http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
( Jung Min Ha ),( Won Sohn ),( Ju Yeon Cho ),( Jeung Hui Pyo ),( Kyu Choi ),( Dong Hyun Sinn ),( Geum-youn Gwak ),( Moon Seok Choi ),( Joon Hyeok Lee ),( Kwang Chul Koh ),( Seung Woon Paik ),( Byung C 대한간학회 2015 Clinical and Molecular Hepatology(대한간학회지) Vol.21 No.3
Background/Aims: Hepatitis-B-related acute-on-chronic liver failure has a poor prognosis. However, the advent of potent oral antiviral agents means that some patients can now recover with medical treatment. We aimed to identify the prognostic factors for hepatitis-B-related acute-on-chronic liver failure including the initial as well as the dynamically changing clinical parameters during admission. Methods: Sixty-seven patients were retrospectively enrolled from 2003 to 2012 at Samsung Medical Center. The patients were classified into three categories: Recovery group (n=23), Liver transplantation group (n=28), and Death group (n=16). The Liver transplantation and Death groups were combined into an Unfavorable prognosis group. We analyzed the prognostic factors including the Model for End-Stage Liver Disease (MELD) scores determined at 3-day intervals. Results: A multivariable analysis showed that the unfavorable prognostic factors were a high initial MELD score (≥28) (odds ratio [OR] =6.64, p=0.015), moderate-to-severe ascites at admission (OR=6.71, P=0.012), and the aggravation of hepatic encephalopathy during hospitalization (≥grade III) (OR=15.41, P=0.013). Compared with the baseline level, significant reductions in the MELD scores were observed on the 7th day after admission in the Recovery group ( P=0.016). Conclusions: Dynamic changes in clinical parameters during admission are useful prognostic factors for hepatitis-Brelated acute-on-chronic liver failure. (Clin Mol Hepatol 2015;21:232-241)
( Jung Hee Kim ),( Dong Hyun Sinn ),( Sung Wook Shin ),( Sung Ki Cho ),( Wonseok Kang ),( Geum-youn Gwak ),( Yong-han Paik ),( Joon Hyeok Lee ),( Kwang Cheol Koh ),( Seung Woon Paik ),( Moon Seok Choi 대한간학회 2017 Clinical and Molecular Hepatology(대한간학회지) Vol.23 No.1
Background/Aims: We investigated the outcomes of early-stage hepatocellular carcinoma (HCC) patients who showed a complete response (CR) to initial transarterial chemoembolization (TACE), with a focus on the role of scheduled TACE repetition. Methods: A total of 178 patients with early-stage HCC who were initially treated with TACE and showed a CR based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria on one month follow-up computed tomography (CT) were analyzed. Among them, 90 patients underwent scheduled repetition of TACE in the absence of viable tumor on CT. Results: During a median follow-up period of 4.6 years (range: 0.4-8.8 years), mortality was observed in 71 patients (39.9%). The overall recurrence-free and local recurrence-free survival rates at 1 year were 44.4% and 56.2%. In the multivariable model, scheduled repetition of TACE was an independent factor associated with survival (hazard ratio [95% confidence interval]: 0.56 [0.34-0.93], P=0.025). When stratified using Barcelona clinic liver cancer (BCLC) stage, scheduled repetition of TACE was associated with a favorable survival rate in BCLC stage A patients, but not in BCLC 0 patients. Conclusions: Scheduled repetition of TACE was associated with better survival for early-stage HCC patients showing a CR after initial TACE, especially in BCLC stage A patients. (Clin Mol Hepatol 2017;23:42-50)
