한국인의 연, 망간, 알루미늄 및 실리콘의 혈중 농도

김정만,안정모,김원술,김정일,신해림,정갑열,김준연 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5

Blood Lead, Manganese, Aluminium and Silicon Concentrations in Korean Adults Jung Man Kim, Jung Mo Ahn, Won Sul Kim1), Jung Il Kim2), Hai Rim Shin, Kap Yeol Jung2), Joon Youn Kim Department of Preventive Medicine, College of Medicine and Industrial Medicine Research Institute. Dong-A University Department of Health Care, Handong University Sunlin Presbyterian Hotpital1) Department of Occupational Medicine, College of Medicine, Dong-A University2) 0bjectives : This study was performed to determine the reference values of blood lead, manganese, aluminium, and silicon in healthy adults. Methods : The subjects were 132 (67 male and 65 female), and classified to three age groups (≤39,40∼49, and 50≤). Hood lead, manganese and aluminium were analyzed by atomic absorption spectrophotometer, and blood silicon was analyzed by direct current plasma optical omission spectrometer. Results : Blood lead levels(geometric mean, S.D) were (3.49, 1.70) ㎍/dL in male auld (3.04, 1.65) ㎍/dL in female, but the difference is not significant, and there was no significant difference between age groups. Mean blood manganese level was 0.99±0.41㎍/dL, and there was no significant difference between sex or age groups. Mean blood aluminium level was 0.59±0.35㎍/dL and there was no significant difference between sex or age groups. Mean blood silicon level was 54.41±27.64㎍/dL in male and 43.34±23.51㎍/dL in female, and the level in male was significantly higher than that in female (p〈0.05). There was significant difference between age groups, and the oldest showed the highest level in male (p〈0.05), but no significant difference between age groups in female. Conclusions : Authors hope that this study would provide basic data for determininig reference values and evaluating health effects.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Palmes Tube를 이용한 실내외 NO₂농도 측정

