연작업자들에서의 δ -aminolevulinic acid dehydratase 유전형질의 다형성이 신기능에 미치는 영향

안익수,황보영,김용배,리갑수,이성수,장봉기,함정오,안규동,이병국 순천향대학교 산업의학연구소 2001 순천향산업의학 Vol.7 No.1

δ-aminolevulinic acid hehydratase (ALAD) is a polymorphic enzyme that has two alleles, ALAD1 (ALAD1-1 as phenotype) and ALAD2 (ALAD1-2 or ALAD2-2 as phenotype). ALAD genotype has been reported to modify the toxicokinetics of lead. To investigate the influence of ALAD genotype polymorphism on renal function in lead workers, author studied 1022 male lead workers and 149 non lead workers in the same industries. For the cross-sectional renal function indices, blood urea nitrogen (BUN), serum creatinine, uric acid and total protein were selected. Blood lead and blood zinc protoporphyrin were also measured as indices of lead exposure. Information on weight, age, job duration, smoking & drinking history were collected. Following results are as follows: 1. Whereas the mean (standard deviation) of blood lead and blood ZPP of lead workers were 27.2±12.5 ㎍/㎗ and 57.7±37.8 ㎍/㎗, those of non-lead workers in the same premises were 14.9±6.5 ㎍/㎗ and 44.6± 15.8 ㎍/㎗ respectively. The difference of mean blood lead and blood ZPP between two groups were statistically significant. 2. Whereas the prevalence of the variant allele, ALAD2 in 1022 lead workers was 10.2 %, the prevalence of that in 149 non-lead workers was 7.4 %. But there was no difference of prevalence between two groups. 3. The mean±standard deviation of blood lead of subjects with ALAD1 was 25.5± 12.7 ㎍/㎗ and was slightly lower than that of subjects with ALAD2 (26.5±10.9 ㎍/㎗), and the mean±standard deviation of blood ZPP of subjects with ALAD1 was slightly higher than that of subjects with ALAD2 (56.7±37.3 ㎍/㎗ vs 48.9±18.6 ㎍/㎗). But the differences of blood lead and blood ZPP between two genotypes were not statistically significant. 4. There were no differences of cross-sectional renal function indices (BUN, serum creatinine, uric acid and total protein) either by lead workers and non-lead workers or two genotypes. 5. In multiple regression analysis of ALAD genotype on BUN after controlling for possible confounders (sex, weight, job duration, smoking and drinking status), the mean of BUN in ALAD2 subjects was 0.629 ㎎/㎗ lower than ALAD1 subjects with a weak statistical significance (p=0.07). But in logistic analysis of ALAD genotype on median value of BUN revcaled that subjects of ALAD2 genotype were 32% less likely to have median value or more of BUN than subjects of ALAD1 with odd ratio of 0.618 (95% confidence interval 0.411-0.920). 6. In multiple regression analysis of ALAD genotype on serum creatinine after controlling for possible confounders (sex, weight, job duration, smoking and drinking status), the mean of serum creatinine in ALAD2 subjects was 0.0271 ㎎/㎗ lower than ALAD1 subjects with statistical significance (p=0.02). On the other hand, in logistic analysis of ALAD genotype on median value of serum creatinine revealed that subjects of ALAD2 genotype were 30% less likely to have median value or more of scrum creatinine than subjects of ALAD1 with odd ratio of 0.700 (95% confidence interval 0.442-1.080). With the above results, it was found that the variant allcle, ALAD2 appeared to modify the association of lead and renal function and ALAD2 genotype may be supportive for the protective effect of lead.

