• 한국환경보건학회지
• /
• 제47권2호
• /
• pp.155-165
• /
• 2021

Objectives: Acute exposure to high concentrations of chemicals can occur when a chemical accident takes place. As such exposure can cause ongoing environmental pollution, such as in the soil and groundwater, there is a need for a tool that can assess health effects in the long term. The purpose of this study was assessing the health risks of residents living near a chemical accident site due to long-term exposure while considering the temporal concentration changes of the toxic chemicals leaked during the accident until their extinction in the environment using a multimedia environmental dynamics model. Methods: A health risk assessment was conducted on three cases of formaldehyde chemical accidents. In this study, health risk assessment was performed using a multimedia environmental dynamics model that considers the behavior of the atmosphere, soil, and water. In addition, the extinction period of formaldehyde in the environment was regarded as extinction in the environment when the concentration in the air and soil fell below the background concentration prior to the accident. The subjects of health risk assessment were classified into four groups according to age: 0-9 years old, 10-18 years old, 19-64 years old, and over 65 years old. Carcinogenic risk assessment by respiratory exposure and non-carcinogenic risk assessment by soil intake were conducted as well. Results: In the assessment of carcinogenic risk due to respiratory exposure, the excess carcinogenic risk did not exceed 1.0×10-6 in all three chemical accidents, so there was no health effect due to the formaldehyde chemical accident. As a result of the evaluation of non-carcinogenic risk due to soil intake, none of the three chemical accidents had a risk index of 1, so there was no health effect. For all three chemical accidents, the excess cancer risk and hazard index were the highest in the age group 0-9. Next, 10-18 years old, 65 years old or older, and 19-64 years old showed the highest risk. Conclusion: This study considers environmental changes after a chemical accident occurs and until the substance disappears from the environment. It also conducts a health risk assessment by reflecting the characteristics of the long-term persistence and concentration change over time. It is thought that it is of significance as a health risk assessment study reflecting the exposure characteristics of the accident substance for an actual chemical accident.

• 한국식품위생안전성학회지
• /
• 제35권6호
• /
• pp.587-601
• /
• 2020

국내외적으로 유해물질의 통합 노출에 대한 관심은 높아지고 있다. 이러한 흐름에 따라 다양한 경로를 통해 노출될 수 있는 중금속에 대한 통합 노출 연구가 필요하다. 카드뮴과 납은 각각 신장 독성과 인지 장애 등 다양한 독성을 나타낼 수 있으며 또한 발암 물질로 알려져있다. 따라서 본 연구에서는 카드뮴과 납의 노출량 추정 및 통합 위해성 평가를 진행하였다. 2016, 2017년의 7기 국민건강영양조사에 참여한 10,733명의 식품, 물, 흡연과 간접흡연, 호흡, 화장품, 여성용 위생용품을 통한 중금속 노출 추정량을 계산하였다. 결과적으로 카드뮴과 납 모두 식품을 통한 노출이 제일 높게 나타났다. 이외에도 흡연은 카드뮴의 주요한 노출원이었으며, 납은 화장품을 통해 높은 농도로 노출되었다. 통합 위해평가에서도 식품이 가장 큰 영향을 미쳤다. 지역적 특성의 차이는 노출 추정량의 차이를 보이지 못하였으나, 연령 별, 성별 간 노출 추정량은 큰 차이를 보였다. 특히, 월경 중인 성인 여성의 경우 카드뮴, 월경 중이지 않은 여성은 납의 노출 추정량이 더 높으며 신체 대사를 고려하였을 때, 그 위험성이 더 클 수 있음을 암시하였다. 결론적으로 노출량 추정 및 통합 위해평가 모두 식품이 주요 노출원이었다. 다만, 잠재적 위험을 방지하기 위해 다른 경로에 대한 노출량 추정 및 위해평가가 요구된다.

