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Simultaneous intrahepatic and subgaleal hemorrhage in antiphospholipid syndrome following anticoagulation therapy

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World Journal of Gastroenterology 2013年第38期19卷 6494-6499页

作者： In-Chul Park Yang-Hyun Baek Sang-Young Han sung-wook lee Won-Tae Chung sung-Won lee Sang-Hyeon Kang Duk-Song Cho Division of Gastroenterology and Hepatology Department of Internal MedicineCollege of MedicineDong-A University

Warfarin is a widely used *** differences in drug response,a narrow therapeutic range and the risk of bleeding render warfarin difficult to use *** 18-year-old woman with antiphospholipid syndrome received long-term warfarin therapy for a recurrent deep vein *** years later,she developed right flank *** diagnosed intrahepatic and subgaleal hemorrhages secondary to anticoagulation *** stopping oral anticoagulation,a follow-up computed tomography showed improvement in the *** restarting warfarin because of a recurrent thrombosis,the intrahepatic hemorrhage *** decided to start clopidogrel and hydroxychloroquine instead of *** patient has not developed further recurrent thrombotic or bleeding *** hemorrhage is a very rare complication of warfarin,and our patient experienced intrahepatic and subgaleal hemorrhage although she did not have any risk factors for bleeding or instability of the international normalized ratio control.

关键词： Warfarin Liver Subgaleal Hemorrhage Antiphospholipid syndrome

Retreatment with peginterferon and ribavirin in chronic hepatitis C

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World Journal of Gastroenterology 2015年第6期21卷 1994-1999页

作者： Yong Min Jo sung wook lee Sang Young Han Yang Hyun Baek Soo Young Kim Woo Jae Kim Ji Hye Ahn Ji Young lee Department of Internal Medicine Dong-A University School of Medicine

The development of boceprevir and telaprevir was a major step forward in the treatment of chronic hepatitis *** addition,the treatment of these infections has been recently revolutionized by the approval of sofosbuvir and ***,there are several challenges associated with the application of noveldrugs,such as new and more frequent adverse events,new drug interactions,and excessively high treatment *** additional concern is viral *** considerations highlight the fact that direct-acting antiviral agents are not a panacea and may not be the best option for all patients who are in need of *** retrospective study revealed that the sustained virologic response was not significantly reduced following peginterferon and ribavirin retreatment compared with the new *** suggest that patients who experience relapse shortly after completing treatment with peginterferon and ribavirin have a reasonable chance of achieving a sustained virologic response when retreated with these drugs alone.

关键词： Chronic hepatitis C Direct-acting antiviral agents

Gastric ischemia after epinephrine injection in a patient with liver cirrhosis

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World Journal of Gastroenterology 2013年第3期19卷 411-414页

作者： Su Young Kim Seung-Hee Han Kyung Han Kim Sang Ock Kim Sang-Young Han sung-wook lee Yang Hyun Baek Department of Internal Medicine Dong-A University College of MedicineBusan 602-715South Korea

Endoscopic epinephrine injection is relatively easy,quick and ***,it has a low rate of com-plications,and it is widely used for the management of nonvariceal upper gastrointestinal *** have been several case reports of gastric ischemia after en-doscopic injection *** intra-arterial in-jection may result in either spasm or thrombosis,leading to subsequent tissue ischemia or necrosis,although the stomach has a rich vascular supply and the vascular reserve of the intramural *** addition to endoscopic injection therapy,smoking,hypertension and atherosclerosis are risk factors of gastric ischemia. We report a case of gastric ischemia after submucosal epinephrine injection in a 51-year-old woman with hy-pertension and liver cirrhosis.

