• Title/Summary/Keyword: chronic liver fibrosis

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Serological and Histological Changes after Interferon Alfa Therapy in Children with Chronic Hepatitis B (소아 만성 B형 간염의 Interferon Alfa 치료 후 혈청학적, 조직학적 소견의 변화)

  • Ko, Jae-Sung;Chung, Ju-Young;Jang, Ja-Joon;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.56-62
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    • 2000
  • Purpose: The aim of this study was to evaluate the efficacy and histologic changes of interferon-alfa therapy on chronic hepatitis B virus infection in children. Patients and Methods: Thirty five children aged 3~16 years who were seropositive for HBV DNA, HBsAg and HBeAg were enrolled. Interferon-alfa 2a ($3.4\;MU/m^2$) were given for 6 months. Serologic markers of viral replication was evaluated 1 year after therapy. Post treatment liver biopsy was performed in 18 patients who showed serologic response. Results: Serum HBeAg and viral DNA became negative in 22 (63%) of treated children at 12 months after therapy. Serum aminotransferase levels normalized in all of the responders and HBsAg became negative in one responder. Horizontal transmission, serum aminotransferase levels more than twice normal, and active inflammation on liver biopsy were predictive factors for response to interferon therapy. Periportal piecemeal necrosis, lobular activity, portal inflammation, fibrosis, and total histologic activity index were reduced in responders. Conclusion: In children with chronic hepatitis B, interferon alfa promotes loss of viral replication and improves aminotransferase. Serologic response is associated with improvement in hepatic histology.

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Nephropathy in Chronic Lead Poisoning (만성 연중독자에서 발생한 신장해)

  • Kim, Byoung-Gwon;Kim, Sung-Ryul;Hong, Young-Seoub;Rha, Seo-Hee;Kim, Jung-Man;Jung, Kap-Yull;Kim, Joon-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.43-50
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    • 1996
  • We experienced a case of nephropathy in chronic lead poisoning. The patient was 43-year-old male who has been working in secondary lead smelting plant for 14 years. On admission, blood pressure was 160/90 mmHg and the others were non-specific. In past history, he received chelating agent administration for lead poisoning irregularly and medicated for gout, and the blood lead concentration was $180.0{\mu}g/dl$ on 2 months before admission. Smoking habit has been 1 pack per day for 15 years and drinking habit has been 1 bottle of Soju per day but less flow. In liver function test, AST/ALT were 27/28 IU/l and $\gamma-GT$ was 456 IU/l. In blood test, Hb : 11.5 g/dl, Hct : 34.0% and basophilic stipplings were found in peripheral blood smear. Chest PA was normal and abdominal ultrasonographic finding was non-specific except fatty liver. In the test of lead exposure indices, $PbB:83.0{\mu}g/dl,\;PbU:28.3{\mu}g/l$, and blood ZPP was $300.0{\mu}g/dl$. And in renal function test, BUN : 31.4 mg/dl, blood creatinine : 2.7mg/dl, blood uric acid. 9.1 mg/dl, urinary albumin : 100.0 mg/g creatinine, urinary $\alpha_1-microglobulin$ : 120.5 mg/g creatinine, urinary $\beta_2-microglobulin$ : $183.8{\mu}g/g$ creatinine, and 24 hours urinary creatinine clearance was 31.9 ml/min. The ultrasonoguided renal biopsy showed the global sclerosis of glomerulus, moderate atrophy and loss of tubule, and interstitial fibrosis in light microscopy. There were diffuse losses of brush border of proximal tubule in electronmicroscopy.

