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( Bum Su Choung ),( In Hee Kim ),( Byung Jun Jeon ),( Seok Lee ),( Seong Hun Kim ),( Sang Wook Kim ),( Seung Ok Lee ),( Soo Teik Lee ),( Dae Ghon Kim ) The Editorial Office of Gut and Liver 2012 Gut and Liver Vol.6 No.4
Background/Aims: Clevudine (CLV) has potent antiviral activity against chronic hepatitis B (CHB) virus infection. The long-term efficacy and safety of CLV therapy in na?ve patients with CHB were investigated. Methods: In this retrospective study, 152 na?ve Korean patients with CHB who received 30 mg of CLV once daily for at least 12 months were investigated. Results: The cumulative rates at months 12, 24, and 36, respectively, were 65.8%, 74.7%, and 74.7% for undetectable serum hepatitis B virus (HBV) DNA (<12 IU/mL); 77.6%, 86.2%, and 86.2% for normalization of serum alanine aminotransferase (<40 IU/L); 17.6%, 23.5%, and 23.5% for hepatitis B e antigen (HBeAg) loss or seroconversion; and 6.6%, 22.5%, and 30.0% for viral breakthrough. HBeAg positivity (p=0.010), baseline serum HBV DNA level ≥6 log10 IU/mL (p=0.032) and detectable serum HBV DNA (≥12 IU/mL) at week 24 (p=0.023) were independently associated with the development of viral breakthrough. During follow-up, CLV-induced myopathy developed in 5.9% of patients. Conclusions: The results of long-term CLV therapy for the treatment of na?ve patients with CHB showed a high frequency of antiviral resistance and substantial associated myopathy. Therefore, we advise that CLV should not be used as a first-line treatment for na?ve patients given the availability of other more potent, safer antiviral agents. (Gut Liver 2012;6:486-492)
Choung, Bum-Su,Yoo, Wan-Hee Springer International 2012 Rheumatology international Vol.32 No.5
<P>Sjogren's syndrome (SS) is a systemic autoimmune disease characterized by xerophthalmia, xerostomia and extraglandular manifestations. Anemia, leukopenia, thrombocytopenia and lymphoproliferative disorders, including lymphoma are well-known extraglandular, hematological complications of SS. We report here a rare case of patient with primary SS who developed pancytopenia with severe thrombocytopenia as an initial manifestation and successfully treated with IV immunoglobulin (IVIG). The present case suggests that pancytopenia with severe thrombocytopenia can be a difficult-to-treat abnormality, and initial manifestation of primary SS and IVIG might be an effective treatment for severe thrombocytopenia refractory to high-dose steroid in primary SS.</P>
정상 에르고드성을 가지는 확률과정 스펙트럼에 대한 합리적 시계열 데이터 확보
박준범(Jun-Bum Park),김경수(Kyung-Su Kim),정준모(Joonmo Choung),김재우(Jae-Woo Kim),유창혁(Chang-Hyuk Yoo),하영수(Yeong-Su Ha) 한국해양공학회 2011 韓國海洋工學會誌 Vol.25 No.2
The fatigue damages in structural details of offshore plants can be accumulated due to various environmental loadings such as swell, wave, wind and current. It is known that load histories acting on mooring and riser systems show stationary and ergodic bimodal wide-banded process. This paper provides refined approach to obtain time signals representing stress range histories from wide-banded bimodal spectrum which consists of ideally narrow-banded and fully separated two spectrums. Variations of the probabilistic characteristics for time signals according to frequency and sampling time increments are compared with the reference data to be the probabilistic characteristics such as zero-crossing period, peak period, and irregularity factor obtained from an assumed ideal spectrum. It is proved that the sampling time increment more affects on the probabilistic characteristics than frequency increment. The fatigue damages according to the frequency and sampling time increments are also compared with the ones with minimum increment condition which are thought to be exact fatigue damage. It is concluded that the maximum sampling time increment to obtain reliable time signals should be determined that ratio of applied maximum sampling time increment and minimum period is less than approximately 0.08.
