http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
( Seung Kak Shin ),( Yun Soo Kim ),( Hannah Ra ),( Sangho Jeong ),( Hyung Nam Kim ),( Oh Sang Kwon ),( Duck Joo Choi ),( Ju Hyun Kim ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Sonographic liver surface nodularity (LSN) is a useful parameter for diagnosis of liver cirrhosis (LC). Recently, easy-to-use linear type wireless hand-held ultrasound (wireless US) has been introduced. We aimed to assess the performance of wireless US compared to conventional ultrasound system (conventional US) in evaluating the LSN, and to verify the usefulness of LSN measured by wireless US in diagnosing LC. Methods: We enrolled 104 patients who underwent wireless US (SONON 300L, 10 MHz linear transducer, Healcerion), conventional US (Logic E9, 9 MHz linear transducer, GE) and Fibroscan for evaluation of liver diseases between March 2017 and January 2018. LSN measurement (LSNM, defined as the length of curve line in liver surface matching the 2-cm linear segment in left lateral segment) was used to objectively evaluate the LSN. Diagnosis of LC was based on clinical criteria, and was compared with fibroscan results. Results: Among 104 patients, 54 (51.9%) patients were diagnosed with LC. The mean liver stiffness measurement (LSM) on fibroscan (28.1±22.3 vs. 6.7±4.8, P<0.001) and LSNM on conventional US (2.075±0.459 vs. 2.028±0.119, P<0.001) were significantly different between LC and non-LC group. The mean LSNMs (2.051±0.034 vs. 2.052±0.041, P=0.13) on between wireless and conventional US by paired t-test were not significantly different. The sensitivity, specificity, positive predictive value, and negative predictive value of high LSNMs (≥ 2.04) on wireless US in diagnosing LC were 88.9%, 90.0%, 90.6%, and 88.2%, respectively. The mean LSMs (25.7±22.8 vs. 9.6±10.6 kPa, P<0.001) were significantly different between high LSNMs (≥ 2.04) and low LSNMs (<2.04) group. Conclusions: The ability of liver surface nodularity evaluation with wireless US was not inferior to conventional US. Linear type wireless hand-held ultrasound can be a useful tool to easily identify the liver surface nodularity for diagnosis of LC.
( Seung Kak Shin ),( Hyung Joon Yim ),( Jeong Han Kim ),( Chan Uk Lee ),( Jong Eun Yeon ),( Sang Jun Suh ),( Young Kul Jung ),( Yun Soo Kim ),( Ju Hyun Kim ),( Oh Sang Kwon ) 대한간학회 2021 Gut and Liver Vol.15 No.3
Background/Aims: The clinical significance of partial virological response (PVR) in patients undergoing antiviral therapy is not well known. This study investigated whether PVR after 2 years of entecavir (ETV) therapy is associated with hepatocellular carcinoma (HCC) development in cirrhotic patients. Methods: A total of 472 naïve patients with hepatitis B virus (HBV)-associated cirrhosis who were treated with ETV for at least 2 years were retrospectively enrolled. Clinical characteristics, laboratory data, PVR, and noninvasive fibrosis markers (aspartate aminotransferase to platelet ratio and FIB-4 index) at 2 years after ETV commencement were analyzed for HCC risk. Results: After excluding those who developed HCC within 2 years of ETV therapy, 359 patients (mean age, 51±10 years; male 64.3%) were examined. During a median follow-up of 82 months, 80 patients developed HCC. In the univariate analysis, older age (hazard ratio [HR], 1.056; p<0.001), PVR (HR, 2.536; p=0.002), higher aspartate aminotransferase (HR, 1.018; p=0.005), lower albumin level (HR, 0.463; p<0.001), lower platelet count (HR, 0.993; p=0.01), and higher FIB-4 index (HR, 1.141; p<0.001) at 2 years after ETV commencement were risk factors for HCC. In the multivariate analysis, older age (HR, 1.046; 95% confidence interval [CI], 1.022 to 1.072; p<0.001), PVR (HR, 2.358; 95% CI, 1.310 to 4.245; p=0.004), and higher FIB-4 index (HR, 1.103; 95% CI, 1.035 to 1.177; p=0.003) were independent risk factors. Conclusions: PVR and higher FIB-4 index after 2 years of ETV therapy were independent risk factors for HCC. Therefore, efforts to accomplish a complete virological response and reduce the FIB-4 index should be made. (Gut Liver 2021;15:430-439)
