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( Eileen L. Yoon ),( Sang Bong Ahn ),( Dae Won Jun ),( Yong Kyun Cho ),( Do Seon Song ),( Jae Yoon Jeong ),( Hee Yeon Kim ),( Young Kul Jung ),( Myeong Jun Song ),( Sung Eun Kim ),( Hyoung Su Kim ),( 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.4
Background/Aims: L-carnitine is potentially beneficial in patients with hepatic encephalopathy (HE). We aimed to evaluate the impact of L-carnitine on the quality of life and liver function in patients with liver cirrhosis and covert HE. Methods: We conducted an investigator-initiated, prospective, multi-center, double-blind, randomized phase III trial in patients with covert HE. A total of 150 patients were randomized 1:1 to L-carnitine (2 g/day) or placebo for 24 weeks. Changes in quality of life and liver function were assessed at 6 months. The model for end-stage liver disease (MELD), the 36-Item Short Form Survey (SF-36), the psychometric hepatic encephalopathy score (PHES), and the Stroop Test were evaluated in all patients. Results: The total SF-36 score significantly improved in the L-carnitine group after 24 weeks (difference: median, 2; interquartile range, 0 to 11; p < 0.001); however, these values were comparable between the two groups. Furthermore, there was a significant ordinal improvement in PHES scores among patients with minimal HE who were in the L-carnitine group (p = 0.007). Changes in the total carnitine level also positively correlated with improvements in the Stroop test in the L-carnitine group (color test, r = 0.3; word test, r = 0.4; inhibition test, r = 0.5; inhibition/switching test, r = 0.3; all p < 0.05). Nevertheless, the MELD scores at week 24 did not differ between the groups. Conclusions: Twenty-four weeks of L-carnitine supplementation was safe but ineffective in improving quality of life and liver function.
( Eileen L. Yoon ),( Dae Won Jun ),( Sang Bong Ahn ),( Yong Kyun Cho ),( Do Seon Song ),( Jae Yoon Jeong ),( Hee Yeon Kim ),( Young Kul Jung ),( Myeong Jun Song ),( Sung Eun Kim ),( Hyoung Su Kim ),( 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: To evaluate the impact of L-carnitine on the improvement of quality of life (QOL) and cognitive function in liver cirrhosis patients with covert hepatic encephalopathy (HE). Methods: We conducted a multi-center, double-blind, randomized, phase III clinical trial in patients with covert HE. A total of 150 covert HE patients were randomized 1:1 to L-carnitine (1 g) or placebo for 24 weeks. Changes in QOL and cognitive function were assessed at 6 months. West Haven criteria, 36- Item Short Form Health Survey (SF-36), psychometric hepatic encephalopathy score (PHES), and the Stroop Test were evaluated in all patients. Results: The L-carnitine supplement improved QOL compared to baseline. PHES scores were improved and normalization rates of minimal HE were increased in the L-carnitine group compared to baseline; however, median PHES scores and normalization rates were not different between the L-carnitine group and the placebo group at Week 24. Assessment of cognitive inhibition via the Stroop test showed significant improvement following 24 weeks of treatment in the L-carnitine group. Model for end stage liver disease scores were increased in the placebo group and significantly decreased in the L-carnitine group. Changes in total carnitine level positively correlated with rate correct scores of the Stroop test in the L-carnitine group. The incidence of adverse events was not different between the treatment groups. Conclusions: L-carnitine supplement was safe and effective for the improvement of QOL and cognitive dysfunction in covert HE patients with liver cirrhosis. (Clinical trial No. KCT0002029)
소정온,허지연,심혜진,김종원,나덕렬,이필휴,정선주,박문호,주인수,송미숙,김영호,묵인희 대한치매학회 2004 Dementia and Neurocognitive Disorders Vol.3 No.1
Background:Alzheimer's disease (Ad) is a neurodegenerative disorder that is rapidly increasing with the aging society, requiring a need for early diagnosis and prevention. However, diagnosis on AD has only been possible through limited methods such as neuropsychological examination or MRI. AD is characterized by deposition of senile plaques and neurofibrillary tangles in the brain. Aβ peptide in senile plaques seems to play a central role in the neuropathology of AD. Several biochemical markers for AD are available, including reduced Aβ protein, a change in ratio between Aβ40 and 42 and increased level of tau protein in the cerebrospinal fluid (CSF). Methods:This study analyzes anti-Aβ antibody from serums of AD patients using the ELISA. The levels of anti-Aβ antibody from patients with idiopathic Parkinson's disease or stroke and from normal control were compared to that of AD patients. Results:Our results showed a significantly lower anti-Aβ antibody level in AD compared to those with other neurological diseases or control. Conclusions:These data showed that the anti-Aβ antibody level in the serum may be used to diagnose the presence of AD.
