HBeAg 양성 만성 B형 간염환자에서 Clevudine, Entecavir 및 Lamivudine의 초치료 효과

배숙향 ( Suk Hyang Bae ),백양현 ( Yang Hyun Baek ),이성욱 ( Sung Wook Lee ),한상영 ( Sang Young Han ) 대한소화기학회 2010 대한소화기학회지 Vol.56 No.6

Background/Aims: Clevudine is a potent antiviral agent that has demonstrated efficacy in patients with chronic hepatitis B. This study compared the efficacy of clevudine (C), entecavir (E) and lamivudine (L) in treatment-naive patient with HBeAg-positive chronic hepatitis B. Methods: A total of 146 treatment-naive patients with HBeAg-positive chronic hepatitis B received clevudine, entecavir or lamivudine. C group (n=39) received 30 mg of clevudine, E group (n=39) received 0.5 mg of entecavir and L group (n=68) received 100 mg of lamivudine once a day for more than 48 weeks. The efficacy analysis estimated the mean changes of the HBV DNA levels as a virologic response, the normalization of the ALT levels (less than 35 IU/L) as a biochemical response and loss of HBeAg or seroconversion as a serologic response. The serum HBV DNA level was quantified by hybrid capture and real-time PCR assay. Results: Before the administration of clevudine, entecavir and lamivudine, the mean HBV DNA and ALT levels and the gender and age were well balanced among the three groups (p>0.05). For the virologic response at 48 weeks, the mean changes of the HBV DNA levels from baseline of the C, E and L groups were -3.8±2.2, -4.5±1.9 and -2.5±2.1 log copies/mL. C and E group showed superior antiviral activity compared to that of L group (p<0.0001), but no significant differences in antiviral response were noted between C and E groups. For the biochemical response at 48 weeks, the normalization of the ALT levels (less than 35 IU/L) among the C, E and L groups was 82%, 74% and 71%, respectively (p=0.46). The rates of undetectable serum HBV DNA (less than 300 copies/mL) of the C, E and L groups were 39%, 69% and 27%, respectively (p<0.0001). For the serologic response at 48 weeks, the loss of HBeAg was 13%, 31% and 24% and the seroconversion was 10%, 23% and 17%, respectively. There was no difference of efficacy among the three groups regarding ALT normalization or serologic response (p>0.05). Viral breakthrough in C group was noted at 24 weeks (5%) and 48 weeks (21%), but no biochemical breakthrough was noted. The elevation of the serum CK level was noted in only 1 patient of group C at 48 weeks (2.56%) after therapy. For the patients without or with liver cirrhosis (LC), C and E group showed superior antiviral activity compared to that of the L group, but the antiviral activity was more effective in non-LC group than LC group (p<0.0001 vs p=0.036). Conclusions: Clevudine therapy compared with lamivudine for 48 weeks showed significantly potent antiviral efficacy in treatment-naive patients with HBeAg-positive chronic hepatitis B, and especially in the non-LC patients. However, the antiviral efficacy of clevudine was similar to that of entecavir even though taking into account relatively short follow up period and retrospective study. (Korean J Gastroenterol 2010;56:365-372)

증례 : 혈액종양 ; 불응성 급성전구B림프모세포백혈병 환자에서 발생한 장기종 1예

배숙향 ( Suk Hyang Bae ),황진연 ( Jin Yeon Hwang ),김동균 ( Dong Kyun Kim ),김민식 ( Min Sik Kim ),권희진 ( Hee Jin Kwon ),한진영 ( Jin Yeong Han ),김성현 ( Sung Hyun Kim ) 대한내과학회 2011 대한내과학회지 Vol.80 No.4

장기종은 소화기 장벽내 공기가 축적되는 방사선학적 소견이다. 장기종의 원인은 매우 다양하여 그 원인이 아직 명확하지 않다. 백혈병 환자에서 장기종은 약물치료 및 수술적 치료가 필요한 드문 합병증이다. 대부분의 장기종은 경과 및 예후가 좋은 편이지만 응급수술이 필요한 경우도 있으므로 치료 결정이 어려울 때가 많다. 저자들은 불응성 급성전구B 림프모세포백혈병 환자에서 백혈병의 진행과정으로서 장기종이 발생하여 결국 패혈증으로 사망한 증례를 경험하여 보고하는 바이다. Pneumatosis intestinalis (PI) is an imaging phenomenon that represents air in the bowel wall. The cause of PI is variable, although specific etiologic factors remain unknown. It is an infrequent complication in leukemia patients and is associated with several medical and surgical conditions. PI often represents a benign condition, but it can also require surgery. Therefore, the assessment of PI with or without complications can be difficult. Herein, we report on an unusual case of a 63 year-old woman with refractory acute precursor B-cell lymphoblastic leukemia-lymphoma who presented with PI resulting from the leukemic process, and finally expired due to sepsis. (Korean J Med 2011;80:482-485)