• 한국지반환경공학회 논문집
• /
• 제16권4호
• /
• pp.5-12
• /
• 2015

사면붕괴의 위험성이 있는 다양한 실계측 데이터들이 토목기술자들에게 주어졌지만 이를 해석, 가공 후 실시간 사면거동양상을 분석하고 사면안정에 대한 결론을 유도하는 일은 결코 쉬운 일이 아니다. 최근 많은 연구기관들이 실시간 계측시스템을 위험 사면 현장에 설치하고 이를 계측하고 있으나, 대부분이 하드웨어 시스템의 설치에 초점을 맞추고 있어 이들 계측시스템에서 구한 실시간 계측자료를 해석하는 소프트웨어는 상대적으로 약하다고 할 수 있다. 그러므로 이 연구는 시간에 따라 변위가 지속적으로 증가하는 사면거동에 대한 계측자료들이 서로 어떤 상호관련성이 있고 군집화되는지를 보여주고자 하는 데 목적이 있다. 실시간 계측자료들을 분류함에 있어 저자들은 세 가지의 수학적 개념을 사용하고자 한다. 즉 평균변위차지수($AD_{i,j}$), 평균상대변위차($\overline{RD}_{i,j}$) 및 평균상대좌표시스템($\overline{RD}$, AD)을 사용하고자 한다. 이 세 가지 개념은 통계학적 방법 및 사면파괴거동에 토대를 두고 있다. 그러므로 이 방법들은 파괴거동을 일으키는 같은 대상 사면영역의 군집특성을 보여준다.

• Korean Journal of Radiology
• /
• 제25권3호
• /
• pp.277-288
• /
• 2024

Objective: We previously found that the incidence of sarcopenia increased with declining glucose metabolism of muscle in patients with treatment-naïve diffuse large B-cell lymphoma (DLBCL). This study aimed to investigate the relationship between sarcopenia and muscle glucometabolism using ¹⁸F-FDG PET/CT at baseline and end-of-treatment, analyze the changes in these parameters through treatment, and assess their prognostic values. Materials and Methods: The records of 103 patients with DLBCL (median 54 years [range, 21-76]; male:female, 50:53) were retrospectively reviewed. Skeletal muscle area at the third lumbar vertebral (L3) level was measured, and skeletal muscle index (SMI) was calculated to determine sarcopenia, defined as SMI < 44.77 cm²/m² and < 32.50 cm²/m² for male and female, respectively. Glucometabolic parameters of the psoas major muscle, including maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean), were measured at L3 as well. Their changes across treatment were also calculated as ΔSMI, ΔSUVmax, and ΔSUVmean; Δbody mass index was also calculated. Associations between SMI and the metabolic parameters were analyzed, and their associations with progression-free survival (PFS) and overall survival (OS) were identified. Results: The incidence of sarcopenia was 29.1% and 36.9% before and after treatment, respectively. SMI (P = 0.004) was lower, and sarcopenia was more frequent (P = 0.011) at end-of-treatment than at baseline. The SUVmax and SUVmean of muscle were lower (P < 0.001) in sarcopenia than in non-sarcopenia at both baseline and end-of-treatment. ΔSMI was positively correlated with ΔSUVmax of muscle (P = 0.022). Multivariable Cox regression analysis showed that sarcopenia at end-of-treatment was independently negatively associated with PFS (adjusted hazard ratio [95% confidence interval], 2.469 [1.022-5.965]), while sarcopenia at baseline was independently negatively associated with OS (5.051 [1.453-17.562]). Conclusion: Sarcopenic patients had lower muscle glucometabolism, and the muscular and metabolic changes across treatment were positively correlated. Sarcopenia at baseline and end-of-treatment was negatively associated with the prognosis of DLBCL.

• Korean Journal of Radiology
• /
• 제23권2호
• /
• pp.159-171
• /
• 2022

Objective: This study aimed to investigate the impact of baseline values and temporal changes in body composition parameters, including skeletal muscle index (SMI) and visceral adipose tissue area (VAT), measured using serial computed tomography (CT) imaging on the prognosis of operable breast cancers in Asian patients. Materials and Methods: This study retrospectively included 627 Asian female (mean age ± standard deviation [SD], 53.6 ± 8.3 years) who underwent surgery for stage I-III breast cancer between January 2011 and September 2012. Body composition parameters, including SMI and VAT, were semi-automatically calculated on baseline abdominal CT at the time of diagnosis and follow-up CT for post-treatment surveillance. Serial changes in SMI and VAT were calculated as the delta values. Multivariable Cox regression analysis was used to evaluate the association of baseline and delta SMI and VAT values with disease-free survival. Results: Among 627 patients, 56 patients (9.2%) had breast cancer recurrence after a median of 40.5 months. The mean value ± SD of the baseline SMI and baseline VAT were 43.7 ± 5.8 cm²/m² and 72.0 ± 46.0 cm², respectively. The mean value of the delta SMI was -0.9 cm²/m² and the delta VAT was 0.5 cm². The baseline SMI and VAT were not significantly associated with disease-free survival (adjusted hazard ratio [HR], 0.983; 95% confidence interval [CI], 0.937-1.031; p = 0.475 and adjusted HR, 1.001; 95% CI, 0.995-1.006; p = 0.751, respectively). The delta SMI and VAT were also not significantly associated with disease-free survival (adjusted HR, 0.894; 95% CI, 0.766-1.043; p = 0.155 and adjusted HR, 1.001; 95% CI, 0.989-1.014; p = 0.848, respectively). Conclusion: Our study revealed that baseline and early temporal changes in SMI and VAT were not independent prognostic factors regarding disease-free survival in Asian patients undergoing surgery for breast cancer.

