• 한국환경보건학회지
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• 제50권2호
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• pp.125-137
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• 2024

Background: The Korea Risk Information Surveillance System (K-RISS) was developed to enable the early detection of food and drug safety-related issues. Its goal is to deliver real-time risk indicators generated from ongoing food and drug risk monitoring. However, the existing K-RISS system suffers under several limitations. Objectives: This study aims to augment K-RISS with more detailed indicators and establish a severity standard that takes into account structural changes in the daily time series of K-RISS values. Methods: First, a Delphi survey was conducted to derive the required weights. Second, a control chart, commonly used in statistical process controls, was utilized to detect outliers and establish caution, attention, and serious levels for K-RISS values. Furthermore, Bai and Perron's method was employed to determine structural changes in K-RISS time series. Results: The study incorporated 'closeness to life' and 'sustainability' indicators into K-RISS. It obtained the necessary weights through a survey of experts for integrating variables, combining indicators by data source, and aggregating sub K-RISS values. We defined caution, attention, and serious levels for both average and maximum values of daily K-RISS. Furthermore, when structural changes were detected, leading to significant variations in daily K-RISS values according to different periods, the study systematically verified these changes and derived respective severity levels for each period. Conclusions: This study enhances the existing K-RISS system and introduces more advanced indicators. K-RISS is now more comprehensively equipped to serve as a risk warning index. The study has paved the way for an objective determination of whether the food safety risk index surpasses predefined thresholds through the application of severity levels.

• Tuberculosis and Respiratory Diseases
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• 제52권4호
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• pp.385-394
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• 2002

연구배경: 굴곡성 기관지내시경 검사는 검사로 인한 합병증 및 치명률이 적어 각종 폐질환의 진단 및 치료에 널리 사용되고 있다. 그러나 심, 폐기능이 심하게 저하된 환자에서도 기관지경검사가 필요한 경우가 많고, 기관지 내시경 시술중의 저산소혈증이 심각한 심부정맥을 초래할 수도 있기 때문에 저산소혈증의 조기발견 및 적절한 처치는 임상적으로 중요하다. 방 법: 1997년 1월3일부터 1997년 6월 30일까지 경북대학교병원 호흡기내과에서 경기관지폐생검과 기관지 폐포 세척술을 제외한 진단 목적을 기관지내시경 검사를 시행한 379예의 환자를 대상으로 pulse oxmetry를 이용하여 기관지내시경검사를 시행하는 동안과 시술전후에 동맥혈 산소포화도를 지속적으로 감시하였다. 결 과: 1) 남자가 263명, 여자가 116명으로 평균연령은 55세였다. 검사전 시행한 폐기능검사 성적 가운데 FVC는 추정정상치의 백분율의 평균이 $78.9{\pm}20.01%$, $FEV_1$는 추정정상치의 백분율의 평균이 $72.58{\pm}23.89%$, 그리고 $FEV_1/FVC%$는 $66.4{\pm}14.05%$ 이었다. 2) 시술전 기저 동맥혈 산소포화도는 평균 $96.9{\pm}2.85%$였으며, 379예 가운데 62예(16.4%)에서 저산소혈증($SaO_2$ <90%)이 발생하였다. 저산소혈증이 발생한 시기는 기관지경 시술전, 중, 후 각각 12, 37, 13예이었다. 3) 저산소혈증이 있었던 환자들의 성별분포 및 흡연력은 저산소혈증이 없었던 대조군과 유의한 차이가 없었으나, 평균연령은 $59.3{\pm}13.52$세로 정상군의 $54.8{\pm}16.52$세 보다 유의하게 많았고, 기저 산소포화도는 $93.7{\pm}4.29%$로 정상군의 $97.5{\pm}1.89%$에 비해 유의하게 낮았다. 시술시간은 저산소혈증이 있었던 군은 $17.6{\pm}8.93$ 분으로 대조군의 $12.0{\pm}6.30$ 분에 비해 유의하게 길었다. 4) 저산소혈증이 있었던 군의 $FEV_1$은 추정정상치의 백분율의 평균이 $63.6{\pm}22.79%$로 대조군의 $73.9{\pm}23.83%$ 보다 유의하게 낮았고, FVC 및 $FEV_1/FVC%$도 저산소혈증이 있었던 군에서 대조군보다 낮은 경향이었다. 5) 시술전에 저산소혈증이 있었던 12예 가운데 10예는 저농도의 산소투여로 시술을 무사히 진행하였고, 2예는 지속적인 저산소혈증으로 검사를 중단하였다. 시술동안 저산소혈증이 발생한 37예 가운데 27예는 산소투여로, 9예는 깊은 호흡으로 저산소혈증이 소실되었고 1예는 시술을 중단하였다. 시술 후에 저산소혈증이 발생한 13예의 경우 11예는 저산소혈증이 즉시 소실되었으며 2예는 산소투여가 필요하였다. 결 론: 이상의 결과로 기관지 내시경검사시 지속적인 동맥혈 산소포화도의 감시가 필요하며, 특히 저산소혈증의 빈도가 높은 폐기능이 저하된 환자에서는 저산소혈증의 조기발견과 적절한 조치를 위해 반드시 시행해야 할 것으로 생각된다.

