Efficacy of Long-Term Tenofovir-Based Therapy in Chronic Hepatitis B Patients with Previous Nucleos(t)ide Analogues Treatment Experience

( Na Eun Lee ),( Hong Seon Son ),( Sung Hoon Choi ),( Chang Hun Lee ),( Seung Young Seo ),( Seong Hun Kim ),( Sang Wook Kim ),( Seung Ok Lee ),( Soo Teik Lee ),( Dae Ghon Kim ),( In Hee Kim ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Tenofovir disoproxil fumarate (TDF) is considered as the preferred treatment option for chronic hepatitis B (CHB) patients with treatment failure or resistance to prior nucleos(t)ide analogues (NAs) treatment. We investigated the efficacy of long-term TDF-based therapy in CHB patients with previous NAs-experience. Methods: This study included total 251 patients who had previous history of NAs therapy and were treated with TDF mono (n=173) or TDF combined with other NA (n=78) from August 2012 to March 2017. Virologic response (VR) was defined as undetectable serum HBV DNA by PCR (<20 IU/mL). Results: Mean age of patients was 49.3 years, median duration of TDF therapy was 27.2 months, 75.7% were HBeAg-positive, and median HBV DNA was 3.7 log10IU/mL. The cumulative rates of VR were 188/244 (77.0%), 180/211 (85.3%), and 146/161 (90.7%) at 12, 24, and 36 months, respectively. Multivariate analysis showed that body mass index (OR 0.77, 95% CI 0.61-0.95, p=0.0189) and duration of TDF therapy (OR 1.09, 95% CI 1.02-1.18, p=0.0221) was significantly associated with VR. TDF monotherapy, HBeAg-positivity, platelet count, serum albumin was associated with VR in the univariate analysis, but not significant in the multivariate analysis. In relation to renal safety, patients showed renal impairment (7, 3.0%), mild hypophosphatemia (15, 7.2%), severe hypophosphatemia (1, 0.4%). Conclusions: Long-term TDF-based therapy demonstrated highly effective in viral suppression and relatively favorable renal safety in CHB patients with previous NA-experience. The body mass index and duration of TDF therapy was independent factors associated with VR.

가정연계 신체활동이 유아의 기초체력에 미치는 영향

김은정(Eun-Jung Kim),안나영(Na-young An) 한국발육발달학회 2018 한국발육발달학회지 Vol.26 No.2

The awareness of the decreasing physical activities of children today introduced the application of Home-Based physical activities as one of the solutions to the problem. This Home-Based physical activity program provided the families with training materials and wall posters for physical activities as well as the eurhythmics videos accessible through provided QR codes in attempt to assist the families to practice the physical activities taken in children educational institutes from homes. 4910 children of both sexes across the nation partook in this research while the researchers were determined to test the change on children’s physical strength before/after the application of the program. In order to track the change, the researchers have adjusted and supplemented the research tools of Na-young An, Eun-jung Kim, Tae-seop Park (2013) to measure the endurance, muscle strength, flexibility, agility, adaptation, and balance of the children. The research revealed that the children that partook in the program for household physical activities showed an overall superiority on all 6 fields - endurance (scissor jump for 30 seconds), muscle strength (grasping power), flexibility (sitting trunk flexion), agility (30meters shuttle run), adaptation (standing high jump), balance (standing on one foot) - compared to the children who haven’t engaged in the program. Also the researchers found that the general physical strength of the children in the program to have increased periodically during the test. Most of all, there was a significant difference on overall body endurance and right-left balance from which the deduction of the relatedness between the two and the household physical activities was made. In conclusion, Home-Based physical activities have shown to have positive influence on the general physical strength of the children.

