산업단지 및 일반생활 지역의 공기 중 톨루엔에 대한 개인노출 및 생체시료의 상관성 분석

이병준(Byoungjun Lee),허 정(Jung Heo),정다영(Dayoung Jung),김순신(Sunshin Kim),류현수(Hyeon-Su Ryu),최민지(Min-Ji Choi),솨이지엔페이(Jian-Fei Shuai),임성국(Sung-Guk Im),양원호(Wonho Yang) 한국환경보건학회 2017 한국환경보건학회지 Vol.43 No.4

Objectives: The purpose of this study was to assess the correlation relationship between personal exposure and urinary hippuric acid in biological monitoring for airborne toluene in an industrial complex and in general environments. Methods: Personal exposure to toluene and its metabolite, hippuric acid, in urine were simultaneously measured in occupational environments area near an industrial complex and in general environments. The study subjects were divided into three types: 137 workers who use organic solvents in the workplace, 210 residents living near a dyeing industrial complex, and 379 residents living in general environments. The toluene exposures of workers and residents were measured by a passive sampler for four days. The urine of participants was sampled when the passive samplers of personal exposure were collected. Results: The toluene and hippuric acid concentrations of workers were the highest, followed by the concentrations of residents living near a dyeing industrial complex and residents living in general environments. The coefficient of correlation between the concentrations of toluene and hippuric acid among workers was 0.749 (p<0.01) in the workplace. On the contrary, correlations between the concentrations of toluene and hippuric acid among residents living near a dyeing industrial complex and residents living in general environments were all not significant. The relationship between the concentrations of hippuric acid and toluene in three types could be described by the exponential growth model. Conclusions: This study analyzed the relationships between toluene exposure and the concentrations of hippuric acid in urine in high, middle, and low exposure environments, and could be described by the exponential growth model.

한국인 제2형 당뇨병 환자의 골격근에서 인슐린 신호전달체계의 결함

최준혁,이관우,김효정,이동훈,이종우,김정은,엄현채,김경미,최성이,정윤석,김현만 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.5

