한국인 만성음주자들에서 HCV 항체 양성률과 간손상 정도와의 상관관계에 관한 연구

김나영 ( Gim Na Yeong ),김안나 ( Kim An Na ),임선희 ( Im Seon Hui ),김성용 ( Kim Seong Yong ),임용성 ( Im Yong Seong ),이계회 ( Lee Gye Hoe ),박성훈 ( Park Seong Hun ),구명숙 ( Gu Myeong Sug ),최신은 ( Choe Sin Eun ) 대한내과학회 1993 대한내과학회지 Vol.44 No.5

연구배경 : 알콜성간질환에서의 간손상 정도는 일반적으로 알콜섭취 정도와 관계한다고 생각되고 있으나, 이들 만성음주자의 10∼20%에서만 심한 간손상 소견을 보여 알콜섭취 정도 외에 유전인자와 영양상태, 환경요인 및 B형 감염바이러스나 NANB형 간염바이러스와 같은 감염 요인이 관여하리라 추측되어 왔다. 최근 HCV 항체 측정이 가능케 됨에 따라 알콜성간질환에서의 HCV의 역할에 대한 연구가 점차 활발해지고 있으나, 우리나라에서는 아직 이에 대한 보고가 드문 실정이다. 방법 : 이에 저자들은 HBsAg음성이면서, 하루 80g 이상의 알콜을 5년 이상 마셔온 62명의 만성음주자들을 대상으로, HCV 항체 양성률을 알아보고, HCV 항체양성 여부와 이들에서의 간손상 정도와의 상관관계를 비교하였다. 결과 : 1) 우리나라 만성음주자에서의 HCV항체 양성률은 1405%였다. 2) 62명의 대상 환자를 임상소견 및 간조직검사소견에 근거한 간손상 정도에 따라 세군으로 분류하였을 때 간질환의 증거가 없거나 지방섬유화 소견처럼 경미한 간손상을 보인 군은 13명(21%)이었으며, 알콜성감염이나 알콜성간경변처럼 심한 간손상 소견을 보인 군은 36명(58%)이었다. 3) 경미한 간손상을 보인 군에서는 HCV 항체 양성이 1예도 없었고, 만성간염처럼 중간 정도의 간손상을 보인 13명 중에서는 1명이 양성으로 HCV 항체 양성률은 7.7%였으며, 알콜성감염이나 알콜성간경변처럼 심한 간손상을 보인 군에서는 36명 중 8명이 양성으로 22.2%의 HCV항체 양성률을 나타냈다. 4) 만성간염군에서 HCV 항체 양성환자의 bilirubin은 10.3㎎/dl로 HCV 항체 음성환자들의 1.6㎎/dl 보다 높았고, prothrombin time도 40%로 HCV 항체 음성환자들의 93.6%보다 매우 길어져 있었다. 알콜성감염이나 알콜성 간경변처럼 심한 간손상소견을 보인 군에서는 HCV 항체 양성환자들의 62.5%에서 황달 증상이 나타나 HCV 항체 음성환자들의 17.9%에 비해 높았고, HCV 항체 양성 환자군의 globulin은 3.9g/dl로 HCV 항체 음성환자의 3.1g/dl 보다 유의하게 높았다. 결론 : 만성음주자들에서 간손상 정도가 심할수록 HCV 항체 양성률이 높고, 동일한 간손상을 보인 군에서도 HCV 항체 양성환자들의 간기능 HCV 항체 음성환자들에 비해 나쁜 소견을 보였다는 이상의 결과는, HCV 간염이 만성음주자에서의 간손상에 하나의 요인으로 관여할 수 있음을 시사한다 하겠다. Backgrounds: It is generally accepted that development of liver disease in alcoholics is related to alcohol consumption. However, only 10~20% of alcoholics have severe liver disease, and therefore it has been suggests that other factors such as genetic, environmental, nutritional and infections factors including HBV and NANB virus, influence the presence of liver damage. As an assay for HCV antibody becomes available, it has been attracting a substantially increasing interst to study the influence of HCV upon alcoholic liver disease. But in Korea there are few reported studies in this area. Methods: To evaluate the prevalence of hepatitis C virus antibodies in chronic alcoholics and its relationship to the severity of liver disease in chronic alcoholics in Korea, anti-HCV was tested in sera from 62 HBsAg negative chronic alcoholics who had consumed more than 80 gm of ethanol daily for at least 5yr and anti-HCV positive rate was compared withe the severity of liver injury. Results: 1) The prevalence of anti-HCV in chronic alcoholics in Korea was 14.5%. 2) According to the severity of liver injury judged from clinical findings and histological features, alcoholics were divided into three group: normal or fibrosteatosis (13 patients), chronic hepatits (13 patients), alcoholic hepatitis or alcoholic cirrhosis (36 patients). The prevalence of anti-HCV is 0%in normal or fibrosteatosis, 7.7% in chronic hepatitis, and 22.2% in alcoholic hepatitis or alcoholic cirrhosis. 3) This patients positive for anti-HCV with chronic hepatitis showed higher serum bilirubin and longer prothrombin time than did patients negativefor anti-HCV. Moreover the patients with anti-HCV with alcoholic hepatitis or alcoholic corrhosis showed higher prevalence of jaundice and higher serum globulin level than patients negative for anti-HCV. Conclusions: The increased prevalence of anti-HCV in alcoholics with severe liver injury and the impaired liver function in patients with anti-HCV suggests that HCV may be involved in liver damages of somes chronic alcoholics.

