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광주,전남 지역의 A형 간염바이러스 유전자형 변화 및 임상 분석
노두영 ( Du Young Noh ),조성범 ( Sung Bum Cho ),김연주 ( Yeon Joo Kim ),이완식 ( Wan Sik Lee ),박창환 ( Chang Hwan Park ),주영은 ( Young Eun Joo ),김현수 ( Hyen Soo Kim ),유종선 ( Jong Sun Rew ),최성규 ( Sung Kyu Choi ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.6
Background/Aims: Dominant genotype of hepatitis A virus (HAV) in Korea had been known to be genotype 1A in 1990s. Recently, the epidemiologic change of HAV genotype was reported with an upsurge of acute hepatitis A in Korea. The aim of this study was to investigate the change of HAV genotypes and clinical characteristics in Gwangju and Jeonnam province. Methods: From November 2008 to October 2009, a total of 82 patients with acute hepatitis A were enrolled prospectively. HAV genotype was determined using reverse transcriptase polymerase chain reaction and sequencing of the PCR products of VP1/2A region of HAV. Results: HAV RNA was detected in 82% (67/82). The genotype IIIA (88%, 59 cases) was significantly more frequent than genotype IA (12%, 8 cases) (p≤0.01). The subtypes of genotype IIIA were AJ299467 Norway (49%), HA-JNG04-09 Japan (27%), HS-14-12-00 Spain (22%) and H-122 Sweden (2%). The subtypes of IA were FH1 Japan (50%) and HA J04-3 Japan (50%). The substitutions of amino acid were more frequent in genotype IIIA than IA (p≤0.01). There was no difference in the clinical characteristics between the patients with genotype IIIA and IA. Conclusions: Genotype IIIA was a dominant genotype of recent HAV infection in Gwangju and Jeonnam province. This study provides valuable epidemiologic information of genetic distributions of HAV in Korea. (Korean J Gastroenterol 2011;57:346-351)
급성 위식도정맥류 출혈에 내시경 N-butyl-2-cyanoacryl주입요법의 효과 TIPS의 치료 효과와의 비교 검토
노두영 ( No Du Yeong ),박선영 ( Park Seon Yeong ),주소영 ( Ju So Yeong ),박창환 ( Park Chang Hwan ),이완식 ( Lee Wan Sig ),주영은 ( Ju Yeong Eun ),김현수 ( Kim Hyeon Su ),최성규 ( Choe Seong Gyu ),유종선 ( Yu Jong Seon ),김세종 ( 대한소화기학회 2004 대한소화기학회지 Vol.43 No.3
Background/Aims: Though endoscopic therapies such as variceal ligation and sclerotherapy has been performed, bleeding from the large esophageal and gastric varices still poses significant risk of death. Decrease of portal pressure by TIPS (transjugular intrahepatic portosystemic shunt) or surgical shunt was indicated as cause of failure of endoscopic therapies. Treatment of N-butyl-2-cyanoacrylate has been especially effective for gastric variceal bleeding, but comparison with other treatments had not been reported yet. In this study, the effect of cyanoacrylate injection therapy was cross-examined with the result of TIPS in acute esophagogastric variceal bleedings. Methods: From April 1995 to June 2002, endoscopic cyanoacrylate injection therapy (43 cases) and TIPS (63 cases) were performed in our hospital. Each group was analysed regarding their clinical results including initial hemostasis rate, rebleeding rate, survival duration, mortality and morbidity. Results: Initial hemostasis rate was 95.3% in cyanoacrylate group and 92.1% in TIPS group. Cumulative