직업적 연폭로가 일부 신경행동학적 검사수행에 미치는 영향

안익수,안현철,김용배,리갑수,김화성,황규윤,최은,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

In order to investigate that blood lead levels of lead exposed workers is associated with decreased performance in neurobehavioral tests in adults, we investigate 78 workers in a battery industry. Three items among neurobehavioral core test battery of World Health Organization, including digit span, Santa ana dexterity, digit symbol were administered to workers occupationally lead exposed workers by operational guide for the WHO neurobehavioral core test battery. Blood lead (PbB) and zinc protoporphyrin in whole blood (ZZP) were selected as an index of lead exposure. Detailed occupational history such as exposed agent, age, work duration, smoking and drinking habits, were recorded as confounding factors. After controlling age, the results of digit span and digit symbol among the neurobehavioral tests were significant contributed by PbB.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

직업적 연폭로에서 혈중 연량 수준에 따른 선별검사로서의 혈중 ZPP 검사의 타당도

한구석,안현철,김용배,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

In order to evaluate the validity of current screening criteria of lead exposure and to provide effective information for the better health management of lead workers, author investigated the interrelationship between blood lead and blood zinc protoporphyrin(ZPP) and evaluate the validity of blood zinc protoporphyrin as the screening test and blood lead as gold standard of diagnostic test. The total of 2245 lead workers (male workers: 1982, female workers : 263) from 12 lead using industries were studied. Blood lead, ZPP, hemoglobin and hematocrit were selected as lead exposure variables. Personal information on sex, age and work duration were also checked. Blood lead was measured with flameless atomic absorption spectrometry (model: Hitachi 8100) using standard addition method. Blood ZPP was measured with portable hematoflurometer (model: Aviv 206). The results obtained were as follows: 1. The mean blood lead of all lead workers were 0.7±14.3㎍/㎗(Male: 31.0±14.4㎍/㎗, Female: 28.2±12.9㎍/㎗), whereas the mean blood ZPP of those were 68.1±47.5㎍/㎗(Male: 63.9±43.7㎍/㎗, Female: 100.1±61.0㎍/㎗). The mean value of hemoglobin and hematocrit of all lead workers were 14.5±1.5g/㎗(Male: 14.7±1.3g/㎗, Female: 12.3±1.2g/㎗) and 45.4±3.6(Male: 46.2±2.8, Female: 39.5±3.1) respectively. 2. Validity of test using blood zinc protoporphyrin as screening test for blood lead levels of 30㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 50 and 90 ㎍/㎗ of ZPP respectively, showing 50 and 60 ㎍/㎗ of ZPP for all lead workers. While those test for blood lead levels of 40㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 60 and 90 ㎍/㎗ of ZPP respectively, showing 60 ㎍/㎗ of ZPP for all lead workers, those test for blood lead levels of 50 and 60㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 60 or 70 and 100 ㎍/㎗ ZPP respectively, showing 60and 70 or 80 ㎍/㎗ of ZPP for all lead workers. 3. Predictive value of test using blood zinc protoporphyrin as the screening test for different blood lead levels of 30, 40, 50 and 60㎍/㎗ as gold standard of diagnostic test revealed that positive predictive value of screening test were decreased by the increase of blood lead level regardless of csreening criteria value ZPP and negative predictive value of screening test were increased accordingly regardless of screening criteria value of ZPP. On the other hand, within same blood lead level as a gold standard positive predictive values were inceased by the increase of screening criteria value of ZPP, whereas the negative predictive value were decreased accordingly by the the increase of screening criteria value of ZPP. 4. The correlation analysis of all lead workers among study variables revealed that CPbB and natural log transformation ZPP(LZPP) were better correlated with other variables and found to be better estimate than PbB and ZPP themselves. The age was correlated with all other variables, but the work duration was not. The correlation analysis of male and female workers among study variables revealed the same results with all lead workers. 5. The slope of simple linear regression of CPbB (independent variable) with ZPP in female workers(3.223)was steeper than in male workers(2.144). That of lead workers with work duration of less than 1 year was steeper than that of lead workers whose work duration was more than 1 year. But there was no slope difference between two groups divided by their work duration of 2 years less and more. The slope of simple linear regression of CPbB lead (independent variable)with ZPP in lead workers whose blood lead were higher than 30㎍/㎗and 40㎍/㎗ were steeper than those whose blood lead were less than 30㎍/㎗ and 40㎍/㎗. 6. The slope of simple linear regression of CPbB (independent variable) with ZPP in lead industries with low mean blood lead were less steeper than those with high mean blood lead. 7. The slope of simple linear regression of CPbB (independent variable) with LZPP in female workers(0.0308was steeper than in male workers(0.0253). That of lead workers with work duration of less than 1 year was steeper than that of lead workers whose work duration was more than 1 year. But where was no slope difference between two groups divided by their work duration of 2 years less and more. While the slope of simple linear regression of CPbB lead (independent variable) with LZPP in lead workers whose blood lead were hogher than 30㎍/㎗ was not steeper than those whose blood lead were less than 30㎍/㎗, there was no slope difference between two groups whose blood lead were less than 40㎍/㎗ and more than 40㎍/㎗. 8. The slope of simple linear regression of CPbB (independent variable) with LZPP in lead industries with low mean blood lead were less steeper than those with high mean blood lead, but the difference was not significant then that of CPbB and ZPP. With above results, it is recommended that the screening criteria value of ZPP should be down to 60-70㎍/㎗ from 100㎍/㎗ for male lead workers and screening criteria of ZPP for female lead workers was all right with current value of 100㎍/㎗. So it is recommended to make different screening criteria of ZPP for male and female workers like the hemoglobin and hematocrit screening criteria. It is also preferable to use CPbB and LZPP rather than uncorrected PbB and ZPP in the evaluation of lead exposure for lead workers.

