Efficacy and Safety of Sofosbuvir plus Ribavirin Therapy in Treatment-Naive and Treatment-Experienced Korean Patients with Genotype 2 Chronic HCV Infection: A Single-Center, Real-Life Experience

( Dongwuk Kim ),( Wonseok Kang ),( Dong Hyun Sinn ),( Geum-youn Gwak ),( Yong-han Paik ),( Moon Seok Choi ),( Joon Hyeok Lee ),( Kwang Cheol Koh ),( Seung Woon Paik ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Sofosbuvir plus ribavirin therapy has demonstrated potent antiviral activity in patients with hepatitis C virus (HCV) genotype 2 infection. We assessed efficacy and safety of sofosbuvir plus ribavirin therapy in a real-life cohort of Korean patients with genotype 2 chronic HCV infection. In addition, effect of antiviral therapy on liver fibrosis was also assessed in this study. Methods: Between May 2016 and Febraury 2017, a total of 95 patients with genotype 2 chronic HCV infection were retrospectively enrolled at Samsung Medical Center, Seoul, Korea. Those without cirrhosis were treated for 12 weeks, and those with liver cirrhosis were treated for 16 weeks. Changes in liver fibrosis index was assessed by various non-invasive methods, including APRI (AST to Platelet Ratio Index) score, FIB-4 (Fibrosis-4) score and transient elastography. Results: Of 95 patients, 80 patients (84.2%) were treatment naive and 27 patients (28.4%) had liver cirrhosis. High HCV RNA level (≥2 million IU/mL) was observed in 35 patients (36.8%). Pre-treatment mean APRI score was 1.31, mean FIB-4 score was 4.94, and liver stiffness was 13.63 kPa. SVR12 and ETR was achieved in 95 patients (100%). There was no patient who discontinued therapy due to adverse event. Most common adverse event was dizziness, which was observed in 15 patients (15.7%). In addition, there was a significant improvement of APRI and FIB-4 scores, and liver stiffness measurement by transient elastography after treatment (P value <0.001, respectively). Conclusions: In this real-life cohort, sofosbuvir plus ribavirin therapy was very effective and well tolerated treatment option for both treatment- naive and treatment-experienced patients with HCV genotype 2 infection. This therapy was generally well-tolerated, and did not show severe adverse events. Significant improvement of liver fibrosis indices was shown after successful therapy.

S-19 Influence of esophagectomy on the gastroesophageal reflux in patients with esophageal cancer

( Dongwuk Kim ),( Yang Won Min ),( Jae Geun Park ),( Hyuk Lee ),( Byung-hoon Min ),( Jun Haeng Lee ),( Poong-lyul Rhee ),( Jae J. Kim ),( Jae Ill Zo ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

Background/Aims: The present study aimed to assess the influence of esophagectomy with gastric transposition on the gastroesophageal reflux (GER) and gastric acidity in patients with esophageal cancer.?Methods: Fifty-three esophageal cancer patients who underwent 24-hour impedance-pH monitoring after esophagectomy were retrospectively analyzed. We used a solid state esophageal pH probe in which esophageal pH sensor was placed 1.5 cm distal to the upper esophageal sphincter and gastric pH sensor is located 15 cm distal to esophageal pH channel. 24-hour impedance-pH monitoring data and other clinical data including anastomosis site stricture and pneumonia were collected. We defined pathologic reflux with reference to known normative data. Stricture was defined when intervention such as bougienage or balloon dilatation was required to relief dysphagia.?Results: Esophageal and gastric mean pH was 5.47±1.51 and 3.33±1.64, respectively. Percent time of acidic pH (<4) was 6.66±12.49% in the esophagus and 70.53±32.19% in the stomach. Esophageal pathologic acid reflux was noticed in 32.1%, 20.8%, and 35.8% during total, upright, and recumbent time, respectively. Esophageal pathologic bolus reflux was noticed in 83.0%, 77.4%, and 64.2% during total, upright, and recumbent time, respectively. Gastric acidity increased with time after esophagectomy. Esophageal acid exposure time correlated with intragastric pH. However, esophageal pathologic acid reflux was not associated with anastomosis site stricture and pneumonia.?Conclusions: GER frequently occurs after esophagectomy. Strict life-style modification and acid suppression seems necessary to manage GER in patients underwent esophagectomy.