Spider Community of River basin from Korea
Sue Yeon Lee,Jong Kook Jung,Jung Sun Yoo,Joon Ho Lee,Seung Tae Kim 한국응용곤충학회 2013 한국응용곤충학회 학술대회논문집 Vol.2013 No.10
Spider community was surveyed at Nakdonggang River which is the longest river (525 km and 23,384 km2) located East-south part of Korea. Nakdonggang river is developing for water management and environmental conservation including restoration of river ecosystem under “The Four-River Restoration Project”. Sampling was made 3 occasions from June to August in 2009. Eight survey sites were selected from both sides of river in Andong, Sangju, Gumi and Seongju prefectures. Spiders were collected with sweep net for on the plants above ground and pitfall traps for on the ground. A total of 94 species of 71 genera in 24 families were identified from 805 collected spiders. Species richness was high in Salticidae (18 species, 19.1%), Araneidae (12 species, 12.8%), Lycosidae (9 species, 9.6%) in order. Wandering spiders (55 species occupied 58.5%, 493 individuals occupied 61.2%) were higher than webbing spiders (39 species occupied 41.5%, 493 individuals occupied 61.2%) in species richness and abundance. Dominant species were Tetragnatha praedonia (Tetragnathidae) and Neoscona adianta (Araneidae) in webbing spiders, and Anahita fauna (Ctenidae), Pirata procurvus (Lycosidae) and Gnaphosa kompirensis (Gnaphosidae) in wandering spiders with abundance. Collectively, most spiders collected from this study were water preferring spiders and showed different community structure compared to other reports from terrestrial spider fauna. Present result will bevaluable to compare the effect of development on the arthropod fauna after completion of the project.
( Eileen L Yoon ),( Eun Jung Ko ),( Jong Eun Yeon ),( Ji Hye Je ),( Yang Jae Yoo ),( Keun Hee Kang ),( Sun Jae Lee ),( Hyun Jung Lee ),( Sang Jun Suh ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Hyun Joon Yi 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background: The modest efficacy, high cost, and significant adverse reactions are the limitations of sorafenib. There have been no reliable serum markers predictive of response to sorafenib. Circulating miRNAs can be ideal biomarkers. We aimed to identify the specific circulating miRNAs prognostic for good response or favorable survival in advanced HCC patients who are scheduled for sorafenib treatment. Methods: On the basis of miRNAs previously reported to be associated with HCC, 6 target miRNAs, miR-21, miR-221, miR-18a, miR-10b*, miR-139-5p, and miR-224 were chosen. Relative expressions were measured by real-time RT-PCR in the sera of 24 HCC patients collected prior to sorafenib treatment. The sera of 25 liver cirrhosis (LC) patients were used as control. The results were validated in the 16 HCC tissue specimens obtained by needle biopsy and various HCC cell lines. Results: All the miRNAs except miR-21 were found to be overexpressed in the sera of HCC patients compared with those of LC patients (P<0.05). In the sera, there was no miRNA which shows significant difference in the relative expression between responder and non-responder group of HCC patients. Among them, circulating miR-10b* was shown to be overexpressed in the worse survivor (Fold change 2.9, P=0.0082). Tissue- based miR-10b* expression in the worse survivor group was down-regulated (Fold change 0.3, P<0.0001). The presence of macrovascular invasion was the only significant predictive factor for longer survival in our HCC patients. Circulating miRNA-10b* expression level was higher in the presence of macrovascular invasion and miR-10b* was also overexpressed in HCC cell lines with invasive tumor characteristics (P<0.001). Conclusions: Circulating miRNAs can overcome the limitation of miRNAs in the tissue obtained by needle biopsy. Serum miR-10b* may affect the invasiveness of HCC and serves as a prognostic biomarker predicting better survival in advanced HCC patients who are treating with sorafenib.
