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An Epidemiological Study on the Industrial Injuries among Metal Products Manufacturing Workers in Young-Dung-Po, Seoul (일부 금속 및 기계제품 제조업체 근로자들의 산업재해($1980{\sim}1981$)에 관한 조사)

  • Lee, Jung-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.15 no.1
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    • pp.187-196
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    • 1982
  • The followings are the results of the study on industrial accidents occurred at 12 factories manufacturing metal products during the period of 2 years from January 1980 to December 1981 in the area of Yong-Dung-Po in Seoul. The results of the study are as follows: 1. The incidence rate of industrial injuries was 45.7 per 1,000 workers of the sample group and the rate of male (54.0) was three times higher than that of female (17.5). 2. In age groups, the highest rate was observed in the group of under 19 years old with 83.5, while the lowest in the group of 40s. 3. It was found that those who had short term of work experience produced a higher rate of injuries, particularly, the group of workers with less than 1 year of experience showed the highest rate of it as 48.1%. 4. In working time, the highest incidence rate occurred 3 and 7 hours after the beginning of their working showing the rate of 6.0 and 6.1 per 1,000 workers, respectively. 5. The highest incidence rate was observed on Monday as 8.4 per 1,000 workers, and it was 18.3% in aspect of the days of a week. 6. In aspect of the months of a year, the highest incidence was observed on July 1,000 workers and the next was on March as 4.8. These figures account for 11.8% of total occurrence in respective month. as 5. 4 per and 10.5% 7. In causes of injuries, the accident caused by power driven machinery showed the highest rate with 37.5%, the second was due to handling without machinery with 17.2%, and the third was due to falling objects with 14.2%, and striking against objects with 10.2%, and so on. 8. By parts of the body affected, the most injuries 84.3% of them occurred on both upper and lower extremities with the rate of 58.8% for the former and 25.5% for the latter. Fingers were most frequently injured with a rate of 40.3%. Comparing the sites of extremities affected, rate of injuries on the right side was 55.0% and 45.0% on the left side. 9. In the nature of injury, laceration and open wound were the highest with 34. 0%, the next was fracture and dislocation with 31. 9%, and sprain was the third with 8.1%. 10. On the duration of treatment, it lasted less than one month in 68.9% of the injured cases, of which 14.5% of the cases were recovered within 2 weeks, and 54.4% of them were treated more than 2 weeks. And the duration of the treatment tended to be prolonged in larger industries. 11. The ratio of insured accidents to uninsured accidents was 1 to 4.7.

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Risk Factor Analysis and Surgical Indications for Pulmonary Artery Banding (폐동맥 밴딩의 위험인자 분석과 수술적응중)

  • Lee Jeong Ryul;Choi Chang Hyu;Min Sun Kyung;Kim Woong Han;Kim Yong Jin;Rho Joon Ryang;Bae Eun Jung;Noh Chung I1;Yun Yong Soo
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.538-544
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    • 2005
  • Background: Pulmonary artery banding (PAB) is an initial palliative procedure for a diverse group of patients with congenital cardiac anomalies and unrestricted pulmonary blood flow. We proved the usefulness of PAB through retrospective investigation of the surgical indication and risk analysis retrospectively. Material and Method: One hundred and fifty four consecutive patients (99 males and 55 females) who underwent PAB between January 1986 and December 2003 were included. We analysed the risk factors for early mortality and actuarial survival rate. Mean age was $2.5\pm12.8\;(0.2\sim92.7)$ months and mean weight was $4.5\pm2.7\;(0.9\sim18.0)\;kg$. Preoperative diagnosis included functional single ventricle $(88,\;57.1\%)$, double outlet right ventricle $(22,\;14.2\%)$, transposition of the great arteries $(26,\;16.8\%)$, and atrioventricular septal defect $(11,\;7.1\%)$. Coarctation of the aorta or interrupted aortic arch $(32,\;20.7\%)$, subaortic stenosis $(13,\;8.4\%)$ and total anomalous pulmonary venous connection $(13,\;8.4\%)$ were associated. Result: The overall early mortality was $22.1\%\;(34\;of\;154)$, The recent series from 1996 include patients with lower age $(3.8\pm15.9\;vs.\;1.5\pm12.7,\;p=0.04)$ and lower body weight $(4.8\pm3.1\;vs.\;4.0\pm2.7,\;p=0.02)$. The early mortality was lower in the recent group $(17.5\%;\;16/75)$ than the earlier group $(28.5\%;\;18/45)$. Aortic arch anomaly (p=0.004), subaortic stenosis (p=0.004), operation for subaortic stenosis (p=0.007), and cardiopulmonary bypass (p=0.007) were proven to be risk factors for early death in univariate analysis, while time of surgery (<1996) (p=0.026) was the only significant risk factor in multivariate analysis. The mean time interval from PAB to the second-stage operation was $12.8\pm10.9$ months. Among 96 patients who survived PAB, 40 patients completed Fontan operation, 21 patients underwent bidirectional cavopulmonary shunt, and 35 patients underwent biventricular repair including 25 arterial switch operations. Median follow-up was $40.1\pm48.9$ months. Overall survival rates at 1 year, 5 years and 10 years were $81.2\%\;65.0\%,\;and\;63.5\%$ respectively. Conclusion: Although it improved in recent series, early mortality was still high despite the advances in perioperative management. As for conventional indications, early primary repair may be more beneficial. However, PA banding still has a role in the initial palliative step in selective groups.