재발성 연골염에 동반된 빠르게 크기가 증가하는 상행대동맥류 1예

장하성 ( Haseong Chang ),김동욱 ( Dongwuk Kim ),김주원 ( Juwon Kim ),이대근 ( Daegeun Lee ),성기익 ( Kiick Sung ),김덕경 ( Duk-kyung Kim ) 대한내과학회 2016 대한내과학회지 Vol.91 No.3

Here we describe a case of rapidly expanding ascending aortic aneurysm in a patient with relapsing polychondritis. To prevent aneurysm rupture, the patient underwent emergent surgical repair. Silent inflammation can progress in the aorta wall, even in asymptomatic patients with mild disease activity under immunosuppressive treatment, leading to the rapid growth of aortic aneurysms. Close monitoring with routine imaging is needed once a patient with relapsing polychondritis is diagnosed with an aortic aneurysm. (Korean J Med 2016;91:292-295)

Flexible-Device Injector with a Microflap Array for Subcutaneously Implanting Flexible Medical Electronics

Song, Kwangsun,Kim, Juho,Cho, Sungbum,Kim, Namyun,Jung, Dongwuk,Choo, Hyuck,Lee, Jongho Wiley-VCH 2018 Advanced Healthcare Materials Vol.7 No.15

<P>Implantable electronics in soft and flexible forms can reduce undesired outcomes such as irritations and chronic damages to surrounding biological tissues due to the improved mechanical compatibility with soft tissues. However, the same mechanical flexibility also makes it difficult to insert such implants through the skin because of reduced stiffness. In this paper, a flexible-device injector that enables the subcutaneous implantation of flexible medical electronics is reported. The injector consists of a customized blade at the tip and a microflap array which holds the flexible implant while the injector penetrates through soft tissues. The microflap array eliminates the need of additional materials such as adhesives that require an extended period to release a flexible medical electronic implant from an injector inside the skin. The mechanical properties of the injection system during the insertion process are experimentally characterized, and the injection of a flexible optical pulse sensor and electrocardiogram sensor is successfully demonstrated in vivo in live pig animal models to establish the practical feasibility of the concept.</P>

특성길이 변화에 따른 H<SUB>2</SUB>O<SUB>2</SUB>/Kerosene 이원추진제 로켓 엔진의 성능평가

조성권(Sungkwon Jo),장동욱(Dongwuk Jang),김종학(Jonghak Kim),윤호성(Hosung Yoon),권세진(Sejin Kwon) 한국추진공학회 2010 한국추진공학회 학술대회논문집 Vol.2010 No.11

