• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.4
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• pp.201-212
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• 2023

Purpose: The gastrointestinal system is the most commonly affected organ, followed by the lungs, in patients with primary immunodeficiency disease (PID). Hence, it is common for children with PIDs to present with gastrointestinal symptoms. We aimed to analyze the clinical and histopathological findings of patients who were initially admitted to pediatric gastroenterology/hepatology clinics and subsequently diagnosed with PIDs to identify the clinical clues for PIDs. Methods: The demographic, laboratory, and histopathological findings, treatment modality, and outcomes of patients initially admitted to the pediatric gastroenterology/hepatology unit and subsequently diagnosed with PIDs were recorded. Results: The study included 24 patients (58.3% male; median age [range]: 29 [0.5-204] months). Common clinical presentations included chronic diarrhea (n=8), colitis (n=6), acute hepatitis (n=4), and acute liver failure (n=2). The association of autoimmune diseases, development of malignant diseases, and severe progression of viral diseases was observed in 20.8%, 8.3%, and 16.6% of the patients, respectively. Antibody deficiency was predominantly diagnosed in 29.2% of patients, combined immunodeficiency in 20.8%, immune dysregulation in 12.5%, defects in intrinsic and innate immunity in 4.2%, autoinflammatory disorders in 8.3%, and congenital defects of phagocytes in 4.2%. Five patients remained unclassified (20.8%). Conclusion: Patients with PIDs may initially experience gastrointestinal or liver problems. It is recommended that the association of autoimmune or malignant diseases or severe progression of viral diseases provide pediatric gastroenterologists some suspicion of PIDs. After screening using basic laboratory tests, genetic analysis is mandatory for a definitive diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6997-7005
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• 2013

Aim: To present an epidemiological and histological perspective of diseases of the gastrointestinal tract (including liver and biliary tract) at the Section of Histopathology, Department of Pathology, AKUH, Karachi, Pakistan. Materials and Methods: All consecutive endoscopic biopsies and resections between October 1 and December 31, 2012 were included. Results: A total of 2,323 cases were included. Carcinoma was overwhelmingly the commonest diagnosis on esophageal biopsies (69.1%); chronic helicobacter gastritis (45.6%) followed by adenocarcinoma (23.5%) were the commonest diagnoses on gastric biopsies; adenocarcinoma (27.3%) followed by ulcerative colitis (13.1%) were the commonest diagnoses on colonic biopsies; acute appendicitis (59.1%) was the commonest diagnosis on appendicectomy specimens; chronic viral hepatitis (44.8%) followed by hepatocellular carcinoma (23.4%) were the commonest diagnoses on liver biopsies; chronic cholecystitis was the commonest diagnosis (over 89%) on cholecystectomy specimens. Conclusions: Squamous cell carcinoma comprised 88.8% of esophageal cancers. About 67% were in the lower third and 56.5% were moderately differentiated; mean ages 49.8 years for females and 55.8 years for males; 66% cases were from South West Pakistan. Over 67% patients with gastric adenocarcinoma were males; mean ages 59 and 44 years in males and females respectively, about 74% gastric carcinomas were poorly differentiated; and 62.2% were located in the antropyloric region. About 63% patients with colorectal adenocarcinoma were males; mean ages 46.1 and 50.5 years for males and females respectively; tumor grade was moderately differentiated in 54%; over 80% were located in the left colon. In 21.2% appendicectomies, no acute inflammation was found. Acute appendicitis was most common in young people. Hepatitis C (66.3%) was more common than hepatitis B (33.7%); about 78% cases of hepatocellular carcinoma occurred in males; females comprised 76.7% patients with chronic cholecystitis; and 77.8% patients with gall bladder carcinoma. All resection specimens showed advanced cancers. Most cancers occurred after the age of 50 years.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.307-311
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• 1992

Anorexia, nausea, and vomiting are one of the most frequent symptoms in viral hepatits patients. These may be due to poorly detoxified substances by dysfunctioned hepatocytes or by gastritis, but the pathophysiology is not totally understood. The symptoms interfere with adequate nutrient intake and are managed by metoclopramide, which accelerates gastric emptying. Thus delayed gastric emptying may well be a contributing factor to such symptoms. To determine such a relationship, we measured gastric emptying time in 11 normal subjects,9 acute (AVH), and 12 chronic B viral hepatitis (CVH) patients. All were males with a mean age of 23 years. An egg was labeled with 0.5 mCi of $^{99m}Tc-sulfur$ colloid, fried, then eaten between 2 slices of bread with 100 cc of water. Anterior and posterior images were taken at 20 minute intervals over a 2 hour period. A geometric mean of activity pertaining to the gastric region was measured, and $T_{1/2}$ was calculated from the time activity curve. $T_{1/2}$ for normal the group was $57.8{\pm}6.3$ minutes while that for the AVH and CVH group was $58.2{\pm}8.2$ (p=0.40) and $64.1{\pm}10.5$ (p=0.09), respectively. There was 1 AVH Patient and 4 CVH patients with prolonged $T_{1/2}$. Anorexia and nausea was seen in 71% and 46% of the patients, respectively. 80% and 60% of the patients with prolonged $T_{1/2}$ had anorexia and nausea, respectively.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.167-174
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• 1985

