• Title/Summary/Keyword: carcinoma, hepatocellular

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Prediction of Local Tumor Progression after Radiofrequency Ablation (RFA) of Hepatocellular Carcinoma by Assessment of Ablative Margin Using Pre-RFA MRI and Post-RFA CT Registration

  • Yoon, Jeong Hee;Lee, Jeong Min;Klotz, Ernst;Woo, Hyunsik;Yu, Mi Hye;Joo, Ijin;Lee, Eun Sun;Han, Joon Koo
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1053-1065
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    • 2018
  • Objective: To evaluate the clinical impact of using registration software for ablative margin assessment on pre-radiofrequency ablation (RFA) magnetic resonance imaging (MRI) and post-RFA computed tomography (CT) compared with the conventional side-by-side MR-CT visual comparison. Materials and Methods: In this Institutional Review Board-approved prospective study, 68 patients with 88 hepatocellulcar carcinomas (HCCs) who had undergone pre-RFA MRI were enrolled. Informed consent was obtained from all patients. Pre-RFA MRI and post-RFA CT images were analyzed to evaluate the presence of a sufficient safety margin (${\geq}3mm$) in two separate sessions using either side-by-side visual comparison or non-rigid registration software. Patients with an insufficient ablative margin on either one or both methods underwent additional treatment depending on the technical feasibility and patient's condition. Then, ablative margins were re-assessed using both methods. Local tumor progression (LTP) rates were compared between the sufficient and insufficient margin groups in each method. Results: The two methods showed 14.8% (13/88) discordance in estimating sufficient ablative margins. On registration software-assisted inspection, patients with insufficient ablative margins showed a significantly higher 5-year LTP rate than those with sufficient ablative margins (66.7% vs. 27.0%, p = 0.004). However, classification by visual inspection alone did not reveal a significant difference in 5-year LTP between the two groups (28.6% vs. 30.5%, p = 0.79). Conclusion: Registration software provided better ablative margin assessment than did visual inspection in patients with HCCs who had undergone pre-RFA MRI and post-RFA CT for prediction of LTP after RFA and may provide more precise risk stratification of those who are treated with RFA.

Ginsenoside compound K inhibits nuclear factor-kappa B by targeting Annexin A2

  • Wang, Yu-Shi;Zhu, Hongyan;Li, He;Li, Yang;Zhao, Bing;Jin, Ying-Hua
    • Journal of Ginseng Research
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    • v.43 no.3
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    • pp.452-459
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    • 2019
  • Background: Ginsenoside compound K(C-K), a major metabolite of ginsenoside, exhibits anticancer activity in various cancer cells and animal models. A cell signaling study has shown that C-K inhibited nuclear factor-kappa B ($NF-{\kappa}B$) pathway in human astroglial cells and liver cancer cells. However, the molecular targets of C-K and the initiating events were not elucidated. Methods: Interaction between C-K and Annexin A2 was determined by molecular docking and thermal shift assay. HepG2 cells were treated with C-K, followed by a luciferase reporter assay for $NF-{\kappa}B$, immunofluorescence imaging for the subcellular localization of Annexin A2 and $NF-{\kappa}B$ p50 subunit, coimmunoprecipitation of Annexin A2 and $NF-{\kappa}B$ p50 subunit, and both cell viability assay and plate clone formation assay to determine the cell viability. Results: Both molecular docking and thermal shift assay positively confirmed the interaction between Annexin A2 and C-K. This interaction prevented the interaction between Annexin A2 and $NF-{\kappa}B$ p50 subunit and their nuclear colocalization, which attenuated the activation of $NF-{\kappa}B$ and the expression of its downstream genes, followed by the activation of caspase 9 and 3. In addition, the overexpression of Annexin A2-K320A, a C-K binding-deficient mutant of Annexin A2, rendered cells to resist C-K treatment, indicating that C-K exerts its cytotoxic activity mainly by targeting Annexin A2. Conclusion: This study for the first time revealed a cellular target of C-K and the molecular mechanism for its anticancer activity.

