Journal of Yeungnam Medical Science

Volume 25(1); June 2008

Reviews

Long Term Effects of Lamivudine and Adefovir dipivoxil in Chronic Hepatitis B Patients on the Development of Hepatocellular Carcinoma.: Heon Ju Lee; Yeungnam Univ J Med. 2008;25(1):1-18. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.1

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Abstract PDF: Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of 10(4) copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the 21st century.

The Diagnosis and Treatment of Osteoporosis.: Jun sung Moon, Kyu Chang Won; Yeungnam Univ J Med. 2008;25(1):19-30. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.19

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Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.

Citations

Citations to this article as recorded by

Effects of Gloiopeltis furcata Extract on Antioxidant Activity and Osteoblast Differentiation
Jeong Hyeon Kang, Kyung Im Jung, Mi Hwa Park, Geun Hye Oh, Mihyang Kim
Journal of the Korean Society of Food Science and Nutrition.2023; 52(5): 450. CrossRef
Effects of Herbal Medicines on Bone Mineral Density Score in Osteoporosis or Osteopenia: Study Protocol for a Systematic Review and Meta-Analysis
Su Min Hong, Eun Jung Lee
Journal of Korean Medicine Rehabilitation.2021; 31(2): 49. CrossRef
Effects of Joaguihwan (JGH, 左歸丸) Extract on Changes of Anti-oxidation, Anti-inflammatory in RAW 264.7 Cells and on Factors Related with Bone Metabolism in Skull Fractured Rat
Yu Chen Li, Min-seok Oh
Journal of Korean Medicine Rehabilitation.2016; 26(3): 31. CrossRef
The Effects of Long term Osteoporosis Management Education on BMD Level and Medication Compliance in Postmenopausal Women
Dong-Hee Kim, Young-Sil Bae, Sang-Hwa Lee
Journal of Korean Public Health Nursing.2014; 28(1): 102. CrossRef
Consumption of health functional food and dietary habits, nutrient intake and dietary quality of college students in Incheon
So Young Kim, Jeong Soon You, Kyung Ja Chang
Korean Journal of Nutrition.2013; 46(2): 166. CrossRef
The usefulness of MR subtraction technique in metastatic spinal cancer
J-H Cho, H-K Lee, B-J Han, J Lee, K-R Dong, W-K Chung, J-Y Bae
The Imaging Science Journal.2013; 61(5): 419. CrossRef
Correlations between the MR Diffusion-weighted Image (DWI) and the bone mineral density (BMD) as a function of the soft tissue thickness-focus on phantom and patient
Myung-Sam Kim, Jae-Hwan Cho, Hae-Kag Lee, Sang-Jeong Lee, Cheol-Soo Park, Kyung-Rae Dong, Yong-Soon Park, Woon-Kwan Chung, Jong-Woong Lee, Ho-Sung Kim, Eun-Hye Kim, Dae Cheol Kweon, Hwa-Yeon Yeo
Journal of the Korean Physical Society.2013; 62(4): 684. CrossRef
A study on quantitative analyses before and after injection of contrast medium in spine examinations performed by using diffusion weighted image
Jae-Hwan Cho, Hae-Kag Lee, Yong- Kyun Kim, Kyung-Rae Dong, Woon-Kwan Chung, Kyu-Ji Joo
Journal of the Korean Physical Society.2013; 62(4): 700. CrossRef
The Correlation Analysis of BMD in Proximal Femur and Spine with Dual Energy X-ray Absorptiometry
Man-Seok Han, Dong-Heon Cho
Journal of the Korea Society of Computer and Information.2012; 17(9): 165. CrossRef
Influence of Knowledge and Subjective Health Status on Health Promoting Behavior About Osteoporosis in Industrial Workers
Soon Yi Seo, Jung Soon Lee
Journal of muscle and joint health.2012; 19(3): 340. CrossRef
SNR and ADC Value Change before and after the injection of contrast medium during DWI test on metastatic spinal cancer patients
Eng-Chan Kim, Ki-Hong Kim, Cheol-Soo Park, Sun-Yeob Lee, Heung-Joon Yoo, Jae-Hwan Cho, Hyun-Cheol Jang, Bo-Hui Kim, Man-Seok Han
Journal of the Korean Society of Radiology.2011; 5(1): 37. CrossRef
Bone Mineral Density and Factors Affecting in Female College Students
Dong Sook Cho, Jeung Yun Lee
Korean Journal of Women Health Nursing.2008; 14(4): 297. CrossRef

