작업장 누적소음 노출과 혈압과의 관련성

이상윤, 김재용*, 임형준, 윤기정, 최홍렬*, 고상백**, 강대희, 조수헌 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

목적 : 작업장에서의 누적소음노출값과 혈압의 변화 사이의 관계를 관찰하기 위한 단면 연구를 시행하였다. 방법 : 소음발생 제조업체의 남성근로자 중 건강진단 자료, 설문지 자료, 인사기록이 모두 갖추어진 852명을 연구대상으로 하였다. 작업장 소음측정값은 34개 지점에서 측정된 작업환경 측정 보고서 값을 사용하였고, 혈압은 건강진단시 측정한 수축기 혈압과 이완기 혈압 각각의 평균을 이용하였다. 가능한 교란변수들을 건강진단시 설문조사를 통하여 조사하였다. 근로자의 근무기간과 근무했던 작업부서의 소음노출값을 이용하여 누적소음노출값을 추정하였고, 이에 따라 전체 연구대상 근로자를 저소음노출군, 중등도소음노출군, 고소음노출군, 과다소음노출군으로 구분하였다. 누적소음노출값으로 구분한 소음노출군 사이에 평균 수축기 혈압 및 이완기 혈압의 차이가 있는 지를 나이, 비만도지수, 혈중 콜레스테롤값, 고혈압의 가족력, 흡연력, 음주력 등의 가능한 교란변수들의 영향을 통제한 상태에서 비교하였다. 결과 : 가능한 교란변수들을 보정한 상태에서 저소음노출군에서 과다소음노출군으로 갈수록 수축기 혈압 및 이완기 혈압의 증가가 있는지를 관찰하기 위해 일반선형모델을 이용하여 분석하였을 때, 수축기 혈압 및 이완기 혈압 모두 소음노출군이 혈압 변화의 유의한 설명변수였고, 수축기 혈압 및 이완기 혈압 모두 저소음노출군에 비해 과다소음노출군이 각각 2.1 mmHg, 2.7 mmHg 만큼 높았다. 결론 : 이는 만성적으로 누적된 고소음에의 노출로 인하여 혈압 상승의 가능성이 있음을 시사한다. Objectives : The association of workplace cumulative noise exposure and blood pressure was investigated in this study using cross-sectional design. Methods : The study population comprised 852 manufacturing male workers of whom occupational health examination data, questionnaire and personnel records were available. Workplace ambient noise monitoring data was used for calculating individual cumulative noise exposure level. Mean of each systolic and diastolic blood pressure of occupational health examination data was used for individual systolic and diastolic blood pressure level. Possible confounding variables including family history of hypertension, smoking habit, alcohol drinking habit were collected by questionnaire. On the basis of job location and duration of work at the location, a cumulatlve time-weighted average noise level was calculated for each workers. According to this cumulative noise exposure level, each study subject was categorized as low noise exposure group, moderate noise exposure group, high noise exposure group, very high noise exposure group. Among noise exposure groups, mean of systolic and diastolic blood pressure was compared after adjusting possible confounding variables such as age, body mass index, serum cholesterol level, family history of hypertension, smoking history, alcohol drinking habit. Results : After adjusting possible confounding variables, noise exposure group was signnificant explanatory variables for both systolic and diastolic blood pressure, and mean of both systolic and diastolic blood pressure of very high exposure group was higher than that of low exposure group. Conclusions : These findings suggested that the high cumulative noise exposure might elevate the blood pressure.

