직업적 노출에 의한 스티븐스-존슨 증후군에서 트리클로로에틸렌의 노출수준 : 3예의 사례와 문헌고찰을 중심으로

이선웅,김은아,김대성,고동희,강성규,김병규,김민기 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.2

배경: TCE는 심각한 전산적 피부염과 관련 있는 것으로 몇몇 사례들을 통해서 보고되어 왔으나,기존의 사례 보고들에서 노출평가가 수행된 사례는 드물었고 추정되는 노출량 역시 매우 다양하였다. 본 연구에서는 TCE 노출에 의한 것으로 판단되는 스티븐스-존슨 증후군 3예를 확인하고 각 사례들에 대한 작업재연을 통해 노출수준을 추정하였으며,이를 통해 TCE의 직업적 노출수준과 스티븐스-존슨 증후군을 포함하는 전신적 박탈성 피부염 발생의 관계를 이해하고자 하였다. 증례: 사례 1은 24세 필리핀인 여자로 TCE를 이용한 탈지작업을 시작한 35일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스 존슨 증후군과 독성간염으로 진단되었고 증상발생 39일 간부전으로 사망하였다. 증상발생 전 약물 복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준 은 TWA 21.9 ppm과 32.3 ppm이었다. 사례 2는 47세 한국인 남자로 TCE를 이용한 탈지 작업을 시작한 20일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 중독성 표피괴사증 또는 스티븐스 -존슨 증후군, 전격성간염 및 동반된 패혈증으로 진단되었고 증상발생 42일 간부전 및 패혈증으로 사망하였다. 증상발생 전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 30.1 ppm이었으며 세척조 주위의 지역시료는 TWA 116.5 ppm∼229. 7 ppm 이었다. 사례 3은 22세 베트남인 여자로 TCE를 이용한 탐지작업을 시작한 30일 후 발전을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스-존슨 증후군 및 동반된 독성간염으로 진단되었고 증상발생 37일 증세 호전되어 퇴원하였다. 증상발생전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 107.2 ppm이었다. 고찰: TCE에 노출된 일부의 사람들에서 노출 후 2주에서 5주 사이에 심각한 급성 간염이 동반되는 스티븐스­존슨 증후군이 발생할 수 있음을 확인 하였고,이번의 연구결과와 기존의 연구를 종합 할 때 TCE에 대한 감수성이 있는 사람의 상당수는 노출기준 이상의 고 노출에 노 출 후 스티븐스- 존슨 증후군이 발생함을 확인할 수 있었다. 따라서. TCE에 대한 고 노출을 막기 위해 TCE 세척작업에 대한 작업환경 확인과 개선이 우선적으로 필요하며,동시에 노출 후 증상발생기간의 일관성과 노출기준 이하의 저 노출에서의 감작 가능성을 배제할 수 없음을 고려하여,작업시작 후 1개월경의 특수건강검진 역시 고려되어야 할 것으로 판단된다. Back ground: Trichloroethylene (TCE) has been reported to be related to severe generalized exfoliative dermatitis frequently accompanied by toxic hepatitis. The measurements of environmental exposure were limited in the previous case reports and the reported exposure values were also diverse. We reviewed three cases of Stevens-Johnson syndrome associated with TCE. The work environment was measured by the Korea Occupational Safety and Health Agency (KOSHA) after the cases occurred. From the study results, we intended to clarify the relationship between TCE exposure level and Stevens-Johnson syndrome. Case report: Case 1. A 24-year-o1d Filipino female worker developed a skin rash 35 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. She died of hepatic failure 39 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 22.0 to 32.3 ppm (Personal exposure level) with TWA. Case 2. A 47-year-o1d Korean male worker developed a skin rash, 20 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. He was diagnosed with Stevens-Johnson syndrome, toxic hepatitis and sepsis. He died of hepatic failure and sepsis 42 days after the onset ofthe first symptom. He had no previous history of taking medicine or viral infection. The work environment measured 30.1 ppm (Personal exposure level) and 116.5∼229.7 ppm (area exposure level close to the degreasing rnachine) with TWA. Case 3. A 22-year-old Vietnamese female worker developed a skin rash 30 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. Her symptoms improved and she was discharged 37 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 107.2 ppm (Personal exposure level) with TWA. Discussion: These three case reports and the previously reported cases indicated that the majority of people susceptible to TCE develops Stevens-Johnson syndrome after high-level TCE exposure (above the TWA occupational exposure limit of 50 ppm). Therefore, work environmental survey and improvements to the TCE degreasing process are essential to prevent high exposure. Furthermore, considering the consistency of the latency period in symptoms and the possibility of sensitization in low-level exposure, we recommend that the first specific health examination also should be conducted 1 month after workers have commenced working.