중국 고전 사가원림(私家园林)의 공간구성 특성에 관한 연구

셰나 ( Xie¸ Na ),조은길 ( Cho¸ Eun Kil ) 디자인융복합학회(구.한국인포디자인학회) 2021 디자인융복합연구 Vol.20 No.4

본 연구는 중국 고전 사가원림의 우수한 전통을 계승할 필요성을 기반으로, 과학적으로 분석할 수 있는 공간구문론을 이용하여 중국 남북방 지역을 대표하는 원림의 시각적 접근성을 분석하였다. 이를 통해 고전 사가원림 공간 구성의 기본 법칙을 발견하고, 전통적인 원림을 구축하는 지혜를 계승하기 위한 기초적인 자료를 제공하고자 하였다. 본 논문의 연구결과는 다음과 같다. 첫째, 남북방 사가원림이 각자의 지역에서 고유의 사회적·문화적 특색을 반영하고 있음을 알 수 있었다. 둘째, 선조들이 과학 기술이 발전되지 않았음에도 불구하고 전통원림의 공간구성 질서관(秩序觀)을 가지고 구축하였음을 발견하였다. 셋째, 북방 고전 사가원림 공간의 시각적 접근성이 남방보다 조금 더 높은 것으로 나타났는데, 이는 북방의 지리적 조건과 인문적 배경이 영향인 것으로 판단된다. 넷째, 남방과 북방 고전 사가원림 모두 국지적 통합도와 전체적 통합도가 상이하고 명료도가 낮게 나타난 것은 전체 원림 공간에 대한 인식 수준을 고려하기 했다기보다는 원림 속 예술적 경지의 창조와 표현을 통해 문화적 사고와 사회적 현실의 통일을 실현하고 있음을 알 수 있었다. Based on the necessity of inheriting the excellent traditions of Chinese classical private gardens, this article uses Space Syntax to analyze the visual accessibility of representative gardens covering China. This is to explore the gardening wisdom of the ancients and to discover the basic laws of the spatial organization of gardens. The results of the study are as follows. First, the private gardens can fully demonstrate their own characteristics in their respective regional spaces. Second, the results proved that the ancients could still maintain and inherit the space order concept of traditional gardens. Third, the visual accessibility of the private garden space in the north is slightly greater than that in the south. This is affected by the natural and geographical conditions, humanities and etiquette thoughts in the north. Fourth, the local spatial information and overall spatial information of the north-south and north-south classical private gardens are different, indicating that the level of understanding of the overall garden space is low and difficult to understand.

A Na⁺-coupled C₄-dicarboxylate transporter (Asuc_0304) and aerobic growth of <i>Actinobacillus succinogenes</i> on C₄-dicarboxylates

Rhie, Mi Na,Yoon, Hyo Eun,Oh, Hye Yun,Zedler, Sandra,Unden, Gottfried,Kim, Ok Bin Society for General Microbiology 2014 Microbiology Vol.160 No.7

<P><I>Actinobacillus succinogenes</I>, which is known to produce large amounts of succinate during fermentation of hexoses, was able to grow on C<SUB>4</SUB>-dicarboxylates such as fumarate under aerobic and anaerobic conditions. Anaerobic growth on fumarate was stimulated by glycerol and the major product was succinate, indicating the involvement of fumarate respiration similar to succinate production from glucose. The aerobic growth on C<SUB>4</SUB>-dicarboxylates and the transport proteins involved were studied. Fumarate was oxidized to acetate. The genome of <I>A. succinogenes</I> encodes six proteins with similarity to secondary C<SUB>4</SUB>-dicarboxylate transporters, including transporters of the Dcu (C<SUB>4</SUB>-dicarboxylate uptake), DcuC (C<SUB>4</SUB>-dicarboxylate uptake C), DASS (divalent anion : sodium symporter) and TDT (tellurite resistance dicarboxylate transporter) family. From the cloned genes, Asuc_0304 of the DASS family protein was able to restore aerobic growth on C<SUB>4</SUB>-dicarboxylates in a C<SUB>4</SUB>-dicarboxylate-transport-negative <I>Escherichia coli</I> strain. The strain regained succinate or fumarate uptake, which was dependent on the electrochemical proton potential and the presence of Na<SUP>+</SUP>. The transport had an optimum pH ~7, indicating transport of the dianionic C<SUB>4</SUB>-dicarboxylates. Transport competition experiments suggested substrate specificity for fumarate and succinate. The transport characteristics for C<SUB>4</SUB>-dicarboxylate uptake by cells of aerobically grown <I>A. succinogenes</I> were similar to those of Asuc_0304 expressed in <I>E. coli</I>, suggesting that Asuc_0304 has an important role in aerobic fumarate uptake in <I>A. succinogenes</I>. Asuc_0304 has sequence similarity to bacterial Na<SUP>+</SUP>-dicarboxylate cotransporters and contains the carboxylate-binding signature. Asuc_0304 was named SdcA (<U>s</U>odium-coupled C<SUB>4</SUB>-<U>d</U>i<U>c</U>arboxylate transporter from <I><U>A</U></I>. <I>succinogenes</I>).</P>

