• 제목/요약/키워드: Cirrhotic liver

검색결과 71건 처리시간 0.035초

임상간기능검사법(臨床肝機能檢査法)으로서의 교질형방사성금(膠質形放射性金)의 혈중소실율(血中消失率)의 의의(意義)에 관(關)한 연구(硏究) (A Study on the Significance of the Colloidal Radiogold Disappearance Rate as a Simple Clinical Liver Function Test)

  • 홍창기
    • 대한핵의학회지
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    • 제3권1호
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    • pp.1-12
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    • 1969
  • Liver functions in diffuse parenchymal liver disease such as cirrhosis of the liver depend largely on the effective hepatic blood flow rather than on the individual cell functions. Clinical methods of measuring the hepatic blood flow were developed recently by the application of colloidal disappearance rate. In order to correlate the radiogold disappearance rate to conventional biochemical liver function tests, 21 normal subjects and 80 cases of cirrhosis of the liver were studied with both methods. The results are summarized as following: 1. The validity of external counting method to measure the blood disappearance rate of colloidal radiogold was confirmed by in vitro counting of the serial blood samples. 2. The blood disappearance rate of collidal radiogold was essentially the same. as the liver uptake rate of colloidal radiogold in normal and cirrhotic subjects with various degrees of functional disturbance. And it seemed there was no serious extrahepatic removal of the colloidal radiogold. 3. The disappearance rate of colloidal radiogold was not significantly changed by the posture change, but was enhanced by ingestion of 500 ml of water. 4. The disappearance rate of colloidal radiogold was not influenced by single dose of Telepaque, while BSP retention was increased after Telepaque. 5. The mean disappearance half time of colloidal radiogold in normal subjects was $2.49{\pm}0.391$(S.D.) minutes. The mean normal disappearance rate constant (K value) was $0.285{\pm}0.0428$(S.D.)/minute. 6. The colloidal radiogold disappearance half time was abnormally prolonged (over 3.2 min.) in $87.7{\pm}3.68$(S.D.) % of cirrhotic subjects. 7. In patients of liver cirrhosis the blood disappearance rate of colloidal radiogold correlated well to serum albumin and globulin levels and BSP retention which were considered to reflect functions of hepatic parenchymal cells. There was, however, no correlation between colloidal disappearance rate and thymol turbidity test, serum glutamic pyruvic transaminase, and serm alkaline phosphatase activities. The latters were considered to be associated with the activity of liver disease.

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Resistin and Insulin Resistance: A Link Between Inflammation and Hepatocarcinogenesis

  • Elsayed, Engy Yousry;Mosalam, Nesreen Ahmed;Mohamed, Noha Refaat
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권16호
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    • pp.7139-7142
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    • 2015
  • Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer related death overall. The role of insulin resistance in the development of HCC associated with chronic HCV infection has not been established. Resistin is a polypeptide hormone belonging to the adipokine family which could contribute to tumorigenesis and angiogenesis. Our aim was to study serum resistin and insulin resistance as risk factors for HCC in HCV cirrhotic patients. Materials and Methods: This prospective case controlled study included 100 patients with HCV related liver cirrhosis and HCC, 100 patients with HCV related liver cirrhosis without HCC and 50 apparently healthy participants as controls. For all subjects, liver profile, serologic markers for viral hepatitis, lipid profile, alpha-fetoprotein level (AFP), homeostasis model assessment (HOMA) were examined along with resistin. Results: HCC patients had higher mean values of HOMA-IR and resistin than cirrhotic patients and the control subjects (p<0.01). HOMA and resistin were considered independent risk factors in development of HCC, those patients with resistin > 12 ng/ml and HOMA > 4 being 1.6 times more likely to have HCC. Conclusions: HOMA and serum resistin allow for early identification of patients with cirrhosiswho are at substantially increased risk of HCC. Recommendation: HOMA and serum resistin could represent novel markers to identify HCV cirrhotic patients at greater risk of development of HCC.

