• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.666-675
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• 2023

Purpose This study aimed to determine whether the attenuation coefficient (AC) from attenuation imaging (ATI) was correlated with visual US assessment in patients with hepatic steatosis. Moreover, it aimed to assess whether the patient's blood chemistry results and CT attenuation were correlated with AC. Materials and Methods Patients who underwent abdominal US with ATI between April 2018 and December 2018 were included in this study. Patients with chronic liver disease or cirrhosis were excluded. The correlation between AC and other parameters, such as visual US assessment, blood chemistry results, liver attenuation, and liver-to-spleen (L/S) ratio, were analyzed. AC values according to visual US assessment grades were compared using analysis of variance. Results A total of 161 patients were included in this study. The correlation coefficient between US assessment and AC was 0.814 (p < 0.001). The mean AC values for the normal, mild, moderate, and severe grades were 0.56, 0.66, 0.74, and 0.85, respectively (p < 0.001). Alanine aminotransferase levels were significantly correlated with AC (r = 0.317, p < 0.001). The correlation coefficients between liver attenuation and AC and between L/S ratio and AC were -0.702 and -0.626, respectively (p < 0.001). Conclusion Visual US assessment and AC showed a strong positive correlation with the discriminative value between the groups. Computed tomography attenuation and AC showed a strong negative correlation.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.1
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• pp.25-33
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• 2024

Backgrounds/Aims: Parenchymal-sparing anatomical hepatectomy (Ps-AH) based on portal ramification of the right anterior section (RAS) is a new technique to avoid unnecessarily transecting too much liver parenchyma, especially in cases of major anatomical hepatectomy. Methods: We prospectively assessed 26 patients with primary hepatic malignancies having undergone major Ps-AH based on portal ramification of the RAS from August 2018 to August 2022 (48 months). The perioperative indications, clinical data, intra-operative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: Among the 26 patients analyzed, there was just one case that had intrahepatic cholangiocarcinoma The preoperative level of α-Fetoprotein was 25.2 ng/mL. All cases (100%) had Child-Pugh A liver function preoperatively. The ventral/dorsal RAS was preserved in 19 and 7 patients, respectively. The mean surgical margin was 6.2 mm. The mean surgical time was 228.5 minutes, while the mean blood loss was 255 mL. In pathology, 5 cases (19.2%) had microvascular invasion, and in the group of HCC patients, 92% of all cases had moderate or poor tumor differentiation. Six cases (23.1%) of postoperative complications were graded over III according to the Clavien-Dindo system, including in three patients resistant ascites or intra-abdominal abscess that required intervention. Conclusions: Parenchymal-sparing anatomical hepatectomy based on portal ramification of the RAS to achieve R0-resection was safe and effective, with favorable short-term outcomes. This technique can be used widely in clinical practice.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.4
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• pp.308-312
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• 2022

Backgrounds/Aims: Although body surface area (BSA)-based standard liver volume (SLV) formulae have been used for living donor liver transplantation and hepatic resection, hemi-liver volume (HLV) is needed more frequently. HLV can be assessed using right or left portal vein diameter (RPVD or LPVD). The aim of this study was to validate the reliability of using portal vein diameter ratio (PVDR) for assessing HLV in living liver donors. Methods: This study included 92 living liver donors (59 males and 33 females) who underwent surgery between January 2020 and December 2020. Computed tomography (CT) images were used for measurements. Results: Mean age of donors was 35.5 ± 7.2 years. CT volumetry-measured total liver volume (TLV), right HLV, left HLV, and percentage of right HLV in TLV were 1,442.9 ± 314.2 mL, 931.5 ± 206.4 mL, 551.4 ± 126.5 mL, and 64.6% ± 3.6%, respectively. RPVD, LPVD, and main portal vein diameter were 12.2 ± 1.5 mm, 10.0 ± 1.3 mm, and 15.3 ± 1.7 mm, respectively (corresponding square values: 149.9 ± 36.9 mm², 101.5 ± 25.2 mm², and 237.2 ± 52.2 mm², respectively). The sum of RPVD2 and LPVD2 was 251.1 ± 56.9 mm². BSA-based SLV was 1,279.5 ± 188.7 mL (error rate: 9.1% ± 14.4%). SLV formula- and PVDR-based right HLV was 760.0 ± 130.7 mL (error rate: 16.2% ± 13.3%). Conclusions: Combining BSA-based SLV and PVDR appears to be a simple method to predict right or left HLV in living donors or split liver transplantation.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.4
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• pp.386-394
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• 2022