정갑열,김정만,김용규,김준연 동아대학교 의과대학 부설 산업의학연구소 1992 산업의학연구소 논총 Vol.- No.1

실내 공기오염의 주요인자의 하나인 NO₂에 대하여 부산의 도심지역(중구의 남포동, 광복동, 창선동)과 외곽지역(서구, 사하구)의 사무실, 식당, 다방(150개소)을 대상으로 하여 NO₂에 의한 실내외 공기오염의 정도를 파악하고 NO₂에 농도에 영향을 미칠 가능성이 있는 몇가지 인자에 대하여 조사함으로써 NO₂에 의한 인체장해의 예방대책을 수립하기 위한 기초 자료를 얻고자 본 연구를 실시하였다. 조사기간은 1988년 12월부터 1989년 2월까지 동계 3개월간이었고 NO₂에측정은 Palmes method 에 의하였으며 그 결과는 다음과 같다. 1. 도심지역의 NO₂평균농도; 1) 사무실의 홀 : 0.045±0.032 ppm, 2) 식당의 주방 : 0.106±0.049 ppm, 홀 : 0.076±0.030 ppm, 3) 다방의 주방 : 0.082±0.033 ppm, 홀 : 0.077±0.041 ppm 및 4) 옥외 : 0.031±0.009 ppm이었다. 2. 외곽지역의 NO₂평균농도; 1) 사무실의 홀 : 0.036±0.019 ppm, 2) 식당의 주방 : 0.079±0.045 ppm, 홀 : 0.056±0.034 ppm, 3) 다방의 주방 : 0.054±0.024 ppm, 홀 : 0.042±0.024 ppm 및 4) 옥외 : 0.021±0.007 ppm이었다. 3.1일 연료 소비량별 홀의 NO₂농도는 5L 미만 0.037±0.017 ppm, 5∼ 10L 미만 0.047±0.027 ppm, 10∼ 20 L 미만 0.065±0.042 ppm으로 연료 소비량이 증가할수록 홀의 NO₂농도는 유의하게 증가하였다. (p<0.01). 4. 환기를 실시하지 않는 홀의 NO₂농도는가 환기를 실시하는 홀의 NO₂농도 및 옥의 NO₂농도보다 유의하게 높았고(p<0.001), 환기를 실시하는 홀의 NO₂농도는 옥외 농도와 유사하여 인공환기시 홀의 NO₂농도는 상당히 감소하였다. Recently nitrogen dioxide(NO₂) has been regarded as one of the main elements among indoor air pollutants. For the purpose of preparing the fundamental data for evaluation and control on the health effect relevant to NO₂levels, the authors measured the indoor and outdoor NO₂levels by the type of subject(office, restaurant, coffee shop) with some factors related to the indoor NO₂levels. The level of NO₂was measured by Palmes method, and this survey was carried out to 150 subjects in the Pusan area from December, 1988 to Feburary, 1989. The obtained results were as follows; 1. The mean indoor and outdoor NO₂levels at down-town 1) Hall of office : 0.045±0.032 ppm, 2) Hall of restaurant : 0.076±0.030 ppm, Kitchen of restaurant : 0.106±0.049 ppm, 3) Hall of coffee shop : 0.077±0.041 ppm, Kitchen of coffee shop : 0.082±0.033 ppm, and 4) Outdoor : 0.031±0.009 ppm 2. The mean indoor and outdoor NO₂levels at outskirt 1) Hall of office : 0.036±0.019 ppm, 2) Hall of restaurant : 0.056±0.034 ppm, Kitchen of restaurant : 0.079±0.045 ppm, 3) Hall of coffee shop : 0.042±0.024 ppm, Kitchen of coffee sho : 0.054±0.024 ppm, and 4) Outdoor : 0.021±0.007 ppm 3. The NO₂levels of Hall by daily fuel consumption were; 1) ∼5L: 0.037±0.017 ppm, 2) 5 ∼ 10L : 0.047±0.027 ppm, and 3) 10 ∼ 20L : 0.065±0.042 ppm The NO₂levels of Hall were significantly increased with the daily fuel consumption amount. 4. The NO₂levels of vented Hall was significantly lower than the NO₂levels of unvented Hall, which decreased when artificial ventilation was conducted, and the NO₂levels of vented Hall was similar to the outdoor NO₂level.

음식물 섭취에 따른 요중 마뇨산 배설량의 변화

김정일,박태혁,정갑열,신해림,김준연 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5

Objectives ; Urinary hippuric acid levels have been usually determined to evaluate workers exposes to toluene. Food and drink intake could affect urinary hippuric acid excretion and chi study was carried out to investigate what kinds of food and drink would affect urinary hippuric acid excretion. Methods ; The subjects were 136 medical school students. Authors measured urinary hippuric acid levels three times from 10 a. m. to noon; before, one hour after and two hours after food or drink-intake, and they were asked not to eat from the previous night(9 p. m) of testing. We selected six diets(bread and coffee, brown sauce noodle, Korean style meal, noodle, pork-galbi and rice and soybean stew and rice) , six fruits(apple, grape, orange, pear, persimmon and plum) and five beverages(Alps-D□, Demisoda□, Orange juice□, Pear juice□ and Pocari sweat□). Analysis of urinary hippuric acid was performed by high performance liquid chromatography. Results ; Intake of popular Korean diets, fruits and some drinks didn't affect urinary hippuric acid excretion. But intake of sodium benzoate-contained Alpa-D□ increased urinary hippuric acid excretion. Conclusions ; For the health examination on workers exposed to toluene, the history of diet and fruit intake can be negligible, but that of beverage intake should be included.

Palmes Tube를 이용한 지역별 NO₂농도와 직종별 NO₂개인 폭로량에 관한 연구

김준연,박순우,김동일,장봉기,정경동,김두희,홍대용,정갑열,김용규,이종섭,유일수,김정만 동아대학교 의과대학 부설 산업의학연구소 1992 산업의학연구소 논총 Vol.- No.1