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Inhibitory Effect of Angelica Gigantis Radix on Fibrogenesis in Rat Hepatic Stellate Cells (당귀(當歸)가 간성상세포의 섬유화 기전 억제에 미치는 영향)

  • Son, Hyun-Soo;Kim, Young-Chul
    • The Journal of Internal Korean Medicine
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    • v.31 no.3
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    • pp.415-424
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    • 2010
  • Objectives : This study was performed to investigate the anti-fibrogenic effect of Angelica Gigantis Radix on cultured rat hepatic stellate cells. Materials and Methods : Hepatic stellate cells(HSC-T6) were treated with various concentrations of Angelica Gigantis Radix extract for both 24 and 48 hours. The extraction was done either with distilled water or 80% EtOH. After the treatment, cell viability, cell proliferation, procollagen production and the mRNA expression of the ASMA, TIMP1, TIMP2, procollagen Type 1a2, and Cytokine IL-6 production were measured by using MTT assay, BrdU assay, RT-PCR, procollagen Type I C-peptide EIA and IL-6 ELISA assay. Results : The cell viability treated with water extraction was significantly increased, but there were no significant changes treated with 80% EtOH extraction. The cell proliferation treated with water extraction decreased only in the 24 hours group, while there were significant decreases either in the 24 and 48 hours groups treated with 80% EtOH extraction. The mRNA expressions of the ASMA, TIMP2 and procollagen 1a2 decreased in a concentration-dependent manner in the 48 hours group. Procollagen production decreased in a concentration-dependent manner in both the 24 and 48 hours groups. Cytokine IL-6 production increased in a concentration-dependent manner in both the 24 and 48 hours groups. Conclusion : These results suggest that Angelica Gigantis Radix is beneficial in the treatment of cirrhotic patients as well as for patients with chronic hepatitis.

A case study of chronic traumatic pericarditis (Hardware disease) in a Holstein cattle (젖소 만성 창상성심낭염의 증례보고 및 고찰)

  • Kim, Jongho;Lee, Kyunghyun;Roh, Su Gwon;Jo, Heon-Ho;So, ByungJae;Kim, Heui-Jin
    • Korean Journal of Veterinary Service
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    • v.44 no.1
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    • pp.45-49
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    • 2021
  • A 23-month-old Holstein cattle showed excess salivation and reluctance of walking and suddenly died after forced sudden movements. Grossly, numerous fibrous adhesions were present within cranial abdominal cavity including the reticulum and diaphragm and thoracic cavity involving lungs, pericardial sac, and heart. A perforation made by a 10 cm-long sharp-ended wire was detected in the reticulum. Histopathologically, fibrous suppurative epicarditis and myocardial necrosis were observed. Fibrosis with neovascularization were found in lungs, spleen, and liver. And granulomatous reticulitis was observed. For differential diagnosis, no pathogenic bacteria were detected through microbiological tests and PCR results were also negative for bovine susceptible pathogenic antigens. Based on the gross and histopathological examination, we diagnosed this case as chronic traumatic pericarditis. Cattle are inquisitive and prone to swallow various kinds of metallic foreign bodies since they do not use their lips. Therefore, avoiding ingestion of metallic objects in animal feed and animal areas by careful environmental management of farms is required and farmers should give the adequate minerals and vitamins into the feeds not to lick or shallow foreign bodies in case of mineral deficiency. For veterinary practitioners, physical examination, blood tests, and diagnostic imaging (X-ray and Ultrasonography) are required for an exact diagnosis. Furthermore, placing the magnets in rumen would be effective for prophylactic administrations.

Fermented ginseng, GBCK25, ameliorates steatosis and inflammation in nonalcoholic steatohepatitis model