• Korean Circulation Journal
• /
• 제53권11호
• /
• pp.744-755
• /
• 2023

Background and Objectives: Aortic valve replacement (AVR) is considered a class I indication for symptomatic severe aortic stenosis (AS). However, there is little evidence regarding the potential benefits of early AVR in symptomatic patients diagnosed with normal-flow, low-gradient (NFLG) severe AS. Methods: Two-hundred eighty-one patients diagnosed with symptomatic NFLG severe AS (stroke volume index ≥35 mL/m², mean transaortic pressure gradient <40 mmHg, peak transaortic velocity <4 m/s, and aortic valve area <1.0 cm²) between January 2010 and December 2020 were included in this retrospective study. After performing 1:1 propensity score matching, 121 patients aged 75.1±9.8 years (including 63 women) who underwent early AVR within 3 months after index echocardiography, were compared with 121 patients who received conservative care. The primary outcome was a composite of all-cause death and heart failure (HF) hospitalization. Results: During a median follow-up of 21.9 months, 48 primary outcomes (18 in the early AVR group and 30 in the conservative care group) occurred. The early AVR group demonstrated a significantly lower incidence of primary outcomes (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.29-0.93; p=0.028); specifically, there was no significant difference in all-cause death (HR, 0.51; 95% CI, 0.23-1.16; p=0.110), although the early AVR group showed a significantly lower incidence of hospitalization for HF (HR, 0.43; 95% CI, 0.19-0.95, p=0.037). Subgroup analyses supported the main findings. Conclusions: An early AVR strategy may be beneficial in reducing the risk of a composite outcome of death or hospitalization for HF in symptomatic patients with NFLG severe AS. Future randomized studies are required to validate and confirm our findings.

• Tuberculosis and Respiratory Diseases
• /
• 제87권2호
• /
• pp.176-184
• /
• 2024

Background: Results of studies investigating the association between body mass index (BMI) and mortality in patients with coronavirus disease-2019 (COVID-19) have been conflicting. Methods: This multicenter, retrospective observational study, conducted between January 2020 and August 2021, evaluated the impact of obesity on outcomes in patients with severe COVID-19 in a Korean national cohort. A total of 1,114 patients were enrolled from 22 tertiary referral hospitals or university-affiliated hospitals, of whom 1,099 were included in the analysis, excluding 15 with unavailable height and weight information. The effect(s) of BMI on patients with severe COVID-19 were analyzed. Results: According to the World Health Organization BMI classification, 59 patients were underweight, 541 were normal, 389 were overweight, and 110 were obese. The overall 28-day mortality rate was 15.3%, and there was no significant difference according to BMI. Univariate Cox analysis revealed that BMI was associated with 28-day mortality (hazard ratio, 0.96; p=0.045), but not in the multivariate analysis. Additionally, patients were divided into two groups based on BMI ≥25 kg/m² and underwent propensity score matching analysis, in which the two groups exhibited no significant difference in mortality at 28 days. The median (interquartile range) clinical frailty scale score at discharge was higher in nonobese patients (3 [3 to 5] vs. 4 [3 to 6], p<0.001). The proportion of frail patients at discharge was significantly higher in the nonobese group (28.1% vs. 46.8%, p<0.001). Conclusion: The obesity paradox was not evident in this cohort of patients with severe COVID-19. However, functional outcomes at discharge were better in the obese group.

• 농약과학회지
• /
• 제19권3호
• /
• pp.151-160
• /
• 2015

2010년부터 2012년까지 서울 가락동 농수산물도매시장에서 경매되는 채소류 중 들깻잎 4,063건 상추 2,248건을 대상으로 잔류농약 검사를 실시하였다. 들깻잎은 812건에서 농약이 검출되었고 40건이 부적합판정을 받았다. 상추의 경우 108건에서 농약이 검출되었고 잔류허용기준을 초과한 상품은 10건이었다. 검출된 농약은 들깻잎 61종, 상추는 28종이었다. 들깻잎 및 상추 섭취에 따른 다종농약 성분에 대한 안전성 평가는 들깻잎이 0.05% 이하, 상추가 0,1% 이하로서 인체에 대한 위해성은 낮은 것으로 평가되었다.

