• Title/Summary/Keyword: Chronic Hepatitis B

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The Differences in Frequencies and Clinical Manifestations According to the Causes of Membranous Nephropathy in Children (소아 막성 신병증의 원인에 따른 빈도 및 임상양상의 차이)

  • Mun, Yun-Hee;Kim, Se-Jin;Kim, Sung-Do;Cho, Byoung-Soo
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.162-173
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    • 2006
  • Purpose : To report the decreasing indicence of HBV(Hepatitis B virus)-associated membranous nephropathy in children after HBV vaccination and to elucidate the clinical course and treatment strategies of IMN(Idiopathic membranous nephropathy). Methods : We retrospectively reviewed the clinico-pathological findings of HBV-MN and IMN patients who underwent a renal biopsy from 1986 to 2005. We compared the HBV-MN and the IMN groups and the remission and the non-remission groups of patients with IMN. Results : Among 24 cases of MN patients, HBV-MN comprised 6 cases(25%) and IMN 18 cases(75%). Clinical masnifestations were nephrotic syndrome(3 cases, 50%), nephritic syndrome(1 case, 16.7%), asymptomatic(2 cases, 33.4%) in the HBV-MN group, asymptomatic(10 cases, 55.5%), nephrotic syndrome(5 cases, 27.8%), and gross hematuria(3 cases, 16.7%) in the IMN groups. From 1996 to 2000, there were 2 cases(28%) of HBV-MN and 5 cases(72%) of IMN. After 2001 all 10 cases were IMN. In the HBV-MN group, 4 cases(66.7%) received interferon and 1 cases received methylprednisolone pulse therapy. In the IMN group, 16 cases(88.9%) received methylprednisolone, 8 cases(44.4%) were in complete remission, 2 cases(11.1%) were in partial remission, 2 cases(11.1%) were in chronic renal failure, and 5 cases(27.8%) were lost to follow-up with sustained proteinuria, 1 case(5.6%) continued to have frequent relapse of nephrotic syndrome without renal insufficiency. In the comparison between remission and non-remission groups, nephrotic range proteinuria and hypertension were more significantly common in the non-remission group(P<0.05). Conclusion : With HBV vaccination, HBV-MN has decreased markedly. IMN is a rare glomerular disease in children. Because the prognosis for patients with nephrotic range proteinuria is poor this group needs more aggressive treatment.

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The Production of HBsAg in the Recombinant Yeast Cells (재조합 효모 세포내에서의 간염백신 생산)

  • Park, Cha-Yong;Lee, Hei-Chan
    • Microbiology and Biotechnology Letters
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    • v.14 no.6
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    • pp.455-460
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    • 1986
  • Dane particle was prepared from the plasma of chronic HBsAg carrier with high levels of HBsAg activity. DNA extracted front Dane particle core after a DNA polymerase reaction with $\alpha$-($^{32}$P) dNTP, was identified as HBV DNA by liquid scintillation counter and agarose gel electrophoresis-G.M. counting. To produce Hepatitis B surface antigen for use as a vaccine against Hepatitis B virus infection, yeast strains harboring recombinant plasmid with Apase promoter was used. Recombinant plasmid was construced from pHBV 130 and pAN 82, transformed into E coli, and then transferred into yeast strains. HBsAg was produced by derepression in Burkholder minimal medium with controlled inorganic phosphate concentration. The kinetics of HBsAg production was also investigated. Total HBsAg activity increased rapidly between 3 and 6 hours after transfer to phosphate-free medium and reached a maximum at around 9th hour. The transfer into phosphate-free medium after 6 hours in high phosphate cell growth medium gave maximum activity.

