특발성 과호산구 증후군 2예

김은순,엄태현,김준희,신보문,김예희 인제대학교 1999 仁濟醫學 Vol.20 No.1S

특발성 과호산구 증후군은 지속적인 호산구의 과도 생산으로 여러 장기에 손상을 가져오는 백혈구 증가 질환이다. 가장 많이 침범 되는 장기인 심장의 침범여부가 이환율과 생존율의 중요한 요인이다. 폐 침범은 약 40%에서 나타나며 만성, 지속성, 비객담성 기침이 주된 증상이다. 치료는 스테로이드를 투여하는 것인데 스테로이드에 반응하지 않은 경우 세포 독성 약제를 이차적으로 사용할 수 있다. 저자들은 폐를 침범한 특발성 과호산구성 증후군에서 스테로이드에 반응하지 않아 세포독성 약제 및 면역 억제제로 증상의 호전이 있었던 1예와 심장을 침범한 특발성 과호산구성 증후군으로 스테로이드에 반응한 1예를 경험하였기에 보고하는 바이다. The idiopathic hypereosinophilic syndrome is a leukoproliferative disorder marked by a sustained overproduction of eosinophilia with evidence of organ involvement. In patients with organ involvement, initial therapy is prednisone. Cytotoxic agents have been used in patients who are not responsive to corticosteroid. We experienced a 40-year-old woman with lung in volvement who was treated with cytarabine, azathioprine, prednisolone and a 46-year-old man with heart failure who showed partial response.

Immediate Effects of Asymmetric Chewing on Temporomandibular Joint Kinematics

( Tae-joon Um ),( Han-seung Choi ),( Dong Yeop Lee ),( Jae Ho Yu ),( Jin Seop Kim ),( Seung Gil Kim ),( Jiheon Hong ) 대한물리치료학회 2023 대한물리치료학회지 Vol.35 No.6

Purpose: This study investigated the immediate biomechanical effects of unilateral mastication for 10 minutes on the temporomandibular joint (TMJ) with 21 healthy adult participants. Methods: The gum group chewed gum on the right side for 10 minutes, and the control group rested for 10 minutes. Biomechanical data were obtained using a three-dimensional infrared camera before and after intervention. An independent t-test assessed the variation of kinematic data to identify differences between before and after intervention. Results: Among biomechanical variables, the gum group’s length of the left forehead middle region and the temporomandibular joint angle decreased compared to the control group (p<0.05). Conclusion: Caution with unilateral masticatory activity is recommended, as unilateral mastication causes biomechanical changes due to excessive load on the soft tissues of the contralateral TMJ.

Comparison of the Occurrence of Hepatocellular Carcinoma in Patients of Chronic Hepatitis B Treated with Entecavir and Tenofovir

( Tae Hyung Kim ),( Hyung Joon Yim ),( Young-sun Lee ),( Young Kul Jung ),( Han Ah Lee ),( Sun Young Yim ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Jong Eun Yeon ),( Kwan Soo Byun ),( Soon Ho Um ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: In chronic hepatitis B (CHB), nucleos(t)ide analogues (NAs) cannot exterminate the virus, and only suppress its proliferation. Thus, even though NAs improve the liver function, the risk of hepatocellular carcinoma (HCC) persists over time. Since a large cohort study which suggested the superiority of tenofovir over entecavir in reducing HCC risk, there is a great deal of controversy in choosing NAs. In this study, we aimed to meta-analyze the published data from Korea to date together with the unpublished data of our institution to derive the robust conclusion. Methods: We searched on-line database and derived 6 publications from Korea. In addition, we investigated 535 treatment- naïve patients with CHB who were first treated with entecavir (n=298) and tenofovir (n=237) between 2008 and 2016 at Korea University Medical Center (Ansan and Guro Hospitals). We used Kaplan-Meier method, Cox regression model, propensity score matching and meta-analysis. Results: From the 6 publications, 9,844 patients were included, 556 developed HCC. From our institutions, HCC was developed in 59 patients during a median follow-up of 21.6 months. After 1:1 propensity score matching, the kind of antiviral agent did not affect the development of HCC (HR, 0.72; 95% CI 0.31-1.71; P=0.46). Combined with the results of six domestic studies, the tenofovir group did not show significant suppression of HCC development compared to the entecavir group (HR, 0.96; 95% CI 0.74-1.25). Conclusions: In a meta-analysis of seven studies of HBV-endemic area including our own institutional data, HCC occurrence was not significantly different between patients with treated with entecavir or tenofovir.

