• Journal of Digestive Cancer Research
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• v.2 no.1
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• pp.32-36
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• 2014

We report a patient with combined hepatocellular-cholangiocarcinoma confined in the common hepatic duct and scirrhous type of hepatocellular carcinoma in the caudate lobe of liver simultaneously. The patient was a 55-yearsold Korean man with hepatitis B virus (HBV) carrier who was referred from a local hospital due to detected liver mass on abdominal computed tomography (CT). He has presented jaundice and weight loss for the previous 3 weeks. Laboratory examination showed AST/ALT elevation and hyperbilirubinemia. HBsAg was positive. The tumor marker study showed elevated AFP and DCP, not CEA and CA 19-9. Abdominal CT disclosed an about 2.1×0.9 cm sized soft tissue density in hilum with both intrahepatic duct (IHD) dilatations and an about 3×2.1 cm sized arterial enhancing lesion at segment 8 of the liver. Patient received 15 cycles of Gemcitabine/Cisplantin chemotherapy from February 27, 2013 to December 31, 2013. Caudate lobectomy of liver, segmental resection of bile duct and Roux-en-Y hepaticojejunostomy was performed on February 10, 2014. The final pathologic report showed double primary liver cancer, combined hepatocellular-cholangiocarcinoma in common hepatic bile duct and scirrhous type of hepatocellular carcinoma in segment 1 of the liver. This is a very unusual case in which combined hepatocellular-cholangiocarcinoma confined in the large bile duct and two rare hepatic cancers coexisted.

• IMMUNE NETWORK
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• v.9 no.1
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• pp.20-26
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• 2009

We previously reported that $IFN-{\gamma}$ producing T cell responses induced by the combined therapy of DNA vaccine and lamivudine for one year are important for the induction of sustained virological response (SVR). However, $IFN-{\gamma}$ production is not sufficient to predict sustained viremia control in chronic hepatitis B (CHB) carriers treated. Methods: Twelve CHB carriers were intramuscularly immunized 12 times at a 4-week interval with 8mg of HBV DNA vaccine during the standard lamivudine treatment (100mg/daily/1 year). The level of cytokines during and after the combined therapy in plasma of all 12 CHB carriers treated was determined by each ELISA kit. Six out of 12 CHB carriers revisited the clinic, and their HBV DNA levels were examined. Results: The combined therapy increased plasma IL-12 and IL-12/p40 ratio during the treatment (baseline vs. peak level: $41.8{\pm}8.3$ vs. $163.1{\pm}29.2\;pg/ml$; p<0.01 and $0.96{\pm}0.25$ vs. $3.58{\pm}0.86$; p<0.01, respectively), and the peak level of plasma IL-12 and IL-12/p40 ratio was evoked at 6 to 10 months during the combined therapy. In particular, CHB carriers with SVR had two and three-fold higher level of the peak plasma IL-12 and plasma IL-12/p40 ratio than non-virological responders (NVRs), respectively ($218.0{\pm}41.4$ vs. $108.1{\pm}28.6\;pg/ml$; p=0.09 and $5.35{\pm}1.38$ vs. $1.80{\pm}0.29$; p<0.05, respectively), while p40 level was consistent during the combined therapy. In addition, there was no significant temporal correlation between the peak IL-12/p40 ratio and the elevation of serum alanine amino-transferase (ALT) in this study, contrast to $IFN-{\alpha}$ therapy which induced peak IL-12 level following ALT flares. Conclusion: Our results indicate that the combined therapy induces the increase of plasma IL-12 and IL-12/p40 ratio, which are associated with long-term SVR in CHB carriers.

• Journal of the Korean Society of Clothing and Textiles
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• v.17 no.1
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• pp.37-47
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• 1993

