만성 C형 간염 환자에서 페그인터페론 알파2a와 리바비린 병합 치료중 발생한 벨마비 1예

김일환,장제혁,유충헌,최규남,고정해,김윤정,서광원,김지현,박성재,박은택,이연재,이상혁,설상영 인제대학교 2008 仁濟醫學 Vol.29 No.-

페그인터페론과 리바비린 병합요법은 만성 C형 간염의 일차 치료법이다. 저자들은 만성 C형 간염 환자에서 페그인터페론 과 리바비린 병합 요법 중에 발생한 벨마비 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 5년 전부터 만성 C형 간염을 앓아온 48세 남자이며, PEG-IFN α-2a 135μgm 피하주사 주1회와 하루 1200㎎의 리바비린을 투여하였다. 치료시작 후 9개월째 환자는 오른쪽 안면의 근력약화를 호소하였으며 벨마비로 진단되었다. 페그인터페론과 리바비린 병합요법을 지속하면서 관찰하였다. 환자의 벨마비는 페그인터페론 치료를 중단하지 않았음에도 3개월후 증상이 회복되고 이후 벨마비 재발 없이 현재 경과관찰 중이다. 만성 C형 간염에서 페그인터페론과 리바비린 병합 요법시 벨마비의 발생 가능성을 염두에 두어야 하겠다. A Case of Bell's Palsy Associated with Combination Therapy of Pegylated Interferon Alfa-2a (PEG-IFN) and Ribavirin for Chronic Hepatitis C Virus Infection Pegylated interferon alfa(PEG-IFN α) and ribavirin therapy is the first line treatment for chronic hepatitis C. Mild complications of the therapy are common, but more serious complications are rare. We report here a case of Bell's palsy that occurred in a patient with chronic hepatitis C virus infection during combination therapy of PEG-IFN α-2a and ribavirin. The patient was 49-year-old man with chronic hepatitis C (genotype 1b) for 8 years. He had compensated liver cirrhosis with splenomegaly. Therapy with PEG-IFN α- 2a 135mcg/week and ribavirin 1200mg/day was initiated. After 9 months of the therapy, the patient showed a loss of muscular tone on the right side of his face. A diagnosis of Bell's palsy was made. The Bell's palsy resolved over 3 months despite continuation of the combination therapy.

천연항균성 물질을 이용한 Vibrio vulnificus의 살균 및 독소생성 억제효과

조성환,서일원,최종덕,전상수,라택균,정수근,강동훈 國立統營水産專門大學 附設 水産科學硏究所 1993 수산과학연구소보고 Vol.4 No.-

생선회용 해산물에 오염되어, 생식한 경우 발생되는 패혈병의 원인균주인 Vibrio vulnificus의 생육 및 독성생성을 억제할 목적으로 천연 항균제인 Grapefruit종자추출물(GPSE)을 이용하여 그 항균효과를 검토하였다. In vitro 시험결과, Vibrio vulnificus에 대한 GFSE의 생육최소저해농도는 50~100 ppm 정도이었으며, Vibrio vulnificus 균체세포틀 100 ppm 농도의 GFSE 용액으로 처리하고 전자현미경 촬영시료로 조제하여 촬영한 후, 미생물형태을 무처리대조구와 비교, 검토한 결과, GFSE 처리로 세포막 기능이 파괴되어 세포내용물이 균체외부로 유출되어 균체의 생육이 억제되고 균체내부가 빈 ghost 형태의 균체수가 증대되어 GFSE의 항균효과를 확인할 수 있었다. 한편, 생선회용 해산물에 GFSE를 근육주사하고 Vibrio vulnificus를 접종한 수조내에서 사육하여 채취한 어육부를 마쇄하여 일정량씩을 표준사료에 첨가해서 통닭용 병아리를 실험동물로 하여 사양실험을 실시한 결과. 체중증가율, 단백질이용효율, 혈청내 효소활성, 혈청의 주요성분함량 등에 있어서, GFSE 처리수조내에서 사육한 해산물을 첨가한 시료시험구의 경우, 무첨가사료처리구와 비교할 때 뚜렷한 차이를 목격할 수 없었으며, GFSE 첨가에 따른 실험동물의 성장저해 또는 독성현상을 유발하지 않음을 알 수 있었다. 아울러, 각 처리구에서 사양한 해산물의 어육부에 오염된 Vibrio vulnificus의 균수를 측정한 결과, 250ppm 이상의 GFSE 처리구에서는 Vibrio vulnificus를 전혀 검출할 수 없었다. To prevent food-poisoning outbreaks by Vibrio vulnificus the antimicrobial efficacy of grapefruit seed extract (GFSE) was examined. Minimal inhibitory concentration (in vitro) for the microorganism was found to be 50~100 ppm. Transmission electron micrographs of Vibrio vulnificus showed the biocidal action of this natural antimicrobial agent would be related to specific respiratory effect coupled with the destruction of permeable function of microbial cell membrane. After Anguilla japonia GFSE-injected to the body was incubated in the seawater contaminated by Vibrio vulnficus the fish meats were taken up, mixed with control diet and used as a diet in the feeding experiment. In this experiment the effect of GFSE treated with fish muscle on body weight protein efficiency ratio, serum enzymes and serum blood component of broiler chicks was investigated. It is proved from this study that there is neither Vibriosis nor toxicity associated with GFSE itself and fish meats treated with it when it is injected to the fish body at a level of 250 ppm or less.