  • Choi, Naeun;Kim, Jong Won;Jeong, Hyeneui;Shin, Dong Gue;Seo, Jeong Hun;Kim, Jong Hoon;Lim, Chae Woong;Han, Kang Min;Kim, Bumseok
    • Journal of Ginseng Research
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    • v.43 no.2
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    • pp.196-208
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    • 2019
  • Background: Nonalcoholic steatohepatitis (NASH) is one of the chronic inflammatory liver diseases and a leading cause of advanced liver fibrosis, cirrhosis, and hepatocellular carcinoma. The main purpose of this study was to clarify the effects of GBCK25 fermented by Saccharomyces servazzii GB-07 and pectinase, on NASH severity in mice. Methods: Six-wk-old male mice were fed either a normal diet (ND) or a Western diet (WD) for 12 wks to induce NASH. Each group was orally administered with vehicle or GBCK25 once daily at a dose of 10 mg/kg, 20 mg/kg, 100 mg/kg, 200 mg/kg, or 400 mg/kg during that time. The effects of GBCK25 on cellular damage and inflammation were determined by in vitro experiments. Results: Histopathologic analysis and hepatic/serum biochemical levels revealed that WD-fed mice showed severe steatosis and liver injury compared to ND-fed mice. Such lesions were significantly decreased in the livers of WD-fed mice with GBCK25 administration. Consistently, mRNA expression levels of NASH-related inflammatory-, fibrogenic-, and lipid metabolism-related genes were decreased in the livers of WD-fed mice administered with GBCK25 compared to WD-fed mice. Western blot analysis revealed decreased protein levels of cytochrome P450 2E1 (CYP2E1) with concomitantly reduced activation of c-Jun N-terminal kinase (JNK) in the livers of WD-fed mice administered with GBCK25. Also, decreased cellular damage and inflammation were observed in alpha mouse liver 12 (AML12) cells and RAW264.7 cells, respectively. Conclusion: Administration of GBCK25 ameliorates NASH severity through the modulation of CYP2E1 and its associated JNK-mediated cellular damage. GBCK25 could be a potentially effective prophylactic strategy to prevent metabolic diseases including NASH.

The Comparative Effects of Yugmijihwangtang in Donguibogam and Experiment Research Results -Focusing on the Korean Medicine and Traditional Chinese Medicine- (육미지황탕 효능의 동의보감과 실험연구결과의 비교고찰 -한의학과 중의학을 중심으로-)

  • Han, Yoochang;Kim, Myung Dong;Lee, Sundong
    • Herbal Formula Science
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    • v.25 no.2
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    • pp.223-251
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    • 2017
  • Objectives : A lot of experiment results of Yugmijihwangtang(YM) are reported in various kinds of journals. Many of them report on the new effects that are not recorded in the traditional medical texts. So it is necessary to take it into consideration that newly reported effects could be of help to clinical practice, because this process of comparison of Donguibogam and scientific experiment results will have basis to lead into the evidence based medicine. Methods : We compared the effects of in Donguibogam and the experiment results of YM. Results : The effects of YM in Donguibogam are to replenish essence and marrow, and to treat red wen, fatigue, treat hypouresis, urinary sediment, urinary urgency, hematuria, hydrocephalus, speech and movement retardation, yin-deficiency, diabetes mellitus, nonalcoholic fatty liver, melanoma, disability to see near and far sight, tinnitus, hearing loss, alopecia, angiogenesis, cough, cough at night, trachyphonia, and, infantile convulsion. The experiment results of YM since 2000 in both Korea and China are to inhibit atopic dermatitis, renal interstitial fibrosis, anti-oxidant, emphysema, stress, glomerulosclerosis, diabetic nephropathy, chronic glomerulonephritis, hemorrhage, plantar sweating, dermal aging, kidney aging, bone loss, breast cancer, pathological myocardial cell, primary liver cancer, thrombosis, osteoporosis, intrauterine growth retardation, chronic renal failure, IgA nepropathy, slow cerebral development, and hippocampal tissue lesions on the one hand, and to help bone formation, renin-angiotensin- aldosterone system, cerebral recovery, cognitive function and expression, osteoblast proliferation and differentiation, learning and memory, cold-tolerance and oxygen deficit-tolerance and anti-fatigue, endometrial formation, humoral and cell-mediated immunity, immune regulation effect, Hypothalamus-Pituitary-Ovary Axis, and spermatogenesis, on the other hand. Conclusion : When we compared the effects of YM with the experiment results of YM, there existed a considerable gap between them. So, from now on, it is expected that a great effort and consideration are needed to solve these gaps from an academic and clinical point of view.

