U-shaped relationship between urea level and hepaticU-shaped relationship between urea level and hepatic decompensation in chronic liver diseases decompensation in chronic liver diseases

Huapeng Lin,Grace Lai-Hung Wong,Xinrong Zhang,Terry Cheuk-Fung Yip,Ken Liu,Yee Kit Tse,Vicki Wing-Ki Hui,Jimmy Che-To Lai,Henry Lik-Yuen Chan,Vincent Wai-Sun Wong 대한간학회 2022 Clinical and Molecular Hepatology(대한간학회지) Vol.28 No.1

Background/Aims: We aimed to determine the association between blood urea level and incident cirrhosis, hepatic decompensation, and hepatocellular carcinoma in chronic liver disease (CLD) patients. Methods: The association between blood urea level and liver fibrosis/liver-related events were evaluated on continuous scale with restricted cubic spline curves based on generalized additive model or Cox proportional hazards models. Then, the above associations were evaluated by urea level within intervals. Results: Among 4,282 patients who had undergone liver stiffness measurement (LSM) by transient elastography, baseline urea level had a U-shaped association with LSM and hepatic decompensation development after a median follow-up of 5.5 years. Compared to patients with urea of 3.6–9.9 mmol/L, those with urea ≤3.5 mmol/L (adjusted hazard ratio [aHR], 4.15; 95% confidence interval [CI], 1.68–10.24) and ≥10 mmol/L (aHR, 5.22; 95% CI, 1.86–14.67) had higher risk of hepatic decompensation. Patients with urea ≤3.5 mmol/L also had higher risk of incident cirrhosis (aHR, 3.24; 95% CI, 1.50–6.98). The association between low urea level and incident cirrhosis and hepatic decompensation was consistently observed in subgroups by age, gender, albumin level, and comorbidities. The U-shaped relationship between urea level and LSM was validated in another population screening study (n=917). Likewise, urea ≤3.5 mmol/L was associated with a higher risk of incident cirrhosis in a territory-wide cohort of 12,476 patients with nonalcoholic fatty liver disease at a median follow-up of 9.9 years (aHR, 1.27; 95% CI, 1.03–1.57). Conclusions: We identified a U-shaped relationship between the urea level and liver fibrosis/incident cirrhosis/hepatic decompensation in patients with CLD.

Comparison of Alcohol Secondhand Effects among Korean and U.S. College Students

천성수,손애리,이상숙,Henry Wechsler,Easton A. Reid,Rubelyn Inot,Grace Percoheles,김미경 한국보건교육건강증진학회 2009 보건교육건강증진학회지 Vol.26 No.5

Objectives: To compare alcohol secondhand effects among US and Korean students. Methods: Nationally representative 4-year colleges of two countries were involved in this cross-national comparison study. Data from the 2001 U.S. College Alcohol Study and the 2003 Korean College Alcohol Study came from 120 colleges in 38 U.S. states and the District of Columbia and 60 colleges in Korea. Randomly selected 4-year college students from the U.S. (10,924) and Korea (2,385) participated in the study using self-reports of alcohol use and perceptions of drinking as assessed by College Alcohol Study questionnaires. Results: Korean students were tend to more likely to have being a victim of sexual assault or date rape, having to take care of drunken students and finding vomit in the hall or bathroom of residence, than US students, while US students were tend to more likely to have being insulted or humiliated, having a serious argument and quarrel, being pushed, hit, or assaulted, having study/sleep interrupted, and experiencing an unwanted sexual advance than Korean students. In general, US students were more likely to suffer interrelationship problems after drinking while Korean students were more likely to have physical and individual drinking related problems. Objectives: To compare alcohol secondhand effects among US and Korean students. Methods: Nationally representative 4-year colleges of two countries were involved in this cross-national comparison study. Data from the 2001 U.S. College Alcohol Study and the 2003 Korean College Alcohol Study came from 120 colleges in 38 U.S. states and the District of Columbia and 60 colleges in Korea. Randomly selected 4-year college students from the U.S. (10,924) and Korea (2,385) participated in the study using self-reports of alcohol use and perceptions of drinking as assessed by College Alcohol Study questionnaires. Results: Korean students were tend to more likely to have being a victim of sexual assault or date rape, having to take care of drunken students and finding vomit in the hall or bathroom of residence, than US students, while US students were tend to more likely to have being insulted or humiliated, having a serious argument and quarrel, being pushed, hit, or assaulted, having study/sleep interrupted, and experiencing an unwanted sexual advance than Korean students. In general, US students were more likely to suffer interrelationship problems after drinking while Korean students were more likely to have physical and individual drinking related problems.

