흡연이 대학생들의 혈중 카드뮴 농도에 미치는 영향

신주연,임종한,박신구,이지나,장미,허청송,강대희,홍윤철,Shin, Joo-Youn,Lim, Jong-Han,Park, Sin-Goo,Lee, Jee-Na,Jang, Mi,Huh, Chung-Song,Kang, Dae-Hee,Hong, Yun-Chul 대한예방의학회 2004 예방의학회지 Vol.37 No.3

Objectives : This study was performed to examine the influence of smoking on the blood cadmium concentration in university students. Methods : The study included 300 university students. A questionnaire interview was used to collect data. The urine cotinine and blood cadmium levels were measured as biological exposure indices. The data were analyzed using t-tests ANOVA and ANCOVA. Results : The median value of blood cadmium concentration was equal in both males and females ($0.8{\mu}g/l$). This level was relatively low in comparison with the reference value suggested by WHO (2001). ANCOVA showed that smoking related variables, urine cotinine and smoking amount, were significantly associated with the blood cadmium level (P=0.004, 0.015). However, the values with regard to traffic related air pollution were not significantly associated with the blood cadmium level. Conclusions : Smoking is an important source of nonoccupational cadmium exposure in young people. The Blood cadmium level is at least 10% higher in active smokers than in passive or nonsmokers. The level of urine cotinine can be used as an indicator of non-occupational exposure of respirable cadmium due to smoking, as there is a good correlation bestween smoking amount and the urine cotinine level.

건강한 남성에서 혈중 감마지티피 수준과 공복혈당장애 (IFG)의 발생 위험도: 2년 추적 연구

신주연,임종한,고대하,권근상,김용규,김환철,이의철,이주형,남문석,홍성빈,박신구,Shin, Joo-Youn,Lim, Jong-Han,Koh, Dai-Ha,Kwon, Keun-Sang,Kim, Yong-Kyu,Kim, Hwan-Chul,Lee, Yeui-Cheol,Lee, Ju-Hyoung,Nam, Moon-Suk,Hong, Sung-Bin,Park, Shin 대한예방의학회 2006 예방의학회지 Vol.39 No.4

Objectives: An increase in the serum gamma-glutamyltransferase (GGT) concentration has been regarded as a marker of alcohol drinking or liver disease. Some reports, however, have suggested that the serum GGT may be a sensitive and early biomarker for the development of prediabetes and diabetes. In this study we investigated whether serum GGT is a reliable predictor of the incident impaired fasting glucose (IFG), including diabetes. Methods: We performed a prospective study for two years (2002-2004). We analyzed the periodic health examination data from a total of 4,711 men. The examinations were done in the years 2002 and 2004. The analyzed data included a self-questionnaire, a physical examination and the laboratory results. Both IFG and diabetes were defined as a serum fasting glucose concentration of more than 100 mg/dL and 126 mg/dL, respectively. Results: A total of 738 cases (15.7%) of incident IFG and 13 cases (0.3%) of diabetes occurred. The mean serum GGT concentrations were quite different between the normal (38.0 IU) and incident IFG groups (50.3 IU), and the incident diabetes group (66.0 IU) (p<0.001). After multivariable adjustment, the relative risks for incident IFG or diabetes across the baseline GGT categories (<10th, 10th-20th, 30th-40th, 50th-60th, 70th-80th and >90th percentile) were 1.0, 1.172 (0.769-1.785), 1.107 (0.725-1.689), 1.444 (0.934-2.232), 2.061 (1.401-3.031) and 2.545 (1.784-3.631) (p-value for trend: <0.001). The risks significantly increased with increasing levels of GGT for 2 years; when comparing the increased groups (<10%, 10-20%, >20%) versus the decreased over 20% group of GGT, the risks for IFG or diabetes were 1.334 (1.002-1.776), 1.613 (1.183-2.199) and 1.399 (1.092-1.794). Conclusions: Our findings suggest that serum GGT concentrations within its normal range may be an early predictor of the development of IFG and diabetes. As serum GGT is a relatively inexpensive test and a reliable marker, it might have important implications in public health promotion.

