Quality of Life Assessment in Male Patients with Androgenetic Alopecia: Result of a Prospective, Multicenter Study

( Sung Hyub Han ),( Ji Won Byun ),( Won Soo Lee ),( Hoon Kang ),( Yong Chul Kye ),( Ki Ho Kim ),( Do Won Kim ),( Moon Bum Kim ),( Seong Jin Kim ),( Hyung Ok Kim ),( Woo Young Sim ),( Tae Young Yoon ) 대한피부과학회 2012 Annals of Dermatology Vol.24 No.3

Background: Androgenetic alopecia (AGA) is a common hair loss disease with genetic predisposition among men and women, and it may commence at any age after puberty. It may significantly affect a variety of psychological and social aspects of one`s life and the individual`s overall quality of life (QoL). Objective: This study aimed to investigate the QoL of AGA patients and discover the factors that can influence the QoL of AGA patients, including previous experience in non-medical hair care, reasons for hospital visits, age, duration, and the severity of AGA. Methods: A total of 998 male patients with AGA were interviewed, using the Hair Specific Skindex-29 to evaluate the QoL of AGA patients. Results: The results of the Hair Specific Skindex-29 on patients with AGA were as follows: symptom scale: 26.3±19.5, function scale: 24.0±20.1, emotion scale: 32.1±21.8, and global score: 27.3±19.1. According to this assessment, QoL was more damaged if the patient had severe alopecia, a longer duration of AGA, younger age, had received previous non-medical hair care, and visited the hospital for AGA treatment. Conclusion: This study showed that AGA could harmfully affect the patients` QoL. These findings indicate that dermatologists should address these QoL issues when treating patients with alopecia.

Original Article : Endoscopic Papillectomy for Benign Ampullary Neoplasms: How Can Treatment Outcome Be Predicted?

( Dong Won Ahn ),( Ji Kon Ryu ),( Jaihwan Kim ),( Won Jae Yoon ),( Sang Hyub Lee ),( Yong Tae Kim ),( Yong Bum Yoon ) 대한간학회 2013 Gut and Liver Vol.7 No.2

Background/Aims: Endoscopic papillectomy is increasingly performed with curative intent for benign papillary tumors. This study was performed to identify factors that predict the presence of malignancy and affect endoscopic success. Methods: We retrospectively analyzed the medical records of patients who received an endoscopic papillectomy for papillary adenoma from 2006 to 2009. Results: A total of 43 patients received endoscopic papillectomy. The pathologic results after papillectomy revealed adenocarcinoma in five patients (12%), and the risk of malignancy was high in cases of large lesions, preprocedural pathology of high-grade dysplasia or high serum alkaline phosphatase. Endoscopic success was observed in 37 patients (86%) at the end of follow-up (mean duration, 10.4±9.6 months). The factor significantly affecting success was a complete resection at the initial papillectomy (p=0.007). Two patients experienced recurrence 10 and 32 months after the complete resection, but both achieved endoscopic success with repeated endoscopic treatment. Six patients with endoscopic failure received surgical resection. Conclusions: Endoscopic papillectomy is a safe and effective method for the curative resection of benign papillary tumors, especially when complete resection is achieved at the initial papillectomy. Follow-up with surveillance should be performed for at least 3 years because of the possible recurrence of tumors during these periods. (Gut Liver 2013;7:239-245)

Original Article : Long-Term Outcome of Cystic Lesions in the Pancreas: A Retrospective Cohort Study

( Dong Won Ahn ),( Sang Hyub Lee ),( Jai Hwan Kim ),( Won Jae Yoon ),( Jin Hyeok Hwang ),( Jin Young Jang ),( Ji Kon Ryu ),( Yong Tae Kim ),( Sun Whe Kim ),( Yong Bum Yoon ) The Editorial Office of Gut and Liver 2012 Gut and Liver Vol.6 No.4

Background/Aims: The management guidelines for cystic lesions of the pancreas (CLPs) are not yet well established. This study was performed to document the long-term clinical outcome of CLPs and provide guidelines for the management and surveillance of CLPs. Methods: In this retrospective cohort study, an additional follow-up was performed in 112 patients with CLPs enrolled from 1998 to 2004 during a previous study. Results: During follow-up for the median period of 72.3 months, the size of the CLPs increased in 18 patients (16.1%). Six of these patients experienced growth of their CLPs after 5 years of follow-up. Twenty-six patients underwent surgery during follow-up, and four malignant cysts were detected. The overall rate of malignant progression during follow-up was 3.6%. The presence of mural nodules or solid components was independently associated with the presence of malignant CLPs. Seven patients underwent surgery after 5 years of follow-up. The pathologic findings revealed malignancies in two patients. There was only one pancreas-related death during follow-up. Conclusions: The majority of CLPs exhibit indolent behavior and are associated with a favorable prognosis. However, long-term surveillance for more than 5 years should be performed because of the potential for growth and malignant transformation in CLPs. (Gut Liver 2012;6:493-500)

