• Title/Summary/Keyword: Chronic Hepatitis B

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Analysis of Medical Use and Costs Related to the Management of Liver Cirrhosis Using National Patients Sample Data (환자표본자료를 이용한 간경변증 환자의 의료이용 특성 및 의료비용 분석)

  • Kim, Hye-Lin;Park, Jae-A;Sin, JiYoung;Park, Seung-Hoo;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.341-347
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    • 2016
  • Background: Liver cirrhosis causes substantial socio-economic burden and is one of the major severe liver diseases in Korea. Nonetheless, there is only a few studies that analyzes disease burden of liver cirrhosis in Korea. Such study must be carried out due to its increasing need from the invention of new drugs for chronic hepatitis and demand for cost-effectiveness analyses. Methods: Patient sample data with ensured representativeness was analyzed retrospectively to compare the medical costs and uses for patients with compensated cirrhosis and decompensated cirrhosis. Patient claims data that include K74 and K703 from the year of 2014 were selected. Within the selected data, decompensated cirrhosis patient was identified if complications such as ascites (R18), encephalopathy (B190), hepatic failure (K72), peritonitis (K65), or esophageal varices (I85) were included, and they were compared to compensated cirrhosis patients. Results: 6,565 patients were included in the analysis. The average cost per patient was 6,471,020 (SD 8,848,899) KRW and 2,173,203 (4,220,942) KRW for decompensated cirrhosis and compensated cirrhosis, respectively. For inpatients, the average hospitalized days was 38.0 (56.4) days and 27.2 (57.2) days for decompensated cirrhosis and compensated cirrhosis, respectively. For outpatients, the average number of visits was 8.7 (9.1) days and 5.3 (7.5) days for compensated cirrhosis and decompensated cirrhosis, respectively. Conclusion: Compared to compensated cirrhosis patients, decompensated cirrhosis patients had higher costs, especially for hospitalization, injection, examination, and drugs administrated within medical institutions.

Putative Association of ITGB1 Haplotype with the Clearance of HBV Infection

  • Park, Tae-Joon;Chun, Ji-Yong;Bae, Joon-Seol;Kim, Ja-Son Y.;Lee, Jin-Sol;Pasaje, Charisse Flerida;Park, Byung-Lae;Cheong, Hyun-Sub;Lee, Hyo-Suk;Kim, Yoon-Jun;Shin, Hyoung-Doo
    • Genomics & Informatics
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    • v.8 no.1
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    • pp.9-18
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    • 2010
  • Integrins are transmembrane receptor proteins that mediate cell-cell adhesion and cell-extracellular matrix (ECM) adhesion. The deregulation of cell-ECM adhesion and the abnormal expression of beta1 (${\beta}1$) integrins (ITGB1s) are involved in tumor development and metastasis. In the liver, the expression of integrins and ECM proteins can be a cause of hepatocellular carcinoma (HCC) development. We performed direct DNA sequencing of 24 individuals, and identified 23 sequence variants of ITGB1 polymorphisms. Among these 23 variants, 7 common variants were selected based on frequencies and linkage disequilibrium, and then genotyped in a larger-scale group of subjects (n=1,103). The genetic associations of ITGB1 polymorphisms with the clearance of HBV and HCC outcome of HBV patients were analyzed using logistic regression models and Cox relative hazard models. Although there was no significant association observed between the polymorphisms and the HCC outcome of HBV patients, the second most common haplotype (ITGB1 haplotype-2 [C-C-C-C-T-C-T]) was putatively associated with HBV clearance (OR=0.75, p=0.008 and $P^{corr}=0.05$). The minor allele frequency (MAF) of ITGB1 haplotype -2 of the spontaneously recovered (SR) group was significantly higher than that of the chronic carrier group (CC) (freq. = 0.248 vs. 0.199). The information derived from this study could be valuable for understanding the genetic factors involved in the clearance of HBV.

Prevalence of Psychiatric Disorders and Psychosocial Adjustment in Patients with Acquired Immune Deficiency Syndrome(AIDS) (후천성면역결핍증후군(Acquired Immune Deficiency Syndrome ; AIDS) 환자의 정신질환 유병률과 심리사회적 적응)

