• Title/Summary/Keyword: 만성 간질환

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T1-201 Per Rectum Scintigraphy in Chronic Liver Disease: Assessment of T1-201 Uptake Indices (만성 간질환에서의 T1-201 경직장 문맥 신티그라피: T1-201 섭취 지표의 평가)

  • Moon, Won-Jin;Choi, Yun-Young;Cho, Suk-Shin;Lee, Min-Ho
    • 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.

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Subtypes of Hepatitis B Surface Antigen Among Chronic Liver Disease (B형 간염 바이러스 양성인 만성 간질환에서 Hepatitis B 표면항원의 아형)

  • Cho, Hee-Soon;Lim, So-Yeo;Lee, Chae-Hoon;Kim, Kyung-Dong;Kim, Chung-Sook
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.272-278
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    • 1996
  • Four subtypes of hepatitis B surface antigen are useful in the epidemiologic studies of the route of virus transmission and clinical significance of simultaneous occurance of hepatitis B surface antigen and antibody to hepatitis B surface antigen in the same serum as well as useful marker for population migration. The sera were obtained from 214 HBs Ag positive patients who are diagnosed as chronic liver disease and following up in the Yeungnam university hospital. The subtypes were determined by solid-phase sandwich EIA using monoclonal antibodies. Among 214 specimens, the subtype adr was 93.9%, adw was 2.8%, ayr was 0.9%, ar was 0.9%, adwr was 1.4% and ayw was not detected. There were no correlation between subtype pattern and disease. In summary, the subtype adr was prominent in our study and the difference of subtype pattern by severity of disease was not significant. However, to determine the prognostic value of HBs Ag subtype and relationship between subtype and disease progression, long-term follow up will be needed.

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Potential Roles of Hedgehog and Estrogen in Regulating the Progression of Fatty Liver Disease (지방간 진행 조절에 대한 헤지호그와 에스트로겐의 잠재적 역할)

  • Hyun, Jeong-Eun;Jung, Young-Mi
    • Journal of Life Science
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    • v.21 no.12
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    • pp.1795-1803
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    • 2011
  • Non-alcoholic fatty liver disease accompanies the rise in the prevalence of obesity, diabetes and the tendency toward high-fat dietary habits. Specifically, the higher prevalence of non-alcoholic fatty liver disease in men and postmenopausal women seems to be caused by the protective effects of estrogen against liver fibrosis, or lack thereof. There are no effective preventive therapies for liver diseases because the mechanisms underlying the progression of fatty liver diseases to chronic liver diseases and the protective effects of estrogen against fibrogenesis remain unclear. Recently, it has been reported that the hedgehog signaling pathway plays an important role in the progression of chronic liver diseases. Hedgehog, a morphogen regulating embryonic liver development, is expressed in injured livers but not in adult healthy livers. The level of hedgehog expression parallels the stages of liver diseases. Hedgehog induces myofibroblast activation and hepatic progenitor cell proliferation and leads to excessive liver fibrosis, whereas estrogen inhibits the activation of hepatic stellate cells to myofibroblasts and prevents liver fibrosis. Although the mechanism underlying the opposing actions of hedgehog and estrogen on liver fibrosis remain unclear, the suppressive effects of estrogen on the expression of osteopontin, a profibrogenic extracellular matrix protein and cytokine, and the inductive effects of hedgehog on osteopontin transcription suggest that estrogen and hedgehog are associated with liver fibrosis regulation. Therefore, further research on the estrogen-mediated regulatory mechanisms underlying the hedgehog-signaling pathway can identify the mechanism underlying liver fibrogenesis and contribute to developing therapies for preventing the progression of fibrosis to chronic liver diseases.

Clinical manifestation and outcome of alagille syndrome in Korea: a study of 30 patients (Alagille 증후군 환아의 임상 양상과 장기 예후에 대한 연구)

  • Shin, Jee Youn;Kim, You Jeong;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1067-1072
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    • 2006
  • Purpose : The purpose of this study was to examine the clinical courses and long-term outcomes of children with Allagille syndrome in Korea, and to evaluate the prognostic potentials of identified variables. Methods : We reviewed the clinical manifestations and outcomes of 30 children with Alagille syndrome, investigated from 1984 to 2006 until the end of this study (defined as death or last visit; mean follow-up : 5 years). Results : Cholestasis occurred in 100 percent, cardiovascular abnormalities in 83.3 percent, butterfly vertebrae in 30.0 percent, posterior embryotoxon in 43.3 percent, and a characteristic facial appearance in 100 percent. At study conclusion, of these 30 patients, eight had died (26.7 percent); six related to Alagille syndrome. Five patients died of a liver disease complication. Liver transplantation was carried out in five of the 30 patients (16.7 percent) and one of these died due to hyperacute rejection. At age two, cholestasis improved in 17 of the 30 patients. Those who had severe cholestasis at 2 years of age tended to have a complication, such as liver cirrhosis or liver transplantation, or to have died. Conclusion : Hepatic complications account for the most mortalities in patients with Alagille syndrome. Careful and complete assessments should be made in children who have cholestasis at 2 years of age. Further investigations of more cases are required.

