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  • 1
    Online Resource
    Online Resource
    Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-Sero SMART): findings from national representative sample
    Korean Society of Epidemiology ; 2023
    In:  Epidemiology and Health
    Details
    In: Epidemiology and Health, Korean Society of Epidemiology
    Abstract: OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SMART) in 258 communities throughout Korea.METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of anti-spike (anti-S) and anti-nucleocapsid (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022.RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in South Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%.CONCLUSIONS: The K-SMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.
    Type of Medium: Online Resource
    ISSN: 2092-7193
    URL: Article
    DOI: 10.4178/epih.e2023075
    Language: English
    Publisher: Korean Society of Epidemiology
    Publication Date: 2023
    detail.hit.zdb_id: 2590698-7
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  • 2
    Online Resource
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    Sustained off therapy response after peglyated interferon favours functional cure and no disease progression in chronic hepatitis B
    Wiley ; 2021
    In:  Liver International Vol. 41, No. 2 ( 2021-02), p. 288-294
    Details
    In: Liver International, Wiley, Vol. 41, No. 2 ( 2021-02), p. 288-294
    Abstract: Nucleos(t)ide analogue (NA) therapy in chronic hepatitis B (CHB) patients reduces liver‐related mortality. However, long‐term outcomes after pegylated interferon (PEG‐IFN) therapy remain to be elucidated. Therefore, we aimed to investigate the long‐term effectiveness and clinical outcomes of PEG‐IFN therapy. Methods A total of 190 patients treated with PEG‐IFN for CHB or compensated cirrhosis were consecutively enrolled between 2005 and 2014, and 122 patients who completed the treatment were analysed. The initial response was assessed at 6 months post‐treatment and defined as achieving both 〈 2000 IU/mL HBV DNA and HBeAg loss or seroconversion in the HBeAg‐positive group, and 〈 2000 IU/mL HBV DNA in the HBeAg‐negative group. The rates of HBsAg loss, disease progression to cirrhosis or HCC, and sustained off‐therapy response, defined as not requiring further NAs because of low viremia and liver enzymes, were analysed. Results The median follow‐up period was 7.2 years. Forty‐three (35.2%) patients achieved an initial response and 53 patients (43.4%) achieved a sustained response. Initial responders displayed higher rates of sustained response than noninitial responders (69.6% vs 32.5%, P   〈  .001). A higher rate of HBsAg loss was observed in patients who achieved a sustained response than in non‐sustained responders (16.2% vs 2.5%, P  = .01). Disease progression to cirrhosis or HCC was observed in eight patients (6.6%) who were nonsustained responders. Conclusions During long‐term follow‐up after PEG‐IFN treatment, nearly half of patients achieved sustained response without the need of further NA and these patients displayed favourable outcomes, including HBsAg loss and no disease progression.
    Type of Medium: Online Resource
    ISSN: 1478-3223 , 1478-3231
    URL: Issue
    URL: Article
    DOI: 10.1111/liv.v41.2
    DOI: 10.1111/liv.14701
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2124684-1
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  • 3
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    Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 18 ( 2021-09-07), p. 4045-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 18 ( 2021-09-07), p. 4045-
    Abstract: The comparative efficacy and safety between lenvatinib and hepatic artery infusion chemotherapy (HAIC) in patients with unresectable hepatocellular carcinoma (HCC) is still unclear. This multicenter historical cohort study enrolled 244 patients who were treated with HAIC (n = 173) or lenvatinib (n = 71) between 2012 and 2020. Propensity score matching (PSM) was performed, and 52 patients were selected per group. Clinical outcomes and safety were compared. Objective response rate (ORR) was not different between the two groups (26.0% vs. 23.1%, p = 0.736). Before PSM, the HAIC group had a higher proportion of Child-Pugh B and portal vein tumor, whereas the lenvatinib group had more patients with extrahepatic metastases, which was adjusted after PSM. There were no differences in progression-free survival (PFS) and overall survival (OS) after PSM (HAIC vs. lenvatinib, median PFS, 3.6 vs. 4.0 months, p = 0.706; median OS 10.8 vs. 7.9 months, p = 0.106). Multivariate Cox-regression showed that alpha-fetoprotein ≤1000 ng/mL was only an associated factor for OS after PSM in all patients (hazard ratio = 0.421, p = 0.011). Subgroup analysis for patients with a high tumor burden beyond the REFLECT eligibility criteria revealed that the HAIC group (n = 29) had a significantly longer OS than did the lenvatinib group (n = 30) (10.0 vs. 5.4 months, p = 0.004). More patients in the HAIC group achieved better liver function than those in the lenvatinib group at the time of best responses. There was no difference in the incidence of grade 3 and 4 adverse events between the two groups. Therefore, lenvatinib is comparable to HAIC in terms of ORR and OS in unresectable HCC meeting REFLECT eligibility criteria.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm10184045
