• BMB Reports
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• v.40 no.5
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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.

• Korean Journal of Adult Nursing
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• v.17 no.2
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• pp.248-258
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• 2005

Purpose: The purpose of this study is to examine the factors influencing symptom experience in patients with liver cirrhosis(LC). Method: A descriptive correlational study design was used. A convenience sample of 129 subjects was recruited from the gastroenterology department at two university hospitals in Seoul, Korea. Symptom experience in LC was measured with the instrument developed by the researcher based on Theory of Unpleasant Symptoms(Lenz et al, 1995) and the Child-Pugh Score, the Korean version of Profile of Mood States, and the Family Support Questionnaire were used to identify the factors influencing symptom experience. Results: The mean score of symptom experience was relatively low(M=41.67, SD= 24.71). Among individual symptoms, fatigue had the highest score in all dimensions. Fatigue, abdominal distension and/or peripheral edema, muscle cramps, dry mouth, and change in appearance were explored as symptoms needing management. In the regression analysis, symptom experience was found to be influenced significantly by anxiety/depression($R^2=.418$, p=.000) and the severity of LC(Child-Pugh Score)($R^2=.125$, p=.000). These variables explained 54.3% of the variance in symptom experience(F=63.607. p=.000). Conclusion: It suggests that nurses need to take into consideration psychological factor as well as physiological factor in symptom management for patients with LC.

• Clinical and Molecular Hepatology
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• v.24 no.4
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• pp.409-416
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• 2018

Background/Aims: Left ventricular diastolic dysfunction (LVDD) is an early manifestation of cardiac dysfunction in patients with liver cirrhosis (LC). However, the effect of LVDD on survival has not been clarified, especially in decompensated LC. Methods: We prospectively enrolled 70 patients with decompensated LC, including ascites or variceal bleeding, at Daejeon St. Mary's Hospital from April 2013 to April 2015. The cardiac function of these patients was evaluated using 2D echocardiography with tissue Doppler imaging. The diagnosis of LVDD was based on the American Society of Echocardiography guidelines. The primary endpoint was overall survival. Results: Forty-four patients (62.9%) had LVDD. During follow-up (22.3 months), 18 patients died (16 with LVDD and 2 without LVDD). The survival rate was significantly lower in patients with LVDD than in those without LVDD (31.1 months vs. 42.6 months, P=0.01). In a multivariate analysis, the Child-Pugh score and LVDD were independent predictors of survival. Moreover, patients with a ratio of early filling velocity to early diastolic mitral annular velocity (E/e') ${\geq}10$ (LVDD grade 2) had lower survival than patients with E/e' ratio < 10. Conclusions: The presence of LVDD is associated with poor survival in patients with decompensated LC. Therefore, it may be important to monitor and closely follow LVDD patients.

• The Korean journal of internal medicine
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• v.39 no.2
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• pp.248-260
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• 2024

Background/Aims: The model for end-stage liver disease (MELD) serves as an indicator for short-term mortality among patients diagnosed with liver cirrhosis (LC) and is used to prioritize patients for liver transplantation. In 2021, the updated version of MELD, MELD-3.0, was introduced to improve the accuracy of the mortality prediction of MELD. Therefore, this study aimed to compare the efficacy of MELD 3.0 and MELD-Na in predicting mortality among Korean patients with LC. Methods: A retrospective review was conducted using the medical records of patients diagnosed with LC who were admitted to Konkuk University Hospital From 2011 to 2021. The study calculated the predictive values of MELD-Na and MELD-3.0 for 3- and 6-months mortality using the area under the receiver operating curve (AUROC) and compared the results using the DeLong test. Results: Of the 3,034 patients enrolled in the study, 339 (11.2%) died within 3 months and 421 (14.4%) died within 6 months. The AUROCs values for predicting 3 months mortality were 0.846 for MELD-Na and 0.851 for MELD-3.0. The corresponding AUROC values for predicting 6 months mortality were 0.843 for MELD-Na and 0.848 for MELD-3.0. MELD-3.0 exhibited better discrimination ability than MELD-Na for both 3 (p = 0.03) and 6 months mortality (p = 0.01). Conclusions: Our study found a significant difference between the performance of MELD-3.0 and MELD-Na in Korean patients with LC.

