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Invasive and non-invasive diagnosis of cirrhosis and portal hypertension

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World Journal of Gastroenterology 2014年第15期20卷 4300-4315页

作者： Moon Young Kim Woo Kyoung Jeong soon koo baik Department of Internal Medicine Yonsei University Wonju College of MedcineWonju Severance Christan HospitalWonju 220-701South Korea Department of Radiology and Center for Imaging Science Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 440-746South Korea

With advances in the management and treatment of advanced liver disease,including the use of antiviral therapy,a simple,one stage description for advanced fibrotic liver disease has become *** refining the diagnosis of cirrhosis to reflect disease heterogeneity is essential,current diagnostic tests have not kept pace with the progression of this new *** biopsy and hepatic venous pressure gradient measurement are the gold standards for the estimation of hepatic fibrosis and portal hypertension(PHT),respectively,and they have diagnostic and prognostic ***,they are invasive and,as such,cannot be used repeatedly in clinical *** ideal noninvasive test should be safe,easy to perform,inexpensive,reproducible as well as to give numerical and accurate results in real *** should be predictive of long term outcomes related with fibrosis and PHT to allow prognostic ***,many types of noninvasive alternative tests have been developed and are under *** particular,imaging and ultrasound based tests,such as transient elastography,have shown promising *** most of these noninvasive tests effectively identify severe fibrosis and PHT,the methods available for diagnosing moderate disease status are still insufficient,and further investigation is essential to predict outcomes and individualize therapy in this field.

关键词： Hepatic fibrosis Portal hypertension Liver biopsy Hepatic venous pressure gradient Non-invasive test Transient elastography

Alcoholic liver disease: Treatment

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World Journal of Gastroenterology 2014年第36期20卷 12934-12944页

作者： Ki Tae Suk Moon Young Kim soon koo baik Department of Internal Medicine Hallym University College of Medicine Chuncheon 200-704 South Korea Department of Internal Medicine Wonju College of Medicine Wonju Severance Christian Hospital Yonsei University Wonju 220-701 South Korea

The excess consumption of alcohol is associated with alcoholic liver diseases(ALD). ALD is a major healthcare problem, personal and social burden, and significant reason for economic loss worldwide. The ALD spectrum includes alcoholic fatty liver, alcoholic hepatitis, cirrhosis, and the development of hepatocellular carcinoma. The diagnosis of ALD is based on a combination of clinical features, including a history of significant alcohol intake, evidence of liver disease, and laboratory findings. Abstinence is the most important treatment for ALD and the treatment plan varies according to the stage of the disease. Various treatments including abstinence, nutritional therapy, pharmacological therapy, psychotherapy, and surgery are currently available. For severe alcoholic hepatitis, corticosteroid or pentoxifylline are recommended based on the guidelines. In addition, new therapeutic targets are being under investigation.

关键词： Liver disease Alcoholic Treatment

AKT regulates IL-1β-induced proliferation and activation of hepatic stellate cells

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BIOCELL 2023年第3期47卷 669-676页

作者： YONGDAE YOON soonJAE HWANG FATEMA TUJ SAIMA MOON YOUNG KIM soon koo baik YOUNG WOO EOM Regeneration Medicine Research Center Yonsei University Wonju College of MedicineWonju26426Korea Department of Biochemistry Lee Gil Ya Cancer and Diabetes InstituteGAISTGachon University College of MedicineIncheon21999Korea Cell Therapy and Tissue Engineering Center Yonsei University Wonju College of MedicineWonju26426Korea Department of Internal Medicine Yonsei University Wonju College of MedicineWonju26426Korea