Tetralogy of Fallot Associated with Pulmonary Atresia and Major Aortopulmonary Collateral Arteries -Comparison between the different surgical approaches- (폐동맥폐쇄와 주대동맥폐동맥혈관부행지를 동반한 활로씨사징증 -다양한 외과적 치료접근의 비교-)

  • 이정렬;양지혁;김용진;노준량
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.471-479
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    • 1999
  • Background: Patients with tetralogy of Fallot(TOF), pulmonary atresia(PA) and major aortopulmonary collateral arteries(MAPCAs) have been managed by heterogenous surgical strategies. We have taken 5 different surgical approaches to this lesion. In this study, relative advantages and disadvantages of each strategy were discussed by analyzing our surgical results. Material and Method: Between January 1986 and June 1998, 50 patients aged 1 to 177(39${\pm}$31) months at a various morphologic spectrum of this lesion were treated at our institution. The groups, which were classified according to the initial approaches, consisted of one-stage unifocalization(A-1, n=9), staged unifocalization(A-2, n=11), right ventricle to pulmonary artery connection(RV-PA)(B-1, n=11), one-stage RV-PA plus unifocalization (B-2, n=11), and one-stage definitive repair(C, n=8). Morphologic charateristics, operative mortalities, and probabilities of definitive repair were compared between the groups and the causes of death, complications and the follow-up results were described. Result: Mean ages at the first operation were 57${\pm}$18(A-1), 42${\pm}$48(A-2), 18${\pm}$14(B-1), 52${\pm}$55(B-2), and 32${\pm}$34(C) months (p<0.05). Mean numbers of MAPCAs were least in group C (A-1=4.3${\pm}$1.0, A-2=4.5${\pm}$1.3, B-1=4.1${\pm}$1.9, B-2=4.1${\pm}$1.6, C=3.4${\pm}$1.8 : p<0.05). The ratios of the direct and the indirect MAPCAs in each group were not different between the grousps (A-1=91%/9%, A-2=78%/22%, B-1=80%/20%, B-2=80%/20%, C=81%/19% : p>0.05). Nineteen patients had more than 1 dependent MAPCAs. True pulmonary arteries were not present 13 patients and they were confluent in 29. A total of 101 operations were performed. Operative mortalities of initial procedures were 33%(3/9, A-1), 18%(2/11, A-2), 0%(0/11, B-1), 36%(5/11, B-2) and 13%(1/8, C) (p<0.05). Percentages of the definitive repair among the patients of each group were 22%(2/9, A-1), 18%(2/11, A-2). 45%(5/11, B-1), 27%(4/11, B-2), and 100%(8/8, C)(p<0.05). Hypoxic respiratory and cardiac failure(6), hypoxic encephalopathy(2) and sepsis(4) were the major causes of death. Phrenic nerve palsy occured in 5 patients. Thirty-one patients among the survivals have been followed up for a mean duration of 74${\pm}$42(3-145) months. One and five year actuarial survival rates were 73% and 73 %. Conclusion: In conclusion, Right ventricle to pulmonary artery connection used in patients with TOF/PA/MAPCA as an inital procedure appeared to be highly successful in enhancing the chance of satisfactory definitive repair without the significant surgical risks. One-stage total repair at an ealier age group could be performed safely with the resonable outcomes. Unifocalization approach, whether it was performed in a single stage or in the multiple stages, resulted in the high operative mortality and the lowest chance of definitive repair, however more tailored selection of the patients and the long follow-up is mandatory to prove the usefulness of this approach.

