• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권sup1호
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• pp.62-71
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• 2009

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease. Similar to NAFLD in adults, NAFLD in children is associated with obesity and insulin resistance and requires liver histology for diagnosis and staging. However, significant histological differences exist between adult and pediatric NAFLD. The rise in childhood obesity has been accompanied by an increase in pediatric NAFLD. Age, gender and race/ethnicity are significant determinants of risk, and sex hormones, insulin sensitivity and adipocytokines are implicated in the pathogenesis of pediatric NAFLD. There is no consensus for treatment of NAFLD, however, data suggest that diet, exercise and some pharmacological therapies may be of benefit. To evaluate and effectively treat pediatric NAFLD, the pathophysiology and natural history of the disease should be clarified and non-invasive methods for screening, diagnosis, and longitudinal assessment developed.

• 성인간호학회지
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• 제19권2호
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• pp.318-328
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• 2007

Purpose: The purpose of this study was to examine the degree of self-care, symptom experience and disease state among the patients with liver cirrhosis and to identify its correlation. Methods: The subjects were 220 patients with liver cirrhosis who were treated in D-university hospital in Busan. The instruments used for study were the self-care inventory, the symptom experience inventory and modified childpugh classification scale. Results: The average points of the patient's self-care performance, symptom experience, and disease status were 3.67, 29.10 and 6.12 respectively. Their self care was negatively correlated to symptom experience, and symptom experience was positively correlated to disease state. Conclusion: This research findings suggested that active self-care by patients with liver cirrhosis might contribute to reduce various symptoms they can undergo and to prevent aggravation of disease state. Therefore, patients with liver cirrhosis have to carry out self care actively in daily life and discreet nursing intervention should be offered to facilitate their self-care.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.4953-4960
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• 2013

Primary liver cancer is one of the most common cancers at the global level, accounting for half of all cancers in some undeveloped countries. This disease tends to occur in livers damaged through alcohol abuse, or chronic infection with hepatitis B and C, on a background of cirrhosis. Various cancer-causing substances are associated with primary liver cancer, including certain pesticides and such chemicals as vinyl chloride and arsenic. The strong association between HBV infection and liver cancer is well documented in epidemiological studies. It is generally acknowledged that the virus is involved through long term chronic infection, frequently associated with cirrhosis, suggesting a nonspecific mechanism triggered by the immune response. Chronic inflammation of liver, continuous cell death, abnormal cell growth, would increase the occurrence rate of genetic alterations and risk of disease. However, the statistics indicated that only about one fifth of HBV carries would develop HCC in lifetime, suggesting that individual variation in genome would also influence the susceptibility of HCC. The goal of this review is to highlight present level of knowledge on the role of viral infection and genetic variation in the development of liver cancer.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.501-510
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• 2019

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children. The global prevalence of pediatric NAFLD from general populations is 7.6%. In obese children, the prevalence is higher in Asia. NAFLD has a strong heritable component based on ethnic difference in the prevalence and clustering within families. Genetic polymorphisms of patatin-like phospholipase domain-containing protein 3 (PNPLA3), transmembrane 6 superfamily member 2, and glucokinase regulatory protein (GCKR) are associated with the risk of NAFLD in children. Variants of PNPLA3 and GCKR are more common in Asians. Alterations of the gut microbiome might contribute to the pathogenesis of NAFLD. High fructose intake increases the risk of NAFLD. Liver fibrosis is a poor prognostic factor for disease progression to cirrhosis. Magnetic resonance spectroscopy and magnetic resonance proton density fat fraction are more accurate for steatosis quantification than ultrasound. Noninvasive imaging methods to assess liver fibrosis, such as transient elastography, shear-wave elastography, and magnetic resonance elastography are useful in predicting advanced fibrosis, but they need further validation. Longitudinal follow-up studies into adulthood are needed to better understand the natural history of pediatric NAFLD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권2호
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• pp.134-140
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• 2018

Chylomicron retention disease, also known as Anderson's disease, is a rare hereditary hypocholesterolemic disorder, recessive inherited, characterized by nonspecific symptoms as abdominal distension, steatorrhea, and vomiting associated with failure to thrive. We describe a patient with failure to thrive, chronic diarrhea and steatorrhea who the diagnosis of chylomicron retention disease was established after several months of disease progression. The genetic study confirmed a homozygosity mutation in SAR1B gene, identifying a mutation never previous described [c.83_84delTG(p.Leu28Argfs*7)]. With this case report the authors aim to highlight for this very rare cause of failure to thrive and for the importance of an attempting diagnosis, in order to start adequate management with low fat diet supplemented with fat-soluble vitamins, reverting the state of malnutrition and avoiding possible irreversible and desvantating complications.