Original Articles

The Short Term Efficacy of Entecavir Therapy in Chronic Hepatitis B.: Hyun Kim, Hee Bok Chae, Won Joong Jeon, Seon Mee Park, Sei Jin Youn, Jong Ryul Eun, Heon Ju Lee; Yeungnam Univ J Med. 2008;25(1):31-40. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.31

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Abstract PDF: BACKGROUND
/AIMS: Entecavir is a synthetic nucleoside analogue, cyclopentyl guanine nucleoside, which has a potent antiviral effect and the least viral breakthrough in hepatitis B virus (HBV) replication. Entecavir has been available in Korea since 2007 but there are few reports on its effects. The aim of this study was to evaluate the virological response (VR) and biochemical response (BR) to entecavir in HBV patients at 3, 6 and 9 months after treatment with entecavir. MATERIALS AND METHODS: Thirty-three chronic hepatitis B patients who took entecavir for at least 9 months were enrolled. We investigated VR and BR by retrospectively reviewing medical records. Patients who satisfied the following criteria were chosen: 1) initial alanine aminotransferase (ALT) levels = 1.5upper limit of normal (ULN) and 2) initial HBV DNA levels = 5 log10 copies/ml. We measured ALT levels every 3 months until month 9. HBV DNA was measured every 2 or 3 months by polymerase chain reaction (PCR) method. RESULTS: Most patients taking entecavir showed good BR (ALT < 40 IU/L). The BR rates were 61%, 73% and 67% at months 3, 6 and 9, respectively. VR (HBV DNA < 5 log(10) copies/ml or 2 log lower than initial HBV DNA) rates were 82%, 91% and 91% at months 3, 6 and 9, respectively. Undetectable HBV DNA (HBV DNA < 4 log(10) copies/ml) rates were 49%, 73% and 85% at months 3, 6 and 9, respectively. Two patients presented with virological breakthrough without adverse effects until month 9. CONCLUSIONS: Entecavir showed good BR and VR from month 3 and these effects continued through the 9-month observation period. This suggests that entecavir is also a good choice for the first line treatment of chronic hepatitis B (CHB). Further studies are needed to determine the long-term efficacy and drug resistance of entecavir in Korean CHB patients.

The Effects of Hantaan Virus on the Expression of Platelet Activating Factor Receptor and on the Activity of Platelet Activating Factor Acetylhydrolase.: Ji Young Hwang, Jong Won Park, Sae Yong Hong, Ho Sun Park; Yeungnam Univ J Med. 2008;25(1):41-49. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.41

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Abstract PDF: BACKGROUND
The central physiological derangement of hemorrhagic fever with renal syndrome (HFRS) caused by hantaan virus (HTNV) is a vascular dysfunction, manifested by hemorrhage, impaired vascular tone and increased vascular permeability. Platelet activating factor (PAF), whose actions are mediated through a specific receptor, is a potent bioactive lipid. PAF has diverse biological functions in the vascular system, such as increasing vascular permeability, adhesion of leukocytes to the endothelium and reduction of cardiac output, which result in hypotension and shock. The goal of the present study was to investigate whether PAF is involved in the pathogenesis of HFRS. For this purpose, we evaluated the effect of HTNV on the expression of PAF receptor (PAF-R) and on the activity of PAF-acetylhydrolase (PAF-AH) instead of PAF because PAF is rapidly degraded by PAF-AH in vivo. MATERIALS AND METHODS: To evaluate the expression of PAF-R, we performed reverse-transcription PCR, western blot and FACS analyses using HTNV-infected human umbilical vein endothelial cells (HUVECs) and non-infected (control) HUVECs. In addition, we measured the activity of plasma PAF-AH in HFRS patients and normal healthy persons. RESULTS: The mRNA and protein expression of PAF-R was increased in HTNV-infected HUVECs compared with control HUVECs at 2 and 3 days post-infection (d.p.i.). FACS analysis showed that HTNV induced the surface expression of PAF-R in HUVECs from 2 d.p.i. The activity of plasma PAF-AH was 2.5-fold lower in HFRS patients than in normal healthy persons. CONCLUSION: Increased PAF-R expression by HTNV might increase the responsiveness to PAF in endothelial cells. Reduced PAF-AH activity in the blood of HFRS patients might delay PAF degradation. These results suggest that changes in PAF-R and PAF-AH by HTNV might influence to PAF activity and might be involved in the vascular dysfunction of HFRS.

