• BMB Reports
• /
• 제40권5호
• /
• pp.814-824
• /
• 2007

Liver cirrhosis (LC) is defined as comprising diffuse fibrosis and regenerating nodules of the liver. The biochemical and anatomical dysfunction in LC results from both reduced liver cell number and portal vascular derangement. Although several studies have investigated dysregulated genes in cirrhotic nodules, little is known about the genes implicated in the pathophysiologic change of LC or about their relationship with the degree of decompensation. Here, we applied cDNA microarray analysis using 38 HBsAg-positive LC specimens to identify the genes dysregulated in HBV-associated LC and to evaluate their relation to disease severity. Among 1063 known cancer- and apoptosis-related genes, we identified 104 genes that were significantly up- (44) or down- (60) regulated in LC. Interestingly, this subset of 104 genes was characteristically correlated with the degree of decompensation, called the Pugh-Child classification (20 Pugh-Child A, 10 Pugh-Child B, and 8 Pugh-Child C). Patient samples from Pugh-Child C exhibited a distinct pattern of gene expression relative to those of Pugh-Child A and B. Especially in Pugh-Child C, genes encoding hepatic proteins and metabolizing enzymes were significantly down-regulated, while genes encoding various molecules related to cell replication were up-regulated. Our results suggest that subsets of genes in liver cells correspond to the pathophysiologic change of LC according to disease severity and possibly to hepatocarcinogenesis.

• Tuberculosis and Respiratory Diseases
• /
• 제66권1호
• /
• pp.47-51
• /
• 2009

간폐증후군은 간질환이 있는 환자에서 저산소증이 유발되는 상태로 폐내 혈관 확장으로 인해 폐내 동맥혈 산소공급에 결함이 발생하는 질환이다. 현재까지 간이식 외에 간폐증후군에 대한 다른 효과적인 치료법은 없는 것으로 알려져 있다. 국내에서는 간폐증후군의 증례 보고가 드물고, 특히 Child-Pugh 분류 A군에서의 발생 빈도는 낮은 것으로 보인다. 이에 저자들은 Child-Pugh 분류 A군인 대상성 간경화 환자에서 발생한 간폐증후군 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다.

• 대한한방내과학회지
• /
• 제30권1호
• /
• pp.241-248
• /
• 2009

Object : Liver cirrhosis is a disease of the liver in which normal cells are replaced by scar tissue. The purpose of this case is to report the improvement of liver cirrhosis after herb-med, acupuncture & moxibustion complex therapy. Methods : We provided herb-med, acupuncture & moxibustion complex therapy to a patient who suffered from ascites and fatigue. We examined LFT & Child-Pugh class to evaluate the effectiveness of oriental treatment. Result and Conclusion : We observed that herb-mod. acupuncture & moxibustion complex therapy decreased symptoms of liver cirrhosis and improved general condition of a patient who suffered from ascites and fatigue. In the LFT result, Child-Pugh class was improved.

• Journal of Yeungnam Medical Science
• /
• 제17권1호
• /
• pp.66-74
• /
• 2000

1991년 3월부터 1995년 3월까지 영남대학교 의과대학 부속병원 내과에서 입원해서 혈청학적, 방사선학적 및 조직학적으로 간세포함으로 진단받은 156명의 환자 중 진단당시부터 폐전이를 동반한 12명(7.7%)을 제외한 144명의 환자를 대상으로 최소한 5개월 이상을 추적관찰하여 폐전이를 동반한 경우와 동반하지 않은 경우로 나누어 나이, 성별, Child-Pugh 점수, 간경변증 동반유무, AFP치 및 간동맥 색전술여부 등을 조사하여 그 차이점을 비교 분석하여 다음과 같은 결과를 얻었다. 추적관찰 중 폐전이를 동반한 경우가 26례(18.0%)였는데 간동맥 색전술을 시행한 경우가 26례 중 24례(92.3%), 시행하지않은 경우가 26례 중 2례(7.7%)였다. 폐전이를 동반하지 않은 118례 가운데 간동맥 색전술을 시행한 경우가 78례, 시행하지 않은 경우가 40례였다. 따라서 간동맥 색전술 시행후 폐전이를 동반한 경우가 102례 중 24례(23.5%), 간동맥 색전술을 시행하지 않고 폐전이를 동반한 경우가 42례 중 2례(4.7%)로 나타나서 간동맥 색전술 이후 폐전이가 더 빈번함을 알 수 있었다(p<0.01). 그러나, 나이, 성별, Child-Pugh 접수, 간경변증 동반유무 및 AFP치는 차이를 보이지 않았다. 결론적으로 간세포암에서 간동맥 색전술 이후 폐전이가 보다 많이 동반됨을 알 수 있었고 이에 관련되는 근본적인 설명과 그외 관련인자들에 대한 보다 많은 연구가 필요할 것으로 사료된다.

