인천지역 TDI 노출 작업자에서 직업성천식 유병율

김형렬,김철우,홍윤철,전형준,김치년,김현수,이지나,신주연,고동희,노재훈 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : TDI는 직업성천식을 일으키는 대표적인 물질로 알려져 있다. 과거 TDI에 노출된 작업자들의 천식 발생률을 5~6%가량 보고하였고, 국내에서도 2-20%에 이르는 유병율을 보고한바 있다. 작업환경이 많이 개선되고, 노출량이 감소된 최근에도 TDI에 의한 직업성천식에 대한 보고가 많이 이루어지고 있어, 이에 대한 적극적인 조사와 진단과정을 통해 유병율을 구하고 질병발생의 변화양상을 파악해 보고자 하였다. 방법 : 인천지역에서 특수건강진단을 수행하는 2개 기관의 TDI 노출 근로자 400여명 중, 사업장의 규모가 50인 이상이며 사업주가 연구진행을 허락한 사업장에서 근무하는 근로자 중 직접적으로 TDI에 노출되는 작업에 종사하는 근로자 170명을 연구대상으로 하였다. 이들에 대해 설문지와 산업의학의사의 면담을 통한 작업관련성 평가를 근거로 정밀대상자를 선정하고 이들에 대해 메타콜린 유발시험, TDI 유발시험 등을 수행하여 직업성천식을 확인하였다. 결과 : 설문조사 결과 11명이 직업과 관련하여 천식증상을 보이는 것으로 나타났고(6.9%), 이중 7명에서 메타콜린 유발검사 양성소견을 보였다. TDI에 의한 특이유발시험 결과 1명에서 양성반응이 나타나, 이 집단에서 TDI에 의한 직업성천식의 유병율은 0.58%였다. 결론 : 과거 국내연구에서 TDI에 의한 직업성천식의 유병율이 2~20%에 이르렀던 데 비해, 본 연구에서는 0.58%로 나타났다. 이는 국외 논문에서도 나타나는 경향으로 작업장 노출량 감소로 점차 발생률이 감소하는 양상을 보이고 있다. 그러나 이미 증상이 나타난 근로자들이 부서를 옮기거나, 직장을 그만둠으로 인해 그 유병율이 과소평가되었을 가능성도 있다고 판단된다. Objecdives: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. Methods: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. Results: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma. and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1 %). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. Conclusions: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

형광검출 역상 액체크로마토그래피에 의한 Histamine의 정량

유희춘,김형룡,김상현,김대기,이영미,김형민,안년형,신태용 우석대학교 의약품개발연구소 1996 藥學硏究誌 Vol.1 No.-

Histamine을 정확하고 신속하게 정량하기 위해 9.Fiuorenylmethyl chloroformate를 형광유도체화제로 하여 역상 HPLC법으로 정량하였다. 히스타민을 형광유도체화할 때 반응액의 pH, 반응시간, 형광유도체화제의 농도 등 최적 반응 조건을 검토하였다. 이 방법으로 히스타민을 분석한 결과 0.1~0.5ug/ml의 농도범위에서 상관계수가 0.922인 양호한 직선성을 나타내었으며 검출한계는 0.01??/ml였다. A rapid and simple method for the determination of histamine by reverse-phase high performance liquid chromatography with fluorescence detection was established. 9-Fluorenylmethyl chloroformate(FMOC) was used as fluorescent derivative reagent. The optimum conditions for the derivatiation such as pH, reaction time and he concentration of FMOC were investigated. Linearity of calibration curve was obtained between 0.1ug/ml/and 0.5ug/ml(r=0.922) and the limit of detection was 0.01ug/ml.

Shelf Life Determination of Precooked Frozen Meat Dumplings

Lee, Young-Chun,Yang, Hyung-Sub,Kim, Dong-Ho 한국산업식품공학회 2002 산업 식품공학 Vol.6 No.3

Quality of frozen foods is significantly affected by the storage temperature and tie, and the consumers' demand for safe quality frozen foods is increasing. The objective of this research was to estimate the shelf life of frozen cooked meat dumplings, based on the changes in the selected physico-chemical and sensory quality attributes. Precooked frozen meat dumplings sampled from the same lot produced at a frozen food company in Seoul were stored at -10, -15, and -20℃. The meat dumplings sampled at 3- to 4-week intervals were subjected to the determination of volatile basic nitrogen (VBN), thiobarbituric acid (TBA), peroxide value (POV), surface color and shear value after thawing at 5℃ for 15 h. High quality life (HQL) was determined through the triangle test and practical quality life (PQL) through the scoring test. VBN, TBA and POV increased as the storage period was increased. HQL of the frozen meat dumplings were 189 and 252 days at -10 and -15℃, respectively. The estimated PQL were 349, 475, and 491 days at -10, -15, and -20 ℃, respectively. Statistical analysis indicated that there were significant relationships between sensory scores and VBN and POV of the stored meat dumplings. VBN was selected as the most reliable objective quality index for the shelf life determination (PQL) of the precooked frozen meat dumplings.

