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High-risk esophageal varices in patients treated with locoregional therapy for hepatocellular carcinoma:Assessment with liver computed tomography

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World Journal of Gastroenterology 2012年第35期18卷 4905-4911页

作者： Hyojin Kim Dongil choi Joon Hyeok Lee Soon Jin Lee Hangi Jo Geum-Youn Gwak Kwang Cheol Koh moon seok choi Seonwoo Kim Department of Radiology and Center for Imaging Science Samsung Medical CenterSungkyunkwan University School of Medicine Department of Medicine Samsung Medical CenterSungkyunkwan University School of Medicine Biostatistics Unit Samsung Biomedical Research InstituteSamsung Medical CenterSungkyunkwan University School of Medicine

AIM： To assess the diagnostic performance of follow- up liver computed tomography （CT） for the detection of high-risk esophageal varices in patients treated with Io- coregional therapy for hepatocellular carcinoma （HCC）. METHODS： We prospectively enrolled 100 patients with cirrhosis who underwent transcatheter arterial chemoembolization, radiofrequency ablation or both procedures for HCCs. All patients underwent upper endoscopy and subsequently liver CT. Three radiolo- gists independently evaluated the presence of high-riskesophageal varices with transverse images alone and with three orthogonal multiplanar reformation （MPR） images, respectively. With endoscopic grading as the reference standard, diagnostic performance was as- sessed by using receiver operating characteristic （ROC） curve analysis. RESULTS： The diagnostic performances （areas under the ROC curve） of three observers with transverse im- ages alone were 0.947 ± 0.031, 0.969 ± 0.024, and 0.916 ＋ 0.038, respectively. The mean sensitivity, spec- ificity, positive predicative value （PPV）, and negative predicative value （NPV） with transverse images alone were 90.1%, 86.39%, 70.9%, and 95.9%, respectively. The diagnostic performances, mean sensitivity, specific- ity, PPV, and NPV with three orthogonal MPR images （0.965 ± 0.025, 0.959 ± 0.027, 0.938 ± 0.033, 91.4%, 89.5%, 76.3%, and 96.6%, respectively） were not su- perior to corresponding values with transverse images alone （P 〉 0.05）, except for the mean specificity （P = 0.039）. CONCLUSION： Our results showed excellent diagnos- tic performance, sensitivity and NPV to detect high-risk esophageal varices on follow-up liver CT after Iocore- gional therapy for HCC,

关键词： Liver computed tomography High-riskesophageal varices Locoregional therapy Hepatocel-lular carcinoma Multiplanar reformation images

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Formation of unidirectional nanoporous structures in thickly anodized aluminum oxide layer

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中国有色金属学会会刊：英文版 2009年第4期19卷 1013-1017页

作者： Hyun-Chae NA Taek-Jin SUNG seok-Heon YOON Seung-Kyoun HYUN Mok-Soon KIM Young-Gi LEE Sang-Hyun SHIN seok-moon choi Sung YI Division of Materials Science and Engineering Inha University Samsung Electro-Mechanics Co. Ltd.

A series of anodic aluminum oxide(AAO) was grown on the commercially pure 1050 aluminum sheet by controlling electrolyte temperature(2-15 ℃) and anodizing time(0.5-6 h),using a fixed applied current density of 3 A/dm2 in diluted sulfuric acid electrolyte.A crack-free thick AAO with the thickness of 105-120 μm and containing unidirectional nano sized pores(average pore diameter of 5-7 nm) is successfully achieved in the specimens anodized for 2 h,irrespective of electrolyte *** anodizing time reaches 6 h,very thick AAO with the thickness of 230-284 μm is grown,and average diameter of unidirectional pores is in the range of 6-24 *** higher values in both the AAO thickness and pore diameter are attained for the specimens anodized at higher temperatures of 10-15 ℃.A crack is observed to exist in the AAO after anodizing up to 4 h and more.A higher fraction(more than 9%) of the crack is shown in the specimens anodized at higher temperatures of 10-15 ℃ for 6 h and a considerable amount of giant cracks are contained.

