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)

폐암의 세포 증식능과 c-erbB-2 종양단백의 발현에 대한 연구

송규상 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

An immunohistochemical stain for c-erbB-2 oncoprotein and a one step silver stain for AgNORs were performed on the total number of 24 cases of lung cancers. The results were as follows ; 1. c-erbB-2 oncoprotein was detected in 8 of 16 squamous cell carcinomas, 1 of 3 small cell carcinoma, 1 of 2 adenosquamous carcinoma, and 1 of 2 large cell carcinoma. 2. The mean AgNOR numbers percell in lung cancers were higher than those in normal bronchial epithelium. However, there was no difference among histologic types of lung cancers. 3. The mean AgNOR numbers were similar in both c-erbB-2 positive and c-erbB-2 negative squamous cell carcinomas. In summary, the expression of c-erbB-2 oncoprotein is seen in various histologic types of lung cancer and the expression of c-erbB-2 oncoprotein in squamous cell carcinoma may not be related to the cellular proliferative activity by AgNORs.

혈액투석중인 만성신부전 환자에서 골대사 지표로써의 Osteocalcin치

송치운,이진홍,안미애,윤환중,윤상임,성기양,이강현,송민호,이강욱,신영태,김영건,노흥규 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Background : Serum osteocalcin is synthesized by osteoblast and has been shown to be sensitive indicator of bone turnover inpatients with various metabolic bone disease. In renal osteodystrophy, serum osteocalcin is elevated due to decreased renal clearance and elevated level of PTH. This study was done to evaluate the usefulness of serum osteocalcin as a marker of bone metabolism and the correlation with other biochemical markers of bone metabolism. Methods : We measured serum osteocalcin, calcium, phosphorus, ALP(alkaline phosphatase) and PTH(parathyroid hormone) in 37 patients with end stage renal disease on hemodialysis. Osteocalcin was determined by radioimmunoassay and PTH was determined by radioimmunometric assay. Results : 1) The mean level of serum osteocalcin in ESRD patients was 233.8± 218.2ng/ml which was significantly higher than that of controls(p<0.0001). 2) The mean level of serum PTH in ESRD patients was 40.5± 43.8pg/ml was significantly higher than that of controls(p<0.005). 3) There was a significant positive correlation between the level of serum PTH, ALP and the level of serum osteocalcin in ESRD patients. 4) By using multiple regression, PTH is most reliable factor that affect to elevated level of serum osteocalcin ( beta coefficient = 0.687, Sig T<0.05). Conclusion : Serum osteocalcin as a marker of bone metabolism in ESRD patients is more useful than other biochemical marker such as serum calcium, phosphorus, ALP and PTH is a most reliable factor that affect to elevated level of serum osteocalin.

포타슘과 소디움이 白鼠腎臟 動脈에 미치는 影響에 對한 病理學的 硏究

宋圭祥,姜大榮 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.1

There are experimental and epidemiological data which indicate that high sodium intake is a major factor in the genesis of hypertension and that potassium moderates salt induced hypertension. To study the effect on blood pressure and morphologic change of sodium and potassium intake, the male Sprague-Dawley rats were fed diets containing different amount of sodium(4%, 8%) and potassium(1%, 2%, 4%) for six months. The systolic blood pressure was measured monthly from the first month, and the size and morphologic change of renal arteries were also investigated monthly from the second month of feeding. The results were as follows: 1. High sodium intake induces hypertension, and in the case of feeding the same sodium concentration, hypertensinogenic effect is greater in the rats receiving less dietary potassium intake than high potassium intake. 2. There is more statistically significant increase of ED/LD ratio in the high sodium and potassium fed groups than those of the control group (P<0.05). Medium sodium and potassium fed groups also reveal statistical significance(P<0.05). 3. Hyperplasia of endothelial cells and hypertrophy of media are more prominent in the high sodium fed groups than those of the control group, and these changes are more evident in the high sodium intake groups than those of the medium sodium intake groups. In the groups receiving the same sodium concentration, each blood vessel reveals the decrease of ED/LD ratio with increment of potassium concentration, but there is no statistical significance (P>0.05).