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Operative Treatment of Congenitally Corrected Transposition of the Great Arteries(CCTGA) (교정형 대혈관 전위증의 수술적 치료)

  • 이정렬;조광리;김용진;노준량;서결필
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.621-627
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    • 1999
  • Background: Sixty five cases with congenitally corrected transposition of the great arteries (CCTGA) indicated for biventricular repair were operated on between 1984 and september 1998. Comparison between the results of the conventional(classic) connection(LV-PA) and the anatomic repair was done. Material and Method: Retrospective review was carried out based on the medical records of the patients. Operative procedures, complications and the long-term results accoding to the combining anomalies were analysed. Result: Mean age was 5.5$\pm$4.8 years(range, 2 months to 18years). Thirty nine were male and 26 were female. Situs solitus {S,L,L} was in 53 and situs inversus{I,D,D} in 12. There was no left ventricular outflow tract obstruction(LVOTO) in 13(20%) cases. The LVOTO was resulted from pulmonary stenosis(PS) in 26(40%)patients and from pulmonary atresia(PA) in 26(40%) patients. Twenty-five(38.5%) patients had tricuspid valve regurgitation(TR) greater than the mild degree that was present preoperatively. Twenty two patients previously underwent 24 systemic- pulmonary shunts previously. In the 13 patients without LVOTO, 7 simple closure of VSD or ASD, 3 tricuspid valve replacements(TVR), and 3 anatomic corrections(3 double switch operations: 1 Senning+ Rastelli, 1 Senning+REV-type, and 1 Senning+Arterial switch opera tion) were performed. As to the 26 patients with CCTGA+VSD or ASD+LVOTO(PS), 24 classic repairs and 2 double switch operations(1 Senning+Rastelli, 1 Mustard+REV-type) were done. In the 26 cases with CCTGA+VSD+LVOTO(PA), 19 classic repairs(18 Rastelli, 1 REV-type), and 7 double switch operations(7 Senning+Rastelli) were done. The degree of tricuspid regurgitation increased during the follow-up periods from 1.3$\pm$1.4 to 2.2$\pm$1.0 in the classic repair group(p<0.05), but not in the double switch group. Two patients had complete AV block preoperatively, and additional 7(10.8%) had newly developed complete AV block after the operation. Other complications were recurrent LVOTO(10), thromboembolism(4), persistent chest tube drainage over 2 weeks(4), chylothorax(3), bleeding(3), acute renal failure(2), and mediastinitis(2). Mean follow-up was 54$\pm$49 months(0-177 months). Thirteen patients died after the operation(operative mortality rate: 20.0%(13/65)), and there were 3 additional deaths during the follow up period(overall mortality: 24.6%(16/65)). The operative mortality in patients underwent anatomic repair was 33.3%(4/12). The actuarial survival rates at 1, 5, and 10 years were 75.0$\pm$5.6%, 75.0$\pm$5.6%, and 69.2$\pm$7.6%. Common causes of death were low cardiac output syndrome(8) and heart failure from TR(5). Conclusion: Although our study could not demonstrate the superiority of each classic or anatomic repair, we found that the anatomic repair has a merit of preventing the deterioration of tricuspid valve regurgitations. Meticulous selection of the patients and longer follow-up terms are mandatory to establish the selective advantages of both strategies.

