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( Sang Jun Suh ),( Hyung Joon Yim ),( Ji Hye Seo ),( Han Ah Lee ),( Tae Hyung Kim ),( Young Sun Lee ),( Jong Jin Hyun ),( Young Kul Jung ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Jong Eun Yeon ),( Kwan So 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Sorafenib is the standard treatment for advanced hepatocellular carcinoma (HCC). However, the influence of sorafenib on the replication of HBV remains unknown. Herein, we evaluated the rate of HBV reactivation during sorafenib therapy in chronic hepatitis B (CHB) patients with advanced HCC. Methods: Four hundreds thirty five advanced HCC patients who visited three hospitals affiliated with Korea University from January 2004 to December 2012 were retrospectively reviewed. Among them, 327 patients were HBsAg positive. Two hundred sixty four received antiviral therapy before initiation of sorafenib therapy, and 64 patients were treatment naive with regard to anti-HBV therapy. Patients who received sorafenib less than 4 weeks, those who had not follow-up HBV DNA value, and patients who received other treatment than sorafenib were excluded. Finally, 133 and 28 patients were analyzed, respectively in each group. HBV reactivation were defined as increase of HBV DNA >10 times of baselines or ≥ 2000 IU/mL in patients with baselines HBV DNA < 2000 IU/mL. We further investigated reactivation rates in propensity score matched liver cirrhosis patients without HCC. Results: Mean age was 54.87±9.34 and 83.2% were male. All patients were Barcelona Clinic of Liver Cancer Stage C and the sum of tumor diameter was 10.42±5.78 cm. Mean baseline HBV DNA level was 2.84±1.60 log IU/mL. Median survival was 5.97 months. At 12, 24, and 48 weeks of the sorafenib therapy, HBV reactivation occurred in 5.26%, 12.0%, 14.3% of antiviral therapy group while it developed in 28.6%, 39.3%, and 42.9% of HBV therapy naïve group, respectively. The reactivation rates was significantly higher in patient who didn’t received antiviral therapy (p = 0.001). The antiviral therapy (HR 0.250, C.I. 0.104-0.604, p = 0.002) was independent factor related to HBV reactivation by logistic regression analysis. When the 28 HBV therapy naive HCC patients who received sorafenib were compared with propensity score matched 84 HBV therapy naïve liver cirrhosis patients without HCC, the cumulative reactivation rates were also significantly higher in the former group by log-rank test (p <0.001). Conclusions: The risk of HBV reactivation is high in CHB patients receiving sorafenib due to advanced HCC. It would be necessary to administer pre-emptive antiviral therapy before sorafenib initiation.
Cleavage Agents for Soluble Oligomers of Amyloid β Peptides
Suh, Junghun,Yoo, Sang Ho,Kim, Min Gyum,Jeong, Keunhong,Ahn, Jae Young,Kim, Myoung-soon,Chae, Pil Seok,Lee, Tae Yeon,Lee, Jaehwa,Lee, Jeongkuk,Jang, Yun Ah,Ko, Eun Hwa WILEY-VCH Verlag 2007 Angewandte Chemie Vol.46 No.37
<B>Graphic Abstract</B> <P>Clearing the mind: Peptide-cleaving agents for amyloid β-42 (Aβ<SUB>42</SUB>) oligomers (see scheme), the intermediate neurotoxic species in the pathology of Alzheimer's disease, have been obtained from a combinatorial library built using the Co<SUP>III</SUP> complex of 1,4,7,10-tetraazacyclododecane as the reaction center. Effective cleavage of the Aβ<SUB>42</SUB> oligomers occurs at submicromolar concentrations of the agents. <img src='wiley_img/14337851-2007-46-37-ANIE200702399-content.gif' alt='wiley_img/14337851-2007-46-37-ANIE200702399-content'> </P>
Anemia in Chronic Liver Disease
( Sang Jun Suh ),( Han Ah Lee ),( Tae Hyung Kim ),( Young Sun Lee ),( Jong Jin Hyun ),( Young Kul Jung ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Hyung Joon Yim ),( Jong Eun Yeon ),( Kwan Soo Byun ),( Soon 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: The anemia in chronic liver disease is common. The causes can be bleeding, malnutrition, erythrocyte sequestration and underproduction, and medicine’s side effects. Many patients are just regarded as iron deficiency anemia (IDA) and described iron supplements. We investigated the patterns of anemia in chronic liver disease and triage the causes. Methods: The patients invited to Korea university ansan hospital from 2012 to 2016 were investigated retrospectively. 