The Clinical Features of Chronic Neonatal Hepatitis: Non-familial, Non-metabolic and Non-A, B, C Viral Hepatitis (만성 신생아 간염의 임상적 고찰: 비-가족형, 비-대사성, 비-A, B, C형 바이러스성 신생아 간염)

  • Park, Ji Ae;Lee, Chang Hun;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.242-248
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    • 2006
  • Purpose: Neonatal hepatitis is the major cause of neonatal cholestasis and may be divided into infectious, metabolic, genetic, and idiopathic neonatal hepatitis. Non-familial, non-metabolic, and non-A, B, C viral neonatal hepatitis is known to have made satisfactory progress, but little is known about its chronic clinical features. Methods: Clinical and histological assessments were carried out in 34 cases with chronic neonatal hepatitis [elevated serum alanine aminotrasferase (ALT) level for more than 6 months] except for A, B, C viral hepatitis, metabolic, or genetic neonatal hepatitis, who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 1998 to January 2004. Results: Males were more common (70%). Jaundice (100%) and hepatomegaly (44%) were frequent manifestations. Peak serum ALT levels were most commonly below 300 IU/L in 41.2% of patients and peak serum direct bilirubin levels were most commonly between 1.0~5.0 mg/dL in 50% of patients. Ten cases (34%) of 29 patients had positive serum cytomegalovirus (CMV) IgM or urine CMV polymerase chain reaction. Serum ALT level was normalized within 1 year in 11 (37.9%) of 29 cases, and within 2 years in 9 (69.2%) of 13 cases. Serum ALT level was elevated persistently over 2 years in four (30.7%) of 13 cases. Histologic findings such as portal or periportal activity, lobular necrosis, portal or periportal fibrosis were more severe in patients with persistent ALT elevation over 2 years than in those showing normalization of ALT within 2 years (p>0.05). Conclusion: When the elevation of ALT level sustains over 1 year in non-familiar, non-metabolic, non-A, B, C viral neonatal hepatitis, an assessment of the severity of liver injury and a careful monitoring about chronic liver disease may be required.

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A Case of Familial Clustering of Hepatitis C Virus (C형 간염의 가족 내 집단 감염 1례)

  • Jeung, Hoon;Jang, Hyeun Sub;Lee, Yun Jin;Lee, Kyun Woo;Kim, Hye Young;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.91-95
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    • 2005
  • The familial environment may also play an important role in the epidemiology of HCV infection through vertical and horizontal transmission by infected household members. However, it is still controversial whether familial clustering of HCV occurs. We experienced a case of familial clustering of hepatitis C virus. A 10-year old girl presented with nausea, vomiting and anorexia for a month was diagnosed as hepatitis C. Her mother, grandmother, a maternal aunt and her daughter had contracted with HCV. Her laboratory findings showed AST/ALT 63/122 IU/L, positive anti-HCV Ab and HCV RNA ($3.54{\times}10^5copies/mL$). Pathologic findings of the liver biopsy revealed chronic hepatitis with minimal lobular activity, mild porto-periportal activity and mild portal fibrosis. After treatment with interferon-${\alpha}$ 2b for 6 months, the clinical symptoms and laboratory findings were normalized.

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Inhibitory Effects of Standardized Leonurus japonicus Extract and Its Bioactive Leonurine on TNF-α-Induced Muscle Atrophy in L6 Myotubes

  • Lee, Jiyeon;Kim, Changhee;Lee, Hyerin;Hwang, Jae-Kwan
    • Journal of Microbiology and Biotechnology
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    • v.30 no.12
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    • pp.1896-1904
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    • 2020
  • Muscle atrophy, characterized by a reduced number and size of myofibers, occurs due to immobilization, aging, and several chronic diseases. Leonurus japonicus, belonging to the Labiatae family, is widely used as a traditional medicine in Korea, China, and Japan. Previous studies have reported that L. japonicus has various physiological activities, such as anti-bacteria, anti-cancer, and liver protection. Leonurine, which is a major bioactive in L. japonicas, is known to possess biological effects including anti-inflammation, anti-fibrosis, anti-angiogenesis, and anti-diabetes. However, the preventive effects of L. japonicas and leonurine on muscle have not been reported. The current study aimed to determine the inhibitory effects of standardized L. japonicus extract (LJE) and leonurine on muscle atrophy by clarifying their underlying molecular mechanisms in tumor necrosis factor-alpha (TNF-α)-stimulated L6 myotubes. LJE and leonurine stimulated the phosphatidylinositol 3-kinase/Akt pathway that was reduced by TNF-α treatment. LJE and leonurine not only increased the mammalian target of rapamycin pathway for protein anabolism but also decreased the mRNA expression of E3 ubiquitin ligases by blocking the translocation of Forkhead box O, which is closely linked with proteolysis. Additionally, LJE and leonurine alleviated inflammatory responses by downregulating TNF-α and interleukin-6 mRNA expression and reducing the protein expression of nuclear factor-kappa B, a major transcriptional factor of proinflammatory cytokines. Collectively, LJE and leonurine have potential as therapeutic candidates for inhibiting the development of skeletal muscle atrophy by activating the PI3K/Akt pathway and reducing inflammatory responses.