• Parasites, Hosts and Diseases
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• 제54권3호
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• pp.307-313
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• 2016

Serosurveillance for zoonotic diseases in small mammals and detection of chiggers, the vector of Orientia tsutsugamushi, were conducted from September 2014 to August 2015 in Gwangju Metropolitan Area. Apodemus agrarius was the most commonly collected small mammals (158; 91.8%), followed by Myodes regulus (8; 4.6%), and Crocidura lasiura (6; 3.5%). The highest seroprevalence of small mammals for O. tsutsugamushi (41; 26.3%) was followed by hantaviruses (24; 15.4%), Rickettsia spp. (22; 14.1%), and Leptospira (2; 1.3%). A total of 3,194 chiggers were collected from small mammals, and 1,236 of 3,194 chiggers were identified with 7 species of 3 genera: Leptotrombidium scutellare was the most commonly collected species (585; 47.3%), followed by L. orientale (422; 34.1%), Euchoengastia koreaensis (99; 8.0%), L. palpale (58; 4.7%), L. pallidum (36; 2.9%), Neotrombicula gardellai (28; 2.3%), and L. zetum (8; 0.6%). L. scutellare was the predominant species. Three of 1,236 chigger mites were positive for O. tsutsugamushi by PCR. As a result of phylogenetic analysis, the O. tsutsugamushi strain of chigger mites had sequence homology of 90.1-98.2% with Boryong. This study provides baseline data on the distribution of zoonotic diseases and potential vectors for the development of prevention strategies of vector borne diseases in Gwangju metropolitan area.

• 농약과학회지
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• 제10권2호
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• pp.91-98
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• 2006

일본의 시중 판매 및 노지재배 시금치 중 다이옥신 잔류함량을 평가하여 다이옥신 분석에 적정한 농산물 시료량을 검토함과 동시에 농작물과 재배환경 중 잔류함량 상관성에 대하여 다이옥신 동족체별로 비교 연구하였다. 1 Kg 미만을 처리한 시판되는 시금치의 OCDF은 베이스라인에 가깝게 검출되었으나, 2 kg 이상을 처리한 노지재배 시금치의 경우 확실하게 검출되었다. 시판 시금치 재배환경의 대기 중 다이옥신 동족체별 잔류함량 경향이 노지재배 시금치의 재배환경과 유사한 경향을 나타내므로, 정확한 다이옥신 peak 평가를 하기 위해서는 2 kg이상의 시료가 필요하다는 결과를 얻었다. 또한 노지재배 시금치 잎 중 다이옥신 동족체별 잔류함량의 전체 경향을 비교하면 토양에 분포하고 있는 OCDD와 HCDF의 영향을 받은 듯하나 전체적으로는 대기 강하물에 의한 영향이 주요 요인으로 판단된다.