Background:Activated hepatic stellate cells(HSCs)are closely involved in the initiation,perpetuation,and resolution of liver ***-inflammatory cytokine levels are positively correlated with the transition from liver injury to fibrogenesis and contribute to HSC pathophysiology in liver ***:In this study,we investigated the effect of the pro-inflammatory cytokine interleukin(IL)-1βon the proliferation and signaling pathways involved in fibrogenesis in LX-2 cells,an HSC cell line,using western blotting and cell proliferation ***:IL-1βincreased the proliferation rate andα-smooth muscle actin(SMA)expression of LX-2 cells in a dose-dependent *** 1 h after IL-1βtreatment,c-Jun N-terminal kinase(JNK),p38,and nuclear factor-κB(NF-κB)signaling was activated in LX-2 ***,protein kinase B(AKT)phosphorylation and an increase inα-SMA expression were observed in LX-2 *** inhibitor of JNK,p38,or NF-κB decreased cell proliferation,AKT phosphorylation,andα-SMA expression in IL-1β-treated LX-2 ***:These results indicate that JNK,p38,and NF-κB signals converge at AKT phosphorylation,leading to LX-2 activation by IL-1β.Therefore,the AKT signaling pathway can be used as a target for alleviating liver fibrosis by the inflammatory cytokine IL-1β.

关键词： Hepatic stellate cell Interleukin-1β AKT Cell proliferation Fibrosis

Switching-on of serotonergic calcium signaling in activated hepatic stellate cells

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World Journal of Gastroenterology 2011年第2期17卷 164-173页

作者： Kyu-Sang Park Pyo-Jin Sin Dong Hyeon Lee Seung-Kuy Cha Min-Jeong Kim Na-Hyun Kim soon-koo baik Seong-Woo Jeong In Deok Kong Department of Physiology and Institute of Lifelong Health Yonsei University Wonju College of Medicine Department of Physiology College of MedicinePochon CHA University Department of Basic Nursing Science Keimyung University College of Nursing Department of Internal Medicine Yonsei University Wonju College of Medicine

AIM:To investigate serotonergic Ca 2+ signaling and the expression of 5-hydroxytryptamine(5-HT) receptors,as well as Ca 2+ transporting proteins,in hepatic stellate cells(HSCs) . METHODS:The intracellular Ca 2+ concentration([Ca 2+ ]i) of isolated rat HSCs was measured with a fluorescence microscopic imaging *** PCR was per-formed to determine the transcriptional levels of 5-HT receptors and endoplasmic reticulum(ER) proteins involved in Ca 2+ storage and release in cultured rat HSCs. RESULTS:Distinct from quiescent cells,activated HSCs exhibited[Ca 2+ ]i transients following treatment with 5-HT,which was abolished by U-73122,a phospholipase C *** of 5-HT2A and 5-HT2B receptors,but not 5-HT3,was prominent during trans-differentiation of *** with ritanserin,a 5-HT2 antagonist,inhibited[Ca 2+ ]i changes upon application of *** of type 1 inositol-5'-triphosphate receptor and type 2 sarcoplasmic/endoplasmic reticulum Ca 2+ ATPase were also increased during activation of HSCs and serve as the major isotypes for ER Ca 2+ storage and release in activated *** 2+ binding chaperone proteins of the ER,including calreticulin,calnexin and calsequestrin,were up-regulated following activation of HSCs. CONCLUSION:The appearance of 5-HT-induced[Ca 2+ ]i response accompanied by upregulation of metabotropic 5-HT2 receptors and Ca 2+ transporting/chaperone ER proteins may participate in the activating process of HSCs.

关键词： Hepatic stellate cells 5-hydroxytryptamine Intracellular Ca 2+ transient Sarcoplasmic/endoplasmic reticulum Ca 2+ ATPase Inositol-5’-triphosphate receptor Endoplasmic reticulum chaperone

Predictive factors for interferon and ribavirin combination therapy in patients with chronic hepatitis C

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World Journal of Gastroenterology 2007年第46期13卷 6236-6242页