Indoor air quality is important to human wellbeing because people their spend much of time indoors. Current efforts to reduce ventilation rates in building may conserve energy but may also passibly empair human health and welfare through increased levels of indoor contaminants. Nitrogn dioxide( NO₂)has been regarded as one of the important indoor air pollutants. This report updates the assessment of NO₂concentrations at indoor & vehicle road and personal NO₂exposure levels by job groups in four urban cities. NO₂concentrations were measured using the diffusion tube method on 671 subjects in four cities(Pusan, Taegu, Chinju. Iri) from Dec. 1988 to Feb, 1989 and from Dec. 1989 to Feb. 1990. The results of the study obtained were as follows. Ⅰ. Indoor & vehicle road NO₂levels 1. The mean NO₂level was 37.8±19.6(8∼189)ppb and the highest with 42.2±20.5ppb at Bus & Taxi. 2. The NO₂levels by area were as follows: Pusan city, 38.3±20.3ppb: Taegu city, 41.1±17.6ppb: Chinju city, 33.0±19.4ppb: Iri city, 35.8±20.6ppb. 3. The site of the highest NO₂level in Pusan, Taegu, Chinju and Iri city were as follows: Bus & Taxi, 45.4ppb: Vehicle road, 50.8ppb: Bus & Taxi, 37.5ppb: Bus & Taxi. 45.0ppb. Ⅱ. Personal NO₂exposure level 1. The mean level of personal NO₂exposure was 42.7 ±23.1(6∼145)ppb and the highest with 54.0±25.5ppb at office workers. 2. Personal NO₂exposure levels by area were as follows: Pusan city 44.8±20.2ppb: Taegu city, 50.6±24.3ppb: Chinju city, 47.1±23.2ppb: Iri city, 48.0±27.0ppb. 3. The job group of the highest personal NO₂exposure level in Pusan, Taegu, Chinju and Iri city were as follows: Office workers, 50.3ppb: Bus & Taxi drivers, 63.8ppb: Office workers, 59.8ppb: Office workers, 60.0ppb.

前腕部 經穴 取穴에서 骨度分寸法과 一夫法의 比較 硏究

박히준,채윤병,차웅석,박종배,이혜정,이향숙,인창식,고형균,김수영,최일환,김강식,문정배,배기태,유경환,육근영,정병주,손인철,임사비나 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2004 東西醫學硏究所 論文集 Vol.2004 No.-

Background : The cun measurement System, an essential and convenient method in locating acupoints, has been widely used in the practice of acupuncture. However, traditional cun measurement has been criticized for its lack of reliability. Objectives : The purposes of this study are to determine if one cun measured by the directional methods have a consistency with that of proportional methods and to investigate which factors are related with these differences, especially in forearm. Methods : The distance between the elbow crease and the wrist crease of forearm was compared to a reference value of one cun obtained by the directional method. In this method, one cun is one third of the distance between index finger and Small finger of a subject, measured at proximal interphalangeal joint. In addition, to investigate the factors influencing the differences between these two methods, we measured the height and body weight and calculated body mass index (BMI). Finally we analyzed the factors correlated with these lengths by linear regression test. Results : The results showed that one cun obtained by the directional methods were significantly different from one cun by the proportional methods in forearm. It was demonstrated that the length acquired with the directional method was more correlated with body weight and body mass index, while the length obtained by the proportional method was more correlated with the height.

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.

완전대혈관 전위의 심방내 교정술 후 추적 관찰

김연우,노정일,허준,윤명자,김호성,최정연,윤용수,양세원,이정렬,김용진,노준량 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

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).

안면골 골절에 관한 임상적 고찰

이상한,정용,김준연 慶北大學校 齒科大學 1988 慶北齒大論文集 Vol.5 No.1

This is a retrospective study on facial bone fractures. The study was based on a series of 418 patients with facial bone fractures during the period of Jan, 1981 to Dec. 1987. The results obtained were as follows; 1. The ratio of men to women 5.6:1, and then the age frequency was the highest in the second decade(43.5%) and patients from the first decade to the third decade were over 4/5 of total patients. 2. There is a rather seasonal patten of distribution of admissions of facial bone fractures over each 12months period with no statistical significance. 3. The most common location of facial bone fracture was mandible(73.6%), and zygoma complex(13.2%), maxilla(12.2%), and nasal bone(1.5%) were next in the order of frequency. 4. The most common etiologic factor of facial bone fractures was traffic accidents(39.2%), and the next factor in the order of frequency was fist blow(30.0%), falling down(19.6%).