  • Park, Hwi-Jun;Hong, Jin-Pyo;Woo, Jun-Hee;Ahn, Joon-Ho
    • Anxiety and mood
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    • v.5 no.2
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    • pp.103-111
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    • 2009
  • Objectives : We examined quality of life, psychosocial adjustments to illness, changes in sexual functioning, and prevalence of psychiatric disorders in AIDS patients compared to patients with chronic hepatitis B virus infection (CHB). Methods : Thirty-one men with AIDS and 50 men with CHB were enrolled. The Short-Form 12-Item Health Survey (SF-12), the Psychosocial Adjustment to Illness Scale (PAIS), and the Changes in Sexual Functioning Questionnaire short form (CSFQ-14) were administered. Results on these assessments were compared between the 31 AIDS patients and 50 CHB patients. The Structured Clinical Interview for DSMIV (SCID) was administered to determine the psychiatric diagnosis only for the AIDS patients. Results : The Physical Component Summary score (PCS) was lower in AIDS patients than in CHB patients (p<0.001). In the section examining sexual relationships, AIDS patients exhibited a lower level of adjustment (p<0.05) and had more changes in sexual function (p<0.05) than did CHB patients. Administration of the SCID to AIDS patients indicated that the lifetime prevalence of any psychiatric disorder was 56.7% ; 43.3% for mood disorders, 33.3% for alcohol use disorders, 26.7% for anxiety disorders, and 20% for adjustment disorder. Patients who had experienced any psychiatric disorder had more severe psychosocial distress (p=0.004) and evidenced a lower level of overall psychosocial adjustment (p=0.030) than patients who had not. Conclusion : We showed that AIDS patients have a high prevalence of psychiatric disorders, and that AIDS patients with psychiatric disorders were particularly low in levels of psychosocial adjustment. Thus, careful attention should be given to psychiatric aspects of AIDS patients emphasizing the early diagnosis and treatment of psychiatric disorders.

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Distribution of Glutathione S-Transferase Omega Gene Polymorphism with Different Stages of HBV Infection Including Hepatocellular Carcinoma in the Egyptian Population

  • Shaban, Nadia Z;Salem, Halima H;Elsadany, Mohamed A;Ali, Bahy A;Hassona, Ehab M;Mogahed, Fayed AK
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2145-2150
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    • 2016
  • Background: Infection with hepatitis B virus (HBV) is a major global public health problem, with a wide spectrum of clinical manifestations. Human cytosolic glutathione-S-transferases (GSTs) include several classes such as alpha (A), mu (M), pi (P), sigma (S), zeta (Z), omega (O) and theta (T). The present study aimed to investigate the role of GST omega genes (GSTO1 and GSTO2) in different groups of patients infected with HBV. Materials and Methods: HBV groups were classified according to clinical history, serological tests and histological analysis into normal carriers (N), acute (A), chronic (CH), cirrhosis (CI) and hepatocellular carcinoma (HCC) cases. The study focused on determination of the genotypes of GST omega genes (GSTO1 and GSTO2) and GST activity and liver function tests. Results: The results showed that GSTO1 (A/A) was decreased in N, A, CH, CI and HCC groups compared to the C-group, while, GSTO1 (C/A) and GSTO1(C/C) genotypes were increased significantly in N, A, CH, CI and HCC groups. GSTO2 (A/A) was decreased in all studied groups as compared to the C-group but GSTO2(A/G) and GSTO2(G/G) genotypes were increased significantly. In addition, GST activities, albumin and TP levels were decreased in all studied groups compared to the C-group, while the activities of transaminases were increased to differing degrees. Conclusions: The results indicate that GSTO genetic polymorphisms may be considered as biomarkers for determining and predicting the progression of HBV infection.

Oxymatrine Causes Hepatotoxicity by Promoting the Phosphorylation of JNK and Induction of Endoplasmic Reticulum Stress Mediated by ROS in LO2 Cells

  • Gu, Li-li;Shen, Zhe-lun;Li, Yang-Lei;Bao, Yi-Qi;Lu, Hong
    • Molecules and Cells
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    • v.41 no.5
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    • pp.401-412
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    • 2018
  • Oxymatrine (OMT) often used in treatment for chronic hepatitis B virus infection in clinic. However, OMT-induced liver injury has been reported. In this study, we aim to investigate the possible mechanism of OMT-induced hepatotoxicity in human normal liver cells (L02). Exposed cells to OMT, the cell viability was decreased and apoptosis rate increased, the intracellular markers of oxidative stress were changed. Simultaneously, OMT altered apoptotic related proteins levels, including Bcl-2, Bax and pro-caspase-8/-9/-3. In addition, OMT enhanced the protein levels of endoplasmic reticulum (ER) stress makers (GRP78/Bip, CHOP, and cleaved-Caspase-4) and phosphorylation of c-Jun N-terminal kinase (p-JNK), as well as the mRNA levels of GRP78/Bip, CHOP, caspase-4, and ER stress sensors (IREI, ATF6, and PERK). Pre-treatment with Z-VAD-fmk, JNK inhibitor SP600125 and N-acetyl-l-cysteine (NAC), a ROS scavenger, partly improved the survival rates and restored OMT-induced cellular damage, and reduced caspase-3 cleavage. SP600125 or NAC reduced OMT-induced p-JNK and NAC significantly lowered caspase-4. Furthermore, 4-PBA, the ER stress inhibitor, weakened inhibitory effect of OMT on cells, on the contrary, TM worsen. 4-PBA also reduced the levels of p-JNK and cleaved-caspase-3 proteins. Therefore, OMT-induced injury in L02 cells was related to ROS mediated p-JNK and ER stress induction. Antioxidant, by inhibition of p-JNK or ER stress, may be a feasible method to alleviate OMT-induced liver injury.

