Assessment of Hepatic Steatosis Improvement Using Controlled Attenuation Parameter in Patients with Non-Alcoholic Fatty Liver Disease under Regular Follow Up

( Kyu Sik Jung ),( Jun Yong Park ),( Mi Na Kim ),( Hana Park ),( Yun Bin Lee ),( Joo Ho Lee ),( Yeonjung Ha ),( Beom Kyung Kim ),( Seung Up Kim ),( Sang Hoon Ahn ),( Do Young Kim ),( Hana Park ),( Kyu 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: The change of hepatic steatosis in non-alcoholic fatty liver disease (NAFLD) patients under regular follow up has not been widely investigated. We investigated the serial changes of hepatic steatosis assessed by controlled attenuation parameter (CAP) and the predictors for improvement of hepatic steatosis in NAFLD patients. Methods: Among 513 NAFLD patients diagnosed upon ultrasound and CAP > 250 dB/m at baseline, 304 patients underwent repeated CAP measurement at baseline and at follow up. The improvement of hepatic steatosis was defined as a >10% decline of CAP value from the baseline. Results: Mean age of 304 patients was 58.8 ± 11.4 years and 80.1% were male. The mean CAP value significantly decreased from baseline to follow up (292.3 dB/m to 277.1 dB/m, P<0.001). During the median follow up of 15.3 (9.5-20.3) months, 34.5% patients showed improvement of hepatic steatosis. In a univariate analysis, low body mass index (BMI), low weight, low liver stiffness value, low triglyceride level, and low ALT at follow up were predictors for improvement of hepatic steatosis. In multivariate analyses, low weight (P=0.004; hazard ratio [HR],0.965; confidence interval [CI], 0.941-0.988) and low ALT (P=0.004; HR,0.971;CI, 0.951-0.990) at follow up, or low BMI (P=0.006; HR,0.881; CI, 0.805-0.964) and low ALT (P=0.004; HR,0.971; CI, 0.951-0.990) at follow up were the independent predictors. In patients with weight reduction more than 10% (n=22), CAP value significantly decreased (from 288.0 dB/m to 228.9dB/m, P<0.001). Conclusions: Weight reduction, and ALT decrease were independent predictors for improvement of hepatic steatosis. Long term effect of weight reduction on improvement of hepatic steatosis and fibrosis should be investigated further.

제2형 당뇨병 환자에서 Voglibose와 Acarbose의 비교임상연구

정인경,정재훈,민용기,이명식,이문규,김광원,정윤이,박중열,홍성관,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.2

