Efficacy of Long-Term Tenofovir-Based Therapy in Chronic Hepatitis B Patients with Previous Nucleos(t)ide Analogues Treatment Experience

( Na Eun Lee ),( Hong Seon Son ),( Sung Hoon Choi ),( Chang Hun Lee ),( Seung Young Seo ),( Seong Hun Kim ),( Sang Wook Kim ),( Seung Ok Lee ),( Soo Teik Lee ),( Dae Ghon Kim ),( In Hee Kim ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Tenofovir disoproxil fumarate (TDF) is considered as the preferred treatment option for chronic hepatitis B (CHB) patients with treatment failure or resistance to prior nucleos(t)ide analogues (NAs) treatment. We investigated the efficacy of long-term TDF-based therapy in CHB patients with previous NAs-experience. Methods: This study included total 251 patients who had previous history of NAs therapy and were treated with TDF mono (n=173) or TDF combined with other NA (n=78) from August 2012 to March 2017. Virologic response (VR) was defined as undetectable serum HBV DNA by PCR (<20 IU/mL). Results: Mean age of patients was 49.3 years, median duration of TDF therapy was 27.2 months, 75.7% were HBeAg-positive, and median HBV DNA was 3.7 log10IU/mL. The cumulative rates of VR were 188/244 (77.0%), 180/211 (85.3%), and 146/161 (90.7%) at 12, 24, and 36 months, respectively. Multivariate analysis showed that body mass index (OR 0.77, 95% CI 0.61-0.95, p=0.0189) and duration of TDF therapy (OR 1.09, 95% CI 1.02-1.18, p=0.0221) was significantly associated with VR. TDF monotherapy, HBeAg-positivity, platelet count, serum albumin was associated with VR in the univariate analysis, but not significant in the multivariate analysis. In relation to renal safety, patients showed renal impairment (7, 3.0%), mild hypophosphatemia (15, 7.2%), severe hypophosphatemia (1, 0.4%). Conclusions: Long-term TDF-based therapy demonstrated highly effective in viral suppression and relatively favorable renal safety in CHB patients with previous NA-experience. The body mass index and duration of TDF therapy was independent factors associated with VR.

Comparison of Virologic Response and Renal Safety of Long-Term Antiviral Therapy with Tenofovir and Entecavir in Naive Patient with Chronic Hepatitis B

( Hong Seon Son ),( Sung Hoon Choi ),( Na Eun Lee ),( Chang Hun Lee ),( Seung Young Seo ),( Seong Hun Kim ),( Sang Wook Kim ),( Seung Ok Lee ),( Soo Teik Lee ),( Dae Ghon Kim ),( In Hee Kim ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Tenofovir (TDF) entecavir (ETV) are considered as the preferred treatment options for treatment-naïve chronic hepatitis B (CHB) patients. We compared the virologic response and renal safety of long-term TDF versus ETV therapy in naïve CHB patients. Methods: This retrospective study included total 432 patients who were treated with TDF (n=205) or ETV (n=227) from August 2012 to March 2017. Virologic response (VR) was defined as undetectable serum HBV DNA by PCR (<20 IU/mL). Results: Mean age of patients, sex, baseline serum levels of AST, ALT, creatinine, and HBV DNA were not significantly different between TDF and ETV groups. The cumulative rates of VR between TDF and ETV groups were 71.6% vs. 61.8% (p=0.477), 88.1% vs. 79.6% (p=0.058), and 84.8% vs. 83.7% (p=0.966) at 1, 2, and 3 years, respectively. The cumulative rates of genotypic resistance between TDF and ETV groups were 0% vs. 0%, 0% vs. 1.5% (p=0.404), and 0% vs. 2.2% (p=0.447) at 1, 2, and 3 years, respectively. Incidences of renal impairment and hypophosphatemia during treatment up to 3 years were not significantly different between two groups. Multivariate analysis showed that HBeAg-positivity (OR 0.27, 95% CI 0.12-0.58, p=0.0012) and serum HBV DNA at 1 year 2000 IU/mL (OR 0.09, 95% CI 0.03-0.25, p<0.0001) were significantly associated with VR. Conclusions: Long-term TDF and ETV treatments appear to have similar virologic response and renal safety in naïve CHB patient. However, long-term ETV therapy might to be associated with genotypic resistance in 2.2% up to 3 years, while none of patients on TDF therapy did.