Splenic artery steal syndrome (SASS) is a cause of graft hypoperfusion leading to the development of biliary tract complications, graft failure, and in some cases to retransplantation. Its management is still controversial since there is no universal consensus about its prophylaxis and consequently treatment. We present a case of SASS that occurred 48 hours after orthotopic liver transplantation (OLTx) in a 56-year-old male patient with alcoholic cirrhosis and severe portal hypertension, and who was successfully treated by splenic artery embolization. A literature search was performed using the PubMed database, and a total of 22 studies including 4,789 patients who underwent OLTx were relevant to this review. A prophylactic treatment was performed in 260 cases (6.2%) through splenic artery ligation in 98 patients (37.7%) and splenic artery banding in 102 (39.2%). In the patients who did not receive prophylaxis, SASS occurred after OLTx in 266 (5.5%) and was mainly treated by splenic artery embolization (78.9%). Splenic artery ligation and splenectomies were performed, respectively, in 6 and 20 patients (2.3% and 7.5%). The higher rate of complications registered was represented by biliary tract complications (9.7% in patients who received prophylaxis and 11.6% in patients who developed SASS), portal vein thrombosis (respectively, 7.3% and 6.9%), splenectomy (4.8% and 20.9%), and death from sepsis (4.8% and 30.2%). Whenever possible, prevention is the best way to approach SASS, considering all the potential damage arising from an arterial graft hypoperfusion. Where clinical conditions do not permit prophylaxis, an accurate risk assessment and postoperative monitoring are mandatory.

• Clinical Endoscopy
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• v.57 no.4
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• pp.515-526
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• 2024

Background/Aims: The optimal length of the uncovered portion of partially covered self-expandable metal stents (PCSEMSs) used in endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) remains unclear. This study investigated the safety and efficacy of PCSEMSs with different uncovered lengths, with a focus on stent migration and time to recurrent biliary obstruction (RBO). Methods: Outcomes of patients undergoing EUS-HGS using PCSEMSs with 5-mm and 20-mm uncovered portions at our institution from January 2016 to December 2021 were compared. Results: Sixty-two patients underwent EUS-HGS using PCSEMS (5/20-mm uncovered portions: 32/30). Stent migration occurred only in the 5-mm group. There were no differences in RBO rates (28.1% vs. 40.0%) or median time to RBO (6.8 vs. 7.1 months) between the two groups. Median overall survival (OS) was longer in the 20-mm group (3.1 vs. 4.9 months, p=0.037) due to the higher number of patients that resumed chemotherapy after EUS-HGS (56.7% vs. 28.1%, p=0.029). Good performance status, absence of hepatic metastases, and chemotherapy after EUS-HGS were independent predictors of longer OS. Conclusions: No migration was observed in patients treated with PCSEMS with 20-mm uncovered portions. Patients treated with PCSEMS with 20-mm uncovered portions performed at least as well as those treated with 5-mm uncovered portions in all material respects.