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662592-1
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  • 4
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    Safety and effectiveness of direct-acting antivirals in patients with chronic hepatitis C and chronic kidney disease
    Korean Association of Internal Medicine ; 2022
    In:  The Korean Journal of Internal Medicine Vol. 37, No. 5 ( 2022-09-01), p. 958-968
    Details
    In: The Korean Journal of Internal Medicine, Korean Association of Internal Medicine, Vol. 37, No. 5 ( 2022-09-01), p. 958-968
    Abstract: Background/Aims: To evaluate the effectiveness and safety of direct acting antivirals (DAAs) available in chronic kidney disease (CKD) patients with hepatitis C virus (HCV) infection in Korea.Methods: In a retrospective, multicenter cohort study, 362 patients were enrolled from 2015 to 2019. The effectiveness and safety of DAAs including glecaprevir/pibrentasvir, sofosubvir/ribavirin, ledipasvir/sofosbuvir, and daclatasvir/asunaprevir were analyzed for patients according to CKD stage. We evaluated sustained virologic response at week 12 after treatment (SVR12) as primary endpoint. The effectiveness and safety were also evaluated according to CKD stage.Results: Among 362 patients, 307 patients completed DAAs treatment and follow-up period after end of treatment. The subjects comprised 87 patients (62 with CKD stage 3 and 25 with CKD stage (4–5), of whom 22 were undergoing hemodialysis). HCV patients with CKD stage 1 and 2 (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m2) showed SVR12 of 97.2% and 95.4% respectively. SVR12 of CKD stage 3 and 4–5 (eGFR 〈 60 mL/min/1.73 m2) patients was 91.9% and 91.6% respectively. Patients undergoing hemodialysis achieved SVR12 (90.9%). Treatment failure of DAAs in stage 1, 2, 3, and 4–5 was 2.8%, 2.7%, 1.6%, and 4%. DAAs showed good safety profile and did not affect deterioration of renal function.Conclusions: DAAs shows comparable SVR12 and safety in CKD patients (stage 3, 4, and 5) with HCV compared with patients with stage 1 and 2. The effectiveness and safety of DAAs may be related to the treatment duration. Therefore, it is important to select adequate regimens of DAAs and to increase treatment adherence.
    Type of Medium: Online Resource
    ISSN: 1226-3303 , 2005-6648
    URL: Article
    DOI: 10.3904/kjim.2021.486
    Language: English
    Publisher: Korean Association of Internal Medicine
    Publication Date: 2022
    detail.hit.zdb_id: 2500508-X
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  • 5
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    A Real-World Comparative Analysis of Atezolizumab Plus Bevacizumab and Transarterial Chemoembolization Plus Radiotherapy in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis
    MDPI AG ; 2023
    In:  Cancers Vol. 15, No. 17 ( 2023-09-04), p. 4423-
    Details
    In: Cancers, MDPI AG, Vol. 15, No. 17 ( 2023-09-04), p. 4423-
    Abstract: This study aimed to compare the treatment outcomes of atezolizumab-plus-bevacizumab (Ate/Bev) therapy with those of transarterial chemoembolization plus radiotherapy (TACE + RT) in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) and without metastasis. Between June 2016 and October 2022, we consecutively enrolled 855 HCC patients with PVTT. After excluding 758 patients, 97 patients (n = 37 in the Ate/Bev group; n = 60 in the TACE + RT group) were analyzed. The two groups showed no significant differences in baseline characteristics and had similar objective response and disease control rates. However, the Ate/Bev group showed a significantly higher one-year survival rate (p = 0.041) compared to the TACE + RT group, which was constantly displayed in patients with extensive HCC burden. Meanwhile, the clinical outcomes were comparable between the two groups in patients with unilobar intrahepatic HCC. In Cox-regression analysis, Ate/Bev treatment emerged as a significant factor for better one-year survival (p = 0.049). Finally, in propensity-score matching, the Ate/Bev group demonstrated a better one-year survival (p = 0.02) and PFS (p = 0.01) than the TACE + RT group. In conclusion, Ate/Bev treatment demonstrated superior clinical outcomes compared to TACE + RT treatment in HCC patients with PVTT. Meanwhile, in patients with unilobar intrahepatic HCC, TACE + RT could also be considered as an alternative treatment option alongside Ate/Bev therapy.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers15174423
