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손주현(Sohn Joo-hyun),은혜영(Eun Hye-young),박진숙(Park Jin-suk) 한국디자인학회 2010 한국디자인학회 학술발표대회 논문집 Vol.2010 No.10
Through the dialectic of identity design and analyze the structure of the system. Design in the development of various expressive media, consumer tastes, the company's business environments are faced with a variety of communication problems. Unforeseen problems that can respond flexibly to the situation requires a flexible system. Cognitive Constructivism is based in the process of forming a personal knowledge of the process of configuring the reporting individual's subjective experience. Flexible design, the system provides the user identity information in the process of recognizing each individual's experience, refined by a home that you can see what information. Through the dialectic of identity is constantly evolving design and development of the system and individual user experiences for the future development of identity design system is an important factor.
손주현 ( Joo Hyun Sohn ),김태엽 ( Tae Yeob Kim ) 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.4(S)
Since the introduction of hepatitis B virus (HBV) vaccination in Korea, the prevalence of HBV infection has been markedly reduced, but so far HBV infection is currently the leading cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Seeing patients with pregnancy and HBV infection, many clinicians are faced with many unresolved issues such as effects of pregnancy on disease progression, effects of HBV infection on pregnancy, prevention of vertical transmission, management principals of HBV infection before, during and after pregnancy and safety of antiviral drugs during pregnancy. Chronic hepatitis B is usually subsided during pregnancy but it tends to aggravate or flare after delivery. HBV itself seems not but the severity of liver disease may affect pregnancy. The immunoprophylaxis with hepatitis B immunoglobulin and HBV vaccination can effectively prevent vertical transmission of HBV, but its failure has been reported in 5-10%, esp. in mothers with high HBV DNA levels. Recently, several studies were tried to reduce such immunoprophylaxis failure, but there are many unresolved issues before its use for this purpose. The treatment of hepatitis B with oral antivirals in relation to pregnancy should be individualized based on the risk-benefit evaluation for both mother and baby according to willingness of patients, the period of pregnancy (trimester), serum viral load, and the severity of disease.
만성 혈액투석 환자에서의 대사성 산혈증과 음이온차의 양상
손정일(Chong Il Sohn),김병훈(Byoung Hun Kim),신진호(Jin Ho Shin),양석철(Suck Chul Yang),박용수(Yong Soo Park),한동수(Dong Soo Han),안명주(Myung Ju Ahn),손주현(Ju Hyun Sohn),이인홍(In Hong Lee),김순길(Soon Kil Kim),이정희(Jung Hee Lee 대한내과학회 1996 대한내과학회지 Vol.51 No.2
N/A Objectives: The aim of the present study is to evaluate the prevalence of the various patterns of metabolic acidosis and anion gap among chronic hemodyalysis patients. Methods: Analysis of predialysis arterial blood gases and anion gap patterns was performed in 67 stable chronic outpatient hemodialysis patients(>1 year) with acetate buffer. Blood samples were drawn from the arterial line of the atreriovenous fistula for determination of blood electrolytes, chemistries, and analysis of blood gases at the beginning of hemodyalysis. Results: The degree of metabolic acidosis was mild to moderate with mean pH 7.33±0.039. 82% of a total 67 patients had pH between 7.30 and 7.39 with 18% of them between 7.20 and 7.29. Simple as mixed metabolic acidosis was shown in 49 of 67 patients(73%) and 18 of 67 patients(27%), respectively. In comparison of both groups, the group with mixed metabolic acidosis had significantly lower pH(7.29±0.04 vs 7.34±0.03, p<0.001) with higher pCO₂(38.5±3.4, p<0.005) and anion gap(19.6±4.1 vs 17.6±2.9, p<0.05). The classical high anion gap of end stage renal disease (range, 16 to 29 mEq/L) was also noted in 20 of 67 patients(30%). The linear regression analysis between anion gaps and total serum carbon dioxide contents (TCO₂) didn't show any significant correlation in all patients as well as the two subdivided groups with high and normal anion gap. Furthermore, only 13 of 67 patients(20%) were included between 80 and 120% in the ratio of delta anion gap(ΔAG) over delta TCO₂(dTCO₂). Therefore, the majority of hemodialysis patients (80%) showed the discrepancy between the degrees of d AG and ΔTCO₂. The analysis of unmeasured cations(K, Ca) and anions(albumin, phosphate) in the calculation of anion gap(Na ?Cl ?HCO₃) between two groups of high and normal anion gap of all patients as well as 49 patients of simple metabolic acidosis didn't reveal any discernible contributions to the changes of anion gap. Conclusion- This study therefore showed that the mixed acid-base balance and normal anion gap metabolic acidosis is not an exception in chronic stable hemodialysis patients. Also, the impact of hemodialysis in end stage renal disease patients seemed to lead the changes in values of unidentified anions besides fixed mineral acids and/or in those of unrecognized ionic equivalents of plasma constituents.