Gwak, Joo-Han,Kim, So-Jeong,Jung, Man-Young,Kim, Jong-Geol,Roh, Seong Woon,Yim, Kyung June,Lee, Yong-Jae,Kim, Song-Gun,Park, Soo-Je,Rhee, Sung-Keun N.V. Swets en Zeitlinger 2015 Antonie van Leeuwenhoek Vol.107 No.4
<P>A Gram-stain negative, long rod shaped, facultatively anaerobic bacterium, designated strain F2(T), was isolated from coastal sediment of the Korean Peninsula. Strain F2(T) was found to grow at 10-40 A degrees C (optimum 30 A degrees C), at pH 6.0-8.5 (optimum pH 7.5) and at 0.0-8.0 % (w/v) NaCl (optimum 3.0 %). Phylogenetic analysis of the 16S rRNA gene sequence showed that strain F2(T) is closely related to Draconibacterium orientale FH5(T) (with 97.9 % 16S rRNA gene similarity) of the family Prolixibacteraceae of the phylum Bacteroidetes. The major isoprenoid quinone was identified as MK-7 and the main fatty acids as iso-C-15:0 (24.1 %), anteiso-C-15:0 (15.4 %), C-16:0 (10.7 %), iso-C-17:0 3-OH (7.6 %) and iso-C-16:0 3-OH (5.9 %). The major polar lipids were identified as phosphatidylethanolamine, phosphatidylinositol and four unidentified polar lipids. The genomic DNA G+C content of strain F2(T) was determined to be 44.7 mol% and the DNA-DNA relatedness of strain F2(T) with D. orientale DSM 25947(T) was 34.6 +/- A 4.3 %. Nitrate reduction capability and cell morphology of strain F2(T) are distinct from those of the closest relative, D. orientale DSM 25947(T). Based on these properties, we propose strain F2(T) represents a novel species within the genus Draconibacterium, with the name Draconibacterium filum sp. nov. The type strain of D. filum is F2(T) (=KCTC 32486(T) = JCM 19986(T)).</P>
( Jung Hee Kim ),( Kyunga Kim ),( Ki Yeon Kim ),( Wonseok Kang ),( Geum-youn Gwak ),( Yong-han Paik ),( Moon Seok Choi ),( Joon Hyeok Lee ),( Kwang Cheol Koh ),( Seung Woon Paik ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: We evaluated the impact of primary variceal bleeding prophylaxis on long-term outcomes of patients newly-diagnosed with hepatocellular carcinoma (HCC). Methods: A retrospective cohort of 898 patients newly-diagnosed with HCC without a history of variceal bleeding [age: 57.4 ± 10.4, males = 718 (80.0%)] were analyzed for new onset variceal bleeding during follow-up. The effect of primary prophylaxis for variceal bleeding on overall survival was assessed. Results: Variceal bleeding occurred in 72 patients (8.0%) during follow- up. The presence of portal vein thrombosis [hazard ratio (HR), 3.90; 95% confidence interval (CI), 2.09-7.30; p <0.001] and presence of the red color sign or ≥ grade 2 varices at index endoscopy (HR, 7.64; 95% CI, 4.56-12.8; p <0.001) were independent risk factors for variceal bleeding. The occurrence of variceal bleeding was an independent risk factor for mortality (HR, 1.39; 95% CI, 1.06-1.82; p =0.015). At baseline, 138 patients were indicated for primary prophylaxis and 71% received primary prophylaxis, whereas 29% did not. Primary prophylaxis for variceal bleeding for indicated patients was marginally associated with a reduced risk for variceal bleeding (HR, 0.49; 95% CI, 0.21-1.13; p =0.096) and was associated with reduced risk for overall mortality (HR, 0.54; 95% CI, 0.33-0.88; p =0.014). Conclusions: Variceal bleeding increased the risk of overall mortality and primary prophylaxis of variceal bleeding reduced the risk for mortality for indicated patients. These findings suggest that screening and providing primary prophylaxis for indicated patients should be done for patients newly-diagnosed with HCC.
