http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
개별검색 DB통합검색이 안되는 DB는 DB아이콘을 클릭하여 이용하실 수 있습니다.
통계정보 및 조사
예술 / 패션
<해외전자자료 이용권한 안내>
- 이용 대상 : RISS의 모든 해외전자자료는 교수, 강사, 대학(원)생, 연구원, 대학직원에 한하여(로그인 필수) 이용 가능
- 구독대학 소속 이용자: RISS 해외전자자료 통합검색 및 등록된 대학IP 대역 내에서 24시간 무료 이용
- 미구독대학 소속 이용자: RISS 해외전자자료 통합검색을 통한 오후 4시~익일 오전 9시 무료 이용
※ 단, EBSCO ASC/BSC(오후 5시~익일 오전 9시 무료 이용)
<P> <B>See article in <I>J. Gastroenterol. Hepatol.</I> 2010; 25: 1117–1122</B> </P>
Han,,Kwang-Hyub,Kudo,,Masatochi,Ye,,Sheng-Long,Choi,,Jong,Young,Poon,,Roonni,Tung-Ping,Seong,,Jinsil,Park,,Joong-Won,Ichida,,Takafumi,Chung,,Jin,Wook,Chow,,Pierce,Cheng,,Ann-Lii S. Karger AG 2011 Oncology Vol.81 No.suppl1
<P>Abstract</P><P>Hepatocellular carcinoma (HCC) is a highly prevalent disease in many Asian countries, accounting for 80% of victims worldwide. Screening programs improve the detection of early HCC and have a positive impact on survival, but the majority of HCC patients in Asia still present with advanced stage disease. The treatment outcomes of HCC are affected by multiple variables, including liver function, performance status of the patient, and tumor stage. Therefore, it is not easy to apply a multidisciplinary therapeutic approach for optimal management. At present, limited numbers of HCC patients are eligible for curative therapies such as surgery or ablation in Asia. Therefore, most patients are eligible for only palliative treatments. For optimal management, the treatment choice is guided by staging systems and treatment guidelines. Numerous staging systems have been proposed and treatment guidelines vary by region. According to the Barcelona Clinic Liver Cancer (BCLC) guideline based on evidence from randomized clinical trials, only transarterial chemoembolization (TACE) is recommended for intermediate stage HCC and sorafenib for advanced stage HCC. However, treatment guidelines from Asian countries have adopted several other therapeutic modalities such as a surgical approach, hepatic arterial infusion chemotherapy, external radiation, and their combinations based on clinical experiences for intermediate and advanced stage HCC. Although TACE is the main therapeutic modality in the intermediate stage, overall therapeutic outcomes depend on the tumor size. In the advanced stage, the prognosis depends on the tumor status, e.g. major vessel invasion or extrahepatic spread. Thus, a new staging system representing prognoses suitable for Asian HCC patients and a corresponding optimal treatment algorithm should be further investigated using evidence-based data, which will finally bring about an Asian consensus for the management of intermediate and advanced stage HCC.</P><P>Copyright © 2011 S. Karger AG, Basel</P>
<B>BACKGROUND.</B><P>Patients with advanced hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) have a particularly grave prognosis. In the current study, an attempt was made to localize chemoradiation therapy (CCRT) followed by hepatic arterial infusion chemotherapy (HAIC) in patients with locally advanced HCC with PVT and good reserve liver function. The objective of the current study was to evaluate the therapeutic effect of localized CCRT followed by HAIC as a new treatment modality for these patients.</P><B>METHODS.</B><P>Between January 1998 and December 2003, 40 patients were recruited. Concurrent regional chemotherapy using an intra-arterial implanted port plus localized external beam radiotherapy was performed with a total of 45 gray (Gy) over 5 weeks with conventional fractionation and hepatic arterial infusion of 5-fluorouracil (5-FU), which was administered during the first and fifth weeks of radiotherapy. One month after localized CCRT, HAIC with 5-FU and cisplatin was administered every 4 weeks.</P><B>RESULTS.</B><P>One month after localized CCRT, an objective response was observed on the intention-to-treat analysis in 18 of 40 patients (45%). The actuarial 3-year overall survival rate was 24.1% and the median survival time was 13.1 months from the start of radiation treatment. Responders after localized CCRT demonstrated significantly better survival (P = .033) than nonresponders.</P><B>CONCLUSIONS.</B><P>The substantial response rate as well as median survival time noted in the current study encourages the use of this new approach in patients with locally advanced HCC with PVT. Cancer 2008. © 2008 American Cancer Society.</P>
( Han Jak Ryu ), ( Jung Min Lee ), ( Sang Hoon Ahn ), ( Do Young Kim ), ( Myoung Ha Lee ), ( Kwang Hyub Han ), ( Chae Yoon Chon ), ( Jun Yong Park ) 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.3(S)