• Journal of Gastric Cancer
• /
• 제13권4호
• /
• pp.207-213
• /
• 2013

Purpose: We investigated early postoperative morbidity and mortality in patients with liver cirrhosis who had undergone radical gastrectomy for gastric cancer. Materials and Methods: We retrospectively reviewed the medical records of 41 patients who underwent radical gastrectomy at the Chonnam National University Hwasun Hospital (Hwasun-gun, Korea) between August 2004 and June 2009. There were few patients with Child-Pugh class B or C; therefore, we restricted patient selection to those with Child-Pugh class A. Results: Postoperative complications were observed in 22 (53.7%) patients. The most common complications were ascites (46.3%), postoperative hemorrhage (22.0%) and wound infection (12.2%). Intra-abdominal abscess developed in one (2.4%) patient who had undergone open gastrectomy. Massive ascites occurred in 4 (9.8%) patients. Of the patients who underwent open gastrectomy, nine (21.9%) patients required blood transfusions as a result of postoperative hemorrhage. However, most of these patients had advanced gastric cancer. In contrast, most patients who underwent laparoscopic gastrectomy had early stage gastric cancer, and when the confounding effect from the different stages between the two groups was corrected statistically, no statistically significant difference was found. There was also no significant difference between open and laparoscopic gastrectomy in the occurrence rate of other postoperative complications such as ascites, wound infection, and intra-abdominal abscess. No postoperative mortality occurred. Conclusions: Laparoscopic gastrectomy is a feasible surgical procedure for patients with moderate hepatic dysfunction.

• Radiation Oncology Journal
• /
• 제34권3호
• /
• pp.168-176
• /
• 2016

Purpose: The purpose of current study is to evaluate the response of the patients with portal vein thrombosis (PVT) or hepatic vein thrombosis (HVT) in hepatocellular carcinoma (HCC) treated with three-dimensional conformal radiation therapy (3D-CRT). In addition, survival of patients and potential prognostic factors of the survival was evaluated. Materials and Methods: Forty-seven patients with PVT or HVT in HCC, referred to our department for radiotherapy, were retrospectively reviewed. For 3D-CRT plans, a gross tumor volume (GTV) was defined as a hypodense filling defect area in the portal vein (PV) or hepatic vein (HV). Survival of patients, and response to radiation therapy (RT) were analyzed. Potential prognostic factors for survival and response to RT were evaluated. Results: The median survival time of 47 patients was 8 months, with 1-year survival rate of 15% and response rate of 40%. Changes in Child-Pugh score, response to RT, Eastern cooperative oncology group performance status (ECOG PS), hepatitis C antibody (HCVAb) positivity, and additional post RT treatment were statistically significant prognostic factors for survival in univariate analysis (p = 0.000, p = 0.018, p = 0.000, p = 0.013, and p = 0.047, respectively). Of these factors, changes in Child-Pugh score, and response to RT were significant for patients' prognosis in multivariate analysis (p = 0.001 and p = 0.035, respectively). Conclusion: RT could constitute a reasonable treatment option for patients with PVT or HVT in HCC with acceptable toxicity. Changes in Child-Pugh score, and response to RT were statistically significant factors of survival of patients.

• Clinical Endoscopy
• /
• 제56권5호
• /
• pp.578-589
• /
• 2023

Background/Aims: The safety of endoscopic retrograde cholangiopancreatography (ERCP) in hepatic cirrhosis and the impact of Child-Pugh class on post-ERCP complications need to be better studied. We investigated the post-ERCP complication rates in patients with cirrhosis compared with those without cirrhosis. Methods: We conducted a literature search of relevant databases to identify studies that reported post-ERCP complications in patients with hepatic cirrhosis. Results: Twenty-four studies comprising 28,201 patients were included. The pooled incidence of post-ERCP complications in cirrhosis was 15.5% (95% confidence interval [CI], 11.8%-19.2%; I²=96.2%), with an individual pooled incidence of pancreatitis 5.1% (95% CI, 3.1%-7.2%; I²=91.5%), bleeding 3.6% (95% CI, 2.8%-4.5%; I²=67.5%), cholangitis 2.9% (95% CI, 1.9%-3.8%; I²=83.4%), and perforation 0.3% (95% CI, 0.1%-0.5%; I²=3.7%). Patients with cirrhosis had a greater risk of post-ERCP complications (risk ratio [RR], 1.41; 95% CI, 1.16-1.71; I²=56.3%). The risk of individual odds of adverse events between cirrhosis and non-cirrhosis was as follows: pancreatitis (RR, 1.25; 95% CI, 1.06-1.48; I²=24.8%), bleeding (RR, 1.94; 95% CI, 1.59-2.37; I²=0%), cholangitis (RR, 1.15; 95% CI, 0.77-1.70; I²=12%), and perforation (RR, 1.20; 95% CI, 0.59-2.43; I²=0%). Conclusions: Cirrhosis is associated with an increased risk of post-ERCP pancreatitis, bleeding, and cholangitis.