생약제제인 이공산(異功散)의 Cisplatin 유도 신장독성 보호 및 항산화 효과

Lee, Kyung-Tae,Ahn, Kyoo-Seok,Chang, Sung-Goo,Oh, Soo-Myung,Jung, Jee-Chang 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Kyung-Tae Lee, Kyoo-Seok Ahn¹, Sung-Goo Chang², Soo-Myung Oh²and Jee-Chang Jung²¹College of Pharmacy, ²Oriental Medicine and ³College of Medicine, and East-West Medical Reserch Institute, Kyung Hee University, Seoul, Korea. Preventive and Antioxidative Effects of Crude Drug Preparation(E-kong-san) on Cisplatin Induced Nephrotoxicity. Proceedings of International Symposium on East-West Medicine, Seoul. 201-211, 1999. -Nephroprotective effects of a crude drug-prearation (E-kong-san) were determined from cisplatin on rabbit kidney proximal tubule and human renal cortical cells by MTT assays and sustained glucose consumption on ciplatin-induced human renal cortical tissue. Levels of creatinine and blood ure nitrogen(BUN) in serum after administration of cisplatin(0.75mg/kg,i.p.) to E-kong-san(0.75g/kg/day,p.o.)-pretreated rats were markedly lower compared to those of cisplatin-treated rats. Moreover, the administration of E-kong-san significantly inhibited the loss of body weight of cisplatin injected rts. These findings suggest that E-kong-san on the cisplatin induced nephrotoxicity led us to investigate whether the effect of this water extract was a result of anti-oxidation. E-kong-san showed strong free radical scavenger activities on 1,1-dipheny1-2picrylhydrazil(DPPH) radical and xanthine/xanthine oxidase(XOD) generated superoxide anion radical(O2-). We further studied the effects of E-kong-san on lipid peroxidation in rat liver microsomes induced by enzymatic and nonenzymatic methods. E-kong-san exhibited significant inhibition on both ascorbic acid/Fe2+and ADP/NADPH/Fe3+ induced lipid peroxidation in rat liver microsomes. Based on these results, we suggest that-E-kong-san attenuate the cisplatin induced cytotoxicity and its mechanism can be eplained by antioxidant.