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2527080-1
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  • 6
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    A Real-World Comparative Analysis of Lenvatinib and Sorafenib as a Salvage Therapy for Transarterial Treatments in Unresectable HCC
    MDPI AG ; 2020
    In:  Journal of Clinical Medicine Vol. 9, No. 12 ( 2020-12-21), p. 4121-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 9, No. 12 ( 2020-12-21), p. 4121-
    Abstract: Background/Aims: Lenvatinib was recently approved as a first-line oral multikinase inhibitor for unresectable hepatocellular carcinoma (HCC). In this study, we aimed to compare the efficacy and safety of lenvatinib and sorafenib for the treatment of unresectable HCC in patients with prior failure of transarterial treatment. Methods: Between January 2019 and September 2020, 98 unresectable HCC patients treated with lenvatinib or sorafenib as salvage therapy were enrolled from five Korean university-affiliated hospitals. Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and disease control rate were calculated to assess the antitumor response. Results: A total of 43 and 55 patients were treated with lenvatinib and sorafenib, respectively, as salvage therapy after the failure of transarterial treatments. The median PFS was 4.97 months in the lenvatinib group and 2.47 months in the sorafenib group (p = 0.001, log-rank test). The ORR was significantly higher in the lenvatinib group (25.6%) than in the sorafenib group (3.6%, p = 0.002). Use of lenvatinib over sorafenib (hazard ratio: 0.359, 95% confidence interval: 0.203–0.635, p 〈 0.001) was the most significant factor for a favorable PFS after the failure of transarterial treatments in all enrolled patients. For favorable OS, achieving objective response was the significant factor (hazard ratio 0.356, 95% confidence interval: 0.132–0.957, p = 0.041). There were no significant differences in the safety profile between the two groups. Conclusions: In this real-world study, lenvatinib was demonstrated to be more efficacious than sorafenib as a salvage therapy for transarterial treatments in unresectable HCC.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm9124121
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2662592-1
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  • 7
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    Online Resource
    Real-life experience of ledipasvir and sofosbuvir for HCV infected Korean patients: a multicenter cohort study
    Korean Association of Internal Medicine ; 2022
    In:  The Korean Journal of Internal Medicine Vol. 37, No. 6 ( 2022-11-01), p. 1167-1175
    Details
    In: The Korean Journal of Internal Medicine, Korean Association of Internal Medicine, Vol. 37, No. 6 ( 2022-11-01), p. 1167-1175
    Abstract: Background/Aims: To evaluate the efficacy and safety of ledipasvir/sofosbuvir (LDV/SOF) therapy in hepatitis C virus (HCV)-infected Korean patients in a real clinical setting.Methods: A total of 273 patients who received LDV/SOF therapy between May 2016 and February 2021 were consecutively enrolled and analyzed. A per-protocol analysis was performed to evaluate the virologic response.Results: Seventy-five percent were infected with genotype 1, and 25% were infected with genotype 2. A hundred eightyone (66.3%) patients had chronic hepatitis, 74 (27.1%) had compensated cirrhosis, eight (2.9%) had decompensated cirrhosis, and 10 (3.7%) had undergone liver transplantation. Undetectable HCV RNA at week 4 was achieved in 90.2% (231/256) of patients, 99.2% (250/252) achieved the end of treatment response, and 98.1% (202/206) achieved sustained virologic response at 12 weeks post-treatment (SVR12). According to liver function, the SVR12 rates were 99.3% (135/136) in chronic hepatitis, 96.4% (53/55) in compensated cirrhosis, and 100% (6/6) in decompensated cirrhosis. The SVR12 rates according to the genotype were 98.2% (167/170) for genotype 1 and 97.2% (35/36) for genotype 2. An 8-week LDV/SOF treatment in treatment-naïve chronic hepatitis patients with HCV RNA 〈 6,000,000 IU/mL at baseline resulted in 100% (23/23) SVR12 rates. Overall, LDV/SOF was tolerated well, with a 0.7% (2/273) discontinuation rate due to adverse events that were unrelated to LDV/SOF.Conclusions: LDV/SOF is effective and safe for treating HCV-infected Korean patients with high SVR12 rates.