연구배경:아카보스와 보글리보스는 ­glucosidase inhibitors로써 비록 약리학적 작용이나 부작용에 있어서 두 약물간에 차이가 있다는 것은 잘 알려져 있으나 당뇨병 환자를 대상으로 아직 이에 대한 두 약물간에 직접적인 비교에 대해 연구된 바는 없었다. 이에 저자등은 국내 2형 당뇨병 환자에 대해 유효성과 부작용 발현에 대해 두 약제를 비교하고자 무작위법에 의한 위약 대조군의 이중 맹검법 연구를 시행하였다. 방법:시험 약제 투여 4주간의 관찰기를 설정하여 공복혈당의 변화가 30㎎/dL 이하이고, 식후 혈당이 200㎎/dL 이상인 환자로 기타 제외 기준에 해당하지 않은 환자 53명을 대상으로 하여 보글리보스 군(24명)과 아카보스 군(29명)으로 무작위로 나누었다. 치료기간은 총 8주로 하였으며, 4주간 간격으로 혈청학적 검사와 부작용을 분석하여 치료 효과가 부작용을 평가하였다. 결과:1)혈당 변화:보글리보스군은 식후 1시간 혈당이 치료 후 4주, 8주째 의미 있게 감소하였도, 아카보스군은 식후 1시간과 2시간 혈당이 치료 후 4주, 8주째 의미있게 감소하였다. 또한 관찰기 혈당에 대한 치료 4주째 감소량은 아카보스군에서 더 큰 경향을 보였으나, 치료 8주째에는 두 군 간의 강하정도에 의미있는 차이가 없었다(p=0.569). 2)인슐린 치의 변화:보글리스 군은 식후 1시간 인슐린 치가 치료 전에 비해 치료 4주, 8주째 감소하는 경향을 보였고, 공복 인슐린이나 식후 2시간 인슐린치는 치료전 후에 의미 있는 차이가 없었다. 아카보스군에서는 치료 전후로 공복 인슐린, 식후 1시간과 2시간 인슐린치에 의미 있는 차이를 보이지 않았다. 두약제 간에 치료 전과 치료 8주사이의 식후 2시간 인슐린의 감소량이 보글리보스 군에서 의미있게 높았다(p=0.040). 3)당화혈색소:보글리보스 군은 치료 전에 비해 치료후 당화혈색소가 감소하는 경향을 보였고, 아카보스군은 치료 전에 비해 의미있게 감소하였다. 당화혈색소 변화량은 두 군간에 의미 있는 차이는 없었다(p=0.412). 4)지질대사의 변화:중성지방, 콜레스테롤, 고밀도 진단백 콜레스테롤에 대해 두 군간에 의미 있는 차이는 없었다. 5)부작용:소화기계 부작용의 빈도는 치료 4주째 보글리보스 군에서 의미 있게 낮았으나(p=0.028), 치료 8주째 부작용의 빈도는 두 군간에 의미 있는 차이가 없었다(p=0.215). 결론:2형 당뇨병 환자에서 보글리보스와 아카보스의 두 약제의 임상적 유효성과 부작용발현에 대해 비교한 결과 치료 후 8 주 후 혈당강화효과는 두 약제간에 유사한 효과를 보였으나 보글리보스군에서 4주째의 초기 위장관 부작용이 적었다. Background : Acarbose and voglibose are alpha-glucosidase inhibitors. Although different pharmacological effects and adverse abdominal events associated with the two drugs have been reported, no study directly compared acarbose and voglibose in diabetes has been undertaken. To compare the pharmacological effects and gastrointestinal adverse events between two drugs, a randomized, placebo-controlled, double-bind study was performed in type 2 diabetes patients. Methods : The period of study was 12 weeks(observation period: 4 weeks; treatment period: 8 weeks). Fifty-three patients were randomized into two groups(the acarbose group: 24 patients; the voglibose group: 29 patients). The serum glucose, insulin, fructosamine, HbA_1c, cholesterol, triglyceride and the incidence of adverse events were measured. Results : 1) The reduction of glucose from before treatment to 4 weeks after treatment was significantly higher in the acarbose group, but the change before treatment and 8 weeks after treatment in the two groups was similar(p=0.569). 2) The insulin significantly decreased after voglibose treatment(p=0.040). 3) HbAa_1c level tended to decrease in voglibose group, and there was a significant decrease after acarbose treatment. However, the change in HbA_1c level before and after treatment was similar between the two groups(p=0.412). 4) The two drugs did not cause any other changes in the total, HDL-cholesterol and triglyceride. 5) The number of patients with gastrointestinal adverse events was significantly low 4 weeks after voglibose treatment (p=0.049), but the incidence in the two groups was similar after 8 weeks(p=0.215). Conclusions : Acarbose and voglibose significantly improved postprandial hyperglycemia in diabetes. The incidence of gastrointestinal adverse events was low 4 weeks after voglibose treatment(J Kor Diabetes 26:134~145, 2002).