Obesity and the Risk of Mortality in Newly-diagnosed Hepatocellular Carcinoma
( Jung Hee Kim ),( Dong Hyun Sinn ),( Geum-youn Gwak ),( Wonseok Kang ),( Yong-han Paik ),( Moon Seok Choi ),( Joon Hyeok Lee ),( Kwang Cheol Koh ),( Seung Woon Paik ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: The influence of body mass index (BMI) on the outcome of patients with hepatocellular carcinoma (HCC) is unclear, particularly in a hepatitis B virus endemic area. We investigated whether the influence of BMI on survival of newly-diagnosed HCC patients. Methods: A total of 3,104 patients with HCC were analyzed. Patients were stratified into four groups: underweight (<18.5 kg/m2), normal weight (18.5-22.9 kg/m2), overweight (23.0-24.9 kg/m2), and obesity (≥ 25.0 kg/m2). Results: The median survival was significantly different according to the BMI: 2.3, 3.8, 4.2 and 5.2 years for underweight, normal weight, overweight and obesity, respectively (p < 0.001). Compared to normal weight, underweight showed higher risk for mortality [Hazard ratio (HR), 95% confidence interval (CI): 1.37, 1.04-1.82, p = 0.025], overweight showed marginal association with mortality (HR, 95% CI: 0.90, 0.80-1.01, p = 0.097), and obesity showed lower risk for mortality (HR, 95% CI: 0.82, 0.73-0.91, p < 0.001). However, tumor stage and liver function were favorable in overweight/obese patients than normal weight patients, while it was worse in underweight patients. In multiple-regression model, there was no independent association between BMI and patient survival. Conclusions: The survival of obese patients was longer than normal weight patients while it was shorter in underweight patients. However, the observed survival difference was mediated by different clinical characteristics at presentation, and BMI did not independently influenced overall survival of HCC patients.
Lamivudine versus Entecavir for Newly Diagnosed Hepatitis B Virus-Related Hepatocellular Carcinoma
( Jung Hee Kim ),( Dong Hyun Sinn ),( Kyunga Kim ),( Hyeseung Kim ),( Geum-youn Gwak ),( Yong-han Paik ),( Moon Seok Choi ),( Joon Hyeok Lee ),( Kwang Cheol Koh ),( Seung Woon Paik ) 대한소화기학회 2016 Gut and Liver Vol.10 No.6
Background/Aims: Antiviral therapy is a key component in the management of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients. However, whether the potent drug entecavir is more effective than a less potent drug, such as lamivudine, in HBV-related HCC is not clear. Methods: A retrospective cohort of 451 newly diagnosed, HBV-related HCC patients without antiviral therapy at diagnosis, who started antiviral therapy with either entecavir (n=249) or lamivudine (n=202), were enrolled. Results: The median survival was longer for the entecavir group than for the lamivudine group, and lamivudine use (vs entecavir) was an independent factor for mortality (hazard ratio [HR], 1.49; p=0.002). Lamivudine use (vs entecavir) was an independent risk factor for new-onset hepatic decompensation (HR, 1.67; p=0.010) in 318 patients without previous hepatic decompensation, and it was also an independent risk factor for recurrence after curative therapy (HR, 1.84; p=0.002) in 117 patients who received curative therapy. The findings were similar in a propensity score-matched cohort. Conclusions: Overall survival, decompensation-free survival, and recurrence-free survival were better in the entecavir-treated patients than in the lamivudine treated-patients, indicating that the potent antiviral drug should be the preferred choice in HBV-related HCC patients. (Gut Liver 2016;10:939-947)
Insulin Resistance Increases Risk of Hepatocellular Carcinoma in Chronic Hepatitis B Patients
