Original Articles : Clinical significance of occult hepatitis B virus infection in chronic hepatitis C patients

( Jae Young Jang ),( Soung Won Jeong ),( Sung Ran Cheon1 ),( Sae Hwan Lee1 ),( Sang Gyune Kim ),( Young Koog Cheon ),( Young Seok Kim1 ),( Young Deok Cho1 ),( Hong Soo Kim ),( So Young Jin ),( Yun Soo 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3

Background/Aims: We investigated the frequency of occult hepatitis B virus (HBV) infection in anti-hepatitis C virus (HCV)-positive individuals and the effects of occult HBV infection on the severity of liver disease. Methods: Seventy-one hepatitis B virus surface-antigen (HBsAg)-negative patients were divided according to their HBV serological status into groups A (anti-HBc positive, anti-HBs negative; n=18), B (anti-HBc positive, anti-HBs positive; n=34), and C (anti-HBc negative, anti-HBs positive/negative; n=19), and by anti-HCV positivity (anti-HCV positive; n=32 vs. anti-HCV negative; n=39). Liver biopsy samples were taken, and HBV DNA was quantified by real-time PCR. Results: Intrahepatic HBV DNA was detected in 32.4% (23/71) of the entire cohort, and HBV DNA levels were invariably low in the different groups. Occult HBV infection was detected more frequently in the anti-HBc-positive patients. Intrahepatic HBV DNA was detected in 28.1% (9/32) of the anti-HCV-positive and 35.9% (14/39) of the anti-HCV-negative subjects. The HCV genotype did not affect the detection rate of intrahepatic HBV DNA. In anti-HCV-positive cases, occult HBV infection did not affect liver disease severity. Conclusions: Low levels of intrahepatic HBV DNA were detected frequently in both HBsAg-negative and anti-HCV-positive cases. However, the frequency of occult HBV infection was not affected by the presence of hepatitis C, and occult HBV infection did not have a significant effect on the disease severity of hepatitis C. (Korean J Hepatol 2011;17:206-212)

GIS를 활용한 주거용 적지분석에서의 절차적,방법론적 합리성 2: 용인시를 사례로

조규영 ( Kyu Young Cho ),옥진아 ( Jin A Ok ),서주환 ( Joo Hwan Suh ) 한국도시지리학회 2002 한국도시지리학회지 Vol.5 No.2

This study applies the proposed conceptual model for the land use suitability analysis. The study area is Young-In city which is one of the new housing development concentrated regions in the Seoul Metropolitan area. The purpose of this study is to compare the residential planning of the Yong-In City Master Plan (2001) with the proposed conceptual model application. The comparison is based on as follows: 3 methods (simple overlay method; linear standardization and AHP; Fuzzy and AHP) with 4 alternatives (city structural efficiency; environmentally sound development; and equal growth) and their conflict resolutions. The results are slightly different from each other; and very hard to conclude which method is superior. Rather, we may insist on that land use suitability analysis in Yong-In City Master Plan needs to be based on a well guided procedural model. The analysis of the plan is too naive to draw a future plan of the citizens. This may be the same in many other plans, but we need to scrutinize this subject and develop very practical and procedural analysis guidelines and manuals in order to have more rational plans.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Hepatocellular Carcinoma in the Elderly: Clinical Characteristics, Outcomes and Treatment Efficacy, Safety in Older than 75 Years