방송매체를 통한 국악교육의 활성화 방안 연구

신주연(Shin Joo-youn) 한국전통음악학회 2000 한국전통음악학 Vol.- No.1

This study has a purpose to grope for a plan that can activate Korean traditional music education, which is not good enough with school education, through the mass communication. Also, this study has the influence analysis of the mass communication to student, the relation to the mass communication and education, and the educational function of the mass communication in music. Therefore, this study gropes for using the music educational function of the mass communication as a way of educational supplementing the lacing part of Korean traditional music education in school education. This study is researched and analyzed problems of Korean traditional music broadcasting, the broadcasting time of Korean traditional music, the contents and quality of Korean traditional mass communication music, and the variety of contents that can make understand the several genres of Korean traditional music on the basis of the present situation of regular Korean traditional music programs(May. 2000-now)in Korean representative broadcasting studies KBS, MBC, SBS, and EBS. As a result, problems and improving plans are as follows. First, the number of Korean traditional music programs or the amount of its broadcasting time is absolutely low compared with other genres of music. There should be more programs or broadcasting time to form music culture by playing various music to the public as well as students. Second, the time zone of Korean traditional music broadcasting is mostly early in the morning or late at night. This gives on impression that each broadcasting system broadcasts Korean traditional music programs just for justifying itself. In the future, the broadcasting time of Korean traditional music should be modified so that all the family can have affection toward Korean traditional music. Third, certain program is composed only of items of entertainment to gain a better rating. In a case like this can damage the quality of our traditional music. Also, the programs mainly focuse on only certain parts of Korean traditional music in including Pansori, Folk song and Samulnori, and this can be an obstacle in understanding that Korean traditional music genre varies. Therefore, the future Korean traditional music programs should be selected more carefully. Finally, producers of Korean traditional music programs should have common sense on Korean traditional music and they need an expert's advice. More often than not, some examples show the distortion of tradition under the name of 'new'. Therefore, this study proposes how improve Korean traditional music programs.

혼합물에서 화학물질간의 상호작용 효과

임종환,신주연,김용규,Leem Jong Han,Shin Joo-Youn,Kim Yong-Kyu 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.1

Chemical mixtures of components, each of which are present at less than guidance concentrations, may be hazardous due to additivity, interactions, or both. Toxicological interactions may increase the health hazard above what would be expected from an assessment of each component singly, or all components additively. So chemical mixture are a particular issue in public health. There are several approach to assess whether there are additivity or interaction in assessing toxicological effects, such as, components-based approach, physiologically-based pharmacokinetic /pharmacodynamic(PBPK/PD) models, hazard index method, and weight-of evidence method. If we consider interaction or additivity effects in assessing the health effects of chemcial mixtures, we can get more accurate information about toxicological effects and dose-response relationship in chemical mixtures.

위장관 출혈 후 발생한 양측성 앞허혈시신경병증 1예

고재상,김규아,신주연,변석호,Jae Sang Ko,Gyu Ah Kim,Joo Youn Shin,Suk Ho Byeon 대한안과학회 2014 대한안과학회지 Vol.55 No.1

Purpose: To introduce a case of bilateral anterior ischemic optic neuropathy (AION) after blood loss due to gastrointestinal bleeding. Case summary: A 50-year-old male patient with a history of type 1 diabetes mellitus and alcoholic liver cirrhosis presented with 3 days of melena and 1 day of general weakness and dizziness. Initial hemoglobin level was 4.7 g/dL and blood pressure was 100/55 mm Hg. On esophagogastroduodenoscopy, a peptic ulcer with evident recent bleeding was observed. After transfusion of packed red blood cells and endoscopic hemostasis of bleeding, his general condition improved but he complained of blurred vision in both eyes which developed immediately after the onset of melena. Initial best-corrected visual acuity (BCVA) was 0.5 in his right eye and 0.6 in the left eye. On fundus examination, swollen optic disc with blurred margin was noted and he had constricted visual fields. On follow-up, the patient received posterior subtenon triamcinolone injection in his right eye. After the procedure, the BCVA was improved to 0.8 in both eyes, but he still had bilateral pale optic disc with constricted visual field. Conclusions: In the case of visual loss after recent blood loss, AION should be considered as a diagnosis, which can present as bilateral involvement. J Korean Ophthalmol Soc 2014;55(1):161-166

신생혈관녹내장이 동반된 유리체강내 유구낭충증 1예

고재상,김규아,신주연,변석호,Jae Sang Ko,MD,Gyu Ah Kim,MD,Joo Youn Shin,MD,Suk Ho Byeon,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.10