probability of rebleeding was not different between two groups. Overall complication rates associated with the procedure were 50.8% in TIPS group and 9.3% in cyanoacrylate group. There was no significant difference between two groups in their survival rates. Conclusions: Cyanoacrylate injection therapy was relatively safe, and has comparable results with TIPS for uncontrollable and severe esophagogastric variceal bleedings. (Korean J Gastroenterol 2004;43:186-195)
단일기관 40세 이하 병원 직원에서의 IgG Anti-HAV 항체 양성률
노두영 ( Du Young Noh ),조용찬 ( Yong Chan Cho ),전원정 ( Won Jung Jun ),김성균 ( Sung Kyun Kim ),윤경원 ( Kyoung Won Yun ),박선영 ( Seon Young Park ),이완식 ( Wan Sik Lee ),주영은 ( Yeong Eun Ju ),김현수 ( Hyun Soo Kim ),최성규 ( 대한소화기학회 2010 대한소화기학회지 Vol.55 No.3
목적: A형 간염은 경구감염으로 전파되는 급성 감염 질환이다. 최근 A형 간염의 발병률이 광주 전남지역에서 증가함에 따라 전남대학교병원 직원에서도 A형 간염 발생이 증가하였다. 이에 A형 간염에 대한 위험도를 평가하기 위해 전남대학교병원에서 근무하는 40세 이하 직원에서의 IgG anti-HAV 항체 양성률을 조사하였다. 대상 및 방법: 2008년 7월부터 2008년 8월까지 전남대학교병원에서 근무하는 40세 이하의 직원 1,486명 중 1,002명(남성 190명, 여성 812명)에서 IgG anti-HAV 검사를 시행하였다. 연령대를 5세 간격으로 분류하였으며, 21-25세 199명(19.9%), 26-30세 426명(42.5%), 31-35세 215명(21.5%), 36-40세 162명(16.1%)이었다. 결과: IgG anti-HAV 양성은 1,002명 중 329명으로 항체 양성률은 32.8%였으며, 성별 항체 양성률은 남성 40.5%(77/190), 여성 31.0% (252/812)였다. 각 연령대별 항체 양성률은 21-25세 1.5%(3/199), 26-30세 21.4%(92/426), 31-35세 48.4%(104/215), 36-40세 80.2%(130/162)였다. 직접 환자와 접촉하는 직종(의사, 간호사, 보건기사)에서의 IgG anti-HAV 양성률은 28.9%(234/809)였으며, 20대 초반 21-25세 1.7%(3/176), 26-30세 20.7%(78/376), 31-35세 45.5%(71/156), 36-40세 81.2%(82/101)였다. 결론: 20대 초반 병원 직원에서 IgG anti-HAV 보유율이 가장 낮았으며, 연령대가 증가할수록 항체 보유율이 높았으나 30대 초반까지는 항체 보유율이 50% 이하였다. 따라서 A형 간염 환자와 직접 접촉할 수 있는 30대 초반 이하의 병원 직원에서는 A형 간염 백신의 접종이 필요하리라 생각한다. Background/Aims: Hepatitis A is an acute infectious disease transmitted by fecal-oral route. As the incidence of hepatitis A has been increased in Gwangju and Chonnam province of Korea recently, the number of hepatitis A patients in hospital employees has also increased. Thus, we investigated the seroprevalence of IgG anti-HAV in hospital employees below 40 years old. Methods: We analysed the seroprevalence of anti-HAV IgG from 1,002 Chonnam national university hospital empolyees (men: 190, women: 812) who were below 40 years old. The age group was divided by 5 years; 21-25 years old 199 (19.9%), 26-30 years old 426 (42.5%), 31-35 years old 215 (21.5%), 36-40 years old 162 (16.1%). Results: Overall seropositive rate of IgG anti-HAV was 32.8% (329/1,002). The seropositive rate of men was 40.5% (77/190) and that of women was 31.0% (252/812). The seropositive rates of each age group were 1.5% (3/199) in 21-25 years old, 21.6% (92/426) in 26-30 years old, 48.4% (104/215) in 31-35 years old, and 80.2% (130/162) in 36-40 years old. The seropositivity rate of the high risk group (doctors, nurses, technicians) was 28.9% (234/809). Conclusions: The seropositive rate of IgG anti- HAV was the lowest in early twenties of hospital employees and below 50% in early thirties. Therefore, hepatitis A vaccination may be warranted in the hospital empolyees below the early thirties. (Korean J Gastroenterol 2010;55:183-188)