• 보험의학회지
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• 제2권1호
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• pp.34-36
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• 1985

Korea is an endemic area of chronic hepatitis in the world. Liver cirrhosis and liver cell carcinoma, presumed to be related to such chronic hepatitis, are the major causes of death in this country. The purpose of this study is disclosing the sources of chronic hepatitis in Korea establishing its histologic characteristics, disclosing the patterns of progression in chronic hepatitis, delineating its prognosis and finally speculating its etiology. The study group was composed of 183 patients with biopsy-proven acute icteric viral hepaticis, 32 patients with biopsy- proven anicteric hepatitis and 260 patients with biopsy- proven chronic hepatitis. These patients submitted to long-term follow-up by means of liver needle biopsy and/or clinicolaboratory evaluation. The period of follow-up ranged from two months to 18 years. The histological features of the initial biopsy specimens of chronic hepatitis permitted a division of the cases cases into the following five types: Type I. Persisting portal hepatitis : so called persisting hepatitis 43 Type II. Chronic inactive hepatitis with incomplete strand septal fibrosis. This type has thin fibrotic septation in addition to Type I with portal sclerosis 38 Type III. Chronic active periportal hepatitis(CAPH) : so called aggressive hepatitis, characterized by marked piecemeal necrosis. This type has been subdivided further into three groups: AB and C on the basis of histologic features. A CAPH without cirrhosis 15 B CAPH with cirrhosis 99 C CAPH with diffuse acinus type parenchymal nodules; characterized by rosette-forming micronodules 21 Type IV. Subacute hepatic necrosis; characterized by multilobular and/or bridging necrosis. 14 Type V. Persisting lobular hepatitis; characterized by spotty necrosis, which looks very similar to acute viral hepatitis. Such histologic changes should be persisted for more than six months 30 In Korea the main source of chronic hepatitis is the anicteric type. Of the chronic hepatitis observed in the hospital, Type IIIb was the most frequent in its incidence and occasionally exhibited development of hepatocellular carcinoma, but the mortality was highest in Type IIIc during the period of follow-up. Histologic characteristics of these five types suggest a spectrum of chronic hepatitis in Korea from an early and mild stage to advanced and fatal cirrhosis, which is occasionally associated with primary hepatic cell carcinoma. It seems that Type IV can be followed by flare-up of various stages of acute and chronic hepatitis with HBsAg and that many cases of liver cirrhosis prevalent in Korea occur through such an active process of Type IV. The etiology is not established, but in Korea it is mainly related to HBsAg.

• 대한한방내과학회지
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• 제26권4호
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• pp.853-863
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• 2005

Object : This study was performed to investigate the anti-fibrogenic effect of Artemisiae Capillaris Herba(ACH) on cultured rat hepatic stellate cells. Methods : Hepatic Stellate Cells were obtained from a 350gm Sprague-Dawley rat by tissue perfusion system, and the cells for the study were selected after 3 passages of culture on non-coated plastic culture dishes which enable the cells to activate, thus producing collagens in the cell media. Cells were treated with various concentrations of Artemisia Capillaris Herba(ACH) extract powder for 24 or 48 hours. After the treatment, Soluble collagen, procollagen levels and the mRNA of the procollagen type I C were measured by using assay kit and RT-PCR method. Results : Procollagen production by the hepatic stellate cells decreased after the treatment in a time-dependent dose-dependent manner. The mRNA expression decreased consistently with the volume of the secreted procollagen which indicates the herb hat inhibitory effect on fibrogenesis of the liver by regulating one of the fibrosis associated genes in transcription. Conclusion : These results suggest that ACH is beneficial in the treatment of cirrhotic patients as well as for the patients with chronic hepatitis.

• 대한한방내과학회지
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• 제22권4호
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• pp.743-747
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• 2001

Hepatic encephalopathy is caused by disorders affecting the liver. The exact cause of the disorder is unknown. It occurs changes in mental state, consciousness, behavior, personality and changes in mood include forgetfulness, confusion, disorientation, delirium, dementia, decreased alertness, daytime sleepiness, decreased responsiveness, progressive stupor, coma. As 3 admission patients into oriental hospital of daejeon university include 2 cases of cerebral infarction, 1 case of liver cirrhosis, we found those are all hepatic encephalopathy. But until the diagnosis is made, we have many mistakes to find correct. Among the mistackes, specialy mixed thing is to compare hepatic encephalopathy and cerebral infarction. So, we report these cases with a brief review of related literatures.

• Natural Product Sciences
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• 제17권3호
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• pp.216-220
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• 2011

Activation of hepatic stellate cells (HSCs) characterized by increased proliferation and extracellular matrix deposition is identified as the major pathological feature of hepatic cirrhosis. Therefore, suppression of HSC activation has been proposed as an important antifibrotic therapeutic strategy. In the present study, we investigated the antiproliferative activity of root barks of Ulmus davidiana var. japonica (Ulmaceae) by employing HSC-T6 hepatic stellate cells as an in vitro assay system. Further investigation of the n-hexane and $CHCl_3$ fractions of root barks of U. davidiana var japonica led to the isolation of six triterpenoids: friedelin (1), epifridelanol (2), oleanolic acid (3), maslinic acid (4), ${\beta}$-amyrin (5) and ${\alpha}$-amyrin (6), together with ${\beta}$-sitosterol (7) and daucosterol (8). Among these compounds, 2, 3 and 4 significantly inhibited HSC proliferation. In addition, 4 inhibited HSC proliferation in time- and concentration-related manners, via a partially direct toxic effect, as assessed by morphological changes and release of lactate dehydrogenase.