Purpose: To introduce a case of intravitreal cysticercosis presenting as neovascular glaucoma. Case summary: A 42-year-old female who lives in the Philippines visited our clinic complaining of reduced visual acuity and decreased visual field in her right eye. She was treated at another clinic for neovascular glaucoma and posterior uveitis. Initial best-corrected visual acuity was 0.7 and intraocular pressure was 13 mm Hg with Goldmann applanation tonometry. Slit lamp examination showed inflammatory cells in the anterior chamber and vitreous with florid new vessel on iris. On fundus examination, a cystic lesion without movement was observed in the superonasal vitreous as well as tractional band. As other retinal vascular diseases were not observed on fluorescein angiography, the patient was diagnosed with secondary neovascular glaucoma due to cysticercosis. After a single course of intravitreal bevacizumab injection and cyst removal with pars plana vitrectomy, the best-corrected visual acuity was 0.5 and intraocular pressure was 14 mm Hg without recurrence of iris neovascularization during the 3 months of follow-up.

높거나 낮은 유체 역동학 지표에 따른 백내장수술 후 수정체 후낭혼탁 발생 정도의 비교

나윤협(Yun Hyup Na),신주연(Joo Youn Shin),이종현(Jong Hyun Lee),김진형(Jin Hyoung Kim),이도형(Do Hyung Lee) 대한안과학회 2016 대한안과학회지 Vol.57 No.10

Purpose: To compare the incidence of posterior capsular opacification (PCO) based on low and high fluid-dynamic parameters during cataract surgery and evaluate the importance of these findings. Methods: This retrospective study included 125 eyes in 73 patients with senile cataract who received a cataract surgery between September 2013 and March 2014. Patients were divided into 2 groups: those with low (vacuum: 180 mm Hg, aspiration flow: 18 mL/min, bottle height: 55 cm) and high (vacuum: 400 mm Hg, aspiration flow: 22 mL/min, bottle height: 90 cm) fluidic parameters during the nucleus was removal. We measured the total surgery time, ultrasound time, and balanced salt solution consumption during phacoemulsification. Best corrected visual acuity (BCVA), PCO score, PCO percentage and severity were measured at 3, 6 and 12 months postoperatively. Endothelial cell density (ECD) was measured preoperatively and 12 months postoperatively. Results: The study included 20 eyes of 13 patients with low parameters and 20 eyes of 15 patients with high parameters. There was no statistically significant difference in the mean total surgery time, ultrasound time or fluid consumption between the two groups. BCVA and ECD were not significantly different between the two groups during the postoperative follow-up. PCO score, percentage and severity were higher in the low parameter group at 3, 6 and 12 months postoperatively. Conclusions: Surgery with low fluid-dynamic parameters is equally effective as with high parameters in terms of surgical time and postoperative BCVA. However, the incidence of PCO was higher in the low fluid-dynamic parameter group up to 12 months. Surgical efforts to reduce remnant lens epithelial cells are needed during low fluidic-dynamic parameter surgery. J Korean Ophthalmol Soc 2016;57(10):1555-1562 목적: 유체 역동학 지표의 설정값 차이에 따른 백내장수술 후 수정체 후낭혼탁의 발생 정도의 차이를 비교 평가하고자 한다. 대상과 방법: 2013년 9월부터 2014년 3월까지 노년 백내장으로 진단 받고 백내장수술을 한 환자 73명, 125안 중 수정체 핵 제거 시유체 역동학 지표가 낮은 군(진공값 180 mmHg, 흡입 유속 18 mL/min, 평형염액 높이 55 cm)과 높은 군(진공값 400 mmHg, 흡입유속 22 mL/min, 평형염액 높이 90 cm) 두 군으로 나누어 후향적으로 비교 관찰하였다. 수술 중 수술 시간, 초음파 사용 시간, 평형염액 사용량을 비교하였으며 수술 후 3개월, 6개월, 12개월에 최대교정시력, 수정체 후낭혼탁 점수, 백분율 및 심각도를 각각 비교 분석하였다. 수술 전과 수술 후 12개월에는 각막내피세포밀도를 측정하였다. 결과: 최종 포함된 대상자는 낮은 지표군 13명 20안, 높은 지표군 15명 20안이었다. 초음파유화술 중 총 수술시간, 초음파 사용시간, 평형염액 사용량은 두 군 간에 유의한 차이가 없었다. 수술 후 3개월, 6개월, 12개월에 측정한 최대교정시력은 두 군 간에 유의한 차이가 없었고, 수술 후 12개월에 두 군 간의 각막내피세포 감소율은 차이가 없었다. 수정체 후낭혼탁 점수, 백분율 및 심각도는 낮은 유체 역동학 지표군에서 유의하게 높았다. 결론: 낮은 유체 역동학 지표를 이용한 초음파유화술은 높은 유체 역동학 지표를 이용한 그룹과 비교 시 수술 후 시력결과나 수술 시간적인 면에서 충분히 효과적이다. 하지만 1년까지의 경과관찰 기간 중 수정체 후낭혼탁이 더 빨리 생기는 모습을 보이기 때문에 수술 중 이를 줄이기 위한 노력이 필요하다. <대한안과학회지 2016;57(10):1555-1562>

