http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
( Eileen L. Yoon ),( Dae Won Jun ),( Sang Bong Ahn ),( Yong Kyun Cho ),( Do Seon Song ),( Jae Yoon Jeong ),( Hee Yeon Kim ),( Young Kul Jung ),( Myeong Jun Song ),( Sung Eun Kim ),( Hyoung Su Kim ),( 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: To evaluate the impact of L-carnitine on the improvement of quality of life (QOL) and cognitive function in liver cirrhosis patients with covert hepatic encephalopathy (HE). Methods: We conducted a multi-center, double-blind, randomized, phase III clinical trial in patients with covert HE. A total of 150 covert HE patients were randomized 1:1 to L-carnitine (1 g) or placebo for 24 weeks. Changes in QOL and cognitive function were assessed at 6 months. West Haven criteria, 36- Item Short Form Health Survey (SF-36), psychometric hepatic encephalopathy score (PHES), and the Stroop Test were evaluated in all patients. Results: The L-carnitine supplement improved QOL compared to baseline. PHES scores were improved and normalization rates of minimal HE were increased in the L-carnitine group compared to baseline; however, median PHES scores and normalization rates were not different between the L-carnitine group and the placebo group at Week 24. Assessment of cognitive inhibition via the Stroop test showed significant improvement following 24 weeks of treatment in the L-carnitine group. Model for end stage liver disease scores were increased in the placebo group and significantly decreased in the L-carnitine group. Changes in total carnitine level positively correlated with rate correct scores of the Stroop test in the L-carnitine group. The incidence of adverse events was not different between the treatment groups. Conclusions: L-carnitine supplement was safe and effective for the improvement of QOL and cognitive dysfunction in covert HE patients with liver cirrhosis. (Clinical trial No. KCT0002029)
( Eileen L. Yoon ),( Sang Bong Ahn ),( Dae Won Jun ),( Yong Kyun Cho ),( Do Seon Song ),( Jae Yoon Jeong ),( Hee Yeon Kim ),( Young Kul Jung ),( Myeong Jun Song ),( Sung Eun Kim ),( Hyoung Su Kim ),( 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.4
Background/Aims: L-carnitine is potentially beneficial in patients with hepatic encephalopathy (HE). We aimed to evaluate the impact of L-carnitine on the quality of life and liver function in patients with liver cirrhosis and covert HE. Methods: We conducted an investigator-initiated, prospective, multi-center, double-blind, randomized phase III trial in patients with covert HE. A total of 150 patients were randomized 1:1 to L-carnitine (2 g/day) or placebo for 24 weeks. Changes in quality of life and liver function were assessed at 6 months. The model for end-stage liver disease (MELD), the 36-Item Short Form Survey (SF-36), the psychometric hepatic encephalopathy score (PHES), and the Stroop Test were evaluated in all patients. Results: The total SF-36 score significantly improved in the L-carnitine group after 24 weeks (difference: median, 2; interquartile range, 0 to 11; p < 0.001); however, these values were comparable between the two groups. Furthermore, there was a significant ordinal improvement in PHES scores among patients with minimal HE who were in the L-carnitine group (p = 0.007). Changes in the total carnitine level also positively correlated with improvements in the Stroop test in the L-carnitine group (color test, r = 0.3; word test, r = 0.4; inhibition test, r = 0.5; inhibition/switching test, r = 0.3; all p < 0.05). Nevertheless, the MELD scores at week 24 did not differ between the groups. Conclusions: Twenty-four weeks of L-carnitine supplementation was safe but ineffective in improving quality of life and liver function.
