만성 B형 간염에서 라미부딘 치료중 발생한 Viral Breakthrough 예의 임상 결과

안수현,장윤정,오성남,최도원,백수정,정원석,최창원,김경오,임형준,조남영,박종재,김재선,박영태,이명석,연종은,변관수,이창홍 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.4

목적: 만성 B형 간염의 치료 중 발생하는 약제 내성 변이종은 임상적으로는 치료 중 음전되었던 혈청 HBV DNA가 다시 양전되는 viral breakthrough 로 진단할 수 있다. 현재 약제 내성 변이종이 발생했을 경우라도 라미부딘 치료를 계속 유지하는 것을 권장하고 있으나, viral breakthrough 발생 예들의 장기적 임상경과가 아직도 불명확하여 이것을 일반화하기는 어려운 상황이다. 이에 라미부딘 사용 중 viral breakthrough 가 발생한 예들을 대상으로 그 임상경과를 알아보고자 하였다. 대상과 방법: 9개월 이상 라미부딘을 투약한 만성 B형 간염 환자로 viral breakthrough가 발생한 74명을 대상으로 하였다(남/여 54/20, 평균연령 42세). Viral breakthrough 후 혈청 ALT치, 총 빌리루빈치, HBV DNA 역가, HBeAg, anti-HBe를 정기적으로 검사하면서 임상경과를 관찰하였다. Viral breakthrough 후 라미부딘의 투약기간은 평균 13개 월(1-41개월)이었다. 결과: Viral breakthrough 발생후 혈청 ALT치가 정상으로 유지되었던 환자는 8예(11%)에 불과했고 나머지 66예(89%)에서는 ALT치가 증가하였으며, 이중 30예(41%)에서 급성 악화(ALT 정상 상한치의 5배 이상 상승)를 보였다. 급성악화는 viral breakthrough 후 3개월 내에 19예 (63%)에서 발생하여 3개월 내에 발생한 예가 많았으나 12개월 이상 지나서 나타나는 예도 약 20%에서 있었다. 비대상성 악화는 6예에서 관찰되었다. Viral breakthrough 후 급성악화가 일어난 예와 없었던 예의 비교에서 급성악화를 예측할 수 있는 인자는 발견할 수 없었다. Viral breakthrough 후 발견할 수 없었다. Viral breakthrough 후 HBeAg이 음전된 예는 8예(11%)였으나 그 임상경과는 양호하지 않았다. 결론: 만성 B형 간염 환자 에서 라미부딘 투여 중 발생한 viral breakthrough 예 중 상당수에서 급성악화가 발생하였으며, HBeAg 이 소실되더라도 그 임상경과는 양호하지만은 않았다. Viral breakthrough 발생 후 주의 깊은 임상경과 의 관찰이 요구되며, 앞으로 viral breakthrough 후 급성악화 예에 대한 대규모 연구와 적절한 치료방향의 제시가 이루어져야 할 것으로 생각된다. Background/Aims: Long-term lamivudine therapy can induce the emergence of lamivudine resistant hepatitis B virus (HBV) mutants. Clinically emergence of the mutant is expressed by the reappearance of disappeared HBV DNA in serum. Continued lamivudine treatment has been usually recommended in cases of viral breakthrough. However, the clinical outcome in patients with viral breakthrough is not clear. The aim of this study was to investigate the clinical course of chronic hepatitis B patients after viral breakthrough during lamivudine therapy. Methods: A total of 74 patients with chronic hepatitis B who showed viral breakthrough after at least 6 months of lamivudine treatment were included in this study. They had positive HBeAg and HBV DNA before treatment. The median follow-up duration after breakthrough was 13 months. Results: After viral breakthrough, only 8 patients (11%) maintained normal ALT levels and 66 patients (89%) showed elevation of ALT. 30 patients (41%) showed acute exacerbation of hepatitis (ALT increase over five-times upper normal limit). These acute exacerbations occurred within three months after breakthrough in 19 patients (63%). In the cases of acute exacerbation, 6 patients showed decompensated progression such as elevation of serum total bilirubin. One of them died of hepatic failure. A predictive factor for acute exacerbation was not found. HBeAg seroconversion occurred in 8 patients after viral breakthrough but their clinical course was highly variable. Conclusions: Chronic hepatitis B patients who had viral breakthrough during lamivudine therapy should be followed carefully and regularly in mind of potential clinical deterioration. New strategies are needed to manage the cases of acute exacerbation after viral breakthrough.(Korean J Hepatol 2002;8:389-396)

