• Journal of Chest Surgery
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• v.18 no.1
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• pp.128-139
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• 1985

Seven patients [six women and one man] with obstruction of hepatic portion of inferior vena cava was operated on, from May, 1969 to January, 1985. Of seven patients, six were undergone corrective operation for IVC obstruction and another one was not operated because of far advanced liver cirrhosis. The occlusions were found at or close to the level of diaphragm and they were membranous or diffuse with or without thrombi. Most of their symptoms were referable to either inferior vena caval or hepatic venous obstruction and onset of the symptoms was usually gradual, beginning between the age of their thirties and forties. Most of the patients showed marked elevation of peripheral venous pressure of lower extremity [29-40 cm H2O] preoperatively, which decreased significantly after corrective operation [17-30 cm H2O]. Venous catheterization for pressure study and venography were essential for confirming the diagnosis. Of six cases, in which corrective operations were done, Transatrial membranotomy with or without IVC dilatation were performed in five cases [case 1, 2, 3, 5, 6], using cardiopulmonary bypass and in another one case, bypass operation between IVC, distal to obstruction, and RA was done using Dacron tube graft under the thoracoabdominal incision. All survived and their conditions were improved.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.33-37
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• 2009

Purpose: Liver transplantation is considered as the treatment of choice in many acute and chronic liver diseases, and it is becoming more common. Since successful microscopic anastomosis of hepatic artery is a crucial requirement of successful liver transplantation, we studied and analyzed the result of hepatic artery anastomosis of liver transplantation in our liver transplantation center. Methods: 145 liver transplantations were performed between February 2005 and May 2008. Male to female ratio of the liver transplantation recipients was 3.4 : 1. Anastomosis of portal vein, hepatic vein and biliary tract was performed by the general surgeon, and anastomosis of hepatic artery was performed by the plastic surgeon under the loupe or microscopic vision. After the hepatic artery was reconstructed, anastomosed site status and flow were checked with Doppler ultrasonography intraoperatively and with contrast enhanced CT or angiography postoperatively if necessary. Results: Out of 145 liver transplantations, cadaveric liver donor was used 37 cases and living donor liver transplantation was performed 108 cases including the 2 dual donor liver transplantations. As for the baseline diseases that resulted in the liver transplantation, there were 57 cases of liver cirrhosis and hepatocellular carcinoma due to hepatitis B, taking up the greatest proportion. Single donor hepatic artery was used in 114 cases, and mean artery diameter was 2.92 mm and mean artery length was 24.25 mm. Hepatic artery was used as the recipient artery in every case except the 8 cases in which gastroepiploic artery was used as alternative. Out of 145 cases of hepatic artery anastomosis, 3 cases resulted in the thrombosis of the hepatic artery, requiring thrombectomy and re - anastomosis. In all 3 cases, thrombosis was found in left hepatic artery and there was no past history of hepatic artery chemoembolization. Conclusion: Incidence of hepatic artery thrombosis after the anastomosis of hepatic artery during liver transplantation was 2.1%, which is considered sufficiently low.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.1771-1777
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• 2012

The impact of anatomic resection (AR) as compared to non-anatomic resection (NAR) for hepatocellular carcinoma (HCC) as a factor for preventing intra-hepatic and local recurrence after the initial surgical procedure remains controversial. A systematic review and meta-analysis of nonrandomized trials comparing anatomic resection with non-anatomic resection for HCC published from 1990 to 2010 in PubMed and Medline, Cochrane Library, Embase, and Science Citation Index were therefore performed. Intra-hepatic recurrence, including early and late, and local recurrence were considered as primary outcomes. As secondary outcomes, 5 year survival and 5 year disease-free survival were considered. Pooled effects were calculated utilizing either fixed effects or random effects models. Eleven non-randomized studies including 1,576 patients were identified and analyzed, with 810 patients in the AR group and 766 in the NAR group. Patients in the AR group were characterized by lower prevalence of cirrhosis, more favorable hepatic function, and larger tumor size and higher prevalence of macrovascular invasion compared with patients in the NAR group. Anatomic resection significantly reduced the risks of local recurrence and achieved a better 5 years disease-free survival. Also, anatomic resection was marginally effective for decreasing the early intra-hepatic recurrence. However, it was not advantageous in preventing late intra-hepatic recurrence compared with non-anatomic resection. No differences were found between AR and NAR with respect to postoperative morbidity, mortality, and hospitalization. Anatomic resection can be recommended as superior to non-anatomic resection in terms of reducing the risks of local recurrence, early intra-hepatic recurrence and achieving a better 5 year disease-free survival in HCC patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.4
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• pp.702-706
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• 2010