Therapeutic mechanisms and beneficial effects of non-antidiabetic drugs in chronic liver diseases
Han Ah Lee,Young Chang,Pil Soo Sung,Eileen L. Yoon,Hye Won Lee,Jeong-Ju Yoo,Young-Sun Lee,Jihyun An,Do Seon Song,Young Youn Cho,Seung Up Kim,Yoon Jun Kim 대한간학회 2022 Clinical and Molecular Hepatology(대한간학회지) Vol.28 No.3
The global burden of chronic liver disease (CLD) is substantial. Due to the limited indication of and accessibility to antiviral therapy in viral hepatitis and lack of effective pharmacological treatment in nonalcoholic fatty liver disease, the beneficial effects of antidiabetics and non–antidiabetics in clinical practice have been continuously investigated in patients with CLD. In this narrative review, we focused on non-antidiabetic drugs, including ursodeoxycholic acid, silymarin, dimethyl- 4,4’-dimethoxy-5,6,5’,6’-dimethylenedixoybiphenyl-2,2’-dicarboxylate, L-ornithine L-aspartate, branched chain amino acids, statin, probiotics, vitamin E, and aspirin, and summarized their beneficial effects in CLD. Based on the antioxidant, anti-inflammatory properties, and regulatory functions in glucose or lipid metabolism, several non–antidiabetic drugs have shown beneficial effects in improving liver histology, aminotransferase level, and metabolic parameters and reducing risks of hepatocellular carcinoma and mortality, without significant safety concerns, in patients with CLD. Although the effect as the centerpiece management in patients with CLD is not robust, the use of these non-antidiabetic drugs might be potentially beneficial as an adjuvant or combined treatment strategy.
Impact of Previous Acute Decompensation on Tolerance to Acute-on-Chronic Liver Failure
( Eileen L. Yoon ),( Do Seon Song ),( Hee Yeon Kim ),( Chang Wook Kim ),( Jin Mo Yang ),( Young Kul Jung ),( Hyung Joon Yim ),( Baek Gyu Jun ),( Jung Gil Park ),( Young Chang ),( Jeong-ju Yoo ),( Sang 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1
( Eileen L. Yoon ),( Jeong Han Kim ),( Won Hyeok Choe ),( So Young Kwon ),( Won-choong Choi ),( Byung-chul Yoo ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Tenofovir (TDF) is a potent agent for chronic hepatitis B (CHB) and TDF monotherapy has been widely accepted for treatment of multi-drug resistance. We aimed to evaluate safety of switching to TDF monotherapy from TDF-based combination therapy. Methods: This is a retrospective study of CHB patients who had been treated with TDF-based combination therapy and switched to TDF monotherapy after achievement of virological response (VR; undetectable HBV DNA by real-time PCR) in Konkuk university hospital and Sanggye Paik Hospital. Results: Total 38 patients were included in this study. Median age was 51 years old and 28 patients were male (73.7%). HBeAg positive patients were 31 (81.6%). Combination types were lamivudine (LMV) plus TDF (19, 50%) and entecavir (ETV) plus TDF (19, 50%). VR duration before switching to monotherapy was median 16.1 months and monotherapy duration was median 7.5 months. Within 6 months, HBV DNA became detectable in 4 patients and one of them was related with poor compliance to antiviral treatment. Excluding one patient with poor compliance, two patients had been treated with LMV plus TDF combination therapy and one patient had been treated with ETV plus TDF combination therapy. Resistance types before combination treatment were LMV only resistance, ETV resistance, and adefovir only resistance each. VR durations of these patients were one month, 13 months and 6 months. Conclusions: Generally, switching to TDF monotherapy from TDF-based combination treatment was safe and effective. Some cases showed that longer consolidation therapy after achievement of VR might be required for safe switching to TDF monotherapy.
