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Hepatitis B virus reactivation in patients with hepatocellular carcinoma undergoing anti-cancer therapy

World Journal of Gastroenterology 2014年第24期20卷 7675-7685页

作者： jeong won jang Division of Hepatology Department of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoul 137-701South Korea

Patients with hepatocellular carcinoma (HCC) often experience hepatic morbidity. Hepatitis B virus (HBV) reactivation is well documented as a serious hepatic morbidity during anti-cancer therapy. Reported rates of HBV reactivation in chronic carriers with HCC undergoing chemotherapy range from 4%-67%. Apart from chemotherapy, HBV reactivation has been increasingly identified in settings of hepatectomy and local ablation therapies. The rates of HBV reactivation vary with different levels of immunosuppression and depend on treatment, viral factors, and patient characteristics. The principal concern relating to reactivation is that a substantial proportion of patients with reactivation suffer from liver dysfunction during therapy, which often leads to disruption of planned, potentially life-prolonging treatments, adversely affecting the patients’ final outcome. The first step in the management of HBV reactivation is identification of patients at risk of reactivation by testing for HBV serology prior to commencing anti-cancer therapy. Although it is a serious complication, HBV reactivation is preventable with prophylactic anti-HBV drugs. Multiple publications have shown the benefit of prophylactic or preemptive antiviral therapy in this setting and justified such an approach before the start of therapy. Given the tumors and underlying cirrhosis, long-term use of antivirals with high potency and low risk of resistance is recommended in patients with HCC. This topic review will summarize the epidemiology, pathogenesis, and clinical issues related to HBV reactivation in HCC patients, and will discuss proper management against HBV reactivation during anti-cancer therapy for HCC.

关键词： Hepatitis B virus Virus activation Hepatic morbidity Hepatocellular carcinoma Immunosuppression

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Sarcopenia in the prognosis of cirrhosis: Going beyond the MELD score

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World Journal of Gastroenterology 2015年第25期21卷 7637-7647页

作者： Hee Yeon Kim jeong won jang Division of Hepatology Department of Internal Medicine Seoul St. Mary’s Hospital College of Medicine the Catholic University of Korea

Estimating the prognosis of patients with cirrhosis remains challenging, because the natural history of cirrhosis varies according to the cause, presence of portal hypertension, liver synthetic function, and the reversibility of underlying disease. Conventional prognostic scoring systems, including the Child-Turcotte-Pugh score or model for endstage liver diseases are widely used; however, revised models have been introduced to improve prognostic performance. Although sarcopenia is one of the most common complications related to survival of patients with cirrhosis, the newly proposed prognostic models lack a nutritional status evaluation of patients. This is reflected by the lack of an optimal index for sarcopenia in terms of objectivity, reproducibility, practicality, and prognostic performance, and of a consensus definition for sarcopenia in patients with cirrhosis in whom ascites and edema may interfere with body composition analysis. Quantifying skeletal muscle mass using cross-sectional abdominal imaging is a promising tool for assessing sarcopenia. As radiological imaging provides direct visualization of body composition, it is useful to evaluate sarcopenia in patients with cirrhosis whose body mass index, anthropometric measurements, or biochemical markers are inaccurate on a nutritional assessment. Sarcopenia defined by cross-sectional imaging-based muscular assessment is prevalent and predicts mortality in patients with cirrhosis. Sarcopenia alone or in combination with conventional prognostic systems shows promise for a cirrhosis prognosis. Including an objective assessment of sarcopenia with conventional scores to optimize the outcome prediction for patients with cirrhosis needs further research.

关键词： Liver cirrhosis Model for end-stage liverdiseases score Mortality Prognosis Sarcopenia

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Update on hepatitis B virus infection

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World Journal of Gastroenterology 2014年第37期20卷 13293-13305页

作者： Chan Ran You Sung won Lee jeong won jang Seung Kew Yoon Division of Hepatology Department of Internal MedicineCollege of MedicineSeoul St. Mary’s HospitalThe Catholic University of Korea