• Journal of the Korean Society of Food Science and Nutrition
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• v.44 no.4
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• pp.491-496
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• 2015

The purpose of this study was to assess the antioxidant, anti-inflammatory, and immuno-enhancing effects of Daebong persimmon (DP) and Bansi (BS) in vivo. Two types of astringent persimmons (DP and BS) were used for this experiment. C57BL/6J mice were assigned to the following groups: 1) lean control, 2) high-fat diet control (HF), 3) A region DP (3% wt/wt) with HF diet (A-DP), 4) B region DP with HF diet (B-DP), 5) C region DP with HF diet (C-DP), 6) D region BS with HF diet (D-BS), and 7) E region BS with HF diet (E-BS). All mice were sacrificed after 4 weeks of treatment, after which blood and tissues were collected. Antioxidant enzyme activities, inflammatory markers, and immune factors were evaluated. DP and BS treatments did not alter food intake or body weight, compared with HF. Administration of B-DP increased catalase activities in serum. Hepatic levels of malondialdehyde, a product of lipid peroxidation, were significantly lower in A-DP mice than in the HF group. A-DP had down-regulatory effects against inflammation induced by high-fat diet feeding, as shown by significant reduction of interleukin (IL)-$1{\beta}$, IL-6, and tumor necrosis factor-${\alpha}$. Additionally, A-DP treatment exerted an immuno-stimulatory effect, as shown by increasing levels of immunoglobulin G. DP treatment improved the level of insulin-like growth factor-1. These results indicate that DP has beneficial health effects on oxidative stress, inflammation, and immunity in vivo.

• Food Science and Preservation
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• v.17 no.3
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• pp.398-404
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• 2010

It is known that onions, or bioactive compounds therein, providehealth benefits. The present study was designed to investigate whether a concentrated onion extract lowered blood lipid levels in rats fed a high-fat diet. Initially, male Sprague-Dawley rats were housed singly in an environment in which temperature and light duration were controlled, and had free access to a nutritionally adequate AIN-93G diet and deionized water. After an acclimatization period, rats were weight-matched and assigned to one of the following five groups: 1) a control group, fed the AIN-93G diet mixed with 10% (w/v) lard and 0.7% (w/v) cholesterol to induce hyperlipidemia (control); 2) three experimental groups, fed the AIN-93G diet mixed with a high-fat source plus concentrated onion extract at three different levels (termed the low-dose, medium-dose, and high-dose groups); and, 3) a placebo group, fed the AIN-93G diet with fats plus the same concentrated extract but devoid of onion-derived material. All five groups freely ingested their respective diets over 6 weeks. At 0, 3, and 6 weeks, blood samples were collected from the orbital sinus following overnight food deprivation. At 6 weeks, livers were collected. Both control and experimental groups continually gained body weight throughout the study. No significant differencein body weight gain was observed among groups. However, the serum concentrations of triglycerides, total cholesterol, and non HDL-cholesterol were significantly reduced by ingestion of concentrated onion extract. Also, the hepatic levels of total lipids and total fatty acids, especially C18:1 (oleic acid), were significantly decreased in rats fed a high level of concentrated onion extract, compared with the control and placebo groups. These results provide clear evidence that ingestion of a concentrated onion extract has a profound inhibitory effect on serum lipid levels in rats fed a high-fat diet. Our findings indicate that a concentrated onion extract may be used to alleviate hyperlipidemia by lowering serum cholesterol and triglyceride levels.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.36-40
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• 2011

