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( Young-sun Lee ),( Sung Won Chang ),( Ha Seok Lee ),( Haein Bak ),( Sehwa Kim ),( Min-jin Lee ),( Chan Uk Lee ),( Young Kul Jung ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Hyung Joon Yim ),( Jong Eun Yeon 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: AJCC staging is the most commonly used staging system in most solid tumors, and recent AASLD hepatocellular carcinoma (HCC) guideline also endorsed this AJCC staging system based on status of tumor, node, and metastasis. Recently, 8th edition of AJCC staging system was released in December 2016. This study aimed to compare prediction of survival in HCC patients between 7th AJCC staging system and 8th AJCC staging system. Methods: From 2004 to 2013, 2211 newly diagnosed HCC patients were consecutively enrolled in three Korea University medical centers and the medical records of patients were retrospectively reviewed. Each patients were classified following both of 7th AJCC staging system and 8th AJCC staging system. Results: Chronic hepatitis B (1523, 68.9%) was main attributable factor in development of HCC, followed by chronic hepatitis C (256, 11.6 %) and alcohol consumption (241, 10.9%). 1514 patients (68.5%) died during study period and median overall survival (OS) was 24.7 months. According to 7th AJCC staging system, 894 (40.4%) patients were included into stage I; 459 patients (20.8%) into stage II; 180 patients (8.1%) into stage IIIa; 354 patients (16.0%) into stage IIIb; 3 patients (0.1%) into stage IIIc; 119 patients (5.4%) into stage IVa; and 202 patients (9.1%) into stage IVb. According to 8th AJCC staging system, 400 (18.1%) patients were categorized into stage IA; 498 patients (22.5%) into stage IB; 442 patients (20.2%) into stage II; 193 patients (8.7%) into stage IIIa; 357 patients (16.1%) into stage IIIb; 119 patients (5.4%) into stage IVa; and 202 patients (9.1%) into stage IVb. Both 7th staging system and 8th staging system show distinct survival outcomes according to each stage. Although 7th AJCC staging system significantly well predicted 1 year of survival than 8th AJCC staging system (AUROC; 0.796 vs 0.784, P=0.013), AUROCs of 3 year and 5 year were similar in 7th and 8th AJCC staging system (0.754 vs 0.752 in 3 year, P=0.601; 0.744 vs 0.742 in 5 year, P=0.643). Conclusions: Both 7th and 8th AJCC staging system show distinct survival outcome according to each stage. Moreover, both 7th and 8th AJCC staging system are similar in prediction of survival outcomes.
( Young-sun Lee ),( Ha Seok Lee ),( Ji Hoon Kim ),( Sung Won Chang ),( Myung Han Hyun ),( Haein Bak ),( Sehwa Kim ),( Min-jin Lee ),( Chan Uk Lee ),( Young Kul Jung ),( Yeon Seok Seo ),( Hyung Joon Yi 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.1
Background/Aims: To prevent the perinatal transmission of hepatitis B virus (HBV) from mother to child, administration of an antiviral agent during pregnancy has been attempted in women who are either hepatitis B e antigen positive or have a high viral load. In this systematic review and meta-analysis with randomized controlled trials, we analyzed the efficacy and safety of tenofovir disoproxil fumarate (TDF) in preventing the perinatal transmission of HBV in pregnant women who have high HBV DNA titers. Methods: Multiple comprehensive databases (PubMed, EMBASE, and Cochrane databases) were searched for studies evaluating the efficacy of TDF for the prevention of perinatal transmission of HBV. Results: Two studies (one open label study and one double blind study) were included and analyzed. Intention-to-treat analysis (527 pregnancies) showed that the preventive effect of TDF was not significant (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.13 to 2.17; p = 0.38, I<sup>2</sup> = 81%). However, the per-protocol analysis showed that TDF significantly reduced perinatal transmission (OR, 0.10; 95% CI, 0.01 to 0.77; p = 0.03, I<sup>2</sup> = 0%). There was no significant difference between the TDF group and the control group with respect to maternal and fetal safety outcomes. Conclusions: In pregnant women who have high HBV DNA titers, TDF can reduce the perinatal transmission from mother to child without significant adverse events.