Uncertain Association between Tenofovir and eGFR Reduction in Patients with Chronic Hepatitis B

( Kwang Il Seo ),( Byung Chul Yun ),( Sang Uk Lee ),( Byung Hoon Han ),( Eun Taek Park ),( Jin Wook Lee ),( Seo Ae Han ),( Dohyeong Lee ),( Sung Jun Kim ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Tenofovir disoproxil fumarate (TDF) is known to be associated with nephrotoxicity in patients with human immunodeficiency virus (HIV). TDF is a potent antiviral agent to treat chronic hepatitis B (CHB) infections and the prescription has been increased rapidly in worldwide. Intermittently, nephrotoxicities due to TDF in CHB patients were reported in some cases. Therefore, we have been interested the real-life incidence of renal toxicity in CHB patients treated with TDF. Methods: From January 2012 to December 2014, medical records of patients who had been treated with TDF or entecavir (ETV) in Kosin University Gospel Hospital were reviewed retrospectively, focused on the estimated GFR (eGFR) reduction. Results: A total of 295 patients received TDF or ETV. Twenty-five patients treated for 30 days or less, and 45 patients without follow-up creatinine level were excluded. The following patients were also excluded : baseline eGFR < 60 (ml/min/1.73m2) patients (n = 9), polycystic kidney disease (n = 1), decreased eGFR due to aggravating factor (n = 17). Among 198 patients, 99 received TDF and 99 ETV. In 18 patients, eGFR was reduced by more than 30% compared to baseline. Half of them treated with TDF and the other half with ETV. Baseline eGFR (P=0.006) and age (P=0.015) were significantly correlated with eGFR reduction. The presence of LC (P=0.684), Non-selective beta blocker (P=0.309), type of antiviral agents (P=0.927), and BMI (p=0.965) were not associated with the eGFR reduction. Subgroup analysis of CKD stage 2 (60<eGFR<90) or older than 60 years did not show any significant association between antiviral agents and eGFR reduction. Conclusions: More than 30% reduction of eGFR was observed in 9% CHB patients receiving antiviral agents. Baseline eGFR and age were significantly correlated with eGFR reduction. There was no significant correlation between the type of antiviral agents (TDF of ETV) and the decrease in renal function.

Out of Sequence Measurement 환경에서의 MPDA 성능 분석

徐日煥(Il-Hwan Seo),林永澤(Young-Taek Lim),宋澤烈(Taek-Lyul Song) 대한전기학회 2006 전기학회논문지 D Vol.55 No.9

In a multi-sensor multi-target tracking systems, the local sensors have the role of tracking the target and transferring the measurements to the fusion center. The measurements from the same target can arrive out of sequence called the out-of-sequence measurements(OOSMs). Out-of-sequence measurements can arise at the fusion center due to communication delay and varying preprocessing time for different sensor platforms. In general, the track fusion occurs to enhance the tracking performance of the sensors using the measurements from the sensors at the fusion center. The target informations can arrive at the fusion center with the clutter informations in cluttered environment. In this paper, the OOSM update step with MPDA(Most Probable Data Association) is introduced and tested in several cases with the various clutter density through the Monte Carlo simulation. The performance of the MPDA with OOSM update step is compared with the existing NN, PDA, and PDA-AI for the air target tracking in cluttered and out-of-sequence measurement environment. Simulation results show that MPDA with the OOSM has compatible root mean square errors with out-of-sequence PDA-AI filter and the MPDA is sufficient to be used in out-of-sequence environment.