Background/Aims: The emergence of lamivudine-resistant mutant hepatitis B virus (HBV), with aminoacid substitution in the YMDD motif of DNA polymerase, has been reported in the long-term lamivudine use group. However there is no report about the emergence of mutant viruses during the short-term lamivudine therapy. The objective of this study was to investigate the emergence of YMDD mutant HBV during short-term lamivudine therapy. Methods: We evaluated twenty-eight chronic hepatitis B patients who were HBeAg and HBV DNA positive and treated with lamivudine 100mg p.o. daily for 12 weeks. First, we investigated the emergence of YMDD mutants by nested polymerase chain reaction (PCR) method developed by Chayama et al in 19 patients who lost HBV DNA during lamivudine therapy but showed HBV DNA re-emergence 2 weeks after the end of therapy. Second, DNA subcloning and sequencing of HBV DNA polymerase including YMDD motif was undertaken in one patient's serial blood samples at 0, 8, 12 weeks to confirm the results of nested PCR. Results: YMDD motif mutation was detected in 17(90%) out of 19 patients at the end of therapy and the type of mutations were YIDD only. At the end of therapy, mutant was predominant in 5 patients, both mutant and wild type were similar in proportion in 3 patients, and wild type was predominant in 9 patients. When we carried out nested PCR serially with samples of 0, 2, 4, 8, 12, 14 weeks after initiation of therapy in 5 patients who were mutant predominant at 12 weeks, YIDD mutant began to be detected from 2 weeks in 4 patients and from 4 weeks in one patient. However, rapid turnover from mutant to wild type happened after the end of therapy, so only wild type was detected in 3 patients and wild type became predominant in 2 patients at 2 weeks after the end of therapy. All the sequencing results of serial blood samples in one patient were consistent with nested PCR data. Conclusions: The presence of YMDD motif HBV polymerase mutant may be possible before administration of lamivudine in Korean chronic hepatitis B patients. Nested PCR assay would be an useful method to detect YMDD mutant. (Korean J Hepatol 1999;5:173-183)
Progressive liver fibrosis is a similar feature of all chronic liver diseases and eventually develops liver cirrhosis. The prognosis and treatment plans of chronic liver diseases depend strongly on the degree of liver fibrosis. These facts raise clinical interests in quantifying liver fibrosis. Although liver biopsy has been the gold standard for assessment of liver fibrosis, it has some technical limitations and risks. Accordingly, an increasing need for alternative non-invasive method to quantify liver fibrosis has been a major challenge that has stimulated search for new non-invasive methods. Such methods for diagnosing liver fibrosis have progressed significantly over the last few years notably with the appearance of several serological markers which have been reported to predict the presence of significant fibrosis or cirrhosis in patients with chronic liver disease with considerable accuracy. However, complicated calculation, cost problems, and influences of extrahepatic conditions make it less accessible to clinicians. Recently, liver stiffness measurement using FibroScan(R) is emerging as a new diagnostic method for liver fibrosis. It is totally non-invasive and reproducible and gives an immediate result without intra- and inter-observer variability. Its clinical use in comparison with liver biopsy and several available serologic markers is now intensively being investigated. Here, we review the currently available data on FibroScan(R).(Korean J Med 74:463-471, 2008)
Aims: Partial virological response(PVR) to nucleos(t)ide analogues are defined by patients with detectable HBV DNA by real-time PCR assay(> 10-15 IU/ml) at week 48. Clinical importance of NUC PVR relates to the high risk of developing resistance to long-term HBV treatment and requires rescue therapy from potent drugs with high genetic barrier such as entecavir or tenofovir. Long -term ETV therapy is known to result in VR in treatment-naive patients. However, clinical significance of tenofovir is not known. We aim to assess the rates of PVR to tenofovir, the predictive factors associated with PVR, and clinical course in treatment-naive patients with chronic hepatitis B. Methods: Between November 2012 and December 2014, total of 519 treatment naive patients with CHB received first-line tenofovir at Severance Hospital. The primary endpoint was the proportion of patients showing a partial virological response (PVR) during treatment. Multivariate analysis was done to evaluate predictive factors independently associated with the time to PVR. Patients with decompensated liver cirrhosis or HCC or organ transplantation prior to the TDF treatment were excluded. Results: Among 519 patients with tenofovir therapy, virological response was achieved in 400 patients(77%) at 24 weeks of TDF therapy. Upon 48weeks of therapy, 119(22.9%) patients achieved PVR and 45(37.8%) patients achieved VR among PVR patients, following 96weeks of therapy. HBeAg positive patients achieved more PVR(119, 43.59%) compared with HBeAg negative patients(60, 26.4%). Patients with PVR were younger (mean±SD, 47±13 years, P=0.004), had higher baseline HBV DNA levels (6.2±2.1 log10 IU/ml, P=0.009) and showed less HBeAg positivity(54.6%, P<0.001) and less HBeAg seroconversion(32.5%, P<0.001) compared with patients without. Using multivariate analysis, platelet (Odds ratio [OR] 1.005, 95% CI 1.001-1.008, P=0.01) and baseline HBV DNA level (OR 1.172, 95% CI 1.028-1.337, P=0.018) were predictive factors for PVR. Conclusions: Following 24weeks of TDF therapy, 400 patients(77%) achieved VR. 119(22.9%) patients showed PVR after 48weeks of TDF therapy. 96 weeks of TDF therapy results in VR of PVR patients(45, 37.8%) Baseline HBV-PCR(log IU/ml) was higher in patients with PVR than patient without PVR and more patients with HBeAg showed PVR. Patients with PVR achieved less HBeAg seroconversion than patients without PVR. Elevated baseline platelet levels and baseline HBV DNA levels are predictive factors for PVR.