• Biomolecules & Therapeutics
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• 제31권3호
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• pp.253-263
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• 2023

The biogenesis and biological roles of extracellular vesicles (EVs) in the progression of liver diseases have attracted considerable attention in recent years. EVs are membrane-bound nanosized vesicles found in different types of body fluids and contain various bioactive materials, including proteins, lipids, nucleic acids, and mitochondrial DNA. Based on their origin and biogenesis, EVs can be classified as apoptotic bodies, microvesicles, and exosomes. Among these, exosomes are the smallest EVs (30-150 nm in diameter), which play a significant role in cell-to-cell communication and epigenetic regulation. Moreover, exosomal content analysis can reveal the functional state of the parental cell. Therefore, exosomes can be applied to various purposes, including disease diagnosis and treatment, drug delivery, cell-free vaccines, and regenerative medicine. However, exosome-related research faces two major limitations: isolation of exosomes with high yield and purity and distinction of exosomes from other EVs (especially microvesicles). No standardized exosome isolation method has been established to date; however, various exosome isolation strategies have been proposed to investigate their biological roles. Exosome-mediated intercellular communications are known to be involved in alcoholic liver disease and nonalcoholic fatty liver disease development. Damaged hepatocytes or nonparenchymal cells release large numbers of exosomes that promote the progression of inflammation and fibrogenesis through interactions with neighboring cells. Exosomes are expected to provide insight on the progression of liver disease. Here, we review the biogenesis of exosomes, exosome isolation techniques, and biological roles of exosomes in alcoholic liver disease and nonalcoholic fatty liver disease.

• 사상체질의학회지
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• 제31권2호
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• pp.22-30
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• 2019

Objectives The aim of this study is to investigate the related factors of nonalcoholic fatty liver disease (NAFLD). Methods The subjects were 187 persons diagnosed as fatty liver by abdominal ultrasonography. They were divided into three groups according to the severity of fatty liver: control, mild, moderate or severe. The three groups' general characteristics, laboratory results, liver function indexes, metabolic syndrome indexes, tumor markers, heart rate variability values and Sasang constitution distribution were compared and analyzed. Results Male ratio, height, weight, body mass index, red blood cell count, hemoglobin level and creatinine level were higher in NAFLD groups than in control group. The levels of sodium and amylase were higher in control than in NAFLD. In liver function, the levels of aspartate transaminase, alanine transaminase and gamma-glutamyl transpepsidase of NAFLD were higher. In metabolic syndrome index, systolic blood pressure, diastolic blood pressure, waist circumference, total cholesterol, triglyceride and low density lipoprotein cholesterol levels were higher in NAFLD, while high density lipoprotein cholesterol level was higher in control. The alpha-feto protein level was higher in NAFLD, and the heart rate variability was not different between NAFLD and control groups. In Sasang constitution, Taeeumin ratio of NAFLD was higher than of control. Conclusions The results suggest that nonalcoholic fatty liver is clinically related to liver dysfunction, metabolic syndrome, tumor markers, and Sasang constitution. Further studies are needed to control nonalcoholic fatty liver disease and prevent severe disease such as cirrhosis and cancer caused by fatty liver.