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The Hepatoprotective Effect of Active Compounds of Kochiae fructus on D-Galactosamine-Intoxicated Rats (지부자 활성성분이 D-Galactosamine 투여에 의한 흰쥐의 간손상에 미치는 영향)

  • Kim, Na-Young;Lee, Jeong-Sook;Park, Myoung-Ju;Lee, Kyung-Hee;Kim, Seok-Hwan;Choi, Jong-Won;Park, Hee-Juhn
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.8
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    • pp.1286-1293
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    • 2004
  • This study was conducted to investigate the biological activity and hepatoprotective effect of various fractions and isolated compounds from Kochiae fructus (KF) extract on D-galactosamine (GaIN)-intoxicated rats. Male Sprague-Dawley rats were divided into control, GaIN treated group (GaIN), GaIN plus KF methanol extract treated group (KFM 200-GaIN), GaIN plus KF butanol extract treated group (KFB 200-GaIN), GaIN plus momordin Ic treated group (Momordin Ic 30-GaIN) and GaIN plus oleanolic acid treated group (Oleanolic acid 30-GaIN). KFM (200 mg/kg BW), KFB (200 mg/kg BW), momordin Ic (30 mg/kg BW) and oleanolic acid (30 mg/kg BW) were orally administered once a day for 14 days. GaIN (400 mg/kg BW) was injected at 30 minutes after the final administration of the compounds. The activities of serum aspartate aminotransferase and alanine aminotransferase were increased in the GaIN group compared to the control group and significantly lower in the KFB 200-GaIN, momordin Ic 30-GaIN and oleanolic acid 30-GaIN group than in the GaIN group. Hepatic lipid peroxide level was increased in the GaIN group compared to the control group and was lower in the KFM 200-GaIN, KFB 200-GaIN, momordin Ic 30-GaIN and oleanolic acid 30-GaIN group than in the GaIN group. Activities of xanthine oxidase and aldehyde oxidase in liver were higher in the GaIN group than in the control group and were significantly decreased in the KFB 200-GaIN, momordin Ic 30-GaIN and oleanolic acid 30-GaIN group compared to the GaIN group. Hepatic glutathione, ${\gamma}$-glutamylcysteine synthetase and catalase activities were decreased in the GaIN group compared to the control group and were higher in the KFB 200-GaIN, momordin Ic 30-GaIN and oleanolic acid 30-GaIN group than in the GaIN group. Activities of hepatic glutathione reductase, glutathione S-transferase, superoxide dismutase and glutathione peroxidase were lower in the GaIN group than in the control group and were improved in the KFM 200-GaIN, KFB 200-GaIN, momordin Ic 30-GaIN and oleanolic acid 30-GaIN group compared to the GaIN group. Therefore, the current results indicate that momordin Ic administration alleviated the GaIN-induced adverse effect through enhancing the antioxidant enzyme activities.

Studies on the Hemodynamic Changes in Cirrhosis of the Liver (간경변증(肝硬變症)에서의 혈역학적(血力學的) 변화(變化)에 관(關)한 연구(硏究))

  • Kim, Jung-Il;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.2
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    • pp.11-27
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    • 1970
  • Cardiac output, plasma volume and renal plasma flow were determined to evaluate hemodynamic changes in 29 patients with cirrhosis of the liver. The results obtained were as follows. 1. The mean plasma volume was 3793+895ml and it was significantly higher than the normal controls. The mean blood volume ($5266{\pm}1222ml$) and blood volume per kg body weight ($95.7{\pm}23.41ml$) were also increased significantly. The mean plasma volume per kg body weight ($69.1{\pm}19.1ml$) showed increased tendency and the mean difference between blood volume and plasma volume per kg body weight ($26.4{\pm}7.05ml$) was in lower limit of normal range. 2. The mean cardiac output was $7708{\pm}2652ml/min$ and it was significantly increased. The mean cardiac index ($4924{\pm}1998ml/min/M^2$), stroke volume ($96.2{\pm}34.2ml/beat$), stroke index ($62.3{\pm}27.34ml/M^2$) and fractional cardiac index ($1.54{\pm}0.577$) were also increased significantly. The mean total -peripheral resistance was $1664{\pm}753.8\;dynes\;sec\;cm^{-5}M^2$ and it was significantly lower than the normal controls. 3. The mean renal plasma flow was $537{\pm}146.8ml/min/1.73M^2$ and it was normal to decreased tendency. The mean endogenous creatinine clearance ($66.7{\pm}23.0ml/min/1.73M^2$) was significantly decreased. Filtration fraction was variable, but it was slightly lower than normal in most cases. The mean renal fraction of cardiac output ($11.4{\pm}6.27%$) was relatively decreased. 4. Although renal plasma flow was normal or decreased in general, it was definitely diminished in patients with creatinine clearance less than $60ml/min/1.73M^2$, resistant ascites, and signs of azotemia (elevated BUN and serum creatinine). 5. Diminished glomrular filtration rate with low filtration fraction and decreased renal fraction of cardiac output observed strongly supported increased renal afferent arteriolar resistance. 6. Renal circulatory impairment preceded azotemia or oroliguria in cirrhosis. 7. Clinical findigns and liver function were not correlated with hemodynamic changes, except for esophageal varices associated with high cardiac output obsedved. 8. No definite correlation of renal hemodynamics with plasma volume or cardiac output was found.

