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( Eileen L. Yoon ),( Tae Yeob Kim ),( Do Seon Song ),( Jin Mo Yang ),( Hee Yeon Kim ),( Chang Wook Kim ),( Young Kul Jung ),( Hyung Joon Yim ),( Soung Won Jeong ),( Sang Gyune Kim ),( Jae Young Jang ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: To investigate long-term mortality according to the severity of alcoholic hepatitis and the presence or absence of previous acute decompensation (AD) in alcoholic cirrhotic patients with acute deterioration. Methods: A total of 894 alcoholic cirrhotic patients (male 747, mean age 53.1 years) with acute deterioration were prospectively followed up. Severe alcoholic hepatitis (SAH) was defined by a modified discriminant function ≥32. Enrolled patients were divided into 3 groups according to the presence and severity of AH; group1, alcoholic cirrhosis without AH; group2, alcoholic cirrhosis with non-SAH; group3, alcoholic cirrhosis with SAH. AD was defined as: acute development of overt ascites, hepatic encephalopathy, gastrointestinal bleeding, and infection. Results: During follow-up duration (14.3±10.7 months), long-term mortality were higher in patients with group 3 than those in group 1 and 2, but there was no significant difference between group 1 and 2 (group 1, 160/596; group 2, 27/141; group 3, 76/157, P<0.001). Also, in 671 patients who survived for more than 3 months following acute deterioration (long-term survivors), long-term survival curve between groups showed a similar pattern (P=0.004). Interestingly, in group 1, the presence of previous AD negatively affected long-term survival in total and long-term survivors (P<0.001 and P=0.004, respectively). However, in group 3, previous AD negatively affected long-term survival in long-term survivors (P=0.009), but not in total patients (figure 1). Especially in long-term survivors of group 3, previous AD showed hazard ratio of 2.47 (95% confidence interval, 1.16-5.28, P=0.019). Conclusions: Compared with the long-term prognosis of patients with acute deterioration except for AH, that of SAH was poor, but that of non-SAH was similar. However, in patients with acute deterioration except for AH and SAH patients overcoming acute deterioration, the presence of previous AD had a great impact on long-term prognosis. These findings will help to determine the therapeutic plan.
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 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Chronic hepatitis B(CHB) patients with multi-drug experience are frequently switched to tenofovir-monotherapy, recently in Korea. We aimed to evaluate safety and efficacy of switching to tenofovir-monotherapy from tenofovir-based combination therapy upto 24 months. Methods: This is a retrospective study of multi-drug experienced CHB patients who have switched from tenofovir-based combination therapy to tenofovir-monotherapy after achievement of virologic response(VR, less than 20 IU/mL) in two centers from 2013 to 2018 Results: A total of 39 patients were included. Median age was 52 years old. Twenty nine patients were male(74.4%). HBeAg positive patients were 32(82.1%). Thirty three patients(84.6%) had experienced not only nucleoside analogues, but also nucleotide analogues previously. Median duration of VR before switching to monotherapy was 16.3 months and median duration of monotherapy was 32.0 months(range, 3-55). VR at 12 and 24 months were achieved in 36 patients. One patient lost to follow-up after 12 months of monotherapy without non VR. Two patients experienced virologic breakthrough during 24 months of tenofovir-monotherapy. All the 5 patients who experienced non VR easily achieved VR within 3 months with tenofovir-monotherapy, but all of them had experienced adefovir previously. Duration of consolidation with combination therapy after VR were less than 6 months in 4 out 5 patients who showed non-VR during 24 months of tenofovir-monotherapy. Conclusions: Switching to tenofovir-monotherapy in multi-drug experienced patients is generally safe and effective upto 24 months. Constant monitoring of virus may be required in patients with previous adefovir-exposure and short duration of consolidation after VR achievement.
필리핀 CAGAYAN 유역에서 선택된 지방정부기구의 폐기물관리 프로그램
( Eileen C. Bernardo ) 한국폐기물자원순환학회 2002 APLAS Vol.2002 No.2
필리핀에서 가장 심각한 문제 중의 하나는 폐기물의 부적절한 취급에 의해 발생된 오염이다. Republic Act 9003 또는 the Ecological solid Waste Management Act of 2000 은 2001년 1월 26일 법으로 정해졌다. 이 법률은 생태학적인 폐기물관리가 이루어지도록 하고 지방정부기구로 하여금 각 권력을 보완하고 강화하는데 책임이 있음을 규정하고 있다. 본 연구의 목적은 (1) Cagayan 유역에서의 선택된 지방정부의 현행 폐기물관리프로그램을 조사하고, (2) 분할 적용 범위와 폐기물관리의 3Rs 을 조사하며, (3) 여러 지방정부기구에서 행해진 폐기물처분 실태를 조사한다. 본 연구는 지방정부기구들이 생태학적인 폐기물관리프로그램을 통하여 폐기물관리 문제에 총력을 기울이고 있음을 보여준다. 비록 이러한 프로그램이 자금 부족 및 논리성 부족과 같은 문제에 부딪히고 있지만, 각 지방정부기구에서는 폐기물관리문제를 해결하기 위하여 노력하고 있다. One of the most serious problems in the Philippines is pollution caused by improper handling of solid wastes. Republic Act 9003 or the Ecological solid Waste Management Act of 2000 was signed into law on January 26, 2001. The Act provides for an ecological solid waste management and for the Local Government Units (LGUs) to be responsible for its implementation and enforcement in their respective jurisdictions. The objectives of this study are to: (1) determine the current Solid Waste Management Programs of selected LGUs in the Cagayan Valley Region; (2) determine the extent of application of segregation and the 3Rs of waste management; (3) determine the solid waste disposal practiced in the different LGUs. This study shows that the LGUs are addressing the issue of solid waste management through their ecological solid waste management programs (ESWMPs). Although these programs are hindered by several problems including lack of funding and logistic support, efforts are being undertaken in the different municipalities to solve the problem on solid waste management.