간세포암에서 분자표적치료제의 현황

서상준 ( Sang Jun Suh ),임형준 ( Hyung Joon Yim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.3

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death in Korea. Curative treatment is only possible when the disease is diagnosed at the early stage. The prognosis of patients with HCC is even dismal in advanced stages. No systemic cytotoxic chemotherapy has proven to be beneficial in overall survival. Recently, the understanding of the molecular pathogenesis led to the development of new therapies. With the evidence of dysregulation of critical genes associated with cellular proliferation, growth factor signaling, cell cycling, apoptosis, and angiogenesis in HCC, a number of molecular target agents are under clinical trials. Sorafenib is the first systemic anticancer drug which has proven to gain survival benefit in the global as well as Asia-Pacific trials. However, the survival gain is still modest, and further efforts to improve outcomes in patients with HCC are necessary by developing novel drugs or combining other forms of therapies. This article will review signaling pathways in HCC and introduce molecular target agents under investigation currently. (Korean J Gastroenterol 2013;61:136-146)

연구논문 : 급성 A형간염에 의한 간내 강성도의 변화

서연석 ( Yeon Seok Seo ),엄순호 ( Soon Ho Um ),서상준 ( Sang Jun Suh ),정은석 ( Eun Suk Jung ),장진수 ( Jin Su Jang ),권용대 ( Yong Dae Kwon ),박상훈 ( Sang Hoon Park ),금보라 ( Bo Ra Keum ),김용식 ( Yong Sik Kim ),진윤태 ( Yoon T 대한간학회 2008 Clinical and Molecular Hepatology(대한간학회지) Vol.14 No.4

목적: 만성 간염 환자에서 liver stiffness (LS) 측정이 간섬유화를 평가하는 데 매우 유용한 검사로 알려져 있으나, 일부 환자에서는 LS와 실제 간섬유화 단계 사이에 상당한 차이가 관찰된다. 본 연구는 간의 괴사염증 정도가 이런 두 검사 결과 사이의 차이에 관여하는가를 평가하기 위해 시행하였다. 대상과 방법: 급성 A형간염으로 본원에 입원한 환자를 대상으로 하였다. 입원 후 환자의 혈청 ALT 수치와 bilirubin 수치의 변화에 따라 환자의 입원 당시 급성 A형간염의 단계를 염증단계, 황달단계 및 회복단계로 분류하였으며, 회복단계에서 입원한 환자(입원 후 ALT 및 bilirubin 수치가 계속 감소하는 경우)는 본 연구에서 제외하였다. 입원 시 LS를 측정하였으며 상태가 호전되어 퇴원한 후 추적하였다. LS값과 급성 A형간염의 진행단계, LS 측정 당시의 혈청 AST, ALT 및 bilirubin 수치와의 상관관계를 분석하였다. 결과: 76명의 급성 A형간염 환자가 본 연구에 포함되었으며 연령의 중앙값은 29세였다(남자 46명 여자 30명). 이들 중 33명(43.4%)은 염증단계에, 43명(56.6%)은 황달단계에 입원하였다. 염증단계에 입원한 33명에서 급성 A형간염의 증상이 발생한 후 혈청 ALT가 최고치에 도달할 때까지의 기간은 7±3일이었으며, 전체 대상 환자에서 증상이 발생한 후 bilirubin이 최고치에 도달할 때까지의 기간은 11±4일이었다. 입원 중 측정한 LS값은 8.9±3.3 kPa였다. LS값은 bilirubin 수치와만 상관관계를 보였으며, LS 상승(>7.08 kPa)과 관련이 있는 인자도 bilirubin 수치뿐이었다. 급성 간염의 증상이 발생한 후 LS값은 점차 상승하다가 증상 발생 후 8~9일 정도에 최고치에 도달한 후 점차 감소하였다. 결론: 심한 간의 괴사염증은 LS를 높여 간섬유화 단계를 실제보다 과대평가할 수 있으므로 급성 악화를 동반한 만성간염 환자에서 LS를 측정한 경우 결과의 판정에 유의하여야 할 것으로 생각된다. Backgrounds/Aims: In some patients with chronic hepatitis, liver stiffness (LS) findings do not reflect fibrosis stage. This study was performed to evaluate whether acute liver inflammation could influence LS findings. Methods: Patients with acute hepatitis A admitted to our hospital were included. Hepatitis was classified on admission using serum ALT and bilirubin levels as inflammation phase, jaundice phase, or recovery phase. Patients who admitted during the recovery phase (whose ALT and bilirubin levels fell continuously during hospitalization) and therefore, their peak-ALT and peak bilirubin levels could not be determined were exduded. Enrolled patients underwent FibroScan during hospitalization and after discharge. Results: Seventy-six patients with acute hepatitis A were enrolled (median age, 29 years; 46 men and 30 women). Among them, 33 (43.4%) and 43 (56.6%) patients were admitted during the inflammation phase and jaundice phase, respectively. For patients admitted during the inflammation phase, mean (±SD) time from symptom-onset day to maximum ALT level was 7 (±3) days. For all patients, mean time from symptom-onset to maximum bilirubin level was 11 (±4) days. Mean LS during admission was 8.9 (±3.3) kPa (median, 8.4 kPa). LS was significantly correlated with serum bilirubin level, which was the only factor found to be significantly associated with the increased LS (>7.08 kPa). In all patients, LS increased gradually from the symptom-onset and peaked at 8-9 days later. Conclusions: Severe hepatic inflammation can affect the LS findings and thus, care is required when assessing fibrosis stage using LS measurement in patients with severe inflammation. (Korean J Hepatol 2008;14:465-473)

