혈중 감마지티피 상승의 임상적 의의

신주연,김용규,박신구,이지나,김환철,임종한,홍윤철 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.1

목적: 혈중 감마지티피는 주로 알코올 섭취와 간세포 손상의 지표로서 이용되어져 왔으나 최근에는 혈중 감마지티피가 체내의 산소성 스트레스를 민감하게 반영하는 지표이며, 혈중 감미지티피를 이용하여 만성질환의 발생을 조기에 예측할 수 있다는 주장들이 있다. 이에 본 연구에서는 일반 인구 집단을 대상으로 한 건강검진 자료를 분석하여 혈중 감마지티피의 상승에 영향을 미치는 요인들을 분석하고 혈중 감마지티피와 산소성 스트레스와의 관련성 및 임상적인 이용 가능성을 알아보고자 한다. 방법: 2001년부터 2003년까지 한 대학병원 산업의학과에서 건강검진을 실시한 15,546명을 대상으로 하였고 신체계측, 혈액검사 그리고 설문지의 정보를 분석하였다. 총 15,546명 중 남성은 9,660명 이었고 여성은 5,886명 이었다. 연령, 성별, 체질량지수, 흡연, 음주, 운동량 비타민 복용 여부에 따른 혈중 감마지티피의 평균을 분석하였고, 성별에 따른 다변량 분석을 실시하였다. 다변량 분석에는 연령, 체질량지수, 음주빈도, 흡연량, 혈색소, 이완기혈압, 공복시혈당, 총콜레스테롤, ALT를 포함하였다. 결과: 연구 대상자들의 혈중 감마지티피의 평균은 남성에서 평균(±2SD)이 47.51(±111.62)이었고, 여성에서는 19.09(±42.02) 으로서, 대체적으로 정상 범위에 있다고 보여 지나 개인차가 상당히 크다는 사실을 알 수 있었다. 다변량 분석의 결과에서는 혈중 감마지티피의 상승에 영향을 미치는 요인이 성별에 따라 다소 달랐으나 남녀 모두에게 연령, 음주빈도, 흡연량, 이완기혈압, 공복시혈당, 총콜레스테롤, ALT가 유의한 영향이 있음을 확인할 수 있었다. 그리고 다변량 로지스틱회귀분석의 결과에서 '임상적 비정상'을 예측함에 있어 혈중 감마지티피가 진단적 유용성이 있음을 확인하였다. 결론: 긴존에 일반적으로 알려져 있는 것처럼 혈중 감마지티피를 단순히 알코올 섭취와 간세포 손상의 지표로서만 볼 수 없으며, 성별, 연령, 흡연, 고지혈증, 당뇨, 고혈압 등 많은 다른 요인들에 의해서 영향을 받으며, 혈중 감마지티피를 산소성 스트레스를 반영하는 생물학적 지표로 해석할 수도 있다. 따라서 혈중 감마지티피의 상승을 임상적으로 해석할 때는 (비록 정상인 범위에 있다하더라도), 알코올 섭취나 간세포 손상 뿐 아니라 다른 여러 요인들을 함께 고려해야 한다. 더욱이 혈중 감미지티피의 상승을 만성질환 즉, 고혈압, 당뇨, 고지혈증 등의 발생을 조기에 발견할 수 있는 지표로서 임상영역이나 건강검진시 유용하게 활용할 수 있을 것이다. Objectives: Incresed gamma-glutamyltransferase (GGT) concentration has mainly been used as a biologic marker of alcohol drinking and liver diseases. However, some recent reports have suggested that serum GGT concentration may be an early biomarker of oxidative stress and associated with chronic diseases like hypertension, DM, hyperlipidemia, CHD, stroke etc. In this study, we analysed the factors associated with increased serum GGT level and evaluated the clinical application of serum GGT in predicting the risk of chronic diseases. Methods: The data were collected from 15,546 periodic health examinations, 9,660 males and 5,886 females, done at one university hospital from 2001 to 2003. We analysed self-questionnaire, physical examination and laboratory data. Statistical analyses(t-test, ANOVA, Pearson's correlation analysis, multiple regression analysis and logistic regression analysis) were done by SPSS for windows 10.0. Results: Mean serum GGT levels were quite different according to age, sex, BMI, smoking and alcohol drinking (all P-value <0.001), but were not different by regular vitamin intake or not (P-value = 0.117). There was significant correlation between serum GGT level and the variables (of age, BMI, blood pressure, Hb, fasting blood sugar, total cholesterol, AST and ALT) (all P-value <0.001). In sex-specific multiple regression analysis, increased serum GGT level was significantly associated with age, alcohol drinking, smoking, blood pressure, fasting blood sugar and ALT in males (all P-value <0.001), and with age, alcohol drinking, smoking, Hb, blood pressure, total cholesterol and ALT in females (all P-value <0.05). In sex-specific logistic regression analysis, increased serum GGT level was significantly associated with risk of 'clinical abnormalities'. This risk increased about 13-fold in males and 4.6-fold in females for serum GGT level over the third quatile, compared with under the first quartile. Conclusions: Serum GGT level is increased not only by alcohol drinking or liver diseases, but also by many other factors associated with chronic diseases and behavioral factors. Thus many factors should be considered in evaluating an increase in GGT level, even when within the upper normal range. Serum GGT level may be a predictor for the early development of chronic diseases.