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Factors Associated with Periductal Fibrosis Diagnosed by Ultrasonography Screening among a High Risk Population for Cholangiocarcinoma in Northeast Thailand

  • Intajarurnsan, Sutheera;Khuntikeo, Narong;Chamadol, Nittaya;Thinkhamrop, Bandit;Promthet, Supannee
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4131-4136
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    • 2016
  • Background: The population in northeast Thailand continues to present with hepatobiliary abnormalities, particularly periductal fibrosis (PDF) which is the result of chronic infection with liver fluke (Opisthorchis viverini; OV) and may lead to the development of cholangiocarcinoma (CCA). Although the prevalence of OV infection has been decreased due to a liver fluke control program over decades, the prevalence of PDF remains high. This study aimed to investigate demographic factors associated with PDF risk based on ultrasonography (US) screening. Materials and Methods: This cross-sectional study is part of the Cholangiocarcinoma Screening and Care Program (CASCAP), a prospective cohort study. Multiple logistic regression was used for data analysis. Results: In 55,246 subjects, the overall prevalence of PDF was 33.0% (95%CI: 32.6 - 33.4). Males (33.9 %) were at higher risk for developing PDF than females (32.2 %) (ORcrude = 0.93; 95%CI: 0.89 - 0.96; p-value < 0.001). Factors associated with an increased PDF risk, in addition to OV infection, included old age (${\geq}70$ years) (ORadj = 1.28, 95% CI: 1.14 - 1.44, p < 0.001) and hepatitis B infection (ORadj = 1.31, 95% CI: 1.11 - 1.55, p = 0.001). In contrast, number of praziquantel treatments (> 2 times) (ORadj = 0.54, 95% CI: 0.47 - 0.63, p < 0.001) and diabetes mellitus (ORadj = 0.57, 95% CI: 0.49 - 0.65, p < 0.001) were significantly associated with a decreased PDF risk. Conclusions: Future US screening should closely examine older people and hepatitis B subjects for the purpose of PDF surveillance among high risk groups for CCA. However, the results of inverse associations require further investigation in order to confirm our findings.

Clinical Study on the efficacy of Panax ginseng C. A. Meyer on Acute viral(B) Hepatitis- (1) (고려인삼이 비루스성 급성간염의 치료효과에 미치는 임상학적 연구(1))

  • 구국회;주충노
    • Journal of Ginseng Research
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    • v.7 no.2
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    • pp.115-124
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    • 1983
  • The effect of ginseng administration on the patients of acute viral (B type) hepatitis has been oberved and the results were as follows. The albumin/globulin ratio of the ginseng administered group has significantly improved 4 weeks after admission while that of control group has not been improved suggesting that the ginseng might be effective in improving the protein metabolism. The thymol turbidity test again gave a similar result. Recovery of the disorder of bilirubin metabolism was also accelerated in the ginseng administered group compared with control group. The raised bilirubin value of the former returnedto the normal value 2 week after admission while that of the latter reached to normal 4-5 weeks after admission. However no significant difference of the bilirubin level between ginseng treated and non-treated groups could be observed. Cholesterol metabolism is also stimulated in ginseng administered group. The lowered cholesterol level of the ginseng group returned to normal 3-4 weeks after admission while that of latter reached to normal 5-6 weeks after admission. The raised S-GOT and S-GPT levels of the ginseng treated group returned to the normal value 3-4 weeks after admission while those of control group rehimed to normal in 5 weeks after admission suggesting that the ginseng improved impaired liver function. The improvement of the raised transaminase level seemed to be accelerate6 by the ginseng administration, however, no significant difference of the transaminase level between the ginseng treated and non-treated group could be observed. A significant effect of ginseng on the raised alkaline phosphatase level was observed. From the above results, it seemed that ginseng might stimulate the improvement of the disturbance of liver function, particularly at the early phase of its development of acute liver disease suggesting that panax ginseng might play a significant role in preventing the disease developing to be chronic.