허갑범,이현철,임승길,송영득,차봉수,원영준,김선호,김경래,권석호,정보영,남수연,김태승,엄재화 대한내분비학회 1997 Endocrinology and metabolism Vol.12 No.2
Backgrounds: Pituitary hyperplasia can mimic pituitary adenoma. In MRI, enlarged pituitary gland is enhanced homogenously with upward convexity of the superior margin of the gland .The best definition of hyperplasia in the pituitary hyperplasia seems to be a multiplication of one or more cell types. But definition, etiology and clinical courses of this disease are not clear, Method : We reviewed clinical symptoms, MRI, and pathologic findindings in 6 patients with pituitary hyperplasia. Result: 1. Major clinical symptoms were headache(100%), visual field defect(84%), polyuria/polydipsia (64%), and irregular mensturation(32%). Other symptoms were amenorrhea(16%) and galactorrhea (16%). 2. Three of five cases showed abnormal responses to combined pituitary function test, 3. MRI findings were pituitary hyperplasia(4), macroadenoma(l), and microadenoma(1). 4. In two operated cases, there was no adenoma. One case showed hyperplasia of lactotroph cells, the other was hyperplasia of gonadotroph cells confirmed by the examination of immunocytochemistry. Conclusion : Pituitary hyperplasia should be considered in patients with enlarged pituitary gland without focal mass lesion. (J Kor Soc Endocrinol 12:155-164, 1997)
( Byung Jun Jeon ),( Bum Su Choung ),( In Hee Kim ),( Dae Ghon Kim ),( Soo Teik Lee ),( Eun Young Cho ),( Gum Mo Jung ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1
Background: Symptomatic acute hepatitis A virus (HAV) infection in adulthood is increasing in Korea recently. The aim of this study was to analyze the clinical severity according to age groups in patients with acute hepatic A and to investigate factors associated with complicated hepatitis A. Methods: We performed a retrospective analysis of 726 patients who were diagnosed with acute viral hepatitis A from January 2005 to September 2011 at three tertiary hospitals at Jeonbuk Province. We analyzed the clinical severity according to age groups, <20 year (n=84), 21-39 years (n=546), ≥40 years (n= 96). Complicated hepatitis was defined as hepatitis combined with one of three major complications, such as severe jaundice (peak total bilirubin level ≥15 mg/dL), acute renal failure, acute liver failure. Results: Of total 726 patients, mean age was 30.1 years, 453 (62.4%) were male, HBsAg was positive in 33 (4.5%). Severe jaundice occurred in 43 (5.95%), acute renal injury occurred in 16 (2.2%), and acute liver failure occurred in 24 (3.3%). The incidence of acute renal insufficiency was significantly increased according to the aging groups were <20: 1.2%(1/84); 21-39: 1.8% (10/546); ≥40: 5.4%(5/96) (p=0.032).The incidence of severe jaundice and hepatic failure were also significantly increased according to the aging groups [<20: 3.7% (3/84); 21-39: 5.2% (27/546); ≥40: 15.6%(13/96), p=0.003, and <20: 0.0% (0/84); 21-39: 3.6% (19/546); ≥40: 5.4% (5/96), p=0.045]. Multivariate analysis showed that old age (≥40years) (p=0.006), female (p=0.002), and HBsAg positivity (p=0.013) were significant risk factors for complicated hepatitis A. Conclusions: Old age group (≥40 years) showed more likely complicated with severe hepatitis A compared to younger age groups. In addition, female and HBsAg positivity were also significantly associated with complicated hepatitis A.