볼리비아 로즈목에 의한 다형홍반 양상을 보인 직업성 알레르기 접촉피부염 증례

신주연,홍윤철,임종한,박신구,이지나,김환철 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

배경 : 로즈목(rosewoods) 중 볼리비아 로즈목(Machaerium Scleroxyon)은 강력한 감작물질을 함유하고 있어서 외국에서는 이로 인한 자극 또는 알레르기 접촉피부염의 발생이 증가하고 있음에도 불구하고 지금까지 우리나라에서는 볼리비아 로즈목을 비롯한 수입목재에 의한 직업성 피부질환의 보고가 부족하였고, 이에 저자들이 볼리비아 로즈목에 의한 다형홍반 양상을 보인 직업성 알레르기 접촉피부염의 증례를 경험하였기에 보고하고자 한다. 증례 : 49세 남자로서 여러 가지 수입목재를 절단하고, 다듬는 작업을 하다가 소양감을 동반한 홍반성의 피부 증상이 발현되었고, 전신으로 증상부위가 확대되어 2주 동안 병원 입원 치료를 하게 되었으며, 이후 본원 산업의학과에서 피부첩포 검사 후 최종적으로 볼리비아 로즈목에 의한 알레르기 접촉피부염으로 확진되었다. 결론 : 수입목재들로 인한 직업성 피부질환 발생에 대한 광범위한 실테 조사가 필요하며, 이를 토대로 작업장에서의 직업성 피부질환의 발생을 감소시키기 위한 다각적인 예방, 관리 대책의 수립이 필요하다. Background: Woods are capable of causing allergic or irritant contact dermatitis which typically occurs on exposed areas. Because Bolivian rosewood exclusively contains the strong sensitizer R-3,4-dimethoxdalbergione, an increasing number of cases of initant and allergic contact dermatitis has been reported. Case report: A 49-year-old, male, wood worker, who handled a variety of woods, developed allergic contact dermatitis. A patch test confirmed a positive reaction to one of the exotic woods, Bolivian rosewood. Allergens found in Bolivian rosewood caused this patient's dermatitis, which cleared when he avoided &is wood. Conclusion: Exotic woods such as Bolivian rosewood can induce occupaiional contact dermatitis. Measures to lower the incidence of work-related dermatitis are needed in the workplace. Especially, when cutting or sanding woods, workers should wear proper personal protection.

영광 원자력발전소 3,4호기의 계통 병입에 따른 전력계통의 안정도 해석

박철원,권명현,김철환,신명철 成均館大學校 科學技術硏究所 1994 論文集 Vol.45 No.2

This paper deals with consideration for transient stability of power system The analysis of transient stability is very important because it detects the possibility of large scale outage by system collapse caused system configuration change and load unbalance. Two units YGN 3&4 will be connected to the YGN 1 & 2 switchyard through two 345KV circuits until 1996 because of the nuclear power plant construction according to power demand increment. Therefore it is necessary to study stability analysis, fault capacity calculation and power flow problem in assumption of two units YGN 3&4 operation interconnected with the power system Finally, considerations of the effect of interconnection and the establishment of preservation methods for reliability of stable opration of the power system are included in this paper.