关键词： Hematemesis Epinephrine Gastric ischemia Liver cirrhosis Hypertension

Acoustic radiation force impulse elastography for hepatocellular carcinoma-associated radiofrequency ablation

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World Journal of Gastroenterology 2011年第14期17卷 1874-1878页

作者： Hee-Jin Kwon Myong-Jin Kang Jin-Han Cho Jong-Young Oh Kyung-Jin Nam Sang-Yeong Han sung wook lee Department of Radiology Dong-A University HospitalDongdaesindong 3gaSeo-guPusan 602-715South Korea Department of Internal Medicine Dong-A University HospitalDongdaesindong 3gaSeo-guPusan 602-715South Korea

AIM:To evaluate the potential usefulness of acoustic radiation force impulse (ARFI) images for evaluation of hepatocellular carcinomas (HCC)-associated radiofrequency ablation. METHODS:From January 2010 to June 2010,a total of 38 patients with HCC including recurred HCCs after RFA underwent ARFI elastography. The brightness of tumor was checked and the shear wave velocity was measure-d for the-quantification of stiffne-ss. According to theb-rightne-ss,the-tumors we-re-classifie-d as b-righte-r,samecolor and darker compared with adjacent parenchyma. Using the same methods,8 patients with recurred HCCs after RFA state were evaluated about the brightness compared with adjacent RFA ablation area. RESULTS:In the 38 patients with HCCs,20 (52.6%)were brighter than surrounding cirrhotic parenchyma. Another 13 (34.2%) were darker. The others (5 cases,13.2%) were seen as the same color as the adjacent liver parenchyma. Post-RFA lesions were darker than previous tumor and surrounding parenchyma in all 38 cases. However,recurred HCCs were brighter than the treated site in all 8 cases. CONCLUSION:Using ARFI technique is helpful for differential diagnosis in order to detect recurred HCCs more easily in patients with confusing status.

关键词： Hepatocellular carcinoma Elastography Radiofrequency ablation

Splenic infarction associated with sorafenib use in a hepatocellular carcinoma patient

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World Journal of Gastroenterology 2011年第2期17卷 267-270页

作者： Sang Ock Kim Sang Young Han Yang Hyun Baek sung wook lee Ji Sun Han Byung Geun Kim Jin Han Cho Kyung Jin Nam Department of Gastroenterology and Hepatology Dong-A University HospitalDongdaesin-dong Seo-gu Busan 602-103 South Korea Dong-A University Collegeof Medicine 3-ga Dongdaesing-dong Seo-gu Busan 602-103South Korea Department of Radiology Dong-AUniversity Hospital Dongdaesin-dong Seo-gu Busan 602-103South Korea

Sorafenib,a multitargeted tyrosine kinase inhibitor,has been shown to improve survival in patients with advanced hepatocellular carcinoma(HCC).As the clinical use of sorafenib increases,many adverse effects have been reported,such as hand-foot skin reaction,diarrhea,anorexia,asthenia,alopecia,weight loss,hypertension and arterial ***,there are no prior reports of splenic infarction as an adverse effect of ***,a case of splenic infarction in a patient with HCC who was treated with sorafenib is reported. The patient had no other predisposing factors to explain the splenic infarction except for the administration of *** splenic infarction improved after sorafenib was discontinued;however,the HCC progressed.

关键词： Hepatocellular carcinoma Sorafenib Tyrosine kinase inhibitor Adverse effects Splenic infarction

Nonconvulsive status epilepticus disguising as hepatic encephalopathy

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World Journal of Gastroenterology 2015年第16期21卷 5105-5109页

作者： Yong Min Jo sung wook lee Sang Young Han Yang Hyun Baek Ji Hye Ahn Won Jong Choi Ji Young lee Sang Ho Kim Byeol A Yoon Department of Internal Medicine Dong-A University School of Medicine Department of Neurology Dong-A University School of Medicine

Nonconvulsive status epilepticus has become an important issue in modern neurology and *** is based on difficulty in definitively elucidating thecondition and its various clinical phenomena and on our inadequate insight into the intrinsic pathophysiological *** nonconvulsive status epilepticus being a situation that requires immediate treatment,this disorder may not be appreciated as the cause of mental status *** the pathophysiology of nonconvulsive status epilepticus remains unknown,this disorder is thought to lead to neuronal damage,so its identification and treatment are *** status epilepticus should be considered in the differential diagnosis of patients with liver cirrhosis presenting an altered mental *** report a case of a 52-year-old male with liver cirrhosis presenting an altered mental *** was initially diagnosed with hepatic encephalopathy but ultimately diagnosed with nonconvulsive status epilepticus by electroencephalogram.