• 한국해양학회지:바다
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• 제25권4호
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• pp.81-96
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• 2020

해수 중 용존 암모늄 분석에는 Berthlot's 반응의 분광광도법이 일반적으로 사용되었으나, 최근에는 OPA (orthophthaldialdehyde-sulfite) 형광시약을 이용한 형광법이 국제적으로 활발하게 사용되고 있다. 본 연구에서는 2017년도 호주연구선 Investigator에서 수행된 국제 영양염 선상 상호비교 실험에서 두 기관(KIOST(분광광도법, 1차 선형 회귀식 기울기만 사용), 호주CSIRO(형광법, 2차 비선형 회귀식 사용))간의 영양염 표준물질과 현장 해수시료의 용존 암모늄 농도값 차이(약 0.31 𝜇M)의 원인을 이해하기 위해 분석방법 간 검출한계, 분광광도법에 내재된 시약 굴절률, 검량선식 등에 의한 영향을 고찰하였다. 본 연구에서 측정된 분광광도법의 방법검출한계(0.063 𝜇M)와 시약 굴절률 바탕값(0.054 𝜇M)은 두 기관의 용존 암모늄 농도값 차이를 각각 20%, 17% 정도 설명할 수 있었다. 그러나 분광광도법의 검량선을 형광법과 동일한 2차식 또는 선형회기식의 기울기와 절편으로 농도를 계산할 경우, 두 기관 간의 용존 암모늄 농도값 차이는 현장에서 측정된 분광광도법의 방법검출한계 이하로 줄었다. 따라서 국제 영양염 선상 상호비교 실험에서 영양염 표준물질과 해수 현장시료에서 나타난 두 기관 간의 용존 암모늄 농도값 차이는 분광광도법과 형광법의 분석방법 차이에 의한 영향보다는 두 방법에 사용된 상이한 검량선식 영향인 것으로 판단된다. 향후 해수시료의 용존 암모늄 자료를 비교할 때 분석방법의 차이보다는 분석에 사용된 기저선, 표준용액열 개수, 검량선식 등에 대한 정보에 유의할 것을 권장한다.

• Tuberculosis and Respiratory Diseases
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• 제47권3호
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• pp.321-330
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• 1999

