제주도 지하수 질산염 농도의 시·공간적 변화 특성: 장기(1993-2015) 모니터링 자료의 평가

김호림(Ho-Rim Kim),오준섭(Junseop Oh),도현권(Hyun-Kwon Do),이경진(Kyung-Jin Lee),현익현(Ik-Hyun Hyun),오상실(Sang-Sil Oh),감상규(Sang-Kyu Kam),윤성택(Seong-Taek Yun) 대한자원환경지질학회 2018 자원환경지질 Vol.51 No.1

1993년부터 2015년까지 관측된 제주도 지하수 장기모니터링 관측정(N = 4,835)에서 수집된 지하수 수질자료(N = 21,568)를 기반으로 질산성질소의 시공간적 변동 특성을 평가하였다. 제주도 지하수의 질산성질소 농도의 중앙값은 2.5 mg/L로서 다른 국가나 대륙의 조사 결과에 비해 다소 높거나 유사한 것으로 나타났다. 또한 지하수 용도, 행정구역 및 고도 별로 유의한 차이를 보였다. 특히, 산간 지역에 비해 저지대 해안가에 위치한 농업 및 주거지역에서 농도가 높음을 확인하였다. Mann-Kendall 및 Sen’s slope 분석을 활용한 질산성질소 농도의 추세 분석 결과, 하류 저지 대에 비해 중산간지역에서의 질산성질소 농도 증가 경향이 뚜렷하였다. 제주도 내 토지 피복의 시계열 변화 특성과 결부 지어 보면, 중산간지역의 오염 증가 추세는 농업지역의 확장 등 인위적 활동 증가에 기인한 결과로 판단된다. 반면,기지정된 지하수자원특별관리구역에서는 전반적으로 질산성질소 농도의 감소 경향이 나타났는데, 이는 지하수 관리 측면에서 수질관리를 위한 적극적인 정책이 유효함을 시사한다. 본 연구에서는 제주도 지하수의 질산성질소 오염관리를 위한 적정 방안을 제안한다. The spatio-temporal variations of nitrate concentrations in groundwater of Jeju Island were evaluated by an analysis of time series groundwater quality data (N = 21,568) that were collected from regional groundwater monitoring (number of wells = 4,835) for up to 20 years between 1993 and 2015. The median concentration of NO 3 -N is 2.5 mg/L, which is slightly higher than those reported from regional surveys in other countries. Nitrate concentrations of groundwater in wells tend to significantly vary according to different water usage (of the well), administrative districts, and topographic elevations: nitrate level is higher in low-lying agricultural and residential areas than those in high mountainous areas. The Mann-Kendall trend test and Sen’s slope analysis show that nitrate concentration in mid-mountainous areas tends to increase, possibly due to the expansion of agricultural areas toward highland. On the other hand, nitrate concentrations in the Specially Designated Groundwater Quality Protection Zones show the temporally decreasing trend, which implies the efficiency of groundwater management actions in Jeju. Proper measures for sustainable groundwater quality management are suggested in this study.

통합심리치료의 인지분화훈련이 정신분열병 환자의 기초 인지기능에 미치는 영향

이희상,현명호,조현상,이연희,김태용,장순아,노규식,정기립,이만홍,유계준 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