1632 patients were test for anemia lab. The definition of anemia is <13.0g/dl(men) or 8.1g/dl(women) according to WHO’s threshold. Reticulocyte production index (RPI) is calculated by [reticulocyte count (%)*hematocrit/ 45]/reticulocyte maturation time. If RPI ≥2.5, it is classified as hemolysis or hemorrhage. If RPI < 2.5, it was checked red cell morphology. Normocytic (MCV 80-100) is classified as hypo-proliferative disorder, and macrocytic (MCV >100) or microcytic (MCV <80) is classified as maturation disorder. In hypo-proliferative disorder, eGFR (using MDRD fomula) < 30ml/min/1.73 m2 is classified as renal disease. If CRP >3mg/dl, it is classified as inflammatory disorder. In maturation disorder, if transferrin saturation (Fe/TIBC) <15% or ferritin <18 ng/ml, it classified as IDA. In macrocytic morphology, if the patients diagnosed as alcoholic disease, it is classified as folate and/or vitamin B12 deficiency. Others are classified as undetermined. This classification is modified from ‘algorithm of the physiologic classification of anemia’ of Harrison’s Internal Medicine. Results: Total 441 patients were available for analysis. 11 patients were classified as hemolysis/hemorrhage according to RPI ≥2.5. 430 patients were divided as hypo-proliferative (n=275) and maturation disorder (n=155) according to RBC morphology. IDA 72, renal disease 9, inflammatory disease 30, and thiamine folate deficiency 61 patients were classified. 258 patients were undermined. In IDA 72 patients, 38 patients were treated with iron supplement. In other causes 111 patients, 16 patients were described iron. In undermined 258 patients, 75 patients described iron. The proportion who diagnosed and appropriately treated with iron supplement was 8.8%, and 3.7% were miss treated, and 17.5% needed further evaluation. Conclusions: A lot of patients with anemia in chronic liver disease are treated with undetermined diagnosis. Using algorithm, many patients could be classified and treated appropriately.
Suh, Ji‐,Yeon,Cho, Gyunggoo,Song, Youngkyu,Lee, Chang Kyung,Kang, Jong Soon,Kang, Moo Rim,Park, Sung Bin,Kim, Young Ro,Kim, Jeong Kon RADIOLOGICAL SOCIETY OF NORTH AMERICA INC 2012 JOURNAL OF MAGNETIC RESONANCE IMAGING Vol.35 No.6
<P><B>Abstract</B></P><P><B>Purpose:</B></P><P>To evaluate the reliability and accuracy of the apparent diffusion coefficient (ADC) for monitoring antiangiogenic treatment in a longitudinal study.</P><P><B>Materials and Methods:</B></P><P>Tumor volume and ADC were monitored by T2‐weighted magnetic resonance imaging (MRI) and diffusion‐weighted MRI, respectively, in 18 mice with angiogenesis‐dependent tumors (U118MG) before (day 0) and after 2, 7, 14, and 21 days of administration of the antiangiogenic agent sunitinib maleate (<I>n</I> = 12) or vehicle (<I>n</I> = 6). Percent changes in tumor volume and ADC were calculated and correlations between tumor volume and ADC were evaluated.</P><P><B>Results:</B></P><P>Tumor volume and ADC showed a negative correlation at 69 of the 72 (96%) follow‐up measurements. In the 13 mice with tumor regrowth, ADC started to decrease before (27%) or at the same time (73%) as tumor regrowth. Pretreatment ADC and percent change in ADC change on days 0–2 were similar in mice with positive and negative responses to treatment (0.851 vs. 0.999, 24% vs. 16%). Percent change of ADC showed significant negative correlation with percent change in tumor volume in both the control (<I>r</I> = −0.69) and treated (<I>r</I> = −0.65) groups.</P><P><B>Conclusion:</B></P><P>Percent change in ADC is a reliable and accurate marker for monitoring the effects of antiangiogenic treatment, whereas pretreatment ADC and early changes in ADC (ie, days 0–2) are limited in predicting treatment outcome. J. Magn. Reson. Imaging 2012;35:1430–1436. © 2012 Wiley Periodicals, Inc.</P>
Genomic profiling combined with gene expression profiling in primary central nervous system lymphoma
Sung, Chang Ohk,Kim, Sang Cheol,Karnan, Sivasundaram,Karube, Kennosuke,Shin, Hyung Jin,Nam, Do-Hyun,Suh, Yeon-Lim,Kim, Seok-Hyung,Kim, Ji Yeon,Kim, Seok Jin,Kim, Won Seog,Seto, Masao,Ko, Young-Hyeh American Society of Hematology 2011 Blood Vol.117 No.4