Endoscopic ultrasound-guided coiling and glue is safe and superior to endoscopic glue injection in gastric varices with severe liver disease: a retrospective case control study

  • Kapil D. Jamwal;Rajesh K. Padhan;Atul Sharma;Manoj K. Sharma
    • Clinical Endoscopy
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    • 제56권1호
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    • pp.65-74
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    • 2023
  • Background/Aims: Gastric varices (GV) are present in 25% of cirrhotic patients with high rates of rebleeding and mortality. Data on endoscopic ultrasound (EUS)-guided treatment in severe liver disease (model for end stage liver disease sodium [MELD-Na] >18 and Child-Turcotte-Pugh [CTP] C with GV) are scarce. Thus, we performed a retrospective comparison of endoscopic glue injection with EUS-guided therapy in cirrhotic patients with large GV. Methods: A retrospective study was performed in the tertiary hospitals of India. A total of 80 patients were recruited. The inclusion criteria were gastroesophageal varices type 2, isolated gastric varices type 1, bleeding within 6 weeks, size of GV >10 mm, and a MELD-Na >18. Treatment outcomes and complications of endoscopic glue injection and EUS-guided GV therapy were compared. Results: In this study, the patients' age, sex, liver disease severity (CTP, MELD-Na) and clinical parameters were comparable. The median number of procedures, injected glue volume, complications, and GV obturation were better in the EUS group, respectively. On subgroup analysis of the EUS method (e.g., direct gastric fundus vs. paragastric collateral [PGC] coil placement), PGC coil placement showed decreased coil requirement, less injected glue volume, decreased luminal coil extrusion, and increased successful GV obturation. Conclusions: EUS-guided treatment is more efficient and safer, and requires a smaller number of treatment sessions, as compared to endoscopic treatment in severe liver disease patients with large GV. Furthermore, PGC coil placement increases the complete obliteration of GV.

Recent Advancement in Renal Replacement Therapy

  • Ota, Kazuo
    • 대한의용생체공학회:의공학회지
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    • 제5권2호
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    • pp.121-126
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    • 1984
  • A new approach to texture classification for quantitative ultrasound liver diagnosis using run difference matrix was developed. The run difference matrix comprised the gray level difference along with a distances. From this run difference matrix, we defined several vectors and parameters such as DOD, DGD, DAD vector, SHP, SMO, SMG, LDE, LDEL etc.Each parameter values calculated in fatty, cirrhotic, normal and chronic hepatitic liver images were plotted in a plane and we found that RDM method was more sensitive to small structural changes than the conventional run length method and showed improved classification ability between the diseases.

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산양의 Liver cirrhosis 발생보고 (Liver Cirrhosis of Korean Native Goat in Korea : A Case Report)

  • 민병만;박경애;김환균;조용성;김성열;구찬희;정운익;김홍집
    • 한국동물위생학회지
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    • 제16권1호
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    • pp.57-64
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    • 1993
  • This survey was performed to report rare outbreak of liver cirrhosis in Korean native goat (KNG) which was died of Yangpyeong's goat farm on Feb. 1992. The examination for the KNG was carried out by clinical signs, necropsy and various lab-oratory test including parasitic, bacterial and histological test. The KNG looked jaundice, ascite, hemorrhage of lumen, abomasum and intestine, and brownish smooth cirrhotic liver at necropsy. Histological examination for liver revealed considerable proliferation of connective tissue and piecemeal necrosis which was caused by chronic active inflammation in interlobules and intralobules. There were atrophic micro and macro nodules which were sur-rounded by connective tissue. The lobular structure lack almost all central vein. The portal areas appearred proliferation of bile ducts, blood vessels and connective tissues. These connective tissue infiltrated heavily with plasma cells, Iymphocytes and histocytes. Histological examination for brain proved to be hepatic encephalopathy by virture of congestion and edema in cerebral medullary. From these results were demonstrated miked nodular, active, postnecrotic liver cirrhosis.

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Effect of Hepatic Cirrhosis on the Pharmacokinetics of Theophylline in Rats

  • Nam, Bang-Hyun;Sohn, Dong-Hwan;Ko, Geonil;Kim, Jae-Baek
    • Archives of Pharmacal Research
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    • 제20권4호
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    • pp.318-323
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    • 1997
  • The experimental hepatic cirrhosis was induced either by bile duct ligation (BDL) or by pretreatment with dimethyinitrosamine (DMNA). The pharmacokinetics of theophylline were studied after a single intravenous or a single oral administration. Using the ultrafiltration method, protein-drug binding experiments were also carried out. The bilirubin level was several-fold increased by BDL, but not by DMNA treatment. The albumin content was decreased in both cirrhotic groups. The total clearance (Clt, ml/kg/hr) of theophylline in both hepatic cirrhosis groups significantly decreased and the terminal half-life $(t_{1/2})$ in the cirrhotic rats was increased about two-fold after intravenous and oral administration. The volume of distribution at steady state (Vdss, ml/kg) was increased slightly in the cirrhotic groups. Protein binding in BDL $(8.67{\pm}4.85%)$ decreased about four-folds, but in DMNA $(73.00{\pm}9.85%)$ similar result war observed as compared with the control. Increased free fraction of theophylline did not increase the volume of distribution in BDL. Therefore decreased total body clearance of theophylline was mainly due to decreased intrinsic clearance of theophylline in the liver. The absolute bioavailability of theophylline in these experiments was between 63.8 and 72.8%(66.1% in BDL, 63.8% in Sham operated and Control, 72.8% in DMNA). These results suggest that in the experimental hepatic cirrhosis model, administration route does not affect the disposition of theophylline.