Consideration of Cut-off Value for Fibrosis Serum Marker by Liver Fibrosis Stage in Chronic Hepatitis C Patients (만성 C형간염 환자에서 간섬유화 등급별 혈청표지자들의 Cut-off값에 대한 고찰)

  • Nam, Ji-Hee;Kim, Jung-Hoon
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.539-546
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    • 2019
  • Liver biopsy is invasive and it is a risk of complications. Nevertheless, liver biopsy is gold standard for predicting liver fibrosis. To compensate for these shortcomings, in this study, the liver fibrosis stage was divided using Fibroscan(R) in 200 chronic hepatitis C patients. And, the usefulness and cut-off values of fibrosis index based on four factors(FIB-4), AST to platelet ratio index(APRI) and AST/ALT ratio(AAR) calculated as serum tests were investigated by analyzing ROC curve. As a result, using FIB-4 and APRI rather than AAR is appropriate for evaluation of liver fibrosis. And using APRI to predict significant Fibrosis(F2) and FIB-4 is considered useful for predicting cirrhosis(F4). By applying the advantages of the serum based liver fibrosis marker, which are convenient and repeatable, liver fibrosis follow-up term can be reduced, and furthermore, the prevalence of liver cirrhosis and hepatocellular carcinoma(HCC) can be reduced.

Dihydroartemisinin inhibits HepG2.2.15 proliferation by inducing cellular senescence and autophagy

  • Zou, Jiang;Ma, Qiang;Sun, Ru;Cai, Jiajing;Liao, Hebin;Xu, Lei;Xia, Jingruo;Huang, Guangcheng;Yao, Lihua;Cai, Yan;Zhong, Xiaowu;Guo, Xiaolan
    • BMB Reports
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    • v.52 no.8
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    • pp.520-525
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    • 2019
  • Dihydroartemisinin (DHA) has been reported to possess anti-cancer activity against many cancers. However, the pharmacologic effect of DHA on HBV-positive hepatocellular carcinoma (HCC) remains unknown. Thus, the objective of the present study was to determine whether DHA could inhibit the proliferation of HepG2.2.15 cells and uncover the underlying mechanisms involved in the effect of DHA on HepG2.2.15 cells. We found that DHA effectively inhibited HepG2.2.15 HCC cell proliferation both in vivo and in vitro. DHA also reduced the migration and tumorigenicity capacity of HepG2.2.15 cells. Regarding the underlying mechanisms, results showed that DHA induced cellular senescence by up-regulating expression levels of proteins such as p-ATM, p-ATR, ${\gamma}-H_2AX$, P53, and P21 involved in DNA damage response. DHA also induced autophagy (green LC3 puncta gathered together and LC3II/LC3I ratio increased through AKT-mTOR pathway suppression). Results also revealed that DHA-induced autophagy was not linked to senescence or cell death. TPP1 (telomere shelterin) overexpression could not rescue DHA-induced anticancer activity (cell proliferation). Moreover, DHA down-regulated TPP1 expression. Gene knockdown of TPP1 caused similar phenotypes and mechanisms as DHA induced phenotypes and mechanisms in HepG2.2.15 cells. These results demonstrate that DHA might inhibit HepG2.2.15 cells proliferation through inducing cellular senescence and autophagy.

Analysis of Existing Guidelines and Randomized, Controlled, Clinical Trials for Development of [Guideline of Clinical Trial on Herbal Medicinal Product for Liver Cancer] (간암 한약제제 임상시험 가이드라인 개발을 위한 한약제제 무작위배정 대조군 임상시험 고찰)

  • Han, Ga-jin;Kim, Dong-hun;Park, Eun-joo;Seong, Sin;Kim, Sung-su;Leem, Jung-tae
    • The Journal of Internal Korean Medicine
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    • v.40 no.1
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    • pp.89-116
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    • 2019
  • Objective: This study aimed to ascertain what should be considered in the "Guideline for Clinical Trials with Herbal Medicinal Products for Liver Cancer," by analyzing existing guidelines and clinical trials. Methods: Committee for the development of a guideline, consisting of 6 Korean medicine doctors, reviewed guidelines and clinical trials on using herbal medicine for treating liver cancer. The trials were analyzed in terms of inclusion and exclusion of participants, intervention, comparators, outcomes, and trial design. We then compared the results of our analysis with the guidelines to identify issues we must to consider when following the "Guideline for Clinical Trials with Herbal Medicinal Products for Liver Cancer." Several guidelines for antitumor agents and clinical trials on herbal medicine were obtained from the Ministry of Food and Drug Safety homepage, etc. The search terms were as follows: "liver neoplasms"; "herbal medicine"; "medicine, Korean traditional"; and "medicine, Chinese Traditional.". Results: Ten articles were obtained from pubmed and Embase. There was no guideline for clinical trials on using herbal medicine for treating liver cancer. All the participants in the reviewed articles had primary liver cancer, and the type of intervention varied (e.g., decoction, patches, and capsules. The comparators included placebos and conventional treatments such as chemotherapy. The outcome assessment methods were tumor response, quality of life, survival, and liver function tests. Adverse events occuring during the trial were also evaluated. Conclusion: Findings were derived by reviewing existing guidelines and comparing them with clinical trials on liver cancer and herbal medicinal products. These results will be utilized in the development of the "Guideline for Clinical Trials with Herbal Medicinal Products for Liver Cancer."