Construction of 1H-15N Double Resonance Solid-State NMR Probe for Membrane Proteins in Aligned Bicelles

Tae-Joon Park,김지선,Seung-Hoon Um,김용애 대한화학회 2010 Bulletin of the Korean Chemical Society Vol.31 No.5

1H-15N heteronuclear dipolar coupling solid-state NMR experiments on lipid bilayer or bicelle samples are very useful for the structural studies of membrane proteins. However, to study these biological samples using solid-state NMR, a specific probe with high efficiency and high capability is required. In this paper, we describe the optimized design, construction,and efficiency of a 400 MHz wide-bore 1H-15N solid-state NMR probe with 5-mm solenoidal rf coil for high power, multi-pulse sequence experiments, such as 2D PISEMA or 2D SAMMY.

Treatment and Prognosis of Advanced HCC with Metastasis

( Tae Hyung Kim ),( Soon Ho Um ),( Han Ah Lee ),( Jung Mi Chang ),( Dae Hoe Gu ),( Jem Ma Ahn ),( Yeon Seok Seo ),( Hyung Joon Yim ),( Yoon Tae Jeen ),( Hong Sik Lee ),( Hoon Jai Chun ),( Chang Duck K 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: As hepatocellular carcinoma (HCC) progresses, it is accompanied by deterioration of liver function, which makes treatment difficult. In particular, advanced HCC involves not only impairment in liver function and general condition but also vascular invasion and other organ metastasis. It is very heterogeneous stage and needs to be further subdivided. In the present study, we investigated treatment outcomes and the factors associated with prognosis in HCC patients with distant metastasis. Methods: We analyzed data of 103 patients with advanced HCC with distant metastasis at initial diagnosis from June 2004 to June 2015. The patients received the first treatment for HCC in our hospital. Results: Mean age of patients was 57.3 ± 11.6 years and men were predominant (80.6%). The median observation period was 3.2 (0.3-39.1) months, and 99 (96.1%) of these patients died. There were no significant association with survival in sex, age, etiology and the number of liver tumors (p = 0.274, 0.094, 0.854 and 0.280, respectively). In univariate analysis, bilobar tumor distribution, invasion of main portal vein or IVC, Child-Pugh class, and treatment modality showed significant association with shorter survival. (p = 0.033, <0.001, 0.015, <0.001, and <0.001, respectively). In multivariate analysis, Child-Pugh class (p<0.001) and initial treatment modality (p=0.001) were significantly independent factors for survival. In Kaplan-Meier curve, systemic chemotherapy-alone or combination of locoregional treatment (LRT) and cytotoxic chemotherapy has no significant difference on survival compared with best supportive care as initial treatment. (median survival time, MST, 2.3 vs. 1.6 months) However, LRT alone (MST) or combination of sorafenib and LRT (MST 4.8, 4.3 months) showed significant survival benefit. (p = 0.001, 0.002). Conclusions: The Child-Pugh score and treatment modality in HCC patients with metastasis showed significant prognostic relevance. We also found that locoregional control for primary liver mass therapy is important in the treatment of sorafenib.

Comparison of HPV Genotyping Assays and Hybrid Capture 2 for Detection of High-Risk HPV in Cervical Specimens.

