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한호균,고은정,최현호,김병철,양승엽,조근태 대한신경손상학회 2016 Korean Journal of Neurotrauma Vol.12 No.2
Objective: Traditionally, it is generally recommended that antiplatelet agent should be discontinued before surgery. However, decompressive craniectomy (DC) in patients with traumatic brain injury (TBI) is performed emergently in most cases. Therefore, DC cannot be delayed to the time when the effect of antiplatelet agent on bleeding tendency dissipates. In this study, we evaluated the effect of preinjury antiplatelet therapy on hemorrhagic complications after emergent DC in patients with TBI. Methods: We retrospectively investigated patients with TBI who underwent emergent DC between 2006 and 2015. The patients were separated into two groups according to the use of preinjury antiplatelet agent: group 1 (patients taking antiplatelet agent) and group 2 (patients not taking antiplatelet agent). The rate of hemorrhagic complications (postoperative epidural or subdural hemorrhage, newly developed, or progression of preexisting contusion or intracerebral hemorrhage within the field of DC) and the rate of reoperation within 7 days after DC were compared between two groups. Results: During the study period, DC was performed in 90 patients. Of them, 19 patients were taking antiplatelet agent before TBI. The rate of hemorrhagic complications was 52.6% (10/19) in group 1 and 46.5% (33/71) in group 2 (p=0.633). The rate of reoperation was 36.8% (7/19) in group 1 and 36.6% (26/71) in group 2 (p=0.986). No statistical difference was found between two groups. Conclusion: Preinjury antiplatelet therapy did not influence the rate of hemorrhagic complications and reoperation after DC. Emergent DC in patients with TBI should not be delayed because of preinjury antiplatelet therapy.
한국 밀식사과원의 정지전정에 따른 수체생장과 생산성 및 경영효율 비교
정혜웅,김경훈,송태영,홍성일,한호균,김귀권,신종협,여덕환,김병철,박준권,Jung, H.W.,Kim, K.H.,Song, T.Y.,Hong, S.I.,Han, H.K.,Kim, K.K.,Shin, J.H.,Yeo, D.H.,Kim, B.C.,Park, J.K. 국립한국농수산대학교 교육개발센터 2017 현장농업연구지 = Journal of practical agricultural resear Vol.19 No.1
The present study conducted a comparison on tree growth and productivity of high-density apple orchards by several orchard management systems: making scaffolds by heading-back and thinning out pruning (T-1), maintaining scaffolds upward and bearing shoots downward (T-2), managing branches slightly upward without heading-back (T-3), keeping leaders downward and shoots pending (T-4), maintaining leaders high and branches horizontal with severe pinching (T-5), making leaders with lower branches vigorous and upper shoots pending (T-6), and controlling very high planting density with bending branches (T-7). In conclusion, the orchards of (T-5) and (T-6) management systems showed a superior performance in controlling tree growth, productivity, and quality of fruits. Also, superior management efficiency was obtained in the orchards of (T-5) and (T-6).
성낙균,김혜민,Yukihiro Asami,김동현,조양래,Ravi Naik,장예린,장구식,한호진,Srinivas Rao Ganipisetti,차현주,황준성,이경호,고성균,장재혁,류인자,권용태,이경상,Hiroyuki Osada,이경,김보연,안종석 생화학분자생물학회 2019 Experimental and molecular medicine Vol.51 No.-
Hypoxia-inducible factor-1α (HIF-1α) mediates tumor cell adaptation to hypoxic conditions and is a potentially important anticancer therapeutic target. We previously developed a method for synthesizing a benzofuran-based natural product, (R)-(-)-moracin-O, and obtained a novel potent analog, MO-460 that suppresses the accumulation of HIF-1α in Hep3B cells. However, the molecular target and underlying mechanism of action of MO-460 remained unclear. In the current study, we identified heterogeneous nuclear ribonucleoprotein A2B1 (hnRNPA2B1) as a molecular target of MO-460. MO-460 inhibits the initiation of HIF-1α translation by binding to the C-terminal glycinerich domain of hnRNPA2B1 and inhibiting its subsequent binding to the 3’-untranslated region of HIF-1α mRNA. Moreover, MO-460 suppresses HIF-1α protein synthesis under hypoxic conditions and induces the accumulation of stress granules. The data provided here suggest that hnRNPA2B1 serves as a crucial molecular target in hypoxiainduced tumor survival and thus offer an avenue for the development of novel anticancer therapies.
