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Park Jeayeon,Kang Minjung,하종원,이하정 대한이식학회 2022 Korean Journal of Transplantation Vol.36 No.3
Varicella zoster virus (VZV) infection can follow a virulent course, leading to possible infection-related mortality in immunocompromised hosts. Visceral disseminated VZV infection is a rare disease with a high mortality rate in immunocompromised patients. We present a case of acute liver failure and acute myocarditis due to visceral disseminated VZV infection in an immunocompromised patient who had recently received kidney transplantation and who subsequently showed dramatic improvement after treatment with intravenous acyclovir and intravenous immunoglobulin. Severe epigastric pain preceded the vesicular skin lesions; therefore, the diagnosis and treatment could have been delayed. Such delays have caused mortality in most previous cases. Therefore, it is necessary to consider visceral disseminated viral infection in the differential diagnosis of immunocompromised patients when multi-organ failure progresses with an unknown cause.
Treated chronic hepatitis B is a good prognostic factor of diffuse large B-cell lymphoma
Jeayeon Park,Sung Won Chung,Yun Bin Lee,Hyunjae Shin,Moon Haeng Hur,Heejin Cho,Min Kyung Park,Jeonghwan Youk,Ji Yun Lee,Jeong-Ok Lee,Su Jong Yu,Yoon Jun Kim,Jung-Hwan Yoon,Tae Min Kim,Jeong-Hoon Lee 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.3
Background/Aims: Chronic hepatitis B (CHB) is a risk factor for non-Hodgkin lymphoma (NHL). Our recent study suggested that antiviral treatment may reduce the incidence of NHL in CHB patients. This study compared the prognoses of hepatitis B virus (HBV)-associated diffuse large B-cell lymphoma (DLBCL) patients receiving antiviral treatment and HBV-unassociated DLBCL patients. Methods: This study comprised 928 DLBCL patients who were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) at two referral centers in Korea. All patients with CHB received antiviral treatment. Time-to-progression (TTP) and overall survival (OS) were the primary and secondary endpoints, respectively. Results: Among the 928 patients in this study, 82 were hepatitis B surface antigen (HBsAg)-positive (the CHB group) and 846 were HBsAg-negative (the non-CHB group). The median follow-up time was 50.5 months (interquartile range [IQR]=25.6–69.7 months). Multivariable analyses showed longer TTP in the CHB group than the non-CHB group both before inverse probability of treatment weighting (IPTW; adjusted hazard ratio [aHR]=0.49, 95% confidence interval [CI]=0.29–0.82, P=0.007) and after IPTW (aHR=0.42, 95% CI=0.26–0.70, P<0.001). The CHB group also had a longer OS than the non-CHB group both before IPTW (HR=0.55, 95% CI=0.33–0.92, log-rank P=0.02) and after IPTW (HR=0.53, 95% CI=0.32–0.99, log-rank P=0.02). Although liver-related deaths did not occur in the non-CHB group, two deaths occurred in the CHB group due to hepatocellular carcinoma and acute liver failure, respectively. Conclusions: Our findings indicate that HBV-associated DLBCL patients receiving antiviral treatment have significantly longer TTP and OS after R-CHOP treatment than HBV-unassociated DLBCL patients.
Shin Hyunjae,Lee Ha Seok,Noh Ji Yun,고준영,Kim So-Young,Park Jeayeon,Chung Sung Won,Hur Moon Haeng,Park Min Kyung,Lee Yun Bin,Kim Yoon Jun,Yoon Jung-Hwan,Ko Jae-Hoon,Peck Kyong Ran,Song Joon Young,Shin E 대한면역학회 2023 Immune Network Vol.23 No.5
Coronavirus disease 2019 (COVID-19) vaccination may non-specifically alter the host immune system. This study aimed to evaluate the effect of COVID-19 vaccination on hepatitis B surface Ag (HBsAg) titer and host immunity in chronic hepatitis B (CHB) patients. Consecutive 2,797 CHB patients who had serial HBsAg measurements during antiviral treatment were included in this study. Changes in the HBsAg levels after COVID-19 vaccination were analyzed. The dynamics of NK cells following COVID-19 vaccination were also examined using serial blood samples collected prospectively from 25 healthy volunteers. Vaccinated CHB patients (n=2,329) had significantly lower HBsAg levels 1–30 days post-vaccination compared to baseline (median, −21.4 IU/ml from baseline), but the levels reverted to baseline by 91–180 days (median, −3.8 IU/ml). The velocity of the HBsAg decline was transiently accelerated within 30 days after vaccination (median velocity: −0.06, −0.39, and −0.04 log10 IU/ml/year in pre-vaccination period, days 1–30, and days 31–90, respectively). In contrast, unvaccinated patients (n=468) had no change in HBsAg levels. Flow cytometric analysis showed that the frequency of NK cells expressing NKG2A, an NK inhibitory receptor, significantly decreased within 7 days after the first dose of COVID-19 vaccine (median, −13.1% from baseline; p<0.001). The decrease in the frequency of NKG2A+ NK cells was observed in the CD56dimCD16+ NK cell population regardless of type of COVID-19 vaccine. COVID-19 vaccination leads to a rapid, transient decline in HBsAg titer and a decrease in the frequency of NKG2A+ NK cells.