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요중 비소농도와 N-acetyl-β-D-glucosaminidase 농도와의 관련성 평가
이용찬,임동혁,엄상용,김용대,김헌 충북대학교 의과대학 충북대학교 의학연구소 2010 忠北醫大學術誌 Vol.20 No.1
Purposes: This study was performed to evaluate the possibility of impairment of renal tubular function by exposure to inorganic arsenic of low concentration. Materials and methods: Study subjects were 867 individuals (365 men and 502 women) who resided around abandoned mine areas in Chungbuk Province, Republic of Korea. Information about the life style, drinking water type, seafood intake, and mine working history was gathered, and urinary arsenic concentration and N-acetyl-β-d-glucosaminidase (NAG) activity were measured. The correlation between arsenic concentration and urinary NAG activity was tested in groups classified according to urinary NAG activity and seafood consumption prior to urine sampling. Results: No statistically significant difference in urinary arsenic concentrations was observed between different gender and age groups. The participants those who ate seafood within three days before the urinary sample showed a higher mean urinary arsenic concentration than those who did not. In a correlation analysis between natural logarithm of urinary arsenic concentrations and that of urinary NAG activities, no statistical significance was found in a total sample as well as within a gender group. In a group with the urinary arsenic concentrations higher than the geometric mean and the urinary NAG activities higher the geometric mean, the correlation coefficient between two variables was 0.182 and significant. (p-value<0.05) Conclusions: It is suggested that renal tubular damage could be induced by non-occupational exposure to low level inorganic arsenic. 연구목적 : 본 연구는 폐금속광산 주변지역 주민들을 대상으로, 저농도 비소노출에 의하여 신세뇨관 기능이상이 유발될 수 있는지를 평가하는 것을 목적으로 시행하였다. 대상 및 방법 : 충청북도에 소재하고 있는 폐금속광산의 주변에 거주하는 주민 867명을 대상으로 직접 면접조사를 실시하였다. 대상자의 소변을 채취하여 요중 비소농도와 요중 N-acetyl-β-D-glucosaminidase (NAG) 활성을 측정하였고, 조사대상자를 역학적 변수에 따라 구분하여 두 변수 사이의 상관관계를 분석하였다. 결과 : 소변시료를 채취하기전 3일 이내에 해산물을 섭취한 사람들의 요중 비소농도는 그 기간동안 해산물을 섭취하지 않은 사람들의 농도에 비하여 유의하게 높았다. 조사 대상자들의 요중 NAG 농도의 평균값은 남녀차이가 없었으나, 65세 미만 대상자와, 표본을 채취하기 전 3일 이내에 해산물을 섭취한 사람들의 요중 NAG 활성도의 평균값은 그렇지 않은 사람들에 비하여 유의하게 낮았다. 요중 비소농도가 기하평균 이상이고, 요중 NAG 활성이 기하평균 이상인 군에서 두 변수의 상관관계가 0.182 로 유의하였다. 결론 : 정상범위의 비소 노출이라도 요중 비소농도가 8.28 μg/g creatinine을 초과하는 경우에는 미세한 신장손상을 유발할 가능성이 있으며, 해산물을 섭취함으로써 체내에 흡수되는 비소는 이러한 신독성이 거의 없다.
