• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.35-39
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• 2015

Background: Hepatocellular carcinoma (HCC) is one of the most frequent cancers in South East Asian countries including Cambodia, where prevalence of chronic carriers of hepatitis B and C virus (HBV and HCV) is reported to be very high. We reviewed HCC cases admitted to a cancer hospital in Phnom Penh, which is the only one hospital for cancer treatment and care in Cambodia during the study period. Materials and Methods: Information was collected from medical records of 281 cases (210 males and 71 females) diagnosed as primary HCC from 2006 to 2011. Results: The subjects were 7-81 years old with a median age of 53 years. Hypochondriac pain was the most common complained symptom (74%). One third of the cases presented with jaundice. Nearly half had ascites at their first visit. One third had liver cirrhosis. Nearly three fourths of the cases presented with tumor sized more than 50 mm in diameter, and in almost all cases (97.4%) the size was more than 20 mm. Among 209 subjects tested, hepatitis virus carriers were 75.6%; 46.4% for HBV only, 21.5% for HCV only, and 7.7% for both viral infections. Median age of patients with HBV was about ten years younger than those with HCV. Conclusions: This study revealed the characteristics of HCC cases in Cambodia, although there were several limitations. Most HCC cases were infected with HBV and/or HCV, and diagnosed at late stages with complications. This implicated that public health intervention to prevent HBV and HCV infection is of high priority.

• Journal of Ginseng Research
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• 제7권2호
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• pp.115-124
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• 1983

The effect of ginseng administration on the patients of acute viral (B type) hepatitis has been oberved and the results were as follows. The albumin/globulin ratio of the ginseng administered group has significantly improved 4 weeks after admission while that of control group has not been improved suggesting that the ginseng might be effective in improving the protein metabolism. The thymol turbidity test again gave a similar result. Recovery of the disorder of bilirubin metabolism was also accelerated in the ginseng administered group compared with control group. The raised bilirubin value of the former returnedto the normal value 2 week after admission while that of the latter reached to normal 4-5 weeks after admission. However no significant difference of the bilirubin level between ginseng treated and non-treated groups could be observed. Cholesterol metabolism is also stimulated in ginseng administered group. The lowered cholesterol level of the ginseng group returned to normal 3-4 weeks after admission while that of latter reached to normal 5-6 weeks after admission. The raised S-GOT and S-GPT levels of the ginseng treated group returned to the normal value 3-4 weeks after admission while those of control group rehimed to normal in 5 weeks after admission suggesting that the ginseng improved impaired liver function. The improvement of the raised transaminase level seemed to be accelerate6 by the ginseng administration, however, no significant difference of the transaminase level between the ginseng treated and non-treated group could be observed. A significant effect of ginseng on the raised alkaline phosphatase level was observed. From the above results, it seemed that ginseng might stimulate the improvement of the disturbance of liver function, particularly at the early phase of its development of acute liver disease suggesting that panax ginseng might play a significant role in preventing the disease developing to be chronic.

• 약학회지
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• 제48권6호
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• pp.379-383
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• 2004

Biphenyl dimethyl dicarboxylate (DDB) has been used for the treatment of chronic viral hepatitis B and drug-induced hepatitis through the inhibition of lipid peroxidation and c ovalent binding of drug metabolites to lipids of microsomes. The bioequivalence of two DDB products was evaluated according to the guidelines of KFDA. The test product was Hepaphil soft capsule(R) made by KMS Pharm. Co. Containing 3 mg DDB and the reference product was Nissel tablet(R) made by Taerim Pharm. Co. Containing 25 mg DDB. Twenty healthy male subjects, 25.4(22~30) years old and 66.7(54~77)kg, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After two tablets or two capsules were orally administered, blood was taken at predetermined time intervals and the concentration of DDB in plasma was determined using a validated HPLC method with UV detector. Two pharmacokinetic parameters, $AUC_t$ and $C_{max}$, were calculated and analyzed statistically for the evaluation of bioequivalence of the two products. Analysis of variance was carried out using logarithmically transformed parameter values. The 90% confidence intervals of $AUC_t$ and $C_{max}$ were log 0.91~log1.00 and log 1.05~log 1.15, respectively. These values were within the acceptable bioequivalence intervals of log 0.8 to log 1.25. Thus, the criteria of the KFDA guidelines for the bioequivalence was satisfied, indicating that Hepaphil soft capsule is bioequivalent to Nissel tablet.