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

불순물 첨가 BGO 섬광체 단결정의 육성과 열형광 특성

김성철,김중환,김종일,정중현,도시홍,김기동,이대원 동의대학교 기초과학연구소 1996 基礎科學硏究論文集 Vol.6 No.1

Eu or Fe doped BGO scintillation crystals were grown by Czochralski method. In order to get information about traps in the grown BGO crystals, we measured trap parameters including activation energy, frequency factor and the kinetic order of thermoluminescence, and compared such parameters with thermoluminescent characteristics of pure BGO scintillation crystals. In addition, optical transmittance of the grown BGO crystals was measured.

치아 수복용 불소함유 glass filler의 제조 및 특성

김대성,최세영,김경남,김광만,김중곤 대한치과기재학회 1998 대한치과재료학회지 Vol.25 No.3

The purpose of this study was the reaching test of restorative glass according to composition. Mixtures of SrF₂, CaF₂and SiO₂were fused in platinum crucible. The glasses were ground and fraction which passed through a 400 mesh (38㎛) sieve were collected. The powder specimens were analyzed by a DTA and XRD. Then powder specimen were inserted to D. I. water with various of dissolution time and composition at 37℃. Fluoride ion, cation release, solubility, and pH change were estimated. It was clear that the glasses were formed except S0.65. In S0.40, Tg, Ts, and Tc were 630, 672, and 813℃ respectively. In initial 0.5 hrs., amounts of released fluoride ion and cation were about 90% of total released amounts and released rate was decreased with dissolution time. Amount of released fluoride ion and cation were increased with decreasing SiO₂ in glass filler. And released rate was decreased rapidly by adding CaF₂. This was caused by structural variation in glass filler. Solubility was similar tendency with ion released. The pH of D.I. water was 4.5. But in intial 0.5 hrs., pH was 8.2∼9.8., and decreased according to dissolution time. This is caused by ionic changing with cation and H* ion.

알데히드탈수소효소 2(ALDH2) 및 CYP2E1 유전자 다형성에 따른 요중 뮤콘산 농도와 요중 8-hydroxydeoxyguanosine과의 관련성

김용대,강종원,엄상용,장연위,김성훈,김은영,이철호,문재동,김헌 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.2

