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( Yu Jun Wong ),( Prem Harichander Thurairajah ),( Rahul Kumar ),( Kwong Ming Fock ),( Ngai Moh Law ),( Sin-yoong Chong ),( Fria Gloriba Manejero ),( Tiing-leong Ang ),( Eng Kiong Teo ),( Jessica Tan 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.3
Background/Aims: Despite the disproportionally high prevalence rates of hepatitis C virus (HCV) amongst the incarcerated population, eradication remains challenging due to logistic and financial barriers. Although treatment prioritization based on disease severity is commonly practiced, the efficacy of such approach remained uncertain. We aimed to compare the impact of unrestricted access to direct-acting antiviral (DAA) among incarcerated HCV-infected patients in Singapore. Methods: In this retrospective study, we reviewed all incarcerated HCV-infected patients treated in our hospital during the restricted DAA era (2013-2018) and unrestricted DAA access era (2019). Study outcomes included the rate of sustained virological response (SVR), treatment completion and treatment default. Subgroup analysis was performed based on the presence of liver cirrhosis, HCV genotype and HCV treatment types. Results: A total of 1,001 HCV patients was followed-up for 1,489 person-year. They were predominantly male (93%) with genotype-3 HCV infection (71%), and 38% were cirrhotic. The overall SVR during the restricted DAA access era and unrestricted DAA access era were 92.1% and 99.1%, respectively. Unrestricted access to DAA exponentially improved the treatment access among HCV-infected patients by 460%, resulting in a higher SVR rate (99% vs. 92%, P=0.003), higher treatment completion rate (99% vs. 93%, P<0.001) and lower treatment default rate (1% vs. 9%, P<0.001). Conclusion: In this large cohort of incarcerated HCV-infected patients, we demonstrated that unrestricted access to DAA is an impactful strategy to allow rapid treatment up-scale in HCV micro-elimination. (Clin Mol Hepatol 2021;27:474-485)
Yu Jun Wong,Vy H. Nguyen,Hwai-I Yang,Jie Li,Michael Huan Le,Wan-Jung Wu,Nicole Xinrong Han,Khi Yung Fong,Elizabeth Chen,Connie Wong,Fajuan Rui,Xiaoming Xu,Qi Xue,Xin Yu Hu,Wei Qiang Leow,George Boon-B 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.3
Background/Aims: Chronic hepatitis B (CHB) and fatty liver (FL) often co-exist, but natural history data of this dual condition (CHB-FL) are sparse. Via a systematic review, conventional meta-analysis (MA) and individual patient-level data MA (IPDMA), we compared liver-related outcomes and mortality between CHB-FL and CHB-no FL patients. Methods: We searched 4 databases from inception to December 2021 and pooled study-level estimates using a random- effects model for conventional MA. For IPDMA, we evaluated outcomes after balancing the two study groups with inverse probability treatment weighting (IPTW) on age, sex, cirrhosis, diabetes, ALT, HBeAg, HBV DNA, and antiviral treatment. Results: We screened 2,157 articles and included 19 eligible studies (17,955 patients: 11,908 CHB-no FL; 6,047 CHB-FL) in conventional MA, which found severe heterogeneity (I2=88–95%) and no significant differences in HCC, cirrhosis, mortality, or HBsAg seroclearance incidence (P=0.27–0.93). IPDMA included 13,262 patients: 8,625 CHB-no FL and 4,637 CHB-FL patients who differed in several characteristics. The IPTW cohort included 6,955 CHB-no FL and 3,346 CHB-FL well-matched patients. CHB-FL patients (vs. CHB-no FL) had significantly lower HCC, cirrhosis, mortality and higher HBsAg seroclearance incidence (all P≤0.002), with consistent results in subgroups. CHB-FL diagnosed by liver biopsy had a higher 10-year cumulative HCC incidence than CHB-FL diagnosed with non-invasive methods (63.6% vs. 4.3%, P<0.0001). Conclusions: IPDMA data with well-matched CHB patient groups showed that FL (vs. no FL) was associated with significantly lower HCC, cirrhosis, and mortality risk and higher HBsAg seroclearance probability.