作者： Joonho Yoon Jong In Lee soon koo baik Kwang Ho Lee Joon Hyung Sohn Hyean-Woo Lee Jun Namkung Sei Jin Chang Jong-Whan Choi Hyun-Won Kim Byung-Il Yeh Department of Biochemistry and Institute of Basic Medical Sciences Wonju College of MedicineYonsei UniversityWonju 220-701Republic of Korea Department of Internal Medicine Wonju College of MedicineYonsei UniversityWonju 220-701Republic of Korea Department of Internal Medicine Wonju College of MedicineYonsei UniversityWonju 220-701Republic of Korea Institute of Lifelong HealthWonju College of MedicineYonsei UniversityWonju 220-701Republic of Korea Department of Anesthesiology Wonju College of MedicineYonsei UniversityWonju 220-701Republic of Korea Department of Biochemistry and Institute of Basic Medical Sciences Wonju College of MedicineYonsei UniversityWonju 220-701Republic of Korea Institute of Lifelong HealthWonju College of MedicineYonsei UniversityWonju 220-701Republic of Korea Department of Preventive Medicine and Institute of Occupational Medicine Wonju College of MedicineYonsei UniversityWonju 220-701Republic of Korea Institute of Lifelong HealthWonju College of MedicineYonsei UniversityWonju 220-701Republic of Korea

AIM： To confirm the predictive factors for interferon （IFN）-α and ribavirin combination therapy for chronic hepatitis patients with hepatitis C virus （HCV） genotype lb. METHODS： HCV RNA from 50 patients infected with HCV genotype lb was studied by cloning and sequencing of interferon sensitivity determining region （ISDR）, PKR- eIF2α phosphorylation homology domain （PePHD）. Patients were treated with IFN-α and ribavirin for 6 mo and grouped by effectiveness of the therapy. A variety of factors were analyzed. RESULTS： Our data showed that age, HCV RNA titer, and ISDR type could be used as the predictive factors for combined IFN-α and ribavirin efficacy. Characteristically, mutations in PePHD appeared only when the combination therapy was effective. Other factors, such as sex and alanine aminotransferase （ALT） level, were not related to its efficacy. Adjusting for age and HCV RNA titer indicated that the ISDR type was the most potent predictive factor. CONCLUSION： HCV RNA ISDR type is an important factor for predicting efficacy of IFN-α and ribavirin combination therapy in Korean patients.

关键词： Hepatitis C virus -lb Interferon-m Ribavirin Interferon sensitivity determining region PKR-eIF2α phosphorylation homology domain

Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis

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World Journal of Gastroenterology 2013年第16期19卷 2543-2549页

作者： Sang Jung Park Jin Dong Kim Yeon Seok Seo Beom Jin Park Min Ju Kim soon Ho Um Chang Ha Kim Hyung Joon Yim soon koo baik Jin Yong Jung Bora Keum Yoon Tae Jeen Hong Sik Lee Hoon Jai Chun Chang Duck Kim Ho Sang Ryu Department of Internal Medicine College of Medicine Korea University Department of Internal Medicine Cheju Halla General Hospital Department of Radiology College of Medicine Korea University Department of Internal Medicine Yonsei University Wonju College of Medicine Wonju Christian Hospital

AIM: To evaluate the significance of computed tomography (CT) findings in relation to liver chemistry and the clinical course of acute hepatitis. METHODS: Four hundred and twelve patients with acute hepatitis who underwent enhanced CT scanning were enrolled retrospectively. Imaging findings were analyzed for the following variables: gallbladder wall thickness (GWT), arterial heterogeneity, periportal tracking, number and maximum size of lymph nodes, presence of ascites, and size of spleen. The serum levels of alanine aminotransferase, alkaline phosphatase, bilirubin, albumin, and prothrombin time were measured on the day of admission and CT scan, and laboratory data were evaluated every 2-4 d for all subjects during hospitalization. RESULTS: The mean age of patients was 34.4 years, and the most common cause of hepatitis was hepatitis A virus (77.4%). The mean GWT was 5.2 mm. The number of patients who had findings of arterial heterogeneity, periportal tracking, lymph node enlargement > 7 mm, and ascites was 294 (80.1%), 348 (84.7%), 346 (84.5%), and 56 (13.6%), respectively. On multivariate logistic regression, male gender [odds ratio (OR) = 2.569, 95%CI: 1.477-4.469, P = 0.001], toxic hepatitis (OR = 3.531, 95%CI: 1.444-8.635, P = 0.006), level of albumin (OR = 2.154, 95%CI: 1.279-3.629, P = 0.004), and GWT (OR = 1.061, 95%CI: 1.015-1.110, P = 0.009) were independent predictive factors for severe hepatitis. The level of bilirubin (OR = 1.628, 95%CI: 1.331-1.991, P < 0.001) and GWT (OR = 1.172, 95%CI: 1.024-1.342,P = 0.021) were independent factors for prolonged cholestasis in multivariate analysis. CONCLUSION: In patients with acute hepatitis, GWT on CT scan was an independent predictor of severe hepatitis and prolonged cholestasis.