성인의 급성 설사에 대한 로페라미드 옥사이드의 효과: 위약과의 무작위 이중 맹검 비교 다시설 시험

박영태,정희진,박중원,이계희,김나영,임선희,윤병철,한동수,이오영 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.31 No.5

피부 스포로트리쿰증에서 Itraconazole 경구 투여의 효과에 대한 관찰

원영호,전선도,김성진,이승철 대한의진균학회 1998 대한의진균학회지 Vol.3 No.2

Background: The effectiveness of some therapeutic modalities for cutaneous sporotrichosis may be changed depending on the individual and geographic characteristics, and the clinical type. Itraconazole has been known to be effective for it, however, there have been no standard and ideal guideline on the oral dosage and duration yet. Objective 8: Methods: In this study, we evaluated the effectiveness of oral itraconazole in patients with cutaneous sporotrichosis in relation to dosage and clinical status. The observation of 17 patients with sporotrichosis were made retrospectively, Oral itraconazole was administered at the dose of 200 mg daily in 15 adults over 18 years old and 100 mg in the other 2 children. Results: The duration for healing was within 30 days in 4 cases, within 60 days in 4 cases, within 90 days in 2 cases, within 120 days in 3 cases, and within 150 days of therapy in 2 cases. The average duration in all cases was 12.1 ± 8.6 weeks. Comparison our results to the previous reported one revealed that more shorter treatment time was needed in cases treated with 200 mg daily than that with 100 mg. There was no treatment failure by drug intolerance or resistance. The duration for healing was significantly shorter in the patient groups with prevalence duration more than 5 months, however there was not any significant difference in sex of patients, and the clinical types. The cases with the lesion on the face and cases with fixed type tended to be healed more rapidly than the others, Conclusion: Oral itraconazole may be a safe and effective antifungal agent for the treatment of cutaneous sporotrichosis in a daily dose of 200 mg for 3 months on the average. However, duration for healing could be influenced by the clinical status.

신경인성 방광의 치료에서 요도부목 설치의성공례와 실패례 -증례 보고-

임선희,나은우,이일영,문혜원,임신영,정도영 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.1

숯에 대한 考察

吳永仙,宋泰元 대전대학교 한의학연구소 2000 혜화의학회지 Vol.9 No.1

After analyzing the datas to propose the rightful recognition and research direction for the long used charcoal, the following conclusions are obtained. 1.The 'soot' is pure Korean which has the meaning of 'fresh power' and is translated in English as charcoal which is composition of china and cool meaning good. 2.The main dispositions of the charcoal are 85% of carbon, 10% of water, 4% of minerals and 2% of essential so that the understanding of properties and effects of carbon are essential. 3.It is usually appeared that there are purifying and detoxifying effects of the woods and the room in practical use of charcoal. 4.In everyday life, it removes the odors, regulates the humidity and prevents the decaying. 5.It is often used medically for activating liver functions, regulating digestive functions and for diseases with inflammations, fever or bleeding. 6.The charcoal is used in medical treatment internally as well as externally. Above conclusions shows that the objective research is needed for clinical use considering the physical and chemical properties in future.

특징형상기반 3차원 역설계 시스템

최영,이원선 중앙대학교 미래신기술연구소 2002 미래신기술연구소 논문집 Vol.11 No.1

역공학은 실재의 물체로부터 데이터를 측정하여 컴퓨터 해석 가능한 데이터의 형태로 표현하고 이을 설계 및 각종 분야에 응용하고자 하는 기술이다. 본논문에서는 특징형상의 개념을 이용하여 기계 부품의 주요 데이터를 측정하고 이를 상용의 3차원 CAD 시스템에 인터페이스하여 특징형상 기반의 3차원 모델을 생성하는 연구를 수행하였다. Reverse engineering is a technique that helps designers to quickly generate computer interpretable data from existing physical objects. We developed feature driven solid modeling system based on 3D digitizer. This system has part and assembly modeling modules. It was also shown that STL data for rapid prototyping can be successfully generated from the solid.