关键词： Liver cirrhosis Hepatic encephalopathy Nonconvulsive status epilepticus Electroencephalogram

Efficacy of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第26期18卷 3426-3434页

作者： Yang Hyun Baek Kyoung Tae Kim sung wook lee Jin Sook Jeong Byeong Ho Park Kyung Jin Nam Jin Han Cho Young Hoon Kim Young Hoon Roh Hyung Sik lee Young Min Choi Sang Young Han Department of Internal Medicine Dong-A University College of MedicineBusan 602-103South Korea Department of Pathology Dong-A University College of MedicineBusan 602-103South Korea Department of Radiology Dong-A University College of MedicineBusan 602-103South Korea Department of Surgery Dong-A University College of MedicineBusan 602-103South Korea Department of Radiation Oncology Dong-A University College of MedicineBusan 602-103South Korea

AIM:To investigate the efficacy of hepatic arterial infusion chemotherapy(HAIC) using floxuridine(FUDR) in patients with advanced hepatocellular carcinoma(HCC) confined to the ***:Thirty-four patients who had advanced HCC with unresectability or unsuccessful previous therapy in the absence of extrahepatic metastasis were treated with intra-arterial FUDR chemotherapy at ourhospital between March 2005 and May *** the 34 patients,9 patients were classified as Child class C,and 18 patients had portal vein tumor thrombus(PVTT).One course of chemotherapy consisted of continuous infusion of FUDR(0.3 mg/kg during day 1-14) and dexamethasone(10 mg on day 1,4,7 and 11),and this treatment was repeated every 28 ***:Two patients(5.9%) displayed a complete response,and 12 patients(35.3%) had a partial *** tumor control rate was 61.8%.The median overall survival times were 15.3 mo,12.4 mo and 4.3 mo for the patients who were classified as Child class A,Child class B and Child class C,respectively(P = 0.0392).The progression-free survival was 12.9 mo,7.7 mo and 2.6 mo for the patients who were classified as Child class A,Child class B and Child class C,respectively(P = 0.0443).The cumulative survival differed significantly according to the Child-Pugh classification and the presence of *** addition to hepatic reserve capacity and PVTT,the extent of HCC was an independent factor in determining a poor *** most common adverse reactions to HAIC were mucositis,diarrhea and peptic ulcer disease,but most of these complications were improved by medical treatment and/or a delay of ***:The present study demonstrates that intra-arterial FUDR chemotherapy is a safe and effective treatment for advanced HCC that is recalcitrant to other therapeutic modalities,even in patients with advanced cirrhosis.

关键词： Hepatic arterial infusion chemotherapy Floxuridine Advanced hepatocellular carcinoma Child-Pugh classification Portal vein tumor thrombus

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

Implementation of tactical maneuvers with maneuver libraries

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Chinese Journal of Aeronautics 2020年第1期33卷 255-270页

作者： Do hyeon lee Chang-Joo KIM sung wook HUR Seong han lee School of Aerospace Information Engineering Konkuk UniversitySeoul 05029Republic of Korea

This study creates and combines the general maneuver libraries for fixed-wing aircraft to implement tactical ***,the generalized maneuver libraries are established by analyzing the characteristics of tactical maneuvers required in *** 7th order polynomial is applied to both the creation of the maneuver libraries and the generation of the trajectories or flight paths for modal *** track the desired trajectory,we design the Attitude Command Attitude Hold(ACAH)system and the Rate Command Rate Hold(RCRH)system using Model Following Controller(MFC).Moreover,the Line-of-Sight(LOS)guidance law is *** particular,the CONDUIT~?is employed to optimize the gains so that the control systems meet the aircraft Handling Qualities(HQ)***,flight simulations are performed for the longitudinal loop,immelmann-turn,and climb-slalom-descent maneuvers to verify that tactical aggressive maneuvers are realizable via the combination of maneuver *** study can contribute to the development of flight techniques for aircraft tactical maneuvers and to the revision of air force operational manuals.

关键词： 7th order polynomial Attitude command attitude hold system Handling qualities Maneuver libraries Rate command rate hold system Tactical maneuvers