위선암에서 E-cadherin의 표출양상에 관한 연구

강동하,김대중,김창진,김의한,양승하 순천향의학연구소 2000 Journal of Soonchunhyang Medical Science Vol.6 No.2

Gastric adenocarcinoma is the most common malignant tumor in Korea. Many oncogens have been found in malignant tumor cells. E-cadherin located in cell membrane is important for progression and metastasis of tumor. To evaluate the expression of E-cadherin according to histopathologic features and the relation between E-cadherin and prognosis on gastric adenocarcinoma, we have performed immune staining, using mouse HECD-1 for 97 cases. The results were as follows; 1) Gastric adenocacinoma showed the loss or marked reduction of the expression of E-cadherin in 30.9% of 97 cases, and early carcinoma 34.2% and advanced 28.8%. 2) According to differentiation of gastric adenocarcinoma, cases showing the loss or marked reduction of the expression of E-cadherin was well differentiated form 16.1%, moderately 35.7%, poorly 31.9% and mucinous carcinoma 100%. 3) According to the degree of invasion in early carcinoma, cases showing the loss or marked reduction of the expression of E-cadherin was carcinoma within mucosa 41.2% and carcinoma invaded to submucosa 28.6%, but there is no significant difference according to types. 4) According to absence or presence of lymph node metastasis in advanced carcinoma, cases showing the loss or marked reduction of the expression of E-cadherin was 17.6% in non-metastatic cases and 33.3% in metastatic cases, but there is no significant difference according to degree of invasion. Above results indicated that the loss or marked reduction of the expression of E-cadherin in gastric adenocarcinoma may be related to prognosis of the patients.

사무직 근로자에서 직무스트레스 및 VDT작업과 목·어깨 근골격계 증상과의 관련성

이의철,김환철,정달영,김동현,임종한,박신구 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.3

직무스트레스와 감기와의 관련성

김동현,박신구,김환철,이의철,김정훈,임종한 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.2

목적: 국내외를 통해 직무스트레스와 감기 등과 같은 감염질환과의 관련성에 대한 연구는 많지 않으며, 특히 국내에서의 연구는 거의 전무한 실정이다. 이에 직무스트레스와 감기와의 관련성을 확인하고자 한다. 방법: 일개 대학병원의 산업의학과에서 보건관리대행을 이행하고 있는 83개의 사업장, 근로자 6,699명에 대해 한국형직무스트레스-단축형(KOSS-SF) 설문지를 배부하였고 회수된 4,637명의 설문지 중 부적절한 응답과 다른 호흡기와 관련한 폐질환을 앓고 있는 237명을 제외한 최종분석 근로자 4,400명(65.7%)의 설문자료를 근거로 연구를 시행하였다. 결과: 감기 경험과의 단변량분석에서 유의한 차이를 보인 요인들과 일상생활 스트레스를 보정한 후 시행한 직무스트레스와 감기 경험과의 로지스틱 희귀분석 결과 직무 자율성 결여를 제외한 직무스트레스 하부 영역 전반(직무요구, 관계갈등, 직무불안정, 조직체계, 보상부적절, 직장문화)에 걸쳐 통계적으로 유의한 차이를 보여주었다. 또한 직무스트레스와 감기 경협 첫수와의 관련성을 확인하기위한 다중회귀분석에서도 비슷한 양상을 보였다. 결론: 직무자율성 결여를 제의한 한국형 직무스트레스 요인 전체가 감기와 관련성을 나타내었다. Objectives: To investigate the relationship between job stress and the common cold which is one of the most common infectious disease. Methods: A KOSS (Korean Occupational Stress Scale)-based questionnaire survey was conducted targeting 6,699 workers, of which 4,637 questionnaires were returned and the data for 237 were excluded due to poor response and having pulmonary disease other than common cold. Consequently, 4,400 (65.7%) returned questionnaires were analyzed. Multiple logistic regression analysis and multiple linear regression, adjusted for daily life stress, confounding variables and both, were used to evaluate the relationship between job stress and the common cold. Results: After adjustment for confounding variables and daily life stress, most of the subscales of job stress contributed to an increased risk of common cold. Conclusions: These results indicated that job stress may play a significant role in increasing the risk of the common cold and that further preventive efforts and studies are needed to reduce job stress and address infectious disease caused by job stress among Korean employees.