Hepatic Decompensation in Cirrhotic Patients Receiving Antiviral Therapy for Chronic Hepatitis B

( Hye Won Lee ),( Terry Cheuk-fung Yip ),( Yee-kit Tse ),( Grace Lai-hung Wong ),( Beom Kyung Kim ),( Seung Up Kim ),( Jun Yong Park ),( Do Young Kim ),( Henry Lik-yuen Chan ),( Sang Hoon Ahn ),( Vinc 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: It is unclear if anti-hepatitis B virus (HBV) treatment can eliminate incident hepatic decompensation. Here we report the incidence and predictors of hepatic decompensation among cirrhotic patients receiving antiviral therapy for chronic hepatitis B. Methods: This is a post hoc analysis of two prospective HBV cohorts from Hong Kong and South Korea. Patients with liver stiffness measurement (LSM) ≥10 kPa and compensated liver disease at baseline were included. The primary endpoint was incident hepatic decompensation (jaundice or cirrhotic complications) with competing risk analysis. Results: 818 patients (mean age, 54.9 years; 519 male [63.4%]) were included in the final analysis. During a mean follow-up of 58.1 months, 32 (3.9%) patients developed hepatic decompensation, among whom 34% were secondary to HCC. Three (0.4%) patients experienced variceal bleeding alone, 27 (3.3%) had non-bleeding decompensation and 13 (1.6%) had more than 2 decompensating events. On multivariable analysis, baseline LSM (adjusted hazard ratio [aHR] 1.03), diabetes (aHR 3.27), platelet (aHR 0.99), and international normalized ratio (aHR 7.99) were independent predictors of hepatic decompensation. 30/506 (5.9%) patients fulfilling the Baveno VI criteria (LSM ≥20 kPa and/or platelet count <150ⅹ10⁹/L) and 2/312 (0.6%) patients not fulfilling the criteria developed hepatic decompensation (P<0.001). Conclusions: Hepatic decompensation is uncommon but not eliminated in patients receiving antiviral therapy for HBV-related cirrhosis, and only a third of decompensating events are secondary to HCC. The Baveno VI criteria, which was originally designed to detect varices needing treatment, can be effectively applied in this population to identify patients at risk of decompensation.

Adsorption Behaviors and Mechanism of Single/Multi-Metals by Ion Exchange Resins

Xinping Qian,Shaohui Lin,Xianshe Feng,Garry L. Rempel,Henry Grace,Qinmin Pan 한국고분자학회 2019 폴리머 Vol.43 No.6

Adsorption of Fe(Ш), Co(II), Cu(II), Zn(II) and K(I) by strong acid resins, Dowex 50WX2 200-400 (H) and Amberlite IRP-69, was studied to investigate the adsorption behaviors and mechanism in single-metal and multi-metal systems. The results showed that 99.9% Fe(III) can be removed by Dowex 50WX2 200-400 (H) in 100 min ([Fe(Ш)] < 40 mg/L, resin amount = 50 mg, pH = 3.0, 60 ºC). Mechanism studies revealed that Langmuir model and pseudo-second- order kinetic equation illustrate better fit for the adsorption of Fe(Ш). Furthermore, the investigations on multi-metal adsorption indicated that resins display a similar adsorption ratio for the same-valence metal ions (Co(II) = Cu(II) = Zn(II)), and a more selective adsorption for high-valence metal ions than low-valence metal ions (Fe(III) > Co(II) > K(I)). The above results can be used for the treatment of wastewater and the recovery of metals from the spent catalysts.