연구목적 : 정신분열별 환자들을 대상으로 통합심리치료의 소프로그램인 인지분화훈련을 실시하여 실행기능, 개념형성능력, 언어능력 및 추론력에 대한 훈련이 보다 더 하위단계의 인지기능인 주의력, 기억력, 반응시간 등을 호전시킬 수 있는 지를 알아보고자 하였다. 연구방법 : DSM-IV상 정신분열병으로 진단된 24명의 입원환자를 무작위로 양분하여 한 군은 인지분화훈련군으로 다른 한 군은 대조군으로 나누었다. 훈련군은 4주동안 1주일에 3회(매회 60분간)로 총 12회의 통합심리치료의 인지분화훈련을 받았으며 대조군은 동일한 시간동안 정신건강교육을 받았다. 훈련전후에 훈련군과 대조군을 대상으로 개정판 Wechsler 기억검사로 주의집중력, 장·단기 기억력을 측정하였고 Vienna test system중 결정반응시간검사로 반응시간, 반응결정시간, 반응운동시간을 평가하였다. 연구결과 : 1) 주의집중력에서는 훈련군과 대조군사이에 집단간 효과, 집단내 효과 및 상호작용 효과가 없었다. 2) 단기기억력에서는 훈련군과 대조군사이에 집단내 효과는 있었으나(F(1,24)=10.46. p〈.05). 집단간 효과, 상호작용 효과는 없었다. 3) 장기기억력에서는 훈련군과 대조군사이에 집단내 효과는 있었으나(F(1,24)=15.09. p〈.05). 집단간 효과, 상호작용 효과는 없었다. 4) 반응시간에서는 상호작용 효과(F(1,24)=5.18, p〈.05)가 있었다. 5) 반응운동시간에서는 집단간 효과, 집단내 효과 및 상호작용 효과가 없었다. 6) 반응결정시간에서는 상호작용 효과(F(1.24)=6.00, p〈.05)가 있었다. 결 론 : 통합심리치료의 인지분화훈련은 정신분열병 환자에서 하위단계의 인지기능 중 반응시간(특히 반응결정시간)을 단축시키는 효과가 있었다. Objectives : The purpose of this study was to investigate the effects of cognitive differentiation training of Integrated Psychological Therapy(a training program of executive function, concept formation, language, and abstraction) on micro-level cognitive function such as attention, memory and reaction time in patients time in patients with schizophrenia. Methods : Twenty-four inpatients diagnosed as schizophrenia using DSM-IV were randomly assigned to 2 groups. The training group went through a total of 12 sessions of cognitive differentiation training for 4 weeks. The control group received psychoeducation program during the same period. Wechsler Memory Scale-Revised and Decision-Reaction Timer of Vienna Test System were administered to all patients, both before and after the training program. Results : 1) In the attention and concentration scores of Wechsler Memory Scale-Revised, between group, within group and interaction effects of training were not significant. 2) In the short-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=10.46, p〈0.05), but the between group and interaction effects did not reach significance. 3) In the long-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=15.09, p〈0.05), but the between group and interaction effects did not reach significance. 4) In the reaction time scores of Decision-Reaction Timer, interaction effect of training was significant(F(1,24)=5.18, p〈0.05). 5) In the motor time scores of Decision-Reaction Timer, between group, within group and interaction effects of training were not significant. 6) In the decision time scores of Decision-Reaction Timer, interaction effect of training was significant(F(1,24)=6.00, p〈0.05). Conclusion : Our findings suggest that cognitive differentiation training of Integrated Psycho-logical Therapy is partly effective on improving micro-level cognitive functions such as reaction time(especially, decision time) in patents with schizophrenia.

업종에 따른 연 취급 사업장의 기중 연 농도 및 연 노출 수준 평가

이병국,김용배,리갑수,안현철,김화성,이용진,황규윤,장봉기,이성수,안규동 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

