Background: The occurrence of hepatocellular carcinoma (HCC) is a major concern during antiviral therapy for chronic hepatitis B. There are conflicting opinions regarding the effects of entecavir (ETV) and tenofovir disoproxil fumarate (TDF) on HCC prevention. We assessed these two antiviral medications for preventing HCC in treatment-naïve patients with chronic hepatitis B. Methods: We conducted a retrospective cohort study using nationwide claims data from the Korea Health Insurance Review and Assessment Service. We included 55,473 treatmentnaïve adult cases where ETV or TDF treatment was started between 2013 and 2017 (cohort 1).The ETV and TDF groups were matched 1:2 based on age, sex, comorbidities, hospital type, and index date year. Patients were followed up until December 2018. The outcome was the development of HCC. Subgroup analyses were conducted according to sex, age, hospital type and the presence of cirrhosis. We also compared the outcomes of patients who had started antiviral therapy during the 2012–2014 period (cohort 2). Results: The matched participants (18,491 in the ETV and 36,982 in the TDF groups) were a part of the study for, on average, 41.2 months. The incidence of HCC did not differ significantly between the ETV (1.46 per 100 patient-years) and the TDF (1.36 per 100 patient-years) treatments (hazard ratio, 0.93; 95% confidence interval, 0.86–1.01; P = 0.081). By contrast, HCC incidence was significantly higher in the ETV group than tenofovir group of cohort 2. Conclusion In patients with chronic hepatitis B, the ETV treatment did not result in a higher rate of HCC than the TDF treatment.

Background: The occurrence of hepatocellular carcinoma (HCC) is a major concern during antiviral therapy for chronic hepatitis B. There are conflicting opinions regarding the effects of entecavir (ETV) and tenofovir disoproxil fumarate (TDF) on HCC prevention. We assessed these two antiviral medications for preventing HCC in treatment-naïve patients with chronic hepatitis B. Methods: We conducted a retrospective cohort study using nationwide claims data from the Korea Health Insurance Review and Assessment Service. We included 55,473 treatmentnaïve adult cases where ETV or TDF treatment was started between 2013 and 2017 (cohort 1).The ETV and TDF groups were matched 1:2 based on age, sex, comorbidities, hospital type, and index date year. Patients were followed up until December 2018. The outcome was the development of HCC. Subgroup analyses were conducted according to sex, age, hospital type and the presence of cirrhosis. We also compared the outcomes of patients who had started antiviral therapy during the 2012–2014 period (cohort 2). Results: The matched participants (18,491 in the ETV and 36,982 in the TDF groups) were a part of the study for, on average, 41.2 months. The incidence of HCC did not differ significantly between the ETV (1.46 per 100 patient-years) and the TDF (1.36 per 100 patient-years) treatments (hazard ratio, 0.93; 95% confidence interval, 0.86–1.01; P = 0.081). By contrast, HCC incidence was significantly higher in the ETV group than tenofovir group of cohort 2. Conclusion In patients with chronic hepatitis B, the ETV treatment did not result in a higher rate of HCC than the TDF treatment.

Background: Due to the COVID-19 pandemic, from 2020, many pharmaceutical companies have developed vaccines. To determine the efficacy of AstraZeneca's and Pfizer's vaccines, which were the first and second vaccines to be approved in Korea, respectively, we developed a method to measure their antibody-generating efficacies using immunology analyzers and a rapid antibody test available in Korea. Methods: The antibody-stimulating efficacies of the Pfizer and AstraZeneca vaccines were evaluated using Centaur® XPT SARS-CoV-2 (Siemens Healthineers, Germany), Elecsys® AntiSARS-CoV-2 S (Roche Diagnostics, Germany), and STANDARD F SARS-CoV-2 nAb FIA (SD Biosensor, Korea). Healthcare workers were enrolled in two groups: the Pfizer (121) and AstraZeneca (117) groups. Antibody levels were measured pre-vaccination, three weeks after vaccination, and 16 weeks after vaccination. Results: The Pfizer group comprised 41 males and 80 females, while the AstraZeneca group comprised 38 males and 79 females. Antibody results were analyzed after excluding four individuals who had recovered from COVID-19. Between weeks 3 and 16, there was no significant difference (P= 0.5, 1.0) between the results of the Roche and Siemens antibody tests in the Pfizer vaccine group. However, the SD biosensor results comparing with the Roche and Siemens antibody tests at three weeks after the initial vaccination showed a significant difference (P < 0.0001). Analysis of the Roche antibody test results before, at three weeks, and at 16 weeks after the administration of the Pfizer and AstraZeneca vaccines revealed a statistically significant difference between before and at three weeks after the first injection (P < 0.0001). Conclusion After two doses of the Pfizer and AstraZeneca vaccines, antibody formation was above the 90 th percentile of the measurement range in all subjects.