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INFLUENCES OF DRY METHODS OF RETROCAVITY ON THE APICAL SEAL (치근단 역충전와동의 건조방법이 폐쇄성에 미치는 영향)

  • Lee, Jung-Tae;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.24 no.1
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    • pp.166-179
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    • 1999
  • Apical sealing is essential for the success of surgical endodontic treatment. Root-end cavity is apt to be contaminated with moisture or blood, and is not always easy to be dried completely. The purpose of this study was to evaluate the influence of dry methods of retrocavity on the apical seal in endodontic surgery. Apical seal was investigated through the evaluation of apical leakage and adaptation of filling material over the cavity wall. To investigate the influence of various dry methods on the apical leakage, 125 palatal roots of extracted human maxillary molar teeth were used. The clinical crown of each tooth was removed at 10 mm from the root apex using a slow-speed diamond saw and water spray. Root canals of the all the specimens were prepared with step-back technique and filled with gutta-percha by lateral condensation method. After removing of the coronal 2 mm of filling material, the access cavities were closed with Cavit$^{(R)}$. Two coats of nail polish were applied to the external surface of each root. Apical three millimeters of each root was resected perpendicular to the long axis of the root with a diamond saw. Class I retrograde cavities were prepared with ultrasonic instruments. Retrocavities were washed with physiologic saline solution and dried with various methods or contaminated with human blood. Retrocavities were filled either with IRM, Super EBA or composite resin. All the specimens were immersed in 2% methylene blue solution for 7 days in an incubator at $37^{\circ}C$. The teeth were dissolved in 14 ml of 35% nitric acid solution and the dye present within the root canal system was returned to solution. The leakage of dye was quantitatively measured via spectrophotometric method. The obtained data were analysed statistically using one-way ANOVA and Duncan's Multiple Range Test. To evaluate the influence of various dry methods on the adaptation of filling material over the cavity wall, 12 palatal roots of extracted human maxillary molar teeth were used. After all the roots were prepared and filled, and retrograde cavities were made and filled as above, roots were sectioned longitudinally. Filling-dentin interface of cut surfaces were examined by scanning electron microscope. The results were as follows: 1. Cavities dried with paper point or compressed air showed less leakage than those dried with cotton pellet in Super EBA filled cavity (p<0.05). However, there was no difference between paper point- and compressed air-dried cavities. 2. When cavities were dried with compressed air, dentin-bonded composite resin-filled cavities showed less apical leakage than IRM- or Super EBA-filled ones (p<0.05). 3. Regardless of the filling material, cavities contaminated with human blood showed significantly more apical leakage than those dried with compressed air after saline irrigation (p<0.05). 4. Outer half of the cavity showed larger dentin-filling interface gap than inner half did when cavities were filled with IRM or Super EBA. 5. In all the filling material groups, cavities contaminated with blood or dried with cotton pellets only showed larger defects at the base of the cavity than ones dried with paper points or compressed air.

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The Comparative Imaging Study on Mn-phthalocyanine and Mangafodipir trisodium in Experimental VX2 Animal Model (실험적으로 유발시킨 VX2 동물모델에서의 Mn-phthalocyanine과 Mangafodipir trisodium의 비교영상)