In order to obtain an useful information for health management and biological monitoring of lead exposed workers, Authors tried to investigate air lead level and the lead exposed level of workers in lead industry according to occupational category. The subjects in our study were 2074 workers in 7 lead-using industries, and study subjects were divided into 4 occupational categories such as storage battery industry (type 1), primary smelting industry (type 2), secondary smelting industry (type 3) and litharge making industry (type 4). Blood zincprotoporphyrin concentration (ZPP), blood lead concentration (PbB) and urinary δ -aminolevulinic acid (ALAU), hemoglobin (Hb), hematocrit (Hct) were selected as the indices of lead exposure. Personal variables such as age, work duration were also collected. The results were as follows. 1. The geometric mean air lead in 9 lead-using industry was 0.1133±4.3120 ㎎/㎥, and that in type 1, 2, 3 and 4 was 0.1038±3.4952 ㎎/㎥, 0.0429±3.4329 ㎎/㎥, 0.1877±2.5123 ㎎/㎥ and 0.9961±5.2910 ㎎/㎥, respectively. 2. The mean ZPP in 9 lead-using industry was 53.1±28.0 ㎍/㎗, and that in type 1, 2, 3 and 4 was 52.0±24.8 ㎍/㎗, 48.0±16.4 ㎍/㎗, 109.8±85.6 ㎍/㎗ and 74.3±37.8 ㎍/㎗, respectively. There was significant difference in ZPP according to occupational category (P<0.01). The percents of lead workers whose ZPP were above 100 ㎍/㎗ in type 1, 2, 3 and 4 were 4.0%, 1.7%, 34.3% and 21.6%, respectively. 3. The mean PbB in lead-using industry was 26.0±11.2 ㎍/㎗, and that in type 1, 2, 3 and 4 was 25.3±11.1 ㎍/㎗, 26.7±8.8 ㎍/㎗, 50.3±15.2 ㎍/㎗ and 36.4±11.0 ㎍/㎗, respectively. There was significant difference in PbB according to occupational category (P<0.01). The percents of lead workers whose PbB were above 40 ㎍/㎗ in type 1, 2, 3 and 4 were 10.4%, 7.7% 71.9% and 43.2%, respectively. 4. While the correlation of Hb corrected PbB with ZPP was higher than non corrected PbB, the correlation of log-transformed ZPP with PbB was higher than non corrected ZPP. 5. Simple linear regressions of PbB and corrected PbB as independent variable with ZPP, log-transformed ZPP and ALAU as dependent variable were statistically significant (P0.01). Coefficient of determination of corrected PbB with other variables was higher than non corrected PbB. As the result of this study, it was suggested that reconsideration of environmental and biological monitoring program was highly recommended for secondary smelting and litharge making industry.

성인에서 Haemophilus influenzae 감염증의 임상양상과 미생물학적 특성

이종섭,황병연,정희진,김우주,박승철,이도현,이창규,신종희,황규잠,이영희 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.2

목적 : H. influenzae는 성인에서 흔히 호흡기 감염을 일으키는 균주로, 최근 ampicillin 내성 β-lactamase 생성 균주들이 지속적인 증가를 보이고 있어, 이에 국내 성인에서 H. influenzae에 의한 감염의 임상양상과 분리된 균주들의 미생물학적 특성을 조사하고자 하였다. 방법 : 1998년 3월부터 1999년 9월까지 고려대 구로병원에 내원한 환자중에서 H. influenzae가 분리된 68명을 대상으로 임상양상을 조사하고 항균제 감수성 검사를 시행하였다. 분리된 33주에 대해서 혈청형, 생물형, 세포외막 단백분석을 시행하였고, β-lactamase 생성여부에 따른 감염 환자군간 임상상 및 예후의 차이를 비교하였다. 결과 : 환자의 평균연령은 68세였고, 지역사회 획득감염이 전체의 85%를 차지하였다. 폐렴과 기관지염과 같은 하기도 감염이 전체환자의 75%를 차지하였고 분리 검체 역시 객담이 84%로 가장 많았다. 환자의 71%가 기저질환을 가지고 있었으며, 그 중에 만성 폐쇄성 폐질환, 심혈관 질환, 악성종양, 당뇨병이 대부분이었다. 혈청형으로는 nontypeable 형이 68%로 가장 많았고 b형은 한 예도 없었다. β-lactamase 생성율은 63.2%였고, β-lactamase 양성균주의 항균제 내성율이 음성균주에 비하여 높았으나 β-lactamase 생성 여부에 관계없이 cefotaxime, azithromycin, ciprofloxacin에 대하여 100%의 감수성을 나타내었고 cefaclor, cefuroxime에 대해서는 10% 이하의 낮은 내성율을 보여 이들 항균제들이 치료에 효과적일 것으로 사료된다. 세포외막 단백분석에서는 C형과 D형이 전체의 64%로 가장 많았으며, 혈청형과의 유의한 연관성은 보이지 않았다. 결론 : 성인에서 H. influenzae는 주로 만성 기저질환자에서 급성 호흡기감염 또는 만성 폐쇄성 폐질환의 급성 악화를 유발한다. 기존의 보고에 비해 β-lactamase 양성율이 증가하였고, 이에 따른 항균제 내성율도 증가하여 항균제의 선택에 유의하여야 할 것으로 생각된다. 세포외막 단백분석상 특정한 유형의 균주에 의해 감염이 집중적으로 발생하고 있어 향후 역학 조사의 도구로 이용할 수 있겠다. Purpose : H. influenzae is one of the common causative microorganisms of respiratory tract infections in adults. Recently. β-lactamase producing, ampicillin-resistant H. infiuenzae has become worldwide problem as well as in Korea. We studied to investigate the clinical features and microbiologic characteristics of H. infiuenzae infections in adults. Materials & Methods : From March 1998 to September 1999, 68 patients were enrolled in this study. Clinical features of H. infiuenzae infections were investigated, 68 isolates were subjected to the β-lactamase test, and 33 isolates were used for serotyping. biotyping, antibiotic susceptibility and outer membrane protein (OMP) analysis. Results : Mean age of study patients was 68 years-old and the acquisition rate in community was 85%. Pneumonia and bronchitis were the most common type of infection such as 80%, sputum was the most common clinical specimen for H. mQuenzae isolation. 70% of patients had chronic underlying diseases. Non-typeable strains were 68% and β-lactamase producing rate was 63%. There was no difference in the clinical features and prognosis of H. influenzae infection between the β-lactamase positivie and -negative groups. The susceptibility of cefotaxime, azithromycin, and ciprofloxacin was 100% and that of cefaclor, cefuroxime was under 10% in spite of β-lactamase positivity. In OMP analysis, C and D types were dominant (64%). Conclusion : H. influenzae caused acute respiratory infections in adults with chronic underlying disorders. This study shows higher β-lactamase producing rate and antibiotic-resistance rate than that were reported previously. OMP analysis shows that two major types of strains cause clinical infections intensively.