서민복식문화에 관한 연구 (Ⅱ) : 경북 금오산 주변지역의 민속조사 결과를 중심으로 Field Research Around the Mt . Kumo Area

홍나영,이은주,임재영 한국의류학회 1995 한국의류학회지 Vol.19 No.1

The authors study on the traditional textile production and the formal dress throuth the field research concerning the folk attitude toward dress style around the Mt. Kumo area. In this area, people produced and wove hemp, cotton, and silk except ramie. Because of poor production of raw materials, they produced textiles only for self-sufficiency. Every household dealt with dyeing on a small scale. In the past, people dyed cloth natually using plants as material. Natural dyeing, however, gradually changed into chemical one since the Japanese rule. The formal dresses, which people wore on particular occasions such as the hundredth day after child's brith, the first birthday, and traditional holidays, were very meager due to poor living standards. People could not see the formal dresses with full decoration. Bride and bridegroom were the village-owned wedding dresses, and if they could not afford to, they simply put cloth on to remember the occasion. People around the Mt. Kumo area, however, provided fully-decorated shroud and ritual robes to the level of other better-off areas. It seemed to be the result of influence of deeprooted Confucianism in Gyungbuk province. This Phenomenon could be found in the folk dress style in other regions as well as the Mt. Kumo area in Gyungbuk province.

한국인 정신분열병과 HLA-DRB1 대립유전자의 관련성

황나영,김종원,오흥범,조지희,오선영,홍진표,박종익,이동은 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

연구목적: 유전이 정신분열병의 중요한 원인이라는 것은 널리 인정되어 왔다. 본 연구는 한국인 정신분열병과HLA-DRB1 유전자좌와의 관련성을 알아보고 외국인 대상의 보고들과 비교함으로써 한국인 정신분열병의 유전적 특성을 밝히고자 시행하였다. 방법: 정신분열병 환자 70명을 대상으로 HLA-DRB1 대립유전자를 고해상도 수준까지 분석하였다. 저해상도 수준의 HLA-DR결과는 정상 한국인 2,000명의 연구 보고와 비교하였으며 고해상도 수준의 HLA-DRB1 결과는 정상 한국인 229명의 연구 보고와 비교하였다. 결과: 저해상도 수준에서는 HLA-DR11이 정신분열병 환자군에서 9.0%, 정산인에서는 3.8%의 빈도를 보여 환자군에서 통계적으로 유의하게 높은 빈도를 보였으며(p=0.005), 고해상도 수준에서는 HLA-DRB1*1101이 환자군에서 9.0%로 정상인의 1.8%보다 유의하게 높은 빈도를 보였다(p<0.001). 결론: 본 연구에서는 한국인 정신분열병과 HLA-DR11(HLA-DRB1*1101)이 양적 상관관계를 보여 백인에서 DR4와 부정적 상관관계를 보인 결과나 일본인에서 DR1(DRB1*0101)과 양적 상관관계를 보인 결과와 상이하였다. 이러한 한국인 정신분열병 환자의 유전적 특성은 가족연구 혹은 더 많은 수의 환자를 대상으로 한 관련연구를 통하여 재확인되어야 할 것이다. 중심단어:정신분열병·HLA-DRB1·관련연구. Objective: A genetic predisposition is widely accepted in schizophrenia. This study was intended to fine any association of HLA-DRB1 alleles with korean schizophrenics and thereby compare the results of other ethni groups. Method: The subjects were 70 unrelated Korean patients. Low and high resolution typing of HLA-DRB1 alleles were performed. The comparison groups were 2,000 unrelated healthy Koreans for low resolution HLA-DR and 229 unrelated healthy Koreans for HLA-DRB1 alleles. Results: Gene frequencies of HLA-DR11(patients 9.0%, healthy control 3.8%, p=0.005) and HLA-DRB1*1101(patients 9.0%, healthy control 1.8%, p<0.001) were significantly higher in Korean schizophrenics. Conclusion: The frequency of HLA-DR11(HLA-DRB1*1101) is significantly higher in Korean schizophrenics than in healthy Koreans. HLA-DR4 and HLA-DR1, which were known to be associated with Caucasian and Japanese schizophrenics, respectively, did not show statistical association with Korean schizophrenics. This association need to be reassured though further studies with families or association study with larger numbers of subjects. KEY WORDS:Schizophrenia·HLA-DRB1·Association study.

장기간 보관한 멸균물품의 오염 상태에 관한 연구

주홍순,조순덕,정재심,신동분,임바올라,노은지,이선희,송영미,최정화,백병윤,김미나 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.1

여성의 유방자가검진의 지식 정도

구한나,박인경,박하영,성초아,장다엘,홍은민 이화여자대학교 간호과학대학 2012 이화간호학회지 Vol.- No.46

Purpose: This study was to grasp women’s knowledge about Breast Self-examination. Methods: We collected data from 317 women who lives in certain city, Korea using structured questionnaire from 5th, August to 20th, September. The collected data was analyzed by SPSS 19.0. Results: The average score of women’ Breast Self-examination knowledge was 6.79±3.68 (of 17). There are three categories in knowledge about Breast Self-examination. Average score of category is 2.31 ± 0.71(of 4) for knowledge of breast cancer, 2.11 ± 0.57(of 5) for knowledge of breast cancer symptom, 2.37 ± 0.45(of 8) for knowledge of Breast Self-examination. Knowledge about Breast Self-examination according to general characteristics varied significantly for different age, marital status, education, and history of breast disease. Knowledge about Breast Self-examination according to characteristics related Breast examination was higher for women who received Breast Self-examination education, received Breast Self-examination education by lecture, performed Breast Self-examination, and who received Clinical Breast Examination Conclusion: People who are teenager and over sixties, their knowledge of Breast Self-examination was low. Therefore, effective Breast Self-examination education program should be provided for women who are teenager and over sixties to promote their Breast Self-examination practice regularly.