( Seung Kak Shin ),( Young Kul Jung ),( Seung Jun Jang ),( Hae Lim Baek ),( Hyun Hwa Yoon ),( Soo Yong Park ),( Min Young Rim ),( Hyeonsu Park ),( In Ku Yo ),( Oh Sang Kwon ),( Yun Soo Kim ),( Duck Jo 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background: Multi-antiviral drug resistance is a major problem in the treatment of patients with chronic hepatitis B (CHB). Tenofovir disoproxil fumarate (TDF) is recommended for ADV or entecavir (ETV). However, until recently TDF was not available in Korea. ADV and ETV combination therapy may be a viable alternative to TDF in patients with either ADV or ETV resistance. This study investigated the efficacy of ADV and ETV combination therapy in patients with multidrug resistance. Methods: Forty-one patients were enrolled and were administered ADV and ETV combination therapy for at least 12 months. Blood was drawn at baseline and at 12, 24, 36, 48, and 60 months after commencing treatment, and virological response was analyzed. Results: After ADV and ETV combination therapy, ALT normalization was 68%, 73%, 80% 90%, and 93% in 12wks, 24wks, 36wks, 48wks, and 60 wks, respectively. HBV DNA reduction was -1.5, -1.8, -1.9, -1.8, and -1.9 log10IU/mL in 12wks, 24wks, 36wks, 48wks, and 60 wks, respectively. 29 of HBeAg positive patients showed the following low HBeAg seroconversion rate: 3%, 7%, and 10% in 24wks, 48wks, and 60wks, respectively. In addition, virological response group showed lower initial HBV DNA level (P=0.014) and lower HBeAg positive rate (P=0.016) compared with non-virological response group. Conclusions: ADV and ETV combination therapy could be considered in selected chronic hepatitis B patients who have low initial HBV DNA level and HBeAg negative status.
( Seung Kak Shin ),( Oh Sang Kwon ),( Jong Joon Lee ),( Duck Joo Choi ),( Yun Soo Kim ),( Ju Hyun Kim ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: NADPH oxidase (NOX)-derived reactive oxygen species (ROS) is implicated in liver fibrosis. 8-hydroxydeoxyguanosine (8-OHdG) can have antioxidant effects by inhibiting Rac1. Rac1 is a known activator of NOX enzymes. The aim of this study was to investigate the role of NOX and the antifibrotic effects of 8-OHdG in vitro and in vivo models of liver fibrosis. Methods: Adult Sprague-Dawley rats were allocated to 3 groups: sham-operated rats (n=7), rats underwent bile duct ligation (BDL) (n=6), and BDL rats treated with 8-OHdG (60 mg/kg/day by gavage feeding) (n=6). All rats were sacrificed on day 21. Hepatic fibrosis in liver tissue was assessed. In vitro, human stellate cell line LX-2 was stimulated by angiotensin II (10uM). The ROS production was measured by confocal microscopy. The mRNA expressions in liver tissue and LX-2 cell were analyzed by quantitative real-time PCR. Results: 8-OHdG significantly attenuated the hydroxyproline level (620.6±169.1 vs 1110.3±357.9 ug/g liver tissue, p=0.019) and the degrees of collagen stain (2.04±0.86 vs 5.11±0.26 %, p<0.001). The NOX1 and NOX2 protein expression in liver tissue by immunofluorescence was attenuated in 8-OHdG treatment groups. 8-OHdG significantly attenuated the mRNA expression of NOX1 (7.3 vs 2.7 folds, p=0.022), NOX2 (10.5 vs 3.9 folds, p=0.001), α-SMA (6.2 vs 2.6 folds, p=0.017), TGF-β (7.7 vs 3.4 folds, p=0.001) collagen Iα (25.7 vs 9.0 folds, p<0.001). Angiotensin II induced increase of the DCF fluorescence intensity in LX-2 cells was attenuated by 8-OHdG. 8-OHdG significantly attenuated the mRNA expression of α-SMA (6.2 vs 1.2 folds, p=0.001) TGF-β (7.8 vs 1.5 folds, p<0.001) collagen Iα (13.3 vs 0.74 folds, p<0.001) in LX-2 cells treated with angiotensin II for 72 hours. Conclusions: NOX-derived ROS is a critical role in vitro and in vivo models of liver fibrosis. 8-OHdG ameliorates the liver fibrosis through the inhibition of NOX-derived oxidative stress.