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Evaluation of Computer-Assisted Quantitative Volumetric Analysis for Pre-Operative Resectability Assessment of Huge Hepatocellular Carcinoma

  • Tang, Jian-Hua;Yan, Fu-Hua;Zhou, Mei-Ling;Xu, Peng-Ju;Zhou, Jian;Fan, Jia
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.3045-3050
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    • 2013
  • Purpose: Hepatic resection is arguably the preferred treatment for huge hepatocellular carcinoma (H-HCC). Estimating the remnant liver volume is therefore essential. This study aimed to evaluate the feasibility of using computer-assisted volumetric analysis for this purpose. Methods: The study involved 40 patients with H-HCC. Laboratory examinations were conducted, and a contrast CT-scan revealed that 30 cases out of the participating 40 had single-lesion tumors. The remaining 10 had less than three satellite tumors. With the consensus of the team, two physicians conducted computer-assisted 3D segmentation of the liver, tumor, and vessels in each case. Volume was automatically computed from each segmented/labeled anatomical field. To estimate the resection volume, virtual lobectomy was applied to the main tumor. A margin greater than 1 cm was applied to the satellite tumors. Resectability was predicted by computing a ratio of functional liver resection (R) as (Vresected-Vtumor)/(Vtotal-Vtumor) x 100%, applying a threshold of 50% and 60% for cirrhotic and non-cirrhotic cases, respectively. This estimation was then compared with surgical findings. Results: Out of the 22 patients who had undergone hepatectomies, only one had an R that exceeded the threshold. Among the remaining 18 patients with non-resectable H-HCC, 12 had Rs that exceeded the specified ratio and the remaining 6 had Rs that were < 50%. Four of the patients who had Rs less than 50% underwent incomplete surgery due to operative findings of more extensive satellite tumors, vascular invasion, or metastasis. The other two cases did not undergo surgery because of the high risk involved in removing the tumor. Overall, the ratio of functional liver resection for estimating resectability correlated well with the other surgical findings. Conclusion: Efficient pre-operative resectability assessment of H-HCC using computer-assisted volumetric analysis is feasible.

간경변 초음파 영상에서의 노이즈 제거를 위한 Median Modified Wiener Filter 알고리즘의 유용성 (Usefulness of Median Modified Wiener Filter Algorithm for Noise Reduction in Liver Cirrhosis Ultrasound Image)

  • 김승연;강수민;이영진
    • 한국방사선학회논문지
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    • 제17권6호
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    • pp.911-917
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    • 2023
  • 임상 초음파 검사를 사용한 간 표면의 결절성 변화를 관찰하는 방법은 간경변 진단에 유용하게 사용되고 있다. 하지만 초음파 영상에서 필연적으로 발생되는 speckle 노이즈는 간표면과 echo 패턴 변화의 식별을 어렵게 하므로 간경변 진단에 부정적인 영향을 끼친다. 본 연구의 목적은 간경변 초음파 영상의 노이즈를 효율적으로 줄일 수 있는 변형된 중간값 위너 필터(median modified Wiener filter, MMWF)를 모델링하여 적용 가능성을 확인하는 것이다. ACR 팬텀과 실제 간경변 환자를 통해 초음파 영상을 획득하였고, 각각의 영상마다 제안하는 MMWF 알고리즘과 conventional filter 들을 적용하였다. 획득된 초음파 영상들의 정량적 화질 평가인자로는 변동 계수(coefficient of variation, COV)와 가장자리 상승 거리(edge rise distance, ERD)를 사용하였다. ACR 팬텀과 실제 간경변 환자의 초음파 영상 모두에서 MMWF 알고리즘이 conventional filter 보다 COV와 ERD 값이 모두 향상되었음을 확인하였다. 결론적으로 제안하는 MMWF 알고리즘은 노이즈 레벨을 줄일 수 있음과 동시에 공간 분해능을 향상시킬 수 있어 간경변 환자의 진단률 향상에 기여할 수 있을 것으로 기대한다.