Development of a Label-Free LC-MS/MS-Based Glucosylceramide Synthase Assay and Its Application to Inhibitors Screening for Ceramide-Related Diseases

  • Fu, Zhicheng;Yun, So Yoon;Won, Jong Hoon;Back, Moon Jung;Jang, Ji Min;Ha, Hae Chan;Lee, Hae Kyung;Shin, In Chul;Kim, Ju Yeun;Kim, Hee Soo;Kim, Dae Kyong
    • Biomolecules & Therapeutics
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    • v.27 no.2
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    • pp.193-200
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    • 2019
  • Ceramide metabolism is known to be an essential etiology for various diseases, such as atopic dermatitis and Gaucher disease. Glucosylceramide synthase (GCS) is a key enzyme for the synthesis of glucosylceramide (GlcCer), which is a main ceramide metabolism pathway in mammalian cells. In this article, we developed a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to determine GCS activity using synthetic non-natural sphingolipid C8-ceramide as a substrate. The reaction products, C8-GlcCer for GCS, could be separated on a C18 column by reverse-phase high-performance liquid chromatography (HPLC). Quantification was conducted using the multiple reaction monitoring (MRM) mode to monitor the precursor-to-product ion transitions of m/z $588.6{\rightarrow}264.4$ for C8-GlcCer at positive ionization mode. The calibration curve was established over the range of 0.625-160 ng/mL, and the correlation coefficient was larger than 0.999. This method was successfully applied to detect GCS in the human hepatocellular carcinoma cell line (HepG2 cells) and mouse peripheral blood mononuclear cells. We also evaluated the inhibition degree of a known GCS inhibitor 1-phenyl-2-decanoylamino-3-morpholino-1-propanol (PDMP) on GCS enzymatic activity and proved that this method could be successfully applied to GCS inhibitor screening of preventive and therapeutic drugs for ceramide metabolism diseases, such as atopic dermatitis and Gaucher disease.

Severe acute alcoholic hepatitis and liver transplant: A never-ending mournful story

  • Obed, Aiman;Bashir, Abdalla;Stern, Steffen;Jarrad, Anwar
    • Clinical and Molecular Hepatology
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    • v.24 no.4
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    • pp.358-366
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    • 2018
  • Severe acute alcoholic liver disease (SAAH) unresponsive to medical therapy shows one-year-mortality rates of up to 90%. Most transplant centers request six months of alcohol abstinence prior to transplantation, the so-called "6-month rule." This regulation is not based on strong evidence, repeatedly making it a topic of controversial debates. The majority of patients with SAAH will die before fulfilling the 6-month rule. Therefore, liver transplantation (LT) protocols are becoming more flexible towards the rigid abstinence regulation, especially concerning SAAH patients. We conducted a literature review regarding LT in SAAH and its outcomes, including post-transplant mortality and recidivism. We studied available data on PubMed from 2011 and onwards whilst including articles dealing with genetic components, medical therapy and historic snapshots of alcoholism. Emerging studies recommend LT in SAAH not responding to medical therapies even without realizing the required abstinence period, since the majority of these patients would die within 6 months. SAAH without response to medical therapy has one-year-mortality rates of up to 90%. The 6-month rule is not based on strong evidence and is repeatedly a topic of controversial debates. There is genetic linkage to alcoholism and medical therapy is not as effective as estimated, yet. The 6-months-regulation has not shown to evidently decrease the risk of recidivism post-LT, which is a lifesaving treatment in SAAH patients. Insisting on rigid sobriety rules results in excluding patients with a low risk of recidivism from being transplanted. Moreover, the genetic linkage of alcoholism must be recognized.

