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HBeAg 양성 만성 B형 간염에 대한 인터페론 치료의 장기 추적관찰 -원발성 간세포암 발생률을 중심으로-
최대로 ( Dae Ro Choi ),장명국 ( Myoung Kuk Jang ),문한국 ( Han Kook Moon ),김성만 ( Seong Man Kim ),이준호 ( Jun Ho Lee ),이자영 ( Ja Young Lee ),김경호 ( Kyung Ho Kim ),박준용 ( Joon Yong Park ),이진헌 ( Jin Heon Lee ),김학양 ( H 대한내과학회 2005 대한내과학회지 Vol.69 No.2
목적 : 만성 B형 간염환자에서 인터페론 알파 치료가 간염의 진행과 생존에 미치는 장기적 영향에 대한 자료는 부족하다. 저자들은 HBeAg 양성 만성 B형 간염 환자에서 인터페론 알파 치료가 환자의 임상적 결과와 생존에 영향을 미치는 인자들에 대해 평가하기 위하여 본 연구를 시행하였다. 방법 : 1988년 1월부터 2000년 12월까지 한림대학교 강동성심병원에서 생화학, 혈청학, 영상검사 및 간 조직 생검으로 확진된 HBeAg 양성, 만성 B형 간염환자 중에서 인터페론 치료를 받은 98명의 환자를 대상으로 하였다. 인터페론 투여 종료 후 1년 이내에 HBeAg이 최소 2회 이상 연속으로 소실된 경우를 지속적 반응군으로 정의하였다. 직접 환자와 전화하거나 환자의 의무기록을 검토하여 자료를 확인하였으며, 치료 후 추적 조사가 되지 않는 환자들은 한국중앙암등록본부의 데이터베이스의 자료를 이용하여 확인하였다. Kaplan-Meier 방법을 이용하여 누적 생존율 및 간세포암의 누적 발생률을 확인하였다. 결과 : 대상 환자는 남자 78명, 여자 20명이었고, 평균연령은 32.4±10.7세였으며, 평균 추적기간은 92.0±45개월이었다. 총 98명의 환자 중 38명(39%)에서 초기 반응을 보였으나, 12명에서 재발하여 지속적 반응을 보인 경우는 26명(27%)이었다. 6명(6%)에서 간세포암 발생이 확인되었으며, 연령(39세 이상)이 높은 군에서 유의하게 간세포암 발생률이 높았다(p<0.001). 간부전, 정맥류 출혈 등 간 질환과 관련된 사망은 9명(9.2%)이었으며 양군간 생존율에는 유의한 차이가 없었다. 결론 : HBeAg 양성인 만성 B형 간염을 인터페론으로 치료했을 때, 지속적인 반응이 유지되는 환자군에서 생존기간이 연장되고, 간세포암 발생이 감소하는 경향을 보였으나 통계학적인 유의성은 없었다. 그러나 인터페론 치료 시작 당시의 나이가 많은(39세 이상) 환자군에서 간세포암 발생 위험이 높은 것을 확인하였다. 향후 인터페론 반응군에서 통계학적으로 유의한 생존기간 향상 및 간세포암 발생률 감소를 확인하기 위해서는 더 많은 환자군에서 장기간의 추적 연구가 필요할 것으로 생각된다. Background : Data on the long-term effects of interferon alpha (IFN) treatment on disease progression and mortality in patients with chronic hepatitis B (CHB) are limited. To evaluate factors that influence clinical outcome and survival, we performed a follow-up study on hepatitis B e antigen (HBeAg) positive CHB patients treated with IFN. Methods : A total of 98 patients with biopsy-proven HBeAg-positive CHB were treated with IFN- between 1988 and 2000 and followed. Data were collected by review of medical record, direct contact, or using database from Korea Central Cancer Registry. Sustained response (SR) to treatment was defined as HBeAg loss within 12 months after the end of IFN therapy and maintenance of HBeAg negativity for at least 3 years. We tried to find the factors associated with SR, hepatocellular carcinoma (HCC) incidence and survival. We also compared the cumulative rate of HCC and survival between SR group and non-sustained response (NSR)/nonresponder group. Results : The mean IFN dose was 375±205 mega units. Mean follow-up was 92.0 months (SD 45 months). Twenty-six patients (27%) had sustained response to IFN treatment, although transient response was seen in 39% (38 out of 98 patients). Nine patients died of liver-related causes (hepatic failure, variceal bleeding) during follow-up. There were no significant differences of clinical outcomes such as survival and HCC incidence between responders and nonresponders (p=0.18, p=0.10, respectively). However, HCC developed in 6 patients, all of whom were nonresponders with an age older than 39 years. Conclusion : Age of 39 years and above at the time of IFN treatment might increase the risk of developing HCC. Therefore, interferon should be applied at the younger age to prevent HCC in patients with HBeAg-positive CHB.(Korean J Med 69:150-156, 2005)