Case Reports

Chronic Obstructive Pulmonary Disease with Severe Pulmonary Hypertension: A Case Report.: Chan Soh Park, Hyun Jung Chin, Seok Min Kim, Chang Woo Son, Sung Ken Yu, Jin Hong Chung, Kwan Ho Lee; Yeungnam Univ J Med. 2008;25(1):50-57. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.50

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Abstract PDF: Pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein or pulmonary capillaries. Depending on the cause, pulmonary hypertension can be a severe disease with markedly decreased exercise tolerance and right-sided heart failure. Pulmonary hypertension can present as one of five different types: arterial, venous, hypoxic, thromboembolic, or miscellaneous. Chronic obstructive pulmonary disease with severe pulmonary hypertension is a rare disease. A 52-year-old man presented with a complaint of aggravating dyspnea. The mean pulmonary arterial pressure was 61.5 mmHg by Doppler echocardiogram. The patient was prescribed diuretics, digoxin, bronchodilator, sildenafil, bosentan and an oxygen supply. However, he ultimately died of cor pulmonale. Thus, diagnosis and early combination therapy are important.

A Case of Adult onset Henoch-Sch?nlein Purpura with Acute Renal Failure.: Seok Min Kim, Kyung Ae Chang, Sun Young Jung, Chan Soh Park, Jong Won Park, Jun Young Do, Yong Jin Kim, Kyung Woo Yoon; Yeungnam Univ J Med. 2008;25(1):58-63. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.58

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Abstract PDF: Henoch-Schonlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and C3 deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

Three Cases of Fever Unknown Origin with Lymphoproliferative Features and a Unique Pattern of 18-FDG Uptake on the Fusion PET/CT.: Dae Young Yun, Young Hoon Hong, Yong Uk Jung, Myung Jin Oh, Choong Ki Lee; Yeungnam Univ J Med. 2008;25(1):64-71. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.64

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Abstract PDF: Evaluation of a fever of unknown origin (FUO) is complex. Recently, PET scanning has been approved for screening in FUO evaluation. We treated three cases of FUO associated with increased FDG uptake in the bone marrow of the femur and tibia on the fusion PET/CT; all three had the same pattern of uptake. Bone marrow biopsies revealed mature lymphocyte and histiocyte infiltration and myxoid changes in one case, and cortical bone involvement in another case. The cases were all young females who had fever with neutropenia and relative lymphocytosis that lasted for several weeks and then remitted spontaneously. Even though the results of the studies were not diagnostic, the unique uptake pattern on PET/CT and the histology might be related to the cause of the illness and should be studied further to assess the association with classic FUO.

A Case of Liver Abscess in A Child.: Seung Taek Oh, Kwang Hae Choi; Yeungnam Univ J Med. 2008;25(1):72-77. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.72

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Abstract PDF

Liver abscess in children is rare in developed countries; the incidence is 25 per 100,000 admissions in USA. Common complications are pleural effusion, empyema, pneumonitis, hepatopleural or hepatobronchial fistula, intraperitoneal or intrapericardiac rupture, septic shock, cerebral amebiasis, etc. These complications may lead to death if the management is delayed. However, recent management results in a mortality of less than 15%. We report a case of liver abscess in a child. He manifested with fever and abdominal pain in the right upper quadrant. On computerized tomography scans, multiple cystic lesions were seen in both lobes of the liver and were 5 to 55 mm in size. In laboratory findings, neutrophilic leukocytosis, peripheral eosinophila, elevated values of ESR, C-reactive protein, and elevated serum AST, ALT, ALP and GGT were detected. Furthermore, we determined the organisms in the blood culture and serum. Blood culture was positive for Streptococcus spp., and amebic indirect hemagglutination antibody titer was increased to 1:512.

Citations

Citations to this article as recorded by

A case of pyogenic liver abscess in a 10-year-old girl
Jung Lim Byun, Sun Hwan Bae, Sang Woo Park
Korean Journal of Pediatrics.2010; 53(5): 666. CrossRef

General Anesthesia for Extracorporeal Shockwave Lithotripsyin Child with Lesch-Nyhan Syndrome.: Sang Jin Park, Il chi Kwon, Won Ki Lee, Deok Hee Lee; Yeungnam Univ J Med. 2008;25(1):78-83. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.78

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Abstract PDF: Lesch-Nyhan syndrome is an inborn error of purine metabolism resulting from hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) deficiency and leading to excess purine production and uric acid over-production. It is a very rare X-linked recessive disorder, characterized by movement disorder, cognitive deficits, and self-injurious behavior. However, because of the high incidence of calculi, patients may present for surgery of urinary tract, and have increased risk of difficult intubation, aspiration pneumonia, renal insufficiency or sudden death. We report the case of a 5-year-old boy with Lesch-Nyhan syndrome who underwent successive extracorporeal shockwave lithotripsy under general anesthesia.

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