• The Korean Journal of Nuclear Medicine
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• v.17 no.2
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• pp.49-55
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• 1983

By radioimmunoassay, serologic markers of Hepatitis B Virus were studied in 44 patients with acute viral hepatitis, 10 patients with chronic persistent hepatitis, 10 patients with chronic active hepatitis, 44 patients with liver cirrhosis and 25 patients with primary hepato cellular carcinoma. The results were follows: 1) HBsAg was present in 77.2% of AVH, 40% of CPH, 80% of CAH, 55.1% of LC and 68 % of PHC. In this HBsAg positive groups, all but one in liver cirrhosis had Anti-HBc. 2) Anti-HBs was most commonly detected in CPR and accompanied by Anti-HBc except one case in AVH. 3) Anti-HBc was the only marker detected in 11.4% of AVH, 20% of CPH, 20% of CAH, 16.3% of LC and 8% of PHC. 4) HBeAg was most commonly found in HBsAg-positive CPH but Anti-HBe was most frequently detected in PHC. 5) The absence of HBV markers was noted in 2.3% of AVH, 10% of CPH, 8% of PHC except CAH and LC.

• The Korean journal of internal medicine
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• v.39 no.3
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• pp.448-457
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• 2024

Background/Aims: Improved knowledge of local epidemiology and predicting risk factors of multidrug-resistant (MDR) bacteria are required to optimize the management of infections. This study examined local epidemiology and antibiotic resistance patterns of liver cirrhosis (LC) patients and evaluated the predictors of MDR bacteremia in Korea. Methods: This was a retrospective study including 140 LC patients diagnosed with bacteremia between January 2017 and December 2022. Local epidemiology and antibiotic resistance patterns and the determinants of MDR bacteremia were analyzed using logistic regression analysis. Results: The most frequently isolated bacteria, from the bloodstream, were Escherichia coli (n = 45, 31.7%) and Klebsiella spp. (n = 35, 24.6%). Thirty-four isolates (23.9%) were MDR, and extended-spectrum beta-lactamase E. coli (52.9%) and methicillin-resistant Staphylococcus aureus (17.6%) were the most commonly isolated MDR bacteria. When Enterococcus spp. were cultured, the majority were MDR (MDR 83.3% vs. 16.7%, p = 0.003), particularly vancomycin-susceptible Enterococcus faecium. Antibiotics administration within 30 days and/or nosocomial infection was a significant predictor of MDR bacteremia (OR: 3.40, 95% CI: 1.24-9.27, p = 0.02). MDR bacteremia was not predicted by sepsis predictors, such as positive systemic inflammatory response syndrome (SIRS) or quick Sequential Organ Failure Assessment (qSOFA). Conclusions: More than 70% of strains that can be treated with a third-generation cephalosporin have been cultured. In cirrhotic patients, antibiotic administration within 30 days and/or nosocomial infection are predictors of MDR bacteremia; therefore, empirical administration of broad-spectrum antibiotics should be considered when these risk factors are present.

• The Korean Journal of Nuclear Medicine
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• v.33 no.1
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• pp.49-56
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• 1999

Purpose: Heart to liver ratio on T1-201 per rectal scintigraphy (shunt index) is known to be useful in the assessment of portal systemic shunt. We assessed T1-201 uptake pattern and early liver/heart uptake rate of T1-201 and correlated with shunt index in patients with chronic active hepatitis (CAH) and liver cirrhosis (LC). Materials and Methods: Fifty eight patients with biopsy-proven chronic liver disease (35 with CAH, 23 with LC) underwent T1-201 per rectum scintigraphy after instillation of 18.5 MBq of T1-201 into the upper rectum. We evaluated hepatic uptake (type 1 : homogeneous, 2: inhomogeneous segmental, 3: inhomogeneous nonsegmental) and extrahepatic uptake of spleen, heart and kidney (grade 0: no uptake, 1: less than liver, 2: equal to liver, 3: greater than liver). We measured the early liver/heart uptake rate (the slope of the liver to heart uptake ratio for 10 min) and shunt index (heart to liver uptake ratio). T1-201 uptake pattern and early liver/heart uptake rate of T1-201 was correlated with the pathologic diagnosis and shunt index. Results: Hepatic uptake patterns of type 1 and 2 were dominant in CAH (CAH: 27/35, LC. 8/23), and type 3 in LC (CAH: 8/35, LC: 15/23)(p<0.005). The grades of extrahepatic uptake were higher in LC than in CAH (spleen: p<0.001, other soft tissue: p<0.005). The early liver/heart uptake rate of CAH ($0.110{\pm}0.111$) was significantly higher than that of LC ($0.014{\pm}0.090$)(p<0.001). The sensitivity and specificity of the early liver/heart uptake rate were 77.7% and 67.7% in differentiating LC from CAH. There was negative correlation between early liver/heart uptake rate and shunt index (r=-0.3347, p<0.01). Conclusion: Hepatic and extrahepatic uptake pattern and early liver/heart uptake rate on T1-201 per rectum scintigraphy are useful in the assessment of portal systemic shunt in patients with chronic liver disease.