상수처리에서 염소소독부산물 현황과 제어에 관한 연구

김영진 ( Kim Yeong Jin ),임용성 ( Im Yong Seong ),신판세 ( Sin Pan Se ),현길수 ( Hyeon Gil Su ) 한국수처리학회 2004 한국수처리학회지 Vol.12 No.1

N/A The formation of disinfection by-products(DBPs) is one of the major issue in drinking water quality control. A significant amount of Trihalomethanes (THMs) and Haloacetic acids (HAAs) are produced by chlorinating the raw water or organic compounds extracted from natural water. With an advances in the analysis of chlorination by-products and their health effects, numerous organic halides such as HAAs, THMs, haloacetonitriles. etc have been identified at low level. Animal studies have demonstrated that dichloroacetic acid(DCAA) causes a carcinogen. A five kinds of HAAs such as MCAA, DCAA, TCAA, MBAA and DBAA are regulated under the U.S Environmental Protection Agency`s proposed Disinfectant Disinfection By-Products Rule. The goal of this study was to control DBPs contained in the drinking water from HM, DS, MJ and PES water treatment plants(WTP). The results obtained from this study are as fallows : for HMWTP, DSWTP, and MJWTP, the THMs concentrations were 22∼29,%/L, 22∼28㎍/L, and 6∼8㎍/L, and the HAAs concentrations were 1∼22㎍/L, 1∼16㎍/L. and 0.4∼16㎍/L, respectively, which were very low value compared to USEPA rule of DBPs. The HAAs was seen to be decreased rapidly in the sand filter of the WTP. This was caused by the HAAs biodegraded in the sand filter. In addition, HAAs can be removed in the advanced treatment process although an adsoption of the THMs is gone.

전신성 홍반성 루푸스 환자에서 자가항체 검출을 위한 이중면역확산법, ELISA, Western Blot법의 비교 및 자가항체와 임상양상의 연관에 관한 연구

유창달 ( Chang Dal Yoo ),차훈석 ( Hoon Seok Cha ),김성욱 ( Seong Wook Kang ),이은봉 ( Eun Bong Lee ),백한주 ( Han Joo Baek ),임용성 ( Yong Seong Im ),김현아 ( Hyun A Kim ),신찬수 ( Chan Su Shin ),송영욱 ( Yeong Wook Song ),최강원 대한류마티스학회 1996 대한류마티스학회지 Vol.3 No.2

Objective: To investigate the autoantibody profile and its clinical association in patients with systemic lupus erythematosus. Methods: The frequency and clinical correlation of autoantibodies were studied in 73 patients with systemic lupus erythematosus who have been followed in Seoul National University Hospital. Double immunodiffusion, ELISA and immunoblot were used for the detection of autoantibodies. Results: The frequency of each autoantibody measured by double immunodiffusion was as follows; anti-Ro 53.4%, anti-La 11.0%, anti-Sm 20.5%, anti-U1 RNP 20.5%. The frequency of each autoantibody by ELISA was as follows; anti-Ro 69.9%, anti-La 27.4%, anti-Sm 54.8%, anti-Ul RNP 68.5%, anti-dsDNA 72.6%, anti-cardiolipin 47.2% (IgG 43.1%, igM 15.3%). The frequency of each autoantibody by immunoblot was as follows; anti-Ro 15.1%, anti-La 42.5%, anti-Sm 46.6%, anti-Ul RNP 42.5%. anti-ribosomal P(P0) 27.4%. Anti-Ro was associated with decreased frequency of nephrotic syndrome. Anti-Ul RNP was associated with increased frequency of malar rash, Raynaud phenomenon and decreased frequency of nephritis. Patients with both anti-Ro and anti-La had more frequent serositis than those with anti-Ro only. Patients with both anti-Sm and anti-Ul RNP had less frequent thrombocytopenia than those with anti-Ul RNP only. And patients with anti-Sm and anti-dsDNA had more frequent arthritis than those with only one of both antibodies. There was a positive correlation of autoantibody titers between anti-Ro and anti-La, anti-Sm and anti-Ul RNP, anti-dsDNA and anti-cardiolipin (IgG). Taking the result of immunoblot as a standard, both of double immunodiffusion and ELISA showed low sensitivity but high specficity for anti La. As for anti-Sm and anti-Ul RNP, double immunodiffusion showed low sensitivity but high specificity, whereas ELISA showed high sensitivity but low specificity. Conclusions: In our study, some autoantibodies (anti-Ro, anti-Ul RNP) were associated with certain clinical manifestations while others not. Immunoblot being used as a standard method, ELISA showed higher sensitivity but lower specificity for anti-La, anti-Sm and anti-Ul RNP compared with immunodiffusion. It is recommended that in interpretating the laboratory findings of these autoantibodies these parameters of each method should be considered.

중증 근무력증과 동반된 전신성 홍반성 루푸스 1 예

이은봉,김현아,송영욱,백한주,강성욱,차훈석,유창달,임용성 대한내과학회 1997 대한내과학회지 Vol.53 No.2

Myasthenia gravis(MG) is an autoimmune disorder characterized by the presence of anti-acetylcholine receptor antibody and weakness of voluntary muscles. The pathogenesis of MG is decreased numbers of acetylcholine receptors at postsynaptic membranes of neuromuscular junctions. It has been reported that MG often coexists with other autoimmune disorders. This is a case report of systemic lupus erythematosus coexisting with MG in a 23 year old female patient presenting with dysarthria, dysphagia, and limb weakness. We report the case with relevant literature review.