• 대한영상의학회지
• /
• 제79권5호
• /
• pp.264-270
• /
• 2018

목적: 간기능이 보존된 간세포암 환자에서 간문맥 고혈압이 고주파열치료 후 종양 재발에 미치는 영향을 평가한다. 대상과 방법: 2010년 1월에서 2017년 3월 사이에 Milan criteria 및 Child-Pugh class A를 가진 신규 간세포암 환자 중 본원에서 고주파열치료를 시행한 환자가 본 연구에 포함되었다. 종양 재발에 대한 예측인자를 찾기 위해 Cox proportional hazard model을 이용한 단변량 및 다변량 분석을 수행하였다. 결과: 모두 178명의 환자가 본 연구에 포함되었다. 추적 관찰 기간의 중앙값은 42.8개월이었다. 국소 재발률은 문맥고혈압 여부에 따라 뚜렷한 차이를 유발하지 않았다(p = 0.195). 3년 및 5년 원위부 간내 종양 재발률은 문맥고혈압이 없는 환자의 경우 각각 29.5%와 53.7%, 그리고 문맥고혈압이 있는 환자의 경우 51.9%와 63.6%였으며 두 군 사이의 차이는 통계적으로 유의하였다(p = 0.011). 단변량 및 다변량 분석에서 문맥압항진은 원위부 간내 종양 재발에 대한 독립적인 예측 인자이었다(p = 0.008). 결론: Child-Pugh class A를 가진 간세포암 환자의 경우, 문맥고혈압은 종양 재발에 불량 예후인자로 작용하였다.

• 한국환경보건학회지
• /
• 제38권5호
• /
• pp.380-385
• /
• 2012

Background: Manganese (Mn) has been found to increase the signal intensity of the globus pallidus (GP) on T1-weighted magnetic resonance images (MRI). We performed this study in order to determine the features of liver disease that correlate with pallidal signal intensities. Methods: We assessed blood Mn levels and pallidal signals in T1-weighted MRI in 49 patients with liver cirrhosis and 23 healthy controls. Results: Increased signal intensity in the GP was observed in 30 of 49 (61.2%) patients with liver cirrhosis, with the pallidal index (PI) in patients with Child-Pugh classes B and C differing significantly from the PI in controls. Multiple linear regression analysis showed that blood Mn concentrations and Child-Pugh scores in cirrhotics were significantly associated with increased PI after controlling for other confounders (p<0.05 each). Conclusions: Pallidal signals on T1-weighted MRI are mainly observed in advanced liver cirrhosis. The present study suggests that advanced liver cirrhosis may be a human model for manganism.

• 대한한방내과학회지
• /
• 제37권1호
• /
• pp.135-142
• /
• 2016

Objectives: To introduce the effect of traditional Korean medicine (TKM) treatment with Injinoryeong-san on alcoholic liver cirrhosis (ALC).Methods: A 37-year-old man with a history of alcohol ingestion for the past five years was diagnosed with ALC based upon his clinical symptoms, sonogram results, and laboratory studies. The patient received TKM treatment with acupuncture, moxibustion, and Injinoryeong-san in parallel to Western medicine for two weeks. The clinical assessment was monitored based upon changes in the Child-Pugh score and ultrasonography, body weight, and abdominal circumference for measuring the amount of ascites.Results: The patient’s clinical symptoms improved with decreases in abdominal circumference and body weight. Ultrasound revealed a regression of the amount of ascites in the abdominal cavity. Laboratory results also improved significantly, and the Child-Pugh score increased from class B to A.Conclusions: This case report showed a significant improvement of ALC with relatively simple treatment for only a short period and therefore supported the potential of TKM treatment in ALC.