간문맥 종양혈전을 동반한 간세포암종의 예후 인자

서상준 ( Sang Jun Suh ),임형준 ( Hyung Joon Yim ),이동원 ( Dong Won Lee ),현종진 ( Jong Jin Hyun ),정영걸 ( Young Kul Jung ),김지훈 ( Ji Hoon Kim ),서연석 ( Yeon Seok Seo ),연종은 ( Jong Eun Yeon ),변관수 ( Kwan Soo Byun ),엄순호 대한간암학회 2017 대한간암학회지 Vol.17 No.1

Background/Aims: Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) exhibits poor prognosis. The aim of this study is to evaluate factors associated with survival of HCC patients with PVTT to suggest better therapeutic options. Methods: Patients with HCC which were newly diagnosed at three tertiary hospitals between January 2004 and December 2012, were reviewed retrospectively. Among them, Barcelona Clinic of Liver Cancer stage C patients with PVTT were identified. Factors affecting overall survival (OS) were analyzed and efficacies of the treatment modalities were compared. Results: Four hundred sixty five patients with HCC and PVTT were included. Liver function, tumor burden, presence of extrahepatic tumor, alfa fetoprotein, and treatment modalities were significant factors associated with OS. Treatment outcomes were different according to the initial modalities. OS of the patients who received hepatic resection, radiofrequency ablation (RFA), transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), sorafenib, systemic cytotoxic chemotherapy, radiation therapy (without combination), and supportive care were 27.8, 7.1, 6.7, 5.3, 2.5, 3.0, 1.8, and 0.9 months, respectively (P<0.001). Curative-intent treatments such as hepatic resection or RFA were superior to noncurative-intent treatments (P<0.001). TACE or HAIC was superior to sorafenib or systemic chemotherapy (P<0.001). Combining radiotherapy to TACE or HAIC did not provide additional benefit on OS (P=0.096). Conclusions: Treatment modalities as well as baseline factors significantly influenced on OS of HCC patients with PVTT. Whenever possible, curative intent treatments should be preferentially considered. If unable, locoregional therapy would be a better choice than systemic therapy in HCC patients with PVTT. (J Liver Cancer 2017;17:60-71)

해외에서 유입된, 급성 간염을 동반한 뎅기열 1예

서상준 ( Sang Jun Suh ),서연석 ( Yeon Seok Seo ),안재홍 ( Jae Hong Ahn ),박은범 ( Eun Bum Park ),이순재 ( Sun Jae Lee ),손장욱 ( Jang Uk Sohn ),엄순호 ( Soon Ho Um ) 대한간학회 2007 Clinical and Molecular Hepatology(대한간학회지) Vol.13 No.4

비대상성 간경변증 환자에서 발생한 간세포암종 치료로 간이식전 시행한 간동맥 화학색전술과 정위적 방사선 치료

김상훈 ( Sang Hoon Kim ),박주희 ( Joo Hee Park ),서상준 ( Sang Jun Suh ),정영걸 ( Young Kul Jung ),임형준 ( Hyung Joon Yim ) 대한간암학회 2014 대한간암학회지 Vol.14 No.2

Liver transplantation is the only curable treatment modality for hepatocellular carcinoma with advanced liver cirrhosis. While treatment outcome of the liver transplantation is improving, time needed to standby until the surgery is getting longer because of both the lack of liver donors and increasing demands for the transplantation. Therefore, importance of bridging therapy before the liver transplantation is recently highlighted. We herein report our recent experience about a patient who successfully undergone transarterial chemoembolization (TACE) and stereotactic radiation therapy (START) as bridging therapy and later had liver transplantation operation. (J Liver Cancer 2014;14:135-138)

스캐닝 평면 음향 홀로그래피에서의 스펙트럴 분산 보정

권휴상(Hyu-sang Kwon),김용조(Yong-joe Kim),J. S. Bolton,서재갑(Jae-gap Suh),박준홍(Jun-hong Park),서상준(Sang-jun Suh) 한국소음진동공학회 2002 한국소음진동공학회 학술대회논문집 Vol.2002 No.5