대장암종에서 암관련 유전자들의 Promoter Methylation과 암종 발생 및 진행과의 관게에 대한 연구

정동준,이정은,민영기,조성우,백무준,양승하,김의한,김창진 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

The colorectal corcinoma is one of the most common malignant tumor in Korea and its carcinogenic mechanism has not been elucidated exactly yet. So far, the most common carcinogenic mechanism has been known to be multiple genetic changes. But, the CpG island hypermethylation has been revealed to be one of the most important carcinogenic mechanism second to the genetic changes. The epigenetic changes characteristically imprint and transfer to the next generation without changes of nucleotide sequences. When the CpG island of promoter or 5'- exon 1 of a specific gene is methylated by DNA methyltrasferases (DNMTs), the gene expression is inhibited. Carcinogenic mechansisms by promoter methylation has been well known, but the progression of the cancer has not been elucidated yet. The molecular researches on the carcinogenic mechanisms largely depended on the tumor tissue containing various components of cell, due to difficulties in harvesting pure homogeneous tumor cells. Promoter methylatonof the cancer related genes as APc, hMLH2, p16, DAP-K and MGMT in 50 cases of sporadic colorectal carcinoma was studied. The pure normal colorectal epithelial cells, and cancer cells from superficial and deep invasive portion were harvested respectively by laser captured microdissection(LCM), and DNA was extracted from them. The promoter methylation was studied by methylation specific poymerase reaction (MSP) after bisulfite modification of the DNA and the expression of the genes by immunohistochemistry. The results suggests that promoter methylation of the cancer related genes are closely related with the colorectal carcinogenesis and it occurrs from early phase of carcinogenesis, progressing constantly to the late stage. And the promoter methylation of normal epithelial cells increased by age. The p15, known to be the genes related to hematologic malignancy, was closely related to the colorectal carcinoma as well.

전형적인 DISIDA scan 소견의 Rotor 증후군 1예

황의태,염동한,권지혜,임종주,최창수,김태현,김학철 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

만성의 비용혈성 직접형 고빌리루빈혈증은 Rotor 증후군과 Dubin-Johnson 증후군의 특징적인 소견으로, Rotor 증후군은 드문 양성 유전성 질환이며, Dubin-Johnson 증후군과 감별을 필요로 한다. 본 저자들은 황달을 주소로 내원한 26세 남자 환자에서 고빌리루빈혈증에 대한 검사를 시행하여 담도폐쇄 소견없이 간담도 스캔상 전형적인 Rotor 증후군의 소견 즉, 강한 심장 배후방사능이 지속되면서, 간담도계의 조영은 지연 촬영에서도 관찰되지 않으며 신장으로의 배설이 계속 관찰되는 특징적인 소견과 정상 간조직 검사 결과로 Rotor 증후군으로 진단한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Chronic nonhemolytic conjugated hyperbilirubinemia characterizes both Rotor and Dubin-Johnson syndromes. Rotor syndrome is a rare, benign familial disorder and needs to be differentiated from Dubin-Johnson syndrome. Cholescintigraphy is a simple and informative procedure for the diagnosis, which can differentiate Rotor syndrome from Dubin-Johnson syndrome. A 26-year-old man was admitted due to asymptomatic persistent jaundice. Physical examination revealed icteric sclera without hepatosplenomegaly. Laboratory findings showed increased serum bilirubin with direct bilirubinemia. Markedly decreased hepatic uptake and poor visualization of the gallbladder and biliary tract were shown in ^(99m)Tc-DISIDA scan. Histology of the liver showed no diagnostic abnormality without pigmentation. But, we report a case of Rotor syndrome that showed characteristic cholescintigraphic findings with normal urinary total coproporphyrin excretion.