백혈병환자에서 Liposomal Amphotericin B로 치료된 파종성 Fusarium 감염 1예
이지연,김성범,박대원,신성희,김용현,윤소영,엄중식,최철원,정희진,김우주,김준석,김장수,이갑노 대한감염학회 2003 감염과 화학요법 Vol.35 No.5
Fusarium spp.는 사람에서 드물게 각막염, 조갑진균증, 상처나 화상부위감염 등을 유발하는 것으로 알려져 있으나 최근에는 면역저하자에서 기회감염의 원인균으로 증가하고 있는 추세이다. 면역저하자에서 파종성 감염이 있는 경우에 예후는 치명적이나, 증례가 많지 않고 진단방법이 제한되어 있어 조기 진단과 신속한 치료가 쉽지 않다. 그러나 특징적으로 피부병변의 동반이 흔하여 면역저하자에서는 피부 병변의 면밀한 관찰과 함께 Fusarium 감염을 조기에 의심하여 피부생검이나 배양을 하는 것이 진단에 도움이 되리라 생각된다. 파종성 Fusarium 감염의 치료로는 감염 부위의 국소적 외과적 절제와 전신적 항진균제의 사용이 필요하고 현재까지는 amphotericin B가 비교적 효율적인 항진균제로 알려져 있으나 면역저하자에서 이에 반응을 하지 않는 경우가 많다. 저자들은 급성골수성백혈병 환자에서 관해유도화학요법 시행 후 호중구감소상태에서 피부병변과 폐침윤이 발견되었고 피부의 중심부 궤양을 동반한 구진성 병변에서 배양검사를 통해 파종성 Fusarium 감염을 진단하였으며 liposomal amphotericin B (AmBisome )를 사용하여 성공적으로 치료한 예를 경험하여 보고하는 바이다. Fusarium spp., basically a superficial pathogen, is a newly emerging fungal pathogen of opportunistic infections in immunocompromised patients. At present, although Fusarium spp. are relatively resistant to amphotericin B, the combination of amphotericin B and surgical debridement appear to be optimal treatment for disseminated infection. Recently we experienced a 32-year-old neutropenic patient after induction chemotherapy for acute myelocytic leukemia presented with skin lesions and infiltrations in both lungs. We diagnosed with disseminated fusariosis by skin culture and successfully treated the patient with liposomal amphotericin B. We emphasize a high index of suspicion for skin lesions especially in immunocopromised patients.
Eom, Sang-Yong,Moon, Sun-In,Yim, Dong-Hyuk,Lee, Chul-Ho,Kim, Guen-Bae,Kim, Yong-Dae,Kang, Jong-Won,Choe, Kang-Hyeon,Kim, Sung-Jin,Choi, Byung-Sun,Yu, Seung-Do,Chang, Soung-Hoon,Park, Jung-Duck,Kim, He The Korean Academy of Tuberculosis and Respiratory 2012 Tuberculosis and Respiratory Diseases Vol.72 No.3
Background: Korean regression models for spirometric reference values are different from those of Americans. Using spirometry results of Korean adults, goodness-of-fits of the Korean and the USA Caucasian regression models for forced vital capacity (FVC) and forced expiratory volume in one second ($FEV_1$) were compared. Methods: The number of study participants was 2,360 (1,124 males and 1,236 females). Spirometry was performed under the guidelines of the American Thoracic Society and the European Respiratory Society. After excluding unsuitable participants, spirometric data for 729 individuals (105 males and 624 females) was included in the statistical analysis. The estimated FVC and $FEV_1$ values were compared with those measured. Goodness-of-fits for Korean and USA Caucasian models were compared using an F-test. Results: In males, the expected values of FVC and $FEV_1$ using the Korean model were 12.5% and 5.7% greater than those measured, respectively. The corresponding values for the USA Caucasian model were 3.5% and 0.6%. In females, the difference in FVC and $FEV_1$ were 13.5% and 7.7% for the Korean model, and 6.3% and 0.4% for the USA model, respectively. Goodness-of-fit for the Korean model regarding FVC was not good to the study population, but the Korean regression model for $FEV_1$, and the USA Caucasian models for FVC and $FEV_1$ showed good fits to the measured data. Conclusion: These results suggest that the USA Caucasian model correlates better to the measured data than the Korean model. Using reference values derived from the Korean model can lead to an overestimation regarding the prevalence of abnormal lung function.