사례보고 : 원발성 간세포암종의 늑골전이를 경동맥화학색전술로 치료한 1예
정영걸 ( Young Kul Jung ),연종은 ( Jong Eun Yeon ),김청호 ( Chung Ho Kim ),이현정 ( Hyun Jung Lee ),이영선 ( Young Sun Lee ),윤아일린 ( Eileen L. Yoon ),정은석 ( Eun Suck Jung ),최종환 ( Jong Hwan Choi ),김지훈 ( Ji Hoon Kim ),변 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.3
뼈는 간세포암종의 전이 장소 중 세 번째로 흔하게 발생하는 곳으로 이에 대한 치료는 제한적이다. 55세 남자 환자가 우하흉부 통증으로 내원하여 원발성 간세포암종과 우측 8번 늑골전이로 진단되었다. 혈관조영술에서 우측 8번 늑간동맥으로부터 공급되는 늑골의 종양이 관찰되어 총 3회의 경동맥 화학색전술을 시행하였고, 이후 두 차례의 컴퓨터 단층촬영에서는 우측 8번 늑골 종양 부위에 치밀한 리피오돌 침착이 관찰되었으며, 통증은 소실되었다. 이에 저자들은 경동맥화학색전술로 치료한 원발성 간세포암종 환자의 늑골전이 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Bone is a common site of metastasis in patients with hepatocellular carcinoma (HCC). We report a rare case of rib metastasis from HCC treated by transcatheter arterial chemoembolization (TACE). A 55-year-old man with liver cirrhosis presented with right lower chest pain. The diagnosis was an HCC with a bone metastasis in the right eighth rib. Intra-arterial injections of doxorubicin mixed with Lipiodol and Gelfoam particles were instituted through the right eighth intercostal artery. Computed tomography and a Tc99-labeled scan performed 2 months after the third TACE revealed no viable HCC in the right eighth rib. (Korean J Hepatol 2009;15:357-361)
( Hyun Jung Lee ),( Eileen L Yoon ),( Sang Jun Suh ),( Keun Hee Kang ),( Hae Rim Kim ),( Seong Hee Kang ),( Yang Jae Yoo ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Hyung Joon Yim ),( Jong Eun Yeon ),( Soon 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background: The long-term benefits of interferon (IFN) -based therapy on preventing cirrhosis and hepatocellular carcinoma (HCC) in chronic hepatitis C (CHC) patients have not been well investigated in Korea. Our study aimed to assess the incidence of cirrhosis and HCC and to identify the risk factors associated with disease progression in CHC patients during 10 years. Methods: A total of 280 patients who were registered as CHC between 2001 and 2010 were retrospectively reviewed. Results: Among 280 subjects, 222 patients (79.3%) received antiviral treatment. Cirrhosis already existed in 37 patients (13.2%) at baseline. Of the 243 patients who had not cirrhosis initially, 17 (7.0%) developed cirrhosis. The 10-year cumulative incidence of cirrhosis was significantly lower among patients with antiviral therapy (8.2%) than those without antiviral therapy (43.0%) (P<0.001). Among patients with antiviral therapy, sustained virologic responders (0.6%) had significantly lower incidence of cirrhosis than non-responders (16.7%) (P<0.001). Cox proportional hazards regression showed sustained virologic responders was the only significant independent factor for reducing risk of cirrhosis development (hazard ratio=0.086, P=0.029). During the follow-up period, 17 patients (6.1%) developed HCC. All these patients had pre-existing cirrhosis (11 patients) or newly developed cirrhosis (6 patients) at the time of HCC diagnosis. The 10-year cumulative incidence of HCC was higher among patients without antiviral therapy (42.7%) than those with antiviral therapy (6.1%) (P<0.001). But, multivariate analysis showed underlying cirrhosis was the only independent risk factor associated with HCC development (hazard ratio=7.702, P=0.010). Conclusions: A sustained virologic response (SVR) secondary to IFN-based therapy could reduce cirrhosis development CHC patients. But, the strongest predictor for the development of HCC was underlying cirrhosis rather than antiviral therapy or SVR.
신종범,Jung Hwan Yu,Young-Joo Jin,Hyung Joon Yim,Young Kul Jung,Jin Mo Yang,Do Seon Song,Young Seok Kim,Sang Gyune Kim,김동준,석기태,Eileen L. Yoon,Sang Soo Lee,Chang-Wook Kim,Hee Yeon Kim,Jae Young Jang,Soung 대한간학회 2020 Clinical and Molecular Hepatology(대한간학회지) Vol.26 No.4
Background/Aims: This study examined the risk factors associated with mortality in cirrhotic patients hospitalized with variceal bleeding, and evaluated the effects of acute-on-chronic liver failure (ACLF) on the prognosis of these patients. Methods: This study was retrospectively conducted on patients registered in the Korean acute-on-chronic liver failure study cohort, and on 474 consecutive cirrhotic patients hospitalized with variceal bleeding from January 2013 to December 2013 at 21 university hospitals. ACLF was defined as described by the European Association for the Study of Liver-Chronic Liver Failure Consortium. Results: Among a total of 474 patients, 61 patients were diagnosed with ACLF. The cumulative overall survival (OS) rate was lower in the patients with ACLF than in those without (P<0.001), and patients with higher ACLF grades had a lower OS rate (P<0.001). The chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score was identified as a significant prognostic factor in patients hospitalized with variceal bleeding (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.30–1.50; P<0.001), even in ACLF patients with variceal bleeding (HR, 1.32; 95% CI, 1.19–1.46, P<0.001). Concerning the prediction of the mortality risk at 28- and 90-day using CLIF-SOFA scores, c-statistics were 0.895 (95% CI, 0.829–0.962) and 0.897 (95% CI, 0.842–0.951), respectively, and the optimal cut-off values were 6.5 and 6.5, respectively. Conclusions: In cirrhotic patients hospitalized with variceal bleeding, the prognosis was poor when accompanied by ACLF, especially depending upon CLIF-SOFA score. CLIF-SOFA model well predicted the 28-day or 90-day mortality for cirrhotic patients who experienced variceal bleeding.