유방병변에서의 Nucleolar Organizer Regions에 대한 연구

송규상 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2

To study the proliferative activity of cells in benign and malignant breast lesions, a one step silver staining technique to identify argyrophilic nucleolar organizer regions had been applied in 11 cases of fibrocystic change, 11 cases of fibroadenoma, 15 cases of invasive ductal carcinoma without metastasis, 9 cases of invasive ductal carcinoma with metastasis, and 3 cases of medullary carcinoma, respectively. The results were as follows: 1. AgNORs in both fibrocystic disease and fibroadenoma were relatively small and uniform in size and shape. Epothelial cells in fibrocystic change had 1.49 AgNORs per cell in average Stromal cells and epithelial cells in fibroadenoma contained 1.58 AgNORs and 2.02 AgNORs per cell in average, respectively. 2. Invasive ductal carcinomas and medullary carcinomas showed relatively irregular AgNORs. The mean numbers of AgNORs in invasive carcinoma with or without metastasis were 3.23 and 3.41 per cell. Medullary carcinomas contained 3.18 AgNORs per cell. There were no statitical differences among malignant tumors. 3. The numbers of AgNORs were statistically different between benign and malignant lesions. These data suggested that the mean AgNORs counts was useful in differentiation between benign and malignant breast lesions. However, it seemed that they did not correlate with malignant types and status of metastasis.

일부 지역 제조업체 안전·보건관계자들의 지식 및 태도에 관한 연구

송영표,리갑수,이성수,안규동,이병국 순천향대학교 산업의학연구소 1996 순천향산업의학 Vol.2 No.1

The useful preventive measure for industrial accidents in manufacturing industries could be achieved through automation, education of workers on safety, proper work practice and etc. The success of prevention of industrial accident could be haevily relied on the awareness of accident prevention of workers and management personnel in each industries. In order to obtain general awareness of industrial accident in terms of knowledge and attitude and to provide useful information for the proper preventive measure of industrial accident, questionnaire survey was done with manufacturing industries in Chunan area which has 5 and more workers. Questionnaire with 50 question items were sent to 570 relevant personnels in 471 manufacturing industries. Out of 560, 460 relevant personnel replied to the questionnaire. The results obtained were as follow; 1. While most manufacturing industries(391 industries, 86.7%) under study reported that they had full time occupational safety and health personnel, only 30 manufacturing industries(6.5%) with legal requirement of such personnel did not have relevant ones. 2. Most popular position for the personnel of safety and health duty were section chief(33.2%), and 46.8% of safety and health personnel were in the age group of 30-39. Whereas 66.9% of them were titled as production chief and management chief. 3. Most safety and health personnel(98.5%) reported that disseminated information from professional organization of occupational safety and health were very useful to carry out their safety and health duties. 4. Eight one percent respondent received safety education from governmental organization or affiliated institute and most of them (97.3%) reported that such education was very effective. 5. While 61.8% of respondent reported the necessity of field inspection by inspector for routine and consultation, 30.0% of respondent wanted document inspection without real field inspection. But most respondent replied that such inspections were useful for conducting safety and health prevention. 6. While 93.7% of respondent thought that accident prevention were helpful for production, 88.8% and 86.0 of them replied that accident prevention could influence the cost of production and quality of products, respectively which eventually influenced the competitiveness of each industries. 7. Eighty five percent of respondent replied that accident could be prevented with educational, personal and material resources. 8. While 96.5% of respondent replied that their industries provided safety education, out of them 26.2% industries thought that their safety education were superficial. The most popular frequency of safety education was once per month(56.0%) and 31.0% industries provided once a week. On the other hand 13.1% of industries provided every day safety education on regular basis. 9. While 45.2% of respondent replied that employer had strong commitment for safety and health, 41.3% of respondent replied that there were some changes and progression of employer's attitude for safety and health issues. 10. While 49.2% of respondent replied the necessity of legal requirement of safety personnel, 45.8% of respondent replied that voluntary requirement for safety personnel were more practical and helpful for accident prevention. 11. The necessity of periodic health examination were replied from most respondent(90.0%) and 73.0% of respondent thought that periodic health examination were helpful for the promotion of worker's health, but 56.4% of respondent criticized that periodic health examination were superficial and needed revision of content and method of periodic health examination. 12. Most respondent(92.7%) agreed the necessity of environmental measurement and 64.4% of respondent had their confidence on the result of environmental measurement, whereas 56.7% of respondent replied that their industries were repaired and improved according to the recommendation of environmental measurement and 85.6% of respondent replied that some kind of countermeasure for the recommendation such as supplies of personal protective equipments were done.

