• 대한핵의학회지
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• 제4권1호
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• pp.37-42
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• 1970

In an endeavor to help understand some typical scan findings and portal hemodynamics in liver cirrhosis, several commonly occurring scan changes and esophageal varices as demonstrated by esophagram were correlated one another from quantitative and qualitative stand points. Clinical materials consisted of 34 patients with proven diagnosis of liver cirrhosis and esophageal varices. Liver scan was performed with colloidal 198-Au and the changes in the size and internal architecture of the liver, splenic uptake and splenomegaly were graded and scored by repeated double-blind readings. The variceal changes on esophagrams were also graded according to the classification of Shanks and Kerley following modification. Of 34 patients, 91% showed definite reduction in liver volume (shrinkage) constituting the most frequent scan change. The splenic uptake and splenomegaly were noted in 73.5 and 79.4%, respectively. The present study revealed no positive correlation between the graded scan findings including shrinkage of the liver, splenic uptake or splenomegaly and severity of variceal changes of the esophagus. Exceptionally, however, apparently paradoxical correlation was noted between the severity of mottlings and varices. Thus, in the majority (73.5%) of patients mottlings were either absent or mild. This interesting observation is in favor of the view held by Christie et al. who consider the mottlings to be not faithful expression of actual scarring of the cirrhotic liver. This also would indicate that variceal changes are to be the results of intrahepatic arteriovenous shunting of blood with hypervolemic load to the portal system rather than simple hypertension secondary to fibrosis and shrinkage.

• 대한한방내과학회지
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• 제39권3호
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• pp.293-301
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• 2018

Objective: The purpose of this clinical trial is to examine the efficacy and safety of electroacupuncture on liver cirrhosis patients suffering from muscle cramps. Methods: A total of 14 liver cirrhosis patients with muscle cramps were treated by electroacupuncture three times a week for four weeks (12 times total). The electrical stimulation was a frequency of 100 Hz. Evaluation of the muscle cramps was measured by a questionnaire of subjective symptoms. The patients' condition was evaluated four times over a period of eight weeks. We also assessed the deterioration of liver disease using the Child-Pugh score and blood tests. Results: This study proves that four weeks of electroacupuncture treatment is effective in reducing the frequency of muscle cramps and that the effects of electroacupuncture treatment lasted during another four-week follow-up period after treatment. Conclusions: This study suggests that electroacupuncture treatment is beneficial for improving muscle cramps in liver cirrhosis patients (p=0.000). Electroacupuncture is thought to be a safe treatment for liver cirrhosis patients with muscle cramps without contributing to the worsening of liver function. Further study with a larger sample size is needed to confirm our findings.

• Asian Pacific Journal of Cancer Prevention
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• 제16권11호
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• pp.4769-4775
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• 2015

Background: Hepatocellular carcinoma (HCC) is the fifth most prevalent cancer and thirdly leading cause of cancer-related death worldwide. The estimated risk of hepatocellular carcinoma is 15 to 20 times as high among persons infected with HCV as it is among those who are not infected, with most of the excess risk limited to those with advanced hepatic fibrosis or cirrhosis. Glypican3 (GPC3) plays a key role in relation to signaling with growth factors, regulating the proliferative activity of cancer cells. Glutamine synthetase (GS) catalyzes the synthesis of glutamine from glutamate and ammonia in the mammalian liver. GS was suggested as a specific marker for tracing cell lineage relationships during hepatocarcinogenesis. In normal liver, GS expression is seen in pericentral hepatocytes, but not by midzonal or periportal hepatocytes. In HCC, strong and diffuse GS expression in seen in tumor cells. Results: Glypican3 immunopositvity was highly specific and sensitive indicator for hepatocellular carcinoma as well as glutamine synthetase which was found to be a sensitive and specific indicator for development of hepatocellular carcinoma when compared to cirrhosis, liver cell dyspalsia and metastatic carcinomas. Statistical analysis revealed a significant association between GPC3 and GS with tumor size (P=0.003, p=0.006, respectively). Diffuse staining significantly associated with large tumor size while, focal and mixed staining was detected more with small tumor size. Studying the relation with tumor grade also revealed significant association between diffuse GPC3 and GS staining with high tumor grade. Diffuse staining was detected in 91.7% and 100% respectively of poorly differentiated specimens and only in 33.3% and 22.2% of well differentiated specimens. Conclusions: While using GPC3 and GS to screen for premalignant hepatic lesions remains controversial, our data suggest that GPC3 and GS may be a reliable diagnostic immunomarkers to distinguish HCC from benign hepatocellular lesions. However, negative immunostaining should not exclude the diagnosis of HCC.