  • Park Hyun-Jeong;Ko Sung-Min;Kim Yong-Sun;Chang Yongmin
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.1
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    • pp.32-41
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    • 2004
  • Purpose : To measure the NMR relaxation properties of MnPC, to observe the characteristics of liver enhancement patterns on MR images in experimentally implanted rabbit VX2 tumor model, and to estimate the possibility of tissue specific contrast agent for MnPC in comparison with the hepatobiliary agent. Materials and Methods : Phthalocyanine (PC) was chelated with paramagnetic ions, manganese (Mn). 2.01 g (5.2 mmol) of phthalocyanine was mixed with 0.37 g (1.4 nlmol) of Mn chloride at $310^{\circ}C$ for 36 hours and then purified by chromatography ($CHCl_3:\;CH_3OH=98:2$, volume ratio) to obtain 1.04 g $(46\%)$ of MnPC (molecular weight = 2000 daltons). The T1/T2 relaxivity (R1/R2) for MnPC were determined at a 1.5 T (64 MHz) MR spectrometer. VX2 tumor model was experimentally implanted in the liver parenchyma of rabbits. All MR studies were performed on 1.5 T. The human extremity radio frequency coil of a bird cage type was employed. MR images were acquired at 17 to 24 days after VX2 carcinoma implantation.4 mmol/kg MnPC and 0.01 mmol/kg Mn-DPDP were injected via the ear vein of rabbits. T1-weighted images were obtained with spin-echo (TR/TE=516/14 msec) and fast multiplanar spoiled gradient recalled (TR/TE : 80/4 msec, $60^{\circ}$ flip angle) pulse sequence. Fast spin-echo (TR/TE=1200/85 msec) was used to obtain the T2-weighted images. Results : The value of T1/T2 relaxivity (R1/R2) of MnPC was $7.28\;mM^{-1}S^{-1}$ and $55.56\;mM^{-1}S^{-1}$ respectively at 1.5 T (64 MHz). Because the T2 relaxivity of MnPC that bonded strongly, covalently manganese with phthalocyanine was very high, the signal intensity of liver parenchyma was decreased on postcontrast T2-weighted images and we could easily distinguish the VX2 carcinoma within the liver parenchyma. When MnPC was administrated intravenously, the tumor margin delineation was more remarkable than Mn-DPDP-enhanced images. The enhancement of liver parenchyma with MnPC persisted at relatively high levels over at least one hour after injection of the contrast agents. Conclusion : The hepatic uptake and biliary excretion of MnPC, which are similar to Mn-DPDP, suggest that this agent is a new liver-specific agent. Also, MnPC seems to be used as a dual contrast agent (T1 and T2) with high T2 relaxivity. However, it is warranted that MnPC needs further investigation as a potential contrast agent for MR imaging of the liver. That is, further characterizations of MnPC are needed in vivo and in vitro before clinical trials. The diagnostic potential of MnPC will also have to be examined more in the animal models of additional types.

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The Measurement of Blood Loss and Its Effect on Red Cell Survival Studies with $^{51}Cr$ (실혈(失血)이 적혈구수명(赤血球壽命) 측정(測定)에 미치는 영향(影響)에 관(關)한 연구(硏究))

