만성 연중독자에서 발생한 신장해

김병권,김성률,홍영습,나서희,김정만,정갑열,김준연,Kim, Byoung-Gwon,Kim, Sung-Ryul,Hong, Young-Seoub,Rha, Seo-Hee,Kim, Jung-Man,Jung, Kap-Yull,Kim, Joon-Youn 대한예방의학회 1996 Journal of Preventive Medicine and Public Health Vol.29 No.1

We experienced a case of nephropathy in chronic lead poisoning. The patient was 43-year-old male who has been working in secondary lead smelting plant for 14 years. On admission, blood pressure was 160/90 mmHg and the others were non-specific. In past history, he received chelating agent administration for lead poisoning irregularly and medicated for gout, and the blood lead concentration was $180.0{\mu}g/dl$ on 2 months before admission. Smoking habit has been 1 pack per day for 15 years and drinking habit has been 1 bottle of Soju per day but less flow. In liver function test, AST/ALT were 27/28 IU/l and $\gamma-GT$ was 456 IU/l. In blood test, Hb : 11.5 g/dl, Hct : 34.0% and basophilic stipplings were found in peripheral blood smear. Chest PA was normal and abdominal ultrasonographic finding was non-specific except fatty liver. In the test of lead exposure indices, $PbB:83.0{\mu}g/dl,\;PbU:28.3{\mu}g/l$, and blood ZPP was $300.0{\mu}g/dl$. And in renal function test, BUN : 31.4 mg/dl, blood creatinine : 2.7mg/dl, blood uric acid. 9.1 mg/dl, urinary albumin : 100.0 mg/g creatinine, urinary $\alpha_1-microglobulin$ : 120.5 mg/g creatinine, urinary $\beta_2-microglobulin$ : $183.8{\mu}g/g$ creatinine, and 24 hours urinary creatinine clearance was 31.9 ml/min. The ultrasonoguided renal biopsy showed the global sclerosis of glomerulus, moderate atrophy and loss of tubule, and interstitial fibrosis in light microscopy. There were diffuse losses of brush border of proximal tubule in electronmicroscopy.

일부 지역 주민들의 모발 수은 농도와 혈중 수은 농도와의 상관성

김경연,서정욱,김병권,김유미,김록범,김대선,김정만,김춘진,홍영습,Kim, Gyeong-Yeon,Seo, Jeong-Wook,Kim, Byoung-Gwon,Kim, Yu-Mi,Kim, Rock-Bum,Kim, Dae-Seon,Kim, Jung-Man,Kim, Choon-Jin,Hong, Young-Seoub 한국환경보건학회 2013 한국환경보건학회지 Vol.39 No.2

Background: This study was carried out for the purpose of comprehensively evaluating the mercury exposure level of residents in several areas and the correlation between hair mercury concentration and blood mercury concentration. Method: One thousand one hundred ninety seven subjects were sampled from 30 sites using random assignment sampling. We performed a questionnaire survey and measured the level of total mercury in hair and blood samples from all subjects. Results: The geometric mean concentrations of hair and blood mercury in all subjects were 1.27 mg/kg [95% confidence interval (CI): 1.23-1.32 mg/kg] and 5.24 ${\mu}g/L$ [95% CI: 5.07-5.41 ${\mu}g/L$], respectively. Male (1.56 mg/kg in hair, 6.00 ${\mu}g/L$ in blood) was significantly higher than that of female (1.03 mg/kg in hair, 4.56 ${\mu}g/L$ in blood), and the concentrations were elevated as age increased up to the 50s. Education, smoking, alcohol drinking, and using of pesticides were also shown to influence mercury concentrations in hair and blood. The ratio of hair/ blood mercury concentration was 261.3. The total mercury concentration in hair was identified to be significantly related with total mercury concentration in blood (r=0.814, p<0.001). Conclusion: The geometric mean concentrations of hair and blood mercury were higher than the levels provided in international recommendations. The total mercury concentration in hair was positively correlated with the concentration in blood. The results of this study suggest that hair mercury be considered as a useful tool for the evaluation of mercury exposure.

