• 한국콘텐츠학회논문지
• /
• 제16권4호
• /
• pp.729-740
• /
• 2016

본 연구에서는 만성 B형간염 환자의 자가간호 수행을 위한 스마트폰 애플리케이션 개발을 위해 374명의 만성 B형간염 환자를 대상으로 소비자 요구도를 조사하였다. 대상자들의 평균 연령은 46.2세였다. 만성 B형간염 관련 정보를 취득하는 경로는 인터넷(41.3%), 의료진(23.8%), TV(15.6%) 순이었고 스마트폰은 6.2%에 불과하였다. 스마트폰에서 정보를 취득하지 않는 이유는 '유용한 애플리케이션이 없어서'(75.9%), '정보를 믿을 수 없어서'(15.0%)로 답하였다. 애플리케이션 개발 시 사용 의도는 '활발히 사용하겠다'(59.9%), '필요시 사용하겠다'(33.2%)로 조사되었다. 애플리케이션 개발 시 요구되는 기능은 '질병 관련 지식 전달'(27.1%), '투약달력'(16.8%), '정보에 대한 참고문헌'(15.5%), '검사결과 기록'(14.6%) 등이었다. 나이 및 교육 정도에 따른 스마트폰 활용능력은 차이가 있었으나 스마트폰 개발 필요성에 대해서는 차이가 없었다. 또한, 나이 및 교육 정도에 따라 애플리케이션의 콘텐츠 요구 정도는 차이가 있었다. 이에, 나이와 교육수준을 고려한 만성 B형간염 환자의 자가간호 수행을 위한 스마트폰 애플리케이션을 개발한다면 만성 B형간염 환자의 자가간호 수행에 도움을 줄 수 있는 도구로 널리 활용될 수 있을 것이다.

• Perspectives in Nursing Science
• /
• 제7권1호
• /
• pp.50-54
• /
• 2010

The studies of M. Colombo (1989) and W. Lange (1992) showed that 30~40% of people became chronic after suffering from hepatitis B virus (HBV) and C virus (HCV) infection, and about 50% of the chronic cases transformed into primary liver cancer. There have been few studies done in Mongolia on hepatitis infection among health professionals, particularly in nurses. In a study done by Chimedsuren (8), the study showed that 19.4% of people with identified surface hepatitis B antigen (HBsAg) and antibodies to hepatitis C virus and 8% of people with the identified nucleotide of RNA for the hepatitis C virus (polymerase chain reaction) had an acute form of hepatitis C. Studies on the hepatitis virus genome damaging effect on liver cells showed that genotype 8 (A, B, C, D, E, F, G, TTV) had the most damaging effect on liver cells (Hahn and Faeka, 2007). Several studies have shown a relationship between hepatitis B virus infection and a lack of compliance regarding safety regulations and rules by medical personnel. Results of a study from the Maternal and Child Health Research Center showed that tests done to detect hepatitis B virus antigen and antibodies to C virus did not reveal anything. Both antigen and antibodies in 69% cases did not show, and separately, B virus and antibodies to hepatitis C virus were identified in 13% and 9%, respectively. Results of the tests taken from health personnel in Shastin Central Hospital showed that in 76% of the cases, the B virus antigen with C virus antibodies was not identified. In 8% of the cases, the B virus antigen was present on its own. The combination of B the virus antigen and C virus antibodies were present in 8% of nurses and doctors, respectively. 82% of the cases had negative results for the detection of a combination of B virus antigen and C virus antibodies taken from health personnel from the State Central Clinical Hospital whereas the B virus antigen and C virus antibodies by themselves were present in 7% and 14% of the cases, respectively. Combined cases of the B virus antigen and C virus antibodies were identified in 4% of the personnel. Results of the tests taken from the health personnel in the Hospital of the Ministry of Justice and Internal Affairs showed that in 79% of the cases, the B virus antigen with C virus antibodies were not identified. Separately, the B virus and antibodies to hepatitis C virus were identified in 8% and 13% of the cases, respectively.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제17권1호
• /
• pp.41-46
• /
• 2014

Purpose: The spontaneous seroconversion rate of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) virus infection in children is lower than that in adults. However, few studies have investigated the rate of transition from the immune-tolerant to the early immune-clearance phase in children. Methods: From February 2000 to August 2011, we enrolled 133 children aged <18 years who had visited the Department of Pediatrics, Kyungpook National University Hospital. All subjects were in the immune-tolerant phase of HBeAg-positive CHB virus infection. The estimated transition rate into the early immune-clearance phase was calculated using the Kaplan-Meier method. Results: Among the 133 enrolled pediatric CHB virus infection patients in the HBeAg-positive immune-tolerant phase, only 21 children (15.8%) had converted to the early immune-clearance phase. The average age at entry into active hepatitis was $10.6{\pm}4.8$ years. The incidence of transition from the immune-tolerant to the early immune-clearance phase in these children was 1.7 episodes/100 patient-years. When analyzed by age, the estimated transition rate was 4.6%, 7.1%, and 28.0% for patients aged <6, 6-12, >12 years, respectively. Conclusion: In children with CHB virus infection, the estimated rate of entry into the early immune-clearance phase was 28.0% for patients aged 12-18 years, which was significantly higher than that observed for children aged <12 years (11.7%; p=0.001).