关键词：阳极氧化铝纳米孔单向结构层电解液温度平均直径氧化时间硫酸电解液

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Tenofovir rescue therapy for chronic hepatitis B patients after multiple treatment failures

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World Journal of Gastroenterology 2012年第47期18卷 6996-7002页

作者： Yu Jin Kim Dong Hyun Sinn Geum-Youn Gwak moon seok choi Kwang Cheol Koh Seung Woon Paik Byung Chul Yoo Joon Hyeok Lee Department of Medicine Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 135-710South Korea

AIM:To evaluate the efficacy and safety of tenofovir disoproxil fumarate(TDF) for chronic hepatitis B(CHB) patients after multiple ***:A total of 29 CHB patients who had a suboptimal response or developed resistance to two or more previous nucleoside/nucleotide analogue(NA) treatments were *** subjects were treated with TDF alone(n = 13) or in combination with lamivudine(LAM,n = 12) or entecavir(ETV,n = 4) for ≥ 6 *** virologic response(CVR) was defined as an achievement of serum hepatitis B virus(HBV) DNA level ≤ 60 IU/mL by real-time polymerase chain reaction method during *** assessment was based on serum creatinine and phosphorus *** patients had histories of LAM and adefovir dipivoxil(ADV) treatment and 18 patients were exposed to LAM,ADV,and ***-seven patients(93.1%) were hepatitis B e antigen(HBeAg) positive and the mean value of the baseline serum HBV DNA level was 5.5 log IU/mL ± 1.7 log IU/*** median treatment duration was 16 mo(range 7 to 29 mo).RESULTS:All the patients had been treated with LAM and developed genotypic and phenotypic resistance to *** to ADV was present in 7 patients and 10 subjects had a resistance to *** patient had a resistance to both ADV and *** cumulative probabilities of CVR at 12 and 24 mo of TDF containing treatment regimen calculated by the Kaplan Meier method were 86.2% and 96.6%,*** one patient failed to achieve CVR,serum HBV DNA level decreased by 3.9 log IU/mL from the baseline and the last serum HBV DNA level during treatment was 85 IU/mL,achieving near *** patients in this study showed viral breakthrough or primary non-response during the follow-up *** cumulative probability of HBeAg clearance in the 27 HBeAg positive patients was 7.4%,12%,and 27% at 6,12,and 18 mo of treatment,*** efficacy of TDF containing regimen was not statistically different according to the presence of specific HBV mutatio

关键词： Tenofovir Chronic hepatitis B Treatment failure

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Clinical course of sub-centimeter-sized nodules detected during surveillance for hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第21期18卷 2654-2660页

作者： Yang Won Min Geum-Youn Gwak Min Woo Lee moon seok choi Joon Hyoek Lee Kwang Cheol Koh Seung Woon Paik Byung Chul Yoo Department of Medicine Samsung Medical Center Sungkyunkwan University School of MedicineSeoul 135-710 South Korea Department of Radiology Samsung Medical Center Sungkyunkwan University School of MedicineSeoul 135-710 South Korea

AIM: To evaluate the outcome of sub-centimeter-sized nodules (SCSNs) detected during surveillance for hepatocellular carcinoma (HCC) in patients at risk. METHODS: We retrospectively analyzed a total of 142 patients with liver cirrhosis or chronic hepatitis B or C without a prior history of HCC in whom a SCSN was detected during HCC surveillance. We calculated the rate of HCC development from SCSNs in the study population and analyzed the differences in the baseline clinical characteristics and imaging features between the patients with SCSNs that eventually developed into HCC and patients with SCSNs that did not develop into ***: During 667 person-years of follow-up, HCC developed in 33 patients. The calculated HCC development rate was 4.9% per year. The cumulative one-, two-, three- and five-year HCC development rates were 5.6%, 10.6%, 14.1% and 20.4%, respectively. Upon baseline comparison, the HCC group was older (54.4 ± 8.3 years vs 48.9 ± 9.4 years; P = 0.003) and had lower albumin levels (3.56 ± 0.58 g/dL vs 3.84 ± 0.55 g/dL; P = 0.012) and higher baseline alpha-fetoprotein (AFP) levels (8.5 ng/mL vs 5.4 ng/mL; P = 0.035) compared to the non-HCC group. Nodule pattern and initial radiologic diagnosis also differed between the two groups. Multivariate analysis revealed that age [P = 0.012, odds ratio (OR) =1.075, 95% confidence interval (CI) =1.016-1.137], sex (P = 0.009, OR = 3.969, 95% CI: 1.403-11.226), and baseline AFP level (P = 0.024, OR = 1.039, 95% CI: 1.005-1.073) were independent risk factors for developing HCC. CONCLUSION: The overall risk of HCC development in patients with SCSNs is similar to that in liver cirrhosis patients. Patients with these risk factors need to be closely monitored during follow-up.