부산, 경남 일부 폐금속광산 지역주민들의 혈중 및 요중 카드뮴 농도

김효준(Hyo Jun Kim),김병권(Byoung Gwon Kim),김대선(Dae Seon Kim),서정욱(Jeong Wook Seo),유병철(Byeng Chul Yu),김영욱(Young Wook Kim),홍영습(Young Seoub Hong) 대한직업환경의학회 2010 대한직업환경의학회지 Vol.22 No.1

만성 연중독자에서의 다발성 뇌석회화 병변

김성률,김병권,홍영습,담도온,최순섭,정갑열,김준연,Kim, Sung-Ryul,Kim, Byoung-Gwon,Hong, Young-Seoub,Dam, Do-Won,Choi, Soon-Seob,Jung, Kap-Yull,Kim, Joon-Youn 대한예방의학회 1995 Journal of Preventive Medicine and Public Health Vol.28 No.2

We experienced a case of occupational lead poisoning employed in a secondary lead smelting plant for 12 years. The patient was 39-year-old male and had been felt dizziness, recent memory impairment and intermittent severe abdominal pain for 2 years. On admission, blood lead level was $92.9{\mu}g/dl$, urinary lead level was $19.9{\mu}g/l$ and zinc protoporphyrin level was $226.0{\mu}g/dl$. On the blood test, hemoglobin was 10.6g/dl and showed normocytic normochromic anemia. There were no abnormal findings in the biochemical and hormonal tests. Decrease of I.Q. and use of words in speaking were found in the psychiatric and psychologic examinations. We observed the finding of motor polyneuropathy in the nerve conduction velocity test. Computed tomographic finding showed calcification lesions in the basal ganglia, dentate nuclei, caudate nuclei, and especially characteristic multiple calcifications were located in the subcortical white matter.

국내 3-7세 어린이의 혈중 납, 수은, 카드뮴 농도와 관련요인

서주희,김병권,김유미,김록범,정진용,홍영습,Seo, Ju-Hee,Kim, Byoung-Gwon,Kim, Yu-Mi,Kim, Rock-Bum,Chung, Jin-Yong,Hong, Young-Seoub 한국환경보건학회 2014 한국환경보건학회지 Vol.40 No.4

Objectives: Children are more susceptible to heavy metal toxicity than adults. The purpose of this study was to evaluate heavy metal concentrations in the blood of Korean preschoolers and investigate the association between metals in blood and related factors. Methods: A total of 512 subjects from 36 to 83 months of age were sampled. A questionnaire survey was performed and the levels of lead, mercury and cadmium were measured in the blood samples of all subjects. Their parents were interviewed in order to obtain information on basic characteristics, dietary patterns, socio-economic factors, and indoor/outdoor environment of the preschoolers. Multiple linear regression was used to analyze the association between the above factors and lead, mercury or cadmium concentrations. Results: The geometric mean concentrations of lead, mercury and cadmium in the blood were $1.45{\pm}1.58{\mu}g/dL$, $2.14{\pm}1.74{\mu}g/dL$ and $0.23{\pm}1.91{\mu}g/dL$, respectively. Results from multiple linear regression analysis showed that blood lead levels were associated with birth weight and paternal smoking status. Daily mercury intake from food and maternal education were also shown to influence mercury concentrations in blood. Also, blood cadmium concentrations were associated with maternal age and having a bus garage near the place of residence. Conclusion: This study suggests that smoking status, dietary patterns and the environmental status near the residence should be considered as important factors for preventable sources of heavy metal exposure in preschoolers.