우리 나라 보건관리대행서비스 평가 연구

하은희,조수헌,김선민,주영수,한상환,하미나,권호장,홍윤철,김창엽 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.1

Group occupational health service programme started in 1990 is one of the measures to cope with limited human and financial resources in occupational health. The programme has expanded rapidly to include 52 institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. This study has aims to develop the criteria to assess the quality of newly developed group occupational health service programme, and to investigate the quality of institutions, and finally to develop policies for the quality improvement. 1) Criteria development : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, followings are included as core elements of qualitative occupational health programme; accessibility, continuity, comprehensiveness, technical quality, intersectoral collaboration, emphasis on preventive services, community participation, and adequacy. Again each element is divided into five major components of national health system infrastructure developed by the World Health Organization; development of health resources, organized arrangement of resources, delivery of health care, economic support, and management. In turn, each component is categorized into three aspects of quality assessment, structure, process and outcome. Expert panel selected several criteria for each category to evaluate the programme. Criteria were modified according to each group of interviewees, to produce two sets of questionnaire, one for chief operating officer and another for nurses in the institutions, and the chief operating officer and workers in the workplace. 2) Subject : Of all 52 institutions, 25 voluntarily participated in the survey. At individual institution, chief operating officer and practicing nurses were interviewed in depth. After intensive education for interviewees, every interviewees, every interview was performed with standardized guideline and questionnaire. The quality of the 'Group occupational health service programme' was found to be lower than expected. Especially in continuity, comprehensiveness, technical quality, community participation and adequacy, lower quality in structural aspect was commonly identified throughout all the institutions,. Quality in terms of accessibility and continuity highly varied among institutions., To improve quality of the programme, more comprehensive and systematic programme such as accreditation has to be introduced. In addition, human resources, governmental fund and information systems for individual workers are to be developed. As a long range plan, integration of occupational health services into the national health systems and pooling of financial resources and planned allocation should be considered.

Mannitol 투여에 의한 핍뇨성 급성 신부전 1례

이홍준,나기찬,정은경,박상기 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.2

Mannitol, a hexahydroxy chemically related to mannose, is a non-electrolytic, osmotic agent, It has been known that mannitol may cause serious life-threatening situation if administered in a patient with renal problem. Recently, it has been published that mannitol itself may be nephrotoxic in a patient without preexisting nephrologic disorders. We experienced a case of acute oliguric renal failure caused by long use of mannitol in order to reduce intracranial pressure and cerebral edema after operation of left posterior communicating aneurysm, and reported with recent literature review.

국가예방접종전산등록체계 개발을 위한 민간의료 기관 하부구조 및 환경 조사연구

이무식,김은영,이건세,이석구,홍지영,김건엽,김대경,신의철,이연경,기몽서,나백주,김영택 한국모자보건학회 2003 한국모자보건학회지 Vol.7 No.2

학생청소년의 불안성향과 문제행동 유형간의 상관분석

김헌수,이재우,나철,김영돈,김민호,김은희,권지란,박광식,이길홍,민병근 중앙대학교 의과대학 의과학연구소 1987 中央醫大誌 Vol.12 No.4

The purpose of the present study was to examine the relationship between their problem behavioral pattern and anxious trends among Korean student adolescent. Zung's measurement of anxiety level undergone through used of the self-rating anxiety scale. the data were collected through the questionaire survey which was conducted on Dec.1, 1983. Subjects served for this atudy consisted of 1,404 syudents in Korea, randomly sampled from Korean student population by means of census method. The data were analysed by CDC-174 computer of KAIST, using SPSS pogram. Statistical methods empoyed were χ^2 test and Eta measures. the results of this study were as follows. 1. It showed that students psychological anxious trends had greatest significant correlation with adolescent student's problem brhavioral pattern, but the cardiovascular, respiratory, gastrointestional and genitourinary anxious trends has not significantly related with student's problem behavioral pattern. 2. Students group with undersocialized aggressive, undersocialized nonaggressive,undersocialized school-norm avoidant, or socialized nonaggressive behavioral patterns were less anxious, whereas those with socialized latent aggressive, socialized sexual, or socialized modellong behavioral patterns were higher anxious.