김동현,이천균,최종원,서정훈,조용석,원선영,박병규,전한호,신상윤 연세대학교의과대학 2017 Yonsei medical journal Vol.58 No.3
Purpose: This study examined 2-year outcome of consecutive therapy using entecavir (ETV) followed by telbivudine (LdT) in subjects with undetectable hepatitis B virus (HBV) DNA level and normal alanine aminotransferase level after the initial 6 months of ETV treatment. Materials and Methods: Sixty subjects were randomized to continue with ETV or switch to LdT. Significant difference in baseline characteristics was not found between the two groups. Persistent HBV DNA level of 20–60 IU/mL in three consecutive samples collected three months apart or singly measured HBV DNA level of >60 IU/mL was defined as virological rebound. Results: During 96 weeks of follow-up, all subjects of the ETV-only group (n=30) resulted in undetectable HBV DNA level. On the other hand, 83.3% (n=25) of the LdT-switched group showed treatment success. Virological rebound time varied from week 24 to 84 after switching to LdT. HBV DNA level was 180 to 2940 IU/mL at rebound time. All subjects with virological rebound (n=5) showed drug-resistant mutation: three had mutation rtM204I, and two had mutation rtM204V. Consecutive treatment using ETV followed by LdT showed virological rebound in 16.7% of subjects during 96 weeks of follow-up. HBV DNA negativity during initial ETV therapy could not be achieved in patients who switched to LdT. Conclusion: Consecutive treatment using ETV followed by lamivudine was ineffective for treating chronic hepatitis B. LdT was found as a more potent antiviral agent than lamivudine. However, this conclusion requires larger-scale, long-term prospective reviewsof the treatment effects of ETV-LdT switch therapy.
S-120 : 코일 색전술로 치료된 선천성 간문맥전신단락증 1예
이현숙,전한호,최종원,박병규,원선영,서정훈,이천균,김태환,조용석 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
서론: 간문맥전신단락(Intrahepatic portosystemic venous shunt, IPSVS)은 매우 드문 질환으로 고암모니아혈증과 간성혼수를 동반한 경우는 치료가 필요하다. 내과적 치료로 경구 락툴로즈 등을 사용하거나 외과적 수술을 고려할 수 있으며, 중재적 치료로 경도관색전술을 이용해 단락을 차단할 수도 있다. 증례: 77세 여자 환자가 3시간 전부터 발생한 행동장애와 의식변화를 주소로 내원하였다. 환자는 7년 전 같은 증상으로 입원하여 선천성 간문맥전신단락증에 의한 간성혼수로 진단받고 경구 락툴로즈 투약치료 중이었다. 내원시 의식은 기면상태였으며 활력징후는 혈압 134/83 mmHg, 맥박 93회/분, 호흡 16회/분, 체온 36.7℃이었다. 말초혈액검사상 암모니아가 179 umol/L로 증가되었고 이학적 검사상날개치기 진전(flapping tremor)을 보였다. 심전도와 흉부 및 복부단순촬영은 정상이었고 뇌 전산화단층촬영에서도 특이 소견 없었다. 복부전산화단층촬영상 간의 전체적인 모양은 정상 범주이나 좌 내측 간문맥지와 중간 간정맥이 확장되어 있고 그 사이에 굵고 구불구불한 간문맥전신단락이 있었다. 환자는 락툴로즈 관장 후 의식은 호전되었지만 선천성 간문맥전신단락에 의한 고암모니아혈증에 대해 내과적 치료중 재발한 간성혼수로 판단하여 입원 4일째 중재적 코일 색전술을 시행하였다. 우측 총대퇴정맥을 천자한 후 주간문맥으로 접근하여 총 19개의 detachable microcoil (Interlock, Boston scientific, Natick, MA)을 사용하여 shunt embolization을 하였으며, 시술 후 shunt를 통한 혈류가 차단됨을 확인할 수 있었다. 치료 후 지속적으로 암모니아 수치가 감소하여 시술 4일 후 34 umol/L로 회복되고 퇴원하였다. 2주 후 외래 경과관찰에서 암모니아를 비롯한 간기능 수치는 모두 정상이었고 1개월 후 시행한 복부 전산화단층촬영에서 효과적으로 단락이 차단되고 양측 간문맥 분지들이 시술 전에 비해 굵어진 모습이 확인되었다. 고찰: 간문맥전신단락은 간 조직검사나 외상 또는 문맥고혈압에 의해 이차적으로 발생할 수 있으며 발생학적 변이로 인한 선천적 원인으로 발생하는 경우는 매우 드물다. 본 증례는 선천적 원인으로 인한 간문맥전신단락증으로 본 증례와 같이 고암모니아혈증과 간성혼수를 동반하는 경우 치료가 필요하며 비수술적인 치료로 경도관색전술을 이용해 단락을 차단할 수 있었다. 우리나라에서는 2010년과 2012년 단 두 차례 색전술을 통해 치료한 선천성 간문맥전신단락증 증례가 보고된 바 있다. 저자들은 코일을 이용한 색전술을 통해 비수술적인 방법으로 치료된 선천성 간문맥전신단락증 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다.