최근에 치명적인 바이러스, 특히 에이즈를 이르키는 Human Immunodificiency Virus (HIV), 또는 간에 심각한 병을 이르키는 Hepatitis B Virus (HBV)와 같은 무서운 바이러스가 환자의 피나 분비물을 통하여 의사에게 전염되는 사례가 늘어감에 따라 이제는 환자의 피나 분비물의 침투를 막기 위해 방수성과 방균성을 가진 수술복 착용이 절대적으로 필요하게 되었다. 따라서 본 연구의 목적은 1. 수술가운을 만드는 5가지 대표적인 직물의 방수성과 방균성을 측정하고 2. 세탁시 표백제의 사용유무가 그 직물의 방수성과 방균성에 미치는 영향을 알아보고 3. 반복세탁이 그 직물의 방수성과 방균성에 미치는 영향을 알아 보는데 있다. 이 실험을 위해 3가지 재사용 수술가운과 (Gore-tex$^R$, membrane reinforced; Compel$^{TM}$, fabric reinforced; Acep$^{TM}$, non-reinforced) 두 가지 일회용 가운 (Evolution$^R$ gown, fabric reinforced; Evolution$^R$ Specialty, film reinforced)이 사용되었다. 표백제를 사용한 세탁이 직물의 방수성과 방균성에 미치는 영향을 알아보기 위해 재사용 가운을 세탁, 건조, 살균을 하였다. 세탁과 살균의 빈도수는 1, 20, 40, 50, 60, 70, 80번 이였다. 방수성 측정방법으로 1. Impact Penetration test (AATCC 42-1985), 2. Elbow Lean test, 3. Synthetic Blood Resistance test (ASTM F 23. 40. 01)가 사용되었고 방균성 측정방법으로 Viral Resistance test (ASTM F 23. 40. 02)가 사용되었다. 실험 결과는 다음과 같다. 1. Gore-Tex$^R$ 가운과 Evolution$^R$ Specialty 가운은 방수성과 방균성의 성질을 가졌다. 그러나 표백제를 사용하여 70번 세탁한 Gore-Tex$^R$ 가운은 membrane의 구조가 파괴되어서 방균성을 상실했다. 2. Evolution$^R$ 가운, Acep$^{TM}$ 가운과 Compel$^{TM}$ 가운은 오직 Impact Penetration test만 통과했다. 즉 이 직물들은 큰 압력의 가함이 없는 splash resistance만 가지고있다. 그러나 Acep$^{TM}$ 가운과 Compel$^{TM}$ 가운은 20번과 60번 세탁 후 각각 그들의 splash resistance 마져도 상실했다.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.13-18
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• 1983

This study was attempted to define epidemiologically the possibility and the magnitude of sexual transmission of HBV in Korea. Two groups of prostitutes; one group (309) deals with Koreans, the other group (126) deals with American soldiers stationing in Korea, were tested for the presence of HBsAg and anti-HBs. The prevalence rate of HBsAg or anti-HBs was significantly higher in prostitutes who deal with Koreans (41.7%) than in prostitutes who deal with American soldiers (30.2%) (p<0.025). Among the prostitutes who deal with American soldiers, there was no appreciable difference in the prevalence rate of HBsAg or anti-HBs by the duration of prostitution. However, among the prostitutes who deal with Koreans, the prevalence rate was increased with the duration of prostitution, although it did not reach the statistically significant level (p=0.12). There was no remarkable association between the prevalence rate of HBsAg or anti-HBs and educational level, history of operation or history of transfusion. The data support the possibility of sexual transmission of viral hepatitis B but it seems seems sexual transmission does not contribute significantly to the prevalence rate of HBsAg or andi-HBs in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.225-229
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• 2012

Background: Males have a higher prevalence of hepatocellular carcinoma (HCC) than females in general, but the reasons for the sex disparity are still obscure. DNA copy number alteration (CNA) is a major feature of solid tumors including HCC, but whether CNA plays a role in sex-related differences in HCC development has never been evaluated. Methods: High-resolution array comparative genomic hybridization (CGH) was used to examine 17 female and 46 male HCC patients with chronic hepatitis B virus (HBV) infection in Shanghai, China. Two-tailed Fisher's exact or ${\chi}^2$ tests was used to compare CNAs between females and males. Results: The overall frequencies and patterns of CNAs in female and male cases were similar. However, female HCC tumors presented more copy number gains compared to those in males on 1q21.3-q22 (76.5% vs. 37.0%, P = 0.009), 11q11 (35.3% vs. 0.0%, P = 0.0002) and 19q13.31-q13.32 (23.5% vs. 0.0%, P = 0.004), and loss on 16p11.2 (35.3% vs. 6.5%, P = 0.009). Relative to females, male cases had greater copy number loss on 11q11 (63.0% vs. 17.6%, P = 0.002). Further analyses showed that 11q11 gain correlated with 19q13.31-q13.32 gain (P = 0.042), 11q11 loss (P = 0.011) and 16p11.2 loss (P = 0.033), while 1q21.3-q22 gain correlated with 19q13.31-q13.32 gain (P = 0.046). Conclusions: These findings suggest that CNAs may play a role in sex-related differences in HBVassociated HCC development.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7675-7679
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• 2013