( Jung Hee Kim ),( Dong Hyun Sinn ),( Geum-youn Gwak ),( Wonseok Kang ),( Yong-han Paik ),( Moon Seok Choi ),( Joon Hyeok Lee ),( Kwang Cheol Koh ),( Seung Woon Paik ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: To date, few data is available whether insulin resistance (IR) increases hepatocellular carcinoma (HCC) risk in patients with chronic hepatitis B virus (HBV) infection. Methods: This retrospective cohort included 2,119 chronic HBV infected individuals [age: 50.2 ± 7.7, male = 1,266 (59.7%), diabetes = 149 (7.0%), obesity ≥ 25 kg/m2 = 722 (34.0%)] who participated in a regular health screening exam that included fasting blood glucose and C-peptide levels between 2004 and 2013. IR was estimated with homeostasis model assessment index (HOMA2-IR) using C-peptide and fasting blood glucose levels. Association between IR and development of HCC were assessed. Results: During a median of 5.1 years of follow-up (min-max: 1.0 - 10.5 years), 57 patients (2.7%) developed HCC. The 5-year cumulative incidence rate of HCC gradually increased with the increase of HOMA2-IR [0.6%, 1.4%, 3.7% and 4.0% for 1st (<0.93), 2nd (0.93-1.25), 3rd (1.25-1.68) and 4th (≥1.68) quartile of HOMA2-IR, p = 0.009]. HCC risk was higher when HOMA-IR was ≥ 1.2 [hazard ratio (95% CI): 2.02 (1.07-3.79), p = 0.029, adjusted for age, sex, aspartate aminotransferase to platelet ration index, HBV DNA levels and antiviral therapy]. The HCC incidence rate was constantly higher when HOMA-IR was ≥ 1.2 compared to patients with HOMA-IR < 1.2 for all-clinically relevant subgroups analyzed. Conclusions: The IR was associated with the development of HCC, indicating that IR may contribute to the hepatocarcinogenesis in chronic HBV infected patients. Assessing IR can be helpful for stratifying individual risk for HCC.
( Jung Hee Kim ),( Dong Hyun Sinn ),( Sung Wook Shin ),( Sung Ki Cho ),( Wonseok Kang ),( Geum-youn Gwak ),( Joon Hyeok Lee ),( Kwang Cheol Koh ),( Seung Woon Paik ),( Moon Seok Choi ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Transarterial chemoembolization (TACE) is performed with curative intent in some patients with early stage hepatocellular carcinoma (HCC) in real clinical practice. As radiological complete response (CR) after TACE does not always match histological total necrosis, scheduled second TACE has been tried for early stage tumor with complete response after first TACE, which lacks sufficient supporting data. Methods: A total of 178 patients with early stage HCC, defined by Barcelona Clinic Liver Cancer stage (BCLC) 0 or A, who were initially treated with TACE and showed CR by mRECIST criteria at one month follow-up computed tomography (CT) were analyzed. Among them, 90 patients received scheduled second TACE in absence of viable tumor at one month follow-up CT, while 88 patients were monitored without TACE until viable lesions are detected (on-demand approach). Results: During a median 4.6 years of follow-up (range: 0.4 - 8.8 years), mortality was observed in 71 patients (39.9%), with a 5-year survival rate of 60.4%. Overall and local tumor recurrence was observed in 135 (75.8%) and 103 (57.9%) patients. The overall and local recurrence-free survival rate at 1 year was 44.4% and 56.2%. In multivariable model, treatment strategy (scheduled second TACE vs. on-demand) was independent factor associated with survival [hazard ratio (HR) (95% confidence interval (CI)): 0.56 (0.34-0.93), p = 0.025], along with underlying liver disease, Child-Pugh class, and BCLC stage. BCLC stage was more advanced for those who received scheduled second TACE. When stratified according to the BCLC stage, scheduled second TACE was associated with favorable overall survival rate (62.1% vs .39.1% at 5-years) and lower local recurrence rate (68.1% vs. 89.5% at 2-years) in BCLC stage A patients, but not in BCLC 0 patients. Conclusions: Scheduled second TACE was associated with better survival and lower local recurrence rate for BCLC A stage tumor showing CR after initial TACE . Scheduled second TACE strategy may play a significant role for this subset of early-stage HCC patients, which warrants further validations.