Long-term Prognosis of Cirrhotic Patients Who Survived from Acute-on-chronic Liver Failure
( Eileen L. Yoon ),( Tae Yeob Kim ),( Do Seon Song ),( Hee Yeon Kim ),( Chang Wook Kim ),( Young Kul Jung ),( Dong Hyun Sinn ),( Kim Sang Gyune ),( Jae Young Jang ),( Soung Won Jeong ),( Won Kim ),( H 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: This study aimed to investigate the impact of ACLF on long-term survival after surviving the ACLF events in patients with acute deterioration. Methods: A total of 1177 acutely deteriorated patients who survived more than 3 months were consecutively collected and followed up in KACLiF study. ACLF was defined by EASL CLIF-C definition. Kaplan-Meier method was used to calculate survival. Results: Mean duration of follow up was 18.2±9.1months. The prevalence of ACLF was 8.8%(74/838). Most common etiology of cirrhosis was alcohol(62.3%). The survival of ACLF group was shorter than no ACLF group(25.6±1.2months vs. 30.7±0.4months, p=0.013). In subgroup of 558 patients with prior decompensation, survival of ACLF group was shorter than no ACLF group (23.3±1.7months vs. 29.1±0.6months, p=0.020). However, in subgroup of 515 patients without prior decompensation, survivals were not different between groups (p=0.289). Additionally, survivals of grade 1 and no CLIF-C ACLF patients were not different regardless of presence of prior decompensation. However, with prior decompensation, survivals of grade 2 and higher ACLF patients were shorter than grade 1 and no ACLF patients (19.3±2.6months vs. 29.0±0.6months, p=0.008). According to etiology of cirrhosis, survivals of alcoholic patients were shorter than non-alcoholic patients(30.2±1.8months vs. 23.6±1.3months, p=0.045). In the presence of prior decompensation, the experience of ACLF had worse effect on survival in alcoholic patients than non-alcoholic patients (30.0±2.4 vs 20.1±1.8, p=0.027). However, the survivals of those patients were not different in the absence of prior decompensation. Conclusions: Long-term mortality after survival from ACLF is dependent on the presence of prior decompensation. In the presence of prior decompensation, grade 2 and higher ACLF negatively affects survival even after recovery of ACLF. Also, effects of ACLF experience is more potent in alcoholic patients. Therefore, efforts to prevent acute decompensation and progression of organ failures may be important to improve the survival of cirrhotic patients.
( Eileen L Yoon ),( Jong Eun Yeon ),( Ji Hye Je ),( Yang Jae Yoo ),( Keun Hee Kang ),( Hyun Jung Lee ),( Sang Jun Suh ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Hyun Joon Yim ),( Kwan Soo Byun ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background: Sorafenib is an only treatment proven to be beneficial for survival in advanced HCC patients. However, aggravation of the patients` performance status (PS) frequently limits the use of sorafenib in field-practice. We aimed to assess the real-world efficacy of sorafenib and factors significantly resulting in the early discontinuation of sorafenib use less than 4-weeks. Methods: We retrospectively analyzed the medical records of 102 patients who were treated for advanced HCC with sorafenib in Korea University Guro Hospital, between 2008 and 2012. Patients were divided into “Early discontinuation (ED) group (n=32)” and “Traceable for response (TR) group (n=70)” according to the treatment duration. Results: Best response rates of our center in the TR group were as follow: CR (3/70, 4.3%), PR (9/70, 12.9%), SD (26/70, 37.1%), and PD (32/70, 45.7%). The median overall survival and time to progression were 11.29 months and 2.93 months. Cox regression analysis revealed that worse PS upon discontinuation in the TR group and lymph node involvement were negatively related to the survival [HR 2.92 (95% C.I 1.37-6.25, P=0.005) and HR 3.85 (95% C.I 1.33-11.16, P=0.013), respectively]. Baseline characteristics of patients, liver function, and tumor characteristics were compared between the groups. ECOG PS 0 patients accounted for 31.3% and 70.0% in ED and TR group (P<0.001). Prevalence of Child A patients were 50.0% and 82.9% in the ED and TR group, respectively (P=0.002). Infiltrative type of tumor and presence of macrovascular invasion were more frequent in the ED group (P=0.014 and P=0.016). Among the reasons of treatment discontinuation, aggravation of PS was noted as high as 65.6% and 37.1% in the ED and TR group, respectively (P=0.010). Conclusions: Not only tumor characteristics, but also the baseline PS and aggravation of PS significantly affected the field-practice of sorafenib in both the ED and TR group.