关键词： Acute hepatitis Cholestasis Computed tomography Prognosis Gallbladder

Assessment of scoring systems for acute-on-chronic liver failure at predicting short-term mortality in patients with alcoholic hepatitis

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World Journal of Gastroenterology 2016年第41期22卷 9205-9213页

作者： Hee Yeon Kim Chang Wook Kim Tae Yeob Kim Do Seon Song Dong Hyun Sinn Eileen L Yoon Young Kul Jung Ki Tae Suk Sang Soo Lee Chang Hyeong Lee Tae Hun Kim Jeong Han Kim Hyung Joon Yim Sung Eun Kim soon koo baik Byung Seok Lee Jae Young Jang Young Seok Kim Sang Gyune Kim Jin Mo Yang Joo Hyun Sohn Heon Ju Lee Seung Ha Park Eun Hee Choi Dong Joon Kim Korean Acute-on-Chronic Liver Failure Study Group Department of Internal Medicine College of MedicineThe Catholic University of KoreaSeoul 06591South Kerea Institute of Medical Science Hanyang UniversitySeoul 04763South Kerea Department of Internal Medicine Samsung Medical CenterSeoul 06351South Kerea Department of Internal Medicine Inje University Sanggye Paik HospitalSeoul 01757South Kerea Department of Internal Medicine Korea University Ansan HospitalAnsan 15355South Korea Department of Internal Medicine Hallym University Chuncheon Sacred Heart HospitalChuncheon 24253South Kerea Department of Internal Medicine Gyeongsang National University HospitalJinju 52727South Kerea Department of Internal Medicine Catholic University of Daegu School of MedicineDaegu 42472South Kerea Department of Internal Medicine Ewha Womans University School of MedicineSeoul 07985South Kerea Department of Internal Medicine Konkuk University School of MedicineSeoul 05030South Kerea Department of Internal Medicine Hallym University Sacred Heart HospitalAnyang 14068South Kerea Department of Internal Medicine Yonsei University Wonju College of MedicineWonju 26426South Kerea Department of Internal Medicine Chungnam National UniversitySchool of MedicineDaejeon 35015South Kerea Department of Internal Medicine Soonchunhyang University College of MedicineSeoul 04401South Kerea Department of Internal Medicine Soonchunhyang University Bucheon HospitalBucheon 14584South Kerea Department of Internal Medicine Hanyang University Guri HospitalGuri 11923South Kerea Department of Internal Medicine Yeungnam University College of MedicineDaegu 42415South Kerea Department of Internal Medicine Inje University Haeundae Paik-HospitalInje University College of MedicineBusan 48108South Kerea Institute of Lifestyle Medicine Yonsei University Wonju College of MedicineWonju 26426South Kerea 不详

