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( Joon Yeul Nam ),( Jong Ho Lee ),( Hee Yoon Jang ),( Kanghyug Choi ),( In-gyoon Ha ),( Eun Sun Jang ),( Jin-wook Kim ),( Sook-hyang Jeong ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Although there are several prediction models for hepatocellular carcinoma (HCC) development in chronic hepatitis B virus (HBV) infection including various proportion of liver cirrhosis, they are not based on the entirely cirrhotic patients on antiviral therapy. This study aimed to develop a new model of convolutional neural network (CNN) using deep learning technique for the prediction of HCC among HBV-related cirrhosis on the potent antivirals. Methods: The subjects were 424 patients with HBV-related cirrhosis on entecavir therapy and followed for median 62.0 months at a single tertiary hospital in Korea. Four existing models (PAGE-B, CU-HCC, HCC-RESCUE and ADRESS-HCC) were applied to our subjects and, compared for the accuracy of each model at 5 years using Harrell’s c-index. A New model using CNN was developed, and accuracy of the new model was calculated. Results: During the follow-up period, HCC developed in 86 out of 424 patients (20.3%) with 5 year cumulative incidence of 22%. In discrimination assessment, PAGE-B (c-index= 0.612), HCC-RESCUE (c-index=0.613), and ADRESS-HCC (c-index=0.606) showed a better discriminatory power compared to CU-HCC (c-index=0.563). The predicted 5 year cumulative HCC incidence among PAGE-B, CU-HCC, and HCC-RESCUE using the reported cutoff of each model were 16.0%, 21.1%, and 41.2%, respectively. However, application of the PAGE-B, CU-HCC, and HCC-RESCUE for our cohort showed a predicted 5 year HCC incidence of 23.6%, 17.2%, and 21.7%, respectively, suggesting an underestimation in PAGE-B, but overestimation in CU-HCC, and HCC-RESCUE. Accuracy of new model using CNN was 79.7 %, which seems to be a better performance. Conclusions: Our new model of CNN may present better prediction than the preexisting 4 models for HBV-related cirrhosis on potent antivirals. Further validation study is warranted.
Kim, In-Wha,Moon, Yoo Jin,Ji, Eunhee,Kim, Kyung Im,Han, Nayoung,Kim, Sung Ju,Shin, Wan Gyoon,Ha, Jongwon,Yoon, Jeong-Hyun,Lee, Hye Suk,Oh, Jung Mi Springer-Verlag 2012 European journal of clinical pharmacology Vol.68 No.5
<P>The purpose of this study was to characterize the effects of clinical and genetic variables on the pharmacokinetics and complications of tacrolimus during the first year after kidney transplantation. One hundred and thirty-two Korean kidney recipients who received tacrolimus were genotyped for ABCB1 (exons 12, 21, and 26) and CYP3A5 (intron 3). Tacrolimus trough levels, dose, or dose-adjusted trough levels and complications were compared among patients during the early stage (3, 7, 14, 30, and 90 days) and up to 1 year according to the genotypes. A donor source-adjusted linear mixed model with multilevel analysis adjusting for age, body weight, hematocrit, and serum creatinine showed that CYP3A5 genotype is associated with dose-adjusted level of tacrolimus (p < 0.001). The influence of ABCB1 polymorphisms on the pharmacokinetics or complications of tacrolimus was less certain in our study. The incidence of acute rejections was significantly higher in recipients of cadaveric donor kidney (p < 0.05). A generalized estimating equation model analysis showed that alopecia and hyperlipidemia were associated with dose-adjusted level of tacrolimus (p < 0.001). Genotype of CYP3A5 variants along with significant clinical covariates may be useful in individualizing tacrolimus therapy in kidney transplantation patients.</P>