Yu Jun Wong,Chen Zhaojin,Guilia Tosetti,Elisabetta Degasperi,Sanchit Sharma,Samagra Agarwal,Liu Chuan,Chan Yiong Huak,Li Jia,Qi Xiaolong,Anoop Saraya,Massimo Primignani 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.1
Background/Aims: The utility of Baveno-VII criteria of clinically significant portal hypertension (CSPH) to predict decompensation in compensated advanced chronic liver disease (cACLD) patient needs validation. We aim to validate the performance of CSPH criteria to predict the risk of decompensation in an international real-world cohort of cACLD patients. Methods: cACLD patients were stratified into three categories (CSPH excluded, grey zone, and CSPH). The risks of decompensation across different CSPH categories were estimated using competing risk regression for clustered data, with death and hepatocellular carcinoma as competing events. The performance of “treating definite CSPH” strategy to prevent decompensation using non-selective beta-blocker (NSBB) was compared against other strategies in decision curve analysis. Results: One thousand one hundred fifty-nine cACLD patients (36.8% had CSPH) were included; 7.2% experienced decompensation over a median follow-up of 40 months. Non-invasive assessment of CSPH predicts a 5-fold higher risk of liver decompensation in cACLD patients (subdistribution hazard ratio, 5.5; 95% confidence interval, 4.0–7.4). “Probable CSPH” is suboptimal to predict decompensation risk in cACLD patients. CSPH exclusion criteria reliably exclude cACLD patients at risk of decompensation, regardless of etiology. Among the grey zone, the decompensation risk was negligible among viral-related cACLD, but was substantially higher among the non-viral cACLD group. Decision curve analysis showed that “treating definite CSPH” strategy is superior to “treating all varices” or “treating probable CSPH” strategy to prevent decompensation using NSBB. Conclusions: Non-invasive assessment of CSPH may stratify decompensation risk and the need for NSBB in cACLD patients.
전영주(Young Ju Jeon),도준형(Jun-Hyeong Do),김장웅(Jang Wong Kim),김상길(Sang Gil Kim),이혜정(Hae Jung Lee),이유정(Yu Jung Lee),김근호(Keun Ho Kim),김종열(Jong Yeol Kim) 한국한의학연구원 2011 한국한의학연구원논문집 Vol.17 No.2
Objectives : The purpose of this study is to develop an apparatus which can take a facial image by self-operated capturing technique. The user can obtain one’s facial image immediately after adjusting facial tilt and focusing distance. The system has been designed for classifying Sasang typology based on facial image. Methods : The system is composed of a Webcam, one-way glass mirror and mini LCD. The Webcam takes a facial image which is displayed on the mini LCD. Then the user can see and adjust to the right position in the real time through the image mirror-reflected from the mini LCD. The optical sensor is used to estimate the proper focusing distance. To verify the performance of the system, 11 characteristic points on the facial image are used and compared with high performance DSLR camera(D700) by applying the coefficient of variance and Bland-Altman Plot. Results : The developed system and D700 show enough agreement with the small coefficient of variance to analyse constitutional types with a facial image. However, the result of Bland-Altman plot shows that the width parameters have distortions owing to short focusing distance. Conclusions : The system is expected to be utilized on u-healthcare services for home environment after improving the distortion in the width parameters.
( Young Jin Lee ),( Heung Yeol Kim ),( Chun Jun Lee ),( Wong Yu Kim ),( Ijo Jeong ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-
This retrospective study evaluated bone mineral density (BMD) in premenopausal invasive cervical cancer patients with concurrent chemoradiation (CCRT). We retrospectively analyzed the BMD of spinal bone and the femur in 16 invasive cervical cancer patients treated with CCRT. All BMD was measured by dual-energy X-ray absorptiometry. For a 1-to-2 matched case-control study, 32 patients with benign uterine myoma whose age and body mass index are consistent with the case group were selected. All of the patients and control women had reached their menopause. The lowest BMDof patients treated with CCRT for invasive cervical cancer was significantly lower (p<0.05) than those of control women. The serum levels of calcium and phosphate were not significantly different between the patients with cervical cancer and control women. Age, height, body weight and body mass index were not significantly different between the two groups. Our study results suggest that invasive cervical cancer patients treated with CCRT have a lower BMD, resulting in an increased risk of osteoporosis.
Clinical Features and Predictors of Dysplasia in Proximal Sessile Serrated Lesions
Yi Yuan Tan,Gary Sei Kiat Tay,Yu Jun Wong,James Weiquan Li,Andrew Boon Eu Kwek,Tiing-Leong Ang,Lai Mun Wang,Malcolm Teck Kiang Tan 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.4
Background/Aims: Proximal colorectal cancers (CRCs) account for up to half of CRCs. Sessile serrated lesions (SSLs) are precursorsto CRC. Proximal location and presence of dysplasia in SSLs predict higher risks of progression to cancer. The prevalence of dysplasiain proximal SSLs (pSSLs) and clinical characteristics of dysplastic pSSLs are not well studied. Methods: Endoscopically resected colonic polyps at our center between January 2016 and December 2017 were screened for pSSLs. Data of patients with at least one pSSL were retrieved and clinicopathological features of pSSLs were analysed. pSSLs with andwithout dysplasia were compared for associations. Results: Ninety pSSLs were identified, 45 of which had dysplasia giving a prevalence of 50.0%. Older age (65.9 years vs. 60.1 years,p=0.034) was associated with the presence of dysplasia. Twelve pSSLs were 10 mm or larger. After adjusting for age, pSSLs ≥10 mmhad an adjusted odds ratio of 5.98 (95% confidence interval, 1.21–29.6) of having dysplasia compared with smaller pSSLs. Conclusions: In our cohort of pSSLs, the prevalence of dysplasia is high at 50.0% and is associated with lesion size ≥10 mm. Endoscopic resection for all proximal serrated lesions should be en-bloc to facilitate accurate histopathological examination fordysplasia as its presence warrants shorter surveillance intervals.