건성안증후군 환자의 주관적 증상 중증도와 관련있는 객관적 지표들

서민환(Min Hwan Seo),신주연(Joo Youn Shin),이도형(Do Hyung Lee),김진형(Jin Hyoung Kim) 대한안과학회 2017 대한안과학회지 Vol.58 No.3

목적: 건성안증후군 환자의 증상 중증도 질문지 중 하나인 ocular surface disease index (OSDI) 점수와 객관적인 지표 사이의 상관관계를 알아보고, OSDI 중증군에 영향을 주는 생활환경요소 위험인자에 대해 알아보고자 한다. 대상과 방법: 본원에서 처음으로 건성안증후군 진단을 받은 총 30명(30안)을 대상으로 후향적 연구를 하였다. 쉬르머검사, 각막 및 결막염색검사, 눈물막파괴시간검사, 마이봄의 질(Quality of Meibum)검사와 OSDI 설문조사를 하였다. 또한 결막측정장치인 Lipiview?潁? 사용하여 눈물지질층두께, 부분눈깜빡임횟수를 측정하였으며, 하안검판 마이봄샘촬영 후 Image J?? 프로그램을 이용하여 하안검판에서 마이봄샘이 차지하는 백분율을 측정하였다. 각각의 안구지표들과 OSDI 점수 사이에 Pearson 상관분석, 다중선형회귀분석을 하였다. OSDI 중증군의 생활환경요소 위험인자에 대해 알아보고자, 성별과 함께 환자의 생활환경요소인 불면증, 컴퓨터사용력, 각막 관련수술, 냉난방환경노출 유무에 대해 로지스틱회귀분석을 하였다. 결과: Pearson 상관분석 결과, 마이봄의 질과 나이, 결막염색점수, 부분눈깜빡임횟수, 각막염색점수 순으로 OSDI와 높은 상관관계를 보였으며, 다중선형회귀분석 결과, 마이봄의 질과 나이가 OSDI에 영향을 주는 인자로 나타났다. 로지스틱회귀분석 결과, 4시간 이상 컴퓨터 사용군(교차비 7.43, p-value=0.02)이 유의한 생활환경요소 위험인자로 작용하였다. 결론: 중증 건성안증후군 환자 치료 시 마이봄샘기능부전, 나이 요소가 주관적 안구불편함의 중증도와 관련이 크다는 점과 증상이 심한 군에서는 장기간의 컴퓨터사용과 같은 생활환경인자 교정이 중요하다는 점에 대한 인지가 필요하다. Purpose: To evaluate the correlation between the ocular surface disease index (OSDI score) and objectively quantifiable parameters in dry eye syndrome patients, and to assess environmental and lifestyle risk factors in severe OSDI patients. Methods: The present study was retrograde and included 30 patients (30 eyes) diagnosed with dry eye syndrome at Ilsan Paik Hospital for the first time. Shirmer’s test, corneal staining, and conjunctiva staining were assessed, and tear break-up time, meibum quality, and OSDI questionnaires were performed. We measured the lipid layer thickness in tear meniscus and counted the amount of partial eyelid blinking using Lipiview??. Moreover, we modified images of the lower lid meibography and calculated the percentage of meibomian glands outside the lower tarsal plate using the ImageJ?? software. We analyzed the Pearson’s correlation and performed a multiple linear regression analysis between the test values and OSDI. In addition, logistic regression analysis was used to determine the risk factors of the severe OSDI group, such as insomnia, level of computer use, and exposure to fully air-conditioned indoor environments. Results: According to the Pearson’s correlation analysis, quality of the meibum showed the highest statistically significant correlation with OSDI, followed by age, conjunctiva staining score, counts of partial blinking, and corneal staining score. The multiple linear regression analysis revealed that quality of the meibum and age were statistically significant factors affecting the OSDI score. Based on the logistic regression analysis, using a computer for more than 4 hours at a time exhibited a 7.43-fold odds ratio for severe OSDI (p-value = 0.029). Conclusions: Meibomian gland dysfunction and age should be considered to be important factors, especially in treating dry eye syndrome patients who complain severely. Moreover, we should also consider environmental factors such as long-term computer use for the treatment of dry eye syndrome patients with severe symptoms.