40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

Medicinal Chemistry : EVALUATION OF CADMIUM-INDUCED NEPHROTOXICITY USING URINARY METABOLOMIC PROFILES IN SPRAGUE-DAWLEY MALE RATS

( Yu Kyung Lee ),( Eun Young Park ),( Shi Won Kim ),( Ji Yeon Son ),( Tae Hyung Kim ),( Won Gu Kang ),( Tae Chun Jeong ),( Kyu Bong Kim ),( Seung Jun Kwack ),( Jae Won Lee ),( Suh Mann Kim ),( Byung M 영남대학교 약품개발연구소 2015 영남대학교 약품개발연구소 연구업적집 Vol.25 No.-

The aim of this study was to investigate urinary metabolomics profiles associated with cadmium (Cd)-induced nephrotoxicity and their potential mechanisms. Metabolomic profiles were measured by high-resolution 1H-nuclear magnetic resonance (NMR) spectroscopy in the urine of rats after oral exposure to CdCl2 (1, 5, or 25 mg/kg) for 6 wk. The spectral data were further analyzed by a multivariate analysis to identify specific urinary metabolites. Urinary excretion levels of protein biomarkers were also measured and CdCl2 accumulated dose-dependently in the kidney. High-dose (25 mg/kg) CdCl2 exposure significantly increased serum blood urea nitrogen (BUN), but serum creatinine (sCr) levels were unchanged. High-dose CdCl2 (25 mg/kg) exposure also significantly elevated protein-based urinary biomarkers including osteopontin, monocyte chemoattractant protein-1 (MCP-1), kidney injury molecules-1 (Kim-1), and selenium-bingding protein 1 (SBP1) in rat urine. Under these conditions, six urinary metabolites (citarate, serine, 3-hydroxyisovalerate, 4-hydroxyphentllactate, dimethylamine, and betaine) were involved in mitochondrial energy metabolism. In addition, a few number of amino acids such as glycine, glutamate, tyrosine, proline, or phentlalanine and carbohydrate (glucose) were altered in urine afrer CdCl2 exposure. In particular, the metabolites involved in the glutathione biosynthesis pathway, including cysteine, serine, methionine, and glutamate, were markedly decreased compared to the control. Thus, these metabolites are potential biomarkers for detection of Cd-induced nephrotoxicity. Our results further indicate that redox metabolomics pathways may be associated with Cd-mediated chronic kidney injury. These findings provide a biochemical pathway for better understanding of cellulat mechanism underlying Cd-induced renal injury in hunmans.

요통 크리��에 6개월간 내원한 요통환자의 임상적 분석

김영수,윤수한,박형천,김상진 대한신경외과학회 1987 Journal of Korean neurosurgical society Vol.16 No.4

2268 cases of low back pain were analysed at the low back pain clinic, Department of Neurosurgery. Yongdong Severance Hospital Yonsei University College of Medicine from January to July 1986. 1) About 85.4% were in between 20's and 50's of age groups. 30's(25.7%) and 40's(24.7%) were common. Teenagers were about 5.9%. Male to female ratio was 1 : 1.1. 2) By occupations housewives were most common(40.5%), office workers 26.4% light workers 13.2%, and students 12.7% in order. But drivers(2.4%) and heavy workers(1.9%) were relatively rare. 3) About 30.7% of all patients had some history of trauma. Among them lifting was most common in 45.8%, exercise 17.8%, and traffic accident 10.8%. 4) About 37.8%(860 cases) had had various treatments before they came to our clinic. Among them, 63.6% had visited to other hospitals. 98 cases had had lumbar disc surgery at other hospitals. Among 860 cases physical therapies were 33.8%, acupunctures 22.8%, herb medications 13.4%, moxibustions 12.5%, chiropractics 5.5%, and religious methods 1.4%. 5) Diagnostic work up were done in 85%. Plain spine X-rays were taken in 97.8%, spine CT scan 53.7%, and myelography (Iopainidol) 7.6%. 6) Etiology of the low back pain were herniated lumbar disce 44.8%, mechanical low back pain syndromes 26.4%, degenerative spondylosis 22.1%, traumas 2.8%, spinal cord tumors 1.3%, failed back surgery syndromes 1.1%, spondylolysis 0.9%, spondylolisthesis 0.3% and infections 0.3%. 7) About 15.8% of all patients were admitted. Surgical treatments were done in 12.1%(275 cases), among them chemonucleolysis with chymopapain(Discase) were 6.6%(151 cases), lumbar discectomy 5.5%(122 cases) and posterior lumbar interbody fusion 2 cases. 8) In the past history 98 cases(4.3%) had had lumbar disc surgery at other hospitals. Among them, 8 cases were reoperated.