연구배경: 제2형 당뇨병에서 나타나는 인슐린 저항성은 간, 지방, 근육 같은 말초조직에서 인슐린의 작용이 떨어지는 것을 말한다. 제2형 당뇨병의 발생기전에 인슐린 저항성과 인슐린 분비능 저하가 같이 관여함은 잘 알려진 사실이다. 인슐린의 세포내에서의 저항성을 규명하기 위한 인슐린의 세포내 신호전달체계에 대한 연구가 활발히 진행되고 있으며 몇몇 연구에서 인슐린 저항성을 가진 골격근육에서 IRS와 관련된 PI3-kinase의 활성감소와 Akt kinase의 활성감소를 보고하고 있으나 아직까지 명확하게 그 기작이 설명되어지지 않고 있다. 본 연구에서는 정상성인, 제2형 당뇨병 환자를 대상으로 경구당부하검사 및 인슐린 클램프검사를 시행하고 인슐린 클램프 검사시 대상인의 근육을 채취하여 인슐린 신호전달 체계(IR-β, IRS, Akt(PKB, Rac) kinase, GSK-3)를 연구하였다. 방법: 연구대상자는 한국인으로서 경구당부하검사상 정상인 및 당뇨병 환자 각각 11명, 9명을 대상으로 하였으며, 정상인은 건강인으로 과거력상 당대사에 영향을 줄 질환이 없고, 현재 당대사에 영향을 줄 약물 복용 및 다른 소견이 없는 경구당부하검사상 정성 내당능을 보이는 대상자로 하였다. 당뇨병환자는 모두 제2형 당뇨병 환자로 이환기간이 만 5년 이내인 경우로 하고, 인슐린으로 치료하는 대상자는 제외하도록 하였다. 대상자의 연령, 체질량지수, 체지방량, 공복시 총콜레스테롤, 중성지방, 고밀도지단백 콜레스테롤 및 HbA1c, 인슐린, C-peptide를 측정하였고, "HOMA model"을 이용하여 베타세포의 기능와 인슐린저항성 정도를 평가하였다. 정상혈당클램프 검사(euhlycemic hyperinsulinemic clamp test)를 시행하고 인슐린 투입 전과 인슐린 투입 30분후, 두차례에 걸쳐 대퇴부 근육생검을 실시한후 western 법으로 IR-β, IRS, Akt kinase, GSK-3의 인산화량을 측정하였다. 결과: 정상인 11명과 당뇨병 환자 9명을 대상으로 하였으며 대상자의 평균 연령, 평균 체질량지수, 체지방량, 허리/엉덩이 둘레의 비(waist hip ratio; WHR)는 두 군간에 차이가 없었다. 평균 공복혈당은 정상군 98.0±0.3㎎/dL, 당뇨병군 208.1±16.5㎎/dL(p<0.05), HbA1c는 정상군 5.4±0.5%, 당뇨병군 9.2±0.6%(p<0.05)였다. "HOMA model"을 이용한 베타세포의 기능과 인슐린저항성은 정상군 56.4±8.5%, 1.4±0.2, 당뇨병군 72.2±52.3%(p<0.01), 10.2±6.3(p<0.01)였으며 정상혈당클램프 검사상 포도당 이용률은 정상군 8.2±0.6㎎/㎏/min, 당뇨병군 3.7±1.1㎎/㎏/min(p<0.01)로 정상군과 당뇨병군간에 유의한 차이를 나타내었다. Western blot법으로 IR-β, IRS, Akt kinase, GSK-3의 인산화량을 인슐린 투입전과 인슐린 투입 30분후 측정하였을 때 IR-β에서는 정상군이 103.9±2.3에서 241.3±18.6, 당뇨군이 108.9±2.2에서 198.7±6.3으로 증가하였다(p=NS). 이는 인슐린 투입후 당뇨병군이 정상군과 비교하여 인산화량의 증가정도가 통계적인 차이가 없었다. IRS에서는 정상군이 111.6±7.3에서 295.6±17.2, 당뇨군이 114.5±6.1에서 222.0±23.2로 증가하였으며(p<0.05), 인슐린 투입후 당뇨병군이 정상군과 비교하여 인산화량의 증가정도가 약 24% 감소하였다. Akt kinase에서는 103.4±6.0에서 416.8±29.5로 증가하였으며(p<0.01), 인슐린 투입후 당뇨병군이 정상군과 비교하여 인산화량의 증가정도가 약 43% 감소하였다. GSK-3에서는 정상군이 107.7±6.7에서 595.7±28.1, 당뇨군이 104.3±4.8에서 443.3±12.9로 증가하였으며(p<0.01), 인슐린 투입후 당뇨병군이 정상군과 비교하여 인산화량의 증가정도가 약 25% 감소하였다. 결론: 제2형 당뇨병 환자에서 정상인과 비교하여 인슐린 자극후 IR-β는 인산화량의 증가정도가 큰 차이가 없었으나, IRS, Akt kinase, GSK-3에서는 인산화량의 증가 정도가 감소되는 것으로 보아 상위 인슐린 신호전단체계부터 결함이 있는 것으로 생각된다. Background: The glucose uptake rate is the limiting step in glucose utilization and storage. The failure of insulin to stimulate glucose uptake in muscle appears to be a primary defect of insulin resistance. This study was undertaken to examine the effect of physiological hyperinsulinemia on the phosphorylation of the insulin receptor (IR-β), insulin receptor substrate (IRS), Akt kinase and GSK-3 in isolated skeletal muscle, in people with type 2 diabetes(n=9) and control subjects(n=11). Methods: 75g OGTT and euglycemic hyperinsulinemic clamp test were done. And vastus lateralis muscle was obtained before and 30 min into the euglycemic clamp. Western blots were performed for tyrosine phosphroylation of insulin receptor substrate (IRS) and phosphorylation of the insulin receptor(IR-β), Akt and GSK-3. Result: There were no statistical differences in the mean age, BMI and body fat between the control subjects and diabetic patients. The fasting blood sugar and HbA_1c in controls and diabetic patients were 98.0±0.3 and 208.1±16.5ng/dl, and 5.4±0.5 and 9.2±0.6%, and 1.4±0.2 in the control subjects, and 72.2±52.3%(p<0.01) and 10.2±6.3(p<0.01) in the diabetic patients, respectively. The insulin resistance from the euglycemic hyperinsulinemic clamp test were 8.2±0.6㎎/㎏/min and 3.7±1.1ng/㎏/min in the control subjects and in the diabetic patients, respectively(p<0.01). Compared with the normal controls, insulin-stimulated IR phosphorylation was no different to that in the diabetic patients. However, insulin-stimulated IRS phosphorylation, insulin-stimulated Akt phosphorylation and insulin-stimulated GSK-3 phosphorylation were reduced in the diabetic patients compared with the normal controls by 24, 43 and 25%, respectively(p<0.05). Conclusion: In Korean type 2 diabetic patients, the insulin resistance may be due to the impairment of the upstream insulin signal molecular network. Further studies will focus on determining whether these signaling defects are the cause of the development of insulin resistance, or secondary to the altered metabolic state, associated with type 2 diabetes mellitus (J Kor Soc Endocrinol 17:685∼697, 2002).