The Korean Society of Gastroenterology& SLDDS 2032 : Slide Session ; K-BP-22 : Pancreatobiliary ; Optimal Follow-Up and Long-Term Clinical Outcome of Pancreatic Cystic Lesions

( Dong Won Ahn ),( Sang Hyub Lee ),( Dong Kee Jang ),( Kwang Hyun Chung ),( Ban Seok Lee ),( Ji Bong Jeong ),( Ji Kon Ryu ),( Yong Tae Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Although it is generally accepted that cystic lesions in the pancreas (CLPs) 3 cm or less in size and without features suggesting malignancy can be managedconservatively with follow-up, the optimal duration and interval of follow-up for CLPs is not yet well established. Methods: Patients with CLPs 3 cm or less in size and without features suggesting malignancy received follow-up with computed tomography at 6, 12, 18, and 24 months and then per 12 months. A retrospective analysis with prospectively collected data was performed. Results: A total of 205 patients with CLPs detected from 2004 to 2009 (initial mean size, 1.8±0.7 cm) received follow-up during the median period of 56.6 months. Within the fi rst 12 months of follow-up, no patients experienced the growth of cyst and three patients (1.5%) underwent surgery for the presence of symptoms related to CLPs. 11 patients (5.4%) experienced the growth of cyst after 5 years of follow-up. A total of 18 patients underwent surgery during follow-up and four malignant cysts were detected. Overall rate of malignant progression during follow-up was 2.0%. The malignant progression occurred after 48 months and 60 months of follow-up in one and three patients, respectively. Conclusions: Long-term follow-up more than 5 year should be performed because of the potential for malignant transformation of CLPs. The 12 months interval of follow- up for asymptomatic CLPs might be suffi cient in clinical practice.

The Real-Life Data of Daclatasvir and Asunaprevir Treatment in Korean Patients with Hepatitis C Genotype 1b Infection

( Hye Won Lee ),( Ha Kyung Jung ),( Beom Kyung Kim ),( Seung Up Kim ),( Do Young Kim ),( Sang Hoon Ahn ),( Kwang-hyub Han ),( Jun Yong Park ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Daclatasvir plus asunaprevir (DCV+ASV) treatment has demonstrated potent antiviral activity in patients with genotype 1b hepatitis C virus (HCV) infection. We investigated the real-life data of DCV+ASV treatment in Korea. Methods: A total of 351 patients with chronic hepatitis C started to treat with DCV+ASV from August 2015 to July 2016. We excluded patients with resistance-associated substitutions (RAS) positive and hepatocellular carcinoma at baseline. The patients received DCV (60mg once daily) plus ASV (100mg twice daily) for 24 weeks. Finally, 251 patients who finished DCV+ASV treatment and they were followed up for 12 weeks after the end of treatment were analyzed. We investigate viroglogic response and the changes of liver fibrosis with non-invasive markers and transient elastography before and after completion of the treatment. Results: The median age was 62 (range, 52-71) years and 154 (60.2%) patients were female. 77.7% were non-cirrhotic and 64.1% were treatment-naïve. The intention-to-treat analysis showed that all patients achieved end-of- treatment response and 98.0% (246/251) patients achieved sustained virological response (SVR) 12. In addition, 96.3% (103/107) of patients older than 65 years and 96.1% (49/51) with cirrhosis achieved SVR12. There was significant improvement in liver stiffness (LS) values by transient elastography (TE), FIB-4 and APRI scores at SVR12. LS values were significantly lower in SVR12 (16.69±14.97 vs. 12.69±10.14, p=0.001). Five patients discontinued this treatment due to treatment failure (n=1), gastrointestinal trouble (n=1), viral breakthrough (n=1), creatinine elevation in patients with chronic kidney disease (n=1) and elevation of liver enzyme (n=1). Conclusions: DCV+ASV dual therapy resulted in high SVR12 rates, a clinically significant improvement in parameters of liver fibrosis and was well tolerated in Korean patients with genotype 1b HCV infection. Further studies are needed to monitor the long-term results of the DCV+ASV treatment.