Chronic infection with hepatitis B virus (HBV) leads to the development of hepatocellular carcinoma and/or chronic liver failure. Despite extensive research, the immunopathogenesis is not completely understood. Viral persistence and clinical outcomes following HBV infection depend on viral factors and host factors; including genetic factors that determine a host’s immune mechanisms. The primary goal of chronic hepatitis B (CHB) treatment is to eradicate HBV or to at least maintain suppression of HBV replication. Despite recent advances in anti-viral agents for chronic HBV infection, complete eradication of the virus has been difficult to achieve. Agents for the treatment of CHB are divided mainly into two groups: immunomodulating agents and antiviral nucleos(t)ide analogues (NAs). Although NAs are safe, effective and easily administered orally, their long-term use poses the risk of drug resistance. Currently, international evidence-based guidelines have been developed to support physicians in managing CHB patients. However, treatment of patients with drug resistance is still challenging, as only a few classes of anti-HBV drugs are available and cross-resistance between drugs can occur. In addition, as the currently available genotypic test for detection of drug resistance still has limitations in identifying the different substitutions present in the same viral genome, the development of a new virologic test to overcome this limitation is necessary. Among the predictive factors associated with response to pegylated interferon (PEG-IFN) therapy, hepatitis B surface antigen quantification is considered to be a surrogate marker for monitoring response to PEG-IFN. Current practice guidelines stress the importance of profound and durable HBV viral suppression in the treatment of CHB patients. To this end, it is essential to choose a potent antiviral drug with a low risk of resistance for initial treatment of CHB to achieve sustained virological response. This rev

关键词： Hepatitis B virus Chronic hepatitis B Nucleos(t)ide analogue Pegylated interferon Antiviral therapy

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Hepatocellular carcinoma,decompensation,and mortality based on hepatitis C treatment:A prospective cohort study

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World Journal of Gastroenterology 2022年第30期28卷 4182-4200页

作者： Gwang Hyeon Choi Eun Sun jang Young Seok Kim Youn Jae Lee In Hee Kim Sung Bum Cho Han Chu Lee jeong won jang Moran Ki Hwa Young Choi Dahye Baik Sook-Hyang jeong Department of Internal Medicine Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnam 13620South Korea Department of Internal Medicine Soonchunhyang University Bucheon HospitalBucheon 14584South Korea Department of Internal Medicine Inje University Busan Paik HospitalBusan 47392South Korea Department of Internal Medicine Chonbuk National University HospitalJeonju 54907JeonbukSouth Korea Department of Internal Medicine Chonnam National University Hwasun HospitalHwasun 58128South Korea Department of Gastroenterology Asan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea Department of Internal Medicine The Catholic University of KoreaSeoul 06591South Korea Cancer Control and Population Health Graduate School of Cancer Science and PolicyNational Cancer CenterGoyang 10408South Korea

BACKGROUND Prospective studies of the long-term outcomes of patients with hepatitis C virus(HCV)infection after treatment with interferon-based therapy(IBT)or directacting antivirals(DAA)are limited in many Asian *** To elucidate the incidences of hepatocellular carcinoma(HCC)and death/transplantation based on treatment with IBT or DAA,to compare the outcomes of the sustained virologic response(SVR)to IBT and DAA,and to investigate outcome-determining factors after *** This cohort included 2054 viremic patients(mean age,57 years;46.5%male;27.4%with cirrhosis)prospectively enrolled at seven hospitals between 2007 and *** were classified as the untreated group(n=619),IBT group(n=578),and DAA group(n=857).Outcomes included the incidences of HCC and death/*** incidences of the outcomes for each group according to treatment were calculated using an exact method based on the Poisson distribution.A multivariate Cox regression analysis was performed to determine the factors associated with HCC or death/transplantation,followed by propensity score matching to confirm the *** During a median of 4.1 years of follow-up,HCC and death/transplantation occurred in 113 and 206 patients,respectively,in the entire *** with the untreated group,the incidences of HCC and death/transplantation were significantly lower in the IBT group[adjusted hazard ratio(aHR)0.47,95%CI:0.28-0.80 and aHR 0.28,95%CI:0.18-0.43,respectively]and the DAA group(aHR 0.58,95%CI:0.35-0.96,and aHR 0.19,95%CI:0.20-0.68,respectively).Among 1268 patients who attained SVR with IBT(n=451)or DAA(n=816),the multivariable-adjusted analysis showed no differences in the risks of HCC(HR 2.03;95%CI:0.76-5.43)and death/transplantation(HR 1.38;95%CI:0.55-3.49)between the two *** was confirmed by a propensity score-matching *** factors for HCC after SVR were age,genotype 1,and the presence of *** Treatment and achieving SVR

关键词： Hepatitis C virus Direct-acting antiviral Sustained virologic response Hepatocellular carcinoma Mortality