용접흄 폭로 근로자들의 폐기능에 관한 연구

홍영습,김병권,김성률,담도온,김정만,정갑열,김준연,Hong, Young-Seoub,Kim, Byoung-Gwon,Kim, Sung-Ryul,Dam, Do-Won,Kim, Jung-Man,Jung, Kap-Yull,Kim, Joon-Youn 대한예방의학회 1995 예방의학회지 Vol.28 No.1

In order to study the effect of welding fume exposure upon the pulmonary function test, we examined 131 shielded arc welding workers, and 152 $CO_2$ arc welding workers as cases and 177 control workers for their general characteristics, and forced vital capacity (FVC), forced expiratory volume in one second $(FEV_{1.0})$, forced expiratory volume in one second as a percent of FVC $(FEV_{1.0}%)$, and maximal mid-expiratory flow (MMF) were obtained from the spirogram. In shielded arc welding group and $CO_2$ arc welding group, FVC, $FEV_{1.0},\;FEV_{1.0}%$, and MMF were significantly decreased than control group, especially marked in the MMF finding. The distribution of workers below normal range was as follows. in the shielded arc welding group, 2 workers(1.5%) for FVC, 17 workers(13.0%) for $FEV_{1.0}$, 5 workers(3.8%) for $FEV_{1.0}%$, 28 workers(21.4%) for MMF, and in the $CO_2$ arc welding group, 3 workers(2.0%) for FVC, 25 workers(16.4%) for $FEV_{1.0}$, 8 workers(5.3%) for $FEV_{1.0}%$, and 37 workers(24.3%) for MMF, and significant increase by exposure duration was found in MMF. The distribution of workers who had ventilation impairment was as follows: 5 workers(3.8%) for obstructive type, 2 workers(1.5%) for restrictive type in the shielded arc welding group, and 7 workers(4.6%) for obstructive type, 2 workers(1.3%) for restrictive type, and 1 worker(0.6%) was combined type of the $CO_2$ arc welding group. In the respect of these results, the significant pulmonary function and ventilatory impairment were observed in welding fume exposed workers who had not abnormal finding in chest X-ray, and MMF considered as the most sensitive pulmonary function index by welding fume exposure. Therefore even if it is hard to doing pulmonary function test in the first health examination of workers according to the Industrial Safety Health Act in the welding fume exposure workers, it is desirable to consider doing PFT. Also evaluating the ventilation impairment, it is necessary, to observe the change of MMF that marker of effort-independent portion.

흑연로 원자 흡광 광도기와 유도 결합 플라즈마 질량 분석기를

권정연(Jung-Yeon Kwon),김병권(Byoung-Gwon Kim),임현주(Hyoun-Ju Lim),서정욱(Jeong-Wook Seo),강민경(Min-Kyung Kang),김유미(Yu-Mi Kim),홍영습(Young-Seoub Hong) 한국환경보건학회 2018 한국환경보건학회지 Vol.44 No.5

Objectives: The aims of this study were to compare concentrations and the correspondence of human blood cadmium by using graphite furnace atomic absorption spectrometry (GF-AAS) and inductively coupled plasmamass spectrometry (ICP-MS), which are representative methods of heavy metal analysis. Methods: We randomly selected 79 people who agreed to participate in the research project. After confirming the linearity of the calibration curves for GF-AAS and ICP-MS, the concentrations of cadmium in a quality control standard material and blood samples were measured, and the correlation and the degree of agreement were compared. Results: The detection limit of ICP-MS (IDL: 0.000 µg/L, MDL: 0.06 µg/L) was lower than that of GF-AAS (IDL: 0.085 µg/L, MDL: 0.327 µg/L). The coefficient of variation of the quality control standard material showed stable values f or both ICP-MS (clinchek-1: 5.35%, clinchek-2: 6.22%) and GF-AAS (clinchek-1: 7.92%, clinchek-2: 5.22%). Recovery was relatively high for both ICP-MS (clinchek-1: 95.1%, clinchek-2: 92.8%) and GF-AAS (clinchek-1: 91.4%, clinchek-2: 98.8%), with more than 90%. The geometric mean, median, and percentile of blood samples were all similar. The agreement of the two instruments compared with the bias of the analytical values found that about 81% of the analytical values w ere within ± 30% of the deviation from the ideal reference line (y=0). As a result of the agreement limit, the value included in the confidence interval was about 94%, which shows high agreement. Conclusion: In this study, we confirmed there was no significant difference in concentrations of a quality control standard material and blood samples. Since ICP-MS showed lower concentrations than GF-AAS at concentrations below the method detection limit of GF-AAS, it is expected that more precise results will be obtained by analyzing blood cadmium with ICP-MS.