关键词： Chronic liver disease Hepatocellular carcinoma Risk factor Sub-centimeter-sized nodule

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Virological response to adefovir monotherapy and the risk of adefovir resistance

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World Journal of Gastroenterology 2011年第30期17卷 3526-3530页

作者： Dong Hyun Sinn Geum-Youn Gwak moon seok choi Kwang Cheol Koh Seung Woon Paik Byung Chul Yoo Joon Hyeok Lee Hyang Ie Lee Department of Medicine Samsung Medical CenterSungkyunkwan University School of Medicine135-710 SeoulSouth Korea Department of Internal Medicine Eulji University Hospital302-799 DaejeonSouth Korea

AIM:To evaluate virological response to adefovir(ADV) monotherapy and emergence of ADV-resistant mutations in lamivudine(LAM)-resistant chronic hepatitis B ***:Seventy-seven patients with documented LAM resistance who were treated with 10 mg/d ADV for>96 wk were analyzed for ADV ***:At week 48 and 96,eight(10%)and 14(18%)of 77 LAM-resistant patients developed the ADV-resistant strain(rtA181V/T and/or rtN236T mutations),*** B virus(HBV)DNA levels during therapy were significantly higher in patients who developed ADV resistance than in those who did *** of ADV resistance at week 96 was 11%,8%and 6%among patients with complete virological response(HBV DNA level2000 IU/mL)at week 12,week 24 and week 48,*** DNA levels >2000 IU/mL at week 24 showed best performance characteristics in predicting ADV ***:Development of ADV resistance mutations was associated with HBV DNA levels,which could identify patients with LAM resistance who are likely to respond to ADV monotherapy.

关键词： Hepatitis B virus Viral DNA Adefovir Lamivudine Drug resistance

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Seroprevalence of anti-HAV among patients with chronic viral liver disease

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World Journal of Gastroenterology 2011年第2期17卷 236-241页

作者： Hyun Chin Cho Seung Woon Paik Yu Jin Kim moon seok choi Joon Hyeok Lee Kwang Cheol Koh Byung Chul Yoo Hee Jung Son Seon Woo Kim Division of Gastroenterology Samsung Medical CenterSungkyunkwan University School of Medicine Division of Gastroenterology Center for Health PromotionSamsung Medical CenterSungkyunkwan University School of Medicine Biostatics Team Samsung Medical CenterSungkyunkwan University School of Medicine

AIM:To investigate the current seroprevalence of hepatitis A virus(HAV) antibodies in patients with chronic viral liver disease in *** also tried to identify the factors affecting the prevalence of HAV antibodies. METHODS:We performed an analysis of the clinical records of 986 patients(mean age:49±9 years,714 males/272 females) with chronic hepatitis B virus(HBV) or hepatitis C virus(HCV) infection who had undergone HAV antibody testing between January 2008 and December ***:The overall prevalence of IgG anti-HAV was 86.61%(854/986) in patients with chronic liver disease and was 88.13%(869/986) in age-and gendermatched patients from the Center for Health *** anti-HAV prevalence was 80.04%(405/506) in patients with chronic hepatitis B,86.96%(20/23) in patients with chronic hepatitis C,93.78%(422/450) in patients with HBV related liver cirrhosis,and 100%(7/7) in patients with HCV related liver *** anti-HAV prevalence according to the decade of age was as follows:20s(6.67%) ,30s(50.86%) ,40s(92.29%) ,50s(97.77%) ,and 60s(100%) .The antiHAV prevalence was significantly higher in patients older than 40 years compared with that in patients younger than 40 years of *** analysis showed that age≥40 years,female gender and metropolitan cities as the place of residence were independent risk factors for IgG anti-HAV seropositivity. CONCLUSION:Most Korean patients with chronic liver disease and who are above 40 years of age have already been exposed to hepatitis A virus.