FCL(5-FU, Carboplatin, Leucovorin) 항암 화학요법에서 Gm-CSF의 효과

최지영,김현수,김종숙,박상준,윤환중,조덕연,남상륜,김삼용 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

Background: One of the major side effects of cancer chemotherapy is myelosuppression. Neutropenia and/or thrombocytopenia are dose-limiting factors in chemotherapy. Colony-stimulating factor induces proliferation and functional maturation of hematopoietic progenitor cells. GM-CSF is primarily active on progenitor cells of granulocytic and monocytic lineage. Methods: Fifteen patients with histologically proven malignancy diagnosed at Chungnam National University Hospital from January 1993 to August 1995 were included in this study. We could evaluate the clinical efficacy of GM-CSF in 13 patients undergoing FCL(5-FU, Carboplatin and Leucovorin) chemotherapy; the first cycles involved no GM-CSF while the second cycles involved GM-CSF on day 6 through 15 of chemotherapy. Results: 1) The subjects were fifteen patients in all, there were five patients with head and neck cancer, which was the most common types of maligancy. There were four patients with colon cancer, two patients with stomach cancer, and one patient with breast cancer, gallbladder cancer, cervix cancer and cholangiocarcinoma respectively, two patients, who did not complete two cycles of chemotherapy were excluded. 2) Age distribution was from 38 years to 78 years with a median age of 57. 3) In FCL chemotherapy cycles with GM-CSF, the duration of neutropenia(<500/μL) was 0.5±0.3 day, while FCL chemotherapy cycles without GM-CSF, it was 2.9±0.7 day(P=0.008). 3) There was no significant difference in platelet count between the two chemotherapy cycles(P=0.133). 4) Febrile duration without GM-CSF was 4.9±2.1 day, but with GM-CSF the duration was 1.3±0.7 day, which was significantly different(P=0.003). The duration of antibiotics use with GM-CSF was 1.7±1.2 day and without GM-CSF was 6.8±3.2 day, also significantly different(P=0.002). But hospital stay between the two cycles were not significantly different(P=0.064). Conclusion: GM-CSF was effective in preventing or restoring bone marrow depression after FCL chemotherapy.