The Comparison of Clinical Outcomes between Inactive Chronic Hepatitis B and HBeAg Negative Hepatitis B with Virologic Response

( Seong Kyun Na ),( Byung-cheol Song ),( Eun Kwang Choi ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Nucleos(t)ide analogues (NA) suppress HCC development in chronic hepatitis B (CHB) patients. This study is aimed to compare incidence of hepatocellular carcinoma and survival between inactive chronic hepatitis B (CHB) patients and HBeAg(-) CHB patients with virologic response. Methods: We retrospectively analyzed NA-naïve inactive CHB patients (n=80) and HBeAg(-) CHB patients on entecavir with virologic response (VR, DNA<2000 IU/mL) (n=72) at Jeju National University Hopital in Jeju, Korea, between March 2007 and December 2010. Decompensated liver cirrhosis patients were excluded. Results: Median follow-up duration was 8.1 years (interquartile range[IQR] 7.0 - 9.0). Age, sex distribution were not different between two groups, however, patients with liver cirrhosis was higher in HBeAg(-) CHB group (8.8% versus 30.6%, P=0.001). During the follow up, one HCC (1.3%) and 10 HCCs (13.9%) were developed, in inactive group and HBeAg(-) CHB group, respectively. Estimated 10-year HCC incidence rates were 1.5% in inactive group and 25.4% in HBeAg(-) CHB group (P<0.001). Progression to decompensation was comparable (no event in inactive group, one hepatic encephalopathy in HBeAg(-) CHB group, P=0.278). Liver-related death was also similar (no death in inactive group, one death in HBeAg(-) CHB group, P=0.278). In multivariable analysis, HBeAg(-) CHB (adjusted hazard ratio[aHR] 10.17 (95% confidence interval[CI] 1.20-86.29), P=0.034) and liver cirrhosis (aHR 11.02 (95% CI 2.61-46.63), P=0.001) were significant risk factors for HCC. Conclusions: Between inactive CHB patients and HBeAg(-) CHB patients on entecavir with VR, overall survival was comparable. However, HCC incidence was significantly higher in HBeAg(-) CHB patients with VR.

대동맥 판막 치환술 후 반복되는 Acinetobacter baumannii 균혈증의 원인이 된 대동맥염 1예

정용필,김성철,송은희,장은영,김은경,김윤지,성흥섭,김미나,최상호,우준희,김양수 대한감염학회 2007 감염과 화학요법 Vol.39 No.3

감염성 대동맥염은 흔하지 않지만 매우 위중한 질병으로 Salmonella so.와 S. aureus가 주된 원인균이다. 아직까지 병원내 감염의 주요 원인균인 Acinetobacter baumannii에 의한 감염성 대동맥염은 보고된 바가 없었다. 저자들은 대동맥 판막 치환술을 시행받은 76세 남자 환자에서 적절한 항생제 투여에도 반복되는 A. baumannii 균혈증의 원인이 감염성 대동맥염으로 진단되었던 1예를 경험하였기에 보고하는 바이다. Infectious aortitis is an uncommon yet, life threatening disease. Early surgical treatment and prolonged antibiotic therapy is crucial to survival. Salmonella sp. and Staphylococcus aureus are the most common organisms isolated. There is no case report of infectious aortitis caused by Acinetobacter baumannii, which has recently emerged as a major cause of health care-associated infections. Here, we describe a 76-year-old male with infectious aortitis who experienced recurrent bacteremia due to A. baumannii in spite of adequate antimicrobial therapy after aortic valve replacement.