• 대한한방내과학회지
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• 제41권2호
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• pp.166-176
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• 2020

Objectives: This study reports on the effect of Integrative Medicine Therapy (IMT) on a patient with pancreatic cancer with liver metastasis. Methods: One pancreatic cancer with liver metastasis patient was treated using IMT in conjunction with Gemcitabine/Abraxane since September 2019. The cycle was repeated every four weeks for a total of 11 times. At the same time, the patient was treated with IMT. Tumor size was measured by scanning with Computed Tomography (CT). Adverse events were evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After treatment with Gemcitabine/Abraxane and IMT for eight months, the size of the body and tail of the cancer tumor and several hepatic metastatic regions decreased (partial response, [PR]), size, and number of multiple nodules in both lungs decreased. No evidence of newly developed metastatic lesions was found. The patient has maintained a good treatment outcome and has shown prolonged overall survival. Conclusions: This case demonstrates that treatment with IMT may have substantial benefits for patients with end-stage pancreatic cancer.

• Clinical Endoscopy
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• 제56권2호
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• pp.229-238
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• 2023

Background/Aims: Shear wave elastography (SWE) is used for liver fibrosis staging based on stiffness measurements. It can be performed using endoscopic ultrasound (EUS) or a transabdominal approach. Transabdominal accuracy can be limited in patients with obesity because of the thick abdomen. Theoretically, EUS-SWE overcomes this limitation by internally assessing the liver. We aimed to define the optimal technique for EUS-SWE for future research and clinical use and compare its accuracy with that of transabdominal SWE. Methods: Benchtop study: A standardized phantom model was used. The compared variables included the region of interest (ROI) size, depth, and orientation and transducer pressure. Porcine study: Phantom models with varying stiffness values were surgically implanted between the hepatic lobes. Results: For EUS-SWE, a larger ROI size of 1.5 cm and a smaller ROI depth of 1 cm demonstrated a significantly higher accuracy. For transabdominal SWE, the ROI size was nonadjustable, and the optimal ROI depth ranged from 2 to 4 cm. The transducer pressure and ROI orientation did not significantly affect the accuracy. There were no significant differences in the accuracy between transabdominal SWE and EUS-SWE in the animal model. The variability among the operators was more pronounced for the higher stiffness values. Small lesion measurements were accurate only when the ROI was entirely situated within the lesion. Conclusions: We defined the optimal viewing windows for EUS-SWE and transabdominal SWE. The accuracy was comparable in the non-obese porcine model. EUS-SWE may have a higher utility for evaluating small lesions than transabdominal SWE.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.853-857
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• 2015

Background: Gastric cancer is the most common cancer in the Iranian population. The aim of this study was to determine the effect of clinicopathological factors on prognosis by meta-analysis. Materials and Methods: A literature search was conducted using MEDLINE, EMBASE and Cochrane library and extensive literature search using the Persian databases until February 2011. Prospective follow up studies with multivariate analysis of overall survival of the patients with gastric cancer were included in this review. The data were analyzed by CMA.2. Publication bias are checked by funnel plot and data are shown as Forest plots. Results: From a total of 63 articles, 14 retrospective studies which examined 5 prognostic factors and involving 10,500 patients were included. Tumor size (>35mm) was the main significant factor predicting an unfavorable prognosis for the patients with gastric cancer (RR=1.829, p<0.001) followed by presence of distant metastases (RR=1.607, p<0.001), poor differentiation (RR=1.408, p<0.001) and male sex (RR=1.194, p<0.001). Lymph node metastases (RR=1.058, p=0.698) and moderate differentiation (RR=0.836, p=0.043) were not statistically significant as prognostic factors. Conclusions: This meta-analysis suggests that tumor size>35mm, poor differentiation, presence of distant metastasis and male gender are strongly associated with a poor prognosis in Iranian patients with gastric cancer.

• Tuberculosis and Respiratory Diseases
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• 제72권1호
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• pp.88-92
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• 2012

A 37 year old female presented with epigastric pain and weight loss over a period of 3 months. Her abdominal CT finding showed a 4.5 cm size hepatic mass and 4.3 cm size pancreatic head mass with multiple macronodules in the liver. At the same time, her chest CT revealed a 5 cm size necrotic mass in the left lower lobe of the lung with multiple bilateral pulmonary nodules. We diagnosed these lesions as tuberculosis through multiple biopsies. She was treated with anti-tuberculous medication. After taking the medications, her symptoms were improved. Twelve months later, imaging studies indicated an improvement in the patient's health. Here we report a case report of multi-organ macronodular tuberculosis in lung, liver and pancreas.