한국인 정신분열병환자에서 MTHFR 유전자의 단일 염기 다형성인 C677T와 A1298C의 연관성 분석

김제원(Je-Won Kim),강호진(Ho Jin Kang),김병권(Byoung Gwon Kim),홍영습(Young-Seoub Hong),김성환(Seong Hwan Kim),최병무(Byeong Moo Choe) 대한생물치료정신의학회 2009 생물치료정신의학 Vol.15 No.2

Objectives: Methylenetetrahydrofolate reductase (MTHFR) plays an important role in folate metabolism, and the C677T and A1298C single nucleotide polymorphisms(SNPs) of the MTHFR gene may be associated with schizophrenia. The relationship between MTHFR SNPs and schizophrenia is unclear in Korean schizophrenic patients. The purpose in this study was to determine the association between the MTHFR gene SNPs and schizophrenia in Korean patients. Methods: Three hundred and sixty six patients with schizophrenia and 359 normal control subjects were used to identify the SNPs. Genetic analysis was carried out in the C677T and A1298C SNP regions using the SNP-IT™ assay. The allele, genotype and haplotype frequencies were compared between the two groups. The subgroups were divided on the basis of the onset age, and the allele frequencies and genotype frequencies were individually compared among the subgroups. Results: Gene variation of the MTHFR C677T and A1298C SNPs did not show significant differences between the schizophrenic patients and controls. In addition, no association between their SNPs and the onset age of schizophrenia was found. Conclusion: A genetic association between the C677T and A1298C SNPs on the MTHFR gene and Korean schizophrenic patients was not found in this study.

소아 기관지 천식과 부비동염에서 면역 반응의 비교

김형수 ( Hyung Su Kim ),이주희 ( Ju Hee Lee ),윤현진 ( Hyun Jin Yun ),김병권 ( Byoung Gwon Kim ),정진아 ( Jin A Jung ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2010 소아알레르기 및 호흡기학회지 Vol.20 No.3