심부정맥 혈전증의 도관유도 혈전용해술 또는 약물기계적 혈전제거술 후에 하대정맥 여과기 제거율과 임상적인 특징

노효근(Hyo Keun No),김중석(Joong Suck Kim),김장용(Jang Yong Kim),김경래(Kyung Rae Kim),신석환(Seok-Hwan Shin),안승익(Seung-Ik Ahn),조영업(Young Up Cho),김세중(Sei Joong Kim),이건영(Keon-Young Lee),허윤석(Yoon-Seok Hur),최선근(Sun Keu 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.6

Purpose: Inferior vena cava (IVC) filter is commonly practiced to prevent pulmonary embolism during endovascular therapy of deep vein thrombosis (EndoDVT). When the thrombus is trapped inside the filter during intervention, its removal is quite challenging. The purpose of this study is to determine retrieval rates of IVC filter after EndoDVT and its characteristics. Methods: Patients who underwent EndoDVT in Inha Unversity Hospital from June 2004 to May 2009 were reviewed retrospectively. Retrievable IVC filter was inserted before EndoDVT. EndoDVT was done by catheter directed thrombolysis or pharmacomechanical thrombectomy using urokinase. IVC filter retrieval was decided according to computed tomography after 2 weeks. Results: 126 patients were treated with EndoDVT. Optease (n=101) and Tulip (n=25) IVC filters were inserted. IVC filters were retrieved in 42.9% (54/126). There was no IVC filter related complication during its insertion and removal. IVC filter was not retrieved in 72 patients. Reasons for its failure include residual thrombosis in IVC filter (n=28), high risk for recurrent DVT (n=34), massive pulmonary embolism (n=8), and death (n=2). Residual thrombus inside IVC filter disappeared in 5 patients during 6-month follow up. Conclusion: IVC filters retrieval rate after EndoDVT was 42.9%. This can be improved by thorough patient follow up and extended retrievability.

Dkk-1 Promotes Angiogenesis through Epithelial-Mesenchymal Transition in Hepatocellular Carcinoma

( Sang Hyun Seo ),( Hye Jung Park ),( Kyungjoo Cho ),( Hye Won Lee ),( Beom Kyung Kim ),( Jun Yong Park ),( Do Young Kim ),( Sang Hoon Ahn ),( Seung Up Kim ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: Dickkopf-1(DKK1), a negative regulator of the Wnt/ ß-catenin pathway, has been recently found to be up-regulated in hepatocellular carcinoma (HCC). However, the biological function of DKK1 in HCC has not yet been well documented. Our previous in vitro data suggest that DKK1 can enhance angiogenesis by endothelial cell, independent of the Wnt signaling pathway. This study aimed to investigate the tumorigenic potential and angiogenic role of DKK1 in mouse model. Methods: We assessed tumorigenic functions of DKK1 in Hep3B cells expressing endogenous DKK-1 and in DKK1-deficient Hep3B cells created using CRISPR/Cas9 technology. These edited cells were injected subcutaneously in immunosuppressed mice and tumor growth was followed for 6 weeks. With the evidence of tumorigenic potential in DKK1, transgenic mouse models expressing DKK-1 or luciferase were developed using hydrodynamic transfection. Transposons encoding an activated form of human H-RAS were mixed with transposons encoding either DKK1 or luciferase. All mice were monitored at least twice per week and sacrificed when moribund. Subcutaneous tumors and tumor-bearing livers were formalin fixed for hematoxylin- eosin and immunofluoroscence staining. Results: DKK1-deficient Hep3B xenografts exhibited significantly less growth compared to control Hep3B cells expressing DKK1. In addition, the forced expression of DKK1 with H-RAS through the hydrodynamic transfection formed many tumors in the liver, compared to luciferase liver. We investigated the expression of angiogenesis markers, including CD31, VEGFR2 and mesenchymal markers, including vimentin, fibronectin in the subcutaneous tumors and tumor-bearing livers. Quantity of angiogenic and mesenchymal cells were found to be reduced in the established DKK1 homozygous knockout mice (all P<0.05). Taken together, it was confirmed that the expression of CD31 (P<0.0001), VEGFR2 (P<0.0001), vimentin, and fibronectin (P<0.0001) were up-regulated with DKK1 in the mouse liver. Conclusions: Our findings indicate that DKK1 appears to facilitate angiogenesis, and the progression of HCC through inducing the EMT.