배경: 인공호흡기 연관 폐렴(ventilator-associated pneumonia, 이하 VAP)의 원인균 동정의 표준적인 방법으로는 기관지내시경을 통한 검체보호솔질법(protected specimen brush, 이하 PSB)이 인정되고 있다. 그러나 PSB가 고가이고 국내의 경우 전량 수입에 의존하고 있어 보편적으로 사용하기 어렵다. VAP의 진단에는 PSB외에 기관지폐포세척술(bronchoalveolar lavage, 이하 BAL)이 흔히 이용되나 호흡부전으로 인공호흡기를 사용하는 환자에서 다량의 BAL을 시행하기 어렵고, 시술 후 환자 상태가 악화될 수도 있다. 이에 저자들은 기왕에 항생제를 투여 받고 있던 중 VAP가 발생한 환자들을 대상으로 바이러스를 포함한 원인균의 동정 검사에 필요한 최소한의 BAL검체(25 ml) 만 채취하는 소량의 BAL(이하 miniBAL)을 시행하여 동일한 부위에서 시행한 PSB에 의한 세균 배양 검사 성적과 비교함으로써 miniBAL 검사의 진단적 효용성을 알아보고자 하였다. 방법: 연구는 1997년 5월 1일부터 1998년 8월 31일까지 서울 중앙병원 성인 중환자실에서 항생제를 투여 받고 있던 중 연속적으로 VAP가 발생한 38명(41 예)의 환자를 대상으로 하였다. 환자들의 평균연령은 $61{\pm}14$세이었으며 남녀 비는 3.6:1 이었다. PSB는 단순 흉부사진상 병변이 심한 부위에서 시행하였고, 동일부위에서 miniBAL을 연속적으로 시행하였다. miniBAL은 생리식염수를 50 ml씩 투여하여 총 25 ml가 모일 때까지 세척을 반복하였다. VAP 원인균의 판정 기준은 PSB와 BAL을 통해 얻은 검체를 정량 배양법으로 배양한 뒤 PSB는 $10^3cfu/ml$ 이상, BAL은 $10^4cfu/ml$ 이상인 경우에 양성으로 판정하였다. 결과: 25 ml BAL을 얻기 위해 기관지 내시경을 통해 주입한 생리 식염수의 양은 평균 $93{\pm}32ml$ 였다. PSB의 경우에는 총 41예 중 19예(46.3%), miniBAL의 경우 18예(43.9%)에서 원인균이 검출되었다. PSB와 miniBAL은 41예 중에서 35예에서 일치하는 결과를 나타내어 진단 일치율은 85.4%였다. VAP가 호전된 환자는 39명 중에서 19명(48.7%)이었고 miniBAL과 PSB를 통해 원인균이 발견된 환자들(12/19 명, 63.2%)이 발견되지 않았던 환자들(7/20명, 35%)에 비해 VAP 호전율은 높았으나 두 군사이의 통계학적 차이는 없었다(P>0.2). 검사 전, 검사 중 그리고 검사 후의 분당 평균 심 박동수는 각각 $111{\pm}22$회, $125{\pm}24$회, $111{\pm}26$회이었으며 동맥혈 산소분압은 각각 $97{\pm}3%$, $92{\pm}10%$, $95{\pm}3%$ 이었다. 검사 전파 검사 중의 심 박동수는 유의하게 증가되었으나 (p<0.05) 검사 전과 검사 10분 후의 심 박동수는 차이가 없었다(p>0.5). 검사 전과 비교하여 검사 중과 (p<0.05) 검사 후의 (p<0.005) 동맥혈 산소포화도는 유의하게 저하되었으나 모두 정상범위 내에 있었다. 검사 시행 중 저혈압 2예, 동맥 산소 분압의 저하 3 예의 부작용이 있었으나 검사 종료후 곧 회복되었고, 심방조동(atrial flutter)으로 l예에서 검사가 중단되었으나 8일 후에 문제 없이 miniBAL이 시행되었다. 결론: MiniBAL 배양검사의 결과는 PSB에 의한 결과와 높은 일치율을 보이고 비교적 안전한 검사방법이므로 VAP 의 원인균 규명에 PSB와 고식적인 BAL을 대치할 수 있는 진단 방법으로 사료된다.

• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.747-761
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• 1994

Workers' periodic health examination is the main tools used to manage the health problems of most workers in Korea. The most common health problem found in workers' periodic health examination is liver disorder. Liver disorder is also one of the most common health problems in general population and one of the leading causes of mortality in adult population. Regulation proposed by government (No. 207, Ministry of Labor, 1992) defines the criteria for selection of workers with the liver dysfunction for further evaluative examination and the examination items used for diagnosis of the workers with liver dysfunction. This study was designed to evaluate the proficiency of each examination items presently defined in Regulation and propose the optimal examination items for detection of the liver disorders found by workers' periodic health examination. Study subjects are 186 workers with abnormal liver function tests in screening examination of workers' periodic health examination. Questionnaire survey including past history of liver disorder, drinking history, height and weight was done. Physical examination by physician, routine test items defined by Regulation (SGOT, SGPT, $\gamma$-GTP, protein, albumin, total and direct bilirubin, alkaline phosphatase, $\alpha$-feto protein, HBsAg and anti-HBs), anti-HCV antibody test and liver ultrasonography were done. Results are as follows; 1. Result of evaluative examination utilizing only the items defined in Regulation was; There were 75 workers with suspected live. disorder(40.3%), 63 with no liver dysfunction (33.9%), 13 with suspected hepatitis B(7.0%), 10 workers with hepatitis B(5.4%), 10 workers with hepatitis B carrier state(5.4%), 10 with alcoholic liver disorders(5.4%), 5 with fatty liver(2.7%). When alternative diagnostic criteria applying additional examination items (drinking history, body mass index, anti-HCV antibody and ultrasonography) diagnosability of liver disorder was increased. When all four items were included, final results were; 23 workers (17.8%) with hepatitis B (10 carriers, 13 suspects and 10 hepatitis B), 10 (5.4%) with hepatitis C(4 carriers, 5 suspects and 1 hepatitis C), 13(7.0%) with alcoholic liver disorder, 45(24.2%) with fatty liver (40 suspects, 5 fatty liver), 410%) with suspected liver disorders and 44 (23.7%) with normal liver. 2. Of examination items defined by Regulation, only SGOT, SGPT, $\gamma$-GTP and HBsAg were significantly different in abnormal rate and mean value, and all other laboratory findings did not showed significant difference between two groups. Drinking history, body mass index and anti-HCV antibody test which are the items that authors included in this study, also showed significant difference between two groups. Utilization of body mass index (BMI) for abnormal liver function group in diagnosis of fatty liver had high specificity (97.6%) but sensitivity (22.3%) was low. Therefore we suggest that SGOT, SGPT, $\gamma$-GTP, HBsAg, alcohol drinking history, BMI and anti-HCV Ab were useful for diagnosis of liver disorders among worker's periodic health examination.