In situ 고상 에피택시 방법에 의한 CoSi₂/Si(111)구조의 형성

이정주,강민성,김현수,최치규,이운환,이종덕,이영백,김건호,이정용 濟州大學校 基礎科學硏究所 1996 基礎科學硏究 Vol.9 No.2

초고진공에서 공상에피택시(solid-phase epiyaxy, SPE) 방법으로 CoSi₂를 Si(111)기판 위에 에피택시 성장시켰다. 2MeV⁴He++ ion후방산란 분광기와 사중결정 x-선 회절기 및 고분해 투과전자 현미경을 이용하여 성장된 CoSi₂의 상과 조성, 결정성, 그리고 계면의 미시구조를 조사하였다. 초고진공상태의 실온에서 Si(111)-7X7기판에 Co를 약 20 ~50 ?? 중착한 후 SPE에 의하여 실리사이드를 형성시키는 경우 600℃에서는 B-형의 CoSi₂가, 그리고 700℃에서는 A형의 CoSi₂가 선택적으로 에피택시 성장하였으며, 정합성은 B-CoSi₂[110]//Si[110] and CoSi₂(111)//Si(111)이, 그리고 700℃에서는 A-CoSi₂[110]//Si[110], CoSi₂(002)//Si(002)을 나타내었다. Epitaxial films of CoSi₂were grown on Si(111) substrates by in situ solid-phase epitaxy in a ultrahigh vacuum. The phase, the chemical composition, the crystallinity, and the microstructure of the Silicide/Si interface were investigated by 2-MeV⁴He++ ion-backscattering spectrometry, quadruple crystal X-ray diffractometry, and high-resolution transmission eletron micorscopy. High-quality films of either B-type or A-type CoSi₂ could be grown selectively on Si(111) substrates by depositing ~ 20 ~ 50 ?? of Co on a Si(111)-7X7 substrate followed by in situ annealing at 600℃ or 700℃ for 10 min. The matching face relationships are CoSi₂[110]//Si[110] and CoSi₂(111)//Si(111) by B-type CoSi₂ and CoSi₂[110]//Si[110]//Si[110] and CoSi₂(002)//Si(002) for A-type CoSi₂.