  • Lee, Mun-Ho;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.1
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    • pp.27-36
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    • 1970
  • 적혈구(赤血球) 수명의 측정에는 $^{51}Cr$-표지적혈구법(標識赤血球法)이 임상적(臨床的)으로 이용(利用)되고 있으며 이는 이론상(理論上) steady state 즉(卽) 측정기간(測定期間)동안 순환(循環) $^{51}Cr$량(量)-적혈구량(赤血球量)이 일정(一定)할 때에 한(限)하여 유효(有效)하며 unsteady state 때는 true red cell survival을 알기 위하여서는 측정치에 영향을 주는 요인(要因)에 대하여 각각(各各) 교정(校正)해 줄 필요(必要)가 있다. 이 요인(要因)중에 특히 실혈(失血)로 인(因)한 영향에 관(關)하여는 계통적인 연구(硏究)가 적다. 이에 저자(著者)들은 $^{51}Cr$표지적혈구법(標識赤血球法)을 이용(利用)하여 실혈(失血)이 적혈구(赤血球) 수명측정(測定)에 미치는 영향을 인체(人體)에서 실험 관찰하여 몇가지 성적을 얻었다. 연구대상(硏究對象)은 총(總) 56명(名)의 청장년(靑壯年)으로 급성실혈군(急性失血群)과 만성실혈군(慢性失血群)으로 구분(區分)하여 급성실혈군(急性失血群)은 위장출혈등(胃腸出血等)이 없는 2대(代)의 의대생(醫大生)으로 $^{51}Cr$표지적혈구법(標識赤血球法)을 사용하여 적혈구(赤血球) 수명을 측정하는 동안($10{\sim}14$ 일간(日間)) 1일당(日當) 10ml(6명(名)), 25ml(4명(名)), 50ml(4명(名)), 75ml(4명(名)), 100ml(6명(名))를 각각(各各) 사혈(瀉血)한 군(群)과 10일간(日間) 1,000ml를 사혈한 군(群) 즉 200ml씩 5회(回)(4명(名)), 500ml씩 2회(回)(4명(名))로 세분(細分)하였으며 만성실혈군(慢性失血群)은 직업적인 공혈자(供血者)로 반복사혈로 생긴 9명(名)의 빈혈자와 십이지장충증(十二指腸蟲症)에 감염(感染)되어 구충(驅蟲)한 중등도(中等度)의 철결핍성 빈혈환자 7명(名)으로 나누어 관찰하였다. 측정(測定) 방법(方法)으로는 Gray 및 Sterling법(法)을 개설한 방법(方法)으로 $^{51}Cr$표지적혈구(標識赤血球)의 계측시료(計測試料)로서 전혈(全血) 및 적혈구(赤血球)를 사용(使用)하였다. 실험(實驗)성적은 1. 1일당(日當) 실혈량(失血量)이 증가(增加)할수록 적혈구(赤血球)수명($T\frac{1}{2}$)은 짧아짐을 알 수 있었다. 즉(卽) 1일당(日當) $20{\sim}50ml$ 사혈군에서는 $T\frac{1}{2}$이 현저히 짧아지는 rapid phase을 나타내고 1일당(日當) 50ml이상(以上) 사혈군에서는 짧아지는 정도(程度)가 완만한 slow phase을 나타낸다(Fig. 6). 2. 1일량(日量) 10ml 및 25ml식(式) 사혈한 군(群)의 적혈구수명(赤血球壽命)을 측정(測定)하는데 있어 적혈구(赤血球)를 사용하였을 때에는 $T\frac{1}{2}$측 정치에 유의한 차(差)가 없었으며 이 범위 내에서는 Hct., Hb. 및 혈청철치(血淸鐵値)도 역시 유의한 차(差)가 없었다. 3. 1일량(日量) 50ml 및 75ml, 100ml씩 사혈한 군(群)에서는 적혈구(赤血球)만을 사용(使用)하였을 때와 전혈(全血)을 시료(試料)로 하였을 때 사이에 $T\frac{1}{2}$의 측정치에 유의한 차(差)가 있었으며 이 때는 Hct., Hb. 및 혈청철치(血淸鐵値)에도 변화(變化)가 있었다. 즉(卽), 전혈(全血)을 사용한 적혈구(赤血球) 수명($T\frac{1}{2}$)의 측정치가 적혈구(赤血球)만를 사용(使用)한 적혈구(赤血球) 수명($T\frac{1}{2}$)의 측정치 보다 짧았다. 4. 일정(一定)기간(10 일(日)) 사혈의 총량(1000ml)이 같을 매는 200ml를 5회(回) 사혈한 군(群)이나 500ml를 2회(回) 사혈한 군(群) 사이에 적혈구(赤血球) 수명($T\frac{1}{2}$)에 유의(有義)한 차(差)를 볼 수 없었다. 5. 직업적 공혈자의 반복사혈로 인(因)한 만성(慢性) 빈혈환자 9명(名)에서의 $^{51}Cr$적혈구(赤血球)수명($T\frac{1}{2}$) 측정치는 평균(平均) 19.2일(日)로 짧아져 있으나 적혈구수명측정전후(赤血球壽命測定前後)에 충분(充分)한 철제(鐵劑)를 투여(投與)하여 Hct., Hb. 및 혈청철치(血淸鐵値)를 증가(增加)시켰으며 이때 볼 수 있었든 Hct치(値)를 규준(規準)하여 교정한 적혈구(赤血球)수명($T\frac{1}{2}$)은 거의 정상(正常)범위 안에 있어(27.6일(日)) 이러한 인자(因子)를 고려하지 않으면 잘못 이해할 수가 있다. 6. 구충자충(鉤蟲仔蟲)을 구충한 7명(名)의 중등도(中等度) 철(鐵)결핍성 빈혈환자에서의 적혈구(赤血球)수명($T\frac{1}{2}$) 측정치는 25일(日)$\sim$31일(日)로 평균(平均) 28일(日)이었으며, 이때 장 출혈량은 1일(日) $1.0{\sim}3.5ml$이었다. 단시일내의 급성실혈시에는 이와같은 소량의 실혈(失血)도 적혈구(赤血球)수명($T\frac{1}{2}$) 측정치에 영향을 보여 줌을 알 수 있었다. 따라서 이러한 정도의 실혈은 실험오차에 기인하는 것인지 아니면 장기 출혈에서는 이러한 소량의 실혈이 적혈구(赤血球)수명($T\frac{1}{2}$) 측정에 영향을 미치지 않는 것인지는 아직 확실히 말할 수 없다. 8. $^{51}Cr$-표지적혈구(標識赤血球)로 측정한 적혈구(赤血球)수명($T\frac{1}{2}$)은 측정시의 실혈량(失血量)에 큰 영향을 받음을 알 수 있으며 저자(著者)들은 $^{51}Cr$표지적혈구(標識赤血球)를 이용(利用)한 적혈구(赤血球) 수명 측정때 검사기간중 실혈량이 적혈구수명치(赤血球壽命値)에 미치는 관계를 상술(上述)한 실험치(實驗値)를 기초(基礎)로 하여 다음과 같을 교정식(校正式)을 고찰(考察)해 보았다. $^{51}Cr\;T\frac{1}{2}=17.0e^{-0.0495}+18.4e^{-0.000924x}$ 단(但) X : 1일(日) 실혈량(失血量)(단위(單位) ml)