• 대한간호학회지
• /
• 제39권6호
• /
• pp.805-817
• /
• 2009

Purpose: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. Methods: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. Results: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. Conclusion: Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제16권2호
• /
• pp.80-88
• /
• 2013

Purpose: To identify the predictive factors of long-term therapeutic response or resistance to lamivudine treatment in children and adolescents with chronic hepatitis B. Methods: Eighty one children and adolescents with chronic hepatitis B were included, who received lamivudine treatment for at least 6 months. Their condition was monitored for at least 12 months (12-88 months) thereafter. Twenty one (25.9%) were preschool children ($age{\leq}6$). For patients who had developed HBeAg seroconversion or breakthrough, univariate and multivariate analyses were used to identify the effects of age, gender, pretreatment alanine aminotransferase (ALT) and hepatitis B virus DNA levels. Results: HBeAg seroconversion occurred in 49 (60.5%) of the 81 patients after the initiation of the lamivudine therapy. In 65 patients whom were monitored for over 24 months, the seroconversion rate was significantly higher in younger patients (p=0.040), especially in those patients of preschool age ($age{\leq}6$, p=0.031). The seroconversion rate was significantly higher in higher pretreatment ALT (p=0.003). The breakthrough occurred in 21 (25.9%) of the 81. The breakthrough rate was lower in younger aged patients ($age{\leq}6$), and with higher pretreatment ALT levels, but no significant difference. Conclusion: Younger age is a good predictor of HBeAg seroconversion in children with long-term lamivudine treatment as well as high pretreatment ALT levels.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제3권2호
• /
• pp.169-174
• /
• 2000

목 적: 만성 C형 간염 환자에서 인터페론 치료후 녹내장이 발생하였다는 보고가 전세계적으로 1례 있어왔다. 최근 저자들도 15세된 만성 B형 간염 환자에게 인터페론 투여 후 녹내장이 생긴 예를 경험한 바 있어 만성 B형 간염 환자에서 인터페론 치료와 녹내장 발생과의 연관성을 알아보고자 본 연구를 전향적으로 시행하였다. 방 법: 1998년 2월부터 1999년 7월까지 인하대학교 병원에서 만성 B형 간염으로 진단 받고 인터페론 알파를 투여받은 9명의 환아(남아 4명, 여아 5명)을 대상으로 전향적으로 연구하였다. 인터페론 투여 전, 투여 3개월 후, 6개월 후 안과적 검사를 통하여 시력검사, 안압, C/D비, 시야검사를 측정 비교하였다. 결 과: 1) 대상환아들의 평균 연령은 $11.7{\pm}4.1$세, 투여기간은 6개월이었고 평균 투여량은 5백만 단위였다. 2) 각 환아들의 인터페론 투여 전 시력, 안압, C/D비를 투여 3개월 후, 6개월 후에 비교하였을 때 유의한 변화는 없었다. 3) 시야검사에서는 시야결손은 한 명도 발생하지 않았다. 결 론: 만성 B형 간염 환아에게서 인터페론 치료 후 녹내장이 발생하여, 이후 9명의 만성 B형 간염 환아를 대상으로 인터페론 치료 후 안압증가 여부 등을 전향적으로 조사하였지만 유의한 차이는 없었다. 하지만 인터페론 투여 후 녹내장 및 안과질환 발생 가능성에 대해 지속적인 관심이 필요할 것으로 보인다.

• The Korean Journal of Physiology and Pharmacology
• /
• 제17권5호
• /
• pp.375-383
• /
• 2013

Hepatocellular carcinoma (HCC) related to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections is thought to account for more than 80% of primary liver cancers. Both HBV and HCV can establish chronic liver inflammatory infections, altering hepatocyte and liver physiology with potential liver disease progression and HCC development. Cyclophilin A (CypA) has been identified as an essential host factor for the HCV replication by physically interacting with the HCV non structural protein NS5A that in turn interacts with RNA-dependent RNA polymerase NS5B. CypA, a cytosolic binding protein of the immunosuppressive drug cyclosporine A, is overexpressed in many cancer types and often associated with malignant transformation. Therefore, CypA can be a good target for molecular cancer therapy. Because of antiviral activity, the CypA inhibitors have been tested for the treatment of chronic hepatitis C. Nonimmunosuppressive Cyp inhibitors such as NIM811, SCY-635, and Alisporivir have attracted more interests for appropriating CypA for antiviral chemotherapeutic target on HCV infection. This review describes CypA inhibitors as a potential HCC treatment tool that is contrived by their obstructing chronic HCV infection and summarizes roles of CypA in cancer development.