조선업 도장작업자의 유사노출군과 노출변이; 크실렌 노출을 중심으로

고상백,노영만,임현우,신용철,김수근,최홍열,김재용,장성훈 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

목적 : 조선업 도장 작업자의 크실렌 노출을 평가하기 위하여, 수행직무 및 밀폐특성에 따라 유사노출군으로 구분하여 노출 변이 및 동질성을 파악하고자 하였다. 방법 : 3회 이상 반복측정이 이루어진 근로자 중동일공정에서 직무상 변동이 없는 근로자 총 28명을 대상으로 하였다. 노출농도 값을 대수전환(lOgtransformation)하여 근로자간, 근로자내 노출 분산요소을 추정하기 위하여, nested randomeffects ANOVA model을 활용하였다. 선정된 유사노출군 내 구성원의 측정 평균이 동일하다고 할수 있는지를 검정하기 위하여 분산요인(9f)을 산출하였고, 쿨즈0.031일 경우 동일하다고 생각하였다.또한 노출 값을 대수전환하여 95 %의 근로자(b-R9s)가 2배수 범위 내에 측정값을 가질 경우 동일하다고 생각하였다. bwRSS의 값을 유사노출군내의 근로자들간(between worker)의 기하표준편차(bwsy)를 구한 후 exp(3.92 bwsy)로 계산하여 산출하였고, 그 값이 2이하이면 동일하다고 생각하였다. 결과 : 일반적으로 유사노출군은 노출농도가 비슷한 것이라는 생각과는 달리, 직무에 근거한 유사노출군은 동질성 검정상 이질적이었다. 분무도장과 붓도장 모두 bwRss은 2를 초과하였고, 룰 또한 0.031를 초과하여 변이 폭이 컸다. 그러나 밀폐특성에 따른 노출 분포의 변이성은 직무만으로 구분했을 때의 변이지표 보다 그 수치가 낮아 밀폐특성으로 직무의 변이성을 설명 할 수 있었다. 결론 : 직무에 근거한 유사노출군이 동질적이지알다는 결과는 유사노출군으로 구분된 근로자의 업무특성이 하나의 유사노출군으로 설정할 수 없다는 점을 시사한다. 따라서 향후 작업환경 측정 시 직무뿐만 아니라 특정 업무(specific task) 또는 세부작업현황까지 파악할 필요성을 제시하고 있다. Objectives : This study was conducted to assess the concentration of xylene exposure and exposure variability of a similar exposure group (SEG) in accordance with job title and confined space. Method : The study subjects included 28 workers working in the painting process in the ship-building industry. Measurement of subjects were repeated three times. Within and between-worker exposure valiance components were estimated from log-transformed exposure concentrations employing a one-way nested random effects analysis of variance model. A uniformly exposed group was defined as one where the between-worker variance(σB2) was less than or equal to 0.031 or bwR95 ≤2, where bwR95 =exp(3.92 bwSy) , representing the radio of the mean exposures of the 97.5th and 2.5th percentile groups of the workers sampled. Result : The results indicated that, contrary to popular belief, similar exposed groups based on job title were heterogeneous. The between-worker variance(σB2) is large(≥0.031) and the ratios of the 97.5th and 2.5th percentile workers of the log normally distributed exposures of each group of worriers was more than 2. However dividing job title into confined space (in-block, out-block, in/out-block) decreased the between-worker exposure variability. Conclusion : This study focused on the quantitative aspects of exposure in painters in the ship-building industry. We cannot accept the assumption that SEG are uniformly exposed, as a major component of variation in exposure relates to differences in tacks or other factors. Therefore, the observational schemes can be improved by investigating Job-specific task and practice.