Um, Tae Hyun,Lee, Eun Hee,Chi, Hyun-Sook,Kim, Jong-Won,Hong, Young-Joon,Cha, Young Joo Institute for Clinical Science] 2011 Annals of clinical and laboratory science Vol.41 No.1

<P>High-risk types of human papillomavirus (HR-HPV) are among the primary causes of cervical cancers. Hybrid Capture 2 (HC-II) (Digene, Gaithersburg, MD), which detects 13 HR-HPVs as a group, is the only HPV assay approved to date by the United States Food and Drug Administration. In Korea, several HPV genotyping assays are commercially available, including HPV RFMP (GeneMatrix Co., Seoul), HPVDNACHIP (Biomedlab Co., Seoul), and MyHPV Chip (Mygene Co., Seoul). We compared the results of these assays with those of HC-II. Among 553 residual samples of liquid-based Pap tests, a total of 435 (78.7%) were available for HPV assays. They were classified into four cytologic categories: normal, atypical squamous cells of undetermined significance (ASCUS), low-grade cervical squamous intraepithelial lesions (LSIL), and high grade SIL or carcinoma (HSIL+). Among these samples, 23.0%, 40.6%, 82.5%, 93.8% were HR-HPV positive by HC-II, respectively; 6.6%, 18.1%, 44.4%, 84.4%, by HPV RFMP, respectively; 5.7%, 24.5%, 54.0%, 84.4%, by HPVDNACHIP, respectively; and 6.6%, 11.6%, 42.9%, 84.4%, by MyHPV, respectively. Compared with HC-II, the concordance rates and kappa values were 70.6% and 0.421 for HPV RFMP; 75.4% and 0.514 for HPVDNACHIP; and 67.8% and 0.367 for MyHPV. The concordance rates and kappa values between genotyping assays were 85.1% and 0.644 for HPV RFMP and HPVDNACHIP; 83.4% and 0.574 for HPV RFMP and MyHPV Chip; and 82.8% and 0.579 for HPVDNACHIP and MyHPV Chip. In conclusion, compared with HC-II test, the genotyping tests showed more than fair concordance but lower sensitivity in the detection of HR-HPVs, limiting their usefulness as HR-HPV screening tools.</P>

Prognostic Impacts of the Change in Muscle Mass on Patients with Cirrhosis

( Tae Hyung Kim ),( Young Kul Jung ),( Sun Young Yim ),( Young-sun Lee ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Hyung Joon Yim ),( Jong Eun Yeon ),( Kwan Soo Byun ),( Soon Ho Um ) 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1

LC : A Randomized, Multi-center, Phase IV Open-label Study to Evaluate the Long-term Effect of Carvedilol versus Propranolol on Reduction in Portal Pressure in Patients with Cirrhosis: An Interim Analysis

( Tae Yeob Kim ),( Joo Hyun Sohn ),( Soon Ho Um ),( Yeon Seok Seo ),( Soon Koo Baik ),( Moon Young Kim ),( Jae Young Jang ),( Soung Won Jeong ),( Young Seok Kim ),( Sang Gyune Kim ),( Dong Joon Kim ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1

Background: Carvedilol, a potent non-cardioselective beta blocker with vasodilating properties due to alpha-1 blockade, is more effective in reducing portal pressure than propranolol in randomized controlled hemodynamic studies. Recently, longterm low dose of carvedilol may be suggested an option for primary prophylaxis in patients with high-risk esophageal varices. The aim of this study is to evaluate long-term effect of carvediolol versus propranolol on reduction in portal pressure in patients with cirrhosis. Methods: We conducted this ongoing prospective randomized multicenter study (target sample size: 130 patients) between July 2011 and February 2013 and analyzed clinical and hemodynamic measurement data of 99 cirrhotic patients with severe portal hypertension (HVPG > 12 mmHg). During that period, these patients were randomized to either carvedilol (mean dose 11.6±2.2 mg/day in 50 patients) or propranolol group (mean dose 153.5±100.2 mg/day in 49 patients). After randomization, 8 patients and 11 patients were dropped out in carvedilol and propranolol group, respectively. The responders were defined to achieve a fall in HVPG to < 12 mmHg or a 20% reduction from baseline values 6weeks after treatment. Results: There were no significant differences between carvedilol and propranolol group in age, sex, etiology, Child-Turcott- Pugh score, MELD score, severity of HVPG, presence of ascites and baseline serum parameters. In per-protocol analysis, the rate of responder of patients with receiving carvedilol was 54.8% (23/42) as compared with 45.2% (16/38) of those with receiving propranolol (P=0.258). In intent-to-treat analysis, the rate of responder between carvedilol and propranolol group were 46.0% and 32.7%, respectively (P=0.174). The mean decrease of HVPG was 15.6±18.1% and 8.1±30.1%, respectively (P=0.188). Finally, there was no significant difference in adverse events between two groups. Conclusions: In this interim analysis, low dose of carvedilol showed similar effi cacy in reducing portal pressure compared to propranolol in cirrhotic patients with severe portal hypertension.