Out-of-Sequence-Measurement Processing for Probabilistic Multiple Hypothesis Tracker with Measurement Reordering

Seo, Il-Hwan,Song, Taek-Lyu 제어로봇시스템학회 2010 Transaction on control, automation and systems eng Vol.12 No.1

In a multi-sensor central level tracking system, owing to random delay in transmission and varying preprocessing time for different sensor platforms, an earlier measurement from the same target can arrive at the fusion center after a later one. Practical data fusion schemes are challenged by the inevitable appearance of measurements that are out of sequence, called, "out-of-sequence measurements" (OOSMs). The question is how to incorporate these OOSMs in a track that has already been updated with a later observation in order to enhance the performance of the tracking system. Several approaches for a sequential algorithm to find a solution for the OOSM problem have been discussed in previous papers. An approach to address the OOSM problem in the probabilistic multi-hypothesis tracker (PMHT), being a batch algorithm, was proposed in previous paper. However, the situation of this approach was not an OOSM case but, rather, an out of sequence scan (OOSS) where a batch of data was lost and then only one scan of measurements from the lost batch arrived with the present batch. In this paper, we propose an approach that has a measurement reordering step to address the OOSM problem in the PMHT within the framework of the OOSM case and report on the performance with the simulation results. The simulation results indicate that the proposed approach may be a suitable solution for the OOSM problem in PMHT under the proper conditions of length of batch, amount of lag, density of clutter, and probability of detection for the target.

Impact of Haemophilus Influenzae Colonization in Bronchiectasis Patients

( Seo Hee Yang ),( Myung Jin Song ),( Yeon Wook Kim ),( Byung Soo Kwon ),( Sung Yoon Lim ),( Yeon-joo Lee ),( Jong Sun Park ),( Young-jae Cho ),( Ho Il Yoon ),( Jae Ho Lee ),( Choon-taek Lee ),( Hyung 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Background Haemophilus influenzae and Pseudomonas aeruginosa are known to be the most common colonizers in patients with bronchiectasis. It is known that P. aeruginosa is responsible for lung function decline and frequent exacerbations. Although H. influenzae is a frequent colonizer, its impact on patients is not well known. Therefore, we aimed to elucidate the impact of H. influenzae colonization in bronchiectasis. Method This retrospective study screened adult patients diagnosed with bronchiectasis (ICD-10) at Seoul National University Bundang Hospital between 1 April 2003 and 16 May 2021. Those without the Results of respiratory specimen culture and chest CT were excluded. Propensity score matching method was used to select those with H. influenzae colonization and those without. We compared the severity of bronchiectasis according to the bronchiectasis severity index (BSI), risk of exacerbation, difference in lung function, and mortality risk. Result The prevalence of H. influenzae colonization was 1.75% (79 of 4500 patients). After 1:2 propensity score matching, 78 and 154 patients were selected in the Haemophilus and non-Haemophilus groups, respectively. Although there was no significant between both groups regarding baseline characteristics, patients colonized with Haemophilus had higher BSI (6 vs 4, P=0.002), particularly with more exacerbation history (40.6% vs 18.6%, P=0.002) and pulmonary infiltrates (52.2% vs 37.2%, P=0.045). Patients with H. influenzae revealed higher risk of mild exacerbation without the need for hospitalization (adjusted incidence rate ratio 0.15 with 95% confidence interval 0.12-0.24). Lung function and mortality rates were not significantly different according to the presence of Haemophilus species. Conclusion Patients with H. influenzae colonized bronchiectasis had a higher BSI, no difference in lung function, a higher risk of mild exacerbation, but no difference in mortality. We suggest that H. influenzae colonization can be considered as an indicator for disease severity and risk of mild exacerbation among bronchiectasis patients.