업종에 따른 연 취급 사업장의 기중 연 농도 및 연 노출 수준 평가

이병국,김용배,리갑수,안현철,김화성,이용진,황규윤,장봉기,이성수,안규동 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

In order to obtain an useful information for health management and biological monitoring of lead exposed workers, Authors tried to investigate air lead level and the lead exposed level of workers in lead industry according to occupational category. The subjects in our study were 2074 workers in 7 lead-using industries, and study subjects were divided into 4 occupational categories such as storage battery industry (type 1), primary smelting industry (type 2), secondary smelting industry (type 3) and litharge making industry (type 4). Blood zincprotoporphyrin concentration (ZPP), blood lead concentration (PbB) and urinary δ -aminolevulinic acid (ALAU), hemoglobin (Hb), hematocrit (Hct) were selected as the indices of lead exposure. Personal variables such as age, work duration were also collected. The results were as follows. 1. The geometric mean air lead in 9 lead-using industry was 0.1133±4.3120 ㎎/㎥, and that in type 1, 2, 3 and 4 was 0.1038±3.4952 ㎎/㎥, 0.0429±3.4329 ㎎/㎥, 0.1877±2.5123 ㎎/㎥ and 0.9961±5.2910 ㎎/㎥, respectively. 2. The mean ZPP in 9 lead-using industry was 53.1±28.0 ㎍/㎗, and that in type 1, 2, 3 and 4 was 52.0±24.8 ㎍/㎗, 48.0±16.4 ㎍/㎗, 109.8±85.6 ㎍/㎗ and 74.3±37.8 ㎍/㎗, respectively. There was significant difference in ZPP according to occupational category (P<0.01). The percents of lead workers whose ZPP were above 100 ㎍/㎗ in type 1, 2, 3 and 4 were 4.0%, 1.7%, 34.3% and 21.6%, respectively. 3. The mean PbB in lead-using industry was 26.0±11.2 ㎍/㎗, and that in type 1, 2, 3 and 4 was 25.3±11.1 ㎍/㎗, 26.7±8.8 ㎍/㎗, 50.3±15.2 ㎍/㎗ and 36.4±11.0 ㎍/㎗, respectively. There was significant difference in PbB according to occupational category (P<0.01). The percents of lead workers whose PbB were above 40 ㎍/㎗ in type 1, 2, 3 and 4 were 10.4%, 7.7% 71.9% and 43.2%, respectively. 4. While the correlation of Hb corrected PbB with ZPP was higher than non corrected PbB, the correlation of log-transformed ZPP with PbB was higher than non corrected ZPP. 5. Simple linear regressions of PbB and corrected PbB as independent variable with ZPP, log-transformed ZPP and ALAU as dependent variable were statistically significant (P0.01). Coefficient of determination of corrected PbB with other variables was higher than non corrected PbB. As the result of this study, it was suggested that reconsideration of environmental and biological monitoring program was highly recommended for secondary smelting and litharge making industry.

납 폭로 근로자에서 δ-aminolevulinic acid dehydratase 유전형질이 zinc protoporphyrin 및 δ-aminolevulinic acid에 미치는 영향

이병국,황규윤,장봉기,김용배,리갑수,안현철,김화성,이성수,안규동,박종범 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

The inhibition of δ-aminolevulinic acid dehydratase (ALAD) in the heme synthetic pathway results in increased protophoryphyrin (ZPP) and δ-aminolevulinic acid (ALA) and is responsible for some of toxicological effects of lead. This enzyme is coded by the ALAD gene containing 2 co-dominant alleles. The polymorphisms of ALAD gene may be related to differential effects of lead on ZPP and ALA, ALAD genotype was measured in 975 Korean male lead workers, of whom 897 were homozygous for ALAD1 (ALAD 1-1 genotype) and 96 were heterozygous for ALAD2 (ALAD 1-2 genotype). Blood lead in subjects with ALAD1 was significantly higher than those with ALAD2 (p = 0.01). No difference between ALAD genotypes was found for age, exposure duration, ZPP, ALA, hemoglobin, hematocrit, body mass index, tobacco and alcohol use. After adjustment for possible confounders, ALA and ZPP became significantly elevated in ALAD1 subjects (p = 0.004 and 0.055, respectively). This result suggests that ALAD1 subjects may be more susceptible to the hematotoxicologic effects of lead than ALAD2 subjects.