심인성 어지럼증 환자의 정신과적 증상에 관한 연구

이경규,이지영,김현우,이정엽,백기청,김재일,이근호 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 어지럼증을 호소하는 환자들 중에 심인성 어지럼증 환자가 상당수 있다는 것은 알려져 있고, 이러한 심인성 어지럼증과 동반되는 정신질환으로는 불안장애, 우울장애, 인격장애 등이 있다. 이에 본 연구에서는 심인성 어지럼증 환자들의 빈도와 정신과적 증상을 알아보고자 하였다. 방 법 : 어지럼증 환자들에게 평형검사, 자세운동측정검사, 자세변화검사, caloric testing을 시행하여 심인성, 말초성 및 중추성의 3군으로 분류한 후 각각 14명, 16명, 32명을 대상으로 하였다. 대상환자들에게 한국판 Beck 우울척도검사(K-BDI), Spielberg의 상태-특성 불안검사(STAI). 간이정신진단검사(SCL-90-R)를 이용하여 정신과적 증상을 측정하여 이들 세 군을 비교분석하였다. 결 과 : 1) 심인성 어지럼증을 가진 환자는 어지럼증을 나타내는 환자 총 62명중에서 14명으로 22.6%를 차지하였다. 2) K-BDI에 따른 세 군간의 비교에서는 세 군간에 유의한 차이를 보이지 않았다. 3) STAI에 따른 세 군간의 비교에서 상태불안(STAI-S) 및 특성불안(STAI-T) 모두에서 세 군간에 유의한 차이를 보이지 않았다. 4) SCL-90-R에 따른 세 군간의 비교에서는 9개의 척도 중에서 공포불안척도에서만 중추성 어지럼증군이 47.56±6.90, 말초성 어지럼증 군이 53.50±13.74, 심인성 어지럼증 군이 58.50±16.05로 심인성 어지럼증 환자군이 중추성 어지럼증 환자군에 비하여 유의하게 높은 것으로 나타났다(p<0.01). 5) 통증 증상에 있어서는 세 군간에 유의한 차이를 보이지 않았고, 위장관 증상과 성기능 장애 증상은 중추성과 말초성 어지럼증 군이 심인성 어지럼증 군에 비하여 유의하게 높은 것으로 나타났다(p<0.01). 결 론 : 상기 결과를 토대로 했을 때 어지럼증 환자들에 대한 정신과적 접근을 위하여 각 군을 나누는 것은 별 의미가 없으며 어지럼증 환자들의 어지럼증 자체에 대한 직접적이고 집중적인 치료가 더욱 필요할 것으로 생각된다. Objectives : This study was aimed to investigate psychiatric symptoms in patients with psychogenic dizziness and compare these findings with those of patients with central and peripheral dizziness. Methods : A total of 62 patients with dizziness was the subject of investigation, and patients were classified into 32 with central type, 16 with peripheral type, and 14 with psychogenic type. Korean standardized Beck Depression Inventory(K-BDI), State and Trait Anxiety Inventory(STAI), and Korean standardized edition of Symptom Checklist 90 Revised(SCL-90-R) were used for the assessment. Statistically, Pearson's chi-square test and one-way ANOVA with Scheffe's test were used with SPSS/PC for windows 6.0. Results : The results were as follows : 1) The proportion of psychogenic dizziness was 22.6% of the total subjects. 2) Total scores of K-BDI were not significantly different among the 3 groups. 3) Total scores of state anxiety and trait anxiety were not significantly different among the 3 groups. 4) In SCL-90-R, psychogenic dizziness group showed significantly higher score of phobic anxiety only(p<0.01) than central dizziness group. And others were not significantly different among the 3 groups. 5) In additional somatic symptoms, pain score was not different among the 3 groups, but gastrointestinal and sexual symptoms scores of central and peripheral dizziness group were significantly higher than those of psychogenic dizziness group(p<0.01). Conclusion : These results suggest that psychiatric symptoms in patients with psychogenic dizziness are not different from those of patients with central or peripheral dizziness. Therefore, the more direct and intensive treatment may be necessary regardless of the type of dizziness.