골다공증성 대퇴골 골절의 위험인자 평가

정선관,박성훈,김혜원,이영환,윤권하,최시성,노병석,원종진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

cis-platin에 의한 급성구토예방의 Dexamethasone의 4가지 정주량의 비교

김원,강지은,서영선,이동민,서정균,신병철,정기영,박유환,정춘해 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

B5-hydroxytryptamine _3수용체(5-HT_3) 길항제와 dexamethasone의 동시투여가 cis-platin에 의한 급성 구토를 막는데 가장 효과적이다. 그러나 현재까지 가장 적절한 정주dexamethasone의 용량이 알려져 있지 않았다. 이에 dexamethasone의 4가지 다른 용량을 투여하여 그 효과를 비교하였다. 환자는 임의 추출되어 cis-platin 투여 45분전에 15분 동안 정주로 각각 dexamethasone 5, 10, 15, 20 mg을 투여 받았다. cis-platin 투여 30분전에는 ondansetron 8 mg이 부가하여 정주 되었다. 1999년 3월부터 2000년 2월까지 54명의 환자가 연구에 등록되어졌고 53명의 환자가 연구 대상으로 실험에 4군 (dexamethasone 5 mg 13명, 10 mg 14명, 15 mg 13명, 20 mg 13명)으로 나뉘어 평가 되어졌다. 급성구토와 구역질의 완전한 예방은 dexamethasone 5 mg을 투여 받은 환자에서 각각 69.2%, 60.9%, dexamethasone 10 mg을 투여 환자에서 69.1%, 61%, dexamethasone 15 mg 투여 환자에서 78.5%, 66.9%, dexamethasone 20 mg을 투여 환자에서 83.2%, 71.0%로 나타났다. 구토로부터 완전한 예방은 dexamethasone 20 mg을 투여 환자에서 5, 10 mg을 투여 환자와 비교하여 높았고, dexamethasone 15 mg을 투여 군에 비교하여서는 약간 우수한 효과만 있었다. 구역질으로부터의 완전한 예방도 월등한 것은 아닐지라도 20 mg을 받은 환자에서 높았다. 항 구토 치료는 특별한 불편 없이 조절되었고, 부작용의 발생에서 4가지그룹간에는 커다란 차이가 발견되지 않았다. Dexamethasone의 20 mg 정주양이 cis-platin으로 인한 급성구토를 예방하는데 가장 효과적인 예방량으로 사료되어진다. Background and objective: A 5-hydroxytryptamine _3(5-HT_3) receptor antagonist plus dexamethasone is the most efficacious antiemetic prophylactic treatment for the prevention of cis-platin induced acute emesis, but the optimal intraveous (Ⅳ) dose of dexamethasone is unknown. This prompted us to perform a randomized, double-blind, dose-finding study that compared four different doses of dexamethasone. Materials and Methods: Patients were randomized to receive dexamethasone, either 5, 10, 15, 20 mg, administered by 15-minute Ⅳ infusion 45 minutes before cis-platin. Ondansetron 8 mg was added to dexamethasone and was administered Ⅳ 30 minutes before cis-platin. From March 1999 to February 2000, 54 patients were enrolled onto the study and 53 were assessable according to the intention-to-treat principle (13 patients received 5 mg; 14 patients, 10 mg; 13 patients, 15 mg and 13 patients, 20 mg of dexamethasone). Results: Complete protection from acute vomiting and nausea was achieved by 69.2% and 60.9% of patients, respectively, who received 5 mg of dexamethasone, by 69.1% and 61.0% of those who received 10 mg, by 78.5% and 66.9% of those who received 15 mg, and by 83.2% and 71.0% of those who received 20 mg of dexamethasone. Complete protection from vomiting was significantly superior in patients who received 20 mg compared with those who received 5 and 10 mg of dexamethasone (P<05) and was superior, but not significantly, compared with those who received 15mg. Complete protection from nausea was superior, but not significantly, in patients who received 20 mg of dekamethasone. Multifactorial analysis confirmed these results. Antiemetic treatment was well tolerated, and no significant difference was found among the four groups in the incidence of adverse events. Conclusion: A 20mg single Ⅳ dose of dexamethasone should be considered the most efficacious prophylactic dose for the prevention of ois-platin induced acute amesis in treatment of cancer.