<B>Abstract</B><P>Of the genetic changes in primary central nervous system lymphoma (PCNSL), little is known. To detect copy number alterations and differentially expressed genes in PCNSL, we analyzed a total of 12 PCNSL samples with high-resolution array-based comparative genomic hybridization and performed expression profiling in 7 of the 12 samples. The most frequent deletion found in 8 patients (66.7%) occurred in 9p21.3 containing CDKN2A. We compiled the top 96 genes (family-wise error rate, P < .05) showing the greatest differential expression between PCNSL and normal lymph node tissues. From these, we selected 8 candidate genes (NPFFR2, C4orf7, OSMR, EMCN, TPO, FNDC1, COL12A1, and MSC) in which expression changes were associated with copy number aberrations. All 8 genes showed both down-regulation in expression microarray and deletion in array-based comparative genomic hybridization analyses. These genes participate in cell signaling or cell adhesion. In addition, low mRNA expression of C4orf7 was significantly associated with poor survival (P = .0425). Using gene set enrichment analysis, we identified several signal transduction pathways, such as Janus kinase-signal transducers and activators of transcription pathway and adhesion-related pathways, which may be involved in pathogenesis of PCNSL. In conclusion, this study identified novel tumor suppressor genes that may serve as therapeutic targets of PCNSL.</P>
Ice Collision Analyses for Membrane Tank Type LNG Carrier
Suh, Yong-Suk,Ito, Hisashi,Chun, Sang-Eon,Han, Sang-Min,Choi, Jae-Yeon,Urm, Hang-Sub The Society of Naval Architects of Korea 2008 Journal of ship and ocean technology Vol.12 No.1
As arctic energy resource is attracting public attention, arctic shipping market will also be growing in large as expected to increase in LNG trade from Arctic area to the western countries by shipping. During the voyages through such routes, collision with icebergs may be possible. In the present report, ice collision analyses are carried out from a practical point of view to verify the safety of hull structural strength of LNG carriers equipped with GTT $MKIII^{TM}$ membrane type cargo containment system. From the results of collision analyses and the operation-friendly design concept of no-repairing of cargo containment system, a safe operating envelope against ice collision is proposed for LNG carriers of membrane type cargo containment system. Based on the currently proposed safety criteria, it is concluded that LNG carriers with membrane tank type can operate safely with regard to the integrity of CCS in regions where collision between LNG carrier and iceberg is expected.
( Sang Jun Suh ),( Young Kul Jung ),( Sun Young Yim ),( Ji Hye Je ),( Yang Jae Yoo ),( Hae Rim Kim ),( Sung Hee Kang ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Hyung Joon Yim ),( Jong Eun Yeon ),( Soon Ho 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Among the patients with hematologic malignancy, hepatitis occurs after recovering from neutropenic fever. Clinical course is decided according to appropriate treatment to causative pathogen. Various organisms can cause acute hepatitis in immunecompromised host, early inspection to the causative pathogen is essential. We investigated which pathogen cause acute hepatitis after recovering from neutropenic fever in patients with hematologic malignancy. Methods: From January 2011 to april 2014, we included the patients with acute hepatitis (elevated Aspartate transaminase and/or total bilirubin above 2 times upper limit of normal range) within two weeks after recoverinig from neutropenic fever. We excluded the patients with acute hepatitis within two weeks after infused by chemoagent or hepatotoxic drugs. Results: Neutropenic fever was occurred in 173 patients, and 43 patients were appropriate to acute hepatitis of above criteria. Male gender was 28 patients, mean age was 51 years. Causative pathogen was identifi ed in 22 patients. The pathogen was aspergillus 5, infl uenza 4, O.tsutsugamushi 2, varicella zoster virus 1, hepatitis E virus 1 pateint, and other 9 patients were bacterial infection. Among 43 patients, 13 patients occurred septic shock and 11 patients were died. Among survived 2 patients, 1 patient was diagnosed as pulmonary aspergillosis and recovered after therapy with voriconazole, other 1 patients was recovered after therapy with broad-spectrum antibiotics under diagnosis of unknown origin pathegen. Conclusions: Acute hepatitis occur in about 25% after recovering from neutropenic fever, and mortality rate was 25% in the patients with acute hepatitis. Early investigation is essential to such patients, and test for aspergillus and infl uenza would be essential.