It has been well recognized that the various cutaneous manifestations associated with the liver diseases. A clinical study was made of 255 patients (AVH 84, LC 70, HC 41, CAH 26, CPH 23, AH11) with the liver diseases at Yeungnam University Hospital during the periods from May to November, 1985. The authors classified the cutaneous manifestations into 7 groups according to pathogenesis, and compared them with other reports. The results were as follows; 1. In 255 patients with various liver diseases, 161 patients (63%) showed the various cutaneous manifestations. 2. The various cutaneous manifestations were jaundice and/or pruritus (43.1%), vascular changes (39.6%), allergic manifestations (10.6%), nail changes (5.1%), hormone-induced changes (4.3%), pigmentary changes (3.5%) and others (2.4%) in that order. 3. Cutaneous manifestations were associated most frequently with liver cirrhosis (1.6 groups) and the least with chronic active hepatitis (0.7 group). 4. Allergic manifestations were seen mainly in patients with acute viral hepatitis. Three patients showed the serum sickness-like prodrome. 5. The other cutaneous manifestations were seen mainly in patients with chronic liver diseases.

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.95-100
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• 2013

Background: This study was performed to investigate the epidemiologic and clinical features of acute respiratory viral infection in hospitalized children. Methods: From 2010 to 2012, we tested nasopharyngeal swab specimen in 1,584 hospitalized children with multiple real-time polymerase chain reactions to identify 10 kinds of respiratory viruses (including influenza virus A, B (FluA, FluB), respiratory syncytial virus (RSV), human metapneumovirus (MPV), adenovirus (AdV), human coronavirus (CoronaV), human enterovirus (HEV), human bocavirus (HBoV), parainfluenza virus (PIV), and human rhinovirus (Rhinovirus)). We analyzed the positive rate, annual and seasonal variations, and clinical features (respiratory tract and non-respiratory tract) according to the retrospective review of medical records. Results: Respiratory viruses were detected from 678 (42.8%) of 1,584 patients. The most common detected virus was RSV (35.0%), and then AdV (19.0%), HEV (18.1%). The critical period of the respiratory viral infection was during the first 12 months of a child's life. PIV increased by 8.4%, 12.1%, and 21.1% annually. Bronchiolitis was most frequently caused by RSV, and croup was frequently caused by PIV. The most common cause of meningitis was HEV. Hepatitis-associated respiratory virus was developed 111 in 678 cases. Conclusion: Although this study was confined to a single medical center for three years, we identified the epidemiology and clinical feature of respiratory viruses in Daegu from 2010 to 2012. Future surveillance will be necessary for annual and seasonal variations.

• Journal of Ginseng Research
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• v.48 no.2
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• pp.129-139
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• 2024

Liver diseases are a significant global health burden and are among the most common diseases. Ginssennoside Rg3 (Rg3), which is one of the most abundant ginsenosides, has been found to have significant preventive and therapeutic effects against various types of diseases with minimal side effects. Numerous studies have demonstrated the significant preventive and therapeutic effects of Rg3 on various liver diseases such as viral hepatitis, acute liver injury, nonalcoholic liver diseases (NAFLD), liver fibrosis and hepatocellular carcinoma (HCC). The underlying molecular mechanism behind these effects is attributed to apoptosis, autophagy, antioxidant, anti-inflammatory activities, and the regulation of multiple signaling pathways. This review provides a comprehensive description of the potential molecular mechanisms of Rg3 in the development of liver diseases. The article focuses on the regulation of apoptosis, oxidative stress, autophagy, inflammation, and other related factors. Additionally, the review discusses combination therapy and liver targeting strategy, which can accelerate the translation of Rg3 from bench to bedside. Overall, this article serves as a valuable reference for researchers and clinicians alike.