Ciprofloxacin 제제의 생물학적 동등성에 관한 연구

최철희,신재국,신완균,유호진,이경훈,정원석,장인진,신상구 대한화학요법학회 1991 대한화학요법학회지 Vol.9 No.1

국내 시판중인 ciprofloxacin 제제인 Citopcin®(250㎎ tablet)의 동등성을 검토하기 위해 제조원인 Bayer사의 Citopcin®(250㎎ tablet)를 기준제제로 하여 18명의 건강한 남성 피험자를 대상으로 500㎎ 1회 교차 경구 투여후 약동학적 성상을 분석비교한 결과는 다음과 같다. 시험제제의 생체 이용율의 지표인 AUC, C_(mao), T_(max) 및 MRT들의 평균치는 백분율차이에 있어 모든 기준제제 지표의 ± 20% 이내였으며, 이들 생체 이용율 지표들은 분산분석 검정에서 차이를 인지할 수 없었다.생체 이용율 지표들의 기준제제에 대한 백분율 90% 대칭 신뢰구간 검토시 모든 경수들에서 ± 20% 이내의 조건을 만족하였으며 AUC의 경우에는 대칭형 신뢰구간으로 변환시 95% 신뢰구간에서도 동등성의 조건을 만족하였다, 이상의 시험결과로 시험제제인 Citopcin®은 기준제제인 Ciprobay®와 생물학적 동등한 제제로 판단되었다. The pharmacokinetics of ciprofloxacin was studied for the evaluation of the bioequivalence of the generic ciproflocacin products. Two single doses of 500㎎ each of ciprofloxacin(Ciprobay® 250㎎ tablet as a reference compound and Citopcin® 250㎎ tablet s a test compound) were administered orally to ighteen male volunteers in a balanced, randomized crossover design. Pek plasma levels of ciprofloxacin were observed about 1 hour after the doses and the peak concentrations of both products were similar(Ciprobay®, 3.18㎍/㎖; Citopcin®, 2.89㎍/㎖). The values of other pharmacokinetic parameter of ciprofloxacin computed for Ciprobay® are presented in that order: AUC=13.53:12.47㎍·h/㎖, T_(max)=1.28:1.14 hours; MRT=5.30:5.08 hours; t_(1/2)β=3.65:3.47 hours. No satistically significant, differences were detected when AUC and the other parameters were compared with the method of ANOVA. Using the criteria of 90% confidence interval for the assessment of bioequivalence al the parameters were acceptable. The products were found to be equivalent on the premise that no significant difference was detected when the relevant pharmacokinetic parameters were compared, and the confidence limit analysis showed acceptable results.

흰쥐에서의 신규 항암제 BR-28702-2의 체내동태

용철순,이신웅,전철수,채희상,신원섭,백우현 영남대학교 약품개발연구소 1995 영남대학교 약품개발연구소 연구업적집 Vol.5 No.-

The purpose of this study was to determine pharmacokinetic parameters of BR-28702-2, a new antineoplastic agent which is the conjugate of nucleotide and phospholipid, and to compare them with those of ara-C. Male rats were cannulated in the left femoral vein and received a single i.v. bolus dose of either BR-28702-2 or ara-C. BR-28702-2 was also administered i.p. and plasma samples were analyzed by reversed-phase HPLC. The t_(L/2(β)) of ara-C(1.22 hr.) was significantly smaller than that of BR-28702-2(4.420 hr.). The absolute bioavailability of BR-28702-2 after i.p. injection was 1.125%. This lower bioavailability, together with previous reports that marked antineoplastic activity was observed when given i.p., indicates that BR-28702-2 would act as a depot system to release active moieties. Further works. therefore, need to be done to characterize active metabolites.

血液檢査에 나타난 肝疾患과 高脂血의 處方으로서의 食餌療法과 運動療法 : 30대, 40대 성인을 중심으로

申澈世 한국항공대학교 1992 論文集 Vol.30 No.-

The purpose of this article is to investigate the physical conditions of adults on 30's and 40's and to find out the diet therapy and the particular execises for treating their disorders considering their communities. The findings are as follows: To better their physical fitness they need planned diet habits provided with well-balanced nutrients and follow the proper therapy of physicians. To treat the hyperlipidemia, as execise therapy, we suggest that they control their weight and also abide well-planned execise schedules. In addition, we survey the correlation of the life span and the execises.

노인운동이 혈중 신경전달물질과 측두엽 혈류 변화에 미치는 영향

신철호 남서울대학교 2007 남서울대학교 논문집 Vol.13 No.4

The Purpose of this experiment was to identify the effect of dancesports in postponing the loss of brain blood flow in the men people. So the Neurotransmitter(Dopamine) was analyzed in the blood for 12 weeks, divided into 4 terms. By selecting one male subject, the SPECT was used to take picture of their brain. the results are as following. Dancesports didn't cause detectable change in the Dopamine of men. When the integrating the results, it was possible to notice the Dopamine in men didn't show significant change until the 4th term. We consider that the short term exercises didn't affect the change of Dopamine. However, after adapting to the long term exercises, it seemed to be partial effective. So the increase of maintaince of Dopamine, which is the cause of vessel expansion, is thought to increase the brain blood and effective in preventing brain vein disease. Key words : Dopamine, Neurotransmitter, SPECT