Involvement of the liver is very common in military tuberculosis, but despite this fact, jaundice and hepatocellular dysfunction very rarely occur in this disease. Here, we report the case of a 59-year-old male patient who presented with acute hepatitis. After being admitted for fever and right upper quadrant pain for a 3-day period, military tuberculosis was diagnosed and treated with antituberculosis medication. Despite treatment, which was based on laboratory results and radiologic findings suggestive of acute hepatitis, fever persisted, jaundice developed, and hepatic enzyme levels increased. Percutaneous liver biopsy was performed to assist in the differential diagnosis of acute hepatitis and findings from the biopsy specimen revealed typical hepatic tuberculosis. Antituberculosis treatment was initiated, and the fever gradually subsided and hepatic enzyme levels decreased.
Biopsy ; Diagnosis, Differential ; Fever ; Hepatitis ; Humans ; Jaundice ; Liver ; Male ; Middle Aged ; Military Personnel ; Tuberculosis ; Tuberculosis, Hepatic

Obesity is a major public health problem and significant risk factor for many serious diseases including coronary artery disease, cancer, and diabetes. This study was performed to investigate the hypolipidemic effects and anti-hypertensive effect of Dangyuja (Citrus grandis Osbeck) peel, which is bred on Jeju island, in rats fed a high-fat diet. This study was conducted on 4 equal rat groups which were fed as follows; normal diet group (ND), high fat diet group (HFD), high fat diet supplemented with powdered peel of Dangyuja (1%, wt/wt) group (HFD+Dangyuja), and high fat diet treated with sibutramine simultaneously at a dose of 10 mg/kg group (HFD+Sibutramine). After feeding the high fat diet, body weight gain and relative weight of adipose tissues and liver significantly increased in HFD group, but Dangyuja peel supplementation protected these HFD-induced changes. The levels of serum triglyceride, total cholesterol, low-density lipoprotein (LDL)-cholesterol, and the atherogenic index significantly decreased in the HFD+Dangyuja peel group compared with the HFD group. The systolic blood pressure was significantly increased by feeding the high fat diet, whereas the supplementation of Dangyuja peel effectively prevented the elevation of blood pressure. Therefore, these results suggest that Dangyuja exerts a beneficial effect on obesity by improving lipid metabolism and alleviating obesity-related hypertension.
Animals ; Blood Pressure ; Body Weight ; Cholesterol ; Coronary Artery Disease ; Cyclobutanes ; Diet ; Diet, High-Fat ; Hypertension ; Lipid Metabolism ; Lipoproteins ; Liver ; Obesity ; Public Health ; Rats ; Risk Factors

The combination of atazanavir (ATV) and lopinavir/ritonavir (LPV/RTV) with nucleoside reverse transcriptase inhibitors (NRTI) has been used as a salvage regimen for human immunodeficiency virus (HIV)-positive patients. In this paper, we discuss two cases of HIV-positive patients who had long histories of virological failure following a heavy treatment of antiretroviral drugs, but then achieved virological suppression with double-boosted protease inhibitor (PI) regimens. In patients with multiple genotypic resistance to PIs and NRTIs, virological suppression can be achieved with a combination of ATV plus LPV/RTV with an NRTI backbone. The two cases in this report suggest that a combination of ATV plus LPV/RTV could be a useful salvage regimen for the subset of HIV-positive patients with limited treatment options.
Adult ; Drug Resistance, Multiple, Viral ; Drug Therapy, Combination ; HIV Infections/*drug therapy ; HIV Protease Inhibitors/*administration & dosage ; Humans ; Male ; Oligopeptides/*administration & dosage ; Pyridines/*administration & dosage ; Pyrimidinones/*administration & dosage ; Ritonavir/*administration & dosage