    Type of Medium: Online Resource
    ISSN: 1226-3303 , 2005-6648
    URL: Article
    DOI: 10.3904/kjim.2022.013
    Language: English
    Publisher: Korean Association of Internal Medicine
    Publication Date: 2022
    detail.hit.zdb_id: 2500508-X
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  • 8
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    Comparison of tenofovir and entecavir on the risk of hepatocellular carcinoma and mortality in treatment-naïve patients with chronic hepatitis B in Korea: a large-scale, propensity score analysis
    BMJ ; 2020
    In:  Gut Vol. 69, No. 7 ( 2020-07), p. 1301-1308
    Details
    In: Gut, BMJ, Vol. 69, No. 7 ( 2020-07), p. 1301-1308
    Abstract: The use of tenofovir (TDF) and entecavir (ETV) in patients with chronic hepatitis B (CHB) has led to a decrease in the incidence of hepatocellular carcinoma (HCC) and liver-related events. However, whether there is a difference between the two agents in the extent of improving such outcomes has not been clarified thus far. Therefore, we aimed to compare TDF and ETV on the risk of HCC and mortality. Design A total of 7015 consecutive patients with CHB who were treated with TDF or ETV between February 2007 and January 2018 at the liver units of the Catholic University of Korea were screened for study eligibility and 3022 patients were finally analysed. Study end points were HCC and all-cause mortality or liver transplantation (LT) within 5 years after the initiation of antiviral therapy. Propensity score matching (PSM) and inverse probability of treatment weighting methods were used. Results No difference was observed between TDF and ETV in the incidence rates of HCC in the entire cohort (HR 1.030; 95% CI 0.703 to 1.509, PSM model, p=0.880) and subgroups of patients with chronic hepatitis and cirrhosis. Also, no difference was observed between TDF and ETV in the incidence rates of all-cause mortality or LT in the entire cohort (HR 1.090; 95% CI 0.622 to 1.911, PSM model, p=0.763), and patients with chronic hepatitis and cirrhosis. Conclusion This study has demonstrated the clinical outcomes in patients with CHB who received TDF or ETV treatment. There was no difference in the intermediate-term risk of HCC and mortality or LT between the two drugs.
    Type of Medium: Online Resource
    ISSN: 0017-5749 , 1468-3288
    URL: Article
    DOI: 10.1136/gutjnl-2019-318947
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 1492637-4
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  • 9
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    Prediction of Hepatocellular Carcinoma by On-Therapy Response of Noninvasive Fibrosis Markers in Chronic Hepatitis B
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  American Journal of Gastroenterology Vol. 116, No. 8 ( 2021-08), p. 1657-1666
    Details
    In: American Journal of Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 116, No. 8 ( 2021-08), p. 1657-1666
    Abstract: Antiviral therapy improves hepatic fibrosis and reduces hepatocellular carcinoma (HCC) incidence. This study aimed to evaluate whether on-therapy changes in scores for fibrosis index based on 4 factors and aspartate aminotransferase-to-platelet ratio index are associated with HCC development and establish an HCC risk score model incorporating noninvasive fibrosis marker (NFM) response. METHODS: This multicenter study recruited 5,147 patients with chronic hepatitis B (4,028 for derivation cohort and 1,119 for validation cohort) who were given entecavir/tenofovir for 〉 12 months between 2007 and 2018. A risk prediction model for HCC was developed using predictors based on multivariable Cox models, and bootstrapping was performed for validation. RESULTS: The 10-year cumulative HCC incidence rates were 12.6% and 13.7% in the derivation and validation cohorts, respectively. The risk of HCC significantly differed with early NFM response, with a marked reduction in HCC risk in patients achieving a significant decrease in NFM by 12 months ( P 〈 0.001). NFM response, sex, age, and cirrhosis were independently predictive of HCC. We developed the Fibrosis marker response, Sex, Age, and Cirrhosis (FSAC) score based on regression coefficients of each variable. For the 10-year prediction of HCC, FSAC showed higher C-index values than PAGE-B, modified PAGE-B, CU-HCC, and REACH-B (0.84 vs 0.77, 0.80, 0.77, and 0.67, respectively; all P 〈 0.005). The predictive performance of FSAC was corroborated in the validation cohort, with higher C-index than other models (all P 〈 0.050). DISCUSSION: On-therapy changes in NFM are an independent indicator of HCC risk. FSAC incorporating NFM response is a reliable risk score for risk estimation for HCC with better performance than other models.
    Type of Medium: Online Resource
    ISSN: 0002-9270 , 1572-0241
    URL: Article
    DOI: 10.14309/ajg.0000000000001219
    RVK:
    XA 18920
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 10
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    Unusual Treatment of Gastric Mucosa Associated Lymphoid Tissue Lymphoma Unresponsive to Helicobacter pylori Eradication
    Korean College of Helicobacter and Upper Gastrointestinal Research ; 2013
    In:  The Korean Journal of Helicobacter and Upper Gastrointestinal Research Vol. 13, No. 2 ( 2013), p. 109-
    Details
    In: The Korean Journal of Helicobacter and Upper Gastrointestinal Research, Korean College of Helicobacter and Upper Gastrointestinal Research, Vol. 13, No. 2 ( 2013), p. 109-
    Type of Medium: Online Resource
    ISSN: 1738-3331
    URL: Article
    DOI: 10.7704/kjhugr.2013.13.2.109
    Language: English
    Publisher: Korean College of Helicobacter and Upper Gastrointestinal Research
    Publication Date: 2013
    detail.hit.zdb_id: 3071420-5
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