특수교육 정보화 체제 구축 방안 연구

김종무,강경숙,강대식,Kim-Sung, Kellie K. 국립특수교육원 2001 연구보고서 Vol.- No.8

본 연구는 특수교육 정보화 관련 국내 · 외 문헌자료와 사례를 소개하고, 국내 특수교육정보화 실태 조사를 실시하여 첫째, 기초 통계자료를 확보하고 둘째, 효율적이면서도 실제적인 정보화체제 구축방안을 제시하는데 그 목적이 있다. 그동안 국내에서 광범위하게 추진되었던 교육정보화 사업에 있어서 전체 학교 학내망 설치와 같은 가시적인 정보화기반 구축 사업에 대해서는 전반적으로 성공적이라는 평가를하고 있지만 특정 수요 집단에게는 정보격차의 심화 및 접근성 문제의 심각성 등 부정적인 결과를 초래하기도 하였다. 이에 본 연구에서는 국내·외 특수교육 정보화 사례와 자료를 소개하고, 국내 특수교육정보화 실태를 파악하기 위한 설문조사를 실시하였다. 설문조사 대상은 특수학교 교사, 학생, 장애학생 부모, 장애인관련 단체 및 기관, 시 · 도교육청이었고, 조사 결과 특수학교 교사의 경우 컴퓨터 보유, 인터넷 사용 등에 있어서는 매우 양호하게 나타났으나 정보 활용기술에 해당하는 영역 즉, 장애학생을 교수하기 위한 자료의 제작과 교수-학습과정에서의 적용 수준에서는 저조하게 나타났다. 비장애학생과 비교할 수는 없지만 장애학생의 컴퓨터보유와 인터넷 사용 유 ·무에 관해서는 40~60%의 응답자가 긍정적으로 응답하였고 체계적인 지원이 수반된다면 좋은 결과가 있을 것으로 분석되었다. 본 연구에서는 정보화 지원 체제 구축 방안으로 크게 예산지원과 행정지원을 포함하여 특수학교, 교사, 학부모, 장애학생, 행정가, 장애인관련 기관 등의 요소로 구분하여 지원 방안을 제시하였다. 소개된 지원내용을 간략히 정리하면 다음과 같다. 첫째, 특수교육정보화 체제 구축을 위한 예산 지원은 외국의 사례에서도 나타났듯이 안정성과 지속성을 확보하기 위하여 '초·중등교육법', '특수교육진흥법'을 통해 지원에 관한 세부 사항을 법으로 규정해야한다. 둘째, 특수교육 정보화 사업과 관련된 부처간 행정 협조체제의 수립과 사업 중복성 등을 피하기 위하여 전담기구나 기관의 지정이 요구된다. 셋째, 특수학교의 경우, 학내망 설치와 더불어 장애인 접근성 문제의 해결을 위한 프로그램 개발과 하드웨어 장비의 지원, 교실간 네트워크 구축, 학교간 WAN 구축 등의 사업이 추진되어야 하며, 특수학급의 경우는 정보화 환경구축이 미흡하기 때문에 소속 교육청 과의 네트워크 구축을 통한 정보공유 및 행정업무의 연계가 필요하고, 다양한 교수-학습자료의 지원이 절실히 요구된다. 넷째, 특수교육 교사의 연수 기회를 확대하고 전문성을 키워줄 수 있는 연수내용과 방법의 개선이 필요하다. 장애학생 교육을 위한 학습자료 제작 기법, 장애인용 프로그램 사용법, 특수단말 장비 및 정보매체 활용 기법 등의 프로그램을 개발하여 집체+원격+화상 형태의 입체적인 연수가 요구된다. 다섯째, 장애학생 부모를 위한 정보화 지원은 학교-교육청간 협력하에 부모 교육 프로그램을 개발하여 우선, 학교와 인근 지역의 장애인관련 기관을 활용하여 정보소양 교육을 실시하고, 언제, 어디서나 교육이 가능한 원격이나 사이버시스템 등을 매개로 부모의 여건을 배려해줄 수 있는 편리한 교육방법이 준비되어야 한다. 여섯째, 교육청별 특수교육 담당장학사의 정보화 수준은 양호한 것으로 평가되지만 특수교육 정보화를 위한 특수학교(급) 교사의 연수지원을 위한 예산규모의 확보나 프로그램 개발 지원 등은 매우 부족한 것으로 나타났는데, 교육부(국립특수교육원)를 중심으로 전체 교육청의 특수교육 정보화 업무를 단일 체제로 묶는 인프라를 구축하여 예산, 프로그램, 네트워크 등을 공유토록 하여 효율성을 확보해야 한다. 일곱째, 장애인관련 단체는 정보화 업무 담당자를 배치하여 장애인과 일반인을 대상으로 활발한 정보화 교육이 이루어지고 있었지만 재정지원이 아직도 부족하고, 장애인용 프로그램과 기기의 보급이 부족하여 한계가 있는 것으로 드러났는데, 마찬가지로 장애인관련 기관을 하나로 묶는 인프라의 구축을 통해 사용되는 프로그램을 표준화시키고 예산지원의 중복성을 피해야하며 기관 이용자에 대한 관리의 편리성도 함께 도모해야 할 것이다. This study intends to collect baseline data and to present effective and practical methods of establishing special education IT system. An extensive review of both domestic and foreign literature and case studies of best practices were conducted for this research as well as the evaluation of the current state of technology usage and adoption in special education in Korea. Previous nationwide educational technology projects have accomplished notable and successful results such as building Intranet for schools. However, such efforts have, in away, created and aggravated the disproportionate gap, often called as the digital divide, against certain groups of people with unique needs. Also, the accessibility to such technology and information has emerged as a serious problem as the role of technology expanded. This study introduced both domestic and foreign examples of technology in special education and relevant resources, and conducted a large-scale survey to examine the current stage of technology adoption and usage in special education in Korea. The survey was administered to special education teachers, students, parents of students with disabilities, disability-related organizations and relevant agencies, and to municipal and provincial department of education. The results found satisfactory levels of computer ownership and usage of Internet among special education teachers. However, utilizing and incorporating such Information and technology into classroom activities and into teaching material development were still limited. Although the data were not comparable to those from students without disabilities, about 40 to 60 percent of the respondents showed positive attitudes toward computer ownership and Internet usage of students with disabilities, suggesting desirable outcomes with appropriate systematic support. Based on the findings, this study recommended detailed methods of building broad financial or budgetary assistance systems for special education schools, teachers, parents, students, administrators, and disability-related organizations. First, as shown in the experiences of foreign countries, financial support from the government to establish the system for the special education information technology has to be mandated under the 'Elementary and Secondary Education Act', the 'Special Education Promotion Act' to ensure and enhance stability and continuity. Second, designation of a single commanding and responsible agency is called for to efficiently coordinate inter-agency collaboration among governmental agencies and departments, and to avoid redundancy of work. Third, for special education schools, tasks such as building school-wide Intranet, development of software solving accessibility issues, subsidizing funds for computer hardware purchase, connecting classrooms through networking system and establishing inter-school WAN are of critical importance. Fourth, the contents and methods of professional development and training for special education teachers should be improved to professionalize teachers, and expansion of such opportunities are also called for. Fifth, IT support for parents of students with disabilities is also important. Parent education and training programs should be developed through active collaboration between local department of education and schools, and such training programs may be offered at schools or disability-related facilities. Distance learning or online courses, which the parents can access regardless of time or location, are other feasible alternatives. Sixth, the results found that administrative staffs of special education at each local department of education displayed satisfactory competence levels. However, the amount of budget assigned for special education teacher training or program development was seriously insufficient. Therefore, the Ministry of Education (or KISE) should build a universal infrastructure of IT, which encompasses and shares budget, program and network systems across all the IT offices of the local department of education. Seventh, although most disability organizations have IT specialist and offered IT education programs for both persons with and without disabilities, they have been experiencing continued problems of insufficient financial support and lack of adaptive technology devices and accessible programs. Therefore, building a universal infrastructure across disability organizations is called for to standardize programs, to prevent overlaps in funding, and thus, to enhance administrative efficiency.

