Original Article : The Effect of Intestinal Permeability and Endotoxemia on the Prognosis of Acute Pancreatitis

( Young Yool Koh ),( Woo Kyu Jeon ),( Yong Kyun Cho ),( Hong Joo Kim ),( Won Gil Chung ),( Chang Uk Chon ),( Tae Yun Oh ),( Jun Ho Shin ) The Editorial Office of Gut and Liver 2012 Gut and Liver Vol.6 No.4

Background/Aims: Early intestinal mucosal damage plays an important role in severe acute pancreatitis (AP). Previous studies have shown that intestinal permeability (IP), serum endotoxin and cytokines contribute to the early intestinal barrier dysfunction in AP. This study explored the predictive capacity of IP, endotoxemia and cytokines as prognostic indicators in AP patients. Methods: Eighty-seven AP patients were included in the study. The patients were classified into three groups according to the Balthazar computed tomography severity index (CTSI). We compared the biochemical parameters, including IP, serum endotoxin level and cytokine level among the three groups. The associations of IP with serum endotoxin, cytokines, CTSI, and other widely used biochemical parameters and scoring systems were also examined. Results: IP, serum endotoxin, interleukin (IL-6) and tumor necrosis factor (TNF)-α had a positive correlation with the CTSI of AP. Endotoxin, IL-6, TNF-α, CTSI, the Ranson/APACHE II score, the duration of hospital stay, complications and death significantly affect IP in the AP patients. Conclusions: We believe that IP with subsidiary measurements of serum endotoxin, IL-6 and TNF-α may be reliable markers for predicting the prognosis of AP. Further studies that can restore and preserve gut barrier function in AP patients are warranted. (Gut Liver 2012;6:505-511)

Reye 증후군:18 세 남자에 발생한 1 예

한상율,박명석,임태희,박병섭,임종윤,고영박 대한내과학회 1987 대한내과학회지 Vol.32 No.4

A case of Reyes syndrome in a 18-year-old male patient, who was transferred to the hospital because of bizarre behvior, is reported. There were respiratory tract infection and ingestion of aspirin preparation prior to the illness. Serum transaminase levels and serum ammonia levels were elevated. In microscopir examintion of the liver, diffuse microvesicular fatty infiltration was observed. We think that nonpediatricians should consider the possibility of this disease in adult patients with altered consciousness.

Clinical impacts of hazardous alcohol use and obesity on the outcome of entecavir therapy in treatment-naïve patients with chronic hepatitis B infection

Won Gil Chung,Hong Joo Kim,Young Gil Choe,Hyo Sun Seok,Chang Wook Chon,Yong Kyun Cho,Byung Ik Kim,Young Yool Koh 대한간학회 2012 Clinical and Molecular Hepatology(대한간학회지) Vol.18 No.2

Background/Aims: The aim of this study was to analyze the clinical impacts of obesity and hazardous alcohol use on the outcome of entecavir (ETV) therapy in chronic hepatitis B (CHB) patients. Methods: The medical records of 88 treatment-naïve patients who were diagnosed with CHB and received ETV between March 2007 and September 2009 were analyzed retrospectively. Body mass index (BMI) values and Alcohol Use Disorders Identifi cation Test (AUDIT) scores were obtained at 6 months after the initiation of ETV (0.5 mg daily) treatment. Results: A BMI of 25 kg/m2 or more was recognized as an indicator of obesity, and a total AUDIT score of 8 or more was recognized as an indicator of hazardous alcohol use. Of the cohort, 24 patients (27.3%) were obese and 17 (19.3%) were hazardous alcohol users. The rate of seroconversion, alanine aminotransferase (ALT) normalization, and hepatitis B virus (HBV)-DNA negativity (<300 copies/mL) at 3, 6, and 12 months of treatment did not differ significantly between the normal-BMI and high-BMI groups. Moreover, the rate of seroconversion and HBV-DNA negativity at 3, 6, and 12 months of treatment did not diff er signifi cantly between the nonhazardous and hazardous alcohol users. However, the frequency of ALT normalization at 12 months was signifi cantly lower among hazardous alcohol users (91.5% vs. 70.6%; P =0.033). Conclusions: Obesity and hazardous alcohol drinking have no significant impact on the outcome of ETV treatment. However, the ALT normalization rate at 12 months after initiation of ETV treatment was signifi cantly lower among the hazardous alcohol users. (Clin Mol Hepatol 2012;18:195-202) Background/Aims: The aim of this study was to analyze the clinical impacts of obesity and hazardous alcohol use on the outcome of entecavir (ETV) therapy in chronic hepatitis B (CHB) patients. Methods: The medical records of 88 treatment-naïve patients who were diagnosed with CHB and received ETV between March 2007 and September 2009 were analyzed retrospectively. Body mass index (BMI) values and Alcohol Use Disorders Identifi cation Test (AUDIT) scores were obtained at 6 months after the initiation of ETV (0.5 mg daily) treatment. Results: A BMI of 25 kg/m2 or more was recognized as an indicator of obesity, and a total AUDIT score of 8 or more was recognized as an indicator of hazardous alcohol use. Of the cohort, 24 patients (27.3%) were obese and 17 (19.3%) were hazardous alcohol users. The rate of seroconversion, alanine aminotransferase (ALT) normalization, and hepatitis B virus (HBV)-DNA negativity (<300 copies/mL) at 3, 6, and 12 months of treatment did not differ significantly between the normal-BMI and high-BMI groups. Moreover, the rate of seroconversion and HBV-DNA negativity at 3, 6, and 12 months of treatment did not diff er signifi cantly between the nonhazardous and hazardous alcohol users. However, the frequency of ALT normalization at 12 months was signifi cantly lower among hazardous alcohol users (91.5% vs. 70.6%; P =0.033). Conclusions: Obesity and hazardous alcohol drinking have no significant impact on the outcome of ETV treatment. However, the ALT normalization rate at 12 months after initiation of ETV treatment was signifi cantly lower among the hazardous alcohol users. (Clin Mol Hepatol 2012;18:195-202)