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First Successful Dynamic Cardiomyoplasty in Korea (심근 성형술 1례 보고)

  • ;;;;;;;;Igor Dubrovski, Ph.D.
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.393-397
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    • 1998
  • A 25-year-old man with viral cardiomyopathy and chronic active hepatitis successfully underwent dynamic cardiomyoplasty for the first time in Korea on July 30, 1996. The patient had been intermittently dyspneic for 5 years and was admitted to our center twice because of heart failure. For the past 2 years, he was NYHA functional class III status with a left ventricular ejection fraction(LVEF) of around 30%. The patient was born with scoliosis and showed a short stature. The liver function showed elevated liver enzymes, and hepatitis B antigen was positive. The liver biopsy revealed chronic active hepatitis. The preoperative echocardiogram showed decreased left ventricular function with grade II mitral and grade II tricuspid regurgitation with dilated left and right atrium. Recently his symptoms worsened and we decided to perform a dynamic cardiomyoplasty. The left latissmus dorsi muscle(LDM) was mobilized and tested with lead placement on his right lateral decubitus position. The patient was positioned into supine and, after median sternotomy, the heart was wrapped with the mobilized muscle. The Russian made cardiomyostimulator(EKS-445) and leads (Myocardial PEMB for heart and PEMP-1 for LDM) were used. The total operation time was 8 hours and there were no perioperative episodes. Postoperatively the LDM had been trained for a 10 week period and currently the stimulation ratio is maintained at 1:4. The postoperative LVEF did not increase with the value of 30-35%. However, the patient feels better postoperatively with slightly increased activity.

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Chronic liver diseases following HBV carriers (B형 간염바이러스가 유발하는 간질환의 가족병태)

  • Lee, Gi-Jun;Cho, Jung-Hyo;Cho, Jong-Gwan;Son, Chang-Gue
    • Journal of Haehwa Medicine
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    • v.14 no.2
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    • pp.87-91
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    • 2005
  • Hepatitis B virus (HBV)는 전 세계적으로 약 3억 5천만 명이 만성적으로 보균하고 있으며, 한국에서도 보건의학적으로 가장 중요하여 높은 간암의 발병율과도 밀접한 관련이 있다. 최근에 와서 HBV가 유도하는 임상적 위험질환의 병태생리에 대해서 면역학적 지식의 발전을 바탕으로 이해가 깊어졌는데, 바이러스 자체보다는 인체의 다양한 면역반응이 질병의 경과에 더욱 중요하다. 이러한 사실로 한의학적 치료법의 과학적 연구는 만성 HBV 보균자들에게 효과적인 치료방법으로 적용될 것으로 기대될 수 있는데, 우선 여기서는 전형적으로 HBV와 관련해서 의학적 문제를 모두 가지고 있는 한 가족을 통해서 HBV에 대한 폭넓은 이해에 도움을 얻고자한다.

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Heavy Hymenolepis nana Infection Possibly Through Organic Foods: Report of a Case

  • Kim, Bong Jin;Song, Kyung Seob;Kong, Hyun-Hee;Cha, Hee-Jae;Ock, Meesun
    • Parasites, Hosts and Diseases
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    • v.52 no.1
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    • pp.85-87
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    • 2014
  • We encountered a patient with heavy Hymenolepis nana infection. The patient was a 44-year-old Korean man who had suffered from chronic hepatitis (type B) for 15 years. A large number of H. nana adult worms were found during colonoscopy that was performed as a part of routine health screening. The parasites were scattered throughout the colon, as well as in the terminal ileum, although the patient was immunocompetent. Based on this study, colonoscopy may be helpful for diagnosis of asymptomatic H. nana infections.

2022 KLCA-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

  • Korean Liver Cancer Association (KLCA) and National Cancer Center (NCC) Korea
    • Korean Journal of Radiology
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    • v.23 no.12
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    • pp.1126-1240
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    • 2022
  • Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common cancer among men in South Korea, where the prevalence of chronic hepatitis B infection is high in middle and old age. The current practice guidelines will provide useful and sensible advice for the clinical management of patients with HCC. A total of 49 experts in the fields of hepatology, oncology, surgery, radiology, and radiation oncology from the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2018 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions. These guidelines provide useful information and direction for all clinicians, trainees, and researchers in the diagnosis and treatment of HCC.