극소 저출생 체중아에서 SMOFlipid의 투여가 미숙아 질환 예방에 미치는 영향: Cholestasis 예방 중심으로

김문진 ( Moon Jin Kim ),배혜정 ( Hye Jung Bae ),조윤숙 ( Yoon Sook Cho ),김귀숙 ( Kwi Suk Kim ),김향숙 ( Hyang Suk Kim ),이혜숙 ( Hye Suk Lee ),이주영 ( Ju Young Lee ),김이경 ( Ee Kyung Kim ),김한석 ( Han Suk Kim ) 한국정맥경장영양학회 2013 한국정맥경장영양학회지 Vol.5 No.2

Purpose: Very low birth weight infants (VLBWI) are found to have a higher incidence of cholestasis due to long-term total parenteral nutrition (TPN). Although there have been some studies on relationships between omega-3 fatty acids and reduced incidence of cholestasis, the advantages that the fatty acids provide for premature infant diseases have not yet been fully understood. The aim of this study was to evaluate the advantages of SMOFlipid, a lipid emulsion product that contains omega-3 over other lipid emulsion products that do not. Methods: The medical records of 182 newborn (127 boys and 55 girls) were reviewed retrospectively between April 2010 and August 2012. These infants were born with a birth weight of <1,500 g and administered either of lipid emulsions (Intra MCT 20% or SMOFlipid) from birth to a full-feeding condition at our neonatal intensive care unit. Cholestasis is defined as serum direct bilirubin (DB) >1.0 mg/dL when total bilirubin (TB) is <5 mg/dL or DB/TB ratio is >20% when TB >5 mg/dL. Results: The incidence of cholestasis was found to be lower in the SMOFlipid group than in the medium-chain triglyceride/long chain triglyceride (MCT/LCT) group (7.3% [4/55] versus 18.9% [24/127], P=0.046). At the start of lipid emulsion administration (day 0), the baseline bilirubin level showed no significant difference between the two groups. However, the maximum value of DB on days 7∼ 14 was lower in the SMOFlipid group than in the MCT/ LCT group (0.8 [0.3∼2.2] versus 1.1 [0.3∼2.8] mg/dL, P= 0.030). The DB/TB ratio was also lower in the SMOFlipid group than in the MCT/LCT group (10.2% [4.9%∼40.0%] versus 24.1% [5.1%∼62.5%], P=0.002). Conclusion: This study concluded that SMOFlipid was effective in the prevention of cholestasis in VLBWI. Therefore, omega-3-containing lipid emulsion can be highly recommended in premature babies, especially in VLBWI who require TPN support. (JKSPEN 2013;5(2):67-75)

Ketorolac 주사제와 Ketoprofen 주사제의 약물 사용 평가

배희경,김정미,손기호,최경업,이숙향 韓國病院藥師會 2004 병원약사회지 Vol.21 No.2

The nonsteroidal anti-inflammatory drugs(NSAIDs) provide relief from the acute pain associated with surgery or trauma. However, the use of NSAIDs needs to be carefully considered because they may produce severe adverse effects such as gastrointestinal(GI) bleeding or renal toxicity. The objectives of this study were to evaluate the appropriateness of using injectable Ketorolac(KRL) and injectable Ketoprofen(KPF) in Samsung Medical Center and to find out methods to improve their use. The charts of 101 patients who received KRL and 85 patients who received KPF for one month(Feb. 2003), were retrospectively reviewed. The criteria of DUE were based on the standard of the American Society of Health-System Pharmacists(ASHP) and modified appropriately according to our hospital settings. Only 34.7% of the patients in the KRL group and 67.1% in the KPF group were found to meet criteria for justification for use. Analysis of critical indicators revealed that the appropriateness in measuring of SCr within 48 hours before initial dose was 53.5% for the KRL group and 27.1% for the KPF group. The appropriateness of maximum daily dosage and duration of therapy accounted for 97.0% and 85.1% of the KRL patients according to the ASHP criteria(120 mg/day, 5 days) and for 94.1% and 66.3% of the KRL patients according to Korean National Insurance criteria(90mg/day, 2days). On the basis Martindale's usual dosage(200 mg/day, 3days), 82.4% of KPF use was appropriate in maximum daily dosage and 75.3% in duration of therapy. It was found that 10.9% of the KRL patients and 5.9% of the KPF patients had complications such as GI effects, CNS effects, etc. In outcome measures, the pain decreased in 98.0% of the KRL patients and 96.5% of the KPF patients. In conclusion, justification for use was inadequate and consideration for critical indicators was insufficient. Therefore, we suggest that there is necessity to elevate the level of physicians' understanding regarding the use of injectable NSAIDs and to provide continuous interventions of pharmacists.

[P8-162] Effects of Fucoidan supplementation on Helicobacter pylori in humans

Hyang-In Back,Sun-Young Kim,Min-Gul Kim,Ji-Young Jeon,Soo-Wan Chae,Jung Shik Bae,Young Suk Kim,Yu Jeong Hwang,Soo Teik Lee 한국식품영양과학회 2009 한국식품영양과학회 학술대회발표집 Vol.2009 No.11

Blockade of cytokine-induced endothelial cell adhesion molecule expression by licorice isoliquiritigenin through NF-kappaB signal disruption.