農村에 있어서의 腸管系寄生蟲의 豫防對策 三槽式腐敗槽便所의 살아있는 寄生蟲卵 및 病原性腸內細菌의 環境汚染 遮斷效果

金東燦,李溫永,金舜姬,韓義正,金南洙 國立保健硏究院 1977 국립보건연구원보 Vol.14 No.-

섬유종류 및 잔골재용적비에 따른 HPFRCC의 공학적 특성에 관한 실험적 연구

이의배,이동혁,나철성,조봉석,김재환,김무한 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)

In general, concrete showed brittle fracture but HPFRCC(High Performance fiber reinforced cementitious composite) showed ultra high ductile behavior in the hardened state, because of the fiber bridging properties. So a variety of experiments have being performed to access the performance of HPFRCC recently. In this study, to develope HPFRCC with high ductility and strain capacity, effects of fiber types and sand volume fraction were investigated. And results of this study were as follows; · HPFRCC reinforced with PVA or hybrid fiber were superior to PP or singleness. · Effect of sand volume fraction on HPFRCC reinforced with PP was insignificant.

중소규모 사업장 근로자의 직무스트레스로 인한 결근, 조퇴 현황과 한국형직무스트레스 하부요인과의 관련성

김정훈,박신구,김동현,김환철,임종한,이의철,이동훈,이지영 大韓産業醫學會 2009 대한직업환경의학회지 Vol.21 No.2

목적: 중소규모 사업장 근로자들의 직무 스트레스로 인한 결근, 조퇴의 현황과 한국형 직무 스트레스 하부 요인과의 관련성을 알아보고자 하였다. 방법: 중소규모 사업장 83곳 근로자들에 대해 한국형 직무스트레스요인 평가도구-단축형(KOSS-SF)과 사회 일반적 특성, 직업적 특정 및 직무스트레스로 인한 결근이나 조퇴 경험여부 등을 묻는 구조화된 자가 기입식 설문을 실시하였고, 응답한 4,350명에 대해 최종 분석을 시행하였다. 직무스트레스로 인한 결근, 조퇴와 한국형 직무스트레스 하부 요인들과의 관련성을 확인하기 위하여 로지스틱 회귀분석을 시행 하였다. 결과: 직무 스트레스로 인한 결근, 조퇴를 한 근로자는 남자에서 7%(196명), 여자에서 8%(113명) 로 조사되었고 한국형 직무 스트레스 하부요인과의 관련성에서는 남, 여 모두 직무요구, 관계갈등, 조직체계, 보상부적절, 직장문화 영역의 스트레스가 높은 군에서 통계적으로 의미있게 직무스트레스로 인한 결근, 조퇴율이 증가하였다. 결론: 중소규모 사업장 근로자들의 직무 스트레스로 인한 결근, 조퇴와 한국형 직무 스트레스 하부요인과의 관련성은 남자에서는 조직체계 영역이 가장 높았고, 여자는 직장문화 영역에서 가장 높은 관련성을 보였다. Objective: The aim of this study was to examine the actual conditions of absence and early leave due to job stress of 4,350 workers in 83 small and medium scale industries, and its relationship to job stress factors using Korean Occupational Stress Scale-Short Form (KOSS-SF). Methods: A structured self-reported questionnaire was used to assess each respondent's Sociodemographics, job stress, experience of absence and early leave due to job stress. Seven KOSS-SF domains of job stress were used. We estimated the relation of absence and early leave due to job stress and job stress factors using logistic regression analyses. Results: Absence or early leave due to job stress occurred in 7% of male workers and 8% of female workers. Multiple regression analysis revealed a significantly positive association job stress-related absence/early leave and job demand, interpersonal conflict, organizational system, lack of rewards and occupational climate. Conclusions: Absence and early leave due to job stress is significantly attributed to organizational System and lack of reward for men, and occupational climate and organizational system for women.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.