Comparison of Virologic Response and Renal Safety of Long-Term Antiviral Therapy with Tenofovir and Entecavir in Naive Patient with Chronic Hepatitis B

( Hong Seon Son ),( Sung Hoon Choi ),( Na Eun Lee ),( Chang Hun Lee ),( Seung Young Seo ),( Seong Hun Kim ),( Sang Wook Kim ),( Seung Ok Lee ),( Soo Teik Lee ),( Dae Ghon Kim ),( In Hee Kim ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Tenofovir (TDF) entecavir (ETV) are considered as the preferred treatment options for treatment-naïve chronic hepatitis B (CHB) patients. We compared the virologic response and renal safety of long-term TDF versus ETV therapy in naïve CHB patients. Methods: This retrospective study included total 432 patients who were treated with TDF (n=205) or ETV (n=227) from August 2012 to March 2017. Virologic response (VR) was defined as undetectable serum HBV DNA by PCR (<20 IU/mL). Results: Mean age of patients, sex, baseline serum levels of AST, ALT, creatinine, and HBV DNA were not significantly different between TDF and ETV groups. The cumulative rates of VR between TDF and ETV groups were 71.6% vs. 61.8% (p=0.477), 88.1% vs. 79.6% (p=0.058), and 84.8% vs. 83.7% (p=0.966) at 1, 2, and 3 years, respectively. The cumulative rates of genotypic resistance between TDF and ETV groups were 0% vs. 0%, 0% vs. 1.5% (p=0.404), and 0% vs. 2.2% (p=0.447) at 1, 2, and 3 years, respectively. Incidences of renal impairment and hypophosphatemia during treatment up to 3 years were not significantly different between two groups. Multivariate analysis showed that HBeAg-positivity (OR 0.27, 95% CI 0.12-0.58, p=0.0012) and serum HBV DNA at 1 year 2000 IU/mL (OR 0.09, 95% CI 0.03-0.25, p<0.0001) were significantly associated with VR. Conclusions: Long-term TDF and ETV treatments appear to have similar virologic response and renal safety in naïve CHB patient. However, long-term ETV therapy might to be associated with genotypic resistance in 2.2% up to 3 years, while none of patients on TDF therapy did.

Are Spinal GABAergic Elements Related to the Manifestation of Neuropathic Pain in Rat?

Jaehee Lee,Seung Keun Back,Eun Jeong Lim,Gyu Chong Cho,Myung Ah Kim,Hee Jin Kim,Min Hee Lee,Heung Sik Na 대한생리학회-대한약리학회 2010 The Korean Journal of Physiology & Pharmacology Vol.14 No.2

Impairment in spinal inhibition caused by quantitative alteration of GABAergic elements following peripheral nerve injury has been postulated to mediate neuropathic pain. In the present study, we tested whether neuropathic pain could be induced or reversed by pharmacologically modulating spinal GABAergic activity, and whether quantitative alteration of spinal GABAergic elements after peripheral nerve injury was related to the impairment of GABAergic inhibition or neuropathic pain. To these aims, we first analyzed the pain behaviors following the spinal administration of GABA antagonists (1Ռg bicuculline/rat and 5Ռg phaclofen/rat), agonists (1Ռg muscimol/rat and 0.5Ռg baclofen/rat) or GABA transporter (GAT) inhibitors (20Ռg NNC-711/rat and 1Ռg SNAP-5114/rat) into naïve or neuropathic animals. Then, using Western blotting, PCR or immunohistochemistry, we compared the quantities of spinal GABA, its synthesizing enzymes (GAD65, 67) and its receptors (GABA_A and GABA_B) and transporters (GAT-1, and -3) between two groups of rats with different severity of neuropathic pain following partial injury of tail-innervating nerves; the allodynic and non-allodynic groups. Intrathecal administration of GABA antagonists markedly lowered tail-withdrawal threshold in naïve animals, and GABA agonists or GAT inhibitors significantly attenuated neuropathic pain in nerve-injured animals. However, any quantitative changes in spinal GABAergic elements were not observed in both the allodynic and non-allodynic groups. These results suggest that although the impairment in spinal GABAergic inhibition may play a role in mediation of neuropathic pain, it is not accomplished by the quantitative change in spinal elements for GABAergic inhibition and therefore these elements are not related to the generation of neuropathic pain following peripheral nerve injury.

