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( Yoon Hee Chun ), ( Young Eun Chon ), ( Seung Up Kim ), ( Chun Kyon Lee ), ( Jun Yong Park ), ( Do Young Kim ), ( Kwang Hyub Han ), ( Chae Yoon Chon ), ( Sin Young Kim ), ( Sang Hoon Ahn ) 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.3(S)
Chon,,Young,Eun,Kim,,Kwang,Joon,Jung,,Kyu,Sik,Kim,,Seung,Up,Park,,Jun,Yong,Kim,,Do,Young,Ahn,,Sang,Hoon,Chon,,Chae,Yoon,Chung,,Jae,Bock,Park,,Kyeong,Hye,Bae,,Ji,Cheol,Han,,Kwang-Hyub Yonsei University College of Medicine 2016 Yonsei medical journal Vol.57 No.4
<P><B>Purpose</B></P><P>The severity of non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) population compared with that in normal glucose tolerance (NGT) individuals has not yet been quantitatively assessed. We investigated the prevalence and the severity of NAFLD in a T2DM population using controlled attenuation parameter (CAP).</P><P><B>Materials and Methods</B></P><P>Subjects who underwent testing for biomarkers related to T2DM and CAP using Fibroscan® during a regular health check-up were enrolled. CAP values of 250 dB/m and 300 dB/m were selected as the cutoffs for the presence of NAFLD and for moderate to severe NAFLD, respectively. Biomarkers related to T2DM included fasting glucose/insulin, fasting C-peptide, hemoglobin A1c (HbA1c), glycoalbumin, and homeostasis model assessment of insulin resistance of insulin resistance (HOMA-IR).</P><P><B>Results</B></P><P>Among 340 study participants (T2DM, n=66; pre-diabetes, n=202; NGT, n=72), the proportion of subjects with NAFLD increased according to the glucose tolerance status (31.9% in NGT; 47.0% in pre-diabetes; 57.6% in T2DM). The median CAP value was significantly higher in subjects with T2DM (265 dB/m) than in those with pre-diabetes (245 dB/m) or NGT (231 dB/m) (all p<0.05). Logistic regression analysis showed that subjects with moderate to severe NAFLD had a 2.8-fold (odds ratio) higher risk of having T2DM than those without NAFLD (<I>p</I>=0.02; 95% confidence interval, 1.21–6.64), and positive correlations between the CAP value and HOMA-IR (ρ=0.407) or fasting C-peptide (ρ=0.402) were demonstrated.</P><P><B>Conclusion</B></P><P>Subjects with T2DM had a higher prevalence of severe NAFLD than those with NGT. Increased hepatic steatosis was significantly associated with the presence of T2DM, and insulin resistance induced by hepatic fat may be an important mechanistic connection.</P>
Most of the current ITS could not transfer knowledge which is fit to various users in different levels through user friendly interface. Also, current ITSs with different educational domains are developed independently in spite of common interest among them. The reusable model of ITS on this paper based on model-oriented approach of KADS(Knowledge Acquisition and Documentation System) has following characteristics: First, It is reusable system; Second, It is possible to represent the knowledge in higher educational domains; Third, Hypermedia is used for user friendly interface.
Chronic HBsAg carriers is defined as those who have HBsAg in their sera longer than 6 momths persistently. In general, chronic HBsAg carriers have no subjective symptoms and their liver functions are normal so that they are often regarded as those who have no liver pathology at all. The hepatic status of chronic HBsAg carriers is still controversial, and the pathologic findings of asymptomatic chronic HBsAg carriers shows marked differences according to the investigators. To clarify this issue a prospective study was performed in 41 asymptomatic chronic carriers with normal liver functions and no hepatomegaiy. All the Chronic HBsAg carriers underwent peritoneoscopic liver biopsy using Vim-Silverman needle, Viral markers, age and sex distribution, occupations, reasons for HBsAg test, peritoneoscopic fingings, pathologic findings, and pathologic findings by HBeAg and anti-HBc status were analyzed in chronic HBsAg carriers. The results were as follows; 1) Both HBsAg and anti-HBc were positive and anti-HBs negative in all 41 carriers, HBeAg and anti-HBe were tested in 33 of 41 carriers. HBeAg was positive in 15cases (45.4%), anti-HBe positive in 16cases (48.5%), end both negative in 2cases (6.1%). 2) The peak incidence was in the 3rd and 4th decades (70.7%), and the female outnumbered the female at a rate of 1.73 to l. 3) In 46.4% of the carriers, the peritoneoscopic findings were consistent with chronic liver diseases. 4) In 34.1% of the carriers, the pathologic findings were consistent with chronic liver diseases including 2cases of chronic active hepatitis with cirrhosis, and 3cases of chronic active hepatitis. 5) Of the 15cases with HBeAg positive, 7cases (46.7 %) had chronic liver diseases, 5cases (33.3%) non- specific findings, and 3cases (20.3%) normal liver. Of the 16cases with anti-HBe positive, only 3cases (18.8%) had chronic liver diseases, 11cases (68.8%) nonspecific findings, and 2cases (1.4%) normal liver. In conclusion, 34,1% of chronic HBsAg carriers had chronic liver diseases even though their liver functions were normal and they had no hepatomegaly. It is recommended that a liver biopsy be done in evey chronic HBsAg carrier to confirm his undorlying liver disease although his liver functions are normal and he has no hepatomegaly.