Disruption of rsmA Gene of Pectobacterium carotovorum subsp. carotovorum LY34 and Effect on Pathogenicity

Kim, Min Keun,Kang, Tae Ho,Kim, Sung Kyum,Jeong, Yu Seok,Yun, Han Dae,Kim, Hoon The Korean Society for Applied Biological Chemistr 2012 Applied Biological Chemistry (Appl Biol Chem) Vol.55 No.6

The rsmA gene was cloned from soft-rot bacterium Pectobacterium carotovorum subsp. carotovorum LY34 (Pcc LY34), and its role in pathogenicity was investigated by marker exchange mutagenesis. From a cosmid library of Pcc LY34 genomic DNA, a positive clone carrying the rsmA gene was selected, and the gene was cloned by polymerase chain reaction (PCR) amplification. The gene is 186 bp in size and encodes a protein of 62 amino acids with a predicted molecular mass of 6,839 Da. The calculated pI of the RsmA is 8.16. The phylogenetic tree showed that the RsmA of Pcc LY34 appeared genetically identical to the CsrA of Pectobacterium atrosepticum SCRI1043 (100% identity) and similar to the CsrA of Yersinia pestis KIM10+(98.3%). The gene was disrupted by the $Km^r$ gene, and the cells became mutated (i.e., $RsmA^-$ mutant). The pathogenicity test revealed that the disease rating of the $RsmA^-$ mutant only differed slightly from that of the wild type on a slice of potato tuber and a Chinese cabbage stalk. These results suggest that RsmA is not an essential factor for the pathogenicity of Pcc LY34 and that the rsmA gene of Pcc LY34 is not completely derepressed in the $RsmA^-$ mutant for virulence-related genes, contrary to the results of Erwinia carotovora subsp. carotovora $RsmA^-$ mutant, which proved hypervirulent for celery petioles. These results showed that the microenvironmental conditions of the host and/or strain of pathogen are important for the coordination of virulence gene expression.