NAFLD Is Associated with High Prevalence and High Recurrence Rate in Patients with Breast Cancer
( Young-sun Lee ),( Sung Won Chang ),( Ha Seok Lee ),( Haein Bak ),( Sehwa Kim ),( Min-jin Lee ),( Chan Uk Lee ),( Young Kul Jung ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Hyung Joon Yim ),( Jong Eun Yeon 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Breast cancer is most common cancer in women worldwide. The incidence of breast cancer is correlated with metabolic component including diabetes, hypertension, and obesity. Likewise breast cancer, metabolic components are important risk factors for development of NAFLD. In this study, we analyzed the prevalence of NAFLD in patients with breast cancer and the effect of NAFLD on the prognosis of breast cancer. Methods: Patients with breast cancer were enrolled from January 2007 to June 2017. Patients who had other chronic liver were excluded. Hepatic steatosis was evaluated by non-enhanced CT scan. We diagnosed NAFLD when the mean attenuation of the liver is lower than 40 HU or 10 HU lower than that of the spleen. 123 healthy controls who took non-enhanced CT scan were also analyzed. Results: Total 1587 patients were enrolled from January 2007 to June 2017. The prevalence of NAFLD in patients with breast cancer was 15.8% (251/1587) and it was significantly higher comparing with healthy control (8.9%, 11/123)(P=0.036). After propensity score matching, the difference of NAFLD prevalence was still significant between control group (8.9%, 11/123) and breast cancer patients (17.9%, 22/123) (P=0.040). In breast cancer patients, overall survival did not showed significant difference between NAFLD group and non-NAFLD group (P=0.304) (Figure A). However, recurrence-free survival was significantly higher in patients without NAFLD comparing with those with NAFLD (P=0.009) (Figure B). Among breast cancer patients received endocrine treatment, NAFLD group showed higher cumulative incidence of significant liver injury comparing with non-NAFLD group (P<0.001). Conclusions: The prevalence of NAFLD in patients with breast cancer is significantly high compared to healthy control group. Moreover, breast cancer patients with NAFLD showed poor prognosis in terms of recurrence. Therefore, diagnostic evaluation to determine whether or not NAFLD is present would be important in managing patients with breast cancer.
A Latent Class Analysis of Obesogenic Behaviors Among Adolescents in the Republic of Korea
Haein Lee,In Seo La 한국간호과학회 2021 한국간호과학회 학술대회 Vol.2021 No.10
Aims: Despite the multidimensional characteristics of obesity-related behaviors, few previous studies have investigated patterns obesogenic behaviors among Korean adolescents. This study aimed to explore sex-specific patterns of obesogenic behaviors and to identify predictors of latent class membership. Methods: We analyzed a nationally representative data from the 14th (2019) Korea Youth Risk Behavior Survey (29,841 male adolescents and 27,462 female adolescents). Specifically, we conducted a multiple-group latent class analysis (LCA) to identify sex-specific patterns of obesogenic behaviors (i.e., breakfast, sugar-sweetened beverage, fast food, and fruit/vegetable consumption, total physical activity, non-academic internet use, smoking, and drinking). Since the likelihood-ratio test indicated that measurement invariance across sex was not established, we separately analyzed the data of male and female adolescents. Additionally, an LCA with covariates was used to investigate the predictors of distinct subgroups of adolescent obesogenic behaviors. Results: Male and female adolescents demonstrated similar patterns and three-latent class models best fit the data from both samples: “mostly healthy behaviors”, “poor dietary habits and a high level of Internet use”, and “poor dietary habits and substance use.” The probabilities of latent class membership differed between male and female adolescents. Specifically, the proportions of these three classes were 53.9%, 35.4%, and 10.8% for male adolescents, respectively, and 47.9%, 44.8%, and 7.4% for female adolescents, respectively. In addition, school year, area of residence, perceived academic performance, perceived stress, depressive feelings, and sleep satisfaction significantly predicted the latent class models in both samples. The latent class model among female adolescents was additionally found to be associated with perceived economic status. Conclusions: Given the homogeneous patterns of obesogenic behaviors among male and female adolescents, health professionals should develop adolescent weight control programs tailored to sex-specific patterns of obesogenic behaviors.
Macular Ganglion Cell Layer Assessment to Detect Glaucomatous Central Visual Field Progression
Haein Moon,Jin Young Lee,Kyung Rim Sung,Jong Eun Lee 대한안과학회 2016 Korean Journal of Ophthalmology Vol.30 No.6
Purpose: To investigate the use of ganglion cell inner plexiform layer (GC-IPL) thickness, as measured by spectraldomain optical coherence tomography, to detect central visual field (VF) progression. Methods: This study included 384 eyes from 384 patients (219 preperimetric and 165 perimetric glaucomatouseyes; average follow-up, 4.3 years). Photographic assessment of retinal nerve fiber layer (RNFL) and serialVF analysis were performed to detect glaucoma progression in the central (within 10°) area. Study inclusionrequired at least five serial spectral domain optical coherence tomography exams at different visits. Thelong-term test-retest variability of average GC-IPL thicknesses was calculated in 110 stable preperimetricglaucomatous eyes. The sensitivity and specificity of GC-IPL measurements for the detection of central VFprogression were calculated in an event-based analysis using the calculated variability as a cut-off and werecompared with those of central RNFL photographic assessment. Results: The intersession test-retest variability, defined as the 95% confidence interval, was 1.76 μm for averageGC-IPL thickness. The sensitivity and specificity of the average GC-IPL thickness for detecting central VFprogression were 60.7% and 78.9%, respectively. Among six sectors, the inferonasal GC-IPL sector showedthe highest sensitivity (53.6%). The sensitivity of the ≥1 sector GC-IPL to detect central VF progression wassignificantly higher than that of central RNFL photographic progression (p = 0.013). Other GC-IPL parametersshowed comparable sensitivity and specificity to detect central VF progression compared with RNFL photographicprogression. Conclusions: Serial GC-IPL measurements show comparable performance in the detection of central glaucomatousVF progression to RNFL photographic assessment.