최종원,김세현,서정훈,조용석,원선영,박병규,전한호,이용강,이천균 연세대학교의과대학 2018 Yonsei medical journal Vol.59 No.3
Purpose: To estimate long-term outcomes after treatment modification in patients with chronic hepatitis B (CHB) treated withentecavir (ETV) and telbivudine (LdT). Materials and Methods: The study enrolled 131 nucleos(t)ide analogue (NA)-naïve CHB patients treated with ETV or LdT. Duringthe 3-year study, NA treatment history including the incidence, the type of treatment modification, reasons for the modification,and overall complete virologic response (CVR) rate were retrospectively evaluated using the patients’ medical records. Results: Among the 131 patients, 84 and 47 were initially treated with ETV and LdT, respectively. During the course of 3-yearstudy, 82 patients in the ETV group (97.6%) maintained initial treatment whereas only 19 in the LdT group (40.4%). In the LdTgroup, 26 patients (92.9%) switched to another NA and another NA was added in 2 (7.1%) patients. An assessment of the CVR rateat 3 years, including treatment modification, showed that 89.3% and 95.7% of patients in the ETV and LdT groups, respectively,had undetectable serum hepatitis B virus DNA levels (p=0.329). Among LdT patients with treatment modification, the cumulativeincidence rate of a CVR for rescue therapy was significantly higher in the tenofovir than in the ETV group (p=0.009). Conclusion: During the 3-year study, there were no significant differences in the CVR between the ETV and LdT groups if appropriaterescue therapy was considered.
신상윤 ( Sang Yun Shin ),김범경 ( Beom Kyung Kim ),박병훈 ( Byung Hoon Park ),박선철 ( Seon Cheol Park ),박준철 ( Jun Chul Park ),손명균 ( Myoung Kyun Soon ),이승률 ( Seung Yul Lee ),임의 ( Eui Im ),전한호 ( Han Ho Jeon ),정경수 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.4
Fibrosing mediastinitis is a rare disease that is characterized by the proliferation of dense fibrous tissue of the mediastinum. The pathogenesis of fibrosing mediastinitis is unknown in most cases. However, histoplasmosis, tuberculosis, autoimmune disease, radiation therapy, and other idiopathic fibroinflammatory diseases have been implicated in some cases. Most clinical features are related to an obstruction or compression of the mediastinal structure. Fibrosing mediastinitis is often progressive and occurs diffusely throughout the mediastinum. We encountered a case of fibrosing mediastinitis of a very focal lesion without evidence of mediastinal involvement. The condition was confirmed by biopsy and graft bypass surgery was performed because of SVC syndrome. (Tuberc Respir Dis 2007; 63: 387-391)