• 대한핵의학회지
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• 제26권1호
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• pp.72-81
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• 1992

Pharmacologic coronary vasodilation in conjunction with myocardial scintigraphy has become an accepted alternative to dynamic exercise testing for the diagnosis of coronary artery disease. Although dipyridamole has traditionally been used for this purpose, it causes frequent side effect, which at times can be life-threatening. Moreover, dipyridamole dose not elicit maximal coronary vasodilation in a substantial number of patients receiving the usual i.v. dose. Adenosine is an endogenously produced compound that has significant effects as a coronary vasodilator and rapid onset action and extremely short half-life (< 10 seconds). The diagnostic accuracy and safety profile of adenosine $^{99m}Tc-MIBI$ myocardial scintigraphy were evaluated and comparison with exercise $^{99m}Tc-MIBI$ was performed. Twenty-eight subjects underwent $^{99m}Tc-MIBI$ imaging after adenosine infusion and exercise $^{99m}Tc-MIBI$ imaging. Adenosine was infused intravenously at a dose of 0.14mg/kg/body weight per minute for 6 min and MIBI was injected at 3 minute. Adenosine caused an incerease in heart rate ($64{\pm}12$ at baseline versus $74{\pm}16$ beats/min at peak effect, p<0.001), a mild decrease in systolic and diastolic blood pressure and a slightly increase in PR interval(p; NS). Side effects were reported in 92% of patients and were mostly mild in nature and promptly resolved within 1 or 2 minutes of termination of adenosine infusion. Facial flushing (53%), chest pain (36%), mild dyspnea (39%), headache (21%), throat discomfort (21%) were frequent symptoms. ST segment depression (> 1 mm) and second degree AV block in electrocardiography occured in 11% of the patients, respectively. The overall sensitivity and specificity for individual coronary stenoses in 16 patients underwent coronary angiography were 88% and 95%, respectively. The agreement ratio of segmental perfusion between adenosine and exercise images was 92% (Kappa index=0.82). In conclusion, $^{99m}Tc-MIBI$ myocardial perfusion scintigraphy with intravenous adenosine is a feasible, safe and highly accurate noninvasive technique for the detection of coronary artery disease and results are at least comparable with those of exercise $^{99m}Tc-MIBI$ scintigraphy.