일개 대학병원 간호사의 직무스트레스와 주사침 상해와의 관련성

김환철(Hwan-Cheol Kim),김용규(Yong-Kyu Kim),이의철(Yeui-Cheol Lee),신주연(Joo-Youn Shin),이지나(Jee-Na Lee),임종한(Jong-Han Leem),박신구(Shin-Goo Park) 대한직업환경의학회 2005 대한직업환경의학회지 Vol.17 No.3

신생혈관녹내장에서 발생한 친수성 아크릴 인공수정체혼탁의 임상양상

최헌진(Hun Jin Choi),한동진(Dong Jin Han),신주연(Joo Youn Shin),이도형(Do Hyung Lee),서지원(Ji Won Seo),정인권(In Kwon Chung),이종현(Jong Hyun Lee) 대한안과학회 2021 대한안과학회지 Vol.62 No.11

목적: 신생혈관녹내장안에서 백내장수술 후 발생한 친수성 아크릴 인공수정체혼탁의 임상양상에 대하여 보고하고자 한다. 대상과 방법: 2006년 1월부터 2010년 12월까지 내원한 신생혈관녹내장 환자에서 인공수정체혼탁이 발생했던 11안(10명)의 의무기록을 후향적으로 분석하였다. 인공수정체혼탁안 중 3안에서 인공수정체교환술을 시행하였으며, 제거된 인공수정체는 육안 및 광학현미경으로 검사하였다. 인공수정체 광학부를 시상 절단하여 von Kossa 염색, 주사전자현미경(scanning electron microscope, SEM), 엑스선 에너지 분광분석기(energy dispersive X-ray spectroscope, EDX)를 통하여 분석하였다. 결과: 인공수정체혼탁은 모두 친수성 아크릴 인공수정체에서 발생하였다. 소수성 인공수정체를 삽입했던 증례에서는 혼탁이 발생하지 않았다. 인공수정체혼탁이 발생했던 10명 가운데 9명이 당뇨망막병증, 1명이 중심동맥폐쇄 환자였다. 혼탁 발생은 인공수정체삽입 후 평균 19.45 ± 8.52개월, 신생혈관녹내장이 병발된 이후 평균 14.37 ± 8.51개월 경과 후 발생하였다. 제거한 인공수정체의 von Kossa 염색에서 칼슘침착을 확인할 수 있었다. 인공수정체의 주사전자현미경검사에서 전체 광학부에 앞쪽 표면 걸쳐 과립상 미세침착물을 관찰하였으며 엑스레인 분광분석에서 칼슘을 확인할 수 있었다. 결론: 신생혈관녹내장이 발생할 수 있는 당뇨망막병증, 중심동맥폐쇄, 중심정맥폐쇄 등의 환자에서 백내장수술 후 친수성 아크릴 인공수정체를 사용함에 있어서는 보다 신중한 고려가 필요할 것을 생각한다. Purpose: To report the clinical features of patients with opacification of hydrophilic acrylic intraocular lens (IOL) after cataract surgery in neovascular glaucoma. Methods: This retrospective case series included 11 eyes of 10 patients with IOL opacification and neovascular glaucoma (NVG) between January 2006 and December 2010. We included and analyzed cases with opacification of hydrophilic acrylic IOL. An IOL exchange was performed in three cases, and the explanted IOLs were examined grossly and evaluated by light microscopy. Sagittal sections of the optics of the IOLs were evaluated by Von Kossa staining, scanning electron microscopy (SEM), and energy- dispersive X-ray spectroscopy (EDX). Results: All 11 eyes of 10 patients were implanted with hydrophilic acrylic IOLs. In addition, there were no cases of hydrophobic acrylic IOL opacification. Nine patients of the 10 patients had diabetic retinopathy and one patient had central retinal artery occlusion. The mean period of IOL opacification after IOL implantation was 19.45 ± 8.52 months and the mean period of IOL opacification after the occurrence of NVG was 14.37 ± 8.51 months. The deposits of the explanted IOLs were shown to consist of calcium by von Kossa staining. The explanted IOLs showed fine whitish irregular granular deposits on the entire anterior surface of the optics by SEM and the presence of calcium deposition was confirmed by EDX analysis. Conclusions: Care is required when using hydrophilic acrylic IOLs in patients with risk of neovascular glaucoma, such as those with diabetic retinopathy or central retinal artery occlusion.