• Journal of Hospice and Palliative Care
• /
• 제17권3호
• /
• pp.170-178
• /
• 2014

목적: 섬망은 말기암환자에서 생길 수 있는 중요한 합병증으로 임상적으로나 삶의 질 적인 측면에서 매우 중요한 문제이다. 이에 호스피스 병동에 입원한 말기암 환자에서 섬망 발생과 관계된 위험 요인들을 알고자 연구를 시행하였다. 방법: 2011년 5월부터 2012년 9월까지 일개 지역 두개의 종합병원 내 호스피스 병동에 입원한 환자 중 의식이 명료하고 다른 정신과적 질환이나 약물 중독이 없는 환자를 대상으로 전향적으로 추적하여 섬망 발생 여부를 확인하였다. DSM-IV 진단기준에 맞게 2명의 의사에 의해 진단된 경우 섬망군으로 분류하였다. 입원 시 인지기능(mini-mental status examination, MMSE), 우울 점수(Beck depression inventory, BDI), 불안 점수, 불면 척도(Insomnia Severity Index, ISI), 혈액검사 결과와 섬망 발생 여부를 로지스틱 회귀분석으로 비교하고, 유의한 항목에 대해 Cox의 비례위험모형으로 교차비를 구하였다. 결과: 선정기준에 부합하는 연구 대상자 96명 중 41명(42.7%)에서 섬망이 발생하였다. 로지스틱 회귀분석 결과 일차 암 위치, 인지기능 장애(MMSE < 24), 우울($BDI{\geq}16$), 불면($ISI{\geq}15$)의 Odds ratio (OR)이 통계적으로 유의한 결과를 보였다. 이들 4가지 인자에 대해 입력 방법을 이용해 시행한 Cox 회귀분석 결과, 우울의 OR 5.130(95% CI 2.009~13.097), 인지기능저하의 OR 5.130 (95% CI 2.009~13.097)로 나타났다. 결론: 호스피스 병동에 입원한 말기암환자에서 우울하거나 인지기능 장애가 있을 경우 섬망 발생의 위험이 유의하게 높았다. 호스피스 환자에게 우울이나 인지기능에 대한 주의 깊은 관찰이 필요할 것이다.

• 한국식품위생안전성학회지
• /
• 제16권1호
• /
• pp.21-26
• /
• 2001

유기인계 농약은 주로 수확률을 증가시킬 목적으로 과일, 채소, 곡류를 포함한 농산물에 사용하는 살충제로, 최근의 위해성평가기술은 독성기전이 동일한 물직들에 대해서 기준이 되는 물질의 특성을 1로하여 상대독성계수를 고려하므로 동시노출평가(cumulative risk assessment)를 수행하고 있다. 본 연구에서는 식품섭취를 통한 유기인계 농약의 동시다중노출에 기인된 위해정도를 판단하기 위하여 유기인계 농약과 다소비노출가능식품 등을 대상으로 cumulative risk assessment 를 실시코자 하였다. 펑가에 고려된 농약은 우리나라에서 사용빈도가 높은 농약(Acephate, Azinphos-methyl, Chlorpyrifos, Diazinon, Dimethoate, Ethion, Malathion, Methamidophos, Methidathion, Parathion-methyl, Phosmet, Pirimiphos-methyl) 12종이었고, 평가대상식품은 국내에서 유통되는 다소비식품을 위주로 곡류 4종(쌀, 보리, 밀, 옥수수), 과일류 5종(사과, 감, 밀감, 바나나, 배), 및 채소류 13종(배추, 양배추, 상추, 시금치, 오이, 토마토, 호박, 양파, 고추, 마늘, 무, 파, 당근)을 포함하여 총 22종의 식품을 대상으로 하였으며, 시료의 대표성을 부여하기 위하여 샘플링은 전국 4개 대도시(서울, 부산, 광주, 대전)를 대상으로 총2회 실시하였다. 12종의 유기인계 농약의 동시다중 노출에 대한 위해성평가를 위하여 노출평가시 TEF(독성등가치, Toxic Equivalency Factor) 방법을 적용하였고, FAO/WHO 의 만성인체노출평가방법을 기초로 우리나라 일반 성인을 대상으로 다수의 식품섭취를 통한 다수의 농약에 대한, 동시인체노출평가를 실시하였다. 노출의 안전수준을 결정하기 위해 필요한 독성값은 chlorpyrifos를 기준으로 하여 U.S.EPA 에서 제시한 AChE저해작용을 endpoint로 하는 RfD 값을 활용하였으며, 다수의 유기인계 농약으로부터 동시노출 되었을 때 나타날 수 있는 비발암독성에 대한 위해도를 결정하기 위하여 위험지수(Hazard Index, HI) 방법을 사용하였다.