Simvastatin이 골결손부 회복에 미치는 영향

강정호,김규태,최용석,이현우,황의환 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.3

Purpose : To observe and evaluate the effects of Simvastatin-induced osteogenesis on the wound healing of defective bone. Materials and Methods : 64 defective bones were created in the parietal bone of 32 New Zealand White rabbits. The defects were grafted with collagen matrix carriers mixed with Simvastatin solution in the experimental group of 16 rabbits and with collagen matrix carriers mixed with water in the controlled group. The rabbits were terminated at an interval of 3, 5, 7, and 9 days, 2, 4, 6, and 8 weeks after the formation of defective bone. The wound healing was evaluated by soft X-ray radiography. The tissues within defective bones were evaluated through the analysis of flow cytometry for the manifestation of Runx2 and Osteocalcin, and observed histopathologically by using H-E stain and Masson’s trichrome stain. Results : 1. In the experimental group, flow cytometry revealed more manifestation of Runx2 at 5, 7, and 9 days and Osteocalcin at 2 weeks than in the controlled groups, but there was few difference in comparison with the controlled group. 2. In the experimental group, flow cytometry revealed considerably more cells and erythrocytes at 5, 7, and 9 days in comparison with the controlled group. 3. In the experimental group, soft x-ray radiography revealed the extended formation of trabeculation at 2, 4, 6, and 8 weeks. 4. Histopathological features of the experimental group showed more fibroblasts and newly formed vessels at 5 and 7 days, and the formation of osteoid tissues at 9 days, and the newly formed trabeculations at 4 and 6 weeks. Conclusion : As the induced osteogenesis by Simvastatin, there was few contrast of the manifestation between Runx2 and Osteocalcin based on the differentiation of osteoblasts. But it was considered that the more formation of cells and erythrocytes depending on newly formed vessels in the experimental group obviously had an effect on the bone regeneration.

폐결핵 환자 혈청에서 수용성 Interleukin 2 수용체 및 Adenosine Deaminase 활성도에 관한 연구

고정희,박성규,백상현,박찬권,박병수,안진영,최우석,박정규 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.1

Interleukin-2 (IL-2) induces T cell proliferation in an autocrine manner and provides a means by which antigen triggered T cells can be clonally expanded in vitro. During the following activation, the activity of IL-2 is mediated by specific high affinity IL-2 binding membrane receptors which are expressed shortly after activation. In this process, a 42 KD-fragment (soluble IL-2R) is continuously cleaved off and circulates as a soluble marker of T lymphocyte activation. Elevated level of soluble IL-2R has been identified in the serum of patients with malignant autoimmune and allergic disorders, systemic parasitic infection, undergoing graft versus host disease, acute or chronic lymphocytic leukemia and HIV-infection. ADA (adenosine deaminase) completes the process of differentiation of T cell and is essential for progression of T cell maturation. Therefore level of ADA is to correlated with magnitude of T cell immune response. The fact that expression of sIL-2R and ADA activity increases in peripheral blood T-lymphocytes of patients with active pulmonary tuberculosis suggests that T cell activation might have a major role in the pathogenesis of pulmonary tuberculosis. In order to evaluate the T cell immune response in pulmonary tuberculosis, we measured the serum concentration of sIL-2R and ADA activity in 17 patients with current pulmonary tuberculosis, 10 chronic inactive pulmonary tuberculosis, 10 as normal controls. (1) Current pulmonary tuberculosis had significantly higher levels of sIL-2R (237.24±95.47)when compared with those of inactive tuberculosis (78.6±11.06). and the control (68.17±15.4) group. (2) ADA activity in current pulmonary tuberculosis was significantly increased (34.41±20.63) when compared with those of inactive tuberculosis (24.7±14.36) and control (17.65± 5.94) group. (3) There was good correlation between sIL-2R concentration and ADA activity in serum in current pulmonary tuberculosis group. (4) sIL-2R concentration and ADA activity was decreased significantly 6 months after anti-tuberculosis drug medication. In conclusion, sIL-2R concentration and ADA activity in serum in current pulmonary tuberculosis group was increased when compared with those of inactive pulmonary tuberculosis and the control group. By the way, T cell mediated immune response was enhanced in current pulmonary tuberculosis, but in inactive chronic pulmonary tuberculosis who had treated by antituberculosis drug medication, the concentration of sIL-2R and ADA activity was nearly normal.