폐 상피양 세포암에 특이한 Ribonuclease의 작용기전에 관한 연구

이성윤,지행옥,고재경 한양대학교 의과대학 1993 한양의대 학술지 Vol.13 No.1

A neutral ribonuclease (RNase) specific to the epidermoid carcinoma of the lung was isolated from the lung cancer tissue to investigate processes involved in carcinogenesis and suppression of the lung cancer. Also studied were the substrate specificity and mechanism of action of the neutral RNase specific to the lung cancer. Neutral RNase activity in the lung tissue obtained by surgery was unchanged in four varieties of lung cancers (epidermoid carcinoma in 20 cases, 472±1859 umole/g/hr; adenocarcinoma in 5 cases, 5165±1575 umole/g/hr; karge cell carcinoma in 3 cases, 5870±2305 umole/g/hr; small cell carcinoma in 3 cases, 5405±2822 umole/g/hr; control in 31 cases, 4380±1520 umole/g/hr), indicating that RNase assay in the lung tissue could not be used as a biochemical marker for the lung cancer. Neutral RNases in the epidermoid carcinoma tissue of the lung were separated by a DEAE-cellulose column chromatography into 6 peaks, of which the peak Ⅰ neutral RNase isozyme was specific to the epidermoid cancer of the lung. High performance liquid chromatorgraphy (HPLC) and polyacrylamide gel electrophoresis (PAGE) patterns for peak Ⅰ protein from epidermoid carcinoma tissue of the lung appeared to be different from those of control lung tissue. The subpeak Ⅰ-5~8 (in HPLC pattern) that was supposed to be associated with RNase was greatly increased in the lung cancer, indicating that peak Ⅰ protein from epidermoid carcinoma tissue of the lung was specific to the lung cancer and that peak Ⅰ RNase specific to the cancer was located in HPLC subpeak Ⅰ-5~8. The peak Ⅰ neutral RNase was observed to be highly active toward poly C, poly AC and poly ACU and less active toward poly U and RNA, indicating that the peak Ⅰ neutral RNase was the secretory type of RNase. No activity was found toward polydezyribonucleotides and double stranded polyribonucleotides. Majority of products of poly C digest by the peak Ⅰ neutral RNase was analyzed to be oligoribonucleotides, indicating that the RNase was endonuclease in nature. Observations that the peak Ⅰ neutral RNase was specific to the epidermoid carcinoma of the lung and that the enzyme was endonuclease in nature suggested that the RNase might play an important role in process involved in the suppression of the lung cancer.

토끼 간조직의 Stimulatory Guanine Nucleotide 결합 단백의 αsubunit 에 대한 cDNA 염기서열에 관한 연구

이상훈,노연희,한중수,고재경 한양대학교 의과대학 1993 한양의대 학술지 Vol.13 No.1

G proteins, a family of guanine nucleotide-binding protein superfamily, are involved in transmembrane signaling systems as transducers. In this study cDNAs encoding αsubunit of the stimulatory G protein (G α ) from rabbit liver were cloned and their nucleotide sequences were determined : a λgt 11 cDNA library from total cellular poly (A)' mRNA in rabbit liber was screened for recombinant λDNA that codes for G α with labeled probe. The probe used was an EcoRI digested 3' end fragment of cDNA for G α from olfactory neuroepithelium of rat. Six of the approximately recombinant clones were screened by in situ hybridization and by autoradiography, detecting sixteen positive clones. These clones were tested using polymerase chain reaction (PCR) technique and thirteen of them were turned out to have two sets of conserved sequence in αcDNA. Four clonse among them were selected form analysis of their cDNA sequences, showing the presence of two types of cDNA, namely and with the total length of nucleotide sequence of1.392bp and 1.613bp, respectively . From nucleotide sequence analysis the amino acid residues of -1 and α-2 were deduced : they contain 335 and 386 amino acid residues (including the initiator methionine), respectively. The calculated molecular weights for and were 38.9kd and 44.6kd, respectively. The significant difference in size between two cDNAs for G αseemed to be due to the assumption that alternative promoter and leading exon might be involved in transcribing the mRNA for . Two types of cDNA from rabbit liver shared over 95% of amino acid homology with that from rat olfactory neuroepichelium if deleted portions are not counted. More information on the cDNAs could be obtained through further studies such as Sl nuclease protection experiment, expression and mutation study.