Purpose: $^{18}F$-FDG injected dose to the patient is quite different between the recommended dose from manufacturer and the actual dose applied to each of hospitals. injection of inappropriate $^{18}F$-FDG dose may not only increase the exposed dose to patients but also reduce the image quality. we thus evaluated the proper $^{18}F$-FDG injected dose to decrease the exposed dose to patients considering the image quality. Materials And Methods: NEMA Nu2-1994 phantom was filled with $^{18}F$-FDG increasing hot cylinder radioactivity concentration to 1, 3, 5, 7, 9 MBq/kg based on the ratio of 4:1 between the hot cylinder and background activity. after completing the transmission scan using ct, emission scan was acquired in 3D mode for 2 minutes 30 seconds/bed. ROI was set up on hot cylinder and background radioactivity region. after measuring $SUV_{max}$ those regions, then analyzed SNR at the points. clinical experiment has been conducted the object of patients who have came to smc from november 2009 to august 2010, 97 patients without having a hepatic lesions were selected. ROI was set up in the liver and thigh area. after measuring $SUV_{max}$, the image quality was compared following the injected dose. Results: in phantom study, as the injected radioactivity concentration per unit mass was 1, 3, 5, 7, 9 MBq/kg, $SUV_{max}$ was 23.1, 24.1, 24.3, 22.8, 23.6 and SNR was shown 0.48, 0.54, 0.56, 0.55, 0.55. according to increment of the injected dose, $SUV_{max}$ and SNR was increased under 5 MBq/kg but they were decreased over 7 MBq/kg. in case of clinical experiment, as increased the injected radioactivity concentration per unit mass was 4.72, 5.34, 6.16, 7.41, 8.68 MBq/kg, $SUV_{max}$ was 2.68, 2.67, 2.26, 1.88, 1.95 and SNR was shown 0.52, 0.53, 0.46, 0.46, 0.44. if the injected dose exceeds 5 MBq/kg, showed a decrease pattern as phantom study. Conclusion: increasing $^{18}F$-FDG injected dose considered patient's body weight improve image quality within a certain range. if it exceeds the range, it can be reduced image quality due to random and scatter coincidences. this study indicates that the optimal injected dose was 5 MBq/kg per unit mass the injected radioactivity concentration in 3d wb pet/ct.

• Journal of the East Asian Society of Dietary Life
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• v.24 no.2
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• pp.166-175
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• 2014

This study was conducted to investigate the hepatoprotective effects of fermented Smilax china leaf ethylacetate extracts by Aspergillus oryzae on carbon tetrachloride-induced liver injury in mice. Experimental mice were divided into four groups (five mice/group) (NC; normal control group, CB; basic diet supplemented before $CCl_4$ treatment group, NS ; basic diet mixed with 0.5% Smilax china leaf ethyl acetate extract supplemented before $CCl_4$ treatment group, FS; basic diet mixed with 0.5% fermented Smilax china leaf ethyl acetate extract supplemented before $CCl_4$ treatment group) fed for 4 weeks each. In the $CCl_4$-treated groups (CB, NS and FS) compared with the NC group, liver weights, activities of alanine aminotransferase, aspartate aminotransferase, xanthine oxidase and aldehyde oxidase, contents of triglycerides, total cholesterol and LDL-cholesterol in serum, and hepatic lipid peroxide levels increased, whereas body weight gain and contents of glutathione and HDL-cholesterol decreased. Furthermore, in the FS groups compared with the NS and CB groups, increased or decreased indicators by $CCl_4$ treatment significantly decreased or increased, respectively. This study suggests that fermented Smilax china L. leaf extracts may regulate xanthine oxidase and aldehyde oxidase inhibitory activities and hepatoprotective effects due to flavonoid aglycone derived from its glycoside in leaves of Smilax china by fermentation of A. oryzae.

• Journal of Nutrition and Health
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• v.48 no.4
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• pp.299-309
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• 2015

Purpose: The purpose of this study was to examine the effect of black soybean (CJ-3) testa extracts on lipid profiles in streptozotocin (STZ)-induced diabetic rats. Methods: One control group and four STZ-induced diabetic groups with different doses of black soybean (CJ-3) testa extracts treatment [0 mg/kg (diabetic control, EX), 250 mg/kg (EX-250), 500 mg/kg (EX-500), 1,000 mg/kg (EX-1000)] were orally administered for 4 weeks. Results: All CJ-3 treatment groups had remarkably lower serum triglyceride (TG) levels than that of EX group (p < 0.05) whereas hepatic TG contents did not show any differences. Results from serum total cholesterol (TC) concentrations of EX-250 and EX-1000 groups were decreased compared to EX group (p < 0.05). Furthermore, protein levels of 3-hydroxy-3-methyl-glutaryl-Coenzyme A (HMG-CoA) reductase from the liver decreased in all treatment groups (p < 0.05). However, significant differences were not observed in serum glucose and insulin, and glucose transporter 4 (GLUT-4) protein expression in skeletal muscle tissue. Conclusion: These results suggest that black soybean testa extracts could be useful for improvement of hyperlipidemia and hypercholesteremia in diabetes.