• Journal of Preventive Medicine and Public Health
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• 제39권3호
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• pp.229-234
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• 2006

Objectives: Cardiovascular disease is one of the main causes of death and morbidity in Korea. In this study, the prevalence and incidence of developing hypertension in a male-workers' cohort were investigated during 3-years follow-up with a view to find the risk factors that affected the development of hypertension. Methods: Among the 5,374 people who participated in a routine health check up, 3,852 people with normal blood pressure and who had no history of hypertension were prospectively followed up for 3 years. The classification of hypertension was based on the JNC7 report (the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure). Life style factors and underlying diseases that were related to the risk factors of hypertension were collected by using a self-report questionnaires via the internet. Results: The prevalence of hypertension was 28.3% (1,520/5,374) at the first screening (2001). It was found that the incidence in 2004 of hypertension for the follow-up subjects (3,711) who had normal blood pressure in 2001 was 7.6 per 100 person-year. Multiple logistic regression analysis of the variables related to the risk factors of hypertension was carried out. The relative risks were 1.037 (95% CI=1.022-1.053) as the age increased 1 year and 1.039 (95% CI=1.023-1.055) as the body mass index increased $1kg/m^2$. The relative risk for the prehypertensive group was 2.501 (95% CI=1.986-3.149) compared to the normotensive group. These results showed that age, body mass index and the baseline blood pressure were significantly related to the incidence of hypertension. Conclusions: The incidence of hypertension was 7.6 per 100 person-year during follow-up. It was concluded that the risk factors for developing hypertension in the short-term were age, BMI, and prehypertension; Especially, this showed that it is necessary for prehypertensives to manage their body weight and blood pressure to prevent hypertension in middle-age by modifying their life style.

• 한국임상약학회지
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• 제22권4호
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• pp.330-339
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• 2012

Background : Hypertension is treated with both lifestyle modification and pharmacotherapy. The Seventh Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7), published in 2003, provides a streamlined management approach to hypertension for the primary care physician. The JNC-7 is the gold standard also in Korea. According to the JNC-7, special therapeutic considerations are recommended for high-risk individuals with compelling indications. The presence of compelling indications in any given patient should be considered when selecting specific pharmacotherapy to treat hypertension. However, in patients with compelling indications, it is unknown that hepatotoxicity is caused by Calcium Channel Blocker (CCB), one of 1st anti-hypertensive drugs. Now, the CCB is the most used 1st anti-hypertensive drug in Korea Therefore, we evaluated the changes in blood liver function parameters (ALT, AST, Total bilirubin, serum albumin) for the study group. Methods : We randomly collected and retrospectively analyzed Electronic Medical Record data (n=28,788) of patients, and who took calcium channel blockers(non-dihydropyridines; diltiazem, verapamil, dihydropyridines; amlodipine, barnidipine, benidipine, clinidipine, efonidipine, felodipine, isradipine, lacidipine, lercanidipine, nicardipine, nifedipine, nimodipine), with having liver function tests (LFTs) from July 1st 2009 to June 30th 2010 at the Seoul National University Hospital in Korea. Control groups are two antihypertensive agents: RAS blockade (ARB; candesartan, irbesartan, losartan, olmesartan, telmisartan, valsartan, ACE-I; cilazapril, enalapril, fosinopril, imidapril, perindopril, ramipril) and, Diuretics (loop; furosemide, torsemide, thiazide; hydrochlorothiazide[HCTZ], indapamide). Patients not having LFT results at these three standard points of time(baseline, during, medication, and after finishing medication) were excluded. The collected data were analyzed by using the SPSS (Version12.0) and Microsoft Excel (Version2007). Results : 711 patients who were treated CCB (297), RAS blockade (232) or Diuretics (182) monotherapy were selected for the study. In selected patients, liver damage degree(changes of each LFTs value) was higher in diuretics group than other groups, followed by RAS blockade and CCB. In diuretics group's was loop-diuretics group was higher than thiazide-diuretics group. In CCB group, Nondihydropyridine-CCB's damage degree was higher than Dihydropyrine-CCB's that. Conclusions : Despite the limitations due to the retrospective study, among patients with abnormal LFTs, the use of CCBs led to a less liver damage than other 1st anti-hypertensive agents. It can be recommended CCBs as one of the initial treatments of hypertension in patients with liver disease.