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Safety of Anti TNF Therapy in Patients Receiving Anti Hepatitis B Drug
( Chan Uk Lee ),( Ji Hoon Kim ),( Young-sun Lee ),( Jong Eun Yeon ),( Kwan Soo Byun ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: There were insufficient previous studies on the use of anti TNF therapy during anti Hepatitis B drug treatment. This medical record review assessed the safety of anti TNF therapy in 4 patients with inflammatory bowel disease, ankylosing spondylitis and during nucleos(t)ide analogues(NA) treatment. Methods: A retrospective analysis of patients treated with anti TNF during NA treatment was conducted. The primary outcome was markers of hepatitis B reactivation, including aspartate aminotransferase, alanine aminotransferase, and hepatitis B viral load at each follow up visit. Results: In total, 7 patients with surface antigen positive were included in the study: 3 inactive carrier and 4 were being treated by NA. At baseline, 6 patients had normal liver function tests and low or undetectable HBV DNA levels, except for 1 patient with short NA administration period. Three patients received with tenofovir, and 1 received treatment with entecavir. In 4 patients with NA treatment, the HBV DNA titer was not checked or decrease and AST, ALT value remained within the normal limits throughout follwup. Conclusions: Our study provides reassuring data about the safety profile of anti TNF therapy in patients with NA treatment previously. These data are encouraging and should lead to initiation of controlled trials of anti TNF therapy in hepatitis B.
( Chan Uk Lee ),( Ji Hoon Kim ),( Young-sun Lee ),( Jong Eun Yeon ),( Kwan Soo Byun ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Pyogenic liver abscesses (PLA) is known to be caused by disruption of the colon mucosa with secondary bacteremia via the portal route, as occurs for example in tubular adenoma or colorectal cancer. This large scale population based study aim to investigate clinical characteristics of patients with both colorectal neoplasm and PLA. Methods: We reviewed medical records of 256 patients with PLA who underwent screening colonoscopy but was not diagnosed cancer excluding colorectal cancer by imaging study, from January 2004 to January 2018. Differences between patients with and without colorectal cancer or high grade dysplasia were evaluated in baseline demographics, imaging, pathogens and mortality. Results: Of the total patients, 7.8% (n=20) were diagnosed with adenocarcinoma, 2.3% (n=6) had adenomatous polyp with high grade dysplasia and 16% (n=41) had adenomatous polyp with low grade dysplasia only. More frequent diabetes mellitus was observed in group with colorectal cancer or high grade dysplasia (14/26 vs. 70/230 patients, P=0.026). There were significant differences in serum glucose, HbA1C, hemoglobin, carcinoembryonic antigen and age, hospitalization period, mortality, compared two groups. But no significant differences were found in abscess size, abscess location, liver biochemical test excluding serum albumin. 66.8% of the patients presented growth in culture The most common isolated pathogen were Klebsiella pneumonia but was not differ between groups(15/26 vs. 118/230 patients, P=0.342). Conclusions: We found that the prevalence of colorectal neoplasm among the patients with PLA was similar or higher than other studies. Screening colonoscopy should be considered for colorectal neoplasm in patients with PLA, especially for patients with diabetes mellitus.
김종렬(Jong-Ryoul Kim),박봉욱(Bong-Wook Park),변준호(June-Ho Byun),김용덕(Yong-Deok Kim),신상훈(Sang-Hoon Shin),김욱규(Uk-Kyu Kim),정인교(In-Kyo Chung) 대한구강악안면외과학회 2005 대한구강악안면외과학회지 Vol.31 No.2
The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients’age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one’s clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey’s syndrome after parotidectomy. We examined Frey’s syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.