한국인 정상교합자의 3차원 디지털 모형을 이용한 순,협측 치면 곡률

채지현,송진욱,차정열,최정수,박영철 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.2

본 연구는 한국인의 치아형태에 적합한 브라켓 베이스를 만들기 위해 임상 치관의 순, 협측 곡률을 3차원적으로 계측하여 치관의 곡률 자료를 얻고자 하였다. 정상적인 해부학적 형태를 가지는 구강모형 30쌍을 3차원 디지털 모델로 제작한 후, FA점을 기준으로 수평 기준면과 수직 기준면을 설정하였다. 이 기준면에 대한 치면의 곡선을 형성한 후, 곡률을 이차방정식의 계수로 표현하였다. 수평면과 수직면의 곡률과 FA점을 기준으로 근심과 원심, 치은측과 교합면측의 곡률을 측정한 결과, 상악견치와 상악 제2소구치 외에는 남녀간 치면 곡률의 유의한 차이가 없었다. 하악 측절치, 상악 견치, 상하악 제1, 2소구치와 제1대구치에서 근원심 또는 치은교합면측 치면 곡률의 유의한 차이가 관찰되었다 (P < 0.05). 본 연구에서 얻어진 순, 협측 치면의 곡률 자료는 한국인의 치아 형태에 적합한 Straight Wire Appliance 개발의 기초 자료로 활용될 수 있다. Objective: This study was performed to investigate the labio/buccal clinical crown curvatures of Korean permanent teeth and to obtain the curve-ratio data in an attempt to fabricate bracket bases fit for each individual Korean permanent tooth. Methods: Three-dimensional digital models were made from 30 sets of dental casts with normal anatomic structures. According to the FA points, horizontal and vertical reference planes were established and lines were drawn on the tooth surfaces in reference to these planes. The curvature was expressed as the coefficient of a quadratic equation. Lines mesial, distal, gingival and occlusal to the horizontal, vertical reference planes and the FA point were drawn. Results: The curvature measured for each line revealed that there are no significant differences between male and female, except for maxillary canines and maxillary second bicuspids (P > 0.05). There were notable differences in the mesio-distal or gingivo-occlusal curvatures among the mandibular lateral incisors, maxillary canines, maxillary and mandibular first and second bicuspids and first molars (P < 0.05). Conclusions: The labial & buccal crown curvatures of teeth in Korean normal occlusion were measured on the mesial and distal, gingival and occlusal sides respectively in this study. Based on these data, a SWA can be developed to fit the individual features of Korean tooth crowns.

조혈모세포이식 후 발생한 주폐포자층 폐렴에 대한 고찰

주지현,최정현,이동건,백지연,고윤호,이혜정,김세희,신호진,박윤희,박지영,김유진,신완식,김춘추 대한감염학회 2001 감염 Vol.33 No.4

Background : Pneumocytitis cainii pneumonia (PCP) can occur in immunocompromised hosts especially such as AIDS or cancer patients. Although recent research had focused on PCP in AIDS patients, few studies have described the clinical presentations of PCP in recipients of stem cell transplantation (SCT). We evaluated the clinical manifestations of PCP in SCT patients admitted at St. Mary's hospital, Seoul, Korea. Methods : The medical records of 17 PCP patients undergoing SCT between Feb. 1998 and Feb. 2000 were reviewed. The diagnosis of PCP was confirmed through the demonstration of Pneumocytitis cainii via either cytology of brochoalveolar lavage (BAL) or histological technique of lung biopsy. CMV disease and CMV infection were confirmed by BAL culture and antigenemia respectively . Results : Seventeen patients were all recipients of allogeneic SCT and 7 of 17 patients were performed non-sibling SCT. Patients presented with symptoms including brief period (4 ∼23 days) of fever (76%), dyspnea (70%), cough (64%), and signs such as rare(58.8%), Sixteen patients (94%) had been receiving immunosuppressive agent such as cyclosporine A (64%) or Fk506 (35%) without PCP prophylaxis. Eleven patients (64%) were treated with corticosteroid with mean dose of 16 mg/day prednisolone and mean duration of 4.6 months after post-SCT period. Twelve patients were co-infected with CMV. Another co-infected miCroorganisms were Pseudomonas aeruginosa, Mycobacterium tuberculosis, herpes simplex virus, parainfluenza virus, Average duration of treatment with trimethoprim-sulfamethoxazole (TMP/SMX) was 21 ±9 days. Four patients died, and three of them were related with PCP. Conclusion : PCP developed frequently in patients who were taking immunosuppressive drug due to graft versus host disease or were not taking TMP/SMX prophylaxis. High risk patients showing fever, cough, or dyspnea should be considered to take early bronchoscopic intervention for detection of PCP. When treat for PCP, it also be considered to the possibility of coinfection such as CMV. (Korean J Infect Dis 33:273∼279, 2001)

