• Journal of Preventive Medicine and Public Health
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• 제23권3호
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• pp.345-357
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• 1990

Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권4호
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• pp.207-218
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• 2013

Long term outcomes after liver transplantation are major determinants of quality of life and of the value of this heroic treatment. As short term outcomes are excellent, our community is turning to take a harder look at long term outcomes. The purpose of this paper is to review these outcomes, and highlight proposed treatments, as well as pressing topics needing to be studied. A systemic review of the English literature was carried in PubMed, covering all papers addressing long term outcomes in pediatric liver transplant from 2000-2013. Late outcomes after pediatric liver transplant affect the liver graft in the form of chronic liver dysfunction. The causes include rejection particularly humoral rejection, but also de novo autoimmune hepatitis, and recurrent disease. The metabolic syndrome is a major factor in long term cardiovascular complication risk. Secondary infections, kidney dysfunction and malignancy remain a reality of those patients. There is growing evidence of late cognitive and executive function delays affecting daily life productivity as well as likely adherence. Finally, despite a good health status, quality of life measures are comparable to those of children with chronic diseases. Long term outcomes are the new frontier in pediatric liver transplantation. Much is needed to improve graft survival, but also to avoid systemic morbidities from long term immunosuppression. Quality of life is a new inclusive measure that will require interventions and innovative approaches respectful not only on the patients but also of their social circle.

• 약학회지
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• 제51권1호
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• pp.7-12
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• 2007

Hepatic cirrhosis is an important feature of chronic liver disease. Liver cirrhosis is characterized by hyperaccumulation of fibrous tissue components and is commonly observed in latter or terminal states of chronic hepatic disease. The antifibrotic effects on liver cirrhosis by oriental herbs extraction material were examined in bile duct ligated rats. Oriental herbs extraction (0.99 mg/kg rat weight/day) was administrated to cirrohotic rats for 4 weeks. Liver collagen content of bile duct ligated rats was significantly increased. And liver histology showed collagen fiber deposition was increased as well as the normal architecture was lost with large zone of necrosis being observed. Herbs extraction administrated rats showed significantly decreased liver collagen content, accumulation of collagen fiber in histological analysis, and biochemical markers of hepatic diseases. Those results demonstrate the usefulness of herbs extraction materials as an antifibrotic agent for liver cirrhosis.

• 대한미생물학회지
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• 제21권2호
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• pp.233-241
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• 1986

Patients of chronic hepatic diseases(n=107) including chronic hepatitis caused by hepatitis B virus infections(n=31), liver cirrhosis(n=53), and hepatocellular carcinoma(n=23) were examined to ascertain genetic relationship between chronic hepatic diseases and histocompatibility antigen. Peripheral blood lymphocytes were separated from whole blood by the method of Ficoll/Hypaque gradient. Total 54 histocompatibility antigens(class I antigens: 41, class II antigens: 13) were analysed by performing of complement dependent microlymphocytotoxicity method using Terasaki's and Catholic Medical College tissue typing plates. HLA antigen frequencies were compared with those of 661 normal controls. The following results were obtained: 1. HLA antigen frequencies of HLA-Bw46, -Bw76, -Cw1, -Cw6, and HLA-DR8 in chronic hepatitis patients were shown to be higher than those in controls(P<0.01). 2. HLA antigen frequencies of HLA-Bw46, -Cw7(P<0.01), and HLA-B37, -Bw58, -Cw1, -MT1(P < 0.05) in liver cirrhosis patients were shown relatively higher frequencies than those in controls. 3. In patients with hepatocellular carcinoma, antigens of HLA-A1, -A26, -Cw3, -Cw7 and HLA-DR6 were dominantly detected. 4. There were negative associations with HLA-Cw4, and -DR4 in patients of chronic hepatic diseases(P < 0.05).