골막기원세포의 조골세포 분화과정에서 나타나는 혈관내피전구세포의 증식
김종렬(Jong-Ryoul Kim),송정호(Jung-Ho Song),김욱규(Uk-Kyu Kim),박봉욱(Bong-Wook Park),하영술(Young-Sool Hah),김진현(Jin-Hyun Kim),김덕룡(Deok Ryong Kim),조영철(Yeong-Cheol Cho),성일용(Iel-Yong Sung),변준호(June-Ho Byun) 대한구강악안면외과학회 2009 대한구강악안면외과학회지 Vol.35 No.4
Purpose : The purpose of this study was to examine the expression of various angiogenic factors during osteoblastic differentiation of periostealderived cells and the effects of osteogenic inductive medium of periosteal-derived cells on the proliferation of endothelial progenitor cells. Materials and methods : Periosteal-derived cells were obtained from mandibular periosteums and introduced into the cell culture. After passage 3, the cells were divided into two groups and cultured for 21 days. In one group, the cells were cultured in the DMEM supplemented with osteogenic inductive agent, including 50g/ml L-ascorbic acid 2-phosphate, 10 nM dexamethasone and 10 mM -glycerophosphate. In the other group, they were cultured in DMEM supplemented without osteogenic inductive agent. VEGF isoforms, VEGFR-1, VEGFR-2, and neuropilin-1 mRNA expression was observed. Human umbilical cord blood-derived endothelial progenitor cell proliferation was also observed. Results : The expression of VEGF isoforms was higher in osteogenic inductive medium than in non-osteogenic inductive medium. The expression of VEGFR-2 was also higher in osteogenic inductive medium than in non-osteogenic inductive medium. However, the expression of VEGFR-1 and neuropilin-1 was similar in both osteogenic inductive medium and non-osteogenic inductive medium. In addition, conditioned medium from differentiated periosteal-derived cells stimulated human umbilical cord blood-derived endothelial progenitor cell numbers compared to conditioned medium from non-differentiated periosteal-derived cells. Conclusion : These results suggest that in vitro osteoblastic differentiation of periosteal-derived cells has angiogenic capacity to support endothelial progenitor cell numbers.
Chan Uk Lee,Young-Sun Lee,Ji Hoon Kim,Minjin Lee,Sehwa Kim,Young Kul Jung,Yeon Seok Seo,Hyung Joon Yim,Jong Eun Yeon,Kwan Soo Byun 대한간암학회 2019 대한간암학회지 Vol.19 No.2
Background/Aims: Sorafenib is the standard treatment for patients with advanced hepatocellular carcinoma (HCC). We aimed to investigate the prognosis predictors and the role of second-line cytotoxic systemic chemotherapy (CSC) in patients with advanced HCC after sorafenib discontinuation in the pre-regorafenib era. Methods: From 2007 to 2015 in the pre-regorafenib era, the medical records of 166 HCC patients, who had permanently discontinued sorafenib, were retrospectively reviewed. For further analysis of survival factors after sorafenib treatment failure, we compared the survival of patients who had maintained liver function after second-line treatment with the best supportive care (BSC) group and selective BSC (SBSC) group. Results: After discontinuation of sorafenib, median overall survival (OS) was 2.8 (1.9-3.7) months. The OS in patients who discontinued sorafenib due to adverse effect, progression, and poor clinical condition were 5.5 (2.4-8.6), 5.5 (2.2-8.9), and 0.9 (0.5-1.3) months, respectively (P<0.001). The independent predictive factors of survival after sorafenib failure were serum level of bilirubin and albumin, α-fetoprotein, discontinuation cause, and second-line CSC. In comparison with survival between second-line CSC and BSC group, the CSC group showed better survival outcome compared to the BSC group (10.6 vs. 1.6 months, P<0.001) and SBSC group (10.6 vs. 4.2 months, P=0.023). Conclusions: The survival after sorafenib failure in patients who discontinued sorafenib due to progression and adverse effects was significantly better than in those who discontinued treatment due to clinical deterioration. In the pre-regorafenib era, patients who received second-line CSC showed better survival than those who received only supportive care after sorafenib failure.
변재욱 ( Jae-uk Byun ),이종민 ( Jong-min Lee ),김회율 ( Whoi-yul Kim ) 한국정보처리학회 2006 한국정보처리학회 학술대회논문집 Vol.13 No.2
뼈 나이 평가는 소아 뼈의 골화정도, 내분비선 장애 등을 쉽게 알아 볼 수 있어 소아 방사선 의학에서 자주 사용되는 방법이다. 뼈 나이 평가를 위해서는 골단판과 손마디 뼈의 길이 넓이 등뼈 정보가 필요하기 때문에 골단판 영역의 추출이 선행되어야 한다. 하지만 골단판의 성장이 많이 진행되어 손마디 뼈 부분과 붙어 있는 경우 골단판 추출이 어려운 점이 있다. 본 논문에서는 골단판 성장 여부와 상관없이 다양한 나이의 디지털 X-ray 영상에서 손가락의 골단판을 추출하는 알고리즘을 제안한다. 손가락 경계선의 레이블링 처리를 이용하여 정확한 손가락 영역을 추출하고 골단판 위치의 통계적 특성을 사용하여 골단판의 후보 지역을 생성한다. 그리고 골단판 영역에서는 손가락 영상의 수직 투영 미분값이 크기 때문에 후보 지역 내에서 수직 투영 미분값의 변화량으로 골단판의 위치를 정확하게 추출한다. 다양한 나이에 대해 실험해 본 결과 제안한 방법은 골단판의 성장 여부와 상관없이 골단판과 손가락 뼈가 붙은 곳에서도 골단판의 통계적 특성을 사용해 정확한 골단판 영역을 추출할 수 있었다.