일개 대학병원에서 일년간 분리된 반코마이신 내성 장구균의 임상 분자역학적 연구

송진영,김창억,김성욱,우흥정,김미란,이규만,이란,장미화,정희진,김우주 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.4

목적 : 한강성심병원에서는 2000년 3월 반코마이신내성 장구균이 처음 분리되어, 원내전파를 막기 위한 노력을 하였으나, 분리가 지속되었다. 따라서 이에 대한 좀더 자세하고 객관적인 자료를 얻기 위해 본원에서 분리된 반코마이신내성 장구균에 대한 임상분자 역학적 연구를 시행하게 되었다. 방법 : 2000년 3월부터 2001년 2월까지 한림대학교 한강성심병원에서 분리된 장구균을 대상으로 디스크 확산법, 최소발육억제 농도등의 측정을 통해 반코마이신 내성여부를 확인하였으며, 반코마이신내성 장구균을 대상으로 PFGE를 시행하여 형별 분석을 하였다. 결과 : 분리된 균주는 총 32균주로 모두 E. faecium이었다. 항생제 내성 검사 결과 모두 Van A형이었다. PFGE 결과 1a형이 8검체, 1b형이 5검체, 2a형이 4검체, 2b형이 4검체, 3a형이 2검체, 3b형이 5검체였고, 그 외 4, 5, 6형이 각각 1검체씩이었다. 총 32균주 중 56%(18/32)의 균주가 같은 시기, 같은 병실에서 동일한 PFGE 형을 보이면서 분리되었다. 결론 : 반코마이신내성 장구균의 PFGE 분석 결과 여러 종류의 반코마이신내성 장구균이 유행하였음을 알 수 있다. 그러나 같은 기간, 같은 병실에서 분리된 균주의 PFGE 형이 같은 것이 상당수 있었다. 이는 반코마이신내성 장구균의 원내 전파가 있었음을 의미한다. 따라서 반코마이신내성 장구균의 전파의 발생 및 전파 방지를 위해서는 보다 효과적인 감염관리 활동이 필요할 것으로 생각된다. Background: Vancomycin-resistant enterococci(VRE) have been a rising problem worldwide. In March 2000, VRE was first isolated from a patient in Hangang Sacred Heart hospital. Although efforts to prevent transmission of VRE were performed, isolations continued. So molecular epidemiological study of VRE was done. Method : The minimal inhibitory concentration(MIC) to vancomycin and teicoplanin, and pulsed field gel electrophoresis(PFGE) pattern of VRE isolated from March 2000 to February 2001 were evaluated. Results : 32 VRE were isolated. All of the VRE were Enterococcus faecium and showed Van A resistance phenotype. We found out that a significant number of VRE isolated during same period and in same room, were same PFGE patterns. (18 cases/ 32 isolates= 56%) Conclusion: This study demonstrated the spread of VRE of same PFGE patterns. It suggests the nosocomial spreads of VRE.

위 MALT 림프종에서 다발성 림프절 전이로 오인된 동시성 림프절 결핵 1예

김성은,김규종,김도현,송준영,문대성,장리라,유찬희,문원,박무인,박선자,김영옥 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

28세 남자가 내시경적 점막절제술을 통해 저등급 위MALT 림프종으로 진단되었다. 병기설정을 위해 18F-FDG PET 검사를 시행하였고 우측 쇄골상부, 우측상/하부 기관주위, AP window 부위에 강한 섭취가 관찰되어 전이성 림프절로 판단하였다. 그러나, 우측 쇄골상부 림프절에서 시행한 절제생검에서 만성육아종성염증소견이 관찰되었고 조직의 결핵 중합효소연쇄반응에서도 양성 반응을 보였다. 2개월간 항결핵제의 사용 후 시행한 추적 컴퓨터단층촬영 검사에서 림프절 크기의 감소를 보여 최종적으로 위 MALT 림프종에서 광범위 림프절 전이로 오인된 동시성 림프절 결핵으로 진단되었다. A 28-year-old man was diagnosed as gastric MALT lymphoma in diagnostic EMR (endoscopic mucosal resection). He subsequently underwent an 18F-FDG PET. 18F-FDG PET showed intense multifocal uptake in right supraclavicular, right upper and lower paratracheal, and AP window areas that was considered radiologically to represent widespread metastatic lymphadenopathy. Excisional biopsy of a supraclavicular lymph node, however, revealed chronic granulomatous lymphadenitis with a positive reaction of Tb-nested PCR. After antituberculosis treatment for 2 months, a follow-up CT scan showed complete resolution of the lesions. Intense 18F-FDG uptake could be due to an infectious process such as synchronous tuberculous lymphadenitis. Therefore, this could mimic a malignant condition such as lymphoma with extensive lymph node metastasis due to a false-positive finding, which may lead to a misdiagnosis.