Baseline Factors Associated with Compensation in Patients with Hepatitis B Virus-Related Decompensated Cirrhosis Commencing Antiviral Therapy

( Tae Hyung Kim ),( Soon Ho Um ),( Yoo Ra Lee ),( Han Ah Lee ),( Sun Young Yim ),( Young Sun Lee ),( Sang Jun Suh ),( Young Kul Jung ),( Yeon Seok Seo ),( Ji Hoon Kim ),( Hyung Joon Yim ),( Jong Eun Y 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Decompensation in patients with liver cirrhosis deteriorates the quality of life and reduces the survival sharply. It is well-known that treatment with nucleos(t)ide analogues can restore liver function, resolve the decompensation and reduce mortality in patients with hepatitis B virus (HBV) related cirrhosis. This study aimed to reveal the efficacy of entecavir and tenofovir, which are preferred as initial treatment for chronic hepatitis B, in patients with HBV-related decompensated cirrhosis Methods: Patients with HBV-related decompensated cirrhosis who received entecavir or tenofovir as the initial antiviral therapy were retrospectively identified. Patients with chronic kidney disease or coexisting malignancy, such as hepatocellular carcinoma, were excluded. The primary outcome was the compensation, defined as reduction of Child-Pugh-Turcotte (CTP) score to five. Results: A total of 251 patients were enrolled. Mean age was 53.6 ± 10.8 years and 147 patients (58.6%) were men. CTP grade C presented in 146 patiens (58.2%). During a median follow-up of 34.3 months, the compensation and death occurred in 153 and 71 patients, respectively. Kaplan-Meier plots showed that type of antiviral agents did not influence significantly on compensation (log-rank test, P=0.088) and survival (P=0.295). In multivariate Cox-regression analysis, the compensation significantly occurred more frequently with lower BMI (odds ratio [OR], 0.955; 95% confidence interval [CI], 0.918- 0.993; P=0.021), higher platelet count (OR, 1.006; 95% CI, 1.004-1.011; P<0.001), log value of serum AFP level (OR, 1.905; 95% CI, 1.486-2.443; P<0.001) and absense of ascites (OR, 1.762; 95% CI, 1.234-2.517; P=0.002). Conclusions: The effects on prognosis of HBV-related decompensated cirrhosis were comparable between entecavir and tenofovir. We identified four predictive factors including BMI, platelet count, serum AFP level and ascites for reversibility of decompensation in patients with HBV-related cirrhosis.

Construction of ¹H-¹⁵N Double Resonance Solid-State NMR Probe for Membrane Proteins in Aligned Bicelles

Park, Tae-Joon,Kim, Ji-Sun,Um, Seung-Hoon,Kim, Yong-Ae Korean Chemical Society 2010 Bulletin of the Korean Chemical Society Vol.31 No.5

$^1H-^{15}N$ heteronuclear dipolar coupling solid-state NMR experiments on lipid bilayer or bicelle samples are very useful for the structural studies of membrane proteins. However, to study these biological samples using solid-state NMR, a specific probe with high efficiency and high capability is required. In this paper, we describe the optimized design, construction, and efficiency of a 400 MHz wide-bore $^1H-^{15}N$ solid-state NMR probe with 5-mm solenoidal rf coil for high power, multi-pulse sequence experiments, such as 2D PISEMA or 2D SAMMY.