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1779-1782
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• 2012

Background & Objectives: In patients with gastric cancer, the most frequently reported family history of cancer also involves the stomach. The aim of this study was to assess the presence of gastric precancerous lesions in first-degree relatives of patients with gastric cancer and to compare the obtained results with those of individuals with no such family history. Methods: Between 2007 and 2009, 503 consecutive persons more than 30 years old were enrolled in the study covering siblings, parents or children of patients with confirmed adenocarcinoma of stomach. The control group was made up of 592 patients who were synchronously undergoing upper gastrointestinal endoscopy for evaluation of dyspepsia without gastric cancer or any family history. All subjects were endoscopically examined. Results: The overall prevalence of Helicobacter pylori was 77.7% in the cancer relatives and in 75.7% in the control group. Chronic gastritis was found in 90.4% vs. 81.1% (P<0.001). Regarding histological findings, 37(7.4%) of the study group had atrophy vs. 12(1.7%) in the control group (P<0.001), while no difference was observed for intestinal metaplasia (20.3%vs. 21.6%, P=0.58). Dysplasia were shown in 4% of cancer relatives but only 0.4% of the control group (P<0.001). There was no gender specificity. Conclusions: Findings of our study point to great importance of screening in relatives of gastric cancer patients in Iran.

• Toxicological Research
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• 제12권2호
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• pp.213-221
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• 1996

In order to develop a suitable secondary renal disease model and diagnostic markers of renal disease in the rat, the change of PIIIP (aminoterminal procollagen III peptide) in serum and hydroxyproline levels in the renal tissue that reflect the synthesis of extracellular matrix (ECM) during development of experimental renal diseases were observed. Two types of experimental primary diseases, diabetes mellitus administrated by streptozotocin (STZ, 75 mg/kg, i.p.) and liver cirrhosis produced by bile duct ligation/scission (BDL/s) operation, were induced. The hydroxyproline level increased according to the high PIIIP and NCl(carboxyterminal procollagen IV peptide) in Western blot analysis as early as 1 week in the STZ treated-rat kidney. Increased renal ECM was observed at 15 weeks in STZ and BDL/s model under the microscopic examination. High PAS positive reaction was found in capillary basement membrane in STZ treated-rats and mesangium in BDL/s operated rats at this time, showing the histological characteristics of diabetic nephropathy and cirrhotic glomerulonephritis in human, respectively. Such secondary renal failure were supported by additional tests including urinalysis and renal function test. The serum PIIIP detected by ELISA was a useful parameter to estimate synthesis rate of renal ECM during development of renal disease without extrarenal fibrosis i.e. liver cirrhosis in rats. This study is proposed that STZ treatment or BDL/s operation may be a suitable experimental animal model for the induction and development of chronic secondary renal diseases. Morover, it was found that hydroxyproline level in renal tissues was a good parameter of the change of renal ECM at the early stage of the diseases without apparent histological changes. Especially, serum PIIIP could be a choice as a diagnostic or prognostic marker during the development of renal diseases in rats.

• Laboraroty Animal Research
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• 제34권4호
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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.

• 동국한의학연구소논문집
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• 제3권
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• pp.163-169
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• 1994

Alcohol is a major risk factor for several diseases and excessive, long-term alcohol consumption are caues physical alteration-fatty liver, hepatitis, cirrhosis, breaking down, Wernicke-karsakoff's syndrome, weight loss, and poor immunity-in virtually all organ and tissue. This study was observed that liver, kidney, and stomach were altered in mouse by the effect of chronic alcohol administration. The mouse were sacrificed to obtain the tissue after mouse were orally injected with 25 % ethanol $18m{\ell}/kg/day$ for 120days. The tissue were stained by hematoxylin and eosin and then observed by light microscope. The results of this study were as follows : 1. The congestion was appeared in liver after 120days alcohol admistration. 2. The destruction of glomerulus were increased and the parietal cell of Bowman's capsule were swelled such as cuboidal cell after 120days alcohol administration. The congestion was appeared in alcohol administrated group. 3. The mucosa and gastric pit were destructed and the ulceration was appeared in stomach after 120days administration. The parietal cells and chief cells were damaged. Above results were shown that the tissue were damaged by chronic alcohol administration.