고농도 과산화수소를 이용하는 1,200 N 급 이원추진제 로켓 엔진 개발을 위한 기존 연구와 더불어, 특성길이의 영향 및 추력 측정을 통한 실질적인 성능을 평가하였다. 특성길이는 0.95, 1.07과 1.20 m, 총 3가지 경우에 대하여 실험을 수행하였으며, 특성길이의 증가에 따라 C<SUP>*</SUP> 효율 및 Isp 효율 모두 증가함을 확인하였다. 설계 당량비에서의 최대 C<SUP>*</SUP> 및 Isp 효율은 각각 98.4%와 93.1%로 측정되었다. 엔진 성능 평가 결과를 바탕으로 분해된 과산화수소를 이용한 엔진에서의 최적 특성길이를 제안하고, 설계 당량비에서의 추력 및 비추력 효율을 이용하여 진공에서의 엔진성능을 예측하여 보았다. 그 결과, 지상 218.4 s, 진공 253.3 s의 비추력과, 진공 추력 1035.3 N의 성능을 예상할 수 있다. In addition to the previous study for development of a 1,200 N-class bipropellant rocket engine with concentrated hydrogen peroxide, the effect of characteristic length and thrust measurement were experimentally evaluated. Tests with characteristic lengths of 0.95, 1.07, and 1.20 m were performed and C<SUP>*</SUP> and Isp efficiencies were increased as increasing characteristic length. The maximum C<SUP>*</SUP> and Isp efficiencies were 98.4% and 93.1% respectively. Based on the evaluation of the designed engine, the optimized characteristic length was proposed in using the engine adapted decomposed hydrogen peroxide and the engine performance at vacuum-level was evaluated using thrust and Isp efficiency at the designed equivalence ratio. As a result, 218.4 s at sea-level, 253.3 s at vacuum-level, and vacuum thrust of 1035.3 N can be estimated.

지방자치단체 발생주의·복식부기 회계제도의 개선방안에 관한 연구

문광민(Moon, Kwangmin),김동욱(Kim, Dongwuk),임동완(Lim, Dongwan),윤성일(Yoon, Sungil) 서울행정학회 2018 한국사회와 행정연구 Vol.29 No.2

본 연구는 우리나라 발생주의·복식부기 지방회계제도의 발전을 위한 개선방안을 요인별로 비교하여 일정기준에 따른 우선순위를 도출하는 것을 목적으로 하고 있다. 이를 위해 본 연구에서는 선행연구를 검토하여 우리나라 지방회계제도의 주요 쟁점을 도출하고, 계층화분석법(AHP)을 이용하여 이에 대한 우선순위를 분석하였다. ‘중요성’과 ‘실행용이성’ 판단기준에 따라 지방회계제도의 발전을 위한 세부과제들을 핵심과제, 중장기과제, 단기해결과제, 선택과제 등으로 분류하였다. 지방회계제도의 요인별 우선순위 분석결과는 다음과 같다. 첫째, 핵심과제로는 지방회계관련 법체계 정비 및 회계예규보완, 회계 법규와 실무가이드 구분 제작 등으로 나타났다. 둘째, 중장기과제로는 결산검토의 결산감사 전환 및 감리제도 단계적 도입, 회계교육관련 하위법규의 제정 및 구체화 등으로 나타났다. 셋째, 단기해결과제로는 e-호조 데이터베이스 기능강화 등으로 나타났다. 넷째, 선택과제로는 예산에 발생주의 지표 활용, 발생주의 예산제도 도입 등으로 나타났다. This study was designed to analyze the priority of factor for the development of the double-entry book-keeping system and accrual basis accounting in Korea. To this end, in this study, we examined prior studies to draw major issues from the local government’s accounting system and to analyze their priorities using the Analytic Hierarchy Process (AHP). Based on the criteria of judgment of ‘importance’ and ‘ease of implementation’, detailed tasks for the development of the local accounting system were classified into core tasks(Must Have’s), midium-and long-term tasks(Low Hanging Fruit), short-term tasks(Quick Win), and selective tasks(Money Pits). The analysis results of the priority order by the local accounting system are as follows. First, the core tasks were readjustment of legal systems related to local accounting and complement of accounting rules, and separation of accounting regulations and business guides etc. Second, the midium-and long-term tasks were introduction of audit of settlement of accounts, the supervision system, and establishment of sub-regulations related to accounting education, and so on. Third, the short-term tasks were to enhance the function of the e-hojo database. Fourth, selective tasks were the utilization of the accrual basis indicators in budget formulation, and the introduction of accrual basis budgeting system.