The Effect of Metformin Treatment on CRBP-I Level and Cancer Development in the Liver of HBx Transgenic Mice

  • Kim, Jo-Heon;Alam, Morshedul;Park, Doek Bae;Cho, Moonjae;Lee, Seung-Hong;Jeon, You-Jin;Yu, Dae-Yeul;Kim, Tae Du;Kim, Ha Young;Cho, Chung Gu;Lee, Dae Ho
    • The Korean Journal of Physiology and Pharmacology
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    • v.17 no.5
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    • pp.455-461
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    • 2013
  • Retinoids regulate not only various cell functions including proliferation and differentiation but also glucose and lipid metabolism. After we observed a marked up-regulation of cellular retinol-binding protein-I (CRBP-I) in the liver of hepatitis B virus x antigen (HBx)-transgenic (HBx Tg) mice which are prone to hepatocellular carcinoma (HCC) and fatty liver, we aimed to evaluate retinoid pathway, including genes for the retinoid physiology, CRBP-I protein expression, and retinoid levels, in the liver of HBx Tg mice. We also assessed the effect of chronic metformin treatment on HCC development in the mice. Many genes involved in hepatic retinoid physiology, including CRBP-I, were altered and the tissue levels of retinol and all-trans retinoic acid (ATRA) were elevated in the liver of HBx Tg mice compared to those of wild type (WT) control mice. CRBP-I protein expression in liver, but not in white adipose tissue, of HBx Tg mice was significantly elevated compared to WT control mice while CRBP-I protein expressions in the liver and WAT of high-fat fed obese and db/db mice were comparable to WT control mice. Chronic treatment of HBx Tg mice with metformin did not affect the incidence of HCC, but slightly increased hepatic CRBP-I level. In conclusion, hepatic CRBP-I level was markedly up-regulated in HCC-prone HBx Tg mice and neither hepatic CRBP-I nor the development of HCC was suppressed by metformin treatment.

Needs of Preoperative Blood Sample Test in Surgical Extraction: Suggestion of New Policy (치아 외과적 발거 전 혈액검사의 필요성과 이의 정책적 제시)

  • Seo, Mi Hyun;Kim, Soung Min;Oh, Jin Sil;Myoung, Hoon;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.332-336
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    • 2012
  • Purpose: The third molar extraction is one of the mostly performed procedures in the department of oral and maxillofacial surgery. In most of dental clinic or hospital, the third molar extraction used to be frequently performed in an office-based surgery, and most patients did not have specific medical history with young ages. Medical history taking are dependent on the only way by asking to the patients about their individual conditions. Therefore, as the specialists of the oral and maxillofacial surgery in the field of dentistry, we suggest a new policy that the preoperative lab must be performed routinely before extraction of the third molar. Methods: This study is based on 1,096 patients who have been managed with third molar extractions, from March 2008 to September 2011 by a single surgeon. The preoperative lab, including complete blood count, coagulation panel, chemistry and serology, was performed before any surgical procedures. The results were informed to the patients regardless of their abnormalities, and any abnormalities related to the surgical procedures, such as platelet count and coagulation factors, were checked and corrected safely. Results: Through the preoperative blood test, systemic diseases that the patients had not recognized before, such as anemia, leukopenia, fatty liver and chronic renal disease, were identified. Patients with acute or chronic leukemia, Hepatitis B, and HIV positive, were also detected as a small number. Also, the possibilities of the cross-infection between dentists and patients or between patients and patients, and any other emergency situations can be prevented; as well as the public health condition can be improved, too. The patients were satisfied with low cost preventive blood test and high quality of medical services. Conclusion: Therefore, routine medical lab testing, including history taking are needed before an office-based minor surgery, such as third molar extractions, and these results were suggested as a new policy in the field of dentistry.