The clinical manifestation of Hepatic encephalopathy is personality change, vacant behavior, lethargy, flapping tremor, muscle twitching, noisy, abusive, violent, coma. The purpose of this clinical study was done to report the improvement of hepatic encephalopathy after oriental medical treatment (herb-med, acupuncture, moxibustion). We applied Ukieum-ja and Sopungsungi-won to patient who had liver cirrhosis and hepatic encephalopathy. We examined the Change of CBC, LFT and Clinical Manifestation to evaluate the effectiveness of oriental medical treatment. We observed that oriental medical complex treatment decreased symtoms and improved general condition of a patient. So we report this clinical study to be helpful in treating patients of hepatic encephalopathy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.4
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• pp.236-245
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• 2024

Purpose: The prevalence of nonalcoholic steatohepatitis (NASH) is increasing with the increasing prevalence of childhood obesity. Although NASH has a high risk of progression to liver fibrosis and cirrhosis, few studies have reported noninvasive markers for predicting hepatic fibrosis in children. This study aimed to evaluate and compare the diagnostic accuracies of serologic biomarkers and scoring systems for hepatic fibrosis in obese children with NASH. Methods: A total of 96 children were diagnosed with NASH based on liver biopsy findings and divided into two groups according to the degree of liver fibrosis: mild (stage 0-1) or advanced (stage 2-4). Clinical and laboratory parameters and serum levels of hyaluronic acid and type IV collagen were measured. The aspartate aminotransferase/platelet ratio index (APRI) and fibrosis-4 (FIB-4) score were calculated. Results: Among the noninvasive markers, only serum type IV collagen level and FIB-4 were significantly different between the two groups. The area under the receiver operating curve of each biomarker and scoring system was 0.80 (95% confidence interval [CI]: 0.70-0.90) for type IV collagen at an optimal cutoff of 148 ng/mL (sensitivity 69.8%, specificity 84.6%), followed by 0.69 (95% CI: 0.57-0.83) for APRI, 0.68 (95% CI: 0.56-0.80) for FIB-4, and 0.65 (95% CI: 0.53-0.77) for hyaluronic acid. Conclusion: Type IV collagen as a single noninvasive serologic biomarker for hepatic fibrosis and FIB-4 as a hepatic fibrosis score are beneficial in predicting advanced hepatic fibrosis and determining proper diagnosis and treatment strategies before fibrosis progresses in obese children with NASH.

• The Journal of Korean Medicine
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• v.23 no.2
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• pp.39-56
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• 2002

Objective : The aim of this study is to investigate the inhibitory effect of lnjinchunggantang-derivative on acute and sub-acute hepatic fibrosis induced by $CCl_4$, and to compare the efficiency of lnjinchunggantang-derivative, Salviae Radix and Scirpi Tuber.Zeloariae Rhizoma on acute and sub-acute hepatic fibrosis induced by $CCl_4$. Method : Western blotting for collagen type N, quantitative RT-PCR and gross & histological findings on liver tissue (Hematoxylin & Eosin stain, Reticulin stain, Masson-Trichrome stain) were studied. Results : In the study on collagen type N expression, lnjinchunggantangcderivative, Scirpi Tuber.Zeloariae Rhizoma and Salviae Radix showed inhibitory effect in western blotting. In quantitative RT-PCR assay, lnjinchunggantang-derivative showed inhibitory effect on collagen type N expression in acute hepatic fibrosis model, whereas lnjinchunggantang-derivative, Scirpi Tuber.Zeloariae Rhizoma and Salviae Radix showed inhibitory effect on collagen type N expression in sub-acute hepatic fibrosis model. In the gross findings of acute and sub-acute hepatic fibrosis models,lnjinchunggantang-derivative, Salviae Radix and Scirpi Tuber. Zeloariae Rhizoma showed inhibitory effect on hepatic fibrosis in the order. In the histological findings of acute and sub-acute hepatic fibrosis models in Hematoxylin & Eosin, Reticulin and Masson-Trichrome staining, the liver of $CCl_4$-only group showed atrophy and necrotic change with white nodules whereas that of $CCl_4$+ Injinchunggantang-derivative showed no significant histological change with well preservation of the tone of the tissue, and Scirpi Tuber. Zeloariae Rhizoma and Salviae Radix group showed minimal fibrotic changes. In the scoring system of the extent of the inhibition of the hepatic fibrosis, lnjinchunggantang-derivative group showed statistically significant inhibitory effect(p<0.05) whereas Scirpi Tuber.Zeloariae Rhizoma and Salviae Radix group showed no statistically significant effect in the acute hepatic fibrosis model. In the sub-acute hepatic fibrosis model, lnjinchunggantang-derivative, Scirpi Tuber.Zeloariae Rhizoma and Salviae Radix group showed statistically significant effect (p<0.01). Conclusion : These results show that lnjinchunggantang-derivative, Salviae Radix and Scirpi Tuber.Zeloariae Rhizoma have inhibitory effect in the order on hepatic fibrosis induced by $CCl_4$ by suppressing the expression of collagen type N, ultimately preventing liver cirrhosis. To obtain more credible results in this experiment, developement of a new experimental model more similar to human hepatic fibrosis is still needed.