Bacillus subtilis 저온충격 단백질 Csp 유전자 결손이 저온 환경에서의 생장에 미치는 영향

안정미 ․ 이상수 배재대학교 자연과학연구소 2011 自然科學論文集 Vol.22 No.1

Cold shock proteins (CSPs) are expressed in cold conditions in order to adapt to that cold conditions. Three cold shock proteins CspB, CspC and CspD exist in Bacillus subtilis. To know the effect of cold environment on the cell growth each three cold shock gene was deleted. Growth curves in the conditions of 37℃ and 20℃ were compared to understand cold acclimation of these deleted mutant cells. Also, growing cells in the conditions of 37℃ to the log phase and then cold shock treatment which growing temperature was changed from 37℃ to 15℃ was carried out. The results of cold acclimation showed that both of the growth rate of wild type and Csp deleted mutants at 37℃ is nearly same but the growth rate of mutant cells was reduced compared to the wild type cell. On the other hands, both of wild type and mutant cells show nearly same growth rate on cold shock. These results demonstrate that Csp deleted mutants are not cold sensitive.

파라캇에 의한 대뇌 피질 손상 : 증례 보고

안미영,신동익,이형석,백신혜,이성현,이상수 충북대학교 의과대학 충북대학교 의학연구소 2010 忠北醫大學術誌 Vol.20 No.1

Paraquat is widely used as a universal herbicide. Paraquat induces brain damage in case of fatal poisoning. It is well documented that paraquat exposure is associated with Parkinson's disease. However, many reports suggest paraquat is not selective for the dopaminergic nigro-strial system. Preferably, there are reports that cortical neurons were found to be more sensitive to paraquat. A39-year-old woman committed suicide by drinking 20 ml of a 20% solution of Paraquat. After 5 days, she had a convulsive seizure and lost consciousness. Brain MRI showed diffuse cerebral cortical edema of bilateral frontal and temporal lobes. She died 2 days after progressive pulmonary fibrosis. Here, we report a patient with paraquat induced cortical lesion. 파라캇은 세계적으로 널리 쓰이는 제초제이다. 파라캇은 중독되었을 경우 뇌손상을 일으키기도 한다. 파라캇과 파킨슨병과의 관련성은 비교적 잘 알려져 있다. 하지만, 파라캇이 도파민 줄무늬흑체 계통(dopaminergic nifro-striatal system)에 선택적이지 않다는 많은 보고들이 있다. 오히려, 대뇌피질이 파라캇 중독에 더욱 민감하다는 일부 보고들도 있다. 39세 여자환자가 자살할 목적으로 20% 농도의 파라캇 20 ml를 마시고 본원에 내원하였다. 환자는 입원 5일째 갑자기 전신 발작 증상과 함께 의식 저하 소견을 보였다. 다음날 시행한 뇌자기공명영상 촬영상 양쪽 측두엽과 전두엽에 대칭성 세포 도겅부종 소견을 보이고 있었다. 그녀는 2일 후 폐섬유화증에 의한 호흡부전으로 사망하였다. 저자들은 파라캇 중독 환자에서 대뇌 피질 손상을 확인한 1예를 경험하였기에 보고하는 바이다.

세 건의 재해사고를 통한 우리 나라의 재해대책 분석

안무업,황성오,임경수,강성준 대한응급의학회 1993 대한응급의학회지 Vol.4 No.2

Disaster is a any community or regional events that disrupts community functions and activities and cause concern for the lives, health, and property of the citizens of that community. Successful management of disaster requires adequate planning and practice drills. Emergency medical service must play an important role in disaster management because any disaster produces various types of patients who need emergent care. We tried to analyse korean disaster planning in review of three recent disasters including aircraft crash, ship submergence, and road traffic accident. The result of disaster survey shows that there are many defects in Korean disaster plan at the stage of notification, propagation, rescue, stabilization and withdrwal and emergency medical service system is not being involved in disaster management because korean disaster plan is a civil-defence model. We conclude that current korean disaster plan is inadequate for management of disaster and it should be reinforced.