만성 B형 간염 및 항바이러스제 내성 B형 간염의 모니터링과 치료 전략
김태엽 ( Tae Yeob Kim ),손주현 ( Joo Hyun Sohn ) 대한소화기학회 2007 대한소화기학회지 Vol.49 No.6
Clinical management of chronic hepatitis B is rapidly evolving after the recent development of new antiviral drugs. These agents have been shown to be effective in improving virological, biochemical, and histological features in high proportion of the patients with chronic hepatitis B. However, these drugs can not eliminate hepatitis B virus (HBV) directly. It can only suppress HBV replication. Furthermore, the emergence of drug resistant HBV has become problematic according to the long-term use of oral antiviral drugs. Therefore, physicians should be careful in selecting whom to treat, when to start treatment, how long to treat, how to monitor patients before, during and after the treatment, which drug to choose, and how to manage patients with drug resistance. This review will focus on the monitoring and treatment strategy for chronic hepatitis B and drug resistant hepatitis B, quoting some clinical data of recently introduced or promising future drugs. (Korean J Gastroenterol 2007;49:346-355)
회복된 B형간염 환자에서 Rituximab 치료 이후 발생한 전격성 간부전을 동반한 B형간염 바이러스의 재활성화 1예
정승민 ( Seong Min Chung ),손주현 ( Joo Hyun Sohn ),김태엽 ( Tae Yeob Kim ),유기덕 ( Ki Deok Yoo ),안용우 ( Yong Woo Ahn ),배중호 ( Joong Ho Bae ),전용철 ( Yong Cheol Jeon ),최정혜 ( Jung Hye Choi ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.4
It is well known that the reactivation of hepatitis B virus (HBV) may occur as an acute hepatitis after chemotherapy or immunosuppressive therapy. Although most of these cases have been reported in HBsAg-positive patients, there have been a few reports of HBV reactivation in HBsAg-negative patients. There have been concerns for the need to screen the reactivation as well as anti-viral prophylaxis in HBsAg-negative patients with possible HBV occult infection who are planning to undergo chemotherapy or immunosuppressive therapy. Rituximab, an anti-CD20 monoclonal antibody, is effective in the treatment of non-Hodgkin`s lymphoma. However, rituximab can affect the immunity against HBV, consequently increasing viral replication. In fact, there have been reports of HBV reactivation after treatment with rituximab. Here, we report a case of HBV reactivation following rituximab plus systemic chemotherapy in diffuse large B cell lymphoma patient who was HBsAg negative, anti-HBs positive, and anti-HBc positive, ultimately leading to treatment-unresponsive fulminant hepatic failure.
1996년도 제35차 대한소화기학회 추계학술대회 / 일반연제 : 위장관 ; 대장암의 선별법으로서 분변내 잠혈검사의 비교 - 대장암의 조기진단 방법에 관한 연구 제1보 -
박준용,이오영,한동수,손주현,윤병철,최호순,함준수,이민호,기춘석,박경남,박일규 ( J . Y . Park,O . Y . Lee,D . S . Han,J . H . Sohn,B . C . Yoon,H . S . Choi,J . S . Hahm,M . H . Lee,C . S . Kee,K . N . Park,I . K . Park ) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1
연구논문 : 만성 바이러스간질환에서 간섬유화의 다양한 비침습 혈청표지자검사의 비교
김선민 ( Sun Min Kim ),손주현 ( Joo Hyun Sohn ),김태엽 ( Tae Yeob Kim ),노영욱 ( Young Wook Roh ),은창수 ( Chang Soo Eun ),전용철 ( Yong Cheol Jeon ),한동수 ( Dong Soo Han ),오영하 ( Young Ha Oh ) 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.4
목적: 만성 바이러스간질환에서 병의 경과와 예후를 평가하고 치료반응을 예측함에 있어 간섬유화의 진단은 중요하다. 최근 간섬유화 평가에 표준방법이지만 침습적 간생검을 대신하여 여러 가지 비침습적 진단법이 이용되고 있고, 또한 새로운 검사법들이 개발되고 있다. 저자들은 만성 B형 및 C형간염 환자를 대상으로 임상에서 광범위하게 흔히 시행하는 혈액검사와 임상 소견을 이용한 아래와 같은 진단법들만으로 간섬유화를 얼마나 정확하게 평가할 수 있는지 알아보고, 단일 검사로 간섬유화를 평가하는 데 유용하다고 알려져 있는 hyaluronic acid(HA)와 IV형 콜라겐 농도와 비교하여 그 임상적 유용성을 평가하였다. 대상과 방법: 2002년 3월부터 2007년 2월까지 만성 바이러스간 질환으로 간생검을 시행받은 225명의 환자(HBV 180명, HCV 43명, HBV+HCV 2명)를 대상으로 분석하였다. 간생검을 시행하는 날에 말초혈액검사, 혈액응고검사, 혈청생화학검사를 시행하고, 혈중 HA, IV형 콜라겐 농도를 측정하였다. 