A Comparison of Alcohol Secondhand Effects among Korean and U.S. College Students

Sungsoo Chun,Aeree Sohn,Easton A. Reid,Rubelyn Inot,Mi-Kyung Kim,Grace Percoheles,Sang-Sook Lee,Henry Wechsler 한국보건교육건강증진학회 2009 보건교육건강증진학회지 Vol.26 No.5

목적: 이 연구는 한국과 미국대학생의 음주로 인한 간접피해수준을 상대적으로 비교하기 위해 설계되었다. 방법: 하버드대학교의 대학생음주연구(CAS)의 2001년도의 원자료 10,924명의 데이터와 한국대학생음주연구(KCAS)의 2003년도의 원자료 2,385명의 데이터를 하나의 파일에 함께 넣어서 분석하였다. 조사도구는 CAS의 대학생용 조사설문지를 사용하였으며, 한국의 주종과 량과 관련하여서는 표준잔과 량을 기준으로 적용하였다. 지난 한 달 동안의 음주하였다고 한 학생의 알코올관련문제 및 간접피해의 정도를 비교하였으며, 연령과 음주빈도와 음주량 통제하여 로지스틱회귀분석의 결과로 제시하였다. 결과: 한국대학생들이 술 취한 동료를 돌봄, 성적인 폭행, 데이트 강간, 구토물들을 발견하는 것 등의 간접피해를 많이 받는 반면에 미국대학생들은 모욕을 당함, 심하게 다툼, 밀침을 당함, 학업에 방해를 받음, 폭행을 당함, 원치 않은 섹스를 함 등의 간접피해를 더 많이 겪고 있다. 결론: 미국대학생들은 상호관계에 의한 간접피해를 많이 느끼는데 비해서, 한국대학생들은 개인적이고 신체적인 간접피해를 더 많이 느끼고 있다. Objectives: To compare alcohol secondhand effects among US and Korean students. Methods: Nationally representative 4-year colleges of two countries were involved in this cross-national comparison study. Data from the 2001 U.S. College Alcohol Study and the 2003 Korean College Alcohol Study came from 120 colleges in 38 U.S. states and the District of Columbia and 60 colleges in Korea. Randomly selected 4-year college students from the U.S. (10,924) and Korea (2,385) participated in the study using self-reports of alcohol use and perceptions of drinking as assessed by College Alcohol Study questionnaires. Results: Korean students were tend to more likely to have being a victim of sexual assault or date rape, having to take care of drunken students and finding vomit in the hall or bathroom of residence, than US students, while US students were tend to more likely to have being insulted or humiliated, having a serious argument and quarrel, being pushed, hit, or assaulted, having study/sleep interrupted, and experiencing an unwanted sexual advance than Korean students. Conclusion: In general, US students were more likely to suffer interrelationship problems after drinking while Korean students were more likely to have physical and individual drinking related problems.

A Comparison of Alcohol Secondhand Effects among Korean and U.S. College Students

Chun, Sung-Soo,Sohn, Ae-Ree,Reid, Easton A.,Inot, Rubelyn,Kim, Mi-Kyung,Percoheles, Grace,Lee, Sang-Sook,Wechsler, Henry Korean Society for Health Education and Promotion 2009 보건교육건강증진학회지 Vol.26 No.5