Antitumor and Immuno-modulatory Effect Against Mouse Sarcoma 180 of Crude Polysaccharides Extracted from Fruiting Body of Armillaria tabescens (뽕나무버섯부치(Armillaris tabescens)의 자실체에서 추출한 조다당류의 생쥐 Sarcoma 180에 대한 항암 및 면역증강 효과)

  • Lee, Geon-Woo;Kim, Hye-Young;Lee, U-Youn;Lee, Tae-Soo
    • The Korean Journal of Mycology
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    • v.35 no.2
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    • pp.101-108
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    • 2007
  • Armillaria tabescens, one of edible and medicinal mushrooms belonging to Agaricales of Basidiomycota, has been known to have outstanding curative effects on chronic hepatitis and cholecystitis and inhibitory effects on the sarcoma 180 and Erhrlich carcinoma of mice. Neutral saline soluble (0.9% NaCl), hot water soluble and methanol soluble substances (hereinafter referred to Fr, NaCl, Fr. HW and Fr, MeOH, respectively) were extracted from fruiting body of the mushroom. In vitro cytotoxicity tests showed that crude polysaccharides were not cytotoxic against cancer cell lines such as NIH3T3 and Sarcoma 180 at the concentration of $2000\;{\mu}g/ml$. Intraperitoneal injection with crude polysaccharides exhibited life prolongation effect of $28.8{\sim}46.5%$ in mice inoculated with Sarcoma 180, respectively. Fr. NaCl improved the immunopotentiation activity of B lymphocyte by increasing the alkaline phosphatase activity by $1.8{\sim}2.1$ folds, respectively. In case of Fr, NaCl, the numbers of peritoneal exudate cells and circulating leukocytes were increased by 9 and 1.9 folds, respectively.

A Study on Health Behavior of the Populations in Urban and Rural Area (도시·농촌지역 주민의 건강행태에 관한 연구)

  • Lee, Jeong-Mi;Kwon, Keun-Sang;Lee, Ju-Hyoung;Jeon, Gap-Sung
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.213-225
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    • 2005
  • Objectives: This study was carried out to evaluate the socio-demographic, style of living, and health related behaviors of community residents between urban and rural areas in Jeonbuk province. Methods: The data was obtained from 2,086 residents who lived in Jeonbuk province from July to September 2001 which included 1,238 residents in urban area and 848 residents in rural area. Results: The results were as follows; There were significant differences socio-demographic characteristics including occupation and educational level of the populations between urban and rural areas. In the urban populations, housewives, professional classes, and people who received collage graduate education were significantly higher, people who were engaged in the primary industries and lower educational classes(below middle school), in contrast, were significantly lower than in the rural populations. In the practice of health behavior, consumption of health foods and amount of exercise in urban populations were significantly higher than in the rural, whereas the state of health, prevalence of chronic disease, Body Mass Index(BMI), consumption of ethanol and cigarette, and hours of sleep were not significantly different between the urban and rural populations. In the eating habits, rate of surfeit, vaccination of hepatitis B, and screening of cancer in the urban populations were significantly higher than in the rural, rate of regular meal, taste of salted food, consumption of vegetables, in contrast. were significantly lower than in the rural. But, consumption of coffee, intake of meat, and periodic medical checkup were not significantly different between urban and rural communities. Logistic regression analysis revealed that the factors associated with subjective thought on health state were sex, age, occupation, educational level, exercise, and consumption of coffee. Logistic regression analysis to find related factor with prevalence of chronic disease was conducted. As a results, age, educational level, BMI, intake of meat, screening of cancer, and consumption of health foods were related to prevalence of chronic disease. Conclusions: The study showed that special attention to device the health plan are necessary and it suggested that consideration of regional differences are required to provide the community health projects.

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Computer-Aided Diagnosis for Liver Cirrhosis using Texture features Information Analysis in Computed Tomography (컴퓨터단층영상에서 TIA를 이용한 간경화의 컴퓨터보조진단)

  • Kim, Chang-Soo;Ko, Seong-Jin;Kang, Se-Sik;Kim, Jung-Hoon;Kim, Dong-Hyun;Choi, Seok-Yoon
    • The Journal of the Korea Contents Association
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    • v.12 no.4
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    • pp.358-366
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    • 2012
  • Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules leading to loss of liver function. Liver Cirrhosis is most commonly caused by alcoholism, hepatitis B and C, and fatty liver disease, but has many other possible causes. Some cases are idiopathic disease from unknown cause. Abdomen of liver Computed tomography(CT) is one of the primary imaging procedures for evaluating liver disease such as liver cirrhosis, Alcoholic liver disease(ALD), cancer, and interval changes because it is economical and easy to use. The purpose of this study is to detect technique for computer-aided diagnosis(CAD) to identify liver cirrhosis in abdomen CT. We experimented on the principal components analysis(PCA) algorithm in the other method and suggested texture information analysis(TIA). Forty clinical cases involving a total of 634 CT sectional images were used in this study. Liver cirrhosis was detected by PCA method(detection rate of 35%), and by TIA methods(detection rate of 100%-AGI, TM, MU, EN). Our present results show that our method can be regarded as a technique for CAD systems to detect liver cirrhosis in CT liver images.