• IMMUNE NETWORK
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• 제10권4호
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• pp.126-134
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• 2010

Background: $CD8^+$ T cells contribute to the clearance of Hepatitis B virus (HBV) infection and an insufficient $CD8^+$ T cell response may be one of the major factors leading to chronic HBV infection. Since the HBx antigen of HBV can up-regulate cellular expression of several immunomodulatory molecules, we hypothesized that HBx expression in hepatocytes might affect $CD8^+$ T cell activity. Methods: We analyzed the activation and apoptosis of $CD8^+$ T cells co-cultured with primary hepatocytes rendered capable of expressing HBx by recombinant baculovirus infection. Results: Expression of HBx in hepatocytes induced low production of $interferon-{\gamma}$ and apoptosis of CD8+ T cells, with no effect on CD8 T cell proliferation. However, transcriptional levels of H-2K, ICAM-1 and PD-1 ligand did not correlate with HBx expression in hepatocytes. Conclusion: Our results suggest that HBx may inhibit $CD8^+$ T cell response by regulation of $interferon-{\gamma}$ production and apoptosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.130-136
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• 2008

목 적: 소아 만성 B형 간염 환아들에서 라미부딘 치료의 효과와 지속성에 대해 알아보고자 하였다. 방 법: 1998년 1월부터 2008년 5월까지 서울아산병원 소아과에서 만성 B형 간염으로 진단받고 라미부딘치료를 받은 44명의 환아들의 의무기록을 후향적으로 분석하였다. 12개월 이상 추적 관찰했던 환아들을 대상으로 발병시 성별, 연령, 치료 전후의 ALT, 혈청 HBVDNA, HBeAg, anti HBe, HBsAg, anti HBs의 변화를 조사하였고, 치료의 지속성과 내성 발현에 대해 조사하였다. 결 과: 라미부딘 치료 후 3년 이내에 총 44명의 환아중 21명(48%)에서 혈청 전환이 이루어졌고, 34명(77%)에서 HBV DNA가 음전되었으며, 41명(93%)에서 혈청ALT가 정상화되었다. Kaplan-Meier법에 의한 HBeAg 누적 혈청 전환율은 3년째에 60%로 나타났다. 치료를 마친 환아 25명 중 혈청 전환된 18명의 환아 모두 약물중단 이후 최대 3년 추적 관찰시 재발 없이 지내고 있어 라미부딘 치료 반응의 지속성을 보여 주었다. 치료 중 12명(27%)에서 돌파 현상이 나타났고, 11명(25%)에서 YMDD 돌연변이가 발견되었다. 치료 전 혈청 ALT 수치는 혈청 전환을 이룬 군에서 더 높았지만, 통계적 유의성은 없었다(338${\pm}$542 IU/L vs. 144338${\pm}$163 IU/L, p> 0.05). 결 론: 만성 B형 간염 환아에서 라미부딘 치료시 절반 정도에서 치료 효과를 기대할 수 있었다. 라미부딘의 치료 반응은 장기적으로 지속되었으며, 향후 약제 내성 돌연변이의 증가에 따른 이차 약제에 대한 추가적인 연구가 필요하다고 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6997-7005
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• 2013