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최대봉(Dae-Bong Choi),노승국(Seung-Kook Ro),신영재(Young-Jae Shin),김수태(Soo-Tae Kim) 한국기계가공학회 2006 한국기계가공학회 춘추계학술대회 논문집 Vol.2006 No.-
The rubber rollers for color print must be cut precisely. The special purpose cylindrical grinding machine with a wide width grinding wheel is used to get the high-quality and productivity increasing for the rubber rollers. It is important to know the characteristics of the rubber roller grinding machine for more the high-quality rubber rollers. The special purpose rubber roller grinding machine has the compact structure and the spindle easy to assemble after balancing for high-speed grinding. Therefore, the dynamic and thermal characteristics of the rubber roller grinding machine are measured and evaluated. The surface configuration of the grinded rubber rollers was compared to the raw rubber rollers.
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최대봉(Dae-Bong Choi),김수태(Soo-Tae Kim),노승국(Seung-Kook Ro),조현택(Hyun-Taek Cho) 한국기계가공학회 2012 한국기계가공학회지 Vol.11 No.2
High speed machining is the core technology that influences the performance of machine tools, and the high speed motor spindle is widely used for the high speed machine tools. The important problem in high speed spindle is to minimize the thermal effect by motor and bearing and frequency effect. This paper presents the thermal characteristic analysis and frequency experiment for a high speed spindle considering the flow rate of cooling oil. A high speed spindle is composed of angular contact ceramic ball bearings, high speed built-in motor, oil cooling jacket and so on. The thermal analyses of high speed spindle need to minimize the thermal effect and maximize the cooling effect and they are carried out under the various cooling conditions. Heat generations of the bearing and the high speed motor are estimated from the theoretical and experimental data. To find out the characteristic of vibration, the high speed spindle is excited in operational range. This result can be applied to the design and manufacture of a high speed tapping spindle.
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농부가 아닌 환자에서 발생한 긴털가루진드기(Tyrophagus Putrescentiae)에 의한 기관지천식 1례
최대로,김형수,고창옥,김희선,윤호성,박용범,김상훈,이재영 대한천식 및 알레르기학회 2004 천식 및 알레르기 Vol.24 No.1
Storage mites are believed one of the most important allergens in farmers and rural regions. Tyrophagus putrescenitiae, belonging to storage mites, is found not only within storehouses but also in the house dust, and the third most common mites following Dematophagoides farinae and Dermatophagoides pteronyssnus in house dust in Korea. The sensitization rate to Trophagus putrescentiae was reported as high as that of house dust mite in patients visiting the allergy clinic in large cities in Korea. We experienced a 69-year-old man who had suffered from dyspnea, wheezing, and coughing for 10 years. He retired from the teaching profession, and had lived in a large city. Deajeon. The skin prick test showed a positive reaction to Tyrophagus putrescentiae and negative reactions to house dust mites. The bronchial challenge test with Tyrophagus putrescentiae showed late asthmatic reaction. We confirmed a Tyrophagus putrescentiae induced asthma in non occupational setting. (J Asthma Allergy Clin Immunol 24 : 141-5, 2004)
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