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Predictive value of ^(18)F-fluorodeoxyglucose PET/CT for transarterial chemolipiodolization of hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第25期18卷 3215-3222页

作者： Myeong Jun Song Si Hyun Bae Ie Ryung Yoo Chung-Hwa Park jeong won jang Ho Jong Chun Byung Gil Choi Hae Giu Lee Jong Young Choi Seung Kew Yoon Department of Internal Medicine College of MedicineThe Catholic University of KoreaSeoul 137-040South Korea Department of Nuclear Medicine College of MedicineThe Catholic University of KoreaSeoul 137-040South Korea Department of Radiology College of MedicineThe Catholic University of KoreaSeoul 137-040South Korea

AIM： To investigate the correlation of 18F-fluorodeoxy- glucose （18F-FDG） positron emission tomography （PET） with clinical features and the prediction of treatment response. METHODS： A total of 83 hepatocellular carcinoma （HCC） patients undergoing 18F-FDG PET before transar- terial chemolipiodolization with systemic chemo-infusion between October, 2006 and May, 2009 were retrospec-tively enrolled. The patients included 68 men and 15 women （mean age, 60 ~ 10.7 years）. The effect of 18F- FDG-monitored PET uptake on clinical features and on the evaluated treatment response was ascertained with modified Response Evaluation Criteria in Solid Tumors. The PET parameters of maximal standardized uptake value of the tumor （Tsuvmax）, the ratio of the tumor maximal standardized uptake value （SUV） to the liver maximal SUV （Tsuvmax/Lsuwax） and the ratio of tumor maximal SUV to the liver mean SUV （msuvmax/LSUVrnean） were tested as predictive factors. RESULTS： Among the 3 SUV parameters, the TSUV- =maxdLsuvmean ratio （cutoff value of 1.90） was significantly associated with tumor burden including tumor size, tu- mor number, α-fetoprotein levels and tumor stage （P 〈 0.001, P = 0.008, P = 0.011, P 〈 0.001, respectively）. The objective response rates in patients with a high SUV ratio （≥ 1.90） were significantly better than those with a low SUV ratio （〈 1.90）（P = 0.020）. The overall survival rates of patients exhibiting a low Tsuvmax/Lsu- Vmean ratio （〈 1.90） and those with a high SUV ratio （≥1.90） was 38.2 and 10.3 mo, respectively （P 〈 0.01）. However, the time to progression showed no significant difference between the groups （P = 0.15）. CONCLUSION： 18F-FDG PET can be an important predictor of HCC treatment. In particular, the Tsuvmax/ Lsuwean ratio （cutoff value of 1.90） can provide useful information in treatment prognosis for HCC patients treated with Iocoregional therapy.

关键词： 18F-fluorodeoxyglucose positron emissiontomography Transarterial chemolipiodolization withsystemic chemo-infusion Treatment response Predic-tive factor, Overall survival

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Association between the early high level of serum tacrolimus and recurrence of hepatocellular carcinoma in ABO-incompatible liver transplantation

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2727-2738页

作者： Ji won Han Jong Young Choi Eun Sun Jung Ji Hoon Kim Hee Sun Cho Jae-Sung Yoo Pil Soo Sung jeong won jang Seung Kew Yoon Ho Joong Choi Young Kyoung You Department of Internal Medicine The Catholic University of KoreaSeoul 06591South Korea The Catholic University Liver Research Center College of MedicineThe Catholic University of KoreaSeoul 06591South Korea Department of Hospital Pathology The Catholic University of KoreaSeoul 06591South Korea Department of Surgery The Catholic University of KoreaSeoul 06591South Korea

BACKGROUND Clinical factors predicting graft survival(GS)after ABO-incompatible(ABOi)liver transplantation(LT),and differences between recipients with and without hepatocellular carcinoma(HCC)are *** To analyze the impact of serial serum tacrolimus trough concentration in recipients with or without(HCC)in ABOi living-donor liver transplantation(LDLT).METHODS We analyzed a historical cohort of 89 recipients who underwent ABOi LDLT,including 47 patients with *** The 1-,3-,5-,and 10-year GS rates were 85.9%,73.3%,71.4%,and 71.4%,respectively,and there were no significant differences between HCC and non-HCC *** multivariate Coxregression analyses,tacrolimus trough concentrations below 5.4 ng/mL at 24 wk post-LT,in addition to the antibody-mediated rejection(AMR)were associated with poor-graft *** HCC patients,AMR[hazard ratio(HR)=63.20,P7.3 ng/mL were significant predictive factors for HCC *** propensity score matching,patients with high tacrolimus concentrations at 4 wk had significantly poor recurrence-free *** Elevated tacrolimus levels at 4 wk after ABOi LDLT have been found to correlate with HCC ***,careful monitoring and control of tacrolimus levels are imperative in ABOi LT recipients with HCC.

