• Title/Summary/Keyword: Diffuse Liver Disease

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Liver Size Measurement Method by Ultrasonography and Reference Range based on Normal Adult Physique Index (초음파검사에 의한 간 크기 측정방법 및 정상 성인의 체격지수별 참조범위)

  • Kim, Yong-Kyun;Han, Dong-Kyoon
    • Journal of radiological science and technology
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    • v.41 no.1
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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.

Gene Regulations in HBV-Related Liver Cirrhosis Closely Correlate with Disease Severity

  • Lee, Se-Ram;Kim, So-Youn
    • BMB Reports
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    • v.40 no.5
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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.

Production and Characterization of a Transgenic Mouse Model of Human Liver Cancer (형질 전환 기법을 이용한 인체 간암의 마우스 모델 제작 및 특성 규명)

  • Li, Zhong-Shu;Lee, Jung-Woong;Hyun, Byung-Hwa;Lee, Chul-Ho;Jeong, Kyu-Shick;Fang, Nan-Zhu;Yeom, Young-Il
    • Reproductive and Developmental Biology
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    • v.31 no.3
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    • pp.145-152
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    • 2007
  • Transgenic mice were generated by microinjecting a plasmid DNA containing the SV40 (simian virus 40) large T antigen (Tag) gene fused with mouse albumin promoter/enhancer sequences into fertilized one-cell mouse embryos. Among eleven founder transgenic animals, four developed hepatocellular carcinoma, two showed kidney cancer and one developed skin and brain tumors. Three stable transgenic lines, #1-2, #1-6 and #1-11 were established. Members of the lines #1-6 and #1-11 reproducibly developed liver tumors by 8 to 10 weeks of age but did not exhibit any phenotypic changes in other tissues. Histological changes loading to liver tumor formation occurred with predictable kinetics and could be classified into three distinct stages; (a) newborn to 3 weeks of age, characterized by hyperplastic hepatocytes with reduced amounts of cytoplasm without any nuclear alterations, (b) between 4 to 8 weeks of age, characterized by diffuse liver cell dysplasia without observable tumor nodules, and (c) 9 weeks of age and thereafter, characterized by hepatocellular carcinomas in the background of extensive liver dysplasia. Metastasis to the lung from a liver carcinoma was observed in #1-11 founder animal. This transgenic mouse system displays similarities with human liver cancers in a number of aspects and provides a useful model for the study of molecular events involved in hepatocarcinogenesis.

Analysis of Image for Liver Disease using Blood Test in the Ultrasound Fibroscan (Fibroscan에서의 혈액검사를 이용한 간질환의 영상분석)

  • Lee, Jeong-Hyun;Kim, Dong-Hyun;Kim, Changsoo
    • The Journal of the Korea Contents Association
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    • v.15 no.8
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    • pp.389-396
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    • 2015
  • The liver fibrosis is a disease we often see in clinical medicine, and the persistence and repeatition of inflammation and necrosis of liver cells continue for several years, and it is proceeded to cirrhosis. So decrease of death rate and prevalence rate by complications of cirrhosis and hepatocellular carcinoma is main task of clinical medicine by protection of chronic liver ailment patients from proceeding to cirrhosis and hepatocellular carcinoma. So this study tried to represent the ultrasonic image, blood test, the relationship with liver stiffness of diffuse liver ailment patients as numbers. This study was performed with patients from whom the image was taken by ultrasonic and 141 people who were treated by fibroscan, the basic data for blood test was obtained from the test results at the time when ultrasonic image and liver fibroscan was performed. The statistical analysis was performed by One-way analysis of variance(ANOVA) to verify difference between groups. The value of liver stiffness was increased in the order of normal, chronic liver disease and cirrhosis. As a results, ALT and Albumin have no statistical difference between object groups, and there are statistical differences in the results of ultrasonic decoding at age, AST, ALP, Bilirubin, PLT, PT, and kPa, and they are statistically meaningful(p<0.005). And the value of liver stiffness of chronic liver ailment was presented only as over 12.5kPa in other study, but it was represented as numbers for quantitative diagnosis by presenting average kPa threshold value according to disease in this study. And by presenting relationship of diagnosed results, it is considered that it could be used as first tool to diagnose chronic liver ailment patients according to their disease.

A Study on the Significance of the Colloidal Radiogold Disappearance Rate as a Simple Clinical Liver Function Test (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))

  • Hong, Chang-Gi
    • The Korean Journal of Nuclear Medicine
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    • v.3 no.1
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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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BENIGN SYMMETRIC LIPOMATOSIS OF TONGUE: REPORT OF A CASE (혀에 발생한 대칭성 지방종증의 치험례)

  • Kim, Jong-Ryoul;Lee, Jae-Yeol
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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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.

Pathogenecity on experimentally infected dogs with Babesia gibsoni (Babesia gibsoni의 실험적 감염 개에 대한 병원성)

  • Suh, Myung-deuk;Chung, Mi-ra
    • Korean Journal of Veterinary Research
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    • v.40 no.3
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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.

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Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma: is it different between Over and Under 50 Years of Age?

  • Monabati, Ahmad;Vahedi, Amir;Safaei, Akbar;Noori, Sadat;Mokhtari, Maral;Vahedi, Leila;Zamani, Mehdi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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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.

Acalculous Diffuse Gallbladder Wall Thickening in Children

  • Lee, Ji Haeng;No, Young Eun;Lee, Yeoun Joo;Hwang, Jae Yeon;Lee, Joon Woo;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.2
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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.

A Novel Homozygous LIPA Mutation in a Korean Child with Lysosomal Acid Lipase Deficiency

  • Kim, Kwang Yeon;Kim, Ju Whi;Lee, Kyung Jae;Park, Eunhyang;Kang, Gyeong Hoon;Choi, Young Hun;Kim, Woo Sun;Ko, Jung Min;Moon, Jin Soo;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.4
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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.