• 한국방사선학회논문지
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• 제17권7호
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• pp.1057-1065
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• 2023

비침습적 간섬유화 진단은 만성 간질환 환자들에게 매우 중요한 사항이다. 많은 환자들에게 간조직검사를 시행할 수가 없기 때문에 의미 있는 간섬유화 정도를 조기에 예측함으로써 만성 간질환의 치료와 간세포암 및 간경변증으로 인한 합병증을 감소시킬 수 있다. 본 연구는 비침습적인 간섬유화 검사 방법 중 간초음파 소견과 함께 전단파 탄성 초음파를 이용하여 간섬유화의 정량적 측정과 간탄성도 수치와 연관성을 갖는 혈청학적 인자도 비교 분석하였다(p<0.05). 그 결과 정상 집단의 횡파탄성측정값은 4.55 ± 0.69 kPa였으며, 에코 패턴의 비정상 대조군은 8.27 ± 1.83 kPa로 B형 간염 보균 집단에서 전단파 탄성 초음파 측정값이 높게 나타났으며, 혈청학적 인자들 중 AST, ALT, GGT, PT가 SWE 범주에 따른 섬유화의 정도에 따라 통계학적으로 유의한 양의 연관성을 보였으나(p<0.05) ALP와 TB는 통계적으로 유의미한 차이를 나타내지 않았다(p=0.163, p=0.567). 반면에 Albumin과 PLT는 유의한 음의 연관성을 보였다(p<0.05). 임상적으로 간경변 증후가 없는 만성 B형 간염 환자들의 간섬유화 추적 관찰 및 반복 검사 시 간초음파와 전단파 탄성 초음파 검사를 통한 탄성도 값을 추가로 활용한다면 검사자 간 객관적 진단에 있어 도움이될 것이며, 일차적인 진료에 유용할 것으로 사료된다.

• 성인간호학회지
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• 제12권1호
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• pp.52-63
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• 2000

In Korea, most of the patients with chronic liver diseases have been using some kind of alternative therapies at home. however, the question is why do people turn to alternative therapy and how the patients are able to use the alternative therapies widely, though the effects have not been proven scientifically. Therefore, it is necessary to explore the process of the patients' experiences using the alternative therapies. The 16 participants were from internalmedical departments in hospital and the permission was received to participate in this study from the subjects. The data were collected with interviews and participants observations, analyzed by the grounded theory methodology of Strauss and Corbin(1990). With the analysis of the data, 15 categories were generated such as psychological pressures, barriers of role performances, distrusts of western medicine, blind obediences to the treatments, attitudes towards alternative therapies, supportive systems, obstacles to taking alternative therapies, financial burdens, collecting informations, pursuing alternative modalities, efforting diversities, analyzing by themselves, managing the body, accepting the disease, and ambivalence. The paradigm model was developed to identify the relationships of categories. The central phenomenon of the experiences of seeking alternative therapies was named jagi momdasrim. The central concept of jagi momdasrim is a mind-set to desire to wellness and to take more responsibility for one's own healing by pursuing alternate healing modalities rather than the western medical system. The process of jagi momdasrim evolved several stages such as seeking, finding, struggling, overcoming, fulfilling, and governing the diseases. Four patterns of taking alternative therapies were found as follows: the bulsin-chujong-hyung, the suyoung-hyung, the yangdari-gulchiki-hyung, the chamjae-hyung. In conclusion, the phenomenon of alternative therapies as consumer-driven force to heal the chronic liver diseases of the patients could be explained as an adaptive behavior through the process of jagi momdasrim. However, since most of the participants practicing some kind of alternative therapies had no evidences of its effects and never tried to consult with their medical doctors about alternative therapies, we should approach more actively. Therefore, it is recommended for nurses to listen and watch the patients behaviors of using alternative therapies and find out how to educate the patients about the proper and safe way to take the alternative therapies.