( Seung Kak Shin ),( Oh Sang Kwon ),( Chang Hwi Yoon ),( Young-joo Jin ),( Jin-woo Lee ),( Sangheun Lee ),( Ki Jun Han ),( Young Nam Kim ),( Tae Hun Kim ),( Yun Soo Kim ),( Duck Joo Choi ),( Ju Hyun K 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Combination of daclatasvir (DCV) and asunaprevir (ASV) has been approved in Korea for the treatment of genotype 1b (GT1b) hepatitis C virus (HCV) infected patients. The efficacy in virologic response, improvement of liver function and non-invasive fibrosis marker in liver cirrhosis (LC) were investigated. Methods: All HCV GT1b patients who were treated with DCV and ASV for at least 4 weeks from August 2015 to January 2017, were retrospectively enrolled. Virologic response was measured at 4 weeks (rapid virologic response, RVR), at 24 weeks (end of treatment response, ETR), and at 12 weeks after the end of treatment (sustained virologic response, SVR12). Liver function, aspartate transaminase to platelet ratio index (APRI), FIB-4 index, and fibrosis index (FI) were compared between before and after treatment (SVR12). Results: Patients with GT1b patients (n=474) were examined for resistance associated variants (RAVs). Sixty-seven patients had RAV. A total of 290 RAV-negative patients were treated with DCV and ASV for at least 4 weeks. Baseline characteristics were obtained: age (54±11 years), gender (male: 50.3%), LC (29.0%), treatment-naïve (74.8%), ALT (58.5±49.2 IU/L), HCV RNA (1,915,001±4,969,456 IU/mL). RVR (255/277, 92.1%), ETR (190/195, 97.4%), and SVR (146/152, 96.1%) rates were obtained. SVR rates were not significantly different between non-LC (102/104, 98.1%) and LC patients (44/48, 91.7%) (p=0.080). SVR rates were not significantly different between treatment- naïve (103/106, 97.2%) and treatment-experienced patients (43/46, 93.5%) (p=0.368). In LC patients (n=48), there were significant changes of albumin (3.8±0.8 to 4.0±0.5 g/dL, p=0.036), platelet count (109.6±52.6 to 120.3±58.5 x103/mm3, p=0.004), APRI (2.6±3.1 to 0.8±0.6, p=0.001), FIB-4 (7.6±6.5 to 2.9±1.6, p<0.001), and FI (3.1±1.1 to 2.9±1.2, p=0.058) after treatment. Conclusions: DCV and ASV treatment for HCV GT1b infected Korean subjects without RAV achieved high SVR rates. In addition, improvement of liver function and non-invasive fibrosis marker were noted in patients with LC.
PE-098: Effect of Rifaximin on the Hepatic Fibrosis in Bile Duct Ligated-rat Model
( Seung Kak Shin ),( Oh Sang Kwon ),( Jong Joon Lee ),( Duck Joo Choi ),( Yun Soo Kim ),( Ju Hyun Kim ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Several recent studies suggest that the nonabsorbable antibiotic rifaximin could reduce endotoxemia and ameliorate hepatic fibrosis. The aim of this study was to investigate the effect of rifaximin on the hepatic fibrosis in animal model. Methods: Adult Sprague-Dawley rats were allocated to 6 groups: sham-operated rats [G1 (n=6) and G4 (n=7)], rats underwent bile duct ligation (BDL) [G2 (n=4) and G5 (n=6)], and BDL rats treated with rifaximin (50 mg/kg/day by gavage feeding) [G3 (n=9) and G6 (n=5)]. G1, G2 and G3 were sacrificed on day 9. G4, G5 and G6 were sacrificed on day 21. Liver tissue was stored in -70°C refrigerator or fixed in formalin. Hepatic fibrosis was assessed by hydroxyproline assay and quantified by Sirius red staining with image analysis. Results: The concentrations of hydroxyproline (μg/g liver tissue) were 236.4±103.1 in G1, 444.8±114.4 in G2, and 312.5±131.6 in G3. The concentration was higher in G2 than in G1 (p=0.025). However, there was no difference between G2 and G3. The degrees of collagen stain (%) were 0.22±0.04 in G1, 1.64±0.53 in G2, and 1.66±0.44 in G3. The degree was higher in G2 than in G1 (p=0.001). However, there was no difference between G2 and G3. The concentrations of hydroxyproline were 311.5±72.9 in G4, 1110.3±357.9 in G5, and 944.3±209.3 in G6. The concentration was higher in G5 than in G4 (p<0.001). However, there was no difference between G5 and G6. The degrees of collagen stain (%) were 0.19±0.03 in G4, 5.04±0.18 in G5, and 4.42±0.68 in G6. The degree was higher in G5 than in G4 (p<0.001). However, there was no difference between G5 and G6.