Efficacy of switching from adefovir to tenofovir in chronic hepatitis B patients who exhibit suboptimal responses to adefovir-based combination rescue therapy due to resistance to nucleoside analogues (SATIS study)

( Hye Won Lee ),( Jun Yong Park ),( Beom Kyung Kim ),( Moon Young Kim ),( Jung Il Lee ),( Young Suk Kim ),( Ki Tae Yoon ),( Kwang-hyub Han ),( Sang Hoon Ahn ) 대한간학회 2016 Clinical and Molecular Hepatology(대한간학회지) Vol.22 No.4

Background/Aims: It remains to be determined whether switching from adefovir (ADV) to tenofovir (TDF) provides better virological outcomes in patients exhibiting suboptimal responses to ADV plus nucleoside analogue (ADV+NA) therapy for NA-resistant chronic hepatitis B (CHB). Methods: In this prospective trial, patients who showed partial responses (defined as serum hepatitis B virus [HBV] DNA >60 IU/mL) to ADV+NA therapy for NA resistance were randomly allocated to receive TDF plus NA (TDF+NA group, n=16) or to continue their current therapy (ADV+NA group, n=16). The primary end point was the proportion of patients with complete virological response (CVR, defined as serum HBV DNA < 60 IU/mL) at 48 weeks. Results: The median age was 52 years (16 men), and 28 were positive for hepatitis B e antigen (HBeAg). The baseline characteristics did not differ significantly between the two groups. The proportion with CVR was significantly higher in the TDF+NA group than in the ADV+NA group at 24 weeks (81.3% vs. 25.0%, P=0.001) and 48 weeks (87.5% vs. 37.5%, P=0.002). Furthermore, a decrease in the serum HBV DNA level of >2log₁₀ IU/mL was more likely in the TDF+NA group at both 24 and 48 weeks (68.8% vs. 56.3%, P=0.014 vs. 81.3% vs. 56.3%, P=0.001, respectively). During the follow-up, the rate of HBeAg seroconversion was higher in the TDF+NA group than the ADV+NA group (12.5% vs. 6.25%, P=0.640), as was that for the hepatitis B surface antigen (6.25% vs. 0%, P=0.080). No serious adverse events due to antiviral agents occurred. Conclusions: In patients exhibiting suboptimal responses to ADV+NA therapy for NA-resistant CHB, switching from ADV to TDF might provide better virological outcomes. (Clin Mol Hepatol 2016;22:443-449)

40세 이하에서 발생한 원발성 간암의 임상상

최원,전재윤,한광협,문영명,백용한,이관식,문희용 대한소화기학회 2000 대한소화기학회지 Vol.35 No.2

Background/Aims: Most of hepatocellular carcinoma (HCC) develops during 6th and 7th decade, and HCC development at the age under 40 is unusual. To understand the usefulness of HCC screening test and to determine guidelines for the treatment in young age patients group, we compared the clinical characteristics and prognosis of the patients with HCC retrospectively between patients under 40 and patients over 40. Methods: A retrospective analysis of the clinical data and survival rate was performed for 603 patients who were admitted to Yonsei medical center from April 1991 through April 1994. We divided the patients into two groups: young age group (≤40 years) and senior group ( 40 years). Results: Among 603 patients examined, the number of patients in young age group was 67 (11.1%) and their male to female ratio was 10.2:1. Most patients (93%) had subjective symptoms at admission and sixty-four (95.5%) of 67 young HCC patients were HBsAg-positive. However, none of them was anti-HCV-positive. Elevated serum αfoprotein level ($gt;400 ng/ml) was more common in the young age group (77.6%) than in the senior group (63.9%). According to the gross type, massive type was more common in the young age group (42.4% vs. 27.9%). The association of cirrhosis was less common in young age group than in the senior group (59.7% vs. 71.6%). The cumulative survival rate of 1, 2, and 3 year in the young age group was 35.4%, 29.2%, and 16.6%, respectively. Such rates were similar to those of the senior group. Conclusions: HCC development in young age group was closely related with hepatitis B viral infection and HCC screening test may be needed in young male patients with chronic hepatitis B.

