• Gut and Liver
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• v.12 no.6
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• pp.615-622
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• 2018

Despite the well-proven, safe and effective therapies for hepatitis B infection, delivery of treatment remains a significant challenge in resource-poor settings. Geopolitical and economic restrictions present additional difficulties in providing care in North Korea. However, treatment of patients with chronic hepatitis B remains a top priority for both the North Korean Ministry of Public Health and international agencies working in North Korean hepatitis healthcare facilities. Working in partnership, a path was created to institute this much-needed program. A consortium of United States and Australian humanitarian non-governmental organizations along with generous individual and corporate donors working in concert with local and national health authorities have succeeded in establishing the first hepatitis B treatment program in North Korea. The essential elements of this program include renovation of existing hepatitis hospitals, access to antiviral medications, establishment of laboratory facilities, creation of medical documentation and record-keeping, training of local health care professionals, and quarterly visits by international volunteer physicians and laboratory experts. Management and treatment decisions are made bilaterally. To date, nearly 1,500 patients have been evaluated, and over 800 have been started on long-term antiviral therapy. It is envisioned that this program will eventually be managed and funded by the Democratic People's Republic of Korea Ministry of Public Health. This program's success demonstrates a potential model for delivery of antiviral therapy for patients suffering from hepatitis B in other developing countries.

• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.1014-1031
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• 2022

The Kasai portoenterostomy is the first-line treatment for the restoration of the flow of bile to the small intestine in patients with biliary atresia. Various complications can occur after Kasai portoenterostomy, including ascending cholangitis, biliary cirrhosis, and portal hypertension. Of these potential complications, ascending cholangitis in the most common. In cases of patients having uncontrolled complications due to progressive liver cirrhosis, portal hypertension, or progressive hyperbilirubinemia, liver transplantation is the indicated as treatment plan. Lifelong follow-up, particularly involving imaging studies, is important for the identification of various complications arising from biliary atresia after Kasai portoenterostomy. Additionally, imaging studies play a crucial role in the evaluation of potential liver donors and recipients. US is a key imaging modality utilized in the management of patients who undergo Kasai portoenterostomy, while CT and MRI are imperative to obtaining an accurate diagnosis.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.3
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• pp.331-339
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• 2007

Purpose: This study aimed to investigate LDQOL (Liver Disease Quality of Life) and its related factors of patients with Hepatitis B. Method: A cross-sectional descriptive study. The LDQOL was formally translated to Korean and reliability was examined. One hundred thirty eight patients following gastroenterology outpatient clinic of S. hospital in Seoul, Korea participated. Results: The mean age of the patients was 45.43 years and 87.7% were men. The mean score of LDQOL was 77.34, and mean scores of subscale were followed; symptom of liver disease (SxLD) (82.12), effect of liver disease (ELD) (25.50), concentration (Conc) (84.47), memory (Mem) (83.24), health discomfort, (HD) (75.18), sexual function (SFun) (75.71), sexual problem (SProb) (84.70), Loneliness (85.50), Hopeless (67.43), and stigma of liver disease (SLD) (91.64). Women had a lower LDQOL score for Loneliness (p=.034), and over 45 year-old patients had a lower LDQOL overall score (p=.000). Patients who were HBV carriers, or who had Chronic Hepatitis B or Liver Cirrhosis reported lower QOL respectively(p=.032). Conclusion: Although the liver disease itself seemed to be stable, patients with HBV experienced poor QOL in ELD, SProb, SFun, and Hopeless. Therefore nursing interventions in these aspects are needed.

• Investigative Magnetic Resonance Imaging
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• v.21 no.3
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• pp.125-130
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• 2017

Purpose: To evaluate the clinical significance of T1 high signal intensity on the globus pallidus as a predictor of severe hepatic encephalopathy in patients with acute-on-chronic liver failure (ACLF), which is a distinct syndrome characterized by multi-organ dysfunction including cerebral failure. Materials and Methods: From January 2002 to April 2014, we retrospectively reviewed the magnetic resonance imaging (MRI) findings and clinical and magnetic resonance (MR) features of 74 consecutive patients (44 men and 30 women; mean age, 59.5 years) with liver cirrhosis. The chronic liver failure-sequential organ failure assessment score was used to diagnose ACLF. The pallidal index (PI), calculated by dividing the mean signal intensity of the globus pallidus by that of the subcortical frontal white matter were compared according to ACLF. The PI was compared with the Model for End-Stage Liver Disease (MELD) score in predicting the development of ACLF. Results: Fifteen patients who were diagnosed with ACLF had higher hepatic encephalopathy grades (initial, P = 0.024; follow-up, P = 0.002), MELD scores (P < 0.001), and PI (P = 0.048). In the ACLF group, the mean PI in patients with cerebral failure was significantly higher than that in the patients without cerebral failure (1.33 vs. 1.20, P = 0.039). In patients with ACLF, the area under the curve (AUC) for PI was 0.680 (95% confidence intervals [CI], 0.52-0.85), which was significantly lower than that for the MELD score (AUC, 0.88; 95% CI, 0.77-0.99) (P = 0.04). Conclusion: The PI can be an ancillary biomarker for predicting the development of ACLF and severe hepatic encephalopathy.