• 대한한의학회지
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• 제24권4호
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• pp.120-126
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• 2003

Object : This study was done to evaluate the inhibitory effect of Samul-tang (Siwu-tang) on collagen production by cultured murine hepatic non-parenchymal cells. Methods : Hepatic non-parenchymal cells were cultured from normal Sprague-Dawley rats and established in a primary cell culture on uncoated plastic culture plates. The Samul-tang (Siwu-tang) was treated into the cell culture media for 72 hours and the cells were harvested for analysis. Analyses were done on cell proliferation, [3H]thymidine incorporation assay and procollagen type IC-peptide. Results : The cultured cells resembled fibroblasts in shape and produced procollagen which is consistent to fibrogenesis in vivo. Proliferation of the non-parenchymal cells was inhibited slightly and the [3H]thymidine incorporation assay showed a dose-dependent decrease by Samul-tang (Siwu-tang) treatment. Production of procollagen type I C-peptide was decreased by low-concentration treatment of the Samul-tang (Siwu-tang), but increased by high-concentration treatment. Conclusion : It seemed that the cells were responding to the Samul-tang (Siwu-tang) in low-concentration, thus producing less collagen. However, when the drug was administered with high enough concentration to cause excessive stimulation of cells, it seemed that the activated cells might overly produce procollagen, the precursor of collagen, thus aggravating fibrosis of the liver. So, it is considered that the proper concentration of Samul-tang (Siwu-tang) is important when treating patients with liver cirrhosis based on the patients' status.

• Investigative Magnetic Resonance Imaging
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• 제12권2호
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• pp.115-122
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• 2008

목적: SPIO-enhanced MRI상에서 얻은 radiological non-invasive hepatic fibrosis index (RNHFI)와 AST/혈소판 비(AST to platelet ratio index, APRI)간의 상관관계를 알아보고자 하였다. 대상 및 방법: 5년동안 SPIO-enhanced MRI를 시행받은 환자들을 대상으로 하였다. 환자들을 간경변 집단과 비(非)간경변 집단으로 분류했다. PACS를 이용, 각 환자의 SPIO-enhanced MRI에서 RNHFI (간실질 신호강도 표준편차의 평균(SD), 잡음교정 변이계수(CV))를 산출했고, 각 환자의 실험실 검사 결과를 이용, APRI를 산출했다. Student's t-test를 이용하여 두 집단간의 RNHFI와 APRI의 차이를 비교했다. 각 집단에서, RNHFI와 APRI간의 이변량 상관분석을 시행했다. 결과: 간경변 집단에서, SD, CV의 평균은 각각 $10.3{\pm}3.7$, $0.19{\pm}0.08$였다. 비간경변 집단에서, SD, CV의 평균은 각각 $6.5{\pm}1.6$, $0.08{\pm}0.05$였다. 두 집단의 평균 APRI는 각각 $2.04{\pm}1.7$, $0.32{\pm}0.32$였다. RNHFI와 APRI는 두 집단 사이에서 의미 있는 차이를 보였다 (p<0.05). 간경변 집단에서, SD와 APRI는 양의 상관관계를 보였다 (r=0.5, p<0.001). 결론: SD값이 간섬유화의 간단하고 유용한 예측 인자가 될 수 있을 것으로 기대된다.

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

• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.265-269
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• 2017

Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.

• 대한한방내과학회지
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• 제24권1호
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• pp.21-32
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• 2003

Objective : The aim of this study is to investigate the inhibitory effect of Injinchunggantang on hepatic sclerosis induced by $CCl_4$. Methods : Weight, liver function test and complete blood cell count, gross findings, and findings on liver tissue of the past(Hematoxylin & Eosin stain, Masson-Trichrome stain) were studied. Results : When it comes to the change of rats' body weight, The $CCl_{4^+}$Injinchunggantang group lost far less weight than The $CCl_{4^-}$only group. In the liver function test, which is focused on various areas such as total cholesterol, alkaline phosphotase, albumin, aspartate transaminase, alanine transaminase, The $CCl_{4^+}$Injinchunggantang group was much more closer to normal limit than the $CCl_4$ only group. In the complete blood cell count, including white blood cell, red blood cell, hemoglobin, hematocrite, platelet, The $CCl_{4^+}$Injinchunggantang group significantly closer to normal limit than $CCl_{4^-}$only group. In the gross findings of hepatic fibrosis models, Injinchunggantang showed inhibitory effect on hepatic fibrosis in the order. In the past findings of hepatic fibrosis models in Hematoxylin & Eosin, Masson-Trichrome staining, the liver in $CCl_{4^-}$only group showed atrophy and necrotic change with white nodules, whereas that of $CCl_{4^+}$Injinchunggantang group showed lesser significant change with the well_preserved tone of the tissue. In the extent of the inhibition of the hepatic fibrosis, the Injinchunggantang group showed statistically significant inhibitory effect(p<0.05) in the sclerosis model. Conclusions : These results show that Injinchunggantang have inhibitory effect on hepatic sclerosis induced by $CCl_4$ and further ultimately prevent liver cirrhosis. To obtain more credible results in this experiment, the invention of a new experimental model more similar to human hepatic sclerosis is still needed.

• 동의생리병리학회지
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• 제16권5호
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• pp.1066-1069
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• 2002

Wilson's disease is a rare inborn error of metabolism inherited as a autosomal recessive trait. The disease has varied mode of manifestations. It is characterized by different neurologic disorder and hepatic disease. I experienced a case of Wilson's disease in 40 year old woman who was suffered from liver cirrhosis, severe anorexia, and classical neurologic symptoms such as tremour, dysarthria and ataxia. The symptoms was not relieved by D-penicillamine, Youngyanggaksan and Samchulgunbi-tang but anorexia was improved significantly by same medication.