( Ji Ho Seo ),( Sunmin Kim ),( Eunae Cho ),( Chung Hwan Jun ),( Sun Young Park ),( Sung Bum Cho ),( Chang Hwan Park ),( Hyun Soo Kim ),( Sung Kyu Choi ),( Jong Sun Rew ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) has been increasing because the increase in the longevity of the general population. But there is no proper management based on age stratification in elderly patients. We compared clinical characteristics, outcomes and treatment efficacy, safety between oldest-old (aged more than 85 years), middle-old (aged between 80 and 85 years) and young-old (aged between 75 and 80 years) patients with HCC. Methods: We conducted a retrospective cohort study, from January 2010 to December 2016, at Chonnam National University Hospital. A total of 550 elderly patients whose data included demographics, co-morbidity, etiology of liver disease, presence of cirrhosis, staging of HCC, treatment modality and treatment related adverse event were evaluated retrospectively. Also overall survival was assessed in enrolled patient. Results: Fifty one patients (oldest-old; median 87 years old), 153 patients (middle-old; median 82 years old) and 346 patients (young-old; median 77 years old) were diagnosed with HCC. Both oldest- and middle-old patients, compared to young-old patients had significantly lower rate of alcohol-related disease (13.7% vs 20.9% vs 34.1%, P = 0.001). There were no significant difference in underlying sex, body mass index, presence of co-morbidity, hepatitis C-related disease and stage of HCC. The Child-Pugh class (CPT class A 88.9% vs 84.1% vs 83.6%, CPT class B 11.1% vs 15.9% vs 15.0% and CPT class C 0.0% vs 0.0% vs 1.3%, respectively, P = 0.912) and Model for End Stage Liver Disease score (mean MELD score 7.22±3.34 vs 5.88±3.01 vs 5.77±3.14, P = 0.166) were no significant difference between the patients with active treatment. The modified UICC staging (stage I 5.6% vs 17.1% vs 18.6%, stage II 55.6% vs 46.3% vs 47.3%, Stage III 22.2% vs 24.4% vs 24.8%, Stage IV-A 11.1% vs 6.1% vs 4.9% and Stage IV-B 5.6% vs 6.1% vs 4.4%, respectively, P = 0.826) and Barcelona Clinic Liver Cancer staging (stage 0 5.6% vs 9.8% vs 9.3%, stage A 16.7% vs 17.1% vs 22.1%, stage B 27.8% vs 29.3% vs 24.8%, stage C 50.0% vs 43.9% vs 41.2% and stage D 0.0% vs 0.0% vs 2.7%, respectively, P = 0.878) were no significant difference between the patients with active treatment. Furthermore, there were no difference between the age groups in treatment modality (Surgical resection 0.0% vs 3.3% vs 5.2%, P = 0.166; Radiofrequency ablation 2.0% vs 8.5% vs 11.0%, P=0.113; Transcatheter arterial chemoembolization 21.6% vs 34.6% vs 41.6%, P=0.014; Best supportive care 62.7% vs 40.5% vs 29.2%, P < 0.001), adverse event related treatment (P = 0.731) and disease-free survival days (329 .3±309.1 days vs 271.7 ± 414.2 days vs 357.2 ± 511.6 days, P = 0.336). Multivariate analysis showed that age, performance status, CTP class, MELD score, modified UICC staging, presence of portal vein thrombosis and ruptured HCC are risk factors for mortality. Conclusions: Clinician should make an active treatment in elderly patients with HCC not a age but performance status, liver function and disease status of cancer.

公共土地開發事業 地方化問題와 代案에 관한 小考

조길환,황의진,김영곤 여수대학교 1998 論文集 Vol.13 No.2

Since 1980 the Korea Land Development Coporation has played a major role in land development by means of a Public Initiated Land Development Scheme. This strategy has attempted to correct the market failure of the generation of large sum of windfall profits. In accordance with reimplementation of the local autonomous ruling system since 1991, the demend for local government initiated land development have increased rapidly as local governments attempt to math the influence of national local development policy. In this regards, it is very useful for urban planners to analyze the merits and dismerits of the local government initiated land development schemes in view of national agency's development. This paper recommends several mitigation measures to improve the settlement of the local government initiated land development scheme.

都市公營開發事業에 對한 考察

조길환,황의진,김영곤 여수대학교 1998 論文集 Vol.13 No.2

This Paper studied the background and characteristics of the adopted public development among the system of housing land development that is executing in our country nowadays And it defined the reasons of problems that is caused by a social change in the Project of public development at the level of city public development toward a service that the public development effects to the City planning. So it would like to propose reform methods in develo-ping housing area to give basic data in establishing system of city public development by the local selfgoverning body as the methods for a construction of effective city space and smooth supply of housing area is presented as follows. First : In order to ensure a legitimacy of an exercise of government power for the business of public development, the gualification of a practical system of public development is to be strengthened. According to the guideline of the policy of city development or nation's housing or land, the condition of Yelated areas, the characteristics of business subject, the system of public development is to be selected. The object of the public development such as the developing business of residential land for the low-incomed class, the suitable business that is developed by the pu-blic, the developing business of land in national basic industries is to be realized and objectified more. Second : A differtial application of distribution price of the residential land according to not only the distribution of residential land related with housing construction business and its use or object but also the storage of public land and reformation of system and distribution object of public development land through an activation of the system of land selling in advance. Third : The idleness one of planning developed land such as a rational management for restriction of privaty ownership of developing profit, the establishment of effective restoration system of the developed profit, and establishment of land developing fund is to be controlled. Fourth : To ensure a reinvestment resources for continuous propulsion of the city developing business, its effective propulsion of developing business by a preaying distribution and induction of land demand and distribution acceleration ncouragement of purchase interest) is to be drived. So the distribution acceleration and fund revulsion is to be smooth with a rational reform of a distribution method by a minimization of dependency degree of outer fund in an early period of development and establishment of inverstment resources by a restoring profit of the public development. Fifth : A method of activation in city developing business is to be considered by a diversity of the developing subject. Sixth : The search for distribution method of space for city environment and the enlargement method of equipment space is to be considered.