ML-Based Angle-of-arrival Estimation of a Parametric Source

Lee, Yong-Up,Kim, Jong-Dae,Park, Joong-Hoo The Acoustical Society of Korea 2001 韓國音響學會誌 Vol.20 No.e3

In angle of arrival estimation, the direction of a signal is usually assumed to be a point. If the direction of a signal is distributed due to some reasons in real surroundings, however, angle of arrival estimation techniques based on the point source assumption may result in poor performance. In this paper, we consider angle of arrival estimation when the signal sources are distributed. A parametric source model is proposed, and the estimation techniques based on the well-known maximum likelihood technique is considered under the model. In addition, Various statistical properties of the estimation errors were obtained.

Design and Implementation Technique of the Specific Embedded System for an Instantaneous Wireless Image Observation

Yong Up Lee 보안공학연구지원센터 2016 International Journal of Smart Home Vol.10 No.9

For an instantaneous wireless image observation service, the specific embedded system design and implementation technique which has the instantaneous maximum 1 fps (frame per second) rate for a 160x128 size image is proposed by applying the intelligent sensing concept based on the IoT (Internet of Things) technique to the wireless remote observation, and embodied in prototypes, which are consisted of the intelligent remote monitoring node based on the Zigbee embedded modules with a small digital camera, the provisional ad-hoc wireless network channel, and the main node for system control in this work. Through of the real wireless remote observation experiment, the proposed technique is more proper for the instantaneous and provisional observation situation of the fast start and high successes rate since the observation speed enhancement over three times is attained by the proposed methodology than the conventional observation technique.

Short-range Visible Light Positioning Based on Angle of Arrival for Smart Indoor Service

Yong Up Lee,Seop Hyeong Park 대한전기학회 2018 Journal of Electrical Engineering & Technology Vol.13 No.3

In visible light (VL) positioning based on angle of arrival (AOA) estimation for smart indoor service, the AOA parameters obtained at the receiver has sometimes a random and distributed angle form instead of a point angle form due to the multipath transfer of the actual visible light and short positioning distance. The AOA estimation of a VL signal with a random and parametric distributed angle form may give incorrect AOA parameter estimates, which may result in poor VL positioning performance. In this paper, we classify the AOA parameters of the received VL signal into three forms according to the actual positioning channel environment and consider the short-range VL positioning method. We propose a subspace-based AOA parameter estimation technique and a data fusion method, and analyzed the proposed method by simulation and the measurement of the real VL channel characteristics.

Performance Analysis of User Selection for Multiuser Two-Way Amplify-and-Forward Relay

Yong-Up Jang,Lee, Yong H IEEE 2010 IEEE communications letters Vol.14 No.11

<P>This paper considers a multiuser two-way relay channel (MU-TWRC) in which a base-station and a selected mobile-station (MS) among K number of MSs exchange messages during two time slots with the help of a half-duplex amplify-and-forward relay. We analyze the performances of a MU-TWRC. The closed-form expressions of the lower bound of the average rates are derived. The asymptotic expressions of the average rates are also analyzed in the limit of large K. Analysis and simulation results indicate that the former matches well to the latter, and the performance of a MU-TWRC can increase as K increases or be bounded to some constant according to the channel conditions.</P>

Long-Term Renal Function Changes in Patients Receiving Tenofovir vs. Entecavir In Chronic Hepatitis B Patients: A Multicenter Study

( Yong Eun Chon ),( Seung Up Kim ),( Yeon Seok Seo ),( Hye Won Lee ),( Han Ah Lee ),( Mi Na Kim ),( Yun Ho Roh ),( Jun Yong Park ),( Do Young Kim ),( Sang Hoon Ahn ),( Won Young Tak ),( Soo Young Park 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1

Long-Term Effects of Entecavir and Tenofovir Treatment on the Fibrotic Burden in Patients with Chronic Hepatitis B

( Yong Eun Chon ),( Seung Up Kim ),( Yeon Seok Seo ),( Hye Won Lee ),( Han Ah Lee ),( Mi Na Kim ),( Yun Ho Roh ),( Jun Yong Park ),( Do Young Kim ),( Sang Hoon Ahn ),( Won Young Tak ),( Soo Young Park 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1