소화성 궤양에서 삼제 병합 요법의 저용량에 의한 Helicobacter pylori 제균률과 궤양 치유효과

김예리,박봉안,이재동,이종혁,김인숙,박형석,진춘조,김상윤,박의우 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

Helicobacter pylori is the major cause of histologic chronic gastritis and is strongly associated with peptic ulcer disease, gastric cancer and lymphoma. Several recommendations for the management of the Helicobacter pylori infection have been developed. However, there has been no clear therapeutic regimen for the optimal treatment of Helicobacter pylori infection. This study was desinged to evaluate the eradication rate and the ulcer healing rate of the triple regimen with low-dose clarithromycin(0.5g/day) in peptic ulcer patients. Forty three patients with gastric ulcer(n=15) and duodenal ulcer(n=28) were enrolled. The patients were treated either with omeprazole 20mg b.i.d. amoxicillin 0.5g b.i.d. and clarithromycin 250mg b.i.d. (low-dose regimen group, n=29) or with omeprazole 20mg b.i.d., amoxicillin 1.0g b.i.d. and clarithromycin 0.5g b.i.d.(high-dose regimen group, n= 14) for 2 weeks. After 4 weeks, the patients were evaluated for the eradication of Helicobacter pylori and the healing of ulcer. And gastritis scores according to the Sydney system were evaluated before and after 4 weeks from the end of the triple regimen. There was no significant difference in the eradication rate and the ulcer healing rate between the low-dose regimen group, group and the high-does regimen group. In the low-does regimen group, the mean initial scores of chronic inflammation and activity were decreased after the eradication of Helicobacter pylori. In conclusion, the low-dose triple regimen is as effective as the high-dose triple regimen on the eradication of Helicobacter pylori and the ulcer healing rate in peptic ulcer disease.

자궁경부암의 수술 및 방사선치료 후 국소재발 판정에 대한 MR 및 CT 평가

전하정,이명자,김형석 한양대학교 의과대학 1997 한양의대 학술지 Vol.17 No.2

The objectives of our study were to analyze the CT and MR findings of local tumor recurrence at vaginal stump in patients of cervical carcinoma treated with hysterectomy and radiotherapy, and to assess the diagnostic value of the MR study. We retrospectively analyzed the CT(n=17) and MR (n=10) findings in 19 patients, who had uterine cervical carcinoma after hysterectomy with radiation therapy (extended-field irradiation and/or brachytherapy). The CT findings of local tumor recurrence were localized mass like lesion(n=5), slightly enhanced infiltrating lesion (n=4) and enhancing mass with central necrosis (n=1). The MR findings wer local iso-signal intensity mass on T1-weighted image and irregular high-signal intensity mass on T2-weighted image. The false positive results were three (two on CT and one on MR), due to inflammation and local fibrosis. On the basis of our study, the CT was the proper screening method for follow up in patients with cervical carcinoma after treatment. But, if any suspicion of tumor recurrence, MR was the useful tool to exclude the local fibrosis and inflammation, and to decide the next studies such as biopsy or observation with MR follow up.

요추간판 탈출증으로 오인된 요천추부 척수종양 예들에 대한 분석

김상진,김영수,박형천 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.6

The authors analysed 6 cases of lumbosacral tumors simulating lumbar disc diseases. Spine CT scan is the important diagnostic method for the investiagation of lumbar disc diseases. But if the clinical feature is not correlated with lumbar CT scan, myelography must be performed to see any cauda equina tumor. At myelography, contrast medium should be run well up to the thoracic segments routinely, especially if no defect is found in the lumbar area.