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Interleukin 1 Receptor Antagonist(IL-1ra) Gene Polymorphism in Children with Henoch-$Sch{\ddot{o}}nlein$ Purpura Nephritis (Henoch-$Sch{\ddot{o}}nlein$ Purpura 신염에서 Interleukin 1 Receptor Antagonist(IL-1ra) 유전자 다형성)

  • Hwang, Phil-Kyung;Lee, Jeong-Nye;Chung, Woo-Yeong
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.175-182
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    • 2005
  • Purpose : Interleukin 1 receptor antagonist(IL-1ra) is an endogenous antiinflammatory agent that binds to IL-1 receptor and thus competitively inhibits the binding of IL-1$\alpha$ and IL-1$\beta$. Allele 2 in association with various autoimmune diseases has been reported. In order to evaluate the influence of IL-1ra gene VNTR polymorphism on the susceptibility to HSP and its possible association with disease severity, manifested by severe renal involvement and renal sequelae, we studied the incidence of carriage rate and allele frequency of the 2 repeats of IL-1ra allele 2($IL1RN^{*}2$) of the IL-1ra gene in children with HSP with and without renal involvement. Methods : The IL-1ra gene polymorphisms were determined in children with HSP with(n=40) or without nephritis(n=34) who had been diagnosed at Busan Paik Hospital and the control groups(n=163). Gene polymorphism was identified by PCR amplification of the genomic DNA. Results : The allelic frequency and carriage rate of $IL1RN^{*}1$ were found most frequently in patients with HSP and in controls. The allelic frequency of $IL1RN^{*}2$ was higher in patients with HSP compared to that of controls($4.7\%\;vs.\;2.5\%$, P=0.794). The carriage rate of $IL1RN^{*}2$ was higher In patients with HSP compared to that of controls($8.1\%\;vs.\;6.8\%$, P=0.916). The allelic frequency of $IL1RN^{*}2$ was higher in patients with HSP nephritis compared to that of HSP($5.3\%\;vs.\;2.9\%$, P=0.356). The carriage rate of $IL1RN^{*}2$ was higher in Patients with HSP nephritis compared to that of HSP($10.0\%\;vs.\;5.9\%$, P=0.523). Among 13 patients with heavy proteinuria(>1.0 g), 11 had $IL1RN^{*}1$, 1 had $IL1RN^{*}2$ and the others had $IL1RN^{*}4$. At the time of last follow up 4 patients had sustained proteinuria and their genotype was $IL1RN^{*}1$. Conclusion : The allelic frequency and carriage rate of $IL1RN^{*}1$ were found most frequently in patients with HSP and in controls. Our study suggests that the carriage rate and allele frequency of the 2-repeats of IL-1lra allele 2($IL1RN^{*}2$) of the IL-1ra gene may not be associated with susceptibility and severity of renal involvement in children with HSP (J Korean Soc Pediatr Nephrol 2005;9:175-182)

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