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- 저자 : 정고은 ( Goh Eun Chung ) (검색결과 3 건)
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스테로이드 저항 중증 궤양성 대장염 환자에서 스테로이드와 Cyclosporin A의 병합 투여와 스테로이드 단독 연장 투여의 치료 효과 비교
정고은 ( Goh Eun Chung ),천재희 ( Jae Hee Cheon ),이종열 ( Jong Yeul Lee ),예병덕 ( Byong Duk Ye ),김상균 ( Sang Gyun Kim ),김주성 ( Joo Sung Kim ),정현채 ( Hyun Chae Jung ),송인성 ( In Sung Song ) 대한소화기학회 2006 대한소화기학회지 Vol.48 No.4
목적: 중증 궤양성 대장염 환자에서 정맥 내 스테로이드의 투여 기간과 cyclosporin A의 병합투여 효과에 대해서는 정립된 바가 없다. 이번 연구의 목적은 스테로이드 저항 중증 궤양성 대장염 환자에서 cyclosporin A와 스테로이드를 병합 투여한 군과 스테로이드를 단독으로 4주까지 연장하여 투여한 군에서 단기 치료 효과를 비교하고자 하였다. 대상 및 방법: 1999년 4월부터 2005년 5월까지 서울대학교 병원에서 중증 궤양성 대장염의 급성 악화로 입원치료를 받은 59명의 환자, 총 84예를 대상으로 후향으로 분석하였다. 결과: 2주 동안의 정맥 내 스테로이드 치료를 시행한 결과 45예(53.6%)에서 치료에 반응을 보였으며, 39예(46.4%)에서는 반응을 보이지 않았다. 치료에 반응을 보이지 않은 39예 중 3예(7.6%)에서 수술을 시행받았고, 나머지 36예에서는 cyclosporin A와 스테로이드를 병합하여 투여하거나 스테로이드를 단독으로 연장하여 투여하였다. Cyclosporin A와 스테로이드를 병합 투여한 16예 중 12예(75%)에서 치료에 반응을 보였고, 스테로이드를 단독으로 연장하여 투여한 20예 중 16예(80%)에서 치료에 반응을 보여서 양 군 사이에 반응률에는 유의한 차이를 보이지 않았다(p=1.00). 결론: 2주 동안의 정맥 내 스테로이드 치료에 반응하지 않는 중증 궤양성 대장염 환자에서 cyclosporin A와 스테로이드의 병합 투여는 스테로이드를 단독으로 연장하여 투여한 경우에 비해 추가 장점이 없는 것으로 보이며, 정맥 내 스테로이드는 첫 2주 이후에도 4주까지는 비교적 안전하고 효과적으로 투여할 수 있을 것으로 생각한다. Background/Aims: Maximal duration of intravenous (IV) corticosteroid (CS) treatment and efficacy of cyclosporin A (CsA) have not been clarified for patients with severe ulcerative colitis. We aimed to evaluate and compare the effectiveness of CS and CsA combination therapy with prolonged CS therapy alone in patients with severe UC refractory to initial CS therapy. Methods: We retrospectively reviewed the medical records of 84 episodes of severe UC in 59 patients between April 1999 and May 2005. Results: Among 84 episodes with IV CS therapy, 45 (53.6%) experienced an early response, while 39 (46.4%) did not respond within 2 weeks. The remaining 36 episodes excluding 3 which underwent colectomy were assigned to either combination therapy of IV CS and CsA or prolonged IV CS treatment alone for additional 2 weeks. Twelve of 16 episodes (75.0%) responded to therapy with combinations of IV CsA and CS, and 16 of 20 episodes (80.0%) to prolonged IV CS treatment alone. There was no statistical difference in response and colectomy rate after 4 weeks between CsA-use group and CsA-non-use group (p=1.00). Conclusions: These results suggest that CS and CsA combination has no additional benefit over prolonged CS therapy alone in terms of short-term response and that CS can be safely prolonged even after the first 14 days of treatment for severe UC. (Korean J Gastroenterol 2006;48:263-268)
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정고은 ( Goh Eun Chung ),김동희 ( Dong Hee Kim ) 대한내과학회 2014 대한내과학회지 Vol.86 No.4
Nonalcoholic fatty liver disease (NAFLD) is recognized as the most common liver disease with an estimated prevalence of 20-30% in the Western world and 16-33% in Korea. NAFLD encompasses a broad spectrum of hepatic dysfunction ranging from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma. The increasing prevalence of NAFLD is particularly worrying because patients appear to have higher non-liver-related and liver-related death, as compared to the general population. Given its well-known association with metabolic comorbidities, NAFLD is commonly asso ?ciated with obesity, type II diabetes, dyslipidemia, and metabolic syndrome. The natural history of NAFLD remains unclear due to its indolent clinical course and the lack of well-designed prospective studies. The prognosis of NAFLD depends on the histological subtype, while NASH may be associated with liver fibrosis and cirrhosis and may progress to hepatocellular carcinoma. The overall and liver-related mortality are increased in patients with NASH, as compared to NAFL and the general population. NAFLD is strongly associated with cardiovascular disease and type 2 diabetes, so it should also be considered a metabolic liver disease. Further long-term studies of the natural course of NAFLD are warranted. (Korean J Med 2014;86:399-404)
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한국인 비알코올성 지방간 질환 환자에서 P2/MS 및 기타 비침습적 섬유화 지표의 유효성
유수종 ( Su Jong Yu ),김동희 ( Dong Hee Kim ),이정훈 ( Jeong Hoon Lee ),정고은 ( Goh Eun Chung ),임정윤 ( Jeong Yoon Yim ),박민정 ( Min Jung Park ),김윤준 ( Yoon Jun Kim ),윤정환 ( Jung Hwan Yoon ),장자준 ( Ja June Jang ),이효석 ( 대한소화기학회 2011 대한소화기학회지 Vol.57 No.1
Background/Aims: P2/MS is a noninvasive marker for detecting hepatic fibrosis in patients with viral hepatitis. However, the applicability of P2/MS in patients with nonalcoholic fatty liver disease (NAFLD) has not yet been validated. This study aimed to validate P2/MS and compare it to other noninvasive fibrosis scoring systems in Korean patients with NAFLD. Methods: Consecutive patients who underwent liver biopsy between January 2002 and December 2009 at Seoul National University Hospital, Seoul, Korea were enrolled in this study. Fibrosis stage was determined using the METAVIR scoring system. Results: A total of 235 patients were included in the study: advanced fibrosis (METAVIR F3-F4) was present in 7 patients. No patient was over-staged among 162 patients with a P2/MS score above the high cut-off (95), resulting in a high negative predictive value (NPV) of 100% (95% confidence interval, 97.1-100). There was no significant difference between the area under the receiver-operating characteristic curve (AUROC) of the FIB-4 (0.964) and the AUROC of the NAFLD fibrosis score (0.964) or P2/MS (0.940) for detecting advanced fibrosis. If P2/MS was implemented in the Korean patients with NAFLD, 68.9% of liver biopsies might be avoided. Conclusions: P2/MS has a high NPV for excluding advanced fibrosis in Korean patients with NAFLD, and can reduce the burden of liver biopsy in the majority of cases. Since there were few patients with advanced fibrosis, further studies are warranted in a cohort including more patients with advanced fibrosis to validate the low cut-off value. (Korean J Gastroenterol 2011;57:19-27)
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