쇼트피닝 가공 최적조건 탐색을 위한 실험적 연구

신용승,김태형,윤종학,노승남,이철구 서울産業大學校 2002 논문집 Vol.53 No.1

The shot peening process is most often used to improve fatigue properties of metal parts. In order to achieve optimum, repeatable and reliable fatigue enhancement from the shot peening process, the important shot peening parameters must be controlled. In this paper, the optimum shot peening condition is investigated. Rotary bending fatigue test was accomplished to investigate the effects of shot peening on the fatigue strength. Experimental results show that the fatigue strength was tremendously increased by optimum peening.

급성 심근경색 초기에 도플러 심초음파를 이용한 좌심실 이완기 기능의 평가

신원용,김주성,김철현,이광희,최태명,현민수,김성구,권영주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background : Congestive heart failure after acute myocardial infarction relate to left ventricular systolic sysfunction. Also, left ventricular diastolic function contribute to heart failure. The aims of this study were, firstly to characterize left ventricular diastolic function by transmitral flow velocity, and secondly to study the significance of Doppler measurements in relation to the development of heart failure in the early phase of myocardial infarction. Method : Pulsed Doppler echocardiography of transmitral flow was assessed in 34 patients with acute myocardial infarction. According to the Doppler transmitral flwo velocity profile, the study patients were assigned to the three groups: normal filling pattern (DT > 140ms, IVRT < 100ms), relaxation abnormality (DT > 140ms, IVRT ≥ 100ms), pseudonormal or restrictive pattern (DT ≤ 140ms). Also, on the basis of the presence of heart failure during first week of hospitalization, the patients were divided into two groups: patients with no sign of heart failure (Killip class Ⅰ) and heart failure (Killip class Ⅱ-Ⅳ). Results : Of the 34 patients studied, 10(29%) were normal filling pattern, 17(50%) abnormal relaxation and 7(21%) were restrictive patterns. The left ventricular ejection fraction(EF, 40 ±6%) of restrictive pattern was significantly lower than that of normal filling pattern of abnormal relaxation(p < 0.01). And, the IVRT, DT, E/A and left ventricular EF were reduced in patients with heart failure(14 patients) compared to no sign of heart failure(20 patients)(p<0.05). Of the patients with heart failure, IVRT and left ventricular EF were reduced in patients with DT≤140 ms compared to DT> 140ms(p=0.001). Conclusion : Left ventricular diastolic dysfunction is present early after onset of symptoms of acute myocardial infarction. Assessment of left ventricular diastolic function complements measurements of systolic function in the evaluation of cardiac function. DT, IVRT, E/A and left ventricular EF are useful predictors for development of congestive heart failure following acute myocardial infarction.

인슐린 비의존형 당뇨병 환자에서 혈장 Endothelin-1농도의 변화

신양수,조희충,김원식,국기용,김용화,정종훈,문철웅,배학연,양성훈 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.2

Endothelin(ET) is a 21-residue peptide originally isolated from the cultured porcine endothelial cells. There are at least three genes for endothelin:endothelin-1(ET-1), endothelin-2(ET-2), and endothelin-3(ET-3). Endothelins are present in various human biological fluids including plasma, urine, breast milk, and saliva and have been found elevated plasma ET concentrations in patients with diabetes mellitus, Patients undergoing maintenance hemodialysis due to chronic renal failure, patients with acute myocardial infarction, and patients with subarachnoid hemorrhage. Endothelial cell damage is suspected to occur in diabetic patients and may be one important cause of angiopathy, a major complication in diabetes mellitus. The elevation of ET in diabetic patients may be a marker of, and further exacerbate, their vascular disease. We measured the levels of ET-1 in plasma of 50 patients with non-insulin dependent diabetes mellitus(NIDDM) and 25 normal subjects by radioimmunoassay. The plasma ET-1 concentration (mean±S.D.) in NIDDM was 6.461 A2.510 f㏖/ ㎖, and was significantly higher than in normal subjects (4.567±1.155f㏖/㎖) (P<0.05). The plasma ET-1 concentration (mean±S.D.) in diabetic retinopathy group( 7.15±2.454 f㏖/ml) was significantly elevated than those in otherwise uncomplicated groups (5.348±2.390 f㏖/㎖)(P<0.01). The correlation between any clinical parameters and plasma ET-1 levels in NIDDM was not significant, In conclusion, this study suggest that the elevated levels of ET-1 in diabetic patients may be play a important role in the pathogenesis of diabetic complications.