복발효 감식초의 품질

김미경,김미정,김소연,정대성,정용진,김순동 대구효성가톨릭대학교 식품과학연구소 1994 식품과학지 Vol.6 No.-

고품질의 감식초를 농가에서 자가생산하기 위한 기초적 자료를 마련할 목적으로 자연발효시킨 경우와 복발효시킨 경우의 품질을 비교하였다. 그 결과 복발효시킨 식초는 자연발효 식초에 비하여 초산농도가 1/2인 3%정도였다. 그리고 HPLC 법으로 측정한 유리당의 총함량은 자연발효 식초는 6%, 복발효시킨 것은 5%였다. 감식초내에 함유된 유기산류로는 oxalic acid, malic acid, lactic acid, citric acid, succinic acid, glutaric acid 등 이었으며 자연발효시킨 경우가 전반적으로 함량이 높았다. 특히 자연 발효시킨 경우 lactic acid함량이 높았다. 그러나 감과실의 flavour와 과실의 고유색상과 맛은 복발효시킨 경우가 강하게 나타났다. To prepare the basic information for the fermentation of high quality persimmon vinegar in the farm, the quality of the complex fermented persimmon vinegar(CFPV) was compared to that of naturally fermented persimmon vinegar(NFPV). The titratable acidity of the CFPV was 3% which was the half concentration of the NFPV. The content of total free sugar by HPLC was 6% in CFPV and NFPV was 5%. Organic acid compositions in persimmon vinegar were oxalic acid, malic acid, lactic acid, citric acid, succinic acid and glutaric acid in addition to acetic acid. Total content of the organic acids in NFPV was higer than that in CFPV. Especially, the content of latic acid in NFPV was very higher than that of CFPV. The flavour, color and taste of persimmon fruit itself in CFPV were stronger than those in NFPV.

대스팬 지붕구조물의 바람에 의한 동적거동을 고려한 풍하중 평가에 관한 연구

김대영,김지영,김한영,이명호,김상대 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)

Generally, wind loads for large span structures are evaluated with surface pressure data acquired in wind tunnel test. Unlike cladding wind loads, the structural wind loads could be over-estimated with only peak pressures of each surface pressure point because the peak pressures on a surface are not well correlated at a given time. Also, the load shapes of wind loads, and the load effects and dynamic behaviors of a structure should be considered in the wind load assessment. In this study, several wind load evaluation methods were applied to Gwangmyeong Velodrome dome and the results were compared to analyze the properties of each method for the suggestion of a proper evaluation procedure.

Drosophila quinaria Species Group의 遺傳的 近緣關係

成耆昌,金正洙,金大鎰,金彧,金溶聲 성균관대학교 기초과학연구소 1985 論文集 Vol.36 No.2

The genetic relatedness among the Korean Drosophila quinaria species group, including D. nigromaculata, D. unispina, D. brachynephrose, and D. angularis, has been examined by using horizontal starch gel electrophoresis. The results showed that none of the ten isozyme patterns examined for these four species was identical. The average genetic similarity among the four species was found to be 0.440. The similarity among three species. D. unispina, D. brachynephrose, and D. angularis was 0.466. The relatedness was found to be closest between D. nigromaculata and D. unispina, showing 0.640. D. nigromaculata and D. angularis showed relatedness of 0.258. The results suggested that these four species appear to be genetically related at the level of sibling species. The percent polymorphism in D. brachynephrose was found to be 76.9%, showing significant genetic variations.