치커리와 쑥갓의 무균자엽절편체 생산 효율 증진

황현정,전혜정,최근원,김영채 경희대학교식량자원개발연구소 2005 硏究論文集 Vol.24 No.-

치커리와 쑥갓에 있어 식물조직배양이나 형질전환 과정에 필요한 무균 절편체를 얻기 위한 적절한 방법을 제안하기 위해 기내 파종을 위한 소독조건과 배지조성 및 종류에 관한 실험들이 실시되었다. 치커리 'Precole'은 10% NaOCl, 15분간, 'Chiavari'는 5% NaOCl, 15분간이 기내파종 시 발아 및 자엽전개를 촉진시키고 오염발생을 억제하는 조건으로 선발되었다. 쑥갓에서는 발아 및 자엽전개율에 있어 NaOCl 처리 간에 차이는 없었지만 10% NaOCl, 30분간 처리에서 가장 낮은 오염율이 관측되었다. 치커리와 쑥갓의 발아와 자엽전개율 모두 인조토양배지의 사용으로 MS 배지에 비해 현저히 향상 되었다. 비록 육안으로는 오염여부를 관측할 수는 없었지만 이들 인조토양배지에서 자란 쑥갓 묘의 자엽을 MS배지에 치상하여 배양 시에는 오염증상이 나타났으며 이들을 NaOCl 1%로 15분간 소독 후 치상한 결과 오염율을 현저히 낮출 수 있었다. Experiments on the sterilization condition and medium composition and type for in vitro sowing were conducted to suggest a proper way to produce enough aseptic explants for tissue culture or transformation study in chicory and garland chrysanthemum. Fifteen minutes soaking treatment with 10% NaOCl for chicory 'Precole' and 15 minutes with 5% NaOCl for chicory 'Chiavari' were selected as proper sterilization conditions to promote in vitro germination and cotyledon expansion and inhibit the seedling contamination from seed itself. In garland chrysanthemum, there was no significant difference in germination and cotyledon expansion ratio among NaOCl treatments, but the lowest seedling contamination ratio was observed by 30 minutes soaking with 10% NaOCl. Both germination and cotyledon expansion ratio in chicory and garland chrysanthemum were significantly increased by using the artificial soil media in contrast to MS media. Although seedling contamination with the artificial soil media could not be observed with bare eyes, cotyledon explants harvested from the plants grown on the media showed some fungal growth when they were placed onto MS media for further culture. However the percentage of the contamination from these explants was dramatically decreased by 15 minutes sterilization with 1% NaOCl.

모 컴퓨터 회사 근로자 건강증진 사업 전개를 위한 수요조사

임현우,안병용,최환석,박정일,김경수,이강숙,김정아,구정완 가톨릭대학산업의학쎈타 산업의학연구소 1997 韓國의 産業醫學 Vol.36 No.4

Before conducting the health promotion program, we surveyed the health risk appraisal(HRA) of 210 workers (186 men and 24 women) in a computer company, for the need assessment, selection of target population, priority setting, and as a standard for comparision after performing the program. The smokers were 115(88.6%), and drinkers (over 1 bottle of Soju per week) were 91(44.8%) in men. Entire women and 148(78.0%) men never or irregularly exercise. Type A personality were 73(39.2%) in men, 8(33.3%) in women, and 26(14.0%) of men and 6(25.0%) of women were high stress risk group. 53(25.2%) of men and 2(8.3%) of women were obese (BMI ≥25kg/m²), and workers who consumed exess of total calory compared with recommendation were 142(76.3%) in men and 18(75%) of women. By the health risk appraisal, it was suggested that smoking cessation program, drinking counselling, exercise prescription, stress management, and weight control program should be conducted effectively for the high risk group.

고유량 고효율 혈액투석막 재사용의 임상경험

조현경,김승정,임병국,정혁준,최영일,마경애,신규태,김흥수,김도헌 대한신장학회 2001 대한신장학회잡지 Vol.20 No.3