백서에서 치아회분말과 연석고의 혼합매식술에 관한 실험적 연구:혼합 비율에 따른 비교

조재오,여환호,김영균 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.1

This study was performed to determine the ideal mixing ratio of toothash and plaster of Paris. The histopathologic and histomorphometric study of bone response of five implant materials, toothash(Group A), tooth and plaster mixture, mixing ratio due to weight 2 : 1(Group B), 3 : 1(Group C), 4 : 1(Group D), and plaster Paris(Group E), were performed in rat calvarial defect. No sign of extensive inflammatory reaction was defected. Newly-formed bony ingrowth occurred in all experimental groups except for group E at 12 weeks after operation. Bone was deposited directly on the surface of implant materials. The highest rate of direct bony union between implant material and newly-formed bone occurred with the group B, followed group C, D, and A.

상악동에 발생한 국균증의 치험2례

조재오,김영균,여환호,김수민,김수관 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

Aspergillosis of the maxillary sinus was rare disease, but it was increasing tendency with overuse antibiotics, streoid hormones, and anticanncerous agents. The clinical features and X-ray findings are similar to chronic suppurative paranasal sinusitis. Aspergillosis of the maxillary siuses may occur as a chronic diseae in an otherwise healthy person. This infection is usually confined to a single paranasal sinus, the maxillary antrum, though it can involve the orbit and may initiate with findings of proptosis and decreased vision. The disease is characterized by a wide range of initial symptoms, and should be considered as a possible diagnosis in sinusitis refractory to antibiotics and antral lavage. The choice of treatment of this disease is radical surgery and adjunctive systemic antifungal therapy. We experienced a case of right maxillary sinus aspergillosis in a 34 years old male who has dull pain on Rt. zygoma area, and a case of left maxillary sinus aspergillosis in a 30 years old male who had been suffered from nasal stiffness and frontal headache for 3-4 years. We reported two cases with review of literature.

진성다혈구증에서의 심근 및 뇌경색증 1예

조영호,유벙전,서영환,조경상,김상도,정춘해 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.2

Polycythemia vera is one of the myeloproliferative diseases, and as such, is an example of clonal hematopoiesis. The progeny of a single, abnormal, hematopoietic stem cell gain a grwoth advantage over their normal counterparts resulting in overproduction of red cells generally accompanied by overproduction of granulocytes and platelets as well. There are a variety of nonspecific symptoms at onset related to the increased red cell mass and hematocrit accompanied by the more specific manifestations of pruhtis, erythromelalgia, and hepatic, portal, and mesenteric vein thrombosis. Splenomegaly and hypertension are common. Thrombosis and leukemia are frequent complication in polycythemia vera and are associated with severa organ damage and a high mortality. We report here the case of occurrence of myocardial and cerebral infarction in a patient with polycythemia vera.

악관절 내장증의 외과적 치험례

조세인,여환호,김영균 대한 두개하악장애학회 1994 대한두개하악장애학회지 Vol.6 No.2

Internal derangememt of TMJ is defined as an abnormal relationship of articular disk to the Mandibular condyle, fossa and articular eminence. Anterior disk displacement of the disk causes the common symptoms of reciprocal clicking and limitation of mouth opening. Most Patients with internal derangements can be managed by conservative teatments. But surgical treatment is indicated for those patients who have chronic internal derangement that has failed to respond to nonsurgical treatment. The objective of surgical treatment is to eliminate pain and to restore normal function. Meniscectomy is indicated for the internal derangement of disk with perforation and gross morphological changes, nonreactive to conservative treatments. After meniscectomy, variable materials have been used for disk reconstruction. We present a case of interanal derangement of TMJ that was sucessfully treated by meniscetomy and autogenous auricular cartilage graft for disk replacement.