Original Articles : Clinical impacts of hazardous alcohol use and obesity on the outcome of entecavir therapy in treatment-naive patients with chronic hepatitis Binfection

( Won Gil Chung ),( Hong Joo Kim ),( Young Gil Choe ),( Hyo Sun Seok ),( Chang Wook Chon ),( Yong Kyun Cho ),( Byung Ik Kim ),( Young Yool Koh ) 대한간학회 2012 Clinical and Molecular Hepatology(대한간학회지) Vol.18 No.2

Background/Aims: The aim of this study was to analyze the clinical impacts of obesity and hazardous alcohol use on the outcome of entecavir (ETV) therapy in chronic hepatitis B (CHB) patients. Methods: The medical records of 88 treatment-naive patients who were diagnosed with CHB and received ETV between March 2007 and September 2009 were analyzed retrospectively. Body mass index (BMI) values and Alcohol Use Disorders Identifi cation Test (AUDIT) scores were obtained at 6 months after the initiation of ETV (0.5 mg daily) treatment. Results: A BMI of 25 kg/m2 or more was recognized as an indicator of obesity, and a total AUDIT score of 8 or more was recognized as an indicator of hazardous alcohol use. Of the cohort, 24 patients (27.3%) were obese and 17 (19.3%) were hazardous alcohol users. The rate of seroconversion, alanine aminotransferase (ALT) normalization, and hepatitis B virus (HBV)-DNA negativity (<300 copies/mL) at 3, 6, and 12 months of treatment did not differ significantly between the normal-BMI and high-BMI groups. Moreover, the rate of seroconversion and HBV-DNA negativity at 3, 6, and 12 months of treatment did not diff er signifi cantly between the nonhazardous and hazardous alcohol users. However, the frequency of ALT normalization at 12 months was signifi cantly lower among hazardous alcohol users (91.5% vs. 70.6%; P=0.033). Conclusions: Obesity and hazardous alcohol drinking have no significant impact on the outcome of ETV treatment. However, the ALT normalization rate at 12 months after initiation of ETV treatment was signifi cantly lower among the hazardous alcohol users. (Clin Mol Hepatol 2012;18:195-202)

B형 간염 예방접종 효율에 관한 연구 - 한 농촌지역에서의 혈청학적 표지자에 대한 분석

송관욱(Kwan Uk Song),김훈(Hun Kim),고문수(Moon Soo Koh),장웅기(Woong Ki Chang),김동준(Dong Jun Kim),박충기(Choong Kee Park),유재영(Jae Young Yoo),최보율(Bo Yool Choi) 대한내과학회 1999 대한내과학회지 Vol.57 No.6

N/A Background : The objectives of this study are to determine the positive rate of HBV serologic markers and infection rate, and to evaluate the efficiency of hepatitis B vaccination. Methods : Study subjects included 905 persons in 1988-1989 and 744 persons in 1993-1994 living in typical rural communities in Korea. Three serologic markers(HBsAg, anti-HBs, anti-HBc) were tested by radio-immunoassay(RIA). Supplemental informations were collected by self-administered questionnaire and interview on age, sex, history and frequency of vaccination. Results : 1) Among non-vaccinees, HBsAg, anti-HBs, anti-HBc positive rates and infection rate in 1993-1994/1988-1989 were 5.4%/6.5%, 49.1%/45.9%, 48.3%/44.1% and 60.6%/54.5% respectively. The infection rate showed a trend of continuous increase as the age increased, while statistically significant increase was seen over age 20. 2) Overall vaccination rate was 18.1% in 1988-1989 and 37.9% in 1993-1994, showing statistically significant increase in vaccination rate. The rate in younger age groups were higher than in older groups in 1988-1989, but there was no difference by age groups in 1993-1994. Among vaccinees, anti-HBs only positive group occupied 42.7% in 1988-1989 and 41.3% in 1993-1994. HBs Ag negative and anti-HBc positive group occupied 26.2% in 1988-1989 and 36.73% in 1993-1994. Conclusion : 1) Among non-vaccinees, HBsAg positive rate was decreased, but the hepatitis B infection rate was not decreased. 2) The test for selection of eligible person of vaccination and education program for completion of vaccination schedule must be reevaluated to improve the efficiency of hepatitis B vaccination. (Korean J Med 57:994-1005, 1999)