해상 어류가두리양식장의 환경영향 평가: II. 가두리 양식장 퇴적물의 산소-황화수소 경계면에서 황화수소의 산화율 및 무산소 퇴적층에서 황산염 환원율 추정
이재성,김기현,유준,이필용,정래홍,이원찬,한정희,이용화,Lee, Jae-Seong,Kim, Kee-Hyun,Yu, Jun,Lee, Pil-Yong,Jung, Rae-Hong,Lee, Wong-Chan,Han, Jung-Jee,Lee, Yong-Hwa 한국해양학회 2004 바다 Vol.9 No.2
We measured the vertical profiles of $O_2$, H$_2$S, and pH in sediment pore water beneath marine cage fish farms using a microsensor with a 25 ${\mu}{\textrm}{m}$ sensor tip size. The sediments are characterized by high organic material load. The oxygen consumption, hydrogen sulfide oxidation, and sulfate reduction rates in the microzonations (derived from the vertical distribution of chemical species concentration) were estimated by adapting a simple one-dimensional diffusion-reaction model. The oxygen penetration depth was 0.75 mm. The oxic microzonations were divided into upper and lower layers. Due to hydrogen sulfide oxidation within the oxic zone, the oxygen consumption rate was higher in the lower layer. The total oxygen consumption rate integrated with reaction zone depth was estimated to be 0.092 $\mu$mol $O_2$cm$^{-2}$ hr$^{-1}$ . The total hydrogen sulfide oxidation rate occurring within 0.7 mm thickness was estimated to be 0.030 $\mu$mo1 H$_2$S cm$^{-2}$ hr$^{-1}$ , and its turnover time in the oxic sediment layer was estimated to be about 2 minutes. This suggests that hydrogen sulfide was oxidized by both chemical and microbial processes in this zone. The molar consumption ratio, calculated to be 0.84, indicates that either other electron accepters exit on hydrogen sulfide oxidation, or elemental sulfur precipitation occurs near the $O_2$- H$_2$S interface. Total sulfate reduction flux was estimated to be 0.029 $\mu$mol cm$^{-2}$ hr$^{-1}$ , which accounted for more than 60% of total $O_2$ consumption flux. This result implied that the degradation of organic matter in the anoxic layer was larger than in the oxic layer. 유기물이 많이 유입되는 해상어류가두리 양식장 퇴적물에서 전극 크기가 25$mu extrm{m}$인 미세전극을 이용하여 공극수의 산소, 황화수소, pH의 미세연직 농도를 측정하였다. 산소와 황화수소의 연직분포에서 얻어진 미세구간에 1차 확산ㆍ반응모델을 적용하여 각 구간에서의 산소 소모율, 황화수소 산화율, 황산염의 환원율을 추정하였다. 산소투과깊이는 0.75 mm였으며, 미세구간은 상부와 하부층 2개로 나누어졌다. 산소소모는 황화수소의 산화 영향으로 상부층에 비해 하부층에서 높았고 총산소소모플럭스는 0.092 $\mu$mol $O_2$$cm^{-2}$ $hr^{-1}$였다. 산화층에서 황화수소 산화는 0.7 mm 두께에서 0.030$\mu$mo1 H$_2$S $cm^{-2}$ $hr^{-1}$의 결과를 나타냈으며, 이 곳에서 황화수소의 turnover time은 약 2분으로 화학적 산화와 생물학적 산화가 동시에 일어나고 있었다. 황화수소와 산소의 소모율 비는 0.84로 황화수소 산화에 산소 이외의 다른 전자수용체가 사용되거나 산소-황화수소 경계면 주변에서 황 침전의 가능성을 시사하고 있었다. 추정된 총 황산염 환원 플럭스는 0.029$\mu$mol $cm^{-2}$ $hr^{-1}$로서 총산소소모플럭스의 60% 이상을 차지하고 있어 무산소 환경에서 유기물 분해가 산화환경에서보다 큰 역할을 하는 것으로 나타났다.