• 한방비만학회지
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• 제21권2호
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• pp.49-58
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• 2021

Objectives: The purpose of this study was to investigate the effect of white pan bread added with Kamut (Triticum turgidum spp.) on high fat diet (HFD)-induced obese C57BL/6 mice. Methods: The white pan bread or white pan bread with Kamut (BK) were administered for 8 weeks in HFD-induced obese C57BL/6 mice. To evaluate the effect and its mechanisms of BK on obese mice, we measured body weight change, serum lipid profiles, histopathological analysis, and protein expression of CCAAT/enhancer binding protein-α (C/EBPα) in the liver. Results: Administration of BK significantly decreased body weight in HFD-induced obese mice. In addition, BK-administered group significantly reduced serum total cholesterol, glucose, and high-density lipoprotein cholesterol levels compared with the HFD-induced control group. The HFD-induced mice had damaged liver tissue and increased the size of adipose tissue, but BK-administered group attenuated liver damage and decreased the size of adipocyte. Furthermore, administration of BK significantly down-regulated C/EBPα in the liver compared with HFD-fed mice. In particular, BK-administered group has higher inhibited body weight, serum lipid profiles, and C/EBPα expressions than white pan bread-administered group. Conclusions: This study demonstrated that administration of BK attenuated HFD-induced obesity by regulation of C/EBPα than consumption of white pan bread. Therefore, BK could be developed as a bread for prevention of obesity.

• Korean Journal of Radiology
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• 제20권4호
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• pp.580-588
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• 2019

Objective: To evaluate the impact of energy and access methods on extrahepatic tumor spreading and the ablation zone in an ex vivo subcapsular tumor mimic model with a risk of extrahepatic tumor spreading. Materials and Methods: Forty-two tumor-mimics were created in bovine liver blocks by injecting a mixture of iodine contrast material just below the liver capsule. Radiofrequency (RF) ablations were performed using an electrode placed parallel or perpendicular to hepatic surface through the tumor mimic with low- and high-power protocols (groups 1 and 2, respectively). Computed tomography (CT) scans were performed before and after ablation. The presence of contrast leak on the hepatic surface on CT, size of ablation zone, and timing of the first roll-off and popping sound were compared between the groups. Results: With parallel access, one contrast leak in group 1 (1/10, 10%) and nine in group 2 (9/10, 90%) (p < 0.001) were identified on post-ablation CT. With perpendicular access, six contrast leaks were identified in each group (6/11, 54.5%). The first roll-off and popping sound were significantly delayed in group 1 irrespective of the access method (p = 0.002). No statistical difference in the size of the ablation zone of the liver specimen was observed between the two groups (p = 0.247). Conclusion: Low-power RF ablation with parallel access is proposed to be effective and safe from extrahepatic tumor spreading in RF ablation of a solid hepatic tumor in the subcapsular location. Perpendicular placement of an electrode to the capsule is associated with a risk of extrahepatic tumor spreading regardless of the power applied.

• Journal of Animal Science and Technology
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• 제56권5호
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• pp.20.1-20.5
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• 2014

An experiment was conducted to evaluate the effect of form and particle size of feed supplemented with L-threonine on growth performance, carcass characteristic and blood biochemical parameters of broiler chickens. The experimental design was a $2{\times}2{\times}2$ factorial arrangement of treatments evaluating two feed forms (pellet or mash), two feed particle sizes (fine or course), and two inclusion rates of dietary L-threonine (with or without) which adopted from 7 to 42 days of age. In this experiment, 360 a day old chicks in two sexes were assigned in each treatment and each experimental unit was included 15 chicks. Feed consumption and weight gain were measured weekly. At 35 days of age, blood samples were taken to analysis blood biochemical parameters. At the end of the experimental period, two birds were slaughtered in each treatment and carcass analysis was carried out. The results showed that the effect of feed form on body weight gain and feed intake in whole of experimental period was significant (P < 0.05). Broilers fed pelleted diets had more weight gain than the mash group. Growth performance parameters were not affected by feed particle size and dietary L-threonine supplementation in whole of experimental period (P > 0.05). The results of carcass analysis showed that liver and gizzard relative weights were influenced by feed form (P < 0.05). However, pancreas and liver relative weights were affected by feed particle size and dietary L-threonine supplementation, respectively (P < 0.05). Triglyceride and VLDL levels were affected by feed form and dietary L-threonine supplementation (P < 0.05). The effect of feed particle size on blood biochemical parameters was not significant (P > 0.05). In conclusion, the experimental results indicated that feed form increased feed consumption and weight gain in whole of experimental period (1 to 42 days of age) while feed particle size and dietary L-threonine had no effect on broiler performance.