• 대한방사선기술학회지:방사선기술과학
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• 제41권1호
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• pp.13-24
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• 2018

Liver size is an important component in the diagnosis and follow-up of diffuse liver disease when testing for liver disease using ultrasonography. However, difficulties lies in determining the presence of hepatomegaly and liver atrophy because the method used for measuring liver size differs from one examiner to another and there is no relevant standard based on body build. The present study aims to propose a more objective method for liver size measurement and a reference range based on body build. A total of 260 normal adults (130 males, 130 females) participated in the study. Ultrasonography was performed in all participants to measure the size of the right lobe, left lobe, quadrate lobe, and caudate lobe of liver. Based on Physique Index(PI), a value derived from multiplying weight(kg) by height($m^2$), size of physique was divided into three groups including Group I with PI<150, Group II with $150{\leq}PI{\leq}250$, and Group III with PI>250. Thus, mean liver size by PI and a reference range with 95% reliability were suggested. The superoinferior diameter of right lobe was $12.34{\pm}1.18cm$ in males and $11.07{\pm}0.93cm$ in females, and its reference range was 10.64~11.0cm for Group I, 11.78~12.12cm for Group II, and 13.02~13.84cm for Group III. The anteroposterior diameter(T) of left lobe was $5.93{\pm}1.09cm$ in males and $5.18{\pm}0.99cm$ in females, and its reference range was 4.77~5.17cm for Group I, 5.49~5.79cm for Group II, and 6.68~7.44cm for Group III. The transverse diameter was $3.51{\pm}0.60cm$ in male participants and $3.42{\pm}0.49cm$ in female participants and its reference range was 3.29~3.51cm for Group I, 3.36~3.55cm for Group II, and 3.52~4.0cm for Group III. The caudate lobe index was $11.65{\pm}2.88cm^2$ in males and $9.62{\pm}2.18cm^2$ in females and its reference range was $8.83{\sim}9.75cm^2$ for Group I, $10.62{\sim}11.47cm^2$ for Group II, and $11.89{\sim}14.26cm^2$ for Group III. As a basic measurement method of liver size, the present study suggests measuring the superoinferior diameter for right liver lobe, the anteroposterior diameter for left liver lobe, the transverse diameter for quadrate lobe, and the caudate lobe index for caudate lobe. It is expected that this method along with its relevant reference range can be used as useful indicators in determining hepatomegaly and liver atrophy upon the diagnosis and follow-up testing of diffuse liver disease.

• BMB Reports
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• 제40권5호
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• pp.814-824
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• 2007

Liver cirrhosis (LC) is defined as comprising diffuse fibrosis and regenerating nodules of the liver. The biochemical and anatomical dysfunction in LC results from both reduced liver cell number and portal vascular derangement. Although several studies have investigated dysregulated genes in cirrhotic nodules, little is known about the genes implicated in the pathophysiologic change of LC or about their relationship with the degree of decompensation. Here, we applied cDNA microarray analysis using 38 HBsAg-positive LC specimens to identify the genes dysregulated in HBV-associated LC and to evaluate their relation to disease severity. Among 1063 known cancer- and apoptosis-related genes, we identified 104 genes that were significantly up- (44) or down- (60) regulated in LC. Interestingly, this subset of 104 genes was characteristically correlated with the degree of decompensation, called the Pugh-Child classification (20 Pugh-Child A, 10 Pugh-Child B, and 8 Pugh-Child C). Patient samples from Pugh-Child C exhibited a distinct pattern of gene expression relative to those of Pugh-Child A and B. Especially in Pugh-Child C, genes encoding hepatic proteins and metabolizing enzymes were significantly down-regulated, while genes encoding various molecules related to cell replication were up-regulated. Our results suggest that subsets of genes in liver cells correspond to the pathophysiologic change of LC according to disease severity and possibly to hepatocarcinogenesis.

• Reproductive and Developmental Biology
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• 제31권3호
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• pp.145-152
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• 2007

본 연구에서는 SV40 Tag을 마우스 albumin 유전자의 promoter/enhancer 조절 하에 발현하도록 설계된 재조합 유전자를 마우스 1세포기 수정란에 미세 주입하여 형질 전환마우스를 제작하고 이들의 인체 간암 모델로써의 적합성을 조사하였다. 형질 전환이 확인된 총 11개체의 founder 생쥐들 중 4개체가 간암을 일으켰고, 두 개체는 신장암을, 한 개체는 피부 및 뇌에서 종양을 각각 일으켰다. 이들로부터 외래 유전자를 계대 유전하는 3가계를 얻었다(#1-2, #1-6, #1-11). 이들 가계의 자소들에서 8주령(#1-2, #1-6)혹은 10주령(#1-11)시부터 간암이 반복적으로 발생되었으며, #1-11 founder개체에서 폐로 암세포가 전이된 것 외에는 다른 조직에서의 형태학적 변이가 발견되지 않았다. 간암 발생은 조직학적 변화에 따라 3단계로 나눌 수 있었다. 즉, 출생에서 3주령까지는 간세포의 과량증식을 보이나 세포핵의 이상은 관찰되지 않았으며, 4주령부터 7주령(#1-2, #1-6) 혹은 9주령(#1-11)까지는 diffuse liver cell dysplasia를 나타내지만 tumor nodule은 발견되지 않았고, 그 이후에는 liver dysplasia를 배경으로 간암이 발생하였다. 본 연구에서 작출한 간암 모델 마우스는 인체 간암과 일부 유사한 소견을 보였는바 인체 간암 기전 연구를 위한 유용한 동물 모델로 이용할 수 있을 것으로 생각된다.