( Yoon Hea Park ), ( Beom Kyung Kim ), ( Jun Yong Park ), ( Seung Up Kim ), ( Do Young Kim ), ( Ja Kyung Kim ), ( Kwan Sik Lee ), ( Kwang Hyub Han ), ( Chae Yoon Chon ), ( Sang Hoon Ahn ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background: Chronic hepatitis B (CHB) can progress to cirrhosis and hepatocellular carcinoma (HCC), either of which can lead to a liver-related death. The progression of liver disease in hepatitis B virus (HBV) infection is fostered by active virus replication. Recently, antiviral therapy with minimal side effects have become available to achieve sustained suppression of HBV replication, thereby preventing cirrhosis, hepatic failure, and, ultimately, HCC. The aim of this study is to reappraise the clinical courses regarding disease progression in the era of antiviral therapy for Korean CHB patients who were potential candidates for antiviral therapy. Methods: Between 2001 and 2005, treatment-naive CHB patients without cirrhosis were enrolled and followed-up for at least 5years. During follow-up period, patients have received antiviral therapy according to the Korean Association for the Study of the Liver guideline, if indicated. Ultrasonography and laboratory assessment were performed regularly. Primary endpoints were development of cirrhosis, or hepatic decompensation, HCC, or liver-related deaths, which were examined using Kaplan-Meier method. Results: Of 360 patients, 323 (89.7%) received antiviral therapy such as lamivudine (70.6%), entecavir (8.7%), or telbivudine (6.5%). During a median follow-up period of 94 months, cirrhosis developed in 29 (8.1%) patients, hepatic decompensation in 4 (1.1%) patients, and HCC in 15 (4.2%) patients. The annual incidence of cirrhosis, hepatic decompensation, and HCC were 1.05%, 0.14%, and 0.53% per person-year, respectively. Age was an independent prognostic factor for developing cirrhosis (hazard ratio [HR] 1.075; 95% confidence interval [CI] 1.037-1.116), whereas those for developing HCC were age (HR 1.060, 95% CI 1.012-1.111) and progression to cirrhosis (HR 17.470, 95% CI 5.081-60.063). Conclusions: In the era of antiviral therapy, the overall clinical courses of patients with CHB in Korea have been much improved since the introduction of lamivudine in 1999. However, older age and cirrhosis still remain risk factors for HCC.
Yoon,,Jin,Young,Lee,,Jung,Min,Kim,,Do,Young,Choi,,Gi,Hong,Park,,Young,Nyun,Chung,,Joo,Won,Kim,,Eun,Young,Park,,Jun,Yong,Ahn,,Sang,Hoon,Han,,Kwang-Hyub,Chon,,Chae,Yoon Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.2
<P>An undifferentiated (embryonal) liver sarcoma (ULS) originates from a primitive mesenchymal cell, with a predilection for childhood and very rare occurrence in adults. We report a case of a ULS that was incidentally found in a 53-year-old female. Our case was initially interpreted as a large hydatid cyst, which was later suspected to be a neoplastic lesion because its size was increasing and a solid portion was newly detected after shrinkage of the cyst following drainage. The patient underwent successful right hepatic lobectomy with complete resection, and is currently disease-free without adjuvant therapy. Although it is difficult to diagnose a hepatic cyst as a ULS due to its rare occurrence in adulthood and lack of specific findings, its possibility should be considered, especially when its size is increasing, because early diagnosis and curative resection are necessary for a favorable outcome.</P>