AIM To assess the performance of proposed scores specific for acute-on-chronic liver failure in predicting shortterm mortality among patients with alcoholic *** We retrospectively collected data from 264 patients with clinically diagnosed alcoholic hepatitis from January to December 2013 at 21 academic hospitals in Korea. The performance for predicting short-term mortality was calculated for Chronic Liver FailureSequential Organ Failure Assessment(CLIF-SOFA), CLIF Consortium Organ Failure score(CLIF-C OFs), Maddrey'sdiscriminant function(DF), age, bilirubin, international normalized ratio and creatinine score(ABIC), Glasgow Alcoholic Hepatitis Score(GAHS), model for end-stage liver disease(MELD), and *** Of 264 patients, 32(12%) patients died within 28 d. The area under receiver operating characteristic curve of CLIF-SOFA, CLIF-C OFs, DF, ABIC, GAHS, MELD, and MELD-Na was 0.86(0.81-0.90), 0.89(0.84-0.92), 0.79(0.74-0.84), 0.78(0.72-0.83), 0.81(0.76-0.86), 0.83(0.78-0.88), and 0.83(0.78-0.88), respectively, for 28-d mortality. The performance of CLIF-SOFA had no statistically significant differences for 28-d mortality. The performance of CLIF-C OFs was superior to that of DF, ABIC, and GAHS, while comparable to that of MELD and MELD-Na in predicting 28-d mortality. A CLIF-SOFA score of 8 had 78.1% sensitivity and 79.7% specificity, and CLIF-C OFs of 10 had 68.8% sensitivity and 91.4% specificity for predicting 28-d *** CLIF-SOFA and CLIF-C OF scores performed well, with comparable predictive ability for short-term mortality compared to the commonly used scoring systems in patients with alcoholic hepatitis.

关键词： Acute-on-chronic liver failure Alcoholic hepatitis Mortality Prognosis Scoring system

Efficacy of Pegylated Interferon Monotherapy versus Sequential Therapy of Entecavir and Pegylated Interferon in Hepatitis B e Antigen-Positive Hepatitis B Patients： A Randomized, Multicenter, Phase IIIb Open-Label Study （POTENT Study）

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Chinese Medical Journal 2018年第14期131卷 1645-1651页

作者： Dae Won Jun Sang Bong Ahn Tae Yeob Kim Joo Hyun Sohn Sang Gyune Kim Se Whan Lee Byung Ho Kim Dong Joon Kim Ja Kyung Kim Hyoung Su Kim Seong Gyu Hwang Won Choong Choi Won Young Tak Heon Ju Lee Ki Tae Yoon Byung Cheol Yun Sung Wook Lee soon koo baik Seung Ha Park Ji Won Park Sol Ji Park Ji Sung Lee Department of Internal Medicine Hanyang University Seoul Hospital Hanyang University Seou104763 Korea Department of Internal Medicine Nowon Eulji Hospital Eulji University Seou101830 Korea Department of Internal Medicine Hanyang University Guri Hospital Hanyang University Guri 11923 Korea Department of Internal Medicine SoonChunHyang University Bucheon Hospital SoonChunHyang University Bucheon 14584 Korea Department of Internal Medicine SoonChunHyang University Cheonan Hospital SoonChunHyang University Cheonan 31151 Korea Department of Internal Medicine Kyung Hee University Hospital Kyung Hee University Seoul 02453 Korea Department of Internal Medicine Chuncheon Sacred Heart Hospital Hallym University Chuncheon 24252 Korea Department of Internal Medicine Kangdong Sacred Heart Hospital Hallym University Seou105355 Korea Department of Internal Medicine Gangnam Severance Hospital Yonsei University Seou106273 Korea Department of Internal Medicine CHA Bundang Medical Center CHA University Seongnam 13496 Korea Department of Internal Medicine Sanggye Paik Hospital Inje University Seoul 01757 Korea Department of Internal Medicine Kyungpook National University Hospital Kyungpook National University Daegu 41944 Korea Department of Internal Medicine Yeungnam University Medical Center Yeungnam University Daegu 42415 Korea Department of Internal Medicine Pusan National University Yangsan Hospital Pusan National University Yangsan 50612 Korea Department of Internal Medicine Kosin University Gospel Hospital Kosin University Pusan 49267 Korea Department of Internal Medicine Dong A University Medical Center Dong A University Pusan 49201 Korea Department of Internal Medicine Wonju Severance Christian Hospital Yonsei University Wonju 26426 Korea Department of Internal Medicine Haeundae Paik Hospital Inje University Pusan 48108 Korea Department of Internal Medicine Hallym University Sacred Heart Hospital Hallym University Anyang 14068 Korea Department of Cli

