률을 의미 있게 증가 시키지는 않는 것으로 보고되었다. 국내에서 비호지킨 림프종과 강직성 척추염이 함께 발병한 증례가 보고된 적이없어, 비호지킨 림프종의 일종인 소포림프종으로 치료 중 강직성 척추염이 진단되어 비스테로이드성 진통소염제를 사용해서 증상이 호전된 증례를 경험하여 문헌 고찰과 함께 보고하는 바이다. Several autoimmune and chronic inflammatory conditions have been consistently linked with an increased risk of hematologic malignancies. Although ankylosing spondylitis (AS) is a chronic inflammatory disease, previous studies have demonstrated that it is not associated with an increase in risk of malignant lymphomas. Cases of AS accompanied by hematologic malignancies such as multiple myeloma, chronic myelogenous leukemia, and Hodgkin`s disease have been reported. In Korea, AS with non-Hodgkin`s lymphoma or follicular lymphoma has not been reported. We experienced a 38-year-old male who had been diagnosed with follicular lymphoma with bone metastasis, who achieved complete remission after having been treated with chemotherapy, developed new inflammatory back pain. An MRI of his hip showed an active inflammation of the left sacroiliac joint and a positive HLA-B27. The patient was diagnosed with AS and was treated with naproxen, which improved the pain in his back and buttock.

후종인대 골화증과 동반된 미만성 특발성 골격성 과골증 (DISH)

이상길 ( Sang Gil Lee ),이지수 ( Ji Soo Lee ),박용범 ( Yong Beom Park ),이원기 ( Won Ki Lee ),백용한 ( Yong Han Paik ),송정식 ( Jung Sik Song ),최윤종 ( Yun Jong Chae ),이찬희 ( Chan Hee Lee ),송창호 ( Chang Ho Song ),이수곤 ( Soo 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.1

We experienced a case of diffuse idiopathic skeletal hyperostosis(DISH) associated with ossification of the posterior longitudinal ligament. A 58-year old man presented with clumsiness and hypesthesia of both hands. He showed weakness of sensory defit and weakness of motor function of hands. The lateral radiograph of cervical spine showed anterior hyperostosis and ossification of the posterior longitudinal ligament. A magnetic resonance image of cervical spine revealed a low-density defect posterior to cervical spine with evidence of spinal stenosis. Ossification of the posterior longitudinal ligament is a rare manifestation associated with DISH, and we report this case with a review of the literature.