농산물의 기능성에 대한 이해와 활용

  • Kim, Seong-Ran;Han, Dae-Seok
    • Bulletin of Food Technology
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    • v.12 no.2
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    • pp.3-9
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    • 1999
  • 최근 의학의 진보에 따라 체격이나 평균수명은 향상되었으나 다수의 사람들이 특별한 질병의 상태가 아니면서 건강하지도 않은 반쪽 건강 상태에 있으며, 암, 동맥경화, 심장질환, 고혈압, 당뇨병, 간질환 및 만성 위장병의 증가가 문제시 되고 있다. 이들 질병의 예방이 식생활과 밀접한 관련이 있다는 사실이 알려지면서 식품의 영양소와 기호성 이외에 기능성, 건강지향성을 재인식하게 되었으며, 건강한 식생활이 건강관리의 한 방법으로 자리를 차지하게 되었다. 따라서 올바른 식품과 영양에 대한 지식이 일상의 식생활에 적극적으로 반영되면서 많은 사람들이 식원병을 예방하고 건강을 유지할 수 있을 것이다. 본 보고에서는 양과 질의 측면에서 영양학적으로 우수한 특성을 갖거나 민간전승적으로 건강에 좋으며, 식품의 과학적 효과가 입증된 대표적인 농산물의 종류와 활용에 대하여 살펴보았다.

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Development of Educational Materials for Management and Prevention of Chronic Hepatitis (만성 B형 바이러스성 간질환의 예방 교육매체 프로그램 개발)

  • Shin, Gye-Young;Lee, Sun-Ock;Kim, Mae-Ja
    • Research in Community and Public Health Nursing
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    • v.13 no.3
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    • pp.503-512
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    • 2002
  • Purpose: This study was conducted to develop educational materials for preventing type B viral hepatitis infection. Prior to this study, a survey had been conducted to define the educational needs of persons with hepatitis B antigen. Method: Based on the results of the former study and a review of the literature, the content of the educational materials was confined to the transmission cycle and its prevention in type B hepatitis. A professional team that consisted of writers and producers videotaped the lectures provided by professors and instructors in a nursing school. A professional graphic designer produced the leaflet to enhance the visual effects. Results: The contents of the educational materials for type B hepatitis were composed of six parts: (1) the prevalence rate (or morbidity) of type B hepatitis antigen positive and its recent trend, (2) transformation of hepatitis. (3) transmission cycle of hepatitis infection, (4) persons who are susceptible to hepatitis and need a vaccination, (5) preventive approach hepatitis vaccination and the guideline for patients' daily lives for preventing infection and (6) questions and answers. The materials were delivered in the form of lectures, visual charts, graphics, and multi-media. Conclusion: The educational materials developed in this study may provide practical information and knowledge on strategies to prevent type B hepatitis. The educational materials may be utilized in primary health care centers or school health services.

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당뇨병의 예방및 관리

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.26 no.11 s.288
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    • pp.6-13
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    • 2002
  • 지난 30여년 동안 급속한 경제 성장과 생활 양식의 변화는 우리 사회에 많은 변화를 초래하였고 한국인의 질병 양상에도 많은 영향을 주었다. 동물성 식품과 지방질 섭취의 증가, 신체활동 감소,노령인구 증가, 생활양식의 서구화 및 도시화 등은 한국인에서 만성질환의 발생과 이환을 증가시키고 있다. 통계청의 2001년 사망원인통계를 보면 1위가 암, 2위가 뇌혈관 질환, 3위가 심장질환, 4위가 당뇨병, 5위가 간질환으로 모두 잘못된 생활습관으로 인한 만성질환이다. 이중에서도 당뇨병은 지난 1991년 이후 암 다음으로 많이 증가한 질병으로 인구 10만명 당 23.8명이 당뇨병으로 사망했으며 하루 평균 당뇨병으로 31명이 사망한다. 2002년 4월, 대한당뇨병학회의 "한국인의 당뇨병 발생 현황 보고"에 따르면 우리나라 성인의 당뇨병 유병률은 10%선으로 최소 3백만명에서 최대 5백만명 정도가 당뇨병을 앓고있다. 우리나라는 식생활의 서구화, 고령화 등으로 당뇨병 환자가 급증하고 있어 생활 양식의 개선이 이루어지지 않을 경우 앞으로 10년 안에 전체 국민의 1/4정도인 1천2백만명 가량이 당뇨병으로 고통을 받게 될 것이라 한다. 당뇨병은 당뇨뿐만 아니라 그에 따른 만성 합병증이 매우 무서운 병으로 일단 발병하면 적극적인 치료에도 불구하고 정상으로 회복되기 어렵다. 따라서 합병증의 효과적인 예방을 위해서는 특별한 임상 증상이 없더라도 당뇨병을 처음 진단 받은 날부터 주기적인 검진을 통하여 조기에 발견해 낼수 있도록 노력하여야 한다. 이와 더불어 주기적인 혈액 검사와 주치의 면담을 통하여 정상 혈당을 유지할 수 있는 혈당 조절 방법과 함께 만성 합병증을 예방할 수 있는 생활 습관 개선(금연, 금주,표준체중 유지,규칙적 운동,정상 혈압 유지,정상 혈중 지질 유지등)을 반드시 실천하여야 한다.

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