• 대한핵의학회지
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• 제22권1호
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• pp.39-45
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• 1988

To evaluate diagnostic accuracy of liver scintigraphy we analysed liver scans of 143 normal and 258 patients with various liver diseases. Three ROC curves for SOL, liver cirrhosis and diffuse liver disease were fitted using rating methods and areas under the ROC curves and their standard errors were calculated by the trapezoidal rule and the variance of the Wilcoxon statistic suggested by McNeil. We compared these results with that of National Institute of Radiological Science in Japan. 1) The sensitivity of liver scintigraphy was 74.2% in SOL, 71.8% in liver cirrhosis and 34.0% in diffuse liver disease. The specificity was 96.0% in SOL, 94.2% in liver cirrhosis and 87.6% in diffuse liver diasease. 2) ROC curves of SOL and liver cirrhosis approached the upper left-hand corner closer than that of diffuse liver disease. Area (${\pm}$ standard error). under the ROC curve was $0.868{\pm}0.024$ in SOL and $0.867{\pm}0.028$ in liver cirrhosis. These were significantly higher than $0.658{\pm}0.043$ in diffuse liver disease. 3) There was no interobserver difference in terms of ROC curves. But low sensitivty and high specificity of authors' SOL diagnosis suggested we used more strict decision threshold.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9773-9779
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• 2014

Background: Colorectal cancer (CRC) is one of the prime causes of mortality around the globe, with a significantly rising incidence in the Middle East region in recent decades. Since detection of CRC in the early stages is an important issue, and also since to date there are no comprehensive epidemiologic studies depicting the Middle East region with special attention to the average risk group, further investigation is of significant necessity in this regard. Aim: Our aim was to investigate the prevalence of preneoplastic and neoplastic lesions of the colon in an average risk population. Materials and Methods: A total of 1,208 eligible asymptomatic, average- risk adults older than 40 years of age, referred to Firuzgar Hospotal in the years 2008-2012, were enrolled. They underwent colonoscopy screening and all polypoid lesions were removed and examined by an expert gastrointestinal pathologist. The lesions were classified by size, location, numbers and pathologic findings. Size of lesions was measured objectively by endoscopists. Results: The mean age of participants was $56.5{\pm}9.59$ and 51.6% were male. The overall polyp detection rate was 199/1208 (16.5 %), 26 subjects having non-neoplastic polyps, including hyperplastic lesions, and 173/1208 (14.3%) having neoplastic polyps, of which 26 (2.15%) were advanced neoplasms. The prevalence of colorectal neoplasia was more common among the 50-59 age group. Advanced adenoma was more frequent among the 60-69 age group. The majority of adenomas were detected in the distal colon, but a quarter of advanced adenomas were found in the proximal colon; advance age and male gender was associated with the presence of adenoma. Conclusions: It seems that CRC screening among average-risk population might be recommended in countries such as Iran. However, sigmioidoscopy alone would miss many colorectal adenomas. Furthermore, the 50-59 age group could be considered as an appropriate target population for this purpose in Iran.

• 한국방사선학회논문지
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• 제9권4호
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• pp.227-234
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• 2015

본 연구는 간 초음파영상에서 통계적 속성 기반의 밝기 히스토그램에 기초한 픽셀 질감분석 파라미터(평균밝기, 왜곡도, 균일도, 엔트로피)와 간과 콩팥실질의 밝기 차를 이용한 영상분석을 통해 미만성 간질환의 컴퓨터보조진단 적용 가능성을 알아보고자 하였다. 실험은 간 초음파영상(정상, 지방간, 간경화)에서 관심영역($50{\times}50$픽셀)을 설정하고 4가지의 픽셀 질감분석 파라미터와 간과 콩팥의 실질 밝기의 차를 이용하여 질환인식률을 평가하였다. 그 결과 평균밝기, 균일도, 엔트로피의 질환인식률은 100%, 왜곡도 96%로 높게 나타났으며, 간과 콩팥의 실질 밝기 차는 정상 $-1.129{\pm}12.410$, 지방간 $33.182{\pm}11.826$으로 뚜렷한 차이를 나타내었으나, 간경화의 경우 $-1.668{\pm}10.081$로 정상과는 다소 작은 차이를 나타내었다. 이러한 결과를 바탕으로 높은 질환인식률을 보인 픽셀 질감분석 파라미터와 실질 밝기 차를 이용한 컴퓨터보조진단은 미만성 간질환의 감별에 유용한 도구로써 임상적인 활용 가능성이 있으며, 판독 오류를 최소화하고 정확한 진단과 치료방향 제시에 도움이 될 것으로 기대된다.