Daclatasvir Plus Asunaprevir for the Treatment of Patients with Hepatitis C Virus Genotype 1b Infection: Real-World Efficacy, Changes in Liver Stiffness and Fibrosis Markers, and Safety

( Hye Won Lee ),( Se Rim Oh ),( Dong Yun Kim ),( Yechan Jeong ),( Seungtaek Kim ),( Beom Kyung Kim ),( Seung Up Kim ),( Do Young Kim ),( Sang Hoon Ahn ),( Kwang-hyub Han ),( Jun Yong Park ) 대한간학회 2018 Gut and Liver Vol.12 No.3

Background/Aims: The treatment with daclatasvir plus asu-naprevir (DCV+ASV) is associated with potent antiviral effects in patients with genotype 1b hepatitis C virus (HCV) infec-tion. We investigated the real-world efficacy, changes in liver stiffness and noninvasive fibrosis markers, and the safety of DCV+ASV treatment in Korean patients. Methods: In to-tal, 363 patients with chronic hepatitis C were treated with DCV+ASV between August 2015 and January 2017. Finally, we analyzed the data of 270 patients who were monitored for at least 12 weeks after the end of treatment. Results: The mean age was 60.7 years, and females predominated (60.4%). Most patients (64.8%) were treatment-naïve, and 56 patients (20.7%) had cirrhosis. Two hundred fifty-seven (95.2%) and 251 (93.0%) patients achieved end-of-treatment responses and sustained virological responses at 12 weeks posttreatment (SVR12), respectively. The SVR12 rates were higher in patients who were <65 years of age, males, without cirrhosis and had lower HCV RNA levels. All LS values and fibrosis-4 and aspartate aminotransferase-to-platelet ratio in-dex values declined from baseline to the time of assessment of SVR12. Conclusions: The DCV+ASV therapy resulted in a high SVR12 and improved liver fibrosis; the treatment was well tolerated in patients with genotype 1b HCV infections. (Gut Liver 2018;12:324-330)

Tunable single-mode Fabry-Perot laser diode using a built-in external cavity and its modulation characteristics.

Jeong, Yong Deok,Won, Yong Hyub,Choi, Sang Ook,Yoon, Jong Hyun Optical Society of America 2006 Optics letters Vol.31 No.17

<P>A tunable single-mode laser is obtained by using a weakly coupled cavity structure involved in a coaxially packaged Fabry-Perot laser diode. The cleaved end facet of the coupling fiber becomes an optical reflector and forms an external cavity with a laser facet. The single-mode oscillation condition is controlled and stabilized by tuning the operating temperature. The tuning range is about 10 nm with the side-mode suppression ratio of more than 27 dB when the temperature changes from 11.5 degrees C to 25 degrees C. Direct modulation characteristics were investigated, and our results show that a shorter external cavity can bear deeper modulation depth.</P>

P!.!14:The Experience of Daclatasvir and Asunaprevir Treatment in Korean Patients with Hepatitis C Genotype 1b Infection

( Hye Won Lee ),( Beom Kyung Kim ),( Seung Up Kim ),( Jun Yong Park ),( Do Young Kim ),( Sang Hoon Ahn ),( Kwang-hyub Han ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Daclatasvir plus asunaprevir (DCV+ASV) has demonstrated potent antiviral activity in patients with hepatitis virus C (HCV) genotype 1b (GT-1b) infection. The use of DCV+ASV was approved by the Korean health insurance last August. We investigated short-term result of DCV+ASV treatment in Korea. Methods: We analyzed 236 consecutive CHC patients treated with DCV+ASV from August 2015 to December 2015. The patients received DCV (60mg once daily) plus ASV (100mg twice daily) for 24 weeks. End of treatment (EOT), sustained virological response at post-treatment Week 12 (SVR 12) and safety outcomes were evaluated. Results: The median age was 62.0 (range: 28-86) years, and 107 45.3%) patients were male. Among 236 patients, 98 (41.5%) patients just completed DCV+ASV treatment. Except for six patients with viral breakthrough, 92 (93.9%) patients achieved EOT. According to treatment group, 94.8% (55/58), 100% (17/17), 100% (12/12) and 72.7% (8/11) patients showed EOT in treatment-naive, non-responder, relapse, and interferon ineligible/intolerant group, respectively. Three (50%) patients who failed EOT showed baseline NS5A-93H mutation. Cirrhosis and hepatocellular carcinoma (HCC) were identified in 34 (15.5%) and 32 (14.6%) patients, of which 33 (97.1%) and 16 (50%) showed EOT. Among 16 (6.8%) patients with NS5A-93H or NS5A-L31M/V resistance-associated variants RAVs), 13 (81.3%) patients achieved ETR. With multivariate analysis, NS5A RAVs was identified as an independent predictor for treatment failure in DCV+ASV. The incidence of serious adverse events was 1.4%. Treatment was stopped due to aggravation of renal function, gastrointestinal trouble and increase of ascites. Conclusions: Dual therapy with DCV+ASV resulted in high EOT rates and well-tolerated in Korean patients with HCV GT-1b infection. Further studies are needed to monitor long-results of DCV+ASV treatment.