• Korean Journal of Radiology
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• v.24 no.5
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• pp.465-475
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• 2023

Objective: To evaluate the feasibility of ultrasound shear wave elastography (SWE) for predicting hepatic fibrosis and native liver outcomes in patients with biliary atresia. Materials and Methods: This prospective study included 33 consecutive patients with biliary atresia (median age, 8 weeks [interquartile range, 6-10 weeks]; male:female ratio, 15:18) from Severance Children's Hospital between May 2019 and February 2022. Preoperative (within 1 week from surgery) and immediate postoperative (on postoperative days [PODs] 3, 5, and 7) ultrasonographic findings were obtained and analyzed, including the SWE of the liver and spleen. Hepatic fibrosis, according to the METAVIR score at the time of Kasai portoenterostomy and native liver outcomes during postsurgical follow-up, were compared and correlated with imaging and laboratory findings. Poor outcomes were defined as intractable cholangitis or liver transplantation. The diagnostic performance of SWE in predicting METAVIR F3-F4 and poor hepatic outcomes was analyzed using receiver operating characteristic (ROC) analyses. Results: All patients were analyzed without exclusion. Perioperative advanced hepatic fibrosis (F3-F4) was associated with older age and higher preoperative direct bilirubin and SWE values in the liver and spleen. Preoperative liver SWE showed a ROC area of 0.806 and 63.6% (7/11) sensitivity and 86.4% (19/22) specificity at a cutoff of 17.5 kPa for diagnosing F3-F4. The poor outcome group included five patients with intractable cholangitis and three undergoing liver transplantation who showed high postoperative liver SWE values. Liver SWE on PODs 3-7 showed ROC areas of 0.783-0.891 for predicting poor outcomes, and a cutoff value of 10.3 kPa for SWE on POD 3 had 100% (8/8) sensitivity and 73.9% (17/23) specificity. Conclusion: Preoperative liver SWE can predict advanced hepatic fibrosis, and immediate postoperative liver SWE can predict poor native liver outcomes in patients with biliary atresia.

• Korean Journal of Occupational Health Nursing
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• v.4
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• pp.84-101
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• 1995

The periodic health examination have been shown the important role on early detection, early treatment and prevention of disease. Until now, there have been many studies that showed the effectiveness of the periodic health examination on the early detection and early treatment of disease to some extent. But there are few studies about primary prevention before health problem arise. In this case-control study, 29 newly detected hypertensive cases, 31 liver disease cases and 65 controls which are all available for 6-year data in the periodic health examination of a occupational field were compared to investigate the significant increase trend of health status between the groups. The results will be used for the occupational health nurses to provide appropriate primary prevention to the employees. The hypertensive and liver disease cases were divided observation-needed group and treatment-needed group. The data on systolic blood pressure, diastolic blood pressure, Body Mass Index and Broca Index in hypertensive cases and SGOT, SGPT, Body Mass Index and Broca Index in liver disease cases were analyzed by t-test and ANOVA. The specific findings are summarized as follows. 1. In the comparison between the hypertensive cases and controls, SBP and DBP of the observation-needed group and the treatment-needed group were significantly higher than the data of the controls for past 6 years. It was 2-3 years ago showing increase over 140/90mmHg of blood pressure in the hypertensive cases before they are categorized as hypertensive cases. In the observation-needed group and the treatment-needed group, the trend of the blood pressure for 6 years were significantly higher than the one of the controls. 2. In the comparison between the liver disease cases and controls, SGOT and SGPT of the observation-needed group and the treatment-needed group were significantly higher than the data of the controls for past 6 years. It was 2 years ago showing increase within upper normal limit of SGOT and 5 years ago of SGPT in the liver disease cases before they are categorized as liver disease cases. In the observation-needed group and the treatment-needed group, the trend of the liver enzyme for 6 years were significantly higher than the one of the controls. With these results, the author proposed that intervention for the primary prevention such as continuous follow-up, health education and weight control to the population who has over 140/90mmHg of blood pressure and upper normal limit of AST and ALT.

• The Journal of Internal Korean Medicine
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• v.38 no.6
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• pp.1068-1075
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• 2017

Objectives: This report describes the case of a patient suffering alcoholic liver disease with lower limb weakness, which was improved by Korean medical treatments. Methods: For relieving symptoms, Korean medical treatments, including acupuncture, moxibustion, and herb medication, were performed. To evaluate the effects of the treatments, a liver function test (LFT), the Hughes grading scale, and weight were used. Results: After treatments for 29 days, symptoms were improved, and the LFT value was decreased. Conclusions: This report suggests that Korean medical treatments may be one solution for alcoholic liver disease.