• Journal of Biomedical Engineering Research
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• v.14 no.4
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• pp.341-348
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• 1993

Automated system to analyze liver function test results is presented based on fuzzy logic knowledge. Clinician's knowledge and experience was first expressed in linguistic terms fol- lowed by conversion to numerical values to create membership functions of disease possibility for each test item and liver disease. Membership functions were then compensated for different relative importances of test items. Liver diseases considered were acute viral hepatitis (AVH), chronic persistent hepatitis(CPH), chronic active hepatitis(CAH), and liver cirrhosis(LC), Liver function test results of alanine aminotransferase(ALT), aspartate amino- transferase(AST) , glutamate dehydrogenase(GDH), ornithine carbamyltransferase(OCT) , ALT/AST, and 10* GDH/ALT in 218 patients were analyzed by the present system, welch resulted in 80% accuracy. AVH and CAH showed the highest 93 % and the lowest 58% ac- curacies, respectively, which was similar to the clinician's expectation. The simple mathemat- ical formulation of the present system would enable an easy implementation in commercial analysis instruments. Also, the identical fuzzy logic can be applied to similar diagnostic envi- ronments in general.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.6019-6026
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• 2015

Background: The aim of this study was to assess the relationship between IL-18 gene polymorphisms and HBV-related diseases and whether these polymorphisms influence its expression in the Guangxi Zhuang population. Materials and Methods: We enrolled 129 chronic HBV infected (CHB) patients, 86 HBV-related liver cirrhosis (LC) patients and 160 healthy controls in our study. Polymerase chain reaction-restriction fragment length polymorphism methods were used to detect IL-18 gene -607C/A, -137G/C polymorphisms, and an ELISA kit was employed to determine serum IL-18 levels. Results: No correlation was found between the -607C/A polymorphism and risk of HBV-related disease. For the -137G/C polymorphism, the GC genotype and C allele were associated with a significantly lower risk of CHB (95%CI: 0.32-0.95, p=0.034 and 95%CI: 0.35-0.91, p=0.018) and HBV-related LC (95%CI: 0.24-0.89, p=0.022 and 95%CI: 0.28-0.90, p=0.021). A similar decreased risk was also found with the A-607C-137 haplotype. With respect to IL-18 expression, it was significantly lower in both patient groups, but no association was noted between the two polymorphisms in the IL-18 gene and its expression. Conclusions: Our study indicated that the -137C allele in the IL-18 gene may be a protective factor for HBV-related disease, and serum IL-18 level may be inversely associated with CHB and HBV-related LC.

• Environmental Analysis Health and Toxicology
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• v.12 no.3_4
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• pp.55-59
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• 1997

Furfural, an organic solvent, is widely used as synthetic component material in producing chemical products. However, furfural has been reported that it shows strong toxicities to human being showing intense stimulus to skin, eyes, mucous membrane and nerve system. It is also known to cause anemia, liver cirrhosis, kidney failure and genetic toxicity in the human being working in the exposed area. LD$_{50}$ of furfural for peritoneal injected mouse has been known around 20mg/kg, but the acute toxicity on aquatic organisms such as fish, daphnid or algae are not well known, compared to those on rodents. In this experiment, we studied on the fish toxicity of furfural using Japanese Medaka (Orvzias latipes) and Common Carp (Cvprinus carpio). We also observed histological changes in the fish organs. The LC$_{50}$ were 12. Smg/L in Japanese Medaka and 21.8 mg/L in Common Carp, respectively. When Common Carps were exposed to 120mg/L of furfural concentration for 30 minutes, blood congestion in gills and lysis of secondary lamella were shown. Though the muscle of caudal fin was not completely eroded, its epidermic cells were shown to be necrotic in various parts. Tissue atrophy and cell necrosis were also shown in the liver of Common Carps exposed to furfural. From these results, furfural seems to cause histological damages on liver, an internal organ as well as on external organs such as gills and fins eventhough the fish were exposed for a short-term.