질소오염 감소를 위한 질소수지표 개발에 관한 연구 : 충청북도 사례연구 For Province Chungcheongbuk-do

송재옥,홍성규 建國大學校 自然科學硏究所 2004 建國自然科學硏究誌 Vol.15 No.-

These days, the environment has been polluted as a result of many kinds of agricultural activities, such as over-fertilization and excessively injected agricultural medicine and livestock-wastewater. Especially, superfluously used nitrogenous fertilizers have worsened both ground water and earths surface water. In Korea, compared to other developed countries, there has been an extensive use of nitrogenous fertilizer, affecting the cleanliness of ground water. Under these circumstances, it is imperative to study the pollution by nitrogenous fertilizer. In order to estimate the extent of potential pollution by nitrogenous fertilizer, this study establishes a nitrogen parameter by providing the balance between the inputted quantity of nitrogen element (marked as plus) and the output quantity of nitrogen element (marked as minus). For the calculation of surface nitrogen balance, nitrogen input was calculated by fertilizer consumption and cattle manure input etc., and nitrogen output was mainly harvested crop products. This balance, by indicating the extent of potential pollution, may be used to improve the effectiveness of environment policy making. In Province Chungcheongbuk-do(Chungbuk), a surplus of nitrogen is 15.3kg/10a. However, each region has different levels of surplus based on the amounts of nitrogenous fertilizer used, soil and climate. We observe that the policy to reduce pollution by nitrogen must be applied based on environmental characteristics of each region. In conclusion, the nitrogen parameter has significance in planning environmental policy that is appropriate to each region, by helping to analyze the effect on rural household income and to solve other environment-related problems.

원소 및 화합물 명명(命名)에 대한 초등학교 교사들의 이해

송영미,공영태,김성규 진주교육대학교 초등교육연구소 2005 科學敎育硏究 Vol.28 No.-

This study aimed at proper application of the revisional nomenclature for chemical elements and compounds in the Elementary school science textbooks. For this purpose, this study analyzed teachers' understanding on the nomenclature for compounds who taught at schools, and also analyzed the kinds of the chemical elements and compounds shown in the 7th curriculum science textbooks and teachers's guides. The tasks were teachers' attention to the revision of the nomenclature for chemical elements and compounds, teaching conditions of the nomenclature for the chemical elements and compounds in the science textbooks and teacher's guides, teacher' understanding about the revisional nomenclature for chemical elements and compounds to analysis of the chemical elements and compounds in each grade science book of the 7th curriculum of elementary school. The subjects who taught at elementary schools in Gyeongnam were administered questionnaires which were used for the conditions of their understanding of the chemical elements and compounds in the elementary school science textbooks. Among a total of 200 questionnaires which were administered to the subjects, 179 were returned, and except for uncompleted 22, 157 were used in analysis. A statistical processing program of SPSS 10.0 was used to estimate the frequency and percentage of each variable. In addition, the difference among variables was found out using x² test. The findings of this study were as follows: For the attention to the revised nomenclature for compounds, most of teachers did not know about the revision itself because of the lack of related materials but they thought that in accordance with the change in the world it is necessary for any revision on existing method to be made. For the teaching conditions of the revisional nomenclature for chemical elements and compounds, teachers had difficulties in introducing it to students, on the other hand, the teaching books for teachers did not help them properly explain it because of the insufficiency of the books. Also teachers did not pay much attention to the revisional nomenclature systems for the compounds in the textbooks for students and the books for teachers. For the conditions of teachers' understanding about chemical elements and compounds, they did not completely understand about most of the attributes of the chemical elements and compounds in the textbooks. Especially, the questions raised about sodium chloride, propane, acetone, and sodium hydroxide to teachers showed different significance according to their age. When they were provided with 10 items of the revision, most of teachers answered that they had difficulties in understanding them. The analysis of the chemical elements and compounds of science textbooks and teacher's guides in each grade showed that the kinds of the chemical elements and compounds introduced in 3-6 grades included 44 in science textbooks, 42 in experiment and observation textbooks, and 112 in the books for teachers. What is more, the compounds which were revised by the revisional nomenclature were 50. In conclusion, this study suggests that teachers were not well informed of the revision of the nomenclature and had difficulties in understanding it. And even though teachers felt the need of the revisional nomenclature for chemical elements and compounds in accordance with the change in the world, they were afraid of the sudden change after revision. This means that even though the revisional nomenclature for chemical elements and thecompounds in the textbooks for students and the books for teachers needed, it should be preceeded by the sufficient training for the teachers.