Background: A missense mutation in exon 7 (R249S) of the p53 tumor suppressor gene is characteristic of aflatoxin B1 (AFB1) exposure. AFB1 is believed to have a synergistic effect on hepatitis virus B (HBV) carcinogenesis. However, results of studies comparing R249S prevalence among patients are conflicting. The aim of this study was to determine the prevalence of the R249S mutation in hepatocellular carcinoma (HCC) patients with or without positive HBsAg. Materials and Methods: Paraffin embedded liver tissues were obtained from 124 HCC patients who underwent liver resection and liver biopsy in King Chulalongkorn Memorial Hospital. Restriction fragment length polymorphism (RFLP) was utilized to detect the R249S mutation. Positive results were confirmed by direct sequencing. Results: Sixty four (52%) patients were positive for HBsAg and 18 (15%) were anti-HCV positive. 12 specimens tested positive by RFLP. Ten HCC patients (8.1%) were confirmed to be R249S positive by Sanger sequencing (AGG to AGT). Out of these 10, six were HBsAg positive, and out of the remaining 4, two were anti-HCV positive. The R249S prevalence among HCC patients with positive HBsAg was 9.4% compared to 6.7% for HBsAg negative samples. Patients with the R249S mutation were younger ($55{\pm}10$ vs $60{\pm}13$ year-old) and tended to have a more advanced Edmonson-Steiner grade of HCC, although differences did not reach statistical significance. Conclusions: Our study shows moderate prevalence of aflatoxin B1-related p53 mutation (R249S) in HCC with or without HBsAg. HBsAg positive status was not associated with R249S prevalence.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5759-5762
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• 2012

The objective of the study was to evaluate the efficacy of a health check-up program among Thai people at the National Cancer Institute in the years 2008-2009. The program included history taking, physical examination, chest X-ray, EKG, and laboratory tests. A total of 28,240 women and 9,665 men were included in the study, with mean ages of 44.5 and 46.9 years, respectively. The study showed that obesity, as assessed by a BMI over 25.0 kg/m2, in men and women was present in 41.4% and 30%, respectively. Biochemical study revealed that anemia was prevalent in 21.6% of men and 20.1% of women. High plasma glucose level (>115 mg/dL), cholesterol level (>200 mg/dL), triglyceride level (>190 mg/dL) in men was 13.8%, 63.8%, 22.6% and 7.7%, 61.1%, 8.9% in women. Hepatitis B virus infection was found 7.5% in men and 4.1% in women. In this study, 177 new cancer cases were detected, of which 35 were breast, 19 were cervical and 26 were colorectal, most of these cancers being detected at early stage. In addition, precancerous states was also found including 718 cases of benign and 99 cases of adenoma in situ. In conclusion, an annual check up may detect abnormalities that have no obvious clinical symptoms of disease. Early detection of asymptomatic neoplasms and precursor lesions should contribute to a prompt provision of treatment and further decline of death from cancer.

• Korean Journal of Clinical Pharmacy
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• v.21 no.3
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• pp.224-227
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• 2011

Entecavir is a potent and selective guanosine analogue that has demonstrated a significant antiviral efficacy against hepatitis B virus (HBV). The aim of this study was to evaluate the safety and pharmacokinetic profile after a single dose of entecavir 1 mg administration in Korean healthy male subjects. Eight volunteers were enrolled. After a single dose of 1 mg entecavir was orally administered, blood samples were collected at specific time intervals from 0-168 hours. The plasma concentrations of entecavir were determined by LC-MS/MS. The pharmacokinetic parameters were determined from the plasma concentration-time profiles. The mean values for $AUC_{last}$ and $AUC_{inf}$ were $14.84{\pm}7.81ng{\cdot}hr/mL$ and $20.71{\pm}8.80ng{\cdot}hr/mL$, respectively. The mean value for $C_{max}$ was $9.19{\pm}4.91ng/ml$ and median value for $t_{max}$ was 0.58 hr. No adverse events were reported by subjects or found on analysis of vital signs or laboratory tests. The results are suggested to be useful in clinical trials of entecavir in Korean subject including bioequivalence study.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8589-8594
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• 2016