Kwon, Hyang-Mi,Choi, Yean-Jung,Choi, Jung-Suk,Kang, Sang-Wook,Bae, Ji-Young,Kang, Il-Jun,Jun, Jong-Gab,Lee, Sang-Soo,Lim, Soon Sung,Kang, Young-Hee The Society 2007 Experimental biology and medicine Vol.232 No.2

<P>Numerous polyphenolic compounds have been found to inhibit adhesion and migration of leukocytes to sites of inflammation that are partly regulated by the expression of cell adhesion molecules (CAM) such as vascular cell adhesion molecule-1 (VCAM-1), E-selectin, and platelet endothelial cell adhesion molecule-1 (PECAM-1). Licorice root extracts have been used in traditional Chinese, Tibetan, and Indian medicine for the treatment of pulmonary diseases and inflammatory processes. Expression of CAM proteins was examined in human umbilical vein endothelial cells (HUVEC) treated with a licorice component (isoliquiritigenin, 18beta-glycyrrhetinic acid, glycyrrhizin, formononetin, or ononin) and exposed to TNF-alpha. The involvement of NF-kappaB in the transcriptional control of CAM proteins was assessed by degradation of IkappaBalpha and nuclear translocation of NF-kappaB using Western blotting techniques and immunocytochemical staining. At nontoxic > or =10 microM, isoliquiritigenin blocked the induction of VCAM-1 and E-selectin on activated HUVEC and markedly interfered with THP-1 monocyte adhesion to TNF-alpha-activated endothelial cells. Isoliquiritigenin abolished TNF-alpha-induced mRNA accumulation of VCAM-1 and E-selectin. Additionally, immunocytochemical staining revealed that isoliquiritigenin attenuated PECAM-1 expression induced by TNF-alpha. In contrast, other components recognized in licorice, 18beta-glycyrrhetinic acid, glycyrrhizin, formononetin, and ononin did not down-regulate the expression of VCAM-1 and/or PECAM-1 activated by TNF-alpha, implying that these components are inactive in modulating adhesion of leukocytes to stimulated endothelial cells. Isoliquiritigenin downregulated CAM proteins in TNF-alpha-activated HUVEC at the transcriptional levels by blocking degradation of IkappaBalpha and nuclear translocation of NF-kappaB. These results demonstrate that the induction blockade of VCAM-1 and E-selectin by isoliquiritigenin was directly mediated by its interference with the CAM mRNA transcription through NF-kappaB-dependent mechanisms under inflammatory conditions.</P>

난소의 표피양낭종 1예

이향숙,최귀동,김창배,김현삼 예수병원 1997 예수병원학술지 Vol.18 No.-

Radical Scavenging and Antimicrobial Effects of Spergularia marina Griseb

Chang-Suk KONG,Jung-Ae KIM,Hyang KIM,Myeong-Sook KWON,Min-Joo BAE 한국생물공학회 2013 한국생물공학회 학술대회 Vol.2013 No.4

玄蔘의 Saponin 成分 檢索 : on the Saponin of the Radix

남인숙,배병숙,최보향,최인수,최태수,김동언,김언주,정미영,조규옥 曉星女子大學校 藥學大學 學生會 1988 曉星藥誌 Vol.4 No.-

Crude saponin(100g) were obtained by extracting the radix(5kg) of Scrophalariae koraiensis Nakai. Crude saponin were positive in the Liebermann-Burchard test. We observed 5 sports by TLC using BuOH saturated with H_2O : ethyl acetate : water(4:1:5, upper phase) as solvent and 1% Ce(SO_4)_2 in 10% H_2SO_4 as a color former. We divided into 3 fractions by common column chromatography using BuOH saturated with H_2O : ethylacetate : water(4:1:5, upper phase) as solvent.

CTX-M-Type β-Lactamase in<i>Escherichia coli</i>Isolated from Sick Animals in Korea

Lim, Suk-Kyung,Lee, Hee-Soo,Nam, Hyang-Mi,Jung, Suk-Chan,Bae, You-chan Mary Ann Liebert 2009 Microbial Drug Resistance Vol.15 No.2

<P>About 408 Escherichia coli were isolated from sick farm animals and pets during 2003-2006. Of these isolates, four strains showed resistance to third-generation cephalosporins. The bla(CTX-M-14) gene was encountered in three E. coli strains, each of which were isolated from two cows and a dog, respectively, and bla(CTX-M-15) was identified in an E. coli isolated from a pig. All bla(CTX-M) genes were found to be transferred. The pulsed-field gel electrophoresis pattern indicated that the CTX-M-type beta-lactamase-producing E. coli isolates were genetically diverse. This study shows the emergence of CTX-M-type beta-lactamase-producing E. coli in animals for the first time in Korea. Study results suggest the need for awareness and comprehensive monitoring of extended-spectrum beta-lactamases in animals because gene transfer can occur between animals as well as humans.</P>