Antioxidant and Anticarcinogenic Effects of Domestic Yellow Cherry Tomato (국내산 황색 방울토마토의 항산화활성 및 암세포 생육억제 효과)

  • Choi, Suk-Hyun
    • The Journal of the Korea Contents Association
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    • v.21 no.11
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    • pp.518-527
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    • 2021
  • This study verifies the polyphenol and flavonoid contents of a dried extract, as well as its antioxidant effect and growth inhibitory effect on cancer cells to investigate the potential of yellow cherry tomatoes as a physiologically active food material. The polyphenol and flavonoid contents were determined as 10.96 ± 1.57 and 4.12 ± 0.41 mg/g, respectively. The antioxidant activity was confirmed by measuring DPPH and ABTS radical scavenging ability, and RC50-the concentration that reduces free radicals by 50%-were determined as 490.83 ± 17.35 ㎍/mL and 355.90 ± 0.79 ㎍/mL, respectively. The dried extract showed no cytotoxicity with respect to normal hepatocytes (Chang) and no growth inhibitory activity with respect to A549 lung cancer cells, whereas dried extract showed growth inhibitory activities of 15.2% and 18.4% with respect to human cervical adenocarcinoma (HeLa) and human hepatocellular carcinoma (HepG2) cells, respectively, when treated with a concentration at 100㎍/mL. The results of this study confirm the potential of yellow cherry tomatoes as a physiologically active food material by verifying their antioxidant activity and their growth inhibitory activity with respect to cervical and liver cancer cells.

Hepatitis C Virus Nonstructural Protein 5A Interacts with Immunomodulatory Kinase IKKε to Negatively Regulate Innate Antiviral Immunity

  • Kang, Sang-Min;Park, Ji-Young;Han, Hee-Jeong;Song, Byeong-Min;Tark, Dongseob;Choi, Byeong-Sun;Hwang, Soon B.
    • Molecules and Cells
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    • v.45 no.10
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    • pp.702-717
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    • 2022
  • Hepatitis C virus (HCV) infection can lead to chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. HCV employs diverse strategies to evade host antiviral innate immune responses to mediate a persistent infection. In the present study, we show that nonstructural protein 5A (NS5A) interacts with an NF-κB inhibitor immunomodulatory kinase, IKKε, and subsequently downregulates beta interferon (IFN-β) promoter activity. We further demonstrate that NS5A inhibits DDX3-mediated IKKε and interferon regulatory factor 3 (IRF3) phosphorylation. We also note that hyperphosphorylation of NS5A mediates protein interplay between NS5A and IKKε, thereby contributing to NS5A mediated modulation of IFN-β signaling. Lastly, NS5A inhibits IKKε-dependent p65 phosphorylation and NF-κB activation. Based on these findings, we propose NS5A as a novel regulator of IFN signaling events, specifically by inhibiting IKKε downstream signaling cascades through its interaction with IKKε. Taken together, these data suggest an additional mechanistic means by which HCV modulates host antiviral innate immune responses to promote persistent viral infection.

Echinococcus granulosus Protoscolex DM9 Protein Shows High Potential for Serodiagnosis of Alveolar Echinococcosis

  • Kim, Jeong-Geun;Han, Xiumin;Kong, Yoon
    • Parasites, Hosts and Diseases
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    • v.60 no.1
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    • pp.25-34
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    • 2022
  • Alveolar echinococcosis (AE) caused by infection with E. multilocularis metacestode, represents one of the most fatal helminthic diseases. AE is principally manifested with infiltrative, proliferating hepatic mass, resembling primary hepatocellular carcinoma. Sometimes metastatic lesions are found in nearby or remote tissue. AE diagnosis largely depends on imaging studies, but atypical findings of imaging features frequently require differential diagnosis from other hepatic lesions. Serological tests may provide further evidence, while obtaining reliable AE materials is not easy. In this study, alternative antigens, specific to AE were identified by analyzing E. granulosus protoscolex proteins. An immunoblot analysis of E. granulosus protoscolex showed that a group of low-molecular-weight proteins in the range from 14 kDa to 16 kDa exhibited a sensitive and specific immune response to AE patient sera. Partial purification and proteomic analysis indicated that this protein group contained myosin, tubulin polymerization promoting protein, fatty-acid binding protein, uncharacterized DM9, heat shock protein 90 cochaperone tebp P-23, and antigen S. When the serological applicability of recombinant forms of these proteins was assessed using enzyme-linked immunosorbent assay, DM9 protein (rEgDM9) showed 90.1% sensitivity (73/81 sera tested) and 94.5% specificity (172/181 sera tested), respectively. rEgDM9 showed weak cross-reactions with patient sera from the transitional and chronic stages of cystic echinococcosis (3 to 5 stages). rEgDM9 would serve as a useful alternative antigen for serodiagnosis of both early- and advanced-stage AE cases.