목적: 천식과 부비동염은 염증성 반응이라는 동일한 병리학적 현상이 호흡기계 내의 서로 다른 표적기관에서 나타나는 것일 뿐 근본적으로 하나의 연계된 기도질환이라고 알려져 있다. 본 연구에서는 부비동염과 천식 사이의 혈청학적 검사를 통해 주된 면역반응의 차이점과 임상 양상을 비교해 보고자 하였다. 방법: 2005년 3월부터 2008년 2월까지 동아대학교 의료원 소아청소년과와 부산의료원 소아청소년과 알레르기센터를 방문한 118명의 학동기 환자들을 대상으로 말초 혈액 호산구수 총 IgE, 7종 흡입항원 (유럽 집먼지진드기 아메리카 집먼지진드기, Alternaria 바퀴벌레 고양이, 개, 화분) 에 대한 특이 IgE와 IL-4, IFN-γ를 측정하였다. 이들은 부비동염으로 진단된 환자31명 (A군), 천식으로 진단된 환자 36명 (B군), 천식과 부비동염이 병발된 환자 51명(C군)으로 나누어 결과들을 비교하였다. 결과: 말초 혈액 호산구수와 총 IgE는 A군에서 현저하게 낮았다. 흡입항원에 대한 피부 단자 시험의 경우 유럽 집먼지진드기와 아메리카 집먼지진드기에 대한 양성률은 B군과 C군이 비슷하였으나, Alternaria와 개에 대한 양성률은 C군에서 고양이와 화분에 대한 양성률은 B군에서 높게 나왔다. C군에서 임상증상은 골고루 나타나면서 알레르기 비염의 동반률은 B군과 비슷하였으며 기관지 유발 검사 민감도는 높게 나왔다. 혈청IL-4는 C군와 C군이 A군보다 의미있게 높게 나왔으며, (P<0.001) IFN-γ의 경우 A군이 <0.001) C군보다 의미있게 높게 나왔다. 결론: 기관지 천식에서는 Th2 면역반응이 부비동염에서는 Th1 면역반응이 주된 역할을 하지만 두 질환의 동반유무에 따라 면역반응이 다양하게 관찰되어진다. Purpose: Bronchial asthma and sinusitis have been grouped together and classified as one airway-related disease, with the same underlying inflammatory etiology. Through serological examination,we ascertained a difference in the immune response between bronchial asthma and sinusitis.Methods: We measured the peripheral blood eosinophil count, total IgE and specific IgE to 7aeroallergens ( Dermatophagoides pteronyssinus, Dermatophagoides farinae, Alternaria, cockroach,cat, dog and pollen), and interleukin (IL)-4 and interferon (IFN)- of 118 school aged patients γ-who visited Dong A University Medical Center and Busan Medical Center from March 2005 to February 2008. We divided these patients into 31 diagnosed with sinusitis (Group A), 36 diagnosed with bronchial asthma (Group B), and 51 diagnosed with both sinusitis and asthma (Group C).Results: The peripheral blood eosinophil count and total IgE were markedly lower in group A. Dermatophagoides pteryonyssinus and Dermatophagoides farinaehad higher sensitization rates than other aeroallergens in groups B and C. The sensitization rates to Alternaria and dog were higher in group C than in group B, and the sensitization rates to cat and pollen were higher in group B than in group C. In group C, clinical symptoms occurred evenly and allergic rhinitis was concurrent, similar to group B; however, the sensitivity of the bronchial provocation test was higher than in group B. Serum IL 4 in group B and C were significantly higher than in group A (P<0.001), and serum IFN was significantly higher in group A than in group C (P<0.027).Conclusion : Bronchial asthma was primarily related to IL-4 and Th2 cytokines, while sinusitis was primarily related to IFN and Th1 cytokines. According to the degree of ssociation between the 2 diseases, various immune responses were observed.

국민건강영양조사 자료를 활용한 혈 중 납과 카드뮴의 고혈압과의 관련성

서정욱(Jeong-Wook Seo),김병권(Byoung-Gwon Kim),김유미(Yu-Mi Kim),최병무(Byeong-Moo Choe),서상민(Sang-Min Seo),홍영습(Young-Seoub Hong) 한국환경보건학회 2018 한국환경보건학회지 Vol.44 No.4

Objective: A significant association between blood lead levels and hypertension has been reported in many studies. The relationship between cadmium and hypertension has been debated as well. We aimed to study the association of lead, cadmium, and both with hypertension in the Korean general population. Methods: We examined 5,967 adult men and 6,074 women who participated in the Korea National Health and Nutrition Examination Survey III-VI (2005, 2008-2013 years). Logistic regression models were used to examine the relationship between blood lead concentration and blood cadmium concentration and hypertension using log-transformed blood lead and cadmium concentrations as independent variables after covariate adjustment. Results: Adjusted for general characteristics, the odds ratio of log-lead to hypertension was 2.71 (1.82-4.03), and log-cadmium to hypertension was 2.52 (1.83-3.47). Estimates were found to be statistically significant (p<0.001). When a multiple logistic model was applied, the odds ratio of log-lead and log-cadmium for hypertension were 2.24 (1.50-3.36) and 2.24 (1.62-3.10), respectively. The standardized estimate coefficients of log-lead and log-cadmium for hypertension were 4.77 and 6.65, respectively. Conclusion: We observed the association of blood lead concentration, blood cadmium concentration, and both with hypertension. This study suggests that exposure to lead and exposure to cadmium are both risk factors for hypertension.