제주도 한라산 1100 고지 대기 에어로졸의 조성 및 특성

김원형,강창희,신찬성,고선영,홍민선 濟州大學校 基礎科學硏究所 2003 基礎科學硏究 Vol.16 No.1

The atmospheric aerosols collected at the 1100 site located in Mt. Halla have been analyzed to investigate their compositions and chemical characteristics. The average concentrations of water-soluble cautions were in the order of NH_(4)^(+)>Ca^(2+)>Na^(+)>K^(+)>Mg^(2+) during the spring, showing high increase of Ca^(2+) concentration with the value of 0.60㎍/㎥, and NH_(4)^(+)>Na^(+)>K^(+)>Ca^(2+)>Mg^(2+) during the other seasons. The average concentrations of anions have shown in the order of SO_(4)^(2-)>NO_(3)^(-)>Cl^(-) for all seasons, and SO_(4)^(2-) and NO_(3)^(-) had higher concentrations in spring with the values of 4.84㎍/㎥ and 1.08㎍/㎥, respectively. From the analytical data of size-segregated particles by cascade impactor sampling, the components of NH_(4)^(+), SO_(4)^(2-), NO_(3)^(-) and K^(+) were distributed mainly in fine particles, but Ca^(2+), Na^(+), Mg^(2+) and Cl^(-) were included mostly in coarse particles. The correlation coefficients of nss-SO_(4)^(2-)/NH_(4)^(+), nss-SO_(4)^(2-)/K^(+) and NO_(3)/nss-Ca^(2+) showed quite high values with 0.871, 0.857 and 0.654, respectively. Based on the study of enrichment factors, it is considered that Na^(+), Mg^(2+), Cl^(-) and Ca^(2+) components were delivered from oceanic and soil sources, but SO_(4)^(2-), NO_(3)^(-) and NH_(4)^(+) might have other source origins. The factor analysis study showed the aerosol at the 1100 site was influenced mainly by anthropogenic factors, followed by oceanic and soil factors.

알루미늄 합금을 이용한 초소형 사각컵 성형품의 특성

김원일,이승준,이정환,이영선 慶南大學校 附設 工業技術硏究所 1999 硏究論文集 Vol.17 No.-

벌지 성형기술이 상업적인 초소형 성형공정에 널리 사용되고 있지만, 일축 인장시험은 재료의 초소성을 평가하는 방법으로 아직도 가장 일반적으로 사용되고 있다, 그러나 1축 인장시험으로부터 얻은 결과들은 다축 응력상태의 실제 성형품의 특징을 해석하는데는 적용할 수가 없다. 본 논문은, 다축 응력상태로 초소성 성형에 의해 만들어진 사각컵 성형품으로부터 얻은 인장시험시편을 사용하여 변형률과 공동의 량에 따라 인장강도와 연신율을 조사하였다. 이 실험의 결과로부터 Al-6%Cu-0.4%Zr 알루미늄 합금의 인장강도와 연신율은 변형률과 공동에 따라 감소하였다. Although the bulge forming technique is currently employed in commercial superplastic forming processes, the uniaxial tensile test is still the most commonly used method for the evaluation of the superplasticity of materials due to its simplicity in testing. However, the results obtained from the uniaxial tensile test can not be applied in analyzing the characteristics of the real parts formed in multi-axial stress state. In this paper, using the tensile test specimen obtained from the squats·cup manufactured by superplastic forming in multi-axial stress state, tensile strength and elongation have been investigated according to the strain and cavity volume fraction. From the result of experiment. tensile strength and elongation are decreased according to the strain and cavity in Al-6% Cu-O.4%Zr alloy.