• 한국콘텐츠학회논문지
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• 제15권8호
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• pp.389-396
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• 2015

간 섬유화는 임상에서 흔히 접하는 질환으로, 간세포 염증 및 괴사가 수년간 지속 및 반복되는 질환으로 간경변이 진행된다. 따라서, 만성 간질환 환자에서 간경변 및 간세포암으로의 진행을 막음으로써 간경변의 합병증 및 간세포암에 의한 사망률 및 유병률을 감소시키는 것이 주요한 임상 과제라 할 수 있다. 이에 본 연구에서는 미만성 간질환 환자에게서 초음파 영상, 혈액검사, 간탄력도와의 상관관계를 수치화 하고자 하였다. 본 연구에서는 P사의 초음파 진단기 (IU-22)로 영상을 획득한 환자와 Fibrosccan을 시행 받은 141명을 대상으로 시행하였고, 혈액 검사는 초음파 영상과 간섬유 스캔을 시행한 시점의 검사 결과로 기초자료를 획득하였다. 각 자료에 대한 통계 분석은 집단 간 차이 검증을 위해 일원분산분석(One-way, ANOVA)을 시행하여 검증하였다. 탄성 초음파의 수치는 정상, 만성간질환, 간경변 순으로 증가하였다. 판독 결과에 따라 ALT, Albumin은 대상군 간 통계학적 차이를 보이지 않았으며, 나이, AST, ALP, Bilirubin, PLT, PT, kPa에서 초음파 판독 결과에 따라서 차이가 있고, 통계적으로 유의(p<0.05)하였다. 그리고 다른 연구에서 만성 간질환 탄성 초음파 수치값이 12.5kPa 이상이라고만 제시하였으나, 본 연구에서는 질환별 평균 kPa임계값을 제시하여, 정량적으로 진단이 가능하게 수치화를 하였다. 또한, 진단결과의 상관관계를 제시하여 질환별 만성 간질환 환자의 진단에 일차적인 도구로 사용될 수 있으리라 사료된다.

• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권6호
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• pp.690-693
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• 2007

Benign symmetric lipomatosis(BSL) is a lesion characterized by symmetrical and diffuse growth of adipose tissue. It is commonly found in the posterior neck or upper trunk, manifesting itself as an entity known as Madelung disease or Lanoid-Bensaude syndrome. Lipomatosis affecting the tongue is very unusual. The etiology of BSL is unknown, but It can be associated with alcoholism, liver dysfunction, hypothyroidism. Because of its diffuse histologic feature, complete resection of the lesion is often difficult. Seventy one years old male patient, whose chief complaint was multiple nodules of tongue was referred to our department. The lesion was diagnosed histopathologically as BSL and subsequently removed surgically. So we report this rare case of BSL with literature review.

• 대한수의학회지
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• 제40권3호
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• pp.587-599
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• 2000

This study was conducted to observe the severity of the disease and pathogenecity of Babesia gibsoni parasite on the splenectomized dogs(SPD) and nonsplenectomized(intact) dogs (NSPD) experimentally infected with B gibsoni. The average prepatent period was 4 days in the SPD and 8 days in the NSPD, respectively. Peak parasitaemia(PE) ranged from 26% to 34% of erythrocytes infected in the SPD and from 4% to 5% in the NSPD. Latent parasitaemia was still detectable 40 days as low as under 1.0% of erythrocytes infected after the initial parasitaemia in the SPD. Blood packed cell volume(PCV) decreased to as little as 6.4% to 6.9% in the SPD. The clinical signs were mild fever and anemia in the NSPD, remissions and exacervations of temperature, intermittent or spike-like increases of temperature, progressive polychromatophilic macrocytic anemia with anisocytosis, icterus, marked loss of appetite, rarely haemoglobinuria, and deep brown-yellowish urine in the SPD. Gross pathologic changes mainly involved slightly enlargement of liver and spleen in the NSPD and marked enlargement of liver in the SPD. Anatomic changes associated with the disease included diffuse periportal and centrilobular hephatitis, and membranoproliferative glomerulonephritis. Hyaline droplets, resulting protein metabolic alterations, were found in the convoluted ephithelium of the kidney. The density of lymphocytes within the liver sinusoids was markedly increased. Aggregates of large monocytes and macrophages were demonstrated in the centrilobular veins of the liver. The density of these cells in the centrilobular veins were greatest in the SPD. The forms of B gibsoni parasite found in the acute stage of SPD were large signet ring form, small signet ring form, pyriform, elongated form, comma form, head-phone form, oval form, peared form, racket-like form, amoeboid form, triangle form, quartered form, dot form, band form and multiple, and rosette form, et al. The severity of the disease and pathogenecity of B gibsoni parasite were mild in the NSPD but fatal in the SPD.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2285-2289
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• 2016