BACKGROUND/AIMS: The introduction of highly active antiretroviral therapy (HAART) has significantly modified the course of HIV infection. However, the HAART regimens, and especially those including protease inhibitors (PIs), have been shown to cause diabetes mellitus. We evaluated the incidence and clinical manifestations of HIV-infected Koreans who received HAART and the risk factors for diabetes mellitus in those patients. METHODS: We conducted a retrospective cohort study and a case-control study to evaluate the clinical manifestations, the incidence and the risk factors for diabetes mellitus in 215 HIV-infected patients who were on HAART at Yonsei University College of Medicine from 1991 to 2006. RESULTS: 215 patients were analyzed and the total duration of follow up was 1079 person-years. The incidences of diabetes mellitus and impaired fasting glucose were 1.39 case/100person-years and 6.02 case/100person-years. Most of the cases were non-obese type II diabetes and these patients showed insulin resistance and impaired beta cell function. On the risk factor analysis, the factors contributing to the development of diabetes were age, a decrease of the viral load and indinavir use. CONCLUSIONS: In our study, the incidence of diabetes among Korean HIV-positive patients on HAART was 1.39case/100person-years. Age, a decrease of the viral load and indinavir use were the risk factors for development of diabetes mellitus.
Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; Case-Control Studies ; Cohort Studies ; Diabetes Mellitus ; Fasting ; Follow-Up Studies ; Glucose ; HIV ; HIV Infections ; Humans ; Incidence ; Indinavir ; Insulin Resistance ; Protease Inhibitors ; Retrospective Studies ; Risk Factors ; Viral Load

To evaluate factors associated with human immunodeficiency virus type 1 (HIV-1) proviral DNA load, we conducted a cross-sectional study of 36 chronically HIV-1- infected individuals with undetectable plasma viral RNA. We used real-time polymerase chain reaction to determine the number of HIV-1 proviral DNA copies per 10(6) peripheral blood mononuclear cells. The mean level of plasma viral RNA when the CD4+ T cell count was above 500 cells/microliter without highly active antiretroviral therapy (HAART) was significantly associated with proviral DNA load at the time of undetectable plasma HIV RNA with HAART. Strategies to reduce the level of plasma viral RNA when patients' CD4+ T cell counts are above 500 cells/microliter without HAART could help reduce HIV-1 proviral DNA load.
Anti-HIV Agents/therapeutic use ; Antiretroviral Therapy, Highly Active ; CD4-Positive T-Lymphocytes/virology ; Cross-Sectional Studies ; DNA, Viral/*analysis ; Female ; HIV Infections/drug therapy ; HIV-1/*genetics ; Humans ; Male ; Polymerase Chain Reaction ; Proviruses/*genetics ; RNA, Viral/blood

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominantly inherited syndrome. MEN1 is characterized by the presence of functioning and nonfunctioning tumors or hyperplasia of the pituitary gland, parathyroid glands, and pancreatic islet cells. In addition, MEN1 carriers can have adrenal or thyroid tumors and non-endocrine tumors, such as lipomas, angiofibromas, and leiomyomas. Although leiomyoma is not a major component of MEN1, it is thought to occur more frequently than expected. However, there has been no report of a case of MEN1 with leiomyoma in Korea so far. This report describes a patient with multiple leiomyomas in MEN1. A 50-year-old woman was referred for further evaluation of elevated calcium levels and osteoporosis. Biochemical abnormalities included hypercalcemia with elevated parathyroid hormone. There was hyperprolactinemia with pituitary microadenoma in sella MRI. An abdominal MRI demonstrated adrenal nodules and leiomyomas in the bladder and uterus. Endoscopic ultrasonography demonstrated esophageal leiomyoma and pancreatic islet cell tumor. A subtotal parathyroidectomy with thymectomy was performed. Sequencing of the MEN1 gene in this patient revealed a novel missense mutation (D350V, exon 7). This is the first case of MEN1 accompanied with multiple leiomyomas, parathyroid adenoma, pituitary adenoma, pancreatic tumor, and adrenal tumor.
Base Sequence ; Female ; Humans ; Leiomyomatosis/genetics/*metabolism/*pathology/radiography ; Magnetic Resonance Imaging ; Middle Aged ; Multiple Endocrine Neoplasia Type 1/genetics/*metabolism ; Mutation/genetics