Limb Lengthening in the Osteoporotic Bone

Hui Taek Kim(김휘택),Seong Ho Whang(황성호),Jeong Han Kang(강정한),Jong Seo Lee(이종서),Sang Jin Cheon(천상진),Chong Il Yoo(유총일),Hee Kyung Chang(장희경) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.8

목적: 스테로이드로 골 다공증을 유도한 가토에서 신연 골형성을 연구하였다. 대상 및 방법: 성숙한 가토에서 스테로이드 투여 용량에 따라 1군(스테로이드를 투여하지 않은 군), 2군(0.4 ㎎/㎏/day 2주간 투여한 군), 3군(0.4㎎/㎏/day 4주간 투여한 군), 4군(0.8 ㎎/㎏/day 2주간 투여한 군), 5군(0.8 ㎎/㎏ 4주간 투여 한 군)으로 나누었다. 스테로이드 투여 후 경골 간부에 외고정 기구를 고정한 후 절골술을 시행하였으며 4주간 골신연술을 시행하였다. 1주마다 단순 방사선 사진 촬영과 골밀도 및 퍼센티지 골밀도를 측정하고, 최종 신생골 형성 정도에 따라 3개의 군으로 나누어 조직학적 분석을 하였다. 결과: 양호한 가골을 형성한 가토는 모두 1군이었다. 그들의 요추 골밀도는 평균 5.1% 감소되었으며, 신연 1주 후 신연부 퍼센티지 골밀도는 50 이상이었다. 결론: 성숙한 가토에서 요추 골밀도가 10% 이상 감소되었거나, 신연 1주 후 퍼센티지 골밀도가 50 미만인 경우 사지 연장술 중 문제점의 발생이 예상된다. 인체에 있어서도 유사한 수치가 적용될 수 있으리라 생각된다. Purpose: This study investigated the results of distraction osteogenesis in steroid-induced osteoporotic rabbits. Materials and Methods: Mature rabbits were assigned to the following five steroid dosage groups: Ⅰ (none); Ⅱ (0.4 ㎎/㎏/day for 2 weeks); Ⅲ (0.4 ㎎/㎏/day for 4 weeks); Ⅳ (0.8 ㎎/㎏/day for 2 weeks); Ⅴ (0.8 ㎎/㎏/day for 4 weeks). After the steroid injection, the tibias were osteotomized and distracted for 4 weeks. The rabbits were classified radiographically into three groups according to the quality of new bone formed, and the Bone mineral density (BMD) and percentage BMD for these groups were then compared. The microscopic results supported the radiographic groupings. Results: The rabbits that formed good calluses were all from group Ⅰ, and their average lumbar BMD remained high (mean decrement, 5.1%). These rabbits had a percentage BMD ≥50 after 1 week of the distraction. Conclusion: Problems can be expected during limb lengthening in mature rabbits that shows a lumbar BMD decrease ≥10%, or a percentage BMD <50 after 1 week of the distraction. Similar guidelines may be indicated for humans.

Azathioprine Induce Hyperbilirubinemia in Inflammatory Bowel Disease: A Hospital Based Cohort Study

( Kwang Il Seo ),( Won Moon ),( Seun Ja Park ),( Moon In Park ),( Sang Uk Lee ),( Byung Chul Yun ),( Byung Hoon Han ),( Eun Taek Park ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Intestinal mucosal injury is supposed to cause liver disease. Abnormal liver function tests are frequently observed in inflammatory bowel disease (IBD). Therefore, we investigated the hepatic biochemistry changes in IBD. Methods: IBD patients who were newly diagnosed and followed up with the results of hepatic biochemistries at the both time points of diagnosis (before IBD treatment) and then 2 year later (after IBD treatment) were enrolled. The biochemical profile including aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TB), direct bilirubin (DB), alkaline phosphatase (ALP), Gamma-glutamyltransferase (GGT) were analysed. Results: One hundred forty-six (77 patients of crohn’s diseas and 69 ulcerative colitis) patients were able to confirm the liver function test at second year after first diagnosis. HBsAg positivity was found in 9 (6.2%) patients and anti-HCV antibody in 1 (0.7%). Radiologic diagnosis of fatty liver was found in 15 (10.2%) patients and gallbladder stone in 10 (6.8%). Within first year, 85 (58.2%) patients started azathioprine (AZA) treatment. At diagnosis, 45 (30.8%) patient revealed abnormal hepatic biochemistry. AST was elevated than upper limit of normal (ULN) in 9 (6.2%) patients, ALT in 11 (7.5%), TB in 14 (9.5%), DB in 16 (11%), ALP in 21 (14.6%) and GGT in 15 (10.3%). At 2 year later, 59 (40.4%) patients showed abnormal hepatic biochemistry. TB was elevated significantly compared to baseline (P< 0.001) and absolute elevation of TB ( >0.5mg/ dL) was related with AZA (P=0.006). In AZA group, hyperbilirubinemia (>1.2mg/dL) was found in 6 (7.1%) patients at initial diagnosis, but 19 (22.4%) patient at 2 year later. In this group, absolute TB elevation was found in 63 (64.1%) patients. Eighteen (21.2%) patients were normal at diagnosis, experienced newly developed hyperbilirubinemia after AZA treatment. Conclusions: Abnormal liver function tests were observed in nearly one-third of IBD patients at diagnosis. Azathioprine elevated TB level significantly in inflammatory bowel disease.