关键词： ABO-incompatible Liver transplantation Tacrolimus Hepatocellular carcinoma

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Outcome of transarterial chemoembolization-based multi-modal treatment in patients with unresectable hepatocellular carcinoma

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World Journal of Gastroenterology 2015年第8期21卷 2395-2404页

作者： Do Seon Song Soon Woo Nam Si Hyun Bae Jin Dong Kim jeong won jang Myeong Jun Song Sung won Lee Hee Yeon Kim Young Joon Lee Ho Jong Chun Young Kyoung You Jong Young Choi Seung Kew Yoon Department of Internal Medicine College of Medicine The Catholic University of Korea Department of Internal Medicine Cheju Halla General Hospital Department of Radiology College of Medicine The Catholic University of Korea Department of Surgery College of Medicine The Catholic University of Korea

AIM:To investigate the efficacy and safety of transarterial chemoembolization(TACE)-based multimodal treatment in patients with large hepatocellular carcinoma(HCC).METHODS:A total of 146 consecutive patients were included in the analysis,and their medical records and radiological data were reviewed ***:In total,119 patients received TACE-based multi-modal treatments,and the remaining 27 received conservative *** survival(P<0.001)and objective tumor response(P=0.003)were significantly better in the treatment group than in the conservative *** subgroup analysis,survival benefits were observed not only in the multi-modal treatment group compared with the TACE-only group(P=0.002)but also in the surgical treatment group compared with the loco-regional treatment-only group(P<0.001).Multivariate analysis identified tumor stage(P<0.001)and tumor type(P=0.009)as two independent pre-treatment factors for *** adjusting for significant pre-treatment prognostic factors,objective response(P<0.001),surgical treatment(P=0.009),and multi-modal treatment(P=0.002)were identified as independent post-treatment prognostic ***:TACE-based multi-modal treatments were safe and more beneficial than conservative *** surgery after successful downstaging resultedin long-term survival in patients with large,unresectable HCC.

关键词： Hepatocellular carcinoma Multimodal treatment Tran

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Risk factors of biliary intervention by imaging after livingdonor liver transplantation

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World Journal of Gastroenterology 2016年第7期22卷 2342-2348页

作者： Soon Kyu Lee Jong Young Choi Dong Myung Yeo Young Joon Lee Seung Kew Yoon Si Hyun Bae jeong won jang Hee Yeon Kim Dong Goo Kim Young Kyoung You Division of Hepatology Department of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoul 06591South Korea Department of Radiology College of MedicineThe Catholic University of KoreaSeoul 06591South Korea Department of Surgery College of MedicineThe Catholic University of KoreaSeoul 06591South Korea

AIM:To determine the risk factors of biliary intervention using magnetic resonance cholangiopancreatography(MRCP) after living donor liver transplantation(LDLT).METHODS: We retrospectively enrolled 196 patients who underwent right lobe LDLT between 2006 and 2010 at a single liver transplantation center. Direct duct-to-duct biliary anastomosis was performed in all 196 patients. MRCP images routinely taken 1 mo after LDLT were analyzed to identify risk factors for biliary intervention during follow-up, such as retrograde cholangiopancreatography or percutaneous transhepatic biliary drainage. Two experienced radiologists evaluated the MRCP findings, including the anastomosis site angle on three-dimensional images, the length of the filling defect on maximum intensity projection, bile duct dilatation, biliary stricture, and ***: Eighty-nine patients underwent biliary intervention during follow-up. The anastomosis site angle [hazard ratio(HR) = 0.48; 95% confidence interval(CI), 0.30-0.75, P < 0.001], a filling defect in the anastomosis site(HR = 2.18, 95%CI: 1.41-3.38,P = 0.001), and biliary leakage(HR = 2.52, 95%CI: 1.02-6.20, P = 0.048) on MRCP were identified in the multivariate analysis as significant risk factors for biliary intervention during follow-up. Moreover, a narrower anastomosis site angle(i.e., below the median angle of 113.3°) was associated with earlier biliary intervention(38.5 ± 4.2 mo vs 62. 1 ± 4.1 mo, P < 0.001). Kaplan-Meier analysis comparing biliary intervention-free survival according to the anastomosis site angle revealed that lower survival was associated with a narrower anastomosis site angle(36.3% vs 62.0%, P < 0.001).CONCLUSION: The biliary anastomosis site angle in MRCP after LDLT may be associated with the need for biliary intervention.