• Applied Microscopy
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• v.42 no.3
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• pp.115-123
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• 2012

Human placenta extract (hPE) has therapeutic potential against certain diseases such as burn injury, liver cirrhosis and chronic wound through stimulating tissue repair processes. However, the effects of hPE on liver regeneration in animals are unknown. This study investigated the effect of hPE on the expression of proliferating cell nuclear antigen (PCNA) during liver regeneration induced by partial hepatectomy (PH) in rats. The activities of AST, ALT and ALP increased during a few days after PH. A high level of ALP was particularly seen at day 3 in the control group. All the levels of experimental groups were normalized by day 5 after PH. On immunohistochemistry, the expression of PCNA increased at the early days, showed a peak at day 3 after PH. The PCNA staining was more obvious in the experimental group over the whole period. By western blotting, PCNA seemed to be more strongly expressed in the hPE injected group in the early stage and fell to almost undetectable levels at day 7. On immunocytochemical observations, the number of PCNA-gold particles in the nuclei at day 1 of the hPE treated groups was more than those of the untreated groups. The results suggest that hPE could accelerate liver regeneration induced by PH involving the expression of PCNA in rats.

• The Journal of Internal Korean Medicine
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• v.22 no.4
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• pp.613-619
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• 2001

Objectives: The purpose of this study was to examine the efficacy of Gamichunggan-san(Jiaweiqinggan-san) on 25 patients who have suffered from alcoholic liver disease. Methods: Gamichunggan-san(Jiaweiqinggan-san) was administered to patients for over 1 months continuously. We checked improvement of clinical symptoms, changes of chemistry hematological test and especially lymphocyte count. Results: The results obtained are summarized as follows. Gamichunggan-san(Jiaweiqinggan-san) has significant effect on the improvement of clinical symptoms. And the improvement ratio of AST, ALT, ${\gamma}$-GTP was 77.8%, 61.5%, 76.2%. In patients with alcohoiic hepatitis, WBC was increased effectively within normal range and those with liver cirrhosis, All of the patients with the inverted ratio of lymphocyte was improved. Conclusions: From the above results, it is suggested that Gamichunggan-san(Jiaweiqinggan-san) have significant effects on recovery of liver malfunction and immune modulation, and also could be recommended as a prescription for alcoholic liver disease.

• Journal of Gastric Cancer
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• v.11 no.1
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• pp.23-30
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• 2011

Purpose: ${\alpha}$-fetoprotein (AFP)-producing gastric cancer is a rare tumor with high rates of liver metastasis and a poor prognosis. Many studies have been performed but there have been no comprehensive investigations of the clinicopathological and prognosis. Materials and Methods: Six hundred ninety four patients with gastric cancer who underwent a curative gastric resection in Hanyang University Hospital from February 2001 to December 2008 were evaluated retrospectively after excluding active or chronic hepatits, liver cirrhosis and preoperative distant metastasis. Among them, thirty five patients had an elevated serum level of AFP (>7 ng/ml) preoperatively. The clinicopathological features of AFP-producing gastric cancer were analyzed. Results: There was poorer differentiation, a higher incidence of lymph node metastasis, more marked lymphatic and vascular invasion in the AFP-positive group than in the AFP-negative group. The 5-year survival rate of the AFP-positive group was significantly poorer than that in the AFP-negative group (66% vs. 80%, P=0.002). A significantly higher incidence of liver metastasis was observed in the AFP-positive group than in the AFP-negative group (14.3% vs. 3.6%, P=0.002) with a shorter median time period from the operation to the metachronous liver metastasis (3.7 months vs. 14.1 months, P=0.043). Multivariate survival analysis revealed the depth of invasion, degree of lymph node metastasis and AFP-positivity to be the independent prognostic factors. Conclusions: AFP-producing gastric cancers have an aggressive behavior with a high metastatic potential to the liver. In addition, their clinicopathological features are quite different from the more common AFP-negative gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6955-6959
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• 2013