Background: Liver cancer is one of the most common causes of death in the world. In Korea, hepatitis B virus (HBV) is a major risk factor for liver cancer but infection rates have been declining since the implementation of the national vaccination program. In this study, we examined the secular trends in liver cancer mortality to distinguish the effects of age, time period, and birth cohort. Materials and Methods: Data for the annual number of liver cancer deaths in Korean adults (30 years and older) were obtained from the Korean Statistical Information Service for the period from 1984-2013. Joinpoint regression analysis was used to study the shapes of and to detect the changes in mortality trends. Also, an age-period-cohort model was designed to study the effect of each age, period, and birth cohort on liver cancer mortality. Results: For both men and women, the age-standardized mortality rate for liver cancer increased from 1984 to 1993 and decreased thereafter. The highest liver cancer mortality rate has shifted to an older age group in recent years. Within the same birth cohort group, the mortality rate of older age groups has been higher than in the younger age groups. Age-period-cohort analysis showed an association with a high mortality rate in the older age group and in recent years, whereas a decreasing mortality rate were observed in the younger birth cohort. Conclusions: This study confirmed a decreasing trend in liver cancer mortality among Korean men and women after 1993. The trends in mortality rate may be mainly attributed to cohort effects.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.56-78
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• 1998

Objective: Chronic hepatitis B infection (CHB) occurs in 6% to 10% of population in Korea. In ethinic communities where prevalence of chronic infection is high such as Korea, transmission of hepatitis B infection is either vertical (ie, by perinatal infection) or by close family contact (usually from mothers or siblings) during the first 5 years of life. The development of chronic hepatitis B infection is increasingly more common the earlier a person is exposed to the virus, particularly in fetal and neonatal life. And it progress to cirrhosis and hepatocellular carcinoma, especially in severe liver damage and perinatal infection. Histopathology of CHB is important when evaluating the final outcomes. A numerical scoring system which is a semiquantitatively assessed objective reproducible classification of chronic viral hepatitis, is a valuable tool for statistical analysis when predicting the outcome and evaluating antiviral and other therapies. In this study, a numerical scoring system (Ludwig system) was applied and compared with the conventional histological classification of De Groute. And the comparative analysis of cinical findings, family history, serology, and liver function test by histopathological findings in chronic hepatitis B of children was done. Methods: Ninety nine patients [mean age=9 years (range=17 months to 16 years)] with clinical, biochemical, serological and histological patterns of chronic HBV infection included in this study. Five of these children had hepatocelluar carcinoma. They were 83 male and 16 female children. They all underwent liver biopsies and histologic evaluation was performed by one pathologist. The biopsy specimens were classified, according to the standard criteria of De Groute as follows: normal, chronic lobular hepatitis (CLH), chronic persistent hepatitis (CPH), mild to severe chronic active hepatitis (CAH), or active cirrhosis, inactive cirrhosis, hepatocellular carcinoma (HCC). And the biopsy specimens were also assessed and scored semiquantitatively by the numerical scoring Ludwig system. Serum HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc (IgG, IgM), and HDV were measured by radioimunoassays. Results: Male predominated in a proportion of 5.2:1 for all patients. Of 99 patients, 2 cases had normal, 2 cases had CLH, 22 cases had CPH, 40 cases had mild CAH, 19 cases had moderate CAH, 1 case had severe CAH, 7 cases had active cirrhosis, 1 case had inactive cirrhosis, and 5 cases had HCC. The mean age, sex distribution, symptoms, signs, and family history did not differ statistically among the different histologic groups. The numerical scoring system was correlated well with the conventional histological classification. The histological activity evaluated by both the conventional classification and the scoring system was more severe as the levels of serum aminotransferases were higher. In contrast, the levels of serum aminotransferases were not useful for predicting the degree of histologic activity because of its wide range overlapping. When the histological activity was more severe and especially the cirrhosis more progressing, the prothrombin time was more prolonged. The histological severity was inversely related with the duration of seroconversion of HBeAg. Conclusions: The histological activity could not be accurately predicted by clinical and biochemical findings, but by the proper histological classification of the numerical scoring system for the biopsy specimen. The numerical scoring system was correlated well with the conventional histological classification, and it seems to be a valuable tool for the statistical analysis when predicting the outcome and evaluating effects of antiviral and other therapies in chronic hepatitis B in children.