대규모 유전자 분석 기법을 이용한 육미지황원의 유전자 발현 연구

강봉주(Kang Bongjoo),김윤택(Kim Yuntaik),조동욱(Cho Dongwuk) 한국한의학연구원 2002 한국한의학연구원논문집 Vol.8 No.2

4-Vessel Occlusion 허혈동물모델에서의 대규모 유전자 발현 연구

강봉주,홍성길,김윤택,김영옥,조동욱 한국한의학연구원 2000 한국한의학연구원논문집 Vol.6 No.1

Cerebral ischemia, the most prevalent form of clinical stroke, is a medical problem of the first magnitude. Substantial efforts are being made to develop drugs which will protect the brain from the neurodegeneration followed by an ishemic stroke. A key factor in this process is the increasing an evidence that free radical is involved in the mechanisms of ischemic brain damage. We investigated the macro scale gene expression analysis on the global ischemic induced by 4-vessel occlusion in Wister rats. The recent availability of microarrays provides an attractive strategy for elaborating an unbiased molecular profile of large number of genes during ischemic injury. This experimental approach offers the potential to identify molecules or cellular pathways not previously associated with ischemia. ischemia was induced by 4-vessel occlusion for 10 minutes and reperfused again. RNA from sham control brain and time-dependent ischemed brain were hybridized to microarrays containing 4,000 rat genes. 589 genes were found to be at least 2 fold regulated at one or more time points. These survey data provide the foundation studies that should provide convincing proof for ischemia and oxidative stress on gene expression.

MCAo 허혈동물모델에서 육미지황탕 효능에 관한 프로테오믹스 연구

강봉주(Kang BongJoo),김영옥(Kim Youngok),조동욱(Cho Dongwuk) 한국한의학연구원 2007 한국한의학연구원논문집 Vol.13 No.1

In the post-genome era. analysis of the cellular transcriptome using microarray or the cellular proteome using a 2-D gel electrophoresis and MALDI-TOF mass spectrometry are most widely used. Stroke is one of the most important causes of death along with cancer and cardiac disease. When pathological change of cells in developed from cerebral ischemia accompanied by stroke administration of neuroprotective drugs before stroke can decreases the degeneration of neuronal cells. The purpose of the present study was to assess the neuroprotective effect and protein expression after administration of P004, middle cerebral artery model of cerebral ischemia in rats. SD rats were subjected to middle cerebral artery occlusion. P004 (1.000 ㎎/㎏) was administered 2 times at 0, 90 minutes after middle cerebral artery occlusion (MCAo). Rats were killed at 48 hours, and infarct area and volume were determined by histology and computerized image analysis. We investigated the protein expression profile on the global ischemia induced by MCAo. This proteomic analysis enable us to identify several proteins differently expressed in infarct brain tissue. The aims of this study were to do investigation comparing the neuroprotection activities of P004 and to understand the mechanism of acted as neuroprotective drug.

특성길이 변화에 따른 H₂O₂/Kerosene 이원추진제 로켓 엔진의 성능평가

조성권(Sungkwon Jo),장동욱(Dongwuk Jang),김종학(Jonghak Kim),윤호성(Hosung Yoon),권세진(Sejin Kwon) 한국추진공학회 2011 한국추진공학회지 Vol.15 No.3

In addition to the previous study for development of a 1,200 N-class bipropellant rocket engine with concentrated hydrogen peroxide, the effect of characteristic length and thrust measurement were experimentally evaluated. Tests with characteristic lengths of 0.95, 1.07, and 1.20 m were performed and C<SUP>*</SUP> and Isp efficiencies were increased as increasing characteristic length. The maximum C<SUP>*</SUP> and Isp efficiencies were 98.4% and 93.1% respectively. Based on the evaluation of the designed engine, the optimized characteristic length was proposed in using the engine adapted decomposed hydrogen peroxide and the engine performance at vacuum-level was evaluated using thrust and Isp efficiency at the designed equivalence ratio. As a result, 218.4 s at sea-level, 253.3 s at vacuum-level, and vacuum thrust of 1035.3 N can be estimated.