关键词： Chronic hepatitis B Chronic hepatitis C Hepatitis A virus Korea Seroprevalence

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Disease progression in chronic hepatitis C patients with normal alanine aminotransferase levels

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World Journal of Gastroenterology 2013年第14期19卷 2256-2261页

作者： Dong Hyun Sinn Geum-Youn Gwak Jae-uk Shin moon seok choi Joon Hyeok Lee Kwang Cheol Koh Seung Woon Paik Byung Chul Yoo Department of Internal Medicine Sanggye Paik HospitalInje University School of Medicine Department of Medicine Samsung Medical CenterSungkyunkwan University School of Medicine

AIM:To investigate whether the disease progression of chronic hepatitis C patients with normal alanine aminotransferase(ALT) levels differs by ALT ***:A total of 232 chronic hepatitis C patients with normal ALT( 26 IU/L(highnormal),respectively(P = 0.043),and it was 1.4% and 4.8% for female patients with baseline ALT levels ≤ 22 IU/L(low-normal) and > 23 IU/L(high-normal),respectively(P = 0.023).ALT levels fluctuated during the follow-up *** the follow-up,more patients with "high-normal" ALT levels at baseline experienced ALT elevation(> 41 IU/L) than did patients with "lownormal" ALT levels at baseline(47.7% vs 27.9%,P = 0.002).The 5 year cumulative incidence of disease progression was significantly lower in patients with persistently "low-normal" ALT levels than "high-normal" ALT levels or those who exhibited an ALT elevation > 41 U/L during the follow-up period(0%,8.3% and 34.3%,P < 0.001).CONCLUSION:A "high normal" ALT level in chronic hepatitis C patients was associated with disease progression,suggesting that the currently accepted normal threshold of serum ALT should be lowered.

关键词： Alanine aminotransferase Upper limits of normal Disease progression Hepatitis C virus Hepatocellular carcinoma

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Milan criteria are useful predictors for favorable outcomes in hepatocellular carcinoma patients undergoing liver transplantation after transarterial chemoembolization

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World Journal of Gastroenterology 2006年第43期12卷 6992-6997页

作者： Do Young Kim moon seok choi Joon Hyoek Lee Kwang Cheol Koh Seung Woon Paik Byung Chul Yoo Sung Wook Shin Sung Wook Choo Young Soo Do Jong Chul Rhee Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea Depart- ment of Radiology Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea

AIM: To evaluate whether the Milan criteria are useful in patients with hepatocellular carcinoma (HCC) who received transarterial chemoembolization (TACE) before liver transplantation (LT). METHODS: Thirty-six HCC patients who fulfilled the Milan criteria after having received TACE and subsequently underwent LT were included (TACE + LT group) in the study. As controls, 21 patients who also met the Milan criteria and underwent LT without prior treatment were selected (LT group). Post-LT clinical outcomes, such as HCC recurrence, survival rate, and histologic features of explanted livers, were compared between the two groups. RESULTS: Baseline characteristics were not different between the two groups. Pre-LT maximal tumor diameter in TACE + LT group was similar to that of LT group (2.0 ± 0.6 cm vs 2.3 ± 0.9 cm; P = 0.10). Post-LT histologic findings also revealed similar maximal tumor diameter in the two groups (2.4 ± 1.4 cm vs 2.3 ± 0.9 cm; P = 0.70). Explanted livers showed similar incidence of unfavorable pathologic features. The morality within 60 d after transplantation was not different between the two groups (8.3% vs 9.5%; P = 0.99). Post-LT 5-year survival rate (57% vs 74%; P = 0.70) and cumulative recurrence rate (8.3% vs 4.8%; P = 0.90) were not significantly different between the two groups. CONCLUSION: The Milan criteria are still a useful selec- tion criteria showing favorable outcomes in HCC patientsreceiving TACE before LT.