골육종의 억제과정에 미치는 Ribonuclease 의 작용

김성준,이경태,고재경 한양대학교 의과대학 1993 한양의대 학술지 Vol.13 No.1

Neutral ribonuclease (RNase) highly active toward polycyidylate (poly C) was isolated from osteosarcoma tissue by DEAE-cellulose column chromatography and was found to be specific to the bone sarcoma by means of a high performance liquid chromatography (HPLC) and polyacrylamide gel electrophoresis (PAGE). Also studied were substrate specificity and the product analysis of the neutral RNase to understand the role of the enzyme specific to osteosarcoma in pathogenesis of the bone sarcoma. Neutral RNase activity was greatly increased in osteosarcoma tissue, suggesting that in could by used as a marker for the bone sarcoma. Neutral RNases in osteosarcoma tissue were separated by a DEAE-cellulose column chromatography into 5 peaks, of which peaks Ⅵ and Ⅶ RNase isozymes were not found in the control bone tissue. The activity of peak Ⅰ RNase isozyme was most active among the RNase isozymes separated. HPLC and PAGE patterns for the proteins associated with the peak Ⅰ neutral RNase of osteosarcoma appeared to be different those of the control, suggesting that the enzyme might be specific to the bone sarcoma. The peak Ⅰ neutral RNase isozyme specific to the osteosarcoma was found to be active toward ss polyribonucleotide (highly active toward C-C, C-U and A-U linkages). Majority of the poly C digest by the RNase specific to the osteosarcoma was observed to be oligoribonucleotides with chain length of 4-25, indicating that the enzyme was endonuclease in nature. The present study indicate that 1) neutral RNase activity was greatly increased in osteosarcoma tissue, 2) the enzyme could be used as a marker for osteosarcoma, 3) the peak Ⅰ neutral RNase isozyme isolated from osteosarcoma tissue might be specific to the bone sarcoma, 4) the RNase isozyme was active toward ss polyribonucleotide and 5) the RNase isozyme was endofibonuclease in nature, suggesting a possible role of the RNase isozyme in the suppression of the osteosarcoma.

난소성 장액성 낭선암에 특이한 단백의 분리에 관한 연구

이상훈,장상근,고재경,김두상 한양대학교 의과대학 1992 한양의대 학술지 Vol.12 No.1

In order to correlate changes in the nature of proteins in the serous cystadenocarcinoma tissue of the ovary with those in the cystic fluid and ascitic fluid of patients with the ovarian cancer, proteins in the ovarian tissue, cystic fluid and ascitic fluid of patients with serous cystadenocarcinoma were isolated by a DEAE-cellulose column chromatography and HPLC. (1)Concentrations of protein in the ovarian cancer tissue, cystic fluid and ascitic fluid of patients with serous cystadenocarcinoma were unchanged as compared with those of controls. (2)Proteins in the ovarian tissues were isolated by a DEAE-cellulose column chromatography into 7 peaks in both serous cystadenocarcinoma tissue and control ovarian tissue. The DEAE-peak Ⅲ protein was divided into two parts (peak ?? and ??) in the ovarian cancer, but not in the control, indicating that the DEAE-peak Ⅲ?? was specific to the ovarian cancer. The DEAE-peak Ⅴ common to both serous cystadenocarcinoma tissue and its control was further separated by a HPLC into 4 peaks each. Although the HPLC patterns for proteins of both tissues appeared to be different, presence of proteins specific to the ovarian cancer was not confirmed in the ovarian cancer tissue. (3)Proteins in the ovarian cystic fluid were isolated by a DEAE-cellulose column chromatography into 5 peaks for serous cystadenocarcinoma and 4 peaks for serous cyst as the control of which the peak Ⅳ protein was divided into two parts(peak ?? and ??) in the ovarian cancer, but not in the control. Two protein peaks (DEAE-peak ?? and ??) in the ovarian cancer, but not control. Two protein peaks (DEAE-peak ?? and Ⅷ) were observed to be specific to the ovarian cancer. (4)Proteins in the ascitic fluid were separated by a DEAE-cellulose column chromatography into 7 peaks for the ovarian cancer and 5 peaks for the serous cyst, of which the peak Ⅳ protein was also divided into two parts as in the cystic fluid of the ovarian cancer, but not in the control. Three protein peaks (peak Ⅲ, ?? and Ⅷ) appeared to be specific to the ovarian cancer. These results indicated that concentrations of proteins were unchanged, but the nature of proteins were changed in the cancer tissue, cystic fluid and ascitic fluid of patients with serous cystadenocarcinoma and that proteins specific to the ovarian cancer were present in at least one for the ovarian cancer tissue, two for the cystic fluid and three for the ascitic fluid. The proteins specific to serous cystadenocarcinoma in the cystic and ascitic fluid appeared to be released from the ovarian cancer tissue and could be used as biochemical markers for the cancer.