Background： Until now, various types of combined therapy with nucleotide analogs and pegylated interferon （Peg-INF） in patients with hepatitis B patients have been tried. Howe6ver, studies regarding the benefits of de novo combination, late-add on, and sequential treatmentare very limited. The objective of the current study was to identify the efficacy of sequential treatment of Peg-INF after short-term antiviral treatment. Methods： Between June 2010 and June 2015, hepatitis 13 e antigen （HBeAg）-positive patients （n = 162） received Peg-IFN for 48 weeks （mono-treatment group, n = 81） and entecavir （ETV） for 12 weeks with a 48-week course of Peg-IFN starting at week 5 of ETV therapy （sequential treatment group, n = 81）. The primary endpoint was HBeAg seroconversion at the end of follow-up period after the 24-week treatment. The primary endpoint was analyzed using Chi-square test, Fisher＇s exact test, and regression ***： HBeAg seroconversion rate （18.2% vs. 18.2%, t = 0.03, P = 1.000） and seroclearance rate （19.7% vs. 19.7%, t = 0.03, P = 1.000） were same in both mono-treatment and sequential treatment groups. The rate of alanine aminotransferase （ALT） normalization （45.5% vs. 54.5%, t = 1.12, P = 0.296） and serum hepatitis B virus （HBV）-DNA 〈2000 U/L （28.8% vs. 28.8%, t = 0.10, P = 1.000） was not different in sequential and mono-treatment groups at 24 weeks of Peg-INF. Viral response rate （HBeAg seroconversion and serum HBV-DNA 〈2000 U/L） was not different in the two groups （12.1% vs. 16.7%, t = 1.83, P = 0.457）. Baseline HBV-DNA level （7 log10 U/ml vs. 7.5 log10 U/ml, t = 1.70, P = 0.019） and hepatitis B surface antigen titer （3.6 log10 U/ml vs. 4.0 log10 U/ml, t = 2.19, P = 0.020） were lower and predictors of responder in mono-treatment and sequential treatment groups, respectively. Conclusions： The current study shows no differences in HBeAg seroconversion rate, ALT normalization, and HBV-DNA levels between mono-therapy and sequential therapy regimens.

关键词： Entecavir Hepatitis B Peginterferon Alfa-2a

Probabilistic seismic performance assessment of lap-spliced RC columns retrofitted by steel wrapping jackets

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Earthquake Engineering and Engineering Vibration 2016年第2期15卷 223-238页

作者： Eunsoo Choi Heejung Youn baik-soon Cho Department of Civil Engineering Hongik University Department of Civil Engineering CTRCInje University

In this study, the seismic fragility curves of two reinforced concrete（RC） columns that were lap-spliced at the bottom and retrofitted with steel wrapping jackets were generated. Their seismic performance was probabilistically assessed in comparison to that of lap-spliced or continuous reinforcement RC columns. This study used two types of steel wrapping jackets, a full jacket and a split jacket. Analytical models of the four types of columns were developed based on the experimental results of the columns using Open SEES, which is effective in conducting nonlinear time history analyses. A suite of ten artificial ground motions, modified from recorded ground motions, was used to perform nonlinear time history analyses of the analytical models with scaling of the peak ground acceleration from 0.1 g to 1.0 g in increments of 0.1 g. The steel wrapping jackets did not increase the medians for yield（slight damage state） of the lap-spiced column and did not exceed the corresponding median of the continuous reinforcement column. However, the two steel jackets increased the medians for failure by 1.872 and 2.017 times, respectively, and exceeded the corresponding median of the continuous reinforcement column by 11.8% and 20.5%, respectively.

关键词： columns reinforcement reinforced exceed acceleration scaling median assessed split probabilistic