关键词： Milan criteria Hepatocellular carcinoma Transarterial chemoembolization Liver transplantation

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Characteristics and outcomes of chronic liver disease patients with acute deteriorated liver function by severity of underlying liver disease

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World Journal of Gastroenterology 2016年第14期22卷 3785-3792页

作者： Yun Soo Hong Dong Hyun Sinn Geum-Youn Gwak Juhee Cho Danbee Kang Yong-Han Paik moon seok choi Joon Hyeok Lee Kwang Cheol Koh Seung Woon Paik Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Department of Health Sciences and Technology SAIHST Sungkyunkwan University Deaprtment of Health Behavior and Society and Epidemiology Johns Hopkins Bloomberg School of Public Health

AIM: To analyze characteristics and outcome of patients with acute-on-chronic liver failure(ACLF) according to the severity of underlying liver disease. METHODS: One hundred and sixty-seven adult patients with chronic liver disease and acute deteriorated liver function, defined by jaundice and coagulopathy, were analyzed. Predisposition, type of injury, response, organ failure, and survival were analyzed and compared between patients with non-cirrhosis(type A), cirrhosis(type B) and cirrhosis with previous decompensation(type C).RESULTS: The predisposition was mostly hepatitis B in type A, while it was alcoholic liver disease in typesB and C. Injury was mostly hepatic in type A, but was non-hepatic in type C. Liver failure, defined by CLIF-SOFA, was more frequent in types A and B, and circulatory failure was more frequent in type C. The 30-d overall survival rate(85.3%, 81.1% and 83.7% for types A, B and C, respectively, P = 0.31) and the 30-d transplant-free survival rate(55.9%, 65.5% and 62.5% for types A, B and C, respectively P = 0.33) were not different by ACLF subtype, but 1-year overall survival rate were different(85.3%, 71.7% and 58.7% for types A, B and C, respectively, P = 0.02).CONCLUSION: There were clear differences in predisposition, type of injury, accompanying organ failure and long-term mortality according to spectrum of chronic liver disease, implying classifying subtype according to the severity of underlying liver disease is useful for defining, clarifying and comparing ACLF.

关键词： Acute-on chronic liver failure Classification Injury Organ failure Survival

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Laser-assisted deposition of Cu bumps for microelectronic packaging

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中国有色金属学会会刊：英文版 2012年第S3期22卷 683-687页

作者： Won-seok choi Joohan KIM Department of Nano IT Fusion Program Seoul National University of Science and Technology Department of Mechanical and Automotive Engineering Seoul National University of Science and Technology

Cu bump was transferred using a focused laser pulse for microelectronic *** Nd:YAG laser pulse (maximum energy of 500 mJ;wavelength of 1064 nm;fluences of 0.4-2.1 kJ/cm2) was irradiated on a sacrificial absorption layer with copper *** focused laser beam induced plasma between the semi-transparent donor slide and the sacrificial layer,causing a shock *** shock wave pressure pushed the Cu layer and transferred material to deposit a bump on substrate.A beam-shaper was used to produce uniform pressure at the interface to reduce fragmentation of the transferred material on the *** calculated shock wave pressure with respect to laser fluence was 1-3 GPa.A Cu bump of diameter of 200 μm was successfully deposited at laser fluence of 0.6 kJ/cm *** pressure control at the sacrificial layer using a laser pulse was critical to produce a bump with less *** technique can be applied to forming Cu bump for an interconnecting process in electronics.

关键词： laser induced forward transfer bump deposition Nd:YAG pulsed laser micro system packaging beam shaping

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