关键词： Magnetic resonance cholangiopancreatography Liver transplantation Living donor Biliary intervention Endoscopic retrograde cholangiopancreatography Percutaneous transhepatic biliarydrainage

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Saccharomyces boulardii as a single trigger of food protein-induced enterocolitis syndrome: Seven case reports

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World Journal of Clinical Cases 2025年第6期13卷 35-40页

作者： Jin-Bok Hwang Hyo-jeong jang Department of Pediatrics Keimyung University School of MedicineDongsan Medical CenterDaegu 42601South Korea

BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to *** boulardii(***),a probiotic prescribed frequently in clinical settings,has been reported to trigger FPIES in an infant with soy-triggered *** this report,we describe a new clinical FPIES in which *** was the sole triggering factor of acute FPIES adverse reaction in seven healthy *** SUMMARY Seven FPIES cases triggered by only *** were gathered from 2011 to the *** of the patients had previously experienced any allergic reaction to cow’s milk,soy,or complementary *** age of the patients was 4-10-months old,and the symptoms of FPIES developed after ingestion of ***,which is mostly prescribed for the treatment of gastroenteritis or antibiotic-associated *** patients experienced severe repetitive vomiting 1-3 hours after *** *** lethargy,marked pallor,and cyanosis were also *** IgE-mediated hypersensitivity developed in any *** was followed by initial intense vomiting in approximately 5-10 hours after *** ingestion,and only one case showed bloody,purulent,and foul-smelling *** patients stabilized quickly,mostly within 6 *** got all improved within 24 hours after discontinuation of *** *** can be the sole trigger of acute FPIES and be prescribed cautiously even in healthy children without FPIES.

关键词： Food protein-induced enterocolitis syndrome Food hypersensitivity Saccharomyces boulardii Probiotics Child Case report

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A study on hydrogen uptake and release of a eutectic mixture of biphenyl and diphenyl ether

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Journal of Energy Chemistry 2020年第3期29卷 11-16页

作者： Munjeong jang Byeong Soo Shin Young Suk Jo jeong won Kang Sang Kyu Kwak Chang won Yoon Hyangsoo jeong Center for Hydrogen Fuel Cell Research Korea Institute of Science and Technology(KIST)5 Hwarang-ro 14-gilSeongbuk-guSeoul 02792Republic of Korea Divison of Energy and Environment Technology KIST SchoolKorea University of Science and Technology5 Hwarang-ro 14-gilSeongbuk-guSeoul 02792Republic of Korea Department of Chemical and Biological Engineering Korea UniversityAnam-ro 145Seongbuk-guSeoul 02841Republic of Korea School of Energy and Chemical Engineering Ulsan National Institute of Science and Technology50UNIST-gilUlsan 44919Republic of Korea KHU-KIST Department of Converging Science and Technology Kyung Hee University26 Kyungheedae-roDongdaemun-guSeoul 02447Republic of Korea

Hydrogen storage in Liquid Organic Hydrogen Carrier(LOHC)systems is appealing for the safe storage and distribution of excess renewable energy via existing gasoline infrastructures to *** present the eutectic mixture of biphenyl and diphenyl ether of its first use as a LOHC *** material is hydrogenated with 99%selectivity without the cleavage of C–O bond,with commercial heterogeneous catalysts,which is confirmed by nuclear magnetic spectroscopy and gas chromatography-mass *** concentration,dehydrogenation enthalpy,and thermo-neutral temperature are calculated using a density functional *** results indicate that O-atom-containing material exhibits more favorable dehydrogenation thermodynamics than that of the hydrocarbon *** H2-rich material contains6.8 wt%of gravimetric hydrogen storage capacity.A preliminary study of catalytic dehydrogenation on a continuous reactor is presented to demonstrate a reversibility of this material.

关键词： Hydrogen storage Liquid organic hydrogen carrier Diphenyl ether Dehydrogenation Thermodynamics

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