( Joon Yeul Nam ),( Jong Ho Lee ),( Hee Yoon Jang ),( Kanghyug Choi ),( In-gyoon Ha ),( Eun Sun Jang ),( Jin-wook Kim ),( Sook-hyang Jeong ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Prediction of development of hepatocellular carcinoma (HCC) among hepatitis B virus (HBV)-related cirrhosis patients on potent antiviral therapy is not well defined. This study aimed to investigate the incidence and predictors of HCC development in cirrhosis patients on entecavir therapy. Methods: This single center, retrospective cohort study included 424 consecutive patients with HBV-related cirrhosis who underwent entecavir therapy from 2007 to 2013. Surveillance for HCC was based on semiannual ultrasonography and serum alpha fetoprotein (AFP) measurement. HCC incidence and the related factors were analyzed. Results: The subjects showed a median age of 52.7±10.1 years with 63.5% of male, mean body mass index (BMI) of 24.2±3.1 kg/㎡, HBeAg positivity in 41.5%, baseline HBV DNA level of 1.39x10<sup>8</sup> IU/mL, and mostly Child-Pugh class A (80.9%). During median follow-up of 62.0 months (interquartile range, 29.0-83.0), 90.8% (385/424) reached complete virologic response of entecavir therapy. The overall incidence of HCC was 86 out of 424 patients (20.3%); incidence rate of 2.54/100 person-yr at 1 yr, 8.07/100 at 3 yr, and 8.37/100 at 5 years of follow-up. The multivariate analysis showed that the independent factors related to HCC development were BMI ≥23 (hazard ratio (HR), 1.89; 95% confidence interval (CI), 1.23-3.39; P=0.006), and high FIB-4 (≥3.25; HR, 5.65; 95% CI, 1.35-23.72; P=0.018) or intermediate FIB-4 (≥1.45 and <3.25; HR, 4.58; 95% CI, 1.08-19.41; P=0.039). Conclusions: HCC incidence rate among HBV-related liver cirrhosis on entecavir therapy was 2.54/100, 8.07/100, and 8.37/100 person-yr at 1, 3 and 5 yr, respectively. High BMI and high to intermediate FIB-4 score were independent factors for HCC development.
김종호 ( Jong Ho Kim ),배귀현 ( Kwi Hyun Bae ),최연경 ( Yeon Kyung Choi ),하인균 ( In Gyoon Ha ),박근규 ( Keun Gyu Park ),김정국 ( Jung Guk Kim ),이인규 ( In Kyu Lee ) 대한내과학회 2013 대한내과학회지 Vol.84 No.5
Fever of unknown origin (FUO) is not infrequently a diagnostic dilemma for clinicians. Common infectious causes include endo-carditis and abscesses in adults, and noninfectious causes include neoplasms and certain collagen vascular diseases. Endocrine causes of FUO are rare. The only endocrine disorder likely to present as FUO is subacute thyroiditis. Subacute thyroiditis usually occurs in middle-aged women as viral prodrome, neck tenderness, classic symptoms of thyrotoxicosis, and an elevated erythrocyte sedimentation rate. The patient may have abrupt onset of fever and chills with complaints of thyroid pain, or only low-grade fever with poorly characterized anterior neck pain. We present a case of FUO in a 48-year-old female who had had fever and neck pain for more than one month. Despite an extensive evaluation, the patient had persistent fever and no cause was found, with the exception of subacute thyroiditis. The fever resolved from the second day of treatment with low-dose steroid (prednisolone, 10 mg per day). This case illustrates that subacute thyroiditis should be considered in cases of FUO. (Korean J Med 2013;84:733-736)
장하균(Ha-Gyoon Chang),여인권(In-Kwon Yeo),장우진(Woojin Jang) 한국조명·전기설비학회 2008 한국조명·전기설비학회 학술대회논문집 Vol.2008 No.5월
수은이 함유된 방전등과 같은 조명기구의 사용이 제한되는 특수구역의 산업용 조명설비로 200 W 이상의 높은 소비전력의 백열등기구들이 사용되고 있다. 인공광원으로 백열전구는 매우 낮은 발광효율로 전력소모가 많고, 높은 방사열로 인해 화재의 염려가 있어 램프보호유리구를 장착하므로 낮은 조명률로 광 손실이 높게 발생한다. 또한 산업지역 내에서는 일반적으로 각종 전동기 및 공기조화 설비의 가동으로 진동이 심하며 여기에 백열전구 사용 시 당초 예상되는 수명보다 더욱 단축되고 있다. 이러한 지역에 설치된 백열등을 조명등기구 효율(Luminaire Efficacy)이 높은 친환경 에너지 절감형 차세대 광원인 LED조명등으로 대체하여 산업설비 지역 내 공급되는 조명용 소비전력을 크게 줄여 에너지 절약효과를 높임과 동시에 양호한 조명율의 LED등기구를 사용함으로써 실내조도를 향상 시키며, 백열전구 대비 색온도가 높은 LED광원을 사용함으로써 조명환경 개선에 따른 작업능률을 높이기 위해 특수지역의 산업용 LED조명등을 개발하였다.