The outcome of perinatal prophylaxis for HBeAg positive mothers according to the maternal HBV-DNA levels at the delivery time (HBeAg 양성 산모의 분만 직후 HBV-DNA 수치에 따른 주산기 예방조치의 결과)

  • Jeong, On;Kim, Jong-Hyun
    • Clinical and Experimental Pediatrics
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    • v.50 no.4
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    • pp.348-354
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    • 2007
  • Purpose : Perinatal hepatitis B viral infection is decreasing; however, 10% of babies to HBeAg positive mothers still become chronic carriers despite perinatal prophylaxis. Although, the cause of prophylaxis failure is still unclear, an importance of maternal HBV-DNA level at the delivery time has been suggested. This study was established to certify if it would be a useful predictable factor for the outcome of perinatal prophylaxis. Methods : Twenty-nine HBeAg positive mothers whose babies had known outcomes of prophylaxis were selected. To determine the amount of maternal HBV-DNA, a quantitative PCR was performed with the WHO International Standard for HBV DNA NAT assays. Results : The mean logarithm HBV-DNA level of mothers with failed outcomes was significantly higher than that of mothers with succeessful outcomes (7.99 vs. 6.72, P=0.015). The predictable maternal HBV-DNA cut-off level to prophylaxis outcome was $2.83{\times}10^7copies/mL$ (100 pg/mL). None out of the case 16 (0%) who had below this level, and 5 out of 13 (38.5%) who had above this level of maternal HBV-DNA failed in perinatal prophylaxis. Conclusion : Mothers with higher levels of HBV-DNA at delivery time would be prone to a worse outcome of prophylaxis using the conventional approach. Perinatal prophylaxis failure rate can be reduced, if we try to introduce more potent prophylactic treatment into the cases with this risk factor.

The Comparison of Interferon-${\alpha}$ Treatment by Dosages and Retreatment for Chronic Hepatitis B in Children (소아 만성 B형 간염 환아에서 Interferon-${\alpha}$의 용량 차이 및 재치료에 따른 치료 효과 비교)

  • Jang, Chang-Hwan;Lee, Kyung-Hee;Hwang, Wi-Kyung;Oh, Ki-Won;Park, Woo-Saeng;Lee, Jun-Hwa;Ko, Cheol-Woo;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.152-160
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    • 2003
  • Purpose: We compared the therapeutic efficacy of low dose with that of standard dose of interferon (IFN) treatment and also compared the first IFN treatment with retreatment. Methods: We have studied 51 children (age, 2~14) treated for chronic hepatitis B from March 1990 to August 1999. Twenty seven children had been treated with $3\;MU/m^2$ ($2.66{\pm}0.66\;MU/m^2$) of IFN-${\alpha}$ three times a week for 6 months (range, 6~12 months), whereas 24 children with $6\;MU/m^2$ ($4.45{\pm}0.94\;MU/m^2$). There was no significant difference in gender, age, initial ALT and HBV DNA levels between each comparative group. Results: Among the 27 children treated with $3\;MU/m^2$ of IFN, ALT level had normalized in 11 children (41%) and anti-HBe seroconversion occurred in 9 children (33%) one year after the initiation of treatment. In comparison, among the 24 children treated with $6\;MU/m^2$ of IFN, ALT normalized in 12 children (50%) and anti-HBe seroconversion occurred in 7 children (29%). In comparing the first treatment group to retreatment group, ALT level had normalized in 23 children (45%) and anti-HBe seroconversion occurred in 16 children (31%) among the 51 children treated with the first course of IFN treatment. In comparison, ALT normalized and anti-HBe seroconversion occurred in 3 children (25%) among the retreated 12 children. Conclusion: There was no significant difference in the therapeutic efficacies between $3\;MU/m^2$ and $6\;MU/m^2$ dose of IFN treated groups in ALT normalization and anti-HBe seroconversion. The retreatment efficacy of IFN-${\alpha}$ was as effective as the first treatment.

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