The incidence of hepatocellular carcinoma (HCC) is relatively high in Southeast Asia. Globally, HCC has a high fatality rate and short survival. The objectives of this retrospective cohort study were to review the epidemiology and survival of HCC patients at a tertiary centre in north-east of Peninsular Malaysia. Subjects were adult HCC patients diagnosed by histopathology or radio-imaging. Secondary liver carcinoma was excluded. Kaplan Meier and multiple Cox proportional hazard survival analyses were used. Only 210 HCC cases from years 1987-2008, were included in the final analysis. The number of cases was increasing annually. The mean age was 55.0 (SD 13.9) years with male:female ratio of 3.7:1. Approximately 57.6% had positive hepatitis B virus, 2.4% hepatitis C virus, 20% liver cirrhosis and 8.1% chronic liver disease. Only 2.9% had family history and 9.0% had frequently consumed alcohol. Most patients presented with abdominal pain or discomfort and had hepatomegaly, 47.9% had an elevated ${\alpha}$-fetoprotein level of 800 IU/ml or more, 51.9% had multiple tumors and 44.8% involved multiple liver lobes. Approximately 63.3% were in stage 3 and 23.4% in stage 4, and 82.9% did not receive any treatment. The overall median survival time was 1.9 months (95% confidence interval (CI): 1.5, 2.3). The 1-month, 6-month, 1-year and 2-year survival rates were 71.8%, 23.3%, 13.0% and 7.3% respectively. Significant prognostic factors were Malay ethnicity [Adjusted hazard ratio (AHR) 1.6; 95%CI: 1.0, 2.5; p=0.030], no chemotherapy [AHR 1.7; 95%CI: 1.1, 2.5; p=0.017] and Child-Pugh class C [AHR 2.6; 95%CI: 1.4, 4.9; p=0.002]. HCC in our study affected a wide age range, mostly male, in advanced stage of disease, with no treatment and very low survival rates. Primary prevention should be advocated in view of late presentation and difficulty of treatment. Vaccination of hepatitis virus and avoidance of liver toxins are to be encouraged.

• The Korean Journal of Nuclear Medicine
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• v.21 no.1
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• pp.17-24
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• 1987

Authors classified 161 cases of photon defects due to the gall bladder on hepatic parenchymal scintigraphy on $^{99m}Tc-phytate$ and $^{99m}Tc-DISIDA$ according to the position of the gall bladder, the pattern of photon defects and the hepatobiliary diseases. The results were as follows; 1) Conocordance of $^{99m}Tc-DISIDA$ and $^{99m}Tc-phytate$ hepatic parenchymal images in photon defect due to the gall bladder was 94% of 32 cases. 2) The frequency according to the position of the gall bladder was in order to 68% of the gall bladder of the lower margin of the liver, 30% of the intrahepatic gall bladder and 2% of the extrahepatic gall bladder, and the frequency of the photon defects due to the gall bladder was in order to 81% of the intrahepatic gall bladder, 71% of the gall bladder of the lower margin of the liver and 20% of the extrahepatic gall bladder. 3) The pattern of the photon defects due to the gall bladder was 47% of funnel shape in the intrahepatic gall bladder, 69% of semilunar shape in the gall bladder of the lower margin of the liver and 100% of semilunar shape in the extrahepatic gall bladder. 4) All of 9 cases of the intrahepatic gall bladder at the lateral area of the right lobe and the gall bladder of the lower margin of the liver at the right hepatic angle were associated with liver cirrhosis with the right lobe atrophy and the left lobe hypertrophy, 2 cases of the gall bladder of the lower margin of the liver at just-left side of the porta hepatis with hepatoma in the right lobe and 1 case of the intrahepatic gall bladder at the central portion of the right lobe with choledochal cyst.

• Korean Journal of Clinical Laboratory Science
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• v.43 no.3
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• pp.113-119
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• 2011

This study was designed to determine the effects of larval extracts from Protaetia brevitarsis seulensis shade dried larva from Korea and China on liver tissues of hepatic injury groups. The experimental groups are divided into five groups; Normal, carbon tetrachloride single injection ($CCl_4$), Pb-CHI ($CCl_4$ + P. brevitarsis shade dried larva from China), Pb-KOR ($CCl_4$ + P. brevitarsis shade dried larva from Korea) and SIL ($CCl_4$ + 0.35% silymarin) groups. Sprague Dawley rats were oral injected with $CCl_4$ at a dose l mg/kg (20% in corn oil) for induction of liver damage for 4 weeks. Each experimental group was fed with a dose 50 mg/kg of larval extracts based on medicinal preparations from 3 weeks to 4 weeks after $CCl_4$ treatment. At the end of 4 weeks, we evaluated the serum levels of glutamate-oxaloacetate transaminase (GOT), glutamate-pyruvate transferase (GPT), alkaline phosphatase (ALP) and blood urea nitrogen (BUN) in serum and the cytokine levels of tumor necrosis factor-${\alpha}$) (TNF-${\alpha}$) and transforming growth factor-${\beta}$ (TGF-${\beta}$) in the cells isolated from spleen and liver. The histological analysis was also conducted. The $CCl_4$ injection reduced body weight, induced congestion of middle lobe and hepatocytic degeneration, resulting in disintegration of hepatic cords, and increased biochemical markers of blood related to hepatic injury. On the other hand, the Pb-CHI and Pb-KOR group decreased the levels of biochemical markers in blood and cytokine levels in spleen and liver. Especially, the Pb-KOR group facilitated the recovery of biochemical values of blood related to hepatic injury, hepatic lesions and fibrosis. Taken together, larval extract from P. brevitarsis might prevent acute hepatotoxicity and enhance the recovery of liver fibrosis and cirrhosis induced by $CCl_4$, and the ingredients could be a promising candidate for the prevention and treatment of hepatic disorders.