목적: 이 연구는 한국과 미국대학생의 음주로 인한 간접피해수준을 상대적으로 비교하기 위해 설계되었다. 방법: 하버드대학교의 대학생음주연구(CAS)의 2001년도의 원자료 10,924명의 데이터와 한국대학생음주연구(KCAS)의 2003년도의 원자료 2,385명의 데이터를 하나의 파일에 함께 넣어서 분석하였다. 조사도구는 CAS의 대학생용 조사설문지를 사용하였으며, 한국의 주종과 량과 관련하여서는 표준잔과 량을 기준으로 적용하였다. 지난 한 달 동안의 음주하였다고 한 학생의 알코올관련문제 및 간접피해의 정도를 비교하였으며, 연령과 음주빈도 와 음주량 통제하여 로지스틱회귀분석의 결과로 제시하였다. 결과: 한국대학생들이 술 취한 동료를 돌봄, 성적인 폭행, 데이트 강간, 구토물들을 발견하는 것 등의 간접피해를 많이 받는 반면에 미국대학생들은 모욕을 당함, 심하게 다툼, 밀침을 당함, 학업에 방해를 받음, 폭행을 당함, 원치 않은 섹스를 함 등의 간접피해를 더 많이 겪고 있다. 결론: 미국대학생들은 상호관계에 의한 간접피해를 많이 느끼는데 비해서, 한국대학생들은 개인적이고 신체적인 간접피해를 더 많이 느끼고 있다. Objectives: To compare alcohol secondhand effects among US and Korean students. Methods: Nationally representative 4-year colleges of two countries were involved in this cross-national comparison study. Data from the 2001 U.S. College Alcohol Study and the 2003 Korean College Alcohol Study came from 120 colleges in 38 U.S. states and the District of Columbia and 60 colleges in Korea. Randomly selected 4-year college students from the U.S. (10,924) and Korea (2,385) participated in the study using self-reports of alcohol use and perceptions of drinking as assessed by College Alcohol Study questionnaires. Results: Korean students were tend to more likely to have being a victim of sexual assault or date rape, having to take care of drunken students and finding vomit in the hall or bathroom of residence, than US students, while US students were tend to more likely to have being insulted or humiliated, having a serious argument and quarrel, being pushed, hit, or assaulted, having study/sleep interrupted, and experiencing an unwanted sexual advance than Korean students. Conclusion: In general, US students were more likely to suffer interrelationship problems after drinking while Korean students were more likely to have physical and individual drinking related problems.

Serum fibrosis index-based risk score predicts hepatocellular carcinoma in untreated patients with chronic hepatitis B

( Lilian Yan Liang ),( Hye Won Lee ),( Vincent Wai-sun Wong ),( Terry Cheuk-fung Yip ),( Yee-kit Tse ),( Vicki Wing-ki Hui ),( Grace Chung-yan Lui ),( Henry Lik-yuen Chan ),( Grace Lai-hung Wong ) 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.3

Background/Aims: Serum fibrosis scores comprised of common laboratory tests have high utility to assess severity of liver fibrosis. We aimed to derive and validate a hepatocellular carcinoma (HCC) risk score based on serum fibrosis scores to predict HCC in treatment-naive chronic hepatitis B (CHB) patients. Methods: Fifteen thousand one hundred eighty-seven treatment-naive adult CHB patients were identified to form the training cohort in this retrospective study. Individual fibrosis score was included to construct a new HCC prediction score. The score was externally validated in an independent treatment-naive Korean CHB cohort. Results: 180/15,187 patients (1.2%) in training cohort and 47/4,286 patients (1.1%) in validation cohort developed HCC during a mean follow-up of 52 and 50 months, respectively. The newly developed HCC risk score, Liang score, is composed of gender, age, hepatitis B virus DNA, fibrosis-4 (FIB-4) index, and ranges from 0 to 22. Area under the time-dependent receiver operating characteristic curve of Liang score was 0.79 (95% confidence interval, 0.70-0.89). A cutoff value of nine provided an extremely high negative predictive value of 99.9% and high sensitivity of 90.0% at 5 years in the validation cohort. Patients with Liang score ≤9 had HCC incidence <0.2% per year in both training and validation cohorts, in whom HCC surveillance might be exempted. Conclusion: A novel HCC risk score, Liang score, based on FIB-4 index, is applicable and accurate to identify treatment-naive CHB patients with very low risk of HCC to be exempted from HCC surveillance. (Clin Mol Hepatol 2021;27:499-509)