( Byung Jun Jeon ),( Bum Su Choung ),( In Hee Kim ),( Dae Ghon Kim ),( Soo Teik Lee ),( Eun Young Cho1 ),( Gum Mo Jung ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-
Background: Symptomatic acute hepatitis A virus (HAV) infection in adulthood is increasing in Korea recently. The aim of this study was to analyze the clinical severity according to age groups in patients with acute hepatic A and to investigate factors associated with complicated hepatitis A. Methods: We performed a retrospective analysis of 726 patients who were diagnosed with acute viral hepatitis A from January 2005 to September 2011 at three tertiary hospitals at Jeonbuk Province. We analyzed the clinical severity according to age groups, <20 year (n=84), 21-39 years (n=546), ≥40 years (n= 96). Complicated hepatitis was defined as hepatitis combined with one of three major complications, such as severe jaundice (peak total bilirubin level ≥15 mg/dL), acute renal failure, acute liver failure. Results: Of total 726 patients, mean age was 30.1 years, 453 (62.4%) were male, HBsAg was positive in 33 (4.5%). Severe jaundice occurred in 43 (5.95%), acute renal injury occurred in 16 (2.2%), and acute liver failure occurred in 24 (3.3%). The incidence of acute renal insufficiency was significantly increased according to the aging groups were <20: 1.2%(1/84); 21-39: 1.8% (10/546); ≥40: 5.4%(5/96) (p=0.032).The incidence of severe jaundice and hepatic failure were also significantly increased according to the aging groups [<20: 3.7% (3/84); 21-39: 5.2% (27/546); ≥40: 15.6%(13/96), p=0.003, and <20: 0.0% (0/84); 21-39: 3.6% (19/546); ≥40: 5.4% (5/96), p=0.045]. Multivariate analysis showed that old age (≥40years) (p=0.006), female (p=0.002), and HBsAg positivity (p=0.013) were significant risk factors for complicated hepatitis A. Conclusions: Old age group (≥40 years) showed more likely complicated with severe hepatitis A compared to younger age groups. In addition, female and HBsAg positivity were also significantly associated with complicated hepatitis A.
( Seung Young Seo ),( In Hee Kim ),( Bum Su Choung ),( Seong Hun Kim ),( Sang Wook Kim ),( Seung Ok Lee ),( Soo Teik Lee ),( Dae Ghon Kim ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1
Background: This study was aimed to investigate the long-term efficacy of entecavir (ETV) monotherapy and ETV plus adefovir (ADV) combination for ADV refractory chronic hepatitis B (CHB) patients with prior lamivudine (LMV) resistance. Methods: A total of 91 ADV refractory CHB patients with prior LMV resistance who received with ETV (1.0 mg/day) (Group A, n=46) or ETV (1.0 mg/day) plus ADV (10 mg/day) (Group B, n=45) for more than 48 weeks were included. Results: Overall serum HBV DNA negativity by PCR (≤20 IU/mL) were 25/91 (27.5%) at week 48 and 27/67(40.3%) at week 96, respectively. A significantly higher proportion of patients on group B achieved negative serum HBV DNA [group A vs. group B; 11/46 (23.9%) vs. 14/45 (31.1%) at week 48, p=0.002; 10/29 (34.5%) vs. 17/38 (44.7%) at week 96, p= 0.004]. However, the rates of serum alanine aminotransferase normalization and HBeAg loss or seroconversion were similar in two groups. The incidence of virological breakthrough in group B was significantly lower than in the group A [group A vs. group B; 8/46 (17.4%) vs. 0/45 (0.0%) at week 48, p=0.006; 13/29 (44.8%) vs. 1/38 (2.6%) at week 96, p<0.001]. Treatment strategy (group A vs. group B) was independently significant factor associated with viral breakthrough in multivariate analysis (Odd ratio 5.887, 95% CI 1.663-119.364, p=0.015). Conclusions: As a rescue therapy in ADV refractory CHB patients with prior LMV resistance, ETV plus ADV combination therapy was more efficient than ETV monotherpay in reducing of viral breakthrough during treatment.