납 폭로 근로자에서 δ-aminolevulinic acid dehydratase 유전형질이 zinc protoporphyrin 및 δ-aminolevulinic acid에 미치는 영향

이병국,황규윤,장봉기,김용배,리갑수,안현철,김화성,이성수,안규동,박종범 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

The inhibition of δ-aminolevulinic acid dehydratase (ALAD) in the heme synthetic pathway results in increased protophoryphyrin (ZPP) and δ-aminolevulinic acid (ALA) and is responsible for some of toxicological effects of lead. This enzyme is coded by the ALAD gene containing 2 co-dominant alleles. The polymorphisms of ALAD gene may be related to differential effects of lead on ZPP and ALA, ALAD genotype was measured in 975 Korean male lead workers, of whom 897 were homozygous for ALAD1 (ALAD 1-1 genotype) and 96 were heterozygous for ALAD2 (ALAD 1-2 genotype). Blood lead in subjects with ALAD1 was significantly higher than those with ALAD2 (p = 0.01). No difference between ALAD genotypes was found for age, exposure duration, ZPP, ALA, hemoglobin, hematocrit, body mass index, tobacco and alcohol use. After adjustment for possible confounders, ALA and ZPP became significantly elevated in ALAD1 subjects (p = 0.004 and 0.055, respectively). This result suggests that ALAD1 subjects may be more susceptible to the hematotoxicologic effects of lead than ALAD2 subjects.

갑상선기능저하증에 기인한 내인성 급사 1예 보고

이정규,전지현,김민정,이규재,김한겸,조현득,채양석 大韓法醫學會 1999 대한법의학회지 Vol.23 No.2

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on mediline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.

Effects of Pilger Rolling and Heat Treatment on Microstructure and Corrosion Resistance of Ag-electroplated 304 Stainless Steel Tubes

Hyun Park,Woo‑Jin Lee,Jae‑Han Son,Han‑Kyun Shin,Sung‑Kyu Hong,Hyo‑Jong Lee 대한금속·재료학회 2022 METALS AND MATERIALS International Vol.28 No.8

We introduce a cost-effective method that combines electroplating with metal cold working processes to manufacture compositetubes with robust corrosion resistance. First, a 3-step electroplating process was developed to form an adhesive anduniform Ag coating on the outer wall of a 304 stainless steel tube. The process consisted of a Ni-strike step for removing thepassivation layer of the initial 304 tube, Cu deposition for smoothing the surface by adding a buffer layer, and Ag deposition. To reinforce the interfacial adhesion between the electroplated layers and the 304 tube and increase the area of the Ag coating,a pilger rolling or pilger rolling + heat-treatment process was performed after the Ag electroplating process. Scanningelectron microscopy of the composite tubes after each process indicated that the as-deposited Ag coating changed fromhaving a rough to smooth surface after only pilger rolling and with additional heat treatment. Electron backscatter diffractionanalysis of the microstructures and textures of the tubes revealed that dynamic recrystallization occurred extensively duringpilger rolling, resulting in the formation of a relatively defect-free grain structure without heat treatment. Furthermore,electrochemical polarization curves determined that the Ag-coated composite tubes are superior to the uncoated 304 tubein terms of corrosion resistance under Cl−atmosphere, owing to the formation of a AgCl passivation layer during testing. Surface analysis of the composite tubes suggests that the properties of the AgCl passivation layer are related to the grainsize of the Ag coating and the density of plastic-deformation-induced defects.

지속성 외래 복막투석 환자에서 염증 지표와 고해상도 B 모드 경동맥 초음파 소견의 연관성에 관한 연구

송현용,송영수,안철우,강신욱,최규헌,하성규,이현철,이호영,한대석 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