• Journal of Korean Biological Nursing Science
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• v.15 no.2
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• pp.43-53
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• 2013

Purpose: This study was intended to analyze the types and measurement parameters of non-pharmacological interventional studies for nonalcoholic fatty liver disease (NAFLD). Methods: NAFLD related literatures were systematically reviewed. The existing literatures were searched electronically using the data base of PubMed, a Medline data base of the National Library of Medicine with the key words of nonalcoholic fatty liver disease, NAFLD, nonalcoholic steatohepatitis, and NASH. The criteria for inclusion in this review were 1) non-pharmacological intervention, 2) human, 3) English. Finally, 20 articles were included in the review. Results: The major findings of this study were as follows: 1) the types of non-pharmacological intervention were exercise (35%), caloric restriction (30%), and lifestyle modification with combination both of exercise and caloric restriction (35%), 2) Almost all studies adopted various measurement parameters derived from pathophysiological mechanism-based biomarkers such as anthropometric indices, biochemical parameters, body fat mass, and liver biopsy results. Conclusion: Non-pharmacological interventions have been reported to be effective to improve NAFLD status, and many objective biomarkers confirmed supported these findings. Therefore, the development of nursing interventions for NAFLD subjects is needed and the consideration of using mechanism-based biomarkers is suggested to verify nursing outcomes objectively.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.25 no.3
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• pp.165-175
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• 2018

Purpose: The purposes of this study were to examine symptom experiences, perceived health status, disease status, and self-care compliance of patients with liver cirrhosis and to identify the factors that affect their self-care compliance. Methods: The study design was a cross-sectional design and 148 patients who were being treated at D-university hospital in Busan participated in the survey. The data were analyzed using t-test, ANOVA, Bonferroni test, Pearson correlation coefficients, and multiple linear regression analysis. Results: The factors affecting self-care compliance were symptom experiences, disease status, age, and gender. These factors explained 21.6% of the variance in self-care compliance of patients with liver cirrhosis. Conclusion: The findings indicate that nursing interventions that prevent patients' symptoms are needed to promote self-care compliance in patients with liver cirrhosis. The patient should also be helped to recognize the need for self-care compliance from an early stage.

• Laboraroty Animal Research
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• v.34 no.4
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• pp.133-139
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• 2018

Nonalcoholic steatohepatitis (NASH) is becoming common chronic liver disease because of the increasing global prevalence of obesity and consequently Nonalcoholic fatty liver disease (NAFLD). However, the mechanism for progression of NAFLD to NASH and then cirrhosis is not completely understood, yet. The triggering of these hepatic diseases is thought from hepatocyte injury caused by over-accumulated lipid toxicity. Injured hepatocytes release damage-associated molecular patterns (DAMPs), which can stimulate the Kupffer cells (KCs), liver-resident macrophages, to release pro-inflammatory cytokines and chemokines, and recruit monocyte-derived macrophages (MDMs). The increased activation of KCs and recruitment of MDMs accelerate the progression of NAFLD to NASH and cirrhosis. Therefore, characterization for activation of hepatic macrophages, both KCs and MDMs, is a baseline to figure out the progression of hepatic diseases. The purpose of this review is to discuss the current understanding of mechanisms of NAFLD and NASH, mainly focusing on characterization and function of hepatic macrophages and suggests the regulators of hepatic macrophages as the therapeutic target in hepatic diseases.

• Korean Journal of Veterinary Research
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• v.29 no.4
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• pp.531-540
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• 1989

A new sudden death in rabbits appeared in China and Korea in 1984 and 1985, respectively, and was recognized to be an acute infectious disease caused by a virus. The disease was reported as a "new viral disease," and thereafter, a tentative name of "viral hemorrhagic disease", "hemorrhagic pneumonia" or "viral hemorrhagic pneumonia" has been described in the case reports. But authors had called the viral disease "rabbit viral hepatitis" due to picornavirus infection, because the principal lesion of the disease was an acute hepatitis. The purpose of this report is to describe the electron microscopic findings on the livers in experimentally infected rabbits. All the livers of the affected rabbits were shown to have degenerative changes of a type that is characteristic of acute hepatitis. In the liver cells, there were dilation of rER and mitochondria, vacuole formation of various sizes, and appearances of many virus-like particles in the vicinity of rER, granular bodies and crystalline arrays of viral particles in the cytoplasm with necrotic changes of the nucleus. Clusters of virus-like particles and viral crystals appeared in the cytoplasm of sinusoid endothelial cells and Kupffer's cells with morphological changes of organelles. Also viral crystals were demonstrated in the cytoplasm of macrophages among the liver cells. On the whole, the liver cells had many virus-like particles and a few crystalline arrays of viral particles. Therefore, this implies that the liver cells are the main site of the viral replication in inducing the viremia. It was concluded that the liver was the primary target organ of this viral disease, and the pathological and the ultrastructural evidence suggest that the virus may be belong to genus enterovirus.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.411-429
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• 1997