Chronic HBV Infection in Children: The histopathologic classification and its correlation with clinical findings (소아의 만성 B형 간염: 새로운 병리조직학적 분류와 임상 소견의 상관 분석)

  • Lee, Seon-Young;Ko, Jae-Sung;Kim, Chong-Jai;Jang, Ja-June;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.56-78
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    • 1998
  • Objective: Chronic hepatitis B infection (CHB) occurs in 6% to 10% of population in Korea. In ethinic communities where prevalence of chronic infection is high such as Korea, transmission of hepatitis B infection is either vertical (ie, by perinatal infection) or by close family contact (usually from mothers or siblings) during the first 5 years of life. The development of chronic hepatitis B infection is increasingly more common the earlier a person is exposed to the virus, particularly in fetal and neonatal life. And it progress to cirrhosis and hepatocellular carcinoma, especially in severe liver damage and perinatal infection. Histopathology of CHB is important when evaluating the final outcomes. A numerical scoring system which is a semiquantitatively assessed objective reproducible classification of chronic viral hepatitis, is a valuable tool for statistical analysis when predicting the outcome and evaluating antiviral and other therapies. In this study, a numerical scoring system (Ludwig system) was applied and compared with the conventional histological classification of De Groute. And the comparative analysis of cinical findings, family history, serology, and liver function test by histopathological findings in chronic hepatitis B of children was done. Methods: Ninety nine patients [mean age=9 years (range=17 months to 16 years)] with clinical, biochemical, serological and histological patterns of chronic HBV infection included in this study. Five of these children had hepatocelluar carcinoma. They were 83 male and 16 female children. They all underwent liver biopsies and histologic evaluation was performed by one pathologist. The biopsy specimens were classified, according to the standard criteria of De Groute as follows: normal, chronic lobular hepatitis (CLH), chronic persistent hepatitis (CPH), mild to severe chronic active hepatitis (CAH), or active cirrhosis, inactive cirrhosis, hepatocellular carcinoma (HCC). And the biopsy specimens were also assessed and scored semiquantitatively by the numerical scoring Ludwig system. Serum HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc (IgG, IgM), and HDV were measured by radioimunoassays. Results: Male predominated in a proportion of 5.2:1 for all patients. Of 99 patients, 2 cases had normal, 2 cases had CLH, 22 cases had CPH, 40 cases had mild CAH, 19 cases had moderate CAH, 1 case had severe CAH, 7 cases had active cirrhosis, 1 case had inactive cirrhosis, and 5 cases had HCC. The mean age, sex distribution, symptoms, signs, and family history did not differ statistically among the different histologic groups. The numerical scoring system was correlated well with the conventional histological classification. The histological activity evaluated by both the conventional classification and the scoring system was more severe as the levels of serum aminotransferases were higher. In contrast, the levels of serum aminotransferases were not useful for predicting the degree of histologic activity because of its wide range overlapping. When the histological activity was more severe and especially the cirrhosis more progressing, the prothrombin time was more prolonged. The histological severity was inversely related with the duration of seroconversion of HBeAg. Conclusions: The histological activity could not be accurately predicted by clinical and biochemical findings, but by the proper histological classification of the numerical scoring system for the biopsy specimen. The numerical scoring system was correlated well with the conventional histological classification, and it seems to be a valuable tool for the statistical analysis when predicting the outcome and evaluating effects of antiviral and other therapies in chronic hepatitis B in children.

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