• Food Science and Preservation
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• v.21 no.2
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• pp.170-174
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• 2014

Hepatitis A virus (HAV) infection leads to acute liver failure and death through the intake of contaminated food. The polymerase chain reaction (PCR) has been used to detect HAV in food samples. HAV detection takes a long time, however, due to the virus concentration step required before PCR assay. In this study, a rapid method of detecting the HAVs present in lettuce using immunomagnetic separation combined with quantum dots (IMS-QDs) assay was developed. The detection limit of IMS-QDs for HAV was 10 $TCID_{50}/mL$, similar to the result that was obtained using RT-PCR combined with PEG or IMS. The application of IMS-QDs assay completed the viral detection within one hour, but this was not possible using PEG combined with RT-PCR. In conclusion, IMS-QDs assay is a rapid and efficient method for detecting HAV at a low concentration in agricultural products.

• Safety and Health at Work
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• v.3 no.1
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• pp.77-83
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• 2012

Zoonoses represent a public health risk recently pointed out by the spreading of previously unknown human infectious diseases emerging from animal reservoirs such as severe acute respiratory syndrome and avian influenza caused by H5N1-virus. These outbreaks have shown that animal breeding activities can pose a significant public health risk. Until now, the risk of zoonoses has probably been underestimated, particularly in occupational settings. The emergence or re-emergence of bacterial (Mycobacterium bovis and Brucella spp) or viral (hepatitis E virus) infections shows that zoonoses should be considered as emerging risks in agricultural and animal breeding and should be addressed by specific preventive interventions. Close cooperation and interaction between veterinarians, occupational health physicians and public health operators is necessary, for a worldwide strategy to expand interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment. This is what the One Health Approach was intended to be.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.2
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• pp.114-123
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• 2017

Purpose: The goal of this study was the early diagnosis of ABCB11 spectrum liver disorders, especially those focused on benign recurrent intrahepatic cholestasis and progressive familial intrahepatic cholestasis. Methods: Fifty patients presenting neonatal cholestasis were evaluated to identify underlying etiologies. Genetic analysis was performed on patients suspected to have syndromic diseases or ABCB11 spectrum liver disorders. Two families with proven ABCB11 spectrum liver disorders were subjected to genetic analyses to confirm the diagnosis and were provided genetic counseling. Whole exome sequencing and Sanger sequencing were performed on the patients and the family members. Results: Idiopathic or viral hepatitis was diagnosed in 34%, metabolic disease in 20%, total parenteral nutrition induced cholestasis in 16%, extrahepatic biliary atresia in 14%, genetic disease in 10%, neonatal lupus in 2%, congenital syphilis in 2%, and choledochal cyst in 2% of the patients. The patient with progressive familial intrahepatic cholestasis had novel heterozygous mutations of ABCB11 c.11C>G (p.Ser4*) and c.1543A>G (p.Asn515Asp). The patient with benign recurrent intrahepatic cholestasis had homozygous mutations of ABCB11 c.1331T>C (p.Val444Ala) and heterozygous, c.3084A>G (p.Ala1028Ala). Genetic confirmation of ABCB11 spectrum liver disorder led to early liver transplantation in the progressive familial intrahepatic cholestasis patient. In addition, the atypically severe benign recurrent intrahepatic cholestasis patient was able to avoid unnecessary liver transplantation after genetic analysis. Conclusion: ABCB11 spectrum liver disorders can be clinically indistinguishable as they share similar characteristics related to acute episodes. A comprehensive genetic analysis will facilitate optimal diagnosis and treatment.

• Journal of Life Science
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• v.32 no.2
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• pp.94-100
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• 2022

Chronic infection by hepatitis B virus (HBV) greatly increases the risk for liver cirrhosis and hepatocellular carcinoma (HCC). The outcome of HBV infection is shaped by the complex interplay of the mode of transmission, host genetic factors, viral genotype, adaptive mutations, and environmental factors. The pregenomic RNA transcription of HBV for their replication is regulated by the core promoter activation. Core promoter mutations have been the reason for acute liver failure and are associated with HCC development. We obtained HBV genes from a patient in Myanmar who was infected with HBV and identified gene variations in the core promoter region. For measuring the relative transactivation activity of the core promoter, we prepared the core-promoter reporter construct. Among the gene variations of the core promoter, the mutations of C1731T and G1806A were associated with increase in the transactivation of the HBV core promoter. Through computer analysis for searching for a tentative transcription factor binding site, we showed that the mutations of C1713T and G1806A newly created C/EBPβ and XBP1-responsive elements of the core promoter, respectively. The ectopic expression of C/EBPβ largely increased the HBV core promoter containing the C1713T mutation and that of XBP1 activated the M95 promoter containing the G1806A mutation. Our efforts to treat and prevent HBV infections are hampered by the emergence of drug-resistant mutations and vaccine-escape mutations. Our results provide the biological properties and clinical significance of specific HBV core promoter mutations.