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- 저자 : ( Hyunhwa Yoon ) (검색결과 3 건)
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( Hyunhwa Yoon ),( Young Kul Jung ),( Seung Jun Jang ),( Seung Kak Shin ),( Hae Lim Baek ),( Soo Yong Park ),( Min Young Rim ),( Hyeonsu Park ),( In Ku Yo ),( Oh Sang Kwon ),( Yun Soo Kim ),( Duck Joo 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background: The combination theraphy with peginterferon and ribavirin has been used to treat chronic hepatitis C for several years in Korea, yet there is a few reports regarding the results of the genotype 2, 3. We evaluated factors influencing SVR in Korean patients with genotype 2 and 3 chronic hepatitis C after combination theraphy conducted at a single center. Methods: This study was performed to investigate the factors that affect sustained virologic response (SVR) who underwent combination theraphy consist of peginterferon and ribavirin. Reptrosepctively, a total of 98 patients untreated genotype 2 and 3 chronic hepatitis C were enrolled and completed the treatment (52 males(53.06%), genotype 2: 96 (97.96%)). Duration of the treatment was 16-24 weeks. Response of the treatment was evaluated by rapid virologic response (RVR), end treatment virologic response (ETR) and sustained virologic response (SVR). Results: The RVR, ETR, SVR were 88.78%, 92.86% and 91.84% respectively. The total number of patients who did not have SVR were 8, of which 3 patients were non responsive to antiviral agents, and 5 patients showed evidence of relapse of HCV infection. Among the 5 patients with relapse, dose was not reduced in 2 patients, whereas dose reduction was done to 3 patients who showed adverse effects, such as hematologic disorders (anemia, leukopenia, thrombocytopenia), poor oral intake, and general weakness. Univariate analysis showed that the RVR was the only independent factor that affected the SVR(odds ratio=11.857, 95% confidence interval: 2.427-57.920, P<0.001). Conclusions: Our study showed that combination theraphy with peginterferon and ribavirin as an initial treatment for genotype 2 and 3 chronic hepatitis C is very effective, and that the SVR rate is significantly associated with the RVR and might be a useful response factor that is readily available in clinical practice, and especially for genotype 2 and 3 patients.
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핵 교리 진화의 공통 경로와 최근 북한의 핵 확전 개념
황일도 세종연구소 2021 국가전략 Vol.27 No.3
By way of the declaration of tactical nuclear development at the 8th Party Congress and the continuing short-range missile modernization program, the prediction that North Korea would use its nuclear weapons as a war-fighting capability in the theater of Korean Peninsula is becoming a palpable reality. This evolution of nuclear doctrine replicates the common pattern of the denial deterrence & first use doctrine adopted by several nuclear-armed states, which face potential enemies on land borders and whose conventional capabilities are inferior to the opponents. These precedent countries have sought the possibility to countervail conventional inferiority by lowering the threshold between conventional warfare and tactical nuclear exchange as much as possible, while avoiding strategic nuclear retaliation even after their first use of tactical nuclear weapons. As it seems salient that the North Korea’s nuclear escalation concept is also changing in a similar orientation, the ROK-US alliance's deterrence strategy needs to be focused on how to stymie the expectation of Pyongyang that the stages of tactical nuclear use and strategic nuclear use could be insulated, on the bedrock of sophisticated understanding of the country's escalation notion. 8차 당대회에서의 전술핵 개발 선언과 계속되는 단거리미사일 현대화 프로그램을 통해 북한이 핵무기를 한반도 전구 내에서의 실전전력(war-fighting capability)으로 활용하려 할 것이라는 예측이 현실화되고 있다. 기존의 대미 응징억제 교리에 더해진 이러한 핵 교리 진화는 ▵잠재적국과 국경을 마주하고 있고 ▵해당 잠재적국에 비해 재래식 전력이 열세였던 핵무장 국가들이 예외 없이 택했던 거부억제-핵선제사용 교리의 공통적 패턴을 재현하는 것이라 할 수 있다. 이들 선행사례 국가들은 재래식 교전과 전술핵 교전 사이의 문턱(threshold)을 최대한 낮춤으로써 재래식 열세를 상쇄하는 한편, 전술핵 사용 이후에도 전략핵 응징보복을 피할 수 있는 가능성을 모색해 왔다. 북한의 핵 확전 개념 역시 유사한 방향으로 변화하고 있다고 판단되는 바, 한미연합측의 억제 전략은 북측 확전 개념에 대한 정교한 인식을 바탕으로 전술핵과 전략핵 교전 단계가 분리될 수 있을 것이라는 평양의 기대를 효과적으로 저지하는데 집중될 필요가 있다.
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HCC : Vascular Enhancement Patterns of HCC with Contrast-Enhanced Ultrasound
( Hae Lim Baek ),( Yun Soo Kim ),( Young Kul Jung ),( Oh Sang Kwon ),( Ju Hyun Kim ),( Duck Joo Choi ),( Yeon Suk Kim ),( Yang Suh Ku ),( Seung Jun Jang ),( Seung Kak Shin ),( Hyunhwa Yoon ),( Soo Yon 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background: Classic enhancement pattern of hepatocellular carcinoma(HCC) with dynamic CT or MRI includes hyperenhancement in arterial phase and hypoenhancement during portal and delayed phase. It is known that vascular pattern after SonoVue injection is similar to that observed with CT or MRI. However, atypical enhancement and washout pattern are not unusually encountered with CEUS. We have studied CEUS patterns of HCC in 32 consecutive patients with HCC. Methods: 32 HCCs were analysed(mean age 55.5, 6 females, 26 males). Twenty two were diagnosed with liver biopsy, and in 10 patients diagnosis was made with typical dynamic CT or MRI findings. CEUS using SonoVue(Bracco, Milan, Italy) were performed. Arterial, portal and delayed phases were determined as -30s, 31-120s and 121-360s. Results: HBsAg and anti-HCV were positive in 24 (75%) and 5 (15%) patients, respectively. Mean tumor size was 5.3±4.3 cm (1.1-20.0 cm). Mean serum alpha fetoprotein was 9,174 ng/mL (1.3-200,000 ng/mL). All the HCCs showed arterial enhancement (hyper or iso-). Arterial hyperenhancement was observed in 26 (81%) lesions, and remaining 6 (19%) HCCs showed isoenhancement relative to the adjacent liver parenchyme. Hypoenhancement (wash-out) in portal phase was observed in only 9 (28%) lesions (mean diameter: 5.1±4.2 cm), and remaining 23 lesions (72%) were isodense in portal phase (mean diameter: 5.4±4.5 cm). Hypoenhancement in delayed phase was observed in 28 lesions (88%) (mean diameter: 5.8±4.4 cm). And remaining 4 lesions showed persistent isoenhancement until 6 min, and their mean diameter was 2.2±0.9 cm (P=0.126). Enhancement during arterial phase, isoenhancement during portal and hypoenhancement during delayed phase was observed in 19 (59%) lesions, which was most common enhancement pattern. Conclusions: Arterial hyperenhancement with isodense portal phase and hypoenhancement in delayed phase was most common CEUS finding in HCC. It seems that tumor size affects on the hypoenhancement during delayed phase in CEUS.
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