표준 마이크로폰 감도 교정을 위한 진동막의 모달 파라미터 측정

권휴상(Hyu-sang Kwon),서상준(Sang-jun Suh),서재갑(Jae-gap Suh),박준홍(Jun-hong Park) 한국소음진동공학회 2002 한국소음진동공학회 학술대회논문집 Vol.2002 No.5

엔테카비어 1 mg을 투여 중인 항바이러스 내성 만성 B형간염 환자에서 제네릭 약제로의 교체 시 치료 효과

안영은 ( Young Eun Ahn ),서상준 ( Sang Jun Suh ),김태형 ( Tae Hyung Kim ),정영걸 ( Young Kul Jung ),임형준 ( Hyung Joon Yim ) 대한소화기학회 2021 대한소화기학회지 Vol.77 No.1

Background/Aims: Clinical equivalence of generic antiviral agents for chronic hepatitis B (CHB) has not been demonstrated, particularly in cases with previous antiviral resistance. Entecavir 1 mg is prescribed frequently as a mono- or combination therapy in antiviral-resistant CHB patients. This study evaluated the efficacy and safety of switching to generic entecavir 1 mg (Baracle^®) in CHB patients taking brand-name entecavir 1 mg (Baraclude^®) alone or in combination with other nucleotide analogs after the development of antiviral resistance. Methods: This study was a single-arm prospective study. The primary endpoint was undetectable HBV DNA (<20 IU/mL) at 12 months after switching treatment. The biochemical and serologic responses, virologic breakthrough, and antiviral resistance rates were also evaluated. Results: Forty CHB patients with undetectable HBV DNA through the brand-name entecavir 1 mg treatment as a mono- or combination therapy after developing antiviral resistance to nucleos(t)ide analogs were enrolled in this study. No significant difference in the HBV DNA non-detection rate was observed between the baseline and 12 months after switching therapy (p=0.324). Furthermore, non-inferiority of the generic entecavir 1 mg to the brand-name entecavir 1 mg with 10% margin in maintaining undetectable HBV DNA was demonstrated (95% CI -2.80 to 8.20%). Similarly, no difference in the biochemical response rate was observed after switching therapy. Serum hepatitis B e antigen loss was observed in 12.5%. No virologic breakthrough was reported. Conclusions: Generic entecavir 1 mg is a reasonable alternative to the brand-name entecavir 1 mg in antiviral-resistant CHB patients with viral suppression. (Korean J Gastroenterol 2021;77:22-29)

한국어교육과 한국문화교육의 상호 역할에 대한 바람직한 시각

양영희(Yang Young-hee),서상준(Suh Sang-jun) 우리말글학회 2010 우리말 글 Vol.50 No.-

The purpose of this paper is to establish the proper relationship between Korean language education and Korean culture education. Korean culture education has been thought as one of tools for raising communication skills, occupying subordinate position in the field of Korean language education. This paper, however, will consider these two types of education as the original one standing in the equal position since they have different goals and contents. The reason why the efforts to unify Korean cultaure with Korean language education could not result in satisfying outcome is that the relationship of these two areas has not been clearly fixed. By looking straight at the present situation, this paper sets up the relationship between these two as follows: Korean culture contributes to achieve the goals of Korean language education by standing as the elementary background on Korean language education, also Korean language serves to instruct Korean culture systematically by becoming the teaching tools for Korean culture education. As taking this point of view, we are able to divide central points of Korean studies into two parts: Korean language education and Korean culture education. That is to say, the former lightens its functional responsibility and the latter retrieves its essential role and value.

한국어 교육에서의 국어학적 지식 역할

양영희(Yang Young-hee),서상준(Suh Sang-jun) 우리말글학회 2009 우리말 글 Vol.46 No.-

This study focused on identifying the role of language education in the field of teaching Korean as a second language (L2). First, the organized knowledge in Korean studies should be used when teaching Korean. The cases that spelling different from pronunciation in Korean language are much more than any other languages and it is because of historical changes. To explain the procedure of those changes, people who are related to teaching Korean should understand Korean phonology in general. Next, when the teachers have re-education, the present point of view on Korean education should be considered with much more importance in choosing the curriculum or subjects. There are two types of teachers: Some have to review the existed knowledge of Korean language, and the others have to learn the curriculum of the study from the beginning. As the two different courses which are offered by different teachers must be run separately, Korean education should be in charge of all sorts of matters related to Korean studies. Finally, the knowledge of Korean studies is also necessary in developing the textbooks for teaching of Korean language. In the process of developing various textbooks classified by the level or aim, there are opinions that regional language and preferential vocabularies should be reflected on the textbooks. So dialectology and lexis that belong to the subordinate field of Korean studies are essential to select appropriate vocabularies. In conclusion, Korean education should take a certain role in organizing textbooks for Korean language.