Background: Epstein-Barr virus (EBV) positive diffuse large B-cell lymphoma (DLBCL) of the elderly is an entity introduced in the latest WHO classification of lymphoid tumors and defined in patients older than 50 years without prior lymphoma or immunodeficiency. However, recently it has also been seen in patients under 50. There is thus debate as to whether these are separate entities. Materials and Methods: In this retrospective study, we analyzed de novo DLBCL admitted to our institute over a period of two years. Clinical data included age, sex, nodal and extranodal presentation. The results of an immunohistochemistry (IHC) panel were also reviewed. IHC findings were mainly used to sub-classify DLBCL as germinal center vs. non germinal center types. IHC for identification of LMP-1 (latent membrane protein) and in situ hybridization for detection of EBV-encoded RNA (EBER) was performed. EBV prevalence, clinical data and IHC findings were compared between patients under and over 50 years of age. Results: Out of 95 DLBCL, 11.6% were EBV positive (7.5% and 14.5% in the young and old groups). We did not find any significant differences in IHC subclasses and clinical data between EBV positive DLBCL (EBV+DLBCL) of young and old groups. Conclusions: EBV+DLBCL are not exclusive to patients older than 50 years. With regard to clinical data as well as IHC subclasses, no differences were evident between EBV+DLBCL of young and old groups. Our suggestion is to eliminate any cut off age for EBV+DLBCL.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권2호
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• pp.98-103
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• 2014

Purpose: Gallbladder (GB) wall thickening can be found in various conditions unrelated to intrinsic GB disease. We investigated the predisposing etiologies and the outcome of acalculous GB wall thickening in children. Methods: We retrospectively analyzed 67 children with acalculous GB wall thickening who had visited our institute from June 2010 to June 2013. GB wall thickening was defined as a GB wall diameter > 3.5 mm on abdominal ultrasound examination or computed tomography. Underlying diseases associated with GB wall thickening, treatment, and outcomes were studied. Results: There were 36 boys and 31 girls (mean age, $8.5{\pm}4.8years$ [range, 7 months-16 years]). Systemic infection in 24 patients (35.8%), acute hepatitis in 18 (26.9%), systemic disease in 11 (16.4%), hemophagocytic lymphohistiocytosis in 4 (6.0%), acute pancreatitis in 3 (4.5%), and specific liver disease in 3 (4.5%) predisposed patients to GB wall thickening. Systemic infections were caused by bacteria in 10 patients (41.7%), viruses in 5 patients (20.8%), and fungi in 2 patients (8.3%). Systemic diseases observed were systemic lupus erythematosus in 2, drug-induced hypersensitivity in 2, congestive heart failure in 2, renal disorder in 2. Sixty-one patients (91.0%) received symptomatic treatments or treatment for underlying diseases. Five patients (7.5%) died from underlying diseases. Cholecystectomy was performed in 3 patients during treatment of the underlying disease. Conclusion: A wide range of extracholecystic conditions cause diffuse GB wall thickening that resolves spontaneously or with treatment of underlying diseases. Surgical treatments should be avoided if there are no definite clinical manifestations of cholecystitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권4호
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• pp.263-267
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• 2017

Patients with lysosomal acid lipase (LAL) deficiency and glycogen storage disease (GSD) demonstrated hepatomegaly and dyslipidemia. In our case, a 6-year-old boy presented with hepatosplenomegaly. At 3 years of age, GSD had been diagnosed by liver biopsy at another hospital. He showed elevated serum liver enzymes and dyslipidemia. Liver biopsy revealed diffuse microvesicular fatty changes in hepatocytes, septal fibrosis and foamy macrophages. Ultrastructural examination demonstrated numerous lysosomes that contained lipid material and intracytoplasmic cholesterol clefts. A dried blood spot test revealed markedly decreased activity of LAL. LIPA gene sequencing identified the presence of a novel homozygous mutation (p.Thr177Ile). The patient's elevated liver enzymes and dyslipidemia improved with enzyme replacement therapy. This is the first report of a Korean child with LAL deficiency, and our findings suggest that this condition should be considered in the differential diagnosis of children with hepatosplenomegaly and dyslipidemia.