난소암조직 Acid Deoxyribonuclease의 분리와 성상에 관한 연구

김두상,김영신,고재경,한중수 한양대학교 의과대학 1992 한양의대 학술지 Vol.12 No.1

In order to find out a possible role of acid deoxyribonuclease (DNase) in carcinogenesis of the ovary, activity of the enzyme was measured and the nature of the enzyme was studied in serous cystadenocarcinoma and endodermal sinus tumor of the ovary following the purification of the acid DNase in the tumor tissue of the ovary. (1)The acid DNase activity was greatly increased in the tumor tissues of the ovary, serous cystadenocarcinoma and endodermal sinus tumor tissues, while neutral and alkaline DNase activities were unchanged in the tumor tissues. This may indicate that the acid DNase can be used as a biochemical marker for the ovary tumors. (2)Proteins in the tumor tissues of the ovary were separated by a DEAE-cellulose column chromatography into 7 peak, respectively, of which one peak protein each appeared to be specific for serous cystadenocarcinoma and endodermal sinus tumor. (3)Acid DNases in the tumor tissues of the ovary were isolated into a single peak, respectively. The size of peak in the tumor tissues was greater than that in the control tissue of the ovary, indicating that the acid DNases in the tumor tissues were activated, but not specific for the tumors. (4)Acid DNases in the tumor tissues of the ovary were partially purified by centrifugation and a DEAE-cellulose column chromatography. The purified enzyme was highly active against double stranded DNA (ds-DNA), even though some activity was found against single stranded DNA (ss DNA). Observations that acid DNase from serous cystadenocarcinoma tissue was highly active and specific to ds DNA compared with ss DNA suggested that the enzyme might play a role in transforming normal ovarian cells into cancer cells.

하청 근로자들의 건강수준 평가

최홍열,고상백,장세진,차봉석,임형준,이상윤,김재용,강동묵,조수헌 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.1