• Journal of Applied Biological Chemistry
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• v.59 no.1
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• pp.25-29
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• 2016

Hepatitis B virus infection can cause hepatic fibrosis leading to cirrhosis and hepatocellular carcinoma. However the mechanism remains poorly understood. In this study, we found that Hepatitis B virus X-protein (HBx) increases vimentin, fibronectin, slug, snail and NOX4 expression. Because NOX4-mediated reactive oxygen species can increase slug and snail, which can induce fibrosis, HBx may be a key regulator of hepatic fibrosis development via NOX4 induction.

• Toxicological Research
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• v.24 no.2
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• pp.113-117
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• 2008

Chronic exposure to ethanol induces cumulative damage to the liver starting from fatty infiltration to cirrhosis depending on the dose and duration of exposure. The whole process leading to the development of alcoholic liver disease is very complex and the mechanisms involved are not fully understood. Among many experimental animal models, Lieber-DeCarli liquid diet provides moderate to severe pathophysiological outcome depending on the compositional changes. In the present study, we investigated the temporal changes in the early phase hepatic disease in rats fed with standard Lieber-DeCarli diet. Male Wistar rats were fed with Lieber-Decarli ethanol diet for 6 weeks and the liver samples were obtained after 2, 4 and 6 weeks. Mild fatty infiltration was observed in 2 weeks of feeding and it became evident in 4 and 6 week samples. The level of hepatic triglyceride showed a good agreement with the data obtained in the pathological analysis. Feeding mice with ethanol diet resulted in the maturation and translocation of SREBP-1 to nucleus in the liver. Western blot analysis of the pooled liver sample of control and ethanol fed animals showed a clear-cut time-dependent increase in the expression of nSREBP-1. These data provide important information for selecting proper time point in experimental intervention study in the field of drug development for alcoholic liver disease.

• IMMUNE NETWORK
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• v.10 no.6
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• pp.181-187
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• 2010

Excessive alcohol consumption is one of the critical causative factors leading to alcoholic liver disease (ALD). ALD is characterized by a wide spectrum of liver damage, ranging from simple uncomplicated liver steatosis (fatty liver) to steatohepatitis and liver fibrosis/cirrhosis. It has been believed that the obvious underlying cause for ALD is due to hepatocyte death induced by alcohol itself. However, recent sparkling studies have shown that diverse immune responses contribute to ALD because liver is enriched with numerous immune cells. Especially, a line of evidence has suggested that innate immune cells such as Kupffer cells and natural killer (NK)/NKT cells are significantly involved in the pathogenesis of ALD via production of pro-inflammatory cytokines and other mediators. Indeed, more interestingly, hepatic stellate cells (HSCs), known as a major cell inducing liver steatosis and fibrosis, can be killed by liver NK cells, which could be suppressed by chronic alcohol consumption. In this review, with the view of liver as predominant innate immune organ, we describe the pathogenesis of ALD in which what roles of innate immune cells are and how they are interacting with HSCs.

• Journal of Oriental Neuropsychiatry
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• v.24 no.1
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• pp.75-92
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• 2013

Objectives : The objective of this study is to investigate various factors concerning Hwa-byung Methods : The research for various factors of Hwa-Byung was carried out for 686 female Participants. Hwa-Byung was diagnosed by Hwa-Byung Diagnostic Interview Schedule (HBDIS). Results : The rate of Past History about Chronic Bronchitis, Peptic Ulcer, Chronic Hepatitis/Hepatic Cirrhosis, Allergy, Arthritis, Hyperlipidemia is high in the Hwa-Byung group compared with the Control group. In the study of external environments, Hwa-Byung has tendency diagnosed in monthly income under 2,000,000 won, doing regular occupation, marriage, below graduation from high school. In the study of personal relationship, Hwa-Byung has tendency more influenced by negative influencing people than by positive influencing people. In the study of personal factors, Hwa-Byung has a short sleeping time, does not exercise regularly, feels more overburdened, and understimates their own condition to do easy tasks. Conclusions : According to the below results, in the study of Past History, the rate of Chronic Bronchitis, Peptic Ulcer, Chronic Hepatitis/Hepatic Cirrhosis, Allergy, Arthritis, and Hyperlipidemia is high in the Hwa-Byung group compared with the Control. Hwa-Byung has a tendency to be diagnosed by various factors such as the external environment, personal relationships, and personal factors.