Eom Sang-Yong,Lee Boeun,Hong Seonmi,Hong Young-Seoub,Choi Kyung-Hwa,Kwon Ho-Jang,Yoon Mira,Kang Youn-Seok,Lee Jun Hee,Kim Yong-Dae,Kim Heon 대한의학회 2023 Journal of Korean medical science Vol.38 No.37
Background: This study aimed to evaluate exposure to various hazardous substances emitted by incineration facilities and their likely effect on the health for residents of Bugi-myeon, Cheongju, Korea, which has three incineration facilities. Methods: Heavy metals, polycyclic aromatic hydrocarbons (PAHs), and dioxin concentrations in the air and soil of exposed and control areas were measured. Moreover, the exposure levels to harmful substances and its effects on health were investigated in 1,124 exposed and 232 control adults. Results: PAHs and dioxin concentrations in the air in the exposed area were significantly higher than in the control area. Urinary cadmium and PAHs metabolite concentrations were significantly higher in the exposed group than in the control group. The exposure group also had a higher prevalence of depression and self-reported allergic symptoms than the control group. Conclusion: The possibility of residents in Bugi-myeon being exposed to hazardous substances at incineration facilities cannot be ruled out. To prevent them from further exposure to hazardous substances, it is necessary to prohibit the expansion of additional incineration facilities in this area and to implement continuous monitoring projects for residents.
The level of urinary aflatoxin M1 in Korean adults
Yong-Dae Kim1, Hyojin Kwon, Sun-In Moon, Sang-Yong Eom, Jung-Duk Park, Byung-Sun Choi, Seok-Joon Sohn, Young-Seoub Hong, Ho Kim, Ho-Jang Kwon, Ji-Ae Lim, Hae-Jung Yoon, Gwang-Jin Kim, Heon Kim 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.3
Competitive ELISA methods were used to measure the level of aflatoxin M1 (AFM1) from urine in 1008 Korean adults. Subjects were selected by random sampling in all areas of Korea, except Cheju-do. The recovery rate of AFM1 using this method was 105% (73-124%). The geometric mean of urinary AFM1 in all subjects was 3.43 pg/mL (3.67 ng/g creatinine). The level of AFM1 in males was statistically higher, compared with female subjects. However, the levels of AFM1 did not differ according to age. Subjects in Chungbuk-do showed the highest urinary AFM1 concentration, whereas subjects in Kyeongnam-do showed the lowest concentration. Assuming an excretion rate of 5%, this AFM1 excretion corresponds to approximately 0.1 microgram/day in Korean adults.
Eom, Sang-Yong,Kim, Yun-Sik,Lee, Chung-Jong,Lee, Chul-Ho,Kim, Yong-Dae,Kim, Heon The Korean Academy of Medical Sciences 2011 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.26 No.6
<P>Paraoxonase 1 (PON1) hydrolyzes a number of toxic organophosphorous compounds and reduces lipid peroxide accumulation, and <I>PON1</I> genetic polymorphisms in the coding region modulate serum PON1 activity. In this study, we investigated the association between 3 polymorphisms of <I>PON1</I> located in intron 5 (17899insdelTT and 17974CT) and exon 6 (192QR) and serum PON1 activity. The genetic polymorphisms and serum activity of PON1 were analyzed in 153 healthy Koreans by using a direct sequencing assay and spectrophotometric method, respectively. A significant linkage disequilibrium (LD) was observed between all tested single nucleotide polymorphisms, with the strongest LD observed between 17899insdelTT and 192QR (D' = 0.984). The 17899insdelTT, 17974CT and 192QR genetic polymorphisms were associated with significant differences in serum paraoxonase activity. In multiple regression analyses, smoking, triglyceride level, high-density lipoprotein (HDL) level, and the 17899insdelTT and 192QR genetic polymorphisms were significant determinants of serum paraoxonase activity, while age, smoking, triglyceride level, HDL level, and the 192QR genetic polymorphism were significant determinants of serum arylesterase activity. These results suggest that although the 192QR genetic polymorphism in the coding region of <I>PON1</I> is primarily associated with serum PON1 activity, the intronic polymorphisms are also involved in serum PON1 activity, and this association may be mediated by LD.</P>