Aim: To present an epidemiological and histological perspective of diseases of the gastrointestinal tract (including liver and biliary tract) at the Section of Histopathology, Department of Pathology, AKUH, Karachi, Pakistan. Materials and Methods: All consecutive endoscopic biopsies and resections between October 1 and December 31, 2012 were included. Results: A total of 2,323 cases were included. Carcinoma was overwhelmingly the commonest diagnosis on esophageal biopsies (69.1%); chronic helicobacter gastritis (45.6%) followed by adenocarcinoma (23.5%) were the commonest diagnoses on gastric biopsies; adenocarcinoma (27.3%) followed by ulcerative colitis (13.1%) were the commonest diagnoses on colonic biopsies; acute appendicitis (59.1%) was the commonest diagnosis on appendicectomy specimens; chronic viral hepatitis (44.8%) followed by hepatocellular carcinoma (23.4%) were the commonest diagnoses on liver biopsies; chronic cholecystitis was the commonest diagnosis (over 89%) on cholecystectomy specimens. Conclusions: Squamous cell carcinoma comprised 88.8% of esophageal cancers. About 67% were in the lower third and 56.5% were moderately differentiated; mean ages 49.8 years for females and 55.8 years for males; 66% cases were from South West Pakistan. Over 67% patients with gastric adenocarcinoma were males; mean ages 59 and 44 years in males and females respectively, about 74% gastric carcinomas were poorly differentiated; and 62.2% were located in the antropyloric region. About 63% patients with colorectal adenocarcinoma were males; mean ages 46.1 and 50.5 years for males and females respectively; tumor grade was moderately differentiated in 54%; over 80% were located in the left colon. In 21.2% appendicectomies, no acute inflammation was found. Acute appendicitis was most common in young people. Hepatitis C (66.3%) was more common than hepatitis B (33.7%); about 78% cases of hepatocellular carcinoma occurred in males; females comprised 76.7% patients with chronic cholecystitis; and 77.8% patients with gall bladder carcinoma. All resection specimens showed advanced cancers. Most cancers occurred after the age of 50 years.

• Annals of Clinical Neurophysiology
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• 제19권1호
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• pp.40-45
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• 2017

Background: Telbivudine is a nucleoside analogue used for the treatment of chronic hepatitis B, but it often develops mitochondrial toxicity leading to symptomatic myopathy. In this study, three patients with telbivudine induced myopathy were enrolled in order to investigate the nature and pathogenesis of mitochondrial toxicity caused by long-term use of telbivudine. Methods: Clinical features, laboratory findings, muscle pathology, and quantitation of mitochondrial DNA were studied in three patients. Results: Patients presented with progressive muscle weakness with high serum creatine kinase levels. Light microscopic findings of muscle pathology showed ragged red fibers that reacted strongly with succinate dehydrogenase stain, but negative for cytochrome c oxidase activities. Electron microscopy revealed abnormal mitochondrial accumulation with rod shaped inclusions. The quantitative peroxidase chain reaction showed a depletion of mitochondrial DNA in skeletal muscle of the patients. Conclusions: Nucleoside analogues including telbivudine are potent inhibitors of viral DNA polymerases. However, they are not specific for viral DNA and can disturb mitochondrial replication at the same time. All nucleotide analogues should be used with close clinical observation in order to avoid development of mitochondrial myopathy.

• Clinical Pain
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• 제20권2호
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• pp.131-134
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• 2021

We report a rare case of anti-viral agent induced hypophosphatemic osteomalacia presented with localized and radicular pain. A 51-year-old man, who had been taking adefovir for chronic hepatitis, had experienced low back pain radiating to his right thigh for 2 years. With impression of lumbar disc herniation, he underwent magnetic resonance imaging and found multi-level disc herniation with facet joint synovial cysts. He received transforaminal epidural steroid injections, however, symptoms did not improve. To find other possible causes, additional tests were performed. Blood tests revealed hypophosphatemia and increased serum alkaline phosphatase, and osteoporosis was noted in dual-energy X-ray absorptiometry with multiple hot uptakes in bone scan. After replacement of adefovir to entecavir and supplement of phosphate and vitamin D, phosphate level and the clinical symptoms were improved. This is the first to report the presentation of osteomalacia due to anti-viral agent as radicular low back pain with facet synovial cysts.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.137-142
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• 2008