• Gut and Liver
• /
• 제12권6호
• /
• pp.615-622
• /
• 2018

Despite the well-proven, safe and effective therapies for hepatitis B infection, delivery of treatment remains a significant challenge in resource-poor settings. Geopolitical and economic restrictions present additional difficulties in providing care in North Korea. However, treatment of patients with chronic hepatitis B remains a top priority for both the North Korean Ministry of Public Health and international agencies working in North Korean hepatitis healthcare facilities. Working in partnership, a path was created to institute this much-needed program. A consortium of United States and Australian humanitarian non-governmental organizations along with generous individual and corporate donors working in concert with local and national health authorities have succeeded in establishing the first hepatitis B treatment program in North Korea. The essential elements of this program include renovation of existing hepatitis hospitals, access to antiviral medications, establishment of laboratory facilities, creation of medical documentation and record-keeping, training of local health care professionals, and quarterly visits by international volunteer physicians and laboratory experts. Management and treatment decisions are made bilaterally. To date, nearly 1,500 patients have been evaluated, and over 800 have been started on long-term antiviral therapy. It is envisioned that this program will eventually be managed and funded by the Democratic People's Republic of Korea Ministry of Public Health. This program's success demonstrates a potential model for delivery of antiviral therapy for patients suffering from hepatitis B in other developing countries.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권2호
• /
• pp.637-642
• /
• 2014

The pathogenesis of hepatocellular carcinoma (HCC) related to habitual betel quid (BQ) chewing is unclear. Risk of HCCis increased with adverse hepatic fibrosis. This study aimed to assess the impact of chronic viral hepatitis on adverse hepatic fibrosis in HCC related to BQ chewing. This hospital-based case-control study enrolled 200 pairs of age- and gender-matched patients with HCC and unrelated healthy controls. Serologic hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV), ${\alpha}$-fetoprotein (AFP), and surrogate markers for significant hepatic fibrosis were measured. Information on substance-use habits was obtained with a questionnaire. By analysis of surrogate markers for hepatic fibrosis, the prevalence of significant hepatic fibrosis in patients chewing BQ was between 45.8% and 91.7%, whereas that for patients without BQ chewing was between 18.4% and 57.9%. The difference was significant (P <0.05 for each surrogate marker). Multivariate analysis indicated that cirrhosis with Child-Pugh C (odds ratio (OR) = 3.28; 95% confidence interval (CI), 1.29-8.37), thrombocytopenia (OR = 3.92, 95% CI, 1.77-8.68), AFP >400 mg/L (OR = 2.21, 95% CI, 1.05-4.66) and male gender (OR = 4.06, 95% CI, 1.29-12.77) were independent factors associated with habitual BQ chewing. In conclusion, adverse hepatic fibrosis and severe liver damage play important roles in the pathogenesis of BQ-related HCC, which could be aggravated by chronic hepatitis B and hepatitis C. BQ-cessation programs and prevention of chronic HBV/HCV infection are needed to prevent HCC related to BQ chewing.

• 한국임상약학회지
• /
• 제26권3호
• /
• pp.220-229
• /
• 2016

Background: The treatment goal for patients with chronic hepatitis B infection is to prevent progression of the disease to cirrhosis and hepatocellular carcinoma. Current therapies include standard and pegylated interferon-alfa and nucleoside/nucleotide analogues: lamivudine, adefovir, entecavir, telbivudine, clevudine, and tenofovir. This study aims to analyze changes in the prescribing patterns of chronic hepatitis B (CHB) medications in South Korea between 2013 and 2014. Methods: A cross-sectional study was conducted using National Patients Sample data compiled by the Health Insurance Review and Assessment Service from 2013 and 2014. Patients with CHB were identified with Korean Standard Classification of Diseases code-6 (B18.0 and B18.1) and those who were maintaining active prescriptions with CHB medications covering the index date (December $1^{st}$, each year) were included. The utilization of antiviral therapy was investigated during 2013 and 2014. Results: A total of 4,204 and 4,552 patients in 2013 and 2014 respectively, were included in the analysis. The proportion of male patients was two of third and the patients 41-60 years old accounted for 60% of all analyzed patients. The most utilized drug was entecavir (55.1% in 2013 and 44.8% in 2014) and the second most utilized drug was tenofovir in both years (18.8% in 2013 and 29.0% in 2014). The percentage of combination therapy was 13.6% and 13.1% in 2013 and 2014, respectively. The proportion of tenofovir prescriptions was increased in 2014 compared with 2013. Conclusion: With the development of new drugs and the changes in clinical practice guidelines, the prescription pattern of the antiviral agents for patients with CHB has changed. The rate of utilization of tenofovir has increased.