배 경 : 저알부민혈증 및 C-반응 단백(C-reactive protein, CRP)이 증가된 지속성 외래 복막투석 환자의 사망률이 높은 정확한 이유는 밝혀져 않다. 혈액투석 환자에서처럼 복막투석 환자에서 저알부민혈증 및 염증반응이 심혈관계 질환 위험인자 인지 알아보고자 하였다. 방 법: 비당뇨병성 말기 신부전, 지속성 외래 복막투석 환자 93명의 심혈관계 질환 위험인자들과 복막 투과 특성 및 알부민, CRP 등의 염증지표에 따라 고해상도 초음파를 이용한 경동맥내막-중간막 두께, 내막-중간막 면적, 플라크의 유무 등을 단면적으로 비교하였다. 결 과: 복막 투과 특성은 고투과막군 14명, 중간 고투과막군 38명, 중간 저투과막군 31명, 저투과막군 10명으로 각 군간의 경동맥 내막-중간막 두께, 플라크 유무 및 내막-중간막 면적의 차이는 없었다. 기존 관상동맥 질환 환자는 8예(8.6%)로 내막-중간막 두께는 관상동맥 질환이 없는 환자보다 증가되었고(0.79±0.21 vs 0.60±0.11 mm, p<0.05) 플라크 형성은 더 많이 보이나 통계적 유의성은 없었다(75.0 vs 63.5%, p>0.05). 혈청 알부민치와 경동맥 내막-중간막 면적은 역상관관계를 보였다(r=-0.27, p<0.05). 저알부민혈증 환자(혈청 알부민 <3.5 g/dL)는 정상 알부민혈증 환자보다 내막-중간막 두께가 증가되었고(0.67±0.15 vs 0.61±0.12 mm, p<0.05), 플라크도 유의하게 많았다(68.0 vs 55.8%, p<0.05). 혈청 CRP치와 경동맥 내막-중간막 면적은 양의 상관관계가 있었으며(r=0.21, p<0.05) CRP가 높은 환자(≥0.8 mg/dL, n=18)에서플라크가 많이 관찰되었으나(65.8 vs 50.0%, p<0.05) 경동맥 내막-중간막 두께 및 내막-중간막면적은 양군간에 차이가 없었다. 다변량 회귀 분석상 경동맥 내막-중간막 두께에 영향을 미치는 인자는 고령, 높은 CRP, 기존 심혈관계질환, 낮은 혈청 알부민 순이였다. 결 론 : 복막투석 환자에서 고해상도 초음파를 이용한 경동맥 내막-중간막 두께 측정은 심혈관계 질환 유무 예측의 비침습적 검사가 될 수 있고 저알부민혈증 및 높은 CRP과 같은 만성염증 지속상태가 복막투석 환자에서 죽상 동맥 경화증의 발생을 증가시킨다고 가정할 수 있다. Background : Continuous ambulatory peritoneal dialysis(CAPD) patients with low albumin(LA) and signs of inflammation reflected by increased C-reactive protein(CRP) level have an increased mortality, but the mechanism of this phenomenon is not clear yet. Methods : To answer whether LA and inflammation also enhance cardiovascular risk in CAPD patients, we performed cross sectional study measuring carotid artery intima-media thickness(IMT), calculated intima-media area(cIM area) and the presence of plaque by high-resolution B-mode ultrasonography in 93 non-diabetic CAPD patients. Results : Patients with coronary artery disease (CAD, n=8) had significantly increased IMT(0.79± 0.21 mm vs. 0.60±0.11 mm, p<0.05) and higher prevalence of carotid plaques(75.0% vs. 63.5%) compared to the non-CAD patients. Significant inverse correlation was observed between serum albumin (SA) level and cIM area(r=-0.27, p<0.05). Those patients with LA(SA <3.5 g/dL) had significantly increased IMT compared to non-LA patients(0.67±0.15 mm vs 0.61±0.12 mm, p<0.05). Prevalence of carotid plaques was also significantly higher in LA patients (68.0% vs. 55.8%, p<0.05). CRP level revealed a significant positive correlation with cIM area(r=0.21, p< 0.05). Patients with high CRP(≥0.8 mg/dL, n=18) had higher prevalence of carotid plaques (65.8% vs. 50.0%, p<0.05) compared to those patients with CRP <0.8 mg/dL, but IMT and cIMT area were not different. By multivariate logistic regression analysis, old age, high CRP, history of CAD and low SA were the independent risk factors affecting IMT. Conclusion : Our study strongly suggests that low albumin and chronic inflammatory state of CAPD patients could be associated with increasing atherosclerotic cardiovascular disease. (Korean J Nephrol 2002;21(2):285-294)