목 적 : 하청노동을 이용한 노동 유연화 전략은 근로자들의 고용을 불안정시키고, 근로자들의 삶에 부정적 영향을 미치고 있다. 따라서 이 연구는 하청업체 근로자들의 고용현황을 조사하고, 기존의 업체중심의 건강평가의 문제점을 지적하고자 하였다. 또한 하청업체 근로자들의 건강평가의 현재적 의미와 사회적 배제의 특성을 알아보고자 하였다. 방 법 : 모기업과 하청업체 근로자들의 건강수준을 비교하기 위하여, 정기건강진단(일반, 특수)과 채용건강진단 자료를 이용하고자 하였다. 건강진단에서 누락된 비정규직을 포괄하기 위하여 SF-36을 이용하여 건강설문조사를 시행하였다.결 과 : 조선업 하청업체 근로자들의 고용기간은 짧고, 빈번한 노동이동 현상을 보였다. 3년간 건강진단 수검 현황을 통해 살펴볼 때, 1998년 수검자중 2000년까지 연속해서 검진 받은 수검자는 40.3%였다. 건강진단 결과 유소견자 규모를 통해 모기업과 하청업체간의 건강수준을 비교해 보았다. 모기업은 일반질병 요관찰자와 질병자를 포함한 유소견자가 1,011명으로 약 10 %의 유소견율을 보이고 있고, 질병자의 경우 596명으로 유병률이 5 %를 상회하고 있다. 반면 하청업체의 경우 1,967명의 수검자중 유소견자가 115명으로 6 %의 유소견율을 보이고있고, 질병자는 82명으로 4 %의 유병률을 보이고있다 채용건강진단을 받은 수검자는 6,260명 이었으며, 이 중 유소견자 수는 2,373명으로 전체 수검자의 37.9 %를 차지하였다. 건강설문지의 경우는 전체 건강수준의 총합은 하청보다 원청 근로자가 높았고 통계적으로 유의하였다. 결 론' 정기건강검진 결과는 하청근로자들이 고용형태에 따라 검진을 받지 못한 경우가 많아, 건강 근로자 효과로 표현될 가능성이 있다. 따라서 채용건강진단 결과는 다른 측면에서 하청업체 근로자들의 건강수준의 현실적 반영이라고 할 수 있다. 향후 하청업체 근로자들의 건강문제를 감시하고 개선하려면 기존의 업체 중심의 접근으로는 하청 근로자의 건강문제를 제대로 다룰 수 없고, 업종과 지역을 동시에 고려하여 접근할 필요가 있다. 또한 단기 고용 근로자 및 비정규직 근로자를 사회보장의 확충과 모기업의 연대책임 강화 및 기업복지 차원에서 포괄하는 방안이 모색되어야 하겠다. Objectives : The strategy for the labor flexibility through subcontracted labor have brought a negative effect on the lives of the workers, such as the increase of the unstable employment. This study was conducted to analyze the relationship between the employment of subcontracted firms and the health status of them, and to find out some problems which have been caused in the process of health evaluation and the characteristics of social exclusion. Methods : We reviewed the periodical health examination and preemployment health examination in order to compare health status of the subcontracted workers with those of the parent firm workers. The SF-36 questionnaire was administered to assess the self-perceived health status. Results : The result shows that compared to the working duration of the parent firm workers, those of the subcontracted workers were shorter, and the job transfer rate was higher. In the periodical health examination, the prevalence of occupational and general disease was higher in the parent firm(10%) than in the subcontracted firms(6%). Preemployment health examination plays an important role in worker's health manage- ment. Among 6,260 workers who received preemployment health examination, the prevalence of disease was 37.9%. Mean scores of health status measured by SF-36 were lower in the subcontracted firm than in the parent firm. Conclusions : Due to social exclusion of the subcontracted workers from the periodical health examination, there is a possibility that the periodical health examination have the healthy worker effect. These results suggests that the preemployment health examination could be a more appropriate indicator which is able to assess the health status of the subcontracted workers than the periodical health examination.

Epstein-Barr virus(EBV)와 연관된 Nasal type T/Natural Killer(NK)-cell lymphoma 1예

지두현,최지호,성경제,문기찬,고재경 울산대학교 의과대학 1996 울산의대학술지 Vol.5 No.1

Nasal type T/NK-cell lymphoma는 병리조직학적으로 응고성 괴사가 동반된 혈관중심성 침윤을 특징으로하며 T-cell과 NK-cell 항원을 모두 표현하는 면역조직화학염색 소견을 보이는 매우 드문 피부 림프종으로서 EBV와의 연관성이 흔히 보고되고있다. 저자들은 42세 여자에서 발생한, 전신적인 홍반성 구진, 판, 결절의 임상양상을 보였으며 피부 병변에서의 EBV-encoded RNA(EBER)에 대한 in situ hybridization상 양성소견을 보였고 전산화단층촬영, 골주사, 갈륨주사 등의 검사상 비강, 위장관 및 다른 내부장기 침범소견은 보이지 않아서 피부에만 국한된 경우로 사료되는 nasal type T/NK-cell lymphoma 1예를 보고하는 바이다.

HIV 감염 환자에서 발생한 편평 콘딜롬 1예

이해웅,오상현,장성은,최지호,문기찬,고재경 대한피부과학회 2006 大韓皮膚科學會誌 Vol.44 No.4