Poster Session:PS 1101 ; Gastroenterology (Gastrointestinal Tract) : Two Cases Melanosis Ilei in Family Members Who Had Taken Charcoal for a Long Period

( Hyun Taek Seo ),( Yong Kyu Lee ),( Se Jun Kim ),( Il Eok Jo ),( Hong Min Park ),( Woo Hyuk Kwon ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Introduction: Melanosis ilei is defi ned as the seen coloring of grayish-black or brownish- black pigments in the mucuous membrane at the end of the ileum. Melanosis occurs almost in the large intestine, and rarely in the duodenum and ileum. Cases of melanosis ilei due to the taking of charcoal have been reported rarely, but cases of melansis ilei have been not reported among family members who have taken charcoal for a long period. Case 1: 66-year-old woman (mother) Colonoscopy was performed to detect cancers. She didn`t have any particular medical or family history until performing colonoscopy. Whenever she had an intermittent abdominal pain or dyspepsia, her family had taken a spoonful of powered charcoal from 1990 to 2005. With no particular diagnostic fi ndings, colonoscopy revealed multiple polyps and the coloring of the mucous membrane the end of the ileum. Case 2: 38-year-old man (son) Colonoscopy was performed due to diarrhea that occurred 2 or over 3 times a day. He had been taking antihypertensive drugs, and the family had the history disease that the father died due to liver cancer. The patient has smoked for ten years, and stopped smoking since six months ago. With no particular diagnostic fi ndings, colonoscopy revealed the coloring of the mucous membrane at the end of the ileum. After histological examination of mucous membrane revealed focal black pigments, he was diagnosed as melanosis ilei . Summary: We hereby report two cases of melanosis ilei, which was caused among a family who took charcoal for a long period.

Barriers to treatment of failed or interferon ineligible patients in the era of DAA: single center study

( Kwang Il Seo ),( Byung Chul Yun ),( Weiquan James Li ),( Sang Uk Lee ),( Byung Hoon Han ),( Eun Taek Park ) 대한간학회 2017 Clinical and Molecular Hepatology(대한간학회지) Vol.23 No.1

Background/Aims: Interferon-based treatment is not appropriate for a large number of patients with chronic hepatitis C for various medical and social reasons. Newly developed directly acting antivirals (DAAs) have been used to treat chronic hepatitis C without severe adverse effects and have achieved a sustained viral response (SVR) rate of 80-90% with short treatment duration. We were interested to determine whether all patients who failed to respond to or were ineligible for interferon-based therapy could be treated with DAAs. Methods: Medical records of patients with positive serum anti-hepatitis C virus (HCV) or HCV RNA between January 2009 and December 2013 were reviewed. Demographic, clinical, and treatment data were collected for analysis. Results: A total of 876 patients were positive for both anti-HCV and HCV RNA. Of these, 244 patients were eligible for interferon, although this was associated with relapse in 39 (16%) of patients. In total, 130 patients stopped interferon therapy (67% adverse effects, 28% non-adherent, 4% malignancy, 1% alcohol abuse) and 502 patients were ineligible (66% medical contraindications, 25% non-adherent, 5% socioeconomic problems). Among 671 patients who were ineligible for or failed to respond to interferon therapy, more than 186 (27.7%) could not be treated with DAA due to financial, social, or cancer-related conditions. Conclusions: Newly developed DAAs are a promising treatment for patients with chronic hepatitis C who are ineligible for or failed to respond to interferon-based therapy. Nevertheless, not all chronic hepatitis C patients can be treated with DAAs due to various reasons. (Clin Mol Hepatol 2017;23:74-79)