간섬유화의 정도는 F0(섬유화가 없음), F1(문맥역 섬유화), F2(문맥주변부 섬유화), F3(섬유성 격막) 및 F4(간경변증)의 4단계로 구분하였다. 대상 환자를 F0-1, F2-4 혹은 F0-2, F3-4의 두 집단으로 분류하여 두 집단을 구분하고자 할 때 AAR(AST/ALT ratio), API(age-platelet index), APRI(AST to platelet index), CDS(cirrhosis discriminant score), platelet count, HA, IV형 콜라겐의 예측능을 area under the receiver operating characteristic curve (AUROC)값을 이용하여 비교하였다. 결과: 대상환자의 섬유화의 단계는 F0 집단은 17명, F1 집단은 40명, F2 집단은 61명, F3 집단은 74명, F4 집단은 33명이었다. 의미 있는 간섬유화를 F2 이상으로 판단할 때, 의미 있는 섬유화의 예측에 대한 AUROC 값은 APRI=0.822, CDS=0.776, platelet count=0.773, API=0.756, HA=0.749, IV형 콜라겐=0.718, AAR=0.642 순이었고, F3 이상의 광범위한 섬유화 예측에 대한 AUROC값은 CDS=0.835, platelet count=0.795, API=0.794, HA=0.766, AAR=0.711, IV형 콜라겐=0.697, APRI=0.691 순으로 관찰되었다. 결론: 만성 바이러스간질환에서 간섬유화를 평가하는 데 임상 소견 및 혈액검사를 이용한 방법들이 비침습적 진단법 중 단독 검사로도 유용한 것으로 알려져 있는 혈중 HA와 IV형 콜라겐 농도와 비교하여 우월하거나 대등하였다. 특히 APRI는 다른 인자들에 비해 F2 이상의 의미 있는 섬유화를 예측하는 데 가장 유용하였고, CDS는 F3 이상의 광범위한 섬유화를 예측하는 데 가장 유용하였다. Background/Aims: The aim of this study was to determine the clinical performances of noninvasive serum markers for the prediction of liver fibrosis in chronic viral liver diseases. Methods: We analyzed a total of 225 patients with chronic viral liver diseases (180 with hepatitis B virus, 43 with hepatitis C virus, and 2 with hepatitis B+C virus) who underwent a liver biopsy procedure at the Hanyang University Guri Hospital between March 2002 and February 2007. Serum was also obtained at the time of liver biopsy. Liver fibrosis was staged according to the scoring system proposed by the Korean Study Group for the Pathology of Digestive Diseases. Various noninvasive serum markers were evaluated, including the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR), age-platelet (AP) index, AST/platelet ratio index (APRI), cirrhosis discriminant score (CDS), platelet count, hyaluronic acid (HA), and type IV collagen. Results: There were 17, 40, 61, 74, and 33 patients at stages F0, F1, F2, F3, and F4, respectively. The overall diagnostic accuracies of each marker, as determined by the area under receiver operating characteristics curves, were APRI=0.822, CDS=0.776, platelet count=0.773, AP index=0.756, HA=0.749, type IV collagen=0.718, and AAR=0.642 for predicting significant fibrosis (≥F2); and CDS=0.835, platelet count=0.795, AP index=0.794, HA=0.766, AAR=0.711, type IV collagen=0.697, and APRI=0.691 for predicting extensive fibrosis (≥F3). Conclusions: Conclusions: All noninvasive serum markers evaluated in this study were useful for predicting significant or extensive liver fibrosis in chronic viral liver diseases. In particular, APRI was most useful for the prediction of significant fibrosis, and CDS was most useful for the prediction of extensive fibrosis. (Korean J Hepatol 2009;15:454-463)
만성 C형간염 환자에서 페그인터페론 알파 2a에 의해 반복적으로 발생한 지방층염
송준석 ( June Seok Song ),손주현 ( Joo Hyun Sohn ),정재윤 ( Jae Yoon Jeong ),민지희 ( Ji Hee Min ),최원석 ( Won Seok Choi ),김원중 ( One Zoong Kim ),표주연 ( Ju Yeon Pyo ) 대한소화기학회 2016 대한소화기학회지 Vol.67 No.5
Pegylated interferon alpha (PEG-IFN-α) is widely used to treat chronic hepatitis C in combination with ribavirin. Many adverse effects of PEG-IFN-α, such as hematologic, psychologic, dermatologic, immunologic, and other abnormalities, have been reported, and some serious adverse events lead to PEG-IFN-α treatment discontinuation. For very rare adverse events such as panniculitis, there are no established guidelines on whether to continue PEG-IFN-α treatment. Published reports on panniculitis induced by PEG-IFN-α 2a are sparse. Herein we report a case of repeated occurrences of panniculitis in a patient with chronic hepatitis C, leading to treatment cessation. (Korean J Gastroenterol 2016;67:272-276)