원위부 신세뇨관성 산증에서 산-염기 운반체의 결손

김혜영,한진석,이정상,김현리,김진,이중건,이서진,김근호,진호준,전은실,주권욱,나기영,정우경,오지은,엄재호,궁성수 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.5

The purpose of this study was to elucidate whether the molecular defect of acid-base transporters in renal tubules is related to the functional defect of urinary acidification in distal renal tubular acidosis(RTA). We performed NH₄Cl, furosemide, or bicarbonate loading test to evaluate renal acidification function, and immunohistochemistry using antibodies to H^+ -ATPase, Cl^-/HCO₃^- exchanger(band-3 protein), and Na^+/K^+ -ATPase in kidney tissue in 6 patients with RTA and renal cell carcinoma patients as normal controls. Kidney tissue was obtained either by percutaneous needle biopsy(RTA) or nephrectomy(NC). The results were as follows; 1) In all six RTA patients, proton secretory defect of distal acidification was shown by a failure to lower the urine pH after NHC1 loading or furosemide test or abnormally low urine-blood pCO₂ difference during bicarbonate loading. In two patients with RTA, proximal acidification defect was combined, which was demonstrated by increased fractional excretion of bicarbonate. 2) In mal control, intense H^+ -ATPase and band-3 protein staining was observed in collecting ducts. 3) In distal RTA patients, H6+ -ATPase and band-3 protein staining was not demonstrable or markedly decreased in the intercalated cells of distal nephron. 4) In two patients who had both proximal and distal RTA, H^+ -ATPase staining was markedly decreased in the brush border of proximal tubules as well as the distal nephron. In conclusion, the defect of acid-base transporters in renal tubule was related with the functional defect of urinary acidification in distal RTA.

구순열과 구개열환자의 특성에 관한 분석

나후자,양은진,김선,김수일,김원식 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

The cleft lip and cleft palate has relatively high incidence among congenital anomalies. The etiological factors of these anomalies have been studied widely, but they are not yet understood perfectly. So, the authors reviewed and analyzed retrospectively 505 cases of cleft lip and cleft palate patients who were treated at the Chungnam Uiversity Hospital during the past 12 years from January 1985 to December 1996 for evaluation of etiological factors of cleft lip and palate, and the results were as follows : 1. The male was affected 1.6 times more frequently in cleft lip with palate, but the female was affected 1.8 time more frequently in cleft palate alone. 2. The incomplete cleft lip was 1.7 times higher than complete type and the ratio of left, right and bilateral was 2.1 : 1 : 0.3, and complete cleft lip with palate was 4 times higher than incomplete type and the ratio of left, right and bilateral was 1.2 : 1 : 0.9. 3. The incomplete cleft palate was 6.6 times higher than complete cleft palate. 4. There was positive family history in 11.8% of all the patients. 5. There was combined congenital anomalies with cleft lip and palate in 18.8% of all patients, and the most frequently involved anomaly was the ear anomaly. 6. U.R.I was the most frequently involved disease and herb medicine was the most frequently administered drug during the frist trimester. 7. In educational level of parents, senior high school was 66.5% of all.