목 적: 인터페론은 소아 만성 B형 간염의 치료에 널리 쓰이고 있으나 50% 이상의 환자에서 인터페론 치료에 반응이 없어 추가적인 다른 치료가 필요하다. 라미부딘은 B형 간염 바이러스 복제의 억제제로 B형 간염 치료제로 널리 쓰이고 있으나, 인터페론 치료에 반응이 없었던 B형 간염 환자에 대한 라미부딘의 치료 효과에 대한 연구가 많지 않다. 방 법: 2000년 1월부터 2007년 12월까지 부산대학교병원 소아청소년과에서 만성 B형 간염으로 진단되어 인터페론(interferon ${\alpha}$-2b, 10 $MU/m^2$ 또는 pegylated interferon $1.5{\mu}g/kg$)으로 6개월 간 치료를 받은 33명 중 치료에 반응이 없어 치료 종결 후 6~12개월 뒤부터 라미부딘(3 mg/kg/일, 최고 100 mg/일)으로 치료를 한 8명(남 6명, 여 2명)을 대상으로 라미부딘의 치료 효과를 분석하였다. 임상적 소견에 대해 의무기록지를 후향적으로 검토하였다. 결 과: 인터페론 치료 시작 시 나이는 4.9${\pm}$3.1세, 라미부딘 치료 시작 시 나이는 6.1${\pm}$3.2세였다. 인터페론 치료 전 혈청 ALT는 148.1${\pm}$105.8 IU/L였고, HBV-DNA PCR log값은 6.95${\pm}$0.70 copies/mL였다. 인터페론 치료 후 ALT는 143.1${\pm}$90.4 IU/L였고, DNA PCR log값은 6.46${\pm}$2.08 copies/mL로 치료 전과 차이가 없었고(p> 0.05), 2명에서 HBeAg 음전이 있었다. 모든 환자에서 라미부딘 치료 후 7.4${\pm}$2.1개월에 ALT가 정상화되고, 이미 HBeAg이 음전된 2명을 제외한 6명에서 7.9${\pm}$2.1개월에 HBeAg 혈청전환이 있었다. HBV DNA는 2.4${\pm}$2.8개월에 7명(87.5%)에서 음성화되었다. 2명은 라미부딘치료 종결 후 3년 이상 재발이 없으며, 5명은 완전 반응상태로 24.4${\pm}$9.1개월간 복용 중이다. 1명은 12개월간 라미부딘을 복용하여 혈청 ALT가 정상화되고 HBeAg 혈청전환이 있었으나 바이러스 돌파현상이 발생하여 치료를 중단하였다. 결 론: 연구 대상 환자 수가 적었지만 인터페론 치료에 반응이 없었던 만성 B형 간염 환자에서 라미부딘의 치료는 매우 효과적이었다.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.167-174
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• 1985

1985년 5월부터 1985년 11월까지 영남대학병원 내과에 입원한 간질환 환자 255예를 대상으로 간질환에 동반된 피부 증상을 관찰하여 다음과 같은 결론을 얻었다. 1. 255예중 161예 (63%)에서 피부증상을 동반하였다. 2. 피부증상은 황달 및 소양증 (43.1%), 혈관의 변화 (39.6%), 알레르기성 변화 (10.6%), 조갑변화 (5.1%), 호르몬에 의한 변화 (4.3%), 색소변화 (3.5%), 기타 (2.4%)의 순으로 많았다. 3. 피부증상을 상기 7개 군으로 분류할때 간경화증에서 가장 않은 피부 증상을 동안 하였고 (1.6군), 만성 활동성 간염(0.7군)과 급성 바이러스성 간염 (0.8군)에서 적었다. 4. 알레르기성 변화는 주로 급성 바이러스성 간염(AVH) 환자에 서 나타났고, serum sickness-like prodrome의 증상은 3예였다. 5. 혈관의 변화, 조갑의 변화, 호르몬에 의한 변화, 색소 변화 등은 주로 만성 간질환에서 관찰 되었다.