Recent survey shows that chronic liver disease such as chronic hepatitis, liver cirrhosis and hepatoma is the third leading causes for death in Korea. In oriental medicine, viral hepatitis is related to Hwangdal(黃疸) and alcoholic liver disease is related to Joosang(酒傷). ARTEMISIAE HERBA and PUERARIAE RADIX have long been used in treating those symptoms. This study was done to evaluate the effect of AR1EMISIAE HERBA and PUERARIAE RADIX on viral and alcoholic hepatitis. ARTEMISIAE HERBA and PUERARIAE RADIX were decocted respectively with water and followed by vaccum evaporation. The solution was diluted to adequate concentration. Sprague-Dawley rats were used in this experiment. Each group was given PUERARIAE RADIX or ARTEMISIAE HERBA solution orally and CCl4, d-galactosamine or alcohol was given orally 30 minutes later. After 24 hours of starvation, blood samples were taken to check serum GOT, GPT, LDH and ALP activities, TC, TG, glucose and BUN levels. These results show that ARTEMISIAE HERBA has better effect on liver injury induced by d-Galactosamine than PUERARIAE RADIX and that both ARTEMISIAE HERBA and PUERARlAE RADIX have good effect on acute alcoholic liver disease while in the liver injury induced by $CCl_{4}$, PUERARIAE RADIX has better inhibitory effect on serum AST, ALT and ALP levels and ARTEMISIAE HERBA has better inhibitory effect on serum total cholesterol and triglyceride. And the result that high concentration group has better effect shows these effects are concentration-dependent. Further study on the mechanism of these herbs is still required.

• The Korean Journal of Nuclear Medicine
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• v.32 no.4
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• pp.305-313
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• 1998

The reduction in the amount of asialoglycoprotein (ASGP) receptor, which resides exclusively on the plasma membrane of functioning mammalian hepatocytes, as a consequence of hepato-cellular damage has been demonstrated in various pathologic conditions of the liver. Galac-tosylated human serum albumin (GSA) is a newly developed receptor-binding agent, specific for the ASGP receptor. Tc-99m GSA binds quantitatively to liver ASGP receptors and the rate of accumulation in the liver is dependent on hepatic function represented as the amount of receptor, as well as the amount of ligand injected, its affinity to the receptor and the hepatic blood flow. The findings of Tc-99m GSA scintigraphy were reported to reflect the hepatic function of the patients with large hepatic tumors, obstructive jaundice, acute and chronic liver disease. Tc-99m GSA scintigraphy is an easy and reliable test and has the clinical potentials to evaluate the liver function in the patients with hepatic disorders.

• YAKHAK HOEJI
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• v.41 no.5
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• pp.622-628
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• 1997

Hepatic cirrhosis is a common response to chronic liver injury from many causes and is one of the most common cause of all deaths. This study was carried out to compare experimental hepatic cirrhosis in rats to understand this disease and to apply for the pharmacokinetics in disease state. Following three kinds of experimental models were induced; 1) Bile duct ligation/scission (BDL/S), 2) N, N-dimethylnitrosamine(DMN), 3) Carbon tetrachloride. The hepatic cirrhosis was characterized by examing the liver/body weight ratio, serum biochemical values, hydroxyproline content in liver and histopathological lesions in cirrhotic rat liver. The results are as follows : (1) In BDL/S, the liver was enlarged to 250% of normal liver. In contrast the liver was shrinked to 48% and 78% of the normal liver in DMN and carbon tetrachloride, respectively. (2) In carbon tetrachloride and BDL/S, the serum ALT, AST, ALP and total bilirubin levels were significantly increased to 200~300% of normal level, while ALT and total bilirubin levels were significantly increased in DMN group. (3) Hydroxyproline content in cirrhotic rat liver was significantly 200~500% higher than that of normal liver. (4) Nodular formation with fibrosis was observed in BDL/S, DMN, carbon tetrachloride induced cirrhotic rat liver.